Collaboration, Data-Driven Procurement Creates Healthcare Space’s Inspiring Transformation

Challenge: Atlanta Organizations Unite to Focus on Health and Healing

Grady Memorial Hospital, in partnership with the Atlanta Community Food Bank and Open Hand Atlanta, sought to overhaul an empty space into a healthy food hub that would serve the community in a variety of ways. Hospital patients, visitors, staff and neighbors would access fresh and nutritious meal options at an affordable price at the Jesse Hill Market. Patients with chronic conditions would acquire the skills and knowledge they need to change their lives one meal at a time in the Food Pharmacy and Teaching Kitchen. A focus on food and nutrition would help buoy the collective health and overall quality of life for an entire city.

Transforming a parking garage space into a retail market, a working kitchen and private nutrition consultation offices would prove to be a tall order.

Grady Memorial Hospital’s renovation of an unused space into a functioning Food As Medicine hub made such a positive impact on the community that the project won the 2021 Harry Mellon Award of Excellence – Healthcare for outstanding use of Job Order Contracting (JOC). Click here to find out more about the Harry Mellon Awards, including how to submit your exceptional JOC project for this distinguished honor.

Solution: Collaboration and Transparency Keep the Team on Mission

The Grady Facilities Development team contracted Centennial Contractors Enterprises to do the construction work using a Vizient Job Order Contracting (JOC) program from Gordian. A data-driven procurement method, JOC allows construction project owners to complete many jobs using one competitively-awarded contract. A Vizient JOC program offers owners the added security of working with vetted contractors who have healthcare experience. In addition to a portfolio of more than 20 years of healthcare construction, Centennial Contractors has over 30 years of JOC experience.

“[With JOC] You get to focus on solving problems and work with the subcontractors and the owners to accomplish a scope of work. That mentality is perfect for healthcare.” – Jonathan Brown, Program General Manager, Centennial Contractors Enterprises

Jonathan Brown, Centennial’s Program General Manager with 17 years of construction experience, oversaw the project at Grady Memorial Hospital. “We’re a JOC contractor at our core. We started in 1991 with a JOC project at the Pentagon and were a big Federal contractor through the Nineties. As we got into the late 1990s/early 2000s, we began transitioning to being non-Federal JOC contractors and moving to other realms that fit that same model. When you’re a JOC contractor, you’re an extension of the owner’s staff. You get to know what kind of ceiling tile they like, what type of carpet they like. You get ingrained in their operations. You get to work with the customer, not against the customer — it’s non-adversarial. You get to focus on solving problems and work with the subcontractors and the owners to accomplish a scope of work. That mentality is perfect for healthcare.”

Photos: Grady Memorial Health’s Food as Medicine space gives hospital patients, visitors and staff a bright, welcoming place to find nutritious foods. It is open to the public as well.

That does not mean performing construction work in a medical facility is without its risk, Brown explained. The work is highly technical and requires specialized skills. In some instances, patient lives are on the line. Hospitals frequently change their service offerings. Managing JOC programs for healthcare project owners allows Brown to be involved in construction projects early on and ensure the work is done correctly.

“With JOC, I get to scope and plan with the design team to make sure we can deliver a product that will work and allow operations to keep going,” Brown said.

Before the project began, representatives from Grady, Centennial and Gordian walked the 3,800 square-foot space at a site visit so all parties could get on the same page regarding the project scope. This visit, called a Joint Scope Meeting, allowed Gordian and Centennial to find value engineering opportunities to make the most of the project’s budget. Moving the exhaust for the stovetop hood, for instance, resulted in a cost savings of nearly $9,000.

“With Job Order Contracting, change management for the owner is a lot easier, because the unit price book you use to price the job originally is the same book you use to price the changes, so the line items are all the same. There’s no sticker shock for change orders.” – Jonathan Brown, Program General Manager, Centennial Contractors Enterprises

After the Joint Scope Meeting concluded and all Requests for Information (RFIs) were answered, Centennial began building its line-item price proposal in a secure, cloud-based software platform provided by Gordian. Line items in the proposal are priced using a Gordian Construction Task Catalog® (CTC), a customized unit price book containing local prices for construction work. Once Centennial completed their price proposal, they sent it to Gordian for review to ensure that the scope/drawings matched the line-item price proposal and that the quantities entered were correct. This review was useful to Grady, because they had an experienced third party to confirm the accuracy of the pricing and the price proposal contained the necessary tasks to complete the project. Once this step was complete, Gordian packaged the proposal documentation and delivered it to Grady and the architect/engineer for review. Once approved by all parties, Grady issued a Purchase Order to Centennial to begin work.

As tends to happen during construction, the scope of the project changed while work was underway. Fireproofing on the roof of the parking structure needed to be tested and patched. Locks were added to storage cabinets. Conduit was installed. Ceiling tiles were swapped out. These changes were easily made thanks to the Gordian JOC process. The team scoped the work and selected the appropriate construction tasks from the CTC, almost as if each change order was its own mini project. Transparent, preset pricing let the Grady team know exactly how much the work would cost, and the project continued without any delays due to price negotiations.

Brown explained, “With Job Order Contracting, change management for the owner is a lot easier, because the unit price book you use to price the job originally is the same book you use to price the changes, so the line items are all the same. There’s no sticker shock for change orders.”

There were unexpected challenges and delays. Brown’s Centennial team worked with the city to find a workable water line to tap into, a process that required considerable communication between project stakeholders. Work slowed significantly in late winter/early spring of 2020, in the early days of the coronavirus pandemic. Through all the challenges and delays, Grady, Centennial and Gordian worked together to bring the project to completion.

“That’s where it helps to have a contractor as part of the team,” Brown said. “Having a contractor as an extension of the owner’s staff was critical. Without that, this project still wouldn’t be done.”

Photos: The test kitchen and consultation spaces in the Food as Medicine facility gives patients with chronic diseases the skills and know-how they need to manage their conditions with nutrition.

Result: Enhanced Nutritional Health and Increased Financial Opportunities

Grady Memorial Hospital, with the help of Centennial Contractors and Gordian, transformed a worn parking garage space into a $2.5 million state-of-the-art facility. Patients have an immersive hub for learning how to cook healthy meals and shop for groceries, and the local community has access to nutritious food in a warm, welcoming space. The Food As Medicine program is an investment in preventative measures that will have Atlanta living healthier for years to come. But this is not the only community benefit to come of this project.

Using Gordian’s Job Order Contracting as a vehicle, the Centennial team sought out qualified, minority-owned subcontractors to complete over 30% of the work.

Grady Memorial Hospital was able to offer financial opportunities to historically disadvantaged businesses and exceeded their participation/inclusion goals. Using Gordian’s Job Order Contracting as a vehicle, the Centennial team hired qualified, minority-owned subcontractors to complete over 30% of the work.

Centennial’s Jonathan Brown summed up the project nicely. “Everyone benefited from this project in so many ways. Grady staff and patients have healthy food options. Downtown Atlanta is now more food secure. It was a cool project to be a part of.”