Appendix 3A - Clinical Specifications

Appendix 3A - Clinical Specifications
 North Island Hospitals Project
Appendix 3A - Clinical Specifications
For Comox Valley Hospital and Campbell River Hospital
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ TABLE OF CONTENTS
Component Number
Component Name (Department)
Section
0
IP
0
01
Introduction
1
General Medical/Surgical Inpatient Units
2
IP
02
Intensive Care/Telemetry Unit (ICU/TU)
3
IP
03
Maternity and Newborn Inpatient Unit
4
IP
04
Psychiatry Inpatient Unit
5
AC
01
Emergency Department (ED)
6
AC
02
Ambulatory Care/Day Programs
7
AC
02.01
Orthopaedic Clinic
8
AC
03
Surgical Day Care
9
AC
04
Ambulatory Procedural Care
10
DT
01
Cardio-Pulmonary Diagnostic Services
11
DT
02
Medical Imaging
12
DT
03
Laboratory
13
DT
03.01
Morgue and Autopsy
14
DT
04
Surgical Services
15
DT
05
Therapy Services
16
17
DT
06
Pharmacy
OS-STL
01
Biomedical Engineering
OS-STL
02
OS-STL
03
Environmental Services
20
OS-STL
04
Information Management/Information Technology (IM/IT)
21
OS-STL
05
Materials Management
22
OS-STL
06
Food Services
23
OS-STL
07
Equipment Maintenance
24
OS-STL
08
Equipment Depot
25
OS-STL
09
Medical Device Reprocessing Department (MDRD)
26
OS-GP
01
Central Education and Conference Facilities
27
OS-GP
02
Central Medical Staff/UBC Facilities
28
OS-GP
03
Central Staff Facilities
29
OS-GP
04
Public (Patient and Visitor) Support Services
30
OS-GP
05
Site Support and Business Services
31
OS-GP
06
Central Patient Services
32
18
This Component is Intentionally Blank
19
Attachment 1 - Pneumatic Tube Matrix
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.1
BACKGROUND AND SCOPE
1.1.1
Appendix 3A is the Clinical Specification. Its purpose is to describe and outline the key needs and
building design attributes required by the Authority to successfully implement clinical operations
and achieve their desired model of care. The document describes both big picture concepts and
detailed specific clinical needs. It includes numerous data that will directly and indirectly influence
design decisions. Appendix 3A includes the Functional Space Requirements, which outline the
space that shall be provided in the Building.
1.1.2
Appendix 3A describes program requirements of two community hospitals. The Campbell River
Facility (CRH), located in Campbell River, and Comox Valley Facility (CVH), located in
Courtenay.
1.1.3
The following service components will be provided within each Facility unless otherwise noted:
Inpatient Areas
 General Medical/Surgical Units
 Intensive Care Unit/Telemetry Unit
 Maternity, Newborn, and Pediatric Unit,
o
Centre for Excellence in Aboriginal Maternal Health (Campbell River)
 Psychiatry Unit (Comox Valley)
Ambulatory
Services
 Emergency Department
 Ambulatory Care/Medical Day Care Programs
 Ambulatory Care – Orthopedic Clinic
 Surgical Day Care
 Outpatient Procedural Care
 Cardio-Pulmonary Diagnostic Services
Clinical Services
 Medical Imaging
 Laboratory
 Morgue and Autopsy Suite
 Surgical Services
 Therapy Services
 Pharmacy
 Food Services
 Central Patient Registration, Diagnostic Intake and Specimen Collection
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
Support Services
 Biomedical Engineering
 Environmental Services
 Information Management/Information Technology
 Materials Management
 Equipment Maintenance
 Equipment Depot
 Medical Device Reprocessing Department (MDRD)
Support Areas
 Central Education and Conference Facilities
 Central Medical Staff/UBC Faculty of Medicine Academic Teaching Facility
 Central Staff Facilities
 Public Support Services
 Site Support and Business Services
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.1.4
Centre for Excellence in Maternity Care for Aboriginal Women and Families (CFEMAW) Campbell River
1.1.4.1
CFEMAW is a critical component of the Campbell River Hospital and is poised to
become a leader in Aboriginal maternal health on Vancouver Island. Through the
implementation of initiatives that are evidence based and culturally situated, the Centre
for Excellence will address the maternal health challenges facing Aboriginal women
and work towards better outcomes for this population.
