Health Care 101 Transcription:

Heather Weerheim (00:00):

Well, welcome to Greiner’s in practice series today, we’re going to focus on healthcare 101 and we’re lucky to have Bryan Gingerich here, our healthcare construction executive to start talking about some of his experiences previously Greiner and what he’s working on today. And we’re happy to have you.

Bryan Gingerich (00:19): 

I’m happy to be here.

Heather Weerheim (00:21):

Awesome. Well, let’s get started. Let’s jump into it right away. Did you choose healthcare construction or did it choose you?

Bryan Gingerich (00:29):

Huh, that’s a good question. You know, in all, honestly, it’s not something that I was driven to when I was in, started in construction. I started in the field and worked my way into the office. And in all honesty, I had a person that worked next to me in a cubicle that was somebody that looked like they had their stuff together. They were organized and that they were working in healthcare and they were very excited about it. And I said, I’d like to try that and kind of use this person as a mentor and see if I could model my career after theirs. And that’s how I got started. And then immediately fell in love with it.

Heather Weerheim (01:06):

That’s awesome. So the healthcare world is kind of new to me. So I’m very excited to talk to you more about it and, and learn from you. So can you give me a description of what healthcare construction means? Is it just like regular construction? My background is interiors and specifically corporate interiors, but is it just like ground up? Is it interiors? What does it look like?

Bryan Gingerich (01:29):

It’s a little bit of both. I mean, there’s obviously interiors, there’s new construction but it is a different niche. It’s a very specialized field within our market. It’s a smaller group of people that are actually working in it. One of the things I love about it is that it is so different. It’s, constantly changing due to technology, really drives it. So we are constantly upgrading and reinventing spaces based on new technologies,

Heather Weerheim (01:59):

Hospital versus clinic. What does that describe that to me?

Bryan Gingerich (02:03):

So here at Greiner, we, clearly define the differences between the two. We look at clinic spaces as a B occupancy space. We look at the hospitals as an I occupancy space, and although they both get lumped into the healthcare, you know, bucket they are run pretty differently. We’re building with different materials, we’re using different trade partners and they each have their own level of the, the infection controls and ILSMs, and I know there’s a ton of acronyms and I’m sure we’re going to want to talk about some of those as well, but the process is slightly different inside of the high occupancy and it’s a little bit more expensive,

Heather Weerheim (02:45):

More expensive. That makes sense. And why, or why is that?

Bryan Gingerich (02:48):

You know, working in the hospital, there’s a higher level of scrutiny put on how we do our work, which requires extra funds for infection prevention and interim life safety measures. We’re also typically dealing with higher levels of mechanical and electrical equipment. And, and that’s really the biggest driver is the mechanical and electrical equipment that goes into the I occupancy facilities. But it’s also usually more stout building. Usually we’re talking about building with concrete or steel, right? A lot of those I occupancy buildings are built out of concrete. They just, they have more infrastructure built into them.

Heather Weerheim (03:25):

You bring up a good point when you’re talking about the infrastructure and the MEP contractors, what, does the team look like in healthcare when you’re bringing everyone together is I’m sure pre- planning is very important. So do we have the end user there? Do we have facilities? Do we have an owner rep give me a description of, of how a typical team would come together for a project for a healthcare project?

Bryan Gingerich (03:50):

No, this is a really great question. And one of the reasons that I truly do love working in healthcare, because one of the ways it’s different is it’s a bigger team on a healthcare project is generally a larger team that’s involved, especially if it’s a renovation type project. It’s not typical to have an owners meeting where there might be 20 people involved beyond just having the owner and the architect and the contractor. We have to talk about the different department managers, nurse managers, facilities, managers, EVs, cleaning staffs. I mean, these buildings that we’re working in these facilities are, they’re a very complex organism, right? And they need to continue to run. And every department has to have their say in how it’s built. So one of the fun things about working in healthcare construction is, you know, getting involved early understanding the design, understanding what the owner’s intents are, and then really having to meet with all the stakeholders or the people that we’re going to be effecting to come up with a plan that works. It’s not as simple as rolling out a set of documents saying, this is what we’re going to build and start building it. I mean, there are multiple people that need to have a say in how this thing gets built. So it’s complicated.

