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Management of Building Services Procurement for Highly Serviced Healthcare Facilities K. C.

Lam Department of Building Services Engineering Faculty of Construction and Land Use The Hong Kong Polytechnic University

Abstract The procurement of complex and highly serviced hospital buildings is always fraught with expensive and complex problems of inadequate coordination of building services and hospital engineering services. These problems are detrimental to the success of any hospital projects, and must be resolved by professional project management from design to construction. “Complete” design cannot completely solve poor coordination problems. Issues relating to the multi-head client, conditions of engagement of designers and contractors, division of design responsibilities, allocation of risks and early incorporation of specialist services contractors should all be considered. It is vital that building services design and installation are adequately managed throughout both design and construction stages, and that if this is done, significant improvements in project performance will be realized. A chosen procurement system can affect the complex coordination process, and non-traditional procurement method will improve the chance for project success. Introduction Over the last twenty years clients have become more knowledgeable about the workings of the industry and hold far greater expectations of the building process than ever before. They are attempting to eradicate, or at the very least minimize, the difficulties and ambiguities of traditional procurement. The construction industry and its clients are still seeking reliable methods of procuring construction based on clearly defined roles and responsibilities, where liability for failure is unequivocable. The procurement of complex major publicly funded building projects is an issue which is fraught with many problems. These problems arise where competing demands of complex design and changing public and institutional perceptions of what such buildings should be about are coupled with the need to procure buildings within tight timescales and closely defined budgets to high quality standards. In addition, particularly for publicly funded projects, it is especially important that value for money is seen to be obtained. These problems have historically been particularly acute in Hong Kong in the provision of major health care buildings. The major problems with such projects include their complexity, traditionally lengthy design and construction periods, ongoing and rapid developments in health care planning and technology, and the need for a highly accountable approach to procurement by health authorities. A major factor in the time and cost performance of hospital projects is building services which may account for as much as 50% of project cost. It is vital that building services design and installation are adequately designed and coordinated from design through construction, and that if this is done professionally, greater chance of project success and significant improvements in project performance will be realized. It is beneficial if building services design at design stage, is as near to full design as possible in order to ensure that all aspects of the building services are properly coordinated. At construction stage, effective project management of building services installation is also

the procurement system has a direct bearing on the complex building services design and installation. This led to endorsement of the next form of acquisition. making this selection is difficult. Where the contractor is able to provide a link between design and construction through early appointment. D&B is also a respectable and sensible way of procuring hospital buildings. Clearly. It places the responsibilities for both design and construction on the contracting side of the industry. the use of traditional approach is diminishing. . products that were still inadequate and too expensive and leading to eventual disillusionment. The author has identified that there is no standard solution. At the same time. Close working between all designers and contractors is essential to produce an integrated building in which all building services. The method has been used successfully on large and complex health care projects. it is more likely that project performance can be even further enhanced. For the last twenty years it has been recognized that the management of the complex building services element of hospital projects has many problems. Problems in Highly Serviced Buildings By their very nature building services cannot be designed and installed independently as this vital element has to be fully integrated with other elements in a building and requires a high level of coordination. They started from construction management/additional project management. short completion time and last but not least.e. does not mean that other procurement methods are not suitable. What would be next to Design-Build could be a return to the traditional approach but with more emphases on modern project management principles. This paper examines the problems that have been traditionally associated with building services and discusses if these still apply to work carried out under design and build procurement. their costs. or best buy amongst various building procurement methods. just as they do with dress.e. and the time it took to deliver then. From the author’s detailed study. The author then discusses some critical factors which may be used to improve the project performance of major health care buildings. This paper will compare both traditional approach and Design and Build.essential. (i. a perfect building with good design. considering the trend of a growth of 15% per annum. However the use of this method of procurement is diminishing and is being replaced by design and build and other procurement paths. these fashions come in and out of favours in cycles. However. This. However. and brought to fruition as required by a client. Examination of these problems has been largely restricted to building services and hospital equipment carried out under the traditional procurement system. DesignBuild. systematically organized and combined. the use of Design-Build (D&B) (in fact Develop and Construct model) to procure hospital projects is gaining popularity. of course. They began to look for better methods. Furthermore. D&B can give better performance in integration and coordination of building services. there are fashions in procurement styles and. D&B as a method of building procurement is a fundamental change in the concept of procuring buildings compared with the traditional methods. once again. one might conclude that the future of D&B is very encouraging. but the use of an appropriate procurement strategy has a direct bearing on the success of a project. Eventually the industry (in particular the clients) became disillusioned with the products of this approach. Deciding on what assumptions should be made about the future of D&B is indeed difficult. As hospital buildings grow in size and complexity. In Hong Kong. the method used to control the design and construction of a building project i. The view that design and build is only suitable for very small projects is no longer tenable. structural and building elements are fully planned. This was embraced with enthusiasm and. The traditional approach which we all know is far from perfect. and partnering arrangement. reasonable cost). high quality.

