The Importance of Dynamic Phasing in Healthcare Construction

As any design and construction professional can attest to, dynamic phasing is a critical component in keeping a project on schedule and within budget. Even more so in the healthcare environment – particularly renovation projects – where issues such as unforeseen conditions, staffing, and patient census intersect with infection control, and now a pandemic.

During the design process, careful consideration is given as to how the project will proceed. This takes into account multiple variables ranging from the impacts to occupants, users and neighbors, the ability of doctors and medical personnel to safely deliver care services, and staying within the schedule and budget parameters. However, the initial strategy usually does not survive the first encounter with reality; therefore, a project team must adopt a more fluid approach to project execution to counter the myriad of issues that can – and will – pop up.

Critical to the success of dynamic phasing is communications among project stakeholders, design professionals, and the construction team. Our Construction Administration team helps facilitate that communication in all of our projects. As an example, during the on-going renovation of a nursing tower to be completed in mid-2021, our project team added additional touch-base virtual Owner-Architect-Contractor (OAC) meetings to facilitate improved communications and shorten decision-making times on critical path items, ultimately leading to improved performance.

On the same 12-phase project, the first phase encountered a number of unforeseen issues. These issues, coupled with the increased delivery time for materials due to the COVID-19 pandemic, led to a 9-week delay in the turnover of the phase. By working closely with executive management, nursing staff, and facilities management, we were able to determine the level of staffing for service beds, additional beds available because of the decreased census of non-critical care patients, as well as the number of additional negative pressure rooms recently made available through a partnership with Department of Health and Environmental Control (DHEC) and the Department of Health (DOH). This allowed the project access to two consecutive phases on two different floors, with the completion of phases overlapping with the beginning of new phases. This phasing adaptation allowed the project to make up for the Phase-1 delay and ultimately led to substantial savings in the schedule in the order of 8–11 weeks.

While not every project involving a dozen phases can gain weeks on schedule, the critical element to dynamic phasing is communication and teamwork to permit project construction to be completed as efficiently and effectively as possible. It all comes down to flexibility and coordination.