A. PROBLEM STATEMENT AND BACKGROUND
Background
Ornge is Ontario’s air ambulance and critical care transport provider across a land area covering more than one million square kilometres and serving upwards of 14 million people. Ornge operates a rotor-wing and fixed-wing aircraft fleet and critical care land ambulances. Ornge completes more than 10,000 calls across the fleet annually.
To meet the needs of all patients and deliver on our mandate to support health equity across the province, Ornge is collaborating with Pilatus Business Aircraft to design and build a medical interior for a new Pilatus PC12NGX fixed-wing air ambulance fleet consisting of at least 12 aircraft, which are capable of supporting safe and efficient transport of all patients across Ontario, and across the continuum of age, weight and clinical acuity.
Medical Interior
Ornge requires a stretcher and lift assist system to meet all the current and anticipated operational demands to allow the aircraft and crews to safely and efficiently transport patients up to 500 lb along the most common FW air ambulance routes across Ontario (not including biomedical equipment) in a single stretcher four-seat configuration. The stretcher loading system's design must focus on the safest and most efficient loading and unloading of the patient onto and from the PC12NGX and allow for the safe and efficient delivery of patient care throughout the journey.
The ideal stretcher will accommodate patient positioning in various clinically appropriate positions, including supine, prone, lateral, and Trendelenburg, accommodate patient widths of at least 33 inches without impeding aircraft egress, and be equipped with a mattress that supports patient comfort over long-duration flight. The supplier will be expected to provide a means to securely power load the stretcher into the aircraft with lift assist capabilities for crew members.
Stretcher and Lift Assist System Requirements
- Interoperability with System Partners
Unlike most air ambulance operators, Ornge requires the support of ground Emergency Medical Services (“EMS”), which is municipally operated, resulting in variations in ground transport systems and capabilities with all of the different EMS operators with whom we interface. As part of a new medical interior, Ornge seeks a stretcher and lift assist system which ensures interoperability with the ground EMS system across the province, some 98% of which currently utilize Stryker PowerPro stretchers and retention systems.
In addition to supporting the Ontario EMS system, Ornge’s mission profile includes responses to many remote communities, many of which do not have formal EMS operations. This results in the need for ground transport in these communities to be provided by non-standard, non-ambulance vehicles. As such, Ornge seeks a stretcher and lift assist system that includes options for securing and transporting patients and equipment in these situations in a way that is easily portable, maximizes safety, and seamlessly interfaces with the primary power-loading stretcher system in the aircraft. This system must be certified for all aspects of flight.
- Interoperability with Ornge Vehicles
Operating in a system with multiple asset types, Ornge must maintain internal interoperability, including the need for all biomedical equipment to be mounted and secured seamlessly in each asset and for a stretcher and lift assist system that supports seamless and efficient transitions between fixed-wing, rotor-wing and critical care land ambulances.
- Special Patient Populations
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- Bariatric
The stretcher currently used in Ornge’s existing Pilatus PC-12 NG fleet has a maximum patient and equipment weight of 350 lb. This limits our ability to transport patients above this weight, requiring Ornge to seek alternate transport solutions. This results in delayed transport and is suboptimal from a patient comfort, clinical, and safety perspective. Therefore, the stretcher and lift assist system should be able to transport patients up to 500 lb. (not including biomedical equipment) in a single stretcher four-seat configuration.
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- Neonatal
Ornge supports transporting neonatal and pediatric patients both by Ornge crews and hospital-based neonatal transport teams. All teams currently use a provincial standard transport isolette (Canadian Voyageur Isolette by International Biomedical) in one of 4 configurations. The stretcher and lift assist system must accommodate this equipment, weighing nearly 400 lb. and provide onboard medical air solutions (compressed gas or medical air compressors) to support in-flight respiratory care needs.
Currently, the Isolette utilizes a LifePort TD deck with a LifeLoc system to secure the current FW fleet on the PLUS unit. This should be identified, or the isolette mounting may need to be changed and recertified. The third-party carriers would be the only place that the Isolette mounting system would be used without some interface.
Ornge also provides transport for patients requiring Intra-Aortic Balloon Pump (currently using an Arrow AutoCat II but pending upgrade to latest technologies) and Extracorporeal Membrane Oxygenation (“ECMO”) (presently using CardioHelp) therapy. The stretcher and lift assist system should be designed to support the safe and efficient loading and securing of this equipment in a clinically appropriate location in the aircraft. An ideal solution would include the provision of a means to power-load an Intra-Aortic Balloon Pump (“IABP”) and ECMO equipment from ground to aircraft at the same time as the patient.
Additional Considerations
- Systems included for securing any additional biomedical equipment on the patient stretcher/bridge. They should account for the future reality of changing or adding biomedical equipment.
- The stretcher and lift assist system design should not impede access for maintenance to the center floor area and underfloor area such that access must be gained by a single maintenance person in the field.
B. MATERIAL DISCLOSURES
1. Fairness Monitor
Ornge is using the services of Lakeland Consulting Inc. to monitor the fairness of the procurement process and provide consultative input on strategic procurement matters.
