By Michael Durand / Special to Healthcare Facilities Today

Better project outcomes result from decisiveness when developing the RFP. So, why do some RFPs ultimately lack quality information? This question deserves an answer because the quality of the proposal from an architecture and engineering firm will be in direct proportion to the quality of the RFP.

When the RFP leaves the proposing A/E firm guessing about the true objective of the project, the proposing firm has no clear indication of how best to align expectations of their services in response. It is more advantageous if the request document states the problem and explains how the proposed project fits into the client’s bigger picture. If it includes key pieces of information, it will elicit an informed, sophisticated proposal and give the client an opportunity to select the best-qualified A/E firm for the project.

Ultimately, better project outcomes result from taking a few insightful steps at the beginning of the RFP process.  Here’s how.

1. Defining the objective: Context and prioritizing

In the RFP, the client should clearly define the reason for the project to A/E firms.  This means putting its description into context and including the drivers behind it. Is the project driven by operations, market conditions, or in direct response to competition? Does the project make sense with respect to changes in reimbursement mechanisms brought on by the Affordable Care Act? These factors, although they may not seem relevant for the A/E to receive, provide valuable insights on how the A/E can support the client. With this information, the A/E can align itself as a valuable partner on the project rather than a passive service provider.

Consider an example, where speed to market was a top priority.  In a recent healthcare project, the provider aimed to convert a space that was vacated by the Oncology Department.  The project description was simply to convert vacated space into clinical exam rooms. Without any additional information, the project team anticipated that the bid should highlight interior design and potentially space programming. After the bid was awarded, it became clear during the schematic design phase, that the adjacent clinical space was causing a  bottleneck in operational flow, expanding patient wait times. Adding new clinical exam rooms would allow the provider to increase the ratio of exam rooms to physicians and improve throughput efficiencies. Time was of the essence.

 If this challenge had appeared in the RFP, the bidding firm could have better focused on its fast-track design process and improved the provider’s primary objective: speed to market.

There are several strategies providers can use to better prepare an RFP to meet its primary project objectives.  

 Involve a cross-section of internal personnel. Before the RFP is issued, bring the clinical staff and facilities people into the process. Make sure the scope of work encompasses their concerns that are specific to this area of the building. It could influence the estimated cost of the project. For example, the facilities people may know that the useful life of the air conditioning unit has expired. If the budget is already fixed, leaders might have to reduce scope in other areas. This would give the leaders an opportunity to prioritize exactly what scope of work will remain in the project and to avoid misaligning scope with undiscovered costs.

Involve subcontractors.  More and more frequently, hospitals are retaining ongoing relationships with subcontractors in who are familiar with their facility. They can provide valuable design input and assume single-source responsibility for their specific scope of the project. Their intimate knowledge of the facility can make a more precise work order possible.

Risk management is a critical factor. In some cases, the remediation of aging infrastructure in a hospital may compete for the same capital budget dollars as a less critical interior renovation project. Unfortunately, the voice of the maintenance department for that infrastructure project may be trumped by the agenda of physicians or the marketing department to update the aesthetics of a revenue generating space that patients utilize. In a calculated RFP process, components such as infrastructure upgrades do get consideration in the annual project priorities, which gives facilities people a louder voice.

The RFP should go a step beyond providing technical requirements and include budget as well as scope considerations.

2. Construction budget

Including the construction budget will give the bidders an opportunity to align the scope of work with projected costs. The owner receives a more accurate fee for professional A/E services, and discrepancies between the owner and selected A/E are minimized because expectations of project costs and design parameters are known up front.

Many RFPs require the A/E to design within the construction budget. The A/E responds with its opinion of scope of work against construction budget.

Consider another scenario: One RFP called for an extensive gut and renovation of a 22,000 sf two-story facility. During the A/E bid process, it was discovered that the project budget did not cover several key items—like window replacement—that were identified in the project scope of work. The owner remedied the discrepancy during the bidding process, and alignment of project budget with scope of work was rectified prior to design and construction, when such a discrepancy could have seriously impacted the project.

If the RFP doesn’t ask for a service, how can the consultant put it in the bid and remain competitive? For example, if one A/E’s bid includes a comprehensive checklist to obtain available documents and interview facility maintenance staff, and another A/E’s bid shortcuts this process and simply relies on the information sent by the client, the former bidder may not be price competitive. The client who decides to work with the low bidder only learns of this shortfall after the fact.

The RFP should address a realistic allocation of funds: Look at where the money is being spent and where it needs to be spent. For example, a small critical-access hospital had a daily patient census well below the available number of beds, and it wanted to convert to all private patient rooms for their 25-bed facility. Since this was not possible within budget constraints, the team decided to right-size the project to align more with daily census rather than with the number of rooms. Leaders renovated and provided 12 private rooms in front, which gave the hospital a new facade and a new image. The remaining semi-private rooms could still function as private rooms simply by removing one of the beds from each. Thus, the facility ended up transforming its image with all private rooms at a fraction of the cost.

In addition to project objectives and budget/scope issues, a decisive planning process anticipates the project launch. 

3. Planning to plan: Discovery and evaluation

Consider the RFP as a communications tool and precursor to the project kick-off meeting for the A/E firm, as well as for  internal stakeholders. The RFP sets the direction from which the A/E will begin their engagement with the healthcare project stakeholders. If left to interpret the language of a vague RFP, client stakeholders may take over the original project intent by contributing their interpretation of project priorities, which  may differ from the RFP. With a guideline to channel these initial discussions, project scope can remain in alignment with plans from a very early stage. The discussions set the trajectory of the project. Without proper alignment amongst internal stakeholders, the misalignments will be magnified as the project moves forward and could significantly impact project execution. 

Set parameters for what is expected of the A/E during all phases of the project, and be specific.  Otherwise, leaders can be uncertain as to what level of services they are buying. More often than not, the RFP is a low-price competitive process. If the RFP clearly states the level of services expected, then justification to go with low bid is valid. Ask for specific details from the proposing firm.

Proposing responders should provide a detailed work plan that outlines their approach to the project in the RFP. Tell them specifically what should be included in the work plan. When interviewing a firm, request specific examples that have been successful on other projects that may be applicable to this project. How does the A/E firm develop their product – CAD or BIM?  Is the project a good candidate for BIM? There are industry standards for the level of detail required in the BIM product that can be specified in the RFP.

4. Evaluation

Finally, what level of field investigation is called for in the RFP?

Consider an additional example. When upgrading for an addition, it was determined in the RFP that a limited amount of rework was needed for the electrical/power systems. Then, later in the design process, it was discovered by the contractor that one of the main breakers (outside of the project scope) dated back to 1950’s or 1960’s. Preventive maintenance on that breaker and others had not continued. The manufacturer had gone out of business, and the existing equipment needed to be replaced, causing added costs and a time delay to the project. If the level of field investigation had been outlined in the proposal, this construction delay, caused by waiting for the replacement parts to be ordered and delivered, could have been avoided.

Decisive decisions

When the client invests decisive thought in the RFP, it gives the A&E team an opportunity to validate what it is trying to achieve. While each project is different, what does not change is the insight that more communications and decisive development of the RFP are absolutely indispensable to launch a successful project.

Michael Durand, PE, LEED AP, is Director of Healthcare with Ghafari Associates.  He can be reached at mdurand@ghafari.com or 313.436.8614.