Over the next decade, the Washington University/BJC Medical Center campus at Kingshighway Boulevard in St. Louis will undergo tremendous new construction and renovation inside, outside and under the Midtown footprint.
BJC HealthCare will build a new Barnes-Jewish Hospital and will expand St. Louis Children’s Hospital, while upgrading vehicle and pedestrian traffic access, adding parking and making other improvements to facilities.
The conversion of inpatient hospital space from semi to private rooms of both hospitals is a main element of the construction, said BJC HealthCare Group President Robert W. Cannon.
“The main reason for doing this is largely replacing outdated facilities that can no longer keep up with the contemporary demands of medical care,” Cannon said. “We also have some opportunities for growth here, where the population in general is requiring more health care services.”
BJC has yet to release cost estimates for the campus renewal project. However, a 2013 media report described the BJC campus renewal as a $1 billion project, with bonds being issued by the Missouri Health and Educational Facilities Authority.
The renewal is concentrated at Kingshighway Boulevard and Forest Park Parkway to the north and at Barnes-Jewish Plaza and Kingshighway to the south.
The north end is getting the first makeover.
“We are abolishing about 500,000 square feet of old facilities to make room for these new facilities,” Cannon said. “The facilities themselves are obsolete. Over a 10-year period, we had vacated all the functions out of them, whether those were patient care functions or administrative functions.”
Cannon said the renewal will improve the overall patient and family experience and will improve adult cancer care, women’s health and neonatal intensive care.
“The Siteman Cancer Center is simply out of space, and we need more rooms to care for our cancer patients,” Cannon said.
Consolidation of services is a core strategy.
“In one place,” Cannon said, “you’re going to have a combination of all the labor and delivery services, women’s services and neonatal intensive care services that the community will need.”
The campus renewal project team is led by program manager Jacobs, with ACW Alliance (an Alberici-led joint venture that includes Clayco and SM Wilson) as construction manager; HOK as executive architect; Bard, Rao + Athanas Consulting Engineers (BR+A); and diversity consultant Marks and Associates.
Two phases
The campus renewal project will take place in two phases.
Phase 1will consolidate obstetrics and gynecological services and move these services to the north end of the campus, which includes building a new Barnes-Jewish Hospital and expanding St. Louis Children’s Hospital with private rooms for children and their families.
“There are just more families and more support when people come to the hospital,” Cannon said. “And when we design our private rooms, we think not only about what the patient needs, but what the families and other health care advocates need as well.”
Additional revitalization will include additional surgical space, faculty practice clinics and diagnostics.
Project construction brings with street closures and detours due to demolitions, streetscaping and underground utility work. Parkview Place, located between Barnes-Jewish Hospital north and St. Louis Children’s Hospital, closed July 7 for the next two years while the new Barnes-Jewish Hospital north building is constructed and Children’s Hospital is expanded.
Phase 1 is scheduled for completion at the end of 2017.
Phase 2 of the project will say goodbye to Queeny Tower, located to the south of the hospital campus alongside Highway 40/Interstate 64. The tower will be torn down to expand Barnes-Jewish Hospital’s heart and vascular program; neurology and neurosurgery programs; transplant, trauma and critical care; and general medicine programs.
Then, Cannon said, “a second building will be attached to the existing Barnes-Jewish Hospital East-West Pavilion, and that’s what allows us to take Barnes-Jewish to a fully private-bed hospital.”
‘People, not percentages’
BJC officials said diversity and inclusion are an integral piece of the planning and implementation of the campus renewal project.
“This is really an opportunity and a passion of mine to really ensure that our efforts in diversity are the very, very best we can do,” Cannon said.
June Fowler, vice president of communications for BJC, who serves on the project’s steering committee, said diversity was part of the Request for Proposals (RFP) process.
“When we were trying in our RFP process to identify an architect, a general contractor and a chief engineer, each of those firms came forward with a plan for increasing minority participation on the project,” Fowler said. “That speaks to who we are as an owner. It’s very clear. You don’t come to BJC without a plan about how you increase diversity.”
Fowler said many of the proposals listed business development consultant Marks and Associates as a team member. BJC decided to contract them directly as a diversity consultant.
“We said, ‘Marks and Associates will sit at the table,’” Fowler said. “Diversity is that important to us.”
Marks and Associates works directly with Gregory C. Mohler, vice president of planning, design and construction for BJC Health care, and Valarie Larkin, BJC’s program manager of the project.
Sandra Marks, president and CEO of Marks and Associates, said BJC wanted more than monitoring compliance with inclusion goals for minority- and women-owned businesses (M/WBE). BJC also tracks company metrics through Marks and Associates.
