Organizing for Project Success: A Report From the Academy for Healthcare Infrastructure.

[Image omitted: See PDF.]How should an owner organize a capital project in order to achieve successful outcomes? Can the organization prepare itself to deliver the results it seeks?I have recently been involved as a facilitator and editor for a white paper on how owners might organize themselves to achieve success on major healthcare capital projects with the Academy for Healthcare Infrastructure, which is a program of the National Institute of the Building Sciences (NIBS) in the United States. The project involved interviewing 12 expert participants and producing a document with their consensus opinions about organizing projects. The white paper was presented in January at the annual NIBS Building Innovation conference in Washington, DC ([Hamilton, 2016]), and is available for free download at http://c.ymcdn.com/sites/www.nibs.org/resource/resmgr/AHI/AHI_WhitePaperTeam1.pdfThe 12 participants were recognized North American industry leaders, including representatives of public, private, and governmental healthcare systems, along with architects, engineers, contractors, and construction managers (CMs). These experienced expert professionals were consistent in their responses, leading to a consensus document that identified 12 guiding principles for project organization.Twelve PrinciplesIn many ways, the consensus principles they developed were predictable. They began with requiring vision on the part of the owner to be widely shared and followed with the need for clear, well-documented objectives. They emphasized the need for qualified, experienced internal and external staff together with a stable of prequalified consultants and contractors able to work within a hierarchical reporting structure. The group believed the owner should have standards that simplify decisions and do not stifle innovation. They insisted upon timely, effective communication as well as constant attention to cost and schedule control. Recognizing that these major capital projects involve people and personal relationships, they declared that everyone should have direct performance incentives and decisions ought to be addressed with all relevant persons in the room. Ultimately, they concluded that trust among the internal and external team members and between their organizations was a key to success.These are all commendable principles from which owners might benefit. There can be no doubt that a team of qualified, experienced professionals who work well collaboratively and communicate effectively in a context of trust can succeed. Following the owner's clear, shared vision, meeting the explicit objectives, and following established standards as guidelines mean the project may deliver what is expected. Success is not possible without careful monitoring of budget and schedule, based on accurate reporting and thoughtful course correction. These are common sense principles upon which all were agreed. In addition to the 12 consensus principles, some other material was discussed in which variation was identified.There can be no doubt that a team of qualified, experienced professionals who work well collaboratively and communicate effectively in a context of trust can succeed.Multiple Delivery Models Can Be EffectiveThe interview participants referenced multiple project delivery models. Different delivery models have been successful for large and small projects, private or public. The participants mentioned experience with traditional design-bid-build projects but also mentioned negotiated bid, CM at risk, design-build, and the Public-Private Partnership process. There was mention of two versions of integrated project delivery (IPD) including a contracting structure linking all of the partners, and an IPD-like structure done under a more traditional "hub" of contractual relationships with the owner at the center. The Department of Defense uses design-build, design-bid-build, early contractor involvement, integrated design-build-initial outfitting, and integrated design-bid-build (IDBB), among other models. …