The Pavilion Pre-Submittal Conference April 1, 2010

M. D. Anderson Team Leaders Jim Waters, Project Director, Shell and Core Janet Sisolak, Project Director, Interior Build-out Pam Redden, Project Director, Clinical Operations Dan Butterwick, Chief Architect Greg Hudgins, Project Manager Rich Fitzgerald, Design Facilitator Eve Avivi, Interior Planner Mary Mueller, Sourcing & Contract Management

Project Organization

Project Objectives Enhance the front door of M.D. Anderson Cancer Center Add horizontal expansion space to levels 3, 5 and 7 to support Diagnostic Imaging and Perioperative Enterprise, respectively. Provide expansion space for sterile processing and Perioperative clean supply (basement)

Project Objectives (continued) Free up space on the Alkek floor plate to provide more operating rooms and diagnostic imaging suites Ensure new operating rooms are programmed to optimum size based on procedures to be performed and equipment needed

Project Goals Minimize closure of the front door; stage project to facilitate early opening of drive and new lobby Maintain continuous connectivity between the Alkek Hospital and Lutheran Pavilion on all floors Provide future planning flexibility –Long term strategy for Lutheran Pavilion replacement –Programmatic changes –Future bridge to TMC Garage 2

Site Overview

Design Criteria Package

Basement Level Expansion Block Plan

Level 1 & 2 Expansion Block Plan

Level 3 Diagnostic Imaging Expansion Block Plan Level 3 Diagnostic Imaging Expansion Block Plan

Level 4 Interstitial Expansion Block Plan

Level 5 Existing Alkek POE Level 5 Perioperative Enterprise Expansion Block Plan

Level 6 Interstitial Expansion Block Plan Existing Alkek POE Interstitial

Level 7 Perioperative Enterprise Expansion Block Plan Level 7 Existing Alkek I.C.U.

Existing Alkek Mechanical Level 8 P.O.E. Interstitial/ Mechanical Expansion Block Plan

Key Project Considerations Construction Impacts Design Impacts Operational Concerns Downstream Impacts

Construction Impacts Site Logistics/Staging Construction Access Construction Supply - Bates and Bertner Crane Placement & Removal Vibration/Noise Infection Control - dust Safety-dropped loads

Design Impacts Optimizing the site and creating the right front door image –Confirm both the interior and exterior aesthetic design objectives –Confirm impact to both budget and schedule to optimizing the site MEP Issues –Confirm whether capacity in main building will support the addition. Structural Issues –Rotunda bridges can stand alone, to allow Rotunda to be removed –Design to support future bridge to TMC Garage 2

Operational Concerns Keeping the Rotunda drive closed for extended duration Further closure of Rotunda to pedestrian traffic Visitors - Garage 2 Traffic flow (pedestrian & vehicular) along Bates and Bertner Valet Operations – currently operating out of Clark Clinic Patient Discharges – Currently using Emergency Center PT/OT – Continued closure of gardens used for gait training and pet therapy Flooding Exposure

Questions?