By Arielle Zomer
The design of the hospital’s Wilson Site
When the new Humber River Hospital (HRH) building was being planned back in 2007 at its now current Wilson site location, it began as a desire to ensure our patients and our community were able to access the kind of exceptional care they deserve – putting patient safety, quality and clinical expertise at the forefront of the hospital’s innovative design.
This desire to build a hospital that nurtures patient and family-centred care was pivotal in creating the infrastructure that would be relevant for years to come – recognizing that technology, care pathways, and acute care delivery continues to evolve. Construction began in 2010 and five years later, the hospital opened its doors.
“The hospital was designed to maximize the benefits of digital technology, lean design and green health care principles – all with the goal to support our vision of high reliability care leading to a healthier community,” says Barbara Collins, President & CEO. “From the inception of the new building, the Hospital was envisaged with a lens to being responsive to the ever-changing needs of the community and the health care landscape.”
Maximizing green health care design principles
Recognizing that health, health care and the environment are inextricably linked, the design and construction of the HRH building at its Wilson site adhered to the guidelines and sustainability principles of the Leadership in Energy and Environmental Design (LEED®) rating system since its beginning.
In 2017, HRH received confirmation from the Canada Green Building Council that our building is certified as LEED gold. Achieving our targets has helped us improve air and water quality, reduce greenhouse gas emissions and contribute to the enhancement of the natural environment.
Green highlights include:
- 100% fresh air circulation, well above CSA-Z317 standards
- 20% of materials used to construct the facility contained recycled content and 46% were sourced regionally
- 96% of construction waste was diverted from landfill
- 38% of the project’s total site area includes vegetated open space
- 33% water use reduction and water efficient landscaping using captured rainwater
- Vegetated roof and reflective roofing materials to reduce heat island effect
- Planned and commissioned building systems which demonstrate unprecedented energy efficiency targets:
- Design energy use intensity (EUI) of 348 ekWh/m2
- 47% lower than the Energy Star Portfolio Manager Canada target for hospitals
- HRH features almost 26,000 square feet of dynamic glass. Patients are able to control the window tint in their rooms using Integrated Bedside Terminals. This feature helps the hospital achieve its sustainability goal of 40% less energy usage.
Leveraging infrastructure for infection prevention and control and emergency-preparedness
Well-designed health care facilities are a key component in improving work patterns and preventing health care associated infections. In health care settings, hand hygiene is the single most important way to prevent infections. The use of sinks at all treatment spaces and staff zones in patient rooms, in addition to hand sanitizer stations outside each room and at the head of each bed or treatment stretcher makes handwashing compliance easy.
The facility was designed and built with 80% single patient rooms, each with its own 3 piece patient washroom. Room sign monitors are located outside the entrance to patient rooms – these monitors are integrated with the patient chart and continuously update in digital pictures the contact precautions that are in place and the Personal Protective Equipment (PPE) that should be worn by staff and visitors. PPE is available in a purpose-built wall unit easily accessible at the room entrance.
In total, HRH has 83 negative pressure rooms with ante rooms, throughout the facility in both inpatient and ambulatory procedure areas. These rooms are centrally monitored and digitally alarmed for accuracy and maintenance of proper negative pressure levels.
In addition, the facility was built with a forward view to the likely presence of increased pandemics, ensuring an HVAC system that allows for the immediate reprogramming of a significant number of additional negative pressure spaces including:
- 36 rooms in the Emergency Department’s Acute and Sub-Acute zones
- 2 ER trauma rooms that are full surgical suites
- A 48 bed critical care unit in pods of 12 rooms
- One 32 bed inpatient respiratory unit
“The hospital’s ventilation system supports entirely fresh air– there is no-recirculated air in this building,” adds Collins.
“We designed the facility such that we can isolate inpatient treatment areas from the emergency department and outpatient treatment areas, while still enabling patients to be assessed and treated in designated areas,” says Collins. “Outpatient clinics have negative pressure rooms should a patient visiting the hospital need to be treated, and most treatment spaces in these areas are single rooms.”
The design of the new Hospital building came on the heels of the SARS (Severe Acute Respiratory Syndrome) outbreak of 2003, urging designers to take into account the many lessons learned from that experience. Through this knowledge, the designers were able to create infrastructure that is well-equipped to help prevent against the spread of infectious diseases and handle potential future viral outbreaks.
In addition to considering pandemic needs, the facility design also took into consideration Chemical, Biological, Radiological, Nuclear (CBRN) practices. If a major CBRN event occurred, the HRH ambulance garage that today accommodates up to 8 vehicles, can be quickly be converted to a mass pandemic intake ready area complete with showers. Wastewater from these shower systems are kept separate from the water system that sustains the rest of the hospital. In minor contamination cases, a separate Hazmat Room accommodates a patient shower station, and assessment is available from the ambulance garage.
“We built the hospital with containment in mind to provide the best resources and tools to prevent the spread of infections for patients and visitors,” adds Collins.
Arielle Zomer is the manager of public affairs at Humber River Hospital.