Article 28, Part H, paragraph (1) of the 1945 Constitution states that everyone has the right to receive health services. Furthermore, Article 34, paragraph (3) states that the state is responsible for providing adequate health care facilities and public service facilities. Law Number 17 of 2023 concerning Health, Article 19, states that the government is responsible for the availability of all forms of quality, safe, efficient, and affordable health care.

The increase in life expectancy has not been without impacts on health care service patterns. The increasing elderly population and shifts in Indonesian lifestyles have generally impacted service demand patterns and the epidemiology of certain diseases that require significant funding, including heart disease, cancer, and stroke. This is illustrated by the significant decline in deaths from infectious diseases over the past 10 years, but the proportion of deaths from degenerative diseases (heart and blood vessel, neoplasm, endocrine) has actually increased.

Based on proposals from the Expert Team and the President-elect's Synchronization Team, the proposed programs include efforts to improve health care standards through the development of infrastructure and the development of comprehensive, high-quality hospitals in districts/cities.

There are 66 Class D and D Pratama hospitals that require hospital competency enhancement to support the KJSU (Community Based Health Service) Program. These 66 hospitals are located in 24 provinces, including remote areas.

Against this background, the Ministry of Health is planning to develop hospitals through a program to upgrade hospitals in these areas from Class D/D Pratama to Class C. This program, called the Quick Wins (PHTC) Program, aims to strengthen KJSU services, enabling them to provide Class C-level healthcare services in remote areas.

The strengthening of KJSU in question is an effort to develop health facilities, infrastructure and equipment, namely operating rooms, additional outpatient rooms, inpatient rooms (additional number of beds according to Class C Hospital standards), intensive care rooms, cathlab rooms and ICVCU, radiology rooms (CT-Scan, Mammography), and other supporting rooms if upgrades are needed. The area limit for this upgrade is ±7,000 m2 to accommodate the additional functions of the aforementioned spaces.

In general, the development of public and social facilities uses the principles of service scale, walking accessibility, and integration with the surrounding area. These principles aim to improve the effectiveness of public and social facilities for the residents they serve. The general design principles for shared facilities include accessibility; connectivity; green infrastructure; management; security; and disaster response.

One of the focus locations for the hospital upgrade is Borong Regional General Hospital in East Manggarai Regency. The hospital to be upgraded in East Manggarai is a Class D Regional General Hospital that will be upgraded to Class C, with requirements in accordance with Minister of Health Regulation Number 14 of 2021 concerning Standards for Business Activities and Products in the Implementation of Risk-Based Business Licensing in the Health Sector and Minister of Health Regulation Number 40 of 2022 concerning Technical Requirements for Hospital Buildings, Infrastructure, and Medical Equipment.

The physical construction of the East Manggarai Regional Hospital (RSUD) is planned to be carried out using a single-year design-build contract, specifically for the 2025 fiscal year. To support the construction implementation and the procurement of construction services, on-site supervision and control are required to ensure the physical construction meets quality, time, and cost requirements, and adheres to administrative procedures in accordance with applicable regulations. Given this need, the hospital construction project requires the involvement of a Construction Management consultant to oversee the on-site construction process to ensure it runs smoothly and as planned.

Design-build work is common in several large-scale projects with relatively short turnaround times. This method is highly effective in its implementation. The effectiveness of this method can speed up implementation time, improve collaboration and communication, and increase opportunities for innovation that occur in the field.

One of the projects currently underway is the Borong Nusa Tenggara Timur Hospital Project, run by the Ministry of Health. To expedite the work and implementation, the Design and Build system is being used by Brantas Abipraya, with Pandu Persada as the planner. This research will use this data to assess the progress of the ongoing work.

Design and build projects tend to use lump-sum contracts, making it difficult to assess the percentage of work completed within the limits of daily, weekly, and monthly progress. Similarly, inspections by authorities can be difficult to assess. This is because the planning process is still ongoing, making it difficult to assess the volume and cost of the work being carried out. Therefore, it is difficult for the owner, construction management, and implementing contractor to assess the progress of the work.

In an effort to improve the efficiency of construction projects, various methods and technologies are being developed, one of which is the precast concrete construction system. Precast methods have been widely used due to their numerous advantages, such as improved structural quality, accelerated construction times, and reduced fieldwork. One implementation of this system is the use of precast half slabs, which are semi-finished floor slabs produced in a factory and then finished through casting on-site.

