The project team, led by McCarthy Building Cos. and HKS, was selected for the project after working with MDA on the $240-million Alkek vertical expansion, completed on the campus in 2011.

The Pavilion "includes basement expansion of sterile processing, [while] the first floor is drop-off drives and lobbies where we've connected two of our hospitals [the Alkek and Lutheran patient towers] together with a single lobby," says Janet H Sisolak, project director for MD Anderson. "The existing building that it's connecting to has an interstitial design, so two, four and six are interstitial floors, and then three is IR, five is surgical expansion and PACU [post-anesthesia care unit], and then seven is shelf space for more ORs, with a dedicated PACU as well as respiratory therapy services." Level eight is a mechanical floor.

New construction included in the Pavilion totals 168,737 sq ft, Sisolak says. The project also includes renovations to 84,000 sq ft of existing space, but that is not included under the McCarthy/HKS scope of work.

Multiple Delays

Initial planning on the project began almost 10 years ago. "Back in 2004 and 2005 as we were planning the Alkek vertical expansion for our hospital, one of the things that we do routinely is we see where our volume projections are going, and then we plan our building projects accordingly," explains Sisolak. "So we saw a need for additional surgical suites and imaging expansion to support the inpatient volume. That was really the driver, to find expansion space for imaging and surgery."

The McCarthy/HKS team helped vet initial design concepts in 2007-08 in order to help facilitate MDA in publishing an initial RFP in the first quarter of 2009, explains Al Gomez, project manager for McCarthy. But the recession put the project on hold.

"The second RFQ was issued in first quarter 2010. McCarthy/HKS submitted as a team once again and MDA selected our team in the second quarter of 2010," he says. "Schematic design and design development documents were completed in 2010 and the first part of 2011, when the project once again went on hold per the owner's request. The design was completed in 2012, and mobilization began in first quarter of 2013."

That extended time frame in getting the project from concept to shovel has had a bigger impact on a project of this type, especially when it comes to the coordination of technology.

"Getting the project going was really difficult," Sisolak admits. "When you have a lot of time in between the beginning and the end, every year the technology has the opportunity to change. This was one of the biggest challenges, and it still is a challenge."

For example, the layout of the Pavilion's rooms has evolved dramatically, going from single-plane angio units to a combination of robotic angio with CT on rails, then to the combination modalities now in three rooms on level three, Sisolak explains.

Existing main campus operating rooms were about 450 sq ft, so the design included six new ORs, each at 650 sq ft, and all have their own connectivity to the basement, where MDA has sterile processing, Sisolak says.

The technology also presented a problem in getting all the vendors to understand what their rights-of-way were, Sisolak says. "We were having to innovate with the manufacturer and then the rooms all have ceiling-hung operating room lights and booms, so it was very complicated. Even with the interstitial design-it's unbelievable when you look up at the ceiling and it's wall-to-wall conduits."