About a year and a half after a catastrophic fire shuttered Brockton Hospital, the majority of the five-level building's nearly $90-million renovation project is complete. To reach this point, the hospital's longtime construction contractor plunged forward amid post-fire uncertainties, bringing one function back to life after another, hellbent on restoring hospital care to the community.
“Everybody was dedicated to the process and helping the hospital and the community,” says John Ballas, an executive project manager/vice president at Auburn Construction Co. Inc., the construction manager on the project. “It was great to be part of and a really impressive thing to witness.”
The fire struck on Feb. 7, 2023, closing down a building completed in 1896.
While the 341,000-sq-ft Brockton, Mass. facility’s maternity, pediatric and behavioral health units remain closed indefinitely, according to hospital officials, work on the three-phased project was completed by Aug. 13.
In addition to replacing most of the electrical system, the team updated the hospital’s emergency department, built an outpatient surgical facility, renovated the main lobby, enhanced labs and installed parking lot solar panels providing 1.5 MW of power—all while tracking submittals for an approximately $200-million insurance claim that has been partially paid out as of press time.
The team installed a more redundant and robust electrical switchgear system to power the updated facility after the 10-alarm fire. It is believed to have started in the hospital’s previous main electrical switchgear room.
Photo by Pamela Bhatia (ArtisticImages-ri.com)
The 10-alarm fire believed to have started in the main hospital electrical switchgear room is said to be the most serious fire in Brockton’s history. The results of the fire department and insurance companies’ investigations have not been released.
While the fire didn’t cause any injuries, deaths or significant structural damage, it fried two of the facility’s three electrical distribution switchgears and left the underserved community of approximately 105,000 people located 25 miles south of Boston with only two nearby emergency departments—both of which reported major overcrowding a year after the fire.
Reopening the largest inpatient facility in the service area, covering 21 surrounding communities, also comes as several Massachusetts hospitals—including one in Brockton—are in turmoil. Those hospitals are run by the bankrupt Dallas-based for-profit healthcare system, Steward Health Care.
Brian Backoff, facilities director at Brockton Hospital, called the project team’s effort to reopen his hospital collaborative, flexible and resilient.
“Our construction partners have been "all in from day one,” he said, “working diligently and efficiently to overcome a number of outside factors to restore the building.”
Since the hospital hadn’t been significantly renovated since the 1980s, the project team took advantage of a rare occasion to reimagine a mostly offline hospital by upgrading areas such as the 7,435-sq-ft lobby and cardiac catheterization lab. The team also installed a new CT scanner and MRI machines and brought mechanical systems such as the fire suppression system up to code and regulations.
During the project, the scope grew to include replacing most of the low voltage system throughout the hospital, replacing a majority of ceilings and flooring, painting corridors and rooms, installing a new hot-water system and recertifying the entire medical gas system.
The team built more than 20 new electrical closets on the hospital floors and found space for the services displaced by the electrical closets. The team also replaced mechanical equipment damaged during the fire and subsequent electrical surges and installed three new generators.
“This is one of the more technically complicated renovation projects we have been part of,” said Jordan Stone, founding partner at Peregrine Group, the owner’s project manager. “It is very rare for hospitals to undergo extensive renovations because they rarely shut down, unless there is a catastrophic failure, as was the case with Brockton Hospital.”
The project team broke ground on the 2,700-sq-ft addition to house the electrical gears in April, 2023 before the project’s design was finished designing the space.
Photo courtesy Auburn Construction
On Call
When the fire broke out, emergency responders evacuated more than 160 patients and firefighters spent hours extinguishing what the hospital’s not-for-profit owner, Signature Healthcare, called a “building catastrophe.”
Fortunately, Auburn—which has performed more than 50 projects of varying sizes for the hospital in the last 15 years—was working on two projects at the hospital at the time of the fire, including an approximately $4 million emergency dept. renovation and a $5.5 million project that involved renovating an existing space. Auburn was also building an addition for the hospital’s Ambulatory Surgical Center.
“Name a department in the hospital and probably we’ve worked in it, so we have all that information at our disposal ...,” says Ballas, including the hospital's historical as-builts.
Auburn pulled fire alarm and sprinkler plans for the fire department and printed out big, laminated floor plans, “so people can make notes on things to check,” Ballas says, “like a command center, we helped build a command center.”
The building’s IT systems, electronic records and plans, email and heat were all offline in the middle of winter.
“When that fire happened, you can only imagine how inundated the facility staff and senior leadership of the hospital was,” Ballas said. “Auburn’s first thought was ‘How do we get heat back into the building?’”
Auburn quickly identified locations to heat that would distribute throughout the hospital. It had the temporary heating systems online approximately 48 hours after the fire, Ballas says, with help from Anania Plumbing and Heating.
To alleviate pressure on surrounding hospitals handling Brockton Hospital’s patient overflow, the team worked around the clock to build out two temporary urgent care facilities within two weeks after the fire—one on site and one off site. An existing space at a satellite location was also renovated for the hospital’s optometry department.
Much of the project’s work was performed above the ceilings, 80% of which had to be removed.
Photo courtesy Auburn Construction
Silver Linings
Luckily, the hospital already had some generators, air scrubbers and temporary lights on site to get the cleanup effort started “so that people could operate and begin the work,” says Andrew Brumbach, healthcare studio leader for the Boston office of SmithGroup, the project’s architect, interior designer and mechanical, electrical, plumbing, fire protection and life safety engineer.
Despite residual smoke damage and a lack of power provided by two switchgears in the main electrical room, Ballas says the “fire itself, surprisingly, didn’t cause that much damage.”
