Collaborative Project Delivery: Better than IPD?
All too often, the building process is slowed down by the fear of potential problems. With this fear comes the exhaustive search to find solutions that minimize team members’ potential liabilities and yield a better product. Integrated Project Delivery (IPD), with its emphasis on a culture of collaboration, open communication, and trust, has been touted as a solution to this issue – yet many remain skeptical of its practicality.
Is IPD the be-all, end-all solution? In fact, the same principle of collaboration can produce remarkable results when a team insists on an integrated process – whether or not the policy of collaboration is also accompanied by shared legal risk. The physician-led nonprofit Geisinger Health System proved that positive, cost effective rewards can indeed be achieved when it utilized this model for its award-winning Critical Care Building (CCB).
Although the CCB was not an IPD project, architecture firm Francis Cauffman guided the team through a collaborative approach that reflected the core principles of IPD and the personalities involved. The success of the project was, without a doubt, the result of a dedicated, flexible team that worked as a unified partnership.
The A-B-C’s of IPD
IPD is a policy by which owners and consultants share one contract, and therefore share the risks of a project. According to the AIA California Council 2007, IPD is “a project delivery approach that integrates people, systems, business structures, and practices into a process that collaboratively harnesses the talents and insights of all participants to reduce waste and optimize efficiency through all phases of design, fabrication, and construction.”
IPD has been promoted as a method whereby team members can collaborate on projects in a way that heightens their resourcefulness and creativity. Proponents of IPD also point to the policy as a mandate for cooperation, therefore yielding higher quality. While it is true that using IPD can, in some circumstances, ensure good results, the primary defining factor in the AIA’s description is people.
The key to successful IPD implementation, then, is not the shared contract per se, but the teamwork that is inherent to the process. Even without IPD, project teams can work collaboratively to implement the same tenets and harness the strength of teamwork to produce great results.
Collaboration at the Core
The design and construction of the CCB, which is located on Geisinger’s Wyoming Valley campus, marked the transformation of a community medical center into a regional institution and increased the campus by 50 percent. This building is an outgrowth of Francis Cauffman’s master plan, which envisioned making the new and expanded emergency department a critical “front door” to acute services and the region’s most modern and technically advanced trauma center.
The experience of bringing the CCB to reality illustrates a successful implementation of core IPD principles, without IPD contracts. The real situations encountered during this project speak to the benefits to be gained by working under positive, mutually reinforcing conditions without fear of reprisal and in the best interests of all involved.
Though the project team faced challenges such as restrictive sub-surface conditions, a mountainside site, and the need to keep the campus fully operational during construction, the CCB was completed ahead of schedule and under budget; it has also achieved LEED Silver certification and gained Level II trauma accreditation. This year, the American Society for Healthcare Engineering highlighted the team’s achievements by awarding it the 2010 Vista Award for New Construction – a prestigious national award that recognizes teamwork in the design and construction of health care environments.
Building a Team
From the outset, the Geisinger team embraced an open and direct team approach predicated on a clear understanding that a problem encountered by any team member was a problem to be resolved by the entire group. The goals and needs of the hospital would become the goals of the team and issues would be addressed in an open and honest format without any assignment of blame. In this way, team members would be able to share expertise and respond to problems in a coordinated and unselfish manner.
The CCB team therefore had to be comprised of people who demonstrated the value of teamwork. The formation of a complete construction team at the inception of the project was also critical for its success. For example, at Geisinger’s request, Francis Cauffman assisted in selecting construction manager Alvin H. Butz, Inc.; Butz was chosen because its working style most resembled Geisinger’s open and communicative philosophy. Knowing that they would eventually seek LEED certification, Geisinger also hired contractors who could build according to LEED specifications and would bring a problem-solving mentality and the ability to learn new practices.
The entire team held bi-weekly job meetings and arranged additional meetings when specific needs had to be addressed. Having the architect, construction manager, engineers, client and sub-contractors all at the table meant that the process truly functioned like IPD, because all team members were apprised of issues in real time, allowing for a smoother, quicker decision-making process. Any misunderstandings were addressed without waiting for the review of meeting minutes, which is typical in a less integrated process. Between meetings, new information was distributed to all team members, so that it always moved in both directions along the chain of command.
For this project to be successful, Geisinger knew the team had to feel they were in a true partnership, and so set up non-adversarial contract techniques. Traditional contracts are drafted by a party representing one side of the relationship, whether the owner or the design team. Therefore, these contracts always include language that adds to their party’s protection or reduces their liability. Such contract negotiations can drag on endlessly with additions and alterations on both sides – even with an IPD contract.
