In the first part of this article, we discussed the strategic value of the request for proposals (RFPs)—why this “first date” of the project relationship is crucial to long-term planning, efficient operations, and the ongoing mission of delivering quality healthcare. Now it's time to consider the mechanics of the great RFP: Specifically, what we recommend go in them, and why.

It helps to remember that the RFP serves as one step in a broader process. In some cases, it's preceded by a request for qualifications (RFQ), which helps hone in on a select group of experts for a given type of healthcare project. From there, the project owner may issue a basic RFP to shortlist a few firms. Some savvy owners will then ask for a technical proposal with very specific deliverables, a work plan, and fee quotes. In rare situations, an owner might sponsor a design competition as a means for selection.

What Not To Include

Regardless of the set-up, there are two critical rules to keep in mind. First, be careful what you ask for because, as the old adage goes, you’re likely to get it. Second, you only get what you pay for—so if great design and cutting-edge healing environments are the goals, prepare to accept fair market value. Besides, poor pay drives away great architecture—treating design services as a commodity is just as bad as thinking of medical care in the same terms. The RFP isn’t a means to save money.

What the RFP does, however, is set the bar for performance. It cuts through the variability in the architecture/engineering/construction industry, and it helps attract an architect, A/E firm, or design-build company that can do the job well.

Yet many RFPs often get in the way of just that. For example, it is not unusual to try to use them to comparison-shop on fees. While an RFP ultimately influences the cost of a facility, contrary to conventional wisdom, fees are rarely expected from an initial request. Instead, the best RFPs focus on specific, valuable deliverables that truly influence operations and quality of care. The fee proposals can be followed later by a more detailed technical document outlining phase-by-phase expectations and fees.

Another common misconception is that the RFP writer should ask for highly specific, relevant facility experience. If the criteria are too narrow—such as asking for a list of five hospitals identical to their proposed facility completed in the last five years—one ends up with only a handful of qualifying firms. In such cases, respondents might assume the RFP was written with a specific firm in mind anyway, and just walk away.

What Exactly Does Go In?

No matter what you include, make it concise and specific. Clarity from the big picture down to the details signals that the clients know what they’re doing—and will help prepare themselves and their design team for success. An unclear RFP cobbled from various sources will scare off valuable talent. Ask architect friends for tips on what to include, or for examples of old RFPs they really liked. A quick look at the best requests will show a pattern—and the following contents:

Talk about your organization.What is your mission? Make sure to describe your organization's approach to care, its passion for excellence, and the caliber of facility it demands. What do you hope to achieve within the scope of this project? What new heights will the organization reach because of it? Discuss trends that are crucial to your organization's future. Evidence-based design, patient-centered care, and lean operations may be among the topics on the list. Add a dash of color, too—if sustainability matters most, explain why. Is the main concern environmental impact, energy efficiency, or LEED ratings?

Project organization and delivery model.Explain who will oversee the building work and any preferences you have for handling capital projects. Specific needs—such as integrated A/E services or design-build delivery—should be clearly stated. This helps match project approach and outcome; if the objective is a world-class, highly customized hospital, for example, the delivery method is likely to be highly customized, bringing forth the best in design, engineering, and construction.

Client expectations.Describe the level of quality you’re looking for in the facility and how much the design team will need to “solve” in terms of healthcare delivery and operational models. The RFP should include your vision of the project process from proposal review onward. This gives the architecture and engineering firm a window into your needs, and lets them assess whether they can adequately adapt. If in-house facilities resources are limited, perhaps the ideal firm would provide management assistance. If minority-owned or women-owned businesses are a mandatory part of the mix, describe their expected contribution.

Laying out expectations will naturally define the reasonable experience level that candidate design firms should embody. Include in that description any special tools the A/E providers should bring to the table. For example, some healthcare providers have benefited from using facilities databases, or building-information modeling. These can be powerful applications, but without an explanation of how the deliverables will be used, prospective firms may tender proposals lacking adequate detail.

In addition, explain what kinds of project risk matter to the owner. For example, proposals should pledge that the candidate firms can handle the workload and won’t pull a bait-and-switch, substituting less experienced associates for the seasoned principals who were expected to be in charge. On the other hand, it's best not to spell out contractual liability in the RFP, which may dilute the design message. Save this for a technical proposal.

Project scope.This is where the RFP issuer lays out the project description, key deliverables, the project budget, and specific services. It's also the place to get precise on due dates. If the project is a renovation, include floor plans. Describe who will hold which contracts. If your board needs to share a design package with the bond market, spell out when cost estimates are due and how detailed they should be. If the new building is in a certificate-of-need state, describe the filing process, strategy, and deliverables in good detail. Are philanthropy support services needed? List those, too.

The scope is all about optimizing response and mitigating risk. A well-organized scope enables responding firms to build a responsible fee model, if required. It shouldn’t discourage innovation and creativity either. Your organization may be requesting architectural services, but if a compelling proposal comes in for A/E delivery, there's ample precedent to give it a hard look.

RSVPs for RFPs

That wraps up the big concerns, but of course there's more to consider when preparing an RFP. One vital concern is to whom you send it. Inexperienced owners might just select the top 10 firms listed in a variety of publications. More savvy organizations will get referrals, read the literature, and spend time getting to know design leaders in each specialty.

No matter who gets the RFP, give firms at least three weeks to respond. Alert the candidates beforehand that the RFP is on the way, as well; this ensures more thoughtful proposals from better teams of firms. Be sure to include a list of RFP recipients to allow responding firms a more strategic approach, enhance the quality of the responses, and establish the level of quality desired.

RFPs are like invitations to a dance, and the best ones work like choreography. They set into motion the customized solution that best serves staff, patients, and community. After all, hospitals aren’t manufactured—each is distinctive and purpose-built. The same can be said for great RFPs. HD