Detroit Medical Center Creates Cardboard City During Design

TROY, Mich. — The Detroit Medical Center’s Children’s Hospital of Michigan in Troy opened its doors on Feb. 1. Throughout the course of construction on the 63,000-square-foot hospital, the project team used lean design to lower costs and decrease the building space required for the project.

“When we started the lean process, we started out hopeful that we would save money and drive out waste — drive out waste in terms of steps that people take and processes along the way,” said Ronald Henry, senior vice president, chief facility engineering and construction officer at the Detroit Medical Center.

Using the lean design process resulted in saving approximately 20 percent of building space, which was about 15,000 square feet and $10 million in savings, according to Henry.

Larry Gold, CEO of Detroit Medical Center, was very focused on identifying the target audience and humanizing the construction process, according to Henry. The design had to be “safe, patient-centered and efficient,” Henry said. The medical center wanted to involve those it would serve by bringing in current and former patients, families, technicians, doctors, nurses and administrators to test the new layout.

To better understand how to make the most of the hospital space, the project team built a full-size model to test what worked and what didn’t work. The medical center used a nearby ice rink to build different floors of the children’s hospital for testing. The ice rink provided a large space, with no columns, where the facility could be laid out. During the six months that the project team used the ice rink, they were able to build a total of 300,000 square feet of the building — each week focusing on a separate floor.

The construction crew built the model using cardboard and Duct tape, which is why they dubbed it “Cardboard City.” By creating the spaces with cardboard, the designers were able to change the layout as much as five or six times, as user groups gave feedback. The project team laid out basically the entire facility except for the lobby, which ended up being a mistake in the end.

“For eight months, we had the design team come in, and we would review the floor plan for the lobby,” Henry said. “We couldn’t figure out where to put the reception desk and the security guards. Finally, I said we need to mock it up again, and we had 50 people come through to test out the lobby. By moving these stations and reception desks to different points, everyone agreed to put the reception desk in one spot within three hours.”

Creating a full-scale model of the hospital reduced the amount of Requests for Information (RFIs) from the general contractor by about 50 percent. The main issues they found were beyond the ice rink’s dasher board (or perimeter) because a lot of the spaces they were building were a little bigger than the ice rink and therefore weren’t being accounted for in the model, according to Henry.

While the facility will not seek any specific type of green certification, the team did focus on sustainability, environmental efficiency, safety and patient satisfaction, Henry said. The building reduced the hospital’s staffing needs by 14 percent and created a more hands-on environment for patients. It already tripled its volume projections just two months after opening and has been extremely well received.

The center also reduced cost by using local materials instead of using materials such as aluminum, which would have to be imported. Using masonry and brick allowed the team to create a timeless building that is essentially maintenance free, requiring less washing than a glass and metal building would.

The contractor on the project was Southfield, Mich.-headquartered Barton Malow. Boston-based Shepley Bulfinch Richardson & Abbott served as the architect on the project, while locally based Peter Basso Associates provided engineering services.