Geisinger recognized this potential sticking point and its ability to derail trust within the parties. The team began by addressing this issue in a series of meetings to ensure that all parties were represented, understood, protected, and had thorough knowledge of everyone’s responsibilities. All members also worked together to value-engineer a budget that worked for the project and everyone involved with it. This financial security lent stability to the process and encouraged each team member to stay committed throughout.
A collaborative approach is essential to constructive mediation when problems arise, as they inevitably do during any building project. In these situations, the emphasis is all too often placed on assigning blame before correcting the problem. This is a misdirected attitude: the issue remains unaddressed, the schedule slips, and other concerns mount while the main effort goes to identifying the responsible party and making them accountable. The term for this, “holding their feet to the fire,” implies a medieval torture technique that should have no place in a collaborative project team.
As with every complex planning and construction project, the Geisinger team encountered hurdles along the way. Each one required a unique problem-solving approach. In Geisinger’s collaborative problem-solving method, all participants heard the issues and everyone had the opportunity to contribute to a potential solution, with all options welcomed for discussion. The emphasis was squarely on discussing options, assessing their implications on future work, and finally agreeing on a course of action.
While the team did try to figure out why problems occurred, it justly placed greater emphasis on making sure the project moved forward. The team also strove to identify lessons learned each time so that the same problem could be avoided if a similar situation arose. This process demonstrated that when a team takes as a given that all parties are providing their best professional effort, the emphasis changes from placing blame to finding solutions.
Working with Outside Parties
Another measured benefit to the collaborative process came from the many agencies, both local and federal, that control approval processes for a hospital project of this kind – which can vary from life safety inspections to land development and storm water management. Working closely with these groups in an open and honest forum is not just the path of least resistance; it often proves to be a critical project delivery strategy, keeping the project on schedule and on budget.
Most excellent working relationships have a starting point of honesty and trust, which is what Geisinger has built with its review agencies. As with all of its projects, Geisinger’s policy for the CCB was to keep all appropriate outside parties informed about project developments whenever necessary, resisting the temptation to engage perceived shortcuts. These relationships and open lines of communication ensured that when issues arose over the course of the project, someone from Geisinger could make a phone call to the appropriate agency, who would quickly render a judgment or schedule a meeting on site to study the issue. The key to this was developing relationships in good faith; as one of Geisinger’s plan reviewers has noted, “We know and trust them. They have always proved they will do the right thing.”
One example of how this engagement with outside agencies greatly benefited the team came when, during construction, it was discovered that two patient prep and recovery bays fell a few inches short of the guideline requirements for the area. Rebuilding the bays would have impacted many other surrounding spaces, added weeks to the schedule, and incurred tens of thousands of dollars in additional costs. The team did not seek to assign blame for the error or dwell on the issues that had led to this challenge, such as a tight planning schedule and variations in field dimensions. Instead, it was important to move quickly forward with a solution, because opening day was looming.
Local inspectors were informed of the issue; given Geisinger’s reputation for “doing the right thing,” the reviewers were inclined to collaborate on a solution. They analyzed the bays and found that, in fact, the clinical users could perform their functions safely in the slightly undersized spaces. The reviewers concluded that the design adhered to the principles of the guidelines and that patient care was not being compromised. With all in agreement, the issue was resolved and the project was ultimately approved for occupancy.
The LEED certification process was another example of collaborative teamwork. Geisinger, which currently operates approximately 40% of all LEED-certified healthcare-related buildings in Pennsylvania, made it clear to the team that sustainability would be embraced at all levels: LEED requirements were to be the primary standards for the CCB construction. They had also adopted a policy that they would not “buy” LEED credits by adding scope or cost. With those parameters and no official policy in place, Geisinger relied on their culture to inform policy, and team members had to be forward thinking, proactive, and willing to develop new skills and adapt to this challenge.
The commitment to LEED must come early in a project, because it can be difficult to integrate sustainable features in a cost-effective manner when a project is already underway. The unique needs of medical facilities – especially emergency departments – such as around-the-clock operations, heavy energy and water use, chemical use, and infection control, also pose significant obstacles to sustainability. Making sustainability a defining part of the planning process allowed the CCB team to achieve LEED Silver certification while still coming in under budget.
Team members were able to contribute individually to the LEED process based on their areas of expertise, whether it was the architects advising on efficient glazing system selections or the mechanical designers determining the project tolerance to incorporate multi-system failure preventions. Since approximately 35% of the project cost resided in the complex M/E/P systems serving the building, mechanical and electrical sub-contractors, who were represented by a senior member of their firms at each meeting, vetted many engineering solutions. They reported on factors such as potential early cost savings, ease of constructability, schedule impacts, and long-term benefits.
