Knowledge Transfer in Capital Projects at Cork University Hospital
Sep 6, 2016 -
Author: Tony McNamara, CEO, Cork University Hospital Group
Knowledge transfer is a critical requirement in any learning organisation and in the management of large capital projects it is vitally important to reflect on the processes, systems and dynamics employed and how they can be adapted for other projects. A large €400m capital programme has been underway in Cork University Hospital over the last decade which has enabled emergent learning that is applied to each successive project. Some of the key themes which provide learning for other projects relate to (i) the use of consultancy, (ii) the application of Lean and Six Sigma principles to design, (iii) the equipping and commissioning process, (iv) energy management and (v) the phased opening of new developments to provide for greater control.
Consultancy
In the nature of capital projects, the Project Team engage a Design Team that will fulfil a key technical and engineering requirement for the client. The creation of a close bond between the Project Team and the Design Team is essential to the successful construction of the building in accordance with the approved design.
But the question might well be asked as to the appropriate level of management consultancy in a large capital project. When is it appropriate? How much latitude should the consultancy agent be given? What role can consultancy fulfil that extant structures cannot? These are important questions that can only be addressed in the context of each individual project. Nevertheless it is probably fair to say that a degree of consultancy can bring both objectivity and expertise to particular aspects of project management and the Project Team must be aware and alert enough to recognise both the need and the optimum time for such interventions.
Lean Principles in Design
The implementation of Lean and Six Sigma techniques in building design has become an increasingly important feature because of the downstream revenue costs associated with staffing newly built areas. As an example a new Radiation Oncology Department is to be constructed in Cork University Hospital commencing later this year (2016) and the application of Lean techniques to the design resulted in a quite different internal design which will improve patient flow and reduce staffing costs when opened in 2019.
Equipping and Commissioning Process
The ultimate objective of the Project Team is to govern the construction, equipping and successful commissioning of the development and it must frequently do so in circumstances where changes take place in the external environment that materially impact on the “givens” for the project. These can include enhancements in technology, new medical techniques, improved technical specifications for equipment, new information technology systems and service configuration. It is critical that the Project Team has processes embedded in its workings to recognise these changes and to manage them successfully.
Related to such changes in the environment is the need for careful planning within timeframes that meet the need for the acquisition of current technologies within the approved budget. On the basis of our experience, it is essential to begin the process of equipment specification, tender preparation and processing together with equipment selection early in the project to avoid potential impediments to timelines later. This is particularly important where there are legal and procedural requirements that must be met as part of the governance of the project.
Energy Management
Cork University Hospital was the first hospital in the world to be awarded the Green Flag for its commitment to creating a sustainable environment. A key aspect of this endeavour is the focus on energy management and exploiting opportunities to increase the use of technologies to reduce energy costs as the Hospital works towards achieving our 2020 energy targets.
These objectives have informed successive capital projects and new energy reducing technologies have been applied to successive projects. Indeed the need to implement new and evolving strategies to improve energy management and to maintain our Green Flag status remains a key focus for various Project Teams working on site at the Hospital.
Phased Opening
The Project Team must consider the optimal pace of the commissioning programme and the options for a phased or full opening of the building. It may determine that there are tactical and strategic advantages to either a phased or complete option and our experience suggests that the decision to opt for a single “big bang” opening can create an undue focus on a date that can become the focal point for confrontation with some stakeholders. The Team may wish to evaluate its options and ultimately must reach its own conclusion having weighed up the multiple variables that will inform its decision.
Conclusion
Ultimately it is the responsibility of the Project Team to provide leadership and make determinations on multiple issues that can determine the success of the project. Through a process of learning from other experiences we can continue to add value to the project management process and ultimately improve our capacity to capitalise on the opportunities that infrastructural developments present.
J. A. McNamara, CEO
Related: Our Plans - Capital Developments
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