Modularity Offers Opportunity for Healthcare

Posted on June 15, 2011


Sometimes a good idea can be the wrong idea if addressed at the wrong scale. Modularity is a good example of this.

Modularity, or the use of a repeatable piece or finite ‘kit of parts’ in the design and construction of something, has been discussed for decades as a possibility for major time and cost savings. The idea is that with interchangeable parts or a limited collection of pieces, fabrication will be easier, quicker and the parts themselves will be cheaper to construct. Modifications can be made faster and spare pieces allow for common details and intuitive design around the modules.

On small and medium scales this has worked well. One of my early jobs was with a firm that did laboratory work for Johns Hopkins Hospital. When JH hired a new scientist, researcher or doctor (‘principal investigator’ or ‘PI’, in lab parlance) who required lab space, our firm would demo an out-of-date lab and build it to the new PI’s specifications. All of this was done within their campus standard lab equipment vendor, Kewaunee, which had the easiest method ever for design and specification.

Kewaunee’s tables and accessories were all ‘build as you go’ systems. A demo table was never a table; it was a drawer box + support end + table slab + sink insert + equipment stand. Each piece had a simple letter combo and you designed by knowing what each PI needed. All the parts were in standard lengths and widths, so most everything was interchangeable. Compatibility was 100%.

This was not only easy to design and specify; it was easy to build. And for Johns Hopkins, the costs were easily quantifiable, which meant easy to plan and budget. Old lab equipment could be disassembled and stored for future needs, which was done quite often. This was modularity at its most efficient.

Today, healthcare casework is getting reformulated by several manufacturers for modularity, primarily because it has evolved from expensive, custom and permanent to inexpensive, standard and flexible. The custom lengths, profiles and detailing from twenty years ago has largely been replaced by premanufactured boxes that get door faces slapped on. Furniture manufacturers have seized on this opportunity to change a built-in done by a craftsman to equipment, which means hospitals can depreciate it more aggressively. The quality, aesthetics and flexibility of these modular pieces have also grown.

In the May 2011 issue of Interiors and Sources, DIRTT and Wahu were profiled as two companies working together to provide some modular casework designs for patient rooms. Before that, it was Goelst that put together a sturdy, modular, adaptable medical casework with good design.

Modularity will likely carry through to many other things in healthcare because it is a logical progression. And it makes things so darn easy. Healthcare needs more simplicity and interchangability. More companies working together toward global industry standards will be better than each trying to be proprietary in its own healthcare fiefdom.

However, modularity can be stretched too far too soon. A good example is flexible buildings. When I first heard the idea of a truly modular building, I think it was from then University of Virginia School of Architecture Dean William McDonough. It seemed like a good idea at the time:  a building that was built with enough structural and systems flexibility that it could be an office building, retail outlet and warehouse during its lifetime—never vacant or unusable. However, this concept has not proven realistic in healthcare. Some of the large, innovative healthcare systems feel a generic floor-to-floor height is not a smart infrastructural decision. In effect, they feel the building and its interior spaces are too important to subjugate it to modularity. Space comes first; how it’s built comes second, and never the other way around.

Modularity will continue to evolve and we may see a modular healthcare building in our lifetime. Prefabrication has come a long way lately. In the meantime, keep your eye out for evolution in modularity at a scale hospitals can support because it is easy to implement and simply makes sense.