Managing Change During the Building Process:
Behind the Construction of the Talus Professional Plaza

Managing the complexities of any large commercial building project can challenge the most robust of construction management methodologies.   It’s another challenge altogether to make the construction process run concurrently with not only a building’s design, but also with the evolving business model underlying the design.   This, however, was precisely the situation that Kreizenbeck Constructors faced in the creation of the Talus Professional Plaza.

The Talus building was the vision of a Boise-based neurologist, Dr. Stephen Asher.   Having outgrown the downtown medical office that his physician group had occupied since 1981, Dr. Asher wanted to expand and modernize his facilities.   He knew, however, that the size of his existing practice would not support the cost of a facility that would deliver the level of patient care and convenience he envisioned.   His solution was simple but unprecedented: gather together complimentary physician practices and make them real estate partners who would subsequently share ownership in the building they would also help design.

In fall 2005, Dr. Asher had assembled his partner team and was ready to secure land and engage an architect and construction partner.   The physician partnership, which adopted the name Talus, purchased a six-acre parcel off of Overland Road near the intersection with Eagle Road and selected Doug Houston of Houston – Bugatsch to design their building and Kreizenbeck Constructors to build it.

Paramount in the Talus partners’ criteria for selecting their design and building team was a thorough understanding of medical construction and a highly collaborative working relationship.   As it turned out, Dave Maloney of Kreizenbeck had worked with architect Doug Houston on other medical projects.    “Construction of a medical facility involves a lot of specialties and a level of knowledge of sophisticated systems, products and equipment”,  Maloney points out.    “Fortunately, Kreizenbeck has been involved in nearly every one of St. Alphonsus’ projects for the last 25 years, and Talus’ concept of creating an out patient facility in combination with a medical office building was very familiar to us based on that experience.”

Also familiar to Kreizenbeck were other key project requirements: the ability to handle a complicated, fast track construction process and sensitivity to maintaining a clean worksite within an existing facility.    “Physicians are too busy to provide a lot of direction, but they have a high level of expectation when it comes to maintaining the operational integrity of their work environment. ”

One of the things that became clear at the inception of the Talus project was the need for concurrency in design and construction.   While Dr. Asher and his partners wanted to occupy their new facilities as quickly as possible, the partnership and its ultimate requirements were still in flux.   The number of partners alone grew from nine to thirteen from the beginning of the project.

The evolving needs of the Talus partners made the translation of these needs into design and construction decisions a moving target.    ”At the point that we began construction, the Talus partners had only acquired a portion of their property, ” Maloney recalls.    ”We were five months into construction before final drawings and estimates were completed.   This meant that our initial estimates had to be very flexible.   Even more important, we needed a highly cohesive team and a high level of trust in figuring out what the final objective would be. ”

Another challenge faced by Kreizenbeck was the impact of Hurricane Katrina on the availability and cost of building materials.   Combined with labor shortages resulting from the Treasure Valley construction boom, these factors introduced an additional level of volatility to the project.

Fortunately, the Talus construction project was firmly anchored in the visions of Dr. Asher and Dr. Kyle Palmer.   This vision was of a building that would deliver a new standard of choice, continuity of care and convenience to the Treasure Valley.   Aesthetically, they envisioned a look and feel that Dr. Asher describes as  ”Tuscan. ” Functionally, the Talus physician partners wanted a professional working space organized around an MRI imaging center.   But even here there was an element of uncertainty: during the construction process, legislation was pending affecting the placement of MRI equipment in facilities outside of the hospital.

Working closely with Doug Houston, Kreizenbeck dealt with these uncertainties by locking in the shell and core of the building.    ”We essentially started with a shell without any knowledge of what would go into it, ” says Maloney.    ”Since the MRI space required special design consideration, these drove other considerations.   Doug set gridline dimensions that allowed for flexibility as the rest of the building design evolved. ”

Amazingly, given the above challenges, the Talus Professional Plaza went from ground breaking in July 2006 to completion in June 2007, not withstanding the fact that the construction permit was not finalized until November 2006!   While Dave Maloney cites Kreizenbeck’s and Doug Houston’s experience in the design and build of medical facilities, the ability to manage a complex construction project concurrently with the evolution of a client’s business model and needs was the single most important component of success in building the Talus Professional Plaza.

“My experience with doctors, ” says Maloney,  ”is that they aren’t interested in the lowest cost, just the best value that meets their vision.   They also have a high regard for expertise and professionalism.   Your ability to work collaboratively and flexibly, and to communicate only what is most important to their decision making process, is the quickest way to earn their respect. ”

On Thursday, September 20, Treasure Valley physicians and consumers alike will have the opportunity to tour Meridian’s newest medical facility, the Talus Professional Plaza. What they will see, besides a facility designed to optimize the delivery of neurological and musculoskeletal medical services, is the vision of a Boise neurologist, Dr. Stephan Asher.

In 2004, Dr. Asher began assembling a group of physician partners that were drawn from the medical disciplines of neurology, orthopedics, neurosurgery and pain management. While each maintains their own independent practices, they now share in the ownership of a facility that improves the coordination and continuity of care they offer their patients.

Construction of a medical facility involves a lot of specialties and a level of knowledge of sophisticated systems, products and equipment. Fortunately, Kreizenbeck has been involved in nearly every one of St. Alphonsus’ projects for the last 25 years, and Talus’ concept of creating an out patient facility in combination with a medical office building was very familiar to us based on that experience.

One of the challenges we faced with the Talus project was the fact that the physician partnership and its needs were evolving even as the project began. We were five months into construction before final drawings and estimates were completed, which meant that our initial estimates had to be very flexible. Even more important, we needed a highly cohesive team and a high level of trust in figuring out what the final objective would be.

Another challenge was the impact of Hurricane Katrina on the availability and cost of building materials. Combined with labor shortages resulting from the Treasure Valley construction boom, these factors introduced an additional level of volatility to the project. In spite of these challenges, construction was completed in less than 12 months.

The Talus Professional Plaza represents the first of a three-phase plan to fully develop the physician partnership’s six-acre parcel near the intersection of Overland and Eagle roads. Tomorrow’s open house will expose other medical practices to the potential benefits of the Talus partners’ vision and business model. Having been a part of this project has been very gratifying for Kreizenbeck, and we are looking forward to continuing this relationship into phases II and III.