Flexible design solutions for health care renovations
Erik Good
Senior project manager, Global Construction LLC
Health care construction is one of the most necessary and challenging sectors of commercial construction. As technology advances, regulations change and the needs of patients and employees shift, a constant evolution in design and construction is necessary to meet the objectives of these projects.
The urgency of the onset of COVID-19 has shed light on a need for improved efficiency in the renovation and construction of health care facilities. “An immediate concern is for hospitals to keep elective, or necessary but not life threatening, surgery cases going while dealing with overflowing emergency departments and intensive care unit beds,” said Richard Simone in Healthcare Construction + Operations News.
Implementing facility renovations to create segregated areas and reconfigure existing spaces will be key to maintaining revenue-generating operations. Revisiting modular construction solutions, building new HVAC systems and considering micro-hospital developments for specialized services will lead these developments.
“What drives our clients to modular is the flexibility, time and financing we can bring with it,” said John Lefkus, president and a principal owner of RAD Technology, a modular builder that specializes in radiation, sterilization and oncology facilities.
Urgent care facilities and ambulatory surgical centers separate from large hospital facilities will continue to grow, as they often offer procedures at a lower price and reduce the risk of exposure to infection. In addition, the desire for treatment options to be available closer to patients and for facilities themselves to become smaller and more specialized is increasing the demand for additional free-standing centers. The future of new construction will include an expansion of medical facilities providing services outside of acute care, such as childbirth, dialysis, medical imaging and rehabilitation.
Increased regulations and policies around isolation and surge capacity at hospitals to mitigate COVID-19 have impacted the build environment and will continue to do so. In order to deliver a quality construction project on time and on budget under this new environment, stakeholders must select a team that is up to date on the latest techniques in the health care planning, design, and construction processes as well as Life Safety Code compliance, and understand the special considerations in Infection Control and Risk Assessment. Moving forward, specialized healthcare certifications such as ASHE and ICRA will be expected of all members of the project team.
Onboarding general contractors earlier in the design and preconstruction phase provides another opportunity to maximize efficiency. As issues in supply chains, speedto-market and labor shortages continue to increase as a result of COVID-19, the insight and experience of professional general contractors will be an asset early on. Their ability to advise on material selection and procurement to fit the goals, budget and project timeframe combined with longstanding relationships with subcontractors can mitigate the impact of the aforementioned issues.
To expedite the construction process so that the provider can start servicing patients, the owner, design professionals and contractors are, “Working together to see how these buildings can be constructed as fast as possible,” said Robert Brewer, a partner of Grassi’s architecture and engineering practice in a recent Construction Dive article.
Involving GCs from the get-go can help owners identify any potential obstacles from the start and integrate solutions into the project budget and timeline. Inspections can be scheduled in an efficient sequence, clear purchasing, and delivery dates can be set, and performance standards can be set so that work gets done correctly the first time.
“We have a keen understanding of who can do what and have created a dynamic and flow within our team,” says Bill Bryant, senior project manager at Global Construction. Seasoned professionals also will be able to react on the fly, overcoming obstacles and adapting resource allocations to ensure maximum jobsite productivity.
Finally, selecting a team that values staff and patient safety and understands the expectations of conducting work in an operational facility will still be paramount. Designers and architects who have a holistic view of the project and understand how their decisions impact the construction process will be better suited for these projects. General contractors who have developed systems and practices that ensure uninterrupted patient care and patient, staff and visitor safety will lead the way for the future of medical facility construction.
Featured in the October issue of Health Care & Senior Properties Quarterly
