Rapid deployment of modular hospital facilities has become an essential action in the COVID-15 19 response. Design for Manufacture and Assembly (DfMA) has played a significant role with 16 governments commissioning emergency hospital projects. Due to the conflict between some 17 DfMA strategies or guidelines, their integration requires further thorough investigation. This 18 study aims to explore the integrated approaches to DfMA. A three-step method, including a 19 focus group, eighteen designer interviews, and archival study, formed the basis and validation of the case. Finally, the study identified 31 DfMA measures, revealed three organisational 21 (concurrence, integration and collaboration) and five design attributes that correspond with 22 integration strategies for DfMA. Critical to the integrated approaches to DfMA is breaking the 23 ‘mirroring trap’. This study contributes to the theory development of DfMA in terms of systems 24 integration. Future practitioners can take the example by the case to adapt the project 25 organisational structure to the building production.