The proclaimed Queen of Prefab, Amy Marks, serves as the head of industrialised construction strategy and evangelism at Autodesk Construction Solutions. Previously, Marks was the CEO of XSite Modular, where she devised the language and process now employed globally by companies, nations and building designers to facilitate prefabrication. She boasts a big industry fanbase and speaks often at industry conferences.

Marks feels that the building design, engineering and construction (AEC) industry is stepping up to address the lack of hospital beds required for the COVID-19 crisis. She says that many traditional AEC firms such as Balfour Beatty, HGA Architects and The Boldt Company, Rosendin, are coming up with prefab solutions to this widescale problem. 

One prefabrication company that frequently manufactures in the service of medical facilities is a modular firm known as BLOX. They are creating mobile isolation care units (MICUs). MICUs usually require months to produce, but BLOX has trimmed their production schedule down to weeks and hastened production using BIM and cloud collaboration technologies such as Autodesk Construction Cloud. 

Certain companies that generally specialise in prefabricated housing or classroom units are widening their focus to include healthcare. The AEC industry is turning more and more to prefab to address major healthcare needs.

The main plus of prefabrication, says Marks, is speed. Facilities can be put together far more quickly if their components are custom made to fit together. 

To meet immediate, emergency-driven structural needs, readymade tents, container-styled structures and modular temporary units are emerging across the medical landscape. These structures can be set up and retrofitted with speed and efficiency. 

Once emergency, short-term architectural needs have been met, prefabrication factories can shift their operations to erect more healthcare infrastructure. This approach is both cost- and time-efficient in nature. 

Marks recalls that in 2003, when SARS (Severe Acute Respiratory Syndrome) was spreading throughout China, the country constructed the Xiaotangshan hospital in Beijing through a process of prefabrication, thus erecting the perfect global model for this variety of healthcare structure. And due to their experience in this area, China was able to meet this crisis with a prebuilt inventory of prefabricated components. 

China met the challenge of COVID-19 by stacking and fitting ready made frames onsite—making optimum use of prefabricated elements. The United States is replicating these efforts, along with more complex prefabrication integration, for both large-scale hospital projects and complete volumetric modular and smaller scale medical facilities. 

Marks reminds us that the challenge of hospital construction without prefabrication is that many building designers are starting from scratch design wise, with few structural role models in place.  

Engaging in every new project with new plans and partners is a definite and very time-consuming challenge, even if prefab components are in place. Also in place should be AEC contracts, downstream procurement methodologies, and other methodologies to enact prefabrication on a major scale.  

Cost efficiency is a main drawing point of prefabrication, said Marks. Plus requisite elements like electrical, HVAC, etc., can be decoupled and concurrently built away from site, helping adjust and abbreviate the construction schedule. 

Safety is an additional drawing point. Prefab manufacturing is conducted in a controlled factory environment, with on-site risks subsequently minimised. And of course, at this point and time, the fewer people working on site, the safer and easier it is to manage the site. Marks believes that project teams should seek to prefabricate complex but compact cellular workspaces that optimise project productivity—while at the same time limiting interference with patients. 

Marks believes that an entire ecosystem can be developed around prefabrication methods and manufacture. And when combined with collaboration and digitisation, this will create a formula for success in the time of COVID-19.