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42 Medical Construction & Design | M AY/ J U N E 2015 | MCDM AG.COM more traditional linear Design-Bid-Build delivery method. As the customary delivery system that has been emplo yed in the construction industry for much of the 20 th century, Design-Bid-Build is the three-party paradigm where the owner contracts separately with both a designer and a constructor. The process becomes very linear and prototypically fragmented with sequential design, procurement and then construction. There is very little interaction among the contracted parties, usually resulting in increased errors, disputes, higher costs and ultimately longer schedules. This silo-based approach has led owners to gravitate toward a more Integrated Project Delivery with a single point of responsibility and a more enhanced predictability of outcome. The process ensures the owner receives a well-designed project, on time, on budget and litigation free. Its basis is collaboration — where design, construction and budget decisions are made by a team of architects, engineers, estimators, construction managers and trade subcontractors. Digging deep for design solutions On the AHN Wexford Health + Wellness Pavilion, CannonDesign began the project by using a design research process developed to dig deeply into the needs of the owner, tenant, staf and others. This essential information was then passed along to the architects and engineers as they began the design process. The goal was to develop more than one solution to give the end-users the benefit of selecting a design concept that best suited their needs. Once the design alternatives were developed, a meeting was held with the internal staff of architects, engineers, cost estimators, construction managers and construction superintendents together with outside trade subcontractors, to begin the estimating process and develop construction alternatives. These alternatives were not just explored for the ability to reduce cost, but also for a consistency with the architectural and engineering design intent. Once the first estimate was completed, it was evaluated against the owner's budget and then discussed with its representatives to identif y ways in which the costs could be reduced, if needed. Once it was determined that the project was within budget, a "not- to-exceed" contract was developed with the owner, which included the option of bidding the project with incomplete drawings and 100 percent scope narratives, enabling the firm to choose the apparent low bidders to work with the AE staff to jointly complete the drawings before construction began. The contract also included a construction schedule and a surety bond.