TME Online Articles

Effective Practices for Joint Use of Healthcare Facilities

When planning for the early occupancy of a facility while construction activities are still ongoing, a joint use plan is crucial to identifying responsibilities and deliverables for the contractor and user.

By Lt. Col. Edwin Rodríguez, USA

As the Fort Bliss Hospital Replacement Project approached its substantial completion phase, the U.S. Army Health Facility Planning Agency Project Office was looking for opportunities to expedite the initial outfitting effort.

Timing this aspect depends on the general contractor as well as regulatory and internal requirements of the U.S. Army Corps of Engineers, the contracting agent. Along with these time-intensive activities, departmental equipment and personnel moves must also be considered.

When early occupancy of a facility, such as the Fort Bliss Hospital Replacement Project, is needed prior to the completion of the entire project, gaining an understanding of a phased strategic delivery process is crucial. To complete such a task, a phased occupancy plan or joint use plan (JUP) is required.

PLANNING FOR USERS

The JUP is an agreement between a general contractor and a government agency that pertains to the period prior to the beneficial occupancy date. It is meant to ensure that the time and cost to the government owner representative is minimized for the Military Construction project and the associated fit-up. For other agencies involved with a project, it is necessary to contact them directly to determine how to meet their ordinances and policies in order for them to release their holds at the time of the JUP for the phasing strategy.

When planning a JUP, it is important to involve the owner as early as possible, so that everyone will understand the phasing strategy for occupancy and construction. Typically, this is done by the design team, which requests a preliminary review.

The JUP provides contractors with a better understanding about how a project is being phased in a strategic delivery process. This is especially important for larger projects. The primary interest is in considering the conditions of phasing, the conditions of the project, the permitting process, the inspections process, the documentation needed for life safety, and health concerns.

Work must be able to be performed safely, with no degradation to its quality, and without disruption to any current construction project timelines. The general contractor should ensure that all identified joint use spaces meet minimum acceptance criteria (which are defined through coordination with the government owner representative) prior to the start of any outfitting.

During this time, the general contractor shall maintain full and proper control of, and responsibility for, the operations and security of the whole facility. The government owner representative will take responsibility for securing lockable rooms where possible and accepts the risk of damage and/or theft of early outfitting.

COORDINATION CRITERIA

When planning a JUP, it is important to involve the owner as early as possible, so that everyone will understand the phasing strategy for occupancy and construction. Typically, this is done by the design team, which requests a preliminary review. This meeting is most productive when plan review staff and project manager inspection teams are also present. This assists in making sure all parties understand the concept and execution of the phasing plan.

The inspections team’s project managers must be requested on the preliminary review application. The charges are based on the number of the inspections team members who are required or requested to be present in the meeting.

At the conclusion of the preliminary review meeting, the design team will submit meeting minutes to plan review staff for approval. Some of the topics to be discussed as part of the meeting include a code summary of the project and overall; key plans reflecting the construction and occupancy phasing plan and strategy; how life safety systems and egress will be maintained; how construction activity and staging will be handled during the phasing strategy; permits that will be required for each phasing and building; and site impact issues for egress and accessibility.

Day-to-day coordination on a number of topics is required pertaining to utilities, waste management, and security.

Power. Outfitting contractors shall provide their own ground fault circuit interrupt protection to use power receptacles as necessary (such as surge protectors and universal power supply), as the government is not responsible for any damages to equipment during this agreement.

Water. Water is not potable until the owner’s industrial hygiene performs water tests for quality and purity at or close to the fully operational date.

Planning for vacancies as the project moves forward is important as well. A critical part of vacancy planning is to identify equipment lease agreements, direct supply deliveries, and warranty agreements. Once identified, termination or move dates should be established with the providing companies so all agreements can be re-established at the new facilities.

Debris Removal. During the JUP period, all parties are responsible for removing the daily debris they create and accumulate into a designated dumpster. The general contractor and their subcontractors will continue to be responsible for providing trash and recycling removal containers to collect all refuse, recycling, and debris they accrue, up to and including their final day on site. The general contractor and their subcontractors will provide trash and recycling dumpsters as part of their contract up to the completion of construction or completion of activities. At the beneficial occupancy date, the initial outfitting and transition contractor with the end user will become responsible for providing trash and recycling dumpsters as part of their contract upon commencement of initial outfitting activities and/or the fully operational date.

Dumpster Removal. The general contractor will continue to provide trash and recyclable removal services during the JUP and until construction completion. The initial outfitting and transition contractor will then commence the removal of trash and recyclables until the fully operational date.

Cleaning Activities. During the JUP, each party is responsible for cleaning up after themselves, no matter where on campus. During the Joint Occupancy Agreement period, the same rule applies; however, it is anticipated that the end user will have a contracted cleaning crew that will mobilize to the site once a week to execute basic cleanup services. All stakeholders will ensure that their contractors are abiding and subsequently responsible for the collection of trash, debris, or recyclable materials daily from the area in which they are performing work. The collection of these materials must be placed in an approved disposal container and/or removed daily from the site by the entity who performed the work. It is imperative that the work area remain free of trash for safety and health standards.

Keying Activities. In the case of the Fort Bliss Hospital Replacement Project, the William Beaumont Army Medical Center Facility Management will be the agency that will coordinate the final key schedule and put in a work request through the Operation and Maintenance Engineering Enhancement for key core installation. The office will meet with the locksmith to determine functions.

EXECUTING THE PLAN

Inspections of construction phases that do not require occupancy prior to completion of the entire project will be conducted in the same manner as any other non-phased construction. Minimum acceptance criteria are necessary to begin furniture and equipment installation. The contracting agent should facilitate the end-user inspections of all areas for equipment installation during the JUP, taking into consideration the existing punchlist items. It is the owner’s responsibility to repair any additional damages during the initial outfitting and transition phase.

There are a few basic requirements that must be fulfilled before the installation can begin.

Housekeeping: Designate operational restrooms in the facility and ensure there is a dust-free environment in and around all rooms prior to the installation of equipment.
Critical Items: All HVAC must be installed and operational as per specifications for sensitive equipment such as imaging equipment. Elevators are certified and operational.
IM/IT & Low Voltage: All contractor-supplied cables have been pulled and terminated. Test results must be submitted and approved, and data center, communication closets, and PBX rooms must be using permanent cooling that has been fully commissioned.
Life Safety: All stair enclosure shafts have been completed; permanent handrails, balustrades, and guards have been installed; fire extinguishers delivered; and construction material removed from site.

HANDOVER SUCCESS

Planning for vacancies as the project moves forward is important as well. A critical part of vacancy planning is to identify equipment lease agreements, direct supply deliveries, and warranty agreements. Once identified, termination or move dates should be established with the providing companies so all agreements can be re-established at the new facilities.

During the JUP of the building, the turnover process will continue with the completion of all remaining punchlist items that have not yet been finished, seasonal commissioning, and monthly close out meetings with the major stakeholders. In addition, the turnover process includes the facility’s integration into the Facility Management Program, which is a cooperative effort between the government stakeholders to assure the continued care of the building.