Navigating Healthcare Construction through COVID

Guest Post by Paul Nielsen, Operations Manager, Swinerton

COVID-19 has changed every aspect of our lives, from social distancing to teleworking, masking up to navigating toilet paper shortages. Healthcare facilities have had the added responsibility of balancing construction and renovation plans with unexpected, short-term fluctuations in patient needs while keeping an eye on long-term needs and juggling budgetary implications stemming from COVID’s impact.

Managing Timelines on Healthcare Construction Projects

Whether speeding up, slowing down, or reallocating construction plans, there are important implications that a general contractor reviews with its healthcare partners when altering the project timeline, including:

• Stage of construction – Has the project broken ground? Is it nearly complete?
• Risk associated with the renovation or new construction – does the facility have medically fragile patients? Will safety precautions be feasible during the construction process?
• Urgency behind the project – Can the facility maintain operations without the new construction? Will the new construction support COVID overflow during peak infections?
• Status and flexibility of contracts – Is this the beginning of a new contract agreement? Are you nearing completion on the project? Understanding the terms of your agreement, flexibility your partner provides, and penalties of modifications is critical.
• Availability of materials and labor – Even short-term delays can have long-term implications as materials shortages impact availability and labor is reallocated to other jobs. Before you push back a project, talk with your Construction Supervisor to determine when the project could start up again.
• Capacity to serve as a revenue source for financially strapped healthcare systems – Now, more than ever, finances are tight as medical facilities struggle to balance between patients reluctant to book appointments versus those that are overwhelmed with COVID patients. Additional, separate facilities such as surgery centers or professional office buildings may bring much-needed sources of revenue.

Critical to the success of the project, of course, is maintaining a good relationship and regular, open, collaborative communications across all parties. Supervisors who lead weekly meetings with all contractors engaged in the projects are better able to ensure each party understands where they are in the construction timeline and how their part impacts the process. This enables the team to quickly identify any potential obstacles and find a solution that keeps the project on track and within budget.

Maintaining Safety Protocols

Health and sanitation protocols are essential to keeping safety a top priority at healthcare job sites, and to ensuring an outbreak does not impact the ability to keep the project moving. It has become essential for general contractors to implement tight on-site infection control practices for all construction jobs – especially in healthcare where – including:

• Adapting to shift work to minimize contact between construction employees,
• implementing QR-enabled mobile health questionnaires,
• requiring wristbands and stickers for those who had met requirements for access,
• bulking up on-site infection control staff,
• isolating more areas of the job sites to ensure that staff came into as little contact with patients as possible, and
• setting up negative air pressure rooms that prevent pathogens from spreading.

Leveraging Technology to Keep the Project on Track

Construction in healthcare and other industries during COVID has required ingenuity and innovation, resulting in new uses of existing and new technologies to access construction sites remotely, minimize feet on the ground at each job site, and layer in protections for the client, patients, employees and craftsmen working on site.  

High-definition 3D scanning room technology has proven to be essential in healthcare clients – before and during COVID as it is able to provide:

• Time-stamped work with preserved historical data, providing the ability to collect information on utility, medical gas lines, and other critical infrastructure has been a lifesaver during the renovation of older hospitals and facilities where “as-built” construction does not match the current facility layouts. These 3D scans also provide accurate documentation to support safe, accurate future construction needs,
• minimized client travel thanks to remote walk-through capabilities – clients unable to travel get a 360 degree, 3D view weekly to check status, and
• better coordination with subcontractors, resulting in minimized change orders, reduction in mistakes, fewer subcontractors on the job site, and a host of other benefits.

Robotic “dogs” – Boston Dynamics quadruped robots walk through construction sites to inspect progress, measure and report data points, create a digital twin, and compare as-built to building information modeling (BIM). This technology is ahead of the curve – and as demonstrated in Swinerton’s work in Hawaii, as well as at the specialty medical office building project in Northern California, where they leveraged the robotic dogs to track and create consistent, real-time point cloud data of the 197,800-square-foot medical center with 143 doctors’ offices and 116 exam rooms.

An innovative, proprietary cost estimation application, Hunch, provides clients value even with a very limited starting point – sometimes as little as a napkin sketch. With actual cost estimates falling within seven percent of preliminary “hunch,” healthcare clients are better able to budget in these precarious times as it provides a detailed breakdown of costs by scope, including clarifications on the estimates.

Prefab + modular construction is growing in demand in the healthcare world. With aging infrastructure at many of medical campuses and limited space, modular construction offers healthcare facilities a range of immediate and future benefits, including:

• Site and utilities can be prepared in advance of modular building delivery, eliminating the lengthy process of constructing the structure, building envelope, installing the equipment, utility rough-ins, etc.
• Construction in a controlled environment allows for more precise assembly, generating efficiencies that can reduce cost by as much as 20 percent, decrease assembly time, as well as increase quality and precision.
• The risks associated with tradesmen working in dangerous environments are greatly reduced when the assembly is done on a flat factory floor with access and clearance provided on all sides for machines and assemblymen.
• Modular construction may allow for complete system installation, start-up and testing –  while legacy equipment operates – reducing the impact on facilities for lengthy shutdowns and expensive temporary utilities that would be found on a traditional equipment replacement project.

• The development of templates for different systems such as HVAC and electrical offer long-term benefits of standardization from both a construction cost standpoint, as well as from a maintenance standpoint.
• Regional risks can be factored into developing unique standards to address scenarios such as  high seismic risk, hurricane, tornado, flood, fire, low noise, etc.

While we do not know what the future of COVID looks like, we do know that healthcare continues to play a vital role in managing its impact. COVID is not a showstopper for those fighting to keep patients healthy – and the ability to safely improve upon and build healthcare facilities is vital to that mission. In our most challenging times, we find innovations and improvements to better our processes – these developments will continue to change the face of healthcare construction for years to come.