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APPLICANT COPY + BlacweParin collated the data provided by AHS staff as well as data collected using aur own tool. The findings were summarized end compared across al 18 facies (Section 2). At the request of AHS, data were also presented by program (Seton 3) ‘The ndings rom the tous were summarized by sit and by program in the following manner ‘Te programs/senices and faites on each site were briey described Issues and opportunities identified by the ite and/or the consulting team were summarise High-level functional and faci ratings were provided [Aviorkshop was held where preliminary ndings wee presented and revised based on AHS feedback. The faity and function ratings are graphical splayed ina matric withthe functional (programmer's) ating on the op af each square and the acity (erhitect’) rating onthe bottom. Te meanings ofthe funcional tings are: Department is performing well for curent use. Even if money were made avaiable funds would nat be used to renovate oc change the design ofthis unit ‘There are some functional or design concerns that decrease efficiency and increase potential risks; upgrade/remedlaion |S required inthe intermediate term. ‘There are major operational or design issues that have a negative impact on operations andor elevate rk to an unaceptable eve immediate upgrade/remedation i requires ‘The meanings ofthe facty ratings are ‘The building appears tobe in general complance with current standards and expected condion forits age (Note that engineering assessments were not conducted a part of our work, hence the cautious language). There are some physical concems that do not meet curet standards or expected conliton. The building fabric has ‘characters that would allow renovations to bing it up t,o lose to uent standards. There are major physical problems that do not meet curent standards or expected condtion, The building fabric does not have characteris that woud allow it tobe renovated to bring it up ta, or close to current standards, APPLICANT COPY. Emergency Facility Summary Issues and Opportu ‘Devon General Hospitot 4 Until 2010, there was a demonstrated ability to reduce ER volumes with “Right Care in the Right Place” intiatives (9, after hours cin since then the after-hours clinic has reduced hours of operation, i at capacity, and ER volumes have been impacted (volumes: increasing ratio of CTAS ‘A and CTAS 5 patients) 2._Renovation is needed in the ED to implement fast rack/RAZ and to provide patient care spaces that meet current standards, '3._EMS staff spaces do not meet standards; significant violation of privacy, ete. A There used apc the emergency department sed ech) “ST ge / evan res of te E egies configuration o provide bet vill af wating ao. Thre are sigleant PAC asin tbe | ssrnenneneneny Serta Caray api 6. capaciy press in Energency —— 7. Emergency layout impedes patient flow, undersized and poorly designed to meet the needs of 60,000 viits/year. The waiting room is spit in ‘wo, There ae only 2 seclusion rooms (need 4) and only one negative pressure treatment space. Continue to use 6 hallway spaces routinely plus Additional parking spaces for EMS. There are only 12 monitored beds out of 26 spaces. RAZis chaotic and cangested with no privacy. Satelite DL ‘cannot accommodate a stretcher so only extremity studies can be done here, Leduc Community Hospital 8. The emergency department requires reconfiguration at entrance and elsewhere to provide increase in capacity (RAZ/ast trac) staff note that department has low issues and not all patient care spaces ate fitted with suction/onygen, 9. Until 2010, there was a demonstrated ability to reduce ER volumes with “Right Care in the Right lace” initiatives (ie, after hous clini since then the after hours clnichas reduced hours of operation is at capacity, and ER volumes have been impacted (volumes) n APPLICANT COPY ‘North East Community Health Centre 10, Emergency was bul for 25,000 patients and is now seeing 53,000 people per annum (82 patients/tretcher/day) with growing numbers of CTAS 1 and 2. NECHC has the second highest pediatric emergency volumes in the Zone, Emergency has full ambulance service but no covered ‘ambulance bay/garage. Triage/Patient Registration is small and poory-designed. The Emergency Department is undersized for volumes, has very ‘small rauma room, inadequate storage and poorly-designed negative pressure room. No CT or inpatient beds to back up Emergency. Should Emergency continue to be a service offered on this site? 1. Capacity pressures were noted inthe Bridging lini for unattached patents seen in Emergency Cast Clinic (AMSAFE, and mental health services especially in Emergency. Misericordia Community Hospital 12, Major capacity pressures in Emergency 13, Emergency has 26 treatment spaces is poorly configured, undersized and all areas including trauma rooms are undersized. Halvay spaces used for patient care and for ECGs. Medication storage is not secured. Only one negative pressure room. Seclusion room poses safety concerns. 1 shared entrance for ambulance and walkin patients Royal Alexandra Hospital 14. There are significant capacty pressures (Le. inability to meet the demand for service in a timely and efficient manner) in trauma, Emergency, ‘Adult ICU, 15. The Emergency Department needs major redesign and expansion to meet its current workload demands, Strathcona Community Hospital 16. Both Emergency and Urgent Care are planned fortis site. Is this optimal? 17. Recruitment ofsuficient numbers of medical staff forthe ED is expected to be a challenge for the ist 1-2 years of operation ‘Sturgeon Community Hospital 118. The only negative pressure rooms are in Emergency and ICU 19, Emergency isin very large, new space. 50 built treatment spaces but only 20 in use. Clinical Decision Unit was poorly designed and cannot be used sits vacant. Westview Health Centre 20, Emergency requires major renovations to deal with capacity issues, patient flow, security, lack of clean and soled supply areas, small trauma room, ete. Cannot secure the Unit ater hour, 72 for Sitatchonan Satheons [APPUCANT COPY eae cre ng esp Acie Taman Hosp comanty Hests cate energy Wing community Hsp comet Hong Story Chr Hp APPLICANT COPY Surgery & Operative Services Facility Summary een erat “Edmonton Clinic 1. Each cnc has been specially-designed to meet the requirements of current users. May require renovation ifthe use of any cic area is icp ei Fort Saskatchewan Community Hospital 2. ‘There is unused capacity in inpatient services (6 dosed beds). 