How to build a long-term care home in months instead of years.

By Andre Bohren

The life of a traditional construction project often includes months, if not years, of preconstruction planning before shovels go in the ground. In the summer of 2020, Infrastructure Ontario, Lakeridge Health, PCL, and a team of top-tier consultants and trade partners put their heads together to determine how to compress years of construction and build a new, six-storey long-term care home in just months.

What was needed to accomplish this seemingly impossible task? Strong relationships, and an expert team of professionals from multiple disciplines delivering on a precise strategy—all fueled by a relentless passion to achieve a common goal. The result? After just over a year of construction, Lakeridge Gardens, Lakeridge Health’s new long-term care home at its Ajax Pickering Hospital, achieved substantial performance on March 2, 2022.

“Lakeridge Gardens’ progress over the last year, and especially in the final weeks, was a remarkable achievement,” said Cynthia Davis, president and CEO of Lakeridge Health. “Our partnerships with PCL Construction, Infrastructure Ontario, local and provincial governments, the Durham Region community, and countless other skilled workers, tradespeople, and team members made this possible.”

What follows is a breakdown of how the seemingly unachievable timeline was met.

July 2020: The driving force

The global COVID-19 pandemic highlighted the need for new long-term care homes in the province of Ontario, and a solution was required fast. Jumping to action, the Ontario Government and Infrastructure Ontario launched the Accelerated Build Pilot Program—an innovative approach that leverages hospital-owned land and accelerated construction techniques to get shovels in the ground quickly. This approach helps build urgently needed long-term care homes in large urban areas where scarce and costly land is a significant challenge for prospective developers.

Leveraging available hospital land saved significant time in the process. Within weeks of announcing the new model, Infrastructure Ontario chose Lakeridge Health’s Ajax Pickering Hospital as the site for the long-term care home and issued the Request for Qualifications and Standing Offer (RFQSO). The hunt for a roster of firms that were equipped to rapidly deliver this project began.

The Lakeridge Gardens long-term care home in Ajax, Ontario, stands six storeys tall and covers 273,000 square feet. During construction, 2,605 cubic metres of concrete were placed on the site—enough to pave more than three football fields. (PCL Construction)

October to November 2020: No room for error

With a model of this caliber, PCL established a preconstruction plan early in the RFQSO phase to hit the ground running during construction. While PCL has a long history of experience in delivering projects under aggressive timelines, this project presented a unique set of challenges that required a near-perfect strategy.

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“Going into the preconstruction phase with an open mind was key in developing a successful strategy,” says Dean Xuereb, field operations manager, Canadian Buildings. “We needed to come up with a plan, validate it, receive community buy-in and form a team of consultants and trade partners within a small window of time. Once our team bought in to the modular kit of parts approach, we were able to pitch it to our stakeholders as the most effective method of construction for this project.”

A knowledgeable design team is crucial for carrying out a successful accelerated construction program. Bringing in long-term care design experts G Architects, in joint venture with Parkin Architects, played a large role in mitigating potential design risks and setting up the construction team for success. With the design team working closely with the hospital and local municipalities, a site plan was submitted and prep for the project was underway.

“Making sure we could support the construction schedule and maintain accuracy was top of mind,” explains Phil Goodfellow, partner at G Architects. “It was important to incorporate a simple and straightforward design that was reflective of PCL’s modular solutions approach.”

December 2020: Bringing in the right people

After four months of planning and procurement, PCL and its team of consultants were officially awarded the contract to design and build the long-term care home. As PCL geared up to begin construction, bringing the right people to the table was important.

“Resourcing trade communities that have an exceptional safety culture and experience in delivering a high-quality product within a rapid schedule was vital to being successful,” adds Xuereb. “We hand-picked a team of trade partners that were as committed to delivering this project as we were.”

January 2021: Let the journey begin

PCL officially broke ground in January 2021, commencing one of the most ambitious rapid delivery build projects it has ever taken on. The site was mobilized, and excavation and foundation work began.

While design development often continues simultaneously with construction, adopting a modular kit-of-parts approach allowed the team to minimize up-front design work. PCL was able to manage risks early on and had more control over the outcomes on the project.

