As more and more healthcare organizations are faced with the need to renovate or build new in increasingly competitive regional markets, theyre feeling a sharp pinch on resources. Capital is, of course, a primary concern, but human resources are also being stressed.
Already over-taxed administrators are discovering that the management of the years-long process of planning, designing and building is challenging if not impossible. A one-contract, one-contact solution is emerging as the golden answer.
Design-build is emerging as the most competitive delivery method
True design-build is an integrated, single-source delivery model in which one firm takes on 100% accountability. Unlike design-bid-build models, in which unrelated firms partner on a project, design-build offers strategic planners, architects, engineers and construction managers under one roof. Some even offer interior design, real estate development and financing and ownership structures.
Design-build has gained an increasing share of the construction market, today representing 40% of all non-residential construction work and a rapidly expanding amount of healthcare facility work. Organizations are experiencing first-hand what was recently confirmed by Construction Industry Institute (CII) research. Design-build outperforms design-bid-build (DBB) and other traditional approaches in all areas: costs, change orders, schedules and quality. It can cut project expenses from five to seven percent and delivery times by as much as 33%, according to CII.
Taking advantage of inherent cost savings
Design-build firms can offer highly competitive costs because there are no duplicate or overlapping fees from partnering firms, and integrated delivery is inherently efficient. In addition, a design-build firms infrastructure mitigates the chance of miscalculations because all key personnel sit down from the very beginning, ensuring the best decisions are made at project inception.
This leads to fewer costly change orders down the road. For instance, the industry average is nine percent of total contract value. Design-build firms like Marshall Erdman & Associates (ME&A) average less than two percent.
In addition, the single contract approach enables design-build firms to take advantage of unforeseen circumstances as they crop up. For instance, they can more easily fast-track a construction schedule. During a recent project, ME&A laid a foundation much earlier than anticipatedwhile still in the early stages of design developmentto take advantage of a very dry summer. Because the site generally had very high-moisture soil, the ability to execute this initiative saved the client from the steep expense of soil replacement. Problem arises in the field, it can be dealt with in 24 hours or less, no layers of people and firms
Similarly, the construction managers were able to shift estimates to actual subcontractor proposals early on, which allowed for firmer budgets and cost controls from the start. The architects could weigh the impact of any changes using reliable real-time cost and scheduling information submitted by their colleagues.
And while organizations benefit from an integrated delivery model, they will benefit their communities as well. Most design-build firms sub-contract the actual construction to local firms, while maintaining on-staff construction managers. That translates into a win-win for healthcare organizations: The design-build firm funnels money back into the local economy, while retaining all responsibility for the sub-contractors and construction.
Providing the best model for energy efficiencies and sustainable design
Another enormous benefit has surfaced as sustainable design exploded on the national healthcare scene last year. The Green Guide to Healthcare (GGHC), a benchmarking program that provides the healthcare sector with a voluntary, self-certifying toolkit of sustainable-design best practices, recently released highlights of its 2006 Annual Report. It shows a 45% increase in registered healthcare projects over the year before, half of which are new construction and 60% of which are acute care facilities.
Design-build has been recognized by the sustainable community as the delivery model of choice for effective green building. This is in large part due to the fact that the success and economic benefits of sustainable design are largely dependent on an integrated team approach that incorporates green features from the earliest planning stages. Each sustainable strategy typically has multi-disciplinary impacts that need to be considered. With an integrated infrastructure already in place, not to mention years of experience executing under this model, design-build is the obvious choice.
One firm, 100% accountability
Perhaps the biggest benefit design-build offers is a no “finger-pointing” approach. In addition to full responsibility through project completion, the top firms have highly developed quality assurance programs as well, offering the security of long-lasting value and a clear answer if something does need to be revisited down the road. It simply boils down to a crucial, inherent benefit: one firm 100% accountability.
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