This piece is presented by Journey Group.

The start of the year isn’t the ideal time to start a major construction project in South Dakota.

But that’s what needed to happen for Avera Medical Group to meet an ambitious goal: Treat the first patient in a new west-side emergency department by September 2016.

So steel started going up for the three-story, 85,000-square-foot medical center in January 2106. Nine months later, right on schedule, the building opened.

To make it happen, Journey Group – the project’s general contractor and construction manager at risk – took some creative approaches that delivered.

“It was a pretty fast-tracked schedule, but that was well-communicated, so we could plan,” said Aaron Eich, Journey’s project manager.

Journey and Avera have a decades-long history of working together. Journey often acts as a construction manager at risk on major Avera building projects, which allows the contractor to be brought in very early during the design.

In this case, Journey also hired its mechanical and electrical contractors during the design phase, so all key players could work together to maximize time.

“That allowed them to work with the mechanical and electrical engineers to bring value, get the best cost and address constructability issues with our fast-paced schedule,” Eich said.

High-tech modeling, steel strategy

Journey is a regional leader in using Building Information Modeling, or BIM, technology to virtually construct buildings. Software allows projects to be virtually built and revised as new efficiencies are discovered.

In this case, BIM allowed Journey to get a jump-start on bidding steel for Avera’s project. Because the model showed how many tons would be needed, bids went out and steel was on order before the structural engineering was done.

“That saved us four weeks of waiting,” Eich explained. “A lot of times, you’ll have a foundation done and you have a lag before you get the steel. This took away that lag.”

Once construction began, the winter weather didn’t hold things up, either. Journey put a plan in place to avoid a delay in installing underfloor plumbing.

“When we set steel in the winter on a lot of projects, you can’t really start underfloor plumbing until you get the deck put on the first floor, and often you wait for the ground to thaw before you start,” Eich said. “We built more temporary barriers and heated areas ahead of time to get that underfloor plumbing going as soon as possible.”

The metal panels needed for the side of the building could have presented another potential delay, but a solid subcontractor delivered.

“They used LEAN practices to cut normal panel lead times from six to eight weeks down to two to three weeks, which allowed them to start installing that much sooner,” Eich said.

Journey had a plan for the roof, too. Usually, after concrete is poured, it takes 30 days before crews can put the roof on a building.

“We used a different additive in the concrete that allowed us to put the roof on four days after pouring,” Eich said. “The goal is to make the job flow all throughout construction and get rid of lag, so you move piece by piece through it.”

Avera ready to grow

Right on target, Avera opened for patients in September 2016.

“Overall, it went really well,” Eich said. “The building itself was a very nice design architecturally, and even though we built on an aggressive schedule, the price per square foot ultimately was economical.”

Avera had challenged Journey to finish a complicated building in a short amount of time, and they did, said Dick Molseed, Avera’s executive vice president of strategy and governance.

“And this was not a normal building,” he added. “It has full imaging, laboratory services and a fully functioning emergency department. And they did it.”

Costs also were well managed, he said.

“Constructability is a big part of our design process,” Molseed said. “That’s why Journey is at the table with us starting at concept time.”

While the goal was just to have the emergency department ready to operate – about one-third of the first floor – the entire first floor was done and most major work was down on the second and third floors.

“We wanted to minimize impact for Avera and especially for patients,” Eich said.

Now that the building is fully operational, it’s solidly exceeding Avera’s expectations.

“We’ve doubled what we anticipated,” said Dave Flicek, chief administrative officer of Avera Medical Group. “Patients appreciate the convenience and the different levels of care we can offer in one place, from a 24/7 emergency room to primary care.”

It’s been so popular Avera already has Journey back at work. The top floor was only partially finished. Journey crews now are working to turn it into space for Avera’s growing orthopedics group. The plan is to be done in September.

“We’ll be able to use this facility for years to come,” Flicek said. “Citizens on the west side have embraced the concept and are very satisfied.”