When Cook Children’s Health Care System’s new full-service inpatient pediatric care hospital opens at the end of 2022, it will be the culmination of more than three decades of progress that resulted in integrated project delivery (IPD) between the owner and general contractor Linbeck Group LLC.

库克儿童医疗中心 - Prosper是Greenfield卫星医院的第一家库克儿童系统在其101年历史上建立在其沃思堡基地之外的第一家。全方位服务的医院代表了该组织努力满足迅速发展的北德克萨斯地区需求的下一步。它在该地区拥有60多个主要，专业和紧急护理地点。

Project team members include HKS Inc., Smith Seckman Reid Inc., Dunaway Associates, David M. Schwarz Architects Inc., Keller Studios Inc., Fisk Electric and Dynamic Systems Inc. And almost all of these firms have worked with Cook Children’s in the past as part of similar poly-agreement/IPD arrangements to construct other facilities.

建筑标志着10月的一个主要里程碑，举办了高昂的活动。
Photos courtesy of Linbeck Group LLC

The hospital is Phase II of the health system’s North Campus in Prosper. A 230,000-sq-ft facility on a 23.65-acre site will feature 82 beds—72 medical/surgical beds for low acuity and 10 pediatric intensive care beds. The facility will include an intensive care unit, four operating rooms and three minor procedure rooms, 20 emergency rooms and one CT scan room and one general radiation room. It will also include an infusion center, pharmacy and lab. There will also be major telehealth components—video equipment and a 65-in. television that will allow patients at the Prosper campus to be seen by their physicians at Cook Children’s in Fort Worth.

北校园的第一阶段由多个要素组成。前两个是库克儿童的紧急护理 - 繁荣和烹饪儿童的儿科温书，于2019年秋季开业。这些房间为紧急护理服务提供了七个房间和12个初级保健房间。大约六个月后，烹饪儿童的小儿特色菜和烹饪儿童小儿手术中心开业。其中包括门诊专科诊所和门诊手术中心以及实验室服务以及未来的零售药房和成像中心。

Crews raise the final beam into position during the hospital’s topping out event.
Photos courtesy of Linbeck Group LLC

Demographic Demand

在2020年,将近75000人搬到了北德克萨斯州, according to the U.S. Census Bureau. That placed the region behind only Phoenix for new arrivals. Over the past five years, the North Texas region’s population has surged by more than 650,000 people. The demographic increase has created a housing boom, and the epicenter has been in the band of suburbs to the north of Dallas.

The town of Prosper, with less than 10,000 residents, lies in the path of this demographic wave. It lies approximately 35 miles directly north of downtown Dallas. According to the Census Bureau, Collin and Denton counties (Prosper lies in the former and abuts the latter) each grew by more than 36% between 2010 and 2020. As a result, what was once a rural community is growing fast; developers are putting up housing tracts in the area as quickly as possible. According to Prosper Mayor Ray Smith, the town is expanding at a rate of 30 families per week.

This demographic change is a huge opportunity for Cook Children’s, explains the health system’s director of construction and facilties planning Sam Werschky. The new location allows the health system to address almost all their clients’ needs without requiring patients to travel 60 miles to the Cook Children’s downtown Fort Worth Campus. The Prosper facility will be able to handle all but the most serious cases in-house.

对于繁华镇，医疗中心是其第一个主要建筑项目。对于医疗中心团队，帮助市政当局处理学习曲线带来了挑战和机会。在某些情况下，例如寻路和消防车道标准，主要医疗机构的需求不符合为农村社区建立的要求。

林贝克（Linbeck）助理项目经理卡门·雷诺兹（Carmen Reynolds）说：“我们与Prosper镇紧密合作，以帮助建立建筑指南。”“它需要时间，但在整个项目过程中有助于建立更好的关系。”

服务区域的人口变化也意味着该设施正在考虑未来。该建筑群的区域被建造为外壳，但直到需求足够长以需要它。这种分阶段的方法使医疗中心的扩展可以满足未来的需求。

Similarly, several of the operating rooms are being constructed but not equipped. With the inevitability of new technology emerging for improved services, the units can be upgraded to accommodate state-of-the-art tech with minimal disruption.

