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PDC_2015_Lean_IPD

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PDC_2015_Lean_IPD

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PDC_2015_Lean_IPD

  1. 1. Lessons Learned in the Development of a Framework Funded By: AIA Academy of Architecture for Health Foundation HKS Boldt Supported by: Akron Children’s Hospital
  2. 2. Value Analysis of Lean IPD and TVD Di Ai, MS (Estimation) John Bienko, AIA (Project Management and Design) Upali Nanda, PhD (Design Research) Zofia Rybkowski, PhD (Construction Management) Funded By: AIA Academy of Architecture for Health Foundation HKS Boldt
  3. 3. • TVD (Target Value Design) and Lean approaches to IPD (Integrated Project Delivery) • Advantages and challenges of using Lean thinking in the IPD process. • Definition of “value” and quality metrics. • Framework for cost/benefit assessment based on metrics currently tracked. • Exploration of implicit costs and benefits
  4. 4. • Extensive documentation • Transparency • Input from multiple stakeholders
  5. 5. • Advantages and the challenges of lean thinking • Definition of “value” – explicit benefits and costs that are currently reported/ tracked? – What are the benefits and costs that are currently implicit (not measured/reported) • Framework for benefit-cost (B/C) and/or Return On Investment (ROI) calculations • Tracking the benefits/costs related to design decision making to enable an ROI for both first costs and operational costs?
  6. 6. • Archival Data via E-Builder • Site Visit • Interviews (7) • Focus groups (16 + 4) • Survey (49 of 79)
  7. 7. OAEC* Current state 2P D C A Current state 1 Future state 2 Current state 3 P D C A Future state 3 Current state 4 P D C A Future state 4 P D C A Future state n+1 Future state n Current state n OAEC OAEC OAEC Time à C U L T U R E o f R E S P E C T waste value *OAEC: Owner Architect Engineer Constructor (collaborative) %ofCAPITAL COST Time Cost Quality Safety Morale Minimum Maximum MinimumMaximum Minimum Maximum Minimum Maximum Minimum Maximum Lean Construction reduces waste and adds value using continuous improvement in a culture of respect Adapted from Rybkowski, Z. K., Abdelhamid, T., and Forbes, L. (2013). “On the back of a cocktail napkin: An exploration of graphic definitions of lean construction," Proceedings of the 21th annual conference for the International Group for Lean Construction; July 31-August 2, 2013: Fortaleza, Brazil, 83-92.
  8. 8. VALUE = What you get (benefit) What you give (cost) Saxon (2005) Value is greater than 1 when Benefits exceed Cost and less than 1 when Costs exceed Benefits. We need to consider time value of money.
  9. 9. Target costing as “a system of profit planning and cost management that ensures that new products and services meet market determined price and financial return.” (Ansari, 1997) Allowable Cost Target Cost EstimatedCost Time Progressive reduction of estimated first cost during Target Value Design after Rybkowski (2009)
  10. 10. Movement of funds across system boundaries during Target Value Design after Rybkowski (2009)
  11. 11. Example of movement of funds across system boundaries during Target Value Design, Cathedral Hill Hospital, Sutter Health, after Rybkowski (2009)
  12. 12. TVD is a management practice that motivates designers to deliver customer value and develops design within project constraints (Ballard, 2009) All Projects Non TVD Projects TVD Projects Profit Contingency Cost of work Uncertainity Miscommunication Missing Detail Miscoordination Change Orders Lack of Trust Litigation Uncertainity Miscommunication Miscoordination Trust Collaboration Aligned Incentives Early involvement Coordination with BIM Cross disciplinary problem solving Project Governance Steering design to target value Co-location Prior working relationships Learning as ateam Transparency Total Project Budget Cost Control Mechanism Adapted from Do, 2014 But how is “value” assessed?
