To execute this expansion project with a maximum degree of efficiency, quality, and speed, an integrated project team of specialized, decision-making representatives from each of the stakeholder groups was assembled. The team created a process for planning and development, using a range of tools including performance scorecards and Web surveys to ensure their ability to meet project objectives.

“We recognized that the only way a project of this complexity could be completed on schedule was to create a team of principal experts who could make things happen,” says Brad Pollitt, vice president of facilities for Shands HealthCare.

Phase One of the master plan consists of an 8-story, 500,000-sf, multi-specialty cancer center designed by Flad Architects that increases Shands’ capacity by 192 beds and expands emergency services.

Heads in Beds

The project’s primary goal was summarized by the phrase “heads in beds by mid-09.” This was an ambitious goal given the scale of the overall, long-term plan and the fact that the team had never worked together on a project requiring this level of complexity, details, and collaboration.

“One of the most important things the team had was a commitment to work through any challenge constructively. There was an understanding that we had to trust each other and work together in order to be successful,” says Pollitt.

The team consisted of decision makers from each respective area—owner, architect, engineer, and construction manager—who all played an important role in the project’s success.

“The schedule for this project was 18 months from the time we were hired to when we were supposed to break ground. That’s a phenomenal amount of speed to create a master plan on a campus of this size,” says Bill Flemming, chief operating officer on the Shands expansion, and senior vice president of pre-construction services at Skanska USA Building, the nation’s largest builder of healthcare facilities.

By implementing an aggressive, highly integrated approach, the planning process was executed in 14 months. The project’s success was based upon the team’s commitment to work together as a seamless unit to accomplish specified goals and objectives. Also, with a thorough understanding of the project’s objectives from the outset of the assignment, the team developed specific strategies for achieving those objectives effectively and efficiently.

“Understanding all of the project’s objectives and planning around those goals early in the process, and having a solid game plan for executing them, is the real key,” says Flemming.

Programming, benchmarking, and pricing for the project all occurred in less than six months.

“In order to mobilize very quickly on the front end, we overlapped master-planning, site approvals, and permitting—all of which were very complicated on this project—and that was a very fast, iterative team process across disciplines,” says Laura Stillman, principal/project director with Flad Architects.

Scoring Performance

Utilizing feedback tools, most significantly a scorecard system, during planning ensured the project would reach its objectives. The scorecard was used for measuring project performance in relation to both soft and hard metrics. Every quarter the team would review progress in relation to metric data and respond accordingly.

Soft metrics measure the performance of the team and their success in achieving project goals. They analyze the ongoing accuracy of the cost model and how the team functions and communicates overall. Online surveys are used to assess the quality of execution with ratings of high, medium, or low.

“It’s difficult to establish an absolute score with soft metrics, but we look at whether we are trending up or down. That’s important information to have for moving a project forward,” says Pollitt.

Hard metrics assess project performance in relation to benchmarks for cost, quality, safety, and user satisfaction.

Safety was one of the project’s most important hard metrics. Performance is measured against the national average and stipulates that the total number of safety incidents on the job site could not be higher than 25 percent of the national average.

“Safety is a significant core value for us because we decided as a team to make this project the best it could be—to come in on time and under budget. On this job, we have 800 people doing stretch and flex every morning. Stretch and flex is an exercise routine that has proven to reduce strains and sprains, and most injuries on a construction project are soft-tissue related. The exercise also creates teamwork and establishes relationships,” says Flemming.

Quality metrics measured the value of the overall work process, not just the final outcome.

“Many people think quality is what you see in a completed facility, but there are a lot of quality issues that go beyond the drywall and the paint. We focus on the quality of the process. We measure how good and how satisfactory the documents are, and whether the flow of shop drawings supports the construction side of things in the field,” says Flemming.

User-satisfaction was also identified as a decisive metric in measuring project success.

“We build with safety and timeliness in mind, but we still have to make sure that the users are happy.  We constantly meet with the design team to make sure that the user groups are getting what they need,” says Flemming.

The team also measured how much construction contingency funding was used in order to gauge how much escalation there was in the project.

“It’s possible that escalation could hit a project like this. People tend to think contingencies are simply a slush fund, but we were very disciplined in showing that each contingency has a legitimate purpose that can’t be intermingled. To do that, the spending needs to be measurable at each phase of the project,” says Flemming.

Another tracking tool used by the team to monitor the budget against the target during construction was a “Future Cost Event Log,” which lists all possible future costs that will have to be absorbed due to any changes. The log cites the issue, resolution, cost impact, timetable, and other details so decisions can be tracked. This allows the team to know where things are on a week-by-week basis and for the team to make informed decisions about changes.

“This model is a break from tradition in that there is joint accountability and problem solving. It is true value management as opposed to value engineering,” says Stillman. “The process works because all members of the team are committed to the process. Traditionally, the CM ‘owns’ the budget but, in this model, the entire team owns the budget.”

Total Project Budget

According to Flemming, a high level of cross-disciplinary involvement is the key to successfully creating and adhering to a total project budget.

“One of the things I insisted on was that we all develop the total project budget collectively to make sure nothing was being overlooked,” he says.

The team held bi-weekly meetings to analyze costs in relation to every aspect of planning in order to ensure the project would adhere to the established total budget. These figures were validated regularly and checked against milestones.

“There was a rigorous control of cost in the design phase to clarify proper budgeting of everything we wanted to accomplish. We tracked thousands of elements that included both hard and soft costs, and determined how they would be paid for,” says Flemming.

Communication by Design

Strong internal leadership was another major component to the team’s success. Every major decision-maker from the president of the University to the chief executive officer of the hospital was brought onboard to help move things forward.

“Knowing the organization and its decision-making culture is critical to advancing any project of this scale,” says Stillman.

In order to avoid a repetitive cycle of design, price, and repeat, the team implemented a system of process regulation to keep things moving on a strict timeline. The team held regular design meetings and posted the results on the Web with the understanding that if there were no questions, comments, or changes within a certain time frame, they were deemed to be approved, which helped eliminate the delay “committee thinking.”

“Process regulation is very important in terms of moving things forward. You have to commit to a series of steps and not backtrack after those steps are made,” says Pollitt.

Communication at the principal level ensured that the team could work through any potential challenge. The team was even brought in to consult with University leaders in order to establish the project’s total budget.

“We had to communicate the business reality of the project in very straightforward terms. Not many architectural leaders are involved in high-level budget talks about what to cut and what to keep. That’s the level of communication we had at the executive level of the organization, and it turned out to be a great asset,” says Stillman.

The team also found that one of the most powerful tools for advancing the project in a timely fashion was the high-cost time delay associated with planning.

“It’s amazing how much motivation is generated when you point out that, due to inflation, it’s going to cost millions of dollars to sit around and think about things,” says Pollitt.

By Johnathon Allen

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ISSN: 1096-4894