BOQ for a hospital: systems, finishes and work inside an active ward
A BOQ for a hospital differs from a bill for an ordinary building in three ways: the systems make up most of the lines, the finishes are special, and in a working hospital there is work that does not depend on area at all. I have experience from both sides: an external check of a cost estimate for a hospital tower, covering quantities, scope and the chapter structure, against the BIM models; and work for a construction contractor working inside active wards of a medical centre, where I prepared quotes and interim payment applications measured room by room. On this page I have put together what I learned.
What a BOQ for a hospital includes, and why the systems are most of the bill
The estimate I checked, for a tower with several basement levels, a ground floor and two floors above it, had about 2,400 lines. The structural frame and the masonry were not in scope, and the estimate covered finishes and systems. About 84% of the lines were systems: electrical alone about 37%, followed by HVAC, plumbing and communications. Whoever checks only the architectural chapters checks less than a sixth of the bill.
A bill like this has items that do not exist in a residential building: bedhead units in recovery rooms, distribution boards for imaging rooms, medical isolation transformers, equipotential bonding in the rooms of ventilated patients, a nurse call system, electromagnetic shielding, large generators and uninterruptible power supply (UPS) systems. In medical gases, the takeoff counts alarm panels, outlets and a backup oxygen manifold. Most of these items are counted by number and come from the consultants' bills, as explained on the consultants' bills of quantities page.
Hospital finishes
Finishes in a hospital are chosen for cleanliness, static electricity and noise. The same estimate had cleanroom ceilings, welded anti-static vinyl flooring with conductive skirting, double plasterboard partitions with acoustic insulation, epoxy coating on the basement floors, and slab strengthening to the requirements of the Home Front Command (Israel's civil protection authority), with blast doors. The basements are different too: a hospital basement is usually a finished basement, with flooring, partitions, plaster and paint, so it must not be costed with the averages of a car-park basement.
Checking an estimate against the model
In an external check of an estimate, each item is compared with the quantity calculated from the model. In the check I did, some items came out very close, and some did not:
| Item | Estimate divided by model |
|---|---|
| Flooring | 1.07 |
| Metal tray ceilings | 1.01 |
| Plasterboard ceilings | 1.12 |
| Cleanroom ceilings | 1.27 |
| Curtain walls, external facade only | 1.03 |
| Curtain walls, including internal facades | 0.85 |
The last two rows show why you start from the categories: the same item moves from a surplus to a shortfall only because of which components were included. In the plasterboard partitions the gap was larger, and before deciding who is right you check which partitions were counted on each side. The chapter numbering also did not match the General Specification for building works, Israel's inter-ministerial specification, and that makes it harder to compare bids. I have written about the method itself on the quantity cross-check and model quantities pages.
Working inside an active hospital
When the work is done in a ward that keeps operating, some of the items do not depend on area. In the accounts I prepared for a contractor inside a medical centre, during a period when wards were being converted for ventilated patients, every room was measured separately: length times height times the number of repetitions, for plasterboard partitions, paint and demolition. Next to them were items that a normal project does not have: a temporary wall, removing an acoustic ceiling for reuse, a clean entry and a contaminated exit, automatic doors, labour hours for repairs, and cleaning the ward on Fridays.
In the tender documents for a new ward inside an existing building of another hospital, the specification required dust-tight partitions, phased work, noise restrictions and work outside normal hours at no extra cost. Requirements like these are not measured in m², so they have to go into the unit rate or into a separate item. Connecting a new water line to a live line, with the line located by hand, and temporary distribution boards are items of this kind too. On measuring for accounts: interim payment applications.
In a working hospital it is worth opening a separate chapter in the bill for interface works: temporary partitions, phasing, work outside normal hours, connections to live lines and cleaning. That way their cost is visible, and nobody has to search for it inside the unit rates.
A quantity surveyor is an engineer or a registered building technician, like Yaakov Avital, who measures the drawings or the model and turns them into items that can be priced. In a hospital a large part of the work is coordination between the consultants' bills, and part is measuring what is done inside a building that keeps working.
Frequently asked questions
How is the area defined in a BOQ for a hospital?
In a new building, by the total built area, with all the basement levels counted in full. In an extension or a refurbishment inside an existing building, by the area being worked on, and the interface works are written separately. Before calculating ratios per m², check the area schedule: on one project a row of typical floors was assigned to a different range of floors, and about a fifth of the area was left in doubt. The full scale is on my quantity surveyor fees page, and the price for each project is set in a written quote.
Why check the systems and not only the architecture?
Because in a hospital the systems are most of the lines in the bill. In the estimate I checked they were about 84% of the lines, and a check of the architectural chapters alone does not touch most of the bill.
What is special about accounts for work inside an active ward?
The measurement is room by room, and next to the quantities there are items for temporary work, removal for reuse, separating the clean entry from the contaminated exit, and cleaning. It is worth recording them in every account, because later they are hard to reconstruct.
Can a BOQ for a hospital be checked against a BIM model?
Yes, provided the categories are agreed first: which partitions, which ceilings and which facades are included in each item. Without that, the same quantity can come out as a surplus or as a shortfall.
Have a project? Tell me briefly what the project is and what already exists. When the project is a good fit, I usually reply with focused questions and a written quote.
Contact me for a quote* Created with AI for marketing, for illustration only. Not reviewed by Yaakov Avital and not professional advice. Every project must be checked on its own by a professional quantity surveyor and an engineer.