AGENDA
Download Here: Event Guide | Conference Schedule
PRE-CONFERENCE ACTIVITIES
Wednesday, January 23, 2019
3:30 PM – 6:00 PM
San Diego Harbor Tour (Open to Hospital and Public Agency Representatives Only)
Advanced Registration Required
Before the conference officially begins Thursday morning, we have arranged on Wednesday afternoon a two hour, sunset networking boat tour and mixer for hospital and other healthcare facility representatives.
We will host a limited number of Healthcare Project Delivery Conference delegates. Tour participants will get an up-close look at some iconic sights along the waterfront including the nearby the Navy Submarine base, the Coronado Bridge, the famous Star of India, dry-docking and ship building facilities, and the historic Hotel Del Coronado.
Special Thanks to:
5:00 PM – 8:00 PM
Conference Check-In & Registration
Grand Hall Foy
FORMAL CONFERENCE ACTIVITIES
Thursday, January 24, 2019
7:00 AM – 9:00 AM
Conference Check-In & Registration
Grand Hall Foyer
Morning Coffee Courtesy of Our 2019 Co-Chair Sponsor:
9:00 AM – 9:10 AM
Conference Start: Welcome & Opening Remarks
Grand Ballroom D
9:10 AM – 9:30 AM
Building Connections Between Project Delivery Planning and Performance
Grand Ballroom D
Much of the Nation’s healthcare infrastructure is aging and costly to maintain. In this era of tight budgets and thin margins, maintenance often competes with new investment, and project delivery decisions impact the health of patients and provider systems. In this opening session, Dale Bonner, former healthcare regulator and current chairman of a leading infrastructure developer, will discuss the national imperative to reduce whole-of-life costs and improve performance of healthcare facilities so that more resources can be allocated to direct patient care.
Presenter: Dale Bonner, Executive Chairman, Plenary Concessions
9:30 AM – 10:00 AM
Opening Keynote – A New Phase for Healthcare Project Delivery
Grand Ballroom D
James Pease, regional manager with Facility and Property Services at Sutter Health, serves on the Core Group for the Lean Construction Institute’s Northern California chapter and is executive editor at LeanIPD.com. Sutter Health is currently using Integrated Project Delivery (IPD) for the construction of multiple healthcare projects in California. In our opening keynote address Mr. Pease will share insights, lessons learned, and an evaluation of new approaches to project delivery being taken by Sutter Health and what he sees as emerging trends in the larger market.
Presenter: James Pease, Regional Manager, Sutter Health
10:00 AM – 10:30 AM
Innovative Approaches to Healthcare Project Delivery
Grand Ballroom D
We welcome Mr. Altaf Stationwala, President and CEO of Mackenzie Health, who joins us to share the story of the Mackenzie Vaughan Hospital, a 1.2 million-square-foot health care center scheduled for occupancy in late 2020. This important new facility, to be delivered under the DBFM model, will consist of 367 beds and is one of the first North American hospitals to feature fully integrated “smart” technology with systems and medical devices that speak directly to one another to maximize information exchange. Mr. Stationwala will describe key considerations in selection of the project’s delivery model and share experiences and best practices that have been employed in the hospital’s development.
Presenter: Altaf Stationwala, President and CEO, Mackenzie Health
10:30 AM – 11:30 AM
Applying Alternative Delivery to Our Healthcare Challenges
Grand Ballroom D
Healthcare facilities of all sizes, urban and rural, struggle today with operational and funding challenges that cannot be addressed solely with existing resources. Across the country a preponderance of small to mid-size systems are being forced to reappraise their options and priorities. And while alternative delivery approaches have demonstrated value in expediting projects, providing technology access, and transferring risk; healthcare providers across the country are only starting to consider the use of the model. This session considers why and explores how the private sector and partnerships fit in the context of national healthcare challenge. Daniel Feitelberg with KPMG will moderate this discussion with industry experts on how alternative delivery models are being employed to help aging facilities systems with budgetary constraints and facility challenges.
Moderator
Daniel Feitelberg, Principal, KPMG
Presenters
Claudio Andreetta, Director, Business Development, Johnson Controls
Mike Marasco, CEO, Plenary Concessions
Chris Rick, Project Director, Alternative Financing and Procurement, PCL Construction
Altaf Stationwala, President and CEO, Mackenzie Health
11:30 AM – 11:45 AM
Networking Coffee Break
Expo Hall
Sponsored by:
11:45 AM – 12:45 PM
Networking Roundtable Discussions
Expo Hall
A series of interactive roundtable conversations on critical public-private partnership topics. Each conversation will last approximately 20 minutes, and during the session attendees will be able to participate in 3 different discussions.
