How to build “future-enabled” hospitals



What’s driving the future of healthcare design and construction? This was the focus of a recent discussion Andrew Quirk, senior vice president and national director of our Healthcare Center of Excellence, had with Bob Kehoe of Health Facilities Management Magazine.

Andrew makes a case for building flexible or “future-enabled” spaces that seamlessly integrate technology into the built environment. “We should be looking at buildings that are interchangeable or a kit of parts,” he notes. “This is where we need to be headed, so that buildings can be ordered and installed quickly.”

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Our Nemours/A.I. duPont Hospital for Children project in Wilmington, Del. was designed and built with a focus on the patient family experience.

Furthermore, as more emphasis is placed on the patient experience, healthcare owners need to create appealing and highly effective environments. This means not only building spaces that adapt to meet consumer needs, but also creating environments that allow patients to have multiple services in a single visit. Andrew states: “You have to be focused on patients’ experiences coming in the front door; the product that they’re buying, which is health care; the experience with the clinicians in the environment; and the building’s ease of use.”

To learn more about how design and construction can help you better serve your patients, check out Andrew’s full interview here:

http://www.hfmmagazine.com/display/HFM-news-article.dhtml?dcrPath=/templatedata/HF_Common/NewsArticle/data/HFM/Magazine/2015/Aug/hfm-hospital-construction-trends

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How do you build trust?

How do you build trust within your organization? This was the question posed to Skanska USA CEO Rich Cavallaro in a recent Fortune Leadership Insider column, where the most thoughtful and influential people in business contribute their advice on careers and leadership.  Check out Rich’s response below and stay tuned for more insights from the Skanska leadership team on Fortune and the blog:

Building trust starts with creating stability and confidence by leading with a steady hand: leaders should not overreact to ups and downs, because they will happen in any business. Also, leaders should never play the blame game. Problems will always arise so it’s important to get the team focused on the solution, rather than trying to assign blame. And I believe in taking care of my employees, which means ensuring that each and every one of them feels a connection to their work at Skanska. Through this, they become invested in the outcome of their individual contributions.

However, the single biggest element to building trust is creating an environment where everyone feels safe to speak up to contribute their ideas and expertise. In today’s multi-generational, diverse offices – where millennials work side by side with baby boomers – it’s especially important to make sure that all team members feel valued, respected and engaged, regardless of their gender, race, age or work experience.

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Rich addresses a Skanska team on a Safety Week job site visit.

Inclusion directly impacts performance, especially when it comes to generating innovation. Inclusive groups facilitate more ideas, better ideas and different ideas. On an individual level, performance improves when a person feels included and that has a direct impact on the group. Employees who believe they have more of a voice will exert more effort on behalf of the group, going above and beyond the call of duty. I want my employees to trust not only me, but also the organization, and feel confident their contributions are valued and have impact.

I am a true believer in the power of team building, as there are so many examples of teams delivering remarkable results that could never have been achieved otherwise. We can learn valuable business lessons from sports — teams like the 1980 U.S. Men’s hockey team, which showed what happens when individuals subvert their egos for the good of the team. Take the time to carefully evaluate how teams are structured in your organization. By fostering an inclusive culture and encouraging all of the people within your organization to think and speak up, you will naturally create a culture where employees are happier, more loyal and collaborative. And always remember that trust needs to flow in both directions from employee to leader and vice versa.

This post originally appeared on Fortune.com.

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Richard Cavallaro

posted by Richard Cavallaro

President and CEO, Skanska USA

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4 strategies for minimizing renovation disruptions at healthcare facilities

In this month’s Medical Design & Construction Magazine, Andrew Quirk, Skanska USA senior vice president and national director of our Healthcare Center of Excellence (COE), explores the ways that construction teams can mitigate potential disruptive activities while renovating active healthcare facilities.

Such projects –which many health systems are undertaking to meet patient needs – require surgical levels of precision and planning from the construction team.

