IPD, BIM, Lean Construction, and The Seattle Children's Hospital by Jordan Cash

Integrated Project Delivery, Building Information Modeling, Lean Construction And Seattle Childrenâ&#x20AC;&#x2122;s Hospital

By: Jordan Cash University of Washington Department of Construction Management Professor Carrie Sturts Dossick Final Research Paper Fall 2010

Table of Contents Introduction………………………………………………………………….2 Definitions IPD……………………………………………………………………3 BIM…………………………………………………………………...7 Lean…………………………………………………………………...8 The Seattle Children’s Hospital……………………………………………11 Seattle Children’s and IPD…………………………………………..12 Seattle Children’s and BIM………………………………………….16 Seattle Children’s and Lean Construction…………………………..18 Conclusion…………………………………………………………………20 Appendix…………………………………………………………………..22 Works Cited………………………………………………………………...23 Bibliography………………………………………………………………..24

Introduction The Seattle Children’s Hospital is a breakthrough project. Located in Bellevue, WA, this project has used a complex combination of lean construction practices, Building Information Modeling (BIM), and it is one of the few projects to utilize the advantages of Integrated Project Delivery, or IPD. The utilization of these concepts in the design and construction phases of the project resulted in its unequivocal success. But how specifically did these concepts lend a hand to this project’s success? The purpose of this paper is to explore these concepts; highlighting ultimately the relationships these concepts have with one another and defining how each came into play during the process of the project. Before looking at the project itself, it is important to have a clear understanding of the concepts used in the project. As mentioned, the project used a unique combination of IPD, BIM and lean construction practices.

IPD Integrated Project Delivery (IPD) is a fairly new method of contracting and organizing a project. This method has arisen from the need to end the conflicts and opposing mentalities between contract signees that can often be the result of more traditional contract types (ex: design-bid-build). Trends in the industry that have been supporting the transition to alternate methods of project delivery are centered on economics, productivity, and nature of current owner design requirements.i The construction industry is one of the only industries that has not had a significant increase in productivity over the past ten years. The owners of construction projects are becoming increasingly demanding and concise with their requirements for more definitive and profitable results. The response of these trends has resulted in the invention and implementation of IPD. The key component of IPD that sets it apart from more traditional project procurement methods is the presence of a multiparty contract signed by at least the contractor, architect, and owner. Ideally this can expand to include subcontractors, facility managers, and any other potentially important team member. This contract is structured so that each signee’s interests are aligned with the goals of the project itself. This ensures that each member of the IPD team will be less likely to point the finger of blame at one another, instead working collaboratively to solve problems as they arise. The goal of an IPD contract is to create a collaborative environment that includes all key players as early as possible, ideally during the schematic design phase. IPD is more than simply a new form of contract; it should be remembered that it is an entirely new way of approaching a project. The AIA California Council has put together a document titled “Integrated Project Delivery: A Working Definition” in 2007. This document is the result of collaboration between 35 different professionals from the architectural, contracting, sub-contracting, and engineering disciplines, as well as including input from owners and law professionals. It identifies key principles that each member of the collaborative IPD team must adopt in order for the project to be a success, as well as suggestions of business models that should be used for the successful application of IPD.

