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Sutter Health<br />

A Practical Look at<br />

<strong>Lean</strong> <strong>Construction</strong><br />

David Long, Sutter Health<br />

<strong>Construction</strong> Owners Association of America<br />

San Diego, California<br />

Nov.9, 2006


<strong>Lean</strong> <strong>Construction</strong><br />

I. In the Context of <strong>Lean</strong><br />

II.<br />

Traditional Project Management<br />

III.<br />

Initiative to Change<br />

IV.<br />

Pre-Requisites to Change<br />

V. Sutter’s s <strong>Lean</strong> Program<br />

VI.<br />

Results<br />

VII. Challenges Moving Forward


I. In the Context of <strong>Lean</strong><br />

The Toyota Way<br />

Genchi<br />

Problem<br />

Solving<br />

(Continuous<br />

Improvement & Learning)<br />

Genbutsu<br />

Jeffery Liker<br />

Kaizen<br />

Respect and<br />

Teamwork<br />

People & Partners<br />

(Respect, Challenge,<br />

& Grow Them)<br />

Process<br />

(Eliminate Waste)<br />

Challenge<br />

Philosophy<br />

(Long-Term Thinking)


II. Traditional Project Management<br />

Change From The “Typical” Organization<br />

Command and Control<br />

• Over Budget<br />

• Late<br />

• Poor Quality<br />

• Kill or injure too many during<br />

construction<br />

‣ Insanity:<br />

Doing the same thing<br />

over and over again<br />

and expecting different<br />

results.<br />

Albert Einstein


III. Initiative to Change<br />

Why<br />

• Promise to Manage Within Budget<br />

• Promise to Manage within Scope<br />

• Promise to Manage within Time<br />

Parameters<br />

• Promise to Preserve and Better the Lives<br />

of the Project Participants


IV. Pre-Requisites to Change<br />

• Recognition and Acceptance that<br />

Work can be Approached in New and<br />

Better Ways<br />

• Willingness to Experiment


V. Sutter’s s <strong>Lean</strong> Program<br />

• Engagement of Consultants – LPC<br />

• Adoption of a <strong>Lean</strong> Philosophy – From the Top<br />

• Formation and Expression of the Mission – The<br />

Five Big Ideas<br />

• Challenge the Community to Join in Change<br />

• Started by Applying a Production Control<br />

Process to Projects – Last Planner<br />

• Examined and Began to Improve Our Own<br />

Management Behavior – Meetings, Promises,<br />

Requests, Trust, Leadership.


Five Big Ideas<br />

Emergent Outcomes<br />

Collaborate;<br />

Really Collaborate<br />

Increase<br />

Relatedness<br />

Projects as<br />

Networks of<br />

Commitment<br />

Innovation<br />

Build<br />

Trust<br />

Reliability<br />

Competitive<br />

Continuous<br />

Improvement<br />

Optimize<br />

The Whole<br />

Tightly Couple<br />

Learning w/ Action


Integrated Change to Team Concepts<br />

Integrated Project Delivery<br />

Team<br />

Core Group<br />

Other<br />

Landscape<br />

Other<br />

Subs, vendors,<br />

& consultants<br />

Civil<br />

Site<br />

CPMC<br />

Rep.<br />

Framing<br />

Structural<br />

Mechanical<br />

Mechanical<br />

ARCH.<br />

Rep.<br />

Plumbing<br />

Plumbing<br />

SH FPD<br />

Rep.<br />

CM/GC<br />

Rep.<br />

Landscape<br />

Electrical<br />

Steel<br />

Electrical


What is <strong>Lean</strong> <strong>Construction</strong><br />

In collaboration with LCI, LPC & Sutter Health<br />

• <strong>Lean</strong> on projects means “doing more with less”<br />

(Eliminate Waste).<br />

• Shortens construction time.<br />

• Reduces costs.<br />

• Delivers more value and reduces wasteful surprises.<br />

• Promotes safety. (Accidents are Dramatically Reduced)<br />

• Creating reliable workflow is the initial focus of most<br />

implementation efforts.<br />

• Brings the responsible parties together to create and<br />

activate the network of commitments necessary to<br />

deliver the project.<br />

• The Right people talk about the Right things at the Right<br />

level of detail at the Right time.


