Originally posted Monday, 10 October 2011
Written by Randle Pollock
COAA’s Newest Member of the Board of Directors
The newest member of COAA’s Board of Directors is Susan Lipka, Associate Vice President, Capital Planning and Management, The University of Texas M.D. Anderson Cancer Center in Houston, Texas— which has ranked Number 1 in cancer care for seven of the past nine years in the annual survey published by U.S. News & World Report. Recently, I had a chance to sit down with her to learn more about her remarkable leadership in the design and construction industry. At MD Anderson, she oversees more than 14 million square feet of facilities space. Over the next five years, she and her team will manage $2.4 billion in active projects.
As an Owner, she has been busy building the last ten years, delivering all kinds of projects, using technology and delivery methods that advance the industry, pushing the envelope in design, engineering, and technology, and building capacity along with world-renowned expertise.
But things are different now, for a host of reasons. The healthcare and medical research markets are changing. What they will look like and what kind of facilities will be needed in the future is hardly clear. Asked to look forward, Susan Lipka shared her thoughts and insights about what’s going on, what she’s doing at MD Anderson—and what she sees on the horizon.
On trends that are impacting the future of your organization
Randy Pollock (RP): What demographic trends are you seeing that are impacting your plans?
Susan Lipka (SL): The challenge is designing space for generational differences. There are those who didn’t have electronic devices, social media, or the Internet when they started their careers versus those who are quite savvy with technology. Technology has changed our behavior and expectations on having ready access to everything. How are we going to design buildings that promote social interaction and use of everevolving technology?
We have always designed buildings to be physically adaptable and flexible. I don’t think, however, that buildings have focused adequately on the need for social spaces or options to promote communication among the occupants.
RP: On the one hand, you are seeing more IT infrastructure included in buildings to accommodate higher demand and higher volumes of traffic. On the other hand, do you have a sense of the researcher or physician of the future and what he or she will be doing in five or ten years?
SL: My crystal ball is three years. We’ve seen numerous changes. We used to have one computer monitor. Now we have multi-computer screens on individual work surfaces. Researches are linked around the world and use the technology to video-conference and share information around the clock.
On trends in the design of healthcare and research facilities
RP: Architecturally, what are the most significant changes in the layout or the types of spaces you will be providing for researchers and physicians of the future?
SL: The need to accommodate and support collaboration is significant. We have open labs to promote collaboration, and other informal areas for gathering. It used to be the coffee pot or the kitchen in your home. Now it’s creating those spaces along the continuum for the clinician and the researcher that allows for interaction and exchange of ideas.
The old concept of an individual office is changing with much more open environments. I think that has a lot to do with the social networking. Having a private office is no longer a status symbol to the technologically savvy generation. Now they are in an open environment. That’s the biggest change in facilities that’s come about.
RP: Sustainability initiatives and planning concepts such as “hoteling” are becoming increasingly mainstreamed. Are you are also seeing that in your world?
SL: Yes, regarding hoteling, we’ve done that with our fellows, residents, and interns. They have a space to land; open space is there. We call it a “hot desk.” You are not assigned to that and use whichever one is open. There is a locker for personal things and a computer.
Regarding sustainability: human beings are affected by light, or should I say the lack of light, so we are trying to promote thinner buildings to allow daylight in, glass-front offices to bring light into the core, and daylight harvesting systems to promote a better built environment.
On the uncertainty in the healthcare industry RP: What about the uncertainty that seems to be gripping the healthcare industry?
SL: The issue for us is what’s going to be the funding mechanism. There is an aging population and a higher number of people getting cancer. Certainly the volume is there. How will they be treated and paid for—not only at MD Anderson, but across the country? Along with heart disease, they are the two leading causes of death in this country and it is very expensive.
RP: What’s on the horizon for you?
SL: We have slowed down our building projects, not knowing how healthcare reform is going to affect us—both with our new research building and a new clinical building. We have not stopped, but we are much more cautious.
On what you are doing now
RP: Given what’s been going on with funding uncertainty, instead of building, are you doing more planning?
SL: We are doing a lot of scenario planning. We are a large recipient of National Cancer Institute funding. On the research side, philanthropy has been generous with us. So we are looking at different reimbursement scenarios, what happens to your business, whether it’s on the down side or the up side, and then looking at the population out there. We have been working on developing a model to project space with all of the downstream activity.
If you are a cancer patient here, and you come in the breast center, I can tell you all the diagnostic tests all the lab work and treatments you will typically need. We can track that for every patient and are developing a model for projecting space needs, not only in the clinical areas but also in the support areas, and the capital needed to support that growth.
We are also looking at what happens at the “mother ship,” as well as at our regional care centers.
On whether the economic downturn is causing pressure to “buy local” for professional services
RP: Do you feel any need to emphasize “buying local”?
SL: We always look for “best value.” I am fortunate to be in a very large city—the fourth largest in the country. There are many well-known, respected A&E firms here. So when we put out a request, we are looking for the best.
For example, when we put out an RFQ for a high-rise research building, we were interested in designs for cuttingedge research facilities, not only in technology but also in the affiliation with patient care in an academic medical center. What was the state-of-the-art building without being on the bloody edge? Same thing goes for contractors. What’s the best value?
On alternative delivery methods
RP: All the delivery methods are out there, and MD Anderson has employed some, including designbuild. Do you do Integrated Project Delivery (IPD)?
SL: Legally, in Texas, I can’t do IPD, due to the legislation. In addition, I don’t think it has matured yet between the design and subcontracting community, but it is getting some traction around the country.
A member of COAA’s Communications/Editorial Committee, Randle Pollock is regional director for HDR Architecture (www.hdrinc.com). Based in Princeton, NJ, Randy can be reached at 609.791.7439 and firstname.lastname@example.org.