Data in construction is changing the way health-care facilities are built
Lexco is managing the construction of a state-of-the-art hospital in the Dominican Republic to serve the local population and medical tourists from around the world. BIM (Building Information Modeling) and the use of performance data to benchmark KPIs for success—with a focus on change orders and labor productivity—are critical to meeting the health-care facility’s high-tech requirements. The company’s approach is changing the construction landscape in the Dominican Republic and raising the standard for hospitals in the Caribbean and Central America.
Leading the way in construction management in the Caribbean
A pioneer in construction management, Lexco was established in 2007 in the Dominican Republic’s capital city, Santo Domingo, to provide engineering, management, and construction services in the Caribbean nation. With a specialty in health-care facilities, Lexco’s construction expertise and industry leadership extends to hospital projects throughout the Caribbean and Central America.
As a construction-industry veteran, Lexco founder and president Jorge López introduced the discipline of construction management to the Dominican Republic in the late 1990s and continues to be an advocate for cutting-edge construction technologies. He has paved the way for Lexco to become one of the region’s foremost authorities on BIM with the construction of the CEDIMAT Cardiovascular Center in the Dominican Republic, the most comprehensive heart center in the Caribbean region and one of the first projects in the country designed using BIM methodology.
Lexco managed construction of the 30,000-square-foot CEDIMAT Cardiovascular Center, a cardiac-care facility in Santo Domingo that opened in November 2015. Courtesy of Lexco.
Building an advanced hospital to set new standards of health care in Central America
Nueva Ciudad Sanitaria Dr. Luis Eduardo Aybar, or the New Luis Eduardo Aybar Hospital, was developed as a state-of-the-art facility to replace the outdated Aybar Hospital built in the 1940s. The 12 buildings of the health-care complex—which includes a maternal and child hospital, surgical clinic, gastroenterology center, burn unit, and a monitoring and security center—are spread across 152,000 square meters (around 1.6 million square feet) and make up what will be one of the most modern hospitals in Central America. “It’s a huge hospital,” López says. “It will be the second biggest in Central and Latin America.”
The new facility will serve as both a public hospital and a top medical-tourism destination, designed to attract patients from other countries who seek high-quality treatment at affordable prices. Construction needs to meet rigorous medical codes and standards set by the World Health Organization (WHO), the Joint Commission International for accreditation in patient safety and quality of health care, and the American Institute of Architects, among others. Lexco knew that BIM would be critical to integrating data with the construction processes, materials, and equipment required to meet those standards.
Rendering of the surgical clinic, one of 12 buildings on the health-care campus of New Luis Eduardo Aybar Hospital. Courtesy of Lexco.
Getting everyone on board with BIM
Working in a consortium with Consmara, a local general contractor, and Seminsa, a medical equipment supplier, Lexco began managing the construction of the new Aybar Hospital in 2013, with López serving as the project director. For such a large and complex undertaking, consistency and coordination is key—and from the beginning, Lexco integrated BIM in the design and construction process to meet project goals. But first the company had to overcome the lack of familiarity with and use of BIM in the region.
Lexco’s commitment entailed training all 32 of its design and construction subcontractor firms. With the help of TriArt Group—a local Autodesk reseller, authorized training center, and BIM consultation firm—subcontractors learned what BIM is and how to use Revit in BIM processes. What helped align the many stakeholders of the project—which also included the medical community, government ministers, and even the president of the Dominican Republic—was when they saw the results of using BIM tools and processes: how much faster the design process was compared to 2D modeling, how the information from the building model would empower their work, and how much they could reduce construction waste and catch costly mistakes in advance.
Jorge López (right) leads a group of government stakeholders on a tour of the new Aybar Hospital construction site. Courtesy of Lexco.
“Using Revit, design was a lot faster because all the stakeholders could see everything in the model at once. It was also a matter of information. For example, we stored information about the actual concrete strength of every element in the BIM model. Once they saw the information we could put inside the software, they started to understand the advantages of using it.”
—Jorge López, Founder and President, Lexco
Revit rendering of the Aybar Maternity Hospital lobby.
Maternity Hospital lobby under construction.
Revit rendering of a rooftop installation for HVAC equipment.
Completed installation of HVAC equipment.
Revit rendering of a plumbing system installation.
Completed plumbing system installation.
Photos courtesy of Lexco.
Meeting rigorous health-care codes
The new Aybar Hospital was developed as a local public hospital that will be open to all residents of the Dominican Republic. But there were additional expectations for this government-owned facility: to serve as a destination for medical tourism to draw patients from other countries. BIM was critical to meeting local and international medical and architectural standards, enabling the project teams to integrate that data with the construction processes, materials, and equipment required.
López also notes that the new Aybar Hospital “is the only hospital in the Dominican Republic that has complied with the Americans with Disabilities Act.” Going beyond those requirements, the facility has also installed proto-tactile flooring with changing textures to help people with visual impairment navigate the hospital buildings.
In addition to meeting stringent medical standards, Lexco aims to achieve LEED-level energy efficiency and sustainability requirements through elements such as exterior-wall panels that help improve indoor air quality by 25% and reduce mechanical power by 22%, as well as glass windows and partitions that filter out harmful X-rays and UV rays.
Watch video (3:13 min.): Workers on the new Aybar Hospital construction site. Courtesy of Lexco.
Using performance data to benchmark KPIs for success
Key to the company’s long-term success, Lexco takes data and learnings from one project to the next for better outcomes. For the new Aybar Hospital project, the company used data from its work on the CEDIMAT Cardiovascular Center to reduce change orders and cut time in the procurement process. Using the BIM model to gather and track information about all the materials and products from the beginning, Lexco is better able to preempt changes from stakeholders. “The architects can see everything installed in the 3D model, sometimes even in the final color,” López says, “so there are not so many surprises—and fewer changes.” Because Lexco knows early on in the process exactly what materials and equipment it will need, it can order them much sooner, reducing the time it takes to get them to the jobsite by 28%. “Long-lead items like air conditioning usually take six to eight months. Now we can receive the material two or three months earlier,” he says.
Lexco also tracks the performance of crews to assess the most efficient work processes and materials. In the case of the new Aybar Hospital, this data helped Lexco choose the flooring that would be the most cost-effective while meeting rigorous medical standards. The choice was urethane, a durable polymer floor coating that can withstand heavy traffic and is seamless enough to comply with strict hygiene requirements. “It’s a bit more expensive than ceramic tiles, but the installation time is shorter, and the number of people needed for installation is fewer,” López says.
Setting a new standard for hospital construction management
Construction of the new Aybar Hospital is progressing, and it’s projected to open at the end of 2019. Post-construction, the project’s BIM model will be used to manage building operations. “This is the first project in the Dominican Republic and in the whole Caribbean and Central America that will use a BIM model not only during design and construction but also in facility management,” López says.
The hospital has already received praise from the Pan American Health Organization, WHO’s regional office for the Americas. “The president visited the project to review the jobsite and sent a letter congratulating us for complying with all the WHO standards,” López says.
The New Luis Eduardo Aybar Hospital sets the bar high for health-care facilities in the region. Lexco is applying the tools and techniques learned to other projects, including four hospitals in Panama and another in the Dominican Republic. The company’s dedication to BIM has helped establish new standards for construction-management practices in the Dominican Republic—reshaping the future of the construction industry in the Caribbean and beyond.
The New Luis Eduardo Aybar Hospital rises above the Mejoramiento Social district in northeastern Santo Domingo, Dominican Republic. Courtesy of Lexco.