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2 Oct, 2012

The System Is Dead (R.E. Mix) - Project-X - Project-X: 1995-2003 (CD)

The head loss is given by: hex'. On the other hand, the entrance from a reservoir to a pipe is an extreme case of a sudden contraction. Figure Entrance loss coefficients 2. This pressure unbalance causes a secondary current such as shown in the figure 2. Both movements together - the longitudinal flow and the secondary current produces a spiral flow that, at a length of around diameters, is dissipated by viscous friction.

The head loss produced in these circumstances depends on the radius of the bend and on the diameter of the pipe. There is also a general agreement that, in seamless steel pipes, the loss in bends with angles under 90o, is almost proportional to the bend angle.

The problem is extremely complex when successive bends are placed one after another, close enough to prevent the flow from becoming stabilized at the end of the bend. Fortunately, this is hardly ever the case in a small hydro scheme. Flow regulation is assigned to the distributor vanes or to the needle valves of the turbine. The loss of head produced by water flowing through an open valve depends of the type and manufacture of the valve. If a sudden change of flow occurs, for instance when the plant operator, or the governor system, open or close the gates too rapidly, the sudden change in the water velocity can cause dangerous high and low pressures.

This pressure wave is known as water hammer, or surge, and its effects can be dramatic. The penstock can burst from overpressure or collapse if the pressures are reduced below atmospheric.

According to Newton's second law of motion, the force developed in the penstock, by the sudden change in velocity, will be: F. If the velocity of the water column could be reduced to zero the resulting force would become infinite. Fortunately this is not possible in practice; a mechanical valve requires some time for total closure and the pipe walls are not perfectly rigid and the water column under large pressures is not incompressible.

The following description, reproduced with the permission of the author, Allen R. Inversin from Appendix F of his "Micro-Hydropower Sourcebook", is one of the best physical explanations of this phenomenon.

Initially, water flows at a velocity Vo as shown in a. When the gate is closed, the water flowing within the pipe has a tendency to continue flowing due to its momentum. This action is repeated by the following elements of water c , and the wave front of increased pressure travels the length of the pipe until the velocity of the water Vo is destroyed, the water is compressed, and the pipe is expanded over its entire length d.

At this point, the water's kinetic energy has all been converted to strain energy under increased compression and strain energy of the pipe under increased tension. Because the water in the reservoir remains under normal static pressure but the water in the pipe is now under a higher pressure, the flow reverses and is forced back into the reservoir again with velocity Vo e. As the water under compression starts flowing back, the pressure in the pipe is reduced to normal static pressure.

However, unlike case a , the water is now flowing in the opposite direction and because of its momentum the water again tries to maintain this velocity. In so doing, it stretches the element of water nearest the gate, reducing the pressure there and contracting the pipe h.

This happens with successive elements of water and a negative pressure wave propagates back to the reservoir i until the entire pipe is under compression and water under reduced pressure j.

This negative pressure wave would have the same absolute magnitude as the initial positive pressure wave if it were assumed that friction losses do not exist. The velocity then returns to zero but the lower pressure in the pipe compared to that in the reservoir forces water to flow back into the pipe k.

The pressure surge travels back toward the gate e until the entire cycle is complete and a second cycle commences b. The velocity with which the pressure front moves is a function of the speed of sound in water modified by the elastic characteristics of the pipe material. In reality, the penstock pipe is usually inclined but the effect remains the same, with the surge pressure at each point along the pipe adding to or subtracting from the static pressure at that point.

Also, the damping effect of friction within the pipe causes the kinetic energy of the flow to dissipate gradually and the amplitude of the pressure oscillations to decrease with time. Although some valves close almost instantaneously, closure usually takes at least several seconds. Still, if the valve is closed before the initial pressure surge returns to the gate end of the pipeline g , the pressure peak will remain unchanged - all the kinetic energy contained in the water near the gate will eventually be converted to strain energy and result in the same peak pressure as if the gate were closed instantaneously.

However, if the gate has been closed only partially, by the time the initial pressure surge returns to the gate g , not all the kinetic energy will have been converted to strain energy and the pressure peak will be lower. If the gate then continues closing, the positive pressure surge, which it would then create, will be reduced somewhat by the negative pressure h surge which originated when the gate originally began closing.

Consequently, if the gate opens or closes in more time than that required for the pressure surge to travel to the reservoir and back to the gate, peak surge pressures are reduced. However, the wave velocity in a pipe - the speed with which the pressure surge travels along the pipe - is a function of both the elastic characteristics of water and the pipe material.

An expression for the wave velocity is:. In practical cases, V can be assumed equal to the initial flow velocity V0. However, if t is greater than Tc, then the pressure wave reaches the valve before the valve is completely closed, and the overpressure will not develop fully, because the reflected negative wave arriving at the valve will compensate for the pressure rise.

In chapter 5, several examples related to penstock design will clarify the above physics concepts. For a more rigorous approach it would be necessary to take into consideration not only the elasticity of the fluid and pipe material above, but also the hydraulic losses.

The mathematical approach is rather cumbersome and requires the use of computers. For interested readers Chaudry, Fox and Parmakian, among others, give calculation methods, together with some worked examples. Water flow in open channels In closed pipes the water fills the entire pipe, in an open canal there is always a free surface. Normally, the free water surface is subject to the atmospheric pressure, commonly referred to as the zero pressure reference, and usually considered as constant along the full length of the canal.

In a way this fact, by dropping the pressure term, facilitates the analysis, but at the same time introduces a new dilemma. The depth of water changes with the flow conditions, and in unsteady flows its estimation is a part of the problem. Any kind of canal, even a straight one, has a three-dimensional distribution of velocities. A well-established principle in fluid mechanics is that any particle in contact with a solid stationary border has a zero velocity.

The mathematical approach is based on the theory of the boundary layer; the engineering approach is to deal with the average velocity V.

Classification of open channel flows A channel flow is considered steady when the depth at any section of the stretch does not change with time, and unsteady if it changes with time. An open channel flow is said to be uniform if the discharge and the water depth at every section of a channel length does not change with time. Non uniform flow is a rare occurrence, and with uniform flow, steady uniform flow is understood to occur. Steady variable flow is often stated as gradual or rapid.

Unsteady flow occurs if either the flow depth, or the discharge, over the length of the canal, changes as, for instance, in the case of upstream propagation of a small perturbation wave due to closure or opening of a valve, or in the case of the discharge increase in a collector channel. The amount of energy loss when water flows from section 1 to section 2 is indicated by hL.

Uniform flow in open channels By definition a flow is considered uniform when: 1. The water depth, water area, and the velocity in every cross section of the channel are constant.

The energy gradient line, the free surface line and the bottom channel line are parallel to each other. Based on these concepts Chezy found that 2. Many attempts had been made to determine the value of C. Manning, using the results of his own experiments and those of others, derived the following empirical relation:.

The formula is entirely empirical and the n coefficient is not dimensionless, so the formulae given here are only valid in S. Furthermore the formulae are only applicable to channels with a flat bottom. The analysis of natural watercourses is more complex and the above formulae can only be applied for first approximations.

Efficient cross-section in open channels From 2. That means the hydraulic radius is an efficiency index. As the hydraulic radius is the quotient of the area A and the wetted perimeter P, the most efficient section will be the one with the minimum wetted perimeter.

