“Never forget why we are here. We are not here to answer e-mail, create spreadsheets, or prepare reports. We are here to help patients heal.” –Dave Cozier

One of the newer members of COAA’s national board of directors, David R. Cozier, P.E., is the Vice President of Design, Construction and Facilities for the Mount Carmel Health System (MCHS) based in Columbus, Ohio. Mount Carmel is part of the Trinity Health System headquarted in Livonia, MI, and is the 10th-largest health system and the fourth-largest Catholic healthcare system in the country. Dave also serves in a corporate advisory role, working with other hospitals across the Trinity System, which comprises a network of 47 acute-care hospitals, 432 outpatient facilities, 33 long-term care facilities, and numerous home health offices and hospice programs in 10 states. Trinity recently announced a merger with Catholic Health East; the consolidation will create a health system that serves people in 21 states with 82 hospitals as well as 89 continuing-care facilities and home-health and hospice programs.

In his role, Dave works collaboratively with MCHS leaders in developing the organization’s facility infrastructure and master plans, serves as point person for MCHS with construction contractors and developers, manages construction projects, and coordinates all aspects of physical-plant operations and maintenance. Prior to MCHS, which he joined in 2011, he served the Cleveland Clinic as the senior director of Design and Construction from 2007 to 2011. Before the Cleveland Clinic, he held various facilities, construction, and Seabee leadership positions supporting multiple facilities as an active duty Civil Engineer Corps Officer for the U.S. Navy.

A registered engineer, Dave earned a Bachelor of Science in Civil Engineering from New England College in Henniker, NH, and a Master of Science in Construction Management from Purdue University. He is also a graduate of the Executive Management Program at Dartmouth College.

For a host of reasons, the healthcare market that Dave and the MCHS are in is changing, and the future is hardly clear. In this interview, Dave Cozier shares his thoughts and insights about his work with COAA, what he’s doing at MCHS, and what he sees coming on the horizon.

On COAA

Randy Pollock (RP): How long have you been a member of COAA and what prompted you to join?

Dave Cozier (DC): I have been a member of COAA since 2008, and I helped start the Ohio Chapter. I felt that this was a great networking opportunity and a chance to learn from other Owners. Just the process of meeting with other local construction Owners, sharing stories during the chapter start-up process, and hosting early meetings was very beneficial.

RP: How has your involvement with COAA impacted you professionally and personally?

DC: Involvement with COAA has broadened my professional network and opened doors to professional relationships that otherwise would not have occurred. I was new to the Northeast Ohio area, and COAA helped build a broader network among Owners, architects, contractors, and consultants.

Personally, I feel honored to be part of an organization that supports construction Owners. I have also had the opportunity to attend several national COAA conferences (and serve as a presenter), further expanding my network of Owners and associate members across the country. I’ve even been able to renew old friendships with former colleagues through COAA.

RP: How has COAA affected your staff and colleagues at Mount Carmel Health System?

DC: I have been at Mount Carmel Health System for a little over a year now. I have shared many concepts and ideas with my staff, and most have joined but have not yet attended either a local or national COAA meeting due to travel distance and work schedules. I plan to remedy that this year.

RP: What do you hope to bring to COAA as a board member?

DC: I hope to bring my 30 years of experience as a construction/facilities Owner and share ideas, concepts, and local chapter experience. I also bring military and healthcare experience to the group, adding a little more variety to the predominately higher education experience.

RP: What has been the most rewarding aspect of your involvement with COAA at the chapter level?

DC: I have experienced many rewards at the chapter level: building the local network, sharing ideas, helping to plan meetings and learning sessions, participating in those sessions, sharing the excitement of new concepts and ideas among the local construction community.

On trends in facility design for healthcare

RP: Architecturally, what are the most significant changes in the layout or types of spaces you’re providing at Mount Carmel Health System?

DC: Architecturally, we are trying to balance form, function, and appearance with durability and flexibility of space for our patients, visitors, and staff. Recent emphasis has been on creating welcoming and flexible public and lobby spaces, working to reduce the cost of construction, and improving patient satisfaction and care delivery by getting out of semi-private patient rooms.

RP: Sustainability initiatives are becoming increasingly mainstreamed. How has the push for sustainability affected your work at Mount Carmel Health System?

DC: The Mount Carmel Health System has a focus on providing the best possible care for the body, mind, and soul. I have the privilege of being the sustainability champion for the system. Our focus is on the full life-cycle of a facility, not just the initial “splash” of a new building or initiative. We continue to expand our concepts of sustainability, green building, LEED, flexibility, shared use, technology adaptation, cost effectiveness, branding, and maintaining our mission of patient care.

