Omaha VA Ambulatory Care Center
The Omaha VA Ambulatory Care Center is a three-level, 157,000-square-foot outpatient facility connected to an existing 12-story VA hospital completed in 1950. The first P3 project in the history of the VA system, the project team overcame COVID-19 and substantial weather delays, ultimately opening on time and on budget in August 2020.
The Ambulatory Care Center has capacity to serve approximately 400 patients per day, helping relieve the main Omaha VA Medical Center of most outpatient services. The facility includes eight primary-care clinics, a first-of-its-kind women’s health clinic, one specialty-care clinic, a surgical suite with five operating rooms including pre/post-op space, radiology, on-site lab and a satellite pharmacy with retail.
The new $86 million facility was a trailblazing project for the VA as the first in the nation to take advantage of the C.H.I.P.I.N. for Vets Act. This federal law passed by Congress in 2016 allows the VA to accept private donations to complete construction projects, also requiring the builder to use innovative delivery techniques that fall outside federally prescribed specifications and methods.
Design started in 2017 and unlike previous VA healthcare projects, McCarthy was selected concurrent to design with site work commencing simultaneously. Ultimately, the P3 delivery method drove a highly effective and collaborative team that accelerated completion time from 52 months to 36 months, also reducing the total project cost from an estimated $120 million through traditional delivery to the final $86 million. The project has become a model for future P3 veteran healthcare projects.
McCarthy’s approach included innovative construction delivery methods that enabled this complex, one-of-a-kind project to meet its ambitious budget and schedule expectations. This ensured the project would be viewed as a success by the Veterans Administration, veterans and their families, and the surrounding Nebraska region. Initiatives such as subsurface utility mapping, virtual design and construction, and other advanced technology — as well as using a design assist subcontracting approach instead of a hard-bid approach — enabled the complex project to maintain the overall budget and schedule needs of the project.
Using McCarthy’s in-house subsurface McCarthy Mapping team prior to excavation, the project team quickly identified unmarked utility lines that would have created significant cost implications during construction, as well as challenging topography that ultimately resulted in the facility being constructed at a lower elevation. Instead of traditional excavation, a soil nail wall made it possible to remove soil vertically on a shorter schedule and without interrupting entry or exit to the existing hospital. This innovation saved time and money by negating the need for a temporary main entry and exit during construction.
The project team also used advanced virtual design & construction (VDC) technology applications throughout the design and construction process to facilitate collaboration and enabled the team to maximize budget and schedule efficiencies. Building information modeling (BIM) was used to continuously review and compare design updates and adjust the cost model accordingly. Conceptual cost modeling aligned the project’s budget and program early in the design. Laser scanning confirmed as-built conditions with 3D coordination to not only increase layout precision, but also ensure project controls for scopes such as self-perform concrete.