Western Maryland Health Systems Improve Quality of Construction



Western Maryland Health System (WMHS)


CQM / Contractor-owner relations

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Barton Malow and the Western Maryland Health System wanted a software solution that would automate their punchlists and help track thousands of pieces of healthcare equipment being installed in a new hospital. They found their solution in Latista Field, which they will not only collaborate on during construction, but which WMHS will use after construction for building maintenance. Find out why Latista is perfect for owners and contractors from the hospital’s project manager.


Barton Malow and joint venture partner Mascaro Construction Company’s combined expertise in health care construction led to their selection as construction manager on the $227 million Western Maryland Health System (WMHS) in Cumberland, Md. The seven-floor hospital will encompass 585,000 sq. ft. with diagnosis and treatment areas, a mechanical floor, and a patient tower with 275 beds. The three-year project is expected to be completed in October 2009.

WMHS commissioned the hospital to replace two older facilities. The new WesternMaryland Health System Hospital will combine in and outpatient services in one building, implement the latest in medical equipment and information technology, and feature enhanced safety and comfort for patients and families. The facility was designed by Hord Coplan Macht (HCM) out of Baltimore.


Collaboration is the key to success

Barton Malow’s previous experience in the healthcare building sector allowed them to anticipate the need for a comprehensive process and quality management solution. Hospital construction is a complex endeavor. Because of the broad range of diseases and treatment options a hospital will need to prepare for, there are a variety of structural enhancements and systems that will have to be qualified or commissioned, from purified water and air to radiation shielding for x-rays and cancer treatment. Barton Malow’s selected solution would need to be flexible enough to manage a variety of issues on the Western Maryland Health System’s Hospital.

Installing specialized systems also means that there are more subcontractors to coordinate and communicate with as well. “In a normal hospital room there might be as many as 16 different conduits (water, air, electric, data) so there might be as many as eight different contractors,” said Mickey Meredith, Project Engineer for Barton Malow. Managing so many subcontractors means more than simply communicating deficiencies and expectations; Barton Malow also needed clear time-stamp documentation to show that these expectations were received so that they could hold subcontractors responsible for corrections.

It is particularly important in today’s economy that construction companies add extra value to their customers and establish strong working relationships with them. WMHS was very interested in the solution Barton Malow would ultimately choose. As the ultimate owners and managers of the hospital, they were concerned with the quality of the construction and the resulting maintenance of the building. Barton Malow wanted to provide a solution that would keep WMHS informed of progress and let them stay abreast of quality and deficiency correction efforts. When Barton Malow presented Latista to WMHS, the owners agreed to fund its use on the hospital.

Because of the range of issues and the owner’s particular interest in the project, the punch list phase would be of critical importance to Barton Malow. Any solution that would help accelerate the process of collecting, communicating, and resolving issues or that would make the process more accurate would be a great benefit. A faster, more accurate punch list process facilitates a hospital’s opening on time, which means that patient care and associated revenues start sooner.


Latista Field provides transparency, efficiency, and better management

Latista Field proved to be the comprehensive, web-based and mobile software solution Barton Malow and WMHS were looking for. First introduced in 2006 and now in its fourth version, Latista Field automates quality and punch list processes on the jobsite by standardizing inspection language, integrating digital photos and plan markups with inspections, recording dates and signatures for proof, and generating reports and analysis automatically. It reduces time spent in the construction office transcribing inspections, organizing results, and communicating those results, allowing inspectors to work more efficiently in the field.

Barton Malow had nine Latista Field users, three portable tablet PCs, and several laptops on the WMHS Medical Center. Latista Field data on a tablet would be synchronized at the beginning of the day, and the user would be free to walk the job site without worrying about web connectivity. Tablets were completely self-sufficient and combined the tools necessary for an inspection (clip-board, pen, paper, camera, even tubes of drawings) into one lightweight device. At the end of the day, the tablet would be resynchronized and reports could be emailed to owners and subcontractors.

Starting with a “work-to-complete” rolling punchlist, some of Barton Malow’s inspectors were skeptical that carrying around an unfamiliar computer system would be faster than the pen-and-paper system they knew so well. “Okay, I’ll race you,” said Project Engineer Mickey Meredith. With the side-by-side comparison, the inspectors saw that Latista’s all-in-one solution was faster, especially when taking into account the clerical duties eliminated by entering issues into the database directly. The earlier inspections will get the issues found, tracked, and resolved sooner, so that there is no rush at the end of the project. “It’s a lot easier to keep electronic records rather than shuffling papers,” added Meredith. “Our inspectors have probably saved 20 hours a week on retyping alone.”