内部工作仍在继续。这家230,000平方英尺的医院定于12月开放。
Photos courtesy of Linbeck Group LLC

Integrated Project Delivery

IPD的核心是一个由多方协议控制的过程，该过程将建设项目工作中的所有学科都是一个统一的机构。参与者在合同上受到约束，并分享交付项目的风险和回报。通常，所有者负责直接成本和间接费用，而每个参与者然后根据目标价格为利润池做出了贡献。新利18备用官网登录风险在整个团队中类似地共享，就像返工，效率低下或复制工作由利润池支付，直到用完为止。

The emphasis on individual thinking and group problem-solving was a formidable challenge for early adopters of the process. The need for all parties to become heavily involved in the process for success can be as daunting as the legal requirements.

Cook Children’s first joined Linbeck using an IPD delivery method a decade ago with the construction of a general office building and parking deck on the medical group’s Fort Worth campus. The two firms had a 30 years of experience working together. They were joined by designer HKS, which had previous experience with IPDs.

Ten years later, the group has developed a strong cohesive approach to the IPD process, which made using it for the Prosper project an obvious choice. The scale of the facility as well as the cutting-edge technology it required demanded a high degree of detail and precision in planning.

A key factor to success on IPD projects is involving all participants in the process as early as possible, which was certainly the case with the Prosper facility. This was especially true given the large number of participants involved in the project.

完成后，该设施将成为基于沃思堡的医疗保健系统的第一家卫星医院。
Photos courtesy of Linbeck Group LLC

沃尔奇基说：“您必须将所有聚会从构想中列入董事会。”“当我们构想了Prosper医院的想法时，我们创建了一个证实该项目的文件。”

That document created the road map for the IPD team to follow. From it, key performance indicators are established that help guide the team and that become the milestones required to qualify for profit sharing. The upshots are fewer field changes, reduced waste and increased reliability across the project.

The communication is bolstered by biweekly leadership meetings where targets are discussed, issues are identified and solutions are found. The meetings are geared to ensure the team members are on track to meet key milestone dates.

沃尔奇基说：“每个人都以同样的速度和相同的方向划船。”

这种熟悉度还提供了快速反应以应对意外挑战的灵活性。Prosper项目的时机提供了一个很好的例子。几乎立即，该项目受到供应链问题的困扰，成本增加了整个行业被迫与去年斗争。价格不仅上涨了，而且一些商品的交付时间三倍。

Linbeck project manager Todd Zdunkewicz says that, by that time, they had been preparing for months to handle these problems. The close relationship with Cook Children’s allowed them to move quickly to address it rather than becoming bogged down in negotiations and contract revisions.

“We are fortunate to have the cash flow to take advantage of the prices like we had to,” Werschky says.

The team sped up the budget contracting, and subcontractors handling specialty tasks were brought onboard earlier. Masonry tradepartner DMG was brought on early to complete the design so timelines could be established and quantities could be better calculated.

随着价格和收购材料的价格开始增加，该团队努力分配现金以获取所需的材料。这个过程不是原始IPD安排的一部分，但是团队与所有者之间的强烈合作意识确保了预算的变更已获得批准。

Concrete, for example, became scarce during the summer of 2020. So, in order to maintain a priority status with manufacturers, the project team began doing larger placements, which increased the size of their orders.

前期费用was justified by avoiding even costlier pricing and delays to the project and preserving the profit sharing among the partners.
Zdunkewicz解释说：“这并不像以前那样大的问题。”

厨师儿童医疗中心– Prosper will be the centerpiece of the health system’s 23.5-acre North Campus.
Photos courtesy of Linbeck Group LLC

Building Information Modeling

The importance of communication between team members during the IPD process made building information modeling a crucial tool.

Communication was one of the biggest challenges for the Prosper facility, especially given its complexity. There was a critical need for transparency across the entire IPD team to ensure the project’s success.

Linbeck previously employed these technologies as part of a $220-million expansion to Cook Children’s South Utility Plant and South Tower in 2015. One major advantage the process provided was speeding up the time to clear RFIs to within hours instead of what can typically be a weeks long procedure.

Zdunkewicz说：“这是解决该领域和计划中的冲突的工具。”

定期扫描和审查该项目，以确保正在进行的施工与空间协调的模型相匹配。原始过程提供了一个单个数据库，并在现场中提供了监视器，这是当时向前迈出的一大步。如今，源模型可以通过便携式设备在项目站点上的多个人使用。

结果是一个过程，当识别或升级到项目团队以解决方案时，在现场中解决了方差。

The Prosper project is the first time this team has used a 3D BIM model from start to finish without using a printed set of plans. Project stakeholders expect the model will be useful long after construction is complete as a critical tool for maintenance and upgrade over the life of the facility. Knowing exactly what lies in the walls greatly reduces the disruption of opening them up to find out—a major concern in a health care facility.