Talk about fast track.

Baptist Health System of East Tennessee (BHSET) wanted Johnson & Gaylon, a Knoxville, Tenn.-based construction company, to build two hospitals and a medical office building in 20 months.

"Fast-tracking was a business decision," said John Hellmann, administrator of Knoxville's Baptist Hospital West that opened on July 1. "We wanted this hospital open quickly so we could start serving patients."

The $75 million, 260,000-sq.-ft. healthcare facility is on 23-acres adjacent to I-40 and a burgeoning retail complex, and combines a medical surgical hospital, the Women's Hospital and Baptist Medical Plaza (BMP).

J&G was selected to build the facility for its depth of experience in hospital construction. "When J&G says they can do something, I know I can sleep at night," Hellman said.

Using local subcontractors was a priority.

"We're a local organization. We should do as much as we can to support local companies if we expect the community to support us," Hellman added. Bill Gardener, J&G project manager, said finding local and regional subs for the project was easy because health care is a significant aspect of Knoxville's economic base.

Jim Bush, J&G chairman of the board, said that, from the beginning, everyone bought into the fast-track schedule. "There was a commitment from the owner, architect and our team, including subs," he added.

The project's rapid construction meant J&G was working while Knoxville architect McMurry Barber completed schematics and the design. Gresham Smith and Partners of Nashville also were architects on the project.

"This allowed us to get input on constructability and costs early," said Scott Seaman, vice president and project manager for the Knoxville firm of Lawler Wood Group LLC, which represented the hospital. I. C. Thomasson Associates Inc., with offices in Knoxville, was the project engineer.

To accelerate work, the 3,000-sq.-ft. mechanical plant was constructed separately from the main project. Concurrently, a geo-grid retaining wall foundation was installed, eliminating the time-consuming drilling and pouring of caissons, Bush said.

Structural steel was chosen for its speed of erection and ability to accommodate expansion. The skeleton was designed as four structures, including the Women's Hospital, the medical office building and two structures for Hospital West. As one facility was going up, subs were hanging gypsum board in another.

Alucobond composite panels, plus brick and glass, were chosen for the exterior. In several interior areas, structural columns are exposed.

Chuck Griffin, architect on the project, said, "This allowed us to pass a curtainwall of glass closely to the columns. The columns visually float behind the glass. Fireproofing was achieved using intumescent paint with an architectural finish."

With floor-to-floor dimensions of 16 ft., the space above the ceiling accommodates the HVAC, plumbing and electrical services, plus communications wiring and a pneumatic tube system. In anticipation of expansion, two shell floors were built on top of Women's Hospital and one on Hospital West.

"Every canopy roof was designed as a 'V' to allow maximum height at the dropoffs for fire truck access and to create a dynamic and exciting shape," Griffin said. A thin membrane roof emphasizes the contemporary appearance.

"We wanted to expose the structural components of the canopies and had to work diligently to find ways of integrating the gutters and downspouts so that they wouldn't be seen, or at the very least act as complimentary components of the architecture," he added.

"We wanted to achieve an ethereal effect along the Main Street corridors (which overlooks a 150-by-29-ft., open air green space between the buildings) and wanted the curtain wall and the ceiling to look completely independent, as if the ceiling was floating and the curtain wall continued up the building face. Early discussion about sequencing was essential (to achieve this effect).

"The gypsum board had to be in place and painted before the curtain wall went up because of the tight clearance between the two. There's approximately 5 in. between the gypsum board and the interior face of the curtain wall."

A garden is accessible from both hospitals and the office building. Windows from all facilities overlook the space, which includes fountains, seating, landscaping and a walking path.

A 4-ft. by 28-ft.-wide stained-glass window at one end provides a focal point for a chapel and a contrasting texture to the walls of clear glass.

To ensure the facility's functionality, McMurry Barber constructed full scale, mock-up rooms for hospital staff to preview and critique. "Their input helped in the making of decisions about specifics such as the locations of outlets, TVs, toilet rooms, countertops etc.," Griffin said.

"We built a typical labor, delivery, recovery and post-partum room and a typical patient room. They were helpful in showing staff how some of the equipment could be stored in casework out of patient view."

The hospitals share key ancillary services such as imaging, materiel management, pharmacy, diagnostic laboratory, laundry, mechanical plant and food service. Portions of imaging and surgery also are shared.

Hospital West includes emergency, cardiology, oncology, general surgery and outpatient services. With 75 beds, it has six intensive care beds and seven so-called step-down beds for patients who move from the ICU, but still require a high level of care and monitoring.

The Women's Hospital has 16 beds, including 10 labor, delivery and post-partum rooms plus six general medical surgical beds. The first specialty women's hospital in the region, it provides maternity care, gynecologic treatment and surgery, oncology, breast health and mammography and menopausal treatment. The medical plaza is designed so obstetrics practices are located on the same floor as the Women's Hospital.

"In some cases, BHSET technology choices changed mid-project," said Seaman. "We've had to make modifications to the design to accommodate these." As the project approached completion, vendors installing diagnostic equipment and other technology vied with construction workers for space and time.

Bush said projects with tight time schedules are increasingly the rule. "Owners are becoming more in tune to the use of money," he added. "We're seeing more pressure to meet schedules than a while ago. But this has been a good project because we took a challenge and made it happen. It was a teamwork atmosphere."