Key Principles to Adopt The document provides concise outlines of seven principles for adoption by an entire IPD collaborative team. These principles are essential to the success of an IPD project. 1) Mutual Respect Each member of an integrated project team must realize the importance of collaboration when producing a project contracted under IPD. The owner, architect, consultants, contractor, subcontractors, and suppliers must be “committed to working as a team in the best interests of the project”ii. These key participants must be involved as early as possible with multiple disciplines and interests represented. 2) Mutual Benefit The compensation methods must recognize and reward early involvement. Compensation should revolve around the value added to the project by each member, not based upon his or her presence in the project alone. This will ensure that the value achieved will be at a maximum for the client. This is also dependant on the use of innovative business models that will support efficiency and collaboration. Additionally, risk should be shared among members of an IPD team, which lends to the alignment of goals and the promotion of a collaborative environment. 3) Early Goal Definition As each member is involved early on in the design process, each individual’s insight and perspective will be an integrated element. This will result in adoption of project goals at a much earlier stage in the process, which should be clearly defined and understood by each participant. “True value engineering is obtained by collaborative focus on the project goals, including system performance throughout the facility lifecycle.”ii 4) Enhanced Communication Open, straightforward, and honest communication is key for IPD. Because each member is bound to one another through a single contract, vital information will not be withheld between key players. Alignment of goals also means that a “noblame” (source) environment will be established, leading to collaborative “identification and resolution of problems, not determination of liability.”ii 5) Clearly Defined Standards Increased communication must be based upon clearly defined standards. This is key for the success of communication. Technology must be interoperable between all disciplines.

6) Appropriate Technology Cutting edge technologies are of the utmost importance for successful implementation of IPD. As BIM is usually an integral component of an IPD project, the specific programs for use should be clearly defined at project initiation, which will maximize functionality and interoperability. 7) High Performance Ideally, integrated projects “will lead to optimized design solutions, higher performance buildings, and sustainable design”ii. Business Models The Working Definition of IPD also describes the elements of business models that would be more conducive to the success of an IPD project. Traditional design-bidbuild limits contractor and sub-contractor input until after bids are received, which would be far too late for participation in developing the integrated design. This results in requests for information (RFI’s) and change orders, which may cost the project additional money and have the potential to impede progress. While this document does not list any specific business models that would be well suited for IPD, it does state five elements that a business model should include for an IPD project: 1) Promotion of early involvement of key participants. 2) Equitable balance of risk and reward 3) Compensation structures that reward “best for project” behavior, such as “open book” or incentives tied to project success. 4) Clearly defined responsibilities without neglecting open communication and risk taking. 5) Implementation of management and control structures built around team decision-making.ii The AIA California Council has also produced a document titled “Integrated Project Delivery: Frequently Asked Questions.” Written in 2010, this document has been prepared with specific needs and questions posed by architects. This document includes a diagram that effectively represents the differences between design-bid-build and IPD:

The diagram on the left shows the typical organizational structure of a design-bidbuild contract. The solid blue lines from the owner to the architect and contractor represent the two separate contracts that are drawn up between these parties. The dashed lines in this diagram indicate that, although the architect and contractor are not contractually obligated to one another, they do interact with one another in order for the project to be constructed successfully. This interaction does not usually occur until after the contractor has been chosen based on their bid for the construction of the building. The diagram on the right describes the organization of IPD visually. While the traditional ‘triad’ between the owner, architect, and contractor still exists, this diagram represents the contract between all the key players as a three-dimensional cone shape. This corresponds with the single unifying contract that is present in an IPD project. The image on the right shows the contractor, architect, sub-contractors, supplier, facility manager, and engineers on the same plane as one another. This conveys the even ground upon which each of these key players are placed in relation to each other, using the IPD contracting method.

BIM Building Informational Modeling (BIM) is a 3-dimensional digital representation of a building that is used for multiple levels of coordination between the key players involved in the design and construction of a facility. BIM provides a platform through which the MEP subcontractors, structural engineer, architect, and contractor can coordinate to detect clashes and iron out design issues early on in the process before they can become a major setback to the progress of construction out on the jobsite. The term BIM does not refer to any specific computer program, but rather the specific involvement of cross-disciplinary coordination with technology acting as the means. BIM has arisen in response to the inefficiencies related to 2-dimensional drawings.iii It takes multiple iterations of 2D drawings to represent a single 3-dimensional building, and these multiple iterations are subject to error; if an element is changed in a section drawing, for example, that change must be accounted for in the plan and detail drawings as well. The visual language represented in 2D drawings can be read by those who are accustomed to it, and can be confusing to those who arenâ&#x20AC;&#x2122;t. BIM utilizes 3D modeling that is object-based instead of line-based. If one of these objects is changed in plan view, that change carries over to section/elevation/detail views automatically. This means that spatial conflicts in a building model can be checked automatically, reducing errors and change orders. This lends a hand in keeping the quality of a building high and keeping building completion on time.

