Learn how prefabrication and modular designs are meeting demand and relieving stress on hospitals.
Hospital bed booths are set up at the Jacob K. Javits Convention Center which was turned into a hospital to help fight coronavir

© Eduardo Munoz Alvarez - Getty Images North America

NEW YORK, NY: Hospital bed booths are set up at the Jacob K. Javits Convention Center which was turned into a hospital to help fight coronavirus cases.

At a time when constructing medical facilities to help fight the new coronavirus is a prime goal, prefabricated and modular designs seem to be a perfect prescription.

hospital pods set up in convention center


Hospitals, hotels, office buildings, assisted-living facilities, homeless shelters, and other industries have all used factory-constructed panels, modules, or other predesigned systems to speed production of building parts. In addition, various designs can be used as temporary structures on a site or within a large building, such as a convention center, field house, or hotel, to help relieve stress on hospitals or to house workers. When no longer needed, they can be disassembled, stored, or transported to the next assignment, particularly if a second wave of COVID-19 erupts.

Sheri Koones, author of several books on prefabrication, including Prefabulous Small Houses (The Taunton Press, 2016), points out other benefits of prefabrication over traditional construction, including decreased time and cost in construction and assembly of parts on a site, as well as less waste since factory production is more efficient.

Microorganisms are easier to eliminate in an interior build environment that makes greater use of machinery and reduces human touch and interaction, says Amy Marks, known as the “queen of prefab” for her work helping major architecture, engineering, and construction companies adopt and expand their prefabricated building practices needs. Currently, she heads industrialized construction strategy and evangelism at Autodesk, a San Rafael, Calif.-based multinational corporation that develops software services for design, construction, and manufacturing-related industries.

After so many images were shared of hospitals being quickly erected in Wuhan, China, in early February, many wondered how much these solutions are being used in this country. “Hospitals have been one of the early adopters of prefabrication,” Marks says.

framework for modular unit being built

© The Boldt Company

The Boldt Co., a construction firm headquartered in Appleton, Wis., had its first prefabricated modular solution roll off its assembly line April 16. Designed by HGA, a national multidisciplinary design firm headquartered in Minneapolis, the product was dubbed STAAT Mod for strategic temporary acuity-adaptable treatment module.

“The timing from concept to finished product was pretty remarkable,” says Kate Mullaney, HGA’s national health care market strategist. “We started conversations with the germ of an idea March 15, engaged five companies and 80 reps using digital collaboration tools and virtual reality, and used readily available materials modified to provide hospital quality,” Mullaney says.

Boldt began fabrication using social distancing and health protocols, she says, and had a completed product April 15. “The goal is to offer the highest level of critical care with isolation to aid in infection control. That can’t be replicated in tents, shipping containers, or convention centers,” says Mullaney.

While the modules are more costly than temporary solutions, they’re about half the cost of traditional construction, and they’re built to last 10 years, she adds. Boldt and HGA shipped 64 beds to six East Coast facilities the week of April 20.

One lesson learned in the process has been that once a design is standardized and a supply chain made available, an inventory of finished product is not needed because on-demand fabrication can become a matter of days, Mullaney says, which saves on costs.

Other companies have also reached out to help during the pandemic. Southfield, Mich.–based Vesta Modular was asked to provide quotes for work for the U.S. Army Corps of Engineers, FEMA, and various branches of state and local governments nationwide. The company acts as a turnkey modular general contractor that designs, delivers, and installs modules for different commercial and industrial needs, and also leases its own fleet of existing modular assets for similar requests. To date, it has supplied units to fulfill space needs for an Atlanta-area hospital system, says Christopher J. Mattina, CFO. “We have the ability to deploy modular buildings in a rapid response situation across the U.S., with access to existing structures, factory relationships, and a remote work force,” he says.

Ft. Worth, Texas–based KPS Global is the country’s largest manufacturer of modular insulated panels used for temporary or permanent needs, including walk-in coolers and freezers for leading large retailers and blood banks. The company’s president and CEO, Mike Eakins, says they’ve already offered their panels to FEMA and the U.S. Army Corps of Engineers. “We said we could produce more than 1.5 million square feet of panels in our five plants across the country for temporary hospitals, and more dignified morgues than refrigerated trucks,” Eakins says. However, by the time state and federal agencies realized the scale of the problem, Eakins says, they went with a faster solution—tents in parks and convention centers with areas divided by curtains. “We could have provided what was needed in days, and our products can withstand 60- and 70-mile winds during some storms,” he says.

enclosed isolation room in hospital

© KPS Global

Now, many prefab and modular companies are considering how they can best get ahead of the curve before the next wave of COVID-19 or another crisis emerges in the future.

“There will be a need, maybe with another virus outbreak or natural disaster,” says Jason Heindel, an independent contractor and solutions architect who worked on STAAT Mod for Faith Technologies, an electrical contractor in Menasha, Wis. Eakins says his company is well positioned to ship product anywhere in the country within two days of being notified of a need. “We don’t need to maintain stock. We can meet immediate demands in this type of situation very quickly,” he says.

Because of the efficiencies of prefabrication, countries like Singapore have incentivized its use by making it a requirement to secure certain building permits or use public funding. “There’s no single solution, but a spectrum of solutions for short-, mid-, and long-term” uses, Marks says. “Everyone—architects, engineers, manufacturers, and contractors—needs to collaborate more so we can add permanent beds and be ready to pivot and respond for any crisis.”

modular, multistory construction

© VESTA Modular

Mattina says the real estate industry has to consider alternate forms of construction that may be more sensible to meet demands in different building needs. He expects a greater cross-pollination among residential, commercial, and industrial prefab and modular manufacturers and contractors. For example, his firm is already designing and constructing large urban infill affordable housing developments in the greater Atlanta area, New Orleans, and metro Detroit, where modular designs provide the best solution. Mullaney also says the module HGA helped design could be adapted for other purposes, perhaps for lower acuity clinical solutions, medical classrooms, temporary housing, and other applications.

The Stars Aligned for Boldt and HGA 

The fact that a prototype was almost ready and waiting to be adapted was a matter of timing. The Boldt Co. had been working on a prototype for a modular clinic and exam room for a large Chicago hospital system before the pandemic hit. The day the company finished, word of COVID-19 spread, and many states reacted with shelter-at-home policies. Company executives wanted to adapt what they had for more intensive care. They reached out to HGA, which had been a partner with it on prior health care work, and by the end of the week the two companies had completed a conceptual design for a modular ICU isolation room. “Because we didn’t want to overpromise, we estimated delivery in four to six weeks. Some places said that was too long,” says Ben Bruns, executive vice president of northern operations for Boldt. They went with other solutions. But then other hospitals came calling. And now Boldt is beating its original projection. They expect to get the modular production cycle down to under a week, Bruns says.