east central health Lloydminster Hospital Functional Program & Master Plan Submitted by RMC Resources Management Consultants (Alberta) Ltd. & IBI Group Final June 2007 east central health LLOYDMINSTER HOSPITAL FUNCTIONAL PROGRAM & MASTER PLAN TABLE OF CONTENTS TABLE OF CONTENTS EXECUTIVE SUMMARY I 1. INTRODUCTION 1 1.1 Purpose 1 1.2 Background & Context 1 1.3 Project Scope 3 1.4 Planning Process & Acknowledgments 4 1.5 Document Organization 5 1.6 Glossary of Terms 5 2. PROJECT PARAMETERS 8 2.1 Overview 8 2.2 PNHR Guiding Statements 8 2.3 Catchment Area Review & Population & Bed Projections 10 2.4 Planning Parameters 19 2.4.1 Program & Service Parameters 19 2.4.2 Physical Parameters 23 2.4.3 Functional Parameters 24 3. FUNCTIONAL PROGRAM SUMMARIES 27 3.1 Overview 27 3.2 Functional Evaluation Summary 27 3.3 Potential Bed Capacity of the Existing Hospital 33 3.4 Space Requirements Summary 36 4. SITE & BUILDING REVIEW 40 4.1 Existing Site Conditions 40 4.2 Future Development 42 4.3 Building Condition Overview 44 4.3.1 Summary 44 4.3.2 Architectural & Building Enclosure 44 4.3.3 Structural 48 4.3.4 Mechanical & Electrical 49 5. MASTER PLAN 51 5.1 Summary of Evaluation Findings 51 5.2 Development Options 51 5.3 Recommended Master Plan 54 5.3.1 Schematic Layouts 56 5.3.2 Project Cost Estimate 61 Final 2007-06-30 east central health LLOYDMINSTER HOSPITAL FUNCTIONAL PROGRAM & MASTER PLAN TABLE OF CONTENTS 6. FUNCTIONAL PROGRAM COMPONENTS 6.1 Administration 6-1 6.2 Admitting, incl Public Facilities 6-5 6.3. Ambulatory Services 6-9 6.4 Diagnostic Imaging 6-19 6.5 Emergency 6-23 6.6 Facilities & Maintenance 6-29 6.7 Finance, incl Payroll and Scheduling 6-31 6.8 Food & Nutrition Services 6-36 6.9 Foundation 6-40 6.10 Health Information Services 6-43 6.11 Housekeeping & Laundry 6-49 6.12 Human Resources & Labour Relations 6-53 6.13 Information Technology Services 6-57 6.14 Laboratory 6-62 6.15 Materials Management 6-66 6.16 Medical/Transition Inpatient Services 6-72 6.17 Obstetrical & Surgical Inpatient Services 6-78 6.18 Operating Rooms 6-83 6.19 Pharmacy 6-91 6.20 Therapies 6-94 6.21 Volunteers & Ladies Auxiliary 6-97 APPENDICES A. Lloydminster Hospital Building Enclosure Review A-1 B. Lloydminster Hospital Structural Review B-1 C. Lloydminster Hospital Mechanical & Electrical Review C-1 Final 2007-06-30 east central health LLOYDMINSTER HOSPITAL FUNCTIONAL PROGRAM & MASTER PLAN EXECUTIVE SUMMARY EXECUTIVE SUMMARY OVERVIEW This document constitutes the Functional Program & Master Plan for the Lloydminster Hospital. Its primary purpose is to provide a planning strategy and framework together with recommendations for the redevelopment of the Hospital facilities, to address both immediate and short term priority needs as well as longer range growth needs. Important goals of the Functional Program & Master Plan are to: Address critical service needs. Improve facilities for service delivery now and in the future. Make optimum use of the facilities. The Functional Program & Master Plan will serve as a ‘living document’, reviewed and updated on a regular basis, so that it reflects changing conditions, new directions in its guiding parameters and assumptions, and future initiatives. BACKGROUND The Lloydminster Hospital is now a 20-year old facility. Its operation is the responsibility of the Prairie North Health Region (PNHR) under a joint agreement with East Central Health (ECH) for the delivery of health services in the Lloydminster region. Hospital funding, both operating and capital, is provided by the Alberta and Saskatchewan Departments of Health through the PNHR and ECH. The Hospital was designed in the early 1980’s to serve the needs of approximately 15,500 residents in the City of Lloydminster and its immediate surrounding area. The Hospital reflects the model of health care delivery at that time. Since then there have been a number of major changes that are driving the need to re-examine the Hospital and its current and future development requirements, such as: The restructuring of health services in the 1990’s in both Alberta and Saskatchewan leading to the closure of smaller hospitals in surrounding communities and the consolidation of services in larger centres such as Lloydminster. The significant growth in the economy and population of the Lloydminster region, making it the fastest growing area in Saskatchewan and one of the fastest in Alberta, i.e.: - The City of Lloydminster population surpassed 25,500 persons in 2007. - As a regional economic centre, the City of Lloydminster serves a market area as large as 120,000 people; for health services, it serves a catchment area of 65,000 to 90,000 people. - The Lloydminster area population growth encompasses young families including a local ‘baby boom’, a young industrial- based age group, a growing senior’s population choosing Lloydminster for their remaining years, and a high proportion of Aboriginal population. Final i 2007-06-30 east central health LLOYDMINSTER HOSPITAL FUNCTIONAL PROGRAM & MASTER PLAN EXECUTIVE SUMMARY Extensive changes in the delivery of health care services over the past two decades, placing different demands on the Hospital. The aging of the 20-year old Hospital building and the quality of its original construction have led to ongoing building performance and maintenance issues, e.g. water infiltration, the deterioration of materials and the inability to humidify the interior. The building and some of its major systems have reached a point where major upgrading and/or replacement are required if the building is to serve as a hospital for the next 10 to 20 years and beyond, i.e. building envelope, mechanical systems. PLANNING PARAMETERS The following Program/Service Parameters provide the framework for identifying the future requirements of the Lloydminster Hospital. The Hospital is expected to serve a regional population of 75,000 to 105,000 in the next 10-15 years. The Hospital requires 81 to 87 beds to meet the current demand. The future Acute Care bed needs in Lloydminster are: Year Bed Needs 2011 - 90 to 99 2016 - 96 to 107 2021 - 102 to 116 Plan Lloydminster Hospital as a Level 1 Regional Referral Centre. Expand services such as Mental Health/Psychiatry; Intensive Care; Surgery including Orthopedics, Urology and ENT; Medical beds; Obstetrical LDR’s. Plan for significant growth in Ambulatory Care, i.e.: - Expand from 6 to 12 Day Surgery beds. - Expand from 5 to 12 Dialysis stations. - Provide additional facilities for chemotherapy, endoscopy and specialty clinics. Add MRI services (initially a mobile unit). Plan to accommodate at least 50,000 Emergency visits, including a ‘fast track’ area for more effective service delivery. Expand to 4 OR’s, with potential for further growth. Other Key Planning Parameters include: Locate services on-site if it makes the most sense for services delivery and enhances patient/client access. The future is uncertain, therefore: - Plan open-ended, flexible and adaptable space. - Provide options for future expansion. - Consider expanding the site. Integrate and locate high volume / ambulatory services at ground level and at the same time reclaim Inpatient space. Final ii 2007-06-30 east central health LLOYDMINSTER HOSPITAL FUNCTIONAL PROGRAM & MASTER PLAN EXECUTIVE SUMMARY Increase the ratio of single bedrooms to plan for trends such as family centred care and infectious diseases. Ensure short-term expansion and renovations fit into a comprehensive, long-term redevelopment strategy. EVALUATION FINDINGS The High Priority Hospital services / departments that should be located in new construction include: Ambulatory Care - Chemotherapy, Day Surgery, Dialysis, Endoscopy, Clinics, etc. Emergency. Future Inpatient Beds. Operating Rooms. Therapies. In addition, a number of other Hospital clinical and logistical support services require significant expansion to address existing deficiencies and to serve current and future growth needs. The key findings of the Architectural and Engineering Evaluation of the existing building are: Confirmation that the building mechanical and electrical systems do not have capacity to serve future expansion. Confirmation that the structure can support a new 4th floor inpatient unit. Must address the following building issues to operate as acute care facility for the next 10 to 20+ years: - Replace building envelope to provide environmental control and humidification - may change appearance. - Upgrade elevators - also add in new. - Replace/upgrade mechanical and electrical systems - near end of life cycle. The key findings of the Site Evaluation are: There is significant expansion capacity on the existing 6.3 hectare site, including parking, i.e.50-60% of site area still available. Will likely need to consider future access from 36th Street. Recommend acquiring land across 43rd Avenue for long term future growth needs. RECOMMENDED MASTER PLAN The Recommended Master Plan proposes to expand the Hospital to the east and southeast, i.e. towards the ‘rear’ of the site where the majority of open space is available. The initial Stage 1 expansion would be at least two floors, with the optional capability to add one or two additional floors of inpatient units in the future. Final iii 2007-06-30 east central health LLOYDMINSTER HOSPITAL FUNCTIONAL PROGRAM & MASTER PLAN EXECUTIVE SUMMARY The existing space vacated by services such as Emergency, Ambulatory Care, OR’s, Therapies and Special Care would be renovated to accommodate the required expansion of other clinical and logistical support services, e.g. Admitting, Cafeteria, CSR, DI, Health Information Systems, Information Technology, Materiel Management, Telehealth and Conference facilities, etc. The proposed Stage 1 Development addresses the anticipated growth needs of the Hospital over the next 10+ years, including approximately 110 inpatient beds, a significantly higher proportion of single bedrooms, and expansion of key services such as Ambulatory Care, Emergency, Surgery, Obstetrics and Special Care.