I hope to use this space to share information, updates and insights into the happenings around the Fore River Campus activities and completion of Phase I. I hope it is both informative and interesting. I feel honored to have the opportunity to be involved in this project and look forward to your insight on both the project and the thoughts I share here.
Tim Prince, Vice President - Planning & Ancillary Services, Mercy Hospital
Some of you out there may well remember going on road trips with your family when you were a kid. If your experiences were anything like mine, the trip started REALLY early in the morning. Mom made a "bed" set-up in the "way-back" of the station wagon (yup, that one - pea soup green with wood paneling along the sides) and Dad carried my brother and me out to the car, laying us down on sleeping bags in the back. We'd leave in the dark and roll on down the road. No seat belts or even seats! A few hours later, we'd wake up to the rumbling of the road and the smell of coffee coming from a thermos up front. If it was a long trip, we'd end up at some roadside motel with rooms that opened right to the outside, if we were lucky they opened up on a pool where we could get the 'crazies' out of our system after being in the car all day. And then we got the best part. Raise your hand if you remember these: The massage bed! Beg mom for a quarter (or was it two quarters?), drop it in the slot and the whole bed would shake! We thought it was a riot!
Or how about this: If you've seen the movie Jurassic Park, you'll remember the scene where the family is sitting in the Jeep and there is a glass of water sitting on the dashboard. Before anyone hears or feels anything of concern, the camera zooms in on the glass of water, showing the beginnings of ripples caused by the far off yet quickly nearing thundering of a Tyrannosaurus Rex.
The vibrations we're spending some time talking about on the project are neither of these.
You've likely noticed that there are a set of railroad tracks that border the Fore River site. On this track each day there are three in-bound and three out-bound Amtrak trains as well as up to 12 daily freight trains. Of those freight trains, one or two per day are of a size and weight to cause vibrations across the campus that are imperceptible to you and me, but can be picked up by vibrations monitoring devices. All but those one or two trains per day leave no measurable vibration. We have studied and continue to study the vibrations from the "major" freight trains and their potential impact on activities and equipment. It is our assessment that there are no significant impacts that will result from these vibrations. However, we are pursuing two courses of action to assure long-term comfort with this understanding. First, we will install an electronic monitoring system that will record the train traffic on the tracks, thus giving us time data on train activity. Second, we are talking with the railroad to understand their plans for track maintenance and any plans to re-bed the tracks. We need to know this to assure a proper vibration control system for Phase II (that structure will be closer to the tracks than phase I).
These vibrations are not a surprise. In fact, we have been monitoring and testing on these vibrations since we purchased the land in 2002. We are confident in the stability and strength of the facility and its equipment and that the infrastructure supports effective operations of programs and services. Apparently there are rumors in the community that we will be scheduling surgeries and other services around the train schedule. This is simply not true. We will, however, monitor train activity and measure vibrations over time to assure continued controls on vibrations. Should there be any need to mitigate the vibrations issues, we will take appropriate steps.
So if you want to feel vibrations, I'd suggest you avoid Jurassic Park and don't come looking at the Fore River. Maybe you can find a quarter and head for a Route 66 motel.
I've mentioned before in these entries that there is an extraordinary number of little details that all must come together to finalize a project of this magnitude. Some of you may have heard references and reflections on the difference between being a worker and a master builder. (I include a reflection that includes the story at the end of this entry.) In getting all the little things right, each person who is involved in this project is being a worker, steadfastly addressing a task or question in an effort to get to the best answer, and not always able to see how all the pieces will come together. But if any worker in the chain does less than they can or ignores the details, then the process is not nurtured, the seeds are not watered, and the fruits of the labor are less.