Latista Field has been a time-saving tool for Barton Malow on the Hospital construction. Issues are easy to enter by writing on the tablet with a digital pen or using standardized buttons for common problems. “As a typical walkthrough, we might go through with plans to check where data drops and electrical are supposed to be. If they’re not, we take a picture, circle it, and enter the issue in the system,” explained Meredith. “Subcontractors aren’t able to say they didn’t know something because the issues are described and there’s a picture and a drawing, and the emailed report went out to six other people.”

Project owners and architects were also given access to the Latista database and have the same privileges as one of Barton Malow’s superintendents. When an inspection’s reports are generated and sent out, owners and other relevant parties are copied on the email to subcontractors. “The owners know everything that’s going on, so there is a lot more trust and transparency,” said Project Engineer Mickey Meredith. Getting involved so early and so thoroughly allows WMHS to follow project progress from start to finish and ensure quality results from subcontractors when correcting construction issues.

WMHS also wanted a way to track the equipment being installed in the hospital, so Barton Malow configured Latista Field as an inventory system. Barton Malow added more than 1,000 equipment serial numbers, everything from MRI machines to latex glove dispensers, to an area-based hierarchy. Each serial number includes a chronology of when the equipment was purchased, brought in, installed, tested, and commissioned. “The equipment tracking that we’ve implemented is an iron-clad record of when all this was done,” said Meredith. “Owners will be able to use this as part of the documentation for turnover and maintenance once the project is finished. They even include warranty information.”


Barton Malow provides quality for Western Maryland Health System

As a result of the improved speed and efficiency of communications imparted by Latista Field, Barton Malow managed subcontractors more efficiently and improved their relationship with the owners of the Hospital. Barton Malow appreciated the ability to email subcontractors with the touch of a button and show them definitively the corrections they would be responsible for. “When there’s a walkthrough, the subcontractors follow with their own systems, and we use Latista both to record issues and to show that the subs were told of the problem that needs to be fixed,” said Meredith.

Barton Malow also used Latista Field to follow up with subcontractors on completed work, to ensure that reports were accurate. “We’re watching the floor leveling process, and we’re using the software to document how much has to be done in each room,” said Meredith. “Latista prevents subs coming to us and saying they leveled 100,000 sq. ft. when we can show them that they only did 50,000.”

“It’s easy to show the owners the progress that we have,” said Meredith about the ease of illustrating reports with digital photos and plan markups. “We can print reports to show even a non-construction person what’s going on with the project, whereas before we’d just be walking around pointing and saying, ‘We’ve done this and this and this.’ Owners have never seen anything like it; they think it’s great.”

WMHS and their architects, Hord Coplan Macht, will use Latista at the end of the project to conduct their own punchlist inspections. “Being able to open up the system to WMHS and HCM shows that we have definite control over our jobsite, definite control over our subcontractors, and that alone is a great return on investment,” said Meredith. “We’ll also be able to see what they’re seeing, so we can do the work and control the subcontractors. When the issues are resolved in a particular area, the work is signed off at the tablet, and there are no liabilities whatsoever. Once it’s finished, it’s finished.”

In fact, WMHS has been so impressed with Latista Field that, once construction and turnover are complete, they will take the tablets and software from Barton Malow to use for building maintenance. “All of the plans, diagrams, and construction issues are already in the system,” pointed out Meredith, “so it will be a great diagnostic and documentation tool should anything come up for the hospital in the future.”

For Barton Malow, having strong collaboration with both owners and subcontractors earlier in the construction process will improve punch list issue resolution and lead to the Hospital being specified and commissioned more quickly, and WMHS can look forward to receiving and opening the hospital as scheduled. “The prospect of turning over a better quality hospital is pretty good for us,” said Meredith, “and Barton Malow will be able to take the software and what we learn here and apply it on future job sites as well.”

Latista Technologies is also pleased with how the software has worked for Barton Malow on the WMHS Hospital project. “We know that hospital and health care projects are all unique and require a very strict regimen of quality during and after construction so that they can be commissioned and certified more quickly,” said Latista Executive Vice President Chris Ramsey. “We provide the tools for contractors, owners, and subcontractors to work together on a daily basis so that a project can finish on time and in budget with a minimum of stress, no matter how sensitive the construction might be. It’s great that Barton Malow and the Western Maryland Health System will both get productive use out of the Latista Field quality solution even after the Hospital is completed.”

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