Roundtable conversations are meant to be informal, candid exchanges where participants can ask questions, share experiences, and network. Facilitators will guide discussions by bringing up case studies, targeted issues, and topics impacting the current market landscape.
Sponsored by:
Table 1: Asset Management Strategies for Deferred O&M
O&M is a mounting challenge faced by facility managers across the country, and many have stated that operations and maintenance services are one of the biggest reasons for considering alternative delivery. Today administrators are evaluating delivery model structures that include long-term operations and maintenance obligations to address their deferred maintenance challenges and realize better asset management oversight. This roundtable will discuss contracted deliverables that can keep facilities in good repair and improve operating efficiency.
Presenter: Claudio Andreetta, Director, Business Development, Johnson Controls
Table 2: Getting Practical and Preparing Your Capital Program for the Future
Infrastructure focused organizations including those managing healthcare facilities have discovered that by applying a more strategic approach to asset management they have realized both operational and capital efficiencies, while at the same time improving service. Central to the approach is a better understanding of how assets contribute to the strategic goals of the organization, enabling organizational value, and better ensuring long term outcomes, ultimately enabling organizations to better exploit assets over their lifecycles to support business aims. By adopting a data driven risk based approach, those assets in greatest need can be identified and prioritized, and then by adopting a whole of life approach, the optimum solution can be identified, leading to either enhanced operational and maintenance regimes or the need for a capital project. This discussion is an opportunity for participants to exchange ideas about potential approaches to applying these concepts to the management of their asset portfolio, and how they can extract greater value from their asset portfolio and focus their capital programs on delivery of their business goals.
Presenter: Michael Cowen, Director, KPMG
Table 3: Don’t be Afraid to Talk About Your Project!
In Alternative Project Delivery (APD) delivery mechanisms where confidentiality and commercial matters are paramount to the overall success of the procurement process, clients are sometimes unsure of how much information to disclose to prospective proponents in the pre-procurement stage before Request for Qualifications are issued. And later in the procurement process, during the Request for Proposal (RFP) stage, clients are often counseled to strictly limit feedback on the design during the open competition period. But are these unnecessary restrictions and running the risk of not achieving the highest project success? One of the strongest reasons in favor of APD is to leverage the creativity of the market but is the process smothering the creative flame? Please join us to hear relevant feedback from a developer and an architect on how you can maintain the integrity of the competitive bidding process while maximizing opportunities for innovative design and financing.
Presenters:
Tariq Amlani, Principal, Stantec
Angela Clayton, Group Head, Buildings Division, Plenary Group
Table 4: Healthcare Development in Small Towns and Rural Communities
Healthcare facilities in small towns and rural areas often face unique needs and challenges in planning and developing new projects. In this discussion we will examine how administrators in rural areas and smaller cities have been able to successfully overcome technical obstacles and resource constraints to bring critical healthcare projects in underserved communities to completion. Participants will learn how to develop strategies for development including specific steps to take advantage of best practices in procurement and project planning.
Presenter: Nicolle Griffin Wilkinson, Principal Project Director / Assistant Division Head, Arcadis
& Los Angeles County Public Works
Table 5: Lessons Learned from Five Collaborative Big Rooms
What are the key factors to building an integrated and collaborative project team? We walk thru five variations of project big rooms with co-located teams to find the common drivers that became the building blocks for the project’s success. Working under different Owner contracts and delivery models, all five project teams were motivated to work together to build an integrated team that would work together in the same place. We’ll walk thru how they did it on each project.
Presenter: Jeff Russell, VP Healthcare, Rudolph and Sletten
Table 6: Top Seven Terms and Conditions in Design and Construction Agreements
Design and Construction Agreements are laden with terms and conditions that shift risks from one party to the other. Often, at least one party is not aware of the shifts or has not fully considered the potential consequences. The implications of these shifts can surprise even savvy healthcare project professionals if they are first identified during a dispute or as a result of an insurance claim. This round table will identify key deal points and discuss methods of appropriately allocating and mitigating risks associated with them.
Presenter: Chad Stoker, Associate, Winstead PC
Table 7: Developing Your Project Checklist
Alternative delivery has great appeal to both owners and industry. But how do you get started, and what should you do to stay on the right track? Join our round-table discussion for a check-list of issues you should keep in mind as you embark. This roundtable conversation is designed to help both the owner and industry representatives define the issues they should bear in mind in starting and learn how to evaluate key risks in the first stages of a project. Take away some best practices and lessons-learned that can be integrated into your planning and procurement to make your future project a success.
