Servicing
the future–
with robots
Cleveland Clinic opens advanced materials
handling facility to support unparalleled growth
BY TODD WILLIAMS
Recognizing the unparalleled growth driven by construction of its Heart and Vascular Institute, the Cleveland Clinic has taken a proactive leap by building the largest and most sophisticated healthcare material handling and order fulfillment system in the United States. Located on East 89th St. between Euclid and Carnegie avenues, the structure is a 227,000-sf facility, with an underground Service Center topped by an eight-story, 4,100-car parking garage and an attached 12,000-sf, one story Information Technology office.
The $192 million facility sits on a six-acre site, and was completed in an astonishing two years from start to utilization according to Jay Waddell, senior project manager for Donley’s, Inc., construction manager for the massive project. Waddell added this job is the largest project Donley’s has ever built. It is also the largest LEED registered project in Ohio to date.
According to Bill Peacock, Cleveland Clinic executive director of Operational Support Services, two related issues drove the new construction. First was the additional new hospital construction for the Clinic, and city zoning requirements mandating that additional parking spaces be added. This led to the original need for the new parking garage. Secondly, the 400 new beds added in the Heart and Vascular Institute meant that additional support service space would be desperately needed.
The old service center, located in the basement of the old QQ Garage, was undersized and outdated, with only one elevator serving the area from the first floor docks. The center was insufficient to handle the increased demands of the new hospital space. “Something else was needed,” Peacock recalls.
Operating team
Dave Miano, the project architect, with architectural firm Bostwick Design Partnership, explains that because of the technological complexity of the Service Center, the team of healthcare, architectural, planning, technology and construction experts had to interact creatively in order to develop solutions to a series of complex design challenges.
Bostwick Design Partnership’s work with the Clinic over the last 20 years gave it a unique prospective on how the Clinic delivers healthcare and how the new building fit into the workflow of the campus, making this process smoother. The Schachinger Group, Inc. was added to the team in the very beginning as the primary logistics consultant, programmer and planner for the Service Center’s Operational Departments and their related equipment and systems.
However, ongoing design during construction also brought challenges. According to Waddell, this fast-paced project was literally being designed while under construction. He explained that construction was proceeding faster than the design schedule, which had been extended by changes.
“To mitigate delays in construction,” Waddell adds, “Coordination, cooperation, and trust were paramount to keep work proceeding without expensive delays or come-back work.”
He also notes that because the Service Center project directly impacted almost every department in the Cleveland Clinic, sharing information, coordination of activities and decision-making processes were keys to the success of the job.
“We were under the gun, with time constraints to get the garage open by fall of 2008,” says Peacock. “We met and exceeded deadlines by bringing in all the team early in the game. We also brought in an independent scheduling consultant, R.V. Buric, to keep the project on track.”
Adds Waddell, “Buric’s mission was to take schedule information from four projects: 89th Street, the new heart center, the Glickman Building and the Allee Mall from Chester to Euclid in front of the JJ North and South buildings, and integrate them together for the Clinic. These projects were intertwined, as they had to open together. Maintaining the schedule at each project was critical on many logistical levels, not only construction.”
Location, location
The first challenge for the design/construction/owner team was to find the optimal site for the building. A surface parking lot at the corner of E. 89th Street and Carnegie was chosen because it fit into the Clinic’s master plan for its campus. The site also has great access to the freeway system, which would be convenient for both suppliers delivering to the service center and for clinic employees using the parking deck.
As an added advantage, the location on the western edge of the campus assured that delivery trucks would avoid Euclid Avenue traffic congestion, including both pedestrians and vehicles at the main campus. Also, the site was close enough to the campus tunnel system to allow connectivity, which would be crucial for the behind-the-scenes support services that must be provided for patients. An army of personnel moves a large amount of meals, linens and medical supplies via the tunnel system to the various Clinic buildings on campus.
Previously, materials were transported by hand from building to building, often resulting in long delivery times. Truck traffic often disrupted the traffic flow on campus and created noisy conditions for recovering patients.
Waste management also became an issue as the Clinic expanded.
The heart of the new building is the 183,500-sf Service Center, a technology-driven facility, according to Ed Schachinger, president of The Schachinger Group. The Fairfax, VA-based consulting firm specializes in materials handling and management, waste management, circulation-wayfinding, vertical transport and sterile processing. Approximately 80% of its work is large-scale healthcare and mixed-use projects.
Schachinger says the firm provided the physical and economic feasibility studies, then the functional and space programming, and eventually designed and wrote specifications for vendors for the highly sophisticated materials and waste management systems that occupy the Service Center and extend to the further reaches of the campus via the tunnel system. It also provided in-depth implementation services to assist in the startup of the new facility.
“About 35% of a hospital’s operating costs are in overall materials management-related functions. The highly efficient, state-of-the-art technology systems we designed for this building will produce a 10% to 15% cost reduction or avoidance,” he estimates.
