Before contractors could begin building the new Lake Forest Hospital Outpatient & Acute Care Center in Grayslake, Ill., the team had to deal with delicate sitework issues.

About 7.5 acres of the 44-acre site were wetlands that required mitigation.

The water was handled three ways. Some was mitigated onsite, some off-site to an adjacent landowner and some to a wetland bank.

But mitigation was only part of the story, said Jim Killian, vice president of Lake Forest Hospital. "As we were doing the wetland work, the U.S. Army Corps of Engineers basically modified its whole approval process and delegated it to the local county authority, the Lake County Stormwater Management Commission," he said.

"We were the first large project requiring wetland mitigation delegated to the stormwater management commission. The approval process took about two years."

As part of the building project, the hospital is maintaining and restoring the natural site as prairie and wetlands, Killian added. Formal landscaping will be undertaken only at the main entrance to the facility.

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Two Projects Under Way

The $39 million, 137,000-sq.-ft. acute care center is just one of two projects the hospital is tackling simultaneously. The other is the Hunter Family Center for Women's Health, a wing to the existing facility in Lake Forest and 16 mi. away from the Grayslake building.

Together, the twin projects represent the single largest construction endeavor Lake Forest Hospital has undertaken since its founding in 1899.

Budgeted at $22 million, the 77,000-sq.-ft. wing will feature an entrance and parking lot separate from the rest of the hospital. The project broke ground in August 2002 and was ready for occupancy in January.

The acute care center in Grayslake broke ground in February and is scheduled to be complete in March and occupied the following month. It is being constructed at 1475 E. Belvidere Rd.

"Grayslake is the center of Lake County, and it happens to be the area of the most explosive growth in Lake County," Killian said. "A large portion of the people who seek care from this area drive to Lake Forest, so our goal is to move as many of the doctors and services as possible to this growing population."

Killian described the center as "a hospital without beds." It will feature three floors above a partial basement housing mechanical space. The first floor offers hospital outpatient and support services, the second and third floors will house private offices for doctors.

The Grayslake facility has been "a piece of cake," because it's situated on a site formerly blanketed by farm fields, Killian said.

Ties into Main Hospital

The Lake Forest project was another matter because it ties into the existing facility at 660 N. Westmoreland Rd., and all existing mechanical systems had to be integrated with the new systems, Killian said.

The bottom floor of the four-level women's health wing features outpatient services, including imaging, ultrasound, bone densitometry, a health-screening clinic, conference and meeting space, chapel and retail shop.

The floor above that, designated the first floor because the wing is built on a hill and allows entry on two levels, features postpartum maternity services. The second floor offers labor, delivery and recovery services as well as nurseries. Medical offices comprise the third floor.

"We had to avoid extended mechanical system shutdowns in the existing facility, because of the potential negative impact on patients," Killian said.

The solution required educating the contractor and all subcontractors upfront about the delicacy of the situation and careful coordination of scheduling and execution, he added.

Chris Siefert, senior project manager with Kenosha, Wis.-based Riley Construction Co. Inc., the general contractor on the Lake Forest project, said the mechanical, electrical and plumbing work presented challenges.

In creating the new wing, Riley had to match the hospital's existing 11-ft. floor-to-floor heights. The high ceilings resulted in a compressed plenum space of just 14 to 20 in. for the installation of mechanicals, Siefert said.

"That meant we spent an above-average amount of time reviewing the coordination of the fire protection piping, plumbing waste, vent and water piping, mechanical ductwork and piping, medical gas piping and electrical conduit and wiring," he added.

"If sprinkler pipe was headed north and ductwork was headed west, you had to make sure one was above the other."

Four to five months of meetings coordinating all the mechanical rough-ins, including those for isolation rooms, were required before work could begin, he said.

Working Near a Hospital

Contractors had to work around an existing hospital, which meant limited access to the facility. They also had to make sure the day-to-day life activities of hospital neighbors weren't hindered by construction.

"We had a difficult time with staging, finding areas on the hospital grounds that would not be unsightly but still were readily accessible," Siefert said. "We tried to locate it within the construction limits we had on the project. We really had just two areas for staging."

The work in Lake Forest also required the creation of a large water detention basin adjacent to the new wing and parking lot. The basin was carefully integrated into the campus and "beautifully landscaped," Killian said.

It joins two other basins on the 160-acre campus.

Lake Forest Hospital chose two different general contractors, Riley and Pepper Construction Co. for the acute-care facility, to oversee the building of the two facilities, but there was significant overlap among subcontractors working on the two buildings.

Each project was bid separately, but subcontractors were asked what kind of price break they might offer if awarded both jobs.

Maintaining crew size on each of the projects wasn't easy.

"For example, if you have the same masonry contractor awarded on both projects, you may want him on both projects at the same time." Killian said. "You're competing against yourself."