1988. as the results of inadequately designed and coordinated building services can cause: delay during construction. flexibility. Hence. but in the case of publicly funded work. uncertainty and risk). although “Complete” design is of paramount importance. Hospital projects are often complex with potential for cost and time overruns or the finished building performing less well than planned. it is. The lack of integration and coordination of building services into the main construction work is often argued as the root of building services problems in large hospitals. Thus. and potentially difficult maintenance.. response and integration in the context of the project can be defined as procurement) and forms of contract entered into between the project participants and the client. managed and coordinated. division of design responsibilities. . Pasquire. The way in which the client and the various designers. constraints. cost. This can be as the result of inexperience or because of a lack of appropriate advice. this cannot and will not completely solve poor coordination problems. Parsloe. 1994. the client will also be concerned to ensure that the procurement process employed provides both the necessary degree of public accountability and also the best value for money available at the time. design. the design strategy and the employment of consultants and contractors. Wilkins & Smith. complexity. It is subject to a series of risks and uncertainties and involves a number of organizations temporarily assembled for the project.building services also tend to be more sophisticated and difficult to manage from design to installation. infrastructures and large office complex developments. 1994. Issues relating to multi-head client.al. it is necessary to re-engineer the present approaches to the management of design and construction. To minimize such risks the client should select the procurement strategy which matches the characteristics of the project (time. As a procurement path determines the organization of the design and construction of a project. from previous research (Barton. Michie. Furthermore. Clients embarking on construction work are interested first and foremost in ensuring that the finished product fulfills their general requirements in terms of time. when they want it. early incorporation of specialist services contractors. conditions of engagement of designers and contractors. Loosemore & Davies. price. changes of design. Procurement strategy is the outcome of a series of decisions which are made during the early stages of a project. Procurement – an initial overview Many health care construction clients meet considerable difficulty in obtaining the building they want. These problems are detrimental to the success of any building project. procurement strategy has a major impact on the timescale and ultimate cost of the project. essential to use an appropriate procurement system which is conducive to effective coordination of building services. forms of contract and quality of design and construction management can also affect coordination of building services. Risks are also allocated by means of the associated legal contracts. hotels. To complicate this complex coordination issue. coordination problems would be more acute if services and other building elements are not properly planned. Designing and constructing a hospital is never straightforward. at the right price. Lam. contractors and hospital equipment suppliers work together as a team is determined by the procurement path or strategy (The whole process of creation. The chosen strategy influences the allocation of risk. 1997 and many others) and the author’s in-depth case studies. Kwok. 1978. major monetary claims. cost and quality. allocation of risks. performance and quality level. unsightly services. 1981. Gibb. 1995. et. 1994. 1994. and the ways the design and construction teams work together. communication. It is one of the most important decisions facing the client.

