We Also Build Smiles

Sometimes Building What Matters takes on a whole new meaning.

Our team at Johns Hopkins All Children’s Hospital in St. Petersburg, FL knew they were building a new research and education center directly across from the hospital’s infusion center where children receive regular chemotherapy treatments for a variety of cancers.  They knew there were kids fighting for their lives in that hospital, watching out the window at the hard hats and construction equipment.

“Every day, you walk into the cafeteria and walk past the kids,” says Assistant Project Manager Brandon Page. “You see the issues they are dealing with from the chemo. And you want to help make their day a little brighter.”

Each Friday, the nurses hold what they call a “Friday Dance Party” with the kids to celebrate getting through another week of arduous medical treatment and to lift their spirits. They play music, dance and – as one nurse puts it – “just let loose and have fun.”

Brandon, along with General Superintendent Todd Collier, Project Engineer Justin Koenen, and Assistant Superintendent Calin Noonan, decided to bring the “Friday Dance Party” outside to the job site, complete with multicolored signs and their best moves. The video from Johns Hopkins All Children’s Hospital sets up the story:

Shortly after the first Friday Dance Party, Justin bumped into one of the nurses on campus, who told him the following week, November 4, would be the 13th birthday of a young girl named Katelyne – who was also receiving her last chemotherapy treatment that day before being permanently discharged from the hospital where she had lived since June.

Sensing an opportunity, the crew mobilized a banner – which they signed – and mounted a special “Friday Birthday Dance Party” especially for Katelyne, who watched with her family from her window across the way.

Later, some of the crew visited Katelyne in her room. “She teared up when we brought the signed banner in,” said Justin.

Katelyne Ballesteros had a special happy 13th birthday message from the Skanska construction crew she's been watching from her window of Johns Hopkins All Children's Hospital. Left to right are Katelyne, Todd Collier, Justin Koenen, and Calin Noonan.

Katelyne had a special happy 13th birthday message from the Skanska construction crew she’s been watching from her window of Johns Hopkins All Children’s Hospital. Left to right are Katelyne, Todd Collier, Justin Koenen, and Calin Noonan.

“Seeing the kids and the positive energy of the nurses makes this more than just a project,” said Todd. “Everyone on the project willingly and gladly participates, including all of our subcontractors.”

“It’s so sad for these kids to be going through this. I have a four-year-old and I can’t imagine it,” says Brandon. “They’re innocent and they’ve done nothing wrong. To have to go through something like this is unfair. So anything we can do to give back we do. It should be everybody’s responsibility to do the same.”

Take a look at the full photo album of Katelyne’s Birthday – and her last day in the hospital – here.

Katelyne presented our Skanska USA team with this handmade thank you card for their uplifting effort for her birthday sendoff.

Katelyne presented our Skanska USA team with this handmade thank you card for their uplifting effort for her birthday sendoff.

Skanska USA

Skanska USA

Skanska USA is one of the largest, most financially sound construction and development companies in the U.S., serving a broad range of clients in the public and private sectors, including those in transportation, power, industrial, water/wastewater, healthcare, life science, education, sports & entertainment, data centers, government, aviation and commercial industries.

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Making A Difference, One Customer At A Time

Long term relationships bear some of the sweetest fruit. For Skanska, we’re most effective when we can develop that deep level of trust and an understanding of our customers’ needs over an extended period, leading to projects that exceed not just the technical specifications of the job, but the personal aspirations of what a job well done really is.

Skanska has been engaged with Methodist Hospital and Methodist Children’s Hospital in San Antonio, TX since 2002.  We are currently working on the hospital’s most extensive upgrades to date – a $205 million set of construction projects that include a seven story children’s tower with its own power plant; an expansion of the adult and children’s emergency rooms;  an expanded central tower for Women’s Health Care and critical care services; expanding the Neonatal ICU to 94 beds and a 13-story garage with three levels below grade.

Methodist Hospital in San Antonio is undergoing its most extensive renovation in its history. Skanska crews are challenged to complete the work on schedule while keeping all facilities operating. Credit: Aero Photo.