2. Subject Matter Expert Consulting Services
Ornge is using the services of Pilatus Business Aircraft to provide subject matter expertise consulting services throughout the procurement and implementation process.
3. Stretcher and Lift Assist System Installation
Ornge requires that the stretcher and lift assist system be installed in the aircraft before delivery and will require the stretcher and lift assist system supplier to work collaboratively with Pilatus Business Aircraft to coordinate the installation of the medical interior into the airframe before delivering each new aircraft. After the first installation, Pilatus Business Aircraft will install the remaining stretcher and lift assist systems.
4. Aircraft Delivery Schedule
Ornge will be seeking delivery of the aircraft within North America on the following preliminary delivery schedule of the first 12 aircraft (specific delivery location and delivery dates are subject to change):
Year
2026: Three (3) aircraft with the following delivery dates:
• July 2026
• September 2026
• November 2026
2027: Four (4) aircraft with the following delivery dates:
• January 2027
• July 2027
• September 2027
• November 2027
2028: Two (2) aircraft with the following delivery dates:
• January 2028
2029: Two (2) aircraft with the following delivery dates:
• January 2029
2030: One (1) aircraft with the following delivery dates:
• January 2030
The stretcher and lift assist system is expected to be ready for installation at least six months before the above delivery dates.
5. Centre of Gravity
Stretcher and lift assist system weight and center of gravity may not impact the minimum mission and flight operations requirements. This would include Two pilots (400 lb), two paramedics (400 lb), all mandatory equipment, biomedical and non-biomedical (367 lb), a fuel load of (1700 lb), and a patient of up to 500 lb.
Ornge mission scenario:
- PC12NGX Aircraft equipped with a (yet to be designed) fully certified medical interior installation.
- CYQT-CYTZ
- Bariatric Patient at 500 lb
- 1700 lb of Fuel
- 1090 lb for Crew and Passenger (5 occupants at 200 lb each plus 90 lb of personal baggage / 15 lb per occupant)
- 367 lb medical equipment
6. After Market Maintenance Support and Additional Systems
The successful proponent will be the vendor of choice for aftermarket support, warranty, parts and technical support of the STC product for the life of the stretcher and lift assist system in the Ornge fleet. To purchase additional stretchers or lift assist systems, Ornge will negotiate a Scope of Work, and any work shall only commence on the execution of a Scope of Work.
7. Compliance with MOH Standards
All components must meet the requirements for land ambulance transport as outlined in the MOH Land Ambulance & Emergency Response Vehicle Standard.
8. FAA and TCCA Certification
The proponent will be required to have a stretcher and lift system that has already been manufactured, installed, and certified for use in a fixed-wing aircraft in one of the previously stated jurisdictions. However, the proponent will be required to submit final drawings of the modified (if required) stretcher and lift assist system for the PC12NGX capable of being certified by the FAA and TCCA under the operational conditions described in this RFP, and Ornge will approve them before signing the agreement.
C. MANDATORY SUBMISSION REQUIREMENTS
1. Submission Form (Appendix B)
Each proposal must include a Submission Form (Appendix B) completed and signed by an authorized proponent representative.
2. Pricing (Appendix C)
Each proposal must include pricing information that complies with the instructions contained in Pricing (Appendix C).
3. Other Mandatory Submission Requirements
- Proponent must submit any requested changes to the Form of Agreement (Appendix A). Changes shall be submitted using a red-line version of Schedule 2 to the Form of Agreement as a separate document on MERX.
D. MANDATORY TECHNICAL REQUIREMENTS
Confirm whether or not the proponent can meet the following mandatory requirements:
Proponents should include the below table in their proposal and indicate (X) whether or not they can meet the specified requirement.
Proponents must submit evidence of all mandatory requirements for the proposed stretcher and lift assist system designed for an air ambulance aircraft in Canada. The submission must include an STC or design approval, photographs, and/or graphics of the system used in an in-the-air environment.
If a proponent cannot meet all mandatory requirements, the proposal will be disqualified and not evaluated further.
Requirement
1. Experience designing and installing stretchers and lift assist systems in air ambulance aircraft in Canada.
2. The stretcher and lift assist system is not a theoretical design but:
- Has already been manufactured, installed, and certified for flight in a fixed-wing aircraft in any of the following jurisdictions: Transport Canada Civil Aviation (“TCCA”), Federal Aviation Administration (“FAA”), European Union Aviation Safety Agency (“EASA”) or Civil Aviation Safety Authority (“CASA”),
- Has been designed to load and secure a Stryker Power-PRO XT stretcher, and
- Designed for inter-operable use in the air ambulance and land ambulance environments.
3. The stretcher and lift assist system cannot exceed 550 lb.
4. The stretcher and lift assist system accommodates a patient weighing up to 500 pounds.
5. The stretcher and lift assist system includes a method that supports the manual loading or unloading of a fully loaded stretcher in the event of a loss of system power
