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That hospital project that is out for tender looks promising. Whether it is a renovation, a reconstruction or new construction, health care sector projects, and particularly hospitals, have special requirements. This article will highlight some of the more common restrictions, to help engineers and contractors navigate through a health care sector public tender.

Do not assume that because this project is for the Health Ministry, that it is the same as other Ministry projects. Read the documents carefully to find specialized needs.

Special requirements will be laid out by the engineer in the tender documents. Usually a major project will have detailed drawings and specifi cations. Inside those documents should be all of the special requirements for the job. Do not assume that because this project is for the Health Ministry, that it is the same as other Ministry projects. Read the documents carefully to fi nd specialized needs. A number of issues need to be considered. These include:
• What restrictions apply, such as access, scheduling, noise,
tie-ins?
• How will you reach the area you must work in? Some projects have simple and straight forward access while others require contractors to reach the space in awkward and time consuming ways. A small part of a project may be to replace a diffuser in an intensive care area; doing so may require a containment unit, a meeting with nursing officials and permission from all parties to do the work. As such, a simple task that would take half an hour in an office building, could take as much as a full day in a health care
facility. With new safety requirements for infection control, every time a worker enters or exits a high-risk work zone, he/she may be required to go through a clean-up or other special procedure.
• When can the work be done? The answer depends entirely on the project. If working inside operating rooms or emergency departments, the facility may require that all work be completed between midnight and 8:00 a.m. This avoids most confl icts with the primary users of the area. In other locations, like patient care areas, you may be restricted to working only during daytime hours. If working times are not clearly set out in the contract documents be sure to ask and have them clarifi ed. Within the time restrictions, there may be an additional requirement that limits noise levels. This is especially true around operating theatres. Noise and vibrating equipment activities must additionally be coordinated with the operating room team.
• Smoking is not tolerated in and around health care facilities. Hospital smoke free policies must be taken into account and if workers do require a smoke they may have to travel a considerable distance and this time should be taken into account.
• Existing system tie-ins; when can they be done? The answer depends a lot on the system, and its criticality to patients. Many facilities require several days advance notice for critical systems. Even partial shutdowns of electrical, water, or ventilation systems must be coordinated with all parties that may be affected by them. Many facilities also require a “cool off” period after shutting down equipment to ensure that all areas being taken out of service are well known before the work commences.
• Even a task such as shutting down an exhaust fan to replace a motor, belts or entire fan can be a time consuming venture. The fan may be a critical care item as in the case of isolation rooms where the fans are vital to ensure the care of patients. Even this is not as simple as it fi rst seems: some fans are providing environmental protection for the patient and some are providing vital protection for the care
giver and others.
• Working in certain areas of a hospital requires special techniques. Mental health units are particularly challenging. In these areas, some hospitals require that contractors treat their tool carts the same way surgeons treat their surgical tool trays. You may be required to inventory tools prior to entering and verify upon exiting. Misplaced tools must be accounted for as they may be used as weapons or for selfinfl icted injury. Either way working in these areas requires extra vigilance on the part of the workers.

These are a few of the special requirements that health care facilities may ask of outside contractors. Contractors should be prepared to ask questions so that the intent of the contract documents and the time involved to perform the work is clearly understood by all those involved.