Recently, Above Group completed the design for much-needed modernizations to the nurse call systems at the Butler, Pennsylvania Veterans Affairs Medical Center (VAMC). The VA was seeking to replace its existing nurse call system located within the Community Living Center (CLC) Building 20 and CLC Support Building 2, as well as their existing emergency intercom system located within the Domiciliary (DOM) Buildings 21, 22, 23, 24, and 25. The project’s goals were to:
- provide new and updated current-technology systems with readily available parts and services
- improve the functionality of these systems
- minimize disruption to the Veterans and Staff
- incorporate current building codes, Veterans Affairs (VA) standards, and specific Butler VAMC operational requirements
The Butler VAMC experienced recurring difficulty procuring Original Equipment Manufacturer (OEM) replacement parts and 3rd party OEM support services for their existing obsolete nurse call and emergency intercom systems. This resulted in a challenge for the VA Staff in maintaining consistent and reliable operation of these important systems that are a key component to providing the best possible care for our Veterans. The CLC and DOM Staff user groups also expressed concerns about existing system deficiencies and opportunities for improved system functionality and ease of use. Ryan Gallagher, Butler VA Medical Center’s Healthcare Engineer shared, “The biggest challenges with the existing system was that it was outdated, serviced by a single vendor (JCI), and lacked integration features. This project will provide our clinical nursing team with a quality nurse call and intercom system, enhancing both patient experience and patient safety which are two mission focus areas for our veterans”.
Our team worked closely with the Butler VAMC, user groups, and OEM’s to design new systems for the CLC and DOM buildings. The new Ethernet-based systems address the project’s goals by providing current-technology systems with readily available parts and services, improving the functionality of these systems, and incorporating current building codes and VA standards, including the installation of new system cabling in conduit to comply with survivability requirements for the CLC nurse call system. The new systems are also designed for and capable of supporting future renovations, expansions, or upgrades as needed to accommodate the Butler VAMC’s operational needs.
Above Group project manager, Benjamin Jones identified the predominant challenge as minimizing disruption to the Veterans and Staff during the construction and installation of the new systems. The existing buildings will continue to function during construction, so construction phasing was an important design criterion for the project. Working closely with the VA Staff, a sequence of work and construction phasing plan was developed that resulted in the least amount of feasible disruption and relocation of Veterans while maintaining an efficient and cost-effective construction schedule and plan. Specifically, in the CLC, the construction phasing plan takes advantage of multiple building wings and the ability to temporarily vacate building areas to support construction while minimizing Infection Control Risk Assessment (ICRA) implications. In parallel with construction, the VA Staff also plans to take advantage of vacated spaces to complete facility maintenance and repair projects that are more easily completed in an unoccupied space.
Another notable challenge associated with the project was to align the scope with the budget and adhere to FAR Clause 52.362-22 Design Within Funding Limitations. At the 35% submission, the estimated construction cost was approximately 24% over the budget. During the progression of the design to 50%, Above Group identified an alternate approach for the emergency intercom system in the DOM that centered around re-using existing interbuilding system wiring and implementing analog to IP converters. The cost savings for this alternate approach were estimated and presented to the Butler VAMC for consideration at the 50% submission. After review and concurrence, this alternate approach was implemented into the design for the 75% submission and resulted in an estimated construction cost that was below the budget. Furthermore, this design-to-budget approach not only brought the project scope and cost into alignment, but also resulted in a significantly less disruptive and intrusive solution for the Veterans and Staff in the DOM. It also met the needs and intent of the project goals by installing an updated and current-technology system with the availability of parts and services, while improving the functionality of these systems, and also allowed for scope enhancements to be included to address noted system deficiencies, such as improved audibility of the existing paging system with new loudspeakers, signal processing, amplification, and enhanced loudspeaker coverage.
In summary, Above Group was able to leverage its technical expertise and project management capabilities to partner with the Butler VAMC to design a new nurse call system and emergency intercom system that met the goals and budget of the project, and most importantly, the needs of the VA Staff and Veterans receiving care in the CLC and DOM facilities. Above Group is honored to partner with the VA and combine our passion for Engineering with providing the best possible “care for those who have served in our nation’s military and for their families, caregivers, and survivors”.
As always working with the Above Group team is a pleasant experience as they bring a true team approach to projects. VA Butler looks to be an active player in designs at our campus and Above Group supports this.
Ryan Gallagher
Butler VA Healthcare Engineer