Like most hospital projects, the Sills Wing at the Quinte Healthcare Corporation’s (QHC) Belleville General Hospital, 180 kilometres east of Toronto, has been a challenge to design and build. The centrepiece of the project is the new five-storey wing dedicated to long-term care for patients with multiple health-related issues or requiring rehabilitation. A new 14-bed intensive-care unit and renovations to 22,000 square feet of existing space are also scheduled for the $72-million, 175,500-square-foot development that will be completed in January. But what most distinguishes the development from other hospital projects is the financing – by the general contractor, M. Sullivan & Son Limited.
The development is the first Build-Finance (BF) project under the auspices of Infrastructure Ontario, a provincial Crown corporation formed to build the province’s hospitals and other public services using an Alternative Financing and Procurement (AFP) model to ensure public control and ownership. “It is a definitely a big risk for us,” says the general contractor’s project manager, Todd Simpson of M. Sullivan, a family-run construction company since 1912. “If we don’t meet our completion date, obviously we have to answer to our financial partner and look at paying interest charges.” Bill Andrews, director of capital development for QHC, says Build-Finance “changes the development game for everybody.” The hospital faces added responsibilities, including the completion of code-related items that may not be fully documented in the contract.
Andrews says BF is not easy for a developer. “As the first project to be procured this way, we had multiple contract drafts to work through with the government lawyers. It was a prolonged process getting to the point where we could engage the contractor.”
The contract language has also kept everyone on their toes because it is open to interpretation, leaving the possibility of conflicts between various parties over who is responsible for what. “We were fortunate to have an excellent contractor we could work through issues with to avoid disputes.”
M. Sullivan & Son was awarded the project not only for its competitive bid and extensive experience in the field of health care construction, but also because of the complex financial package it brought to the table, says Simpson. Once financing was in place, the construction somehow looked less daunting, he adds. Prior to site excavation in late July 2007, the general contractor spent several months planning out a complex construction program to minimize disruption of hospital operations.
Work included reconfiguring the surface parking lot and installing utility services below. M. Sullivan also erected a temporary loading dock and worked out the details on how to keep access points to the hospital clear for staff and patients during the project.
The new five-storey Sills Wing is tied into the lower two floors of an existing hospital building. Working without a complete set of drawings or information on the old building’s foundation, the general contractor encountered a few surprises. One was a pleasant one. M. Sullivan had initially planned to underpin the building prior to excavation of the new wing but soil inspection showed that step unnecessary because the building was founded on sound rock.
Not every surprise was so favourable. Because the contractor wasn’t provided with the original drawings, it didn’t know what loads it could carry, says Simpson, adding that during demolition structural beams were discovered where they weren’t expected. A new chiller was installed in the wing while the existing chiller was relocated. Scheduling the process had to be precise because the hospital couldn’t afford any down time. Much of the excavation and foundation work was done during off hours to minimize disruptions to the ICU.
For project architect Kasian Architecture Ontario Incorporated, the challenge was to complete the design on a tight budget while putting special design emphasis on meeting the needs of a variety of patient types with special needs. The new wing provides outpatient and inpatient rehabilitation facilities for adults and children plus long-term rehabilitation and complex care beds. Most of its patients have complex health issues and require significant nursing care.
The first step was to build on the original Master Plan and provide a design that reflects the patient group’s needs and enhances quality of life, says Patsy Poulin, principal and project architect, Kasian. The firm’s design features a series of small communities on each floor – essentially “neighbourhoods within the units.”
The siting of the five-storey tower was also paramount to the success ofthe project, she says, noting that patients’ rooms are oriented to views the Bay of Quinte on Lake Ontario. Each unit has outdoor access (typically small balconies off dining lounge areas). North-facing balconies on upper floors provide outdoor space for sunlight- sensitive patients. Dining space, administrative/staff support areas and rehabilitation areas are located in the central portion of the floors. Two small courtyards at entry level are geared to outpatient rehabilitation programs.
The neutral shaded exterior cladding of the new tower is in keeping with the original hospital buildings, most of which date to the 1960s and were designed by Gordon Arthur Friesen, a leading edge architect in the health care field at the time. The Sills Wing is a poured concrete structure with suspended slab, topped by a structural steel penthouse for utilities.
Cladding is a precast concrete insulated panel system selected for speed of construction.
Kasian also designed a two-storey extension on an existing building that includes shipping and receiving on the lower floor and a 14-bed intensive-care unit on the second floor. Sound proofing proved an important part of the work. All windows in the ICU are triple glazed and the floor is on an isolated slab covered with acoustic insulation to ensure noise from below doesn’t carry up, says Poulin, adding that a large concrete canopy above the receiving area deflects noise from vehicles coming and going.
The Sills Wing is the second of a three-phase redevelopment at the hospital. The next phase, to start later this year, is a centred around a two-storey addition containing emergency services and various other facilities. Construction is planned for the spring.
By Shanon Miller