  13. 13. Predesign Schematic Design Construction Agency Permit/ Construction Design Development Documents Bidding Conceptualization Criteria Detailed Implementation Agency Coord/ Construction Design Design Documents Final Buyout 1 2 4 3 1 2 4 3 Ability to impact cost and function Cost of design changes Traditional Design-Bid-Build process Integrated Project Delivery Process TRADITIONAL DESIGN-BID BUILD INTEGRATED DESIGN DELIVERY
  14. 14. P R E – C O N S T R U C T I O N S E R V I C E Scommonunderstanding SD DD CD Architect hired Engineers hired CM/GC hired time CONSTRUCTION Major trades hired Government review ≤ 100% P R E – C O N S T R U C T I O N S E R V I C E S commonunderstanding SD DD CD Architect hired time CONSTRUCTION Government review 100% Engineers hired CM/GC hired Major trades hired Reprinted with Permission: Will Lichtig
  15. 15. • Akron, OH • 4,619 employees • 780 Medical Staff • Gold Seal of Approval from the Joint Commission • Magnet Recognition Status from American Nurses Credentialing Center • 2,854 transports/509 air in 2012 • 20 Primary Care office network
  16. 16. Innovation production workshops TEAM STRUCTURE Owner Owners Representative Architect Construction Manager Partnership
  17. 17. 368,000SQUARE FEET 39ROOM PEDS ED 6OPERATING ROOMS 75 BED NICU Lot of scope for small budget PROJECT SCOPE
  18. 18. the old way versus the new way DESIGN PROCESS Predesign Schematic Design Construction Agency Permit/ Construction Design Development Documents Bidding Conceptualization Criteria Detailed Implementation Agency Coord/ Construction Design Design Documents Final Buyout 1 2 4 3 1 2 4 3 Ability to impact cost and function Cost of design changes Traditional Design-Bid-Build process Integrated Project Delivery Process TRADITIONAL DESIGN-BID BUILD INTEGRATED DESIGN DELIVERY
  19. 19. TEAM STRUCTURE Sometimes you have to plan innovation • • • • • • •
  20. 20. DECISION MAKING STRUCTURE Ambulatory Care Center and Critical Care Tower BACKGROUND CURRENT STATE ANALYSIS GOAL FUTURE STATE IMPLEMENTATION PLAN UNRESOLVED ISSUES IMPACTS PL AN AC/ DECIDE Ambulatory Care Center and Critical Care Tower BACKGROUND CURRENT STATE ANALYSIS GOAL FUTURE STATE IMPLEMENTATION PLAN UNRESOLVED ISSUES IMPACTS PL AN AC/ DECIDE Ambulatory Care Center and Critical Care Tower BACKGROUND CURRENT STATE ANALYSIS GOAL FUTURE STATE IMPLEMENTATION PLAN UNRESOLVED ISSUES IMPACTS PL AN Ambulatory Care Center and Critical Care Tower BACKGROUND CURRENT STATE ANALYSIS GOAL FUTURE STATE IMPLEMENTATION PLAN UNRESOLVED ISSUES IMPACTS PL AN PLAN DO/ RESEARCH CHECK/ CBA AC/ DECIDEAC/ DECIDE ACT/ DECIDE ADVANTAGES ADVANTAGES ADVANTAGES ADVANTAGES ADVANTAGES ADVANTAGES ADVANTAGES ADVANTAGES • • • •
  21. 21. • Original Estimate at validation 211 million • Target Cost 180 million • Revised Target Cost (after scope change) 182.5 Million • Current Target Cost 177 Million • TOTAL PROJECTED SAVINGS: 5.5 Million Allowable Cost Target Cost EstimatedCost Time
  22. 22. SAFETY Goal: Deliver the project safely with 0 Lost Time, 0 Days Restricted/ Transferred (Based on the DART rate from the Bureau of Labor Statistics). DART Rate 2.2 is the National Average for the working trades involved in healthcare projects. LOCAL PARTICIPATION Goal: 85% of (ICL) project team labor hours spent by people living, as defined by their W-2, in certain counties. Participation is considered for all workers, not just ICL participants. ENERGY EFFICIENCY Goal: Achieve top 10% hospital nationally. LEED® Goal: Achieve LEED Silver certification TEAM PERFORMANCE Goal: Highly Effective Team – Team Pulse Check SCHEDULE Goal: Turn-Over Building 50 Calendar Days Sooner than 24 Month Schedule to Owner for Move-In