With a military veteran population of about a quarter million and another approximately 80,000 active-duty personnel in the San Antonio area, the new 240,000-sq-ft U.S. Dept. of Veterans Affairs San Antonio Outpatient Clinic provides much needed coordinated care to the region. The facility consolidates health care services in primary care, mental health, specialty care, medical-surgical specialties, diagnostic services, eye care, women’s health, radiology services and pharmacy services. The clinic also offers one of the largest spaces committed to dental services in the entire VA system with 24,000 sq ft of space and 32 treatment and exam rooms.

The project, which broke ground in April 2019, is privately owned by U.S. Federal Properties and leased to the Dept. Veterans Affairs for 20 years. To ensure the project met the vision of both the owner and the end user, the design and construction team engaged in a high level of collaboration, transparency, organization and aligning of vision. The team regularly tackled substantial questions about how to meet rigorous and specific federal building requirements in a way that was efficient for every stakeholder.

Photo courtesy of Jacobsen Construction Co.

Delivery and installation of critically important medical equipment was affected by delayed fulfillment of vendor purchase orders. However, the project team resequenced tasks to minimize schedule impacts. For example, many typical early-stage tasks in the MRI suite needed to be delayed because of uncertainty over who the VA would select as the MRI equipment vendor. In response, the project team created a comprehensive plan to fast-track typically early-stage tasks as soon as the MRI equipment specifications were known. As a result, the project saw minimal impact to the overall schedule.

As a medical facility, utility work that included the installation of plumbing, electrical, surgical gases, patient room controls, security systems and fire safety systems proved to be the most demanding part of the project. Building information modeling was used extensively for clash detection and task planning. Utilities included installation of a powder-based fire sprinkler system called FM200, which minimizes water damage to the building in the event of a fire. To comply with local fire regulations, a wet sprinkler apparatus was also installed as a backup to the powder-based system.

Photo courtesy of Jacobsen Construction Co.

The project tallied a spotless safety record with no OSHA recordable incidents and no lost-time accidents during 34,621 work-hours. As many as 300 people worked on site at a given time and project-specific safety training was required for all workers with a focus on anticipated risks and mitigation strategies. All meetings were started with a “safety share” by at least one participant describing one way to work safely. Workers were also required to complete a task plan risk analysis every time a worker switched to a new task. Teams were required to conduct safety meetings weekly, taking an in-depth look at one specific safety topic. Decisions about task sequencing and organization were determined first by analyzing how those decisions affected safety.

Despite numerous challenges, including the catastrophic winter storm of February 2021, the project was completed on time and on budget in August 2021 and already serves up to 1,000 patients daily.