From approaches to technology, communication, and patient engagement, Andrew offers strategies to ensure uninterrupted patient care while construction work is underway – find his insights here: http://mcdmag.epubxp.com/i/536727-jul-aug-2015/48

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At our Nemours/Alfred I. duPont Hospital for Children project in Wilmington, Delaware, the team engaged the patients during construction with a “Where’s Freddy” cutout that got moved every day on the construction site for the children to find from their windows. 

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On Bloomberg Television, CEO Rich Cavallaro discusses infrastructure funding solutions

This Friday, the Highway Trust Fund, which helps states finance major highway and transit projects, is set to expire if Congress does not act to keep the fund solvent. With the deadline looming, Skanska USA CEO Rich Cavallaro recently joined Matt Miller and Stephanie Ruhle of Bloomberg’s Market Makers to discuss the challenges facing U.S. infrastructure and why lawmakers need to embrace such innovative and long-term funding solutions as public-private partnerships (PPP).

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Our consortium’s I-4 Ultimate project in Orlando is an example of how public-private partnerships help green light critical infrastructure projects.

To compete in the world economy, Rich noted, the U.S. needs to have world-class infrastructure to move people, data and products. The current state of American infrastructure is “unacceptable,” he said.

Watch Rich Cavallaro on Bloomberg, here:

http://www.bloomberg.com/news/videos/2015-07-24/how-did-infrastructure-in-the-u-s-get-so-bad-

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In D.C., saying farewell to Lady Bird

It has been two years since our 1,323-ton Lady Bird tunnel boring machine last saw daylight. This month, she completed her mission of carving a 4.5-mile-long, 26-foot-diameter tunnel below Washington, D.C.’s Potomac and Anacostia rivers, and in a ceremony yesterday her cutterhead – the elaborate front section with cutting and slicing tools – was lifted out of the ground. Her complexion had changed, as the bright blue and green paint she was covered with at her outset had long since worn away. But she was still impossible to miss.

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Lady Bird’s 26-foot-diameter cutterhead is presented to the local media. (Photo Credit: DC Water)

Though D.C. residents didn’t see Lady Bird, they still might miss her 443-foot-long presence: she showed her sass via a popular Twitter account – @LadyBirdTBM – and was featured in major stories in ENR, The Washington Post, NPR and in many other publications, as well as TV and radio stations. It was all part of client DC Water’s strategy of explaining what Lady Bird and her siblings are doing: creating storage tunnels to hold raw sewage waiting to be treated at the city’s Blue Plains Advanced Wastewater Treatment Plant. It wasn’t glamorous work, but it was important to helping ensure that future rainstorms don’t cause sewage to overflow into the rivers, thanks to the city’s antiquated combined sewer system. Besides, sometimes even a TBM needs a job.

Lady Bird – named after former First Lady Claudia “Lady Bird” Johnson – certainly left her mark in the nation’s capital. Chomping through all that ground produced 1.2 million tons of soil, all of that lifted to the ground via an innovative carousel system similar to what Skanska first used at New York’s 86th Street Cavern project for the Second Avenue Subway, and then hauled away by nearly 72,000 truckloads. She excels at multi-tasking, so as she advanced underground – up to 150 feet a day – Lady Bird also placed precast concrete segments to line the tunnel. Click here to watch a video of this $30 million lady in action.

Her next destination? Our joint venture doesn’t know for sure,  but it could be anywhere in the world: her German manufacturer, Herrenknecht, is buying her back. (Rumor has it she might soon be snacking on caviar.) Thankfully, two of her siblings remain at work for DC Water to ensure that D.C. isn’t TBM-less: her sister Lucy is helping another Skanska joint venture dig a 23-foot-diamater tunnel just a few miles away, while sibling Nannie is also being operated nearby, but by another contractor team.

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For perspective, a team member stands next to Lady Bird’s 26-foot-diameter cutterhead . (Photo Credit: DC Water)

 

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How we’re approaching sustainable commercial development from a “deeper, holistic perspective”

_MG_5978 without tieMats Johansson, president and CEO of Skanska USA’s commercial development unit, recently spoke with Commercial Property Executive about our long-term and thoughtful  approach with the Class A office and multi-family residential buildings we develop.

