Building the Hospital of the Future

Transcription

1 Building the Hospital of the Future Turning the Page on Planning and Design for New Healthcare Facilities in Canada: The New CSA Z8000 Standard Clifford Harvey, OAA,MRAIC Senior Architect Health Capital Investment Branch Ministry of Health and Long-Term Care

2 AGENDA 1. Questions 2. National Perspective: Health Care Infrastructure 3. Tools and Resources 4. The Future for Health Infrastructure in Canada 5. Health and the Built Environment of Care 6. CSA Z8000 Health Care Facilities 7. Questions 2

3 HIDDEN AGENDA 1. Research 2. Best Practices 3. Sharing 4. Best Practices 5. Research 6. Best Practices 7. Knowledge Transfer 8. Best Practices 9. Questions 3

4 QUESTION If I use the CSA Z8000 standard in Ontario will I get my project s design documentation approved by the ministry. 4

5 QUESTION YES 5

6 QUESTION MAYBE 6

7 NATIONAL PERSPECTIVE History and Legislation Federal Responsibility (1950 s-1970 s) Provincial Responsibility 7

8 QUESTIONS What about procurement? What about construction? What about implementation? 8

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11 INTRODUCTION: DESIGN AS A VERB Why is this important? Design Thinking: Business Planning evolution through LEAN to Design Thinking Medical Planning evolution through specialization to Integrated Planning 11

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14 QUESTIONS Are standards an inhibitor to innovation? Is it possible to have an national standard? What is a health care facility? 14

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16 QUESTIONS 16

17 INTRODUCTION: CSA PRINCIPLES 17

18 INTRODUCTION: CSA PRINCIPLES 18

19 INTRODUCTION: CSA PRINCIPLES 19

20 INTRODUCTION: CSA PRINCIPLES 20

21 INTRODUCTION: FGI PRINCIPLES 21

22 Innovation in Hospital Architecture Stephen Verderber (2010) A Hospital is a complex, contradictory building type, a system of systems There is no definition that succinctly sums up the many types of hospitals, nor the diverse geographic context, populations served, or cultural determinants that shape and continually reshape them Due to the vast variations across cultures and across geographic regions of the world, it is virtually impossible to attempt to comparatively assess the efficacy of one region or locality s minimum planning and design standards compared to any other

23 Innovation in Hospital Architecture Stephen Verderber (2010) Important determinants in identifying these highest ideals include: Local cultural traditions and demographic characteristics of the population Community attitudes towards sickness, disease and health Identification of obstacles to the establishment of sustainable healthcare environment An expectation in the local community that minimum standards will be set and exceeded for the design and construction of healthcare delivery environments Adherence to building codes and regulatory agency licensing protocols Building and sustaining strong community support for local healthcare institutions Establishing sustainable partnerships between not-for-profit and for-profit healthcare institutions Setting and maintaining progressive yet realistic funding and budgeting objectives Establishing and periodically reappraising the organization's strategic future goals.

24 Canada: Health Authorities Legend (c.2010) HA Health Authority Z Zone HR Health Regions RHA Regional Health Authority LHIN Local Health Integration Network HN Health Network DHA District Health Authority 1 HA 1 HA 1 HA 4 HA 6 HA 5 Z 13 HR 1 HA 11 RHA 14 LHIN 18 HR 1 HA 2 HN 9 DHA

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26 Health Infrastructure Planning and Design: Canada s Provinces and Territories Health Infrastructure Planning: Level 1: Provincial / Territorial Budget Level 2: Network Level 3: Program Level 4: Project Health Design 26

27 Health Infrastructure Planning and Design: P/T Resources: Planning? 27

28 Health Infrastructure Planning and Design: P/T Resources: Design? 28

29 Health Infrastructure Planning and Design: Resources Lack of Tools: Why? Lack of Benchmarks? Why? Culture x Measurement = Performance Lack of Research and Education? Why? 29

30 Health Infrastructure Planning and Design: Design Thinking Culture of Health Care Health and the Environment of Care Health Program Environment of Care Network: Home-Primary-Secondary back Home 30

31 Health Infrastructure Planning and Design: Standards CSA Standards: Z8000 Approach: Objective Focus Process Focus Program Focus Building Focus 31

32 Health Infrastructure Planning and Design: CSA Z8000 Health Care Facilities Section 4: OASIS O pera%ons A ccessibility S afety and Security I nfec%on Preven%on and Control S ustainability 32

33 Health Infrastructure Planning and Design: CSA Z8000 Health Care Facilities Clause 5 Planning Process 5.1 Initial Planning Project process Initial assessment Role review Master program Master planning and assessment Functional program Furniture and Equipment Planning Complementary plans Test fit Operational model Site evaluation Existing infrastructure assessment 5.2 Design Schematic design Design development Work planning Mock-ups Contract documents Classification of areas 33

34 Health Infrastructure Planning and Design: CSA Z8000 Health Care Facilities Clause 5 Planning Process 5.3 Construction 5.4 Commissioning General Risk management planning and mitigation Phase Planning Qualification of contractors and construction personnel Contractor orientation Infection prevention and control Noise and vibration management Dust and odour mitigation Service tie-ins and shutdown coordination Site access management Stop work process Signage General Operational commissioning 5.5 Take-over and occupancy Take-over Occupancy Temporary provisions for life safety and emergency response Coordination and interferences Change management As-built documentation

35 Health Infrastructure Planning and Design: CSA Z8000 Health Care Facilities Clause 5 Planning Process 5.6 Post-Occupancy Evaluation (POE) 35

36 Health Infrastructure Planning and Design: CSA Z8000 Health Care Facilities Clause 5 Planning Process 5.6 Post-Occupancy Evaluation (POE) Health Design 36

37 Health Infrastructure Planning and Design: CSA Z8000 Health Care Facilities Clause 6: Site Clause 7: General Clause 8: Inpatient Clause 9: Diagnostics and Treatment Clause 10: Support Services Clause 11: Common Requirements Clause 12: Building Services 37

38 FUTURE IDEAS FOR STANDARDS Blue H Red Tape on Floor Stuff on Walls 38

39 Health Infrastructure Planning and Design: CSA Z8000 Health Care Facilities Questions? Cliff Harvey, OAA, MRAIC Senior Architect MOHLTC 39