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Fast-track scheduling is not a new approach to project delivery. It has been used successfully for many years in industrial and commercial construction. Recently its use has spread to construction of educational, health, and government-owned facilities. The apparent reason for this wider application stems from the current cost escalation within the construction industry which has caused the fixed construction budgets of such groups to decrease in purchasing power over the time it takes to complete a project. Construction costs have been increasing at approximately 12-15% per year.
The time period on many hospital projects from decision to construction until occupancy has been 6 years or longer. Experts agree that the time connected with project delivery can be reduced. A shorter delivery time (1) allows medical care to be delivered to a community earlier, (2) reduces the chance of hospital obsolescence before occupancy because of the rapid changes which take place in the medical field, and (3) avoids increased project cost due to the escalation in costs experienced in the construction industry.
Many believe the use of a sequential construction approach contributes to lengthening the time for project delivery. This approach, generally referred to as conventional, follows a linear sequence of completing first the total programing of a project, then design, and finally actual construction. Each of these activities, which are common to the creation of any building, generally must be completed before the succeeding one begins. Thus, all programing decisions are made before design work begins and construction does not start until total design of the project has been completed. This approach traditionally has been followed in the construction of various kinds of buildings, including hospitals.
Fast-track scheduling and total concept construction, sometimes called “turnkey”, are two approaches evolving in health facility construction to reduce project delivery time and cost. They have received only limited use for hospital construction, including federally assisted projects; however, their use has been increasing in the last few years. Federal agencies such as the General Services Administration and the Veterans Administration have begun to use fast-track on selected projects. The total concept approach has not been used by Federal agencies on hospital projects.
In addition to reducing project delivery time and cost, the fast-track and total concept approaches, unlike the conventional approach, provide construction expertise early in project development. Fast-track scheduling usually necessitates that the project owner utilize the services of a project manager to coordinate and manage the project. Early project control offers potential savings in addition to those attributable directly to fast-track scheduling. Under the total concept approach, a construction expert is included as part of the organization which undertakes total project development.
Fast-track scheduling (also referred to as multi-track scheduling and phased designed and construction) is an approach used to shorten the overall time between the decision to construct a building and its occupancy. In contrast to the conventional approach, programing, design, and construction are overlapped so that one begins before the other is completed.
Basically, with fast-track, the design work is separated into “packages”, such as foundation, superstructure, and exterior walls. When sufficient programing has been completed relating to user requirements and site conditions to determine the overall building area, configuration, height, and mass and site requirements – design work on the foundation package can be initiated. As soon as foundation design is completed, construction can be undertaken while, concurrently, programing of succeeding packages is being completed and design work is proceeding. However, once decisions are made which result in construction of a package, they generally cannot be reversed without incurring substantial costs.
Although the length of time to do any one activity may not be shortened, it is generally agreed within the construction industry that overlapping phases, if properly managed, will result in substantial time reduction over the sequential path followed under the conventional approach. Overall time is reduced by starting and completing construction sooner, as illustrated below.
The use of fast-track for hospital construction has not been limited to the United States. For example, the approach was applied to construction of the new Health Sciences Center at McMaster University, Hamilton, Ontario, Canada. The Health Sciences Center will be used as a teaching and research facility and, in addition, will provide patient care. The estimated construction cost was$57 million. It was reported that 7 years of design and construction time has been condensed to 4 years through overlapping and that 60 percent of the building was in place before interior contracts were awarded.
In addition to new hospital construction, fast-track scheduling has been implemented for additions to existing hospitals and for renovation projects. One large city was implementing an accelerated renovation program to upgrade existing hospitals within the municipal system, and design and construction were overlapped on 12 projects costing over $47 million. A program official stated that project completion time can be reduced by one-third to one-half by overlapping design and construction on renovation work. One reason for this reduction, according to the official, is that construction can begin after 20 to 30 percent of the architect's drawings are completed.
The reduction in time will differ from project to project. The complexities of individual projects, the availability of financing, the size and type of facility, the weather during construction, and the ability to meet project schedules all have a bearing on total project time for the individual facility.
Reprinted from AACE Bulletin, Volume 15, No. 4 by permission of the American Association of Cost Engineering.