1.1.4.1.1
Campbell River Hospital (CRH) Maternity, Newborn and Pediatric Unit will
include the CFEMAW Program. This program will include all areas of the
hospital where maternity patients will receive care, including IP.03
(Maternity Newborn and Pediatric Unit), AC.01 (Emergency Department),
AC.02 Ambulatory Care/ Day Programs), DT.04 (Surgical Services),
OSGP.06 (Central Patient Registration, Diagnostic intake and Specimen
Collection Services. While all areas of the CRH must incorporate visible
representation of First Nations culture into the design, these areas in
particular will require increased respect for First Nations cultural values
represented by First Nations groups of northern Vancouver Island and
surrounding area throughout the development and design. For example,
consider specific architectural features such as the historical Big House in
the entrance to IP.03 (Maternity Newborn and Pediatrics) and OSGP.04
(Public Support- Lobby) in CRH. This CFEMAW program will also require
specific aboriginal design features in all LDRPs in Campbell River but
specifically in the two LDRP rooms designated as aboriginal LDRPs.
Further consultation with the NIHP Aboriginal Working group will be
required to further specify design requirements.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.2
BUILDING CONCEPTS
1.2.1
In order to understand the preferences and needs of the Authority what follows is a description of
general building concepts and organization.
1.2.2
Stacking and Organization:
1.2.2.1
The following service components shall not be located on any ground floor:
1.2.2.1.1
1.2.2.2
1.2.3
The Maternity, Newborn, and Pediatric Unit
The following service components shall be located on the main patient drop off
entrance floor:
1.2.2.2.1
The Emergency Department
1.2.2.2.2
Medical Imaging
1.2.2.2.3
Ambulatory Care/Medical Day Care Unit
1.2.2.2.4
Orthopedic Clinic
1.2.2.2.5
Outpatient Procedural Care
1.2.2.2.6
Central Patient Registration, Diagnostic Intake and Specimen Collection
1.2.2.2.7
Central Education and Conference Facilities
1.2.2.2.8
Public Support Services
1.2.2.3
The MDRD shall be located a floor above or below Surgery.
1.2.2.4
The Surgical Day Care and Post Anesthesia Recovery Room (PARR) shall be located
on the same floor as Surgery.
1.2.2.5
The General Medical/Surgical Units and Inpatient Units shall occupy the top clinical
floors.
Internal Organization:
1.2.3.1
Spoke and Wheel Layout
1.2.3.1.1
In all cases where patient stations are utilized (except where otherwise
noted) the unit organization shall be the “spoke-an-wheel” layout concept.
That is, patient treatment spaces shall be organized around a central team
care station with a race-track corridor circulation system. Provide a
“spoke-an-wheel” unit organization for the following units:
1.2.3.1.1.1
ICU/Telemetry
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.2.4
1.2.3.1.1.2
Maternity
1.2.3.1.1.3
Emergency Department
1.2.3.1.1.4
Outpatient Procedural Care recovery area
1.2.3.1.1.5
PARR
1.2.3.1.1.6
Surgical Day Care
1.2.3.1.1.7
Any other areas that provide multiple patient care stations.
Internal Circulation and Links:
1.2.4.1
The general configuration of horizontal and vertical circulation systems has a direct
impact on healthcare delivery, visitor orientation and wayfinding and the efficiency of
logistical activities. Its structure greatly influences travel times and is a key element that
determines the Facility organization and layout.
1.2.4.2
The architectural characteristics of the various circulation systems help increase
patient, user and employee satisfaction with the hospital environment. In general, the
design of the Facilities must include separate public circulation systems adapted to a
hospital setting. Where possible, the design of the Facilities needs to provide three
main circulation systems for the flow of persons and goods, as outlined below:
1.2.4.2.1
Public circulation reserved for visitors, ambulatory patients and caregivers;
1.2.4.2.2
General medical circulation located within sectors and functional units, and
reserved for employees, bedridden patients, certain ambulatory patients
and supplies;
1.2.4.2.3
Circulation reserved for logistics, in particular support services.
