{"id":16794,"date":"2023-10-17T11:43:45","date_gmt":"2023-10-17T15:43:45","guid":{"rendered":"https:\/\/www.consigli.com\/?p=16794"},"modified":"2023-10-18T11:31:49","modified_gmt":"2023-10-18T15:31:49","slug":"revolutionizing-healthcare-construction-the-power-of-pre-fabrication-pre-purchasing","status":"publish","type":"post","link":"https:\/\/www.consigli.com\/revolutionizing-healthcare-construction-the-power-of-pre-fabrication-pre-purchasing\/","title":{"rendered":"Revolutionizing Healthcare Construction: The Power of Pre-fabrication & Pre-purchasing"},"content":{"rendered":"

Dartmouth Hitchcock Medical Center (DHMC) is the only Level 1 trauma hospital in New Hampshire, providing primary and specialty care to patients throughout New Hampshire and Vermont. Despite DHMC\u2019s technical staff having the ability to support the area\u2019s most complex cases, their facilities could not meet patient base demand and often exceeded capacity, forcing DHMC to turn away hundreds of patients per month.<\/p>\n

In 2018, the DHMC board approved the construction of a new, six-story 240,000 square foot Inpatient Tower, expanding services and capacity by adding 64 state-of-the-art inpatient beds and shell space for future flexible expansion.<\/p>\n

The facility was designed with an interdisciplinary and \u201cfuture-proof\u201d approach. Patient rooms provide flexibility to serve as med\/surg, step-down, or even critical care options, depending on need. Each room is private and offers space for visitors to be with their loved ones during their stay. And, technology is at the forefront, with integrated patient dashboards, MyChart Bedside, and telemetry units, allowing patients to interact with their provider teams at their fingertips.<\/p>\n

The Challenge: Location-based Labor Shortages
\n<\/strong><\/h2>\n

The Upper Valley is a collection of small, quintessential New England towns along the Vermont\/New Hampshire border. The area is large, but the population\u00a0is low, and DHMC is the only hospital within many miles for these residents.<\/p>\n

DHMC\u2019s priorities and obligation to Upper Valley residents extended beyond the care they were providing. It was important to the hospital to put the Upper Valley to work through this significant construction project, and to the extent it was possible, keep the labor and vendor base local.<\/p>\n

Consigli\u2019s knowledge of the New Hampshire subcontractor market and capabilities informed a thoughtful strategy to do just that, ultimately keeping over 50% of the project spend with local firms.<\/p>\n

The Solution: Thoughtful Procurement & Intentional<\/strong>
\nPre-fabrication<\/strong><\/h2>\n

Keeping the Work Local: <\/strong>The Consigli team took a holistic view of the planning and buyout for this project: identify which scope areas could be supported by local subcontractors and vendors,\u00a0and then determine where there were opportunities to introduce creative solutions\u2014like pre-fabrication<\/a> and material pre-purchasing\u2014that would infuse greater efficiencies into the project.<\/p>\n

To start, the team mapped out all local subcontractors with the size, capacity, and experience to take on a project of this scale and complexity. The subcontractors were invited to an open house event where they could learn more about the project, meet the Consigli team, and get a sense of the expectations and timing for bidding.<\/p>\n

\u201cOur plan was to use local labor whenever we could, and when we maxed out that avenue, we explored creative solutions that could enhance the overall delivery of the project,\u201d said Ricky Gala, Senior Project Manager.<\/p>\n

\"\"<\/a><\/p>\n

Pre-purchasing Equipment for Schedule Certainty: <\/strong>During Design Development in February 2020, Consigli and designer HDR proactively mapped out decision deadlines for material\u00a0purchasing, advising on workarounds wherever possible. This is a risk management strategy that Consigli employs on all projects, but it proved critically important and timely at DHMC as COVID hit.<\/p>\n

As the world was facing unprecedented uncertainty in early 2020, Consigli\u2019s DHMC team was preparing to break ground on the long-awaited (and much needed) Inpatient Tower. Instead, their focus shifted toward forecasting looming material shortages, supply chain issues, border shutdowns, and astronomical price increases.<\/p>\n

\u201cFrom the beginning of the project, well before COVID was ever heard of, we planned this project to be as schedule and labor-resilient as possible\u2026and then the pandemic really stress-tested that approach,\u201d said Consigli Director of Pre-fabrication Bill Seery.<\/p>\n

Consigli secured steel prices before costs skyrocketed and bought from a New Hampshire-based steel mill to avoid potential U.S.\/Canada border issues. All M\/E\/P equipment was pre-purchased, locking in early pricing to avoid escalation and circumnavigating long equipment lead times, getting materials to New Hampshire well before they were needed.<\/p>\n

It also provided other benefits, like allowing the M\/E\/P equipment to be designed into the building, and\u00a0all structural slab requirements and electrical could be fully coordinated in advance, eliminating clashes and field re-work.<\/p>\n

This proactive approach extended to commodity items, too. Piping, insulation, roofing, and drywall were prioritized; subcontractor onboarding was expedited, submittals and reviews were fast-tracked, and materials were ordered. Warehouse spaces in Nashua, Enfield, and Seabrook, NH as well as Windsor, VT were used to store the materials until they were needed much later in the project. This fast-tracked procurement approach proved critical as lead times increased nearly 500% on many commodity items during the pandemic.<\/p>\n

By April 2020, the Consigli team had locked in its subcontractor and vendor base, pre-purchased materials, and had a solid plan going into the Inpatient Tower\u00a0groundbreaking, set for July 2020.<\/p>\n

\u201cIf we weren\u2019t proactive about the way we approached procurement and pre-fabrication on this project, we would\u2019ve been caught on our heels when COVID hit,\u201d said Gala. \u201cWe weren\u2019t reacting to a problem and trying to change course. We planned the project in the most efficient way possible, and when the pandemic hit, we were in the best possible\u00a0situation to take it head-on.\u201d<\/p>\n

See how Consigli\u2019s equipment and commodity pre-purchase strategy safeguarded the project when COVID hit, and lead times skyrocketed. <\/strong><\/h6>\n