Heather Weerheim (05:09):

Yeah. It is complicated. It takes a village. Right. And you need all those team members to be successful. I hear you bring up the level of complexity and that poll schedule. I mean, is it fair to say easy to say that if you’re comparing side-by-side hospital renovation versus a standard office TI, the schedule is going to be longer

Bryan Gingerich (05:32):

And not necessarily. But for the most part, yes. I mean, if it’s a phased construction project, it usually needs to run on a little bit slower pace. Right. 

Heather Weerheim (05:42):

Do you work through hospitals are usually open 24/7, would you, would there be any reason to work overnight or different set of hours?

Bryan Gingerich (05:52):

It’s another, another great question. And we hear that a lot because you think, well, great. Just like any other construction job, just do it at night when the night shift, when you gotta remember there’s people sleeping. Right. So it’s more disruptive now to have an they’re running 24 hours a day. Right. So there is still activity in the emergency departments. ORs are typically shut down unless there’s a, a emergency, right. But you’re working around people that are sleeping or you’re working on behavioral wards. So for the most part counter-intuitively the work is done during normal business hours because that’s when the most support is there as well. Right? The facilities teams have their full staff onsite to assist. If things were to, if there were to be an unplanned disruption,

Heather Weerheim (06:37): 

You know, we didn’t talk a lot about 

Bryan Gingerich (06:38):

that’s the biggest or one of the biggest things is that disruption planning,

Heather Weerheim (06:44): 

The disruption planning

Bryan Gingerich (06:45):

That’s something we could have a whole different.

Heather Weerheim (06:48):

Is that healthcare 2 0 1? We didn’t talk, we talked about team members. We talked about engine mechanical and electrical engineers, architecture partners, the end user. Do you call the end user? Is that the facilities staff that you’re describing or is facilities also another layer of team members? Part of the that’s part of the team

Bryan Gingerich (07:13):

Typically inside of a large facility, we’re dealing with our customer really is the facilities, right? On a large, again, you know, battleship sized project, you might be dealing more with the administration side, the hospital administrators, the CEO the directors of ambulatory care or, or whatever you’re building. Right. But for the most part, our, our customer is the facilities group. They’re the ones that, you know, pay the bills, right. And help us through these complicated, disruptive activities. They know what levers to pull and they know where every circuit breaker is. And we have to work together with them when we’re phasing these projects. Again, another reason why we do it typically during the day, right? Cause they’re fully staffed. So it’s a, it’s an amazing you know, to me, it’s amazing, right? To you guys, nobody cares and nobody would ever see this, but the amount of people and widgets and handles and breakers and switches are in some of these mechanical and electrical rooms are, are just to me, they’re amazing. I mean, just filled with the amount of stuff it takes to keep a hospital functioning. You would be surprised if you can tour around some of these places. And there’s some great individuals that understand these systems.

Heather Weerheim (08:42):

The facilities contact ends up being your best friend and should be

Bryan Gingerich (08:48):

hopefully yeah, Our job is to make sure that their job is easy, right? So that there’s no disruptions because when there is, if there is a disruption you know, it goes right to facilities, right. So we need to do everything we can to avoid any kind of unplanned disruption makes sense. You got to plan them.

Heather Weerheim (09:10):

So what are some of the biggest challenges when working in healthcare construction versus regular construction?

Bryan Gingerich (09:18):

Oh definitely the safety aspect of it. So that’s one of the biggest differences between healthcare construction and other construction is we are generally working inside of occupied facilities. And that’s one thing to say, but then put on top of that, that the people around us are, you know, their health is compromised. They’re in various stages of some sort of health issue that they’re going through. Not only that, but there’s high anxiety in inside the structures. So it so much focus is put on keeping patients and staff and visitors safe. And when it, and that’s how we handle the air is the primary one. Right? That’s ICRA. We talk about that as one of the acronyms. And if you’re in healthcare, everybody knows what ICRA is. Right. But if you don’t, it’s yeah. It’s a process that all facilities go through to make sure that the construction has adequate safety measures in place to complete the work.

