“Exciting part of the development process”

Work continues on rebuild project

The Request for Proposals (RFP) was issued at the very end of June, meaning the three teams vying for the project have all of the requirements needed to complete their bids.

For the redevelopment team which has been working furiously throughout the planning phases to get this project over the finish line, it’s a chance to take stock of all their efforts.

“This is an exciting part of the development process,” said Bart DeVries, director of redevelopment at Hamilton Health Sciences. “Our team has spent the better part of two years consulting and planning for the new hospital. Now we’re at the stage where we get to see that hard work materialize in the plans being developed by the design-build teams competing to win the project.”

Working behind-the-scenes

While this is a relatively quiet period in terms of public milestones and updates, lots of work is happening behind the scenes.

“Together with Infrastructure Ontario, we meet with each bid team on almost a weekly basis. Some of these meetings are a few hours in duration to cover their progress on schedules, IT and equipment planning, etc. In August, September, and October there are all-day meetings with each team where they share their current design iterations and walk us through their plans at each stage,” said DeVries, noting that each meeting is attended by an impartial “fairness monitor” to ensure that any information provided by the hospital to one bidder is shared equally with the others.

These meetings are an important part of the development process. They allow each design-build team to receive feedback on its designs in real time and have dialogue with the hospital. The meetings also provide the opportunity to raise red flags if there are potential issues or concerns on either side of the table.

“The RFP includes over 5,500 specific and unique requirements associated with the project. Documentation is provided to the bid teams after each design presentation session outlining which requirements have been satisfactorily met, and those that have not. As you can imagine, many questions come up throughout the process. Between regular meetings with the bidders, and request for information (RFI) requests, all parties have the ability to interact with our requirements and ultimately identify solutions, even though their design is unique from others. Where warranted, we revise some of our requirements to respond to innovations and other changes that will benefit the project,” said DeVries.

“With all projects, especially those which move as fast as the WLMH rebuild is moving, it’s always better to address matters up front so that teams can progress their designs quickly and allow us to minimize what needs to be resolved in the end,” he added.

Building relationships

The regular dialogue also lets the hospital’s team get to know each of the potential design-build teams. The new hospital will take between two and three years to build. It’s important to start building relationships and understanding each team’s dynamics.

“The relationship between the design-build team and the hospital and its planning, design and conformance (PDC) team is critical for the success of any project. Building rapport starts on day one and it’s nice for both sides to get to know each other early on,” noted DeVries.

Meetings with design-build teams will continue until late October 2021. Technical (“design”) submissions for the RFP are due at the end of November 2021. RFP financial (“cost”) submissions are due early January 2022. Evaluation of each will take place and the successful proponent will be announced sometime in March 2022. Shovels are expected to hit the ground by June 2022.

Q&A: Update on the new WLMH

Q. The Stage 3 submission was sent to the Ministry of Health in late March for approval. Where does that currently stand?

A. Our team has been engaged in discussion with the Ministry about the submission. This is normal. Everyone is working toward the same goal of planning and building a great hospital. All parties are working as fast as possible to achieve that goal.

Q. When do we anticipate Stage 3 approval?

A. Approval is expected imminently.

Q. What happens after the Stage 3 submission is approved?

A. Refining the RFP documents has continued since the Stage 3 plan was submitted. The Stage 4A (Approval to Request for Proposal) was submitted to the Ministry on May 28. Final revisions and reviews will continue into mid-June, and we are also preparing for the tendering period.

Q. When will the RFP for the design-build team be posted?

A. Ministry direction is to post the RFP on June 28, which is almost a week earlier than originally scheduled.

GRAPHIC: Countdown to Construction

Q. What happens in Stage 4?

A. The three design-build team candidates will receive the tender documents on June 28. This launches us into formal design presentations from each team as they develop their proposals. Those presentations are followed up with design documents which will be checked for compliance and feedback, and then returned to the teams to progressively elaborate on their designs. This will continue until the proposals are received late fall 2021 at which point there is an extensive evaluation and negotiation process with the preferred proponent, leading to a contract to design-build-finance the project.

Q. What happens during the RFP period? Is there any contact between the hospital and the bidding teams?

A. There are regular touchpoints between the hospital, Infrastructure Ontario (IO) and the three individual teams while the RFP is posted. These conversations will inform the teams’ bids. The procurement process will be overseen by a third-party to ensure transparency and confidentiality are maintained.

Equipping the new WLMH for success

When people think about building a hospital, the shiny new building from a project’s renderings often come to mind. Construction-related comments like “shovels in the ground” or “opening the doors” are tossed around in casual conversation.