Methodist Hospital in San Antonio is undergoing its most extensive renovation in its history. Skanska crews are challenged to complete the work on schedule while keeping all facilities operating. Credit: Aero Photo.

Working at a hospital that serves a 27 county region and 175,000 ER patients every year, the main focus has been on having zero impact on patients and their medical care.

“Our biggest and most important challenge was staging – from entrances open to our work in close proximity to children’s and acute care areas,” said Project Executive Keith Sitzman.  “We recognized early on that the best way to manage the process was with frequent meetings to discuss issues and propose solutions, then communicate to the people using the hospital what they could expect.”

Hospital COO Elizabeth Ortega says one weekly meeting grew into three – and took on the moniker of “Coffee Talks.”

“At first we just wanted to know about what kind of noise we could expect from the project, but it turned into a wonderfully collaborative way to address issues before they became problems,” she says. “In the end, it made us one big team instead of a customer and a construction company. I am very grateful for all that the Skanska team has done to make this project an ongoing success.”

“The complexity of the project is incredible; I’ve never worked like this before,” says Sitzman. “It is technically challenging work; making sure we manage every element of safety. We’re using heavy machinery on the other side of a wall where there are NICU babies who weigh no more than a pound. That makes you much more focused on who you’re building for.”

The staged work will see the NICU, Central Sterile and Supply, Same Day Surgery and the Children’s Emergency Department Expansion open this month. The Children’s Tower will follow in February of 2017. The entire facility is scheduled to be completed in 2019.

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Elizabeth Ortega (back row, second from left) and her Methodist Team on site at the Hospital.

“What is designed on paper is often very cool, but the execution of it is a different story,” says  Ms. Ortega. “The Skanska team had to figure out not just ‘how are we going to build that,’ but ‘how are we going to do it and not impact the care that goes on inside the hospital?’ You won’t find other contractors who will sit down and say ‘We get it, we need to make sure we keep things open.’ Those guys are my advocates in keeping our facility open and running.”

Ortega says many of the Skanska employees on the job have been there so long, they’re just as much part of the hospital family as they are Skanska.

“Some of them have hospital badges that are just as worn as their Skanska badges,” she says. “This has been a true partnership every step of the way.”

Skanska USA

Skanska USA

Skanska USA is one of the largest, most financially sound construction and development companies in the U.S., serving a broad range of clients in the public and private sectors, including those in transportation, power, industrial, water/wastewater, healthcare, life science, education, sports & entertainment, data centers, government, aviation and commercial industries.

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Upgrading Our Hospitals Will Take a New Approach to Design

The last time you were in a hospital, did you take a good look around? What did you see?

Since the middle of the last century, hospitals have grown in size and complexity, but their physical layout has not kept pace with technological innovations and taken advantage of evidence-based design. Yes, they may look different, and feel modern and welcoming, but they have also grown, somewhat unchallenged, in square footage, materials and support systems.  One can look at a healthcare facility and come close to identifying the decade in which it was put into use.

Our Healthcare Center of Excellence (COE) helps hospitals push the boundaries of hospital design, and build for the health care delivery methods of today with an eye to the technologies of tomorrow. Andrew Quirk, head of our Healthcare COE, describes this approach in this piece on Building Design + Construction, here.

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Skanska recently handed over the first patient wing of the Karolinska Solna Hospital in Sweden, which designers say put the patient in the center of the planning. All patients receive a single room and a “thematic care” approach means doctors and specialists visit the patient rather than the other way around.

Skanska USA

Skanska USA

Skanska USA is one of the largest, most financially sound construction and development companies in the U.S., serving a broad range of clients in the public and private sectors, including those in transportation, power, industrial, water/wastewater, healthcare, life science, education, sports & entertainment, data centers, government, aviation and commercial industries.

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The Greening Of Healthcare

As a growing number of hospitals continue to look for ways to decrease operating costs and increase efficiencies, we’re helping them analyze and build upon their own sustainability programs.

