Darrell O. Simpson, senior vice president of development at The Sanders Trust, Birmingham, Ala., offers candid feedback on health care segments, workforce concerns, and the benefits of collaboration, BIM and prefabrication. The Sanders Trust has developed or acquired medical office buildings, inpatient rehabilitation hospitals and specialty hospitals in 23 states valued at more than $1 billion. 

What changes in the health care industry are driving the demand for construction?

We increasingly see a shift in health care systems wanting to be located in retail areas. Mixed-use developments have a health care component as accessibility, convenience and enhanced patient experience continue to be a focus of health care systems. The freestanding ambulatory care market continues to be a feeder source for health care systems. 

We also see growth in the post-acute market with rehabilitation hospitals and senior living facilities. Cancer centers, ambulatory surgery centers, medical office buildings and other specialty health care facilities continue to be more community-based and centrally located to increase patients’ ease of access.

What are some of your main areas of concern that you try to impress upon Contractors?

With regards to the construction side, speed to market and construction cost are big concerns. There is a high demand for construction right now in all market segments, but unfortunately there is a lack of qualified health care subcontractors (thus workforce) in the marketplace. This strain results in increased pressure on project cost and schedule, and is overall my biggest concern for the industry.

With regard to the tenant side, the Affordable Care Act and ongoing health care reform continues to be an obstacle. The increased pressure to reduce cost and increase quality for the providers is passed on to us as landlord/developer in providing cost-effective solutions to our clients. 

What level of collaboration do you like to see among your project team?

At The Sanders Trust, we bring contractors on board during the design process to assist and provide insight as we move through the preconstruction process. This often extends to subcontractors that can add a great deal of value to the process. We find this builds a trusting, mutually beneficial relationship.

How has the planning and delivery of health care projects evolved with BIM, prefabrication and other project management tools?

The Sanders Trust has seen significant improvement in speed to market and quality with BIM and prefabrication especially. BIM has allowed greater collaboration between the design team and the subcontractors, and we see greater prefabrication of above-ceiling MEP components with the use of clash detection.