The team then collectively determined each element’s cost/benefit ratio to the project. They ultimately agreed on a number of energy-saving techniques: a white roof helps to reflect sunlight to keep the building cooler and will last longer than a traditional roof, and efficient systems such as a high-performance variable air volume system and energy-efficient lighting have contributed to an immediate 19% reduction in energy costs – a savings of roughly $100,000 per year – over a comparable, non-LEED facility.
Dealing with Major Changes along the Way
Changes and unexpected challenges are a normal part of any project, and yet they often cause stress and conflict. Here again, the collaborative approach to problem-solving can help address the strains caused by necessary changes and new complications, keeping a project balanced and moving forward.
Acknowledging the fact, early on, that project needs can change creates a shared expectation of flexibility. Change can indeed be managed, and with a flexible and trusting team, even embraced and executed with little fanfare. Accepting that no team member – including the owner – is perfect and without fault, the Geisinger team judged itself on its ability to overcome the natural challenges that are part of each and every complex healthcare construction project. Following are descriptions of some of they challenges that they faced.
- Early in the conceptual stage of the project, the team uncovered an old mine underneath the site. This mine complex, some 70-90 feet below the proposed building, had long since been abandoned, but was large enough in sections to allow a full size coal transport truck to turn through 180 degrees. Analyzing the potential options of shoring up the future footings with expensive sub-grade work, the team finally agreed that they needed to choose a new location.
The team worked together to identify a new site that would still be appropriate for the necessary clinical department adjacencies within the hospital. This shift required a degree of redesigning, which put the project at a further delay. To regain lost time, the team then divided the project into several phases in order to fast-track the land development approval and permitting processes, which brought the project back on schedule.
Before breaking ground, the team then had to relocate the 190-car surface parking lot that occupied the new site and served both patients and staff. As the CCB was built into the northern side of a mountain, level terrain suitable for parking cars – and convenient to the facility – is at a premium, so it was mandatory to replace the parking lot. The relocated surface lot was designed and documented in swift order, so that the lengthy storm water and land development approvals process could be overcome. This was a critical step for the project’s success.
- Another major change came six months before the construction was to be completed, when the owner’s representative predicted a spike in the need for the new facility and asked the team to complete the project sooner than scheduled. By incorporating a second shift, the team was able to finish the project one month earlier than planned. This required extremely careful, consistent communication and open, swift decision-making to ensure the buy-in of all team members.
Despite the challenges it posed to the construction schedule, the team encouraged Geisinger to wait to order equipment until more advanced building designs were available. Because of this smart planning, few changes had to be made. When the expensive new equipment arrived onsite, it was positioned for maximal utilization by staff in the CCB as well as the adjacent building. The additional cost of construction was offset by the extra month of booked medical work, including inpatient and outpatient surgeries.
Hospitals are complex, expensive structures, so many hospital expansion and renovation projects begin with concerns about the egos of the architects, the financial transparency of the construction manager, the needs of various user groups, and the financial risks of the unknowns. So what can other institutions or project management organizations learn from Geisinger’s example? The most important lesson is to hire the professionals with the most expertise and to trust the professionals you hire. The right consultants can lead by example and expertise, as well as communicate concerns in a timely and non-adversarial manner.
Open and honest communication is paramount to a successful project. With that said, it can be a difficult, even somewhat unnatural, transition to trust each of a project’s various team members, whether they are administrators, designers, or constructors, with enough responsibility to potentially sink the entire operation. Trust has to be earned, and takes time. All team members need to understand the time commitment needed to build this trust and at what stage in a project planning this commitment is needed.
Every project inevitably will have hold-outs who take longer with this process with others. Sometimes they are the clinical staff members, who may feel they have the most to lose if their requirements and expectations are not met. At other times it is the designers, who may feel their professional reputation is at stake if they do not stretch the boundaries of design, or feel committed to providing a building that they think the client “needs” – but may not want. Leaving such misgivings unaddressed can constitute a fundamental structural flaw in the delivery of a successful project.
To achieve great results, constant communication and assurances are needed at every turn in the project, and extra effort must be taken with these individuals from the beginning to bring them along and make them comfortable in their roles and responsibilities within the project. When this kind of working trust is established, a project team is without doubt in a position to achieve the kind of success promised by Integrated Project Delivery – even without the multi-party contracts.