In all our actions, we focus on the needs of the end user.

“The tenant who is moving into the building should think about high quality, sustainability and efficiency, and know that we as developers have thought about those things on their behalf,” Mats said. “We want them to know that we understand who they are, and we have adapted the building as much as we can to their needs. That’s our focus. I think all of our projects in progress exemplify this approach.”

Mats has been with Skanska for 21 years, and he led the start-up of our six-year-old U.S. commercial development business, now operating in Boston, Houston, Seattle and Washington, D.C.

To read the whole Q&A click below:

http://www.cpexecutive.com/in-focus/executive-spotlight-mats-johansson-skanska/1004123530.html

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Final element placed for Virginia’s new Midtown Tunnel tube

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A tunnel element is suspended from the catamaran-like barge as the immersion process gets underway.

Our Skanska-led joint venture on Tuesday reached a major milestone: immersing the final 16,000-ton hollow concrete element for the new Midtown Tunnel tube, the centerpiece of our $2.1 billion Elizabeth River Tunnels public-private partnership. Eleven such behemoths – each about 340 feet long – now form a new tunnel stretching between Norfolk and Portsmouth, Va., that is scheduled to open to traffic next year.

Tuesday’s immersion started at 6 a.m., and the final element was at the bottom of Elizabeth River at the Norfolk shore by noon. It capped years of hard and precise work by our SKW Constructors (Skanska-Kiewit-Weeks) design-build joint venture in planning, designing and executing the extremely technically demanding tunnel.

“It’s great to see it actually come together,” said Wade Watson, Skanska vice president and SKW’s project director.

Looking back over the tunnel work, Watson said he’s most proud of the strong team effort that made it all possible. “This is not something that one person can do,” he said.

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On the left, concrete blocks help weigh down the final tunnel element that’s suspended in the catamaran barge, while on the right, construction continues on one of the tunnel approaches.

Construction on the project is now about 65 percent complete. The end of the element immersion process eliminates a lot of the project’s risk, as the work done with floating equipment in the river will be winding down, Watson said.

Our team cast the tunnel elements in two groups at a graving dock near Baltimore, Md., and then floated them 220 miles down the Chesapeake Bay to the project site. There, they weighed down each element with tons of concrete and filled huge ballast tanks with river water, making it heavy enough so a special catamaran barge could lower it – with the help of GPS positioning – into a trench they carved below the river’s surface. Our team immersed the first element in October 2014, and typically they repeated that process every five weeks. It was risky work, but thanks to extensive planning all 11 immersions went smoothly. (Click here to see a graphic showing the immersion process.)

As crews have been immersing the final tunnel elements, other crews have been flowing through previously placed sections, sequentially doing such activities as installing final seals; removing the stout concrete and steel bulkheads that turned each element into a floating vessel; pouring additional concrete on the floors; and installing fireproof boards. Eventually, this outfitting work will include jet fans, sprinkler pipes, lighting and a blacktop driving surface.

Our team expects to remove the final bulkhead – in the just-placed element – in about two months, Watson said. At that point, our crews will be able to theoretically walk from Norfolk to Portsmouth via the new tube.

Elsewhere with the project, crews are completing the vehicle approaches on both sides of the tunnel; completing remaining rehabilitation work on the two tubes of the project’s other tunnel, the nearby Downtown Tunnel; and building an extension to the Martin Luther King Freeway.

Skanska’s Elizabeth River Tunnels work extends beyond design and construction. Our Elizabeth River Crossings consortium is responsible for ongoing operations and maintenance of the new and existing tunnels, as well as connecting roadways – stretching 51 lane miles in total. That includes operating the electronic tolling system, making roadway repairs and providing gas to stranded motorists.

Click here to see a local TV news report on the project, including an interview with Watson.

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NPR talks with our CEO Rich Cavallaro about taking the long-term view on infrastructure and sustainability

This week, Skanska USA CEO Rich Cavallaro talked with Jeremy Hobson of NPR’s Here & Now show about the urgent need for the U.S. to improve and take a long-term view of its infrastructure, with the latest short-term federal transportation funding bill set to expire at the end of this month.