Heather Weerheim (10:21):

And you have to be certified to put that in place.

Bryan Gingerich (10:25):

You don’t have to be, although the trend in the industry now has certainly been to, to offer training like at Greiner, we do the 24 hour training for the supervisors and the 40 hour training for the field people. It takes a special breed of construction worker to work in a healthcare facility too. So because of these things and then there’s higher levels of certification that come through an organization called ASHE that is kind of the recognized entity of you are at a certain level of healthcare construction, or you understand just kind of give us the major providers an idea of who is really trained and really understands the sensitivities of working inside the hospital.

Heather Weerheim (11:10):

Understood. We kind of went through some questions the other day to get prepared for this topic. And we talked about

Bryan Gingerich (11:19):

And you’re going to change them on me, aren’t you?

Heather Weerheim (11:19):

No! We talked about. I love this conversation that came up because we talked about bedside manner. And I thought that was kind of a great way to describe the type of personality or type of I guess, sensitivity that you have to have when working in healthcare construction. We talk about doctors that have a good bedside manner and nurses, but really if we’re working in an occupied space, us as either a project manager or even a superintendent might have to have that too. Can you explain that a little bit?

Bryan Gingerich (11:50):

Yeah. Yeah, sure. I, I, I look at it like over my years, as I’ve, I’ve worked in many different facilities with many different people and I’ve seen people try to work in the healthcare. Not sometimes it doesn’t always work out. I was the word empathy always comes to mind with me a great project manager or a great team leader, whether it be on the construction side or on the design side, it needs to be empathetic and they need to be a good listener. These projects get designed and you have a plan and you say, this is what it looked like today. This is what has to look like tomorrow, but there’s so many people involved that we just need to listen to them and understand what their concerns are and how do we, how do we keep a low profile? How do we when, when something does get noisy which it does in construction, right?

Bryan Gingerich (12:40):

How do we react to their reaction? How are we saying, you know, communicating with them in a way that we hear you and we are, we would make this, you know, correct. Or we’ll, we’ll, we’ll change our course of action a little bit. Maybe we’ll try something different, we’ll move a wall somewhere else to give a little bit more space or put a little bit more insulation in a temporary partition. But going into the healthcare environment, you know, we have to understand that we are the least important people in those meetings, right? So, and that’s another thing.

Heather Weerheim (13:12): 

Check our egos at the door.

Bryan Gingerich (13:12):

that people want to come in and they want to build, and they want to make, you know, they want to build these beautiful buildings and they want to do them as fast and efficient as possible, where, when we’re in an occupied facility, like I said, we have to understand, we are the least important person in that room. Because if, if, if their business gets stopped because of us, it’s a big deal. Yeah.

Heather Weerheim (13:38):

Absolutely, can you give us some examples of who would make a good construction, associate executive project manager, superintendent.

Bryan Gingerich (13:48):

I’m really glad that you bring that up. It’s a great question. Because not everybody is cut out in my opinion to do this kind of work. It’s something we talked about empathy a little bit. It has to have a good positive attitude. They need to be empathetic and good listeners and they can’t be squeamish and some people will come in and it’s a great, I mean, working in healthcare is incredibly rewarding. So I know every job that I’ve done, we’ve left. We’ve finished. And I can honestly say that this was for the good of the communities that I live in. Right. So a lot of people they’re like, I want to be a part of that. Right. That’s great. But then they get in there and they realize, okay, at the sight of blood terrifies me or they get what I call vapor locked when they realize that they are, they’re going to be doing construction activities, which they’ve been trained to do when there’s somebody having surgery, you know, six feet away.

