Gilbane以耶鲁纽黑文健康项目为例分享运营中医院现代化改造经验

The challenge is how to modernize a healthcare facility while patients continue receiving care and physicians, nurses and staff continue providing it.挑战在于，如何在患者持续接受诊疗、医生、护士和工作人员持续提供诊疗服务的同时，对医疗设施进行现代化改造。

Key Takeaways:核心要点：

Plan healthcare renovations around ongoing patient care, using temporary access, infrastructure and carefully sequenced phases to keep critical services operating.围绕持续的患者诊疗来规划医疗设施改造，利用临时通道、基础设施和精心安排的阶段顺序，维持关键服务运行。
Treat every construction decision — including shutdowns, noise, vibration, dust and site logistics — as a potential factor in patient safety and the hospital’s ability to deliver care.将每一项施工决策——包括关停、噪音、振动、粉尘和现场物流——都视为影响患者安全和医院诊疗服务能力的潜在因素。
Build strong communication with clinical teams, facilities staff and community stakeholders, while making infection prevention and adaptability central to the construction plan.与临床团队、设施员工和社区利益相关方建立稳固沟通，同时将感染预防和适应性作为施工计划的核心。

Modernizing an active hospital or other healthcare facility starts with a fundamental reality: Construction must adapt to patient care, not the other way around. The question is not simply how to construct what is shown in the plans. It is how to deliver that work while patients continue receiving care and physicians, nurses and staff continue providing it — sometimes on the other side of a wall, below a floor or in the spaces surrounding the project. 对在用医院或其他医疗设施进行现代化改造，首先要面对一个基本现实：施工必须适应患者诊疗，而不是让患者诊疗适应施工。问题不只是如何按图纸建造，而是如何在患者持续接受诊疗、医生、护士和工作人员持续提供诊疗服务——有时就在墙的另一侧、楼下一层或项目周边空间——的情况下完成这项工作。

That reality is evident in the work across Yale New Haven Health’s New Haven campuses, where our teams are managing very different projects that share a common challenge: modernizing critical healthcare environments while the facilities continue to operate. 这一现实在 Yale New Haven Health 的纽黑文各院区工程中得到体现；我们的团队在那里管理着截然不同的项目，但它们面临共同挑战：在设施持续运行的同时，对关键医疗环境进行现代化改造。

At the York Street campus, the work involves major infrastructure improvements in one of Connecticut’s most complex healthcare facilities. The improvements include critical electrical upgrades and construction of two new penthouses on the 12th and 13th stories, with the neonatal intensive care unit directly below and an active LifeStar helipad nearby. 在 York Street 院区，工程涉及对康涅狄格州最复杂的医疗设施之一进行重大基础设施改善。改善内容包括关键电气升级，以及在12层和13层新建两座顶层设备机房，其正下方是新生儿重症监护室，附近是正在使用的 LifeStar 直升机停机坪。

At the St. Raphael campus, the work includes a nearly four-year, $120 million renovation of emergency department and heart and vascular spaces. The work is being delivered through approximately 10 microphases, with completed portions including a new emergency department entrance and waiting area, relocated CT and radiology functions, and five heart and vascular labs. 在 St. Raphael 院区，工程包括对急诊科和心脏与血管诊疗空间进行为期近四年、耗资$120 million的改造。工程通过约10个微阶段交付，已完工部分包括新的急诊科入口和等候区、搬迁后的 CT 和放射功能区，以及五间心脏与血管实验室。

Together, these projects offer complementary perspectives on healthcare construction. One focuses heavily on the infrastructure that allows a hospital to function, and the other reaches directly into the spaces through which care is delivered. 这两个项目共同提供了医疗施工的互补视角。一个重点关注支撑医院运行的基础设施，另一个则直接深入提供诊疗服务的空间。

Planning several moves ahead 提前规划数步棋

Hospital renovation can feel like a game of chess. Designers and contractors rarely get to make the move they ultimately want to make first. Instead, teams must create temporary conditions, relocate functions and complete enabling work before construction can advance. 医院改造可能像一盘国际象棋。设计师和承包商很少能先走出他们最终想走的那步棋。相反，团队必须在施工推进前创造临时条件、重新布置功能区并完成前置配套工程。

