Healthcare Design - November 2015 - 108


| 11.15
role in the design phase than it traditionally does
under a design-bid-build contract, which can
be a drawback if it isn't yet fully engaged or
focused on the project
* The team relies on the CM for estimating, and
occasionally the pricing may not reflect design
evolution or intent.
Design-build
The design-build model creates a single entity;
there is just one contract. The client provides the
goals and program for the project and works with
a design-build team (contractor and architect)
that's fully responsible for delivery of the project.
It's more often utilized for simpler building types,
such as MOBs or parking garages, rather than
hospital projects. In more complex project types,
such as a significant healthcare expansion or
renovation, design professionals can better serve
the client if they're contracted directly to them
rather than working for the builder.
Pros:
* There's a single contract for both design and
construction
* Schedules can be expedited
* Decisions happen more quickly
* Costs are established early and client risk is
controlled
* The design team is generally contracted
through the general contractor, which simplifies the client interface by having just one party
to work through.
Cons:
* There's a loss of checks and balances in the
architect/general contractor relationship
* The owner's involvement is limited
* The process may not bring the best designer
and best builder together.
Integrated project delivery
The integrated project delivery (IPD) model creates a new contractual business structure that
includes the owner, the architect, and the CM,
which are brought together in a limited partnership. The American Institute of Architects currently defines IPD as "a project delivery method that
integrates people, systems, business structures,
and practices into a process that collaboratively
harnesses the talents and insights of all participants to reduce waste and optimize efficiency
through all phases of design, fabrication, and
construction."
Pros:
* The tripartite team is contractually bound
together under a true IPD contract
108

HCDmagazine.com 11.15

* Multilateral collaboration is encouraged
* It's a high-efficiency delivery model
* Owner risk is limited by a team approach to risk
and reward incentives
* Teams are better able to deliver projects within
budget and schedule.
Cons:
* It requires a sophisticated owner that's willing to
be highly involved in the project delivery
* Contractual issues will often have to be addressed
* Additional risk is created for the design and construction entities, in exchange for incentives that
may or may not be achieved.

Design-assist is a relatively new delivery
model that requires early involvement of
subcontractors.
Design-assist
Design-assist is a relatively new delivery method
that isn't a true contractual arrangement like the
other examples and requires early involvement of
subcontractors. This delivery approach can be used
with almost any of the contracts described above
and is always used with another method. Design-assist is especially valuable when there's need to save
design and construction time or secure time-sensitive materials, or if there's an unusual requirement
of some kind. Specialty contractors (MEP, glazing,
structural steel, elevators, waterproofing) join the
team early to assist in the design.
It's possible to create a more efficient process by
having the subcontractor that will be building the
project assist the design team in developing layouts,
details, and even systems to maintain a certain price
and/or schedule. To be most effective, the designassist team members should be brought onto the
team at the end of schematic design or the first portion of the design development phase.
Pros:
* Approval time is reduced, since the subcontractor
has been engaged in the design process
* There's potential for fewer changes in the field
* Overall scheduling (by securing manufacturing production slots to ensure timely delivery) is
improved
* Prefabrication of building components-which
supports the schedule, project quality, and jobsite
safety-works well with this method.
Cons:
* Competition is reduced because the team commits to a certain subcontractor with an agreed-


