Feasibility study of collaborative design-build curriculum

The design-build method of project delivery is the most preferred by owners. Almost 40 percent of all buildings are currently produced in this manner, and this trend is not likely to change. Owners prefer the single source organization and responsibility design-build offers and projects are often delivered faster, cheaper, and at a higher level of quality. Design-build project delivery was formerly considered unethical architectural practice by the AIA. However, increasing demand for this service has forced the profession to redefine itself to respond to market conditions. Architects are now in danger of losing the control necessary to ensure their designs are constructed in the way they were conceptualized due to reluctance to accept risk. There is equal opportunity for architect led and contractor led design-build. Most architects have elected not to establish themselves as leaders in the design-build arena. If this trend continues, it is likely that the majority of architects will find themselves working as an aesthetic consultant to the builder rather than acting as a project leader. It is also likely, that in this situation, design quality will succumb to ease of construction and cheaper alternatives. Architectural education needs to respond to the conditions of today\u27s marketplace. Schools should offer students the opportunity to explore design-build and encourage them to become leaders who establish control of the process. Using the Jewell Golf and Country Club, a recent design-build student project, as a case study, I evaluate the potential for converting the present department of architecture thesis track into an optional design-build track. A study of this first attempt at the process will be used to make conclusions about the validity of this program

Health Care Policy and Congenital Heart Disease: 2020 Focus on Our 2030 Future

The congenital heart care community faces a myriad of public health issues that act as barriers toward optimum patient outcomes. In this article, we attempt to define advocacy and policy initiatives meant to spotlight and potentially address these challenges. Issues are organized into the following 3 key facets of our community: patient population, health care delivery, and workforce. We discuss the social determinants of health and health care disparities that affect patients in the community that require the attention of policy makers. Furthermore, we highlight the many needs of the growing adults with congenital heart disease and those with comorbidities, highlighting concerns regarding the inequities in access to cardiac care and the need for multidisciplinary care. We also recognize the problems of transparency in outcomes reporting and the promising application of telehealth. Finally, we highlight the training of providers, measures of productivity, diversity in the workforce, and the importance of patient– family centered organizations in advocating for patients. Although all of these issues remain relevant to many subspecialties in medicine, this article attempts to illustrate the unique needs of this population and highlight ways in which to work together to address important opportunities for change in the cardiac care community and beyond. This article provides a framework for policy and advocacy efforts for the next decade