Presenter: Kaveh Badiei, Partner, Ralls Gruber & Niece LLP
Table 8: Structuring and Financing Options in Today’s Market
In this roundtable we review financing options that have been successfully used in delivering recent and noteworthy healthcare facility projects. In this review we will compare tax-exempt and taxable debt models, equity options, and other approaches that owners have taken for their projects. Our discussion will also include an evaluation of current market trends and common terms; as well as a look at today’s market appetite for various financing structures.
Presenter: Charles Toto, Partner, Hawkins, Delafield & Wood LLP
Table 9: Leveraging Alternative Project Delivery to Achieve a Successful Operational Outcome
Project success is judged not only on how a new facility performs, but also on how users perform in the new facility. While Alternative Project Delivery (APD) brings innovation to the development of the facility, experience suggests that the incentive to innovate can drop off significantly upon award of the APD contract. Further, ensuring that facility requirements are met to their fullest takes significant team effort. Owners must play an active role here since achieving the desired operational outcome is a risk that remains with the healthcare organization. We will explore three strategies that owners have applied to play the APD “long game” to get the best facility outcome possible. The discussion will provide participants with practical ways to meet the challenges inherent in APD to maximize the potential to achieve facility and operational success.
Presenters:
Donna Rothwell, Senior Principal, Stantec
John Wieser, Senior Principal, Stantec
Table 10: Integrating Operational Efficiencies and Lean Approaches for Your Next Project
Operational Efficiency, in essence, the ability to get more done with less resources, is critical to success in project delivery for healthcare. Speed to market is also part of the foundation for competitiveness in tomorrow’s healthcare environment and one cannot ensure speed to market without the core foundation of operating the right resources at their maximum level of performance. In this roundtable we will share with participants what key methodologies can be implemented to increase the chances of both being efficient and reducing waste.
Presenter: Lisa A. Feeley, Vice President, Construction & Project Management, Transwestern
Table 11: The Design-Build Learning Curve
With a collaborative delivery inherently embedded in almost any alternative delivery approach, mastering the design-build learning curve is fundamental to successfully implementing projects. This roundtable looks closely at some of the more unique features of the design-build delivery model and common implementation.
Presenter: Tyler Fritz, VP of Building Systems, WSP
Table 12: Applying Asset Management, Life-Cycle Planning, and Sustainability Approaches
Infrastructure focused organizations including those managing healthcare facilities have discovered that applying asset management concepts and strategies at the outset of strategic capital investment projects can deliver cost savings and business efficiencies and ensure that projects deliver their intended benefits and outcomes. Formally documenting responsibilities, life-cycle strategies, maintenance programs and policies, performance measures, and reporting requirements can help ensure that expectations are fully documented and aligned between all parties. If done at the outset, it can help ensure that expectations are aligned at the start and that projects are aligned with asset management practice. This discussion is an opportunity for participants to exchange ideas about potential approaches to apply these concepts to new projects, and how to develop balanced agreements that ensure common objectives are fully documented, reducing risks and uncertainties for all parties.
Presenter: Gareth Lifton, Managing Director, KPMG
Table 13: Healthcare Construction Costs and Market Factors
What do construction costs look like for outpatient and inpatient buildings in California in 2019? What are the market factors that will drive costs in 2019? We walk through the historical cost data ranges for outpatient and inpatient projects in California over the past 10 years, while providing a snapshot of current costs and trends and a brief update on current market forces driving pricing. Join us for this discussion on the best way to position a project to drive the best pricing from high quality subcontractors.
Presenter: Eric Lascurain, Sr. Preconstruction Executive, Rudolph and Sletten
Table 14: Lean IPD, How Does it Impact You?
The Integrated Project Delivery (IPD) Method is gaining traction across the country. The real question that many people are asking is: How does this impact me? This discussion will include a deep dive into the new language that is created around this project delivery method, details that differentiate the Integrated Form of Agreement (IFOA) from standard agreements, and how this project delivery method is reducing risk on projects of all sizes. This will set the new standard for how healthcare projects should be delivered.
Presenter: John Zachara, Vice President, Integrated Facilities Solutions, Inc.
Table 15: Entitlement Oversight – Keys to Expediting Delivery Schedules
Hospitals and healthcare facilities are critical infrastructure for local communities, yet complicated environmental and entitlement burdens can drastically delay project delivery. Using recent examples from Southern California Kaiser Permanente facilities, this panel consisting of Kaiser delivery staff, environmental consulting and architecture teams, will provide discuss keys to expedite approval and delivery of new healthcare facilities.
Presenter: Shawn Shamlou, Principal, Dudek
Table 16: Planning Microgrid Projects
The facility microgrid market sector is quickly developing as owners have verifiable examples of successful installations in healthcare facilities of all sizes. In this roundtable we discuss how the smart design of microgrids can contribute significantly to achieving key microgrid goals such as energy supply reliability and resiliency, source flexibility, cost-effective demand response and carbon reduction.
