The case of Sutter Health

24 October 2017 12.00 - 4.00pm

Euan Keats Education Centre (2nd floor), Princess Royal Hospital, Lewes Road, Haywards Heath

Organisers: University of Huddersfield, Lean Construction Institute UK, Brighton & Sussex University Hospitals NHS Trust

A workshop on new ways of managing hospital projects is organised by the Innovative Design Lab of the University of Huddersfield in collaboration with Lean Construction Institute UK and Brighton & Sussex University Hospitals NHS Trust on October 24, 2017 in Haywards Heath (north of Brighton). The main presenter will be Digby Christian from Sutter Health (US), with extensive experience on innovative management of hospital projects from the client side.

For more information on Sutter Health and Digby Christian, see overleaf.

This free workshop targets an invited audience of senior managers responsible for or overseeing hospital (or other public) projects, and other experts interested in this topic. The workshop provides a rare opportunity of hearing from an insider of a very successful project management renewal programme about new and effective ways of hospital design and construction management.


12.00 Lunch
12.50 Opening and introductions
13.00 Presentation by Digby Christian: How we run our hospital construction projects
14.00 Questions and answers
14.30 Coffee/tea
15.00 Panel discussion (in interaction with the audience) on the feasability of Sutter Health's methods in UK hospital (and other public) projects
16.00 Closure

Sutter Health's methods for hospital construction projects: from meeting the targets to beating them

In the last 10 – 15 years, the ways of organising and managing construction projects have been under considerable development in the US, California leading the effort. Sutter Health has been at the forefront of these efforts, often implementing new ideas as the first or among the first clients. Thus, Sutter Health pioneered new contractual models, Integrated Form of Agreement, for encouraging collaboration and integration between project parties. On basis of that, new horizontal organizational forms, along with supporting spatial solutions (Big Room) have been implemented. For managing the design and construction processes, lean principles and tools have been extensively adopted. Building information modeling (BIM) as well other types of IT have been used to support work processes. Based on all mentioned features, the process of Target Value Design has been implemented for ensuring continuous efforts towards risk mitigation and cost reduction. It is worth mentioning that practically all these new features, often collectively called “Integrated Project Delivery”, are currently being practised by other private providers of healthcare, as well as in public hospital projects in California.

The results, in terms of cost and time, have been remarkable. Although detailed statistical information in this respect for any particular client is difficult to obtain, the following quote by an anonymous private owner is telling:

“Out of the 50 TVD projects that we have completed since 2005, we have been able to consistently deliver projects for 15 % below the market price. Quality, schedule, and scope were not compromised in the process”

In a nutshell, the methods pioneered by Sutter Health are radical: they move the management efforts away from solely complying with budgeted cost and schedule to the question of how much cost can be reduced and the schedule compressed during the project.


Digby Christian

Director of Integrated Lean Project Delivery, Sutter Health

From 2006 - 2007 Digby managed Sutter Health’s very first Integrated Project Delivery (IPD) project, a Medical Office Building in Fairfield, California. From 2007 – 2013 he managed the award-winning project to build the 130 bed, 230,000 sq.ft. Sutter Health Eden Medical Center: under budget, ahead of schedule, and with no compromises to Sutter’s conditions of satisfaction - the first large complex project delivered under an IPD contract in the USA. That project introduced the concept of ‘design for fabrication’ to Sutter Health and created a workplace environment that allowed the team to push the limits of the possible with BIM in the project design phase. He also had lead responsibility for re-negotiating $2.7 Billion in IPD contracts and re-organising the teams, processes and culture at the Van Ness and Geary Campus and St. Luke’s Campuses projects in San Francisco, California. These two projects are currently 70% complete and on budget and on time and due to open in 2018 and 2019. In 2014 he co-authored, then presented a paper on a new concept called Four-Phase Project Delivery at the International Group for Lean Construction conference in Oslo, Norway, which arose out of the learning of the prior seven years. His current responsibilities are the development of an Expedited Project Delivery service line, and the training and mentoring of project delivery staff in the special skills needed to be successful in the integrated lean project delivery environment