October 6, 2015
By Jeffrey Stouffer, AIA, ACHA, Executive Vice President/Health Group Director, HKS, Inc. and Sheryl Valentine, RN, BSN, MBB, MBA, MBOE, Lean Six Sigma Leader, Akron Children’s Hospital

Using a Lean process to achieve better outcomes in design, project delivery, construction and operations is something that sets Akron Children’s Hospital apart. 

A recent research study by the Center for Advanced Design Research (Dr. Upali Nanda) and Texas A&M University (Dr. Zofia Rybkowski) – funded by the Academy of Architecture for Health Foundation –highlighted the Akron project as a case study to identify the metrics that are currently tracked, and should be potentially tracked, to assess both implicit and explicit benefits. 

This study, called the “Value Analysis of a Lean Integrated Project Delivery,” assesses value based on a simple premise: Value is what you get (benefit) divided by what you give (cost). In a presentation at the 2015 ASHE PDC conference, the research team – along with John Bienko from the project team – shared some of the results of this study, as well as the feedback from stakeholders on the overall process. 

These are some key takeaways from the presentation:

  • The project came in $5.5 million under target cost (and $45 million under the original $40 million estimate); however, these calculations do not take into account the additional time that the Lean IPD projects require, due to the extensive needs of co-location and full scale mockups. The team developed a framework to calculate this cost, but without benchmarking with traditional design-bid build projects, a full return on investment (ROI) cannot be assessed.
  • Stakeholder feedback to the Lean IPD process was more positive than traditional project delivery, with the key differentiators identified as collaboration and learning.
  • Full floor Mockups were identified as the most valuable lean strategy by all stakeholders.
  • To conduct a true ROI study, a strong benchmark of design-bid-build projects, a more thorough documentation of incremental costs associated with Lean IPD projects, and a framework for assessing long-term/occupancy implications of design decisions are essential. Akron Children’s Hospital is currently putting a process in place that will measure the outcomes that were the rationale behind key design decisions.

The new hospital has already seen a spike in patient satisfaction scores on willingness to recommend and satisfaction with room (59th percentile to 90th percentile). While the outcomes are a result of facility design, operations and organizational culture, the Lean process allows a clear intentionality linking design thinking to targeted outcomes, and brings accountability to the design and delivery process. 

Click the link to view a brief summary and presentation provided at the ASHE PDC conference: http://www.cadreresearch.org/projects/the-value-analysis-of-lean-processes-in-design-and-integrated-project-delivery.

Posted in Health