Multiphase Upgrade

Stony Brook Hospital Undergoes a Major Overhaul

by Lynne Viccaro O'Leary

A $300 million capital program is transforming nearly every corner of the Stony Brook University Hospital campus in Stony Brook, N.Y.

The hospital's modernization program, which entails both the renovation of existing space as well as new construction, began four years ago and is hitting a turning point in 2006. The institution is nearing completion of a new building in September and just broke ground in April on the central project of the multiyear plan - adding 150,000 sq. ft. in a new wing and renovating another 150,000 sq. ft. of the main hospital building.

Throughout the effort, the institution has been careful to keep current health care trends in mind, particularly with regard to patient comfort, said Jane Franz, chief planning officer for the hospital.

"Studies have shown that patients respond much better to treatment in an environment with more natural lighting, for example, than those where only clinical needs are addressed," she said.

The capital program's expansive scope allowed the institution to take a longer view but required a careful phasing plan, said Neil Heyman, project executive for Gilbane Building of Providence, R.I., the construction manager on the effort.

"The critical focus of the project phasing plan took years to formulate," he said. "The key goal was to maintain ongoing operations and services of the hospital while sustaining the balance of the construction activities."

The hospital put together a core 15-person group - including representatives from the hospital, architect, and construction manager - to develop and implement the phasing plan, which has included erecting temporary barricades, partitions, and enclosure bridges to allow staff and patients to weave through corridors of the existing hospital to avoid areas under construction.

The program got under way in August 2002 with initial renovations, Heyman said. Among the items completed since then are the enclosure of an exterior patio structure, expansion of cafeteria and dining services spaces, and a full rehabilitation and renovation of 170,000 sq. ft. for an inpatient orthopedic surgery center.

Other work in the early years entailed renovations to 55,000 sq. ft. of the Heart Center - a job handled by ACC Construction of New York as general contractor - as well as five cardiac catheterization laboratories, 23 recovery beds, a 10-bed Critical Care Unit, and a 23-bed, step-down unit. The team also added a 2,000-KW emergency generator, expanded the emergency department by 7,500 sq. ft., rerouted the main entry roads on the campus, and added a two-story parking structure - complete with a new helipad on its roof.

New Ambulatory Care Pavilion

Among the major current efforts is the construction of a new ambulatory care pavilion that is slated to open in September. Pavlak Construction of Hauppauge, N.Y., broke ground in the fall of 2004 on the 65,000-sq.-ft. building that will add several new features to the campus.

A primary component of the new $25 million building is the Long Island Cancer Center, which includes the Carol M. Baldwin Breast Care Center and spaces for outpatient medical and surgical oncology, outpatient pediatric oncology, and cancer support services. The pavilion will also house a new outpatient imaging center and pain management services.

The pavilion, which stands on a pile and spread-footing foundation, required extensive sitework to add a new utility infrastructure, concrete sidewalks, and asphalt paving. Clad in an aluminum curtain wall system consisting of metal panels, masonry, and stone, the space incorporates various design materials, such as sheet vinyl, terrazzo tile, glass tile wall, onyx tile wall, wood finish wall, wood ceilings, vinyl wall coverings, and custom millwork, said Tomas Alvarez, design principal with Cannon Design of Grand Island, N.Y., which was architect for the facility.

Alvarez said the hospital wanted the building to have the flexible space functions of a modern facility.

"The design team developed a clinical core area that promotes flexibility, and then wrapped this core area in a glass and metal 'necklace' of public spaces," he added. "We designed the waiting areas with large windows around the perimeter of the building so patients could look out at nature."

But the hospital also wanted the building to be aesthetically consistent with the rest of the modernization project and overall campus. It especially sought a visual connection between the main building and the ambulatory facility.

"The exterior façade served as a 'dress rehearsal' for the main building," he added. "We wanted to ensure that there was a unifying design theme and that the two buildings will have a dialogue."

With an eye toward the future, the design also has to accommodate the changing needs of the hospital, said Robin Cibrano, project principal on the effort for Cannon Design. For instance, the design called for back office space to have removable panels to accommodate current and future imaging technologies.

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Major Upgrade to the Main Building

As work wraps up on the ambulatory facility, construction is taking off on the $120 million centerpiece effort, which broke ground in April. The project will first entail constructing a new addition and three-story wing and then shift to renovating and upgrading the main hospital building's lobby and surgical suite.

The expansion and renovation aims to transform parts of the building that were not people-friendly, Cibrano said.

"It was a typical hospital - there wasn't a lot of light, air, or space to feel comfortable," he said. "We wanted to create an environment that was more pleasant for waiting patients and families through the use of natural light and comfortable furnishings."

Upon its completion in 2008, the new space will house the emergency department and a new Women and Infants' Center with a neonatal intensive care unit, labor and delivery rooms, antepartum and postpartum units, and newborn nurseries.

The 150,000 sq. ft. of new construction includes the addition of 10 operating rooms and expansion of the emergency room unit to accommodate minimally invasive surgical equipment and emerging imaging-assisted procedures.

The effort will later involve rebuilding the hospital lobby and surgical suite in their existing locations, a challenging task because the suite is beneath the main entry's circular drive, which will require significant excavation in front of the hospital.

Although the hospital campus is in a suburban setting, the project team is approaching the effort as if it were an inner-city job because of the phasing and space constraints, Gilbane's Heyman said.

"Accessibility for the patients, staff, and visitors was a particular challenge for the core group," he added. "There is only one entrance [to the hospital] other than the one to the emergency department. We had to close down the main entrance, creating the need for a prefabricated pedestrian bridge."

Heyman said the effort has involved an extensive amount of excavation and basic logistics.

"We tunneled underground, put the bridge in place, and connected it to the parking garage 250 ft. away," he said. "Then, we built a new structure around the temporary bridge and another temporary enclosure where the original entrance was."

The team also had to create temporary patient drop-off zones. It was slated to finish all of the temporary structures in early summer.

The main building's original design has posed a major project hurdle during all of the sitework, in part because the existing topography is tiered, Heyman said. The original structure forms an inverted pyramid below grade.

"For example, the new operating room suite is one story below grade, immediately adjacent to 10 existing operating room suites," he added. "We needed to punch through the existing foundation wall in 20 places in order to connect them, all while the OR suites are currently in service."

During all of the renovation and upgrade work, the phasing plan is ensuring that the hospital continues operating normally, Heyman said. It is also keeping the projects moving along a rapid construction schedule.

"We created three consecutive eight-hour work shifts over a 24-hour period, which allowed us to do our work while patients were being taken care of," he added. "What would normally have taken us three weeks to complete only took one week."

Key Players

Owner: Stony Brook University Hospital

Master Planner: KMD Architects, San Francisco

Construction Manager: Gilbane Building, Providence, R.I.

Structural Engineer: Ysrael A. Seinuk, New York

Architect: Cannon Design, Grand Island, N.Y.

Civil Engineer: Schoor DePalma, Manalapan, N.J.

Electrical Contractor: Gordon L. Seaman Electric, Bohemia, N.Y.

General Contractors: ACC Construction, New York; Pavlak Construction, Hauppauge, N.Y.

Mechanical Contractor: Botto Mechanical Corp., Plainview, N.Y.