The Creep: Hospital Construction Challenges


“I had years of hospital experience. Money isn’t a huge concern on a hospital job — we need to make the date,” said superintendent Lucas Wilke in an interview for our recently-released ebook. Despite the urgent need, a recent survey found that healthcare construction projects are increasingly failing to make their dates.

Fewer hospitals are completing construction projects on or under budget this year compared to last year, according to the 2015 Hospital Construction Survey, conducted by Health Facilities Management (HFM) and the American Society for Healthcare Engineering of the American Hospital Association. Additionally, there were fewer projects on or ahead of schedule in comparison to last year. The survey found only 46% of responders completed their projects on or under budget and/or on or ahead of schedule.

Furthermore, a 2012 study by McGraw-Hill Construction found that healthcare construction projects, like many projects, experience schedule and scope creep. Selecting the best method of delivery for a project can help prevent creep, including delays and overlaps between project phases.

Commonly used delivery methods include Design-Bid-Build, Construction Manager at Risk, Design-Build, Integrated Project Delivery, and Fast Track Construction.

Design-Build is often the preferred method for construction of healthcare facilities because of the unique challenges these facilities present. (See a recent $120 million contract awarded to Gilbane Federal for reference). The ideal Design-Build team would consist of experienced architects, engineers, designers, and construction experts—all in-house. Design-Build projects also benefit from having a single point of contact, more cost savings, and faster project completions. As long as the team keeps the lines of communication open, then transitioning between design and construction phases will be smooth and should help prevent overlap or creep. Communication involves conducting frequent meetings that manage construction, monitor progress, and maintain accountability throughout the process.

Another method that’s getting more popular in the industry is the Fast Track method. This method purposefully overlaps functions and development stages which reduces the amount of time it takes to complete a facility. With a fast track schedule, a hospital may be completed in 18 months versus the typical three years. A successful Fast Track project begins with knowing the scope of the project, knowing the decision makers, and planning early for the future.

No matter which delivery method is used, in order to prevent schedule and scope creep, a project should have a set program, budget, and schedule. The end result should be a facility that meets the needs of the owner, the staff, and the patients.


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