Whitepaper: 05.08.2012

Weathering the Storm

How Mercy and McCarthy are collaborating to rebuild healthcare in Joplin

by Stephen Meuschke, McCarthy Project Manager

At 5:40 p.m. on Sunday, May 22, 2011, the deadliest single tornado in U.S. history struck Joplin, Mo. St. John’s Regional Medical Center, now called Mercy Hospital Joplin, was right in its path, just as the twister strengthened to an EF5 — the highest level possible — and winds in excess of 200 miles per hour pounded the nine-story landmark of community service. More than 100 staff members rescued nearly 200 patients, evacuating in around 90 minutes, never losing sight of why they were there — to take care of their neighbors.

“Our first thought after making sure people were safe was, ‘Where are we going to provide care?’” said Gary Pulsipher, president of Mercy Hospital Joplin. “That very next day, Mercy said we’re not only going to rebuild this hospital, but we’re going to keep these people employed.”

In 2015, the new, permanent hospital will open its doors. While it’s being built, the administrators and clinicians of Mercy have continued to serve the community. Their efforts have been as inspirational as the task has been daunting.

Building in Stages
What Mercy has accomplished, from the first moments of the tornado’s aftermath to today, has never been done before. On May 29 — just a week after the disaster — the hospital was operating from a tent-like structure, known as a Mobile Medical Unit, on loan from Missouri’s Disaster Medical Assistance Team with full electronic health record systems in place. In early November, a modular hospital — resembling a system of trailers — was established to weather the winter. In April 2012, a component hospital opened its doors, with a structure 30 percent stronger than the original hospital and window glass rated for 200-mile-per-hour winds. This hospital could serve Joplin well for decades. However, it will soon be replaced by a state-of-the-art, permanent 875,000-square-foot facility featuring some 260-plus beds and clinic.

Every step of the way, Mercy and McCarthy have been working side by side to make this challenging vision a reality.

“McCarthy has given us what we’ve really needed most. They know how to make things happen,” said John Farnen, executive director of planning, design and construction for Mercy, which includes 31 hospitals and more than 200 outpatient facilities in four states. “They don’t need a set of drawings to get things done. They’re able to figure it out and think on their feet. They just know how to build stuff.”

And that began the very next day after the tornado struck.

The Tent Hospital
“The first few days were just chaos,” Farnen continued.

There was no time for planning meetings — just work days that averaged 20-22 hours. A functioning hospital was literally being erected on a parking lot with pieces being assembled as they arrived.

McCarthy had to lay out the hospital without knowing what was coming next. The challenge was more than just putting up the tent. The McCarthy team had to determine what to do with the critical healthcare functions, including the OR, nuclear medicine and cath labs.

Just one week later, the tent hospital was open to the public. Less-critical sections continued to be added, including a kitchen, dining area, showers and more. A former tent-like structure had become a true hospital.

The Modular Hospital
In a few short months, the tents were replaced by portable buildings made of Styrofoam compressed between sheets of metal. It was such an improvement that one nurse said, “It felt like we were at the Ritz Carlton.” Because the Michigan company that provided the structure had never built a hospital before, McCarthy was called in to collaborate as consultants.

“McCarthy helped us think through what the modular structure would need to make it work as a hospital,” Farnen explained. That included a wide range of needs unique to hospitals, from the sprinkler system to nurse call stations to the ICU.

The Hospital Today
“Early in the recovery, we knew the community would need a true hospital while we build for the future,” said Lynn Britton, president and CEO of Mercy. “It’s remarkable that we were able to get this top-notch facility up and running within eight months.”

And a true hospital it is. Built to serve the community for decades if needed, it was christened Mercy Hospital Joplin, providing 150,000 square feet, a full-size emergency department and 100 overnight beds. It was all crafted from 224 individual modular components, constructed in California and delivered by road and rail to Joplin.

It’s the largest acute care facility ever built with modular construction — twice as large as any project the California company providing the components had ever built before. Also, this was the first hospital project the company ever handled. McCarthy was asked to help guide installation, to ensure the modular building had what it needed to function as a hospital from day one. McCarthy also designed and built the foundation and utility plant.

“McCarthy had the utility plant done in just two and a half months,” Farnen said. “We didn’t have to tell them what was needed, they already knew, including code requirements. Without McCarthy, we couldn’t have opened the modular facility on time.”

And while the modular hospital serves Joplin today, construction of the permanent hospital is well underway.

The Permanent Hospital
As the construction manager for the new 875,000-square-foot, 260-plus private room facility, McCarthy continues to collaborate closely with Mercy to build the permanent Mercy Hospital Joplin in record time. The design team includes Dallas-based HKS, Inc. and Archimages, Inc. out of St. Louis. “We went from initial design to breaking ground in just five months,” Farnen said.

McCarthy will have the new replacement hospital open three and a half years after the tornado hit Joplin, which is approximately half the time one would normally anticipate to plan, design and construct a similar sized hospital.  

“McCarthy is working with us as a true partner to get us to the finish line,” Farnen said. “We’ll appreciate their work even more after we move in, because of the problems we’ll have avoided due to McCarthy’s healthcare experience.”

Looking to the Future
“You hope this project is one in a career,” said Tate Jacobitz, project director for McCarthy. “I can’t think of a better reminder of why we’re all here — to serve the community. There was excitement and force behind us to all pull together and get this hospital back up on its feet.”

Britton added, “We are making this commitment because it’s the right thing to do for Joplin.” Just as the hospitals’ administrators and clinicians are doing the right thing for their community in the face of unknown challenges every day. “There’s no book for this. Even when you’re doing disaster planning, you don’t ever prepare for your building to go down,” said Shelly Hunter, chief financial officer of Mercy Hospital Joplin.

Farnen agreed, “You can’t prepare for an entire community and health care system to be wiped out.”

Pulsipher perhaps sums it up best, “This taught us to plan for the very worst. We will be able to rebuild. Our community is going to be okay, and it’ll come back.”

About the Author
Stephen Meuschke, LEED AP BD+C, is a Project Manager for the Central Division of McCarthy Building Companies, Inc. Currently, Steve is managing all work for the new Mercy Hospital Joplin replacement facility. In this role, he manages McCarthy's construction services on a daily basis and is present at the site full time to oversee effective management by field staff, exercises control over the budget and schedule, and ensures timely and high quality work by all contractors involved. He holds a bachelor of science in Mechanical Engineering from Purdue University. 

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