Northern Groove

...To Ensure Clinical Systems are go for Move-in to New Fort St. John Hospital and Residential Care Facilities

The commissioning process for all existing and new medical equipment has been part of the new Fort St. John Hospital and Residential Care Project ever since the design and planning phase of the new facility.

Commissioning of all medical technology in the new facility is underway ensuring that all systems and components are properly designed and planned for, tendered, evaluated and procured. The equipment must be installed correctly to code and regulations, undergo connectivity and data testing from Information Technology Services, operational testing to device specifications, and certified by regulatory bodies. User education and training must be provided to all by staff for proper and safe operation, with the systems and components properly maintained according to manufacturer specifications.

“In order to be successful the commissioning and certification process involves the participation of many specialists working in the Northern Health organization,” said Francis Keong, Northern Health’s (NH) Regional Manager, Biomedical Engineering. “The Biomedical Engineering department assists the project management team in ensuring adherence to equipment requirements and offers guidance to all processes, regulations and certifications when it comes to medical technology.”

The new facilities in Fort St. John have an NH equipment budget of $24 million including new ‘state of the art’ radiology equipment to renal dialysis equipment.

The larger clinical and some non-clinical systems are in the process of being purchased through the public tendering process managed by the procurement department at Northern Health and Health Shared Services BC.   Additional clinical equipment will include the purchase of drug dispensing systems, bone densitometers, patient monitoring equipment and mammography equipment (funded by the Fort St. John Hospital Foundation) prior to March 31, 2012.

Smaller items such as stretchers and wheelchairs will also be procured early in 2012.

“The Biomedical Engineering department will begin installations and certification of new equipment early in the new year and it will probably take us right up to opening date,” said Keong, adding that completion ahead of schedule would be ideal.

“We also need to accommodate time for the user training before move-in. The schedule for the installations and testing are based on the construction and procurement schedules and the biomed resources required.  A resource plan is in place to manage Northern Health and vendor resources.”

The testing process incorporates the vendor post-installation testing, Biomedical Engineering safety and operational testing, as well as any regulatory certification tests and validation. Once the testing has been completed the device or system will be validated for clinical use.

The commissioning plan will also include the transfer of existing equipment from the existing facility and installation into the new facility during and after move-in. This commissioning process will be slightly different as this will involve Health Care Relocations, Northern Health’s move management company;  end-user consultations;  infection control; and other departments and organizations including ISL Health based on the hospital and residential care move-in schedule which is being finalized by our executive team.

“The NH Biomedical Engineering department is comprised of 17 technologists, one manager and one secretary servicing over 37 sites across the Northern Health region. We are a very busy team and looking forward to the challenge!” said Keong.

In the 1960’s, Star Trek promoted  many new technologies. Nearly 50 years later, a significant number of those technologies have actually appeared – communicators vs. cell phones vs. Vocera?  In 1981, who could have predicted what new technologies would be available and used in 2011?  Google?  iPads?  Facebook?? The list goes on and on.   Nuclear medicine?  Telehealth?  Medical Imaging?  Tele Medicine?? It’s an amazing world, isn’t it?

Now imagine if your job was to design, build and operate a new hospital and residential care facility that needs to endure 30, 50, 75, even 100 years, with the pace of change growing more rapidly each day.  At the same time accomplish that objective when there is a conscious effort to improve costs, efficiencies, quality and sustainability of health care delivery in our communities?  It’s a daunting and wonderful challenge that is all wrapped up in the new Fort St. John Hospital and Residential Care Centre!

The Northern Health Authority and ISL Health are the public and private partners associated with this project.  Both parties are key drivers in shaping the design, construction and operation of our facility, for the next 30 years.  As part of that design work, great care has been taken to utilize technologies that balance cost, efficiency, quality and sustainability.  Who can accurately predict what the health care world will look like in 2041?  Nobody wants to be tearing walls apart in order to put something ‘new’ in.  That’s not cost effective or good business.

Northern Health has focused a lot of attention ensuring that open and adaptable technological infrastructure is in place, before the walls go up.  ISL Health have taken the lead engineering many of the technical solutions based on the service needs Northern Health identified in the project’s original Request for Proposal.

But the focus is not just $$ dollars.  Integrated Technology can provide patients, residents and clinical/non-clinical staff with better tools to enhance the quality of health care.  And that’s where the ‘cool’ part of this project comes in.