Managing in a <strong>Lean</strong> Environment<br />

What does it Look Like<br />

• Trust<br />

• Expose Breakdowns<br />

• Communication<br />

• Human Behavior – Manage Transparently<br />

• Processes<br />

– Target Value Design<br />

– Budget Realignment (Up and Down)<br />

– Last Planner – (Production Planning and Control)<br />

– Integrated Form Of Agreement (Not a Positioning for<br />

Litigation)<br />

– Continuous Learning- Plus/ Delta


Target Value Design<br />

Manage Costs Before Incurred


Target Value Design<br />

Project Definition<br />

Preproject Planning<br />

P<br />

r<br />

o<br />

j<br />

e<br />

c<br />

t<br />

D<br />

e<br />

f<br />

i<br />

n<br />

i<br />

t<br />

i<br />

o<br />

n<br />

Project Initiation<br />

Project Business Plan: If we could build X with<br />

which we could do Y and it cost us Z, would we do<br />

it<br />

Go /<br />

No<br />

Go<br />

Project Design / Alignment Study: Can we build X<br />

with which we can do Y and will it cost us Z<br />

Go /<br />

No<br />

Go<br />

Design<br />

Conform<br />

Conform<br />

Set The<br />

Target<br />

Cost<br />

Note: X, Y, and Z can all change<br />

in the course of the conversation<br />

between means, ends and<br />

constraints, but these must be in<br />

alignment for a “GO” decision.


Last Planner<br />

Planning, Controlling & Correcting


Manage the Network<br />

of Commitments<br />

1<br />

Request<br />

“Will You”<br />

Accepted<br />

Inquiry<br />

PO<br />

Negotiation<br />

Submitted<br />

Preparation<br />

CUSTOMER<br />

4<br />

Clarification<br />

&<br />

Negotiation<br />

Signed<br />

Declare<br />

Satisfaction<br />

“Thank you”<br />

Conditions of<br />

Satisfaction<br />

&<br />

Date of Completion<br />

2<br />

PROVIDER<br />

COMMITMENT<br />

“I Promise I WILL”<br />

Assurance<br />

Performance<br />

3<br />

Declare<br />

Complete<br />

“I’m Done”


Budget Realignment Process<br />

Davies New-MOB<br />

Version: 1 for the abov<br />

341.460.20 WORKING BUDGET<br />

Working (Cur-Work)<br />

CPMC Quantity Unit Rate ST Baseline Current Budget Variance<br />

100. Site/Entitlements/Development/Permits 666,794 - 476,435 666,794 (190,359)<br />

Site/Entitle/Dev/Permits - Budget 1 ea $320,800 320,800 - - 320,800 (320,800)<br />

City/County Plan Check & Permit 1 ea $166,080 166,080 - 296,117 166,080 130,037<br />

OSHPD Permits 1 ea $21,714 21,714 - 30,318 21,714 8,604<br />

Other Permits / Development Fees 1 ea $8,200 8,200 - - 8,200 (8,200)<br />

Connection Fees 1 ea $150,000 150,000 - 150,000 150,000 -<br />

200. <strong>Construction</strong> 30,729,982 - 28,974,832 30,729,982 (1,755,150)<br />

<strong>Construction</strong> - Budget - - - -<br />

<strong>Construction</strong> - Pre<strong>Construction</strong> Services 1 ea $800,000 800,000 - - 800,000 (800,000)<br />

<strong>Construction</strong> - General Contractor 28,929,982 - 25,980,574 28,929,982 (2,949,408)<br />

<strong>Construction</strong> #4 Neigborhood Improvement 1,000,000 - - 1,000,000 (1,000,000)<br />

<strong>Construction</strong> - Offsite 0 - - - -


Integrated Form of Agreement<br />

Build Relationships From The Beginning<br />

• Defines Sutter’s<br />

<strong>Lean</strong> Process<br />

•Defines<br />

Relationships<br />

• Moves Away From<br />

Preparation For<br />

Litigation<br />

•Establishes<br />

Incentives<br />

•Establishes Trust


Plus/ Delta<br />

Continuous Improvement<br />

• Good Meeting<br />

PLUS<br />

• Great Participation<br />

• Good to have the Subs<br />

DELTA<br />

• Meeting Needs to be Shorter<br />

• Need to Include the Engineers<br />

• Have Food Next Time


VI. Results<br />

• Prior to <strong>Lean</strong> Program<br />

– Project 1<br />

– Project 2<br />

• After <strong>Lean</strong><br />

12 Mos. Late $ On Budget<br />

12 Mos. Late $ 50M Over<br />

– ARC - $58M On Time<br />

$ On Budget<br />

– MOB 1 - $20M 2 Mos. Early $ 100k Under<br />

– MOB 2 - $24M 1 Mos. Early $ 1M Under<br />

– Bed Tower $51M<br />

1 Mo. Ahead $ On Budget


VII. Challenges Moving Forward<br />

• Lots of Work – All Need to Help<br />

• Make Sure The Basics Are In Place<br />

• Continue to Encourage Innovation<br />

• Continue Our Open Kimono Learning<br />

• Manage Retraction Back to Old<br />

Thinking


Thank You!<br />

Questions

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