Finding true north is just as essential for project teams and capital projects as it is for personal journeys and accurate navigation. Ask any surveyor. They will tell you that true north by definition is not magnetic North. To find true north from a magnetic compass you have to know the local magnetic variation and how it has varied over time. If you want to get from a point at the bottom of a map to one at the top, you must head true north.
Metaphorically, true north refers to one’s direction in life, as we are often uncertain where we stand, where we are going, and what is the right path for us personally. Knowing our true north enables us to follow the right path.
The same holds true for the life of a healthcare project. Most healthcare projects can take four to five years or more to come to fruition when you account for the time vested in pre- and post-construction. Because healthcare projects take years to implement and given the size of the teams involved, developing a "true north charter" is essential for a healthcare capital project in order to keep the entire team on track and moving in the right direction.
Defining a true north for a capital project takes time and effort, but can yield great benefits and the impact can be transformational. By communicating a shared vision and mission between the client, the project team, and the project, a true north charter can help inspire.
The charter outlines the required conditions of satisfaction that should be strategic, operational, and project specific in nature. The charter should also assign measurable goals to help the team track and assess their achievements through the life of the project. The underlying benefit of defining a true north charter is developing team dynamics built on trust, accountability, transparency, respect, and collaboration.
FINDING BALANCE IN CHOPPY WATERS
Navigating the capital planning and implementation process was much easier when the economy was humming. There was adequate access to funding, and the key driver for planning was volume. However, the healthcare industry has been rapidly evolving under the Affordable Care Act (ACA) and a soft economy. Healthcare reform has compelled health systems, hospitals, and physician groups to reduce costs and improve the quality of care-all with more regulatory requirements and less capital.
Changes to reimbursement methods, along with reductions in healthcare provider compensation, are forcing health systems to rethink their approach to balancing their assets and liabilities, including health care real estate. These factors, particularly when combined with a projected increase in demand for ~79 million aging baby boomers and ~30 million newly insured patients, has operators and owners of real estate repositioning portfolio requirements.
SETTING VISION AND MISSION
Finding true north in these choppy waters requires a keen sense of the market and a strong sense of the institution’s purpose. This starts with the mission and vision of the organization. While all health institutions exist to serve the community, the current market has forced many organizations to focus their efforts on meeting the greatest needs and offers specialization only when the market can support it financially.
A comprehensive strategic plan should highlight the organization’s vision, mission, and key areas of focus and be the baseline navigational tool for the institution and any capital spending. The true north for a capital project is then guided by the organization’s vision and mission statements, and further developed into a tangible project mission statement, guiding principles, target metrics, and target future state operations.
One Midwest health system’s vision and mission states:
“Our mission is to improve the health of the communities we serve through quality health care, education and research. Our vision is to be the best for those who need us. We value safety, compassion, respect and integrity.”
A sample of a project mission statement that could accompany such a corporate mission statement could be: “Through collaboration, team integration, and best practices, the project team endeavors to provide the expanded and improved facility within the owner’s schedule, efficiency, and budget goals while providing high levels of quality, safety, and team satisfaction. By delivering the XYZ Health System New Tower Project, the project team will meet the expectations set by the Health System board, administration, caregivers, support staff, and community through our innovation, collaboration, and professionalism."
STAYING ON TRACK
While the preceding project mission statement provides a framework for positive motivation and influence, it does not deliver the tangible metrics needed to offer feedback to the project team or client to know if the project is on the right path or that the desired outcomes have been achieved. In order to provide continuous feedback and help steer towards the projects "true north," goals must be tangible and measurable.
Guiding principles or goals should address the organization’s strategic and operational goals of the project, as well as the project-specific goals that address team performance. Each specific goal can then be supported by a tactic that can be mapped, tested, and monitored through specific key performance indicators, or KPIs. Prior to construction, KPIs for each tactic should be captured to establish baseline data in order for progress reports and post-occupancy data to be available for feedback and for comparison to future state.
Example strategic goal areas
- Increase Market Share
- Accommodate Private Bed Model
- Invest in New Model of Care
- Invest in Infrastructure to Decrease Operational Costs
Example Operational Goal Areas
- Maximize Staff Efficiency
- Improve Occupancy Efficiency by 15% (throughput)
- Reduce Cycle Times by 10%
- Reduce Medical Errors
- Increase Patient Satisfaction Scores
- Increase Flexibility of the Space
Example Project Goal Areas
- Safety During Construction
- Schedule Adherence
- Quality Product
- Cost Control
- Community Relationships
- Communication and Commitments
- Team Behavior and Relationships
ACHIEVING TRUE NORTH
Perhaps the greatest benefit to setting a capital project’s true north is the ability to provide feedback. It helps build trust for the project team, creates accountability, provides transparency, affords respect, and encourages collaboration for the entire team. Two reporting tools used to inform leadership and project teams on the success in navigating toward true north are the project status report (PSR) and the after action review (AAR).
