PHILADELPHIA, Pa. — Array Architects recently reconvened a group of healthcare facility leaders to continue their discussion on alternative delivery methods. At the top of the discussion list, the panel noted that capital is often a challenge, therefore health systems have to be creative by finding new methodologies to get a quicker, more cost-effective project. A diverse group of healthcare design and construction professionals were asked what their experiences were with the following project delivery methods.
Integrated Project Delivery Model
In an Integrated Project Delivery model, the owner, project manager, builder and design team are partners with trades brought in early to assist. The necessary components of IPD are team assembly, education, project cost validation, contract negotiations, collaborative interaction and definition of scope. Leaders need buy-in at the administrative level as there tends to be concerns about spending money up front. The mindset is that if the money will be saved in the future anyway, then why invest more at the beginning? Audits are done on the regular basis, but you have to get past this hurdle.
The group talked about best practices of this delivery model, and participants came to the agreement that risk should be defined up front so it is managed effectively throughout the life of the project. There are check points that can be used to keep everything on track. Often times a master plan is used as a guide book and definition of the intent.
Construction Management Model
In a Construction Management model, it is not as much about how the contract is structured, but more about how to bring the team together early as collaboration is still important. CMs and architects can still be brought on immediately to spend energy during the pre-construction stage to help eliminate value engineering. The hope is to never have to open up the contract so there is still a feeling of being a team, not multiple entities working on a project; the entire team is together with a common goal.
Design-Build Model
The Design-Build model also requires early involvement of architects, engineers and even medical equipment planners. Some systems bundle multiple projects into one. There is an initial feasibility study, test fit and programming; then turn it over to the CM and design team.
Hybrid Models
Hybrid Models are IPD methods that are modified. They take on the collaborative approach but with independent contracts, which differs from true IPD. These hybrids can close the gap between projects too small for IPD and very large projects that become onerous under traditional contracts. Like the earlier models, hybrids use incentives based on cost and schedule. Tips to be successful are early involvement, collocation and lots of design participation with the trades and the builder through processes such as Design-Assist.
Design-Assist is when subs are brought in up front during plan and specification development, which will ultimately reduce the time and cost of construction. This is because often times the construction team has suggestions for improvements, so incorporating them early on will ultimately enhance constructability.
It was also recommended to document a pricing process when the contract is put into place, trying ways to get an affordable price, understanding who will have the final word. Also make sure design, process and input from the users stay consistent throughout the process. Don’t just focus on the beginning of the process because different users come on board throughout the project. If changes are desired, team members will know the pricing will change.
All project delivery models have common themes that lead to successful projects. For any delivery method, it is important to understand the goals and then measure against them. Make sure to involve as many people as possible early on including the users, and explain how the process will flow. Conduct training sessions so the team understands how the contract works, and create a matrix to measure goals and successes. Consistency is key for any of these methods.
