Applying Big Lean Concepts to a Healthcare Client’s Smaller Projects

Applying Big Lean Concepts to a Healthcare Client’s Smaller Projects

We leveraged a 20-year relationship with a healthcare client in Northern California to bring lean thinking to their serial building program, including standardizing individual project delivery while optimizing the whole across their robust building program. After developing an understanding of integrated project delivery, and following several years of discussion, we finally identified a project where we could put in place a number of lean design and construction ideas.

The Challenge

Historically, and especially at the time, lean integrated projects were predominantly large and complex.  Owners wanted the benefit of lean thinking but felt they couldn’t use lean design and construction on smaller projects because of budget or time constraints. Therefore, we set out to answer the question, “is it possible to leverage big project lean methods on a small project?” With a small scope of 15,000 SF, a modest budget of $3.5 million, and a short, eight-month schedule, any lean methods employed needed to be high value, effective, and either remain cost neutral or provide savings.

The Process

As the project evolved slowly, we were able to plan for over a year with the owner to develop goals and map a path to leverage lean thinking. With a history of negotiated work and a strong network of trusted build partners, the owner was able to develop a sound integration plan for the project. Key elements of the plan included:

  • Process mapping to design the flow of individual diagnostic imaging modalities
  • Super DD exercise with users to advance the detail of the design
  • Casework shop drawings developed in DD phase and used for owner review
  • Co-location in a week-long Big Room to complete DD work collaboratively

The team spent several weeks planning the engagement, agreeing on a week of co-location in a conference room in one of our offices. Team members brought their workstations to the conference room the Friday before and confirmed network connectivity. The team assembled on Monday morning and worked together continuously for the full week. We quickly developed short, iterative cycles of work, clash, revise, repeat. We carved out times for imaging vendors, users, and field staff to visit the Big Room and contribute from their perspective. Each of the stakeholders took turns hosting a day of the week, providing lunch and helping to build a sense of team.

Following the Big Room Week, the team disbanded and returned to their respective offices to complete their building packages. Because the team had thoroughly enjoyed being together, they decided collectively to set up two additional Big Room days to complete subsequent coordination work during the CD phase.

The Results

Simple, common sense solutions carried the day.

  • We selected the builder based on agreed integrated behavior, including design-build trade partners for MEP. The contract was GMP, but with agreed provisions for co-located design time (MEP + GC pre-con clash detection and coordination) and preferred trades (casework) written into the contract.
  • Because we committed to using the BIM for coordination, and because we had shop drawings for casework by the time DDs were complete, we were able to eliminate a significant number of drawings from the permit set (primarily interior elevations) that normally would have been needed for coordination between trades.
  • We spent an hour with the casework vendor, referencing the floor plan and sketching quick elevations of each casework type. They took careful notes, drew up the casework in their CAD/CAM software, and produced shop drawings that included an isometric view of each casework type. We reviewed the shop drawings with the end user, noted changes, and completed the casework design with no duplicative effort or re-drawing.
  • Rather than hosting files in a central location, people simply shared a flash drive with the files, as needed. Activity began as coordination, but quickly transformed to co-design, reducing the amount a re-work from a clash detection cycle.
  • Despite submitting only two interior elevations in the permit set, we added a few additional floor plan notes and an extra casework detail which allowed the plans to sail through review with the AHJ.
  • We reduced the design duration from 18 weeks to 15 weeks because of efficiency gains due to co-location.

Lessons Learned

Integrated behavior. We identified the behaviors we wanted (co-location, sharing of models, shop drawings as design documents, etc.), developed a plan, and wrote them into the basic services provided by the builder and the design-build trade partners. We found no need for a fancy contract.

The Little Big Room approach works! We have employed the Little Big Room approach on subsequent small-scale projects and have concluded that lean behavior is unequivocally scalable and can be a significant value add to any project.