Case study: Harnessing IPD to fast-track a replacement hospital

By Robert J Garra Jr., PE, CannonDesign, Grand Island, N.Y. October 17, 2018

Bayhealth is central and southern Delaware’s largest health care system. The new health care campus anchors its services by hosting an inpatient acute care hospital as well as an adjoining ambulatory care center to create a community-focused health village (see Figure 3).

At the onset of the project, Bayhealth made its goal clear: deliver the hospital at least 3 months earlier than comparable health care projects. Integrated project delivery (IPD) helped the team deliver a high-quality hospital below cost and ahead of traditional schedules. Design goals were focused around enhancing the patient experience in an environment that delivers care safely, effectively, and efficiently through Lean-led design.

To design and deliver the project, CannonDesign, construction-management company Whiting-Turner, and the full IPD team are working closely together to optimize project outcomes and increase efficiency through all phases of design and construction-even co-locating in one space for more than 18 months. The team shares a co-location space adjacent to the existing hospital (not the architect’s or engineer’s offices, and not in a construction trailer), which helped to unite and focus the team (see Figure 4). It provided an environment to work across project-implementation teams (PITs), which takes parties out of their traditional boxes. This allows members to speak up when they see the problem from a different perspective, which members of a traditionally built PIT may not have seen, and offer solutions.

The full team collaborated on testing design schemes against cost parameters and construction methods to evaluate which options would best meet project goals (Figure 5). To help satisfy a requirement to make the building’s space usage 20% more efficient than conventional benchmarks, CannonDesign shifted from multiple outboard mechanical and electrical rooms to a large centralized mechanical and electrical space. Vertical shafts and pathways were blended into the architectural floor plans to maximize the efficiency of the distribution.From an engineering perspective, the following has contributed to a successful implementation to date:

  • Consistency of all team members from the design phase through construction. The team-building efforts implemented early in the process instilled a comfort level and familiarity among project team members. It was made very clear at the beginning of the project that egos were to be put aside. This allowed design problems to efficiently and effectively be solved by pulling in the right people and knowing that all involved held the interest of the project well above their individual interests.
  • Having engineering and trade partner involvement in early user-group meetings meant that not only was information heard firsthand, but what was important to the users was noticed and the “why” was very well understood. In addition, questions were asked that a traditional planning team may not have thought about. This involvement eliminated the need to go back to the owner in many instances, as the initial concept was already outlined.
  • The ability to get ahead of potential construction issues, even during construction, to pull in other trades, PIT teams, etc. and get everyone back in the room to determine a better solution.
  • Celebrating successes and milestones.

“The CannonDesign team worked with diverse stakeholders including administrators, physicians, medical and support staff, and other users. They were able to mediate all parties’ interests and emerge with a design that was welcomed by all,” said Jerry J. Peters, director of facilities planning and construction at Bayhealth. “The team has exceeded our expectations and achieved design excellence in concert with the thoughtful and thorough engagement of users, stakeholders, and the community.”

The new health campus is slated to open in 2019 (see Figure 6). Those interested in project updates and information can visit Bayhealth’ Sussex Campus website.