QUALITY Goal 1: Want Team Approach to Resolving Project Issues Quickly & Efficiently Through Collaboration Goal 2: Want Project Team To Take Pride In Producing Quality Work Goal 3: Want Collaborative Team Approach In Designing & Constructing the Project. STAFF AND FAMILY SATISFACTION Goal 1: Staff and Family that have been integral to the process and a driving force throughout the project and a team that listens to their input. Goal 2: Keep the Staff and family engaged and informed throughout construction. Goal 3: Post Construction Survey refer to the 9 Guiding Principles
  23. 23. SAFETY 18 LOCAL PARTICIPATION 11 ENERGY EFFICIENCY 12 TEAM Performance 9SCHEDULE 10 QUALITY 11 LEED 6 STAFF AND FAMILY SATISFACTION 15 Unavailable Points 8 $160,826,326 $159,198,883 $5,926,335 $2,500,000 $8,683,557 $8,683,557 $5,789,038 $5,789,038 $1,000,000 $1,000,000 $- $505,378 ICL Tracking (Target vs. CWE) Direct Costs Total Project Contingency Base Profit (60% of Potential Profit (PP)) ICL Profit (40% of Potential Profit (PP)) Owner Profit Payment ($1M) ICL Profit (3rd Tier - 10% of Savings) $182,225,256 Current Target $177,676,855 Current Working Estimate
  24. 24. Project Cost Construction Cost
  25. 25. $165,000,000 $175,000,000 $185,000,000 $195,000,000 $205,000,000 $215,000,000 $225,000,000 $235,000,000 $245,000,000 $255,000,000 Estimated Projet Cost Initial Project Target Cost Project Target Cost adjust A Project Target Cost adjust B Current Project Target Cost Gap to Target = apprx. - $5 million
  26. 26. AS OF DEC 2013
  27. 27. Team Week Meeting and Co-location Mock-up Labor X X Material X X Equipment X X Location Cost X X Cost items I Team Week Meetings and Co-location1 A. Material White board Supplies (large Post-It® notes, markers, flipcharts, push pins, masking tape) Floor plans of existing hospital Rolls of paper B. Labor Owner and owner representative Architects General contractors Structural engineer MEP engineer Sub-contractors Vendors C. Equipment Speakers Projector Conference call equipment D. Location Cost Co-location space rent or build cost II Full Scale Mock-up2 A. Material Cardboard Tape and nail to fix cardboard Furniture for mock-up scenario Food and Warehouse Amenities B. Labor Lean facilitator Architects Healthcare administrators Physicians Nurses Clinical Staff Costs Former patients and their parents C. Equipment Equipment for mock-up scenario Warehouse Rent Warehouse Construction labor D. Location Cost Utility [. Total Decision-Making Cost associated with TVD, Lean IPD that happened until Dec. 2013 was $7 Million However, this does NOT take into account the costs a typical DBB process would have which also have extensive meeting time.
  28. 28. Survey (49) Interviews (9) Focus groups (2) Respondent Profile (no. of respondents)
  29. 29. Plus-Delta When asked to construct a +/ Δ chart, stakeholders listed more Δ than + for Design-Bid-Build and more + than Δ for Lean-IPD Design-Bid Build Lean-IPD
  30. 30. Perception of Lean IPD over non-Lean IPD Perceived by Different Stakeholders LEARNING EMERGED AS THE MOST “CONSISTENT” IMPLICIT BENEFIT ACROSS STAKEHOLDERS Yet- we haven’t really invested this as a metric Significant Difference
  31. 31. Perception of Value of Different Lean Strategies FULL SCALE MOCK-UP RATED HIGHER THAN ALL OTHER LEAN STRATEGIES Significant Difference Compared to architects, general contractors’ belief that Target Value Design can add more value to the overall project was significantly higher.
  32. 32. For Architects & Engineers, GC is perceived as having more influence than the owner Although theoretically an Integrated Project Team should have equitable influence, It is not perceived as such by all stakeholders.
