The anatomy of an emergency room move: Scarborough hospital opens new ER


It takes years of planning and attention to a myriad of details to successfully pull off a major move from one operational Emergency Department to a new one. That’s exactly what happened July 8 at The Scarborough Hospital (TSH) .

The transition from the old ED, built in 1957, to a state-of-the-art ED in the hospital’s new $72 million Emergency and Critical Care Centre required precision, timing and strong communication between teams made up of staff, physicians and external consultants.

Those teams involved an eclectic group of professionals, from the movers, general contractor EllisDon and emergency medical systems to information systems, security, facilities, housekeeping, pharmacy, nursing, physicians, porters, diagnostic imaging, registration and bed allocation.

“All staff involved supported each other, and worked as a well-orchestrated team with lots of communication,” says Louise Leblanc, Director of Patient Care for Emergency (Transition), who has worked at TSH for 37 years. “I am not aware of too many hospitals in Ontario that have gone through a similar move, when two EDs are operational at the same time.”

The time of the move was confirmed for 11:30 p.m. on July 7, despite a last-minute arrival of a CTAS Level 1 patient. “The only glitch we had was that cardiac presentation to the old ED just two minutes before closing it down,” explains Kiki Ferrari, Acting Patient Care Director for Emergency and Urgent Care. “We provided the care the patient needed in the old ED and transferred him to the new ED. The outcome was very good.”

By 12:15 a.m., the lights of the old ED switched off and the lights on the new ED were switched on. Nursing and physicians were ready for both EMS and walk-in arrivals.

TSH’s new Emergency Department is 23,000 square feet compared to only 8,000 square feet in the old ED. There are five care zones — pediatric; rapid assessment; critical care; acute care; and ambulatory care — each designed to be self-contained with their own nursing stations and separate patient rooms.

The new ED’s first walk-in patient was impressed with the department’s size, cleanliness and friendly staff. Adel Tofiq was accompanied by his wife, Laila Azizi, when he presented to the triage nurse at 11:36 p.m. “This is great. How often do you come to the Emergency and not have to wait,” Adel says. “I can’t believe how quickly I was seen. This is a great department.”

“We’re still on a high; the staff is elated at the new environment,” says Ferrari. “We’re tweaking things as we go along, tracking and monitoring our set-up to ensure that areas are doing what they’re supposed to do. I expect this ‘tweaking’ will be ongoing for six months.”

Ferrari offers sage advice to other hospitals that may be planning similar moves: “Always focus on providing better patient care when designing a new space. If you focus on that, you’ll come out with a really good design that will lead to better outcomes,” she says. “Be patient, because there are a lot of details involved. And always involve as many frontline staff as you can in all processes. That was the key for us.”