Dialysis facility design - Part II: Minimize costly plan changes

During the development and construction of a dialysis clinic, there are decisions that influence the cost, building quality, and completion date of the project. Change orders-changes to the project after bidding and a contractor has been awarded-are often unavoidable. The owner, architect, and contractor, as well as outside agencies, will at times desire to make changes due to whim or necessity. Often, how you approach these changes has a larger impact on cost and schedule than the change itself. This article, the second of four installments focusing on dialysis clinic design, will review many of the issues that arise in successful project initiation and development from concept through construction, and will address several types of challenges that traditionally occur during the process.