we've had to remain flexible," Butler notes. St. Francis also spent $ 80 million to create a children's hospital facility with 104 new beds and is in the midst of a multiphase project that will create a specialty heart hospital within the main Yale Hospital. Instead of a standalone facility, the new heart hospital will be built as a hospital- within- a-hospital and will be located in space currently used in part for intensive care units inside the system's Yale Hospital. This requires that those facilities be moved; they'll also be expanded at the same time. That in turn requires moving an orthopedics unit. " It's been a real domino effect, with a lot of moving parts that require a lot of coordination and cooperation to happen smoothly," Butler says. In addition to the coordination required, the other major challenge lies in keeping projects moving forward on schedule. " Time is money, not just for us but for the contractors as well," Butler notes. " When you focus on that common goal, it makes it easier to get cooperation." An in- house team of engineers and architects that Butler heads up serves as project managers on the work, and Butler himself keeps a close eye on progress with weekly update meetings on all projects. " It enables us to keep track of what's staying on schedule and what's falling behind and then to quickly address those situations." That has become an issue because Tulsa is enjoying a robust economic time in the construction segment, thanks to the recent surge in oil prices and publicly funded construction endeavors such as a convention center that took three years and significant manpower to complete. " There was a lot of competition for contractors and labor," Butler says. " It hasn't been hard to get contractors, but it has been hard to keep them on the job and get them to devote the resources instead of diverting them to the squeaky wheel all the time." In all, the hospital system has 2 million square feet of space and some 800 beds, plus an 80- bed psychiatric facility on campus. As the shifting of resources takes place, gains are being made and modernizations taking place inside the 1960s- era hospital. For instance, one relocated ICU unit will expand the hospital's number of ICU beds from 30 to 36, in two 18- bed units that are set up more as private rooms than in the original ward- style configuration. " We've been getting good feedback from doctors about the new setup of the ICU units and the way it's all laid out," Butler says. A future project now in the drawing- board stage is an expanded emergency room and trauma facility, one that reflects the hospital's role as a major trauma center for the area. " The emergency room is designed to treat walk- in patients and that sort of thing, but the reality is that we get a lot of ambulance traffic and helicopters flying in," Butler says. The emergency room now cares for 85,000 patients a year, far above the original expected capacity of the facility. " It's a big operation, and it needs space and amenities that match the work being done there." 90 October 08 www. bus- ex. com

October 08 www. bus- ex. com 91 St. Francis Health System Another major project at the facility is a joint venture with the W. K. Warren Foundation, which founded the St. Francis system in 1960 and today directly owns most of the medical offi ce facilities in the system. All the main campus facilities are run from a central physical plant that provides electrical, heating and cooling services. There, an ice vault will be installed that will enable the facility to use off- peak electricity capacity to chill water, which will then be stored in the vault until it is needed during the day. The $ 30 million project has an expected payback period of seven years, based largely on the differential in electric power rates between daytime peak hours and evening rates. The project is feasible, Butler says, because of the size of the system and because the warm climate requires cooling services year- round. That effort is the biggest part of a larger push to increase energy savings through activities such as installing thousands of more effi cient light fi xtures and better regulating motors that operate around the clock. That project and others emphasize the importance of facilities management and improvements to the operation of the system. " I spent a long time on the operations side, so I know what they're trying to achieve in terms of reducing costs and delivering more services even as revenues go down. I'm a fi rm believer that facilities can be a part of the answer for the future of healthcare. Everyone here understands how important it is to have the right facilities at the right time in the right place, whether it's anything from parking garages to a big enough emergency room."