Among all crosssectional areas, the semicircle is the one, which has the minimum wetted perimeter for a given area. Unfortunately such a channel, with a semicircular cross section is expensive to build and difficult to maintain, and so is only used in small section channels built with prefabricated elements. Putting aside the semicircular section, the most efficient trapezoidal section is a half hexagon. The most commonly used channel section in small hydro schemes is the rectangular section, easy to build, waterproof and maintain.

In chapter 5 the selection of the channel section is considered from the construction viewpoint, balancing efficiency, land excavation volumes, construction methods, etc. Principles of energy in open channel flows Uniform flows in open channels are mostly steady, and unsteady uniform flows are rather rare. In practice, most of the uniform flows and a large part of the steady varied flows can be considered parallel to the bottom.

The stress distribution is typically triangular. Nevertheless if the water is flowing over a convex path, such as a spillway, the centrifugal flow acts in an opposite direction to the gravity, and the stress distribution is distorted and looks like figure 2.

If the path is concave, the acceleration force is added to the depth and the stress distribution looks like in figure 2. Consequently the resulting pressure head, for water flows along a straight line, a convex path and a concave path is respectively:.

The specific energy in a channel section or energy head measured with respect to the bottom of the channel at the section is: E. The coefficient can vary from a minimum of 1. Equation 2. When the depth of flow y is plotted, for a certain discharge Q, against the specific energy E, a specific energy curve, with two limiting boundaries, like the one represented The vertex point A on the specific energy curve represents the depth y at which the discharge Q can be delivered through the section at a minimum energy.

For every point over the axis E, greater than A, there are two possible water depths. At the smaller depth the discharge is delivered at a higher velocity and hence at a higher specific energy - a flow known as supercritical flow. At the larger depth the discharge is delivered at a smaller velocity, but also with a higher specific energy - a flow known as subcritical flow.

In the critical state the specific energy is a minimum, and its value can therefore be computed by equating the first derivative of the specific energy equation 2.

The parameter Y is known as the "hydraulic depth" of the section, and it plays a key role in studying the flow of water in a channel. Substituting in equation 2. The quantity Fr is dimensionless and known as the Froude number.

In Figure 2. As shown in figure 2. For higher discharges the curve moves to the right and for lower discharges to the left. It can be obtained from equation 2. For a rectangular channel, the critical depth is given by:. Table 2. From table 2. The estimation of the critical depth, and the supercritical and subcritical ones, permits the profile of the free surface to be determined, in cases such as, the sudden increase in the slope of a channel, the free surface upstream from a gate and spillways, etc..

Bibliography 1. Englewood Cliffs, New Jersey 2. USA 3. Streeter and E. Waterhammer analysis. Dower Publications, New York 8.

Calouste Gulbenkian Foundation, King and E. Stream flow records Evaluating stream flows by discharge measurements Velocity-area method Weir method Slope-area method Stream Flow Characteristics Standardised FDC curves FDCs for particular months or other periods Residual, reserved or compensation flow Estimation of plant capacity and energy output How the head varies with the flow and its influence on the turbine capacity Peaking operation Firm energy Flood Control Design Statistical analysis of flood data Hydrological modelling of the catchment area Introduction All hydroelectric generation depends on falling water.

This makes hydropower extremely site dependent. First of all, a sufficient and dependable stream flow is required. Secondly, the topographic conditions of the site must allow for the gradual descent of the river in a river stretch be concentrated to one point giving sufficient head for power generation.

This head can be created by dams or by leading the water in parallel to the river in a waterway with low head losses compared to the natural stream, or very often, by a combination of both. Planning for the exploitation of a river stretch or a specific site is one of the more challenging tasks that face a hydropower engineer, since there are an unlimited number of practical ways in which a river or site can be exploited.

The hydropower engineer has to find the optimum solution for plant configuration, including dam type, water conveyance system, installed generating capacity, location of various structures etc.

When a site has been identified as topographically suitable for hydropower, the first task is to investigate the availability of an adequate water supply. For an ungauged watercourse, where observations of discharge over a long period are not available, it involves the science of hydrology, the study of rainfall and stream flow, the measurement of drainage basins, catchment areas, evapotranspiration and surface geology.

Figure Schematic layout of a hydro development Figure 3. This loss of potential energy occurs regardless of the path along the watercourse or via an open canal, penstock and turbine. The potential energy lost can be converted to power lost according to the equation: The water can follow the riverbed, losing power through friction and turbulence resulting in a marginal rise in the temperature of the water.

Or it can flow from A to B through an artificial conveyance system with a turbine at its lower end. In this case the power will be used mainly for running a turbine, and a smaller part of the power is lost in friction in the conveyance system.

In the latter case it is the power lost in pushing through the turbine that will be converted to mechanical energy and then, by rotating the generator, to produce electricity. The objective is to reduce construction costs while conserving the maximum amount of power available to rotate the generator.

To estimate the water potential one needs to know the variation of the discharge throughout the year and how large the gross available head is. In the best circumstances the hydrologic authorities would have installed a gauging station in the stretch of stream under consideration, and stream flow time series data would have been gathered regularly over several years.

Unfortunately, it is rather unusual for regular gauging to have been carried out in the stretch of river where the development of a small hydro scheme is proposed. If, however, it does happen, then it will suffice to make use of one of several approaches that can be used to estimate the long-term average annual flow and the flow duration curve for the stretch in question these approaches will be explained later. Whether or not regular gauging has taken place, the first step is to do some research, to ascertain if there are stream flow records for the stretch of river in question.

If not, then in other stretches of the same river or a similar nearby river that permits the reconstitution of the time series for the referred stretch of river. Stream flow records In Europe, stream flow records can be obtained from national hydrological institutes. These stream flow records can be of several different types, each useful for the evaluation of the generating potential of the considered site.

Further information can be obtained at www. Figure Measuring the river stage, definitions 3. Evaluating stream flows by discharge measurements If appropriate stream flow time series cannot be found, the discharge should preferably be directly measured for at least a year. A single measurement of instantaneous flow in a watercourse is of little use. To measure the discharge several methods are available: 3. Velocity-area method This is a conventional method for medium to large rivers, involving the measurement of the cross sectional area of the river and the mean velocity of the water through it.

It is a useful approach for determining the stream flow with a minimum effort. An appropriate point must be selected on a relatively straight, smoothly flowing portion of the river to be gauged figure 3.

The river at this point should have a uniform width, with the area well defined and clean. As discharge varies, the top water level termed the stage of the river rises and falls. The stage is observed daily at the same time each day on a board - marked with metres and centimetres.

In modern gauging stations, instead of a board, that requires regular observations, any one of several water-level measurement sensors is available which automatically register the stage.

To calibrate the stage observations or recordings, periodic discharge measurements from the lowest to the highest are made over a time period of several months. Photo 3. Photo Gauging station in a river The correlation stage-discharge is called a rating curve figure 3. To draw this curve, both the stage and the discharge must be simultaneously read. It is strongly recommended that to begin measuring the low flows, one should use the data to draw a curve that correlates the flows and the 'n' Manning coefficient.

