Bringing Research and Innovation to the Bedside

Architects see in three dimensions. The science and art of their profession is to translate the vision of a client into space that works. And designing for health-care facilities is the most intense process.

Chris Fillingham, the Managing Principal of the Joint Venture Architects (Dunlop Farrow, Moffat Kinoshita, Murphy Hilgers) who are building a new ten-storey tower for St. Joseph’s Healthcare Hamilton says, “An architect needs to work very closely with the user. It’s a process where experience counts, where you need to know what to ask, and where you need to be able to take intuitive leaps. And if you don’t listen just as intensely, you could still go wrong. An architect could be so creative and innovative that the design might not work for health-care professionals on the job.”

Combine tight budgets with an established, compact ground site, and the need for powerful communication skills becomes clear.

St. Joseph’s guiding principles are research, education and patient care. Their vision for renewal called for the integration of basic research with clinical research. This innovative approach is a first in North America. It will see in- and outpatient services closely allied with the research elements of the Firestone Institute for Respiratory Health and Father Sean O’Sullivan Research Centre.

St. Joseph’s Vice President of Diagnostics, Therapeutics and Redevelopment, Rebbeca Repa, says the hope is to bring evidence to the bedside and apply evidence-based practice. “We want to bring best practice benchmarks, research and evidence, and clinical innovation to the patient bed so that we can provide the kind of new and innovative treatments that patients are asking for. We will be practicing new techniques, providing new research at the bedside and having that feed right back into the research process. The point is to have the students, the researchers, the investigators and all the clinicians being able to work as a multi-disciplinary team towards identifying new ways of doing things better and different ways of treating patients.

“Generally we try to keep our clinical efficiencies together and our research efficiencies together because they require different air exchange requirements, different plumbing, different things from a construction point of view that just makes it easier to keep them separate,” says Repa. “So it’s much more complicated to have them together in the same building, but at the end of the day, it produces a much better inter-disciplinary approach, much more innovation, and certainly a greater breeding of new ideas.”

The planning process ground its way from the broad vision of hospital administration and the Ministry of Health and Long-Term Care to the finest grain.

“St. Joseph’s had the opportunity to put things together on the same campus – clinical adjacencies. And we worked with major user groups throughout the organization, such as the Vice President of Nursing, the Chief of Medical Staff, and staff at the departmental level, from the beginning,” says Fillingham. “We planned on a room by room basis, right down to mock ups, so that personnel could say things like place the monitor here not there. That kind of intimate communication leads to efficient and innovative health care design.”

To help staff orient themselves during the planning stages, the architects used new techniques – even inventing techniques – to make the plans clear to staff at St. Joseph’s. “Among others we used 3 dimensional drawing, 3D modeling, computer modeling, and even a mock-up of a full-scale patient room,” says Fillingham. “Those rooms could then become a template for other patient rooms in the new tower.”

As a leading teaching hospital the importance of building infrastructure and access for academic components is also key to St. Joseph’s strategy. The ten-storey tower will house the St. Joseph’s Healthcare/McMaster University Academic Centre. There will be a 200-seat auditorium with state-of-the-art technology to support conferences, meetings, and dissemination of cutting edge research information.

The importance of providing clinicians, scientists, learners, and patients and families with access and capacity to information through the library and information centre is viewed as a priority development.

The redevelopment at St. Joseph’s Healthcare Hamilton is expected to be complete by 2004.