Rich also discussed the use of public-private partnerships (PPPs) to help advance critical public projects, the state of the U.S. construction market, the unique challenges of urban construction, and Skanska’s commitment to sustainability, including green construction.

Regarding infrastructure, “It’s like maintenance in your house,” Rich said. “There’s not enough money to go around for a lot of stuff these days, and the easy thing is to just not do the maintenance. Some day you pay the price for that.”

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CEO Rich Cavallaro at our 7 Line Extension Project in New York City.

A long-term view is better for society, Rich said, as having world-class infrastructure is essential for the continued competitiveness of the U.S. in the world economy.

To advance green building, he said there needs to be a shift in focus from the up-front costs of buildings and civil infrastructure assets to the costs of ownership and operation over their lifespans. That’s an important focus of Skanska, he said, “and something we need to lead the industry in.”

For more from Rich, listen to or read his interview here: http://hereandnow.wbur.org/2015/07/07/skanska-construction-infrastructure

 

 

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This thesis shows how performance management can improve client satisfaction

Early in her construction career, Wendy (Li) MacLeod-Roemer realized there was significant room to improve construction delivery beyond traditional means. To help advance our industry, she decided to pursue a PhD in organization management to understand what changes would be most effective. She dedicated her thesis to exploring how performance management can transform construction projects. Here, Wendy – now one of our senior project managers – explains how her research shows that cost isn’t what is most important to clients.

What inspired your thesis?

I had worked for several years for another general contractor, and I felt that, in general, the architecture, engineering and construction (A/E/C) industry is very conservative and, innovation-wise, operating backward from other industries. I was motivated to improve that and wanted to explore any tools the A/E/C industry can adopt from other industries.

What were the main tools you tried to adopt?

I read a lot about lean manufacturing and the Toyota Production System, and thought it was particularly of interest how the company continuously tracks and visually displays its performance to all workers – from those on the front lines all the way up to the executive level. This constant feedback helps them stay on top of their work, catch potential problems and course correct with agility – all important factors in the success of a project. I thought to myself: “This is such a simple thing, why doesn’t everyone do it?” On construction projects, no matter how many people you ask you’ll probably get a different answer regarding how each individual thinks the project is doing in terms of performance. I explored the “why” behind this and tried to see if construction could adopt what Toyota and other manufacturing industry leaders have been using to see similar successes with improving client satisfaction and performance. I needed to measure the data against something, and so I chose client satisfaction, the foremost indicator of project success.

How did you collect your data?

Project team members involved in day-to-day operations – including project managers and engineers, superintendents, design consultants and client representatives – were sent a handful of survey questions each week surrounding project performance metrics most closely related to their involvement on the project. The metrics included such subjects as commitment reliability (relating to how often promises made – such as for requests for information, submittals and meeting action items – were kept); constraint removal (relating to whatever is preventing a task from proceeding) and such subjective measures as leadership and meeting effectiveness.

The entire team would then receive feedback a couple of days after the survey: circling back this way helped project leaders know which areas to prioritize to improve day-to-day planning and overall project performance. Ultimately, I wanted to collect lots of data so I could see which areas of performance mattered most to the client at any given time – which areas truly predict project success. Is it really cost and schedule, as it often assumed?

What did you find?

Through looking at survey answers and talking with the clients, I found that it wasn’t cost that made them most happy, but rather overall project performance predictability. It is more important to clients that the team is effective and keeps the client in the loop on what is happening and what is planned to happen. This is in part because with complex projects with evolving needs throughout construction, cost can be somewhat fluid.

Another meaningful finding is that greater building information modeling (BIM) use and higher perceived BIM value leads to higher client satisfaction. Perceived BIM value refers to the benefits that construction team members believe that BIM brings to their projects. By using more effective BIM techniques, data showed that it ultimately led to happier clients. This is likely an indirect correlation – perhaps BIM improved the quality of design, which in turn improved on-site work, thus leading to happier clients.

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Sample dashboards used as feedback for the teams.

How was the performance management data displayed to the team?

