The Evolution of AEC Professional Silos

Project Team Advances the Project Delivery Process for California Hospital Reskin Project



Healthcare projects in northern California require specialized knowledge to navigate regulation, technological advancements, and project execution during construction administration. The key stakeholders in the success of traditional design-bid-build project delivery are the owner, architect, and contractor. These project team members must navigate the healthcare project process, which provides a series of regulation challenges. As practitioners of the Architecture-Engineering-Construction (AEC) industry, we are responsible for responding to these challenges through our professional lenses. Our previous insights and biases provide both opportunities for pitfalls and triumphs. The scope of the re-cladding project at John Muir Medical Center included replacing the existing exterior cladding, fenestration, and repairing the existing non-structural spandrel light gauged steel framing. The case study will focus on three parts: identifying the scope of the project exterior facade repair, understanding the framework between each project team members, and providing insights into how to improve the project process for the benefit of future projects. The owner, architect, and contractor will provide examples of the triumphs and failures during the process resulting from the project delivery method. The goal of this paper is to explore how the project team can elevate our profession by providing creative solutions to the contractual and regulation challenges discovered while working on healthcare projects.


Photo of David Olsen, AIA

David Olsen, AIA

Senior Associate

Ratcliff Architects

Photo of Megan Leon, P.E.

Megan Leon, P.E.

Design Engineer


Photo of Christopher Chiuchiolo, LEED AP

Christopher Chiuchiolo, LEED AP

Project Manager


Photo of Andrea Bono, P.E., LEED AP BD+C

Andrea Bono, P.E., LEED AP BD+C

Senior Consulting Engineer – Building Technology

Photo of Nick Rustia, P.E.

Nick Rustia, P.E.

Facilities Development, Project Manager

John Muir Health

Photo of Diane T Sands, MLIS, MFA, MS-GIST

Diane T Sands, MLIS, MFA, MS-GIST


Ratcliff Architects


Part 1 – Project Background

Scope of the project

John Muir Medical Center is a 554-licensed bed hospital with a Level II Trauma Center located in Walnut Creek, California. The project site is composed of a

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Part 2 – Understanding Project Team Relationships

Regulation and Administrative Code

The authority with jurisdiction over plan review approval for hospital buildings is the Office of Statewide Health Planning and Development (OSHPD). Building code regulation in California is

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Part 3 – Improving Process for the Benefit of Future Projects

Project Delivery – Design-Bid-Build

This project implemented the Design-Bid-Build project delivery method. This is the traditional project delivery method that most owners, architects, and contractors are familiar with. This project delivery

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Conclusion and Future Work

In conclusion, the traditional contractual relationships between the owner, architect, and general contractor are established in our work processes. By editing our processes to better understand how to bridge the

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The authors would like to thank their office leadership for their support.

Rights and Permissions

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