Later on the river slope-area method section 3. When a rating curve has been graphically established, based on a number of readings, its mathematical formulation can be readily derived, which facilitates interpretation of the stage readings. The rating curve figure 3. Q3, where Q3 indexes in figure 3. There are ISO recommendations for the correct use of this technique. Measuring the cross-sectional area To compute the cross-sectional area of a natural watercourse it should be divided into a series of trapezoids figure 3.

Measuring the trapezoid sides, by marked rules, illustrated in figure 3. Measuring the velocity Since the velocity both across the flow and vertically through it is not constant, it is necessary to measure the water velocity at a number of points to obtain a mean value.

There are several ways of doing this, two of which are discussed below. A floating object, which is largely submerged for instance a wood plug or a partially filled bottle is located in the centre of the stream flow.

The time t seconds elapsed to traverse a certain length L m is recorded. To estimate the mean velocity, the above value must be multiplied by a correction factor that may vary between 0. The accuracy of this method is dependant on the range of correction factor. By mechanical current-meter. A current-meter is a fluid-velocity-measuring instrument. Current meters are classified in two types:Vertical axis rotor with cups: This type of instrument has a circle of small conical cups, disposed horizontally which rotate about the suspension axis.

The rotor can be repaired in the field. Horizontal axis rotor with vanes propeller : A small propeller rotates about a horizontal shaft, which is kept parallel to the stream by tail fins.

This rotor has the advantage of being less likely to disturb the flow around the measuring point and also for being less likely to become entangled by debris. Each revolution of the propeller is recorded electrically through a cable to the observer and the number of revolutions is counted by the observer, or automatically by the instrument itself, over a short period say 1 or 2minutes.

These observations are converted into water velocities from a calibration curve for the instrument modern instruments, with microprocessor technology will compute this and display it almost immediately. By moving the meter vertically and horizontally to a series of positions whose coordinates in the cross-section are determined , a complete velocity map of the cross-section can be drawn and the discharge through it calculated. In the case of medium to large rivers, observations are made by lowering the meter from a bridge, however, if the bridge is not single-span there will be divergence and convergence of the streamlines caused by the piers, and this can cause considerable errors.

In many instances, however, the gauging site, which should be in as straight and uniform a reach of the river as possible, will have no bridge. In such cases, particularly if it is deep and in flood, a cable to hold a stable boat must be provided, together with a lighter measuring cable to determine horizontal position in the cross-section.

Since the drag on a boat, with at least two occupants and suspended current-meter, is considerable, a securely fastened cable should be used. The presence of suitable large trees at a particular site often necessitates its choice for this reason.

Alternatively, for very large rivers, cableways are sometime used to suspend the meter, directly from a cable car, the instrument in this latter case being positioned by auxiliary cables from the riverbanks or from the cable car itself.

Depths should always be measured at the time of velocity observation since a profile can change appreciably during flood discharges. Observers should also remember such elementary rules as to observe the stage before and after the discharge measurement, and to observe the water slope by accurate levelling to pegs at the water level as far upstream and downstream of the gauging site as is practicable, up to say m in each direction.

As water velocities increase in high floods the weighted current meter will be increasingly swept downstream on an inclined cable. The position of a meter in these circumstances can be found reasonably accurately if the cable angle is measured. Ballast can be increased but only within limits. Rods can be used to suspend the meters but a rigid structure in the boat will then be required to handle the rods, calling for a stable platform on a catamaran-type of craft. Rod vibration and bending are common in deep rivers unless large diameter rods are employed, in which case the whole apparatus is getting very heavy and unmanageable.

By electro-magnetic current-meter. The probe can be mounted on rods and held at various depths or suspended on a cable. It is particularly useful at very low velocities when propeller meters become erratic.

Its sensitivity and lower vulnerability to fouling from weeds and debris make it attractive for use in heavily polluted or weedy streams. Each unit is provided with a surface control box with a digital display and dry-cell batteries.

A set of stainless steel wading rods is also standard equipment. Latest models have built-in battery-charger circuits. It will be appreciated that since each river is unique, a careful assessment of its width, depth, likely flood velocities, cable-support facilities, availability of bridges, boats, etc. The discharge at the chosen measuring point is best obtained by plotting each velocity observation on a cross section of the gauging site with an exaggerated vertical scale.

Alternatively, the river may be subdivided vertically into sections and the mean velocity of each section applied to its area. Usually, the earlier they are involved, the better the result. But even these organisations said they often misinterpreted the real needs of the customer despite great efforts to avoid this. Where project teams are more removed from their users or customers, there is even greater scope for error.

Many innovative ways have been used to obtain this involvement including: G G G G focus groups; facilitated workshops; early prototyping; simulations. Involving the stakeholders is a powerful mover for change, while ignoring them can lead to failure. However, other organisations had taken, or were taking, active steps to improve this discipline across all parts of the business.

There must be project management guidance, training and support for all staff related to projects, including senior managers who sponsor projects or make project-related decisions. Core control techniques identified in the organisations included planning and managing risk, issues, scope changes, schedule, costs and reviews.

Planning as a discipline is seen as essential. If you have no definition of the project and no plan, you are unlikely to be successful. It is virtually impossible to communicate your intentions to the project team and stakeholders. Planning should be seen to be holistic, encompassing schedule, cost, scope and benefits refined in light of resource constraints and business risk Figure 2.

Risk was particularly mentioned: using a staged approach is itself a risk-management technique with the gates acting as formal review points where risk is put in the context of the business benefits and cost of delivery. Projects are risky and it is essential to analyse the project, determine which are the inherently risky parts and take action to reduce, avoid or, in some cases, insure against those risks. Despite good planning things will not always go smoothly.

Unforeseen issues do arise which, if not resolved, threaten the success of the project. The appropriate frequency for the cycle depends on the project, its stage of development and inherent risk. Monthly is considered the most appropriate by many of the organisations although in certain circumstances this is increased to weekly.

From time to time, results, in the form of deliverables, are generated. Completion of activities is evidence of progress but not sufficient to predict that milestones will continue to be met. The project manager should be conCompletion of activities is evidence tinually checking to see that the plan is still fit of progress but not sufficient to for its purpose and likely to realise the busipredict that milestones will ness benefits on time.

Here, the future is more continue to be met. It is a sad fact that many projects are late, or never reach completion. More and more ideas are incorporated into the project scope resulting in higher costs and late delivery. Changes are a fact of life and cannot be avoided. Good planning and a staged approach reduce the potential for major change but cannot prevent it.

Changes, even beneficial ones, must be controlled to ensure that only those which enable the project benefits to be realised are accepted. All the organisations in the study recognise this and have working practices which encourage lateral cooperation and communication rather than hierarchical Figure 2. In some cases this goes as far as removing staff from their own departmental locations and grouping them in project team work spaces.

Generally, the closer people work, the better they perform. Although this is not always practical, closeness can be compensated for by frequent meetings and good communication. Cross-functional team working, however, is not the only facet. It was also seen that decision making has to be on a cross-functional basis.

Decision making and the associated processes was an area where some of the organisations were less than satisfied with their current position. Either decision makers took too narrow a view or insufficient information was available. Another requirement of cross-functional working is to ensure that both corporate and individual objectives are not placed in conflict. For example, one company found that team members on the same project received different levels of bonuses merely because they belonged to different departments.