1.2.4.2.4
Stairwells shall be located so as to shorten staff travel distance between
critical departments. The design of the Facilities should consider windowed
exit stairwells with views of the outdoors to facilitate employee orientation
and comfort, encourage use of the stairwells and increase nighttime safety.
The design of the Facilities should avoid placing stairwells in areas which
restrict exterior views.
1.2.4.2.5
Elevators shall be centrally located for staff and patient movement. Service
elevators will be located to allow efficient ease of access for material
movement. Public elevators shall be visible and easily accessible from the
entrances, parking lots and main circulation on each floor.
1.2.4.2.6
Provide efficient transportation to and from the Clinical Services Building
(CSB). There shall be an enclosed, air conditioned connection corridor
between the Acute Care Building and the CSB on every floor of the CSB.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.2.5
Standardization:
1.2.5.1
1.2.6
1.2.5.1.1
Room length and width
1.2.5.1.2
Fixed Equipment
1.2.5.1.3
Millwork
1.2.5.1.4
Plumbing Fixtures and Location
1.2.5.1.5
Furniture locations
1.2.5.1.6
Patient bed/table location
1.2.5.1.7
Privacy Curtain
1.2.5.1.8
Door Location
Medication Rooms
1.2.6.1
1.2.7
It is the intent of the Authority that the Facilities shall be standardized. All rooms that
have similar functions shall be standardized. This means that where rooms have a
similar function they shall be standardized within the Facility and between both
Facilities. For example, all medication rooms in Comox Valley Facility shall be
standardized and that standardization shall apply to Campbell River Facility. Consider
standardizing the following room elements:
Medication Rooms shall be centrally located and convenient for quick staff access. All
medication rooms are to be fully enclosed unless otherwise directed by the Authority.
All medication rooms shall have at least one door and shall be automatic opening for
authorized staff (i.e. controlled access). All medication room doors shall have direct line
of sight from the team care station. All medication rooms shall have no less than
2800mm in countertop length; room for at least one full height medication refrigerator
and three automated dispensing units and a sink.
Pneumatic Tube Stations:
1.2.7.1
The pneumatic tube system will be a critical component of Facility operations. Access
to tube stations will be provided throughout the Facility.
1.2.7.1.1
Provide pneumatic tube stations at the locations indicated in Attachment 1
to this Appendix.
1.2.7.2
Provide a countertop immediately adjacent to pneumatic tube station.
1.2.7.3
Final placement of pneumatic tube stations in individual departments and type of
station will be determined in collaboration with User Consultation Groups.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.2.8
1.2.9
Functional Space Requirements:
1.2.8.1
Each department in each Facility has a Functional Space Requirement table. Each
room and area listed in the table shall be provided in the Facility. The Functional Space
Requirement tables list additional requirements in the design criteria column for each
room. The net square meter area provided shall be considered the minimum area to be
provided
1.2.8.2
Staff facilities, including toilets and change rooms, must be separate from patient areas
to reduce the risk of staff being isolated with a patient or visitor.
1.2.8.3
Electrical outlets and data outlets must be provided in equipment rooms, supply rooms,
soiled utility, holding rooms, storage and alcoves and be positioned at a height which
promotes ease of access without unnecessary bending.
1.2.8.4
All dimensions of counters and desks must act as a barrier and provide adequate
protection from violent or threatening behaviour.
Patient Lifts
1.2.9.1
1.3
1.3.1
Patient lifts are required in patient care areas throughout the building. For bariatric and
non-bariatric patient lifts Project Co will provide patient lifts at locations as required to
comply with Appendix 3L [Island Health Ceiling Lift Specifications for New Builds] plus
at any addition locations specified in the Clinical Specifications.
INFORMATION MANAGEMENT SYSTEMS
Next Generation EHR Strategy:
1.3.1.1
The Authority’s Next Generation Electronic Health Record (EHR) strategy builds on the
commitment to establish a One Person, One Record solution for the Region, and will
involve the automation of all remaining paper-based processes across the continuum of
care.