Less attention is paid to the thousands of critical items which make the hospital function. Operating tables, IV pumps, task chairs, stretchers, ultrasound machines, waiting room seating, scalpels. In the hospital sector, these items are referred to as furniture, fixtures and equipment, or commonly just “FF&E” and are absolutely essential for the care that’s provided.


Figuring out FF&E

Calculating the FF&E needed for a new hospital is complex, but is also similar to how a family would figure out the décor in their home.


“Think about your living room and all the items in it. You have a couch, chairs, coffee table, maybe a lamp or two, some shelves, possibly a TV, area rug, artwork, books. If you were to move, you’d look at your furnishing and based on their condition and the space in the new house, which should be kept or replaced. That’s essentially what needs to be done when planning for every room in a new hospital,” said Bart DeVries, HHS director of redevelopment.


Knowing what we’ll need starts with knowing what we currently have and what can be transferred to the new building. To help with this process, hospital redevelopment teams lean on industry experts.


“Our team went in last June and did a complete inventory of the existing assets. Each item was tagged, barcoded and logged so we could conduct an assessment for transferability to the new building. Each asset is evaluated individually looking at its age, service history, compatibility in the new space and its current condition,” said Larry Rook, an advisor from Colliers Project Leaders.


Did you know? Approximately 3,500 items were tagged in this process at WLMH.

Once the cataloguing and assessment is done, the team needs to determine what is missing and what needs to be purchased, taking into account the needs and spaces in the new hospital.


For example, the current WLMH has two operating rooms. The new hospital will have four. Even if every item from the existing operating rooms were transferred (and much of it is new so it will be) outfitting would be needed for the two new rooms regardless.

Other factors play into the decisions as well. Timing is a big one.


“You can’t move the contents of an entire hospital to a new building overnight. There will be a period of overlap when the new hospital opens and both hospitals are still operating. The emergency department, for example; if you arrive at 5:59 a.m. at the old site on ‘move day’ you are cared for there and then transferred to the new hospital later. The new site opens at 6:00 a.m. on move day so all patients after that time are seen there. The result is that some items will be bought new to ensure continuity of operations,” noted Rook.

Covering the cost


FF&E for a new hospital can carry a hefty price tag. The multi-million dollar question becomes: who covers this cost? It depends on whether the items are considered “fixed or loose.”


“Generally, fixed items are anything that wouldn’t fall out of the building if you were to pick it up and turn it upside down. Ceiling-mounted surgical lights are a good example. Those are considered to be part of the building and are captured in the construction costs because structural supports need to be provided by the contractor and they have hard-wired electrical connections. Everything else that would shake out are considered loose and the Ministry doesn’t pay for those,” said DeVries.

Related: Take it to the Finish…Building a Healthy Community campaign website


The loose items are funded through the “local share of financing” for the new hospital. In Ontario, new hospitals are cost-shared between the Ministry of Health and the local community which the hospital serves. The local share is the portion the community is required to cover. For more on that, read this.

Related: Local share of financing lands at $50M


The more equipment that’s transferred means less will need to be bought new to open the hospital.


“FF&E costs are a big part of the local share of financing. For the WLMH redevelopment, we’ll be able to transfer almost 40 per cent of the total equipment required, which, compared to other hospital projects, is a considerable amount,” said DeVries, noting that all of the furniture in the new hospital will be bought new.

Three Teams on Shortlist to Build New WLMH


Process for full submissions opens in July, successful team will be announced spring 2022

Today, Infrastructure Ontario (IO) and Hamilton Health Sciences (HHS) announced that three teams have been prequalified to design, build and finance the West Lincoln Memorial Hospital (WLMH) redevelopment project.


Teams were prequalified based on criteria identified in a request for qualifications process that began in November 2020. Selection criteria included design and construction capability, experience, qualified personnel and financial capacity to undertake a project of this size and scope.

The prequalified teams and their prime team members are:


AMICO SACYR ALLIANCE
• Applicant Lead: Amico Design Build Inc. (50%), Sacyr Construction S.A (50%)
• Design Team: IBI Group Architects Canada
• Construction Team: Amico Design Build Inc. (50%), Sacyr Construction S.A (50%)
• Financial Advisor: Operis Business Engineering Limited


ELLISDON INFRASTRUCTURE HEALTHCARE

• Applicant Leads: EllisDon Corporation
• Design Team: Parkin Architects Limited
• Construction Team: EllisDon Corporation
• Financial Advisor: EllisDon Capital Inc.


POMERLEAU HEALTHCARE PARTNERS
• Applicant Lead: Pomerleau Inc.
• Design Team: Cumulus Architects Inc, WalterFedy
• Construction Team: Pomerleau Inc.
• Financial Advisor: Pomerleau Inc.