it has been identified that many projects suffer from inadequate or inappropriate procurement decisions. the project management approach. nature and complexity. TQM and inter-dependent organizations with effective integration. cost.g. (1) the main functions and the responsibilities of those involved in a building project. familiarity and proximity. experienced and knowledgeable in integrated design and coordination of services. . project management used.Making an appropriate choice of procurement path requires that the client’s objectives and the essential nature of the required end product are analysed very early in the life of the project. Then throughout the project. coordination and effective resolution of conflicts. (5) the allocation of responsibilities for design and construction. decision making. (7) the project environment (external factors). and (8) time and resources provided for design and management. procurement form. design. quality and change in design. economical and political factors). and the overall management of the project organization are all consistent with the selected procurement route. care must be taken to ensure that the roles and relationships established. the forms of contracts. good interfacing. • Construction team The client and project characteristics are seen as primary independent variables. design. Therefore. (4) the contract form selected. and the local conditions. the pattern of communication and information systems. experienced and knowledgeable in construction and coordination of specialist contractors. the objective being to achieve optimum results of the dependent variable of project success. obligations and rights. On the basis of this analysis a procurement route is selected. project characteristics. multi-headed client. briefing. the most useful protection that can be offered to a client is a logical and sensible policy for choosing a procurement strategy for each building project. fairness. differentiation and coordination. The other elements are selected or adapted with modifications in order to serve the needs of the primary variables. (3) the management of design and construction. construction. professional project management. (2) the project characteristics. clear responsibilities. and Total Quality Management (TQM). funding and involvement. mutual trust and cooperation. integrated team. The functional approach is based on all common factors to all construction projects. The author has also identified that the appropriate procurement solution adopted for a highly serviced building is in each case largely a function of the key functional factors such as client. time. appointment for full service (complete design information and site supervision). (6) the integration of designers and contractors. Detailed of the major functional factors are: Key function • Client • • • • Project characteristics Organization Contract/risk Design team Requirements for coordination experience. and balanced allocation of risks. Procurement of building services From the author’s research results. contract. All these variables are subject to the influence of the project environment (e. That is.

Hospital projects in Hong Kong have been mainly delivered in a traditional approach where clients appoint consultants to act on their behalf to produce design and supervise the construction. The preferred aim is for contributing parties to work together for a quality result rather than competing against each other. As there will be more than one way to achieve the requirements of the project. then carry out. Where a concept design is prepared before the contractor is appointed. as long as the project is professionally managed by a good building team. the strategy is called develop and construct. and Design and Build: detailed design and construction are both undertaken by a single contractor in return for a lump sum price. Construction Management: design by the client’s consultants and construction overlap. A successful strategy is one which leads to a completed building which meets the client’s objectives. and it is therefore difficult to manage the extremely complex hospital building services design and installation with the building and structural elements. the need to reduce design and construction periods. Common strategies which must be fully analysed are: • • • • • • • • The financial risk that the client is exposed to The degree of control that the client has over the design and construction processes The information required at the time construction contracts are let The extent of involvement of the contractor in the design stage when the contractor may be able to influence the ‘buildability’ and ‘co-ordination’ of the project The organizational arrangements which distribute responsibility and accountability The complexity of the project The integration of the project participant’s activities within a construction environment The management of the project by both client. still predominant. and the need to achieve better project performance have all brought pressure to find better ways and alternative procurement paths to deliver new health care facilities. A fee-earning construction manager defines and manages the work packages. In Hong Kong. It has been identified by the author and many professionals that the traditional approach does not easily foster a co-operative and coordinated project organization. as each will address the various influencing factors to a different extent. Generally. design and construction teams . Traditionalism is. since many clients can benefit from the particular advantages it offers.Procurement paths used in Hong Kong Different procurement strategies provide different ways of allocating risk and responsibility to the organizations contributing to the project. the transfer of risks and management problems to the contractors. procurement arrangements have developed faster since the mid 1980’s in a response to clients who are more demanding and increasingly frustrated with the traditional way. however. The increasing complexity of hospitals buildings. It is important to consider carefully each option. The main types of procurement strategy used for most of the hospital projects in Hong Kong are summarised below: • • • Traditional: design by consultant is completed before contractors tender for. All contracts are between the client and the trade contractors. construction. clients can choose from several different strategies.

