Controlling æmultiple clientsÆ during design

Briefing is an early design process. Many of the problems that develop later in a hospital project can be traced back to a lack of attention given to the briefing process, in particular the multitude of user groups involved. A lack of effective co-ordination and control of these groups can lead to serious design and construction problems. These problems not only lead to protracted inception and design periods, but can also cause contract cost escalation and programme over-runs.

The best construction practices have little value if the requirements of the client are not clearly understood and managed throughout the project life cycle. In order to focus on customer satisfaction, effective management of briefing is paramount.

It hardly needs saying that a fully prepared and documented brief must always be the best basis for good design.

Hospital development characteristics

Project success or failure may be judged in a number of ways. Examples might include:

Delivery within the agreed time frame and budgets.

The contribution the development makes to the built environment as a whole.

The functionality of the building judged by the end users.

The extent of critical architectural acclaim.

However, the most important judgement will ultimately be that made by the client in respect of how well the building satisfies the purposes for which it was commissioned – in short, the extent to which the client believes that “value for money” has been achieved.

A fundamental aim of the briefing process must be to identify not only the employer’s requirements, but also the critical success factors that must be achieved in order for the project to be judged a success.

One of the most striking characteristics that distinguish hospital projects from other projects is the time scale over which they occur and the large costs involved.

Technologically, hospitals are highly complex, requiring the integration of diverse and intricate building and hospital designs. Functionally, they are equally complex, having to satisfy the disparate demands of the general public and the highly trained medical professionals and staff that operate the facility.

The complex process of planning and designing a hospital requires that it is a multidisciplinary endeavour. This process must be organised and systematised, which also involves stages moving progressively from the macro-level of extensive surveys of the needs and demands of all project stakeholders (i.e. users, general public, founder and regulatory bodies) to the micro-level of a specific space in a building designed for a particular function or human activity.

Because of the highly specialised and complex medical technology in healthcare delivery, and the need for expertise of end users for the facility development process, the design process requires the active participation of all professionals and continual interaction between the users. In so doing, the professionals can then translate all functional requirements into an appropriate form.

The briefing processes, therefore, by which the client’s needs and aspirations are transformed into a medium (the project brief), are extremely complex. It is the successful interpretation and balancing of these aspirations and needs during briefing so that the final design solution accurately reflects them, which continues to present such a formidable challenge. The key to success, however, lies – as always – in understanding clients and users. Obviously, failure to consult client/users will almost inevitably result in dissatisfaction among end users, in demands for changes to designs and even built facilities.

Research carried out by the author has revealed that hospital construction projects pose extremely complex managerial problems. Numerous reports have been scathing in their criticisms of the unacceptable delays and cost increases in the delivery of new hospitals. The problems that hospital project managers face are particularly acute during the early stages of the project when the detailed requirements are being established. Research into failed projects has also found that lack of buy-in of key stakeholders is one of the reasons why projects fail.

Briefing model

To be able to understand the method of planning and design, a model is useful. A model is a representation of the relevant aspects of briefing and design with which we are concerned. The model is, in fact, a diagram showing the important variables and the relationship between them. The model shown in Figure 1, developed by the author for his research, is simple and comprehensive enough for understanding briefing.

The three main variables of the model are:

Define client requirements.

Analyse client requirements.

Translate client requirements.

The principal hypothesis is:
When the design team, briefing process and project procedures are appropriate to the client/users and project characteristics, greater success will be attained.

In order to examine the general hypothesis, detailed hypotheses are expressed as follows:

Project success is a function of the quality of the management of the client’s brief.

Project success is a function of the interactions between the design team and client/users.

Project success is a function of project procedure with due regard to communication in the design process.

From this model, the reader should see that end-users are an integral part of this briefing system. The project brief must be developed in an integrated and inseparable relationship between designers and end users.

To be successful, briefing, therefore, requires the application of few principles. First, the number of communication interfaces needs to be reduced. Secondly, the interfaces need to be subject to effective administrative control. Thirdly, the involvement of all stakeholders and designers in developing innovative or creative solutions in order to achieve delivery on cost and time. Most importantly, solutions must maximise benefits for the client/users.

Briefing and design

In the context of the construction process, briefing is the procedure by which the requirements (i.e. specific needs, aspirations and desires) of the client are communicated to the project team. The result of the briefing process is a document that describes the goals of the client in functional, time, cost, quality and scope terms. Irrespective of how the briefing is undertaken, it is a team activity. The brief engages client, users and all designers in collecting, collating, analysing and synthesising the information needed to inform decision-making and decision implementation at the strategic and project planning stages of the construction process. This should lead to the right performance specification of the project. The discussions and decisions made within the briefing process will shape the design team’s perception of the type of building design that will satisfy the customer’s needs.

There are many hospital design and construction problems that can shape the performance of a project. The most critical project failure factor is the management problem associated with the inherent complexity of hospital clients (i.e. pseudo or surrogate client) in terms of the large number of end-users or what is called multi-headed client (i.e. true clients) within the context of a hospital procurement process.

