Healthcare facilities are about as complex a building type as you can get, making a career in the healthcare planning and design field far from a cakewalk. And market conditions are only complicating matters. Hospitals and health systems are responding to the financial realities of reform (and remaining unknowns tied to the Affordable Care Act), implementing measures to support population health, and trying to figure out what to do with an aging building stock—each priority shaping expectations for new building projects and, more importantly, the project team members delivering them.

Healthcare A/E/C firms are responding to the new climate that’s been created, one where shorter schedules are the norm, collaboration is key, and expertise is a must. Healthcare Design asked healthcare design leaders to shed light on the business side of the industry today—specifically, what challenges are top of mind, from talent acquisition to streamlining project delivery to answering evolving client expectations.

In this special report, we profile not just those challenges identified, but the drivers behind them and the solutions being implemented. Here, Michael McLaughlin, executive vice president of Southland Engineering, discusses his firm’s efforts to tackle engineering leadership.

Name: Michael McLaughlin
Title: Executive Vice President
Firm: Southland Engineering (Phoenix)
Number of firm employees: 300
Healthcare revenue in 2016: $300 million (construction revenue)


Business challenge: Engineering leadership
Too often healthcare building owners don’t get the results they expect from engineers and builders. Budgets are exceeded and schedules are missed. They’ve grown tired of the traditional project pattern of “design, bid, value engineer, re-design, and build,” which essentially results in a new facility that’s considered a compromise. The process is inefficient, disjointed, and noncollaborative, and often leaves facility leaders and staff dissatisfied. At root is the fundamental issue of leadership.

Healthcare MEP systems have grown to account for nearly 50 percent of a healthcare facility’s first costs and a significant portion of the ongoing operational costs. Project outcomes are therefore heavily dependent on the success (or failure) of the MEP systems. The role and expectations of the MEP engineer, however, haven’t kept pace with this change. It’s time for the MEP engineer to serve in a leadership role, which will help enable projects to meet and exceed owners’ expectations.

What’s behind it
The traditional expectation of MEP engineers is to provide a technical solution that satisfies the code, standards, and functional needs of a facility. MEP engineers are well-equipped and trained to solve these technical challenges. However, solving a technical issue without regard to cost, constructability, or maintainability is a fundamental flaw that leads to poor project outcomes. The technical solution ultimately defines the cost, constructability, and maintainability of the project and must be considered an equal “input” into the equation if a project team is to expect better results.

Due to the level of complexity required to design, construct, operate, and maintain today’s modern healthcare facilities, the input of owners, architects, engineers, contractors, estimators, facility operators, and a host of other stakeholders that directly influence the outcome of a project must shape MEP designs. This comprehensive contribution in the formative stages of design is crucial to avoid costly re-design or value engineering later, which is a fundamental indication of poor collaboration.

The solution
As part of an engineering, construction, and maintenance company, Southland is in the position to observe projects delivered via a variety of contractual methods over their entire lifecycle. Over the years, we’ve identified and defined success factors that result in better outcomes for clients, regardless of contract type.

Technical expertise. Engineers are faced with regular changes in healthcare codes, standards, technology, and operating procedures. At minimum, our engineers are expected to keep pace with those changes and the variety of potential solutions. Our expectations, however, transcend technical expertise. Engineers must seek to understand what makes the owner’s business successful, how MEP systems can benefit or improve the jobs of medical staff, and what needs and preferences the facility operators hold to ensure the features of the MEP solution remain functional.

Cost. Every line and every word engineers place on drawings and specifications affect the cost of the project. Therefore, it’s critical that engineers understand the impact of their decisions. Since engineers aren’t traditionally trained on cost, they need a partner to provide that insight. Within Southland Engineering, our engineers have real-time access to full-time MEP cost estimators.

Constructability. Since the engineer’s drawings and specifications define what’s to be built, it’s imperative that engineers seek out MEP contractors to help shape the designs. To take it a step further, MEP engineers must design for construction, and this can be done only when trusted construction experts work with MEP engineers at the start of design. We’ve provided our engineers with access to sheet metal, pipefitting, plumbing, and fire protection tradespeople to inform solutions.

Maintainability. MEP engineers aren’t experts in facility maintenance and must rely on facility operators to help shape their designs into a maintainable solution. This is a purposeful choice and requires MEP engineers to engage facility operators during the design stages. If those individuals aren’t available, having access to a trusted facility partner is a critical resource.

Leadership. Given the significant effect that MEP systems have on the outcomes of healthcare projects, MEP engineers must expand their capabilities to become experts at solving technical challenges as well as collaborating, communicating, seeking input, creating valued relationships, taking responsibility, and being accountable for results.

Words of wisdom
MEP engineers have an opportunity and the responsibility to become leaders in connecting engineering decisions to project cost, constructability, and maintainability to improve overall results. Better outcomes can be achieved by engaging stakeholders and using our expertise to optimize solutions on multiple dimensions.