Facility-wide enhancements – including insulating walls and roofs, reduce waste from operations and using renewable power – can have immediate cost savings, with a return on investment in just a few years.

Some facilities are going a step further, leading the charge to “Net-Zero,” an approach that includes whole life cycle cost analysis.

Our infographic below spells it all out:

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Skanska USA

Skanska USA

Skanska USA is one of the largest, most financially sound construction and development companies in the U.S., serving a broad range of clients in the public and private sectors, including those in transportation, power, industrial, water/wastewater, healthcare, life science, education, sports & entertainment, data centers, government, aviation and commercial industries.

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Five ways the patient room in hospitals should be changing

NXT Health, a non-profit that promotes change in the healthcare industry through sponsorship of design innovation, is the creator of the next-generation hospital room, Patient Room 2020. This interactive room is designed for a next-generation inpatient care environment that strives to improve patient experiences and optimize caregiver performance.

NXT Health worked with more than 35 product and service partners. We’re honored to have been one of those partners, providing the project management, permitting and construction estimates for the project. From the innovative designs of lighting experts, software developers, specialty glass manufacturers and custom fabricators, the Patient Room 2020 was built into a 400-square-foot prototype and is on display at DuPont’s Corian Design Studio in New York City.

We think this prototype shows at least five important trends that will influence inpatient rooms of the future. They include:

1)      Blending technology seamlessly: This prototype has what is called a ‘patient ribbon,’ an overhead canopy, above the patient’s bed, that incorporates life controls, an HVAC diffuser, lighting, audio controls, and a color halo. “Each part of that ribbon has been rethought to house as much technology as possible,” says Christopher Whitelaw, director of research and development at Evans and Paul, a partner in the Corian Design Studio and lead fabricator in Patient Room 2020. David Ruthven, principal designer of Patient Room 2020 calls it his “Swiss Army Knife.”  It also addresses the ability to change along with the sea of changes coming as a result of the ACA without the need for major changes to the built environment.  As an example, the ribbon facilitates the growing use of telemedicine.

2)      Providing the patient easy access to information and controls: A solid aluminum frame mounted on wheels combines two ubiquitous elements:  an over-bed table and a touchscreen tablet to form a single piece of mobile furniture that could be utilized in a wide range of healthcare settings. The hybrid tabletop provides room to eat on one side and a table on the other side, allowing the patient’s access to educational content, social networks and control of the temperature, audio and lighting in the room.

3)      Having a better bathroom: The prototype has an adaptable bathroom concept that features a sliding door system which can be reconfigured based on care needs. If a patient needs assistance in the bathroom, the expandable door will make the bathroom area larger to accommodate an assistant.

4)      Improving safety via the caregiver station: Imagine a workstation featuring integrated hand washing indicator lights and concealed accessories. The integrated LED light illuminates the sink in color – red if you have not washed your hands well, and green if you have.

5)      Creating a mobile caregiver hub: Caregivers have the flexibility to move around with a deployable bedside work area with embedded technology, simulated UV light sanitization and wireless device charging stations.

The project serves as an example of what design can do to address the complex challenges that face modern healthcare delivery. This effort was specifically for a patient room, but the reality is that many of the ideas and outcomes can find their way into the outpatient setting and even into your home.  Skanska is proud to be working on a project that values innovation, and the advancement of construction in the healthcare industry to benefit both patients and caregivers.

Check out images of the Patient Room 2020 in the slideshow below.

Andrew Quirk

Andrew Quirk

Skanska USA Senior Vice President and national director of Healthcare Center of Excellence

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Building a home where Alzheimer’s patients can thrive

In this installment of our #BuildingWhatMatters blog series, Senior Project Manager Jeff Elpers explores how design and construction can improve the quality of life for those suffering from Alzheimer’s disease and dementia, and how a new treatment model may transform memory care across the U.S. 