The production of a hospital building is an interactive team process. Input and time are required from clients and hospital designers. If the views of project stakeholders are not properly addressed then the project is unlikely to deliver optimum value for all involved. Only by a process of dialogue and negotiation between the parties can a design be developed and agreed. Unquestionably, the collaborative development of a hospital between client/users and consultants should provide the best chance to give the best health services at an affordable cost, owing to the synergy between operational and design expertise.

Technologically, hospitals are highly complex buildings. Functionally, they are equally complex, having to satisfy the disparate demands of the general public and the highly trained medical staff who operate the facility. Hospital clients typically involve large numbers of endusers and committees. End-users are represented by medical consultants, each of whom typically takes a narrow and specialist view of their particular unit. There will be administrative department heads too, but their needs are usually clear and certain. Each of the medical users is, indeed, the client for their part of the building. These individuals may have higher demands than the normal hospital standard provision, and sometimes, somewhat idiosyncratic ideas about the importance of their part. Each therefore expects to have an equal voice in the briefing and design process. Ironically, they all do not have knowledge or experience in design and construction, but they are able to request changes during the design and construction stages because they are true clients and have a right to make changes.

These end-users have a key role in ensuring that the community obtains the best product from the healthcare point of view. To deliver healthcare efficiently and effectively, healthcare premises must have the right amount of space and the correct tools (i.e. hospital equipment and supporting mechanical and electrical engineering services). Premises must, of course, be handed over with the right equipment and supporting services in the right place in an appropriately designed setting. Designing a hospital is therefore much more complicated than building walls around activities and equipment, so the users’ requirements or needs must be firmly established and clearly communicated to the design team. Ultimate project success depends on the integrated briefing process with reciprocal interaction among the design team and the true hospital clients.

The design team must then analyse the customer’s needs and provide the best design solutions, otherwise, the project will fail to achieve them. Clearly, good understanding and planning of users’ needs should be given high priority in the development of hospital and other healthcare buildings.

Improved management of briefing

It has been identified by the author that successful management of the multiheaded client is very important to the ultimate success of a project. The client should assume a major role in briefing. Sufficient time and resources should be allowed for the briefing process if a long protracted design period is to be avoided. The problem of multi-headed clients should be recognised and managed from the very beginning.

To overcome the information coordination problem, both an in-house or external project briefing co-ordinator/ integrator or procurement manager is necessary. This integrator will assume responsibility for initiating, directing and maintaining the momentum of the briefing process. He will also co-ordinate and integrate users’ needs before communicating the processed brief to the design team. This complied information should make an important contribution to subsequent design work. The co-ordinator also liaises between all users and medical consultants and the project manager and the design team throughout the design and construction phases.

As he will ensure the provision of complete users’ details, the completion of the necessary design analyses and incorporates the users’ needs, this should avoid many communication distortions / gaps / problems and certainly improve the difficult communication between the design team and the multi-headed clients.

This improvement in the communication chain and integration of management and design functions should result in better design, and possibly, a significant reduction in the number of client changes arising from inadequate management of the project briefing.

Recipe for success

The UK Construction Industry Board and the author have identified the following as being the essential qualities of a good brief:

Embody the mission and convey this to the reader.

State what is expected, by when and from whom.

Define the context.

Set out the perceived problem unambiguously.

Establish requirements on cost, quality and time.

Be clear about the allowable time frame for completion of management of information flow.

Tease out the assumptions of the people involved.

Do not leave any “big” questions unanswered.

Be honest without raising unrealistic expectations.

Be able to respond to change.

Be flexible so that different options can be explored.

Be explanatory, stating the reasons for the requirements.

Set out potential conflicts so that the project team can respond.

Effective management of the briefing process is a major determinant of project success. The adoption of “value management” appears to be a crucial and logical approach if the ideal brief set out above is to be achieved, particularly in the case of complex multi-headed clients.

The adoption of value management achieves a range of benefits, including:

Confirmation of the need for a new project.

The open discussion of objectives.

Better understanding within the team and better communication throughout the organisation.

The development of a structured, rigorous and rational framework for evaluation and re-evaluation.

Decisions supported by data and made on the basis of defined performance criteria.

Consideration of alternative solutions.

Decisions made with greater confidence.

A greater potential for increasing value for money in the project.

Increased satisfaction with the end product due to participation by users. More importantly, the client and his designers can crystallise the project brief with a more systematic and multidisciplinary approach.

Lessons learnt

Rational discussion of hospital design is complicated by the fact that hospitals are connected with life and death matters and the growth of a society. Once these absolutes are mentioned, only the best design is acceptable. A major factor in determining success is the effective management of the hospital corporate client body during briefing stage. Research shows that many project outcomes are not successful as a result of the multiheaded client problem together with inadequate management of the briefing process.

The author would summarise his research findings as follows:

Many problems affecting project performance originate in the inception phase, particularly in the preparation of the project and design briefs.

Developing, reinforcing and enhancing the client’s brief with many users efficiently is one of the most critical activities to be undertaken on a hospital project.

Both clients’ and designers’ experience and brief management will have a direct bearing on the quality of the design brief and the final product, the building.

Clients need professional service and advice. Designers should guide the clients (especially inexperienced ones) to manage the briefing process efficiently.

