The equivalent of a new kindergarten class is born every day at Orlando's Arnold Palmer Hospital. With more than 13,000 births in the mid-2000s in a hospital that was designed 15 years earlier for a capacity of 6,500 births a year, the newborn intensive care unit was stretched to the limit. Moreover, with continuing strong population growth in central Florida, the hospital was often full. It was clear that new facilities were needed. After much analysis, forecasting, and discussion, the management team decided to build a new 273-bed building across the street from the existing hospital. But the facility had to be built in accordance with the hospital's Guiding Principles and its uniqueness as a health center dedicated to the specialized needs of women and infants. Those Video Case Guiding Principles are: Family-centered focus, a healing environment where privacy and dignity are respected, sanctuary of caring that includes warm, serene surroundings with natural lighting, sincere and dedicated staff providing the highest quality care, and patient-centered flow and function.
The vice president of business development, Karl Hodges, wanted a hospital that was designed from the inside out by the people who understood the Guiding Principles, who knew most about the current system, and who were going to use the new system, namely, the doctors and nurses. Hodges and his staff spent 13 months discussing expansion needs with this group, as well as with patients and the community, before developing a proposal for the new facility. An administrative team created 35 user groups, which held over 1,000 planning meetings (lasting from 45 minutes to a whole day). They even created a "Supreme Court" to deal with conflicting views on the multifaceted issues facing the new hospital.
Funding and regulatory issues added substantial complexity to this major expansion, and Hodges was very concerned that the project stay on time and within budget. Tom Hyatt, director of facility development, was given the task of onsite manager of the $100 million project, in addition to overseeing ongoing renovations, expansions, and other projects. The activities in the multiyear project for the new building at Arnold Palmer are shown in Table 3.7.
Discussion Questions *
1. Develop the network for planning and construction of the new hospital at Arnold Palmer.
2. What is the critical path, and how long is the project expected to take?
3. Why is the construction of this 11-story building any more complex than construction of an equivalent office building?
4. What percent of the whole project duration was spent in planning that occurred prior to the proposal and reviews? Prior to the actual building construction? Why?
Table 3.7

PRECEDENCE ACTIVITY(IES) 1 Proposal and review 2. Establish master schedule 3. Architect selection process 4. Survey whole campus and its needs 5. Conceptual architect's plans 6. Cost estimating 7. Deliver plans to board for consideration/decision 8. Surveys/regulatory review 9. Construction manager selection 10. State review of need for more hospital beds ("Certificate of Need") 11. Design drawings 12. Construction documents 13. Site preparation/demolish existing building 14. Construction star/building pad 15. Relocate utilities 16. Deep foundations 17. Building structure in place 18. Exterior skin/roofing 19. Interior buildout 20. Building inspections SCHEDULED TIME 1 month 2 weeks 5 weeks 1 month 6 weeks 2 months 1 month 6 weeks 9 weeks 3.5 months 4 months 5 months 9 weeks 2 months 6 weeks 2 months 9 months 4 months 12 months 5 weeks 1 month 2. 4,5 10 12. 13 12 16 15, 19