The success of a medical building project will depend squarely on the talents and disposition of the architect. The selection and supervision of that professional has a major impact on project outcome. Some critical concerns and considerations that will help guide decision makers through the selection and supervision process are described below.
In selecting the architect for a healthcare facility, it is important not to choose an architect who specializes in designing office buildings, sports arenas or zoos. We also should not be inclined to use someone because he or she is a relative, a member of our church or synagogue or the favored choice of an outspoken board member who liked a particular architect’s work on a personal townhouse or office. Instead, hospital executives need to look for a design firm that has in-depth experience with healthcare facilities. This specialized experience becomes critical throughout the project.
For example, when you want to install additional MRI’s in a hospital, the effects of their magnetic fields impose design constraints. The experienced design professional will make sure that there is no interference with other magnetic sources or fields, including other MRI’s. He or she will also assure that the MRI’s are adequately separated and that the design documents provide for suitable shielding, including shielding of electrical outlets and cable conduits. Otherwise, leakage could have severe consequences.
In an example where an experienced health care architect was not used to design a new nursing home project, the corridor width and the patient room door sizes did not conform to the life safety codes applicable to such facilities. The cost of reconfiguration was significant and the delays for final completion of the project were lengthy.
The architect’s consulting engineers should also have relevant health care experience. HVAC engineers designing an air filtration system for a contagious disease containment area should not apply apartment house standards—even on a luxury level—to such program requirements. From where I sit, there are few architectural and engineering firms, even in the large greater New York metropolitan area, which posses in-depth health care experience, so verification of experience becomes essential.
The owner should also assure itself that the architect is practical. The architect must have a clear understanding of the project’s monetary limitations and what can be done and what cannot be done within the owner’s budget. The architect should also be realistic and not attempt to erect an impressive monument to his or her innovative design genius, and in the process ignore the core objectives of the project and its budgetary constraints.
Another area of concern is the sufficiency of the Errors and Omissions Insurance that the architect carries. One will often see policies for only one million dollars, and even those have significant deductibles. Keep in mind that for any significant project, the potential liability arising out of negligent design can far exceed a million dollars. Most architects are willing to take on additional insurance provided the owner picks up the difference in premium on a project basis. If an architect is underinsured but demands a full market fee, the owner may rightfully resist paying additional amounts for supplementary insurance to bring coverage to levels customary for the size of the project in question. An owner should be aware that there are special endorsements available to design/build firms that provide cost effective design liability alternatives.
The last concern is the nightmare architect. Nightmare architects have huge egos, cannot get along with competent contractors and bring those battles back to the owner every other day. They will eventually not get along with owner. These monumental egos can cause huge disruptions, delays and cost for the building owner. Problem architects can be identified during the initial contract negotiations. The health care institution’s attorney will be asking the architect to accept certain specific responsibilities, which the big ego architect will reject as beneath contempt since they constrain or seek to channel his or her artistic talents into pedestrian concerns. The flamboyant and budget-busting architect will be particularly resistant to contractual standards if he or she equates initial selection by the owner as a license not to submit to measurable contract expectations.
Speaking of attorneys, when do you bring in an experienced hospital construction attorney? You bring him or her in as soon as you start discussing the potential project. The sooner you bring in your counsel, the less headaches you will experience, the less delays the project will have and the less wasted money the owner will expend.
Look for our next article in this series, Choosing The Right Contractor.