BY NORM TOLLINSKY

The future of health care is closer than we think. Two new hospitals taking shape in North Bay and Sault Ste. Marie will be among the most technologically advanced health-care institutions in North America when they open their doors 18 to 24 months from now.

Bright, spacious patient rooms, wide corridors with alcoves for charting and equipment storage, Internet connectivity at bedside, electronic health records and surgical suites with high definition video are just some of the design features and amenities staff and patients can look forward to.

Patients having an MRI at the new Sault Area Hospital will be enveloped in a simulated tropical paradise or other soothing environment with soft music, lighting and images of swaying wheat fields or marine life projected onto the walls. Modern heating, ventilation and air conditioning systems will be a pleasant change from the current hospitals, parts of which have no ventilation, let alone air conditioning.

The newly named North Bay Regional Health Centre will include two facilities – the North Bay and District Hospital and the Northeast Mental Health Centre. The co-location of the two institutions reflects a radical break with tradition and will result in “huge” efficiencies, said Glenn Scanlan, executive director of the North Bay Regional Health Centre Project.

“There has always been a stigma associated with mental health patients, but now there’s a change of thinking and delivery models,” said Scanlan. “The focus now is on getting mental health patients on their feet as quickly as possible and back into the real world.”

The design of the new Northeast Mental Health Centre is also unique. Instead of the traditional institutional-type design with long corridors, the new facility looks more like a residential townhouse development with pods accommodating a maximum of seven patients, all linked to common areas for dining, recreation and treatment. Evans Bertrand Hill Wheeler Architects Inc., the North Bay firm responsible for the design, has received international recognition for its work and has been invited to speak at several conferences, said Scanlan.

The North Bay complex will have a total of 388 beds – 113 for the Northeast Mental Health Centre and 275 for the North Bay and District Hospital. This compares with 180 mental health beds and 196 acute care hospital beds currently. Of the 67 fewer beds slated for the mental health centre, 40 are being transferred to the hospital, and the remainder to community settings, said Scanlan.

The co-location of the two facilities will allow for the consolidation of support services, including maintenance, housekeeping, dietary, materials management, lab and radiology, eliminating duplication of effort.

Construction of the 700,000-square foot health centre began in the spring of 2007 and is scheduled for completion in a little over a year. The target date for move-in is somewhere between October 2010 and January 2011.

Technology
The new 600,000-square foot Sault Area Hospital, currently 60 per cent completed, broke ground in August 2007 and is scheduled for occupancy in the spring of 2011.
Both hospitals will be fully wired for new technology. Internet connectivity and computer terminals at patient bedsides in the Sault, for example, will allow health-care staff to deliver educational videos on breastfeeding, cardiac rehabilitation, and caring for yourself after hip surgery, said Andrea Moraco, new hospital project manager. The bedside terminals will also be available to patients on a fee for use basis to surf the web and will be used by caregivers to update patient documentation.

Wireless hand-held devices integrated with the nurse call system will replace pagers, and wireless telemetry is being considered for cardiac monitoring, said Moraco.

A $38 million equipment budget for the new Sault Area Hospital will include the aforementioned new MRI with ambient experience, two new angiography suites, a large bore 16-slice CT, digital mammography, digital radiography and a linear accelerator for radiation therapy. “Currently, Sault Ste. Marie patients and Algoma District patients have had to travel to Sudbury for this kind of treatment,” said Harry Koskenoja, the Sault’s director of hospital development.

Charting alcoves in the hallways will allow nurses to be closer to the point of care. There will also be a hybrid medication dispensing system with biometric verification for high-risk drugs and medication carts with barcode technology for improved patient safety, said Moraco.

The new Sault Area Hospital has been designed to optimize infection control. Dedicated hand-washing sinks will be located next to the door in each patient room and cubicle curtains will be replaced by fixed walls in the new emergency room, which will have 44 beds - twice as many as the current ER.

Improved infection control has also been factored into the design of the new North Bay hospital, which will have a number of patient rooms equipped with ante suites and air handling systems to segregate patients.

Electronic health records
North Bay is already in the process of transitioning to electronic health records and will be the most advanced Meditech site in Northern Ontario, said Scanlan.

“We begin implementing the Advanced Clinicals module in April and, by the time we’re in the new facility, we’ll have electronic health records up and running. All of the clinical documentation and all the charting will be electronic.”

COWs – computers on wheels – are being acquired as part of the implementation.
“Electronic health records will make patient information easier to access and there will be less paper and less storage, said Scanlan. “Paper files used to be a quarter-inch thick. Today they’re an inch or two inches thick because of increased paperwork. Electronic health records eliminate all of that.”

Family physicians in North Bay will be able to access the system to get lab and radiology results and, eventually, Scanlan hopes to expand the system so emergency room doctors can access family physician charts.

A $30 million equipment budget in North Bay will be used to purchase an MRI and an assortment of other digital radiography equipment. Currently, North Bay patients have to travel to Sudbury, Timmins or elsewhere for MRIs. The hospital will also have two high-end suites for laporoscopic surgery with equipment mounted on articulating arms.

Both hospitals were designed with input from health-care staff. In Sault Ste. Marie, the process started with a plan describing how each department would function and detailing its space requirements. Once approved by the Ministry of Health and Long-Term Care, the plan was handed off to the architects, EPOH Inc. of Sault Ste. Marie, who worked with user groups from each department to create a floor plan and determine how the departments would be configured within the hospital relative to one another. Once the floor plan was decided on, the user groups met with the mechanical and electrical engineers to determine the servicing for the department.

In North Bay, between 25 and 30 teams were involved in the review and critique of the design and mock patient rooms were built and displayed to the public in a local mall.
The design of the new Sault Area Hospital minimizes the distance that staff have to walk to provide care and consolidates emergency room and outpatient services on the main floor to minimize traffic inside the building.

Large windows, courtyards and spectacular views were incorporated into the design of both hospitals to lift spirits and promote healing. Built on an escarpment on the northern edge of a forested area overlooking Lake Nipissing, the North Bay Regional Health Centre will even offer patients a glimpse of the odd deer, said Scanlan.

Both hospitals are being built in accordance with Infrastructure Ontario’s alternative financing and procurement (AFP) model, which uses private financing and private sector expertise to keep the project on time and on budget. The North Bay Regional Health Centre was the first hospital in Ontario to be built using the AFP model and the new Sault Area Hospital was the second.

The model provides for the construction, financing and maintenance of the two hospitals over a 30-year timeframe and covers the replacement of mechanical and electrical equipment, flooring and other assets subject to wear.

“Hospitals don’t have big capital budgets,” explained Koskenoja. “Most of the money goes to meet clinical needs, not for investments in building systems, so this way, we’re guaranteed to get those investments.

“Overall, alternative financing and procurement has been a positive experience,” he said. “Infrastructure Ontario brings continuity from one project to another, instead of a hospital going it alone.”

The price tag for each hospital, including construction, financing and maintenance for a 30-year period is approximately $1 billion.