Post on 12-Aug-2020
IMPROVEMENTS IN THE PLANNING, DESIGN AND CONSTRUCTION PROCESS THROUGH INTEGRATED PROJECT DELIVERY
KSHE Healthcare Coalition ConferenceSeptember 18, 2019
An Engineer’s Perspective:Integrated Project Delivery
Speed, Quality, Price
Pressure on the Healthcare Industry
Low Cost & High Quality?
Fast & High Quality?
Low Cost & Want it Now?
SPEED
Pressure on the Healthcare Industry
QUALITY
Pressure on the Healthcare Industry
PRICE
Pressure on the Healthcare Industry
Pressure on the Healthcare Industry
SPEED
Pressure on the PDC Process
QUALITY• Remove Risk• Attractive, Maintainable & Safe• Total Cost of Operation• Resilient, Flexible• Patient & Staff Safe• Success Metrics
Pressure on the PDC Process
PRICE
Pressure on the PDC Process
Shortcomings of Traditional Project Delivery:• The disconnect between “Design” and “Construction”
§ Communication§ Collaboration§ Education§ General lack of trust
• Standard Results§ Misunderstood intent§ Lack of evolution/continuous improvement§ Animosity§ Increased costs, compromised quality, lower value
Traditional Project Delivery
Traditional Project Delivery
CHANGE
Traditional Project Delivery
CHANGE IS EASYYOU GO FIRST
“We cannot solve our problems with the same thinking we used when we created them” – Albert Einstein
Silo Mentality to Teamwork
Evolution in Delivery
Need image of inside a central plant crowded/piping/equiment
Opportunity to Improve
Tools• Integrated Project Delivery Methodology• 3-D software/Building Information Modeling• Lean Construction Processes• Contracting Vehicles
Results• Coordination• Prefabrication
Learning• Design Process• Coordination• Model Management• Project Dynamics
Integrated Project Delivery
Traditional Delivery
Builder Involvement
Designer Involvement
Designer Involvement
Bui lder Involvement
Integrated Delivery
Collaborative Process:• The builder knows what is being designed (and why) and how he’s
going to build it.• The designer knows how it will be built and how his design supports
that process.• The Owner knows what he’s getting and what it costs.
Integrated Project Delivery
Goal: The Elimination of Value Engineering
BIM / 3-D Modeling
BIM / 3-D Modeling
• Plan it before we build it
• Coordinated – it all fits
• Minimize rework
• Consolidating efforts and resources
• Prefabrication
Lean Construction: Pull Planning
IPD Methodology•Collaboration•Communication
BIM / 3-D Modeling•See the fit•Avoid the clash
Lean Construction•Faster•Better•Cheaper
Value
Recipe for Success: Mutual Dependancy
Success via Various Contract Structures:• 3-way/4-way IPD/IFOA agreements
– Shared Savings
– Cost Incentives
• Traditional CM at risk and design team contracts with bridging
agreements
• Design–Build
Contract Structure
Design Assist• Enhanced Coordination• Real Time Pricing
Integrated Project Delivery
Target Value Component Teams• Early Equipment Procurement• System Selection Process
Prefabrication• Strategy• Facilitation
Design Assist – Mission Health
Narrative / Pricing RFP (end of SD)
Prequalification Interview
Project Delivery: Design Assist Process
Design Assist Prequalification
• History• Team• Capabilities• Capacity• Backlog• Quality
Project Delivery: Design Assist Process
Narrative, Pricing RFP (end of SD)
Project Delivery: Design Assist Process
Project Delivery Design Assist Process
Preconstruction
Project Delivery: Design Assist Process
Narrative, Pricing RFP (end of SD)
Project Delivery: Design Assist Process
Partner Selection
• Pre-Construction Presentation– Your Design Assist Role– Your Approach To Complete GMP– No Project Specifications, How Did You Handle– Your Role In Controlling The Budget– Interpretation of Budget Accountability
Project Delivery: Design Assist Process
• Target GMP Budget Presentation– Line Item Review with Backup Support– Quality Take-Off Examples
• Ability & Experience• Pricing Accuracy & Transparency• BIM Capability• Accountability – Ownership of Scope & Cost
Interview
Selection Criteria
Kickoff – Set Expectations & Ground Rules
Project Delivery: Design Assist Process
Total Team:• Design Reviews• Constructability Reviews• Pricing Updates• Trust• Challenge #1 – Align SD
Estimate to Budget• Trade Contractor Design Basis
Model Development (New Approach)
Design Integration: Mechanical
Design Integration: Mechanical
Design Integration: Electrical
Design AssistSt. Thomas Rutherford Medical CenterMurfreesboro, Tennessee
Results: Coordination
• Several Images coming from Sarasota
Project Delivery Design Assist Process
Major Equipment Buyout
Project Delivery: Design Assist Process
• DD Drawings/Specs• Equipment RFPs – Transparent, Competitive Process• Equipment Vendor Interviews• Best & Final Pricing• Owner Selection (Not MEP Subs)• $750k Savings to Budget• Enabled / Initiated Prefabrication• Selection Made During CDs
Atwhatpointdowerealizethateverycomponentinthefacilityhastangibleandpossiblymajorimpactsononeormoreothercomponents?Adecisionmadeononecomponentinasilointroducesariskofimposinganegativeimpactonanothercomponent.
Target Value / Component Team Approach
HVAC
HVAC System
First CostSpace
Requirements
Patient Satisfaction/
Comfort
HAI’s
Maintenance Cost & Access
Energy Cost
Exterior Skin
Glazing
Impact to Electrical Systems
Staff Retention
HVAC
HVAC System
First Cost
Space Requirements
Patient Satisfaction/
Comfort
HAI’s
Maintenance Cost & Access
Energy Cost
Exterior Skin
Glazing
Impact to Electrical Systems
Staff Retention
Glazing
HVAC
HVAC System
First Cost
Space Requirements
Patient Satisfaction/
Comfort
HAI’s
Maintenance Cost & Access
Energy Cost
Exterior Skin
Glazing
Impact to Electrical Systems
Staff Retention
Space Requirements
HVAC
HVAC System
First Cost
Space Requirements
Patient Satisfaction/
Comfort
HAI’s
Maintenance Cost & Access
Energy Cost
Exterior Skin
Glazing
Impact to Electrical Systems
Staff Retention
Maintenance Cost & Access
The Historical Way . . . .
§ First Cost§ Space Requirement§ Patient Satisfaction /
Comfort§ Patient Safety / HAIs
§ HCAHPS / Noise§ Long-Term Maintenance
Goals§ Energy Cost
The Innovative Way
Optimized Decision Making
Conceptualize the Options
Ground Source Heat Pump Water Source Heat PumpVariable Refrigerant Flow
Chiller/VAVActive Chilled Beam
Create & Study Models
Energy Model
First Cost Model
Space Utilization Model
O/M Cost Model
Develop through
SD
Utilize A3
A3
• Full Impact of Prefabrication§ Plan it§ Build it§ Install it
• Early Identification§ What opportunities exist?§ How can design facilitate?§ Impact to design sequences.
• Paradigm§ It’s not about building, it is about
making decisions.
Prefabrication
• Integrated view of “costs”§ Material§ Labor§ Schedule§ Quality
St. Thomas Rutherford Medical CenterMurfreesboro, TN
• Timing of design decisions• Impact to sequencing• Cost offsets
Lessons Learned
Lessons Learned
RevitConstruction
Models
RecordsDrawings As BuiltsOwner
DISCUSSION
KSHE Healthcare Coalition ConferenceSeptember 19, 2019