by Gus Iversen
, Editor in Chief | October 16, 2020
From the October 2020 issue of HealthCare Business News magazine
With this in mind, the selection of the design team should be based on proton therapy experience. The design team operates close to the project developer and integrates the clinical user and vendor requirements. In most countries the construction drawings need to be issued by locally registered A&E firms. A successful project manager will involve the local design team already in the design development stage as a consultant for local building codes and practices.
HCB News: Who are the key stakeholders in a proton construction job, and what advice do you have for keeping them all on the same page?
Proton therapy centers are very complex projects with many stakeholders: clinical users, investors and health care payers, proton therapy vendors, architects and engineers, shielding and regulatory experts, construction companies.
To keep them on the same page, one needs an experienced proton project manager, key performance indicators of which many are related to the schedule, and independent quality assurance processes for progress monitoring. Having raised two children, I feel that incentive programs can provide much better results than contractual penalties; a healthy mix of the two is advisable.
On a more technical level, the design and if possible, also the construction planning, should be done in 3D BIM models, where clashes are much easier to recognize and resolve than in 2D drawings.
HCB News: What are some common causes of construction delays, and what can be done to mitigate them?
The separation of the foundation permit from the building permit can be very beneficial for project efficiency, if the structural engineer has the relevant information as early as possible. There is no substantial cost difference, if a concrete wall is 200 cm or 240 cm thick, but assuming the more conservative thickness for the foundation will prevent delays after the shielding consultant confirms the final thickness. Well-functioning ground water retention and water proofing concepts are also fundamental to minimizing delays.
Many other causes of construction delays can be attributed to undetected clashes of different trades by not having coordinated the 3D design models in enough detail, having left items for “field coordination” or “to be designed by the general contractor” in the design documents.
HCB News: Are there different options for radiation shield vendors? How does one navigate those options?
Shielding walls also have a structural function and typically contain embedded conduits, ducts and water pipes. In-situ poured walls can provide for those functions, but a shielding block design needs to consider those aspects separately.