As hospital ICU beds were filling up with coronavirus patients, Clovis Community Medical Center’s respiratory care reported a chilling fact: the hospital had only 20% of its oxygen reserves remaining. It was mid-December and the COVID-19 patient surge was predicted to get much worse. Already, older, smaller hospitals in the Los Angeles area had run out of oxygen and were scrambling to bring in portable supplies.
Alex Torres, director of facilities planning, construction and plant maintenance at Clovis Community, was listening to the twice-daily COVID-19 update calls when he heard the news. “We typically refill the oxygen tanks once a week during flu season, and once every two weeks during normal operations,” he explained. “In December, we were refilling the tank every other day” due to demands of the pandemic.
The hospital’s bulk oxygen yard was scheduled to be enlarged as part of the $430 million, 4-year expansion and renovation project to add a 144-bed, five-story tower, double ICU space, create six more operating rooms and expand the emergency department. But that part of the project wasn’t slated to be completed until February 2021 — two months too late.
Torres asked Clark Construction Group if they could accelerate their timeline to meet the urgent need.
Expansion essential for increased healthcare access
While many construction projects shut down during the initial lockdown of the pandemic, the Clovis Community expansion forged ahead. Hospital and construction leaders had to figure out how to safeguard construction crews and keep the hospital operating while facing extra challenges. COVID-19 required Clovis Community to expand critical care and isolation areas.
Hospital leaders said there was no thought of pausing. “When we started this expansion, Clovis was one of the fastest-growing cities in California,” said Craig Wagoner, executive vice president and chief operating officer of Community Health System. “The Clovis Community expansion is part of a decade-long strategy to meet the Valley’s growing need for different kinds of inpatient and outpatient care settings — all of which must work together seamlessly.”
Wagoner added, “The challenges of the COVID pandemic have demonstrated the critical need for increased healthcare access and how important it was to continue this project to care for Valley families.”
Over the past year, Clovis Community and Community Regional Medical Center have cared for more COVID-19 patients than all of the 16 hospitals in San Francisco County combined, according to the California Department of Public Health. Annually, Clovis Community admits more than 15,200 patients, performs more than 12,000 surgeries, delivers nearly 4,700 babies and sees 62,000 emergency department visits. In the past decade, the number of patients admitted to the hospital has risen 61% and ER visits have increased by 74%.
Building during pandemic required communication and collaboration
Keeping to Clovis Community’s original expansion timeline required flexibility, increased cooperation and frequent conversations between Clark and hospital leaders. “Every day things were changing, every day we were learning more and more about how the pandemic was affecting the hospital and where they were going to put COVID patients,” said Tyson Johnson, project manager in Clovis Community’s facilities planning and construction department.
Clark coordinated with multiple hospital departments and mapped out patient routes and treatment areas to look for ways to create more separation between construction crews and patients.
Clovis Community in turn helped with health screening of workers at hospital entrances and established on-site COVID testing for construction workers as needed. The hospital’s lab supported the testing to help with quicker turnaround of results. And when contractors struggled to secure face coverings for workers during a nationwide shortage of PPE, hospital leaders helped provide the necessary safety equipment.
Additional N95 respirator masks were key to continuing construction during the summer wildfire season when smoke filled the Valley and the California Division of Occupational Safety and Health (Cal-OSHA) required extra respiratory protection for outside construction workers.
“Safety was a shared priority for our teams,” added Jon Dearinger, Clark’s vice president in charge of field operations on the Phase C project. “The support we received from the hospital was essential to us remaining safe and to making our construction crews feel it was safe to come to work.”
Dearinger said he appreciated that the 300 construction team members have been treated like essential employees and were also provided early access to COVID-19 vaccinations through Community Medical Centers.
Urgent oxygen need prompts heroic efforts
When Clark got the request to move up installation of the oxygen system there was no hesitation. The longtime building partner stepped up and called on its electrical, sheet metal, and oxygen supply subcontractors and helped facilitate approvals needed from the California Office of Health Planning and Development and Cal-OSHA. Together they mapped out an hour-by-hour schedule for crews to follow.
“We were looking all up and down the state and there were numerous hospitals in California that were experiencing oxygen shortages,” said Torres. “We wanted to make sure we were not in that same position.”
During the week construction crews diligently worked, Fresno County made national news headlines for having the fastest-rising coronavirus cases in the nation. In one week, new COVID-19 infections had jumped by 11,672 recorded cases in Fresno County.
Dearinger acknowledged it was a lot to ask right before Christmas when workers were planning to go home to see family. “But we had a lot of people stay behind and jump in on that project,” he said. “I think it was Christmas Eve morning when we actually shut down the hospital system and back-fed it oxygen.”
Clark brought in a 3,400-gallon tanker to feed oxygen into the hospital during the seven hours it took for crews to tie in the new oxygen supply system. Working through the night, the team switched over to a quadruple-sized oxygen tank around 4:30 a.m. and state regulatory agencies signed off on the system later on Christmas Eve. During the whole operation, air pressure and patient care within the hospital was maintained.
“Clark was instrumental in bringing on our new bulk oxygen system online two months ahead of schedule. We completed that work in one week with lots of help from our trade partners,” Johnson praised, listing those partners as New England Sheet Metal, Howe Electric, Praxair and Certified Medical Testing.
Longtime partnership benefits Valley patients
“Clark has served as a trusted partner to Community Medical Centers for nearly two decades. Our ability to navigate the events of the last year, keep this project on track, and support the rapidly evolving needs of this community would not have been possible without the trust and teamwork that exists between our two organizations,” Wagoner said.
Dearinger described the close relationship between the two organizations: “Our west coast healthcare was built around a Community Medical Centers’ job. It was our first hospital job in California and we have more of a family relationship.”
Clark has worked with Community Medical Centers since 2002, constructing or renovating more than 500,000 square feet of medical and support spaces, including the Community Regional trauma center. The construction company is finishing its fifth project on the Clovis Community campus and laid the last steel beam on a new entrance to the hospital in May.
Torres said the expansion project is expected to have a phased opening starting in early 2022. The project includes:
A five-story bed tower with 144 private patient rooms, including 24 ICU beds
Six inpatient operating rooms and two new cardiac operating rooms, and a hybrid operating room with surgical and medical imaging that will be part of a new Heart & Lung Institute
Three new cath labs
Expanded emergency department
Expanded imaging department with new technology
Expanded kitchen and dining, lab and energy plant
A 617-stall parking garage
Clinical and administrative support building
“We are incredibly grateful for Clark’s partnership and leadership, and for the perseverance of our trade partners who helped us move this project forward under extraordinary circumstances,” said Wagoner.
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