Every week for three years, we emailed them the visual performance dashboard summarizing the survey results, and some projects would also post it in their office. The data was displayed much like a dashboard in your car. It had visual graphics like pie charts, line graphs and had traffic lights – green, yellow and red – to illustrate where you should focus your resources. When it showed yellow, it meant you needed to keep an eye on the issue, and red lights showed where you needed put your attention immediately. One of the drivers in creating the dashboard was that everyone is busy and has limited resources – a red light immediately draws your attention to something that’s wrong now.

I studied this on five projects over three years: these were the Palo Alto Medical Foundation’s San Carlos Center near San Francisco for which Skanska was part of the integrated project delivery team, and four projects for Walt Disney Imagineering. I picked San Carlos Center because the client – Sutter Health – is at the forefront of innovation and lean adoption, and Disney is also a leader in using lean for facilities delivery. Survey participation was voluntary, and, during the research period, I had over 10,700 responses from all the project teams, data was collected every single week. Additionally, by introducing this performance management tracking and feedback method, client satisfaction volatility was reduced by 13 percent across all five case studies. Reducing volatility is the first step to increasing satisfaction!

For general contractors, is this something you could use for trade contractors or craft workers?

It’s very flexible. It can be geared toward anything you want to manage. As project teams, you can send the surveys out to your trade contractors to get their feedback to measure specific scopes of work. You can vary the metrics and ask questions more specific to project controls or preconstruction.

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A snapshot of labor productivity over the last 40 years. The blue line shows the increase in productivity across industries with the exception of construction, portrayed by the red line, which has decreased.

How do you envision this method being implemented in the future?

No formal method has been widely disseminated to keep track of construction project performance. To fill this gap, my method offers a very simple and intuitive approach. The survey and statistical analysis tools I used already exist and are easy to use. Ideally, in the future a program could automate all of this and put it together to include both metric data collection and dashboard feedback. It’s kind of like how BIM use diffused throughout the A/E/C industry. There was some resistance at first, but compared to BIM this is much easier to implement. It’s one of my goals to hopefully get Skanska to use this metric-based performance feedback methodology (called MetPerforma) at the regional level where I am, and then adopt it across the board.

All other industries have improved in terms of labor productivity in the last 40 years except for construction, which went down 20 percent! This even included farming, which shot straight up on the index. Economists found that performance management as a practice is directly correlated to productivity, among other contributing factors. My PhD research validated that MetPerforma improves construction performance management as a practice. My vision is for it to ultimately improve field productivity industry-wide.

For more information on Wendy’s dissertation check out her presentation here:

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4 ways convention centers are revamping for the 21st century

In today’s hyper-connected digital world, workers spend their days communicating with their peers via email, text and instant messaging, phone and video chat. And yet, as productive as many of these digital connections are, the need for personal face-to-face interactions remains incredibly strong. There are a staggering 1.8 million conventions, conferences, congresses, trade shows and exhibitions, incentive events and corporate meetings a year in the U.S., totaling more than 225 million participants, according to the Convention Industry Council. Conventions are even essential in the tech industry, with Google and Microsoft holding some of the biggest events – both Google I/O and Microsoft Ignite just finished up in May.

To accommodate this demand for meetings in today’s revived economy and a growing need for venues with widely accessible technology, convention centers across the U.S. are expanding and renovating in order to attract more events and be better hosts. The amount of work projected is higher than it has been in five years. Todays’ convention centers require more flexible spaces, the ability to blend virtual and in-person events, and meaningful sustainability. Here is why:

Flexibility: No event is the same, and convention centers are renovating to ensure they can adapt to different types and sizes of meetings. Gardens, outdoor spaces and small theaters are all in demand, along with spaces that can accommodate anything from an intimate group session to a thousand-strong keynote. Consider an event such as Austin’s SXSW, one of the biggest conventions in the world, which hosts everything from panels, to concerts, to movie screenings and huge parties – no cookie cutter presentation spaces there. What’s more, as events look to bridge the gap between the physical and digital world, spaces need to be flexible enough to accommodate new technology, and there’s increasing demand for spaces that can be used as production studios for video. There is also more demand for highly flexible, unadorned hospitality spaces that can be customized to fit the needs of each event. The Austin Convention Center is looking toward a major expansion of their facility and this type of space is one that they will include. Event producers indicate they want high levels of flexibility and multi-function capability.

