Technology has changed every aspect of our lives. In fact, I had a healthy laugh a few weeks ago when I showed my children an old rotary phone and, get this, they did not know what it was. You see, they are now part of a generation that is accustomed to pulling out a smart phone to have dinner delivered by a complete stranger, groceries packed for pick-up within two hours, or even a potential spouse connection made online.
In the construction world, that same generation is communicating about project details via text and instant messages, checking on the status of material delivery trucks by GPS, and identifying design conflicts through 3-D and 4-D modeling.
In the healthcare arena, technological advances are improving diagnostics, treatment and patient care, as well as access to and storage of confidential patient information. The healthcare industry remains one of the most regulated ones in the nation, which can present some special challenges for design and construction. Nonetheless, when you marry technology, healthcare and construction, you have a real opportunity for success. Here are five lessons to remember when dealing with either new construction or renovation projects involving hospitals or other medical care facilities:
- It is imperative to get your information technology team involved in the design process, as well as a seat at the table during weekly construction meetings. It is no secret that technology changes on a regular basis ... Just check how much your laptop is worth two months after you purchase a new one!In the healthcare industry, the available technology can radically change from the time the design is finished to the time of substantial completion of the construction or renovation. By bringing the IT folks to the design table, you can begin to prepare for many of the changes in technology.
- It is important for all the players to be flexible. Since technology changes so rapidly (see above), flexibility is key to a successful implementation of new equipment, renovation of entire floors, or new construction of a medical facility. I worked on a particular project involving a design change during construction of the in-room work stations, which allowed physicians and nurses to face the patient while reviewing and charting information, as opposed to having their back to the patient, as originally designed.
- Choose equipment that allows all systems to communicate with each other. Although systems are beginning to be more compatible, it is important to talk with your vendors and specialty suppliers to make sure the various systems can integrate properly. You don't want to enter the commissioning period to learn that late in the game that software conflicts may require costly patches in terms of time and money to get a fully integrated system working.
- Get the end-users involved in the design and construction process. This does not mean your nurses will be carrying around hammers and nails. It means that the design team needs to understand the work flow of the end users and be ready to adapt to that information learned in the design process. It is equally important to understand the expectations of the end users and to implement those expectations into the end result.
- Prepare a contingency plan for your IT needs.Stated another way, don't put all your eggs in one basket. While this may seem to be a no-brainer, the entire team needs to talk through contingencies. These contingencies can involve problems, emergencies or expenses. The real lesson is to make sure each player (owner, architect, engineer, contractor) is talking about the same contingency and then to plan for that contingency.
The goal of each of the above tips is to provide consideration and integration of technology, design and construction for the unique challenges in a healthcare project. One of the most important ways to implement these tips, as an owner, is to consider alternative contract delivery methods when you hire your design and construction team.
You may be familiar with the traditional design-bid-build method where you hire an architect to design your project, look to potential contractors who will bid on the work, and ultimately hire a contractor to build the project. Other approaches include integrated project delivery (IPD) and design-build. An IPD approach actually involves a multi-party agreement where the owner, designer and contractor are all work together during design and construction, but each is ultimately responsible for their own work.
Under a design-build model, there is one single source of responsibility for the design and construction (i.e., a design-build contractor) throughout the entire process. This includes preparation of the estimate, to assessments and pre-construction activities, to architectural design, schematics, and engineering, to material selection and subcontractor/vendor selection, to construction, to completion and commissioning. Again, under a design-build approach, everything you need to successfully complete the project on time and within budget is management by one party at risk -- the design-builder.
Matt DeVries is a partner in the Nashville office of Burr & Forman and the former chair of the firm's Construction Practice Group. He is also founder of bestpracticesconstructionlaw.com, a construction-related blog that focuses on technology, project management, legal trends in the industry and lessons learned along the way. For more information, go to burr.com.
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