Temecula Valley Hospital Opens Using Lean Principles

TEMECULA, Calif. — Temecula’s first and only full-service hospital has opened for patients. The 140-bed health care facility opened Oct. 14 to serve the community of more than 100,000 residents with all-private patient rooms, emergency services, outpatient and inpatient surgical services, acute care inpatient services, intensive care, radiology, imaging, laboratory and other outpatient services.

The long-awaited $150 million greenfield hospital was designed by Los Angeles-headquartered HMC Architects and constructed through a joint venture between DPR Construction, headquartered in Redwood City, Calif., and New York-headquartered Turner Construction Company. Working closely with the construction team and Universal Health Services (UHS), HMC used Lean principles to complete the project ahead of schedule and under budget.

“The most unique element of the project is the Lean process in which the project was delivered,” said Steven Wilson, principal with HMC Architects. “Numerous tools and processes exist to drive collaborative behavior down through multiple organizations in order to assure that everyone is sharing a common vision — and when used together, the tools form a system.”

Lean principles allow the owner, architect and contractor to participate in the design and decision-making process from the onset of the project, according to Wilson. The project also used an Integrated Project Delivery (IPD) for further collaboration and to optimize the project’s success.

“It has been documented that there is considerable waste in the construction industry,” said George Vangelatos, principal with HMC. “When Lean measures are coupled with IPD and applied to health care construction, the process can yield greater customer value while eliminating waste and it begins with the right team thinking about the project and not their own needs.”

An off-site “big room” was used as a meeting room for the project team to conduct problem-solving discussions. This open communication and dialogue throughout the design and construction process created a more efficient project with less rework, according to Wilson. The team also used the Last Planner System in order for all members of the team to make accurate commitments and not overproduce, which is seen as wasteful, Wilson said.

“The Temecula Valley Hospital project started with UHS, HMC Architects and a joint venture between DPR Construction and Turner Construction. We then evaluated other team members using the Choosing by Advantage technique to determine who would best fit in to the project’s Lean approach. This allowed the team to openly discuss the best method for getting something done and decisions were made to benefit the project rather than individual firms,” Wilson said. “Once the team was assembled, the focus was on establishing trust, learning, collaboration and innovation to deliver the best project possible. Ideas flowed from every team member and all were empowered to make decisions.”

The team’s ability to meet their responsibilities was reevaluated on a weekly basis for improvement or breakdown. This process, Wilson said, allowed the team to take out six months from the already aggressive schedule. Additionally, a 16-month acceleration was achieved though early collaboration with the Office of Statewide Planning and Development.

“The project team embraced Lean principles to break down the silos of traditional project delivery and required deep collaboration and teamwork. They all accepted the challenge to propel collaborative behavior down through the multiple organizations,” Wilson said. “The cooperation between team members drove down the project costs and fostered innovation, while meeting UHS’s efficiency and schedule goals.”