http://www.HCDmagazine.com

Table of Contents for the Digital Edition of Healthcare Design - November 2015

Healthcare Design - November 2015
Contents
HCD Online
Editorial
Monitor
The Center
The Retailing of Healthcare
Mixed Methods
Come Together
The Driver’s Seat
Generation Next
Going Deep
New Neighbor
Ready, Set, Show
Construction
Research
Special Advertising Section: Buyers Guide
Special Advertising Section: Project Watch
First Look
Healthcare Design - November 2015 - Healthcare Design - November 2015
Healthcare Design - November 2015 - Cover2
Healthcare Design - November 2015 - 1
Healthcare Design - November 2015 - Contents
Healthcare Design - November 2015 - 3
Healthcare Design - November 2015 - 4
Healthcare Design - November 2015 - 5
Healthcare Design - November 2015 - HCD Online
Healthcare Design - November 2015 - 7
Healthcare Design - November 2015 - Editorial
Healthcare Design - November 2015 - 9
Healthcare Design - November 2015 - 10
Healthcare Design - November 2015 - 11
Healthcare Design - November 2015 - 12
Healthcare Design - November 2015 - 13
Healthcare Design - November 2015 - Monitor
Healthcare Design - November 2015 - 15
Healthcare Design - November 2015 - 16
Healthcare Design - November 2015 - 17
Healthcare Design - November 2015 - 18
Healthcare Design - November 2015 - 19
Healthcare Design - November 2015 - 20
Healthcare Design - November 2015 - 21
Healthcare Design - November 2015 - 22
Healthcare Design - November 2015 - 23
Healthcare Design - November 2015 - 24
Healthcare Design - November 2015 - 25
Healthcare Design - November 2015 - 26
Healthcare Design - November 2015 - 27
Healthcare Design - November 2015 - The Center
Healthcare Design - November 2015 - 29
Healthcare Design - November 2015 - The Retailing of Healthcare
Healthcare Design - November 2015 - 31
Healthcare Design - November 2015 - 32
Healthcare Design - November 2015 - 33
Healthcare Design - November 2015 - 34
Healthcare Design - November 2015 - 35
Healthcare Design - November 2015 - 36
Healthcare Design - November 2015 - 37
Healthcare Design - November 2015 - 38
Healthcare Design - November 2015 - 39
Healthcare Design - November 2015 - 40
Healthcare Design - November 2015 - 41
Healthcare Design - November 2015 - Mixed Methods
Healthcare Design - November 2015 - 43
Healthcare Design - November 2015 - 44
Healthcare Design - November 2015 - 45
Healthcare Design - November 2015 - 46
Healthcare Design - November 2015 - 47
Healthcare Design - November 2015 - 48
Healthcare Design - November 2015 - 49
Healthcare Design - November 2015 - 50
Healthcare Design - November 2015 - 51
Healthcare Design - November 2015 - 52
Healthcare Design - November 2015 - 53
Healthcare Design - November 2015 - 54
Healthcare Design - November 2015 - 55
Healthcare Design - November 2015 - Come Together
Healthcare Design - November 2015 - 57
Healthcare Design - November 2015 - 58
Healthcare Design - November 2015 - 59
Healthcare Design - November 2015 - 60
Healthcare Design - November 2015 - 61
Healthcare Design - November 2015 - 62
Healthcare Design - November 2015 - 63
Healthcare Design - November 2015 - 64
Healthcare Design - November 2015 - 65
Healthcare Design - November 2015 - The Driver’s Seat
Healthcare Design - November 2015 - 67
Healthcare Design - November 2015 - Generation Next
Healthcare Design - November 2015 - 69
Healthcare Design - November 2015 - 70
Healthcare Design - November 2015 - 71
Healthcare Design - November 2015 - 72
Healthcare Design - November 2015 - 73
Healthcare Design - November 2015 - 74
Healthcare Design - November 2015 - 75
Healthcare Design - November 2015 - Going Deep
Healthcare Design - November 2015 - 77
Healthcare Design - November 2015 - 78
Healthcare Design - November 2015 - 79
Healthcare Design - November 2015 - 80
Healthcare Design - November 2015 - 81
Healthcare Design - November 2015 - New Neighbor
Healthcare Design - November 2015 - 83
Healthcare Design - November 2015 - 84
Healthcare Design - November 2015 - 85
Healthcare Design - November 2015 - 86
Healthcare Design - November 2015 - 87
Healthcare Design - November 2015 - 88
Healthcare Design - November 2015 - 89
Healthcare Design - November 2015 - 90
