All construction projects begin as balancing acts. Whether it's a backyard pool, a new roof on a house or an $83 million expansion of a children's hospital, the wishes, needs and resources of architects, construction workers and those who will use the new space must all be considered during planning and building.
As the senior project manager of planning, design and construction at Arkansas Children's Northwest (ACNW), Robbie Pierson balances the perspectives of all stakeholders in projects connected to ACNW. One of Robbie's favorite parts of overseeing projects is when all parties reach a consensus during planning.
"That's what's awesome," he said. "When everyone comes together, and we're all in agreement. This is our baby. Let's do it."
Three Sites, Six Projects, One Priority
On the day we shadowed Robbie, a Monday in late August, he was monitoring six active projects in three separate sites. In addition to the massive expansion project that will add 72,000 square feet to the region's only hospital devoted to pediatric patients, he oversees projects at the Medical Office Building across the street from ACNW and Harvey Pediatrics Operated by Arkansas Children's, a clinic in Rogers. The project at the Harvey Pediatrics clinic is smaller - the entrance door is being replaced - but it gives a glimpse into the motivation behind all the construction: improving access to care.
Arkansas Children's isn't replacing the door because it's broken. It functions, but the heavy 10-foot-tall door can be challenging to open, particularly on windy days. "You can imagine how tough that is for a parent carrying a 20-lb car seat," Robbie said. Regardless of the project's size or location, the question always on Robbie's mind is - How will patients and their caregivers be impacted?
Making Concrete Cool
Construction crews start early in August to avoid the summer heat, so Robbie's day begins at 6 a.m. He reviews and files emails, including an automatically generated report on a portion of concrete poured for the new foundation at ACNW. The report lists concrete-related data: the pour date, the temperature, the pounds-per-square-inch of pressure it can support, etc. Similar reports are generated every single time concrete is poured. The data trail helps engineers dissect, understand and prevent any issues. To some people, the reports just look like a dry list of numbers, but to Robbie, the underlying process and data is "really cool."
Robbie said his interest in the science behind construction began when he was an 18-year-old plumbing apprentice with a welding internship and a great mentor. "I was like a sponge," he said. His drive to absorb new information led him to ACNW after years as a plumber, plumbing teacher and construction manager at a university. "I'd never worked at a hospital, but what makes this my favorite job ever is I'm always learning. I don't sit stagnant." When he sees a new construction technique or overhears a new acronym at the hospital, he stops to ask questions and learn. "I love it," he said. "I soak it up."
7 a.m. Site Review
Around 7 a.m. every workday, Robbie tours each construction site with his phone in hand. An app prompts him with the same questions about safety and progress every day for each project. Manually responding to the standardized list ensures nothing gets overlooked or forgotten. On-site, he's like a player-coach, sometimes bringing his tools and experience to provide an extra pair of hands when needed. He's on a first-name basis with the contracted construction crew members. These strong personal connections improve communication, an important factor in creating a culture of safety.
Noise or Smell Disruptions
Monday morning meetings set the tone of safety for the week. At 8:30 a.m., Robbie participated in the system-wide safety briefing, teleconferencing with supervisors and the construction team at Arkansas Children's Hospital in Little Rock. Comparing notes helps the team anticipate and prevent potential problems. At 9:30 a.m., Robbie facilitates a similar meeting for the ACNW team in the trailer that serves as the base of operations for the construction crew. Parts of the meeting are routine, another standardized list of questions that build the habit of safety, which include:
- “Does everyone have appropriate personal protective equipment for his or her work?”
- “What do you need from ACNW today to make your job safer?”
Also on the list is:
- “Do we foresee any noise or smell disruptions with our work?”
Asking the question reminds the crew to consider how their work might unintentionally impact patients. Loud noises can be jarring when someone is waking from anesthesia after surgery, and strong smells can trigger nausea or headaches. On this day, the crew has drilling planned near the surgical rooms. Robbie doesn't expect the drilling to be loud or last long, but makes a note to mention it to ACNW's director of patient care services so she can update the surgical team.
The 9:30 safety meeting also includes an impromptu brainstorming session on maintaining the colorful windscreen surrounding the construction site. Strong north winds blew down a section of the screen and the barriers it was attached to over the weekend. The incident didn't cause any injuries, but the team strategized solutions to prevent it from happening again. Like most aspects of a construction project, it involves more stakeholders than you'd expect. The operations team and designers at ACH, leadership at ACNW, the construction crew and the windscreen manufacturer will all have input into the eventual solution. Robbie listens to all perspectives, balancing those voices while considering the impact on patients and families.
Proactive/Reactive
After the morning meetings, Robbie finds the director of patient care services to update her on the drilling. With patient volume rising, she's eager for project progress because it will increase the surgery team's capacity. Robbie's calm demeanor makes him well-suited to ensure all stakeholders have reasonable expectations for construction.
Robbie said his days are split evenly between proactively anticipating and preventing potential issues and reactively responding to unexpected situations like a fallen windscreen. The day we shadowed him included a proactive visit from the architects responsible for designing ACNW's expansion. Periodically, the architects visit the site to compare how construction compares to the drawings made during planning, called renderings. After each visit, they create new renderings with more details. Robbie listens as architects and construction supervisors discuss progress. The news is good because everything is on schedule.
When the expansion is completed, ACNW will increase the number of patient beds by over 50% and be able to serve more patients with acute gastrointestinal, endocrine and orthopedic conditions, among others. The project also includes a pharmacy and expanded infusion center, to treat patients with cancer and other diseases.
Championing Children
With his deep understanding of construction processes, an enduring curiosity for learning about pediatric care, and a genuine desire to balance the perspectives of everyone involved, Robbie Pierson champions children every day.
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