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Set-based design: case study on innovative hospital design
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  SET-BASED DESIGN: CASE STUDY ONINNOVATIVE HOSPITAL DESIGN Kristen Parrish 1 , John-Michael Wong 2 , Iris D. Tommelein 3 and BozidarStojadinovic 4 ABSTRACT  This paper describes collaboration efforts of a project team that implemented leanconcepts in the course of structural system selection during the design phase of ahospital project. Out-of-the-box thinking, contractual incentives for team work, earlycollaboration, and a set-based design approach led to the development of aninnovative and cost-effective structural system that may set precedent for othermedical facilities to be constructed in seismically active zones. The structural design team on this project rigorously explored the design spaceand tested design alternatives against project value propositions. When pushed by theowner to think more broadly, the structural engineer proposed using a newtechnology, namely viscous damping walls. This concept was developed in Japan buthas not yet been tried on projects in the United States. Because it is a first, thissolution requires not only rigorous analysis and testing by the structural engineer butalso detailed investigation by the state's regulatory agency that issues buildingpermits. This paper describes the team's efforts at defining the design space and theset-based design approach they used. A key lesson from this case study is that teamshave a lot to learn about how to make requests and commitments while pursuing set-based design to be lean. KEY WORDS lean construction, coordination, collaboration, set-based design, stakeholder value,integrated project delivery, relational contracting, viscous damping walls, seismicdesign, structural engineering   1 Graduate Student, Civil and Environmental Engineering Department, University of California,Berkeley, CA, kristen_parrish@berkeley.edu 2 Graduate Student, Civil and Environmental Engineering Department, University of California,Berkeley, CA, jmwong@ce.berkeley.edu 3 Director, Project Production Systems Laboratory http://p2sl.berkeley.edu/ and Professor, Civil andEnvironmental Engineering Department, 215-A McLaughlin Hall, University of California,Berkeley, CA 94720-1712, Phone +1 510/643-8678, FAX +1 510/643-8919,tommelein@ce.berkeley.edu 4 Professor, Civil and Environmental Engineering Department, 721 Davis Hall, University of California, Berkeley, CA 94720-1710, Phone +1 510/643-7035, FAX +1 510/643-8928,boza@ce.berkeley.edu INTRODUCTION Structural system selection during thedesign phase of a hospital project is nosmall task. The system must meetmany requirements imposed byowners, architects, engineers, andothers, most notably in the case beingstudied: California's Office of Statewide Health Planning andDevelopment(OSHPD)(http://www.oshpd.ca.gov/).OSHPD serves the state in the process 413 Parrish, K., Wong, J.M., Tommelein, I.D., and Stojadinovic, B. (2008)."Set-Based Design: Case Study on Innovative Hospital Design."In Tzortzopoulos, P. and Kagioglou, M. (Eds.) (2008). Proceedings of the 16th Annual Conference of theInternational Group for Lean Construction (IGLC 16), 16-18 July, Manchester , UK, pp. 413-423.  Set-Based Design: Case Study on Innovative Hospital DesignKristen Parrish, John-Michael Wong, Iris D. Tommelein and Bozidar StojadinovicProceedings for the 16 th Annual Conference of the International Group for Lean ConstructionProduct Development and Design Management of building permitting by verifying thathospital designs comply with itslegislative framework for seismicsafety. The Hospital Facilities SeismicSafety Act, SB 1953 (1994)(Safety2001), requires that acute carefacilities remain functional during andfollowing an earthquake. In order tomeet these stringent requirements,owners, architects, structuralengineers, contractors, and otherspecialists alike have been forced tore-think their design and constructionstrategies. An accepted structuraldesign solution to achieve seismicperformance in California has been touse base-isolated structural systems(see e.g.,http://nisee.berkeley.edu/lessons/kelly.html). These systems tend to be costeffective, but not necessarily on allhospitals. For example, on sites with asteep grade, as is the case here, it isdifficult to build the moat around thefacility as needed to allow the base-isolated structure to slide. This paperreports on how a structural designteam developed an innovativealternative solution on their project. CASE STUDY BACKGROUND  The California Pacific MedicalCenter's (CPMC) Cathedral Hillproject is a new 600-bed hospital inSan Francisco, California, budgeted at$1.7 billion (Figure 1). The hospital is93,000 m 2 (1,000,000 ft 2 ) with 555parking stalls with a total of 13 aboveand below grade stories. The project issited on sloping terrain, 18 km (11 mi)from the nearest active earthquakefault. Design of the Cathedral Hillhospital began in 2005 and the projectis expected to complete in 2013. Figure 1: Schematic Building Shape and Skin (Photo takenby John-Michael Wong 2/25/08).Figure 2: Viscous Damping Wall Model(Photo taken by John-Michael Wong2/25/08). CPMC is an affiliate of Sutter Health,a major healthcare provider inNorthern California. Sutter Health hasshown a commitment to lean