A significant majority of decisions and implementation plans are playing out to be excellent. From patient flow design, to healing environment elements, to the stained glass and finishes in the chapel, the details are coming together and reflect the warmth, caring and spirituality we expect in our spaces. However, the past few weeks have presented challenges of a few details: we've discovered a few mistakes and problems that can either be accepted - and our schedule kept - or corrected, and our schedule challenged and possibly delayed. Questions have arisen about having the right color tile in the right areas, having each space designed as intended for patient flow, and having the right technology and equipment in the right places. It is now that we have the opportunity to be dedicated workers in an effort to give a foundation for the grand plan that will be achieved over time. The easy path is to accept mistakes. The difficult task is to find solutions, address improvements, and take the risk of making it right. Many people involved in this project, from managers to staff, physicians to volunteers, have weighed in to seek excellence, understand necessary compromise, and weigh in as workers to keep us on track. It feels good to be a worker on a team of dedicated people who care about success, regardless of who gets the credit.
Being a worker
With spring upon us here in New England, I am looking forward to the spashes of color that come with the rebirth of the earth. The sun stays up longer, the flowers poke through, hints of buds on trees and bushes appear. Piles of gray, brown dirt rest where there used to be mounds of snow. And, oh, yeah, mud season!
But even the conservative pace of spring here on the banks of the Fore River cannot slow the pace of color splashing across our site! Each day I walk through the Fore River hospital I get to see new areas of flooring, new walls with color, new finish work around the windows. All these steps are slowly breathing life into the walls and spaces of the building. Like watching a film go from black and white to technicolor, I can see the transformation of the interior spaces from steel frame to warm rooms.
Welcome spring!
With all the back and forth I've been doing lately associated with supporting the first Mercy tenants going into the MOB, as well as the increasing frequency with which I need to be on site to address questions and decisions, we decided I should have a temporary space from which to work. So here I sit in what will be the mammography tech work room (great space!) with a computer to keep me connected (thanks John and Dennis), a chair (thanks Gretchen) and great views!
I've reflected on the view of the building from I-295 and from the Fore River Parkway. I've noted the peacefulness of the entire setting of the campus. And I continue to be awed by the views out from within the building. What I had not really appreciated until now is how the hospital itself, from the vantage point of this medical office building, seems to me to offer a healing view. Just looking at the building gives a sense of strength, peace and healing. It seems welcoming and inviting - and this is before the site has all the amenities of landscaping.
The views from 195 Fore River Parkway are beautiful!
Today's entry comes courtesy of an announcement from Mike Hachey:
I am happy and proud to report on the wonderfully successful move of Fore River Urology and New England Foot & Ankle Specialists to the Fore River Medical Office Building. Led by Gretchen Morin, both practices were finished with their move-in ahead of schedule and were ready for activities Monday and Tuesday. Indeed, early Tuesday morning, the waiting room was graced with its first patients!
There are so many people to acknowledge in this effort. Practice managers Bethany Wilson and Marybeth Winschel did an outstanding job of coordinating the logistical challenge of packing up their existing practices and unpacking and setting up for operations over a very tight timeframe. The entire practice teams were on hand both Friday and Saturday, showing excitement at the prospect of beginning to serve our patients in the new space. Great support and positive energy from Drs Pomeroy, Ameglio, Adey, Hodroff and Meredith helped create a pervasive level of excitement throughout the MOB.
The IT team, led by Dale Shaw and Jonathan Roderick, were on hand en masse to ensure systems were up and running and ready for the first day of operations. They are committed to continued efforts over the next couple of weeks to set up and monitor our systems to assure excellence.
This was the culmination of a great deal of work over the past two years, including original business plan and capital plan development by Vicki Dillingham, site management and planning by Mike Connolly, lease negotiations by Bill Connolly, safety and security planning by Mike Sperry, furniture and equipment coordination by Dan Wallach and global project coordination and planning by Tim Prince.
Finally, Gretchen Morin provided the overall leadership of this effort to create a wonderful environment for the delivery of care to the patients of FRU and NEFAS. Gretchen lived and breathed the MOB for many months and expertly planned and executed the transition as if she had led efforts like this many times in her career. The folks at HRS & Bisson, our movers, noted they had never experienced a smoother move of health care services than the Fore River Medical Office Building move. There is no higher praise than that; we're all very proud of Gretchen and excited about the prospects of Mercy Medical Associates under her leadership.
When operations started this week, there were a few glitches as there always are in transitions of this magnitude. With the same energy, enthusiasm and perseverance that has been exhibited to date in the move to the Fore River, the FRU and NEFAS teams are working through the final issues that present themselves.
