Modular building saves time and costs

Advocate Health Care is a nonprofit health system in Illinois serving patients across 11 hospitals and more than 200 sites of care. To support its mission, Advocate engaged construction firm The Boldt Company to develop an outpatient clinic that reflects Advocate Health’s focus on improving access, streamlining patient experiences and creating healthier communities while ensuring the facility’s development would be guided by Lean construction principles to minimize waste and maximize value.

Construction on the Hoffman Estates (Ill.) Outpatient Clinic began in November 2023 and was completed in November 2024, a mere 12 months later. The 35,000-square-foot facility boasts 44 exam rooms and offers comprehensive clinical services in primary care, pediatrics, orthopedics, obstetrics-gynecology, cardiology, imaging and physical therapy.

During early feasibility studies, Boldt was able to identify a significant cost gap through its use of open-book budgeting and commitment to cost clarity throughout every phase of the project. Increasing costs posed a major hurdle for the team, requiring a full-scale redesign and reprogramming effort, with multiple feedback loops to align design decisions with the clinic’s performance requirements and budget realities.

Considering budgetary constraints, the most notable cost-effective strategy was to embrace prefabrication, which Boldt integrated into the early design phase.

The company specializes in building patient rooms off-site — fully equipped with fixtures, drywall, plumbing and electrical prep — expediting the construction process while enhancing quality and safety.

For the Hoffman Estates Outpatient Clinic, the construction and design team identified opportunities for prefabrication and modularization in multi-trade overhead mechanical, electrical and plumbing racks; exterior wall panels; and examination room pods. In total, 59 rooms (primarily patient care rooms) were prefabricated off-site, saving weeks of work compared to building the rooms on-site. Boldt invited city inspectors to visit the prefab shop, addressing building code concerns and garnering support for this cost-effective approach.

The Boldt team also suggested multiple design changes to stay within budget, such as streamlining the lobby, eliminating architectural embellishments like wing walls and designing a sloped roof, thus eliminating the need for an interior roof drainage system. Each design recommendation was rooted in performance, simplicity and efficiency.

By using this innovative approach, Advocate Health Care and Boldt spent 35% of the overall budget on prefabrication, decreasing the overall project cost by 32%. The use of prefabrication increased speed-to-market by several months while reducing project costs for the Advocate Health Care system. These cost reductions allowed for budgeted dollars to be reallocated elsewhere, like on sustainability solutions such as solar panels and electric vehicle charging stations.

“Although this was built from the ground up amid a fluctuating market, the clinic was delivered on schedule and under budget, making it one of our most cost-effective projects,” says Thaddeus Jedrzejak, Advocate Health Care’s director of planning, design and construction for Midwest non-acute services. “Being able to welcome patients sooner without sacrificing quality helps advance our mission of expanding health care access and building healthier communities.”

The approach taken by Advocate and Boldt serves as a playbook for future facilities as the health care system seeks to expand quickly and affordably. Modular design and prefabrication are scalable and repeatable, with the Hoffman Estates Outpatient Clinic being a perfect “proof of concept” for its future health care facilities nationwide