A request for proposals (RFP) is expected to be issued to these prequalified teams in summer 2021. Once submissions are received, IO and HHS Sciences will evaluate the proposals, select a preferred team and then negotiate a final contract. The successful team is expected to be announced in spring 2022. A fairness monitor will oversee the entire procurement process.

Quotes

“The WLMH RFQ generated interest from leading private-sector teams who want to bring this exciting project to life. Together with Infrastructure Ontario, we are encouraged by the quality of submissions received and look forward to seeing the full proposals from the shortlisted teams in the coming months. By this time next year, the successful design-build team will be selected; one of the final pieces before getting shovels into the ground.”
Kelly Campbell, VP Corporate Services and Capital Development, Hamilton Health Sciences

“The selection of three highly qualified teams to move on to the request for proposals stage is a significant project milestone. Through IO’s P3 process, we are confident these teams will submit competitive bids that will result in the delivery of a state-of-the-art hospital to serve West Niagara for years to come. We are delighted to once again partner with Hamilton Health Sciences as we set our collective sights toward breaking ground in spring 2022.”
Angela Clayton, President, Project Delivery, Infrastructure Ontario

“This is good news for Niagara West residents who have worked hard with HHS and WLMH team to ensure that this new facility moves forward. The Ontario government is committed to delivering this important project for Niagara West; and investing in healthcare across our region. My thanks goes to all who have put so much work into getting to this point, and my congratulations goes to those who have pre-qualified for this infrastructure build. I will keep supporting this build in any way I can!”
Sam Oosterhoff, MPP, Niagara West

Additional Resources


• Sign up for the monthly community newsletter to receive important news, updates and developments at the WLMH site.

SNEAK PEEK: New WLMH renderings

The WLMH redevelopment project once again entered unprecedented territory last week with the Stage 3 submission being sent to the Ministry of Health for approval: the final stage before the project is approved for tender in July!

This submission builds on the Stage 2 approval received in January and summarizes all the details required for the bidders to deliver a concept, design and price to construct the new hospital.

It also means we’re able to develop updated illustrative design renderings for the project! These renderings show what the hospital could look like, based on many of the requirements we’re putting forward to build teams to include in their bids for the project.

Bidders will apply their own innovations and solutions to meet the project’s needs, so these illustrations may still change somewhat.

Graphic: Evolution of Design-Build-Finance Project Design

The images illustrate the final plan with the former WLMH buildings removed; replaced with parks and parking. Due to the constraints on the site and robust specifications that will be in the tender package, it is very likely that the new WLMH will replicate many of the site and building characteristics shown in these renderings.

Stage 3 illustration of new WLMH: view from Main St.
Stage 3 illustration of new WLMH: view from current parking lot on east side of site.
Stage 3 illustration of new WLMH: aerial view of the proposed site (notice the proposed park space along Main St.!)

Reflecting on a remarkable year

What a remarkable year 2020 has been.

As a global pandemic took hold in the community, our team at West Lincoln Memorial Hospital (WLMH) has shown incredible resilience and dedication to keep the hospital open and our patients safe.

Inside the hospital, we’ve invested heavily to upgrade the aging mechanical systems to make the building safer, until we can open the new one. The most significant safety upgrade at the site occurred in the operating rooms and endoscopy reprocessing area. Our site team and the contractor worked tirelessly during the surgical shutdown that occurred in response to the pandemic in order to renovate and reopen the operating rooms on time.

We’re also further down the path than ever before to rebuild WLMH. This year started with the government approving a detailed service plan for the new hospital, which meant we could start designing how those services will function in a brand new building. At the end of October, that plan was sent to the Ministry of Health for review. We’re now looking for a team to design and build the future hospital. This project is moving at unprecedented speed. Our goal is to keep it going.

Through it all, our community, neighbours, families, patients, staff, physicians, volunteers, partners and donors have stood beside us. We thank you for your unwavering support and generosity this and every year. Because of you, WLMH’s future has never been brighter.

On behalf of Hamilton Health Sciences, we would like to wish you a very happy, healthy and safe holiday season.

Ten things to know about the Stage 2 submission

The last seven months were a whirlwind for those involved in WLMH rebuild planning. But, we got the Stage 2 plan done and sent off to the Ministry for review and approval…ahead of schedule!

