Prefabrication enables building sections or components of the building to be assembled offsite in a factory setting, instead of on the jobsite. Because the assembly is taking place in a controlled environment, it’s easier to avoid weather delays and excess material waste. The use of prefabrication in health care projects can benefit patients and employees in several respects. Most universally, properly executed prefabrication brings greater certainty to the overall project delivery and provides employees and future patients certainty that the project will support their work and care.
In cases where the projects adjacent to a continuously operating facility, such as a hospital renovation, patients directly benefit when portions of the work are moved to the shop. Offsite fabrication and assembly dramatically reduce dust and noise from the jobsite, as well as the amount of labor and time required onsite for installation. Additionally, there are typically fewer quality issues with prefabrication. In many instances there also cost reductions and savings that can be passed on.
While the benefits of prefabrication are clear for many types of construction projects, the challenges and constraints in a health care project setting can be more acute, and thus the opportunities even greater. Health care projects are often complex, schedule-driven, and require the highest-quality deliverable—challenges that can often be mitigated with a prefabrication approach.
Based on the limited manpower to reach some of its projects, prefabrication is a key to success for contractors such as McCarthy Building Companies. On the Kaiser Permanente Hesperia Medical Office Building project, prefabrication is a focus to drive cost and schedule performance, while maintaining a quality product.
Kaiser Permanente’s new 54,000-square-foot medical office building is scheduled to open in 2021. The three-story medical office building will include 30 provider offices featuring primary and specialty care services, including family medicine, pediatrics, OB/GYN, and cardiology and physical therapy, among many others. Additional onsite services such as a pharmacy and laboratory will also be a part of the new office building layout, providing advanced facilities and increased accessibility for patients and the surrounding area.
The Kaiser Permanente Hesperia Medical Office Building project is unique in that the designs and prefabrication techniques were implemented as a proof-of-concept with intention to rollout to many additional projects across Kaiser Permanente’s portfolio. By most measures, prefabrication is a volume game—the more the client and project team can drive repetition, especially across multiple projects, the greater the value from a cost, schedule and quality perspective. Kaiser’s approach at Hesperia took this to heart from the outset. As a result, this improves McCarthy’s schedule over that of traditional systems by two to three months, or roughly 20%.
Prefabrication is also ideal for health care projects because of the level of engagement on the owner’s side. Health care owners tend to be more involved in the process, increasingly favoring progressive delivery methods such design-build, and approaching building from a portfolio perspective versus a hands-off, hard-bid, one-off approach that may be more common in other markets. Prefabrication is not an easy solution, however. The team and approach must be considered carefully for a successful outcome.
In lieu of the standard project collaboration starting when subcontractors mobilize to the site, McCarthy has been collaborating almost every facet of this project with remote and offsite teaming prior to the building permit being issued. The amount of offsite prefabrication required for this project drove a need for a significant communication and collaboration with all project partners to ensure issues were resolved on an accelerated basis.
To be successful with this approach, McCarthy has had to adjust traditional processes to ensure it is receiving decisions promptly enough to be able to integrate them into the prefab components long lead time. Trades that are typically coordinated later in the process had integrations with prefab components, which made it necessary to bring them to the design forefront earlier than in a non-prefab scenario.
Kaiser Hesperia employed several prefabrication approaches, which were coordinated through detailed BIM. In addition to many MEP elements, the three-story building is designed around a prefabricated superstructure and prefabricated interior and exterior wall systems. McCarthy’s team evaluated a battery of additional prefabrication options throughout preconstruction—landing on these elements as a best-fit for the client’s and project’s goals.