Communication systems are a key part of many of the new technologies.  For example, Northern Health staff at the new Fort St. John Hospital will be using small devices called  to remotely communicate with each other just like the characters in Star Trek. The device, part of the state of the art communication system engineered by ISL Health, is a wearable hands free voice controlled device that will provides staff with instantaneous communication between staff, patients and residents, as well as alerting functions for improved care and safety. Each device is small enough to clip to a uniform or hang around your neck.

Nurses can use the devices to talk with patients through speakers and microphones installed within the high-tech patient care rooms. This will enable nurses to triage issues remotely while undertaking other duties simultaneously. One of the major benefits of the system is the amount of walking it will save nurses and doctors. This will maximize the time spent at the patient bedside.

The devices can be programmed to tune out accents and look out for individual pronunciations, making them a very effective tool. Vocera is capable of connecting to other communication systems providing staff with immediate access to nurse call, telephone, help desk, intercommunications systems, infant abduction and patient wandering alarm systems.  The last two systems are both crucial elements in monitoring and protecting patients young and old.

The Birthing Centre will use an infant abduction system that involves the use of a special identity tag that has a clever transmitter that “talks” to  sensors located at all exit doors. When an infant’s tag is recognized near an exit door the door locks will automatically lock helping to keep our newborns safe. If a tag is removed from a baby while in use the system automatically notifies the nursing staff.

The 123 bed residential care facility utilizes a similar system for residents at risk of wandering out of the building unsupervised. The system will allow residents to move freely throughout the facility when accompanied with authorized staff but programs safe areas when residents are on their own.

All of the new technology introduced at the Fort St John Hospital and Residential Care Centre has been proven throughout North America and Europe ensuring the Fort St John Hospital and Residential Care Centre  maintains a world class level, in many areas of technology.

Welcome to 2012, the year the Mayans gave up on calendars, life, the universe, and everything.  Well, not til December at least...which means we have 11 more issues of Northern Groove mag to go until, much like Y2K, nothing exciting happens and we sit around and wait for the next bit of nonsense about the end of everything to come around.

Can you see the light?

It’s been an incredible ride for all of us associated with the Fort St. John Hospital and Residential Care Project these past few years.

It was April 2008 when the Province of British Columbia first gave the green light for Northern Health to move forward with the replacement of the Fort St. John Hospital, originally built in 1962 for a population of 4,000 residents. Fort St. John and the vibrant northeast region of British Columbia have grown exponentially since the 1960’s. The new health care facilities will serve a population base in excess of 64,000 people that continues to expand today. Our award-winning project has been designed to meet those increased needs and demands.

A $297.9-million health care project is a significant undertaking, involving a qualified and experienced team of professionals. Our project is based on the public-private partnership concept that enables ISL Health, our private sector partner, to design, construct, finance, and maintain these wonderful facilities for Northern Health for the next 30 years. Northern Health will be providing the cleaning/housekeeping services, laundry/food services and all of the clinical programs.

Since 2008, the Fort St. John Hospital and Residential Care Project has gone through many stages to get us to where we are today, seven months from completion. These stages included the Request for Qualification stage, where Northern Health verified the quality and performance of the parties interested in competing for the project; the Request for Proposal stage, that provided the approved parties with a conceptual idea of what the facilities should look like and how they should function as an acute care facility and residential care facility; and the awarding of the project to our preferred proponent, ISL Health, and signing of the 10,000-page Project Agreement on July 16, 2009. Since September 2009, ISL Health has worked closely with our clinical and non-clinical teams designing the facilities. The P3 process, as it is referred to by industry, allows stakeholders the opportunity to design, develop and construct facilities that are much more insightful and beneficial to the users.

One of the keys to our success has been our ability to integrate the knowledge, experience and wisdom of all of the team members associated with the project. This includes over 250 clinical and non-clinical staff throughout Northern Health. ISL Health, through its international networks, has brought in project managers, architects and engineers from Ireland, Scotland, England, Spain, the United States, Hong Kong and many parts of Canada. And let us not forget the 350-strong contractors, sub-contractors and tradespeople working at the construction site these past two and a half years, who continue to weather the unique climate conditions for which our region is famous.