Over six years of specific planning, and many years more than that in dreaming, have come to fruition with this move. Thank you to all!
In the midst of the opening of physician practices in the Medical Office Building (I noted before that Ankle and Foot went in first and now All About Women and Portland Surgical Associates are in too!), I want to also note that Mercy is actually providing direct clinical service on the campus. Our "roaming lab draw" is up and running.
Tina Deschaine is carrying the flag and waving the banner of Mercy's presence in the MOB with her great service to MOB practices and her attentive nature to patient comfort. Tina's "can do" attitude is a great example of what one person can do to help make this transition a sucess. She offers a great attitude and infectious smile as she embarks on setting the stage for Mercy's work on the Fore River Campus. Working out of temporary space with jumble of printers, faxes, phones, and computers, Tina has set up shop to serve the patients of private physicians' practices when they need blood draws and tests.
Once we open Fore River Primary Care, Tina will be in an official draw station adjacent to the lab. Until then, she's ready and willing to go when called to help patients on their way to health while she serve our physician colleages in the building.
Great thanks to Tina and great thanks to Pat Niboli for their combined efforts in getting a roaming lab up and running at the Fore!
Today's entry is taken from an email from Gretchen Morin to the Mercy folks who are finalizing details on becoming the first Mercy Tenants in the building. Thanks to her for her leadership on this exciting project!
On Monday (March 3, 2008) we received our official Certificate of Occupancy. We completed a walkthrough with the building owners to assess "substantial completion" of the space. A follow-up "official punch" will take place next week. That's the final list of things that need to be tweaked to get our first spaces finalized. Some of those changes will take place after we in the space and seeing patients.
That all being said, it is official - the time has come, despite our doubts at times, we are in fact moving to the Fore River. We will begin christening that new campus as early as Friday when Mercy receives its first shipment of medical furniture in POFAC (soon to be New England Foot and Ankle Specialists). Funny thing is, what seemed like a time that would never come is NOW HERE! I recognize for some of you your moving plans seem sudden, but given the amount of uncertainty we've been faced with along the process, it almost became par for the course. I know that we all feel a little I caught off guard!! But it's real and its exciting, ARE YOU READY?
While you prepare for this mentally and physically, please keep in mind that there are many, MANY people who are working countless hours to ensure that all of our moves, demands, expectations, projects and so-forths are taken care of efficiently. Some of our greatest demands to date have been placed upon our IT team - a team that has been working morning, noon and night, as well as most weekends in order to get it all done. Their dance card is full and if something doesn't move this week, it means that the "stuff" scheduled for next week can't get done either. Please be as helpful as you can in coordinating your work and your efforts so that we can accomplish this mammoth task. And to that team - THANK YOU THANK YOU THANK YOU!!!!!!
As we manage against the move schedule associated with the MOB, keep in mind that we are also moving folks into a new Westbrook Office (behavioral health), a Windham location, and that we have the prep work associated with the Fore River hospital that is also keeping us busy. So, while you need to advocate for all you need please also remember to be kind, be patient, and use understanding when dealing with the projects and people involved. We're all in this together and I know we all want to help the whole team succeed. THANK YOU!
Unless there is some surprise event or issue that comes up, the first patients to be seen on the Fore River campus will meet with physicians on Tuesday, March 4th! Drs. Dorsey and Pingitore are moving into their space as we speak and are scheduled to see patients on Tuesday. Congratulations to them!
A great many details and efforts bring this all together, with the most important current issue being getting the Certificate of Occupancy from the City of Portland. That should be in the hands of Landmark, the owners of the Medical Office Building, this afternoon or Monday. All sorts of other issues, like installation of countertops and getting install of cable service to the building and then to the suite are also being finalized. We also had to finalize a couple easements and traffic reviews. There are also things like telling the Post Office that we're open for business and figuring out how deliveries will be routed to the right place. There is the crazy nuance of the fact that the road and the addresses never existed before. In fact, Mapquest doesn't recognize the addresses 175 and 195 Fore River Parway, but Google Maps does. This is really new - and of course exciting!