“It’s not, ‘We want to do a certain percent with that company,’” Marks summarized BJC’s approach to procurement. “It’s, ‘We want to do more with them than the previous year.’”
Marks said it’s a capacity-building strategy.
“They didn’t just want to see the firms utilized, but they wanted to see them grow,” Marks said.
Marks’ company, in fact, grew in scope.
“To be honest, usually I’m not able to sit at the table with people of this level when I’m doing this kind of work,” Marks said, “and that relationship for me grew my capacity before we even started working on the firms.”
That’s why hitting percentage goals is not a sufficient diversity program.
“People, not percentages, build capacity. It’s people who are passionate about what they are doing,” Marks said.
“And if you put those people in a position of power to make something happen, that’s how it happens. It’s not the percentage; it’s who is implementing the program.”
She said this approach leads to relationships conducive to minority business development.
“When you have a business owner that hasn’t really positioned themselves to think about growth, the percentage doesn’t make them grow. They are giving you want you ask for, and that’s the end of it,” she said.
“If they are positioned for growth and they want to grow, they can come back to you and say, ‘I think I can do a little bit more,’ or ‘I’m not really ready yet, the level you want me, but I am fine if you led me partner with someone.’”
Mohler said one of the inclusion systems on this project is the Capacity-Building Warehouse program. It was developed in conjunction with Marks and Associates to expand the selection of potential firms to conduct day-in, day-out planning, design and construction business with BJC. There are 112 firms in the warehouse.
“The Capacity Building Warehouse has allowed us to look at firms that are emerging firms; firms that have done some projects, but are nowhere ready to take on big projects; firms that have done work before, but not health care projects,” Mohler said.
Floors and ceilings
Cannon said any time a single goal is established, it sets a floor and a ceiling, and that’s not what BJC wants to do.
“We want to challenge every piece of work that gets bid, what the market can bring us, what the firms can accomplish and what the community needs,” Cannon said. “We are trying to do this in a nontraditional way, because in some large part, some of the traditional ways have not moved the community as far as we would like.”
But they do have some numbers to report.
Marks said 48 M/WBE firms have been contracted in the renewal to date. “And for the majority of these firms,” Marks said, “this is their first relationship or this is their first relationship at the level they are currently participating in.”
At bjcconstruction.org, BJC posts its minority workforce and M/WBE participation in the project. Through May 2014, BJC reports more than 150,000 minority workforce labor hours (10 percent minority female and 18 percent minority male) on the campus renewal project, and more than $22 million in M/WBE contracts (5 percent WBE and 13 percent MBE).
“We met the city’s requirements,” Mohler said.
“Twenty-five and five on the business side and then certainly the same on the workforce side,” Marks added.
City of St. Louis ordinance # 69427 established workforce diversity goals for all developers and contractors seeking to bid on city public works contracts, Tax Increment Financed (TIF) projects and city-bonded projects. Total labor hours of these projects should meet or exceed 25 percent for minority, five percent for women, 15 percent for apprentices and 20 percent for city residents.
“We are in the high teens, based upon the contracts that have been let, but the big contracts have not yet been let,” Fowler said. “So we are talking to our general contractor right now about what our expectations are.”
Grow local
BJC is trying to grow local minority companies through this massive project, and this has required a change in approach to inclusion goals, officials said.
“We have a preference – a very strong preference – for the people that we hire on the MBE/WBE side to be from St. Louis,” Fowler said. “We are trying to grow St. Louis.”
She said the local focus discourages setting percentage goals that the capacity of local minority firms could not meet.
“If they’ve got to meet this goal that is unattainable, because of the other projects that are in community, they’ll go outside” of the region for subcontractors, Fowler said. “And our goal is that you stay inside.”
Cannon said that building in and around hospitals has unique constraints.
“It’s highly regulatory. It takes a lot of technical knowledge. You’re often working next to active units that are taking care of patients,” Cannon said.
“We are going to be working in close proximity to some of the sickest of sick cancer patients, and so it takes a longer time in this Capacity-Building Warehouse to get the competency of the firms up to a level that you can meaningfully deploy them on your worksite.”
Cannon said BJC does not want the opportunity of a project of this scale to be wasted.
“We wanted the diverse firms in this town to emerge from this project stronger than when they went into it,” Cannon said, “so that we achieve real progress on the diversity front.”