For example, rebuilding the emergency department entrance at St. Raphael required maintaining ambulance access throughout construction. A lane closure on a congested urban street required establishing temporary circulation and constructing a temporary ambulance canopy before the permanent drop-off could be completed. 例如，重建 St. Raphael 急诊科入口需要在整个施工期间维持救护车通道。在拥挤的城市街道上封闭一条车道，需要先建立临时流线并建造临时救护车雨棚，然后才能完成永久性落客区。

The same principle applies to clinical spaces. Turning over five heart and vascular labs required careful sequencing because taking procedure spaces offline affects services beyond the immediate construction area. In an operating hospital, one construction activity can create a chain of operational consequences. 同样的原则也适用于临床空间。交付五间心脏与血管实验室需要仔细排定顺序，因为让诊疗操作空间停用会影响直接施工区以外的服务。在运行中的医院，一项施工活动可能产生一连串运营后果。

For facilities teams and builders, the construction schedule has to begin with an understanding of the way the hospital operates and not simply the way the building goes together. 对于设施团队和建筑商而言，施工进度计划必须从理解医院的运营方式开始，而不能仅仅着眼于建筑的组装方式。

Treating precision as a patient-care issue 把精度视为患者护理问题

That operational understanding becomes even more important when construction involves the infrastructure that allows the hospital to function. 当施工涉及维持医院运行的基础设施时，这种对运营的理解就变得更加重要。

At York Street, major electrical upgrades touch the backbone of an operating facility. Work must be planned around existing systems and active clinical operations, with shutdowns and changeovers carefully sequenced so new infrastructure can come online while hospital functions continue. The physical constraints add another layer: Equipment and systems have to be moved through and installed within an existing hospital rather than on an open construction site. 在 York Street，重大电气升级改造触及一家运营中医院的骨干系统。施工必须围绕现有系统和正在进行的临床运营进行规划，并精心安排停电与切换的顺序，使新基础设施能够在医院继续运行的同时上线。物理限制又增加了一层难度：设备和系统必须穿过现有医院并在其中搬运和安装，而不是在开阔的建筑工地上作业。

HFT Recommends: 3 Ways to Minimize Disruption During Construction in HealthcareHFT 推荐：医疗场所施工期间最大限度减少干扰的 3 种方法

The additions on the 12th and 13th floors illustrate the same principle in a different way. Construction is taking place directly above an active NICU and adjacent to the LifeStar helipad. When helicopters were inbound, rooftop materials and debris had to be cleared because of the hazards created by rotor wash, requiring the construction team to respond to the needs of emergency operations around it. 12层和13层的扩建工程以另一种方式说明了同样的原则。施工直接在正在运行的 NICU 上方进行，并紧邻 LifeStar 直升机停机坪。当直升机进场时，由于旋翼下洗流造成的危险，必须清理屋顶材料和碎屑，这要求施工团队响应周边应急运行的需求。

At St. Raphael, maintaining approximately 50 emergency department beds while construction proceeds presents another version of that challenge. The goal is not merely to deliver the new space or infrastructure. It is to understand the potential effect of every construction decision on the hospital’s ability to provide care. 在 St. Raphael，施工期间维持约 50 张急诊科床位构成了这类挑战的另一种形式。目标不只是交付新空间或基础设施，而是理解每项施工决策对医院提供护理能力的潜在影响。

Communication as part of the construction plan 将沟通作为施工计划的一部分

Some of the most important tools for an active healthcare project are not physical ones. 对于在用医疗项目，一些最重要的工具并非实物工具。

Before implementing the temporary emergency department entrance at St. Raphael, the project team needed to understand the workflow of emergency department staff and gain their buy-in. Coordination then expanded to hospital facilities personnel, city traffic officials, the mayor’s office and neighborhood alders. 在 St. Raphael 启用临时急诊科入口之前，项目团队需要了解急诊科员工的工作流程并获得他们的支持。随后，协调范围扩大到医院设施人员、市交通官员、市长办公室和社区选区议员。