The more functionally structured an organiThe more functionally structured sation is, the more difficult it is to implement an organisation is, the more effective project management. This is because difficult it is to implement project management, by its nature, crosses effective project management. To make projects succeed, the balance of power usually needs to be tipped toward the project and away from line management see Figure 2. It draws in people from across the organisation who provide their particular expertise and knowledge.

Manufacturing Figure 2. There is often continual competition for scarce resources between projects. One company said that at one time this had reached such a level that it was proving destructive. The impact was often that too many projects were started and few were finished.

I discovered that this problem was dealt with in two separate ways, both of which have their merits. The first Figure 2. In this way the potential conflicts are limited and the decisions and choices are more localised. In fact, the more separate and dedicated you make your resources, the Business Units Business Units Function 1 Function 2 Shared resource Function 3 Shared resource Function 4 Shared resource Shared resource Shared resource dedicated resource Figure 2.

This allows them to deploy the most appropriate people to any project regardless of where they are in the organisation.

It also ensures that there is little duplication of functions within the organisation. This allows quicker and more localised resource management but can lead to duplication of functional capabilities. The down side of such an approach is that you will have to continually reorganise and resize your resource pools to meet demand.

In a fast-moving industry this can mean you may have the right number of people but they may be deployed in the wrong places. It can lead to continual, expensive reorganisations. Most traditional, functionally based organisations follow this approach. The second extreme is to have all staff in a single pool shared and to use effective matrix management support tools for resource allocation and forecasting Figure 2. This method was adopted by the consulting and engineering organisations.

In one case a person may work on up to ten projects in a week and there may be projects in progress at any one time. It is very effective, conceptually simple and totally flexible. Major reorganisations are less frequent but it is also the most difficult to implement in a company which has a strong functional management bias.

In practice, a hybrid between the two extremes will provide the simplicity of purely functionally based organisations with the flexibility of full matrix-managed organisations. The implication is, however, that the resource management and accounting systems must be able to view the company in a consistent way from both perspectives. It is the most flexible way of organising but, without good control systems, is the most complex.

Some could not stress this enough. High emphasis for some meant that between 30 and 50 per cent of the project life is spent on the investigative stages before any final deliverable is physically built. One American company had research data explicAll organisations see the early itly stating that this emphasis significantly stages of a project as decreased time to completion.

Good invesfundamental to success. Decisions taken in the early stages of a project have a far reaching effect and set the tone for the remainder of the project. In the early stages, creative solutions can slash delivery times in half and cut costs dramatically. However, once development is under way, it is rarely possible to effect savings of anything other than a few per cent. Good upfront work also reduces the likelihood of change later, as most changes on projects are actually reactive to misunderstandings over requirements and approach rather than proactive decisions to change the project for the better.

The further you are into the project the more costly change becomes. In all cases, organisations had far more proposals for projects than they could handle. It is, therefore, essential to know what future resources cash, manpower, etc.

It then shows the revenue which will be generated by projects which are currently in progress. The gap between the sum of these and the target revenue needs to be filled.

Clearly, financial planning and resource systems must be able to be updated at any time as projects do not recognise fiscal periods as relevant to start or finish dates. For example, low margin organisations must close the project accounts down to ensure that no more time is spent working on projects which are finished, no matter how interesting! Similarly, component products in an aircraft can be in service long after the project team has dispersed or even well after some team members have retired!

Not to have full records resurrection documents on these critical components for times of need is unthinkable. All the organisations interviewed either have a formal closure procedure or were actively implementing one.

This usually takes the form of a closure report which highlights any outstanding issues, ensures explicit handover of accountabilities and makes it clear to those who need to know that the project is finished.

Another key reason given for formal closure was that it provides an opportunity for learning lessons and improving the processes and workings of the company.

It simply found that if it did not close projects, the list of projects it was doing was just growing by the day. Agree a mark out of 10 and mark the relevant column in the table on p. Compare the answers you receive from the different stakeholder groups. Are there differences? If so, why do you think this is? Which lessons are not being applied? Why not? The previous sections in this chapter described how many organisations use or are moving toward a staged project framework, but that the environments in which they operate are entirely different.

Culture sets out how we behave toward each other, top to bottom and side to side. Structure sets the accountabilities and relationships. Process provides consistency where consistency adds value. Systems make what we do easier, quicker, more reliable and cheaper. Change any one of these and it will impact the others.

Structure and accountabilities Organisation structures vary from pure project to pure functional; this impacts the ease of cross-functional working and project management. In heavily functionally driven organisations, project managers are generally very weak, disempowered and at the mercy of the functional heads of department. In full project organisations, the project managers have greater power and influence over and above heads of department.

In the middle is matrix management. Generally, those organisations which have moved the balance of power away from the line and towards the project, have found project management and cross-functional working more effective and reap greater rewards.

The acceptance of clear definitions of roles, accountabilities and relationships for the key players are most apparent with those organisations which are comfortable with their processes. Some organisations set up cross-functional groups to undertake particular tasks on an on-going basis. The most obvious are those groups which undertake the screening of proposals prior to entry to the project process. In full project structures, the project manager has greater power than the line manager.

This must also apply to any review or decisionmaking bodies which are created. The one most commonly found to be adrift is that relating to financial authorisations. Many organisations have almost parallel financial processes shadowing their project processes, demanding similar but different justifications and descriptions of projects.

This is usually found where finance functions have disproportionate power and act as controllers rather than in an assurance or business partner mode. The better organisations ensured that there was little divergence between decisions required for finance and those relating to strategy.

They make certain that financial expertise is built into the project in the same way as any other discipline, with finance people being included on the project team. Clear accountability for on-going management of the outputs in the line ensures that the right people are involved in the project and that the handover is clean and explicit. Career progression and continuity of employment for people involved in You need your best people to create your future organisation, projects must be a top consideration.

Good organisations ensure that the people who create these changes are retained and that projects are not seen as career limiting and the fast track to redundancy. A large, global company was having difficulty ensuring its people worked cooperatively across department and functional boundaries typical silo behaviour. This had been raised on a number of occasions at senior team level.

One day, the chief executive officer told me he had fixed the problem. There was silence lasting for a full minute. Clearly, this chief executive officer had not fully understood the problem and was merely offloading it onto someone else. Further, he was using a structural solution in an attempt to solve a cultural problem. You will recall Figure 2. It does, however, have a very significant impact on how projects are carried out and how project management is implemented.

For example, the corporate attitude to risk and the way an organisation behaves if high-risk projects have to be stopped will have far reaching effects on the quality of the outputs produced.

One company interviewed explicitly strives to make its own products obsolete as it clearly sees itself as a product leader. It is forever initiating new projects to build better products quicker and more frequently than the competition.

This same company focuses its rewards on teams, not individuals, and takes great care to ensure its performance measurement systems avoid internal conflict. Another company admitted that its bonus schemes were all based on functional performance and not team performance despite 60 per cent of the staff working cross-functionally. These are given almost immediately after the event which prompted the award and are well appreciated.

This same company also has per cent employee ownership and salesmen who are not commissioned. Most of the organisations interviewed encouraged direct access to decision makers as it improves the quality of decisions. As a paradox, those organisations which have the most comprehensive control systems project accounting, resource management, time sheeting, etc.

