cme,
Oh no, respectfully, I disagree with the nutshell description.
First: CV reheat is a violation of ASHRAE 90.1. Reheat can be used only if recovered heat or part of a system reuiring a reheat process.
CV reheat was old school. we do VAV all the time, even for rooms requiring CV applications due to min ACH requirments. The VAV is great to maintain your isolation room pressurization especially during testing and balancing.
Then:
It is anything but a nutshell, you've got serious filtration requirements, invasive/non-invasive procudure rooms, nuclear medicine and lead lining, accelerators, ICU/recovery rooms, LDRP's, bone marrow transplants, morgues, biosafety lab hoods exhaust requirements, operating rooms with laminar flow diffusers, research labs, high supply low return/exhaust requirements, and on and on...
Then you've got a clientelle that is paranoid about contamination, triage, TB or AIDS patients, humidifications requirements, decontaminbation rooms, sterilization of equipment, coordination with medical planner and use careful reading of materail safety data sheets. You need steam year around in hospitals, programs that change with populations age and types of deseases evry 5 years, HVAC systems must accommodate future change in programs without disruption, etc...
Try to renovate an ER suite while maintaining full operation of ER and you'll learn something about serious utility phasing.
You need to read that VA guidleines at least 10 times to get just a grasp of what Hospital design is about AND be in a serious place with healthcare practice where you do nothing but hospitals.
A lot of people do MRI suites here and there and call themselves Hospital specialists.
And you've got some serious fast track projects, hospitals want an 9-month turn around on a project from NTP to occupation, every day is a high billing day in hospitals.
Good luck.