1.3.1.2
The North Island Hospitals represent a significant opportunity for the Authority and its
partners to realize the Authority’s Next Gen strategy in a fully automated environment
and demonstrate the intimate relationship between a single, integrated clinical system,
space, design, and the automation of practice that technology enables - being
referenced as Smart Hospitals.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.3.1.3
This includes the optimized use of a person-centric integrated EHR, on quality care and
clinical outcomes and encompasses the full continuum of care and advanced Clinical
Information System (CIS) capabilities. These capabilities include electronic
documentation; computerized provider order entry, bar code enabled medication
management and embedded clinical decision support; the integration of smart
technologies and smart design principles; communication tools, monitoring, clinical
dashboards, tracking, and alerts etc.; virtual team capabilities between facilities and
across the region; and involve patients and families as part of their care team,
contributing to their health plan and information.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.3.1.4
Positioning the NIHP in the Context of the EHR Supporting the Health and Care of
North Island Residents at Home and in Hospital.
1.3.1.5
Client and Family as Member of the Care Team
1.3.1.5.1
1.3.1.6
Self Registration and Patient eSignature
1.3.1.6.1
1.3.1.7
A patient will have the option to expedite their check in process by self
registering at a kiosk, using the new Government of British Columbia Care
Card to positively identify themselves. Consents for treatment and other
patient acknowledgements will be completed electronically authenticated
with patient eSignature and must be supported with the device strategy.
Electronic Health Record Core Functionality
1.3.1.7.1
1.3.1.8
The care continuum encompassed in the Authority’s North Island will
extend from “home to home”. North Island residents will be integral
member of the care team, and through the use of the secure Cerner
Personal Health Record (PHR) will access and contribute to their record,
personal health goals, and plan for health enabled by technology at home
and while in hospital.
Providers will have access to all of the patients historical information;
information collected within the Authority across the health sectors –
primary care, emergency, acute, mental health and addictions, residential
and home and community care. This includes access to patient
information either historically paper or generated outside the Facility and
scanned to the patient’s electronic record.
Three major Electronic Health Record enabled functions serve as foundations to the
Authority’s strategy.
1.3.1.8.1
Electronic Clinical Documentation
1.3.1.8.1.1
Clinicians will document their assessments within the Cerner
based EHR, where standards and evidence support conditionspecific care plans as well as the master plan for health. Clinical
documentation tools will include voice recognition, structured
electronic entry, and medical device integration. Automated alerts
will also be used to ensure that critical information is pushed to the
forefront of the electronic chart for clinician awareness and action.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.3.1.8.2
Computerized provider order entry and clinical decision support
1.3.1.8.2.1
1.3.1.8.3
Closed loop medication management
1.3.1.8.3.1
1.3.1.9
All medications, investigative procedures and nursing orders will
be ordered electronically with the Next Generation EHR. Bar code
scanning and point of care access to the integrated clinical system
by the inter-professional team will be integral to clinical workflow
and quality outcomes across programs and services.
Safe medication dispensing and point of care administration
practices will be utilized including automated dispense cabinets,
point of care bar coding and documentation technologies that are
integrated into the CIS thereby ensuring right medication is given
to the right patient, efficiencies are optimized, and that
preventable adverse medication events are eliminated.
The Virtual Care Team
1.3.1.9.1
The North Island Hospitals will function as a two acute care community
hospitals working together to provide a regional center for service in
northern Vancouver Island. Technology will be leveraged to enable
collaboration amongst administrative and clinical care team in the
management of patients, clinical programs, and resource within, between
and across the facilities in the North Island and across the Authority.
