Oregon Health and Science University’s (OHSU) Design and Construction department (known as DesCon) consists of a group of more than 40 individuals. Located in Portland, OHSU is an academic medical center with more than 14,000 employees. Spread over multiple campuses, OHSU provides the state’s most comprehensive healthcare services, along with educating the next generation of clinicians and researchers. This combination of healing, teaching, and discovery leads to amazing breakthroughs and innovations that revolutionize the healthcare industry. Complimenting the drive for constant innovation, DesCon employs project leads, certified safety professionals, registered architects, construction inspectors, and office-support services to deliver capital projects, which range from small-office reconfigures to ground-up new facilities.

Over the past four years, the DesCon department has gone through intense and dramatic change by enhancing nearly every aspect of its business practices, processes, and culture. Through persistent effort and application, the department has evolved into a highly driven, engaged, and dedicated team that’s truly determined to improve the design and construction industry. People often ask what our recipe for success is—the reality is it’s simply hard work, dedication, and focus.

When we talk about why we take pride in what we do, it’s quite simple: we’re changing the construction project delivery experience. Every person who has been involved with capital construction likely has a story about a project that cost more than anticipated, took longer than expected, and it didn’t quite come out the way it was planned. DesCon is dedicated to changing this experience.

In order to bring about such change, our department engaged in four key practices: driving leadership, investing in culture, developing project management skill sets, and building relationships.

Driving Leadership

Leadership can be defined simply as taking a group of people from point A to point B. At its core, leadership is very simple. However, you first have to define point B, or where you want to end up. For DesCon, we wanted to be one of the best capital construction departments in the country. When the four members of the DesCon Leadership Team set this vision over three years ago, it was received with mixed feelings. A few people agreed, many were skeptical, and others believed the goal was too far-fetched. We did not seek consensus when creating this vision; instead, the Leadership Team declared an ambitious goal and invited members of the department to join them in the journey.

With the vision set, the DesCon Leadership Team had to figure out what it would take to successfully move the group from point A to B, including getting those with a “wait and see” attitude to become fully engaged. We had to be intentional and direct by setting, holding, and reinforcing our course. The department recognized that the project leads must have a true sense of ownership in their work. Along with owning the project, persistence was crucial in theory and practice to ensure this new understanding would survive and be supported by an unwavering vision. The push for continuous improvement includes constantly changing processes and procedures in order to step away from the status quo.

Enhancing the process for executing RFPs, defining what is measured, and recognizing achievement are all crucial elements to maintaining this vision. Determining how client success criteria are captured before, during, and after the project is delivered enables the client to feel emotionally tied to both the process and end result, which ultimately creates a true relationship.

We had to seek feedback—internal and external—to allow us to continually compare our perception of reality to those around us. One specific approach in this regard was the creation of our Vendor Scorecard Program, which applies to all of our architects and contractors. Every quarter, a survey goes out to our vendors, internal DesCon staff, and key stakeholders within OHSU, and it solicits answers to questions about each vendor’s performance. We collate these responses and then add trending data from our PMIS system to compile a report. This report is then reviewed in a face-to-face meeting of DesCon’s leadership team and the vendor. We spend an hour discussing issues, the survey results, and any other topics brought forward by the participants.

This dedicated effort builds trust by promoting an environment where open feedback is encouraged to identify and review processes, procedures, people, and business practices that are not adding value. Investing in this process creates a solid foundation upon which trust can thrive and the “real” issues (often the most important but the hardest to talk about) are discussed in the open.

Leadership is difficult. Indeed, setting a vision while being intentional in all that you do can be a recipe for failing publicly. Possessing tenacity, knowing when to push/pull/steer, and celebrating with recognition are essential for retaining the vision. Staying true to the process is extremely rewarding.

Investing in Culture

The most significant aspect of a group of people is its culture. Culture is viewed three ways: the culture you think you have, the culture you actually have, and the culture people on the outside see. One of the biggest challenges we faced was aligning these three views. We set forth to define our culture with values of growth, education, recognition, and ownership.

Dedication to growth and education has become a staple in our department. Holding weekly one-hour, drop-in training sessions, with topics driven by the department (not management), empowers team members to take ownership of their professional development. These sessions are led by multiple parties, including department staff, leadership teams, outside departments, campus vendors, and even outside consultants. Over the last three years, these open sessions encouraged the staff to drop in and participate jointly with colleagues to continue growing and advancing the cultural values.

The outcome of these successful weekly trainings has prompted the leadership team to establish three core values and align those three values with corresponding behaviors. The three values are Relationships, Humility, and Results (see sidebar). As those three words are very large concepts, we crafted 3-4 sentences each that articulated what behaviors demonstrate those values in practice. The values are reinforced through recognition, incentives, and even in the hiring and on-boarding processes. In addition to immersing the entire department – including new hires – in cultural understanding, each member reads the book Getting Naked by Patrick Lencioni within the first 30 days of their start date.

After reading the book, the employee gives a book report to the DesCon Director, which helps the employee retain key information. The book report also allows the employee to comment directly and with candor, and from there, the director relates the department’s key expectations and connects them with the book’s concepts on vulnerability. Since the department is essentially a professional services firm within a large organization, we connect very well to the three fears and twelve principles outlined in the book. Continually seeking reinforcement of the principles within the department sets a foundation to spread this knowledge outside of the department.

Culture is the most important and challenging aspect for any organization. By focusing on a culture of true vulnerability, candor, attitude, leadership, and adaptability, we’re able to truly collaborate. This communicates a willingness to genuinely improve and continuously adapt.

Developing Project Management Skill Sets

To develop project management skill sets, our department selects a project management philosophy, and focuses on learning its basics. In organizations around the country—from private to public, large to small—the range of skill sets, backgrounds, and experiences of people involved with delivering projects is tremendous. People from all walks of life manage projects, and since personalities have yet to be standardized, every project is delivered differently.

