Delivering Proton

The collaborative process in IPD helps control costs and schedule while allowing us to focus on designing for the patient experience.

Broadly speaking, the healthcare industry has already embraced integrated project delivery. Soon, it will be standard for healthcare projects to be delivered via IPD. But proton therapy centers are a unique animal. They are, undoubtedly, more complicated to design and build than a typical healthcare facility. Designing a proton center typically requires tasks such as coordinating the placement of 60 miles of conduit, 130,000 lbs of sheet metal with rebar and baseplates in massive concrete walls, all of it documented, coordinated and built over 10,000 file transfers between the design team and the general contractor. All this, not to mention incorporating unique power and water hungry technology found in only a dozen facilities in North America.

In general, IPD has many advantages for proton center design. The integrated project delivery method maximizes the use of the latest cloud-based technology allowing the collective talent of the owner, architects, construction managers, subcontractors and equipment vendor to flourish in a collaborative, real-time effort.

The VOA/ BR+A team has made efficient use of IPD in delivering proton therapy projects in a “design-assist” format. BR+A’s Managing Principal Michael Fahey says, “I tell my staff, if you can deliver a proton center using design-assist IPD format, you can deliver anything. There isn’t a harder thing to coordinate than the mass concrete in my opinion.”

The challenges inherent in proton centers don’t end there. Physicists have their requirements, manufacturers prefer certain bending radiuses for the cabling of their devices, and so on. Not only do industry standards apply, but this facility type has an additional layer of complexity factored in to make sure the design will satisfy all the stakeholders.

Conduits ready to be embedded in the concrete of the Georgia Proton Treatment Center

Conduits ready to be embedded in the concrete of the Georgia Proton Treatment Center

We are beginning to see both vendors and developers in the industry offer separate turn-key proton center solutions in which they offer an expedited process. In both cases, this process relies on assembling the most qualified team in their proton center package, and an experienced team is more likely to use IPD to its fullest extent. VOA/ BR+A are at the forefront of this approach.

Design assist can be used on a conventional design-bid-build project. In design assist, we collaborate with engineers and consultants who are proficient in proton technology. VOA has created a team (MEP engineers, structural engineers, shielding consultants) with the knowledge and experience to navigate the IPD process on a proton center. Ideally, this project team also includes a contractor and subcontractors who are proficient in proton design or can be educated on its particularities early in the process.

With the right partner in place, the design team can focus on the details of the patient experience. Using virtual modeling and coordination during the design and construction phases, the team can pilot the design toward creating a comfortable and welcoming experience for its future patients.

BIM model, Georgia Proton Therapy Center

BIM model, Georgia Proton Therapy Center

When we get the contractors involved during the design phase, we make it mandatory that the contractor demonstrate the effective use of Revit on past projects. The contractor must demonstrate an ability to contribute to a unique 3D model without impeding the collaborative work of the architects and engineers. The complexity of this project type is very demanding on contractors, and general contractors have been slower to embrace this new technology.

Once the collaborative partnership is underway, we’ll set up a unique Revit model on our server and allocate full access to the model but control the amount of editing allowed for each of the partners and consultants involved in the project. We give them real-time secured access through the cloud. We then define roles and responsibilities on how to work together in that one model. That helps avoid duplicate efforts.

Construction, Georgia Proton Therapy Center

Construction, Georgia Proton Therapy Center

In design assist, we transition to working at the shop drawing level early on and quickly bring in MEP elements (conduits, ductwork, etc.) which would only exist on paper in a typical design-bid-build approach. This allows selected subcontractors an opportunity to give their comments and input even on a basic layout. In return, that information gets put back into the construction documents so that by the time CDs are released, that coordination is already done based upon the preferred methods of construction selected by the subcontractors. The biggest benefit is that this method allows subcontractors to go into fabrication sooner.

When we get to the end of the CD phase, we’ve controlled the schedule and we’ve controlled the cost. Sometimes we’ve reduce the cost. We have a fully coordinated set of documents that have been endorsed by the contractor who has been involved in the process. There is no additional two or three month coordination process between contractors in the field because they did that in partnership with us during the design phase. We have found that this has trimmed at least two months off the front end of the construction schedule. As owners are aware, the faster you get to patient treatment, the faster you begin paying off your investment.

Leave a Comment

Write your comment