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Here’s an example of flexible space in a convention center – combining presentations with company displays at Greenbuild.

Building these kinds of spaces – along with long-span ballrooms – requires specialized construction expertise. For example, at our new Raleigh Convention Center project, the exhibit hall, loading dock and services expanded below three adjacent city streets. The building required the construction of three bridges, the excavation of more than 365,000 cubic yards of dirt and the installation of three types of foundation wall systems.

Technology: As with stadium expansions and renovations, convention centers are seamlessly integrating technology. To be ready for everything from live-streaming videos, social media-enhanced presentations, the need for faultless wireless internet and even making sure there are enough charging stations for computers and phones, convention centers are upgrading quickly for today’s increased mobility. This means building advanced infrastructure for Wi-Fi and upgrading distributed antenna systems (DAS) – not easy tasks. Today’s convention goer expects connectivity everywhere. Once thought of as a revenue stream for convention centers, free internet connectivity is an expectation of meeting planners. And while once you could just focus on making sure your exhibition halls were enabled with wireless connectivity, today connectivity is also required for restaurants, outdoor spaces and other social gathering spaces and public plazas. Technology is the most important new growth area for convention centers according to 42 percent of event producers, based on a report from Red 7 Media Research and Consulting.

Here’s an example of the importance of being ready for technology: the Raleigh Convention Center recently hosted 2,500 members of the North Carolina Technology in Education Society at a recent conference. As people today tend to carry more than one wireless device with them, they brought with them more than 3,200 wireless devices – and a tremendous demand for bandwidth! During an event in the ballroom, a speaker asked all 500 attendees to test a certain web platform simultaneously. Their demand crashed the platform’s web server on the other end, but the convention center’s wireless infrastructure was able to support the load. These kinds of experiences are increasingly the norm, so convention centers must be built and refurbished with connectivity front of mind.

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The Raleigh Convention Center was designed and built with wireless infrastructure to support tech-heavy events.

Activity hubs: Much as airports have sought to bring in upscale and local vendors to upgrade the travel experience in the terminal, convention centers are looking to make their facilities stand apart by offering superior and unique amenities. Today’s convention centers are all looking to do more peripheral development – including retail, hotels and supportive infrastructure – within their footprint to capture more revenue.  Red 7 also notes that 54 percent of convention centers have added new revenue streams in 2013. Facilities such as the New Orleans Ernest N. Morial Convention Center have established concessionaire agreements with such vendors as Starbucks, UPS and even spas and other amenities. With Convention Planners booking shorter events, facilities are seeking to maximize the time attendees stay in the building by increasing services. And 60 percent of event producers are supporting that effort by saying they want everything under one roof.

Sustainability:  Convention centers are increasingly looking to increase their level of sustainability, for the environmental benefits as well as for reducing operating costs. A few centers are leading the way. For example, the Vancouver Convention Centre boasts a six-acre living roof with thousands of indigenous plants and rainwater recovery for irrigation; seawater heating and cooling; and a fish habitat built into the building foundations. The Pittsburgh Convention Center has achieved LEED Platinum certification.

But increasingly, sustainability stretches well beyond construction. Green operations of these facilities are becoming the norm through the use of environmentally friendly cleaning products and practices. Recycling has expanded to include compostable containers and dinnerware, as well as concession food donations to the needy at the end of every day. Look for more and more convention centers choosing to adapt green features – from living roofs and food composting to LED lighting and highly efficient HVAC systems – over the next few years.

In a world where we increasingly rely on mobile and internet connections, face-to-face meetings are therefore even more significant. Convention centers need to adapt to the technological needs of their audience, while also creating environments that enhance the real-life experiences that cannot be captured online.

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Tom Tingle

posted by Tom Tingle

Skanska USA senior vice president and national director, Sports and Entertainment Center of Excellence

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