The Use of Evidence-Based Design in the Construction of New Hospitals
Since the 1960s, researchers have been exploring how the design of the built environment effects the health and well-being of occupants and users. By the 1980s, further research began to focus particularly on health care facilities and how design could influence patient healing and medical staff performance. Evidence-based design (EBD) is the process of basing decisions about the built environment on credible research to achieve the best possible outcomes. The desired outcomes of health care design include improvements in the areas of patient healing, patient experience and comfort, medical staff performance, and medical staff job satisfaction. Extensive research has been done in the field of EBD; however, the question remains whether or not the findings are being put into practice as new health care facilities are designed and built. The purpose of this paper is to compare the design of recently constructed health care buildings with fundamental EBD principles to determine whether or not the latest research and knowledge are being used by the health care design community in practice. Based on the five hospitals studied in this paper, evidence suggests that EBD principles are in fact being put to practical use in the industry.
Implementing the Last Planner System: Perceptions about Subcontractors
The management of construction projects has been advanced by the introduction of the Last Planner System® (LPS). This system is an application Lean Management, and it has been successfully applied to all stages of project development. Although the processes required for its implementation have been covered in detail by studies from the point of view of a project's general contractor, relatively few have addressed the perceptions about LPS held by a project's subcontractors. This exploratory study presents the perceptions of three practitioners experienced in Lean Management in general and particularly in LPS about subcontractors' views about this management system. Three main areas relevant to LPS are explored: shared planning, expectations for people, and dynamics in the implementation. Each of these areas are in turn subdivided into specific topics. The experts' opinions show that main concerns are the tension between the current role in planning expected from subcontractors and the higher level of participation demanded by LPS, a lack of knowledge about the system by subcontractors, and the delegation of leadership roles to subcontractors that should be taken by the general contractor.