On May 31, 2012, Northern Health will take ownership of the new Fort St. John Hospital and Residential Care Centre. This will be a very exciting moment for Northern Health, the Peace River Regional District and the Province of British Columbia. In order to get us through the next seven months, a number of important tasks must be completed by our project team.

These tasks include completing the purchase and delivery of $24 million in clinical equipment and commissioning, installing and certifying of the equipment. Transition planning will be finalized, ensuring that our clinical and non-clinical staff members are completely familiar with how they plan to deliver their programs and services at our new facilities. And finally, move management will be undertaken that involves the synchronized movement of existing equipment such as our Fort St. John Hospital Foundation funded CT scanner, furniture, files, staff members and, most importantly, our patients and residents into the new facilities.

At the end of the day, the success of the Fort St. John Hospital and Residential Care Project will be measured by our clinical and non-clinical staff, patients, residents and family members. We look forward to that very special day!

Northern Groove for Movember (er... November) features moustaches, welding adventures with Rain'mo Owl, Home Routes with Marianne Girard, spectacular Spotlight photos, meeting FSJ and the mooses, integral arts in FSJ, funny times with Spontaneous Combustion, what's up at the Rising Spirit, living the good yogi life, facing the music and degrees of musical separation, Cuban beats with Alex Cuba, giving local AWEsome gifts these holidays, the home stretch for the new hospital, and more mustaches!

Check out the November issue of Northern Groove online now and get connected with the Gift Guide!

Over the last two years we have reported many aspects of various activities ongoing at the new site. However, this month we are concentrating on the therapeutic environment that the ISL Health and NHA design team are planning. If you have passed by the site recently you would have noticed the intense amount of work going on around the outside of the new building as Acciona/Stuart Olson Dominion are undertaking the civils and landscaping work which includes putting in the internal road system and car parking lots.

The initial intent is to welcome and receive visitors to the site. The FSJ City design charrettes of 2008/09 recommendations were carefully considered when designing the strong entry into the new facility, and acting as a visual marker, a formal line of street trees will begin as the flow of traffic turns into the site, directing the visitor to the main entrances.  

Once on site, the subtle landscape inspirations will be used for way-finding, using thoughtful plantings of specially selected shrubs, strategically located landscape lighting and different paving materials to differentiate and locate the major entrances.

The areas immediately adjacent to the building will receive the most intensive landscape treatment. At the main entrance, a multi-purpose space is being designed to meet several requirements to entertain large community gatherings and to provide for the family or individual seeking solitude and privacy. To achieve this there will be benches along the walking paths with focused landscaped around the seating areas and the creation of a Spirit Garden. Accordingly a plaza effect has been created and at the centre will be a landscaped island, with a series of smaller spaces designed into it, allowing for a range of experiences. Overlooking the plaza will be a hard landscaped seating area surrounding a raised planter allowing for planting displays. Supplied with a power source, this area will accommodate a large Christmas tree illuminated during the holiday season. Adjacent to the open seating will be a series of smaller garden spaces providing for the more intimate, introspective moments.  
Similarly, the outdoor courtyards at the centre of the residential care buildings will be focused on creating ‘garden’ views from the resident rooms, with the intent being to entice the residents outside and inspire them to explore beyond their residence’s walls. The courtyard gardens will be universally accessible spaces, designed to encourage independent mobility and inspire residents to interact with their environment. As such, the gardens are being designed to provide stimulation, selecting plants that engage the senses in different ways, whether it's through scent, sound, taste or texture.

Lastly, as one moves south, away from the building, the landscape will return to its existing grassland character. A native grass mixture will be planted where site disturbance has occurred and the extensive grass landscape will reach beyond its borders and help blur the property lines. Much of the focus in this area is directed towards the storm-water detention pond that serves the dual function of treating the run-off from the roadways and parking lots as well as providing a focal feature to be viewed from the facility and experienced by the community through the trail system. Runoff from the parking and snow storage areas will be collected in the civil drainage system and directed into the bioswales which help to treat the water on its way to the detention pond. Bioswales are natural landscape features designed to remove silt and pollution from surface runoff water. They consist of a swaled drainage course with gently sloped sides and filled with vegetation, compost and rough stones. The water's flow path, along with the wide and shallow ditch, is designed to maximize the time water spends in the swale, which aids the trapping of pollutants and silt. The pond is designed as a dry pond basin, to hold water only in storm events. When full, it will provide a visual highlight to the landscape.

