Industry: Healthcare
Challenge: Choosing the ideal project delivery method for this clinic remodel: Design-Bid-Build (DBB) versus Design-Build (DB).
Results: The Design-Build approach enabled an accelerated timeline by removing gaps between phases and keeping decision-making centralized within one team.
Rush Commercial completed this 1,635 SF tenant improvement for Propper Smiles Orthodontics in Gig Harbor, WA. The project gave Dr. Nicholas Propp a new clinic where he could serve patients and staff with a custom reception desk, expansive staff lounge, added infrastructure to accommodate three orthodontic chairs, and new flooring and paint throughout.
Like many healthcare providers, Dr. Propp’s goal was to open his new clinic quickly without compromising on quality. Speed, coordination, and clarity throughout the construction process were critical.
At the outset, the team evaluated two possible project delivery methods:
Choosing between these two delivery approaches without the guidance of a knowledgeable contractor can be overwhelming, as confirmed by Dr. Propp.
“It is very daunting to jump into something brand new, so it was helpful to have someone walk us through the process from start to finish."
Why Design-Build Was the Right Choice
The Design-Build approach allowed Rush Commercial to overlap design and construction phases, significantly accelerating the project timeline while improving communication and cost control.
In a traditional Design-Bid-Build model, the process is sequential:
Each step must be completed before the next begins, creating delays and limiting flexibility. In contrast, Design-Build streamlines the process by integrating the contractor and designer from the beginning:
Because these phases overlap, projects move forward faster and with fewer disruptions. Brett Griffin, Project Executive at Rush Commercial, can attest to this.
"With Design-Build, we're aligning design, budget, and construction from day one. That eliminates downtime between phases and keeps the project moving forward without unnecessary delays."
A Faster, More Flexible Process
By choosing Design-Build, the project team was able to respond quickly to changes and maintain momentum throughout the project lifecycle. Dr. Propp saw this benefit firsthand.
“The most useful part of the design-build approach was the ease of making changes as necessary and having our team be able to access the space more easily. I believe that if we didn't use the design-build approach, our construction time would have been delayed significantly. The Rush team was very quick to respond to changes and once we finalized our layout, our permitting process seemed to take no time at all.”
According to Brett, “Because we’re involved early, we can pivot quickly when changes come up, without stopping the project or revisiting completed design work.”
Delivering Speed When It Matters Most
For Dr. Propp, speed wasn’t just a preference; it was critical to launching his practice.
“I knew I wanted to start my practice as soon as possible, so timing was important for me.”
Design-Build enabled an accelerated timeline by removing gaps between phases and keeping decision-making centralized within one team, which is why Brett is a huge proponent of this delivery method.
“For tenant improvements, especially in healthcare, every week saved translates directly to business value. Design-Build helps clients open their doors sooner."
A Seamless, Collaborative Experience
The Design-Build model created a more cohesive experience by aligning all stakeholders under a single team.
Dr. Propp emphasized the value of this integration.
“I see the value in having the team designing the space also be the ones completing the work. It makes for a more seamless process.”
This alignment reduced decision fatigue, improved communication, and ensured that the project stayed true to the client’s vision.
The Final Result
The completed Propper Smiles Orthodontics clinic reflects both functional improvements and a calming patient experience. Key components include:
The project was delivered efficiently, allowing Dr. Propp to begin operations quickly and with confidence.
Design-Build vs. Design-Bid-Build: A Clear Advantage
This project highlights the measurable benefits of Design-Build:
“Design-Build isn’t just faster, it’s smarter. It aligns the entire team around the client’s goals and delivers a better overall experience,” says Brett.
For Propper Smiles Orthodontics, the Design-Build approach proved to be a clear win. Rush Commercial delivered a high-quality tenant improvement on an accelerated timeline, while Dr. Propp benefited from a smoother, more collaborative process.
As more clients prioritize speed, efficiency, and certainty, Design-Build continues to stand out as the preferred delivery method for tenant improvements and beyond.
Learn more about the Propper Smiles Orthodontics remodel here.
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