January 9, 2019

Adopting a New Mindset to Improve Your ED Design Process


Projects, like people, are all unique in their own way. One might conclude that because Haskell specializes in healthcare architectural design our projects and their deliveries are more similar than not, but nothing could be further from reality. Each project is encouraged to adapt to the attributes of its owner, the clinical team, and the community it will serve. One way to do this is through Integrated Project Delivery (IPD).

What Is IPD?

The American Institute of Architects defines IPD as “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 optimize project results, increase values to the owner, reduce waste, and maximize efficiency through all phases of design, fabrication, and construction.”

The “IPD formula” can be adapted to suit an individual owner’s, project’s, and indeed delivery team’s desire and intent. That the IPD delivery method can develop as uniquely as each owner is inclined speaks to a) the desired change and adaptation for project arrangement and delivery within our industry, and b) the flexibility inherent in the model itself.

Successful execution of IPD requires an elemental shift in the historical role and traditional conduct of all parties. Concentration on what is best for the project as a whole and not what may benefit one entity is paramount. Adjusting to this mindset perhaps necessitates a different outlook from what team members were taught or have experienced. This new paradigm is not insurmountable but does require constant reminders and consistent checks-and-balances among the team.

Integral to IPD’s rise within our industry is the ability to deliver projects that embrace LEAN project development, enhance efficient performance within the design and construction process, reduce overall design and construction cost, and balance the need for a profitable engagement with their overall exposure.

The chart below compares the traditional delivery model to IPD. The MacLeamy curve shows that projects become costlier when changes occur later in the design’s development process and during construction. IPD seeks to initiate early collaboration of all parties who provide simultaneous valuable information. Design’s cyclical and iterative process can be more efficient when influenced by all factors at once (as opposed to the traditional linear process).

MacLeamy Curve

IPD in Action

Haskell has had several recent opportunities to utilize the IPD approach for project delivery, including our recent engagement with UHS and Manatee Memorial Hospital (MMH) to deliver a new emergency department. MMH commissioned a 37,000 sf addition to its emergency care center to accommodate the region’s growing population.

The arrangement of this multidisciplinary team initiated early in the project’s design process and benefited from each entity’s expertise. Instituting an atmosphere of trust, transparency, and value-based decision-making encouraged team members’ collaboration.

Here’s how we achieved success for MMH using IPD.

  • Collaborating through a Big-Room Meeting. Information sharing among team members kept all informed of project developments, anticipated obstacles, and potential changes. Attendance was required, and a successful balance was developed for entities that were not local to the project site. In today’s environment numerous technological advances promote communication and teaming. While person-to-person interaction is fundamentally necessary, once initial relationships have been established technology can be used to maintain efficiency and project cost control. As well, project meetings can be adjusted from weekly initially to every other week later in the project.
  • Establishing a Basis-of-Design. Using this process for various project components permits each entity to voice concerns and considerations that should ultimately influence the overall design and what is best for the project holistically. Each entity should share their expectations early in the process so components can be vetted and challenged, and assumptions validated.
  • Evaluating Repetitive Features for Optimization. Like basis-of-design, all parties should analyze aspects that will be repeated throughout the project in multiples so the best decisions can be made. An example on the MMH project was the ED exam room headwall. Each component and its compilation into the overall headwall design was vetted prior to replication throughout the project.

Emergency department exam room headwall

  • Continual Cost-Estimating to Keep the Budget in Check. In lieu of evaluating cost at typical project milestones, such as Schematic Design, Design Development, and Construction Documents, IPD permits this process to occur early, often, and throughout the entire process. This team incorporated a project budget review as part of the reoccurring agenda for each big-room meeting. As products or design arrangements developed the overall team was made aware so they might review, evaluate, and advise.

IPD can be expected to gain traction within our industry. While it’s not yet the prevalent method of delivery it will most likely increase exponentially as more project success stories, such as ours, become prevalent.

Haskell delivers $2± billion annually in Architecture, Engineering, Construction (AEC) and Consulting solutions to assure certainty of outcome for complex capital projects worldwide. Haskell is a global, fully integrated, single-source design-build and EPC firm with over 2,200 highly specialized, in-house design, construction and administrative professionals across industrial and commercial markets. With 20+ office locations around the globe, Haskell is a trusted partner for global and emerging clients.

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