The key features of fragmentation of the construction industry. as well as the constructed product. Appraisal of the traditional approach The traditional (or conventional) procurement system has been used for many years in Hong Kong. especially contractor. and integration of project participants is difficult Poor communication between clients and the project team Problems of buildability (no input by contractor) Uncontrolled design changes can lead to increased cost and delay Problem of design and construction/installation responsibilities The traditional approach has been found to be failing to satisfy clients’ needs as hospital projects are becoming larger and more sophisticated. the traditional system does not easily allow the particular skills of some participants. no ‘buildability’ input by contractor has been exaggerated by many researchers as most hospital consultants are very experienced planners and engineers. to be utilized on the project in order to improve upon the overall performance of the design and construction teams. The merits of this system are: • • • • • • Competitive fairness and public accountability Reasonable price certainty at contract award (but subject to changes or variation orders) The procedure is well know Design-led. The author has studied the issue of coordination of M&E services in several large hospitals (over 1000-beds) which all adopted the traditional approach. For those successful hospitals. The system is also fully understood by all parties of the building team. the author will therefore concentrate on the detailed study of the use of both traditional and design and build procurement strategies. Constructability is important in building design.g. facilitating high level of quality in design (especially for highly serviced hospitals) Higher degree of certainty that quality and functional standards will be met Changes are easy to arrange and value However. coordination of M&E services design and installation between the various consultants and M&E services contractors. some achieved the project targets but some did not. conflict of interest between all parties. the system is far from perfect for some large hospitals which are extremely complex in terms of design and construction. changing roles of specialist contractor. As design and build procurement has been frequently used for some of the new hospital projects in Hong Kong. The conventional approach also makes the integration of the necessarily different but closely interrelated and interdependent contributions of the project participants problematic. Nevertheless. and coupled with greater difficulty in the management of complex design and construction (e. the reasons are the use of good . there are disadvantages such as: • • • • • • The sequential and fragmented nature of the procurement system can result in lengthy design and construction periods The confrontational nature often results in adversarial relationships developing. uncertainty over design liability and management responsibility combined with proactive and impatient clients make the choice of an appropriate procurement system for building projects both difficult and very important. and then amongst the main-contractor and all sub-contractors on site). However.

well co-operative and coordinated efforts from all parties Inadequate resources to implement coordination work Many clients are becoming increasingly dissatisfied with traditional procurement. . the growing complexity of modern hospitals and the higher demand on time. the increasing complexity of buildings. Clients are no longer distant and uninformed. risks and relationships for all participants Effective communication between all parties The system is expensive and not straightforward. proactive. organization and management to meet their more exacting needs. Use of construction management system There are a number of contributing factors to the decline in traditional forms of contract. Clients are becoming more knowledgeable about the workings of the construction industry and are taking positive measures to become more actively involved in building procurement. and requirements in relation to coordination of services design and coordination between designers. responsibilities. The client has indeed to take more risks (time and cost) and responsibilities. and the existence of a good building team working in harmony. other methods such as construction management. Although the traditional form of building procurement is still predominant. Furthermore. and the avoidance of risks from clients have called for non-traditional methods of building procurement. This management-orientated traditional method will enhance project performance but it is still not trouble free. Surveys also indicate this method has not been widely used in Hong Kong. building works contractors and various services contractors Inadequate involvement of designers and contractors on site to manage the complex coordination issue requiring prompt. the major reasons are: • • • • • • • The traditional strategy is open to abuse if attempt is made to let the work before the design is complete (and even incomplete). The success of the system lies on the simple facts that this management-orientated procurement system emphasizes: • • • • • Better management of overall design Good management of construction by the professional construction management team Management of M&E services installation by all parties Careful selection of good building team with clarity of roles. resulting in incomplete design for integration and coordination of M&E services Unprofessional management of building construction and installation of services by the construction team Adversarial working relationships developing between contractual parties. Many clients are therefore dissatisfied with this procurement and are seeking alternative methods of building contract. in effect to manage. The construction management system as expected can produce very significant improvement in the overall project performance as seen by many.management of design and construction. design and build have become more and more popular over the past two decades. While for the unsuccessful projects. the need for greater degree of financial planning. cost and quality. the whole design and construction processes. the need to reduce design and construction periods and the increasing burden of contract administration have all brought increasing pressure to find other ways to plan and coordinate. and teamworking does not exist in the building team Unclear contract document leading to ill-defined roles. resulting in less certainty Inadequate management of design by the design team.