That communication cannot end when the construction plan is approved. 施工计划获得批准后，这种沟通不能就此终止。

Our teams establish direct relationships with hospital department leaders and provide cell phone numbers so staff can immediately reach us if noise, vibration or another construction activity affects their environments. The objective is for the construction team to become part of the hospital team rather than an outside contractor working around it. 我们的团队与医院各部门负责人建立直接联系并提供手机号码，以便员工在噪音、振动或其他施工活动影响其环境时能够立即联系到我们。目标是让施工团队成为医院团队的一部分，而不是在医院周边作业的外部承包商。

For healthcare facilities managers, establishing these communication channels before problems occur can be as important as establishing the physical logistics of the project. 对于医疗设施经理而言，在问题发生前建立这些沟通渠道，其重要性不亚于落实项目的实体物流安排。

Putting patients at the center 以患者为中心

Healthcare construction also brings responsibilities that might be less pronounced in other building types. Infection prevention, dust and airborne-particle control, noise, vibration and access take on greater significance when vulnerable patients might be just feet away from active construction. Team members working in these environments receive healthcare-specific infection-prevention training to prepare them for those conditions. 医疗施工还带来了其他建筑类型中可能不那么突出的责任。当脆弱患者可能距离活跃施工现场仅数英尺之遥时，感染预防、灰尘与空气悬浮颗粒物控制、噪声、振动和进出通道都具有更重要的意义。在这些环境中工作的团队成员会接受针对医疗环境的感染预防培训，为这些状况做好准备。

But patient-first construction is broader than any individual protocol. It is a way of approaching decisions. The most successful healthcare projects align the construction strategy with clinical operations from the beginning. Phasing, temporary infrastructure, logistics, shutdown planning, communication and infection prevention all serve the same objective: protecting the continuity of patient care while healthcare professionals continue doing their jobs and facilities evolve around them. 但以患者为先的施工范畴比任何单项规程都更广泛。它是一种处理决策的方式。最成功的医疗项目从一开始就让施工策略与临床运营保持一致。分阶段施工、临时基础设施、物流、停运规划、沟通和感染预防都服务于同一目标：在医护专业人员继续工作、设施在其周围不断改造的同时，保护患者照护的连续性。

For builders, achieving that goal requires technical expertise and precision. It also requires listening, adaptability and an appreciation for what is happening beyond the construction zone. Iin an active hospital, the work is never simply about the building. It is about building around care. 对施工方而言，实现这一目标需要技术专长和精准作业，也需要倾听、应变能力，以及理解施工区域之外正在发生的情况。在正常运营的医院中，这项工作绝不仅仅关乎建筑本身，而是围绕医疗照护开展施工。

Kevin Pellegatto is a senior project manager with Gilbane Building Co. with 15 years of construction industry experience. He leads the phased renovation of the Yale New Haven Health Saint Raphael Campus emergency department and heart and vascular center, a complex project transforming critical patient-care spaces while the hospital remains fully operational. Kevin Pellegatto 是 Gilbane Building Co. 的高级项目经理，拥有 15 年建筑行业经验。他牵头 Yale New Haven Health Saint Raphael Campus 急诊科与心脏及血管中心的分阶段改造；这个复杂项目在医院保持全面运营的同时，对关键患者照护空间进行改造。

Christopher Toussaint is a senior project manager with the firm and specializes in healthcare infrastructure and highly technical occupied renovations. He manages the Yale New Haven Health emergency power upgrades project at the York Street Campus, where major electrical and building systems improvements are being implemented within a 24/7 hospital environment.Christopher Toussaint 是该公司的高级项目经理，专长于医疗基础设施和技术含量极高的在用建筑改造。他负责管理 Yale New Haven Health 在 York Street Campus 的应急电力升级项目，在 24/7 运营的医院环境中实施重大电气与建筑系统改进。