We're 1 month away (actually 35 days) from the move of Mercy's first practices. This is really happening...and the time is now!
Its December 24th, 2003, 4:30 PM. I am sitting at my desk re-editing the Certificate of Need application for the umpteenth time. My In-laws are in town, its Christmas Eve, and I'm checking statistical projections on bed need capacity and validating projected incremental third-year operating expenses. I think to myself, "What are you working so hard for on Christmas Eve? Its only the future of Mercy at stake!"
In the world of healthcare, at least hospitals and at least in the State and City, there are many players who get to weigh in on what we do with capital investment, building replacement, expansion, new equipment purchases, etc. We've been through CON review, pre-approval, preliminary recommendation for denial, decision moratorium, re-review with new staffers, preliminary approval, subsequent review, partial approval and then, finally reconsideration hearing and final approval. We've also been through Contract Zone approval, Site Plan review, Master Plan review, Site Plan Approval, Master Plan Endorsement, and then a slew of easements, conditions of approval, tax assessment review (we're not-for-profit so we seek tax exemption on our properties), regulatory review on IRS standards for operationalizing a 99-year land lease, DEP and IFW review (dept. of environmental protection and inland fisheries and wildlife), and many others. This is not to mention review by our Board, Catholic Health East and the Bond Issuing Authorities (we took out a $64 Million Bond - a mortgage - on the project). Of course we also sought and received support and endorsement from the Sisters of Mercy for the plan the architecture and the layout. We needed endorsement for the building and opening of a new Chapel and we needed FAA approval for the height of the building: two very different authorities from the skies.
And, of course, we got input from staff, physicians, patients and visitors on what to do, how to connect the pieces and how to incorporate the amenities. All of which have to comply with JCAHO regulations, ADA regulations and Fire Codes. We try to balance all that with appropriate redundancies, emergency systems and back up plans. We also tried to do as much for efficient planning for Phase II without having to redo what we do in Phase I. Simple things like bringing power into the sight required coordination and approval from the power utility, the railroad and DEP. Everyone has a stake in it, everyone has some level of control and influence, and often times the "must haves" directly conflict with one another.
February 12th, 2008. A Mercy team presented to the Planning Board an amendment to the site plan relating to the exact location of a walking trail and the exact treatment of some soil areas that are contaminated with 40 year old ash (from the railroad that used to run along the site). The plan presented was the result of collaboration among City Planning Staff, Construction Management, Environmental Engineers, Landscape Architects, the DEP, and Mercy. We all agreed on a plan that met a number of different goals. Not all of them were met perfectly, but pretty close. Still, after months of negotiations, hours of consultants' fees, and many iterations, we still spent 2 hours discussing whether or not it would be ok to have a 200ish foot long chain link fence in a corner of the site. Sitting there, I had to keep reminding myself that while no one in the conversation seemed to ask about patient care, that all of this was necessary to preserve the Mission, the passion and the dedication of care of the sick. I am lucky that the foundation of our organization is so sound and strong that it can hold me and others up in times of aggravation and give us the serenity to accept the things we cannot change, the courage to change the things we can, and the wisdom to know the difference.
We received the approval for the amendment. One more small success to help us toward treating that next patient, at that next moment in time when he or she is hurting in body, mind or spirit.
I went skiing this weekend with my family. (Happily my 7-year old son's cast on his left arm was removed on Wednesday). We went to Saddleback in Rangely and had a great time. Good snow, good friends and good time together as a family. Excellent! (Granted, the drive up Friday night was a bit hairy, but we took our time and made it safely.)
Anyway, while at Saddleback, I ran into (not literally, I am a fairly decent skiing who stays under control) and chatted with, in no particular order, a member of one of our Board Committees, a local TV News anchor, a local physician, our Governor, an old friend I hadn't seen in 15 years, and a few random people with whom I had the pleasure of sharing a chair lift ride. And each of these folks who either knew my role here or asked where I worked commented on and asked about the "New" Hospital. I am continually amazed at how this project touches so many people and how supportive and happy folks are to see it s progress. Everywhere I go and everywhere I turn people what to know how it's going and when we're opening. I feel lucky to be able to share their excitement and support!