D&B is gaining popularity. and fewer reasons for extension of time Reduction in variations (changes) that usually made by the client/building users Risk allocation to the contractor. While there is a tendency towards specialization in the various building professions. a single source of responsibility is much favoured by the hospital client for the overall management of projects.Design & Build Those factors contributing to the decline in the traditional forms of contracts are creating constant demand on the construction process to improve the standard and quality of service provided for the industry’s clients. quality and value for money. Develop & Construct: contractor responsible for design development. enables construction professionals to adopt an empathetic and constructive approach. working details and construction 2. but also with a new dimension to building procurement in that it is structured. and thus. the total financial commitment before commencing work on site. In the author’s study. All these needs have created the desire to bring the whole construction process under a single point of control. it provides the necessary true multi-disciplinary approach and integration because it forms a designercontractor team at any early stage in the process. towards giving him/her an improved deal and with far greater emphasis upon the client obtaining better value for money. The client has direct contact with the contractor. the two commonly adopted D&B methods (distinguished as “client-led” design) used are: 1. not only in terms of time. Design-Build has the potential to produce more innovative and buildable constructions to meet both these client expectations. The creation of an integrated design and construction team also improves communication and directs teamwork towards satisfying the interests of the client. Reduced total project time with incorporation of the design process into the construction programme. This improves line of communication and enables the contractor to respond and to adapt more promptly to the client’s needs. organization and management. Clients have become more knowledgeable and involved in the workings of construction and their attention is now focussed upon improved performance. Novation D&B: contractor responsible for design development. Design and Build (D&B) gives a fresh approach for project delivery. Multi-disciplinary approach and teamwork is the cornerstone of design-build. and reduction in the number of points of conflict • • • . with a reasonable degree of accuracy. and so responsibility. Effective and integrated design-build procurement. primarily in the interests of the client. but also in the administration and procurement. Because of this merit. Combined. working details and construction with the assignment of the design consultants from the client The Develop & Construct (D&C) method of procurement will usually be selected by the Hospital Authority based on the following criteria: • • • Single point contact and responsibility for all aspects of the project. The construction industry has reacted not only with improved construction techniques and materials. The client knows. so that in the event of design and construction failure. for both the design and construction with one organization. provided he does not introduce changes during the course of the works. directly responsible to the client. their abilities can achieve much more than when operating from quite separate professional standpoints. This opens up a new dimension for communication. it vests authority. the contractor is solely responsible and wholly accountable to the client. cost and performance.

• • • Recent experience of procurement of hospitals (in Hong Kong. and therefore less real competition. particularly when delay in construction is critical to the health care of the society. Design and Build can meet the inspiration of the sophisticated hospital client as the integrated D&B approach is primarily structured in the interest of the client. the single point responsibility. U. D&B procurement is not a panacea. Despite the many drawbacks. he is driven by the perfectly reasonable commercial objective to build as economically and expeditiously as possible to the benefit of his own bottom line (of course. programme and cost will vary Client driven changes (unfortunately essential for most hospital projects) can be more expensive both indirect cost and in disruption costs if the contractor’s building sequence is affected Client brief must be adequate. Limitation for client in choice of design team Design quality is inferior to those produced under traditional procurement method (although well-designed and aesthetically pleasing buildings can be obtained with D&B. The apparent drawbacks of this method are: • • • • • • • • • • Relatively fewer firms are truly specialized in health care facilities. the consultants may experience a conflict of interest owing to the change of employer Client’s project management is by no means easy in comparison with traditional procurement method Many hospital planners and designers are still not so much in favour of the D&C method. Generally. client is now also more proactive in seeking better ways that could enhance project success. D&C has time and cost advantages provided the client is experienced. the client’s control over this aspect is less and difficult) With consultant novation. and it is not without limitation. and Australia) by D&C demonstrated economies in capital and innovation in design A number of major contractors and consultant teams are now experienced in hospital design and construction tendering and procurement More understanding of management of design by client. Secondly. unless the tender price is good). and has also engaged a relatively full design team for the production of scope design. As the industry’s structure moves towards . provides a clear line of redress if technological and contractual difficulties arise. as no matter how conscientious the builder is to build a quality building (more difficult with hospital building). their main concern lies with the safe-guarding of design quality. using creative solutions for both construction and building services. the client is at risk if the contractor does not have full indemnity insurance cover. and in-house design and build firm is an entity (so compensation for weak parts of the firm is not possible) Higher tender price due to less competition (higher risk imposed on the contractor and two separate design teams with some duplicating efforts) Bids are difficult to compare since each design. the client will receive a building that is constructed in a shorter time frame (overlapping fashion). well informed and has enough knowledge about the construction industry as a whole and design and build in particular.K. and the opportunity for disputes would be increased due to incomplete documentation Client is at risk where the contractor does not fully appreciate the full risk associated with design. Similarly. and the contractor has the opportunity to achieve a higher level of cost effectiveness. increase operational efficiency and improve buildability through improved communication. and the checking of the contractor's design and construction works. More importantly. which distinguishes this form of procurement from the others. it can also reduce contractual ambiguity.

