Healthcare MEP crews aren’t slow. They’re inconsistent.

TL;DR Our research showed that tackling inconsistent output is an important opportunity for improving healthcare MEP performance.

MEP systems are among the most critical, and least forgiving, parts of a hospital build. HVAC ductwork, domestic water piping, electrical cable tray, medical gas piping, and pneumatic tube systems compete for the same congested ceiling and wall space as every other service in a heavily serviced building. 

Anecdotally, from conversations with Buildots clients, these systems are also the ones most often cited as the root cause when a healthcare project runs late.

With this in mind, our team at the Intelligence Lab decided to look more closely at how these five systems actually perform across a cohort of real-world global hospital and medical center projects.

What the healthcare MEP data revealed

We drew on 24 hospital and medical center projects across North America, the UK&I and mainland Europe, focusing on the steady production window of 10–90% complete.

For each of the five systems, we looked at two numbers. 

Typical pace is an activity’s median weekly output over the life of the job, essentially, its normal week. 

Best sustained pace is its average weekly output during its best sustained four-week run, the four consecutive weeks where that activity moved fastest.

We deliberately measured best pace over a four-week run rather than a single best week. A single fast week can be an outlier: a lighter scope week, a burst of overtime, work pulled forward from another trade clearing space early. Any of those can produce one freakish number that says more about a one-off coincidence than about what the crew can actually sustain. A four-week run that holds a fast pace is a different kind of evidence. It’s harder to explain away as a fluke, and closer to a real, repeatable ceiling on performance.

Measured this way, the gap between typical and best sustained pace remains consistently wide. Across all five systems, the best sustained four-week pace ran 1.4 to 2.2 times faster than the typical week:

• HVAC ductwork: Best sustained pace is 1.4x the median week.
• Domestic water piping: Best sustained pace is 1.8x the median week.
• Electrical cable tray: Best sustained pace is 1.8x the median week.
• Medical gas piping: Best sustained pace is 2.1x the median week.
• Pneumatic tube systems: Best sustained pace is 2.2x the median week.

What does this gap tell us?

If a trade’s best sustained pace and typical pace were close together, you could reasonably conclude that the typical pace is close to its real ceiling. A 2x gap between what a crew can do and what it usually does suggests that this categorically isn’t the case. 

You might be shouting at your computer right now, saying “Of course a crew speeds up sometimes. More work becomes available, more people get sent to a task, a floor clears out ahead of schedule. None of that needs explaining.”

In our opinion, taking this view is a missed opportunity to improve healthcare MEP performance onsite. Here’s the case for it. 

Firstly, we deliberately measured this within the 10-90% completion window, well clear of the ramp-up at the start of a job and the push at the end, so this isn’t an end-of-project crunch showing up in the data. 

Secondly, whatever drives a fast run (more people arriving, more work opening up, a handoff finally clearing) must have a specific, traceable cause. So does whatever slows a run down. Finding that cause is the whole point. Once a team knows why a run went fast or slow, they can try to recreate or avoid those conditions.

What should I do about it?

In our view, a particularly fast run warrants investigation. You might ask yourself, “What cleared out of the way? What sequencing lined up? Who wasn’t waiting on whom during those weeks?” 

Similarly, a slower stretch is a symptom worth diagnosing. Like any good doctor, there are questions you can ask to arrive at the right answer: “Is it work getting interrupted? Access getting blocked? Handoffs with other trades breaking the rhythm? Or something else entirely?”

None of those questions get asked if nobody notices the pace shifted in the first place. Most jobs don’t track weekly pace for each activity. They track whether a task will hit its finish date, yes or no. So a crew can hit every deadline on time for months while secretly speeding up and slowing down by more than double underneath, and nobody watching the schedule would ever see it happen. The finish date looks fine right, up until it doesn’t. Speed, not just the deadline, deserves its own place on the report.

Of course, we understand that this reflects a single cohort of 24 projects and isn’t an industry-wide verdict! But we think it’s interesting all the same. The next step for our team is to run the same lens across other systems and project types to see how far the pattern holds and where it doesn’t.

So, if you’ve seen a specific bottleneck turn a fast crew into a slow one mid-project, get in touch and we’ll investigate it further.