Contractors interested in moving into the growing health care sector will need to do plenty of homework to win jobs in that industry.
“The health care world is changing even beyond the rate of other industries,” John Marshman, executive director, facilities operations, William Osler Health System in Toronto, told a seminar audience at The Buildings Show in Toronto.
“Ultimately, understanding standards and codes, understanding the opportunities to educate yourselves in health care and understanding a line of sight on directions in procurement, funding and what is happening with the (health) ministry are all things that will position you to be successful…” Marshman said.
Marshman and Roger Holliss, director of engineering, St. Mary’s General Hospital in Kitchener, gave delegates some ideas on the tools and information they will need to meet the requirements of the sector. That includes hospital-specific standards, courses and certifications.
Holliss, who is the president of the board of directors of the Canadian Healthcare Engineering Society (CHES), said membership in CHES can be a valuable start for builders thinking about health care work.
While non-health care members pay $800, they can quickly recover the cost through various benefits, he said. As an example, members have free access to “the big 15” Canadian Standards Association (CSA) standards in health care.
Typically, standards cost about $300 each for non-members, Holliss said.
There are more than 50 health-care specific standards under the CSA, he said, adding some are embedded in building codes. While most are not mandatory, hospitals often use them anyway because they are “the best means for a hospital to establish due diligence” in cases of litigation.
Holliss told delegates that CHES — which has 1,000 members in eight chapters — also offers its members webinars on technical issues such as infection protection and control and its website chatrooms “are a great networking tool.”
“We can help you be more successful in project management,” he said.
Marshman said there are three core standards governing the design, construction, commissioning and operation of health care facilities:
- Z8000, which references the building process through a series of standards and substandards;
- Z8001, references the commissioning stage for new and renovated facilities; and
- Z8002, covers most architectural and building systems in operations that support the health and safety of patients and staff.
Marshman said an important standard for builders is Z317.13, which provides guidance to protect patients and staff during construction/renovation in occupied environments. Training on the standard is required in most hospitals for all subcontractors.
He said successful contractors in health care stay on top of changes (which can occur frequently) to standards.
Holliss pointed out every five years CSA standards are renewed. While some of the revisions are minor, others are major, and they are often in place prior to updates in the national and provincial building codes.
As an example, the Ontario Building Code does not reference the 2017 standard for medical gas design and installation, he said.
Holliss told delegates that a contractor’s chance of being awarded a job improves when they provide proof of certifications for training/education courses. “Even though some of them might not be mandatory, we will ask for them.”
Certifications for infection control and medical gases, for example, cut potential liability and reduce conflict with the health care agency, “which will serve you well on future jobs,” he told delegates.
Holliss advised contractors to get certifications prior to bidding on a contract to improve their chances of winning the job.
Marshman told the audience to watch for contract opportunities through “vendor of record” listings “because it is definitely the way the (government’s) procurement landscape will go.”
He said there is a shift to value-based procurement (outcome-based approach for the user), covering the value of “a whole system versus the value of a specific product or service at a low cost.”
Marshman said if the average cost of a new-build hospital is $1.5 billion, half of that goes towards bricks and mortar and a third for “mission critical stuff.”
The deferred maintenance burden in Canadian hospitals is about $20 billion.
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