On trends in the construction of healthcare facilities

RP: In terms of project delivery/construction-contracting methods, what are the most significant changes in the execution/ implementation of your projects at Mount Carmel Health System?

DC: Our project delivery methods have remained relatively constant: Design-Bid-Build for smaller projects, and Design Assist GMP CM at-Risk for larger and new construction. I am working on the deliberate staff development process of improving teamwork between all parties and keeping up with technology. We are also beginning an initiative to take BIM from construction to facilities management.

On project delivery methods

RP: Which delivery methods have you employed? Which do you most prefer?

DC: In addition to Design-Bid-Build and CM at-Risk, my experience is that Design-Build has not been frequently used in healthcare, since we Owners change our mind and medical equipment faster than the process allows. I also believe that the local culture, individual staff experience, and finance models influence the delivery methods: the ability to change requires knowledge and shared experience, which is exactly what COAA helps to bring to the individual.

RP: Do you do Integrated Project Delivery (IPD)?

DC: We have not employed IPD at Mount Carmel yet. This is because of the lack of experienced team members in the Owner, A/E, and contractor community. I have personal experience on an IPD “lite” project. Finding the right project and timing also affect the delivery model. Mount Carmel is part of a larger healthcare system, and its corporate and legal/contract experience is limited when it comes to IPD.

RP: Would you suggest IPD for the one-time, first time, or infrequent owner?

DC: I believe that the experience of the project leaders affects the use of IPD. If they have experience, they’ll use it; if no experience, they’ll stay with more traditional methods. Every Owner is different, and IPD needs a champion—one of the team members with experience and belief in its application to drive its implementation.

On working at Mount Carmel Health System

RP: How has the slow economy and funding uncertainty affected your work at Mount Carmel Health System?

DC: The economy and funding availably puts pressure on the local Owner to execute efficiently, effectively, and timely. Access to capital has become more competitive, requiring well thought-out projects, business plans, and detailed planning. We work closely with our strategy and planning teams to identify project needs and planning solutions. Speed-to-market is important in a competitive health care environment.

The other “uncertainty cloud” is the Affordable Care Act and the yet-to-be written policies and reimbursement models. This affects revenue, capital availability, investment strategies, and project workload, so 2014 will be an interesting year.

RP: Do you feel any need to emphasize “buying local/ regional”?

DC: Most definitely. Our preference is to keep the money and the service local. Utilizing the services of local firms is important for the community impact of the organization, branding, business reputation, and keeping the local economy strong. We do use national firms, but we encourage teaming with local firms, for both economic and responsiveness reasons. We also participate in a supplier diversity program and encourage development of start-up and diverse firms.

RP: In your position at Mount Carmel Health System, you have facilities, design, and construction reporting to you. Given this, have you been able to smooth the transition between these groups and help them work together in more friendly/ productive manner?

DC: Having personally worked on both sides of the facilities and construction “wall,” I have experienced the banter and impact of a divided team. I am constantly working on tearing down the wall and keeping the communication flowing. Our project managers are physically housed in the local hospital facilities’ offices and live the day-to-day activities of the collective organization. We co-develop standards for finishes, utilities, and equipment. We include the facilities team in the project planning and design process. Facilities also participates in project tours, inspections, and close-out activities, ensuring an “ownership” role in the project.

RP: In the current marketplace, the number of firms pursuing a given opportunity with an institutional client has skyrocketed. How would you advise these firms to differentiate themselves to stand out from competitors?

DC: As a private Owner, we can choose the delivery model and firms that we work with. Maintaining a positive relationship with the construction and design community is very important. I host an average of four firms per week in my office. Strong ethics, experience (staff and project), quality, dependability (do what you say), and cost competitiveness are the focus areas. We tend not to have claims; they won’t work for us again if the relationship degrades to a claim position. We are an engaged Owner and are firm but fair. The successful firms build and maintain the long-term relationship focus.

On trends that are impacting the future of Mount Carmel Health System

RP: What current trends are most impacting the future of your work at Mount Carmel Health System?

DC: There are many trends that impact our future: uncertainty of the Affordable Care Act, local market pressure and competition, patient satisfaction, providing and maintaining high-quality facilities, access to capital, parent/corporate policies and mergers, local economic stability and vendor stability, cost of materials, and sustaining the workforce

RP: In conclusion, do you have anything you’d like to add?

DC: I personally get a lot of satisfaction out of the construction process. It feels good to complete a project and bring “life” to the facility. I like driving by the buildings and reflecting, “I had a part of that.”

A member of COAA’s Communications/Editorial Committee since 2010, Randle Pollock is regional director for HDR Architecture (www.hdrinc.com). Based in Houston, TX, Randy can be reached at 713-335-1949 and randle.pollock@hdrinc.com.