B医院异地新建项目成本控制方案研究
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摘要
本文针对B医院异地新建工程项目的管理,进行详尽的成本控制研究,通过对目前国际流行的EPC、PMC管理模式的优缺点比较,及在医院工程建设项目管理中应用分析,建议B医院建设工程推广PMC管理模式。医院建设工程项目的成本管理是一项系统工程,贯穿于项目的全过程和各个方面,涉及项目的全体人员,成本管理工作的好坏直接影响医院的经济效益。因此,做好建设工程项目的成本预测、成本控制、成本分析等成本管理工作,对全面提高医院管理水平、增加医院经济效益,有很大的推动作用。
Hospital B is a long historical hospital belonged to a university, a territorial medical centre, which collected medical, education, scientific research and prevention in itself. It is the university’s important base for medical education. It is charged with the duty of the training of Medicine Master, PhD postgraduate for several other universities, and it is also an important institution of community health service in society, making contribution to health work and medical personnel training for its locating city, especially in recent years, it has taken various public welfare tasks perfectly, like the prevention of SARS and avian flu, the relief of Sichuan earthquake, the detection and diagnosis of chronic diseases and other treatment services. However, with the development of the modern economic society, the long historical Hospital B is suffering from the problems like the aging buildings, outdated facilities, small sized venues, dilapidated infrastructure, and security breaches. So Hospital B has been unable to meet the urgent needs of health services and safety from the public. The space problem of Hospital B has become a dilemma from the aspect of itself. This problem is a serious threat to the security of all the hospital personnels and patients living in Hospital B. It also makes trouble to the recruitment of high qualified personnels of Hospital B, and inhibit the all aspected development of medical, education, scientific research for Hospital B.
In recent years, B hospital faces the reality positively, and the high classed personnels discuss the problems of hospital reforming and reconstruction. To the problem of rebuilding, there are mainly two kinds of considered solution: The one is to rebuild at the same place, and the other is construct in another place. The first solution can achieve the purpose of solving the fire and other hazards, but it is limited by the original area of Hospital B. It is still unable to reach the standards of Ministry of Health. Moreover, the part of local regional planning is seriously unreasonable. By contrast, off-site reconstruction is more feasible.
In the high authorities and positive efforts of the high class of the university, and in the supports from the district committee and government of District No.1 where is a little fer from the urban area of D city, Hospital B has already reached its initial intention to move to this area. Off-site reconstruction can firstly fundamentally solve the problem of locating, including the problems of locating area, building area, medical procedures and other issues. Then is can reconfigure the health resources, and be able to know about the medical problems of the dramatic increase in population in Western No.1 District (including the convenience of medical care and the saving of medical costs). It can also help to enhance the competitiveness of services in the region, and finally it does not affect the hospital's normal business in the reconstruction period, eliminating the problems of closures and classes suspending and other issues. The project of Off-site reconstruction of Hospital B makes great contribution to the university’s developing to a well-known local university, and to the providing of better teaching base for medical research and training of medical students. At the same time, the implementation of this project meets the new medical reform policy, to improve the service facilities in surrounding communities, to enhance local medical and health levels, and to promote the local economic prosperity in seeking employment. It will also be a great significance. This project is benefited to the refiguration of medical resources in D city, to economic development of No.1 District, to the providing of a better support to the medical education and training of personnel in the university, and to the sustainable development of the Hospital B. This project is a reasonable adjustment of health resources in the city, is an important step to achieve a rational planning of health resources in the city. It is a requirement of the refiguration of health resources and improving, and an inevitable accompanying product of urban development.
The success of a project depends on the project management level of the project investors. Through the demonstration of the funding sources and funds to pay of the project of Hospital B’s relocating, I select the PMC and EPC cost control management. No matter PMC or EPC, the common purpose is to use of professional project management techniques and tools to help the investment management make a right choice, to realize the expecting goal of Hospital B. EPC (Engineer Procure Construct) and PMC (Product Material Control) are scientific and advanced management modes in domestic and foreign regions. They are both implementing managements of modern hospital construction projects. Currently, the majority of China's medium and large construction projects selects the final user, which is also considered as the construction units headquarter or project company, as the owner. So, the strength of construction units headquarter or project company to command and control the project management will play a decisive key to the success of the project. No matter whichever path is chosen, the most fundamental element is the need to introduce advanced foreign management experience and scientific engineering project management, and to probe into our own project management.
