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‘No Room For Error’: The Essential Role Of Preconstruction In Healthcare

A recent multiphased renovation of an active surgical critical care unit, built by Leopardo.

Few construction projects are as complex as those done in healthcare facilities. Besides contending with the intricate network of mechanical and electrical systems that wind through the walls, healthcare contractors must interface with dozens of owner-assigned vendors and subcontractors, from site-work experts to medical equipment manufacturers.

Adding to the complexity, when a facility is being expanded or updated, the property needs to operate as usual while it is under construction, still hosting patients. With physicians, nurses, sick patients and even newborns just feet from the work zone, healthcare construction must be a painstakingly choreographed and planned-out process. 

"There is no room for error in hospitals and medical office buildings," said Giancarlo Pacini, senior vice president at Leopardo. He has worked for over two decades in the healthcare construction practice and today leads the company's healthcare market. "We strive to get involved at the earliest stage possible. The sooner we get on board, the more conflicts we can resolve before construction starts, and the more value we can create." 

To ensure facilities are completed on schedule and without issue, Leopardo takes extra measures during the preconstruction process. Its team of experts step in to guide projects even before building designs have been drawn up, assisting clients with building modeling, budgeting and site selection. 

"We also fully integrate our virtual design and construction group into preconstruction," Pacini said. "This includes 3D aerial drone mapping and 4D site logistics plans for new buildings and additions, early building modeling with REVIT, existing structure laser scanning and modeling, as well as augmented and virtual reality sessions." 

A medical office building for diagnostic imaging, built from the ground up by Leopardo.

Since healthcare facilities can be so complex, owners often make hundreds of tweaks to early conceptual design documents. When those tweaks happen, Leopardo provides in-house, detailed, trade-level estimates and live cost modeling long before schematic design efforts begin. These estimates keep owners current and informed on how much proposed changes will cost. 

Many of the services that other contractors might only offer during the construction phase are in full force during Leopardo's preconstruction process. Since healthcare projects have so many moving pieces, that early involvement provides added value to the project.

The company has also developed a proprietary estimating software that shows every level of detail needed to articulate and analyze estimates and subcontractor bid recapping. That allows for consistency and accuracy from a conceptual estimate all the way through complete construction document bidding. 

But Leopardo's real secret to successful preconstruction is its archive of healthcare project data. Twenty years ago, the company began chasing down every healthcare project it could find, from outpatient facilities and multistory medical office buildings to small and midsized hospital renovation and new construction projects. As a result, Leopardo's preconstruction team has seen just about every possible healthcare scenario.

"There's really nothing that surprises us anymore," Leopardo Director of Business Development Jessica Sherwood said. "We know how to solve every crisis and budget for every change." 

A fully renovated cancer center, built by Leopardo.

While preconstruction helps to deliver even more value to projects, Pacini added that Leopardo's preconstruction team has also resuscitated healthcare projects that were once deemed financially unfeasible. 

"It's inspiring to see patients being cared for in a place where we used our expertise and guidance in order to help revive the project," he said. 

Leopardo's days of specializing in medical office, outpatient and small-to-midsized hospital projects have prepared the company for the state of the modern healthcare system, which is increasingly moving away from sprawling hospital campuses and toward smaller facilities closer to consumers.

The growth and acquisitions common in the healthcare industry today have allowed Leopardo to grow across the country along with its clients. 

"Because clients value our unique services, we've been able to expand nationally along with them," Sherwood said. 

That sort of dedication is incredibly important to Pacini, who said it is never lost on him how significant the work of preconstruction is for healthcare projects. 

"Our healthcare team and preconstruction work are more than just accounting for every brick, beam, wire and piece of pipe — it's also and most importantly about people's lives," he said. "The systems we're working with and around might be feeding an ICU, a cancer center or a nursery. Any error could put a patient in jeopardy. It's critical to have everything in place far in advance. Our team understands this and they thrive on meeting the needs of our customers."

This feature was produced in collaboration between the Bisnow Branded Content Studio and Leopardo. Bisnow news staff was not involved in the production of this content.