Bryan Gingerich (14:50):

And then they know that, that you know, we all know that work in the business, that when you’re in some of the most sensitive areas, you know, they don’t just the hospital. Doesn’t just shut down a wing of operating rooms when they need to have something repaired or remodeled business goes on. So we have to find ways to work within those rules and make sure we keep people safe. So I, you know, I always encourage people that want to, to, to tag along and, and maybe, you know, get involved in some of this stuff, like early on, in most clinic type projects or you know, as an assistant on maybe a larger project. But some people just get to a point where they say, I don’t, you know, this terrifies me too much that I don’t want to do it. 

Heather Weerheim (15:35): 

You know, we joke –

Bryan Gingerich (15:35):

And it goes slower. And, you know, it just moves at a slower pace. Everything is methodically thought out and planned. And some, you know, some people just want to go fast, you know, they want to get stuff done. And I don’t blame them for that. You know, when you’re a carpenter out in the field, you want to be as productive as possible. Right. here, we may ask you as a carpenter in here that you just need to be more focused on having everything absolutely clean. Like, you know, your tools come in they’re on a covered card. You’re walking on sticky mats. You’re when you’re removing trash, you’re putting it in small pieces and do a small dumpster, and then you’re covering that dumpster taping it closed and rolling it through the halls. Right. That pace is, does not suit a lot of people. It’s different.

Heather Weerheim (16:24): 

Yeah,

Bryan Gingerich (16:24):

Absolutely. That’s the tricky part of the job. Right. And it’s also the rewarding part of the job is that if you want, you know, complex just try managing your way around doing construction activities inside of a functioning hospital. It’s like a chess game.

Heather Weerheim (16:40):

So I guess what’s your favorite, would you rather be working on a new, large ground up hospital project in which you’re not working around patients, or do you think you have the personality type that fits that interior hospital?

Bryan Gingerich (16:55):

You know, I’ve been blessed to be part of both in my career. I’ve done the ground up the large battleship sized projects that are brand new. I’ve done the, you know, ultra complex interior renovations of hospitals and kind of like the interior renovation part of it, because it really is a collaborative environment when we design what we want to build, and then we figure out how the hell are we going to build it? So, because there’s so many constraints that are in there. So sitting down with this large team nurse managers, again, I mentioned it before directors of facilities, people, environmental services, people, you name it, just identifying all of the risks that each of these people have, and then trying to build some sort of a matrix right. Of, of phasing plan and then come up with a plan. And a lot of times it’s, here’s a plan. Okay, well that doesn’t work because of this. So then we regroup, we do it again. And a lot of it’s done interactively. It’s done around the table around a set of plans with markers and whatnot, and it really builds a team quick. Especially when you get an owner that’s been through it before and is engaged in it and wants to be part of that process. That’s the funnest part of the healthcare is these detailed planning that have to happen for interior.

Heather Weerheim (18:18):

I would say when you have that level of detail, initially when you plan, it definitely makes for a more successful result. Do you agree?

Bryan Gingerich (18:28): 

Absolutely.

Heather Weerheim (18:29):

Who do you think plays well in this market? Bigger, small GC doesn’t matter. I mean, we kind of maybe answer that question as far as personality, but I guess from more of a high-level general contractor fit.

Bryan Gingerich (18:43):

So I think, you know, in the, in this market in healthcare is a broad term, right? There’s a lot of healthcare construction, and I think there’s room for many different types of contractors within it. When we look at some of the B occupancy type clinic spaces, that’s a great opportunity for somebody that is starting a construction company, or has a young company that wants to work into healthcare. There’s opportunities out there in some of the clinic type spaces.

Heather Weerheim (19:14):

So that would be a good stepping stone to get to the hospital type work.

Bryan Gingerich (19:17):

And these in inside the major systems trust and experience is, you know, trumps a lot of things when it comes to making selections. So it, it takes time to build a healthcare resume and to get into the really complicated projects. When you look at like the redesign or the rebuilding of an operating suite, right. That pool of contractors gets very narrow at that point in this market, there’s a handful of qualified contractors that, that can certainly do it and do a great job, but their teams have evolved with years of experience and, and also knowledge of the facilities. Right. If, you know, in my case, I’ve worked at certain facilities for years, right. I just understand how that system works for them. And it’s just not something you can just step in and do like a, a newer company can’t just come in and say, okay, I’m going to take on that, that operating room renovation.

