Learning from the Cathedral Hill Hospital Project during the Design and Preconstruction Phases

Abstract

This article explores opportunities and limitations of implementing and experimenting with Lean Product Development ideas and practices in the design and engineering of a complex hospital project. In this environment, new forms of contracts have given rise to new forms of organizing teams to deliver capital projects in which architects, engineers, and contractors are co-located to promote collaboration and deliver projects with a strong focus on clients’ needs. The Cathedral Hill Hospital (CHH) project is a 1.2 million square feet urban replacement hospital in San Francisco, California. It is not just designed to be a state-of-the-art hospital but also to break new grounds in multiple areas of design, construction and operations. Since the beginning of project validation in 2007, the Integrated Project Delivery Team has been applying and testing Lean ideas, concepts, tools and processes to develop this very complex project. The article’s nurturing proposition is that CHH has implemented most principles related to the Lean product development system at Toyota, and that these principles are the foundation for the evolving operational system that supports its processes on a daily basis. The article contributes to the literature by providing an account of how different processes worked in a co-located environment.

Keywords:

• information flow
• Integrated Form of Agreement
• leadership
• lean
• learning
• product development

Acknowledgments

The authors would like to thank the team at Cathedral Hill Hospital project. The views and opinions expressed here are those of the authors and do not represent the views and opinions of the organizations involved with the project discussed. An earlier version of this article was presented at the IGLC-20 in San Diego, CA on July 2012 (Lostuvali, Alves, & Modrich, 2012). Thanks are due to the editors, reviewers, and IGLC conference participants for their comments about this article and their encouragement to further detail the contents of the original article and present it to a broader audience.