Northwestern Memorial Hospital (NMH) is an 894-bed academic medical center that’s part of Northwestern Medicine, with a 117-bed community hospital in Lake Forest, Ill., and more than 25 urban and suburban outpatient clinical sites in and around Chicago. Combined, it has more than 5 million square feet of managed space and serves as the primary clinical affiliate of Northwestern University’s Feinberg School of Medicine.

At any time, Northwestern Medicine has a mix of renovation and new construction projects underway.

The teams working on these projects are often challenged during design and construction, due to limited communication between members. In addition, the operators of these buildings are handed over incomplete information on the building upon completion and are unable to use the building data that did exist during the project for ongoing facility management.

To address these challenges, three years ago, NMH released an enterprise mandate to use building information modeling (BIM) for all projects going forward. The first project that was required to meet the mandate was the Outpatient Care Pavilion (OCP). The OCP is a 1-million-square-foot, 25-story building located in the hospital’s downtown Chicago campus. It includes eight floors of parking; six floors of imaging, outpatient surgery, and institutes; and five floors of physicians’ clinics. It’s slated to open in fall 2014.


Start with a plan
To enable successful use of BIM, a BIM addendum was added to the contracts with the architect and the construction manager for the OCP. One of the main ideas behind this addendum is that it requires the project team to collaboratively create a project-specific BIM execution plan (BEP). The BEP sets out the steering and control mechanisms for the BIM process.

The different uses of the model were detailed along with modeling responsibilities and deliverables, and key expectations to allow for a more integrated project process are detailed, too.

Because expectations are set early and clearly, the BEP is an ideal document to monitor BIM compliance. The following are some of the metrics that help track the cost and schedule savings:

  • Number of conflicts/clashes found and resolved prior to construction
  • Number of requests for information (RFI)
  • RFI response and resolution time
  • Budget variance from schematic design to guaranteed maximum price
  • Schedule variance from estimate to actual.

With the BEP in place, the OCP project turned into a laboratory for optimizing BIM processes on all future projects.


BIM for design communication
Before the BIM initiative, communication between ownership and the design and construction teams was conducted primarily through 2-D documents, with limited integration of the team. Owing to its visualization capabilities, BIM allows coordination problems to be known earlier in the project process and then helps the team to develop an informed solution because of a better understanding of the coordination problem.

Communication challenges existed with staff, as well. While department and area managers were invited to take part in planning meetings, it’s challenging to get physicians and nurses into a room to join the end user discussion. A solution was found on the OCP project by placing the BIM model on an iPad with preset views that could be easily accessed.

Combining the visualization and information aspects of BIM with mobile technology allows the clinical, facilities, and support services staff to review their future space when they’re able, rather than waiting for the project team to find a meeting time that suits everyone.


BIM for owner-driven clash detection
NMH mandates that clash detection be used for both design coordination and subcontractor coordination, with guidelines that require certain types of clash tests to be run on a particular schedule that’s determined by the phase and complexity of the project.

In general, the system expects the design team to schedule clash meetings at least on a monthly basis during the design development phase and biweekly during the construction documents phase. At these meetings, the BIM managers from NMH and the general contractor are present. The design team will typically run interference checks, while subcontractors are expected to run construction clash detection sessions on at least a biweekly basis and invite the design and NMH teams to attend.

Through this collaborative and open exchange of clash status, projects have fewer field conflicts or design coordination issues to be resolved through the architect’s supplemental instructions and change orders.

Another advantage of NMH’s presence at these clash meetings is that facility technicians can be brought in to evaluate access spaces for valves, cleanouts, terminal units, etc. The obvious benefit is assurance that ample maintenance access has been designed, but there’s also the added advantage of the facility technician becoming extremely familiar with the building before he or she has to maintain it.


BIM for facility management
There’s been a lot of discussion in the industry regarding use of BIM models for facility management, with Construction Operations Building Information Exchange (COBie) as the format to capture facility data during design and construction. After reviewing a typical COBie spreadsheet with the NMH facilities team, it was deemed too complex for use by maintenance technicians owing to its multiple tabs and detailed data fields. Instead, the system decided to create its own facility data capture requirements.

The first step was to determine a technician’s information needs. Through questionnaires, interviews, and mapping exercises, a list of attributes that a technician typically requires was developed. Second, the facility technicians and managers identified objects either as unique or generic from a maintenance standpoint.

For example, a light fixture is generic because only information on the fixture type is needed as opposed to information specific to every single instance of the fixture. A fan coil unit, however, is unique from a maintenance perspective in that it comes with a specific warranty, model, serial number, and serviceable parts information. These facility attributes were captured on an instance basis for unique equipment types, while a shorter list of attributes was captured for generic items.

Finally, in order to link the 3-D elements of the BIM model to the attributes and operations and maintenance documents, an NMH unique ID was created. For example, CHI-OCP-VAV-03-11 is the third VAV unit on the 11th floor of the OCP. This ID is contained in the model, in the attribute spreadsheet, and in the document management system, allowing NMH to access maintenance data and documentation through URLs contained within each BIM element.


Lessons learned
As NMH has developed its BIM initiatives and processes, a number of lessons have been learned that are helpful to consider when implementing BIM at an organizational level, including the need to:

  • Detail anticipated BIM processes, expectations, and close-out deliverables in all front-end documents (request for proposals, request for bids) and contracts
  • Carefully analyze legacy vendors for project management, document management, and facility management for both capability and interest/willingness to open their systems to collaboration
  • Verify internal resources, management commitment, and inte
    rnal communication
  • Showcase value internally and bring other departments into the mix to build a critical mass for BIM: biomed, IT, property operations, materials management, and others. 

Shrimant Jaruhar is BIM manager, facility, planning, and construction, at Northwestern Memorial HealthCare (Chicago). He can be reached at