the root cause of the project failure lies on the adversarial attitude between contractors. inadequate management of coordination of M&E services.inadequate construction and coordination information. Selection of the main-contractor is also a problem. and they are summarized below: Case 1 . lack of coordination details/unclear coordination roles and responsibilities. The obvious cause of failure is the poor control of nominated services sub-contractors which is an inherent weakness of the traditional procurement system. and unclear contract documentation. • Contractors . The failure of this project is mainly due to unclear contract documentation concerning coordination of services. inadequate management of design check and poor project management during the construction stage. the traditional procurement method is inappropriate and fails to manage building services coordination.e. • Poor working relationship/communication between the design and construction teams as a result of the confrontational nature of this procurement system. Project result is unsatisfactory Reasons: • Client . . lack of professionalism of project participants and existence of adversarial attitude. commitment. the author will briefly discuss some of his case studies. large and complex hospital. However.larger design and construction firms who have ability. design errors. the author has examined several large and highly serviced buildings in Hong Kong. However. lack of site management.inadequate brief. In this case. • Designers – separate teams. and it will be more adopted for future hospital projects in Hong Kong. multi-headed client communication problems and too many changes. unclear coordination roles and responsibilities/site coordination not provided. it does not automatically mean that the traditional system is not a workable system. poor communication. • Unclear responsibilities for coordination by all contractors • Inadequate management of construction. i. and professionalism and who will accept total responsibility for the building they produce. Case studies To compare both traditional and D&B procurement. The reasons are: • Tenders are obtained on the basis of an incomplete design. Details to be investigated and analysed in each case study are: • • • • • • project characteristics management of design management of construction teamwork/team spirit quality of overall project project success or failure factors For this paper. D&B will increase in popularity. inadequate design information. inappropriate contractor selection.Traditional procurement.

the overall result would be even better. However. competence of project participants. good teamwork and TQM system have been identified to be important ingredients in this successful project. there are significant improvements in project result. incomplete design. Case 3 . extra coordination work by M&E consultant.adequate design information.Traditional procurement with project management (PM). the success of this project lies on adequate quality management of design and construction. In theory. the traditional procurement method is difficult to give good result. this procurement path turns out to be a very satisfactory system. large and complex hospital Project result is deemed to be satisfactory even there is a delay in completion date since the client’s target date is again unrealistic. Obviously. • Contractors . planning and design. from design to construction. there are significant improvements in overall project result. Again. there is significant improvement in the overall project result. i.adequate planning and management (Japanese style). A good team spirit and high degree of coordination between project participants also improve the chance of project success.Traditional procurement.good management. all the demerits of this procurement method. effective communication.e. i. quick resolution of problems and good team building. with the introduction of additional project management. with the aid of an efficient project management system. poor coordination of services contractors’ works and poor communication between the project teams have been carefully tackled by effective management of design and construction. Reasons: • Client and designers . poor working relationship. There are still of course some unforeseen coordination as a result of difficult design problems in this project. large hospital complex Project result is not satisfactory in the beginning.Case 2 . effective communication with all participants. good site management. traditional procurement method will not work satisfactorily.e.before using PM . complete brief and structured multi-headed communication system. It is quite clear that the traditional system can go wrong quite easily if there is inadequate project management. Notwithstanding the use of a traditional procurement path. • All parties . well planned coordination work with all contractors. especially with the additional professional construction management team in this project which wholly manages all technical and project management. the traditional system can be a workable system if special attention is given to project management of design and construction. If all contractors belong to one single organization.inadequate management. On the other hand. The other reasons are that all participants are working toward a common goal with high team spirit.with strong PM and TQM. with inadequate of management of design and construction. However. and the provision of the greatly needed control of nominated sub-contractors. Similar to the case 1. in this case. clear documentation. Reasons: • Client . • Designer . case 2 has demonstrated the impact of effective management of design and construction on the project. . However. Again.

