The St. Luke's Episcopal Health System (SLEH) is in the midst of a significant expansion and faculties upgrade, both at their main campus in the Texas Medical Center as well as in communities around Houston. Hospitals are highly complex structures and difficult to design and build. Most healthcare systems respond to complexity with caution — they slow their project teams down to ensure no critical balls get dropped. But such an approach is simply not acceptable in this time of rampant, rapid cost escalation. So the question becomes: How does a hospital ensure quality and control costs?

The team in place at SLEH has developed an answer, and an approach to both major and minor capital investments that simultaneously and successfully meets both challenges. This team will share case studies, lessons learned and real-time solutions that other healthcare organizations can leverage today to achieve real results. The panel includes:
• Mike Reno, Vice President, St. Luke's Episcopal Health System;
• John Putnam, Executive Vice President, Pin Oak Interests;
• Wayne Barger, Sr. Vice President, RTKL; and
• John Barnes, Vice President & Client Executive, Linbeck.

The team will delve into three critical strategies for responding to both complexity and cost:

1. Supply chain integration and strategic procurement. The team incorporates the expertise and feedback of the supply into the design and planning process. Critical subcontractors and suppliers sit around the table from concept development through close-out, offering creative options and important insights, asking tough questions of themselves and other team members, and brainstorming uniquely effective solutions that satisfy SLEH's very particular needs.

2. Lean design and construction. This team has embraced the concepts and challenges of lean, for design efforts as well as construction activity. The emphasis is on productivity and speed, not on protecting territory. The main contributors from each stakeholder group are encouraged and expected to take full ownership of projects and their outcomes, to share a joint commitment to the client to exceed expectations.

3. Early involvement and collaboration. The team operates with transparency and respect, and functions in every regard as a high-performance team. They embrace the definition of the individual's success as the team's success. And since each project begins with all of the key stakeholders and contributors sitting around the table together, communication is clear, goals are shared, and decisions and tasks happen faster with fewer misunderstandings and less re-work.

The value generated by these strategies is enormous. The team will discuss examples from both the main TMC campus as well as a new community-based acute care project. Examples include:

• The Texas Heart Institute at St. Luke's Episcopal Hospital. This Build America award-winning heart hospital and research facility was tough to design and build, but it cost 10% less per SF than comparable facilities and was delivered an average of 9 months faster, generating $75M in incremental revenues for the owner.

• St. Luke's Hospital — Sugar Land. This new community-based acute care facility, located southwest of Houston, was delivered in record time at a SF cost of $247 compared to similar community hospitals built the same time costing $270 per SF.

• Emergency Power Reconfiguration. This project required cutting power to almost every system and piece of equipment in the 1.2M SF main hospital and demanded required tremendous forethought and planning to ensure patient safety. Despite the complexity of this 115-phase project, work was completed on time and the team returned over $3 million in savings.

This team has developed a process and approach that works. And they're happy to tell you why and how you can do the same.