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raditional operating rooms are becoming obsolete, as growing surgical teams and the size of modern medical equipment require more floor space and improved infrastructure at hospitals.
Maui Memorial Medical Center recently decided to modernize its cardiovascular care with a new operating room, and selected Arita Poulson General Contracting LLC (APGC) to lead the project.
Brad Espedal, Arita Poulson COO, says Maui Memorial’s need for “a super-modern heart, brain and vascular operating room is driven by the demand for increased precision and patient safety during complex surgeries.
“These rooms utilize advanced imaging, robotic tools and real-time monitoring systems, which facilitate minimally invasive procedures, reduce risks and improve surgical outcomes, ultimately leading to faster recovery times for patients,” he says.
The project team also included architect Marni Tam from Stantec; Pat Miyahara and Ray Nakagawa, Maui Memorial Medical Center regional project manager and building engineering, respectively; Dorvin D. Leis Co. Inc. Project Manager Randal Tanaka; Canon Medical Systems USA Inc. Senior Installation Project Manager Johnnie White, Jr.; and Ronald Toyama, owner of Hybrid Electrical Services Inc.
While the hospital maintained its normal round-the-clock schedule, the team broke ground on the hospital’s Heart-Brain-Vascular Room #2 Alteration project in April 2023.
“Building a new operating room adjacent to existing ones in a functioning hospital presents several challenges,” Espedal says. “Maintaining a sterile environment is critical, as construction activities can introduce dust and pathogens that may compromise surgical areas. This requires stringent containment strategies and frequent air-quality monitoring.
“Secondly, minimizing noise is essential to avoid disrupting ongoing medical procedures. Utilizing low-noise construction techniques and scheduling high-noise activities during less critical times was necessary. Additionally, ensuring continuous hospital operations necessitates meticulous planning to avoid interruptions in utilities and services, which involves close coordination with hospital staff and careful phasing of construction activities.
“Finally, logistical constraints due to limited space and the need to keep emergency pathways clear can complicate material deliveries and worker access, requiring precise scheduling and communication,” says Espedal.
HIGH TECH UPGRADES
The project called for new medical equipment, which influenced the design of the new operating room.
“Canon Medical Systems provided the bi-plane interventional system [two rotating cameras] … and integrated it with a Baxter monitor/perfusion boom [a unit that monitors IV fluids],” says White. “The system was based on new technology, enhanced workflow and optimized exposure dose while delivering high-quality imaging.”
White says he worked closely with hospital staff on designing the operating room space. After receiving the equipment order and during the planning phase of the project, White conducted site visits, answered questions and provided “input to the hospital and construction team to optimize the room’s efficiency and design.”
To facilitate upgrades to new cardiovascular equipment, Dorvin D. Leis Co. Inc. (DDL), the project’s mechanical contractor, provided modifications to HVAC and medical gas systems, and also furnished and installed an integrated Laminar ceiling system.
“[This] is a complete framing system to support HEPA filter diffusers, fill-in panels, light fixtures and ceiling panels,” explains DDL Neighbor Island Operations Manager Mandy Moikeha of the Laminar system.
“This system is manufactured as a complete assembly to fit in a specific area with little tolerance for field modifications,” she says. “[It] required an intense effort of coordination with existing conditions, new structural support, new ductwork and a strict ceiling height requirement for new equipment to be installed.”
OVERCOMING CHALLENGES
The team also had to clear delivery hurdles in order to finish their work.
Abbey Carpet of Maui’s Warren Orikasa provided specialty homogeneous flooring for the project.
“[That] was a special-order item that required several weeks’ lead time,” he says.
Medical equipment is another sector where shipments to Hawai‘i have long experienced delays.
“By working closely with the Maui Memorial facility team, [APGC] and my colleagues at Canon Medical Systems, we were able to plan and arrange the shipment of the equipment directly from Japan,” says White.
Despite the challenges, the operating room project wrapped in June, slightly more than a year after it began.
“APGC is proud to have worked continuously on Maui Memorial projects for over 20 years,” says Espedal.
“[APGC] would like to acknowledge the efforts of Dorvin D. Leis, Canon Medical Systems and Hybrid Electric for their contributions to the project’s success.
“We also appreciate the hard work and dedication from all our team members and subcontractors, as every role and effort contribute significantly to our collective success,” he says.
Says Orikasa: “The team at Arita Poulson was very responsive and timely in addressing every facet of the project. They … aggressively coordinated and directed the project to its completion by providing excellent responses to the hurdles encountered.”
Open communication throughout the project and ongoing check-ins “allowed a coordinated effort by all parties involved with the project,” notes White.
DDL’s Moikeha acknowledges limited access, space constraints in the ceiling and long lead times for equipment created challenges, but says solid teamwork helped ensure project success.
“We are proud of executing this ‘ship in a bottle’ work,” she says.
Maui Memorial Medical Center
Heart-Brain-Vascular Operating Room #2
Subcontractors
Abbey Carpet of Maui (Resilient flooring and base)
B & K Builders General Contracting LLC (Steel)
Canon Medical Systems USA Inc. (Medical equipment)
Dorvin D. Leis Co. Inc. (HVAC, plumbing, fire sprinklers)
Hybrid Electrical Services Inc. (Electrical)
Island Glass Hawaii LLC (Sliding glass doors)
Maui Metal Framers LLC (Light gauge framing and drywall)
Stantec (Architecture)