The PSR, as its name suggests, provides an overview of your project’s trajectory. More than a reporting mechanism, the PSR should be a management tool that aides the team in achieving the established KPIs.
While many KPIs are tangible and measurable, others related to team dynamics and communication which may only be measured through a survey.
Still, other outcomes can only be measured post-occupancy. The AAR is a structured debrief process and knowledge management tool that provides accountability and insight. Perhaps the greatest benefit of the AAR is the lessons learned that can be applied to future work, teams, and processes. The AAR is developed by the entire project team after project completion. It captures true-north desired outcomes, measurable goals, tactics, and pre-construction metrics in order to summarize the capital project’s process, work products and post construction results.
CONCLUSION
Regardless of the terminology used, be sure to invest time in identifying the direction and process that will deliver the desired results for your project. By following the old adage of “plan your work and work your plan,” your project team will set the foundation to follow true north and ultimately achieve success. And in the process, you will find the underlying benefit of continual improvement.
About the Authors
Steve Higgs is Managing Director and Lora Schwartz is Principal Consultant with CBRE Healthcare.
Related Stories
Hotel Facilities | May 9, 2023
A new camping destination near Utah’s Zion National Park offers a variety of all-season lodgings and amenities
Outdoor lodging brand AutoCamp has opened a new camping destination near Utah’s Zion National Park. A 16-acre property, AutoCamp Zion is located between the Virgin River and the desert of Southern Utah.
Headquarters | May 9, 2023
New Wells Fargo development in Texas will be bank’s first net-positive campus
A new Wells Fargo development in the Dallas metroplex will be the national bank’s first net-positive campus, expected to generate more energy than it uses. The 850,000-sf project on 22 acres will generate power from solar panels and provide electric vehicle charging stations.
Regulations | May 8, 2023
Supreme Court case likely to have huge impact on Clean Water Act
A case before the Supreme Court will likely determine how the Clean Water Act is interpreted and the ruling could open up new areas for development within or adjacent to wetlands.
Senior Living Design | May 8, 2023
Seattle senior living community aims to be world’s first to achieve Living Building Challenge designation
Aegis Living Lake Union in Seattle is the world’s first assisted living community designed to meet the rigorous Living Building Challenge certification. Completed in 2022, the Ankrom Moisan-designed, 70,000 sf-building is fully electrified. All commercial dryers, domestic hot water, and kitchen equipment are powered by electricity in lieu of gas, which reduces the facility’s carbon footprint.
Multifamily Housing | May 8, 2023
The average multifamily rent was $1,709 in April 2023, up for the second straight month
Despite economic headwinds, the multifamily housing market continues to demonstrate resilience, according to a new Yardi Matrix report.
University Buildings | May 5, 2023
New health sciences center at St. John’s University will feature geothermal heating, cooling
The recently topped off St. Vincent Health Sciences Center at St. John’s University in New York City will feature impressive green features including geothermal heating and cooling along with an array of rooftop solar panels. The geothermal field consists of 66 wells drilled 499 feet below ground which will help to heat and cool the 70,000 sf structure.
Office Buildings | May 4, 2023
In Southern California, a former industrial zone continues to revitalize with an award-winning office property
In Culver City, Calif., Del Amo Construction, a construction company based in Southern California, has completed the adaptive reuse of 3516 Schaefer St, a new office property. 3516 Schaefer is located in Culver City’s redeveloped Hayden Tract neighborhood, a former industrial zone that has become a technology and corporate hub.
Mass Timber | May 3, 2023
Gensler-designed mid-rise will be Houston’s first mass timber commercial office building
A Houston project plans to achieve two firsts: the city’s first mass timber commercial office project, and the state of Texas’s first commercial office building targeting net zero energy operational carbon upon completion next year. Framework @ Block 10 is owned and managed by Hicks Ventures, a Houston-based development company.
Market Data | May 2, 2023
Nonresidential construction spending up 0.7% in March 2023 versus previous month
National nonresidential construction spending increased by 0.7% in March, according to an Associated Builders and Contractors analysis of data published today by the U.S. Census Bureau. On a seasonally adjusted annualized basis, nonresidential spending totaled $997.1 billion for the month.
Life of an Architect Podcast | May 2, 2023
Life of an Architect Podcast Ep. 124: Show Me the Money
I get asked a lot about how much money an architect makes. Without understanding a few parameters, that’s like trying to buy a car by the pound. I spend a fair amount of my time discussing the architectural marketplace, where we can find value, what’s the going salary rate based on skill set and experience, and how badly we need this spot or that spot filled.