The Integrated Approach to Project Planning, Design and Delivery

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Integrated Information Technology and Health Care
Facility Design Robert Pratt Pratt Design
Studio
The Greater Chicago Chapter (GCC) of
HIMSS Thursday, January 17, 2008 500pm-800pm
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Introductions

• Bob Pratt
• Pratt Design Studio - Chicago
• Masterplanning, Architecture and Interior Design
• 700 Million in Healthcare Design
• NEW PROCESS

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Broken Process Industry Reason Search for
Improvement Solution Case Study
The Story
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Broken Process
Healthcare Construction Costs

• out of control escalation
• availability of qualified labor
• material escalation of commodities
• unpredictable labor and material markets
• increase in complex technology

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Broken Process
Construction Lags Behind Other Industries

• lack of coordination
• rework
• redesign
• claims
• overstock and inventory
• litigation
• lack of vision (future)

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Broken Process
Productivity

• cost going up, productivity going down
• more expensive, less efficient

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Broken Process
Inconsistent Teams Through Forced Synergy

• every project has different players
• no consistent team relationship
• limited growth in body of knowledge
• wasted time during learning curve
• reinvent the wheel
• disregard for interpersonal skills
• transactional instead of relational

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Industry Reason
Productivity

• each part of the process is isolated
• more sequential than parallel
• no integration on the downstream trades
• limited involvement of major trades in
• design or pricing
• the product and process are unrelated
• lack of relationships to each other
• protect and promote individual interests

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Industry Reason
Reason for Current Situations

• insurance segregation
• legal liabilities
• transaction incentives
• system we know

Architect
Owner
Prime Contractor

• Civil
• Structural
• Mechanical
• Electrical
• Plumbing
• Landscape
• Elevators
• Interior
• Parking

• Planning
• Design Review
• Geotech
• Testing
• Commissioning

• Site
• Steel
• Mechanical
• Electrical
• Plumbing
• Framing
• Flooring
• Painting
• Landscape

• - Emergency
• - OB/Infant
• Treatment
• Operations
• Data/Telecom/Tech
• Food Service

- Surgery - Nursing - Admin - Materials - Medical
Equipment
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Industry Reason
Typical Process Construction Management

• CM on board midpoint Schematic Design
• MEP pricing by peripheral subcontractors
• value engineering rather than value
• management
• trade contractors not until final documents
• are bid
• no trade contractor buy in
• separation of design and implementation
• promotes adversarial relationships
• CM and Architect are contractually
• separated

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Traditional Organization
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Industry Reason
In Summary

• miscommunication
• stove piping
• conflict
• cost overruns
• inefficient
• inconsistent team

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PAIN
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Industry Reason
Owners want excellent hospitals they want
projects produced quickly with minimal waste or
disruption
What Owners Want

• maximize value
• minimize waste
• decrease time to market
• innovation and excellence

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Search for Improvement
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Search for Improvement
Search for Solution
The project will succeed or fail on the merits
of the team as a whole. Explain how your project
plan will promote a relational posture of the
team to increase teamwork and output as opposed
to a transactional posture that simply gives a
product for compensation. Identify ideas for
contracting on this project that streamlines the
contracting process and promotes a comprehensive
product through relational delivery vs.
transactional delivery. - Clay Goser

• the RFP Charge
• faster, more efficient and more cost
• effective
• proposed delivery method, not a building
• how do we promote better working
• relationships?
• a request for education on better business
• practices

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Solution
What is the Solution?

• fully integrated team
• Architect, Engineer, Owner, CM, Mechanical
• Contractor and Electrical Contractor
• expansion of the CM concept
• it creates contractual incentive for teamwork
• breakdown barriers between team members
• integrate design and construction on
• project onset

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Case Study
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Teaming Diagram
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IDA Process Diagram
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Traditional Project Schedule
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IDA Project Schedule
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Room Layout for IDA Charrettes
ELECTRICAL
MECHANICAL
STRUCTURE
ENCLOSURE
SCHEDULE
PLANNING
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Case Study
The Benefits

• increase speed
• break down barriers
• promote teamwork
• share solutions
• better team buy in
• forward thinking for future projects
• maximize value
• life cycle optimization
• implementation effects design and vice versa
• increase knowledge of construction disruptions
• comprehensive option development

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Case Study
Traditional Option Generation
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Case Study
IDA Option Generation
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Overview
Five Points

• repeating teams on projects positive thing
• integrating team yields better results
• not a technical, but cultural problem
• owners drive supply and demand
• maximize value for the entire team

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FUN
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Question and Answer