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Niche markets: hospitals

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  • SIMA
- Posted: February 17, 2017
By Cheryl Higley, Editorial Director
 
Hospital_Aerial (300x201)
Medical campus: Depending on the site, a snow and ice management company may have to service parking garages, physicians’ parking lots, off-site medical buildings, etc., in addition to the main hospital campus. (Photo courtesy of Mercy Health-St. Vincent Medical Center in Toledo, Ohio)

Healing the sick and treating the injured don’t stop when a snowstorm bears down on the community. Perhaps no other property type requires such a demanding level of service than 24/7 medical facilities, including hospital complexes and freestanding emergency departments. Snow and ice management service providers must be on call and ready to perform intricate operations to ensure the safety of patients, visitors, police, and emergency service and medical professionals.

Successful companies servicing this niche market must be able to orchestrate a plan that considers timing, intensive labor requirements and attention to detail.

Start/stop times
Pre-event staging is critical so snow removal operations can begin promptly. B&B Group Inc. services several Central Indiana hospital campuses, numerous outpatient surgery centers and other medical facilities. Kevin Mangin, B&B Group business development & snow operations manager, says equipment and crews are on site and ready to roll before a flake falls. Once operations begin, they remain until the storm ends and the site is clear.

Jake Silvis, owner of Silvis Group in Mount Pleasant, PA, also staffs his hospital properties 24/7 unless otherwise directed by the client. His company also services urgent care facilities, medical buildings and rehabilitation centers, which often have more traditional business hours. It’s sometimes easier to schedule start/stop times for these properties.

“Most of our doctors’ offices and urgent care facilities have a zero-tolerance policy one hour before opening and after closing. Our dispatch team uses weather service monitoring and radar to determine start times for crews in each region of our service area,” he says.

With 24/7 service as the norm, Craig Morse says that gives his crews the flexibility to tackle areas that need the most rapid response. Morse is manager of facility support services for Mercy Health-St. Vincent Medical Center in Toledo, OH. He oversees operations for two hospital campuses, a healthcare center facility, Mercy College of Ohio, two freestanding emergency rooms, cancer center facilities and medical office buildings.

These facilities require different start/completion times, but he says the hospitals’ emergency departments, physicians’ parking lot, family parking lots and all entrances receive priority. He reserves 10 p.m. to 4 a.m. for parking lot service and cleanup when it’s less crowded since fewer visitors are coming and going. The tricky part is managing operations around the different shift changes at the hospital.

“We’re always battling vehicles and are never able to maintain an empty parking lot,” Morse says. “Patients, visitors and emergency personnel are coming at all hours, so we have to be on top of those areas at all times.”

Hospital-entrance (250x168) Medical_1 (250x168)
24/7 access: Emergency departments and entrances to hospitals must be kept free of snow and ice to ensure the safety of patients, family, police, and emergency medical personnel.

Cycle times

Estimating the time it will take to complete service is less of a concern if your staffing model is to keep personnel and equipment on site for the duration of the storm.

For companies that service medical buildings and other non-24-hour facilities, it’s another story.

“You have to consider travel time when you’re considering the logistics for bidding these types of sites,” Morse says. “My sites are within 25 miles of each other, and we logistically place equipment and materials on site at every facility. Our overall operation is about one block from the hospital, so when they get the call, they’re in motion immediately. If you must dispatch and account for drive time, having equipment on site would help with your cycle times.”

Depending on the size of the site and scope of work, Silvis says most of the smaller medical sites are added to regular routes for plowing and salting. Hospitals are staffed with a dedicated sidewalk and plow team but salt trucks may be routed to multiple locations.

“All routes are created so they can be completed prior to the start times of the facilities, but most routes are held to a four-hour cycle time,” he says.

Labor
Chris Marino, owner of Xtreme Snow Pros, manages hospitals and medical facilities throughout the New York/New Jersey metro area. He treats each site as zero tolerance and sets up equipment and teams to ensure the property is safe and open with a fast turnaround.

With 24/7 hospital access required and zero tolerance expected at the other sites, availability of responsible, reliable and skilled labor is essential. His crews are set up with equipment and personnel to clear snow at 1-inch intervals. Staffing is determined by the anticipated size of the event and property size. When staffing, consider equipment operators, sidewalk crews and ice watch personnel, if required.

“Do not underestimate the unique factors that come into play on these sites,” he cautions. “You must be overstaffed and over-prepared because people’s lives are on the line. It is our job to allow the medical professionals to do their job by keeping the property as safe as possible - no excuses.”

Site size/complexity
When preparing a proposal for service, estimators may find that medical facilities resemble other commercial properties in terms of parking lot design and will need to account for size, traffic patterns, parking garages, etc. But Barker says these facilities have several areas that add to the complexity of the site that should not be overlooked, such as helicopter pads and restricted parking that require special codes/access procedures, in addition to the previously mentioned ambulance bays, etc. These areas may require more labor and/or closer attention or special equipment or materials, which would increase service times or costs.