and must be properly managed by the design and construction teams • • • • • • Comparison of the traditional path and D&B in the context of management of coordination of building services From the author’s research results. Both the client and the D&B contractor have committed themselves whole-heartedly to the pursuit of a quality building.for highly serviced buildings.overall performance is satisfactory. • Designer . . Co-ordination of M&E services are both technical and managerial issues. and sufficient co-ordination details. the procurement method should give (1) complete design and construction information. Hence. the differences between the two methods are summarized in the following table. commitment to project success for getting more business and the existence of good teamwork spirit based on long-term partnering relationship. Coordination of M&E services is of first priority amongst all consultants and the various M&E services contractors. Careful selection of designers and contractors . adequate design information and good site supervision. Use of project management . design and construction. Project programme . quality of contract information Realistic design fees and construction costs .Case 4 – Develop and Construct procurement. multi-headed client problems have been overcome. it can be seen that the performance of a project can be influenced by: • The procurement method chosen . the project outcome is a successful one.low/unrealistic fees and tendered sums do not normally encourage complete design and good quality buildings. The whole building team gives greater attention to coordination of services as time is pressing. strong management is needed by the design and construction teams. and coordination problems will affect the completion schedule. • Contractor and designer .for complex project. (2) clear allocation of design/installation responsibilities for building services.very effective management and good brief.good team members and high team spirit usually achieve better project results. they all work very cooperatively. From all the case studies.competent client’s advisors.realistic period should be allowed for adequate planning. The contractor wants to sell the D&B expertise and the client needs to provide the hospital in 1997. Design and Build system has proven to be a very effective procurement method as long as there is good project management of design and construction from all project participants. clear documentation. Reasons: • Client . Project result . a general hospital. and use of non-traditional procurement arrangements can give better project performance as a result of an integrated team approach. and (4) clear and fair contract documents. and this gives a better understanding of the characteristics of the two procurement paths in the context of M&E services. effective management.single organization. (3) cooperative working relationships between all members of the design and construction teams.

Managerial issues .Site coordination by all subcontractors but managed and prepared by the main-contractor . but design is usually incomplete .Difficult to weld the design and members under one umbrella construction teams together Good teamwork and control With potential long term partnering for .Management of separate design and construction teams is difficult .Fosters confrontational attitudes and adversarial working relation-ships due to conflict of interest - - Design must be complete for construction. and both design and construction teams will understand better Quicker response to coordination problems and solution as the contractor is wholly responsible for design and construction - D&B consultant must provide workable drawings.ACE contract for services consultant is a problem. but not fully completed based on ACE condition Difficult to manage coordination on site with the builder and all subcontractors - Management would be easier due to the integrated team approach Coordination must still be managed. Design .Response to problems and provision of solutions will usually be slow due to separate design and construction teams 4. coordination of services is additional duty . but coordination of services is passed to his M&E consultant and the maincontractor .Services contractor is not involved in future hospital projects design.Harder integration & coordination of various designers Better integration & coordination of all . but would be carried out by both design and construction teams and the work will be fully completed This problem could possible still occur. coordinated based on contractor’s second coordination after design is not selection of equipment and plant necessary.Coordination is multiple detailed design and installation responsibilities (designers and Single point responsibility. contractor contractors) and allocation of design must manage all coordination works and construction responsibilities are not always clear 2. and services will have to be Consultant works with contractors. but D&B directly controls his contractors and work much closer and more efficient - 3. or he will assist the contractor as much as he can Both architect and engineers will provide coordinated design and solve coordination problems quickly Similar but will be assisted by the M&E consultant and all services contractors This problem could possible still occur.Traditional D&B 1. but may be diminished due to the maincontractor’s own selected contractors - - . Contract . and both will be involved for .Management of coordination during design stage is essential.Architect is the lead designer.Fully integrated services and detailed coordinated M&E services drawings are essential. Organization Separation of design from construction Integrated design and construction team .

