CMAdvisor May/June 2010 - 10

PROFESSIOnAl PRACTICE CORnER
California health Care Facilities Program— The Experiment
By Alan Plummer, CUMMING
What Didn’t Work: • Lack of communication hub. While there was a team leader for each IPD team, no one individual was identified as a single point of contact for all communications. Without a clearly defined team leader, critical pieces of information often fell through the cracks. Comments such as “did you get the latest drawings for the housing support” were as common as “no, I wasn’t copied on that email.” At best this meant wasting valuable time, at worst it meant basing several days of work on outdated information. • Lack of documentation. Often the informality of quick questions and impromptu meetings didn’t lead to any follow up so that the rest of the IPD team was aware of the decision. There was often a time-consuming process required to track a decision back to its source and verify that a decision was made by someone with the appropriate authority. • Lack of internal analysis. A system for raising concerns should have been in place from the beginning so that team members didn’t feel they had to wait for a formal review of the process by a top manager. One architect says it perfectly in his own critical analysis: “Every team member should feel empowered to pull the cord and stop the train if they can see it’s off the track.” What Worked: • Sharing of methods and resources. The open nature of the work environment meant that each team really didn’t keep “secrets” from the others. Sketches and print-outs of computer generated models were posted openly on the wall, and other teams were welcome to walk by and see the methods used by their “competition.” As the teams merged later in the process, resources between no less than 10 architectural firms, four general contracting firms, and various subcontractors were shared in order to achieve the tight deadlines that otherwise might not have been feasible. • Creative optimization. This was the original intent of having competing teams work concurrently on the same design problem. For example, one design team might come up with a creative method of bringing natural light into the housing cluster space, and another team might come up with a layout that allows for direct supervision of prisoners from all angles. Within the “Co-Opetition” there was no need to sacrifice either of these unique ideas, since the owner would pick and choose the best ideas as the design progressed.

I would like to share some “lessons learned” after working on a massive California Health Care Facilities Program over a three-month period. This unprecedented program utilized several unique delivery methods, many of which are relatively experimental in the construction industry. An appropriate analogy for this program would be a science experiment in which more than one variable is changed simultaneously. The conclusions drawn from this “experiment” can apply to future construction programs. The California Health Care Facilities Program resulted from a 2005 class-action lawsuit brought against the state of California on behalf of inmates within the state prison system, demanding minimum constitutional-level health care. A federal judge found in favor of the plaintiffs, ordering that 10,000 health care beds and other facilities be provided at seven existing prisons. These facilities are unique in the sense that their focus is intended to be healthcare with a security underlay, as opposed to a prison facility with a healthcare underlay.

decided to deviate from the typical project delivery method and opt for a “Co-Opetition” among three teams, each following the “Integrated Project Delivery” method. The logic behind this decision was not only that the program could be designed and delivered more quickly and efficiently, but that this approach would generate more innovative designs and construction methods.

Definitions and Outcomes Integrated Project Delivery (IPD)
Definition: Integrated Project Delivery, commonly referred to by its acronym “IPD,” refers to the process of managing design and construction by a unified team composed of general contractor (GC), architect, engineers, and key subcontractors under a single contract with the owner. It is similar to Design-Build delivery, but expands beyond a prime/ sub relationship between the GC and architect so that all parties share risk and reward commensurate with their expertise. In this instance three teams were selected, led by DPR, Hensel Phelps, and a joint venture between Clark and McCarthy. What Worked: • Working within proximity to the design team. The physical layout of the office space placed all parties together in an open environment, where questions of clarification were as easy as shouting out to an architect across the table, “Hey Joe, which rooms of the patient treatment area need to have radiation shielding.” This cut through the red-tape of submitting RFIs. • Relationships with team members. More so than a traditional project, stronger relationships were formed by seeing other members of the IPD team face-to-face every day.

Co-Opetition
Definition: The term “Co-Opetition” may be unique to this program and refers to the three independent IPD teams working in the same physical space toward the common goal of providing their own design and delivery vision for the program. The “co-op” portion of the word reflects how all three teams ultimately had to work together to arrive at a single prototype design for a corrective medical facility which would be applied to seven different sites. The “-tition” portion of the word means the teams are also engaged in a competition for their design elements to “win” and be carried forward, and to “win” their desired project site. It is worth noting that “Co-Opetition” was the general philosophy from July through the month of November, at which point the three IPD teams essentially combined into a single, “cream of the crop” team that all worked together rather than independently in the design process. It would be accurate to say that after November the “Co-Opetition” ceased and the “Co-Operation” began.

““Co-Opetition” was the general philosophy from July through the month of November, at which point the three IPD teams essentially combined into a single, “cream of the crop” team that all worked together rather than independently.”

“Not only that the program could be designed and delivered more quickly and efficiently, but that this approach would generate more innovative designs and construction methods.”

CMAdvisor May/June

Because the compelling reason for the ruling was the appalling mortality rate in California prisons, as much as six unnecessary deaths per day, there is an acute emphasis on the timeframe in which these new facilities are to be constructed. Therefore, the “owner” (a receiver appointed by the ruling judge)

CMAdvisor May/June

What Didn’t Work: • Co-Opetition intent stifled by imposed guidelines. This was ultimately the core problem that led to the three teams merging into one. A group of representatives from the owner’s side (security consultants, health care consultants, nurses, etc.) would sit down with each team and give mandatory design direction. As these design directions became more focused and specific, they led all three teams closer to the same design solution, defeating the intent of the Co-Opetition. One example was their directive that an officer in the housing clusters must be able to see all angles of the space from any location (the owner group’s interpretation of the phrase “direct supervision”). This single decision ruled out all previous design layouts in the shape of an “L,” radial spokes, and other promising ideas,

CMAdvisor May/June 2010

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