Senior management does not lose sight of what is happening and always knows who is accountable. Organisations can be very successful without any rational approach to business projects but are unlikely to remain successful for long. If you answered b to d you are probably very functionally driven and projects tend to be difficult to undertake. If you answered e you may be in a very fortunate position to be able to source such key people OR you are in the same situation as b to d.

If you answered a you are probably in a good position to reap the rewards of project working or are already doing so! Debate with your colleagues: what motivates your staff to work on projects? If you answered b to d , do you really expect to have your best people volunteering to work on projects?

Resource management and allocation was found to be a problem for many organisations. Those which found least difficulty centrally managed their entire resource across all their departments so that the departments and the projects used the same core system; only the reporting emphasis was different.

Other organisations had developed systems to cope with what they saw as their particular needs; for example, risk management or action tracking. The American organisations had acquired the practice of constantly validating their processes and systems through benchmarking.

Conclusion The benchmarking study confirmed that: G G The staged framework is widely used for business change projects and is delivering better value than more traditional functionally based processes. This is discussed further in Part Two of the book. A cross-functional, project management-based approach is essential. This is discussed further in Part Four of the book. What is apparent is that the infrastructure which makes projects work varies considerably, in particular the level of information that decision makers have to support them.

For example, it is usually relatively easy to decide if a project in isolation is viable or not. However, if you are to decide which of a number of projects should go ahead based on relative benefits, answers to the following questions are needed: G G G G G What overall business objectives is the project driving toward?

On what other projects does this project depend? What other projects depend on this project? When will we have the capacity to undertake the project in terms of people and other resources? Can the business accept this change together with all the other changes being imposed? If so, when? After what length of time will the project cease to be viable?

The challenge lies in having processes, systems, accountabilities and a culture which address these, both at a working level and at the decisionmaking level.

If this is not addressed it will result in: G G G the wrong projects being undertaken; late delivery; failure to realise the expected benefits. This will be in spite of having excellent processes and tools at an individual project level. These questions are addressed in Part Three of this book. In one company, it was not unusual to find directors reporting to graduates on projects.

The directors are on the project teams to add their particular knowledge and skills and not to lead the project. This company saw nothing strange about this arrangement. The most appropriate people were being used in the most appropriate way. A flat structure? Here are a few examples: Reorganising — either the company or a part of it. Tinkering with your structure is usually NOT the solution to your problems, it just confuses people.

The Romans realised this 2, years ago see cartoon. If you are a senior executive, however, this is a great way to hide non-delivery! Functional thinking — not taking the helicopter, the organisation-wide view. Having too many rules — the more rules you have, the more sinners you create and the less happy your people become. Have you ever met a happy bureaucrat? Disappearing and changing sponsors — without a sponsor there should be no project.

Consider terminating such a project to see who really wants it! If I said that a certain aeroplane is likely to crash, would you fly on it? And yet, every day executives approve projects when a simple risk analysis shows they are highly likely to fail. Dash in and get on with it! High activity levels do not necessarily mean action or progress.

Analysis paralysis — you need to investigate, but only enough to gain the confidence to move on. This is the opposite to dash in and ignore the risks. Forgetting what the project is for — if this happens, terminate the project. If it is that useful, someone will scream and remember why it is being done. He or she may have a helicopter view, but might also have their head in the clouds. Manage your projects within a staged framework.

Place high emphasis on the early stages. Address and revalidate the business aspects of the project throughout its life. How to use Part Two Chapters 3 and 4 are for you to read and understand. The workouts are designed to help you place the project framework in the context of the projects you undertake in your organisation. Chapters 5 to 11 comprise a skeleton project management framework. In these chapters, I explain what happens during each stage of a project and who is accountable.

You can use these directly or adopt and adapt them to meet the particular needs and language for your organisation. Each chapter concludes with a project workout in order to review any projects you currently have: choose the workout which matches most closely the life cycle stage of your project.

Appendix B contains some ideas of how to construct your processes in practice. In the final chapters 12 and 13 I take this basic framework and show how you can apply the principles of the staged approach to match diverse business situations.

Projects, in the modern sense, are strategic management tools and you ignore the newly reborn discipline of enterprisewide project management at your peril. It is fast becoming a core competence which many organisations require their employees and leaders to have. It is no longer the preserve of specialists and the engineering sector, but an activity for everyone.

The problem is that most people simply do not have the right skills. Project management is still seen as a specialist discipline requiring special people who are difficult to find and to retain.

It is fast becoming a Project management is simply applied common core competence which many sense. All organisations say that their most organisations require their important asset is their people although the employees and leaders to have. These organisations provide an environment which enables this to happen. Add to this a few, well-chosen project experts and you have a sound foundation for generating successful projects.

Well-managed projects will enable you to react and adapt speedily to meet the challenges of your competitive environment, ensuring you drive toward an attainable, visible, corporate goal. Most organisations are never short of good ideas for improvement and your own is probably no exception.

However, deciding which of all these good ideas you should actually spend time and money on is not easy. You should consider for selection only those projects which: G G G G have a firm root in your strategy see p. Figure 3. Selecting the right projects will help you achieve your business objectives by realising benefits which support your strategy. The project manager is the person who manages the project on a day-today basis, ensuring that its deliverables are presented on time, at the right quality and to budget.

You want the benefits that will accrue. You and your family do not want all the dust, debris and inconvenience that construction will entail, but you accept this is the price together with the monetary cost you are willing to pay in order to obtain the benefits you seek. By the same token, the architect is more interested in designing and seeing constructed an elegant and appropriate solution that will meet your needs. In a good partnership, sponsorship and management are mutually compatible.

As a project proceeds over time, the amount of money invested in it increases. If none of this money is spent on reducing the risks associated with the project then it is poorly spent. Your objective is to ensure that risks are driven down as the project moves from being an idea to becoming a reality see also pp. The investigative stages are crucial and you should hold back any development work until your investigations show you know what you are doing and have proved that the risks are acceptable.

You do this by using a staged approach where each stage serves as a launch pad for the subsequent stage. In this book I have used five stages, but other models are equally acceptable if they suit the environment and culture of your organisation.

Internal and customer-facing projects Regardless of the organisational context, projects may be undertaken: G G Internally, to fulfil a need within an organisation, where the organisation undertakes a project for itself in order to achieve its business objectives and realise certain benefits. For example, a manufacturer may wish to build a new production plant to produce certain product lines efficiently. For customers, where an organisation or supplier undertakes a project, for payment.

For example a civil engineering contractor would undertake a project for the construction of a bridge, but may have no interest in the bridge once it is handed over. There are primarily two type of organisation commonly engaged on projects: G 52 Promoting organisations, which identify a business, strategic or political need, translate this into a set of objectives and, through project management, produce the outputs and changes to ensure those objectives are met.

A promoting organisation may let out part of the project to a contracting organisation or supplier. The implementing stages, where the promoter and contractor undertake their planned work.

The distinction between promoting and contracting organisations is not always obvious, especially in the case where a contractor undertakes the operation of any outputs from the projects as part of an extended project life cycle. In more complex situations the distinctions should be clear within the contractual arrangements and formal authorities agreed between the parties. Stages and gates Stages Stages are specific periods during which work on the project takes place. These are when information is collected and outputs created.

For each stage in the project, you should carry out the full range of work covering the entire scope of functional inputs required Figure 3. These functions should not work on the project in isolation but in a continuous dialogue with each other, thus enabling the best overall solution to be developed.

