#United States #construction #Bentonville #U.S. Healthcare #Design Strategies

A Fresh Approach to Healthcare Construction

The U.S. healthcare system is at a pivotal moment, facing escalating construction costs and significant challenges that demand innovative strategies. Paul Sabal, the Healthcare Practice Leader at HFA Architecture + Engineering, emphasizes the urgent need for a more efficient design and construction process in his recent article for Medical Construction & Design (MCD). This call for change addresses the complexities of current construction practices and advocates for a systematic shift away from traditional methods.

The Current Landscape

Healthcare facilities across the nation are grappling with rising construction expenses and labor shortages, leading to extended project timelines. Factors such as new regulations and the need for advanced technology integration further complicate the existing scenario. Sabal, with over four decades of experience in the field, highlights that conventional methods often fall short of delivering clear, actionable details in project designs.

In traditional design practices, architectural renderings communicate an intent rather than a final product. For instance, a simple line in a blueprint might represent a wall, yet it lacks vital details about the materials and construction methods required. This ambiguity often results in costly requests for information (RFIs) and numerous change orders that hinder project efficiency.

A Paradigm Shift: From Design-Intent to Fabrication

Sabal advocates for a transformation towards a fabrication-based approach. This methodology not only enhances precision in detailing but also reduces the substantial burden of RFIs and change orders. By adopting design for manufacturing and assembly (DfMA) principles, healthcare projects can achieve greater accuracy and coordination during the construction phase. Sabal states that advanced coordination processes should complement the early design stages, allowing for continuous review and adjustment of emerging designs. This proactive approach can significantly minimize costly construction misunderstandings and streamline workflows.

Advantages of Advanced Coordination

The incorporation of advanced coordination teams can lead to marked improvements in project execution. These teams focus on producing comprehensive and precise designs that contractors can readily assess upon entering a project midway. When midstream contractors can work from meticulously crafted documents, they are able to commence construction activities more efficiently, thus enhancing overall productivity. Moreover, they can accurately assess change orders, identify the roots of delays, and collaborate with fabricators to ensure swift delivery of required materials.

Sabal's insights reveal that projects employing these modernized approaches can reduce costs by 5-10%. Additionally, he highlights the potential for procurement savings through strategic partnerships with global supply chain firms focused on construction materials and equipment. Early engagement with these partners allows project teams to secure long lead-time items at fixed prices, protecting against market fluctuations and potential escalations.

Streamlining the Delivery Process

To bring this vision to fruition, Sabal underscores the importance of working with Architecture + Engineering (A+E) firms that host multidisciplinary in-house teams. These teams can integrate various aspects of a project, including interior design, structural engineering, and fire protection services, thereby optimizing workflows and reducing miscommunication. This holistic approach transcends individual elements like prefabrication or building information modeling; it focuses on refining the entire project-delivery process into a cohesive, efficient system.

Aiming for Better Outcomes

Ultimately, by de-risking the design and construction process, the healthcare sector stands to enhance the quality of care provided, expedite project timelines, and crucially, conserve capital resources that can be redirected toward improving patient care and outcomes. Sabal's call to action invites stakeholders in the healthcare architecture and construction domains to embrace a more integrated, detailed, and efficient method of project delivery to tackle the profound challenges facing the industry today.

For those interested in exploring this new paradigm further, Sabal’s full column, Rethinking Traditional Ways: De-risking healthcare construction through integrated approaches, offers a comprehensive overview of the strategies needed to revolutionize healthcare design and construction in the U.S.