Presenter: Suresh Jambunathan, CEO, Enwadev
12:45 PM – 1:45 PM
Networking Lunch
Expo Hall
Sponsored by:
1:45 PM – 2:15 PM
Lunch Keynote: Managing Risks and Optimizing Lifecycle Costs
Grand Ballroom D
Choosing among delivery methods for a large healthcare facility project is a complex task. While each delivery method offers advantages and tradeoffs when compared to traditional Design Bid Build, in certain cases the incentives and magnitude of the potential value proposition for owners must seriously assessed. In this keynote Mike Marasco, CEO of Plenary Concessions, offers a framework of what an analysis should consider, and will speak to the risks and benefits of an alternative delivery model for complex healthcare projects.
Presenter: Mike Marasco, CEO, Plenary Concessions
2:15 PM – 3:15 PM
Afternoon Fireside Chat – New, Smarter Models for Design and Construction – A Conversation with Barb Collins and Heather Chalmers
Grand Ballroom D
Drawing upon her experience leading the design and development of North America’s most technologically advanced hospital, Barbara Collins, CEO of Humber River Hospital, joins Heather Chalmers, President of GE Canada for a wide ranging discussion that explores the role of technology and partnership in creating a higher quality and more sustainable healthcare system for doors open and beyond.
Presenters
Heather Chalmers, President and CEO, GE Canada
Barb Collins, CEO, Humber River Hospital
3:00 PM – 3:15 PM
Networking Coffee Break
Expo Hall
Sponsored by:
3:15 PM – 4:15 PM
Accelerating Environmental Review and Entitlements for Healthcare Projects
Grand Ballroom A
Hospitals and healthcare facilities are critical infrastructure for local communities, yet complicated environmental and entitlement burdens can drastically delay project delivery. This panel will discuss what environmental and entitlement obstacles hospitals are facing and how local agencies are approaching entitlement applications, as well as present innovative solutions to these issues and constraints. Case studies from recently completed healthcare projects in San Diego, Los Angeles, and Riverside Counties will cover topics including each project’s spillover effects on the community (traffic, emergency sirens, and emergency helicopters, etc.) and how impacts on local communities and neighbors are mitigated, especially with the shift in hospital focus to more outpatient care. Case studies for recent successfully completed projects in San Diego and Southern California will be described. In particular, compliance with the California Environmental Quality Act (CEQA) will be described, including recommendations to streamline document preparation and approval through local jurisdictions. The importance of outreach strategy with lead agencies and stakeholders will also be discussed. Details provided from these case studies will be useful to other health care delivery professionals for use in upcoming procurements and RFPs.
Moderator
Shawn Shamlou, Principal, Dudek
Panel
Tom Chessum, FAIA, Principal, CO Architects
Skyler Denniston, Land Use Manager, Kaiser Permanente
Niral Desai, Sr. Project Manager, Kaiser Permanente
Joe Stasney, National Director for Hospital Design and Construction, Kaiser Permanente
3:15 PM – 4:15 PM
Managed Equipment Services – Partnerships to Help Manage the Proliferation of Technology in Hospitals
Grand Ballroom B
Managed Equipment Services (MES) is a specialized partnership between health systems and external equipment and services vendors supplying the healthcare industry. Created more than 20 years ago to significantly reduce healthcare costs in Britain, MES is a tried and true procurement platform with more than 60 contracts successfully operating globally. MES has now migrated to North America, with more than a dozen operating contracts in the U.S. and Canada reducing capital and operating costs by as much as 25% on average.
Recent independent research concludes that MES has emerged as one of the “most effective solutions” for health system procurement in modern times and that demand for MES product will rise significantly in the U.S. during the next decade. Join us to hear various perspectives on the MES model from owners and industry providers alike.
Presenters
Sam Slutsky, Founder and CEO, The Lonsdale Health Group
Grant White, Founder and CEO, Americore Health
Fawn Staerkel, Healthcare Market Director, Johnson Controls
3:15 PM – 4:15 PM
When Nature Attacks How Should We React? Building Resiliency and Disaster Preparedness
Grand Ballroom D
Healthcare facilities have a central role in a community’s resilience and ability to respond and resume services after major natural disasters. However climate change today is introducing complex hazards that challenge traditional assumptions for building capabilities, needs, redundancies, and ability to respond in times of disaster. Should recent high-profile fire and flooding events in California, Texas, and along the East Coast usher in a new age of new building design and construction thresholds for climate-resilient facilities? In this session we will hear about the experiences of three facilities recently impacted by extreme weather events, and how we can design and plan healthcare buildings to be flexible in the face of environmental uncertainty. Panelists will share how their organizations are revaluating risks and planning in the face of extreme weather possibilities. And we will review recent and upcoming projects that
integrate sustainable communications, energy, water and waste infrastructure to a standard of climate resilience to withstand events over the anticipated life of the structure.