Each floor would contain a dif- ferent medical specialty and be linked to the comparable inpatient specialty service in the Whice Building. The ACC would consolidate outpatient clinics , private MGH physicians' offices, ambulatory surgical facilities, laboratories, and other medical sup- port activities , which are now provided at 14 separate locations, into one organizational frame- work and one building.

Yet the ACC would not add any new health care services to those already provided by the hospital, nor would it require additional medical staff. Rather, the proposed center would serve as a means to reorganize and consolidate existing ambulatory care services to provide a single standard of high quality and cost effective ambulatory care. In addition, it would improve the efficiency of health care delivery and reduce the need for long patient waiting times and multiple return visits.

Finally, the ACC would improve the quality of medical education by expand- ing educational programs in primary care and ambulatory referral care.

II-l Prior to issuing the Certificate of Need, the DPH is required - by its own environmental regulations and by those established in Chapter 30, Section 62 of the General Laws of Massachusetts - to consider the potential environmental effects of a planned hospital facility.

This report, submitted in fulfillment of that requirement, is intended to inform decision-makers and the public about the probable environmental impacts of the ACC before it is approved, and to ensure that the MGH use all practical means to minimize foreseeable potential environmental damage.

Working jointly with MGH staff, CSCDC aided in selecting the consultants for technical environmental studies, and coordinated their activities once selected.

In this process, CSCDC 's role was to resolve potential conflicts between the plans for the ACC and the effects of those plans on the physical and social environment, through an open participatory process. To this end CSCDC sponsored two major public meetings to discuss the report and disseminated information through newsletters and public notices. The preceding Chapter I contains a copy of the Environmental Assessment Form, while this Chapter II includes an introduction to the project and a sximmary of its environmental effects.

Following this discussion, the ACC is described in relation to these objectives and estimates are made of its use. II-2 In Chapter IV, Alternatives to the Proposed Ambulatory Care Center, planning criteria are first established which serve as the basis against which three different types of options are des- cribed and evaluated: the no build and delayed build option; alternative uses for the site; and alternative sites for the ACC.

Sites which have been suggested by community residents at public meetings, but which fail to meet the hospital's criteria, are also discussed in this chapter. Chapter V, Description of the Environment, includes a general discussion of the project area and the environmental considerations relevant to it. More detailed information on existing environmental conditions is provided at the beginning of each impact discussion in Chapter VI, Environmental Impacts of the ACC and Mitigating Measures.

In that chapter, the environmental impacts of the proposal to build or not to build hereafter referred to as the proposed ACC build and no build alternatives are assessed in 21 different categories. Each impact discussion begins with a presentation of the criteria used to evaluate the impact being considered and other methodologies concerns unique to the discussion.

The chapter concludes by presenting the measures that will be taken by the hospital or by public agencies to mitigate any potentially negative impacts. In the final Chapter VII, Design and Performance Criteria to Minimize Harm, the planning criteria and control measures presented in Chapter VI are translated into environmental "performance criteria," to be used as standards or guidelines against which the ACC should be evaluated.

In other words , the ACC should "perform" to the level of the criteria. It is intended that the inclusion of these criteria will make it possible to explicitly incorporate environmental considera- tions into the design of the ACC. Under the build alternative, approximately 3 percent more people would visit the hospital daily than visit it now, and these additional people are not ex- pected to increase demand for consumer services sufficiently to warrant new development and altered land use.

By the same token, it is not likely that the additional patients and visitors expected to arrive at the ACC by automobile will impede future development in the area. However, existing traffic II-3 congestion and parking shortages are significant and could constrain future development if measures are not taken to alleviate these problems. Recom- mendations are made in Chapter VII to improve traffic flow and parking. Zoning The need for a zoning variance depends on the design of the ACC and on the interpretation of the zoning regulations.

Under existing conditions, and with a portion of Parkman Street closed, , square feet are available for construction of the ACC without exceeding the FAR floor area ratio of 4, and thereby requiring a zoning variance. The Certifi- cate of Need application assiames that ACC will contain , gross square feet, or , net without mechanical space, and thus a zoning variance would appear to be necessary. However, if the Parkman Street garage is considered an "accessory use" to the ACC, than the ACC site area would be larger, that is, , square feet would be available to construct the project.

Hence the need for a zoning variance will depend on the actual size of the ACC when it is designed, and on the legal interpretation of an "accessory nse.

Grove, Fruit, and Charles streets and Storrow Drive. None of the traffic volumes of these streets exceed the streets' daily capacity, and all but Fruit and N. Grove streets provide an acceptable or nearly acceptable average daily level of service. However, a more critical factor to consider for traffic analysis and plan- ning is that peak hour traffic conditions are congested.

While the roadways themselves appear to have the capacity to provide adequate peak hour service, conditions at the intersections cause traffic flow to deteriorate. The congestion at Charles Circle and Leverett Circle, mistimed and incorrectly installed traffic signals, and illegally parked cars degrade peak hour traffic flow at MGH considerably over what could be provided under optimiam conditions with the exist- ing street system.

Approximately 12, daily visitors to MGH drive more than 4, automobiles. Construction of the ACC would increase the campus population by approxi- mately over the existing 13,, and by over projected campus population of 14, under the no build option. This growth would increase the number of cars to 4,, which is more vehicles arriving at the MGH campus than at present 4, and more vehicles than those projected for the MGH under the no build option 4, The additional II-4 traffic associated with building the ACC would represent a 6 percent increase over existing con- ditions.

These average daily traffic increases would fall within the normal range of daily- fluctuations of street traffic, and would not have a noticable impact on traffic during the peak period. Thus, traffic conditions during peak periods would be comparable to the conditions which exist today.

Fifty-three percent of these. Approximately 1, employees park in the North Station lot and ride the shuttle bus to the campus, while doc- tors park in the Cambridge Street 'and Charles Street garages. The remaining employees, doctors patients, and visitors park either in the Parkman or Fruit street garages which together handle 3, cars per day , or on the street.

At the peak parking period, there is a need for 2, parking spaces which, when compared with the supply of 2, spaces, results in a current deficit of parking spaces. Since the majority of the traffic increase at MGH associated with the ACC would result from patients and visitors both short-term parkers , the increase in demand for parking spaces in would be minimal.

If the ACC were built, the peak parking requirement would rise to 2, spaces, resulting in a deficit of spaces. A number of recommendations Jnave been made to alleviate the parking shortage, under both the build and no build options.

The MGH will investi- gate ways to increase capacity of the North Station lot by improving pavement markings and by in- itiating a valet parking service. Other off-site parking locations will be investigated in the event that the North Station lot is sold to Boston for a new jail site. In addition, the MGH will consider ways to restructure the use of on-campus parking garages to discourage long-term parking. This would force some employees to shift to use of public transportation or car pooling, and would permit use of the Parkman and Fruit street garages by patients and visitors.

A trip-matching service at the hospital would facilitate car pooling and help reduce the parking demand. It is projected that the ACC would exert a demand for 87,, pounds of steam per year. Furthermore, the demand for electricity in the ACC is projected to be 6,, kilowatt hours to operate the air conditioning, lighting, and other equipment.