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“Each modular component of the building was broken into tangible parts and prefabricated off-site parallel to the on-site construction being done,” says John Schmalz, modular construction manager. “Understanding the design requirements, relaying that information to our consultants and trade partners and finalizing the details during the preconstruction phase was how we were able to stay on track.”

The Lakeridge Gardens long-term care home also includes the construction of a new parking garage. Once complete, this will create approximately 530 parking spaces. (PCL Construction)

March to August 2021: The climb to the top

By early spring, the team successfully began construction on the vertical structure. A variety of specialized vendors were outsourced to prefabricate precast concrete, load-bearing wall panels, washroom pods, and mechanical distribution systems. Each key element was manufactured, shipped and installed on-site as the team reached the respective milestone.

The precast concrete and wall panels arrived at the site in March, followed shortly by the washroom pods. Construction of the building’s structure was moving at an incredible pace with the workforce alternating over two shifts per day. By August 2021, the structure of the long-term care home was complete, topping off just eight months into construction.

October 2021: Shifting momentum

In October 2021, PCL began to shift the attention to the home’s interior work, roof, and exterior cladding. Ten months into construction, the home’s overall structure was complete.

“It was important for us to keep the momentum going once we reached this milestone in such a short amount of time,” says Schmalz. “The entire workforce recognized the significance behind what we were trying to accomplish and was willing to work around the clock to complete this project for the community.”

November to December 2021: The home stretch

As the end of construction inched closer, interior finishes became top priority. Despite the pressures of the ongoing pandemic, Lakeridge Health’s clinical team safely supported important decisions that guided design development and clinical functionality throughout the project.

In November, an entire resident floor was mocked up, complete with a fully furnished resident room and working washroom reflective of the clinical team’s review. With final interior work taking shape, the long-term care home was only weeks away from achieving substantial performance.

January 31, 2022: Occupancy at Ontario’s first Accelerated Build Project

After just 13 months, the long-term care home was announced as Ontario’s first Accelerated Build project to achieve occupancy.

March 2, 2022 : The ultimate construction milestone

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Lakeridge Gardens long-term care home crossed the finish line and achieved substantial performance on March 2, 2022, the ultimate construction milestone. Marking the completion of construction, Lakeridge Health took full access to the home to prepare the space for grand opening, which happened on March 25.

“We are deeply privileged to have worked with partners to create the Accelerated Build Program in order to quickly deliver much needed long-term care infrastructure,” says Michael Lindsay, president and CEO, Infrastructure Ontario. “Through a range of accelerating measures such as modular construction, rapid procurement, and the use of hospital lands, we have been able to successfully build this facility faster than the traditional timeline. This project is a resonant example of what can be achieved when innovation, modern solutions, and great partnerships come together.”

The successful outcome on this project was a testament to the passionate drive of all partners involved and the more than 500 tradespeople who worked tirelessly to deliver this new long-term care home without compromising safety, even during a global pandemic. Committing to sending everyone home safely at the end of the day, the workforce performed a total of nearly 500,000 worker hours without a lost-time injury.

“The successful outcome on this project is only possible thanks to the dedicated efforts of countless individuals who worked tirelessly throughout the COVID-19 pandemic to provide long-term care residents with a modern, comfortable, and safe place to call home,” said Marc Pascoli, vice president and district manager of PCL Toronto.

“The LTC accelerated rapid build project has been a true collaborative effort between Lakeridge Health, Infrastructure Ontario, PCL, and the team of subcontractors and trades,” said Mark Murphy, senior director, Capital Planning & Development, Lakeridge Health. “The number of times each organization and the hundreds of trades have stepped up throughout this project are too numerous to count—and all within the context of doing so in a global pandemic. We are all proud of what we have accomplished.”

[This article originally appeared in the May/June 2022 edition of ReNew Canada.]

Andre Bohren is construction manager, 
PCL Constructors Canada Inc.

Featured image: During peak construction of the Lakeridge Gardens long-term care home, there were more than 600 workers on site daily, equal to 4,800 working hours per day. (Lakeridge Health)


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