It’s not a final document until the Ministry approves it, so we can’t say too much at this point. Though we’re too excited not to share some information about the plan. Here are 10 things to know about the WLMH Stage 2 submission:

  • The Stage 2 plan is submitted as part of the Government of Ontario’s five-stage process for building a hospital, with Infrastructure Ontario estimating construction on the new WLMH to begin in 2022.
  • The Stage 2 plan is based on planning details set by the Ministry about the services to be included in the new hospital. The Ministry of Health will make the final decision to approve or request changes to the plan.
  • The submission is not publicly accessible until the Ministry’s final approval is provided. This is anticipated early in 2021.
  • The submission includes:
    • a detailed list of the spaces within the new building;
    • a simplified “block planning” of how those spaces may be configured within the new hospital;
    • a site plan showing elements like parking, site access, landscape, etc.;
    • a list of all furniture and equipment needed for the facility;
    • and, a preliminary cost estimate.
  • Based on Ministry specs to assure accessibility, infection control and service delivery, the proposed hospital will be almost double the size of the current hospital – from 65,000 sq. ft. to roughly 120,000 sq. ft.
  • Approximately 150 staff members from across WLMH and HHS contributed their experience and expertise to this planning. This was on top of their daily duties of providing or supporting the delivery of excellent patient care. We’re incredibly thankful for their efforts to get this done. Particularly because…
  • Stage 2 planning kicked off the week before COVID-19 started showing up in our community. Almost every meeting was done virtually, but the stakeholder engagement was equally as robust as in-person sessions. “We got great questions, ideas and comments in all of our user group meetings. The engagement got even better as we progressed through the process. This was new for all of us, but it was a robust experience and that’s definitely reflected in the final plan,” said Bart DeVries, director of redevelopment.
  • The plan proposes to build the new hospital behind the existing building. Once the new hospital is open, the old hospital will be demolished. This will create a substantial set back from the street to the front door allowing for landscaping and additional parking. The details of what this looks like will be developed in Stage 3.
  • The plan includes four operating suites which is twice the number at the current WLMH. This is consistent with the Ministry’s direction, meaning more people can receive the surgical care they need at WLMH.
  • The plan includes space for a multi-faith room, where patients and families will be able to go for a quiet moment of reflection when they need it. The current site does not have a similar space.

    Want more content on the WLMH rebuild? Here’s the most recent video in our series with WLMH leaders involved in the rebuild, talking about what we’re planning and what we can expect moving forward.

Much ado about (WLMH rebuild project) costing

Last week, Infrastructure Ontario (IO) released its fall Market Update report. The report reiterates the government’s commitment to rebuild WLMH, which we completely expected, but it’s always great news regardless. (The WLMH rebuild project has been included in IO’s updates for almost two years.)

The report, however, noted for the first time that WLMH project is now included in the “$200 – $499 million” budget range, which is an increase from the “less than $200 million” budget range we’ve been working toward. This change on paper has encouraged some excitement in the community and beyond.

We asked our WLMH redevelopment lead for his take on this development.

“I get the excitement about this project, we’re really excited too,” said Bart DeVries, HHS director of redevelopment projects. “Based on my experience with large scale infrastructure projects, this is to be expected. It’s important to note that this development doesn’t mean there have been any significant changes to our planning. The difference between the previous budget range [<$200M] and the new budget range [$200M-$499M] could technically be $1. At the end of the day, the market will dictate what the true value of the project will be and that’s still a little way down the road.”

Budgeting for large, public-private partnership (P3) projects is a complex process with many moving parts. Ultimately the goal is to get the best value-for-money spent.

“The budget refinement process will continue as we proceed through Stage 3 toward construction. We’re still working under the original budget assumptions, which is the prudent approach. We’ve hired our costing team who are experts in budgeting for projects of this size and scope. They will tell us the anticipated project cost based on our requirements, which will be kept confidential and used to inform our plans. The private-sector teams bidding on the design-build contract for the hospital will include their project cost in their bids, which will also based on our requirements. Once a winning bid is selected by IO and HHS together, we will release the fixed-price contract value,” DeVries explained.

Many elements can influence a change in project budget, such as cost and availability of construction materials, labour and skilled trades. Time tends to drive the cost of the required elements up higher so planning needs to account for that possibility. It’s also wise to include contingency for unexpected costs, especially given the impacts the ongoing global pandemic is having and will likely continue to have on supply chains.

“These are the types of things we have been planning for since we started Stage 2 and why we always build contingency in to our projected budget,” he noted.

In terms of WLMH project timelines, we’re aiming to submit our Stage 2 plan to the ministry by Hallowe’en. The Request for Qualifications, which is the initial call for teams eligible to deliver the project, will be posted later this fall. Teams prequalified through this process will be named in early 2021, and invited to respond to a Request for Proposals later in the year.

What’s Up @ WLMH: August 2020

WLMH ORs Reopening September 14

Critical safety upgrades required in the WLMH operating rooms (ORs) are now complete. Activity in the ORs will gradually resume, starting the week of September 14.

