Tag Archives: david cottle

Courtesy of Kitchell

Muzzling noise is more critical when building above babies

David Cottle, Phoenix Children's Hospital

Dave Cottle is Phoenix Children’s Hospital Vice President of Planning, Design and Construction.

By David Cottle, Phoenix Children’s Hospital, and Aron Kirch, Kitchell | Special to AZ Big Media

Noise, vibrations, dust and other disruptions are always a concern during hospital construction but never more sensitive than when the youngest, most vulnerable patients are a mere 5.5 inches away on the floor below. This is what’s happening right now at Phoenix Children’s Hospital, as shell space is built out above the hospital’s Pediatric Epilepsy Monitoring Unit (PEMU), a program of Barrow Neurological Institute at Phoenix Children’s Hospital. In a PEMU, each patient’s room is outfitted with video equipment to capture seizure activity while a child’s brainwaves are recorded. The feedback is used to obtain highly accurate diagnoses leading to more effective treatment plans.

Anticipating future need was strategically built into the design of Phoenix Children’s Hospital’s 11-story patient

tower, which opened to patients in 2011 with three shelled floors to accommodate future expansion. Just a year after opening, volume demands required Phoenix Children’s to set plans

Aron Kirch is a Kitchell project manager.

Aron Kirch is a Kitchell project manager.

in motion to build out the top floors. Today we’re creating extra capacity on the tower’s ninth floor. The 45,000-square-foot space will feature 48 patient rooms. Kitchell is back on site as the general contractor, HKS is the architect and CCRD Partners is the M/E/P Engineer.

Don’t drop anything!

Just imagine how quietly the construction team must proceed to avoid making even the smallest sound or vibration. Noise mitigation is priority number one. It’s a construction site where communication is done via whispers, texts and email, and all field supervisors have radios in case an immediate shutdown of construction activities is necessary. And it’s a site where materials are brought into the building via an external hoist.

PCH, Courtesy of Kitchell

PCH, Courtesy of Kitchell

Everything the team does requires advance thought, meticulous planning and ongoing communication with hospital staff, which began during preconstruction and included deputizing one of the nurses as “construction project manager.” Absolutely nothing could be a surprise; even something as seemingly mundane as lifting a pipe could be an issue, because of the potential of the loud “clang” as the result of dropping it. This advance thought included orchestrating a “make noise” session for staff a month prior to construction. Together with our trade contractors, we demonstrated all noises that could be a potential impact to the eighth floor. This included floor grinding, shot pins, scissor lifts, roto-hammers, cutting, chopping, dropped pipe, saw cutting, shop vac and core drilling.

Here are some of the tactics being deployed to ensure the comfort of the children and their families below the jobsite, while allowing staff to do their work unimpeded:

    A lift was built on the west side of the building to transport everything up and in for construction. Absolutely nothing is brought in through the inside of the building. The lift makes 100 trips daily. Because children love watching construction activities, we decorated the hoist with a decal of Superman so he appears to be flying each time the hoist passes in front of their windows.
    As much work as possible was done offsite, completely removing significant noise and vibration from the job site. For example, headwalls were built offsite and then ingeniously “split in two” to fit inside the outdoor hoist and reassembled once on site.
    Intelligent phasing has been instituted. For example, the loudest activity is drilling into the floor (the ceiling of the 8th floor) which creates echoes and vibrations. Working with hospital staff, we developed a schedule to drill 30 minutes on and 30 minutes off.
    Infection Control Risk Assessment (ICRA) containment on the 8th floor was meticulously planned and executed long before construction began. We used cardboard mock-ups to create the center core of the floor (nurse work areas) and then adjusted areas to fit the changing needs of the facility. These adjustments required plumbing revisions to approximately 30 rooms on the floor below.
    Rubber mats were placed throughout the 45,000-square-foot space to deaden the sound of the carts, which traverse the expanse constantly throughout the day. And all cutting and chopping activities are required to be executed on a rubber mat.
    We’re upgrading the existing shell space fire sprinkler system for the 9th floor build-out, which requires being “wet” every night to keep the system energized. To mitigate the risk of an overnight leak, and potentially putting the 8th floor at risk, we place sensors on the floor at the end of each shift. In the event of a leak, these sensors signal team leaders’ cell phones on a SmartThings app. This allows for response time to be minutes instead of hours.
    The schedule of direct impact activities, such as drilling, cutting, and materials transport, are communicated proactively and requested adjustments are always accommodated. The nursing staff was engaged at the earliest juncture – during preconstruction to experience cardboard “mockups” of the space – to ensure complete collaboration through the life of the project. In fact, our project manager meets with the nursing staff on the 8th floor each morning at 7:15 a.m. to ensure that the flow of construction above is acceptable based on potential changes during the preceding night. This communication is augmented by weekly meetings with the nursing staff (enhanced by homemade cupcakes) to discuss upcoming activities.

When concern for patients and families, communication with staff and thorough forethought are embedded into every plan and every activity, construction doesn’t need to create commotion and disruption, even in a children’s hospital. Meticulous planning and ongoing collaboration with medical staff makes the process seamless and rewarding for all. And cupcakes don’t hurt either!

Phoenix Children's Hospital, Kitchell

Kitchell Delivers PCH Transformation 4 Months Early and $48M Under Budget

Wednesday, June 1, marked a milestone for Kitchell as the $538M patient tower opened at Phoenix Children’s Hospital.

The hospital is Kitchell’s largest project in the firm’s 60-plus year history. Kitchell broke ground on the 11-story facility in May 2008. With hundreds of new beds and new clinics, PCH will now treat children who need outpatient care in a variety of specialties, including dermatology, endocrinology, pulmonology, gastroenterology and orthopedics.