They also want to know "what we're going to do with the old facility." I tell them it is and still will be a hospital and will be fully used for hospital services - including, specifically, the Emergency Department, Orthopedic Services and Heart & Vascular Services, to name a few.
One of the key things I tell people is that while this is "new construction" I don't think of it necessarily as the "new hospital." Our State Street and Westbrook facilities are today and will continue to be places of exceptional care and compassion. We have the pleasure of adding an additional campus to our mix of services and locations. This helps us serve more people in more places.
While the "new" place is obviously getting new design and new stuff, as we move into the Fore River campus, we will be able to give space and support to those services that will continue to serve our patients from State Street. To me, none of this is about "new and old" rather, its about our many locations and the benefits and excellence in each. Just like with the Fore River campus, everywhere I turn here at Mercy, employees and physicians want to know how we're going to use the space that becomes available. To that end we have started a process of "master space planning" for the space that will open up at State Street when we move into the Fore River Campus. There are many ideas with many opportunities that we'll have to weigh against the benefits and costs. We're excited about being able to focus and support programs at State Street as well as those going to Fore River!
Last night on the way home from dinner, I decided to do a drive through on the site. I wanted to get a view of things with a full moon and lights on in the buildings. As I drove through, I was surprised to see a car backed up to the side of the hospital, lights on and motor running. My first thought was, "oh man, there goes more of our copper!" I drove up slowly and saw someone sitting the car. Worried a little about how wise it was to be there, I nonetheless opened my window and said hello - asking him whether he worked for Gilbane (the construction management firm). I was relieved when he told me that he worked for the Security Company.
My experience last night reminded me of two things I wanted to share:
- One afternoon I was down at the sight doing a walk through and saw a car next to a dumpster with a woman standing next to the car. The car was running and the trunk was open. This seemed odd to me and the woman seemed to sort of be on the lookout. I walked over and before I got very close she yelled out, "they told me this was ok."
I said, "um, who told you what was ok?"
"The construction guys said we could take the scrap wire and metal from the dumpster." At which point I see a head pop up from inside the dumpster and a hand reach out with the end of some wire. The woman grabbed it and dropped it in her trunk. I was kind of puzzled and wasn't sure what to do. So I continued where I was going, rounded a corner of the building and used my cell phone to call the Gilbane folks to see if they really allowed someone to be dumpster diving on the site. Before I even got through, our Construction Manager came quickly out of the trailer and shooed the "recyclers" on their way. It was 4:00 in the afternoon! Amazing and sad.
- One night I was on my way home (I drive the Fore River Parkway on my way to and from work). It was dark out. Second to seeing the sunset from the vantage point of the new building, seeing the airport runway lights lit across the darkness of the Fore River as you drive north on the Fore River Parkway is one of my favorite sights. As I rounded the curve and started the downhill to the hospital, I noticed some other lights - specifically, red, flashing lights on top of two fire trucks sitting on the entrance road to the site! I literally did a double take, and wondered why no one had called me. Then suddenly I realized that probably no one at Mercy knew! I turned quickly and pulled in to the site, easing up next to the fire trucks. Getting out of my car and walking toward the firemen dressed up in all there gear I had all sorts of horrible scenarios running through my mind. One of the firefighters said, "Can I help you?"
"I was just curious what's going on."
"Who are you?"
"I'm from Mercy and kinda involved in this project."
I soon learned that someone had called from a cell phone reporting that they had smelled gas. I quickly decided that these guys needed to get closer to the building and needed to know their way around, so I led them around the back access road to the loading dock and service entrance (realizing on the way that if there really was a gas leak and risk of explosion I was driving right toward it). All was fine - could have been a hoax or possibly fumes from the oil tanks across the river. I also learned the next day that we had indeed given the Fire department an orientation to the site but these particular firefighters had not gotten the info. We've already follow up with them further. I just hope I don't see those flashing lights next to the building again!
