Skanska provided preconstruction and construction services for this new outpatient center using an Integrated Project Delivery (IPD) approach. The project included a clinic, commons area, ambulatory surgery center, 18-acre site development and a 1,126-car parking garage. The Palo Alto Medical Foundation's new San Carlos Center was an early adopter of IPD, which is centered on transparency, collaboration and equality. To aid in these principles, around 40 representatives from key members of Skanska, the architect and major trade partners (MEP, structural, civil and finish) were co-located in an 8,000-SF Big Room. The space was designed and built with no cubicle partitions and few doors to foster easy and frequent interactions, and furniture was designed to allow the electrical and data systems to be easily reconfigured as the team's needs changed. Use of the Big Room helped change behaviors from a traditional construction process to a true team effort, making the client the greatest beneficiary with improved productivity, quality and more innovative solutions.