The Importance of Collaboration in MEP Infrastructure Projects

By Kevin Miller, Principal – Certus Consulting Engineers

Collaboration, Integrated Project Delivery (IPD), Design-Assist, and lean construction are everyday terms in the design and construction business. Though these terms sound good, they are often misapplied to describe a process implemented with good intentions, but only involving some of the key players.   

Contrary to the common misapplication of these terms, our team at Certus has advanced expertise at effectively applying and implementing these concepts to provide the best value, specifically for healthcare infrastructure projects.

A common term used in descriptions of any of these terms is the word, “Stakeholder.”  It’s important to note how our team at Certus defines stakeholders in a hospital infrastructure project. Some are obvious, as they are the team members directly connected to the contracted work, but other stakeholders can be more difficult to identify.  In order to clearly set and effectively achieve the desired goals, the list of stakeholders must be expanded.

The following is a list of who we at Certus believe to be the stakeholders:

•  Owner

  • Healthcare System

  • Hospital Administration

  • Facilities Management

  • Environment of Care (EOC)

  • Clinical Staff

• Engineer

  • Engineer of Record

  • Architect

  • Other sub-consultants

• Contractor

  • Prime Contractor

  • Sub-contractors

• Equipment vendors/manufacturers

Regardless of contract structure, everyone on this list ultimately works for the owner. There is one key stakeholder missing from this list – patients and families. In the end, the ultimate stakeholders are the patients and families that the hospitals serve. All of us working in the healthcare sector find our passion, at least in part, because we know that our work can help make someone’s life better.

At the same time, everyone involved in a project is also running a business. At Certus, we believe it is imperative to understand one another’s business to the extent that we can all achieve the end goal of caring for patients, while helping each stakeholder be successful in their respective business.

When talking about MEP infrastructure needs, a hospital COO once said to me, “I want you to find and focus on what will keep the news trucks out of the parking lot.”  We as engineers are really good at detailed analyses to quantify operational savings in maintenance and energy, most often giving results in a simple payback return on investment (ROI).  We could not begin to quantify the ROI of preventing a negative news story for a hospital. This may be an extreme case of a hospital whose infrastructure needs had been long neglected and a new C-suite playing catch-up, but nonetheless an example of how understanding the specific needs of the client’s business helped to define the goals and shape the solutions.  

In the scenario just described, after an overall facility assessment there would likely be multiple risk points defined. Let’s take “limited essential electrical system capacity and no cooling on emergency power” as an example of a highest priority and expand on the Certus approach. Our first recommendation would be to assemble a steering team consisting of leadership from all initial key stakeholders. We would recommend bringing contractors and vendors in as at-risk partners in an open-book arrangement to expedite the process and give everyone “skin in the game” to provide the overall best value.  The team would be led by Certus and we would begin by interviewing hospital administration, facilities and clinical staff, and EOC to understand the needs and risks during both short-term and long-term power outages.  

The obvious solution would be to simply add emergency power capacity and put the existing cooling plant on emergency power. This would result in significant capital cost with no ROI, as it adds maintenance costs with no operational savings or revenue generation. Working closely with equipment manufacturers, MEP and controls contractors, and hospital facilities staff, we develop multiple scenarios such as incorporating high efficiency variable speed chillers that can be demand limited and integrated into the load shed strategy. This solution could allow these new machines to be integrated into an overall plant optimization scheme, saving energy costs throughout the year. It could be argued that a price tag cannot be placed on achieving the initial goal of resiliency and “keeping the news truck out of the parking lot” in the event of a major outage or disaster. However, a collaborative team thinking out of the box can likely develop solutions with additional operational benefits and an ROI.

At Certus, we develop creative solutions. Most importantly, we know the questions to ask and know how to listen. We help to build teams that operate within our core values and where every team member supports one another and the project. The real key is developing project goals as a team, understanding individual goals of each stakeholder, and developing a team relationship that will carry forward to serve the hospital, system, and their patients for years to come.