As part of this discussion we will consider the examples of hospitals in Texas rebuilding after Tropical Storm Allison (2001), Hurricane Ike (2008), and Hurricane Harvey (2017) including the University of Texas MD Anderson Cancer Center, UT Health Houston, UT Medical Branch Galveston, and the example of Mercy Hospital Joplin, Missouri, formerly known as St. John’s Regional Medical Center, which became famous for suffering devastating damage in the 2011 Joplin tornado.
Moderator
Michelle Rieger, Shareholder, Chair, Construction Practice Group, Winstead PC
Panel
Michael Braund, SE, Principal, Degenkolb Engineers
Phil Dendy, Chief Compliance and Risk Officer, University of Texas System
Norman Morgan, AIA, Principal, Regional Director of HKS Health
Patrick Otellini, Project Manager, Swinerton
4:30 PM – 5:30 PM
Delivering Mental Health Facilities
Grand Ballroom A
Mental health facility design is a critical component of patient care. The design of mental health facilities affects how services are provided and the efficiency with which care is delivered. Equally, if not more important, than its direct functional impact, however, is the psychological impact mental health facility design has on its users. Facility design impacts the beliefs, expectations, and perceptions patients have about themselves, the staff who care for them, the services they receive, and the larger health care system in which those services are provided. Moreover, facility design can also have a significant impact on the beliefs, attitudes, and behaviors of staff and on how staff identify and interact with patients and the environment. In this session we look at recent examples of projects delivered, and discuss noteworthy technical architectural and engineering specifications. Join us for this discussion which emphasizes principles and strategies for building state-of-the-art, recovery-oriented environments for mental health settings.
Moderator
Korin Crawford, Executive Vice President, Griffin | Swinerton
Panel
Ena Kenny, Senior Interior Designer, Stantec
Marshall Moncrief, Regional Executive Director, Institute for Mental Health & Wellness, Providence St. Joseph
Pedro Narbaitz, Facility General Manager, Royal Ottawa Mental Health Centre
4:30 PM – 5:30 PM
Innovative Ways to Avoid Construction Disputes – DRBs and Their Application
Grand Ballroom B
Disputes and claims have been a part of construction projects for many years and oftentimes drag out well after the completion of the project, tying up valuable resources and adding costs. Actively managing the dispute or claim or, even better yet, helping avoid the claim or dispute entirely, saves time and money for all the parties involved. By having a DRB start at the beginning of a project, the DRB can often help involved parties avoid a dispute by being proactive with the parties in getting issues settled and avoiding a dispute altogether. This session provides an overview of the DRB process and how it can help avoid disputes or get them settled in a timely and efficient manner.
Moderator
Denis O’Malley, PE, PMP, QSD
Panel
Victor Mercado, Construction Engineer, California Department of Transportation
Craig Ramseyer, Attorney, Procopio, Cory, Hargreaves & Savitch LLP
Elizabeth Tippin, Attorney, Tippin Law & ADR Services
4:30 PM – 5:30 PM
Progressive Design-Build Delivery – A Better Way to Achieve Predictable Project Outcomes
Grand Ballroom D
In progressive design-build, the design-builder is selected primarily (if not exclusively) based on qualifications and is brought on as part of the owners’ team at a very early stage of the design. The design-builder will either assist the owner in developing the design concept or advance the design from what the owner already has developed through its own personnel or an independent design professional. There are several reasons that an owner would choose to use a PDB process vs. the typical two-phase best value process and there have been many advances to the delivery method recently. Enabling owners to get the benefits of having the design-builder introduced to the project at the earliest possible point is merely the tip of the iceberg. Allowing the design-builder to use its expertise to influence the design development process and avoid the time and expense associated with having another designer create the design baseline and then “hand-off” the design to the design-builder after the completion of the procurement process. Another important benefit of PDB is that the owner can achieve a high degree of construction cost certainty as the design is being developed.
Sophisticated owners have been working on ways to develop and perfect the PDB method and along with others have developed advances related to the delivery’s nuances. In this discussion attendees will learn more about these advances of how teams have been able to successfully use this method to deliver multi-billion dollar capital programs. Additionally, the discussion will outline trends along with a more advanced deep-dive into the delivery and its complexities, advances and benefits.
Presenters
Praful Kulkarni, AIA, President + CEO, gkkworks | CannonDesign
Jennifer Farnham, Area Manager, PCL Construction
Eric Smith, Associate Vice Chancellor of Capital Program, UCSD
5:30 PM – 7:00 PM
Opening Night Welcome Reception
Expo Hall
Join us at this special evening networking receptions for all attendees. Enjoy drinks and light fare while meeting with exhibitors, speakers, and conference delegates.