In the phase of cost controlling, since the fierce competition among the current hospitals and various factors as a hospital belonged to a university, Hospital B is limited by a lot of factors of investment. So every stage of the relocation should do well in the cost controlling. From the stage of accurately estimate the investment of feasibility study, the design should be within the capabilities. It should reduce capital investment through a rigorous bidding management. Every step of the practicing construction process is required to undergo in scientific process management to control costs. The stage of completion is required exact audit work to ensure that there is no unnecessary additional cost in this project.
In the phase of schedule controlling, the rapid construction of a modern major hospital, as quickly as possible to occupy the neighboring markets, accepting the large stable patients, and occupying the market share are the primary tasks of Hospital B’s early development. To ensure the speed of the new hospital’s building reconstruction, the first need is to set up an efficient project management work team. After making a scientific and reasonable plan, the team should use the regular system or other methods, to ensure the project schedule in the implementation process. At the same time, they should pay attentions to the risk management. Then they should practice a good project management system to improve the ability of project controlling.
In the phase of quality controlling, firstly it needs to establish a scientific quality controlling system, and train project management work team to enhance the team’s quality. At the same time, carefully choose the designing, construction and supervision units. Hospital construction is system engineering. To fully and effectively control project’s quality, they should practice the whole process of project quality controlling. In the construction and commissioning period, they can measure the construction quality in various paths.
Cost controlling, schedule controlling, and quality controlling. There are interrelated, interrestrained, interbalanced and intercomplemented relationships between these three project management objectives. And we can achieve the "Three Controlling" requirement through rigorous contract management, in order to achieve little investing and the shortest duration, to achieve the objective of meeting the project quality indicators of Hospital B.
China's overall technology level of hospital construction cannot be with the world advanced level. Compared with the international track, the construction industry can only gradually introduce and absorb the foreign advanced technology and management mode. China shall still reform the customary practice that cannot meet the scientific project management gradually, still reform the customary practice that cannot meet international regular system in the construction management aspect. From the compurgation of the two kinds of hospital construction project managements and the research of project management support conditions, I’ve made a comprehensive argument including the size on the location, medical procedures, medical standards, management system, operation mechanism and other factors. Basing on pre-established cost management objectives, I’ve taken a series of preventive and regulatory measures to various kinds of factors and conditions affecting the cost, and made calculation, regulation and supervision on the occurrence of the various costs, to ensure to achieve the goals of cost management, and to ensure to complete this project in the approved budget, so that the relevant business processes can be smoothly implemented, and to achieve the dynamic management and effective controlling of the project management process. Finally, to realize the .success of Hospital B’s relocation.
Hospital B is a long historical hospital belonged to a university, a territorial medical centre, which collected medical, education, scientific research and prevention in itself. It is the university’s important base for medical education. It is charged with the duty of the training of Medicine Master, PhD postgraduate for several other universities, and it is also an important institution of community health service in society, making contribution to health work and medical personnel training for its locating city, especially in recent years, it has taken various public welfare tasks perfectly, like the prevention of SARS and avian flu, the relief of Sichuan earthquake, the detection and diagnosis of chronic diseases and other treatment services. However, with the development of the modern economic society, the long historical Hospital B is suffering from the problems like the aging buildings, outdated facilities, small sized venues, dilapidated infrastructure, and security breaches. So Hospital B has been unable to meet the urgent needs of health services and safety from the public. The space problem of Hospital B has become a dilemma from the aspect of itself. This problem is a serious threat to the security of all the hospital personnels and patients living in Hospital B. It also makes trouble to the recruitment of high qualified personnels of Hospital B, and inhibit the all aspected development of medical, education, scientific research for Hospital B.
In recent years, B hospital faces the reality positively, and the high classed personnels discuss the problems of hospital reforming and reconstruction. To the problem of rebuilding, there are mainly two kinds of considered solution: The one is to rebuild at the same place, and the other is construct in another place. The first solution can achieve the purpose of solving the fire and other hazards, but it is limited by the original area of Hospital B. It is still unable to reach the standards of Ministry of Health. Moreover, the part of local regional planning is seriously unreasonable. By contrast, off-site reconstruction is more feasible.