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Lean In the case of Seattle Children’s Hospital, IPD can be thought of as the ‘backbone’ of the project. Lean and BIM were the supporting tools that helped to make the IPD process successful. Lean is a business management philosophy that was later applied to the construction industry. The following section first defines lean management and then lean construction principles. Lean Management Lean is a management concept that was invented by the Toyota Company in the iv

1930’s . The term “lean” was coined by Jim Womack, Ph.D., in the late 1980’s, at MIT’s International Motor Vehicle Program. The main idea behind lean manufacturing is the heavy emphasis placed on reducing waste while maximizing the value to the customers. The development of this concept was sparked by the Toyota car company’s interest in the Ford Production System during the post-WWII economy. In the 1950’s, the Toyota Motor Company’s chief assembly manager, Taiichi Ohno, began implementing techniques from the Ford Production System to create a modified system that he called the Toyota Production System. Ohno recognized the impact that inventories can have on the capital of a company. A company with a surplus inventory has to spend a lot of revenue for the storage and upkeep of that inventory. Using the concept that Ohno derived, Just In Time (JIT) eliminates the need for vast storage facilities, instead using that money for expansion or for other needs of the company. JIT is just one of a few concepts that lend to the implication of lean manufacturing. JIT is called as such because it uses material ordering principles that result in the materials being delivered onsite the day that they are needed. This means less space needed for inventory, thus less cost to upkeep these storage spaces. The lean principles set in place by Ohno have since been applied to a wide variety of instances, not just limited to the manufacturing industry. This management concept is applicable to “every business and every process”v. It is important to keep in mind that this concept isn’t a business strategy or tactic; it is rather a completely different take on management within a company. The idea of lean management has since been applied to a number of different industries, including the healthcare sector. In the case of Seattle Children’s Hospital, the

specific project in study was an expansion of an existing hospital. The management staff had experience with the application of lean management principles, so it was only natural that they would want to continue this successful management philosophy through to the construction of the Children’s Hospital. Lean Construction Having witnessed the success of lean management principles, the next logical step was to begin to apply these principles to the act of construction itself. Lean construction shares the same goals as lean management/manufacturing: to reduce and eliminate waste while maximizing the value delivered to the client. Historically, the idea of lean production in manufacturing had been denied by constructors because of the fact that a construction project involves many unknowns, and each project presents a unique schedule and cost requirements.vi This is fundamentally different from the mass production of an assembly line, in which the production takes place in a controlled environment with very little unknowns. The principles of lean manufacturing (reducing waste, low production time, and meeting customer expectations) are similar goals in any given construction project. Gregory Howell, director of the Lean Construction Institute, identified the presence of waste in both construction and manufacturing as being derived from the same activity-centered thinking. Lean construction, he points out, shifts this focus to the flow and value of the entire construction process, not just from activity to activity.vi Principles of lean construction should be applied as early as possible, ideally during the design phase. This will ensure that client needs will be identified and addressed early on in the process. Waste should be reduced at the project delivery level, with performance improvements aimed at increasing the total project performance rather than reducing the cost or increasing the speed of a single construction activity. An article written by Construction Business Owner magazine has outlined five reasons why the approach to construction must be rethought, and why lean construction is the answer to these issues. 1) Too much time is spent on the construction site either waiting for the next trade to show up or fixing mistakes. 2) The average construction worker operates at only 40% efficiency. 3) Shortages exist for skilled, qualified workers and it is expected to get worse before it gets better.