With this in mind, the focus is turned to acknowledging and then striving to balance both the art and science of project delivery. For example, within DesCon team members come from a variety of backgrounds and experiences, such as architecture, construction management, interior design, and many more. We invest in training at the department and individual level to hone in on the strengths and value each member brings to the table. We provided formal training from CMAA and PMI, department-wide workshops for Lean tools including Target Value Design, and continue to seek value driven training opportunities including COAA OTI courses. When it comes to project delivery, these educational events allowed us to begin speaking the same language.

Our next step was to standardize DesCon’s method of project delivery. Incorporating good information, techniques, and approaches from the two methodologies, we found a way to establish the phases of a project and outline what we expect out of each phase. This leaves an open-ended forum for the particulars of project needs to determine “how” to accomplish the overall goal. This allows for a very agile breadth of delivery methods, including CMGC and IPD.

By having defined phases and outcomes and allowing the phases to blend, the project leads have the opportunity to determine how to achieve the goals of each phase, which demonstrates the balance of both flexible and rigid natures the methodology celebrates. The project team is given the power to find the best approach to accomplish the goals set for each unique scenario.

This process requires a large amount of trust and empowerment in your employees. Senior leaders often seek control by dictating procedure and intensely prescribing means and methods to achieve results. The opposite of this logic has proven true: state the desired outcome that addresses how each project will change the world, and trust the project’s leaders to deliver.

Building Relationships

Creating and maintaining relationships only strengthens the core mission of any department. To be successful within DesCon, one must be able to recognize the importance of keeping true to relationship proprietorship. Viewing the world as a place full of people who at their core are all trying to do the right thing is very challenging, especially at work. In the business environment, we’re often taught to position ourselves as the center of the universe, but the DesCon team seeks to make others successful.

One key aspect of making others successful is to dissolve the chain of command within the department. Moving to a vulnerability-based organization allows people to be open and honest with each other about themselves, their interactions, and their problems and concerns about others.

Imagine a workplace where all employees are free to question and constructively criticize each other, without fear of ramification or retribution. When the employees exercise this freedom, the typical response is, “That’s interesting—tell me more.” Fostering this type of environment is an achievable reality and one of the key elements in building successful relationships. This is also one of the most difficult aspects of driving culture.

Maintenance of relationships within the department is just as critical as the communication and interaction with outside entities. Every group that provides design and construction services within the organization can relate to internal challenges with IT, financial services, and facilities, among other issues. By recognizing these challenges and approaching them with enthusiasm, employees are provided with a basis to understand their view of the world.

This systematic and patient process slowly build’s trust and relationships, which impact our business in ways beyond what we could have imagined. Some of the parties involved took months—and in some cases, years—to develop even the smallest amount of trust. Every relationship must be constantly maintained in order to keep the relationship strong and healthy.

Results—And What’s Next

The results of this massive effort developed trust, clear direction, and cohesion of the leadership team. In once instance, the process empowered a project team to fully understand an internal client-prescribed solution, and this allowed the team to deliver that client a very different project solution that produced significant savings.

Empowerment through department initiatives as well as in individual projects produces amazing results due to superior employee engagement. It’s not enough to have great PMs; you need a great culture within your department to work hand in hand with great project leaders.

Inspiration of people and the organization creates an inspirational environment and energized culture. People’s accountability is held to the highest regard, which promotes ownership and excitement on a daily basis. Humility is a common value in our organization, and this compliments the drive to make the construction project delivery experience exceptional.

On the surface, it may seem like we have it all figured out, but the truth is, we tried many solutions, and most of them didn’t quite work the first time —only a few actually initially succeeded. Most often we find ourselves taking ideas, trying, and either adjusting or killing the idea and moving on to the next. We’ve found that a winning culture is created by successfully dealing with attempt after attempt, and being accepting if an idea doesn’t work as well as working on it until you find a solution that works.

The next step in our evolution involves building on the ideas and strategies put forth in Patrick Lencioni’s book The Advantage. We’ve put in the difficult work of defining why we exist, what we do, how we behave, and identifying the most important focus for our department’s leadership. The dedication of time, effort, and discipline to repeat these messages diligently connects performance with the success of projects and people. This will allow us to formally incorporate the department’s culture into each and every project, while recognizing how far we’ve come. The road to the ultimate goal is long, but the tenacity and perseverance of our team will only bolster the ever-evolving success of OHSU’s Design and Construction department.


Results: This person achieves results by influencing and inspiring people to deliver. Their focus is on the team objective, and they focus others toward that objective. This person freely provides recognition and praise for the results of others. They hold themselves and others accountable. They contribute to the success achieved by the team as a team. They are an integral part of the team collective, throughout the entire lifecycle of any project or effort.

Relationships: This person builds, maintains, and values healthy relationships in their professional interactions. They appreciate the power of making others successful. This person values the contributions that others make and recognizes them for their effort. They first seek to understand, before seeking to be understood. This person builds and maintains relationships within DesCon, OHSU, and outside of OHSU.

Humility: This person is more concerned about others than themselves. No task is beneath them. This person performs their work with confidence, balanced with seeking, utilizing and appreciating those around them. This person puts the work first, ahead of personal goals. They are a door at which criticism stops while being a window from which praise flows through to others.


About the Authors

Kyle Majchrowski is currently Director of Design and Construction at Oregon Health Science University, an academic medical center located in Portland, OR. Kyle continues his journey on learning, trying, and implementing collaborative project delivery.

Mike Buckiewicz is currently an Associate Project Manager in Design and Construction. He is a part of the Knight Cancer Research Building, a 300,000 square foot research facility being delivered in Integrated Project Delivery (IPD) methodology.