Serving a Growing Population with Prefabrication

Mesa, Arizona has grown by leaps and bounds over the past decade, becoming the most populous city in the East Valley of the Phoenix Metro Area. One of the fastest growing areas in America since the last census, this has resulted in a burgeoning population placing ever more demand on local services. Medical centers are no exception. To meet increased patient care needs and serve as a hub for the East Valley, DPR recently completed work on a five-story vertical expansion above the existing two-story north wing of Banner Desert Medical Center, increasing the licensed bed capacity, renovating aging units and expanding women’s services in Mesa.

Prefabrication was critical in mitigating challenges in the busy region and helping the project realize faster speed to market, create predictable timelines, and minimize impacts on existing hospital operations.

Exterior view of Banner Desert Medical Center in Mesa, Arizona.
Prefabrication was a critical component in the successful completion of Banner Desert Medical Center’s expansion in Mesa, AZ. Photo: Samuel Carl

The new tower creates a women’s-centered care program on the expanded footprint and maximizes connection between services from the existing seven-story pediatric patient tower that opened in 2009.

Banner Health’s primary goal for the project was to increase bed capacity, elevate the patient experience, and support long-term performance of the facility, while expanding women's and children’s services. The reimagined women and children’s entrance will welcome patients and reflects the expanded services. Banner’s investment in the community makes state-of-the-art services accessible to every patient and family.

“At the end of the day, our focus was just on making sure the owner was happy and doing that in a collaborative way, not trying to outshine each other. We knew that we’re all in this together, and if we were to succeed it would be as a team. No one team could succeed while the other two didn’t,” said Tracy Lauer of the design team, Cuningham Group.

View of a hospital room showing a patient bed, couch, chair, station for baby, and a bathroom.
Timing Is Everything

While the original building was designed with expansion in mind, challenges are inevitable in any vertical expansion above active healthcare operations—in this case, a pediatric surgery department. Changes in code requirements in the decade since initial construction coupled with supply chain issues accelerated by the pandemic and an aggressive schedule goal added to the project’s complexity, making robust communication a key factor in project success.

Banner Health Project Executive Nancy Medrano noted, “We collaborated well and kept lines of communication open and honest.”

Prefabrication To Address Challenges

To meet aggressive deadlines despite unforeseen factors, DPR employed a suite of solutions including 150 prefabricated factory-built bathroom units, the building skin, corridors, shared MEP racks and medical gas headwalls. This strategy made the difference in achieving the project’s schedule—especially as labor, supply chain and escalation issues would eventually impact the market amid a city-wide construction boom.

View of a bathroom featuring a toilet, sink, shower head and safety rails.
To meet aggressive deadlines, DPR employed a suite of solutions including 150 prefabricated factory-built bathroom units, the building skin, corridors, shared MEP racks and medical gas headwalls. Photo: Samuel Carl

One key prefabrication component even helped shorten the project’s critical path timeline: the use of SurePods prefabricated bathroom pods. 150 bathroom pods were manufactured offsite and loaded level by level into the five-story expansion, shaving 55 days—more than seven weeks—off the schedule compared to conventional on-site building methods. That not only saved time and cost, but also enabled the hospital to serve patients sooner.

Exterior view of a project being constructed with a crane hoisting prefab materials into place on an upper level.

With three separate healthcare projects planned for construction nearby, Banner sought to use the SurePods bathroom pods and modular headwall solutions across its portfolio—creating economies of scale and providing a templated design to achieve a consistent patient experience across campuses. In an uncommon collaboration, the DPR and Cuningham project teams were challenged to work closely with two other GC/design teams to standardize the design of the prefabrication components and reduce the overall cost. This collaborative approach drove value for capital projects across the health system.

Safer Construction

Building on an active hospital campus brings additional safety risks for workers, medical staff and the public. Working in and around sensitive areas like the hospital’s main entrance and pediatric surgery department, while performing high stakes tasks like critical picks, DPR focused on proactive planning and risk reduction through prefabrication. Without prefabrication of many components, there would have been much more potential for disruptions to hospital operations around the project site.

The team used SidePlate field-bolted steel connections as an alternative to welded joints. In addition to schedule savings, the use of the engineered fasteners meant improved safety—welding over the existing two-story occupied hospital with pediatric OR and PACU directly beneath the vertical expansion was eliminated.

Minimizing Impact to Operations

The exterior skin was also prefabricated. Scaffolding for framing, sheathing, Exterior Insulation Finishing Systems (EIFS), metal panel and block application would add cost and disruptions, and stick-frame construction would require more trade partners on site, adding congestion to an already tight, active campus that struggles for adequate parking. All four new elevations were constructed with panels built offsite, shipped to site and flown into place with cranes. The finished skin installation averaged 2,775 sq. ft. a day by one crew instead of multiple months with six to eight trade partners involved in a conventional setting, minimizing interruptions to the active campus.

Installing overhead MEP elements by traditional means can be complex and, in a 36-bed hospital unit with long corridors, very congested. As part of the project’s critical path, the team opted to use pre-engineered assemblies that integrate mechanical piping and electrical elements within a custom rack chassis. The racks went up quickly, creating schedule savings and reducing the need for onsite labor.

Interior view of ceiling and walls of a construction project being built showing assemblies containing mechanical piping and electrical elements in a custom rack chassis.
As part of the project’s critical path, the team opted to use pre-engineered assemblies that integrate mechanical piping and electrical elements within a custom rack chassis. Photo: Karin Fossett

Every patient bed in the hospital required framing, medical gas and electrical rough-in at the head of each bed, so DPR self-performed modular headwall installation to better control schedule. The prefabricated headwall system allowed for consistency and superior quality control with fewer trade partners. The premanufactured units shifted fabrication to an off-site facility, which reduced the onsite workforce, risk and safety incidents, and eliminated the logistical challenges of mobilizing a large labor force in an operating healthcare environment.

Ultimately, the team at Banner Desert Medical Center was able to meet the needs of the growing Phoenix community via the use of prefab solutions. Predictable timelines, faster speed to market, superior quality control and increased safety contributed to the project’s success.

A shift from field construction to field assembly.

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