3. There is unused capacity in operative sences (ORs). Emergency surgery is provided but the future ofthis has been questioned. The recovery rom (3 stretchers) and the MDR may ni Support the theatres functioning a ful capacity “5._ Capacity pressures in vascular surgery 6._Can only do one vascular procedure 2 7 There is capacity pressure onthe inpatient beds. ‘Clinic areas/eased space on levels 2 and 3 ae closed inpatient care units. 9. Unused capacity inthe ORs however WOR is short of space has flow issues and likely cant increase capaciy. 10, Approximately 33% of surgical 2 11. Orthopedic surgeons assigned to Leduc by ‘surgery template forthe zone No fcity input into these assignments (pacts volumes) and allocated suppor ie. equipment/supplies) to the site may not be reflective of the assigned surgeons activities tes to Leduc Business Unit, 86 APPLICANT COPY Misericordia Community Hospital 112. Major capacity pressures in Surgical Day Ward, Endoscopy, ast Clinic, Lithotripsy, Orthopedic Surgery, Continence/ Urodynamics 13, Barer free access is an issue throughout the facility, outdated 4 bed in-patient wards lack privacy, do not have wheel chair accessible ‘washrooms and create major operational issues on a dally basis, End of life care — Palliative cae isan issue. Ortho cannot accommodate Balkan frames In-patient areas do not have adequate access to Physio Therapy program space 14, Lack intermediate care beds for close observation of patients 15, Surgical Day Ward is congested waiting room is poorly designed. Soiled utility hasan open hopper. Storage is a problem. 16, Poor HVAC in Endoscopy leads to use of curtain instead of doors on procedure rooms. Rooms ae not negative pressure. There is no scrub sink. 117, Outpatient Clinic is used by MCH during the day and by a PCN at night. Very busy. Gowned patients wait in public areas and have histories taken while inthe waiting room. Open storage in hallways. oiled utility does not have a waste disposal system, 18 Undersized and poorly configured OR's share HVAC with L+ and have open floor drains, The Sterile Core has been through mould remediation following flooding. The dumb waiter and clean elevators do not work up to 50% of the time. The Recovery Room bays have a head-out orientation. 19, The wait time fr ithotipsy is 12-18 months. Ths service is expected to move tothe Edmonton Cline. "20. Endo and Cast Clinic space is too smal and creates significant flow issues for patients and staf. "21. iRSM requires additional, consolidated dedicated program space Royal Alexandra Hospital 22. There are significant capacity pressures (ie, inabilty to meet the demand for service in a timely and efficient manner) in cancer surgery, Ophthalmology Clinic 23, There isa shortage of Observation (Intermediate Care/Monitored) Beds throughout the facility negatively impacting patient flow in all services. Some ofthese beds need to have isolation capacity, ‘24. Pressure to expand bariatric programs and to add bariatric operating rooms 25, Currently provide 2/3 of zone arthroplasty and want to consolidate allow risk procedures on this sit. 26 Ophthalmology Clinic is large and busy..does this program need to expand or canis operations be optimized in the current space? Should this program be moved offsite? 27. Outpatient cnc is small and doesnt have needed spaces. Initial patent assessments and some patient recovery take place in hallways. 87 APPLICANT COPY Strathcona Community Hospital — 28, Additional perceived cinical needs include: expanded programming for endoscopy EZ hand centre care, among others. Sturgeon Community Hospital 29. Inpatient units are short of support spaces including staff workstations, public washrooms, staff washrooms, kitchens, and patient lounges. Tub rooms are used for clean supply storape 30. Operating Room/PARR: Lack of laminar air flow in OR resulted in stopping upper extremity orthopedic surgery. Use open case cats that move ‘through public corridors because lifts are often broken down. There are decommissioned sterilizers in the sterile core. Pick lists for surgery are hand-written wth no computerized surgical instrument inventory. PARR has head-out orientation of patient care bays, Frozen sections are being done in PARR now this is an accreditation issue. 31, Endoscopy has good prep/recovery space but procedure room is very small and does not have proper sinks or staff work areas, 32. The only negative pressure rooms are in Emergency and ICU. '33, Women’s Health is located on 2 levels and in mixed Units with medicine and surgery. University of Alberta Hospital 34, Capacity pressures inal critical care units, observation beds, EEG telemetry, trauma, inpatient beds. Need appropriate services for higher-evel- ‘ate patients who are to sick to be admitted to an inpatient bed but not sck enough to be admitted to critical care. '35.Some departmental relationships are not ideal for the provision of services, Le the adult day surgery unit is remote from the adult operating rooms and the PACU. 36. The inpatient units are considerably out-of-date based on current planning practices and guidelines. This creates safety and IPC risks and lack of privacy for patients and families and staf. Storage isa major problem on all units. In addition, units lack centralized support spaces for staff and patients, including or example, classrooms and rehabilitation space. The size ofthe nits (8 beds) reduces operating efficiency. 537 Theresa plan to co-locate the Adult Same Day Admit Services with the Adult ORs on Level 3. 38. The Scope cleaning aea in the ENT dink doesnot meet standards Westview Health Contre 39. Theres capacity pressure on the inpatient beds. 40. Thre inpatient beds (in old central matemal area) are not appropriate for patient care. They have no exterior windows and are isolated from the rest of the nursing unit ‘AL. There is capacity within the ORs, endoscopy area, and the MDR but renovations may be required. 88 ee

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