Springfield, MO

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A Conversation With ... Rod Schaffer

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What is your job?
I manage all the construction and real estate and property management components. I also have the engineering department, which maintains all (CoxHealth) facilities (and) the food service department, housekeeping department, security, grounds and the biomedical departments, which maintain all the medical equipment. We have 62 clinics scattered in 22 counties … plus the hospitals (in Springfield) and Monett.

What are some other recent projects in addition to CoxHealth’s $52.5 million emergency department, opening Sept. 29?
It’s part of a $120 million bond (cycle), which included (the emergency) facility, the Walnut Lawn orthopedic hospital facility, the new surgery center and medical office building, two plant upgrades and a new parking garage.

What are some of the things considered in designing a health facility?
Most progressive health care organizations use evidence-based planning and design (to) support improvement (and) reduce medical errors. There are four guiding principles. We want to design for patient and family experience (and) safety, …. to be an employer of choice and for stewardship. On the ER, we had a pretty good idea of what we wanted, but we had a consultant come in to talk about our through-put processes.

How do you put together your design/construction teams?

Most health care organizations will use national, recognized architects to do their acute-care planning, because it is so specialized. … We’ve decided to use a national planner, Beck, which also has a construction company. But it’s important that we also use as much local talent as possible. For (the ER) we brought in the local group of Walton Construction. On the medical office building/surgery unit, we had Killian to do the project. I’m proud to say that 90 percent of the dollars we spent on our projects stayed local.

Tell us about the ER design.
Every ER room is identical (so that) when a clinician walks into the room and they’re in a critical moment, the chance of them having an error is reduced significantly. … The ER is designed with a pod concept. Everything is self-contained (and) they don’t have to leave the pod. … The trauma population coming in via ambulance or helicopter should not be mixed with walk-ins (because) it causes a lot of chaos, is very difficult to triage, and folks walking in see the trauma and think, “I’m not that sick. I may not need to be here.” The ER garage is on one side, with ambulance access only and helipads directly above, and admitting is on the other side. One of the five pods is not going to be used right now, as we don’t have the volume just yet. (The ER) is designed for 110,000 visits annually, and we’re at about 65,000 annually.

Did the diverging diamond at James River and South National factor into ER site selection?
Yes. Originally, we looked at putting the new ER out in front of the existing ER. But in this business, it is very difficult trying to do construction and keep the doors open. We also felt that the (National and Primrose) intersection couldn’t support the entire volume. Patients can come across National (via an underground tunnel), and we’ve created a loop road system similar to an airport for the campus.

Is the ER Leadership in Energy & Environmental Design-certified?
No. All of our facilities are designed that way, but we chose not to have them certified (because) of the cost. I believe just to get the ER LEED-certified would be half a million dollars, just for a certificate that says, “You meet the criteria.” We thought that was a little pricey and would rather put (the money) back into the unit.

How is the Building Information Management System used in Cox projects?
(It) actually maps all the mechanical systems in one 3-D model. … In a typical project, the mechanical folks don’t have the opportunity to know where all their stuff is going. They have to (determine) that after the fact (and) may find out that a conduit has to run through steel, so there’s a change order. The beam either comes down, or (the designer) has to do a lot of rework. All of that is avoided with this. On (the ER) we had 850 clashes when we started. Assuming half would have been caught, (BIMS) found 425 clashes. At a conservative average of $1,000 per clash, that’s $425,000 saved.
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