Modern Methods of Construction (MMC) for Health Equity in Australia

What does our healthcare system mean to you?

For me, this picture tells a thousand words. In 2017, our daughter arrived six weeks ahead of schedule. A fantastic outcome in construction, however not the same for maternity. We were fortunate to be supported by some of the most amazing, empathetic people in some of the best healthcare facilities. In a period of uncertainty, when you don’t have control, you are at the behest of the backbone of our society in healthcare.

That level of service is not available to everyone in Australia. Health equity is a long-standing challenge that I believe can be tackled by embracing a new approach to procurement and embracing modern methods of construction (MMC).

A great engineering design isn’t defined by its complex analysis, or calculations (although very important), it’s defined by the end users’ experience and interactions with a building. Exceptional hospitals or health facilities are about humans: patients and their families, and the practitioners who work there every day.

How well is the construction of health infrastructure meeting the needs of all today’s people in any location? What are the market dynamics driving infrastructure development? And, how can we design and build differently for future generations in the evolving service delivery of healthcare?

These were some of the topics discussed at the Hospital Planning Design & Construction Forum in Sydney late last year, where I presented on Aurecon’s partnership with the Victorian Health Building Authority in its COVID-19 Emergency Department (ED) response.

The story of responding to COVID

Unable to convert existing operational areas into isolation and resuscitation bays to handle sudden and unexpected rises in cases of coronavirus presenting to emergency, the Victorian Health Building Authority (VHBA) decided to construct temporary emergency departments to enable quarantining and provision of healthcare to patients.

Leading the design and construction of these highly technical hospital emergency departments, we at Aurecon knew that innovation and a flexible framework would be required. We turned to MMC as the answer.

With off-site construction, minimal waste and standardised components, the modules were able to be designed and built in much shorter timeframes than a traditional building programme. It also meant the impact on each hospital’s existing operations was minimised during construction, and there’s better scope for reuse or recycling of modules when the emergency departments are no longer required.

A total of 48 beds located at three hospitals across Victoria, Australia, is now relieving emergency department pressure through the modular facilities.

These are several common questions I get asked about MMC, and my responses are:

What is MMC?

The taxonomy can be confusing. MMC is a broad overarching term that encompasses design for manufacture and assembly (DfMA), offsite manufacture (OSM) and industrialised construction, just to name a few. It is an expedited process suited to repeatable aspects within infrastructure, increasingly for social infrastructure, that is scalable and flexible. This makes projects more agile, enables supply chain involvement earlier in the process, and prevents time value being lost in the end-to-end construction process.

How does it work?

An MMC build is cost efficient (at scale), materials efficient and reusable. The customisable nature makes the programme adaptable to different locations, built for purpose, and able to integrate with existing buildings in different formations.

What are some lessons learned?

A governance structure that defines roles and responsibilities is important to get right at the very beginning of a programme. It is useful to form committees with clear scope and authority to enable quick and efficient decision-making.

Logistics and manufacturing principles are fundamental to the success of a programme and require to be developed and refined to provide an environment for MMC to succeed and deliver the greatest benefits.

Articulate the programme’s vision clearly to obtain stakeholder buy-in and ensure that all communication is transparent and two-way.

With the rapid pace these projects move at, it’s important to exercise a high level of diligence to ensure all documentation is aligned for certification and asset handover in short timeframes.

Is this method relevant across sectors?

Yes, most definitely. It’s not solely the healthcare sector that can benefit. MMC design, powered by digital engineering, is delivering new?social infrastructure facilities and residential accommodation and, equally, within horizontal infrastructure like utilities, road and rail.

Financial pressure, decarbonisation, and expanding population, coupled with a shrinking skilled workforce and global supply chain disruptions, are pushing MMC into mainstream construction. As this is acutely experienced in healthcare as the sector provides such critical (and time driven) services for people, I only see an upward tick in the application of MMC in the future.