Exploring Value Generation in Target Value Design Applying a Value Analysis Model

Target value design (TVD) is a management approach that applies target costing in the design and construction industry. TVD enables a project environment with favorable characteristics to generate value. However, because the TVD’s primary assessment is cost, target cost can be met without necessarily achieving the project’s full value. This research applies the action research approach to implement TVD in a housing project and explores the value generation of the project using a value analysis model (VAM) to study the balance between cost and value fulfillment in the product and design process. According to the results, even though the target cost was achieved, the desired value of the project was not achieved during the project design. However, there is a tendency to increase value over time to a greater extent in the product and not so much in the process. The main contributions of this study are the possibility of comparing cost and value, identifying the emphasis of product over process and cost over value throughout the TVD project. This study enhances the literature on project value generation and maximization, offering new knowledge for a better understanding of how to conduct a value analysis in combination with costing in TVD projects.

Intensive Care Unit Built Environments: A Comprehensive Literature Review (2005-2020)

BACKGROUND

The intensive care environment in hospitals has been the subject of significant empirical and qualitative research in the 2005-2020 period. Particular attention has been devoted to the role of infection control, family engagement, staff performance, and the built environment ramifications of the recent COVID-19 global pandemic. A comprehensive review of this literature is reported summarizing recent advancements in this rapidly expanding body of knowledge.

PURPOSE AND AIM

This comprehensive review conceptually structures the recent medical intensive care literature to provide conceptual clarity and identify current priorities and future evidence-based research and design priorities.

METHOD AND RESULT

Each source reviewed was classified as one of the five types-opinion pieces/essays, cross-sectional empirical investigations, nonrandomized comparative investigations, randomized studies, and policy review essays-and into nine content categories: nature engagement and outdoor views; family accommodations; intensive care unit (ICU), neonatal ICU, and pediatric ICU spatial configuration and amenity; noise considerations; artificial and natural lighting; patient safety and infection control; portable critical care field hospitals and disaster mitigation facilities including COVID-19; ecological sustainability; and recent planning and design trends and prognostications.

CONCLUSIONS

Among the findings embodied in the 135 literature sources reviewed, single-bed ICU rooms have increasingly become the norm; family engagement in the ICU experience has increased; acknowledgment of the therapeutic role of staff amenities; exposure to nature, view, and natural daylight has increased; the importance of ecological sustainability; and pandemic concerns have increased significantly in the wake of the coronavirus pandemic. Discussion of the results of this comprehensive review includes topics noticeably overlooked or underinvestigated in the 2005-2020 period and priorities for future research.

Value Analysis Model to Support the Building Design Process

The architecture, engineering, and construction industry requires methods that link the capture of customer requirements with the continuous measurement of the value generated and the identification of value losses in the design process. A value analysis model (VAM) is proposed to measure the value creation expected by customers and to identify value losses through indexes. As points of reference, the model takes the Kano model and target costing, which is used in the building project design process. The VAM was developed under the design science research methodology, which focuses on solving practical problems by producing outputs by iteration. The resulting VAM allowed the measurement and analysis of value through desired, potential, and generated value indexes, value loss identification, and percentages of value fulfillment concerning the design stage. The VAM permits the comparison of different projects, visualization of the evolution of value generation, and identification of value losses to be eradicated. The VAM encourages constant feedback and has potential to deliver higher value, as it enables the determination of parameters that add value for different stakeholders and informs designers where to direct resources and efforts to enhance vital variables and not trivial variables.

Integrating Lean Exploration Loops Into Healthcare Facility Design

Purpose:

To explore what, when, and how Lean methods and tools can add value during the programming phase of design through providing additional resources and support to project leadership and the architectural design team.

Background:

This case study–based research took place at one large academic hospital during design efforts of a surgical tower to house 19 operating rooms (ORs) and support spaces including pre- and postop, central processing and distribution, and materials management. Surgical services project leadership asked for support from Lean practitioners during the design process.

Methods:

Lean exploration loops (LELs) were conducted to generate evidence to support stakeholders, as they made important decisions about the new building design. The analyses conducted during LELs were primarily focused on the relative advantages of a large footprint with few floors or a smaller footprint with more floors and support spaces not collocated adjacent to ORs on the same floor.

Results:

LELs resulted in quantifications of key operational and design features (e.g., design preferences of employees and patients, horizontal distance travel, and elevator utilization studies), which in turn complemented the architectural design process and created an opportunities to gain buy-in and consensus from stakeholders through their active participation in many of the analyses.

Conclusions:

We found Lean tools and methods to be of most value during programming phase when focused on the high-level operational and design issues to help establish buy-in and consensus among stakeholders, while acknowledging that there is often not enough design detail to perform accurate analysis.

Target Value Design: Applications to Newborn Intensive Care Units

There is a need for greater understanding of the health impact of various design elements in neonatal intensive care units (NICUs) as well as cost-benefit information to make informed decisions about the long-term value of design decisions. This is particularly evident when design teams are considering the transition from open-bay NICUs to single-family-room (SFR) units. This paper introduces the guiding principles behind target value design (TVD)—a price-led design methodology that is gaining acceptance in healthcare facility design within the Lean construction methodology. The paper also discusses the role that set-based design plays in TVD and its application to NICUs.