Getting to the Heart of the Matter

Cardiac catheterization  saves lives by allowing cardiologists to perform minimally invasive procedures working inside a beating heart. When the cardiac cath lab at Gateway Regional Medicial Center in Granite City reached the limits of its life cycle, Helmkamp was called in to build a new unit within the hospital.

Helmkamp performed pre-construction and construction services for a complex re-configuration of the existing cath lab suite including coordination of state of the art cath lab equipment.  Challenges included utilizing a temporary cath lab with all of the required utilities & patient access during construction, installation of new mechanical equipment, extensive electrical upgrades, coordination with new state of the art cath lab equipment, and new finishes.  All  of this work was conducted within an existing facility with active operating rooms on the floor above.

Upon completion of the design, Helmkamp submitted a proposal to renovate the lab on a time & material basis with a guaranteed maximum price.  With exception of the mechanical & electrical work, Helmkamp put the much of the work out for competitive bids in order to get as low a construction cost as possible.

Due to the addition of several mechanical upgrades during the design phase, the final cost proposal exceeded the initial budget amount.  Helmkamp then performed a value-engineering process to bring the cost back down to an amount acceptable to the owner without sacrificing the desired mechanical upgrades.

Before the scheduled start of the project, the existing cath machine failed and could no longer be used.  Helmkamp was called on to install a power pedestal at the mobile cath location; bring power, fire alarm, voice/data to the mobile cath; construct a temporary exterior walkway complete with emergency egress doors, lights and exit signage; rent a temporary UPS and provide diesel fuel for the mobile cath generator.  This work was all done on an emergency basis so that patient care could be restored as soon as possible.

The failure of the existing cath machine and the earlier arrival of the temporary mobile cath did have one benefit.  It allowed the entire cath suite to be renovated in one single phase instead of split into two phases as was originally planned.

The cath lab suite is located very near an operating room on the floor above.  This presented a challenge when performing vibration causing work.  Through close coordination between Helmkamp, Gateway Regional Facilities department and the OR staff; the vibration causing work was accomplished during periods of time when they would not cause disturbance to procedures in the OR.

The space between the new lay-in ceiling and the concrete roof deck above was minimal.  This required Helmkamp to carefully manage the routing of ductwork, piping and conduit to ensure that it would all fit while still meeting the specified lay-in ceiling height.  This is especially true in the equipment room and above the procedure room ceiling due to the additional obstruction of the Helmkamp-installed unistrut system to support the cath equipment and the Helmkamp-installed support structure for the Steris light.  The location of light fixtures, speakers and sprinkler heads in these ceilings had to be rearranged from the original design and very closely managed to make it all fit.

The project included the installation of a new roof top air handler unit.  Helmkamp coordinated closely with Gateway Regional’s Facilities & Security departments prior to setting the unit.  This included reviewing the lift plan with them and getting their approval of it, coordinating the partial shutdown of the driveway and evacuation of staff and patients from the building directly under the path of the lift.

As with all Helmkamp projects, good housekeeping practices both inside and outside of the work area were diligently adhered to.  Most of the demolished materials were removed from the suite in covered gondolas so that dust was not spread throughout the hospital.  In addition to that, dust barriers with negative air monitors were erected around the suite and were left in place during the work and negative air pressure was maintained within the suite.  These temporary partitions were erected in the corridors of the hospital and were erected so as not to impede emergency egress requirements.  Gateway Regional’s Infection Control nurse was very complimentary of Helmkamp’s execution of this project.

To allow for quick and safe access to the work area on the roof above the cath lab suite and to the area of the roof where the new roof top air handler unit and support structure were installed, Helmkamp constructed a temporary stairwell, walkway and fall protection rail system from the outside ground level to the roof.  The temporary stairwell and walkway made access to the roof much quicker than the circuitous route that would have otherwise been required.  This made material deliveries to the roof much easier and expedited the work on the roof.

There were multiple power shutdowns required to make final tie-ins for electrical systems.  Two of these shutdowns affected large portions of the hospital including shutdown of electrical service to the main bank of elevators.  This work was coordinated with Gateway’s facilities and security departments and was performed in the early morning hours over a weekend to minimize disruption to the hospital.

Some shutdowns of the water service that served a large portion of the hospital were also required to make tie-ins.  It was determined that instead of tying in to the mains, it would be better to tie in at the existing shut off valves which were determined to still be in good shape.  By doing this, Helmkamp avoided having to shut off the water mains that would have impacted the rest of the hospital.

There was not sufficient power available to power both the mobile cath lab and the new permanent cath equipment.  To facilitate the startup and testing of the new cath lab equipment, for a period of one week, the power was shut off from the mobile cath and brought to the new cath equipment so that Phillips could start it up and test it.  After this week, power was cut off and restored to the mobile cath.

The existing terrazzo floor was substantially out of level.  Helmkamp performed an extensive amount of grinding down high spots and filling in low spots to get the floor level.  In some areas this required cutting out some of the floor so as not to interfere with the swings of new doors.

Gateway now plans to add a second cath unit on the other side of the control room for the first new lab.