A Case Study on ForWard Pre-Manufactured Modular Headwalls

For nearly 30 years, Steve Ward and Associates, Inc. has been installing headwalls. This is in conjunction with their award-winning millwork and casework in healthcare facilities throughout the country. Like others who serve the healthcare industry, SWA Inc. typically installed ¾” thick plastic laminate panels on top of traditional “stick-and-drywall” construction.

After participating in the LEAN Management Program, SWA Inc. comes to a realization. They realize that most waste (in both material and labor costs) in a hospital casework/millwork package relates to the headwalls. This rings true across new builds, renovations, and retrofits alike.

This is especially alarming to the SWA Team. They know that a headwall frequently defines the environment in the room in terms of patient care and safety. When they interview the actual owners of the healthcare facilities, they learn there are three areas of concern.

The first is the unit cost. The actual cost to build and install the traditional headwall. Then, there is the project cost. What problems are we encountering on the job site, and what does it actually take to complete the job? The amount of coordination between trades and the sheer number of contractor minimums to complete a headwall using traditional “stick-and-drywall” construction drives up the project cost.

Cost of Ongoing Ownership

Finally, the biggest concern to owners is the cost of ongoing ownership. This alone falls under three categories: The first being that under GAAP, companies require long-term depreciation on the traditional headwalls. This is not appealing to CEO’s or CFO’s. Jack O. Bovender Jr., former CEO and Chairman of the Board HCA, was once quoted as saying, “I care about accelerated depreciation, because accelerated depreciation is cash!”

Next is the issue of ongoing maintenance. Today, the Cleveland Clinic has up to 75 full time employees (salaries, benefits, payroll taxes, G&A costs) simply “patching and painting walls.” In healthcare, patient care comes first. As such, when a nurse has to quickly move a piece of equipment, it will hit the wall. Bed locators and bed bumpers next to the bed do very little to mitigate this. This simply drives up the cost.

Finally, healthcare facility owners lament the lost revenue from not “keeping heads in beds.” When repairs are necessary, the patient bed, semi private room, or (in a worst-case scenario) a whole floor has to be shut down. Breaking up drywall. Cutting. Drilling. All this creates a lot of noise and dust. This lost revenue is a major hit to the bottom line.

Moving forWard

In SWA Inc’s constant quest to best serve their clients and the industry. They embark on a search for a better way that to fully address these issues. They find some companies which pre-build the headwall in a warehouse down the street. However, this does little to reduce the project costs. Oftentimes, the headwall can’t fit in the service elevators. So, the facility skin and windows have to be removed. A crane has to be rented just to get the unit into the room. Then, there are ongoing maintenance concerns. Because, the construction is still stick-and-drywall, offering no protection.

The SWA Team feel themselves getting close. They find some manufacturers who attempt to fill the void with pre-manufacture modular headwalls. But, the features and benefits of these products do not meet all of the needs which has to be address. Drywall, even when with aluminum covering, still dents. Laminate chips under the constant impacts to which the areas around the bed are subject daily. The products are “cookie cutter, shrink wrap; here it is, take it or leave it.” According to Stan Parnell, Senior Associate Vice President Callison RTKL, “At first [these headwalls] are fairly well-accepted. But then, architect and design teams push back, as they are not able to enhance the patient experience.”

The SWA Team continues its search.

As so often happens in life, SWA Inc. finds the answer in the backyard of their headquarters in the city of Nashville, TN. A first-rate company, Wellness Inc., has a revolutionary, patented product that perfectly meets ALL the needs of their clients. SWA realizes they could formulate a powerful strategy by acquiring the assets of Wellness Inc. SWA then combines 30-plus years of custom design millwork and casework with this superior new product. Using this new process, architects and designers consult early in the process in order to give them the flexibility necessary to enhance the patient experience. Since no bed locators or bed bumpers are necessary due to the 24-gauge steel backing, the end product is both convenient and aesthetically pleasing.

The forWard Headwall Solutionmoular headwall

To reduce project costs, the “ForWard Headwall, Inc.” would arrive pre-plumbed, tested, and certified for medical gases. It is UL approved, electrically pre-wired, and the low-voltage provisions and pull-strings are already in place. The SWA Installation team coordinates in advance with the GC before arriving onsite to install the framing, which only takes 15 minutes. After the MEP contractors complete the connections, the SWA team installs the finish panels in a matter of minutes.  This approach reduces excess waste by consolidating the number of contractors working in the headwalls space, thus reducing the total project cost.

The ongoing cost of ownership rounded out the value proposition. First, because the ForWard Modular Headwall is a piece of equipment, it is eligible under GAAP for accelerated depreciation. More importantly, because of the 24-gauge steel backing covered with industrial-strength, high-impact vinyl, ongoing maintenance is virtually nonexistent.

Testimonials

In 2009, TriStar StoneCrest Medical Center in Smyrna, TN applies the ForWard modular headwall system (formerly known as Wellness, Inc.) to their patient room walls on the fourth floor. The remainder of the hospital has traditional stick-and-drywall construction. James Golden, Manager Facilities Management, shares his experience for this study: He needs to refresh/repaint 15-30 rooms every two years on all floors except the fourth. James said this is very costly in terms of both materials and labor. Additionally, these rooms have to be shut down during the process, and the hospital loses valuable revenue during this time.

James went on to say there’s no maintenance on the fourth floor the entire nine years the ForWard product is in place. He shares one repair, where a resident drove a nail into the wall to hang a picture. Of course, ForWard already supplies multiple replacement panels for storage, so replacing the panel damage was quick and easy.

James stated that the ForWard Headwalls were much easier for cleaning and implementing infection control procedures. The hospital will be undergoing a major remodel over the next two years, and James will be recommending a total conversion of the remaining patient rooms to the ForWard Headwall Solution.

Other Examples

The University of Tennessee Medical Center in Knoxville, TN has the same experience, with the same results. The first two floors of the Heart Hospital use traditional stick-and-drywall, and the third and fourth floor utilized the patent ForWard Headwall Solution. Subsequently, basing off the comparison data UTMC is able to gather, they decide to include the ForWard Headwall Solution for the remaining patient rooms when they renovate three more floors in the tower.

ForWard Headwall knows that flexibility, regarding design and placement of the outlets, is a major benefit nurse managers and Chief Nursing Executives appreciate. Unlike other pre-fab headwall products where the placement of medical gas and electrical outlets are up to the manufacturer, ForWard gives nurse managers the ability to custom design the modular headwall and the outlet placement to meet their specific needs.

In summary, by incorporating the features and benefits of the SWA Inc. patented ForWard Headwall solution into a healthcare facility, owners reap the following benefits:

  1. Custom design by engaging with the architect and design team to enhance the patient experience. This gives the owner a competitive advantage, especially in marketing materials.
  2. Reducing project costs by having ForWard Headwall control the manufacturing, and most importantly, the installation. This gives the owner one point of contact start to finish, no “passing the buck.”
  3. Drastically lowers cost of ownership as a result of accelerating depreciation, little to no maintenance cost, and keeping heads in beds, bringing revenue to maximum capacity.
  4. Allows nurse management staff to custom design outlet placement to ensure patient care, safety, and life-sustaining capabilities.
  5. Reduces cleaning cost and better infection control and management procedures.

It proves for over 10 years that the Forward Modular Headwall solution affords owners, architects, designers, contractors and nurse managers all the benefits of a pre-fab modular headwall system, with the necessary customization for aesthetic appeal.