Capital Project Solutions – May 2010
Integrated Project Delivery Case Study: Hurley Medical Center Greg Weigle, Principal Consultant Josh McVeigh, Consultant Throughout 2010, Capital Project Solutions will run a series of articles dedicated to Integrated Project Delivery (IPD). We will explore all issues related to IPD, from project identification to team selection to contract and incentive development. With three (3) IPD projects currently underway, we will share case studies and lessons learned throughout the series. Last month’s issue explored the team selection process and discussed how it differs for IPD. This month, we will share a case study on Hurley Medical Center. If you should miss any of the articles or to learn more about other strategies to ensure your project’s success, visit KLMK Group at www.klmkgroup.com. There is a common phrase that goes something like – “if you’ve seen one construction project, you’ve seen them all” – implying that all projects are just alike. Not true with hospital construction. Each project is unique in and of itself and thus each requires a distinct approach to delivery. In keeping up with the topic of IPD, our case study on the Emergency Department project at Hurley Medical Center will provide insight to the IPD process and the power of relational based team selection.
Project Scope Background: Hurley Medical Center (HMC) located in Flint, Michigan is undergoing the expansion and relocation of its Emergency Department (ED). The ED will move from its current location on the north side of campus to a combination of renovated space and new space attached to the east side of the facility. A portion of the existing ED will be renovated for the ED's clinical decision unit (CDU). New space in the basement of the addition will house infrastructure and mechanical space for the ED. As part of the expansion, the main lobby and entry to the hospital will be shifted from the north side of the campus to the south side. The new entrance will face towards the downtown area so as to integrate with the city and the primary approach to the campus. 1
Capital Project Solutions – May 2010 The vehicular traffic will be segregated allowing easier access for traffic.
On the Ground Floor, there will be approximately 29,000 square feet (sf) of new contruction and 25,000 sf of renovation. On the basement level, there will be 14,000 sf of new construction which includes mechanical space, electrical space and unfinished shell space.
HMC's primary goal for the project is to improve the ability to continue to provide emergency services to the communities it serves. HMC currently serves approximately 76,000 patients annually in an ED with 53 total rooms. Based on significant statistical & operational analyses and comparison of best practices to reasonable standards, it was determined that a need existed for a total of 72 rooms which includes triage/treatment, acute, psych, and clinical decision. As a level 1 Trauma Center, acuity is high. Improvements include solving: 1) the lack of treatment rooms, 2) patient privacy, 3) staff & patient care support space, 4) separation of walk-in and ambulances, 5) inadequate mix of room acuity levels, 6) process flows and 7) the limited ability to manage swings and surges. The new ED will correct the above issues and provide care using an operationally efficient model. Project Process Background: In 2008, HMC solicited KLMK Group to assist with converting their plans for a new ED into an active capital project. The first step taken was to conduct a Launch Gap Analysis over a two month period. The results of this process were an aligned vision for the expansion and identification of gaps that needed to be addressed in order to move ahead. During the next step of developing a Project Implementation Plan, it was determined that IPD would provide the best return on investment and enable maximum scope given limited resources and an uncertain business climate. KLMK was able to explain the IPD process, provide education as to the risks/benefits of the delivery method, and assist in the launch of their journey to a new ED.
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Capital Project Solutions – May 2010 The first step in the IPD process was to identify the team. As discussed last month, KLMK began by sending a Request For Integrated Team (RFIT) to Architects, Engineers and Construction Managers simultaneously. The invitees were asked to form teams and submit proposals for consideration. Next, RFIT responses were evaluated and three teams were shortlisted to interview. The shortlisted teams were asked to participate in a design charette scenario which required two half days on site at the hospital. The teams were evaluated for creativity, chemistry, and problem solving approach, as this was more important to the hospital than the actual solution to the charette “problem” itself. Upon completion of the process, the successful team consisted of HDR (Architecture and Engineering) and Granger Construction (Construction Manager). In addition, several local and regional major trade contractors were added by HDR and Granger to complete the team. In early 2009, the design phase was launched and the team commenced work. Since Building Information Modeling (BIM) was utilized on this project, it was very important to have the major trades involved with the development of the model so that the most effective and efficient built solution could be obtained. Design was completed in April 2010 and construction commenced with a groundbreaking ceremony. Key Project Information: The team (Hurley, KLMK, HDR, Granger and the Trades Team) has worked very hard to ensure that the project can meet its scope, schedule and budget goals. Several key items of interest about the project include:
Governance. A committee structure was developed which includes a chain of command from the hospital board to the IPD Team. An Executive Steering Committee, made up of project team members and senior hospital leadership, meets on a monthly basis. A Core Team, consisting of project team members and key hospital representatives, meets weekly to discuss the ongoing key issues of the project. Also, there are several Sub Groups established to address key functions of the project and they communicate and connect with the Core 3
Capital Project Solutions – May 2010 Group. Finally, the IPD Team has several constituent groups, especially the BIM Team which has overseen the development and integrity of the model.
PTCE (Project Target Cost Estimate). The Team has worked very hard to meet all budget targets. Without the IPD process and the commitment of its members, we would not have yet reached the construction phase. The ability to continuously evaluate design, means, and methods by all participants has allowed rapid response to maintain a real time budget and evaluate modifications as the design advanced through each stage. There is a commitment and ownership by all parties to achieve HMC’s goals for the new ED. IPD has created an environment that has made this possible.
Contract. Consensus Docs 300 was used as the basis of the contract. In addition, HMC and Granger (CM) have worked with the community to achieve a project labor agreement which will allow fair and open participation by vendors in its community.
Lessons Learned: Over the course of the last two years, there are three major lessons that we have learned regarding IPD:
Organizational Culture. The success of IPD requires more than just a decision on a process. The organization must be able to adjust to the collaborative environment and be willing to evolve its mindset to support the delivery method. The Client Advisor must assess the capacity of the organization for this delivery method.
Management and Control. The management of an IPD Team is different from the management of traditional CM or design-build teams. It requires a greater understanding of the IPD dynamic and a more relaxed hold on the teams function. The organization must monitor the team but ensure it has self governing abilities.
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Capital Project Solutions – May 2010
External Factors. The IPD structure is sound and can hold up to external challenges such as local labor market conditions, public financing, etc. However, it is vitally important that all parties involved be educated as to the IPD process, this includes the Board of Directors. You cannot assume that people will pick up and understand all the nuances of IPD in an hour discussion. Consistent discussion and collaboration with all stakeholders is necessary to avoid roadblocks.
Hurley Medical Center is a prime example of the impact that IPD can have on a capital facility project. Early on, HMC’s visionary executive team realized the benefits that this delivery method would provide and trusted the process. According to Jamal Ghani, HMC Senior Vice President for Operations, “We wanted to make sure that we had a very clear understanding from the get-go of what we were going to spend, how it would be built, what the outcome would be, how it could be delivered, and how we could be sure that the project will be done on time. Using IPD assured us that we have the team in place and all of the team is aligned to ensure that we have addressed everything.” HMC’s executive team has witnessed how IPD fosters collaboration among their team which has enabled the project to currently be on schedule and within budget.
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