Kari-Pekka Tampio: Target Value Design for the Hospital of the Future

Future Hospital OYS 2030 is a development program that aims to radically modernize the facilities of Oulu University Hospital. To Kari-Pekka Tampio, the Program Director, lean construction is not just a theory but the only feasible way to build for the future.

The Oulu University Hospital facilities were completed in the 1970s. Since then, operational models and technologies have leapfrogged and the old buildings have become outdated. The extensive development program aims at increased productivity and more efficient operations. Increased flexibility, standardization of facilities and operations, use of information technology, and employment of renewable energy are some of the ways to achieve these goals.

Tampio assumed his present position four-and-a-half years ago and built the program organization from scratch. Today, they have a dozen or so experts in the office and over 100 on design teams. The unit is responsible for program development, concept planning, and construction on the hospital campus. So far, they’ve completed small projects, and major new construction is on its way.

“Operational development and reduction of process waste are at the heart of the hospital world,” says Tampio. “We begin with operational design and then move on to the design of physical facilities.” Value-stream mapping is an everyday tool in the program office, as is “Kaizen,” or continuous improvement.

Target Value Design

Target Value Design, TVD, is near to Tampio’s heart. He has studied it extensively and sought advice from Glenn Ballard, a leading U.S. authority in the field. To Tampio, TVD is more than a cost-reduction tactic. He sees TVD as an overarching principle that considers not only construction costs, but the whole life cycle of a facility, including operability.

The program office uses the IPD model in their construction projects. On their first project, right after goal-setting, they called in designers. Later, the contractor joined the alliance and started collaborating with the designers on solutions that would meet constructability and operational requirements. Subcontractors also joined early. This approach has improved confidence in the decision-making on the project, especially relating to foundations, the building frame, and HVAC installations.

A big advantage of lean over a traditional construction project is that design solutions are not finalized before bidding. Designers are not allowed to deliver too early even during construction. Last Planner Sessions (LPS) set the pace for designers. “We hold weekly meetings where we plan the objectives for the week and for the near future, and reflect on the previous week’s achievements,” Tampio explains.

Lessons Learned

“Now that we are in the construction phase [of the Oulu University Hospital project], I can admit that we could have calculated the risk and reward levels in a smarter way. We ended up using traditional risk reserve percentages,” Tampio expresses with regret. “To fix that, we’ve decided to revisit some earlier design choices before making the final decisions.”

Tampio says that for upcoming projects he’s considering involving both designers and contractors from day one. Early integration is a key component of success for such a demanding project.

In hospital construction, change is the only constant. Technologies can become obsolete during a four-year construction period. Being able to design and build flexibly maximizes the value potential of the end product.

“There’s still a lot to do when it comes to lean in Finnish design and construction. I’m eager to share and develop my knowledge. We’ve been a partner in the national construction productivity project, IPT, since 2014,” says Tampio. He’s happy that Finnish clients are beginning to understand the value of lean construction. They need to commit to using lean principles, eliminating waste, and maximizing customer value.

Open, collaborative development has borne fruit. “In just a few years, we’ve been able to make Finland number one in lean construction in Europe,” Tampio concludes.