Marino says the 24/7 nature of the hospitals and the near-constant presence of people and cars will slow the overall completion times for the property.

“Flow of traffic on a site is not calculated into pricing sometimes,” he says. “You will have a lot of idle time not accounted for if the facility is high volume with tight areas.”

Materials and equipment
For the most part, equipment used on these facilities would be comparable to other commercial facilities, matching the appropriate piece to the task at hand and size of property. However, areas that require special attention may limit equipment or materials that can be used.

Pretreats are common in advance of the storm, and some contractors are shifting to liquids.

“Properties are trending toward mandating the use of liquids on their sites. They are realizing the safety and environmental benefits as well as the ability to keep their sites clean inside and out,” Marino says. Silvis agrees, noting that their use of brine has set them apart in the market.

Morse uses calcium chloride by all automatic doors to prevent rock salt from corroding the gears in the door mechanism and to prevent tracking inside. He also works with housekeeping to place walk-off mats at the doors to help keep the areas dry.

The helipads also present a big area of concern. The Mercy Health-St. Vincent Medical Center portfolio has six helipads, and Morse is restricted by his mechanics on what can be used to deice these areas.

“We only use urea, which is less corrosive to the metal blades and helicopter siding,” he says. “They don’t fly when the weather is bad, but when they have to fly, we have to ensure it’s safe.”

helipad (300x201)
Helipad concerns: Special care, including the use of deicers that minimize the potential for corrosion, must be taken on helipad sites.

Marketing strategy

Except for an ill-fated attempt to outsource operations for about 18 months a few years ago, Mercy Health-St. Vincent Medical Center has self-performed all exterior maintenance since the 1970s. He encourages companies who have no experience in this sector to start small and gain experience before jumping into a bid for a full-scale hospital complex.

“It comes down to experience and working in this 24/7 atmosphere,” he says. “If I were hiring someone, I would say having a medical facility background would be a big plus.”

He adds that for companies who are bidding on these properties, they have an opportunity to position themselves as the expert and educate the client on what it takes to deliver comprehensive snow and ice management.

“I had 15 years of snow and ice management experience before I came to this job, so I knew what it took to care for this type of property,” Morse says. “But some facility managers may have no experience at all. Coming into a meeting with that experience could position you well and provide the manager with a sense of comfort that they’re in good hands.”

Unlike some sectors, Silvis says the medical arena isn’t usually driven by the lowest price, which allows quality to shine through: “When meeting with decision makers, we focus on solving problems, which typically start with their ability to mitigate risk. Through solution selling, we educate our prospects on how we will make their property as safe as possible.”
Building a better price for service
For medical facilities, the level of service, start/completion times, cycle times and experience all play leading roles when creating an appropriate price for service. As you build your proposal, consider the following:

Labor
Servicing medical facilities can require significant labor commitments, particularly for hospitals, freestanding emergency rooms, etc., that require nonstop service during an event. Sidewalk service is a priority, so account for these teams appropriately.

Start/completion times
These will depend on the type of facility being serviced, the scope of work and level of service required. Facilities that need to be open and snow-free 24/7 may require a different approach than freestanding medical buildings that have more traditional office hours.

Equipment
Facilities with parking garages will need to consider load limits, height limitations and other hazards. Otherwise, choose equipment best suited for the site size and ultimate efficiency. Some facilities may limit the types of ice management products that can be used.

Services needed
Snow clearing, sidewalk work, stacking and ice management are typical services. Depending on the site size and level of service requirements, hauling, inspections and ice monitoring services may be required and should be factored into pricing.

Cycle times
The total estimated time it takes to service these sites is greatly impacted by the scope of work (e.g., hauling, removal, stacking, ice management, etc.) as well as the level of service. Most freestanding hospitals require zero-tolerance service and a dedicated team that remains on site through the event. Because hospitals are open 24 hours, parking lots will never be completely free of cars due to patients, visitors and employees being on premises. Managing those lots can add to cycle times and may require a different approach than traditional large-area plowing.

Site size & complexity

Primary considerations in this category include not only the size of the complex being bid on, but also the intricate elements of the site - helipads, valet parking, entrances/exits to the facility, emergency bays, etc.

Marketing strategy

Prior experience in successfully servicing this high-demand client type is essential. Showcase that experience with references from satisfied clients. In some cases, the person you will be presenting to will have little to no snow and ice management experience. Educating them on medical facility exterior management and the services you offer can help them better understand the intricacies involved and, perhaps, justify your price. However, given the high level of service required for these facilities, price is less likely to be an issue in the bidding process.
 
Cheryl Higley is editorial director of Snow Business magazine. Contact her at cheryl@sima.org.
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