To the city of Henderson, Nev., Union Village is 151 acres of city-owned property that sold for $11.6 million in April 2011 to boost medical infrastructure in Southern Nevada. But beyond the Las Vegas suburb, it will be the first integrated health village of its kind and the largest healthcare project in the world. On Oct. 8, 2014, ground was broken on the concept that will integrate a healthcare center into retail, entertainment, residential and senior living, and culture centers.

The Invxtus group, a developer from Southern California, initiated the design phase of this venture. Universal Health Services and the local Valley Health System have signed on to build the first phase of the healthcare campus, a 142-bed acute care hospital. For the past 10 months, a nine-member design team has been laying out plans for the new hospital. This process involves integrated project delivery (IPD) and target value design (TVD), utilizing Lean concepts.

The contract is an integrated form of agreement (IFOA) between member partners involved in designing and building the project, including Valley Health System, HMC Architects, Buehler & Buehler, Excel Engineering, Bergelectric, SR Construction, Turner Construction, Amfab Steel, and Southland Industries, which is providing HVAC, plumbing, fire protection and HVAC controls through a design-build effort. The hospital is scheduled to be complete by the end of 2016. In addition, UHS has plans to support the hospital with construction of an ambulatory care building and medical office buildings.

The Union Village development surrounding the hospital will reside on 155 acres and is budgeted at $1.2 billion. This model for healthcare will incorporate senior housing, a fitness club, retail locations, a skilled nursing center, and long-term acute care facilities. Future phases of the development will include movie theaters, office buildings, a hotel/convention center, and additional retail and housing offerings. Union Village will be built in phases and is scheduled to be complete within 10 years.

As the IFOA for Henderson Hospital took shape, partners were chosen based on their experience with Lean principles and IPD. Rather than focus on the traditional methods of low-cost bidders, the process placed a high value on two underlying Lean philosophies: reducing waste while increasing value to the owner. The selected signing partners had to be committed to completing the design and construction on time and under budget while maximizing value through innovation.

When the owner issued the request for proposals to firms that met the criteria stated above, Lean tools such as A3 and Choosing by Advantages (CBA) were used to select the partners. For example, each firm was required to submit their bid in an A3 format, which identifies a problem or need, defines the current situation/state, and develops the goal statement and target state. The format also allows one to perform a root cause analysis, determine countermeasures, create an implementation plan, confirm results, and provide recommendations.

Meanwhile, the CBA process states key factors that are important to the owner and IPD team and identifies the advantage for each firm. The process then ranks those advantages on a 1-100 scale to present a clear picture of which firm represents the top choice. The IPD team determines the ranking as a scale of importance. Cost is still a factor, as it gets its own unique consideration, but it’s not the overriding consideration. Factors are ranked for each firm and totaled to highlight who has the overall advantage. If the scores are the same or close, cost determines the deciding factor.

Some lessons that emerged from the process include:

  • Build trust rapidly to ensure an effective IPD process. The IPD team must act as a high-performing unit, which starts through relationship building and trust. Trust is the cornerstone of the IPD process. You must trust your partners and know that they will have the best interest of the team and client at the forefront of every decision made throughout design and construction.
  • When performing the CBA, make sure a diverse group of people develop and then rank the importance of those factors. Sometimes when an individual is very familiar with the selection process, he/she can overlook factors that are inherent to that trade or scope. Different people with diverse backgrounds can help identify important factors that others may not have viewed as important, which ultimately will help the overall selection process.
  • Similar to performing the CBA process, the A3 process requires a collaborative setting. A3 is a problem-solving tool that requires input from a group of people as opposed to one individual. The more input you can get when trying to solve a problem or make a decision, the better the outcome will be. The A3 process drives collaboration and ensures a concise decision with informed input.


This post is the introduction to a series that will feature various stages of the design and construction of the Union Village health village. Additional posts contributed from Southland Industries and other member partners will highlight aspects of community relations, perspectives from the field, conditions of satisfaction, and much more.

Danny Boh is a project executive at Southland Industries. He can be reached at Ed Miller is a contract executive at Southland Industries. He can be reached at