Sponsored by:
Friday, January 25, 2019
7:00 AM – 8:00 AM
Networking Breakfast
Expo Hall
Sponsored by:
8:00 AM – 9:00 AM
Making the Right Decisions Early On
Grand Ballroom A
While alternative delivery is not necessarily appropriate for all types of healthcare facility projects, how can sponsors meaningfully evaluate the relevance and suitability of different delivery models in the context of individual projects? We address the importance of upfront scrutiny of project objectives, scale, complexity, capital intensity and revenue risk, as it relates to construction of the physical plant. We will review some of the key characteristics that determine the extent to which a deal structure can deliver additional value, based on analyzing and assessing project budgets and investment objectives; documents and agreements; permits and required approvals; project schedules; development team members and bidding and subcontractor selections.
Presenter: Akram A. Atallah, Director of Operations, SBI Consultants, Inc
8:00 AM – 9:00 AM
Thinking Small – IPDs for $10 Million or Less
Grand Ballroom B
While it’s common to hear about mega-projects and their use of Integrated Project Delivery, the reality is that small projects make up a majority of the project landscape across the country. This panel discussion looks at a large healthcare system located in Chicago and its first two IPD projects utilizing an Integrated Form of Agreement. In this session we examine the first agreement of its type to be used for a healthcare project in the Chicago area: an integrated Form of Agreement signed by the Owner, Architect, Mechanical Engineer, Electrical Engineer, and General Contractor (which also included subcontractors that shared in the risk/reward pool).
Panelists will discuss the unique challenges in implementing the ILPD tools from large scale jobs to the $10M and less scale for a new ground-up building and an interior hospital renovation. With a specific focus to be made on key decisions at the project’s outset that were instrumental to 1) significant project cost reduction and 2) how the original construction schedule set at 11 months from groundbreaking was completed in 9 months, 2 months early and in line with the project goal of substantial completion and occupancy.
Presenters:
James Pease, Senior Project Manager, Sutter Health
John Zachara, Vice President, Integrated Facilities Solutions, Inc.
8:00 AM – 9:00 AM
What Does a Successful Project Look Like Today? Understanding Different Project Delivery Approaches
Grand Ballroom D
Healthcare providers must improve efficiency, accuracy and quality while reducing cost. Capital expenditures and projects follow suit. Four widely accepted processes for delivering large capital projects for healthcare systems hailed for improving quality while reducing cost will be the topic for this panels conversation. What are the advantages and disadvantages to each? Are we confusing results with different processes? Is credit for successful outcomes being attributed incorrectly to a new “buzz word”?
The Panel will discuss the central value propositions to each methodology – P3, IPD, D/B and Lean to help attendees understand the merits to each and how it could be applied to attendees’ future efforts. The panel will explore the advantages and potential risk of each methodology. In addition, factors or barriers to successful outcomes such as contracting structure and team behaviors will be addressed. Misunderstandings will be clarified about use of applications such as the difference between a Lean construction process and a Lean Programming process. Each member of the panel is an expert having implemented each methodology its results and effectiveness.
Moderator
Scott Reed, Principal, Stantec
Panel
Randy Leopold, Architect, Senior Director of Project Management, UCSD Capital Program Management
Barbara Wagner, Senior Vice President, Clark Construction Group
Tariq Amlani, P.Eng., Principal, Stantec
9:15 AM – 10:15 AM
Integrated Approaches to Building A Public Facility Microgrid
Grand Ballroom A
The facility microgrid market sector is quickly developing, as stakeholders have verifiable examples of successful installations in the utility, municipal, and healthcare spaces. Microgrids offer facility owners and managers an innovative and reliable solution to fit their unique needs. Smart design of microgrids can contribute significantly to achieving key microgrid goals such as energy supply reliability and resiliency, source flexibility, cost-effective demand response and carbon reduction. This presentation describes strategies for microgrids, including renewable sources, power generation, hot water and chilled water and energy storage systems. The talk will also focus on contract structures and how owners can install microgrids quickly without impacting facility budgets and everyday operations. A discussion on lessons learned from the feasibility and design process through construction, startup and testing will be included in addition to the regulatory aspects to consider in a tactical implementation.