With the U.S. population aging, Alzheimer’s has become the sixth leading cause of death, affecting more than 5.3 million people.  Patients with Alzheimer’s are often cared for in nursing homes or other healthcare facilities. While these provide important and essential care, the realities of life with Alzheimer’s means that patients require specific environments designed to alleviate some of the disease’s unique challenges.

To that end, Skanska recently completed the construction of Abe’s Garden in Nashville, Tenn. Abe’s Garden is believed to be the first memory care community in the U.S. designed and built to demonstrate and disseminate best practices to improve the lives of individuals and their care takers affected by Alzheimer’s disease. The 33,000-square-foot facility can house 42 full-time residents and 15 adult day care/evening care participants.

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Abe’s Garden was designed to feel as home-like as possible, with three family-sized households themed around arts and lifelong learning; connecting to nature; and music and movement. 

Collaborating on an increasingly important type of healthcare facility

While Skanska is an expert at building healthcare facilities, the Alzheimer-centered design elements at Abe’s Garden presented some unique challenges. We took on an extensive planning role, partnering with the customer – Park Manor – and designers to enable a design that met the overall goals while staying within budget.

Designing for Alzheimer’s & dementia

For those with Alzheimer’s, routines are vitally important. Anything out of the ordinary can be incredibly disorienting. Abe’s Garden was therefore designed to feel as home-like as possible, with three family-sized households themed around arts and lifelong learning; connecting to nature; and music and movement. A central enclosed courtyard connects the three households and serves as an important therapeutic environment. Since patients can become upset in unfamiliar places, these households have retro design-features from the 1950s that residents may recognize from their childhood. From a construction point of view, this meant building a commercial healthcare building – complete with all the requisite health, safety and fire code regulations – but with residential finishes. For example, to echo a typical home, the roof was designed with decorative shingles – not something that is usually attached to a commercial-grade steel roof!  Resolving such challenges required our team to devise innovative solutions.

AbesGarden_04

The Abe’s Garden courtyard features a  single looped sidewalk, allowing patients to enjoy walks without the concern of wandering.

In addition to ensuring the facility had a residential feel, we also had to make sure it was secure and safe for patients suffering from memory loss. Alzheimer’s patients are prone to what is termed as “wandering,” so all the complex’s exterior doors accessible by patients were designed to open onto the internal courtyard.  The courtyard’s single looped sidewalk allows patients to enjoy walks without the concern of wandering. Even the doors on the courtyard are designed to make patient’s feel at home: rather than a traditional healthcare facility entrance, each household has its own “front door.”

Patients with Alzheimer’s often also suffer from “sun downing” — behavioral problems that begin at dusk and last into the night. Abe’s Garden aims to alleviate these challenges by maximizing natural light, and incorporating state-of-the-art lighting to support circadian rhythms, reduce glare and minimize shadows. Since older adults have challenges adjusting to changes in lighting, the team incorporated transitional spaces like screened-in porches to help them adapt from outside to inside lighting.

Building on an active campus

We built Abe’s Garden on the existing campus of the Park Manor Senior Lifestyle Community, which remained operational during construction. Additionally, this project included renovating the existing facility’s main entrance and general social spaces. These two facets meant it was especially important that we regularly communicate with residents to ensure their safety and deliver the facility on schedule to minimize disruptions.  We held town halls, in which we invited residents to ask questions, share their concerns and get to know the project team. The residents were very curious about the project and were always trying to see what we were doing! Our monthly town hall gave them the opportunity to ask questions and understand upcoming activities. It’s rare that you get to build such a connection with the people your structure will serve!

Abe’s Garden represents Building What Matters on a number of levels. Not only will it provide essential and differentiated treatment to Alzheimer’s patients, but it will also serve as a model program to help advance best practices in memory care. It’s inspiring to know that our work will help the patients, families and caregivers at Abe’s Garden, while also providing a roadmap for future facilities around the U.S. and the world.

 

Jeff Elpers

Jeff Elpers

Senior project manager

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Helping communities heal in ways big and small

This latest installment of our #BuildingWhatMatters series sheds light on how construction projects can transform communities on a macro-level, but can also have a huge impact on individual lives. This is the story of how a Skanska healthcare project brought the concept of Building What Matters to life for Portland Project Manager Jerry Marmon and his family.

