Capital Project Plan Royal Inland Hospital Patient Care Tower Project March 1, 2017

Transcription

1 Capital Project Plan Royal Inland Hospital Patient Care Tower Project March 1, Project Background Royal Inland Hospital (RIH) is a tertiary level acute care hospital that serves as the only hospital in the Kamloops Local Health Authority (LHA), and serves as the referral hospital for the entire Thompson Cariboo Shuswap Health Services Delivery Area (HSDA). RIH began serving Kamloops in the early 1900 s. The hospital currently has three main buildings on the campus: the South Tower Main Building (constructed in 1965), the Alumnae Tower (constructed in 1965) and the Clinical Services Building (constructed in 2016). RIH is currently facing significant challenges with physical space and related issues regarding patient access, infection prevention and control and patient safety. In addition, work environments are overcrowded and not configured to current standards. In 2011, the Interior Health Authority completed a Master Plan to guide the redevelopment of RIH over a 15 year time-frame in three phases. The first phase, the Clinical Services Building, was completed in 2016 and the second phase, the Patient Care Tower, is the subject of this business plan. The scope and timing of a third phase would be determined as part of a future planning exercise. During preparation of the Business Plan for the RIH Patient Care Tower Project (the Project), alignment between the strategic priorities of the Ministry of Health and Interior Health were integral in determining key areas of focus for the Project. Completion of the Project will have a profoundly positive impact on patients and their families. 2. Project Objectives In support of the Vision and Guiding Principles for the Project, the Project Objectives established by Interior Health are to: Deliver a project scope that is patient centred, supports the guiding principles and achieves departmental objectives for Inpatient Care, Mental Health and Substance Use, Emergency Services, Surgical Services, Maternity and Child Health, Laboratory Services and Morgue; Incorporate design features that enhance the well-being of patients, families, visitors, staff and communities including those with Aboriginal ancestry; Improve patient access and flow within the site; 1

2 Improve the model of care delivery and patient outcomes (including patient safety) through application of patient centred and evidence-based design principles and standards for health care facility design and construction; Create a healthy and safe work environment that improves employee engagement, recruitment and retention, and provides an environment that minimizes the opportunity for workplace injuries; Support the Information Management Information Technology (IMIT) strategic plan by providing a robust, flexible technical infrastructure; Implement integrated electronic health records across the patient continuum of care, including advanced clinical functionality such as electronic clinical documentation, computerized physician order entry, closed loop medication verification and bedside medication verification; Optimize utilization of health care services and resource efficiencies to assist in health system sustainability initiatives; Evaluate the Project based on measurable aspects of the guiding principles, project objectives and departmental objectives through pre-occupancy and post-occupancy reviews; Maintain full 24/7 hospital operations throughout the construction and operational transition phase for the Project; and Minimize overall capital and operating costs for the Project. 3. Project Scope and Status The Patient Care Tower Project is a two-phased project on the Royal Inland Hospital campus. Phase 1 includes construction of the Patient Care Tower. Phase 2 includes renovation of vacated spaces in the existing hospital. Phase 1: Phase 1 is being procured using a Design, Build, Finance and Maintain (DBFM) method. The indicative design work for Phase 1 proposes a ten-story building (including roof-top heliport on Level 10). The Patient Care Tower is planned for approximately 27,088 square metres (gross floor area) of new clinical, administrative and support spaces. The eastern portion of the current Royal Inland Hospital site was selected to locate the new Patient Care Tower due to its relatively undeveloped condition and its close proximity to the existing main building. The Project Company s scope of responsibility will also include the facility and equipment maintenance and repair for the existing campus. Phase 2: Once Phase 1 is complete and programs decanted into the new building, renovations to the resulting available space within the existing facility can begin. This Phase 2 is not included in the DBFM scope, and will be procured using a Design, Bid, Build (DBB) method. 2

