4. What percentage of the whole project duration was spent in planning that occurred prior to the proposal and reviews? Prior to the actual building construction? Why? The equivalent of a new kindergarten class is born every day at Orlando’s Arnold Palmer Hospital. With more than 13,000 births in a hospital that was designed for a capacity of 6,500 births a year, the newborn intensive care unit was stretched to the limit.

Moreover, with continuing strong population growth in central Florida, the hospital was often full. It was clear that new facilities were needed. After much analysis, forecasting, and discussion, the management team decided to build a new 273-bed building across the street from the existing hospital. But the facility had to be built in accordance with the hospital’s Guiding Principles and its uniqueness as a health center dedicated to the specialized needs of women and infants. Those Guiding Principles are: Familycentered focus, a healing environment where privacy and dignity are respected, sanctuary of caring that includes warm, serene surroundings with natural lighting, sincere and dedicated staff providing the highest quality care, and patient-centered flow and function.

The vice president of business development, Karl Hodges, wanted a hospital that was designed from the inside out by the people who understood the Guiding Principles, who knew most about the current system, and who were going to use the new system, namely, the doctors and nurses. Hodges and his staff spent 13 months discussing expansion needs with this group, as well as with patients and the community, before developing a proposal for the new facility. An administrative team created 35 user groups, which Video Case held over 1,000 planning meetings (lasting from 45 minutes to a whole day). They even created a “Supreme Court” to deal with conflicting views on the multifaceted issues facing the new hospital.

Funding and regulatory issues added substantial complexity to this major expansion, and Hodges was very concerned that the project stay on time and within budget. Tom Hyatt, director of facility development, was given the task of onsite manager of the $100 million project, in addition to overseeing ongoing renovations, expansions, and other projects. The activities in the multi-year project for the new building at Arnold Palmer are shown in Table 3.7

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TABLE 3.7 ACTIVITY Expansion Planning and Arnold Palmer Hospital Construction Activities and Times SCHEDULED TIME 1 month 2 weeks 1. Proposal and review 2. Establish master schedule 3. Architect selection process 4. Survey whole campus and its needs 5. Conceptual architect's plans 6. Cost estimating 7. Deliver plans to board for consideration/decision 9. Construction manager selection PRECEDENCE ACTIVITY(IES) - 5 weeks 1 month 6 weeks 2 months 1 month 6 weeks 9 weeks 1 1 1 3 2,4,5 6 6 8. Surveys/regulatory review 6 10. State review of need for more hospital beds ("Certificate of Need") 3.5 months 7,8 11. Design drawings 4 months 10 12. Construction documents 5 months 9,11 13. Site preparation/demolish existing building 9 weeks 11 14. Construction start/building pad 15. Relocate utilities 16. Deep foundations 17. Building structure in place 18. Exterior skin/roofing 2 months 12, 13 6 weeks 12 2 months 14 9 months 16 4 months 17 19. Interior buildout 12 months 20. Building inspections 5 weeks 21. Occupancy 1 month 17 15, 19 20 *This list of activities is abbreviated for purposes of this case study. For simplification, assume each week = .25 months (i.e., 2 weeks = .5 month, 6 weeks = 1.5 months, etc.).