My Building What Matters story is about how Skanska built what mattered for my mother-in-law and how that project saved her life.

Over the 2012 Thanksgiving weekend, my mother-in-law felt ill and went to the doctor.  Her blood work came back irregular and after several additional tests she was diagnosed with Multiple Myeloma, or bone marrow cancer.  As part of her care, she underwent a very aggressive treatment that completely debilitated her immune system.  During this treatment she stayed in the Seattle Cancer Care Alliance House, which has rooms designed to reduce exposure to contaminates and germs for patients in need of isolation while their immune systems rebuild.   Since our Seattle team is closely tied with the local community, Skanska employees often volunteer at the SCAA house. During her stay, my mother-in-law appreciated a weekly event in which Skanska employees make and serve dinner to patients.  She saw and connected with our Seattle employees every week until she was able to go home, and she was amazed at this continuing service they provide.

After this first treatment, she was told she needed to undergo chemotherapy every other week for two years or until test results indicated her cancer was in remission. After spending months in Seattle, she was able to receive her chemotherapy treatments at her local hospital, Good Samaritan Hospital in Puyallup, Wash. Skanska recently expanded and renovated this hospital to a huge community welcome,  including my mother in-law who appreciated being able to receive her treatment in a state-of-the art facility.

MultiCare_Good Sam_Ext3

Skanska expanded and renovated Good Samaritan Hospital in Puyallup, Wash., where Jerry Marmon’s mother-in-law received life saving care for her cancer.

The shortest recovery for Multiple Myeloma is two years under this treatment and the best outcome is to knock it into remission, as no known full cure exists today.  Through the facilities built by Skanska, the use of cutting edge medical treatment, and her outstanding response to this care, we’re happy to say that my mother in-law is on her way to achieving remission. She completed her last chemotherapy treatment this November and is now on the road to getting her body back into shape and enjoying life.

My mother-in-law received a grant from the Leukemia and Lymphoma Society during all of these treatments. Cancer treatment is certainly not inexpensive.  This grant, along with the work Skanska and the medical community performed, was the only possible way that this treatment was made available.  In no short way can our family express our gratitude for these funds and facilities.

This is our story. We continue to thank all those that made it possible, with all our hearts. I am proud to be able to say I work for the company that provided one of those crucial pieces in her care.

Jerry Marmon

Jerry Marmon

Project manager

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Keeping the “ring of risk” in the middle

Brad Pollitt has dedicated his career to healthcare design and construction, having since 1989 overseen University of Florida Health/Shands’ more than six million square feet of facilities. With planning underway for Skanska’s second hospital for UF Health/Shands – the $225 million expansion for their hospital’s cardiovascular/neuroscience programs – we talked with Pollitt about succeeding through integrated teams and the future of healthcare project delivery.

Brad Pollitt, vice president of facilities University of Florida Health/Shands – Gainesville, Fla.
Brad Pollitt, vice president of facilities
University of Florida Health/Shands – Gainesville, Fla.

How do you select project partners?

I take great care in interviewing the people that want to work with us. I want not just a corporate commitment, but a personal commitment too. We hire people, not companies.

What’s something you do to bring project teams together?

Construction projects have what I call the ring of risk. The ring starts out in the center of the table, with everybody generally knowing how much risk they have to own. But traditional construction delivery is antagonistic, and soon everybody is pushing on the ring to try and keep it away from them. If everyone pushes equally, the ring stays in the middle and everyone knows where they are. But not all companies and not all people are equal, so the ring eventually begins to slide. And then you see adverse and unexpected behaviors as people do what they can to get it back in the middle. You end up with the ring moving all over, causing uncertainty in a project and putting someone in a losing situation.