4) The return on equity (ROE) for all US industries is 17.9 per cent, while the ROE for the construction industry is only 9.7 per cent. 5) Customers are frustrated with poor quality, confrontation, excessive change orders in quantity and dollar value, scheduling delays and litigation. The traditional design-bid-build procurement method is fundamentally flawed because it does not promote collaboration and instead can pit contract signers against one another. This method uses the lowest-bidding contractor to perform work, without considering value. This is contradictory to a consumer report that reveals that 73 per cent of consumers are value-focused rather than price-focused. Would this not also apply to clients of construction projects? Lean construction can result in increased profit margins, decreased waste and cost.vii

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The Seattle Children’s Hospital The Seattle Children’s Hospital is the main focus of this paper. As previously stated, it is a project located in Bellevue, Washington that has utilized IPD as the main organizing mechanism, with lean and BIM used as tools that helped to streamline the process and facilitate a more collaborative working environment. This project is the first in the Pacific Northwest to utilize IPD contracting. The Seattle Children’s Hospital is a $75 million project that started in 2007 and was completed in 2010. In total, it consists of a 75,000 square-foot addition onto the existing hospital. This expansion was greatly needed for the hospital and included operating rooms and additional patient rooms to accommodate larger volumes of patients who were previously turned away. The main companies associated with the design and construction of this facility were Sellen Construction as the general contractor (GC), NBBJ Architects, and Seneca Real Estate Group acting as the owner’s representative.

Seattle Children’s and IPD University of Washington professors Carrie Dossick and Yong-Woo Kim have worked to generate a case study of this project with the principles of lean, BIM, and IPD in mind. In this document, titled “What Makes the Delivery of a Project Integrated?: A Case Study of Children’s Hospital at Bellevue, WA”, interviews were conducted between the professors and the owner’s representative, the architect, the contractor, and structural engineer. These interviews helped to give the authors of the case study valuable firsthand perspectives from those key members of the IPD process. In the case study, IPD has been broken down into three subsections as a result of the synthesis of data received from the interviews: (1) Contract type, (2) Culture, and (3) Organization.viii IPD: Contract Type In the case of Seattle Children’s Hospital, the contract type used for the IPD method was the Integrated Form of Agreement (IFOA). While IPD is relatively new in the Pacific Northwest, the team members of the IFOA agreement had some past cases and experiences that they could refer to and learn from to help them establish the correct stipulations for the Seattle Children’s. Most notably, NBBJ Architects had worked previously with Sutter Health in Sacramento, California. The Sutter Health project is an example of successful implementation of IPD in a similar healthcare industry project. The integrated team was able to use that contract, spending “close to 80 man hours” to refine it and shape it to work in the situation of Seattle Children’s Hospital. The IFOA in this case was catered to align interests of the individuals of the integrated team with the interests of the project itself, using trust and shared risks/rewards. The most important aspect of the IFOA contract in the case of Seattle Children’s is that the goals of the individuals involved were aligned with the goals of the project itself. According to the architect, this added to the trusting and collaborative atmosphere, “so the motivation there is simply about everybody wanting to do the right thing; what’s right for the project.”. The main signers of the IFOA were the owner, contractor, and the architect; however, the subcontractors, earthwork contractor, structural engineer, facility manager, and many others were involved early on during the design phase of this project. This contributed to the collaborative atmosphere and the level of investment each member of the IPD team

felt towards Seattle Children’s. While this was true, the contractor expressed that if faced with using an IFOA in IPD in the future, subcontractors and other team members should be included in the IFOA document, incentivized so that their rewards would be outlined in the contract. The IFOA, while establishing shared risk and reward between the key players in the IPD team, was also based upon trust and respect between the members. The structural engineer expressed his thoughts on this aspect of the IFOA, stating “there’s a lot greater chance of […] success, when you have everybody working together like that.” This trusting atmosphere, as pointed out by the structural engineer, is a key element to the success of an IPD project. It is important to keep in mind that not everyone is capable of the level of trust that is inherent in an IFOA-contracted IPD project. It is therefore important that all key members of an IPD team are familiar with one another and have worked with each other in the past. The architect reflected upon this, stating: “[T]he IFOA is a relational type of contract, and it is all about trust and respect. So you’re working with either the owner or a contractor, a subcontractors, so engineers that you trust and respect, you want to work with them[.]” This application of the IFOA and its stipulations directly correlate with some of the key principles to adopt, as outlined in the aforementioned AIA document, “Integrated Project Delivery: A Working Definition”. Most notably, the IFOA contract in the case of the Seattle Children’s Hospital provides for the adoption of the first two key principles: Mutual respect and mutual benefit. IPD: Culture One of the greatest aspects of a project that IPD impacts is its culture. As previously stated, traditional methods of delivery can often create adversarial relationships among contract signees, with contract language geared toward outlining litigation processes instead of defining collaboration and teamwork. The contract has been an expression of expectations with ways of holding each signee accountable for their expectations. The IPD IFOA document is more of a communication tool rather than a legal tool. It helps to define goals, teams, and incentives, instead of defining how to protect individuals’ rights and responsibilities.

