Methodist Dallas Medical Center had plenty to manage in planning for future growth. The resulting six-story, 229,000-sq-ft Charles A. Sammons Trauma and Critical Care Tower will expand the hospital's emergency department tenfold and include new emergency and central sterile departments, expanded surgical services and additional critical care patient floors. The $120-million project also will allow for future vertical expansion of up to 12 stories.

"Because it's an incredibly complicated project, we endeavored to find ways to develop a really strong team to tackle this monster," says Denton Wilson, assistant vice president of design and construction at Methodist Health System. That included bringing team members into the project at the earliest point possible.

Architect Perkins+Will and contractor Austin Commercial both joined in the initial phases in early 2012, and subcontractors were not far behind, coming in as partners as construction documents were being developed.

"I think that's a smart move on the team's behalf, because what's happened now is you've had the subcontractors who will actually be putting the work in place come out here to the site, do a lot of research, provide a lot of input on best practices to the final documents," says Doug Thomas, project manager for Austin Commercial.

Wilson explains that for Methodist, it was critical to bring the general contractor in toward the end of schematic design but before the beginning of design development to allow for first cost model phasing.

"You want to get your major trades on board because they are the ones who really understand the complexity and the cost, the market conditions and what things are worth, but you don't want to do it so early that you can't get a good market analysis," Wilson says.


Planning during the preconstruction phase was critical to the project. "We're asking our entire team to come and have a true seat at the table, to help us get through designability, constructibility and real value analysis," Wilson says. "It's a phenomenal education process for the entire team and it's one of the coolest things to watch when you build that team and put them in a big room, which is an open, honest, trusting, respectful environment, to speak their minds."

The open forum also allows for easier changes while construction is under way. Just recently, the team was able to change a decision made in early planning about LED lighting in common areas.

"You would have never had that opportunity in the past—you made a decision, you had to go with it," Wilson explains.

Mock-up rooms are also helping align all the process team members during construction. "When you actually start implementing lean tools like these, you make a difference," he adds. "Each of these things gives us a better project at a better cost and better schedule, and it's safer."

Noting the growth of more collaboration in many area health care construction projects, Wilson adds that the trend "really supports all the owners at a level they've never been supported at before."