Presenter
Suresh Jambunathan, CEO, Enwadev
9:15 AM – 10:15 AM
A Closer Look – The Yuma Regional Medical Center
Grand Ballroom B
Representatives from Yuma Regional, Archsol and McCarthy join us to highlight this unique project in Yuma. In this panel we feature a rural case study and provide details on the history of the project. The objective of this session is to help provide a working framework for owners evaluating prospective rural projects. And panelists will provide deeper dives into their and their firms’/agency roles and answer questions primarily related, but not limited to:
•Collaboration with city building officials
•Using effective communication (disruption notices etc)
•Keeping an operating hospital operating during construction
•Lean process improvements
•Make-ready phasing
•CMAR/IPD-ish delivery
•Adding scope without schedule impact
Moderator
Nicolle Griffin Wilkinson, Principal Project Director / Assistant Division Head, Arcadis & Los Angeles County Public Works
Panel
Justin Farren, Vice President of Ambulatory Operations, Yuma Regional Medical Center
Alex Laky, Principal, Archsol
Lindsay Johnson, Project Manager, McCarthy
9:15 AM – 10:15 AM
Achieving Greater Value; Infrastructure-as-a-Service
Grand Ballroom D
Healthcare organizations are currently challenged with building new infrastructure and modernizing existing assets while creating appropriate risk transfer scenarios to manage deferred maintenance, rising operating costs and carbon footprint targets. By utilizing alternative delivery models, healthcare organizations are able to focus on their core mission while transferring the risk of cost overruns to a partner better suited to hold and mitigate that risk.
These models allow healthcare organizations to select the level of risk most suitable to their needs while managing and developing infrastructure with a provider that may be better equipped to execute the project. This could ensure both new and existing healthcare facilities are able to sustain efficiency, reliability and affordability in the long term while allowing owners to reinvest in patient care, creating an environment for more effective, modernized facilities managed by a partner with the tools and capabilities to deliver better budgetary and operating outcomes with less overall risk.
This session will focus on how healthcare organizations can approach project delivery in a manner that provides options regarding levels risk transfer to better manage budgets and outcomes. Panelists include representatives from healthcare organizations and service providers experienced in the practice of delivering better healthcare infrastructure through alternative delivery models.
Moderator
Claudio Andreetta, Director, Business Development, Johnson Controls
Panel
Barb Collins, CEO of Humber River Hospital
Rick Norling, former CEO of Fairview Health
John Fleming, Vice President & General Manager, P3, Johnson Controls
10:15 AM – 10:45 AM
Networking Coffee Break
Expo Hall
Sponsored by:
10:45 AM – 11:45 AM
Third Party Investor Capital Options for System and Physical Practices
Grand Ballroom A
Capital constraints and other issues have made third-party partnerships more important than ever. In an era when most hospital systems are trying to conserve revenue, invest in patient care, stretch dollars, deal with compliance, and improve access to technology, it is becomingly increasingly important for consider relationships with third-party capital partners, including those that invest in healthcare real estate (HRE) facilities to stay competitive. Health systems do not necessarily have to sell all – or even a large portion – of their non-core assets to take advantage of what third-party capital partners can provide. Systems can turn to third-party capital providers in a more limited way to sell specific assets to receive an infusion of capital, or right-size their portfolios of owned and leased properties. Providers can also selectively receive capital from, or form joint venture (JV) partnerships with, third parties to develop new outpatient projects, or to borrow capital to invest into service lines with strong returns instead of going to the capital markets.
This session is a panel discussion regarding the use by healthcare providers, both system and physician practices, for the use of third-party investor capital. Panelists will include large and small system representatives, capital providers, and healthcare real estate advisors. Subtopics will include (i) the current market trends and what are key property attributes to attract third party capital, (ii) the anticipated volume in the industry, and (iii) forecast on where experts would find the capital markets in 2019 and beyond.
Moderator
Steve Leathers, Managing Director, JLL
Panel
Jay Gangwal, Principal, IRA Capital, Healthcare RE Investor
Jake Rohe, Principal, PMB Real Estate, Developer
Andrew Saba, Head of Asset Management-Medical Office Real Estate, Stockdale Capital Partners
Gregg Zoll, VP Facilities Management & Development, Sharp HealthCare
10:45 AM – 11:45 AM
Applying Design-Build Best Practices to Healthcare Project Delivery
Grand Ballroom B
The session explores current design-build practices and how they should be adapted for healthcare projects. With a collaborative delivery inherently embedded in almost any alternative delivery approach, mastering the design-build learning curve is fundamental to successfully implementing projects. The panel discussion will focus on identifying key issues and risk transfer considerations unique to design-build delivery followed by an interactive discussion addressing key implementation issues For example: what are the preparation steps needed for an to implement a project without prior hands-on design-build experience? How does the fixed price design-build approach translate to a procurement, particularly in relation to prescriptive- versus performance-based requirements? Is there a progressive design-build option within the DB framework? How does the risk transfer and securitization of existing DBO models compare to traditional delivery? How can commissioning approaches and acceptance metrics for design-build and DBO projects be applied in today’s environment?