The traditional design-bid-build process has created atmospheres of conflict, often resulting in signees pointing the finger at one another if a problem arises. The main goal of IPD is to change that atmosphere to one of collaboration, with IPD team members working closely together to come to a conclusion as a team. Each member displays higher feelings of ownership and investment in an IPD project, which contributes to the collaborative atmosphere. Because of this higher level of investment and teamwork, each member is more open and willing to hear one another’s suggestions to solutions to problems as they arise. A contractor or subcontractor, for instance, may have valuable input to the architect because of their experience and knowledge of how building components will physically go together. This collaboration results in the architect refining the design in such a way that facilitates for more efficient construction, as well as a less costly and time-consuming process. Keeping in mind the collaborative culture that IPD stipulates, the culture also must be one of enthusiasm and open-mindedness. The architect commented on this aspect of IPD culture, stating: “[W]e need[ed] somebody to come in and say ‘You know what, I’m excited that you guys want to try this new stuff, I’m eager, and I don’t really know what I’m getting into, but I’m willing to roll the dice and see how this works.’ And because we selected somebody with that kind of mentality, they were able to hop on board right away and say, ‘Hey, I’ve got an opinion, how about this, this will work.’ So everybody felt ownership right off the bat.” This reflects the somewhat experimental nature of IPD and re-enforces the notion that it is still not a broadly-utilized strategy that is still in its infancy. The IPD team members were all willing to take on the new organizational strategies of IPD with Seattle Children’s Hospital. This does not mean, however, that there were no problems with the adoption of IPD. There were multiple instances where the IPD team had to take a step back to make sure they were adhering to the principles of IPD. The IPD team members were consistently encouraging project participants to offer their input, especially when the work in question was outside of their scope by saying “you need to get out of your silo”. This sentiment adheres to the new frame of mind that must be incorporated with an

IPD project. Most of the team members were new to the concept of IPD and the cultural changes it adopts. The team motto quickly became “are we making the project better?” to ensure that the decisions being made were for the betterment of the project, and not just for individual gain. IPD: Organization IPD not only incorporates alternate contracting methods and a new take on the cultural dynamic between its members, but in order for an IPD project to be successful, its organization must be approached differently. In the case of Seattle Children’s Hospital, the IPD contract was a tri-party IFOA agreement between the owner, architect and contractor, but the IPD design core team was comprised of individuals both from the healthcare side of the project as well as the design and construction side. The design core team was comprised of doctors, nurses, strategic planner, supply manager, information technology manager, medical equipment manager, clinical engineer, as well as the architect, contractor, owner’s representative, subcontractors, and structural engineer. Each week this design core team would meet for an entire day, with each of these individuals present in the room. The goals of these meetings were to include the individuals who would actually be using the facility once it was complete. Their input proved invaluable to the process and the ultimately the functionality of the finished project. These meetings were geared to solve design problems with everyone’s input equally valued, while keeping mind the project’s budget and schedule. The presence of this diverse group of individuals in the weekly meetings meant that the right decisions were made early on with respect to design. This made the entire process more streamlined, eliminating the need to backtrack later to address mistakes or incorrect assumptions that would normally be made on a similar project without the use of IPD.

