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Hospital and Staff Housing Complex

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1 Hospital and Staff Housing Complex
CEM-512 Mohammad Shaflout Ali Abdulkarim I. Sulais Sayer Al-Shammari Mohammed A. Al-Jumaia Mohammed A. Al-Ghamdi Naif Al-Subaey

2 Outline Introduction Project Description Value Engineering Procedure
Information Phase Creative Phase Judgment Phase Development Phase Presentation and Report Phase Summary

3 Introduction A Value Engineering study was conducted on the design development, Phase 3, 50% working drawings proposed for the hospital. The study was conducted at the Architect’s and Engineer’s office in November 1996. The objective of the study was to review the design documents to optimize the cost impact of design decisions. The project involved a hospital of some 350,000 S.F. and a housing complex of five buildings of some 195,000 S.F. The costs validated by the VE team and agreed to by the A/E amounted to approximately $93,000,000.

4 Project Description Requirements of the Hospital
a. Number of Beds = 180 b. Area of land = 500,000 SF. c. Parking one car per bed plus staff and out-patient d. Site plan is provided. e. Housing: It is required to accommodate all doctors and a total of 130 nurses; a recreational area is to be provided.

5 Project Description 2. Civil Structural Engineering a. Site On-site wastewater treatment, effluent recycled for irrigation. Utility building housing chillers, O2, incinerator. b. Structure Pre-cast hollow-core slabs with a reinforced concrete frame. 3. Architectural a. Walls Interior: Drywall partitions with two (2) 1/2” sheets each side. Exterior: Pre-cast concrete panels with upper 20% window area. b. Floor Heavy-duty vinyl flooring, in general, with lobbies and ground-floor granite specified in selected areas. c. Finishing Material of Facia Pre-cast concrete panels d. Partition Wall Finishes Enamel paint. e. Ceilings Armstrong-type painted tiles and waterproofed gypsum board for wet areas. Selected area in basement calls for linear metallic ceilings.

6 Project Description 4. Mechanical Systems The mechanical works include the following systems: a. Domestic hot and cold water system. b. Reverse osmosis/ionized water system. c. Drainage system. d. Rainwater drainage system. e. Oxygen, vacuum and other medical gases network system. f. Heating, ventilation and air-conditioning system, consisting of: • Four (4) air-cooled chillers (size not noted in outside equipment area) • Fan coil units with fresh-air ventilation in general patient rooms • Fan coil units in general out-patient areas • VAV in administration areas Single-zone constant volume, 100% outside air with heat recovery in critical areas. g. Steam boiler for laundry, sterilizing and washer/decontaminators units. h. Fire fighting system: Wet pipe, combined sprinkler standpipe system with combination electric and diesel fire pumps. i. Waste disposal and incinerator system. j. Low-pressure gas (LPG) services. k. Irrigation system. l. Automatic temperature control system.

7 Project Description 5. Electrical Building load is estimated at 6000 KVA. The following systems are proposed: a. Standing Generator System: KVA units. b. UPS Systems: Central plus 2 floor units for selected areas. A minimum of 30 minutes backup used. c. Power Distribution: Vertically via XLPE cable in shafts. d. Lighting: Primary lighting recessed parabolic fluorescent fixtures and energy-saving lamps. Fixtures to have electronic ballasts and deo starters. e. Telecommunication: Distribution will be by horizontal and vertical ladder-type trays. Telephone company to provide backup lines. Standard equipment to be specified. f. Radio Communication: Masts and power to be provided on roof. g. Fire Alarm System: System to be microprocessor-based automatic, analog - addressable system alarm, to be displayed on a digital readout screen, and CRT shall display graphics of system under activated alarm. h. Security System: Four sub-systems to be provided: a) Key management system for low-risk public areas b) Card access control for high-risk areas c) Closed-circuit TV Lightning Protection: System to consist of air terminal, electric device, arrestor., lightning conductors, earthing rods and pits. j. Earthing (Grounding) System: System to consist of Power Co. transformer grounding, equipment grounds, foundation earthing, and special systems, e.g., OR, UPS, medical equipment, low-current systems. k. Special Call Systems: 1) Staff automatic system 2) Nurse call and hospital communications system 3) Radio paging system