1.3.1.9.2
Telehealth technologies will be utilized to enable remote specialist
consultation, discharge planning to remote and rural sites, and clinical
collaboration between the between the two North Island Hospital sites. The
capability will be used to provide outreach subspecialty clinics across the
region. Telehealth will also be used to provide enhanced subspecialty care
within the acute care environment.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.4
1.4.1
GUIDING PRINCIPLES
The North Island Hospitals Project will be designed and built on three guiding principles:
1.4.1.1
1.4.1.2
1.4.1.3
A place we want to work and learn:
1.4.1.1.1
We will create an environment where employees, physicians and
volunteers can work collaboratively in promoting health and wellness
1.4.1.1.2
A facility that fosters teaching, recruitment and retention
Evidence Based Design:
1.4.1.2.1
Quality and Safety: we will use evidenced based design to maximize
quality and safety for patients and staff, as well as maximize efficient
operations
1.4.1.2.2
Future and Needs Focused: the facility will be designed to meet and adapt
to the needs of patients, visitors, employees, volunteers, learners, teachers
and researchers now and into the future
1.4.1.2.3
Similarity: there will be similarity in composition, design and construction
between the two facilities that will result in capital and operational
efficiencies, as well as improved patient, staff and physician experiences
1.4.1.2.4
Technology: we will use technology to integrate services within the
facilities, between the facilities and throughout northern Vancouver Island
Patient Centred: for Islanders, First Nations and the Elderly:
1.4.1.3.1
We will pursue excellence and innovation to deliver safe, quality health
care and improved health outcomes to:
1.4.1.3.1.1
All residents of northern Vancouver Island, but in particular
1.4.1.3.1.2
First Nations: we will be sensitive to diversity and the healing
practices of Aboriginal populations
1.4.1.3.1.3
Elderly populations
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ INTRODUCTION
1.5
1.5.1
DEFINITIONS
The following table provides definitions for key terms and notations used throughout Appendix
3A.
Term or Notation Direct Access Convenient Access Internal Circulation General Circulation Proximity Relationship: Red Arrow Proximity Relationship: Yellow Arrow Proximity Relationship: Green Arrow Horizontal Adjacency Definition Components are located side‐by‐side. Direct Access will be via either vertical or horizontal adjacency unless otherwise noted. Components are located side‐by‐side or with minimal horizontal or vertical separation. Connection between components provided with no separation or via dedicated connection. Connection between components provided via shared spaces or hallways. Required Direct Access and Internal Circulation between components. Horizontal adjacency required unless otherwise specified. Required Direct Access and General Circulation between components. Required Convenient Access and General Circulation between components. Components located side‐by‐side on the same level. Vertical Adjacency Components located one or multiple levels apart, directly on top of one another with a vertical connection (i.e. elevator). Functional Space Requirements Required room counts and room sizing. Recommend/Proposed Functional Spaces Non‐required room counts and room sizing provided as guidance. EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
This specification outlines the functional, operational and physical requirements for the General
Medical/Surgical Inpatient Units functional component
2.1
2.1.1
2.1.2
FUNCTIONAL DESCRIPTION
Statement of Purpose
2.1.1.1
The General Medical/Surgical Inpatient Units exist for the purposes of providing
continuous medical, nursing and allied health care to acute care patients who cannot
be discharged either to home or to another Health Care Facility (HCF). Comprehensive
care services will address disease/injury conditions, protecting and/or restoring
functional abilities, symptom management, spiritual care and discharge planning
including plans for ongoing follow-up and continuing care. Measures to prevent
infection and/or control the spread of infection are an expectation of safe care.
2.1.1.2
The intent is to provide as home-like an atmosphere as possible, with attention given to
providing the necessary services in as unobtrusive way as possible. Sub-units within
the inpatient unit will be referred to as “neighbourhoods” and inpatient rooms as
inpatient “bedrooms”.
Scope of Services
2.1.2.1
Functional Content
2.1.2.1.1
The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
2.1.2.1.1.1
Receiving patients either through the Facility’s “front door” or
the Emergency Department (ED) followed by a holistic model of
assessing, treating and monitoring each patient’s condition
2.1.2.1.1.2
Conducting bedside consultations between patients and
members of their interdisciplinary health care team
2.1.2.1.1.3
Conducting symptom management including minor procedures
requiring support by anaesthetists
2.1.2.1.1.4
Telemetry monitoring of “at risk” patients by centralized staff
and equipment located in the Intensive Care Unit/Telemetry
Unit (See IP.02), and responding to acute episodes by this
centralized (ICU/TU) staff. (Note: Display of telemetry data must
be accommodated at each neighbourhood’s Care Hub.)
2.1.2.1.1.5
Facilitating patients’ access to diagnostic and treatment
services located elsewhere in the Facility
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.1.2.1.1.6
Delivering medications orally, topically, intravenously or by
injection according to each patient’s scheduled or immediate
needs
2.1.2.1.1.7
Providing appropriate design and supports to meet the specific
needs of the elderly as well as for patients with dementia, the
design of the unit will follow the BC Guidelines for the Care of
Patients with Dementia. A minimum of two inpatient rooms per
neighborhood will be designed according to the BC Guidelines
for the Care of Patients with Dementia.