Heather Weerheim (20:17):

So you’re talking about if you’re a newbie coming into this industry and some of the things that you need to know. So we talked about this, well yesterday we did have a, we met up with some clients yesterday and we did in fact go to a hospital to present to them. Some of our construction trends. Again, it’s part of this in practice areas and empowering and educating our clients. And we in fact, had to walk through the hospital. We masked up, we and that was new for me. I don’t have to do that on a basis. Then when I am in a hospital environment, I do get a little anxious. But as a newbie, we talked about that healthcare terminology and the acronyms, how does one who’s entering into this industry? What does it take? How do we learn these acronyms? What can we do? And can you share? I think I have, well, I had ICRA, MOB, I and B Occupancy would have, should we touched on a little bit, but let’s kind of go through some of a few that come to mind.

Bryan Gingerich (21:14):

Well, if you’re, if you work for the federal government or have you been in the military, that probably comes really easy. But the which I’m not, so it took me years to learn all these. There are everything there’s so many complex terms in the health healthcare facility that they boil everything down to acronyms. I always joke about the ICU’s there’s, you know, four different ICU’s PICU, NICU, SICU. You, you know, we need to understand what all these mean, right? Because these departments relate to each other as a newbie coming in, like when we bring in a new team member that says, Hey, I’ve got this desire to work in healthcare. We start with some of the basics and ICRA, and ILSM are the, the two biggest things that affect us.

Bryan Gingerich (21:56):

ILSM is interim life safety measures. So the, the fire code has the list of codes and standards that need to be followed. And what it pretty much boils down to is if you’re taking a, a system out of service, how do you protect that? How do you mitigate that risk? Or if you need to change a path of travel through a hospital, how do you have proper signage? It may involve training of staff. A lot of times you’ll have breakout staff training sessions where we are moving this door from here to here. We need you to, you know, train on the new path. So those are the two, the two big ones that affect us in construction. But again, all the other departments have some sort of acronym for them. And it’s important to know those because they are all interrelated, right? So you need to understand if you’re working in ICU right. It’s pressure relationship to the spaces around it. So it is important to learn what the different acronyms are.

Heather Weerheim (23:00):

And how would someone go about doing that? Asking questions, organizations, construction organizations,

Bryan Gingerich (23:06):

You know, ASHE a great research source. There is twin city health engineers as a resource. There’s definitely groups out there, networking type groups where you can learn some of that. But the, honestly the best way to do it is to start small on some of these interior projects and just you pick it up through meeting the nurse managers and the department directors and facility staffs and the hospital administration, but just, you know, it takes years to really get a great handle on it.

Heather Weerheim (23:35):

So speaking of taking years of getting a great handle on things in our in practice series, to me, it means we’re, we’re coming to work, we’re doing our job, but also open to learning and improving ourselves. So in your personal and or professional career, what are you doing every day to improve yourself?

Bryan Gingerich (23:56):

I am going to go personal on this one. And I’ve been working and getting a lot of joy out of this is coaching, right? I’ve got a 10 year old son and I love to coach his baseball games. I’ve done some basketball coaching as well. Just at that age really trying to instill basic skills in the game and fun for the game. There’s so much competition out there. And just trying to mold the right attitudes. You know, let’s keep at it. Let’s keep learning. 

Heather Weerheim (24:33):

Baseball should be fun, I suppose,

Bryan Gingerich (24:36):

Should be fun at nine and 10 years old baseball should be fun.

Heather Weerheim (24:40):

Well, Bryan, thank you so much for your time and your insight. You are true talent and we’re so lucky to have you at Greiner Construction.

Bryan Gingerich (24:46):

Thank you for having me Heather.

Heather Weerheim (24:49):

Absolutely. Let’s do it again soon for healthcare 2 0 1.