Trucks (nearly 73 per day) bring in supplies and remove waste transfer shipments through 11 receiving bays at one location in the building and
28 small vehicle spaces. From there, supplies are processed in a receiving area and moved along to an order fulfillment area, all managed by a sophisticated WMS. This area is comprised of conveyors, carousels and order tracking monitors that control costs by tracking supplies and distributing only what is needed.
The technology in this area improves staff efficiency because supplies are delivered directly to the caregiver staff and multiple orders are filled together.
Other areas in the underground facility include a high bay storage area with its controlled environment to store items that will not be used immediately; a linen area with one day’s worth of linen ensuring patient beds are always fresh and clean; a large food and nutrition area to prepare and transport cold meals to floors where they are heated and distributed to patients; a central services area incorporating the latest technology in disinfection of items used in clinical and nursing areas; and a separate waste management area to reduce exposure to contaminated medical waste.
Automation is the answer
At the heart of this sophisticated building is what makes it all work, and what connects it to the rest of the Cleveland Clinic: an Automated Guided Vehicle System (AGVS). This is also why it was important to be near enough to the existing tunnel system to connect the basement of the new building. Clinic supplies are now distributed automatically and waste is removed using the AGVS. “Without the AGVS, none of this technology would be feasible. It is the key to the Service Center,” Schachinger emphasizes.
According to Peacock, a number of other material delivery systems were considered, including tugs, towlines and additional manpower. All other systems had flaws that led to the choice of an AGVS. “We went to a number of other hospitals in the country to look at AGV systems. We weighted all other opportunities and this system made the most sense to us. It’s the most economic system that suits our needs now and in the future that we could get,” Peacock says.
Miano outlines the AGVS and how it functions. The system has 84 unmanned, electric motorized vehicles that transport goods from the center to locations throughout the main campus via the tunnel system. These vehicles follow imbedded magnet paths along the tunnel floors and have the ability to stop quickly if a human or an object obstructs their path.
Schachinger explains that the robotic vehicles find their way through the system by using an onboard digital map. They are in constant wireless communication with the central command station. He adds that these AGVs stay within one-half to one-quarter of an inch of their planned route on their magnetic grid pathways.
An integral part of the AGVS are the custom-designed carts that are picked up and carried piggyback on the guided vehicles.
These carts vary in design according to what they carry. There are over 1,000 carts carried by the AGVs including heavy equipment carts, waste carts, food carts, linen carts and other applications. All carts carry a radio frequency identification tag in order to ensure the right cart is going to the correct location on the proper AGV. Furthermore, Service Center workers use state-of-the-art, hand-held PCs to scan codes on the carts. These data are used by the employees to verify the proper delivery specifications for the product. The AGVs are designed to carry loads of up to 1,000 lbs and travel up to two miles before recharging. They carry 35 tons of material every day, including nearly 4,500 patient meals.
The AGVS are responsible, Miano says, for delivering carts of medical supplies, food, and clean linens to building depots along the campus route and returning to the Service Center, with other carts containing trash and soiled linen. In just one day, the AGVS make approximately 5,000 trips and travel about 1,000 miles. The longest round trip from the Service Center is nearly three-quarters of a mile long. The machines are programmed to automatically return to a charging station when they run low on battery power and are also programmed to go to a central cart wash for sanitization. This reduces work hours needed to keep the system running efficiently.
“These AGVs are very efficient. The entire system works on a demand basis rather than a fixed schedule. Sometimes all 84 are out. But normally, about 65 vehicles are online at any given time,” Schachinger notes.
The AGVs delivery system starts at the Order Fulfillment Center. Here a master computer
system tells the human worker, via a “pick to light” system, where to find the needed item and how many of each item should be picked from storage. It is here that workers load containers that are then checked, scanned and loaded onto carts for the AGVs to pick up for delivery.
This system is highly accurate and ensures the proper selection of over 3,000 stock and 100,000 non-stock items handled every year. Because of its efficient interfacing with humans, the fast track feature of the WMS system can practically guarantee two- to two-and-a-half-hour deliveries of non-stock items from the receiving dock to the end user.
What lies beneath
Bringing orders from the Service Center to the rest of the Clinic campus via AGVs involves running the vehicles through the underground tunnel system. In order to get to the existing tunnels, Miano explains that a new tunnel was constructed under E. 89th to connect to the campus tunnel at E. 90th St. The first phase of the tunnel is 150 ft long, 20 ft below grade, and 22 ft wide. The final phase of the tunnel is still under construction and will connect with the existing tunnel. When the final tunnel is finished at year-end, a temporary route through the old QQ Garage basement will be abandoned and the entire garage will be demolished and give way to green space. The complete tunnel will be 470 ft long.