It is also accepted that the choice and use of an inappropriate procurement system is not the only reason for inefficient project management. the technical and managerial problems in relation to coordination still exist but they would all be passed to the contractor side. D&B is highly suited to building services due to greater coordination and integration of the building team through partnering arrangement. and. Inadequate coordination can create many problems. other procurement paths with additional project management of design and construction can give satisfactory project performance Summary The question of whether design and build is the best procurement system is hard to tell as other procurement alternatives (main-contractor and principal services contractor coupled with project management team. but to a lesser extent in D&B due to the integrated nature of design and construction. One thing is clear. from the face of this procurement path. however. Indeed. To protect the contractor’s interest. Coordination problems would still exist. management of coordination of services is very difficult.5. and the avoidance of contractor’s risk as a result of the nature of single point responsibility. the integrated nature of D&B has relieved all the burdens on the client’s design team. To sum up. as far as building services coordination is concerned. no matter how integrated is the team. Probably. and construct management method plus good building team) can also give satisfactory results. and this important issue must be properly coordinated at both design and installation stages in all procurement systems. all coordination problems that the client would normally encounter from the traditional method will no longer exist. but subcontractors also take higher risk as the system does not offer good protection in relation to claims for design change and additional co-ordination works • Management of services coordination is an essential requirement for project success. the risk is high as the client is responsible for design. all coordination problems would still have to managed and controlled by D&B contractor and his specialist contractors expeditiously. Besides. Indeed. the traditional procurement system is not conducive to effective coordination process. Coordination of building services has a direct bearing on the success of a hospital project. people and experience are far more important than strategy. there is no single method of procurement which can be suitable for every project for all time. the author’s discussions can be summarized as follows: . and construction and services are not completely coordinated. With traditional procurement. this is also due to improved communication on the project and good working relationship amongst project participants D&B is not a panacea.In the context of coordination of services. D&B method will not work. and D&B gives a greater control to the services sub-contractors. and coordination is a design problem at large It can be seen from the above comparison that: • • • • • - Builder takes all risks. if design is not fully integrated. Risk . it is also known that there is no standard solution or best buy amongst procurement systems. Coordination of M&E services is of equal importance in the two procurement paths. Services must be fully integrated and coordinated. Of course.

(1996). But it is known that an integrated building team can give better result.G. CIBW92.F. Conditions of Engagement (1981).K. Hong Kong. 83-92. ARCOM 97. p. Conference on Procurement Systems.p. W. CIBW92. A. (1994). U.K. 202-211.p. (1997). 150-159. D&B is not a panacea. P. U. A.p.p. A. W.F. U. (8) Michie. C.K. (1981). p.D.G.C. (6) Lam. 15-26.p. other procurement paths with adequate project management can provide a better alternative than either the traditional or the design and build system.• • • Project success can be enhanced by engendering a team spirit and a high degree of cooperation between project participants. Procurement of major publicly funded health care projects.G. p. Early incorporation of specialist M&E design capability. 179-186. p.1. Special Paper .D. Conference on Procurement Systems.C. The coordination of mechanical and electrical engineering in building production. (3) Gibb. (1988). An analysis of building procurement factors affecting coordination of building services.K. (1994). A. (7) Loosemore.J.C. (4) Kwok. The Association of Consulting Engineers. (9) Pasquire. p. p. p. (10) Parsloe. This can be achieved by the use of non-traditional procurement systems.W.K. BSRIA Report Nr 77420/2. and Sher.J.. ARCOM 95. K. (1994). Hong Kong. 98-104. ARCOM 96. Maintain control or delegate responsibility? The design development dilemma at construction interfaces.p. 1. Coordination of building services in tall building. (2) Barton. Building services and hospital engineering systems must be properly coordinated at both design and installation stages. and Smith. A. CIBW92. Building Journal Hong Kong China. (1978). M..p. U. Hospital development briefing. Impact of building procurement methods on coordination of Building Services.Coordination of mechanical and engineering services.K.p. (1995). (5) Lam. CIOB.F. 6-10. BSER&T. Gibb. U. U.K. p. A professional building team can manage the complex issues of services coordination. p. References (1) A. Conference on Procurement Systems. 57-75. C.G. K.p. Davies. .K. 307-313.E. and Sher. Coordination must be seen as both technical and managerial issues. Gibb. M. P. Integration and coordination of building services and its relationship with project management. (11) Wilkins. Hong Kong. (1994). The allocation of design responsibilities for building engineering services. B.