Case Study: Transforming 48 Shipping Containers into ICU Rooms in Three Weeks

How BMarko Structures designed, developed, and distributed 48 modular ICU units to help combat the COVID-19 crisis. 

                      A fully furnished ICU room inside the modular units.

In March 2020, the coronavirus entrenched itself on American soil. What had started as a few cases in Washington and New York quickly spread to pandemic levels in all 50 states. Schools closed, churches went virtual, and millions of businesses shut down in order to prevent the spread of the virus. 
While many people were asked to stay home and wait for the pandemic to pass, others looked for ways to combine their resources and ingenuity to aid in the fight against the virus. The latter is the case for BMarko Structures, a modular manufacturing company based in the Atlanta suburb of Dacula, which transformed 48 shipping containers into mobile intensive care units (ICUs) for hospitals in Albany and Macon, Georgia.  BMarko made it look easy, but it was far from a smooth and simple process. Let’s start at the beginning to learn how this team went from conception to the finished product.

Start Every Project with a Strong Team 

Antony Kountouris, CEO of BMarko, was looking for a way to help local communities during the COVID-19 crisis. He wanted to take advantage of his team's expertise to turn a set of shipping containers into extra hospital rooms – allowing doctors to have more intensive care unit (ICU) space if the pandemic reached critical proportions. There was just one problem with his plan. BMarko doesn’t normally make hospital ICU rooms out of shipping containers. Furthermore, the hospitals needed the extra rooms now. There was no time for months of research and development.  

Kountouris turned to Heather Cohen, BMarko’s architecture and design lead, who he knew would be perfect for the job. Cohen was uniquely qualified to handle this project. She had previously served as the Senior Project Manager for Vanderbilt University Medical Center (VUMC). During her time there, Cohen worked on implementing regulatory compliance for the various aspects of the VUMC properties.Along with her healthcare experience, Cohen has worked with InterContinental Hotels Group (IHG®), specifically designing layouts for micro-hotel rooms. One of the most important aspects that Cohen brought to the table was her eagerness to participate in the project. Both she and Kountouris were just starting to realize the scale of the project ahead of them.  


From Idea to Blueprints in 48 Hours

                                                     A model of the modular ICU rooms.

Kountouris and Cohen didn’t waste any time developing the modular hospital units. They couldn’t afford to – any hour wasted was time that could delay the project and hold healthcare workers back. Over the course of two days, which included two all-nighters, the BMarko team developed a modular blueprint plan.  There were several aspects of the design that challenged the architecture team. Each room came with highly-specific needs. While a hotel is designed with comfort and relaxation in mind, these units needed to also meet the needs of doctors and nurses while maintaining (or exceeding) medical cleanliness compliance. 

One of the biggest challenges was space planning. How tight could BMarko make the rooms while still creating a functioning ICU? Each unit also needed a functioning bathroom, per hospital standards, that had a large turning radius and space for nurses to help patients. The units needed special doors where equipment could be brought in and out. Even basic design elements like the HVAC system proved to be a challenge, as ICU rooms need specific air pressure, temperature, and air quality standards to protect patients. Once the team locked down a layout, they only had to make minor changes throughout the rest of the process. They knew they needed to create something usable and move on to assembly. 


Starting the Assembly from Scratch 

                 The BMarko team busy transforming shipping containers.

Turning a design into a reality can take several weeks, and BMarko usually requires a six week lead time for every two containers it develops. However, Kountouris and his team managed to design, create, and deliver 48 containers in less than three weeks. This is an impressive feat on its own, but it becomes even more admirable considering that the company had to open a factory, find materials, and hire 130 workers - many of whom had very little training on what they were about to do - within a matter of days. 

This project wasn’t as simple as sending the prints down to the production team. BMarko needed to create the production team first. Kountouris found a previously-closed factory that was willing to work with them last minute and signed a contract for use in less than three hours. They then advertised the new assembly job openings across the web, and spent hours calling anyone who could send workers to take on the project. As workers started to come in, they began making the factory operational, setting up a plan to develop the modular ICU units. When asked about the eight days of production, Kountouris admits that everything was a challenge. There was always someone working from the management side from 7 am to at least 2 am. They were training new employees, finalizing the designs, and trying to get materials as quickly as possible. 

There was no time to order tools and materials and sit for days while they were shipped. The team needed these things immediately. In one day alone, employees made 18 separate trips to Home Depot for materials. The need was so intense that Kountouris said runners would just sit in their trucks and wait for someone to run out with a list of Home Depot needs. It escalated to the point where they cleared out Home Depot locations in the surrounding area of the parts they needed, forcing the runners to expand their radius to pick up materials for the crew. 


How CertainTeed Stepped in to Help 

BMarko wasn’t the only company looking to use its construction niche to make a difference during the COVID-19 pandemic. The employees and leadership at CertainTeed have always looked for ways to help their communities in any way they can. This is why Dennis Michaud, CertainTeed R&D Director, reached out to Kountouris upon hearing about BMarko’s initiative. Michaud asked Kountouris to put together a list of what they needed so that CertainTeed could identify what it could provide. As due diligence, Kountouris reached out to another company to supply materials; that company offered him what he needed for just under $20,000. CertainTeed’s focus was on helping address the pandemic, so it offered all the products for free.

While the offer for free materials was certainly moving, delivering them wasn’t an easy task for the CertainTeed team. They had less than a week to coordinate and deliver the promised goods. Plant Manager Abel Ureste and the team at the CertainTeed Insulation plant in Athens, GA made it happen in record time by shipping materials directly from that plant to BMarko. Additionally, Deb Emory, Sales Representative for CertainTeed Ceilings, avoided lead times by working with numerous distributors, contractors, and even end-customers to pool together enough of the requested, medical-grade materials from multiple local sources within a couple days. The numerous CertainTeed employees and distribution partners involved were proud to do their part during the pandemic.

Kountouris was thrilled with the work of CertainTeed. Many companies had promised goods, but CertainTeed took the work seriously and delivered on time. As a result, BMarko had enough VinylRock™ ceiling panels and fiberglass insulation to assemble the modular ICUs. 



The Completed Hospital Rooms Touch Down     

                             Modular units being installed on the hospital grounds. 

 In less than three weeks, BMarko managed to design and deliver 48 modular ICU units to their respective hospitals in Macon and Albany. Kountouris estimates that this process was 25 times faster than normal for BMarko. These units weren’t just created quickly, they were assembled well. The Georgia Emergency Management Agency (GEMA) toured the facilities and were impressed by the quality.

Throughout the delivery process, the state health representatives and COVID-19 response teams helped coordinate where the units would go. The Georgia Governor took note of the construction efforts. He called the units “one of the best decisions we made early on,” in regard to pandemic preparedness. The story even made the local news, assuring residents in those areas that their hospitals were more than prepared for any potential spikes in COVID-19 cases. It was an exhausting few weeks for Kountouris and his team. However, everyone agreed the stress was worth it. BMarko continues to create more units, and the company has published the modular ICU layout for its Liberty Boxes so other companies can skip the design process and create more hospital units faster. 

Companies like BMarko played a significant role in helping the United States overcome the COVID-19 pandemic. The ingenuity and creativity of Kountouris and his team highlight the best in humanity in leading teams to accomplish the impossible. With BMarko, CertainTeed, the Georgia Emergency Management Agency working together, along with input from hospital staff, we were able to prepare these Georgia cities for the worst of the pandemic – while simultaneously hoping the worst never comes. 

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