In the high authorities and positive efforts of the high class of the university, and in the supports from the district committee and government of District No.1 where is a little fer from the urban area of D city, Hospital B has already reached its initial intention to move to this area. Off-site reconstruction can firstly fundamentally solve the problem of locating, including the problems of locating area, building area, medical procedures and other issues. Then is can reconfigure the health resources, and be able to know about the medical problems of the dramatic increase in population in Western No.1 District (including the convenience of medical care and the saving of medical costs). It can also help to enhance the competitiveness of services in the region, and finally it does not affect the hospital's normal business in the reconstruction period, eliminating the problems of closures and classes suspending and other issues. The project of Off-site reconstruction of Hospital B makes great contribution to the university’s developing to a well-known local university, and to the providing of better teaching base for medical research and training of medical students. At the same time, the implementation of this project meets the new medical reform policy, to improve the service facilities in surrounding communities, to enhance local medical and health levels, and to promote the local economic prosperity in seeking employment. It will also be a great significance. This project is benefited to the refiguration of medical resources in D city, to economic development of No.1 District, to the providing of a better support to the medical education and training of personnel in the university, and to the sustainable development of the Hospital B. This project is a reasonable adjustment of health resources in the city, is an important step to achieve a rational planning of health resources in the city. It is a requirement of the refiguration of health resources and improving, and an inevitable accompanying product of urban development.
The success of a project depends on the project management level of the project investors. Through the demonstration of the funding sources and funds to pay of the project of Hospital B’s relocating, I select the PMC and EPC cost control management. No matter PMC or EPC, the common purpose is to use of professional project management techniques and tools to help the investment management make a right choice, to realize the expecting goal of Hospital B. EPC (Engineer Procure Construct) and PMC (Product Material Control) are scientific and advanced management modes in domestic and foreign regions. They are both implementing managements of modern hospital construction projects. Currently, the majority of China's medium and large construction projects selects the final user, which is also considered as the construction units headquarter or project company, as the owner. So, the strength of construction units headquarter or project company to command and control the project management will play a decisive key to the success of the project. No matter whichever path is chosen, the most fundamental element is the need to introduce advanced foreign management experience and scientific engineering project management, and to probe into our own project management.
In the phase of cost controlling, since the fierce competition among the current hospitals and various factors as a hospital belonged to a university, Hospital B is limited by a lot of factors of investment. So every stage of the relocation should do well in the cost controlling. From the stage of accurately estimate the investment of feasibility study, the design should be within the capabilities. It should reduce capital investment through a rigorous bidding management. Every step of the practicing construction process is required to undergo in scientific process management to control costs. The stage of completion is required exact audit work to ensure that there is no unnecessary additional cost in this project.
In the phase of schedule controlling, the rapid construction of a modern major hospital, as quickly as possible to occupy the neighboring markets, accepting the large stable patients, and occupying the market share are the primary tasks of Hospital B’s early development. To ensure the speed of the new hospital’s building reconstruction, the first need is to set up an efficient project management work team. After making a scientific and reasonable plan, the team should use the regular system or other methods, to ensure the project schedule in the implementation process. At the same time, they should pay attentions to the risk management. Then they should practice a good project management system to improve the ability of project controlling.
In the phase of quality controlling, firstly it needs to establish a scientific quality controlling system, and train project management work team to enhance the team’s quality. At the same time, carefully choose the designing, construction and supervision units. Hospital construction is system engineering. To fully and effectively control project’s quality, they should practice the whole process of project quality controlling. In the construction and commissioning period, they can measure the construction quality in various paths.
Cost controlling, schedule controlling, and quality controlling. There are interrelated, interrestrained, interbalanced and intercomplemented relationships between these three project management objectives. And we can achieve the "Three Controlling" requirement through rigorous contract management, in order to achieve little investing and the shortest duration, to achieve the objective of meeting the project quality indicators of Hospital B.
China's overall technology level of hospital construction cannot be with the world advanced level. Compared with the international track, the construction industry can only gradually introduce and absorb the foreign advanced technology and management mode. China shall still reform the customary practice that cannot meet the scientific project management gradually, still reform the customary practice that cannot meet international regular system in the construction management aspect. From the compurgation of the two kinds of hospital construction project managements and the research of project management support conditions, I’ve made a comprehensive argument including the size on the location, medical procedures, medical standards, management system, operation mechanism and other factors. Basing on pre-established cost management objectives, I’ve taken a series of preventive and regulatory measures to various kinds of factors and conditions affecting the cost, and made calculation, regulation and supervision on the occurrence of the various costs, to ensure to achieve the goals of cost management, and to ensure to complete this project in the approved budget, so that the relevant business processes can be smoothly implemented, and to achieve the dynamic management and effective controlling of the project management process. Finally, to realize the .success of Hospital B’s relocation.
