Architectural design at TWH lets equipment – and people – reach full potential

Since its opening last fall, the new Neuroimaging Department at University Health Network’s Toronto Western Hospital (TWH) has seen a constant stream of visitors from around the world.

They come to see the new technology housed here: how it allows radiologists to “travel” inside a patient’s brain in incredible detail – and to perform minimally invasive micro surgery.

But they also come to see the new architecture: how all the new elements have been brought together to create one of the best and most efficient neuroimaging departments and associated research/teaching facilities in the world.

Revolutionary changes”Timing was perfect,” says Tim Eastwood, project architect with Stantec Architecture. “University Health Network retained Stantec / Murphy Hilgers Architects in Joint Venture for the major upgrading and renovation project at Toronto Western Hospital just as the field of radiology was undergoing some fundamental changes.”

Dr. Karel terBrugge, Head of Neuroradiology at TWH, agrees. “Over the past five to 10 years, there have been enormous shifts in radiology modalities and practices,” he says. “In particular, it has become obvious that radiology has moved beyond diagnostics alone – and image-guided therapy is here to stay.”

“We were designing for a new and quickly changing field,” Eastwood explains. “And we had an opportunity to bring all the elements together in a new way, in this new space.”

To make sure the design kept up with new technology, the architects worked closely with Dr. terBrugge’s department and other hospital, engineering, construction and equipment representatives in an integrated consultation process.

Getting it all together”The first difference most visitors see is the way the department works as a whole,” says Eastwood. “Historically, imaging was used primarily for diagnostics. Most hospitals shoehorned new equipment and staff into their buildings in a way that doesn’t work for today’s needs.

“At Toronto Western Hospital, our team carefully examined how the different pieces of equipment are related, and the workflow between them from both a staff and patient perspective. Then we brought them together into one purpose-built department on Toronto Western’s third floor, with rational flow both to and within the space.”

That dramatically cuts time needed to transfer patients or assemble medical teams, Dr. terBrugge explains.

“The next big difference comes from the department’s expanded functions,” Eastwood says. “There is a separate, controlled-access section for the growing number of surgical procedures. That whole area meets full infection control standards, including carefully designed air handling systems, and scrub sinks outside of rooms.”

“World first” combo suiteA sure highlight for touring visitors – and for the people working here – is the world’s first neuroradiology multi-use suite. It combines:

  • a research/interventional 3.0 T Magnetic Resonance Imaging unit (MRI) – one of the most powerful clinical MRIs in the world
  • a biplane neurological angiography unit.

“This groundbreaking design puts two of the key pieces of interventional imaging equipment into interconnecting operating rooms, with all the shielding from radiation, magnetic fields, vibration, and radio frequencies required for both of them,” Eastwood says. Careful architectural planning creates as much extra space as possible, so that procedures can be done away from the equipment, and/or observers can be present. Patients can be wheeled quickly between the two units, and the entire space can be left open.

“As a result, this combo suite allows for quick response in neurological emergencies, which can be critical for patients. It also offers excellent operating and teaching space,” Dr. terBrugge says.

Efficiency and satisfactionThe surgical intervention section includes another neurological angiography suite and a body angiography suite – and flexibility for the future. Space has been properly built and shielded for another body angiography suite, for example, as well as an MEG (MagnetoEncephaloGraphy) unit. Another space has already been earmarked for onsite training of technologists in the use of new advanced imaging equipment.

Throughout the department, design has led to far greater efficiencies. As one example, shared control rooms for the two diagnostic MRIs and two Computerized Tomography units in the ambulatory section can each be operated by only one technician. “Management has been able to increase activity levels without having to increase staff,” says Dr. TerBrugge, “and staff satisfaction has been dramatically improved.”

Recruiting has also benefitted, he continues. “Anticipating that this was going to happen, a number of the best people came to work here even before the new department opened.”

And the visitors are still coming. “We’ve had to set up a schedule, there are so many,” Dr. terBrugge laughs. For more information:

Tim Eastwood, OAA, MRAIC, LEED AP, Associate, Stantec Architecture Ltd. Tel: 416-596-6666 x 253, teastwood@stantec.comor Andrea Johnson, Senior Marketing Coordinator, Stantec Architecture Ltd., Tel: 416-596-6666 x 241.