The new intensive care unit (ICU) at the Montreal General Hospital (MGH) site of the McGill University Health Centre (MUHC) has won a prestigious North American architectural design award. A delegation from the MUHC along with Sheila Theophanides, associate architect with Fichten Soiferman et Associes, Architectes accepted the ICU Design Citation Award on January 30 during the 32nd Critical Care Congress in San Antonio, Texas. The Society of Critical Care Medicine, the American Association of Critical Care Nurses and the American Institute of Architects Academy on Architecture for Health co-sponsor the award. A panel of physicians, nurses and architects judges the entries.
“The renovation of the MGH site ICU was a very difficult and time consuming undertaking,” says Gerald Soiferman, OAQ, OAA. “The project was very complex, which makes receiving this award that much more gratifying.
Furthermore, it is nice that Fichten Soiferman et Associes is being recognized for its excellence in hospital and health care design.”
“I would like to congratulate the firm of Fichten Soiferman et Associes and I would like to thank everyone at the MUHC who suffered through the renovations for their patience,” says Dr. Ash Gursahaney, MGH site director of critical care medicine. “The renovations took two years to complete and the process was extremely disruptive and noisy for a number of medical wards and departments. Today, the 24-bed unit allows us to take better care of our patients and their families and the ICU health care professionals are working in a brighter, quieter more ergonomically designed environment.”
“Renovations of the MGH site’s ICUs were essential,” says Ron Evans, MUHC architect. “For years, health-care professionals were working in a substandard environment which created a chaotic and cramped environment for patients, families, and staff. The ICUs hadn’t been renovated in 25 years.
Hospital accreditations from 1991, 1994 and 1997 recommended strongly that the MGH site ICU spaces be expanded because the units were well below acceptable standards.”
“For a long time we have been working in inadequate spaces, where doctors and nurses were so limited it interfered with the running of the unit and caused additional stress to the staff,” says Colleen Stone, nurse manager of the ICU. “Due to high-tech equipment the staff was literally climbing over extension wires and cords to get to patients. Today, thanks to the renovations, I find it a lot easier to recruit nurses to the unit because the working conditions are so improved.”
“We are very proud of the design,” says Gerald Soiferman, “but we had to overcome a number of challenges.” One of the major design challenges was the layout of the unit, which was limited by the structure of the MGH. The typical layout of a modern ICU concentrates services within a central core surrounded by an outer ring of patient rooms. This set-up is impossible at the MGH because of the mechanical shafts that run up and down the building housing the plumbing, water pipes, and oxygen lines. As these shafts are fixed, the layout of the new unit is linear rather than circular. To compensate for this drawback, the designers decentralize the nursing stations installing one substation for every four rooms. This requires a lot more equipment as each substation has its own monitors and is hooked up to the main nursing station.
The design of the new unit also incorporates a dedicated elevator allowing the ICU to be in direct communication with the operating suites one floor below. This required cutting existing structural beams and then installing new ones. This procedure is difficult and adds significantly to the cost of the project and is very disruptive.
Dust control and the removal of debris are complex in environments that must be kept sterile. Therefore, workers erected temporary walls to contain the dust and muffle the construction noise so as not to disturb patients on other wards. Also, plastic had to be installed on the ceiling of the floor below to prevent dust from coating the unit.
The ICU renovations began in November 2000 and cost $7-million funds raised by the Montreal General Hospital Foundation from generous donors, individuals, foundations and corporations. The unit opened in March 2002.