RC117 MarApr 2025 - Magazine - Page 13
MASTERING
COMPLEXITY
The challenges of building the next
generation of healthcare facilities
by John Tenpenny
ITH THE DEMAND for more hospitals and at an all-time
high, new healthcare facilities now combine stateof-the art hospital design with the latest virtual
care technology to fundamentally re-engineer
how care is delivered across a health ecosystem.
During a recent webinar hosted by ReNew
Canada—with support from PCL Construction—a panel
of experts involved in the healthcare infrastructure sector
discussed the next generation of Canadian hospitals, from
design to construction.
W
What are some of the challenges faced by designers and
builders as new healthcare projects become larger and
more complex?
CHRIS RICK (PCL CONSTRUCTION): I’ll start on the construction side
昀椀rst. We and our major competitors in this space have
delivered 2,000,000 square feet large acute care hospitals,
that were manageable in the pre-COVID world. Since then,
we’ve had unprecedented cost escalation tied to supply
chain issues. And what we’re 昀椀nding is that the scope of
these larger projects isn’t the challenge. The value is, and
that’s creating challenges, as both general contractors and
subcontractors are pushing up against bonding limits.
And that’s requiring more joint ventures on the very large
projects, which isn’t necessarily as e昀케cient or as e昀昀ective.
We’re also 昀椀nding construction schedules are longer postCOVID, and that there is reduced productivity. There’s
still supply chain fears that make mechanical and electrical
contractors less agreeable to aggressive schedules, and it’s
di昀케cult to get bonding for projects. So, a number of the
cost escalation schedule issues are creating challenges in
delivering large healthcare projects.
SYDNEY BROWNE (DIAMOND SCHMITT ARCHITECTS): As projects become
larger, typically they also become more complex. And
when you’re working on healthcare projects, so much
of what we think about in early design stages has to do
with the connection and movement between one part of
a facility and another. So, it becomes more challenging
to 昀椀nd e昀昀ective ways to connect departments as they get
John Tenpenny is the
editor of ReNew Canada.
john@actualmedia.ca
RENEWCANADA.NET
OUR PANEL:
SYDNEY BROWNE,
Principal, Diamond
Schmitt Architects
KEVIN LITTLE,
Senior Manager for Design & Project
Delivery, New St. Paul’s Hospital Project
at Providence Health Care
CHRIS RICK,
Project Director,
PCL Construction
larger. I would also say that as these projects become larger
and more expensive they very often move to some kind
of a P3 delivery model, which really changes the working
process. It means that we don’t have as much opportunity
as we normally would in a smaller project to have direct
conversations with clinical users, with families, with
patients, with sta昀昀, and there’s a lot more reliance placed
on developing the upfront documents that describe the
project. What comes out of this scale is adaptability and
an opportunity to move in a direction that is more tuned
to change over time, and 昀氀exible, which in the long-term
should be a really important part of the larger scale projects.
KEVIN LITTLE (PROVIDENCE HEALTH CARE): Larger and more complex
is just the nature of what we’re doing here. When we
started excavation [on the new St. Paul’s Hospital], our
contractors were working with a 30 per cent set of drawings
for 2,000,000 square feet. And as you’re progressing
through the excavation and pouring footings, you’re at 50
per cent, and as you’re coming out of the ground, you’re
at 70 per cent. It’s a big rock to push through a very tight
window of time. Previously, I worked on a project with a
complete set of drawings, which is just di昀昀erent then it is
now. [Providence] will own and operate the facility on day
one, so a lot of our people who are doing the reviews of
the building will actually be working in the building. It’s a
whole di昀昀erent model of what we expect out of the delivery
of the project.
MARCH/APRIL 2025 – RENEW CANADA 13