Modeled on a night-blooming desert flower and visible from throughout the Valley, PCH is visually striking but it is the inner workings of the hospital that are most remarkable.

“Working on Phoenix Children’s Hospital has not only been a career highlight for all of us on the team, but it has been personally fulfilling, as well,” says Kitchell senior vice president Dan Pierce. “PCH has touched each of us at some point, whether directly with our own families or with our friends’ families.

“Being a part of this monumental hospital transformation, right down the road from Kitchell headquarters, was gratifying, exciting and even humbling. At different times during construction, we had more than a thousand workers, including subcontractors, on the job site. It was simply amazing.”

“Kitchell has done a great job. The company exemplifies collaboration, integrity and excellence, says David Cottle, executive director of planning, design and construction for PCH.

I have been particularly impressed with the attention to the tiniest details to ensure the best possible quality. This has been a large project wedged into a residential neighborhood. Kitchell made it a top priority to plan and phase the work so that construction congestion had only a limited impact on the surrounding community.”

In addition to more than 1,000 workers on the site at one time, other noteworthy numbers of the PCH tower construction:

•               Number of days from ground breaking to grand opening: 1,107 calendar days

•               Construction man-hours worked:  3,206,803 through mid-May 2011

•               Wire (power): 7,500,000 feet

•               Concrete: 35,496 cubic yards

•               Rebar – 3,267,379 pounds

•               Dirt removed for the Tower basement: 75,000 cubic yards

•               Structural steel: 6,500 tons

•               Lobby/elevator mosaic:  450,000 1”x1” tiles

Phoenix Children's Hospital, sustainable hospital expansion, kitchell, HKS inc.

Sustainable Hospital Expansion – Phoenix Children’s Hospital

Phoenix Children’s Hospital is one of the country’s 10 largest health care facilities for children. With the rapidly growing pediatric population in our market, the hospital recently reached the half-way point of a $588 million expansion, which includes the construction of a new 11-story patient tower that will nearly double available beds by 2012. The hospital is not only providing a healthy future for its patients with this significant expansion, the project has also embraced sustainability practices in its design, construction, and operations that will support a healthy future for our community.

Phoenix Children’s Hospital takes its responsibility as a health care leader seriously. The hospital made the commitment to build green based on several key considerations: increased public health, reduced operational costs, and a focus on corporate social responsibility.

Promoting the health of patients, visitors, employees, community members, and the global community, Phoenix Children’s Hospital’s expansion will result in economic and efficient operations. Along with its construction partners, design architects HKS Inc. of Dallas and general contractor Kitchell of Phoenix, Phoenix Children’s is building one of the most innovative and environmentally sound children’s hospitals in the nation.

At the heart of the Hospital’s sustainability effort is a Central Energy Plant (CEP) that now powers the 34-acre campus in the heart of Phoenix. This high efficiency CEP features an 800-ton water-to-water heat pump chiller, a technology widely used in the Middle East. In fact, Phoenix Children’s CEP employs the first application of the water-to-water heat pump chiller in a healthcare facility of its size in the United States. This innovative technology will translate to substantial energy savings for the hospital, in addition to boosting Phoenix’s conservation efforts overall. Results will include:

  • Conserving of 5.6 million gallons of water annually (the equivalent of the water needs of 120 households);
  • Reducing discharges to the sanitary sewer system by 600,000 gallons per year;
  • Reducing natural gas consumption by 70 percent; and
  • Saving nearly $11 million in energy and operating costs over 15 years.


The new hospital design also maximizes energy and water efficiency. In patient rooms, views of the mountains on both sides of the Valley will be maintained with high-performance low-e windows and sun-shading screens help to minimize solar heat gain. Additionally, the exterior lighting is designed to reduce light pollution. Combined with an efficient mechanical system design, the new building will use 20 percent less energy than maximum capacity required by code. Furthermore, the hospital is also a good steward of the community’s valuable water resources by installing low-flow plumbing fixtures with automatic flushing sensors that reduce water use in the new tower.

Indoor air quality is an important aspect of designing a sustainable hospital that creates a healing environment for Arizona’s youngest patients, and this process begins with selecting materials free of harmful chemicals. No mercury products or urea-formaldehyde resins were used in construction, and the new cooling system will use non-CFC refrigerant which prevents ozone depletion. Recycled flooring products and low-VOC paints and sealants will protect air quality.

Phoenix Children’s Hospital has also implemented a strategic exterior design, planning for indigenous plants and trees to create exterior places of respite. Local flora line the sidewalks and keep visitors cool and reduce solar heat gain. An expanded cafeteria, roof garden, indoor areas with natural views, and other tranquil spaces on the new campus will help keep employees, patients, and families on-site and off the road during heavy traffic times. Notably, the new facility offers convenient bike storage, a staff locker room in the basement of the new tower, and preferred parking for carpool and alternative-energy cars.

Taking the lead in sustainable construction, the project team has created a paperless strategy where portals and online distribution of materials sent to subcontractors save paper, time, and money. Most notably, Kitchell has conducted a large effort in recycling. On average more than 70 percent of construction waste per month is recycled, which keeps a significant amount of materials out of landfills. Lastly, in a region where dust control in the streets and air can be quite challenging during construction, the site takes extreme measures to reduce the effects of dust on the neighboring community.

Utilizing sustainable design principles, thoughtful green construction techniques, and preparing for environmentally friendly operations, the Phoenix Children’s Hospital expansion is setting a new benchmark in sustainable healthcare design and development.