Lobby of new North Alabama Medical Center, Florence, AL

North Alabama Medical Center in Florence, Alabama, tested capacity from the beginning, breaking records starting on the first day when 50 surgeries were performed.

Crossroad of Care: North Alabama Medical Center in High Demand from Day 1

By Greg Bennett

Florence, Alabama, is located on the banks of the Tennessee River and anchors a Quad Cities area that includes nearby towns of Muscle Shoals, Sheffield and Tuscumbia. Florence is home to University of North Alabama and is an educational, economic and medical care hub of the region.

North Alabama Medical Center, Florence, AL

The $230 million facility sits on 25 acres in east Florence, Alabama. The construction project is the second largest in the city’s history.

Photos by Rion Rizzo/Creative Sources Photography

“It won’t be long before we’re looking at expansion and a new, free-standing cancer center. Layton will have my support for those.”

Mike Howard
Chief operating officer, North Alabama Medical Center

For years, the area’s largest and most-used hospital was Eliza Coffee Memorial Hospital, which was built in the 1940s and last had significant updates and renovations in the 1980s. So, after RCCH HealthCare Partners bought the hospital (and a smaller one in nearby Muscle Shoals) in 2010, the company committed to build a new 21st Century facility that would meet the area’s healthcare needs for decades to come.

Alabama is a certificate-of-need state (one of 35 in the country), which means a state regulatory board oversees the approval of new facility construction after determining that the facility is required in a particular area. The process to receive the certificate can be long and involves due diligence by all parties. Such was the case with building what would be eventually known as the North Alabama Medical Center.

Layton’s Commitment to Hiring Local Labor

“The five years we worked through that process allowed the leadership team we selected to improve the quality and grow the hospital,” says Keith Allen, vice president, capital and construction with RCCH HealthCare Partners.

When the certificate of need was granted in 2015, progress toward completion began in earnest, with numerous construction companies answering the call for initial requests for proposal. While Keith was familiar with Layton’s work and was an initial proponent, others were interested in hiring an Alabama-based company to fulfill the work.

Ironically, though, it was Layton’s devotion to the local construction labor market that pushed the Utah-based company to the top of the list.

Patient room at North Alabama Medical Center, Florence, AL

The 263 new patient rooms were seen virtually before they were built physically. Hospital leadership had front-line employees tour the site and make suggestions before construction was completed.

“We felt strongly that we wanted to use local labor,” says Mike Howard, chief operating officer of the North Alabama Medical Center. “Layton not only said they were going to use local labor, but they had done their research and showed how they planned to do it. They were creative and thorough in showing what the local capabilities were and how they were going to use it. It meant a lot to us.”

Layton joined the team, which decided to utilize a design-assist approach that involves key players in the planning stages. Layton partnered with architect Gould Turner Group and other decision makers in developing a plan that would meet the needs of all people using the hospital.

“This allowed us to engage with each other and foster relationships early on in the process,” Keith says. “We saw that we were in this together, with a clear, transparent view to make this successful.”

Layton noticed the synergy early. “It’s not every project that you create the chemistry that gets rid of the line between the owner and the contractor,” says Bill Cofer, senior superintendent for Layton. “On this, the whole team was able to put down those barriers. When we ran into issues, we would have a candid, respectful discussion and quickly move forward.”

John Thomas, senior project manager for Layton, gives much of the credit for this efficient communication to Mike and his team.

“Mike was a good decision maker,” John says. “He was quick and decisive. He would give his directors two days to think about something and then give us a decision.”

Nurses station at North Alabama Medical Center, Florence, AL

The hospital was designed for efficiency. Pneumatic tube systems allow for quicker lab result delivery. Layout makes it clear and easy for visitors to stay in appropriate areas while maximizing staff and physician efficiency.Energy efficiency was also paramount, with decisions made based on making the life cycle costs as low as possible. Early results leave hospital administrators confident that the hospital will be one of the most energy-efficient hospitals in the South.

The early stages involved virtual reality tours of what patient rooms would look like. This Layton technology made adjustments easier, less expensive and less time consuming.

“The ability for the hospital staff to take part in virtual reality walkthroughs was crucial for several reasons,” says Matthew Griffith, vice president and architect with the Gould Turner Group, Inc. “First, the staff was able to get a real-time sense of the scale of their spaces and allowed them the opportunity to fine-tune items such as med-gas, electrical, data and lighting, so there were no surprises when they saw the final built product. The virtual reality was also vital in allowing Layton and the design team the ability to finalize early design decisions and get a head-start on pre-fabrication.”

This devotion to details made completing the work easier, even as challenges arose.

Front-line staff would tour the site throughout the process to assist in any required adjustments and to become familiar with the facility. This helped when the doors opened.

“They didn’t have to spend time even looking for the bathrooms,” Mike says. “They knew the place. They could start fast from the very beginning.”

Which is a good thing.

The facility opened on Dec. 6, 2018, with 131 patients being transported to the hospital from the closing Eliza Coffee Memorial Hospital in about five hours — much quicker than the team planned for.

On the first day the hospital was open, 50 surgeries were performed without a hitch. A usual day would see about 20 surgeries.

“Since the move, we’ve broken every record that we have,” Mike says. “We didn’t ease in. December is typically a busy month for hospitals and we went full tilt from the beginning.”

Even before the hospital officially opened, the public was invited to a grand opening for the long-awaited facility.

“This is a big deal for this community,” Mike says. “During construction, I couldn’t go anywhere without someone asking me about how it was going. The payoff for me was watching people walk in for the first time and just see their jaws drop. It means a lot that the community has embraced it so quickly.”

Media Contact

Bryan Packer
Public Relations Manager
(801) 316-6080

The Details

North Alabama Medical Center

Start Date
November 2016

End Date
Dec. 6, 2018

Total Square Footage

Gould Turner Group, Inc.
Nashville, Tennessee

Key Subcontractors

Greater Georgia Concrete LLC

Delta United

Marathon Electrical Contractors, Inc.

All Commercial Floors, Inc.

Wall Brothers Glass, LLC

MMC Contractors National, Inc.

Coldwater Landscapes, LLC

Charlie Irwin Paining, LLC

All-South Subcontractors, Inc.

Site Work
Carcel & G Construction, LLC

Structural Steel
FabArc Steel Supply, Inc.

Quick Notes

On opening day, 131 patients were moved to the new hospital in about five hours. They were transported by a fleet of 20 ambulances.

The emergency room had people waiting to enter when it opened it’s doors at 7 a.m. on Dec. 6, 2018.

Prefabrication of construction components in the hospital shaved six months from the schedule and saved $2 million in labor costs.