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GET BETTER. INTEGRATING :. GET BETTER. INTEGRATING : Care Delivery, Planning and Construction Excitement, Surprises, Lessons and Rewards. April 19, 2007. Philip Patrick Sun, AIA, ACHA, NCARB. Engineer: Architects just don’t want to do anything logical. Architect:
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INTEGRATING : GET BETTER
INTEGRATING : Care Delivery, Planning and Construction Excitement, Surprises, Lessons and Rewards April 19, 2007 Philip Patrick Sun, AIA, ACHA, NCARB
Engineer: • Architects just don’t want to do anything logical
Architect: • Engineers just don’t have an imagination
Program Manager: • We protect Owners from Architects and Engineers
Architects and Engineers: • Program Managers keep us from working effectively by being between us and the Owner
Owners: • No one seems to be able to control costs or schedule
Owners: • No one seems to be able to control costs or schedule • It’s my money why isn’t it my building?
Owners: • No one seems to be able to control costs or schedule • It’s my money why isn’t it my building? • Why doesn't it work the way you promised it would?
If you do not change, you may end up where you are heading. Lao Tsu
Integrated Program Development SolutionsIPDS Transitioning - Production Current Emphasis on volume, cost, hardware, functional integrity Future Concentrate on quality, responsiveness, innovation, short intervals, flexibility, people, automation * Adapted from Thriving on Chaos by Tom Peters
Integrated Program Development SolutionsIPDS Transitioning – Innovation Current Central Research and Development, cleverness rather than determined customer driven value Future Work as small autonomous units which make large and small customers notice improvements * Adapted from Thriving on Chaos by Tom Peters
Integrated Program Development SolutionsIPDS Transitioning – Structure Current Hierarchical, functional integrity Future Create flat functional organizations, break down barriers, supervisors should create self managed teams, managers facilitate rather than guard turf * Adapted from Thriving on Chaos by Tom Peters
Integrated Program Development SolutionsIPDS Transitioning – Information Current Centralized for consistency, control, and is internally aimed Future Information for all, customer based, managed by the “line” with decentralization a must * Adapted from Thriving on Chaos by Tom Peters
Integrated Program Development SolutionsIPDS Transitioning – Finance and Cost Future Decentralized, deploy finance people to the field as “business team members”, Current Centralized, finance staff as cops * Adapted from Thriving on Chaos by Tom Peters
Integrated Program Development SolutionsIPDS Excellence does not come from believing in excellence – only in constant improvement and constant change. Tom Peters
Integrated Project Delivery: An approach that aligns project objectives with the interests of key participants. It creates an organization able to apply the principles and practices of Lean Matthews and Howell 2005
LEAN: A methodology to manage and improve construction processes with minimum cost and maximum value by considering customer needs. Koskela et al. 2002
Integrated Program Development SolutionsIPDS Bioteaming It represents nature’s way of organizing and managing teams to achieve results.
Integrated Program Development SolutionsIPDS The case study isDelta Health Center’s Clinical Expansion;framed by Health Care Metrics and Upcoming Changes in the USA,the Geographical Context of the “Delta”,the IntegratedApproach,and Current Thoughtsvia an exploration ofHealth Care Needs, Changes, .
ISSUE ONE: High Cost HEALTH CARE COSTS AND OUTCOME “Health expenditures in the United States neared $2.6 trillion in 2010, over ten times the $256 billion spent in 1980..” Source: Martin A.B. et al., “Growth In US Health Spending Remained Slow in 2010; Health Share of Gross Domestic Product Was Unchanged from 2009,” Health Affairs, 2012.
Integrated Program Development SolutionsIPDS The Huffington Post |Updated: 08/30/13 EDT
Integrated Program Development SolutionsIPDS ISSUE TWO: Coverage and Access The number of people without health insurance coverage rose from 49.0 million in 2009 to 49.9 million in 2010… Source: US Census 2010 news release 9-13-2011; (http://www.census.gov/newsroom/releases/archives/income_wealth/cb11-157.html)
Who Are The Uninsured? Children 25% Unemployed 5% *Out of labor force Employed 20% 50% *Students>18, Homemakers, Disabled, Early retirees Source: Himmelstein & Woolhandler - Tabulation from 1999 CPS
Of the 191 members of the World Health Organization the United States ranks 37th in quality of health care. ISSUE THREE: Quality and Outcome
Quality of Health CareWHO evaluation of 191 members 1. France 2. Italy 3. San Marino 4. Andorra 5. Malta 6. Singapore 7. Spain 37. United States
Integrated Program Development SolutionsIPDS “PPACA” or “ObamaCare”
The new federal Patient Protection Affordable Care Act is projected to slow health insurance cost increases, but it will buy only four more years until the costs of coverage exceeds median family income, according to an analysis published in the Annals of Family Medicine.
Integrated Program Development SolutionsIPDS “It is a lot harder to keep people well than it is to just get them over a sickness.” DeForest Clinton Jarvis
Integrated Program Development SolutionsIPDS Kaiser Foundation Analysis of The Health Care Reform Plan
Integrated Program Development SolutionsIPDS THE PROJECT and SUBJECT AREA
Integrated Program Development SolutionsIPDS DELTA HEALTH CENTER is the First (oldest) Federally Qualified Health Care Center (FQHC) system in the country.
Integrated Program Development SolutionsIPDS MISSISSIPPI AND THE DELTA REGION