On the UF Health/Shands Cancer Hospital that was completed in 2009 with Skanska, the overall project team decided that if for some reason the ring of risk started to shift, everyone would work together to put it back in the middle of the table. I’d see this in action over and over again: one of the assistant superintendents would work with the engineer or the architect to help solve a problem. If money was involved, we as the owner would pitch in too. We all worked together to maintain the project’s schedule, its quality and its ultimate success.

What do you predict about the future of delivering healthcare facilities?

With capital becoming less available to healthcare providers, we have to get smarter about delivering facilities. Every hospital out there is a one-off with a unique design. And while we’re prefabricating select areas of projects – such as headwalls, bathrooms and overhead MEP system racks – those are still unique designs. The next step is having a selection of maybe five patient bathroom types from which hospitals nationwide can choose. Maybe we can do the same thing for operating rooms too. Creativity is good to a point, but efficiency is becoming more important to healthcare providers.

Shands_Interior_surgery 3
Industry-standard designs for operating rooms and patient bathrooms should help increase the efficiency of healthcare facility delivery, Pollitt said.

What’s something that design and construction professionals may not realize about those wearing the owner’s hat?

For the outside people we hire to work on a project, their day job is designing or constructing buildings. For the medical professionals or physical plant staff or even the executives who support these projects from the owner’s side, they’re doing so in addition to their full-time jobs – whether that’s caring for patients or operating buildings or so on. While our people may know a lot about open-heart surgeries, for example, they don’t know a lot about constructing buildings. All they know is their hospital is about to spend a lot of money on a project, and with so much money on the line, they need to trust you.

Skanska USA

Skanska USA

Skanska USA is one of the largest, most financially sound construction and development companies in the U.S., serving a broad range of clients in the public and private sectors, including those in transportation, power, industrial, water/wastewater, healthcare, life science, education, sports & entertainment, data centers, government, aviation and commercial industries.

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View integrated project delivery through the lens of this George Washington University Hospital project

More and more, teamwork, trust and collaboration are seen as key to successful project delivery. Yet, few projects seek to maximize the meanings behind those words by making them central to how the project team is structured and functions. One approach that does so – integrated project delivery – binds major stakeholders through a mutual contract such that individual stakeholder success is tied to overall project success, with risk and reward both capped and shared.

While IPD is rare – in part because of the greater up-front effort required – the results are typically powerful, with better cost and schedule performances and a smoother delivery process. To help others learn how IPD might help their projects, we recently checked in with the stakeholder team behind the second true IPD project with which Skanska is involved, an intensive care unit renovation at The George Washington University Hospital in Washington, D.C. Here’s some of what this team recently had to share about this project, when on-site work was just getting underway.

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All in: Seven organizations signed the IPD agreement: Universal Health Services (owner); Skanska (construction manager); WJ Architects (architect of record); In.Design (interior designer); Southland Industries (mechanical design-builder); M.C. Dean (electrical design-builder); and Clark’s Lumber and Millwork (millwork trade partner.) With this arrangement, there are no separate contracts between the owner and the architect, construction managers and key trade contractors, and so on – every key firm is part of one contract to align all interests with that of the project.

Project finances in a new light: Owner Universal Health Services is accepting all risk for project cost and the overhead of the signatory partners, said Christian Pikel, UHS regional project manager. However, each partner’s profit is put at risk through a shared pool. Any savings from the target budget will be shared among participants, up to the profit pool cap.

Consensus-based objectives: Early in the project, team members and end users came together to define the project’s “conditions of satisfaction” – common team objectives. They crafted 10 of these statements, which include improving doctor, nurse and staff work flows within the sixth floor ICU; eliminating unanticipated noise from impacting adjacent spaces (the project is directly above an active intensive care unit); building a work environment in which all team participants demonstrate leadership roles and process improvement; and incorporate surge capacity within the project budget. The team has developed a spreadsheet containing all conditions, and at every meeting they go down the list and rate their recent performance for each, said Andy Rhodes, Southland design engineer/project manager.