Seattle Children’s and BIM Building Information Modeling is changing the way that buildings are designed and constructed, and is a process that has been gaining momentum throughout the past number of years. The success of projects such as the Seattle Children’s Hospital have added wind to the sails of BIM as industry trends are showing that more companies are making the transition from purely 2-dimensional drawings to 3-dimensional object-based visual communication. BIM was used extensively throughout the design and construction of the Seattle Children’s Hospital. The architect, contractor, and structural engineer all had their own 3D models that were openly exchanged throughout the process of design. In the setting of a traditional design-bid-build contract, models aren’t typically shared between the architect and contractor, but in this setting, the core members of the IPD team didn’t think twice about it. They used the models as a means of relying on one another’s information, increasing overall understanding of the project between every member of the team, long before construction actually began. An important feature of using BIM technology is clash detection. Clash detection uses the multiple 3-D models generated by the architect, contractor, and structural engineer and combines them in one interface to test for any discrepancies between the three models. When clashes occur, collaboration must take place in order to find a viable solution to the problem. The architect reported that they began the process of clash detection using Navisworks as early as possible in the design process, using the tool multiple times as they were designing certain spaces of the building program. This resulted in clash detection being nearly 80% complete by the time the Construction Documents were finalized. In addition to using the models for increased communication and understanding of the project as a whole, the model was also used as a scheduling and pricing tool. The use of Navisworks provided a platform for 4-D modeling, which links construction schedule times with elements of the model, making visible the sequence of construction. As mentioned, the architect, contractor, and structural engineer all had separate models that were shared to address design issues as they became apparent. These models were also shared with subcontractors to help them understand the project and what their contribution to the project entailed. As this understanding increased, subcontractors were

able to better refine their pricing, as well as increase their productivity while reducing waste. The general contractor used their model to communicate to the earthwork contractor the complex details regarding their scope of work, resulting in the earthwork contractor having a better understanding of their work which would have been difficult to convey through traditional 2-dimensional drawings alone.

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Seattle Children’s and Lean Construction Lean construction principles were utilized in a number of ways throughout the process of designing and constructing the Seattle Children’s Hospital. The original project program called for an 110,000 sf facility, but with the onset of the financial crisis in 2008, the project scope was scaled down to the current 75,000 sf total.ix Through the use of lean construction strategies, no aspect of the project scope was sacrificed in order to accommodate for this reduction in square-footage. A large contribution to the success of the project was the use of set-based design. In set-based design, multiple iterations of the design are developed, and the most fitting one will be chosen at the last responsible time. These multiple iterations are intended to explore design options concurrently. For instance, the decision must be made at some point along the design process regarding structure type: one could specify concrete load bearing walls, a steel-framed structure, or wooden frame. In the instance of set-based design, each of these options would be developed at the same time, with decisions made as the project progresses to eventually choose one as the design that will be used in the final building. This strategy is used to explore design options to their fullest extent before they are discarded or deemed inappropriate for the context of the project. Set-based design was used in the Seattle Children’s Hospital, however not without problems. The structural engineer expressed that perhaps too much time was spent developing the concurrent design options, and that at some point a decision must be made. Another significant lean construction strategy that was employed in the Seattle Children’s Hospital was the construction of full-scale mockups of specific layouts of rooms and hallways for the facility. These mockups were constructed in an off-site warehouse, and were not built-up to 100% finished quality for ease of alteration and speed of their construction. Doctors, nurses and staff members were brought in to ‘test’ out the constructed mockups. This process was essentially where the ‘trimming the fat’ notion of lean was applied to the design. Using the full-scale mockups, the designers worked closely with staff members to eliminate all potentially wasted space within the rooms, going so far as to count the number of footsteps it took to move from one room to another. For instance, extra space in a supply closet in a specific operation room was eliminated to make room for only the supplies that would be needed in that specific

situation. This entire process made it possible to reduce the total square-footage of the Seattle Children’s Hospital from 110,000 to 75,000 square feet without sacrificing any of the building’s program.

