<P>76The Military Engineer ? July-August ? 2010 the 85 percent design mark. According to Col. Andrew Backus, USA, USACE Norfolk District Commander, IDBB was an attractive delivery method for the FBCH due to ?ve words: size, com- plexity, urgency, uncertainty and funding constraints. BRAC law imposed a hard completion date, so this is a fundamental shift in priorities from the traditional ap- proach to military construction. With the FBCH project, the BRAC tim- ing requirements and the heightened scrutiny of medical care in the National Capital Region really made time ‘?rst among equals in the time-cost-quality tri- ple constraint. That is not to say we arent closely watching cost and quality, but it has clearly been a paradigm shift. IDBB was attractive for FBCH for other reasons, as well. The owner can select both designer and builder speci?c to their expertise with the project type. The owner also controls both contracts directly and can initiate construction immediately even as design is taking shape. Addition- ally, the owner can optimize ECI in the de- sign process and designer participation in the ?eld during construction. Lastly, there is an opportunity to foster a win-win at- titude throughout the entire team by de- signing and building a world-class facility in record-breaking time. Case Study: Fort Belvoir Community Hospital The FBCH project was originally slated as a MILCON replacement hospital for the existing DeWitt Hospital on Fort Belvoir. After BRAC was passed, the project was included in the BRAC program as a com- munity hospital. FBCH is a 1.3-million-ft2 facility with 55 primary and specialty clinics and 120 patient beds, two parking structures with 3,600 parking spots, a central utility plant and a helipad. Overseeing and reviewing the medical aspects of the hospital for USACE are the Medical Facilities Center of Expertise and Standardization, the Health Facilities Planning Of?ce and various user groups that will ultimately occupy and op- erate the facility. World-Class Care. What started as a napkin sketch in February 2007 evolved into a complex design capable of deliver- ing world-class medical services to the sol- diers and families who will use the hospi- tal. The concept is based on the principles of Evidence-Based Design (EBD), which integrates features proven to enhance healing while improving the workplace environment for the healthcare staff. The four principles of EBD include: provide patient- and family-centered care, and care of the whole person; improve healthcare quality and safety; provide a positive work environment; and design for maximum standardization, future ?exibil- ity and growth. Each principle is supported by speci?c design features within FBCH and augmented by the teams commit- ment to sustainability. FBCH is designed to achieve Leadership in Energy and Envi- ronmental Design Silver certi?cation and signi?cantly reduce energy consumption. Once operating, the hospital will consume 27 percent less energy than a typical hospi- tal, equating to nearly $500,000 in annual savings. It will also reduce CO2 emissions by 4,000-T; reduce potable water consump- tion (up to 1.6-million-G annually) by us- ing captured rainwater for irrigation; and has already recycled more than 3,500-T of waste during construction. Schedule. Hospital design started in November 2006, and a 10 percent design was issued for bid in early 2007. Turner/ Gilbane was the successful bidder and worked with USACE and HDR/Dewberry to value engineer the project within bud- get. Based on the value engineering model, both design and construction moved for- ward aggressively. By the time design was substantially complete, construction was already 50 percent complete. The construction contract set an ag- gressive 1,264-day schedule for construc- tion that would prove extremely dif?cult given that the contractor was leaning forward with the design team. Having the construction contractor working in the designers of?ce the ?rst year was ex- tremely helpful in getting an early start on the project, but construction quickly caught up to design. The project schedule was sequenced to work from the outside garages toward the center. This meant starting the central utility plan and park- ing garages ?rst, then the clinic buildings, followed by the hospital tower at the cen- ter. This sequence was initiated for three main reasons: the central critical care building would likely take the longest to design and had the highest risk for rework potential from hyper-fast track; the con- struction of the two-story clinic buildings before the tower would allow the team to bene?t from having built the worlds largest mockup; and workforce concerns prevalent prior to the economic downturn forced the team to consider completing the less-complicated work earlier to allow a full workforce focus on the last building. The IDBB acquisition method in- creased ?exibility, risk and effort for the government while turning a 10-year proj- ect into a ?ve-year project. Lessons Learned Because of the novel acquisition ap- proach for the FBCH, the USACE Norfolk District contracted with McDonough Bol- yard Peck to formally gather and analyze lessons learned for the project, an effort to be completed in three phases. Phase one yielded 38 lessons linked to contract planning and execution, leadership and staf?ng, processes and procedures, and collaboration and partnering. Of these, a critical takeaway related to the IDBB acquisition process: Transi- tion from cost-mode to ?rm-?xed-price mode in an IDBB acquisition is a process to which signi?cant prior planning and management effort must be devoted in order to succeed. Negotiations continue between the owner and contractor as of this writing. The three biggest ‘take-aways from this project so far are: (1) design should have a head-start before construc- tion gets started, or it will impact the ability for both the designer and builder to work ef?ciently. At a minimum, the site infra- structure and foundations package should be completed before construction begins; (2) BIM provided a distinct advantage to the builder in the shop drawing process for better coordination; and (3) the IDBB pro- cess meant the owner is doing both design and construction administration simulta- neously. This concurrent dual role requires additional staf?ng. Christian E. Jahrling, M.SAME, is Vice President & General Manager, Turner Construction Co.; 703-464-3163 or cjahrling@tcco.com. Terence Williams, P.E., LEED AP, is Vice President, HDR Inc.; 703-518-8500 or terence.williams@ hdrinc.com. Aimee O. Alix, LEED AP,M.SAME, is Estimator, Turner Construction Co.; 703-841-7034 or aa- lix@tcco.com</p> <UL><LI><a href="http://www.stallionpublishers.com/publication/609/tofzxaosm/1/1/">Front-Cover</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/609/tofzxaosm/2/2/">Inside-Front-Cover</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/609/tofzxaosm/3/3/">Page-1</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/609/tofzxaosm/4/4/">Page-2</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/609/tofzxaosm/5/5/">Page-3</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/609/tofzxaosm/6/6/">Page-4</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/609/tofzxaosm/7/7/">Page-5</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/609/tofzxaosm/8/8/">Page-6</a></LI> <LI><a href="http://www.stallionpublishers.com/publication/609/tofzxaosm/9/9/">Page-7</a></LI> <LI><a 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