8 Project Description 6. Cost Estimate The estimate was developed by the Project Manager and adjusted and validated by the designers’ estimator. The project estimate at bid and area analysis is as follows: Main Hospital and supporting areas (356,000 S.F.) = $ 74,000,000 Unit Cost $ 210/S.F. Housing and Dormitories plus supporting areas (197,000 S.F.) = $ 18,000,000. Unit Cost = $ 93/S.F. Total Estimated Costs $ 93,000,000

9 Value Engineering Procedure
General Pre-Study VE Job Plan Information Phase Creative Phase Judgment Phase Development Phase Presentation and Report Phase

10 General Value engineering is a creative, organized approach , whose objective is to optimize the life cycle cost and/or performance of a facility. A multidisciplinary team was formed. The objectives of each team member were to: analyze the project, find high-cost areas, recommend alternatives, estimate initial and life cycle costs whenever significant for the original system and for each proposed alternative, and assure that proposed recommendations did not sacrifice essential functions and timely completion of the project.

11 Value Engineering Procedure
General Pre-Study VE Job Plan Information Phase Creative Phase Judgment Phase Development Phase Presentation and Report Phase

12 Pre-Study Receive Project Documents
Reviewed by selected VE team members A list of questions and ideas was generated Reviewed by Medical Equipment Layout Specialist Basic comments Client and A/E

13 Value Engineering Procedure
General Pre-Study VE Job Plan Information Phase Creative Phase Judgment Phase Development Phase Presentation and Report Phase

14 Value Engineering Job Plan
VE team analyzed design documents: Plans, Cost estimates, and Design report. VE study was organized into six distinctive parts: Information Phase Creative Phase Judgment Phase Development Phase Presentation Phase Report Phase Design team and owner made an initial presentation on the design constraints and development.

15 Value Engineering Job Plan
Information Phase Creative Phase Judgment Phase Development Phase Presentation and Report Phase

16 Information Phase Function Analysis Cost/Worth Model
Function Analysis Worksheet (Hospital) Function Analysis Worksheet (Housing) Cost/Worth Model (Hospital) (Housing) For the following areas: Site-Work Structural Architectural Mechanical Electrical Medical Equipment General

17 Function Analysis (Hospital 1/2)

18 Function Analysis (Hospital 2/2)

19 Function Analysis (Housing 1/2)

20 Function Analysis (Housing 2/2)

21 Value Engineering Job Plan
Information Phase Creative Phase Judgment Phase Development Phase Presentation and Report Phase

22 Creative Phase VE team thought of as many ways as possible to provide the necessary functions at a lower initial and/or life cycle cost and design enhancements to improve required functions. Judgment of ideas was restricted.

23 Value Engineering Job Plan
Information Phase Creative Phase Judgment Phase Development Phase Presentation and Report Phase

24 Judgment Phase VE team judged and ranked the ideas generated from the creative phase. Evaluating Factors: State-of-the-art of the idea, Cost to develop, Probability of implementation, Time necessary to implement, Magnitude of idea’s potential benefit, and Aesthetics. Ideas were ranked from 1 to 10. Ideas with a ranking of 8 or more were developed further.

25 Value Engineering Job Plan
Information Phase Creative Phase Judgment Phase Development Phase Presentation and Report Phase

26 Development Phase Economic Factors 10% (Compounded annually)
Discount Rate 30 years Analysis Period Present Worth converted Annualized Method Equivalence Approach Constant Dollars Inflation Approach 9.42 Present Worth Annuity Factor Operating Costs 0.03 cents/KWhr (average) Energy Cost 1 to 5% of capital cost depending on element Maintenance Cost

27 Development Phase Some 127 ideas were generated during the initial review phase, from which 56 ideas were developed. Some 22 design suggestions representing VE team design review type comments were generated These proposals represent potential initial savings of over $16,000,000 and additional follow-on potential savings in operation, maintenance, and increased revenue of about $265,000/year. Suggested recommendations of potential deferred construction costs for supporting and medical equipment are included amounting to some $5,000,000.