A3 library: IPD’s team-based nature makes it ideal for incorporating the principles and tools of lean construction, which focuses on eliminating waste and continual improvement. Of this project’s lean aspects, A3s are being used not just a single-page way to identify, analyze and propose solutions for problems, but as a means of sharing that thinking across projects. “We were able to pull an A3 on a bariatric issue from another project,” said Aimee Fogarty, Skanska project manager. “By re-examining that document, we didn’t have to start from scratch.”

Better-informed design: This project’s designers are finding that IPD enables them to get the input they need to produce a more realistic design the first time. “It helps clarify expectations much sooner, instead of the typical process of doing value engineering later on in traditional models,” said Jenna Santamaria, In.Design senior designer. “I really get excited and enjoy when we have some healthy tension going on in the Big Room: we get to start horse trading back and forth and asking ourselves, ‘What can we do to make this work?’”

Trust in the Big Room: IPD requires more up-front participation from all parties, including significant time spent in regular in-person Big Room meetings in which all team participants work together on project issues. Such meetings require a different mindset. For example, everyone has equal status and say in all matters. To keep everyone focused, multitasking and sidebar conversations aren’t allowed. And trust is of paramount importance. “Each expert involved in the project must trust each other’s judgment because the success of the team determines the overall success of the project,” said Jennifer Macks, Skanska vice president. “Also, to make the most of the collaborative communication and problem-solving scenario, everyone must be comfortable with one another and share their expertise.”

Skanska USA

Skanska USA

Skanska USA is one of the largest, most financially sound construction and development companies in the U.S., serving a broad range of clients in the public and private sectors, including those in transportation, power, industrial, water/wastewater, healthcare, life science, education, sports & entertainment, data centers, government, aviation and commercial industries.

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How to conceive healthcare environments in a better way – the Prognos way

Skanska’s Prognos early cost modeling app for healthcare projects – which InformationWeek magazine lauded this month as one of “20 Great Ideas to Steal in 2014” – originated out of frustration two years ago. Back then, Senior Vice President Andrew Quirk thought that designers, builders and owners began planning healthcare projects with too many preconceived ideas – about room sizes, finishes and so on – beyond what’s required by codes and standards.

By not starting from a mostly blank sheet of paper, opportunities were being missed to deliver more efficient building programs, and in turn potentially increase each client’s return on investment, thought Quirk, national director of Skanska’s Healthcare Center of Excellence.

“I was trying to get to a point where you could help clients think differently about a project, and challenge them to think outside of norms,” Quirk said.

Quirk saw the solution as a tool that would enable Skanska clients to conceive their new physical environments in a better way – and that tool is now Prognos, available for iPads through Skanska’s App Store. With Prognos, healthcare clients build only what they need at the cost they can afford, plus capitalize on revenue-generating spaces and realize energy savings when possible. Prognos (means “prognosticate” or “predict” in Swedish – Skanska’s roots) shows an owner these elements at the onset of a project.

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App in action

Using this app begins with a Skanska team working with a client to evaluate building components –  such as the number of hospital beds, number of floors, size of the emergency department – in real time. The resulting cost model can easily be modified to show different options.

Prognos’ additional features make it unlike anything else in healthcare. Once a construction cost is determined by each hospital service line, Prognos then allows the user to perform “what-if” calculations for energy usage, square foot efficiency and sustainability calculations, as well as to do an ROI analysis. The data is stored in the cloud – enabling adjustments to continue in the future – and a report can be sent directly from an iPad to the client as a reference for future conversations.
To serve clients across the United States, geographical zone information is used for energy calculations, and a city index is used to calculate construction costs, which vary by region.

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But even more important than the numbers is the process that leads to them.

“This supports having a more in-depth dialogue with the client,” Quirk said. “The idea is that by filling out the layers of this app together, both the client and Skanska start asking, ‘What if we did this – what would it do to the model?”

Skanska USA

Skanska USA

Skanska USA is one of the largest, most financially sound construction and development companies in the U.S., serving a broad range of clients in the public and private sectors, including those in transportation, power, industrial, water/wastewater, healthcare, life science, education, sports & entertainment, data centers, government, aviation and commercial industries.

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