Palo Alto Medical Foundation


Southland Industries installed HVAC, medical gas, and plumbing systems for Sutter Health’s Palo Alto Medical Foundation, an approximately 190,000 square foot medical office building and 12,000 square foot OSHPD-3 Ambulatory Surgery Center in San Carlos, California. The project also included a 370,000 square foot above grade parking structure.

The design-assist project presented a unique challenge as it was significantly reduced in scope late in the planning process, requiring a complete redesign of the air handlers and re-coordination of the piping. Effective collaboration was key to getting all trades working together to formulate the best way to execute the project under the smaller scope.


To accommodate the new plans and maintain momentum, Southland employed a variety of management tools and techniques, including:

  • LEAN methods and an Integrated Project Delivery (IPD) model.
  • A “Big Room” collaboration space where all partners worked together, including the architect, electrical contractor, drywall contractor and the general contractor.
  • Tools like Target Value Design, Last Planner and Pull Scheduling to coordinate activities.
  • 3D BIM to create coordinated clash free drawings that were shared with all the trades, and reviewed by a project foreman or superintendent to ensure constructability.

Southland also influenced design decisions that contributed to a more efficient installation process, such as using prefabricated  boiler skids, medical gas systems, plumbing pipe and ductwork. The team also stacked exam rooms to take advantage of vertically-aligned exam room sinks and associated plumbing systems.


The approach yielded many positive outcomes. The prefabricated system was more accurate, which decreased installation costs and time. The close contact afforded by the Big Room ensured trade partners were aligned and committed throughout the project. And the planning tools resulted in a completed project consistent with all 3D models.

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