Gaining experience
Fermin Glasper, president and CEO of Glasper Professional Services (GPS), is one of the MBEs working on the renewal project. GPS is a civil engineering and land-surveying firm that was introduced to the project by Castle Contracting.
“Initially, we started by doing a sub-service utility mapping evolution for the master planning of the renewal project,” Glasper said. “They wanted to understand where the utilities lie on the entire 250-acre campus.”
Glasper said his company has increased its business capacity and received additional work because of his relationship with BJC. GPS also has partnered with BR+A, a Boston firm, to provide civil engineering services for the ongoing design on the project. Now GPS is doing all of the civil engineering for the renewal project, which includes gas, water, sewer; the location and re-routing of those utilities; changes to roadways; grading terrain; hydrology; and three-dimensional modeling.
Mohler said BJC is deliberately working with the local architect and engineering community.
“We said, ‘Let’s grow the architects or engineers, either from a company standpoint or from within a company,’” Mohler said.
“Maybe it’s a majority company, and we look at how to grow the minority piece from within that, either through interns or their work for us. It is not easy, but we are doing it here.”
Mohler cited GPS and African-American architect Karl Grice as two “gems” discovered in the process.
Marks said BJC’s relationship with the National Association of Minority Architects is providing additional opportunities, along with internship programs.
“Through an apprenticeship program like this, your owner is expecting to see those apprentices and keep them here to learn enough so that, when they go on to another place, they have something on their resume,” Marks said.
“It’s one thing to count percentages, but it’s another thing to change people – and that’s what’s happening here.”
Karl Grice, principal of Grice Group Architects in St. Louis, said he has wanted to work in health care for years, but getting those projects proved difficult.
“Most of the clients want firms that are experienced in health care, so for us it was always a ‘Catch 22,’” Grice said. “We couldn’t get on the project because of no experience, and we couldn’t gain experience without being on a project.”
Through the Capacity-Building Warehouse, Grice Group was paired with WA Architects, Inc., an MBE out of Cincinnati. The joint venture, known as Grice+WA, got Grice on the BJC campus renewal project.
“Our staff members can work side-by-side with them, garner that experience and allow our firm to submit on projects in the future.” Grice said. “We would now, in fact, have staff with experience in working on a substantial health care project.”
Grice has an architect and an architect intern embedded at the project management office who are responsible for 3D design modeling on the new tower. BIM, or Building Information Modeling construction software, is being used to create a 3D computerized model of the structure before it is constructed. Grice architects can reveal potential problems in construction before they happen.
“If there’s a light that might be in the way of duct work; an outlet that’s in the wrong place; or a door is swinging and hitting another door, those kinds of things are clearly identified in this computer model and solved before it gets into construction,” Grice said. “It reduces the amount of change orders and delays in the project.”
Firms in the Capacity-Building Warehouse also participate in the BJC 101 program to sharpen business skills and learn how they conduct business with BJC and how to transfer that knowledge. It is led by Marks and Associates in conjunction with BJC design or construction team members.
“BJC 101 is a five-year initiative rolled out on quarterly basis that will allow businesses to grow in various ways, whether it’s an aspect of business, in actual contracting, in bonding, in how BJC does business,” Mohler said.
Growing the competition
Stretching the capacity of M/WBEs also means relying on businesses that currently work for BJC to help the owner in grooming those minority businesses – which is, to some degree, asking them to help grow their future competition.
“You can imagine that’s not always an easy thing for people,” Cannon said. “This is something we have to come together as a community and say, ‘This is very, very important.’
This is really important to us, and we are putting resources behind it in a way that has not been done before.”
Valerie Larkin, program manager, said a version of it has been done before, on a smaller scale, by BJC.
“Two good examples of what we are trying to do here we did 15 years ago when we did the Center for Advanced Medicine,” Larkin said.
“There were two little-bitty companies that we hired – the first time they’d ever worked for BJC. One of them was a little cabinet and installation company called Interface Construction [a WBE], and you know where they’ve gone. And the other one was Castle Construction, which was a backhoe and two dump trunks. Last year, they did $40 million worth of business.
St. Louis’ Interface Construction, founded in 1978 by CEO Sam Hutchison, is an MBE general contracting and construction management firm, that has worked on numerous projects in health care, commercial/retail, educational, industrial and government/municipal markets. Interface has worked on projects valued at “$10,000 to $15,000,000,” according to its website.
“We got them in and helped them along, and they did good and developed,” Larkin said. “If we get three or four firms off of this job that do the same thing, it will be a marvelous success.”
To watch a live webcam of demolition/construction, find out about traffic detours and other information about the project, visit BJCconstruction.org.
