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Mercy Memorial Hospital - Construction Highlight - wisdom of oz

Renovating and expanding Mercy Memorial Hospital in Monroe would have seemed like an insurmountable challenge to many. The project would entail working on a site that has served the area's healthcare needs since 1929 and is nestled within a tightly packed residential area. The final building dating back to the '20s, which had been converted for office use, was removed as a part of the project, but the oldest functioning hospital building was built in 1962 and no major expansions have taken place since the 1960s. Mercy Memorial Hospital was in dire need of a complete overhaul to update its tired image, enhance technical capabilities, and improve its market position. The project team delivered a 70,000-square-foot addition and renovated 77,000 square feet of existing space over a four-year period towards this end.

Transforming the hospital's maze of hallways into a navigable pattern ranked among the most challenging aspects of the project, but the team turned to the Wizard of Oz for inspiration as visitors now simply follow a Yellow Brick Road through the facility to reach their destinations. Creating a path that visitors instinctively follow was one of many wise solutions devised by construction manager Contracting Resources, Brighton, and architect Hobbs+ Black, Ann Arbor.


Improvements made at Mercy Memorial Hospital begin at the front door, where visitors step into a "Town Square" that has been outfitted with fresh retail offerings and easy to follow signage. From there, they begin their journey on the Yellow Brick Road that radiates outward in two directions and travels through new and renovated portions of the facility to provide access to all hospital departments. Before this easy to- follow path was opened to them, visitors actually needed to walk outside to traverse the building. There was a path leading from the north and south ends of the hospital, but it was only open to staff members who could navigate the complex maze of corridors without getting lost. Patients entering the facility through the emergency room, for diagnostic procedures, or for scheduled surgeries, also benefit from a streamlined process.

"We created a logical progression for coming in as a patient and following through to radiology, the cath lab and surgery departments," said John Barker, executive vice president of Hobbs + Black. "There is a quick link to all of these departments from the central core."

Creating this link was easier said than done, as many additions were added to the hospital over the years, which greatly impeded the facility's ability to function as a whole. The surgical department was located in the lower level, yet it was quite undersized by modern standards. Since expanding horizontally underneath the hospital would have been impossible, the entire surgical center was relocated to newly constructed spaces. The new surgery center features four operating rooms, two procedure rooms, and all private pre-op and recovery areas. About 50 percent of the facility's mechanical equipment was replaced to meet the expanded needs of the larger facility and electrical feeds were all meticulously routed from a remote powerhouse behind the hospital. Of their significant improvements include a 25,000-square-foot emergency center, a major new entry on the south end of the hospital, and a renovated radiology department.

The exterior was also given an updated look, but this was done with respect to the architecture that was already in place. Brick matching the existing structure was incorporated into the design, but it was combined with extensive glass and linear elements to give a more timeless appeal. By the time the project was done, the entire hospital was completely transformed.

"We touched every part of the hospital: the operating room, emergency room, radiology, waiting areas, front door, patient rooms, and medical office centers," said Jim Lawrence, vice president of Contracting Resources. "Keeping the hospital running while doing such significant renovations and additions was a challenge."


Mercy Memorial Hospital remained open during the entire project, even as access to the main front entrance, loading docks, emergency departments, and other parts of the facility were closed off. Temporary tunnels, enclosures and access points were needed to bring people in to where they needed to be, while stringent dust control measures were adopted to maintain a clean and safe environment. The project was divided into at least 12 phases to prevent any single activity from impacting hospital operations.

"Phasing was a big issue, as it is with a lot of hospital facilities," said Thomas (hasty, associate, Hobbs + Black. "It was a constant partnership with the hospital. We provided our expertise on how the project could function, but we also depended on their expertise in patient care."

Anytime existing facilities are renovated, there is always the potential for unforeseen complications. Crews cut into scarce parking space when they had to relocate an existing 10-foot diameter storm drain that was shown in another location on as-built drawings. They also had to remove existing ductwork that had been slated for reuse, but was found to be too dirty, all while systematically performing the work to preserve the airflow and to never let air pass from old ducts to new. Any unexpected work needed to be carefully coordinated with the hospital staff.

"We did our best to warn them, especially when noise was involved," said Dave Melville, project manager for Contracting Resources. "There were some things that would be loud no matter what we did."

The project team used drilling and water injection for digging whenever possible to control noise, but jackhammers were needed when crews encountered bedrock while installing a new elevator. Since this area was right next to the patient tower, great care was taken to complete this work as quickly and quietly as possible.

Although the process involved some inevitable growing pains, the fact that it went as smoothly as it did given the tremendous operational constraints is a testament to meticulous planning and unquestionable professionalism. The quality of the finished product speaks for itself, but the strongest evidence of a job well done comes in the hospital's decision, in partnership with Karmanos Cancer Institute and the Toledo Clinic, to rehire Contracting Resources and Hobbs + Black to design and build the Stewart Road Cancer Center on a site two miles away. Completion of this 12,700- square-foot facility is anticipated in spring 2011. Since this facility will be much smaller than the hospital, a Yellow Brick Road probably will not be needed for wayfinding, but the technical wizardry of the project team will undoubtedly shine through as surely as it does at Mercy Memorial Hospital.