Panelists: John Medvec DBIA AIA, Design Manager, Skanska USA Building, Eric Peterson, Preconstruction Manager, McKinstry, Mark Peckover PE LEED AP, Principal, Stantec.

The team began the project in 2017 and completed it in early 2019 with the goal of replacing the main hospital building on the active hospital campus in Lincoln City, Oregon without interruption of healthcare delivery to patients. The hospital provides healthcare to patients located along the Oregon Coast between Astoria and Newport. Project award was based on team qualifications and chemistry and did not initially establish a complete scope of work or construction cost.

The team began the project by developing multiple program options to determine the most efficient fit between healthcare services and patient needs within the service area of the hospital. Each program iteration included a cost model and schedule update so the team could address the solution that provided the best value for the dollars spent. The progressive design-build model simplified the RFQ and award and allowed the team to address multiple challenges as it worked to deliver the project.

Contract relationships changed as the team advanced from programming and concept development through construction documents and construction. The contract organization included the traditional design-build relationships plus direct contracts between the CM and engineers, design-assist trade partners and subcontractors, as well as Owner-held contracts for technology engineering. The CM managed the communication between all parties. Five distinct documentation phases were created to phase permitting, construction, and demolition of the existing hospital.

Examples of challenges the team addressed during project delivery were:

  • Soil conditions threatened to impact the project budget and schedule but were overcome by discussing the feasibility of each solution with the Owner, Geotechnical Engineer, Structural Engineer, and Foundations Trade Partner. Although driven steel pipe piles created a short-term noise and vibration challenge, they were selected as the best option with both a schedule and cost savings over an auger cast piling system.
  • The mechanical team needed to work quickly to respond to equipment procurement challenges and create a process whereby the owner, CM, trade partner, and engineer-of-record could effectively review competitive cost proposals from equipment suppliers. The team was processing contract amendments every few weeks to stay on top of the procurement challenge. The process would have been more efficient if we established a bulk buyout process to minimize the quantity of individual contract amendments.

The progressive design-build delivery model provided opportunities for the team to collaborate, respond to challenging circumstances, learn, and deliver on the Owners goals to develop an innovative, resilient, and efficient critical access hospital on the Oregon coast. Completed prior to the onset of COVID, flexible and multi-use solutions developed to maximize functional space in the hospital were able to be repurposed as the hospital responded to the surge in COVID patients in early 2020.


Design Manager

Skanska USA Building Inc.