A project of this magnitude - $85.3 Million; 151,000 sq. ft. hospital and 80,000 sq. ft. Medical Office Building on 44 total acres of land (28 "buildable") - has an incredible amount of intricate details that affect each other an in aggregate and isolation will have tremendous impact on the day-to-day activities once the campus opens. While we all strive for perfection in our efforts, I am hoping that we can at least settle for excellence.
The difference between perfection and excellence, as I see it, is the impact of reality. And unfortunately, in many situations, we must decide in which areas we are going to knowingly do less than the ideal. This stems from the reality of dollars available, CON limitations, space limits, time limits, structural limits, etc. It doesn't mean we don't want each decision to be the best, it just means that there are real limits to what we can accomplish.
My expectation is that all those involved in the project maintain a vision on the outcome - bringing the passion and mission of the history of Mercy to a new campus and perhaps a new beginning for our next 90 years! We've done this very well so far and I am excited to see the culmination of it all coming to completion. We'll continue to work to get every decision as "right" as reality lets us.
Amy Davis' comments reminded me of a recent conversation with Mike Connolly (Thanks Amy). Mike dedicates A LOT of time to Fore River, and does a great service to Mercy in the process.
On a recent walk through with Mike, he took me into the Fore River Cafe space and showed me some of the many pipes, wiring, and infrastructure that will make this building work. He pointed out that the shut off valves for certain pipes were in a place that would be very difficult to reach after the walls were encolsed. He explained the options to correct the situation and told me what they'd decided to do. We know our maintence team does great work in all kinds of places on all kinds of issues. We are hoping that a brand new building will have fewer of these. However, with Mike's diligence and attentiveness, when problems do arrise, the P&E folks will at least be able to get to the source of problems or concernes once they are identified. We're lucky to have Mike's watchful eyes on the project!
Now that we are into the middle of January, I seem to have found the ability to remember to write "2008" on things that require a date. I have a tough time with that transition each year, but this year there is something a bit more profound each time I write the date.
2008. This is the year that was always in the future. When asked, "When will we be moving?" "2008," I'd say. The future.
Well, it's here! We are 58 days away from Mercy's first tenants moving into the Medical Office Building and 61 days out from when those two practices will see patients there. Four other non-Mercy practices are scheduled to move in two weeks earlier. The hospital is slated to have its first patients in 249 days. 2008. It's here! Yahoo! and Yikes!
Other than being asked whether I'm enjoying all the snow, the comment I get most often from friends, colleagues and random people I meet are, "The building looks great!" (Granted, from my son, I get, "if you're building a hospital, why don't you bring your hammer to work?") I also quite frequently hear, "I love the windows!"
I love the windows, too. But while others love the way they look from the outside, I love the way they look from the inside. Each time I walk through the building, whether it's giving tours (call the development office to sign up for one), checking on the size and status of various spaces, or doing "walk-through checks" on patient flow, I marvel at how peaceful the space feels. It can be in the morning when the building is bustling with construction workers and the sun gleams through the eastern windows, or it can be at 4:30 pm when the sun sets over the water and the airport outside the western windows. In the midst of all that is going on, I feel a sense of calm and peace. I imagine a patient and her family in the quiet of an afternoon cuddling a newborn and watching the sunset. I imaging the OR staff arriving in the early morning and prepping the ACU while the sun streams in over the patient bays.
Envisioning those patient, family and staff experiences helps me in times of challenge while working through the various issues and decisions we face. But I am also drawn to the vision of Mercy staff and physicians finding the calm and comfort of their lounges and break areas. While I realize we may not please everyone, I am excited each time I see an employee's reaction to the space and layout of these areas.
There are many moving parts to a project like this and Mercy is lucky to have many dedicated people working for the success of this endeavor: employees and physicians, contractors and consultants. And that work is both on the building and on how we'll run things once it's built. WE truely are building the future of Mercy - and WE are doing it in a way that honors the past and the present: We're bringing to the Fore River not just a building but the Mission, the history, the values, and the compassion of the Sisters of Mercy and the dedication of the 90 Years of employees who have cared for patients throughout our history. Many thanks to all involved!
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Portland, Maine
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