引文
[1]综合医院建设标准(2008年修订版报批稿)(卫办规财发[2008]122号)2008.6.21
[2]李灵著.项目管理承包模式中相关财务问题分析.国际经济合作,2008.1
[3]寇传仪,贾钰仁著.PMC项目管理工作经验漫谈.山西建筑,2009.11
[4]关于土地性质及征地费用的报告.2009.5.5
[5]施工企业现代成本管理模式.中国建筑工业出版社,2007.8
[6]建设工程项目成本管理.中国计划出版社,2007.1
[7]柳纯露著.系统集成项目管理工程师教程.北京:清华大学出版社,2009.3
[8]赵新赫著.项目建设合同的必然走势——成本加酬金合同.建筑设计管理,2007.3
[9]周栩.曹升元.邹伟武著.高校大型建设项目管理模式的探讨.中南大学学报,2005.4
[10]陈勇强.汪智慧.高明著.项目管理承包模式下激励合同的构建.天津大学学报,2006.4
[11]李景茹.王家远著.项目管理承包(PMC)合同风险规避方法研究.建设监理,2004.4
[12]胡德银著.我国工程项目管理和工程总承包发展现状与展望.中国工程咨询,2003.2
[13]刘运萍.工程承包、项目管理和工程咨询.中国工程咨询,2003.2
[14]刘家明.陈勇强.戚国胜著.项目管理承包商——PMC理论与实践.人民邮电出版社,2005.7
[15] (美)穆罕默德·侯赛因(Mohamed Hussein)著.陈荣译.管理与控制成本Tracking & Controlling Costs.北京大学出版社,2000
[16]王盛祥,刘永泽编著.工业企业成本控制.北京,中国财政经济出版社, 1989. 4
[17]焦跃华.现代企业成本控制战略研究.经济科学出版社,2001.10
[18]王福胜.张林.成本会计学.科学出版社,2008.12
[19]论项目部对工程成本的管理与控制.中国建设工程招标网,2009.11.19
[20]张陈.浅谈企业全面成本管理与控制.制造业信息化门户网站.2009.7.23
[21]罗运湖.《现代医院建筑设计》.中国建筑工业出版社
[22]郭子恒.《医院管理学》.人民卫生出版
[23]张铭琦,吕富殉.《论医学模式的发展对医疗建筑形态的影响》
[24]赵家琪.《医疗与建筑》,《建筑师》
[2]李灵著.项目管理承包模式中相关财务问题分析.国际经济合作,2008.1
[3]寇传仪,贾钰仁著.PMC项目管理工作经验漫谈.山西建筑,2009.11
[4]关于土地性质及征地费用的报告.2009.5.5
[5]施工企业现代成本管理模式.中国建筑工业出版社,2007.8
[6]建设工程项目成本管理.中国计划出版社,2007.1
[7]柳纯露著.系统集成项目管理工程师教程.北京:清华大学出版社,2009.3
[8]赵新赫著.项目建设合同的必然走势——成本加酬金合同.建筑设计管理,2007.3
[9]周栩.曹升元.邹伟武著.高校大型建设项目管理模式的探讨.中南大学学报,2005.4
[10]陈勇强.汪智慧.高明著.项目管理承包模式下激励合同的构建.天津大学学报,2006.4
[11]李景茹.王家远著.项目管理承包(PMC)合同风险规避方法研究.建设监理,2004.4
[12]胡德银著.我国工程项目管理和工程总承包发展现状与展望.中国工程咨询,2003.2
[13]刘运萍.工程承包、项目管理和工程咨询.中国工程咨询,2003.2
[14]刘家明.陈勇强.戚国胜著.项目管理承包商——PMC理论与实践.人民邮电出版社,2005.7
[15] (美)穆罕默德·侯赛因(Mohamed Hussein)著.陈荣译.管理与控制成本Tracking & Controlling Costs.北京大学出版社,2000
[16]王盛祥,刘永泽编著.工业企业成本控制.北京,中国财政经济出版社, 1989. 4
[17]焦跃华.现代企业成本控制战略研究.经济科学出版社,2001.10
[18]王福胜.张林.成本会计学.科学出版社,2008.12
[19]论项目部对工程成本的管理与控制.中国建设工程招标网,2009.11.19
[20]张陈.浅谈企业全面成本管理与控制.制造业信息化门户网站.2009.7.23
[21]罗运湖.《现代医院建筑设计》.中国建筑工业出版社
[22]郭子恒.《医院管理学》.人民卫生出版
[23]张铭琦,吕富殉.《论医学模式的发展对医疗建筑形态的影响》
[24]赵家琪.《医疗与建筑》,《建筑师》