UC Davis Health 48X Complex

University of California, Davis (UC Davis) Health developed the 48X Complex to relieve pressure on its main hospital and meet growing demand for outpatient care. One of the nation’s largest comprehensive outpatient surgery centers, the facility brings advanced surgery and imaging together with pharmacy, rehabilitation and specialty clinics in a single destination.

Speed to market was critical. Progressive Design-Build (PDB) allowed the team to finish two weeks ahead of its contracted completion date. UC Davis Health used a qualifications-driven procurement process and provided stipends to shortlisted teams, emphasizing healthcare experience and collaborative capability over prescriptive technical solutions.

Building a Structure for Fast Decisions

After award, a third-party moderator led off-site workshops to establish team expectations and governance. During design and construction, UC Davis Health leadership co-located with the design-builder, designers and trade partners. The Big Room became a working environment where decisions could be made at the lowest appropriate level rather than repeatedly escalated.

Daily “Rocks in the Road” meetings paired urgent construction issues with an Owner decision-maker on site. Questions that might otherwise have entered the traditional Request for Information (RFI) process were often resolved within 24 hours. The team estimates this approach reduced RFIs by approximately 40%.

UC Davis Health reinforced shared accountability through $4 million in performance incentives tied to schedule, planning reliability and document quality. The team achieved 10 of 11 incentivized milestones.

Early collaboration also enabled extensive prefabrication. The team locked in most interior-wall decisions during design development, supporting rapid installation of 80,000 linear feet of prefabricated walls. The project also incorporated California’s first fully prefabricated bathrooms approved by the Department of Health Care Access and Information. A Level 5 digital twin and robotic layout further improved field accuracy.

The 48X Complex expands outpatient capacity while freeing inpatient resources for more complex care. Its delivery demonstrates how clear governance, aligned incentives and ready access to decision-makers can turn an ambitious PDB schedule into an effective project outcome.

Design-Build Team

Photos

Photo Credits: Kyle Jeffers; DPR Construction; Danny Sandler