1. Lean Construction - Prefabrication
Indiana Society for Healthcare Engineering Conference
Batesville, IN May 14, 2010

2. Agenda Skanska Overview Principles of Lean Vehicles of Change
Contractual
Building

3. Skanska Overview
Skanska AB – one of the world’s leading construction groups
Skanska USA - $4.0 billion in revenues in 2009
33 national offices offer local services with the benefit of national resources
Approximately 8,200 employees nationwide
Among most financially stable and best capitalized construction firms in the world
Market sectors include:
Healthcare
Science and technology
Government
Education
Corporate commercial

4. Skanska Overview
Healthcare is Skanska’s primary market comprising 30 percent of business
Healthcare Center of Excellence brings national resources and expertise
Currently $4 billion healthcare projects in U.S.
Built nation’s first LEED Gold Certified Hospital – Providence Newberg Medical Center
Providence Newberg Medical Center
Consistently ranked among elite construction firms in annual rankings by Engineering News-Record and Modern Healthcare

5. Why Lean? Waste vs. Productivity
$15.8B lost annually due to fragmentation
$10.8B Owners / Operators
$2.2B Trade industry
$1.8B GC’s
$1.2B Architects / Engineers
US Dept of Commerce Bureau of Labor Statistics

6. Symptoms of a Broken System
Numerous RFIs
Changing cast of players
Re-design
Unmet expectations
Delays
Productivity losses
Cost surprises and change orders
Claims and disputes
Compromised scope to "stay in budget"

7. Reaching a New Frontier Leadership, Planning and Management
Traditional
Leadership Dictates direction
Planning Partitioned by disciplines and is linear. Predictive and generally fixed, setting parameters for management
Management Controls are inflexible, autocratic -processes are fixed and measures are isolated and historical
Lean
Facilitates collaborative direction
Collaborative, project based and seeks to integrate efforts to eliminate negative iterations. Learns as project evolves
Develops a “network of commitments” to implement plan, evolves intelligence, measures are integrated and proactive

8. Lean Principles Collaborate – really collaborate
Early engagement of team members
Target Value Design
Last Planner – all parties involved in the schedule
Elimination of waste and duplicate activities
Implement the 5 S’s
Continuous feedback and learning

9. Follow the 5 S’s Sort Separate the necessary from the unnecessary
Simplify Neatly arrange and identify items
Sweep Routine inspections to keep workplace in perfect order
Standardize Document methods and formalize agreements
Self Discipline Hold team accountable to maintain agreed upon standards

10. Project Delivery

11. Typical Project Arrangement
Reinforced by provisions of AIA
and AGC “standard“ contracts.
Owner
Parties act
against each
others'
interests
Designer
Contractor
This relationship has
become increasingly
ambiguous

12. Integrated Project Delivery (IPD)
Integrates people, systems, business structures and practices into a process that collaboratively harnesses the talents and insights of all participants to reduce waste and optimize efficiency through all phases of design, fabrication and construction.
IPD is the process;
BIM and Last Planner
are the collaborative tools
Owner
Contractor
Designer
Rework “vehicle”
One Contract

13. Building Prefabrication

14. Common Misconceptions
Lesser Quality
Redundant Design Needed
Compromises Design Creativity
SEA Project December 2009

15. Value to User Groups Cost Avoidance Open Doors to Facility Faster
User Input, Review and Approvals
Fewer changes
Fewer Inconveniences
Minimal disruption to ongoing operations
Less Manpower i.e. decrease in parking needed, safety issues, etc.
Collaborative Team Effort

16. Southeast Addition Project
American College of Healthcare Executives

17. Southeast Addition Project
484,000 Square Feet
12 Stories (2 shelled for future growth)
178 Private Rooms
Campus Transformation
Southeast Addition Project December 2009

18. Patient Room Design 100% Private Rooms
Standardization of Spaces for Patients/Staff
Acuity Adaptable Patient Rooms
Same Handed (Repetitive) Design
Designed by Caregivers
Patient Room Rendering

19. Understanding Prefabrication
Prefabrication Video

20. Prefabrication Application
5 Patient Floors
3 Wings Per Floor
Corridor of each wing is being prefabricated in a warehouse 2 miles from the project, in 3 phases
Corridor rack modules
Bathroom pods
Patient room headwalls/footwalls

21. Prefabricated Corridor Racks

22. Prefabricated Corridor Racks

23. Prefabricated Corridor Racks
Transportation from Warehouse to Jobsite

24. Prefabricated Corridor Racks
Installation

25. Patient Rooms
Headwall/Footwall & Bathroom

26. Bathroom Pods/Headwalls

27. Construction Benefits
Improved Safety & Quality
Cost Savings
Reduced Manpower Peak
Reduced Waste
Seismic Benefits
Increased Above Ceiling Accessibility

28. Improved Safety Working on the ground instead of height
Replacement Hospital with Patient Tower – Tennessee
Square Feet 625,000
Man Hours Worked 1,005,874
On site Workers 715
LTIR 0.6
New Hospital Project – Tennessee
Square Feet 225,000
Man Hours Worked 768,529
On Site Workers 520
LTIR 0.26
Southeast Addition Project – Dayton, OH
Square Feet 485,000
Man Hours Worked 446,195
On Site Workers 310
LTIR 0
LTIR Industry Average 1.9*
*OSHA Statistics from AGC of America 2007 Reports
Safely working on corridor racks

29. Improved Quality Controlled Environment Cleaner – Infection Control
Materials Ordered to Specific Length
Ductwork Installation
Fewer Connections
Eliminates cross connections
of piping systems
Cleanliness of Warehouse

30. Cost Savings Anticipate Savings up to 1-2% of Construction Cost
Earlier Revenue Generation for MVH
5-10% Schedule Savings
SEA Project December 2009

31. Reduced Manpower Peak
Estimated vs. Actual Manpower (Mechanical, Electrical, Plumbing)

32. Reduced Waste Greenfield Hospital – Ohio Square Feet 544,443
Waste Removal Cost $138,970
New Hospital Project – Florida
Square Feet 423,000
Waste Removal Cost $200,006
Square Feet 480,000
Waste Removal Cost $490,083
Southeast Addition Project – Dayton, OH
Square Feet 485,000
Estimated Waste Removal Cost $91,000

33. Other Benefits Seismic Benefits Increased Above Ceiling Accessibility
Comprehensive Seismic Design vs. Traditional Seismic Bracing
Smaller Quantity Needed for Seismic Materials
Labor Installation Savings
Reduced Cost for Future Renovations
Increased Above Ceiling Accessibility
Improves Ongoing Maintenance for Hospital Systems
Flexibility for Future Additions/Renovations
Organization Accommodates Facility Maintenance

34. Questions?
Andrew Quirk Senior VP Skanska