From a distance, the handwritings on the wall look like graffiti. On closer inspection, the 30-ft-long marker board in the site office of Sutter Health’s $2.1-billion hospital in San Francisco contains much more than scribbles. The 250-sq-ft mural, dubbed the “lessons learned wall,” exhibits suggestions, insights, directions, reminders, warnings, best practices—and lessons.

The public display of reflections didn’t make its debut until the 1-million-sq-ft Sutter Health California Pacific Medical Center Van Ness Campus—undergoing commissioning—was about 70% complete. The teaching tool “was an improvement to a process that was already in place,” says Rob Purcell, director of integrated design and commissioning for VNC’s construction manager-general contractor HerreroBoldt Partners (HB), an equal venture of Herrero Builders and the Boldt Co. “Throughout the project, the team had been documenting and sharing ‘small wins’ in weekly ‘big room’ meetings,” he adds.