Networks of walking and cycling paths will meander through the grass to form a looped trail network for the enjoyment of residents, patients, staff and members of the community. These paths will facilitate community activity and encourage people to explore the surrounding landscape. Finally, the trails connect to the existing neighborhood trail system, and the future neighborhood to the North envisioned by the FSJ Design Charrette, integrating the facility into the community.

Interesting Facts
27.400 m2 of Asphalt situated on site
10800 m3 of base used
16200 m3 of gravel disbursed on site
The pump station has a capacity of dispersing 3000 gallons water per minute
The detention pond is sized at 5.200 m2
1,400 meters of walking and cycling paths
75 block heaters installed
50 street lamps installed
600 m of meandering bioswales

The Fort St. John Hospital and Residential Care Project has reached a major milestone, with the completion of its first department: the Birthing Centre.

The Birthing Centre is the first to be completed as construction crew’s work from south to north on the site. Kelly Joy, the hospital’s Clinical Coordinator for the Birthing Unit, said there is much anticipation regarding the Labour/ Delivery/Recovery/Postpartum (LDRP) process.

“The Birthing Centre is now a reality, not just a discussion point of what is going to work for us. This new unit is so modern compared to the current unit and I feel a real sense of achievement at what the whole team has done together,” said Joy. “We are continuing to work together to plan our new processes for providing quality care and modern practices, such as constant contact between family and newborn and single room maternity care, yet doing our best to keep the room ‘non-clinical’.”

Architect Troy Ransdell, Associate Vice President of Cannon Design, the architects for the project, said the fundamental philosophy of the new birthing centre focuses on patient and family-centered care.

“It’s a design philosophy that places the patient and their family at the fundamental core of design decisions. The idea is to support patient healing by creating environmental conditions that facilitate positive patient outcomes,” said Ransdell.

Joy said some of the more unique features in the birthing unit include having 11 in-patient rooms – including seven LDRPs, and four ante/postpartum rooms – and being able to accommodate the desire of new mothers to have round-the-clock support from their partners/families.

“Each in-patient room has a huge window for lots of natural lighting which is fabulous, and the LDRPs each have their own shower/tub,” said Joy. Other unique features include the layout of the nursery, with a central desk surrounded by four infant cubicles and extra space allowing for enhanced management of sick newborns waiting for transport to a neonatal intensive care unit (NICU); a separate outpatient area which allows for the possibility of program growth in the future; and special security for the new birthing unit.

Ransdell also noted the placement of the birthing centre next to the surgical department for quick access to the operating room (OR) for caesarean sections.

“It’s a bit unique for the birthing unit to be adjacent to a full surgical suite. Additionally the location allowed the department to be removed from the main hospital traffic. Less traffic is good for infant safety and promotes a peaceful healing environment,” he noted.

“Perhaps the most unique feature is how the department was divided into zones. Infant security and privacy is really important so we created departmental zones to advance these concepts. The zones provide higher levels of security and privacy as you go deeper into the department. The most secure zone holds the nursery and actual labour rooms.” 

Tony Boot, Site Superintendent, Hospital Facility, Acciona/Stuart Olson Dominion (the builders), said doing mockups of various rooms in the birthing centre ensured that most Northern Health requests were incorporated into the finished product.

“The Northern Health Authority, along with existing hospital staff, signed off on the rooms before construction began, eliminating any major reconstruction,” said Boot.

Northern Health Project Director, Tom Sparrow, said the completion of the birthing centre is significant because it represents the first step in the final stage of our project, the successful completion of a department.

Both Joy and Ransdell praised the working relationship between the hospital’s clinical staff and ISL Health’s design team led by Glen Kelsey, Design Manager, Acciona./Stuart Olson Dominion. Joy added it was amazing how the design team was able to translate staff input into the construction process.

“We are so pleased that we were able to involve so many of our staff and physicians on the clinical design team and everyone is really excited and maybe a little bit nervous about preparing for the future,” said Joy. 

“We all realize that this is a once-in-a-lifetime opportunity, but with it comes change – in fact, change to everything we do and to every process that we have developed over the past many years. So, in addition to the work that we do every day, we are now on the road to developing new ways that we will work together to deliver outstanding quality care to each of our patients.”