Patients will soon be able to receive high-quality procedures closer to home, in an environment that meets standards for safety and infection control.

Which services will be provided?

Services resuming in the coming weeks include:
• Endoscopy procedures
• Gynecology and general surgery cases, addressing the backlog created by the province-wide COVID-19 surgical shutdown
• Elements of obstetrics services, such as scheduled cesarean births

We continue to focus on building up OR nursing staff levels to increase on-call capabilities at WLMH and support more surgical services over time.

What does this mean for patients?

Patients will be contacted by their health-care provider about scheduling their procedures.

Additional information for obstetrical patients is available here.

We appreciate everyone’s ongoing patience and resilience while these necessary safety upgrades were taking place.


What’s coming up this fall?

Work is progressing on a number of priorities at the site. Here’s a look ahead to what’s happening in the coming months:

September

  • Surgical activity gradually resuming in WLMH ORs
  • Construction starts on CT scanner suite

October

  • Building a New WLMH – Stage 2 submission on track to share with Ministry of Health for review and approval

November

  • Two-Year infrastructure project wrapping up – three months ahead of schedule!

What’s Up @ WLMH: July 2020

Local leader to head up rebuild project team

Hamilton Health Sciences recently made a big hire for the #newWLMH team. Grimsby-resident Bart DeVries is coming on board as our Director of Redevelopment Projects and is taking the lead on the rebuild.

Meet Bart.

Mental health clinic staffer earns elite clinical certification

Congratulations to Aprile Titterson – a social worker at the West Niagara Mental Health clinic at WLMH – on recently completing the Prolonged Exposure (PE) certification for Post-Traumatic Stress Disorder (PTSD). This is a huge accomplishment as Aprile now finds herself in an elite group of only 25 PE Certified Therapists across Canada. With this certification, Aprile’s expertise will expand treatment offered to the West Niagara community for those dealing with PTSD, adding to the considerable clinical supports and services currently provided at the clinic.

“I feel very grateful to work with such a caring and driven team of professionals that prioritize evidence-based practices to best support the community of West Niagara.  Prolonged Exposure is one of the many therapies we utilize to help individuals move forward in their lives. Clinically, it is a very rewarding experience to see how this therapy can help transform a person’s life in such meaningful ways.  Also, a special mention to Christopher Conley who has been such an important driver in bringing so many learning opportunities to the staff at our clinic and often extending the learning to other clinics throughout Niagara region,” says Aprile.

Conley, a Senior Clinical Specialist at the clinic, was Aprile’s certification supervisor and also continues to serve the community as a PE Certified Therapist.

Planning, design and conformance team selected for WLMH project

In case you missed it, we’ve brought B+H Architects / mcCallumSather on as the planning, design and conformance (PDC) team for the rebuild. Read the full announcement here.

Ongoing Infrastructure Updates

Work Completed
– Commissioning of Diesel Generator #1
– Parking Lot Lighting Replacement

Upcoming Work
– ED and BWard – lighting, plumbing fixture replacement, window sills – Fall

What’s Up @ WLMH: COVID-19

We are taking precautions at Hamilton Health Sciences (HHS) to ensure the safety of our staff, physicians, patients, families and community. More information related to COVID-19 is available here:

Hamilton Health Sciences hospital information

Niagara Region Public Health
Hospital access

Visitor guidelines have changed and we have moved to a no-visitor policy with very few exceptions. Based on these guidelines, infrastructure work at WLMH, with the exception of some limited outside work, has been placed on hold. 

Patient care

 The Ministry of Health has mandated all health care facilities to postpone all non-urgent elective activity, including surgeries and non-urgent clinic visits.

Some patients receiving non-urgent scheduled care may access care by phone or virtually

Elective surgeries are being postponed and perioperative services at West Lincoln are temporarily closed. This will support additional patient care capacity and availability of health care professionals in the weeks ahead.  West Lincoln patients requiring urgent surgical procedures will receive care at the appropriate alternative hospital.  Patients will be notified by their surgeon if their surgery is deferred. 

Planning for a new WLMH

The Capital Planning team continues to move forward with planning for the new WLMH. Kick-off meetings took place earlier this month. Work led by non-clinical team members continues to move ahead. We remain committed to moving forward, recognizing COVID-19 presents an evolving situation and patient care requirements remain our top priority. 

Follow us on social media

We’re sharing timely updates and shareable content on our social media channels, like this “five small acts” campaign, which is linked at the handles below.
Twitter: @HamHealthSci
Instagram: HamiltonHealthSciences
Facebook: @HamHealthSci