  33. 33. Architects perceived themselves with lower levels of influence compared with owner and general contractors who perceived their own influences higher than average Self-perception
  34. 34. Architects perceived themselves with lower levels of influence compared with owner and general contractors who perceived their own influences slightly higher than what others perceived. 2.54 3.50 3.50 2.60 2.33 3.24 3.27 3.47 2.96 2.48 0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 Architects (13) General Contractors (6) Owners (8) Engineers (5) Subcontractors (6) Self perception Others' Perception
  35. 35. “what the client feels will improve their ability to deliver quality care”; “to provide the most appropriate building to meet the user’s need without excess”; “exceeding the conditions of satisfaction from the owner” “Most benefit for the least cost”; “ higher quality, lower costs, and increased efficiency Architect Owner “Value is in the eyes of the customer. We were building this building for our patients, families but also our staff to provide the best care environment that allowed to staff to concentrate on care and not have the facility create barriers to that care”. “Adds quality to project and reduces cost to project”. GC “value for the client/ owner becomes value for the team and the project” “A benefit or enhancement that comes as part of a product or service or at a low cost”
  36. 36. Owner User Who is the “customer” shifts- and thus value shifts as well arrow
  37. 37. Plus (What Worked) Delta (What Can Be Improved) Enhanced collaboration Positive professional relationships User engagement and buy-in Learning and education (for team, and larger community) Successful Strategies Mock-ups; Pull planning; Co-location/Team Weeks to allow more face time; Last Planner times, Incremental decision-making; Transparent pricing allowing for more participative discussion on reducing price without compromising value Estimation Accuracy Wasted Time (time wasted in co- location without clear tasks) Perceived imbalance of control/influence: Equal Voice Optimal use of lean strategies Cultural adaptation More early engagement More quality metrics Contract complexity Technology Tying success metrics to post- occupancy benefits
  38. 38. Cost savings opportunities are present in three phases : • Validation • Innovation (design) • Production ROI Implication: In order to calculate Return on Investment, incremental costs must be itemized and considered as well. cost contributors include material (Lean facilitation in workshops and documentation, and mock-up construction), labor (considerable additional time for all participants), equipment (mock-up support), and real estate required for team week meetings and co-location, as well as a full scale cardboard mockup. There are also indirect and overhead costs associated with these items. Focus for this study
  39. 39. • Learning: A tremendous implicit benefit which is not tracked – Team, User and Community – An implicit benefit that is not currently captured • The cardboard mock-up workshop – the most successful lean strategy • More accuracy needed in estimation • Owner perceived as having the largest influence in the process, followed closely by the General Contractor. • Quality is a key component of value but robust measures to access quality are lacking. Greater value can be a result of greater/ same benefit with lower costs.
  40. 40. COST BENEFIT TIME COST SAFETY Of people Involved in Design + Occupants of the building QUALITY Of the project as it relates to people, the community and the organization MORALE of team including Design team/ Owner/ Family representation LEARNING Of the team and the community Production time* Decision time** First cost* Lifecycle cost*** Decision making cost** (labor+ materials) Energy Cost Operational savings*** (note: use of CBA- choosing by advantage tools does take into account lifecycle cost and was used for some key design decisions as documented in A3s) Construction safety* Post-occupancy safety (employee injury, patient harm (infections, falls with injury, errors)*** Efficiency of project* Benefit to patient (clinical quality + safety+ overall satisfaction)*** Benefit to employee (efficiency + safety + satisfaction)*** Benefit to organization (Community goodwill, market share, employee loyalty, patient loyalty etc., Energy Efficiency*)*** Benefit to community (local participation*) (Note: A3s currently capture some of these benefits but lack of metrics is a challenge) Team satisfaction* Team collaboration* Employee engagement / satisfaction during design, construction, and transition* Family engagement / satisfaction during design and construction* Employee satisfaction post occupancy* Family satisfaction post occupancy* Team learning*** Hospital employee learning (relates to change engagement)* ** Community learning (local community that supports the hospital)*** *Metrics Exist Current Metrics List (*): DART rate Incentive Compensation, Use of contingency funds No. of working days to resolve project issues, schedule increase of 2 weeks or more, no. of calendar days sooner than scheduled time Punch list items, LEED certification points, Energy Efficiency, Local Participation Team performance survey, Staff and Family Satisfaction & Engagement Surveys with Workshops participants
  41. 41. + Benefits During Design + Post Occupancy (over the project lifecycle) Defender (Traditional project delivery) Challenger (Lean-IPD-TVD) PERMITTING PROJECT DEFINITION PRE-PROJECT PLANNING DESIGN CONSTRUCTION COMMISSIO NING/ TURNOVER SCHEMATIC DESIGN PRE-DESIGN DESIGN DEVELOPMENT CONSTRUCTION DOCUMENTS AGENCY PERMIT/ BUILDING CONSTRUCTION Time Additional cost for meetings + full- scale mock-up + co-location Reduced cost of construction due to reduced errors and omissions, RFIs, shortened construction period Δ = Challenger - Defender Time Time
  42. 42. To translate these success metrics into an ROI, three additional components are needed, namely: • A baseline of benefits and costs in comparable traditional Design Bid Build projects to allow a benchmark for comparison • A more thorough documentation of incremental (additional) costs associated with the decision- making process involved in a Lean- IPD project • An assessment of the long-term/ occupancy implications of design decisions. This links to the field of Evidence-based Design and must be investigated further.
  43. 43. Questions? Contact us, • Upali Nanda, unanda@hksinc.com • John Bienko, jbienko@hksinc.com • Zofia Rybkowski, zrybkowski@tamu.edu • Di Ai, diai80520@gmail.com

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