Creating a multi-use building for a research center: a management and operations case study and critique.

The human resources (HR) representative would seek to unite the previously separate cultures and numerous sub-cultures, and build common HR practices among the occupants of the building. The HR representative set out to establish and implement measurable performance standards, tie performance standards to business objectives and operational efficiencies, identify reward and recognition mechanisms for various levels of performance, and tie these rewards and recognition systems to business results (US Office of Personnel Management, 2001). Techniques to facilitate the cultural assimilation process included cultural and needs assessments, cross-sectional work groups, employee orientation resources, focus groups, town hall-type forums, and the development of communication models to build and sustain participation and excitement.

The facilities representative focused on the timeframe and implementation sequence, space assignment issues, move logistics, and coordination of move-in services.

The operating policies representative worked to develop a cancer center building manual that would establish a set of shared operating principles for all areas of the facility and address central building services, including security, waste disposal, and parking.

Finally, the financial planning and management representative sought to identify the costs to meet, the financial targets for debt reduction, and financial strategies and projections for ensuring adequate revenues through a combination of grant award and patient revenue, philanthropy, and auxiliary services. Models for debt reduction, developed using Microsoft Excel spreadsheets, were based on varying dollars per square foot, different levels of occupancy until full building occupancy was achieved, and other variances, such as the fluctuating grant revenue of occupants once space was granted.

A cross-section of the cancer center population, including occupants from different locations, sub-cultures, and programs, was invited to participate in functional work groups. All participants were notified that active involvement would be required to achieve established objectives. The functional work groups met weekly; the Managers' Workgroup met monthly initially and bi-monthly thereafter. Sharing among the groups was essential to the planning process, as many areas that appeared separate were actually connected, either operationally or logistically. To keep leadership and other functional work groups apprised of initiatives and objectives, timelines, and progress, reports were developed for each area of the Managers' Workgroup. Cancer center administrative consultants from institutions throughout the nation who had engaged in similar large-scale construction programs and transitions to multi-use buildings were invited to share their experiences with the Managers' Workgroup. Consultant review of progress reports, building specifications, and agenda topics provided valuable information that would aid in the planning process.

Communication as the Key to Change

Communication was instrumental to the success of this endeavor, particularly in creating and sustaining excitement for and "ownership" of an entity both unknown to and larger than most cancer center employees were accustomed to. Consequently, one of the first actions was to add a transitions page to the cancer center's website at http://cancer. ucsd.edu. This page was designed by various Managers' Workgroup participants, built by the IT Director, and managed by the Member Relations Analyst. It was populated with photos of the evolving construction site, including a continuous real-time videocast, information on the project and proposed guidelines for operations, and a forum for suggestions and questions. To keep the UCSD community advised of progress and policies for occupancy, the site also included a new Space Management Policy and Application Form, floor plans of the facility to aid navigation and help occupants familiarize themselves with their new home, and a variety of occupant-related general information resources. Communication among a physically dispersed faculty, formerly transmitted via paper, e-mail and phone, now traveled the information highway of the cancer center's Intranet, ONcLINE. Proven effective approaches to improve communication, as established by Goodman, Cabral, Nemcek, and Powers (1996), included: (1) minimizing the impact of geographic separation on administrative services; (2) connecting personnel electronically; (3) developing compatible computer systems; (4) sharing common information, and (5) planning collectively.

To enhance cross-communication and help ensure the success of clinical operations, the Managers' Workgroup, which included a representative from both the medical school Dean's office and the Medical Center, actively participated in the transition planning meetings with a parallel medical center group comprised of specialists in various service and activity areas.

Flexibility and focus were invaluable to the success of this venture. Due to transitioning workforce members, fluctuating demands and unanticipated challenges, priorities evolved and efforts were refocused on addressing emerging issues and resolving unexpected problems. While planning oversight was under the auspices of the Associate Director for Administration in collaboration with the Director, the day-to-day planning and actualization of the transition were carried out by cancer center staff members through a combination of overtime, work reassignment and adjusted priorities. As no external consultants or additional personnel were hired to oversee the project and its many details, this responsibility was assumed by the HR Manager and the facilities representative, who became integral to the process.

As the construction project evolved and the transition planning and timeline progressed, issues required continuous attention: construction change orders; space usage, assignment, and occupants; security system and food service vendors; furniture selections and configurations for public, shared and office spaces; interior and exterior signage; parking for patients, visitors, staff, and faculty; operational details including telecommunications, copier and mail services, shipping and receiving; facilities maintenance; housekeeping;, safety and fire code compliance; meeting room and public venues management, and publicity and events. Consequently, it was sometimes necessary to postpone planned initiatives to address issues requiring immediate attention.

Because space assignment was a Cancer Center senior leadership function, a Space Advisory Committee (SAC) was appointed by the Director in December 2003, with representation from members of the Manager's Workgroup (including the chair).

The Managers' Workgroup performed exceptionally. Despite changing priorities and challenges, workgroup participants not only made significant progress and contributions to their early objectives and initiatives, but also resolved a plethora of issues that would otherwise have been addressed by external consultants. This group also effectively navigated the university systems, working closely with such key offices as the Health Sciences Dean's Office, Facilities Design and Construction, and Real Estate Development. While benefiting from "in house" knowledge and expertise, the project management approach involved higher risk, as responsibility rested with a few key employees. For example, had the HR Manager or the facilities representative been unable to continue in their roles, the transition would have been compromised. Any institution preparing for such a large-scale project should assess the availability, benefits and drawbacks of internal and external resources.

More difficult than other objectives was the task of merging the medical school and medical center cultures. Turf disputes, policies and priorities regularly interfered with movement toward a unified cancer center organization. Programmed organizational and individual change management was considered key to the overall effort to transform the cancer center from a widely dispersed setting to a physical site with integrated, coordinated systems for translational research and optimal patient care. The Deputy Director for Clinical Oncology/Medical Director successfully forged new working relationships.

By mid-2004, the work of the Managers' Workgroup was turning increasingly to plans for occupancy. With new leadership, the vision for the building was changing. A former focus on the biological aspects of cancer was modified to allow for a greater emphasis on the chemistry and pharmacology surrounding experimental therapeutics. UCSD and San Diego are well-recognized sites of groundbreaking biotechnology, and the building is a natural setting to bring these strengths to bear on curing cancer. At a cost of $483,000, a number of lab bays were retrofitted to triple the number of chemical hoods. Priority recruitments targeted accomplished and promising lab scientists in drug discovery and design, while also seeking clinicians committed to advancing cancer treatment via investigator-initiated trials emanating from a cancer center lab and ending in the clinic.

Space Metrics and Management