More and more Healthcare projects are exploring the use of prefabrication strategies in their construction projects. There are several reasons speculated for this shift. Increased demands for hospital beds and requirements for decreases in facility downtime are significant factors, but first and foremost appears to be the shortage of skilled labor and craftspeople in the construction industry currently. Many industry experts believe that the healthcare sector is suffering more than others from this scarcity because their facilities require a higher level of skill from these positions. Reduction in labor and quality control are two key advantages of prefabricated construction that can help alleviate some of these labor shortages.

The Prefabrication Process

A prefabricated construction process can be broken down into four stages: Design & Planning, Prefabrication, Transportation, and Installation.

Design & Planning

Early collaboration of the entire design and construction team is needed to ensure the successful integration of prefabrication into the design plan. This team includes owners, architects, engineering contractors, and often suppliers and manufacturers. In addition to traditional design efforts, extra coordination is required to execute prefabrication strategies and the necessary corresponding delivery schedules, transportation, and installation means and methods. Early decision making is also critical. Mechanical components, finish materials, and product selections are needed much earlier in the process, thus requiring numerous decisions to be expedited. Virtual reality and physical mockups can aid in this decision making; however, these need to be integrated into the design plan ahead of time.


Many elements of a healthcare environment may be prefabricated. For example, exterior skin panels, MEP infrastructure, bathroom pods, headwalls, and patient rooms are all possible to construct ahead of installation. Prefabrication is most efficient when the needed components are standardized around modular configurations. These standardization efforts also benefit quality control, reductions in waste, and cost control. Prefabricated elements often provide a single source, coordinated, and integrated product with all architectural and MEP features included. Many prefabricated elements can be created in parallel with the rest of the construction rather than in sequence, thus allowing saved time in the overall schedule. Because prefabrication occurs off-site, the environment can be controlled, eliminating lost time due to bad weather, keeping the elements cleaner, preventing damage by other workers, and allowing for testing before installation. Safety can also be increased with the creation of a controlled work environment, enabling workers to work at floor level and use optimized lighting instead of temporary site lighting.


Some of the most apparent benefits of prefabrication are the site impacts. Because the elements are produced elsewhere and transported to the site, the amount of on-site storage, the number of workers, and parking spaces for workers may be reduced. These changes can be significant, especially for urban hospitals. Transportation for prefabricated elements not only includes getting the items from the prefabrication location to the site but also site landing zones, offloading, and move-in paths within the building. Many of these aspects will have been well developed in the planning phases; however, final coordination before transportation is crucial. Proper timing and executed deliveries are even more important due to the often-reduced site space and on-going daily construction activities.


With properly executed prefabrication, when the site is ready to accept an element, the element is ready to be installed. The dimensional accuracy is higher than that of site-built parts, thus providing a better framework for attaching other prefabricated or architectural elements. Because of the repetition of the elements, installation efficiencies steadily increase, and installation times go down. This repetition leads to consistency and fewer mistakes, resulting in better, more consistent quality.


Prefabrication has many benefits; however, there are some disadvantages. Specific challenges can include cost estimating, engaging with the supply chain, collaboration with multiple trades, and sometimes creating relationships with new vendors. Transportation limits (height and weight restrictions), police escort requirements, and traffic restrictions all need to be considered and are often additional costs. Temporary bracing, craneage load capacities, and installation coordination can also add cost. Usually, these costs can be offset by the schedule savings and reduced waste in prefabrication.

The Takeaway

A successful Prefabrication Process requires an innovative team with a collaborative style. With strong teamwork starting at the planning and design stage, prefabrication can improve your next project by increasing safety and quality control, accelerating project schedules, and reducing waste.

Gretchen Kurzawa, AIA, NCARB
Senior Project Manager