Healthcare Design - November 2015 - 91
Healthcare Design - November 2015 - 92
Healthcare Design - November 2015 - 93
Healthcare Design - November 2015 - Ready, Set, Show
Healthcare Design - November 2015 - 95
Healthcare Design - November 2015 - 96
Healthcare Design - November 2015 - 97
Healthcare Design - November 2015 - 98
Healthcare Design - November 2015 - 99
Healthcare Design - November 2015 - 100
Healthcare Design - November 2015 - 101
Healthcare Design - November 2015 - 102
Healthcare Design - November 2015 - 103
Healthcare Design - November 2015 - 104
Healthcare Design - November 2015 - 105
Healthcare Design - November 2015 - Construction
Healthcare Design - November 2015 - 107
Healthcare Design - November 2015 - 108
Healthcare Design - November 2015 - 109
Healthcare Design - November 2015 - Research
Healthcare Design - November 2015 - 111
Healthcare Design - November 2015 - 112
Healthcare Design - November 2015 - 113
Healthcare Design - November 2015 - Special Advertising Section: Buyers Guide
Healthcare Design - November 2015 - 115
Healthcare Design - November 2015 - 116
Healthcare Design - November 2015 - 117
Healthcare Design - November 2015 - 118
Healthcare Design - November 2015 - 119
Healthcare Design - November 2015 - 120
Healthcare Design - November 2015 - 121
Healthcare Design - November 2015 - 122
Healthcare Design - November 2015 - 123
Healthcare Design - November 2015 - 124
Healthcare Design - November 2015 - 125
Healthcare Design - November 2015 - 126
Healthcare Design - November 2015 - 127
Healthcare Design - November 2015 - 128
Healthcare Design - November 2015 - 129
Healthcare Design - November 2015 - 130
Healthcare Design - November 2015 - 131
Healthcare Design - November 2015 - 132
Healthcare Design - November 2015 - 133
Healthcare Design - November 2015 - 134
Healthcare Design - November 2015 - 135
Healthcare Design - November 2015 - 136
Healthcare Design - November 2015 - 137
Healthcare Design - November 2015 - 138
Healthcare Design - November 2015 - 139
Healthcare Design - November 2015 - 140
Healthcare Design - November 2015 - 141
Healthcare Design - November 2015 - 142
Healthcare Design - November 2015 - 143
Healthcare Design - November 2015 - 144
Healthcare Design - November 2015 - 145
Healthcare Design - November 2015 - 146
Healthcare Design - November 2015 - 147
Healthcare Design - November 2015 - 148
Healthcare Design - November 2015 - 149
Healthcare Design - November 2015 - 150
Healthcare Design - November 2015 - 151
Healthcare Design - November 2015 - 152
Healthcare Design - November 2015 - 153
Healthcare Design - November 2015 - 154
Healthcare Design - November 2015 - 155
Healthcare Design - November 2015 - 156
Healthcare Design - November 2015 - 157
Healthcare Design - November 2015 - 158
Healthcare Design - November 2015 - Special Advertising Section: Project Watch
Healthcare Design - November 2015 - 160
Healthcare Design - November 2015 - 161
Healthcare Design - November 2015 - 162
Healthcare Design - November 2015 - 163
Healthcare Design - November 2015 - 164
Healthcare Design - November 2015 - 165
Healthcare Design - November 2015 - 166
Healthcare Design - November 2015 - 167
Healthcare Design - November 2015 - First Look
Healthcare Design - November 2015 - Cover3
Healthcare Design - November 2015 - Cover4
Healthcare Design - November 2015 - AIA1
Healthcare Design - November 2015 - AIA2
Healthcare Design - November 2015 - AIA3
Healthcare Design - November 2015 - AIA4
Healthcare Design - November 2015 - AIA5
Healthcare Design - November 2015 - AIA6
Healthcare Design - November 2015 - AIA7
Healthcare Design - November 2015 - AIA8
Healthcare Design - November 2015 - AIA9
Healthcare Design - November 2015 - AIA10
Healthcare Design - November 2015 - AIA11
Healthcare Design - November 2015 - AIA12
Healthcare Design - November 2015 - AIA13
Healthcare Design - November 2015 - AIA14
Healthcare Design - November 2015 - AIA15
Healthcare Design - November 2015 - AIA16
Healthcare Design - November 2015 - AIA17
Healthcare Design - November 2015 - AIA18
Healthcare Design - November 2015 - AIA19
Healthcare Design - November 2015 - AIA20
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