The team worried more about water damage from fire hoses and was grateful that a third unaffected 480-V switchgear—housed in a smaller secondary electrical room—could be rerouted to temporarily power air handlers. This helped the hospital’s main support building get back online a few months after the fire while the project team redesigned and rebuilt a more robust and redundant permanent electrical system.
“Emergency power has to be separated from normal power, which wasn’t code when they built the original hospital,” Ballas says. "You see why they do that now. Because if there’s a fire, it takes out all power.”
Midway through the summer after the fire some staff started to return to work. By September 2023 the wound care unit partially reopened along with departments providing infusion therapy, outpatient surgeries and colonoscopies. In June, laboratory services opened.
“That was part of the priority list,” Ballas says. “Let's try to get something open ...”
The hospital decided to demolish and renovate the 7,435-sq-ft main lobby, an effort that would have been much more difficult if the hospital was fully open.
Photo courtesy Auburn Construction
Confusion around when more departments would open arose in the spring when hospital officials said the project would be completed by June, only to walk that statement back due to supply-chain issues and failed heating, ventilation and air-conditioning system tests on pre-existing equipment.
Ballas says many of the hospital’s mechanical systems that worked before the fire didn’t work immediately after they were supplied with new power feeds.
“Imagine shutting all power off to your house for a year and then trying to start up anything, it isn’t going to work right away,” Ballas said in July. “There’s been a lot of planning and thought went into priority lists of what we need to test first. The tolerance for error is very slim. If one system or one department can open that supports other departments, that department downstream can't open, and we need to find plan B.”
Similarly, the building had plumbing issues where pipes were sitting idle without running water, Brumbach says.
“There were blockages, there was leaks once they started getting water up and running,” he says, “but it took a number of months before they were able to start doing any of those things because they needed to get through a certain amount of the work first.”
The team also had to wait on new equipment to arrive when it discovered it needed new mechanical units where they thought existing equipment would suffice.
For example, the operating room was a logical area to open first last fall because it had a separate electrical feed, Brumbach says, but it shared an air handling system with the critical care unit. While air balancing the operating room, the team realized “there wasn’t enough air capacity within that system to support both the critical care unit and the operating rooms,” Brumbach says. “We’ve since then had to get a full replacement air handling unit to support the critical care.”
Another curveball came when the team learned after they had closed the ceilings that the fire department requires have a bidirectional antenna that allows their internal radios to work throughout the building including the basement. “They need to run antenna basically down every main corridor throughout the hospital,” Ballas said. “Now we’re back up overhead in every corridor.”
Ballas said the project was under budget when they discovered the necessary rework, and the extra effort took “a little bit out of the savings in a few situations.”
Additionally, every design, redesign and change order had to be priced and reviewed by the insurance company before it could be implemented.
“They either approve it, partially approve it or deny it outright,” Ballas says. “If they just deny stuff outright—but it needs to get done to open—then it’s back on the hospital; they’re doing fundraising drives."
“Just because we identify the problem, and we have the solution,” Ballas says, “doesn't always mean we can just get on it right away.”
To aid in elevating the refreshed lobby, SmithGroup employees contributed to enhancing the exterior courtyard through a pro bono replanting effort.
Photo Courtesy SmithGroup
Overhead
The project team constructed a primary electric room along with a secondary/distribution electric room and re-fed all the subpanels throughout the hospital with new conduit and wire, including updated emergency wiring.
Ballas said the “vast majority of the work” was above the ceilings, 80% of which had to be removed. Electrical contractor J&M Brown deployed a tugging machine to pull 300-yd-long stiff electromagnetic interference (EMI) cables in single pulls “through the twists and turns of the rat maze of Brockton Hospital,” Ballas said.
Working in a mostly unoccupied hospital not only allowed the team to capitalize on an economy of scale that comes with renovating more spaces simultaneously, the team also did so without as much phasing as a typical project in a fully functional hospital requires. SmithGroup's Brumbach says the wiring work they did in the ceilings in the past year and a half would have taken four years in an operating hospital.
“You would have gotten half of a corridor done in one unit every four days,” he says, adding, “We want to get it right because we’re not going to be able to come back and do all of this again.”
Brockton Hospital’s new operating room entrance area and registration zone.
Photo by Pamela Bhatia (ArtisticImages-ri.com)
Design Under Fire
About three days after the fire, the hospital reached out to SmithGroup to hire it as the electrical engineer for fire recovery, but subsequently contracted SmithGroup to design the entire recovery effort after the firm brought an integrated team to meet with hospital leaders. SmithGroup’s effort ultimately produced approximately eight-months-worth of drawings in three months.
In addition to the 341,000-sq-ft renovation, the project team broke ground on the 2,700-sq-ft addition to house the electrical gears in April before the design was finished.
“We basically had to jump ahead with the electrical work before we were able to scope out the rest of the project,” Brumbach says. “Lead times on major electrical equipment is incredibly long right now … we needed to get the switchgear, the generators sized and ordered within two, three months of getting on board. We had to really make a lot of best engineering judgments.”
SmithGroup designed previous projects for the hospital but not since 2019. Auburn’s institutional knowledge about the facilities helped SmithGroup find the most current plans as fast as possible.
“They had the knowledge to be able to pull stuff for us and quickly share information when we would be asked to look at a spot and maybe the drawings we were given didn’t line up with the reality we were seeing,” Brumbach says.
As construction manager, Auburn is coordinating the prime contractors, scheduling and permitting, "to make sure that we’re all working in unity,” Ballas says,
Auburn and some of the hospital’s preferred vendors didn’t worry about billing the hospital in the fire’s aftermath despite being “extremely leveraged at times,” Ballas says.
He adds, “It just goes back to the urgent care mentality. The community needs this, Signature Healthcare has been such a great building partner for so many years, let’s do whatever it takes to get it done and when the dust settles, we’ll try to figure it out.”