Northern Health Authority, ISL Health and School District 60 unveiled a banner featuring local students’ artwork from the first student art contest held last year to help launch this year’s art contest.  Students throughout School District 60 have been challenged to enter the second annual poster contest by submitting innovative artwork that promotes the building of the new Fort St. John hospital and residential care facilities.

Last year a  total of 12 prizes donated by the builder, Acciona/Stuart Olson, were awarded in various age groups which included play station consoles and digital cameras.  James Stotz, 12, one of the prize winners from last year was on hand for the unveiling.  His picture featured a monkey and he was sending the message that doctors don’t monkey around.

The 2011 art contest was launched on Tuesday, May 10, at Fort St. John’s  Interpretive Centre and featured the unveiling of multi-coloured banners decorated with student artworks submitted in last year’s art contest.  On hand for the launch were representatives from Northern Health, School District 60 and  ISL Health.

“Northern Health is very pleased to partner with School District 60 and ISL Health to encourage students from across School District 60 to participate in the art project this year,” said Betty Morris, Chief Operating Officer for the North East Region of Northern Health.

“We had good participation last year on the theme of ‘The importance of hospital to family’ and we anticipate even more participation from students in  year two as they develop their art on the theme of ‘Building the hospital and residential care facilities one room at a time.’”
Added Morris: “We are delighted that ISL Health has created banners from all of the art submissions last year and that these will be hung in schools as well as some of the more public locations in the community.”

Gareth Hurlbut, ISL Health General Manager said that community engagement is critically important for community projects like new hospitals.

“It’s easy for us to build the building, but what’s really important is that we get the local community to understand their building and to be a part of watching it go up, so they can feel like they had a say in it,” Hurlbut said.

Kim Boettcher, District Vice-Principal of Student Learning with School District 60, added that a new health care facility in the city will benefit every family in the area.

“It is important for students to appreciate the benefits of quality health care and they have demonstrated their feelings in the artwork they submitted for last year’s art contest,” said Boettcher.   “Their pictures showed all facets of health care,  from birth in the maternity wing to respectful caring for our elderly.”  

Posters submitted to the 2011 art contest can be done in a range of formats, everything from websites, Facebook pages,electronic images to traditional artwork.  Students can also use any artistic medium including crayon, pencil, felt, paint, pastel or electronic imaging.  

Boettcher noted that the construction of the new Fort St. John hospital is historic as local residents will likely not see another new hospital constructed in the area in their lifetimes.   She stated that all students are encouraged to enter the art contest, including those in home schooling initiatives.

 “We at the education level are interested in supporting healthy living as that is a mandate in our province – healthy kids learn better,” she said.

The deadline for contest entries is June 3, 2011.   All submissions should be sent to Kim Boettcher at the School District 60 office at 10112 – 105th Avenue, in Fort St. John.

Hey kids! How would you like the change to do some creative artwork AND be eligible to win some great prizes?

Northern Health is calling on all students in School District 60, from kindergarten to grade 12, to enter the second annual Kids' Art Contest to promote the building of the new hospital and residential care facilities in Fort St. John.

Three exciting prizes will be awarded in each category:
1st prize - a Wii system; 2nd prize - a flip camera; 3rd prize - a digital camera.

This year's contest theme is "Building the Hospital and Residential Care Facilities One Room at a Time." Here's what you have to do to enter:

• Use this year's theme and think about the different departments and programs that the new health care facilities will offer, including maternity, surgery, emergency, x-ray and residential care
• Design a poster, a website or Facebook page that illustrates what these departments or programs will look like
• Choose any visual artistic tools to create your design - crayons, pencils, felts, paint, pastels or electronic images
• Print your name, grade and school clearly on the BACK of your artwork
• Drop your entry off at the School District office by June 3, 2011 - Attention: Kim Boettcher

Age groups will be divided into the following categories: Kindergarten - Grade 3; Grades 4 - 6; Grades 7 - 9; and Grades 10 - 12. Judging will be done by community, school and hospital/residential care project representatives with winners notified by June 13, 2011.

All winning artwork will become property of Northern Health and be displayed in a photo book produced by Northern Health.

Don't forget! The contest deadline is June 3, 2011. Take your entry to the School District 60 office - 10112-105 Ave. Attention: Kim Boettcher