practicesin its hospital design and deliveryprocesses (Lichtig 2005b) and ismanaging a portfolio of lean projects(e.g., Mikati et al. 2007). As a part of this lean implementation, Sutter Healthencourages project teams to implementthe 'Five Big Ideas' (Macomber 2005):(1) Collaborate, Really Collaborate; 414  Set-Based Design: Case Study on Innovative Hospital DesignKristen Parrish, John-Michael Wong, Iris D. Tommelein and Bozidar StojadinovicProceedings for the 16 th Annual Conference of the International Group for Lean ConstructionProduct Development and Design Management (2) Manage as a Network of Commitments; (3) Increase theRelatedness of the Project Participants;(4) Tightly Couple Learning withAction; and (5) Optimize the Project asthe Whole. These ideas, implementedusing a relational contract called theIntegrated Form of Agreement (IFOA)(Lichtig 2005a, 2005b, 2006), havefostered an environment of collaboration and innovation on theproject.Cathedral Hill project participantsinclude CPMC (owner), SmithGroup(architect), Degenkolb (structuralengineer), Herrick (steel fabricator),Dowco (steel detailer), DynamicIsolation Systems (supplier of viscousdamping walls)(Figure 2), Pankow(concrete subcontractor),Herrero/Boldt (general contractor), andother companies. RELATED WORK D ESIGN M ANAGEMENT T HEORY  The design of a project in theArchitecture/Engineering/Construction(AEC) industry, like the developmentof a new product in other industries,can be managed in different ways. Terwiesch et al. (2002) characterizeiterative and set-based designmanagement approaches in newproduct development projects in termsof ambiguity and uncertainty asdefined by Schrader et al. (1993).Uncertainty is defined as a lack of information. Ambiguity is defined as alack of clarity. Terwiesch et al. explainthat iterative design strategies workbest in ambiguous environments whileset-based design strategies work bestin uncertain environments. Theyexplain that starvation (lack of workfor the downstream participants) canoccur as a result of too little detailbeing available in a set-based designenvironment. Similarly, rework canresult in an iterative designenvironment when the upstreamsuppliers of information pass onspecific yet incorrect detail. Theseobservations are pertinent to this casestudy.Collaborative team work has beenstudied widely. Of particular note herefor its application in AEC is Lottaz etal.'s (1999) use of a constraint-basedapproach to manage the fabrication of beams for a steel frame building withductwork holes cut into them. Lottaz etal. suggest that all project participantsuse an internet based collaborative toolto decide on diameters and locations of ductwork holes. This tool tracksconstraints concerning ductwork aswell as the abilities of each projectparticipant to change the design. Theirimplementation of a constraint-management system allowed forpostponement of commitment tospecific diameters and locations. This,in turn, reduced rework as the steelfabricator was able to fabricatecomponents based on reliableinformation, rather than with assumedvalues that later changed.Macomber and Howell (2003)critique the activity-centredmanagement paradigm definingprojects as a series of transformationsof "energy to 'materials'" and suggestthat projects are actually a "network of commitments," a notion rooted inlinguistic action. Whereas the critical-path method perspective on projectmanagement views a project as anetwork of activities, the linguisticaction perspective views projects asnetworks of requests and promises.Macomber and Howell stress the needfor reliable promising—clearlycommunicating requests and reliably 415  Set-Based Design: Case Study on Innovative Hospital DesignKristen Parrish, John-Michael Wong, Iris D. Tommelein and Bozidar StojadinovicProceedings for the 16 th Annual Conference of the International Group for Lean ConstructionProduct Development and Design Management committing to deliver on thoserequests—in lean project delivery.Gil et al. (forthcoming) discussdesign postponement on largeinfrastructure projects. They develop aset of propositions detailing use casesof iterative design, set-based design,buffers, and modularization. Using thenotions of uncertainty and ambiguitydefined by Schrader et al. (1993), Gilet al. explain that iterative design isfavourable when "they [upstreamdevelopers] believe that the assumedbenefits of adapting their designsoutweighs the costs". They go on topropose "upstream developers will notinvest in set-based exploration whenthey expect downstream uncertaintyand ambiguity to remain unresolveduntil late in the implementation of theupstream design." Similar phenomenawere observed on the projectdocumented here. S ET -B ASED D ESIGN M ETHODOLOGY In current design practice, manydesigners follow a point-basedmethodology, exploring one ormultiple alternatives, but developingeach one separately from the others. They select a design, or point, early inthe process and then develop thatdesign in more detail. When inputfrom others is received, that designmay prove to be infeasible or requiresignificant rework in order to remainacceptable. By contrast, designers mayuse set-based design and postponecommitting to a specific design,allowing them to consider multiplealternatives for longer than is typicalwith a point-based methodology. Adesign team can then