July 2, 2014

The Kaiser Permanente Oakland Hospital's towering achievement

Tower construction on top of existing Oakland Hospital, 8/18/1969.

Kaiser Permanente’s original flagship hospital complex in Oakland, now being replaced with a stunning state-of-the art facility across the street, has faithfully served since 1942. And although all institutions experience growth and remodeling, this particular one holds a distinction that others don’t.

When Kaiser Permanente decided to build the distinctive 12-story, 420-bed hospital tower in the late 1960s, they came up with a technical solution that reduced the inconvenience to members. It was built on top of the existing hospital, thus providing almost uninterrupted patient care during construction.

Here’s how the Kaiser Permanente member newsletter described the expansion in 1969:

Buildings have been built over existing buildings before — such as the new Madison Square Garden in New York City — but as far as we know, this is the first time a hospital has been built above an existing hospital. This method of construction was necessitated by the lack of additional land for expansion of the hospital. The present hospital covers 85 percent of the available land, which doesn't leave enough land for conventional construction.

Engineering diagram of tower pilings, 1969
Engineering diagram of Oakland hospital tower pilings, 1969

A temporary equipment scaffold was erected over the low buildings originally built during World War II to handle the huge shipyard worker population; over the course of four months, massive holes were drilled into the open courtyard areas and eight deep pilings were driven into the ground to an average depth of 120 feet. [i]

The complexity of the construction logistics were obvious and flashy, but it should be noted that huge staffing challenges had to be addressed as well. During and after the tower construction, providing a seamless positive patient experience was a herculean task. In an article submitted to the trade publication Hospital Housekeeping, Manuel Perez, executive housekeeper at the Oakland hospital, explained the issues:[ii]

The move itself was projected in minute detail and practiced by participating teams. After the move, work schedules were modernized and inequities were rectified. Results: high morale, improved effectiveness, and opportunity for cost control…Planning and rehearsals before the actual event had prepared all members of the teams. No undue incident occurred. All of the 150 patients who were to be moved were established in their new Tower rooms by three days of continuous work.

Later, as the original building was being upgraded, Perez reflected upon the lessons learned:

As the remodeling goes on, we constantly use techniques that we learned during the move to the Tower. We learned how to organize our efforts, how to work as a team. We learned to get basic information about details, then fit them together so that they function smoothly. We try to do all this at a minimum of cost. We try to achieve a maximum of satisfaction for patients, and for our fellow-workers in all other departments of the medical center. That kind of approach, we intend never to forget.

The original hospital complex is scheduled to be razed at the end of 2015, but the spirit of member service — affordable, quality care — lives on in the new hospital.

More photos of the history of the Oakland hospital here.

[i] Note that Henry J. Kaiser was no stranger to deep piling work. His Bridge Builders firm built the East Bay Substructure of the San Francisco-Oakland Bay Bridge – the 21 piers between Yerba Buena Island and the Oakland shoreline. This was no simple task, and included digging E-3, “the deepest pier known to man,” located 1,400 feet west of Yerba Buena Island and embedded 242 feet below the surface of the bay. This contract was completed December 24, 1934. See story here.

[ii] "Facility report: Kaiser Foundation Hospital Oakland - Moving into a Tower Addition," manuscript by Manuel Perez, Oakland Hospital Executive Housekeeper, 11/27/1973.