The use of precast half slabs has potential advantages over conventional methods, such as reduced formwork usage, improved work quality, and increased time efficiency. However, using this method also requires a comprehensive analysis, particularly regarding production costs, transportation, installation, and coordination between field workers.

In the Borong Hospital design and construction project, the choice of floor slab construction method was a critical factor influencing the overall success of the project. Given the complex nature of hospital projects, including specific space requirements and high quality standards, an evaluation of the construction methods used was necessary to achieve optimal results in terms of both cost and time.

Therefore, this study was conducted to evaluate the precast half slab design in terms of cost efficiency and implementation time for the Borong Hospital design and construction project. This evaluation is expected to provide a clear picture of the advantages and disadvantages of this method compared to conventional methods and serve as a reference for decision-making on similar construction projects in the future.

In a Design and Build contract system, effective communication can be established between design and construction service providers, allowing for optimal integration of the contractor's and planner's construction knowledge and experience into the design (Ashworth & Perera, 2015). Many provisions are applied in Design and Build projects, one of which relates to provisions for the procurement of imported materials (Fikri et al., 2023). The process of identifying, ordering, shipping, and managing imported materials according to project specifications and schedule requirements is the responsibility of the Design and Build Service Provider (Giovannus, 2020).

In the legal and regulatory context, Law No. 2 of 2017 concerning Construction Services and Regulation of the Minister of Public Works and Public Housing No. 1 of 2020 concerning Standards and Guidelines for Procurement of Integrated Design and Build Construction Works serve as the legal basis governing Design and Build construction projects (Kerzner, 2022).

The Design and Build system, which integrates the roles of designers and construction partners, synergizes intensively with the owner. This demonstrates the significant role of the planner/designer, implementer, and managerial capabilities (project manager, owner) in this project. The project scope significantly impacted the completion time, as overtime was accelerated and additional construction personnel were employed. Suggestions from the implementation of this project include the need to further clarify the rules for collaboration between the planner/designer roles to minimize conflict with both the contractor and the owner (Prasetiya & Winansih, 2024).

Building structures are integrated elements that function as a whole, one of which is the precast structure in buildings. This section will discuss the advantages and disadvantages, connection methods, and basic theories related to analysis, specifically regarding structural planning concepts that refer to applicable regulations.

There are several differences between precast concrete and conventional concrete analysis. Precast design takes into account the lifting conditions of the concrete before it reaches 24 hours of age. Cracking can occur when concrete is lifted very young. Precast design takes into account the lifting method, storage, delivery, and installation of the precast concrete on the project site. Therefore, stronger connections are required.

In general, precast concrete component structural systems can be classified as follows (Nurjaman, 2000, cited in M. Abduh, 2007):

1. Partially precast component structural systems, where the system stiffness is not significantly affected by component breaks, for example, precast slabs and walls where the breaks are not at the beams and columns or at the joint points.

2. Fully precast systems, where columns, beams, and slabs are precast and connected, forming a monolithic structure.

Using the AHP method, work safety criteria were the highest weighted/priority criteria, at 16.4%, followed by structural strength criteria at 13.6%, work quality criteria at 12.7%, implementation cost criteria at 11.8%, implementation time criteria at 9.7%, planning criteria at 8.6%, contractor capability criteria at 7.4%, building form criteria at 7.3%, building aesthetics criteria at 6.9%, and weather changes criteria at 5.7%.

The highest priority value from the calculation results for determining the best alternative indicates that precast concrete is the most frequently chosen concrete method for building construction in Surabaya (64.9%). Meanwhile, conventional concrete methods have a percentage value of 35.1%. (Zainul, Ruslin, and Hamzah, 2011).

Concrete quality control is crucial and must be implemented for all projects, whether funded by the government or the private sector. The stages of quality control and engineering of concrete work include: Preliminary work, namely the study of plans and specifications, a thorough understanding of the project location, equipment and contractor organization, definition of tasks and responsibilities, identification of necessary testing, records and reports. (Rumihin, 2023)

The principle of this precast system is that it is molded or cast before installation. When considering precast systems, the first considerations for using this system are typical shapes and large quantities. Examples of jobs often created using precast systems include water channels, beams, stairs, and other repetitive and numerous projects.

