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Prefabrication and Modular Design in Healthcare: Improved Speed, Better Quality and Cost Savings

Modular construction has been around for a long time, with the first documented prefabricated home assembled in the 1830s. Less than a century later, Sears, Roebuck & Co. began selling made-to-order prefab homes in the early 1900s through its mail-order catalogs.

The technique began showing up in larger-scale projects a few decades after that, with Disney using prefabricated construction to erect its Polynesian Village and Contemporary resorts in the early 1970s.

These days modular design is a regular part of many construction projects, from residences to temporary and permanent hospital buildings to the instantly recognizable Burj Al Arab Hotel and its 202 prefabricated rooms in Dubai, United Arab Emirates.

While the use of modular construction has waxed and waned over the years, with some markets embracing the technique more than others, it’s now making a comeback thanks to its potential to deliver projects faster, improve building quality, and lower construction costs.

And although it can’t alleviate the post-Covid healthcare industry’s prolonged staffing crisis, it’s fair to say that a way to build facilities faster, better, and cheaper would be a boon to the healthcare space.

What is Modular Design?

According to the Modular Building Institute, modular construction – also called modular design or prefabricated construction – is “a process in which a building is constructed off-site, under controlled plant conditions, then assembled on location.”

Modular design has been a popular construction option throughout history, especially following the Second World War, when acute labor and material shortages aggravated a need for fast construction. It has proven very popular in many parts of the world, including Japan and Scandinavia.

But modular construction never really took off in the U.S. in earnest after the postwar period, primarily because of long-standing consumer perceptions of cheap and low-quality prefabricated buildings.

Today, however, a new breed of modular design powered by technology improvements has spurred what management consulting firm McKinsey & Co. describes as “an unprecedented wave of interest and investment.” Lighter weight yet stronger materials; new technology tools that improve design, capabilities, and manufacturing precision; and optimized delivery logistics combined with disruptive new players in the industry have begun to change popular perceptions around modular design.

Modular design is well-suited for a range of healthcare applications, including:

  • Exam rooms
  • Waiting rooms and reception
  • Surgical rooms
  • Emergency rooms
  • Labs
  • Radiology rooms
  • Intensive care units
  • Delivery rooms

Modular design in healthcare also got a noteworthy boost during the early days of the pandemic, when hospitals needed to create makeshift field hospitals on the fly. Modular healthcare projects can use as little as a few percent to as much as nearly 100 percent of a hospital room, depending on project parameters.

What’s Driving the Modular Design Shift

Construction has traditionally lagged behind many other sectors in terms of productivity, which is one reason why 3D printing of building materials and even entire structures – largely performed off-site – has already impacted the sector.

Indeed, large-scale modular construction could represent an industry revolution by shifting many building activities away from traditional construction sites and towards off-site, manufacturing-style production.

There are plenty of reasons why modular approaches could appeal to construction companies and their healthcare sector clients. The high cost of healthcare construction is a major one. High capital costs for major healthcare projects often mean many healthcare systems use outdated physical infrastructure that can’t keep up with today’s healthcare needs.

And with around 10,000 people turning 65 every day in the U.S., and healthcare systems the world over showing severe strain from the Covid-19 pandemic, those needs are only growing.

The scarcity of skilled construction workers and the long duration of many traditional healthcare construction projects are other factors pushing the industry toward modular design. “With current healthcare construction projects averaging over four years, by the time a new facility is built there is a good chance that it is already out of date,” says Grant Geiger, CEO of modular construction firm EIR Healthcare, in Healthcare Facilities Today.

“Modular manufacturing can solve this problem and allow for a fast, low-cost, and scalable solution that is of a higher quality than traditional construction.”

These pressures (and others created by the pandemic) have already driven the use of modular design in several healthcare projects, including the Héroe Research Initiative by the USC School of Architecture, which designed an isolation healthcare facility that can be assembled in several days.

Healthcare design, in general, has also pushed healthcare systems away from centralized acute care hospitals and toward smaller ambulatory, outpatient, and urgent care settings and even micro-hospitals closer to residential areas. In all of these examples, modular design can play an important role.

Advantages of the New Wave of Modular Design

Geiger’s article in Healthcare Facilities Today mentioned above says modular design can achieve a time savings of 45 percent and a 16 percent cost savings. Cutting a construction schedule in half due to higher productivity yields an average of $10.93 in savings per square foot.

Indeed, there are several reasons modular design has made a comeback in the healthcare industry.

Productivity and Speed

Custom-fit modular construction is faster than traditional construction techniques. Many recent modular projects have accelerated their original project timelines between 20 to 50 percent, with one hospital in Missouri building its two-story steel frame in just eight months (at a 30 percent cost savings). A second hospital with prefab elements in Colorado shaved 72 working days from its construction schedule, saving $4.3 million.

Because components or entire rooms are fabricated off-site in a controlled environment, projects aren’t nearly as subject to weather-related or other environmental delays. A modular approach can help companies scale projects faster and without hiring dozens of new employees, a huge bonus for companies experiencing the construction labor crunch.

It also ensures the least possible disruption during renovations by significantly reducing downtime while not requiring a loud and messy job site with dozens of tradespeople coming and going all day.

Quality

Modular construction can also improve project quality, largely because most elements are fabricated off-site and follow a standardized industrial manufacturing process. In this regard, it’s just like the creation of many other highly engineered products.

Thanks to this, construction elements and even entire projects can be subject to industrial strategies such as lean manufacturing and Six Sigma. Six Sigma manufacturing prioritizes quality assurance in the factory and limits products to 3.4 defects (defined as anything not acceptable to the customer) per million, ensuring that most quality issues are caught at the facility and not on site.

That’s a far cry from traditional construction, where the quality of craftsmanship can differ noticeably from room to room within a single project.

Indeed, a KPMG report from 2016 says that nearly 80 percent of contractor respondents agreed that off-site products are higher in quality.

Cost Savings

The amount of cost savings you’ll see from modular design depends on the project. Still, at this point, it’s fairly clear that modular design has the potential for notable cost optimizations. Caution should be observed on this front, however, with McKinsey saying that while “the modular approach also has the potential to yield significant cost savings, that is still more the exception than the norm today.”

The company predicts that companies that can scale modular buildings could realize more than 20 percent in construction cost savings along with improved full-life costs.

Modular design can also save time and costs regarding technology implementations. EIR Healthcare, for its part, regularly works with big tech companies to integrate technology and internet of things (IoT) sensors into hospital rooms on the manufacturing floor – as opposed to disruptive and costly installations after the fact.

Safety

Prefabricated units improve job site safety mainly because of the predictability of the controlled manufacturing environment, and because far fewer tradespeople are required to be on-site.

It can also be a healthier process for patients and staff because it removes the need for messy installations, such as sheetrock, which can kick up dust and impact indoor air quality.

Unicel Architectural Window and Door Systems

Unicel Architectural’s patented Vision Control® louvered technology, aluminum skylights, and stunning timber curtain wall systems for healthcare and other facilities are fabricated in our industrial manufacturing facility, away from the job sites in which they’ll eventually be installed.

This manufacturing process ensures the extremely high quality of Unicel Architectural products while allowing for industry-leading customization, flexibility, and speed.

Contact us today to learn more about how Unicel Architectural’s prefabricated window and door systems can add functionality, sustainability, and panache to your next project.

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