Handling Health Care Challenges

Posted on:

January 20, 2016

Working in hospitals, especially in remodel and upgrade projects, is always a challenge, according to Roger Gundlach, president, Gundlach Sheet Metal Works, Inc., Sandusky, OH.

“You may have to work in a sterile environment, and you may have to keep one end of the department open while you’re working in the other so you end up having lots of partitions and protection devices,” he explains. “You have people on ladders and another person at the base of the ladder to direct hospital personnel around it. You may have to set up, and then if there is an emergency, you may have to tear down, so they can handle the emergency.”

He recalls the company’s recent installation of ductwork in a local hospital that upgraded its entire labor/delivery department. Because the department was located in the middle of the hospital, his crew had to tie into multiple existing systems and reroute ductwork—all while keeping the area in operation. “We would work on one floor, go into an area, tear ceilings down, reroute and reconnect ductwork, finish that area, and go to another floor,” he says.

His technicians often worked at night just to avoid the crowd of electricians, plumbers, and other trades who were jumbled together while trying to complete their assigned tasks. “You can’t get all those people into one space at one time,” he says, “so it sometimes worked better if our guys worked an off shift.”

To control communicable diseases, he indicates that hospitals typically have special filter banks. “If you’re going into the hospital to service or repair that piece of equipment or change the filters of that equipment, it may require special protective clothing and a special breathing apparatus because you could be pulling filters out of a unit that has captured microorganisms or viruses from a communicable disease.” In those cases, he says, technicians change the filters and seal them in airtight plastic bags for hospital disposal.

With 40 to 45 employees, the company averaged close to $8 million in sales and service in 2015, of which about half was construction related.

Managing Multiple Logistics

Even something as simple as getting deliveries can be a challenge in a hospital environment, emphasizes Steve Barnhill, fabrication services manager, Ivey Mechanical Company, a company with offices throughout the southeast and headquartered in Kosciusko, MS.

“A hospital is typically a congested area,” he says. “The logistics of managing people and materials can be a challenge. We need to get our workforce and materials in and out of the facility with minimal disruption because people are trying to recuperate from medical issues. Hospitals don’t have holiday shutdowns. They are 24/7, 365 days a year. You have to understand that and plan accordingly.”

For example, he says, the company has been involved in renovating a hospital in Jackson, MS, for 2 ½ years. “A big part of that renovation has been changing out air handling units with a very limited shutdown,” he explains. “We have to put in a temporary air handling unit, do temporary duct work to support that unit, then go into the space where the existing air handling unit is, demo it, put in a new one and put it in service, and take out the temporary one.”

When working in an existing area of a hospital, Barnhill often brings in special pressure machines that add to the filtration of the air-moving systems. “You have to maintain a slight negative pressure in the area you’re working in because you don’t want dust from the construction activity to be pushed into an operating hospital environment,” he says. “You have to be conscious of the pressure relationship between your work area and the other parts of the hospital.”

The company employs more than 800 and has a total sales volume exceeding $150 million, of which about 25 percent is hospital related. According to Barnhill, the biggest chunk of the hospital work is plan and spec or design assist “where we add the knowledge of cost and constructability factors on the front end of a job.”

Keith Paton, vice president of service, estimates Ivey Mechanical provides service to about a dozen hospitals and 20-plus smaller clinics. “Typically we have preventive-maintenance contracts with our hospital customers,” he says. “We go out and do work periodically to be proactive on maintenance and repairs. We don’t wait until it’s broken down to fix it. We try to predict what will happen and fix it in advance.” He adds that many hospitals have their own maintenance staffs, which he supports when they don’t have enough manpower or experience to complete a complex job.

Paton agrees that hospital work can be dangerous without the proper precautions. “There are hazardous materials, contaminants, and diseases associated with a hospital that we have to know about in advance. We have to be able to keep our people protected. We want everyone to go home safely to their families. That’s a big part of all that we do.”

Put Patient Care First

When you are working in health care, you have to remember that patient comfort and care are your client’s top priorities, which often requires flexibility in scheduling, shift work, and a detailed plan for daily execution, says Joe Nichter, president, Comfort Systems USA Southwest, Chandler, AZ.

“We have had several situations where we have worked in existing facilities with equipment changeovers that had to be scheduled, which included a shutdown for the hospital’s chilled water and steam systems,” he says. “These types of changeovers require significant planning to make sure everything is ready, including parts, equipment, adequate manpower, vendor backup for unplanned material, and the proper supervision to make sure the work is performed in a timely manner with a major focus on safety, quality, and productivity.”

Comfort Systems USA Southwest performs work in assisted living, vivarium, and acute care facilities, medical office buildings, hospitals, surgery centers, and behavioral health and genomic labs. Nichter estimates the company’s sales volume in health care over the last 15 years comes in at $250 million, which covers “everything from a $1,000 valve change to a $20 million new hospital.” About 10 employees specialize in ongoing health care work, a number that might spike to 60 to 70 installers for a new ground-up hospital.

“We believe healthcare is a good niche that provides us with cradle-to-cradle possibilities,” he explains. “We start with the new construction phase, which leads to future expansions and continual work for our building services division. In addition, there are multiple associated businesses that live within the health care industry.”

He points out that the company’s HVAC mechanics receive a medical gas certification as well as training on Infection Control Risk Assessment (ICRA) best practices in healthcare construction, which ensures they know how to contain pathogens, control airflow, protect patients, and work without disrupting adjacent operations.

“Healthcare is a growing market, and the future looks promising for continual growth,” he indicates, “but it requires a significant training investment for your technicians, especially if you are going to be involved in hospital facilities. Lack of preparation can be very costly to the contractor and customer if 100 percent isn’t given to the preplanning for every project. The last thing you want is for your work to disrupt patient care.”