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The use of physical models is common in medical construction. Operating rooms, ERs, and other hospital components are complex, so trial runs are necessary to ensure that vital life-support systems and hospital infrastructure work efficiently in compact spaces. But creating physical mockups is time-consuming and expensive, and discovering errors that require reworking during construction adds to costs and delays. So when Layton Construction embarked on designing a 485,000-square-foot, 280-bed medical center in Florence, Alabama, the company turned to virtual reality (VR) to create virtual mockups during the design phase and at key milestones of the build process. For the medical center, building design prototypes would have meant creating 20 physical spaces in a rented warehouse. Projected costs were about $250,000, and the revision process would have been tedious and labor-intensive. However, Layton had been working on a better way to conduct test walkthroughs of proposed room layouts. By creating realistic 3D models of the medical rooms and asking owners and end users to interact via VR goggles, the firm hoped to give them a real-world context for the rooms’ feel before construction commenced, ultimately reducing potential change orders and other delays.
And it succeeded: The medical center’s mockup construction costs were reduced by 90 percent, and feedback from the visualization experience created many opportunities for prefabrication and design changes that dramatically sped up approvals and construction. The team was able to make prefabrication submittals two months sooner than planned. “Had we done this physically, we would have had to rent warehouse space and devote a crew to building mockups, and then rebuild mockups out of cardboard and similar materials,” says Jon Ferguson, Layton’s corporate manager of visualization. Ferguson says that physical mockups can range from cardboard to full-scale rooms (minus the large, expensive medical equipment), but VR let the team jump right to a lifelike mockup on day one. “The irony is, by doing this virtually, the mockups were more realistic and more useful.”
Mocking Up the Mockup
“We know the construction industry is moving toward VR, and we’ve been working with the equipment and software for a long time,” Ferguson says. “We’ve been looking for a use case, and this new hospital was ideal—the owners are tech-savvy and open to new ideas.” Ferguson’s job is to provide creative oversight for Layton’s business development pursuits. “Anything visual,” he says. “Renderings, models, VR—anywhere that images work better than words.” He turned to a visual demonstration of the technology when presenting the idea of VR mockups, making a quick, good-looking VR space. “I created a ‘mockup of a mockup’ and took it to a meeting with the owners. They loved it, so we moved forward.”
To create the 20 mockups needed, Ferguson worked with Layton’s BIM coordinator to identify rough design models already created in Autodesk Revit. “We got these from the architects, and were able to import them directly into Stingray,” he says, noting that the team went from Revit to 3ds Max to Stingray. “Later, we invited the architects in to consider changes, and they did all the new design work, of the physical space, in Revit.” Stingray, Autodesk’s 3D game engine and real-time rendering software, was used to apply surfaces and textures to the bare-bones models provided by the architects, and to build or import models of the equipment and furniture that would be used in each room.
“We’d get models from manufacturers when we could,” Ferguson says. “STERIS, for example, gave us access to their 3D library, which was a big help. Otherwise, we’d take the spec sheet and build our own models. In every mockup we were shooting for detailed, photorealistic room environments, and were able to achieve that with Stingray.”
The User Experience and Lessons Learned
To put the VR mockups to use, Layton brought end users—nurses, surgeons, facility managers, and so on—and hospital executives to large, open rooms where they could walk about freely and interact with the virtual space. The VR hardware they used was HTC’s VIVE system, and ultimately about 200 people experienced the virtual environment, some as many as five times. “Beforehand, we’d give them a heads up on room features we considered critical,” Ferguson says. “But we also filmed every encounter so we wouldn’t miss any comments on anything users noticed.”
Acclimating users to the VR experience was straightforward, with some hiccups. “After a bit of training, most of the users got it right away. And we never had anyone who couldn’t do it,” Ferguson says. “But there were different levels of ease of use. It didn’t seem to relate to age or any other obvious factor—it’s just the way some brains are wired.” Ultimately, the VR mockups were highly effective, and users provided quality feedback that made the tested rooms more efficient and useful. In one case, users found that where oxygen canisters were placed in labor and delivery rooms, they blocked access to outlets in headwalls. Because this issue was discovered in the virtual environment, the team was able to easily update the model before beginning the build process. “This would have affected existing equipment, and made it not work well,” Ferguson says. “Fortunately, we were able to make changes, and this even allowed us to prefabricate oxygen lines months earlier than expected, saving equipment and about two months of time.”
This pilot project was so successful that Layton Construction has fully committed to using VR, and has since employed the technology about once a week, with improvements each time. “What we did in Alabama was really great, but technology moves so fast that we have to keep working hard to make it better,” Ferguson says. “Since then, the sophistication and scale of our virtual spaces have grown exponentially.” Recent simulations have incorporated sound cues where appropriate, and have included large student-housing projects and commercial real estate exteriors. And it’s becoming possible to conduct collaborative design review—for example, surgical teams can “experience” fully occupied operating rooms. Ferguson even expects to expand its services to augmented reality, where computer-generated images are overlaid onto a real-world environment. “We’re just waiting for a use case.”
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