Moderator
Kaveh Badiei, Partner, Ralls Gruber & Niece LLP
Presenters
Greg Chauhan, Senior Vice President, WEBCOR Builders
Sarah Kuchera, Managing Director, WSP
Pilar Mendez, Project Architect, SmithgroupJJR
Robert L. Layton, Associate General Counsel, Adventist Health System/West
R. Vernon Southerland, Project Executive, Turner Construction Company
10:45 AM – 11:45 AM
Construction Cost Confidence with Quantity Based Project Delivery
Grand Ballroom D
Increase the accuracy of early budgets, reduce contingencies and enhance subcontractor pricing competition. Leverage historical data to predict accurate material quantities and labor production rates early in the project budget development phase. The team will walk thru a technical presentation of its experience working with Kaiser Permanente’s pioneering efforts to standardize its project delivery using quantity-based unit pricing for project budgeting, estimating, subcontract buy-out, billing and cost projecting.
Moderator
Jeff Russell, VP Healthcare, Rudolph and Sletten
Panel
Chang Yi, Senior Project Manager, Kaiser Permanente
Eric Lascurain, Senior Preconstruction Executive, Rudolph and Sletten
Gary Brett, VP Construction Cost Services Healthcare, Cummings
Lynn Hoopingarner, President, Profitable Solutions Inc.
11:45 AM – 1:00 PM
Networking Lunch
Expo Hall
Sponsored by:
1:00 PM – 2:00 PM
The Fundamentals of Preparing a Procurement
Grand Ballroom D
No question is too simple when starting out. This session explores best practices and new approaches to procurement in the context of planning new projects, and will consider how owners can most effectively structure risk transfer in design and construction costs, operational and maintenance challenges, and factors that can impact value for money analysis. What are the top 10 issues you should make sure you address when procuring your next project? Hear from this panel of advisors with hands-on experience about procurement Best Practices and Lesson Learned. This panel will provide guidance on how to navigate the procurement process and identify actions you can take to anticipate issues and achieve resolution so that your next procurement will be successful. Join us in a discussion as we review the importance of types/experience of advisors, level of detail re: technical studies and cost estimating, internal resources and decision-making framework, procurement schedule development and project management.
Moderator
Liam Kelly, Managing Director, KPMG
Panel
Lisa A. Feeley, Vice President, Construction & Project Management, Transwestern
Joey Kragelund, Sr. Healthcare Leader, HKS
Andrea McLean, Vice President, Business Development, Fengate Asset Management
Michael Zorich, Director of Healthcare, IMEG
1:00 PM – 2:00 PM
Energy Strategies and Contract Structures
Grand Ballroom B
Each year hospitals are challenged to provide more services with fewer resources. In order for core responsibilities to be fulfilled, energy utilities – electricity, heating, cooling – must function, flawlessly, at any cost, and especially in disasters. Partnering with an energy expert enables a hospital to focus its scarce human and financial capital towards its core mission, while offloading the performance risk and maintenance responsibilities inherent in operating energy assets. Moreover, an energy expert can be a vital partner in supporting growth, and can leverage emerging technologies to create efficiencies. This presentation will discuss the contracting structures that can be used, and the example of a first-class microgrid serving the University Medical Center of Princeton at Plainsboro where the microgrid fully supplies 100% of the hospital’s electricity, steam, and chilled water needs.
Presenter
Alan Cordova, Business Development Manager, Clearway Energy
1:00 PM – 2:00 PM
Planning for Disruptive Healthcare Technologies
Grand Ballroom A
Healthcare representatives face growing challenges in terms of properly planning for technologies in the market that might stand to disrupt in fundamental ways capacity and usage. What possible opportunities might arise from the disruptive possibilities of new technologies and services. While we are at an early state for many of these new technological forces, we are at a point where there appears to be sufficient data to make some analytical judgments. This panel will seek to provide a framework for analysts to make relative judgments of risk for future projects and discuss the role of partnerships in the context of technological change.
2:15 PM – 3:00 PM
Q&A Discussion Session – What are the Next Steps? Where to Go from Here?
Grand Ballroom D
Join industry leaders for an interactive conversation specifically tailored to audience questions and answers about subjects raised during the conference. Attendees will have the opportunity to submit questions in advance and also join in the discussion of the benefits, values, and applications of alternative delivery approaches in an open dialogue.
Presenters
Lisa A. Feeley, Vice President, Construction & Project Management, Transwestern
Sarah Kuchera, Managing Director, WSP
Pilar Mendez, Project Architect, SmithgroupJJR
James Pease, Senior Project Manager, Sutter Health
3:00 PM
Conference Ends