review sets of design alternatives available to eachteam participant, integrate these sets tofind compatible combinations andweigh input from several projectparticipants at the same time, early on,and throughout project delivery, whilestudying tradeoffs between whatindividual participants value and whatis of value to the project as a whole.Set-based communication helpsparticipants avoid rework and, throughteamwork, develop a more globallysatisfactory design than wouldotherwise be the case.Set-based approaches have beenpursued in a variety of domains, suchas data interpretation to infer proteinstructures (Altman and Jardetzky1986), and construction site layout(Tommelein et al. 1991). It has beenused in new product development by Toyota engineers (Kennedy 2003;Sobek et al. 1999; Ward 2007; Ward etal. 1995). Toyota's approach hasinspired the development of a set-based methodology for rebar design(Parrish et al. 2007, 2008), and itforms the basis for the case studypresented here. R  ELATIONAL C ONTRACTING Relational contracts (MacNeil 1978,Goetz and Scott 1981) can be used tospur the formation and effectiveness of integrated project teams. Lichtig's(2005a, b) relational contract, theIFOA, basically manages two risks: (1)the risk of defects and (2) the risk of cost overruns. On the Cathedral Hillproject, risks and their associated costsare shared amongst team members. The owner jointly with members onthe integrated project team, put moneyinto a shared risk pool. Each memberof the team commits 25% of their feetowards the risk of cost overruns.Unforeseen project costs are paid outof the risk pool. The owner's portion of the risk pool is spent first, followed bythe team members'. The IFOA also hasan incentive sharing provision. If theowner's portion of the risk pool is notspent, that money is divided up among 416  Set-Based Design: Case Study on Innovative Hospital DesignKristen Parrish, John-Michael Wong, Iris D. Tommelein and Bozidar StojadinovicProceedings for the 16 th Annual Conference of the International Group for Lean ConstructionProduct Development and Design Management the team members according to therisk that they took. This pay structuresupports collaboration and innovation,as there is an incentive for the entireteam, not just one team member, toreduce risks. The IFOA mandated thatall project participants collaborate anduse set-based design as soon as theyare brought onto the team. The IFOA is being used on thisproject in conjunction with targetcosting (Ballard 2006). Cost targets areset for the scope of the work, and eachset of design alternatives getsevaluated. The aim of target costing isnot to minimize project cost; rather, itis to maximize value generation whileremaining within the allowable budget. This effort may result in shifting costsfrom the construction phase to thedesign phase, or between target costcategories; e.g., on Cathedral Hill,fabrication drawing production, whichtypically is accounted for as aconstruction cost, took place duringdesign. The owner's willingness toinvest upfront, pays for production of details well before construction begins. SET DEFINITION—MAP DESIGNSPACES  The following set-based designexamples reflect decisions madeduring the Concept/Schematic Design(SD) phase and the PreliminaryDesign/Design Development (DD)phase. During SD, the material andstructural system were decided. DuringDD, the structural system details andpreliminary mechanical, electrical, andplumbing (MEP) layouts were decided. The first step in set-based design isto map the design spaces in order todefine (1) the decision(s) to be madeand (2) the available design options.As a project progresses, the setsexamined at each phase becomeincreasingly more detailed. Clearlyarticulating the level of detail andaccuracy necessary to definealternatives at a given point in timeduring design requires opencommunication and understanding of the values each party can bring andconstraints that affect them. Lack of clarity on these is an obstacle to set-based design. Each project participantmust understand not only what isasked, but also the level of detail(precision) and accuracy that isrequired for the purpose at hand, givenrequests for handoffs made by otherson the team, in order to make a reliablepromise. Too much detail too earlyforces unrealistic and undesirablecommitment, while too little detailmay result in otherwise avoidablerework. P ROBLEM OF T OO M UCH D ETAIL OR  P RECISION T OO G REAT  The difficulty of defining the level of detail (precision) and accuracy neededfor reliable promising to be made isillustrated by conversations thatoccurred during project team meetingsdiscussing (1) openings in walls and(2) the exterior skin system. Example 1 - Wall Penetrations: Inorder to define the structural systemdetails, the structural engineer neededto know the location of wall openingsrequired by the MEP team. In the spiritof collaboration, the MEP team startedto precisely calculate theirpenetrations; they thought thatlocations of openings down to ±10 cm(±4 in) had been asked for. This was adifficult if not an impossible task to doso early in the design process becauseother system parameters had not yetbeen pinned down. That is, there wasstill too much uncertainty in the designfor the MEP team to confidently give 417
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