By Mark Kenneday, / Special to Healthcare Facilities Today

As technology progresses and patient needs change, it is imperative for the healthcare industry to employ efficient, effective and flexible construction procurement processes to keep up. But it’s not that simple. Any project delivery method must overcome the challenges that accompany the unique healthcare environment where privacy is paramount, and disruption is a matter of life and death. Yet technology upgrades and other construction work must get done; safe and reliable hospital facilities are absolutely critical to patient care. For every $1 spent maintaining your facility today, you save $3-4 on deferred maintenance tomorrow. While these stewardship projects aren’t as newsworthy as new construction, there is good reason to bump maintenance and repair toward the top of your priority list. When it comes to enhancing patient suites, upgrading surgical facilities, completing electrical updates or making security enhancements, there are alternative construction project delivery methods and more efficient processes to help you get work started faster.

Harris Health System is a fully-integrated, public healthcare system that provides care to all residents of Harris County, Texas. It is the first accredited healthcare institution in the county to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home that meets or exceeds stringent criteria for patient safety and quality. The system includes 18 community health centers, five same-day clinics, five school-based clinics, a dental center, a dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals, one with a Level 1 trauma center that cares for more than 80,000 emergency patients each year.

As a teaching system, Harris Health educates the next generation of healthcare providers on the latest medical procedures and technological breakthroughs. All the training and care requires building, renovating and maintaining top-notch facilities. In 2011, Harris Health System launched an updated Job Order Contracting (JOC) program that included best practices, such as development of preset prices for construction tasks, including items critical to hospital and healthcare procedures. This level of detail and customization delivered the precision that Harris Health System required.

Simply defined, JOC is a unique Indefinite Delivery Indefinite Quantity (IDIQ) contract that allows multiple projects to be completed through a single, competitively-awarded contract. This one-bid process empowers project owners to quickly and easily procure repair and renovation work as well as some new construction projects. The most successful JOC programs follow best practices that include powerful software for communication, robust procurement-worthy data, contract compliance and scope development and oversight. JOC helps healthcare systems accomplish more redesign and maintenance of existing healthcare spaces by streamlining the construction procurement process. Furthermore, JOC helps to alleviate procurement challenges and allows you to build and maintain crucial facilities and infrastructure with less hassle. 

The efficiency and speed of the Job Order Contracting process resulted in an accelerated construction schedule that led to projects being completed more quickly. Harris Health System also experienced increased cost control through the pre-established unit prices. As of late 2019, Harris Health System had completed $24 million in construction projects through their Job Order Contracting Program, including security enhancements, roof replacement, renovation of medical offices and treatment rooms, upgrades to X-ray equipment and more.

Faster, less expensive procurement models, like JOC, that provide cost transparency and deliver complex projects on time and within budget are becoming more prevalent in the healthcare market. This is true, in part because construction work of any kind is complex, even for unoccupied facilities. For healthcare facilities, there are additional challenges to consider before maintenance or renovations can occur, such as hospital staff, crucial cleanliness standards, emergency traffic throughout the facility and vulnerable patients in need of immediate attention. Projects must be done with minimal disruption to patient care, often at odd hours. Not all contractors are equipped or prepared to work in those conditions. Job Order Contracting gives owners access to readily available contractors who are certified to work in active healthcare spaces. Plus, JOC establishes preset task prices so you can keep project costs under control. The combination of readily available, high-quality certified contractors and cost control is good for your patients and your budget.

JOC can be utilized in the healthcare industry on a blended mix of project types, ranging from new construction to medical equipment replacements to interior renovations and floor modernizations. Here are some of the benefits that have been attributed to the use of JOC for construction procurement in the healthcare space:

• Reduced construction procurement time
• Fewer change orders and claims
• Improved quality of work from certified contractors
• Increased project transparency, accountability and auditability
• Increased Minority/Women-owned Business Enterprises utilization
• Significant cost savings

In order to be a good steward of patient care and deliver the most appropriate and technologically-advanced services, it is important for hospitals and healthcare providers to maintain a speed-to-market edge by leveraging alternative procurement processes. Your constant and paramount concern is patient care. Before a healthcare system or hospital can properly focus on the best treatment for their patients, its leaders must first focus on building and maintaining safe and reliable facilities to host life-saving procedures. A well-thought-out facilities strategy with streamlined construction project execution will help the healthcare industry save time, money and, most importantly, save lives. When it’s time to upgrade equipment, update the waiting area, renovate the operating room or repave the parking lot, Job Order Contracting can be utilized to streamline projects and keep your healthcare facilities — and your patients — thriving.

Mark Kenneday, is the Director of Market Strategy and Development for Healthcare for Gordian.