Like the fireman who runs into the burning building when everyone else is running out, a hospital needs to be a building everyone can go to after leaving their homes or offices in a disaster.
This provides a unique challenge to those designing and building health care facilities, but it's not the only one. San Diego general contractor Rudolph & Sletten know all about the challenges of this kind of building, having built numerous health care and research facilities since the late 1980s, including recently the Sydney Kimmel Cancer Center in San Diego and additions to the Palomar Pomerado Health facility in Escondido.
"In case of a catastrophic event like a big earthquake, an office building just needs to be safe enough where people can get out of the building, but then the building can be condemned," said Greg Palmer, regional vice president of Rudolph & Sletten. "The hospital has to be able to withstand the seismic event and then still be able to treat patients that might have been hurt in the event. So that means that it's more substantial, more stout, able to take a bigger impact of any negative thing that mother nature has to offer."
As a result of this burden, hospital projects are put under heavy scrutiny. Their plans are reviewed more thoroughly than those of other buildings by the California Office of Statewide Health Planning & Development (OSHPD), according to Joseph Hook, vice president and chief estimator for Rudolph & Sletten in Southern California. This adds more time to the projects, and therefore higher costs.
"(It takes) a fairly long time to get construction under way," Hook said. "A long design and permitting process."
In addition to the need to be more structurally sound, there are other challenges that hospitals pose to their builders. Buildings must be built to accommodate technology, which has become an important part of hospitals in recent years. While the burden to make hospitals more technology friendly is borne mostly by designers, when a construction company like Rudolph & Sletten begins to build the hospital, it must rely on expert subcontractors with experience in that field. The same is true for the additional ventilation a lot of hospitals require.
Founded in the early 1960s, Rudolph & Sletten is headquartered in Redwood City and has regional offices in San Diego, Irvine and Roseville. The company builds everything from schools to office buildings, excluding only single-family housing. It moved into the health care sector in the late 1980s, according to Hook.
The company operates as a general contractor, usually using its own workers for concrete and rough carpentry work. It hires subcontractors for mechanical, electrical and other more specialized work. The health care industry is a "limited field" when it comes to subcontractors, Hook said.
"The contractors who do (health care) also do other types of construction, so from that standpoint it's not specialized, but there are a lot of contractors who stay away from health care because it is more difficult," he said.
When building a new hospital or research center, the easier jobs are those where the contractor is starting from scratch, Hook said. One of the biggest challenges is doing construction on an already existing building where patients are being treated or tests are going on inside. This is the case with the Palomar Pomerado Health facility in Escondido.
Andy Hoang, a spokesman for Palomar Pomerado Health, said Rudolph & Sletten has worked to make the process as easy as possible, from the environmental impact report to the current construction that's underway.
"They really worked with us to minimize the effects of the project while running the hospital," Hoang said. "There's no way an organization like Palomar Pomerado Health would be able to build something like this in-house. Having someone like Rudolph & Sletten is key."
An ongoing change in the industry, Hook said, is that more and more health care facilities are trying to be more environmentally conscious with design specifics like bamboo floors, exterior shading and mechanisms to keep storm water on site for reuse, as opposed to flushing it away. Some of these materials are more expensive at first, but end up saving owners money over time.
This more environmentally friendly building is affecting the construction company in all areas.
"There's a whole movement in our industry in the past few years to make our buildings more sustainable, and I think the state government in California is moving in that direction as well," Hook said.
Rudolph and Sletten Inc.
Address: 10955 Vista Sorrento Parkway, Suite 100, San Diego, Ca 92130
Phone: (858) 259-6262
Business Description: Rudolph and Sletten builds everything from biotech laboratories and medical facilities to corporate campuses and educational institutions. As technology progresses, so do the needs of construction. The company adapts to the needs of the industry by staying on the cutting edge of technology while still providing quality-oriented general contracting and construction management services.
Corporate Headquarters: Redwood City, Calif.
Vice President of Southern California, Estimating: Joseph Hook
President & CEO, Corporate: Martin Sisemore
COO, Corporate: Dennis Giles