I've gone through some enlightening experiences recently, all revolving around the issue of trust. Specifically, via various article proposals, interviews, and conference visits, I've taken a tour of the arcane world of design documents. Even more specifically, these documents have to do with the contractual obligations of the major parties to executing a healthcare project: the owner, the architect, and the general contractor.

Permit me not to use the names of the actual parties here. The articles addressing all this will be out soon enough, and the conference was one I attended as a guest, not a reporter. The themes that came out of all of this, though, are intriguing enough in themselves.

I'd start with a statement by an attorney who said that the design and construction field has plenty of good reason to “hate lawyers.” They're responsible, he said, for the dethroning of architects as “master builders,” knowledgeable and responsible in all phases of design and construction. Through crafting of various contractual obligations some 20 or 30 years ago, he said, the lawyers set up an adversarial relationship among owners, architects, and contractors. Building projects haven't been the same since.

For one thing, profound questions have emerged hovering over the entire process. To what extent should architects be responsible for the details, and detailed pricing, of a project? How can general contractors balance pricing and profits with responsibility for quality design and clients' budgets? What should clients/owners bring to the table that would expedite a cost-effective, high-quality project? What happens when these overall questions go unanswered on a specific project?

Still more questions: What's better—separate contracts for everyone involved? One three-way contract holding everyone accountable to a single document? Strong owner representation governing everything? Where does BIM (Building Information Modeling) come in—is its encouragement of collaboration among all parties early on in the process really a good thing?

Interestingly, I found views on all sides of these issues, even in my relatively brief “reality tour.” Only one certainty emerged for me from all this, at least for now: The answers—that is, the “good” answers, or the solutions—depend on the good will, commitment, and transparency of all participants in collaborating for excellence. Anything short of that isn't worth the proverbial paper it's printed on.

But there are many nuances and interesting arguments here. I can say no more right now—stay tuned for future issues of HEALTHCARE DESIGN, in which we address the age-old questions: Will everyone involved find true happiness and, if so, how? HD



Richard L. Peck, Editor-in-Chief

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Healthcare Design 2008 August;8(8):6