The Boston Edison Company has indicated that they will be able to satisfy these energy demands. Subsurface Conditions : Geology and Hydrology Preliminary analysis of the siibsurface soil conditions and building geometry has led to the tentative conclusion that the ACC can be founded on a reinforced concrete mat bearing on the stiff clay at the proposed lowest floor elevation.

This construction technique would probably result in minor settlement of buildings, within 50 feet of the proposed ACC, which are supported by the clay stratum - primarily the Clinics Building and the Parkman Street parking garage. The ACC itself would also settle slightly. Based on what is now known of the engineering properties of the underlying soils, these settle- ments would be within tolerable limits for all of these structures.

If more detailed geo- technical studies indicate that these impacts would be adverse, the foundation system would be changed to deep piles, bearing on the under- lying glacial till or bedrock. Thus, no adverse affects on subsurface conditions of adjoining structures are anticipated from construction of the ACC, by either the concrete mat or deep driven pile foundation, provided that careful geologic and hydrologic studies are conducted during the building design.

Natural Resources On the site, there are no mineral deposits of any value and the flora and fauna which are present are only those which accompany human settlement. Construction of the ACC would not affect the natural resources of the MGH campus and would provide an opportunity for additional land- scaping of the Bulfinch Building courtyard.

Noise Level The greatest increase in noise level would occur during. Standard air pile drivers with exhaust mufflers would result in noise peaks of around 95 dBA for approximately 4 weeks.

If a slurry wall excavation technique were used instead, there would be no significant adverse impacts of construction noise. II-6 The construction noise will have the greatest impact on the intersection of N. Anderson and Parkman streets, where a residential building is now located, and in the White Building courtyard. With equipment quieting measures, these locations would experience noise level increases of 10 and 13 dBA, respectively, which would "sound" twice as loud to an observer.

Along N. Grove Street, adjacent to the construc- tion site , observers would be closest to the con- struction and would experience the highest noise level. However, since this area is presently very noisy, construction noise at this location would be less annoying due to the "masking effect" of the already high noise level.

With noise control equipment , the noise levels at the residential building on the corner of N. However, as construction activities moved to the edge of the site nearest that building, the noise levels would, on occasion, exceed these proposed standards.

The one noise problem which remains is the driving of sheet piles during the excavation stage. Al- though the duration of this activity would be very short, it is likely that the proposed noise regulations would be exceeded during this time period. By the time construction begins, this problem could be solved with the introduction of new pile drivers, now in the prototype stage, which use compressed air and are considerably quieter.

Noise would also be controlled by the use of alternate excavation support system, especially the slurry trench system. Both of these alternatives could increase the cost of the foundation, and thus have to be weighed against their benefits. Solid Waste Estimates of the solid waste generated by the ACC have been based on current wastes data from the Clinics Building survey, conducted during January , and the survey of clinic visitation con- ducted for the EIR.

Each patient visit to the Clinics Building generates about. If the ACC were constructed, out- patient visits would be expected to result in a solid waste load of 4.

This would amount to an additional. Much of this increase in solid waste comes from increased use of disposables, rather than from additional patient visits. II-7 Expansion of the hospital's recycling program could reduce the estimated amount of solid waste that the ACC would generate. The MGH currently recycles cardboard and scrap metal, but if the recycling pro- gram were to be expanded to include paper, I. This then would serve to mitigate the effects of both the additional patient visits to the ACC and the increasing use of disposables.

Air Quality See p. D, response 4 The Moseley and Walcott buildings will be demolished by hand, thereby reducing the dust problems asso- ciated with this phase of the project. Excavation of the site and construction of the ACC will pro- duce dust which can be prevented from becoming windborne by wetting with water or calcium chloride. State and municipal air quality regulations re- quire wreckers and contractors to apply reasonable dust control measures.

Between and , the amoiint of carbon mono- xide, hydrocarbons, and oxides of nitrogen in the air will likely decline, and overall air quality is expected to improve. This figure represents only. Estimates of carbon monoxide levels at six sensitive receptor locations show that the traffic presently on the streets at these locations accounts for a very small percentage of the carbon monoxide levels at these sites.

As vehicular controls become more stringent and the fleet of vehicles on the roads is newer, then carbon monoxide levels will improve even more. Utility Infrastructure Existing water main, storm and sanitary sewer, gas, steam, and electric services are densely packed under the street and in open spaces of the MGH campus. Construction of the proposed ACC would slightly increase demand for most utili- ties.

In , construction of the ACC would increase water and sewer usage by Construction would also impact a number of existing utility lines. In the interest of maintaining the flexibility provided by exist- ing interconnections, the sanitary sewer, water main, and gas lines under a realigned Parkman Street will be relocated. Furthermore, the water, sewer, gas and steam lines northeast of the Moseley Building would have to be realigned to clear ACC foundations and maintain MGH service.

During dry weather. Deer Island handles about mgd and the additional load imposed by the ACC would be approximately. During wet weather, the system is overloaded and sewage is dumped into the Charles River. This facility would improve the water quality in the Charles River Basin and Boston Harbor by reducing the frequency, volume and strength of the sewage overflows.

This facility is planned for completion in , two years before completion of the ACC. Aesthetic Impacts Since the ACC has not yet been designed, the analysis of aesthetic impacts has been confined to volumetric and building size effects, rather than questions related to its texture or form.

These effects include scale and massing, views and shadows. Removal of the Moseley and Walcott buildings and construction of the ACC would increase the visual mass of relatively tall buildings on this part of the MGH campus. The effect of gradually increasing height and bulk, reinforced by the stepped tower of the White Building, would be diminished. In- stead, the impression of the MGH as a large, densely developed institution would be made more immediately apparent to the pedestrian, although the actual design could reduce this somewhat by using setbacks.

Removal of the temporary structures in the Bulfinch courtyard would recreate this large open space as a foreground for the building itself. This change would help to set off the Bulfinch Building as an historic area. Views from Beacon Hill down N. Anderson Street to the Bulfinch Building would be slightly improved by the removal of Temporary Building 2 from the Bulfinch Building courtyard.

From a few lower- floor apartments, at Charles River Park, a small portion of the views of the Charles River and Boston Basin would be lost. However, construction of the ACC would have almost no impact on the views from the Blackston Housing Project for the elderly. In winter, the ACC offers a slight improvement in the Bulfinch Building courtyard during the morning, and a slight degradation on sunny afternoons. County Jail. Pedestrian Level Wind Effects Construction of the proposed ACC presents an op- portunity for enhancing the character of the Bulfinch Building by improving its surroundings.

Removal of the temporary buildings now in the Bulfinch Building courtyard would increase the open space in front of the building and create a more appropriate setting for the building facade. Moreover, the ACC itself, by its length and height, would form a backdrop for the Bulfinch Building, which would tend to display it better than do the buildings presently on the site. Thus, the over- all effect of the ACC on this historic site is positive.

Until the ACC is designed and a model tested in a wind tunnel, there is no way to accurately predict pedestrian-level wind effects. However, the configuration shown in the Certificate of Need does fit two situations which have been studied before and which could have potential wind problems. When the wind blows from the west, which it does approximately 8 percent of the time, winds could be accelerated in the court- yard of the White Building as a result of the relationship of the ACC to the Clinics Building.

