Managing the many details involved in the logistics of building of multiyear, complex healthcare construction project presents a host of challenges for any construction management team. Preconstruction services, incorporating the use of Building Information Modeling (BIM) and other advanced approaches are critical to providing the customer with peace of mind during the construction process, and help to ensure that the project will proceed smoothly and meet its deadlines and budget. Here are highlights of the methods used for the construction of the Shapiro Cardiovascular Center at Brigham and Women’s Hospital (BWH) in Boston by William A. Berry & Son, Inc.

Preconstruction planning

During preconstruction planning, the level of detail in up-front diligence is extensive. The construction manager needs to confirm existing conditions at the site including lay-down area, material deliveries and removal, equipment and road access, and shutdown planning, to name just a few. Comprehensive subcontractor task plans need to be completed well before construction starts, as well as myriad other factors that need to be considered.

To assist this process and the entire preconstruction phase, many construction managers, including Berry, use BIM, an innovative approach to building design and construction that supports continuous and near immediate availability of project data, including design, scope, schedule, and cost information. Berry was one of the first construction managers to use introductory, first-generation BIM technology and is refining its use for large-scale construction projects.

Healthcare construction can be particularly challenging, not only because of the building requirements for medical and surgical suites, as well as laboratories, but also because of the logistics of balancing construction needs while the healthcare facility simultaneously provides care to critically ill patients. Construction under these circumstances demands the utmost attention to detail on every level.

Case in point: the recently completed Shapiro Cardiovascular Center at Brigham and Women’s Hospital in the heart of Boston’s Longwood Medical Center. The 136-bed, 450,000-gross-square-foot facility required complex planning and coordination not only among BWH staff and management but also with neighboring healthcare facilities, surgical areas, and traffic and infrastructure serving more than 20 major clinical, research, and medical education facilities.

Construction was performed in a tightly constrained site with zero lay-down area on a busy city street along the hospital’s main and ER entrances. The site required complex utility relocation involving redirecting all utilities that run down a busy Boston street without shutting off the utilities. This included water lines, drains, electric, tele/data, and gas lines that had to be redirected in a U-shape around an entire city block.
Brigham and Women's Hospital in Boston recently added the Shapiro Cardiovascular Center, a 136-bed, 450,000-gross-square-foot advanced cardiac treatment center. William A. Berry & Son, Inc., was the construction management firm for the three-year, multiphase project

Brigham and Women’s Hospital in Boston recently added the Shapiro Cardiovascular Center, a 136-bed, 450,000-gross-square-foot advanced cardiac treatment center. William A. Berry & Son, Inc., was the construction management firm for the three-year, multiphase project


For the Shapiro Center, Berry engineers used BIM, creating 3-D drawings from a 2-D source and other software (NavisWorks) to do MEP coordination for all of the hospital’s mechanical systems in the preconstruction phase and in the design and estimation of those systems. They also used it to work with the design team to review plans, evaluate constructability, and monitor costs throughout the project.

This approach for installing ductwork, various piping for process work, sanitary and drainage, medical gasses, sound attenuation, and other complex building requirements for hospital construction streamlines the coordination process and keeps everyone up to date on project parameters, which change frequently. While still an evolving technology, BIM helps improve coordination and productivity and lowers costs by reducing errors. For example, on the Shapiro Center, project leaders estimate that using BIM reduced mechanical conflicts by 85%, which translates to a reduction of 30 days in MEP coordination time. It also reduced the client’s exposure to change costs by approximately $250,000.

Currently, Berry is pioneering the use of new technology (Bluebeam PDF Revu CAD software) in building construction. It is doing so as part of a company-wide technology initiative to achieve a paperless environment. Bluebeam makes it possible to convert drawings of any size or scale to a variety of file formats, allowing for markup, editing, and viewing. Many industry experts believe this new software will be the next generation of construction drawing manipulation.


Michael Willett, SCPM, CCI, CCPM

Michael Willett, SCPM, CCI, CCPM

Specialists in MEP, site, structural, and architectural disciplines are all crucial to accurate estimating. MEPs are particularly important because these systems can be some of the most difficult to estimate accurately and can comprise a large portion of project costs. It’s important to have experts in their respective disciplines who can scope out trades with precise details, identify missing components, and make effective value-engineering suggestions. A high level of expertise and accuracy is essential, especially with the complex MEPs involved in both medical and laboratory facilities.

At Berry, in-house staff use onscreen takeoffs, which greatly assist estimating. The software enables the preconstruction manager to design using BIM to do 3-D coordination. The benefits of this technology are multiple: it’s quick, eliminates the costs of drawings, allows for printouts of color drawings showing all the components clearly, and helps clarify assumptions made by the design team, the client, or the CM in comparing those assumptions with the reality of what is needed or wanted. It is also helpful when identifying specific project elements and pinpointing and quantifying them.

LEED certification

If the client is undertaking LEED certification, it is critical to identify this at the start or as early as possible in the preconstruction phase. Getting certified requires detailed estimating, and it’s possible to get “free points” when a project is first started. With help from a CM or design team, a project may get certified fairly early on in the preconstruction process or during construction itself.

As the first “green” building in the Longwood Medical Area, the Shapiro Cardiovascular Center at BWH required the use of energy-conserving, earth-friendly construction elements meeting the LEED guidelines. These included:

  • Numerous windows and daylighting design strategies that allowed more natural light;

  • A reflective roof system selected to deflect heat;

  • Rubber flooring instead of vinyl in the interior so there is no need to strip wax with toxic solvents while simultaneously avoiding numerous VOCs found in more traditional vinyl flooring; and

  • A ventilation system designed to enhance performance in dealing with a host of airborne pathogens.

Many experienced owners and design teams regard preconstruction services as an investment that pays off at project completion. Resolving issues in the preconstruction phase yields many positive results, including reduced errors, lower costs, better planning, and project management. BIM and new, evolving, advanced technologies greatly assist the preconstruction and building processes, ensuring on-time, on-budget results. HD

Michael Willett, SCPM, CCI, CCPM, is Project Executive, William A. Berry & Son, Inc., in Danvers, Massachusetts.

For further information, phone 978.774.1057, e-mail, or visit

Healthcare Design 2008 August;8(8):30-32