28 Development Phase

29 Development Phase

30 A7 Original Design Proposed Design
The clinical labs and hemodialysis department are located between axis 10, 15 and A, F. they are divided into separate areas for blood donation, clinical lab and for hemodilysis. Proposed Design Consider rearrangement of the clinical labs and blood donation as per Sketch No. A-7 the change allows for an improved separation between the donation area and clinical labs, and accessibility of outpatients to donation area. In addition, switching the donation area and hemodialysis area will allow an increase of 3 additional beds for hemodialysis patient. Note: See ME 6 for overall savings generated. Discussion, Advantages and Disadvantages The rearranged layout improves the flow of outpatients to the labs and blood donator to the donation area, keeping the required privacy of the clinical labs. It will allow the addition of hemodialysis beds that will increase the revenue of the hospital. Also, the present design does not accommodate pediatric patients. Additional beds will be designated for this purpose.

31 A7

32 A7

33 A8 Original Design Proposed Design
Calls for 7 in. exterior precast concrete wall panels for both hospital and housing. Proposed Design Use 5 in. precast wall panels for hospital only. Use CMU, plaster and texture paint for housing units. Discussion, Advantages and Disadvantages The VE team discussed this issue with a local manufacturer who indicated that a 5 in. panel would be sufficient. This change will give a considerable weight and will save money. Maintenance cost should be slightly higher for the housings exteriors and for the thinner precast wall panels. It should not exceed $ 3000 / yr.

34 A8

35 A8

36 Development Phase

37 Development Phase

38 E 1,2&4

39 E 1,2&4 Advantage Disadvantage Initial and LCC cost saving
Improve Performance of Power Distribution Disadvantage Minimal increase in maintenance of transformer.

40 Development Phase

41 ME 6 Original Design Proposed Design
Present design call for 4 beds in hemodialysis. Proposed Design Revise design to add 3 additional beds. Discussion, Advantages and Disadvantages This area is in demand. Hemodialysis is a needed service with long lists at existing hospitals. The local market should be more than able to supply the need for the additional beds.

42 ME 6

43 Value Engineering Job Plan
Information Phase Creative Phase Judgment Phase Development Phase Presentation and Report Phase

44 Presentation Phase VE recommendations were further screened by the VE team before the oral presentation of results. At the conclusion of the workshop, VE proposals were reviewed, edited for clarity, and re-evaluated for computation of cost savings.

INTRODUCTION General The Value Engineering Team Executive Briefing VE Study Agenda SECTION 2 PROJECT DESCRIPTION Requirements Civil/Structural Architectural Mechanical Electrical Drawings Cost Estimate of Main Hospital Cost Estimate of the Housing and Dormitories SECTION 3 VALUE ENGINEERING ANALYSIS PROCEDURE General VE Job Plan Economic Factors Hospital Cost/Worth Model Function Analysis Worksheets - Hospital Function Analysis Worksheets Housing Housing Cost/Worth Model Creative/Evaluation Worksheets SECTION 4 SUMMARY OF RESULTS General Value Engineering Recommendations Summary of Potential Cost Savings from VE Proposals Design Suggestions Value Engineering Recommendations/Worksheets APPENDICES A. Report of Hospital Consultant B. Mechanical Engineering Comment C. Marked-up Set of Drawings, 1 Master Only

46 Summary General The team suggests that the Owner considers two options to defer initial cost outlays: Delete nurses’ house and rent space. A rough cash flow analysis indicates Owner will be some $200,000 /yr ahead using an equivalent cash flow analysis avoiding a $3,500,000 capital expenditure. Consider design build, lease-back for 20 years. By doing this Owner will defer some $15,000,000 in capital outlay and own the facilities after 20 years. He incurs some additional annual leasing costs that would be less than amortizing his capital investment over 20 years. Note: The above savings are not additive.

47 Summary- Continued Architectural - 16 Items totaling approximately $3,500,000 Structural -2 Items totaling approximately $130,000 Mechanical - 14 Items totaling about $1,000,000 in initial and $110,000/yr. in annual savings Electrical - 11 items totaling approximately $3,800,000 in initial savings and $100,000/yr. in annual costs Medical Equipment - 9 Items totaling approximately $7,500,000 in initial costs plus $650,000/yr. in additional income

48 Summary- Continued

49 Summary- Continued

50 Summary- Continued Eventually, 35 proposals were implemented. Initial cost savings between $10,000,000 and $12,000,000 should result and annual follow-on costs up to $1,000,000/yr That’s about 11% to 13% savings in initial costs.

51 Thank you… Any ???

52 Cost/Worth Model (Hospital)
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53 Cost/Worth Model (Housing)
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