The amount of the amplification will depend on the design of the building, but could be up to 3 times the free wind velocity in the project area and up to 12 times the protected wind velocity in the courtyard of the White Building.

In addi- tion , if the ACC is constructed with an opening for Parkman Street, pedestrian- level winds could be accelerated through the opening as a result of the pressure differences between the windward and leeward sides of the building. Neither of these impacts are certain, and both depend entirely on the design of the building. A change in the dimensions or orientation of the building and careful design of the ground floor entrance areas could eliminate any pedestrian-level wind problems.

To minimize these risks the building model will be tested in a wind tunnel as it is being designed, and the necessary design changes will be made. Employment The ACC will have beneficial effects on local employment, especially during its construction, but also after it opens. Construction of the ACC will require about 1, man-months of construc- tion effort over a month period. In addition, the ACC would require 30 addi- tional maintenance and security personnel who are not now on the MGH payroll.

Retail Trade The stores in Charles River Plaza, the dominant shopping center in the project area, will benefit slightly from purchases made by the additional patients and visitors at the ACC. Other stores nearer the site which generally cater to the more specialized needs will probably not experience any increased business.

Although it is not possi- ble to estimate the amount of retail expenditure by ACC employees, patients, and visitors, it is certain that these expenditures will be beneficial. At Charles River Park, should 25 physician tenants relocate to the ACC, this could result in a loss of rental income of as much as a quarter of a million dollars a year. However, the vacancy will not occur until , and there is ample time to locate new tenants to offset this economic effect.

In addition, if during construction the hospital were to rent space from Charles Ri. However, the value of commercial property catering to the retail shop- ping needs of ACC employees, patients, and visitors could increase if retail trade were to increase. The entire building would contain a full sprinkle system throughout, and would be designed with crime prevention as an important consideration. Relocation The ACC would not cause any residential or com- mercial relocation.

The only relocation will be that of medical or support facilities associated with the ACC or with the buildings being demolished. D and D for discussion of impact on patient costs. The Massachusetts General Hospital MGH pro- poses to consolidate and upgrade existing ambulatory hospital services by integrating outpatient clinics, private MGH physicians' offices, ambulatory surgical facilities, laboratories, and other medical support activi- ties in a single Ambulatory Care Center ACC.

The Center would house physicians and support personnel providing two kinds of health care: primary and referral. Primary care generally involves an on-going relationship between a doctor and a patient.

For difficult diagnostic and therapeutic problems, the primary care physician recommends referral care, involving sophisticated interaction between one or more specialists, which almost always requires use of testing services such as radiology or laboratory analysis.

The third type of care, episodic care, covers both the acute serious illness or accident which requires immediate attention, and the minor medical or surgical problems which can be treated on a walk- in basis. Such are will be provided in the Emergency Ward and the adjacent Ambulatory Screening Clinic on a round-the-clock basis. Changes in health insur- ance coverage, increased emphasis on preventive medicine and specialist care, and decreased reliance on private physicians have all contributed to this phenomenon.

Clinics visitation has increased stadily from , visits in , to , visits in , or 4. See Table III-l. Emergency Ward visita- tion has grown from 53, per year in , to 75, in Massachusetts D. If one adds the niomber of visits to the neighborhood health centers, the growth rate is even higher. These figures do not include the volume of patient care given in physicians' and surgeons' offices, although growth in this service is probably small, due to the limited space available for private physicians.

Although primary and episodic care have grown rapidly referral care still provides the largest percent of the visits. A survey of ambula- tory care by type of service indicated that referral care was the reason for approximately 55 percent of all patient visits. Primary care accounted for about 32 percent and emergency and eposidic care accounted for the remaining 13 percent.

This information is detailed by number of visits in Table III-2 below. The clinics have been expanded by increasing number of hours of operation, by requiring patients to wait for appointments, and by using all available space.

The clinics are now open two evenings per week, plus Saturday mornings. A patients survey, conducted for this environmental report, indicated that 13 percent of the patients visiting the clinics had waited more than 2 months for their appointments.

Expansion within the Clinics Building, which opened in , has resulted in a maze of corridors and inefficient work space. The clinics are now so busy that patients are subjected to long waits in congested hallways or an overcrowded waiting room, multiple visits for a single diagnosis, and treatment by a different staff of doctors, nurses and technicians during each visit.

III-4 Many patients who might otherwise be crowding the clinics even more are now seeking primary care in neighborhood health centers. These centers provide primary care to local residents in the familiar setting of their own neighborhoods. The small scale of these clinics enables them to provide more personalized service than is possible in the hospital itself. Community residents view these clinics favorably partly for their familiarity and partly because of the backup and referral care provided on the hospital campus.

Table III-3 shows the growth in the use of the MGH-af filiated neighborhood health centers since they began operations. Health Ctr. Major expansion of the East Boston and North End centers is scheduled within the next 2 years. The hospi- tal itself will continue to be the major provider of primary care for the West End, Beacon Hill. The total number of employees, staff, patients, and visitors which are related to in- patient care and research is not expected to grow, and may even decline through modifications to such programs as nurses training.

However, growth in total MGH usage will come about from increased ambulatory services, as described below. It is difficult to reliably estimate growth in MGH outpatient care. Although there are consid- erable historical data and growth projections for hospital inpatient services, little data exist on outpatient activity, and most of these existing outpatient data have been gathered from general community hospitals which do not have the same doctor and patient characteristics as the MGH.

Because the MGH is primarily a specialized research and teaching hospital, doctors only see outpatients on a half-day basis and so the hospital receives fewer outpatient visits than would a general com- munity hospital at the same location. Without construction of a new ambula- tory care facility, the growth in demand for clinic services can be expected to continue at an average rate of 4.

See Figure III This growth rate would lead to , clinic visits annually and 1, daily in See Table III It is likely that this visitation projection is high and, therefore, conservative for the purposes of the EIR , and that it would not be achieved by because of the following underlying assumptions. First, this projection assximes there will be no significant changes in the delivery of outpatient services over the next 5 years if the ACC is not built.

In particular, this projection assumes that expansion of the neighborhood health centers will not curtail growth in patient visits to the MGH campus. In addition, it assumes that the current clinic facilities can accommodate this growth in demand for services.

However, this seems unlikely, due to present limited clinic capacity, since many of the 50 specialty clinics presently operating in the MGH are severely con- strained by both space and hours of operation. During the past few years , experiments have been made to increase hours of operation and, as a rule, more staff were on hand than patients. Thus it seems unlikely that even a 4. However, in the absence of more realistic data, this rate of growth represents a deliberately conservative estimate of the upper limits of growth for out- patient care at MGH.

Not only are clinics severely restrained by this projection, but also private physicians as well. Viva Vivaldi! Heritage From The Father: Episode. Cool Devices 3 Remastered Anniversary Edition.

Cool Devices 4 Remastered Anniversary Edition. Beethoven: Symphony No. Brahms: Symphony No. Bruckner: Symphony No. Gala From St. Petersburg Philharmonic. Rachmaninov: Symphony No. Schumann: Piano Concerto, Symphony No. Urban Striptease Aerobics, Vol. What's New, Scooby-Doo? Dragonart: Drawing Dragons With J. Most Wanted Westerns, Vol. Looney Tunes: Bah HumDuck! AVP: Alien Vs. Predator: Requiem Unrated Version.

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