Conclusion The Seattle Children’s Hospital was an immense success. The backbone of the project was the Integrated Project Delivery method, with BIM and lean principles acting as enabling tools to make the process work smoothly. These strategies allowed for team members to incorporate one another’s suggestions in an ‘equal-ground’ setting, working in a collaborative environment to find solutions to problems as a team instead of in an individualized, cover-only-what-you-areresponsible-for fashion. The IFOA contract established aligned interests, adding to the overall collaborative atmosphere and high level of ownership and investment that each member felt towards the project. The culture was restructured to facilitate the collaborative use of BIM, and the lean principles utilized ensured that the final project delivered would eliminate as much waste as possible, while returning the highest possible value to the client. Please refer to Appendix 1 for a table that further compares Lean, BIM, and IPD. The success of the Seattle Children’s Hospital in Bellevue, Washington signifies a promising shift in the dynamic nature of construction projects. Traditional models of contracting and project delivery can often result in adversarial relationships among contract signers. In order to eliminate this stigma, a more collaborative atmosphere must be adhered to. The question arises: Would the project have been a success without the use of these three strategies? To which the answer would be: Most likely, yes; hospital projects have been successfully designed and constructed in the past using traditional methods. However, through the combined use of IPD, BIM, and lean construction principles, this project was delivered on time, on budget, and with less square footage than what was originally proposed.

Appendix 1 Lean

BIM

IPD

Requires use of computer technologies

Sometimes

Always

Sometimes

Written into contract

Sometimes

Always

Spans entire scope of project

Sometimes

Always

More prominent during design phase

Never. Equally relevant in construction

Sometimes

Always

Requires collaboration between key players More efficient; results in less cost and reduced schedule

Always

Sometimes. (Team is incentivized to meet target cost and schedule, but more efficient results not necessarily an outcome)

Used extensively in the field; has had time to develop as a concept

Always

Sometimes

Never (In its infancy; hasn't been used extensively)

Works Cited i

Autodesk, Inc. "Autodesk Whitepaper: Improving Building Industry Results through Integrated Project Delivery and Building Information Modeling." 2008. Web. 16 Aug. 2010. <http://images.autodesk.com/adsk/files/bim_and_ipd_whitepaper.pdf>.

AIA California Council. "Integrated Project Delivery: Working Definition." The American Institute of Architects, 2007. Web. 25 July 2007. <http://www.kelarpacific.com/resources/Documents/ipd_definition_doc_final_wit h_supplemental_info.pdf>.

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Eastman, Chuck. "Building Information Modeling: What Is BIM?" BIM Resources @ Georgia Tech. Aug. 2009. Web. 17 Aug. 2010. <http://bim.arch.gatech.edu/?id=402>.

"Lean Manufacturing History." Lean Manufacturing Strategy. Web. 29 Sept. 2010. <http://www.strategosinc.com/just_in_time.htm>.

Howell, Gregory A. "What Is Lean Construction." 1999. Web. 16 Aug. 2010.

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Construction Business Owner. "Lean Construction: Maximize Value and Eliminate Waste." Construction Business Owner. Apr. 2007. Web. 15 Aug. 2010. <http://www.constructionbusinessowner.com/topics/general-management/leanconstruction-maximize-value-and-eliminate-waste.html>.

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Dossick, Carrie S., and Yong-Woo Kim. What Makes the Delivery of a Project Integrated? : A Case Study of Children's Hospital at Bellevue, WA. Work in Progress, 2010. Print.

Minich-Pourshadi, Karen. "Go Lean in 2010: Reducing Waste in Construction." HealthLeaders Media for Healthcare Executives - HealthLeaders Media. 4 Jan. 2010. Web. 28 July 2010. <http://www.healthleadersmedia.com/page-2/FIN244358/Go-Lean-in-2010-Reducing-Waste-in-Construction##>.

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