Executive Summary

UCSF, jack of all trades. 
The organization of UCSF Mt. Zion Outpatient Cancer Center project is unique because UCSF is the owner, developer, general contractor, and end user. As the developer, client, and user of the project, UCSF came to the table knowing the programming aspects of the project in terms of types of spaces they wanted/needed, as well as a particular atmosphere they wanted to create for both their patients/visitors and their employees. We investigated how this organizational structure made a better building, but also slowed down the process.

Collaboration
UCSF organized collaboration with doctors, scientists, and administration from the very earliest programming phase to fully capture and realize their vision. There was also a rigorous collaboration between UCSF, Smith Group Architects, Degenkolb Engineers and numerous consultants, medical planners and medical consultants. In the end this partnership led to a design that suited the building's end use very well; that is to provide a very comfortable and non-threatening space for patients and family to cope with, and receive treatments for a life threatening illness, cancer.

Patient Comfort
One of the fundamental pursuits of the project was to provide sensitive, state-of-the-art patient care. A primary goal of both the staff at UCSF and SmithGroup was to incorporate a "warm, friendly atmosphere that offers the utmost in patient comfort". UCSF had caregivers and staff attend key meetings and have workshops where different groups and stakeholders were represented, and encouraged them to take roles in initial planning. They did not wish to project a "corporate image" or to intimidate the patients with the high-end technology used in the facility. 

UCSF, the General Contractor
With UCSF taking care of so many aspects of the project as the head of the house, it was easier for them to make informed decisions throughout all phases of the work. As general contractor, UCSF had structured contractual relationships with everyone involved in the design work and building of the project. While the "jack of all trades" approach was largely successful, the biggest shortcoming of this type of organization was the amount of time it took to get questions, answers and general information filtered through the chain of command. The center opened nearly a year late and this is the main reason why.

Questions, and the Chain of Command
In a traditional organizational structure, questions from the sub contractors travel to the general contractor and then on to the architect to be answered. However, in this particular case, the questions traveled from the sub contractors thru the prime contractor, architect, construction manager, and then two or three levels deep into UCSF's internal structure. Occasionally, questions made it thru the entire chain of command before being resolved and dispersing back down the chain. This is especially critical during construction when even small delays in information can lead to long delays for the trades at the site, and thus a late project.

Summary
As you will see UCSF's input and collaboration was essential in determining the building's success. Having built healthcare facilities in the past, their vision and expectations were very clear as was their idea of how to achieve them. Since this was an untraditional setup, and UCSF had never taken on this type of role, the resulting delays could not have been foreseen. In the end, late but within budget, the building is still seen as successful, especially to the patients who feel comforted while receiving cancer treatments. 

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Fall 2002 Department of Architecture
UC Berkeley