The advantages of using precast systems include more efficient time, which is particularly effective for typical jobs. While the precast work is being prepared, we can work on other parts. While this system has advantages, it also has disadvantages, including requiring more complex analysis than on-site casting. Connection systems must be considered, reinforcement joints must meet the required length, and transportation and installation locations must be considered during planning. (Novdin, 2012)

Advantages of Precast Beams: 1. Technical quality control can be achieved because the production process is carried out in the factory and laboratory testing is carried out. 2. Shorter implementation time. 3. Can reduce construction costs. 4. Not affected by weather.

Disadvantages of Precast Beams: 1. Requires large initial investment and advanced technology. 2. Requires skill and precision. 3. Requires production equipment (transportation and erection). 4. Large-scale construction.

The beam-column junction is an area of extremely high stress interaction. Due to seismic loads, this junction is a potential area for collapse due to the diagonal shear forces generated by the earthquake. Therefore, the beam-column junction must be designed to meet SNI requirements. The connection between precast beams and columns in this article uses a connection like that shown in Figure 1 (Novdin, 2012).

This research focuses on a quantitative description of the progress of work on a design and construction project. Users are asked to choose the format that is easiest to understand in determining the progress of a project. The main objective of this research is to determine the best format for creating daily, weekly, and monthly reports for the design and construction project.

A quantitative approach is used to assess the volume and cost values used in formulating the work progress value. This research was conducted through several main stages, as follows: 1. Identifying the scope of the design and construction project. 2. Collecting and detailing work items in the design and construction project. 3. Compiling unit prices for work that does not deviate from the project scope or the PPK document. 4. Calculating daily volumes that can be identified as work progress. 5. Conclusions and recommendations for the ideal format for determining the design and construction work progress.

The hospital to be upgraded in East Manggarai is a Class D Regional General Hospital, which will be upgraded to Class C. The requirements are in accordance with Minister of Health Regulation Number 14 of 2021 concerning Standards for Business Activities and Products in the Implementation of Risk-Based Business Licensing in the Health Sector, and Minister of Health Regulation Number 40 of 2022 concerning Technical Requirements for Hospital Buildings, Infrastructure, and Medical Equipment.

The address of the Borong Regional General Hospital (RSUD) is in the capital of East Manggarai Regency, Lehong-Borong. Borong Regional General Hospital stands on an area of ±6.5 hectares, which is located in Lehong, Gurung Liwut Village. The analysis in this study focuses on assessing project progress by assessing the volume of work and determining its weight, which is then translated into physical progress reports.

The data analysis stages conducted in this study are as follows: 1. Conducting a literature review on related work. 2. Collecting relevant theories. 3. Reviewing the precast design calculations. 4. Preparing a detailed Budget Plan. 5. Preparing the implementation schedule using the S-curve method and the Critical Path Method (CPM). 6. Comparing the work speed. 7. Developing conclusions and recommendations.

Cost calculations for conventional and precast concrete work are conducted to determine which method is more efficient. Conventional concrete is a concrete work method where the entire casting process is carried out directly on-site. Precast concrete is a construction method where concrete elements are pre-produced in a factory or casting yard, then transported and installed at the project site.

Work begins with the preparation of approved shop drawings. Inspections are conducted to determine the readiness of the work area and the capacity of the crane to be used. The precast beams are first installed as the primary support for the half slab. They are lifted using a mobile crane or tower crane. Once the beams are in position, elevation and alignment are adjusted. Once all beams are properly installed, the precast half slab is installed using scaffolding and pipe supports. After reinforcement connections are made, the topping concrete is poured.

Conventional concrete construction generally takes longer because each stage of the work is carried out in stages and is interdependent. Comparing the construction time between conventional and precast is a crucial aspect in determining the most efficient construction method. Because precast eliminates the need for full formwork installation and dismantling on-site, the precast method significantly speeds up project implementation.

1. The use of a precast structural system in the Borong Hospital Design and Construction project increased construction efficiency compared to conventional methods.

2. From a cost perspective, conventional costs were Rp. 11,099,063,233.00, while precast costs were Rp. 9,948,547,434.71, representing a 5.18% savings of Rp. 1,150,515,798.29.

3. In terms of time, the precast method accelerated the project duration by 46 days (20.91%), reducing the implementation time from 110 days to 64 days.

4. The precast structural system is more effective when applied to multi-story building projects with repetitive work volumes and tight completion targets.

5. Overall, the precast method provides better efficiency than conventional methods when supported by proper planning.