3 Table 1 outlines the components included in the Project scope for both phases of the project. Table 1: Project Scope by Program and Component New Construction: Patient Care Tower Surgical Services Medical/Surgical Inpatient Units Mental Health and Substance Use Inpatient Unit Maternal and Child Services (LDR and NICU) Child and Adolescent Mental Health Crisis and Intervention Program Pediatric Psychiatry Inpatient Unit Ambulatory Care Area Reception, Patient Registration and Retail Space 209 Parking Stalls (44 Parkade, 165 Westlands surface parking) Rooftop Helipad Renovations/Expansions: Existing Building Emergency Department Renovation and Expansion Post Anaesthetic Recovery Renovation and expansion Morgue Renovation and Expansion Laboratory Renovation and Expansion Pediatric Renovation (3N) Work undertaken on the Project to date includes: Completion of a functional program, indicative design and performance specifications (Draft Statement of Requirements); Preparation of a preliminary estimate of project costs prepared by a quantity surveyor; Development of a project budget reflecting the preliminary cost estimates; Analysis of project risks; Analysis of the procurement method for the Project; Discussions with the City of Kamloops and other community stakeholders; Completion and submission of a detailed Business Plan; and The Project was approved to proceed to procurement by the Province of British Columbia and was announced on February 6, Project Costs and Benefits Project Costs: The total estimated capital costs for the project are $417.2 million which includes a project reserve of $10.1 million. The Province and Interior Health will be contributing $225.2 million. The Thompson Regional Hospital District will contribute $172.0 million. The Royal Inland Hospital Foundation will contribute $20.0 million. These cost estimates are based on the functional program, indicative design and Business Plan developed for the Project. The recommended procurement method for Phase 1 of the Project is 3

4 a Design Build Finance Maintain (DBFM) model as it best meets the procurement objectives and provides expected value for money for taxpayers dollars. Design Bid Build (DBB) with the assistance of a construction manager is the recommended procurement option for Phase 2. Project Benefits: The expected Project benefits include: Improved patient care experience with improvements in patient safety, privacy and confidentiality; Reduced risks of infections; Improved compliance with current health care design standards and clinical standards; Increased levels of standardization of clinical spaces; Improved work flows; Greater flexibility in the operation of the hospital; Improved staff working conditions; Provision of appropriate clinical learning space for students, and Improved parking access for staffs, patients and visitors. 5. Project Risks The major risks associated with the Project relate to project scope and functionality, integration, schedule and cost. Scope and Functionality: These risks arise when a building is not sized appropriately and/ or does not have optimum design which results in lower functional, less efficient operations and user dissatisfaction. Measures to mitigate these risks include: Extensive user involvement during development of the functional design phase to ensure higher user satisfaction, integration and functionality; Incorporations of lessons learned from other projects of similar magnitude within Interior Health; and Engagement of an architect and design team to act as shadow consultants and advisors to Interior Health during the Project. This will reduce the likelihood of errors and omissions in the design and construction period. Integration Risk: These risks arise from the possibility that building on an existing brownfield site with an operational hospital could potentially impact ongoing clinical operations. 4

5 Measures to mitigate these risks include: There will be extensive user involvement during the functional design phase to ensure integration with ongoing clinical operations; The Project Agreement will include specific provisions to ensure project delivery, performance and quality standards for integration with ongoing clinical operations are met from financial close through design and construction; and Both Interior Health and the successful proponent will appoint design and construction representatives who will work collaboratively to review, approve, accept or confirm activities in accordance with the Project Agreement. Schedule Risk: This risk arises from the possibility that the procurement process and/ or the design/ construction process take longer than expected. Measures to mitigate this risk include: Engaging Partnerships BC to assist with the procurement process, Procurement and legal documentation will be based on industry-accepted templates; A Request for Qualifications (RFQ) process will be used to short-list the best proponent teams; Contractual documentation will be prepared ahead of time and appended to the Request for Proposal (RFP) so that proponents can consider these documents during proposal preparation; and Concept design drawings will be included in the Request for Proposal (RFP) to support the procurement cycle. Cost Risk: This risk arises from the possibility that overall project cost and construction costs are higher than budget. Measures to mitigate this risk include: The preliminary budget is based on an indicative design and a quantity surveyor report that contains cost contingencies; Estimates of construction escalation and inflation have been built into the budget based on the current market forecasts; and The requirement that Public Private Partnership (P3) proponents meet the mandatory affordability ceiling prior to evaluation of the remainder of the proposal submitted in response to the Request for Proposal (RFP); this ensures that Interior Health does not enter into construction contracts without assurance the project can be completed within budget. 5