Healthcare Design - September 2013 - 44

Is prefab right for you?
Things to consider before pursuing modular
construction
By Ryan Hullinger and Tim Fishking, NBBJ

www.healthcaredesignmagazine.com 09.13
08.13

required column work often doesn't
allow for open spaces like atriums), the
ability to finish these structures with just
about any exterior-be it brick, stone,
stucco, or glass-means today's modular
buildings can look just like conventional
architecture.
And as more modular healthcare projects are deployed, experts believe lingering doubts about the method will dissipate. Aspen Street Architects, Angels
Camp, Calif., designed the Mercy Joplin
replacement hospital in Joplin, Mo.,
relying heavily on modular construction. Founder David Hitchcock foresees
a day when designing a freestanding
clinic, hospital wing, or a critical access
hospital will be similar to picking out a
car, with all the features and amenities

For a new OhioHealth
Riverside Methodist Hospital
Neuroscience Institute patient
tower in Columbus (scheduled
to open in 2015 and designed
by NBBJ), overhead MEP
racks are constructed inside
a warehouse just miles
from the site. The inpatient
floor plates are curved, so
the prefabricated racks are
assembled on the shop floor
to match the curvature of the
tower. Toilet rooms for the
OhioHealth project are also
prefabricated in the same
warehouse.

When deciding whether to pursue prefabricated construction, everything
comes back to return on investment. Prefabrication can reduce cost, save
time, and improve quality, but it also entails an upfront premium in space,
material, schedule, and labor-a premium that delivers value at scale, but
only above a threshold that differs for each project. Here are some of the
factors to consider:
Assembling innovative construction teams-The first and most important step is to understand the builder and its willingness to undertake prefabrication. Some builders are more innovation-focused, and some aren't. It
requires a partnership among the client, architects, engineers, construction
managers, and subcontractors who have the willingness and experience to
think innovatively. Many state and federal contracts are awarded on low-bid
alone, making it difficult to ensure that all the subcontractors are aligned in
their willingness to work together on prefabrication. As a result, many more
extensively prefabricated projects exist in the private sector.
Working with organized labor-The receptivity of the building trades
must also be taken into account. Labor unions aren't categorically opposed
to prefabrication, although multitrade modular construction does represent
a change in "business as usual" and may require some education or negotiation to make this approach attractive. In some regions, a discussion with
labor organizations may need to precede a determination of the viability the
process.
Interfacing with regulatory agencies-The building codes and regulatory agencies that apply to a particular project can either encourage or
discourage prefabrication. One approach is to develop positive relationships
with building officials and inspectors by sharing the process with them
during design and by promoting an open-door policy for them at the warehouse. Generally, inspectors will be appreciative of the opportunity to view
the construction work in the shop, because there they can evaluate the
assemblies much more thoroughly than is possible at the construction site.
Determining costs for off-site shop space and transport-Multitrade
prefabricated construction requires a warehouse in which to assemble
components prior to installation. The cheaper the warehouse, and the
closer to the site, the more cost-effective prefabrication becomes. At
Miami Valley Hospital, the NBBJ team was fortunate to obtain affordable
warehouse space readily available in Dayton, Ohio, within seven miles of
the hospital. On construction sites with available land, shop space can be
temporarily erected on-site, but this also entails a cost premium.
Understanding contracts and insurance-Generally speaking, prefabrication doesn't affect legal liability, although contracts among the subcontractors may be structured a bit differently than they are on traditional
construction projects. Mechanical contractors often already coordinate
multiple trades; however, modular construction requires them to take
responsibility for production, transport, and installation of the components,
which is a different way of thinking about how subcontractors interface.
Also, they must verify that the second site-the warehouse-is covered
under their insurance policy.
Healthcare projects represent the perfect opportunity to consider prefabrication, because so many of their components are highly repeatable, highly
complex, and have a high need for adaptability and upgrading. Carefully
considering the cost and opportunity of the factors above can determine
whether this approach is right for your project.

http://www.healthcaredesignmagazine.com

Healthcare Design - September 2013

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