The new tunnel is 13 ft high but narrows to about nine feet at several places where it threads through a 48-inch city water pumping station transfer line and a 72-inch main sewer line. According to Donley’s Waddell, both lines were constructed in the early 1900’s and were in unknown condition. “We built around the waterline based on the criteria that the lines could not move even one sixteenth of an inch. Had the line breached, the entire construction site and campus underground corridor system, including the existing distribution warehouse, would have been flooded.
Additionally, the damage would have included shutdown of the primary electrical substation providing power for the Cleveland Clinic campus, which was not an option” Waddell notes.
Waddell says that Donley’s utilized a number of strategies to ensure the pipe’s integrity, including changing excavation foundation procedures so as not to put lateral pressures on the pipe, using an extensive bridging and shoring system to protect the pipe as the tunnel was excavated below, and continually monitoring the pipe for movement and settlement. He said at the end of the construction, the City of Cleveland sent divers in scuba gear through a manhole to examine the pipe joints for deteriorations. None were found.
Another water problem overcome by the construction team was the fact that the Service Center is seven to eight feet below the water table. Waddell explains that a dewatering system was employed during excavation to lower the water table and maintain that level until the building was above the third floor. To keep the below grade area watertight, an inert mineral, bentonite, was applied below the foundation and to the walls of the basement. “When water hits this material, it swells and creates a natural barrier to moisture. At all costs we had to avoid the migration of water into the Service Center,” Waddell adds. “In essence, we created an inverse
bathtub.”
“Dealing with these unique water table issues was typical of how our team faced challenges on this project,” says Miano.
Waddell agrees. “The integration of AGVs, the order fulfillment and the commissioning of these systems while completing construction requirements of mechanical commissioning presented the final challenge as the opening deadline drew near. To stay on top of the team issues, we actually went as far as to assign one of our full time staff to be a field liaison with Ed’s (Schachinger’s) group to coordinate the technology with design and construction. We had to interface various technologies, some of them conflicting. We only got one chance to do this right.”
“The speed in which this project was built created challenges,” says Miano. “It was a very complex job. But the Clinic was very engaged and worked very hard to get us the information we needed when we needed it. Now they have a unique Service Center that will fill its needs as it goes ahead with future expansion plans.” BXM
Todd Williams is well-known as a writer about and photographer of commercial construction projects.
Owner: Cleveland Clinic Foundation
Architect: Bostwick Design Partnership
CM: Donley’s Inc.
MHC: The Schachinger Group
Owner’s rep: Balfour Concord
Consultant: Buric Construction Management
Size: 227,000-sf facility, 4,000-car garage, 12,000-sf IT office
Cost: $192 million
Vendors: Acme Arsena Company, Inc., ALL Erection Crane, APSCO Fire Protection /
Tiroly & Associates, Architectural Products Co., ASAP Automation LLC, A.W. Farrell / USA Roofing, AVI Food Systems, Barber & Hoffman, Bastian Material Handling (Parent
Co of ASAP Automation), Bean & Bennett Enterprises, Cavotta Landscapers, Inc., ChemDAQ, Chubb Insurance, Cini•Little International, Inc., The Cleveland Group, Cleveland Marble Mosaic, Commercial Appliance Contracts, Inc., Comm-Steel, Inc., Commercial Dock & Door, CRM Construction Services, Inc, Custom Fabricators, Inc, Cuyahoga Concrete Company, David V. Lewin Corp. (ENG), Dependable Floor Products, Desman Associates, Doan Pyramid Electric, Drake Construction Company, DS Automation GmbH, Dukor Mechanical, Inc., EA Group, Elite Sprinkler Design & Consulting, Forest City Erectors, Inc., Formwork Systems Corp., Fulton & Associates Balance Co, Fox Fire Protection, Franck & Fric, Inc., Form Tech Concrete Forms, Inc. (Div. Of Williams Conc), FROG Navigation Systems, Howard Concrete, Integrity Services, Inc., JP Morgan Construction Risk, Karpinski Engineering, Lawson, LYNX Product Group, Marous Brothers Construction, Michael Benza & Associates, Inc., McKinney Drilling Company, Mike McGarry & Sons Inc., Mr. Excavator, Ohio Pressure Grouting, Pedigo Products, Inc., Peri Formwork Systems, Inc., Playhouse Square Foundation, RAM Construction/Western Waterproofing, Rayhaven Equipment Co., Relocation Specialists, Inc., Remstar Systems Inc, SCS Engineers, Solar Testing Laboratories, Inc., Sommer’s Mobile Leasing, Inc., South East Construction, Stanley Magic Door, Inc, Structural Steel / Rittman, Inc. (Mull Iron), Suncoast Post Tension, Synergent Solutions Inc., Technical Assurance, Inc., VIP, Whiting-Turner Contracting Co, Tempico Medical Processing, 3M Health Care, Totally Sanitized Cleaning, United Foundations, Inc., Zaranec Surveying Co.