The main problems in the briefing process are communication, integration, co-ordination, power and political aspects. Both clients and designers should improve or re-engineer their managerial ability. The design team can manage the briefing process successfully in all procurement methods. However, the use of non-traditional procurement approaches such as the design and build family can sharply focus the multiheaded client problem. The reasons are:

Clients have to confirm their needs much earlier.

Any client’s change is a penalty and the multi-headed client will be responsible for the effect or consequence.

Changes are to be controlled carefully.

Better co-ordination and management by a professional project information co-ordinator or manager who understands design and hospital building.

• Establishment of a better project management system by all participants. Recommendations There are two recommendations that are important in achieving project success. These are all pragmatic managerial issues.

Active management of users Based on the author’s research, here are some useful strategies that a hospital designer may adopt to deal with multiple clients.

Guide them to fully understand the project and the constraints.

Provide information and views to maintain their support.

Maintain their enthusiasm and interest in the project.

Consult with them prior to taking decisions.

Meet with them and seek their input and opinion.

Demonstrate that you are doing your best for them.

Consult with them, involve them and seek to build their confidence in the project and the team.

Encourage them to act as advocates for the project but tame them carefully.

Look after them as they are important to you and the project. All in all, a re-engineered briefing process tailor-made for the multi-headed clients should follow the following steps:

Hospital authority (HA) to provide updated hospital departments and hospital equipment data sheets based on best practice.

Hospital users to update their specific requirements based on HA data from time to time. Revised information reflecting change in hospital technology, and so on to be checked and agreed by both HA and users.

In new project, a client’s integrator is required to co-ordinate all hospital users equipped with best data for their own departments.

The integrator is to manage all client data. He will ensure completion of hospital design information.

The integrator is liaising between the design team manager and all users. He is responsible for all information flows between the designers and the users, thus, simplifying the difficult communication path.

The design team is to develop the design options based on all agreed client data.

The integrator is to double-check each user’s acceptance of the designer’s proposals. If changes are necessary, he will co-ordinate the changes with the design team and the user.

The integrator is also responsible for the co-ordination of hospital equipment procurement and the physical installation work with the design team.

Greater client/user awareness and understanding of the design process, therefore, should enhance the possibility of clients more realistically fulfilling their building ambitions.

The use of value management Value management (VM) is a structured approach to defining what value means to a client in meeting a perceived need by clearly defining and agreeing the project objectives and how they can be achieved. VM is therefore based on function analysis. With this systematic, multidisciplinary effort toward analysing the functions of projects, it is possible to achieve better interaction between designers and users and this should result in better value at the best project cost.

VM has the following benefits:

It relies on the project team getting together to discuss the project with the aim of adding value to the project. This should improve communication and understanding of a project.

It will achieve better design for present and future expansion.

It will create more alternative solutions to meet a user’s needs.

VM should, therefore, improve communication, knowledge management, team dynamics and decision-making in the briefing process. Nonetheless, this approach is still in its infancy and the use of this concept should be adopted by the design team.

Conclusions

Effective briefing is about identifying design problems, reducing them to key statements and communicating their essentials to all the participants. Unless the problems are clearly stated, no satisfactory solutions can be provided. The author’s research findings support his belief that vigorous, conscientious client participation and the use of good brief management from project inception through all the design stages is the prerequisite for success.

The opportunity to improve the briefing process and the final product (the building) through more accurate and realistic feedback data (e.g. from previous projects) can be immensely significant. The opportunity to increase client fulfillment would appear to be equally so.

Management of internal stakeholders is complex. The formulation of the functional project brief in collaboration with the end users provides a unique opportunity to review work practices for the new facility and to ensure that these represent industry best practice.

Unfortunately, it seems that all concerned with the provision of healthcare facilities are still unhappy with the briefing process. The main problem is difficult communication and co-ordination with a multitude of powerful user groups involved in the critical stages of designing a hospital. Despite its apparent importance, briefing remains a problematic part of the project development process. The author’s research also identified that if stakeholders are not properly involved in the development of the project it is unlikely to deliver optimum value for all concerned. Equally, failure by all parties to allocate adequate resources and time for briefing can compound difficulties.

It becomes evident that project performance is not related much to the building procurement system selected. The briefing process has the greatest impact on project time, cost and quality. The importance of getting the brief right before proceeding with subsequent design work is paramount.

References

1 Health Building Note 2 (1992) Briefing and Operation Policies, NHS Estate.

2 Kamara, J.M. (2002) Capturing client requirements in construction projects, Thomas Telford, UK.

3 Latham Sir M. (1994) Constructing the team. The Stationery Office, UK.

4 Loosemore, M., Davies, M.G. (1994) Hospital Development Briefing. CIBW92: Procurement Systems. Hong Kong.

5 Marsh, C. (2003) Building Services Procurement. Spon Press, UK.

6 O’Reilly, J.J.N. (1987) Better Briefing Means Better Buildings. BRE, UK.

7 Parsloe, C. (1990) A Design Briefing Manual. Bracknell, BSRIA.

8 Wilkins, B.W., Smith, A.J. (1994) Procurement of major publicly funded health care project. CIBW92 Conference