2.1.2.1.1.8
The design of the designated bariatric spaces will follow the
VIHA standards for the design of Bariatric inpatient rooms.
2.1.2.1.1.9
Providing design and specific supports to ensure the control of
infection.
2.1.2.1.1.10 Managing acute episodes and short-term pain management for
palliative patients, and end of life patients, the design of the
rooms must accommodate the needs, spiritual and cultural for
palliative and end of life patients.
2.1.2.1.1.11 Conducting discharge planning including activation focusing on
returning the patient to their highest level of functioning
2.1.2.1.1.12 Conducting shift reports and participating in interdisciplinary
team conferences
2.1.2.1.1.13 Documenting each patient’s progress and health status using
an electronic medical record (EMR)
2.1.2.1.1.14 Addressing each patient’s nutritional needs by providing meals
at the bedside and nutritional consultations
2.1.2.1.1.15 Educating patients and lay members of their support network
2.1.2.1.1.16 Accommodating in-service education, demonstration and
practice for new staff, and recurrent training for existing staff on
safe patient handling protocols
2.1.2.1.1.17 Providing assistance to patients’ personal needs as necessary
(e.g., feeding and maintaining hygiene)
2.1.2.1.1.18 Accommodating participation by lay members of a patient’s
support network in providing care
2.1.2.1.1.19 Providing respite and relaxation opportunities for both patients
and their visitors
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.1.2.1.1.20 Managing all functions conducted in the unit including
scheduling and managing staff, controlling inventories of
consumable supplies, scheduling rounds, conducting service
quality evaluations, maintaining standards of maintenance and
cleanliness in all areas of the unit and communicating with staff
on facility-wide and professional topics
2.1.2.1.1.21 Bedside dialysis will be provided at a minimum of two beds
within each IPU neighbourhood. Provide a minimum of four
rooms, capable for dialysis, per unit. Refer to the PCC inpatient
unit for an example of the preferred design.
2.1.2.2
Exclusions
2.1.2.2.1
2.1.2.3
2.1.2.2.1.1
Large and/or formal educational lectures
2.1.2.2.1.2
Provision of mechanical life support (See IP.02
Intensive Care Unit/Telemetry Unit)
2.1.2.2.1.3
Psychiatric Inpatient Care (See IP.04)
2.1.2.2.1.4
Maternity, Newborn and Pediatric Care (See IP.03)
2.1.2.2.1.5
Long term palliative care
Anticipated Trends in Service Delivery
2.1.2.3.1
The following list specifies functions either related to or supportive of
services accommodated in the General Medical/Surgical Inpatient Units, but
are understood to occur in other functional components in the Facility.
The following lists trends expected within the planning horizon of this project,
and that are expected to affect the nature and/or extent of functions
accommodated within this component. Effects of these trends shall be
reflected in the component’s design.
2.1.2.3.1.1
Inpatient bedrooms must be capable of accommodating
a range of acuity levels or a single patient’s changing
acuity level with little or no changes to the room’s
configuration or supplies/equipment content. This
feature will reduce the need for in-hospital patient
transfers.
2.1.2.3.1.2
Decentralization of more diagnostic and treatment
services to the inpatient units is predicted as equipment
becomes smaller and more mobile.
2.1.2.3.1.3
The number of bariatric patients admitted to hospital is
predicted to increase.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 2.1.3
IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
The mean age of patients admitted to hospital is
predicted to increase as is the incidence of comorbidity, patients with complex health issues and
patients with dementia.
2.1.2.3.1.5
The mean age of staff working on the inpatient units is
predicted to increase.
2.1.2.3.1.6
Shortages of key staff positions are predicted to
increase, including staff in the highly trained,
specialized professions.
2.1.2.3.1.7
Infection control will remain a high priority in all areas of
the Facility
2.1.2.3.1.8
Food services will become more responsive to each
patient’s needs as opposed to provision on a fixed
schedule.
Scope of Education Functions
2.1.3.1
2.1.4
2.1.2.3.1.4
Medical and nursing students and students in the allied health professions from
technical colleges and universities will receive practical skills training through
internships and co-op programs. All teaching and supervision functions will be
accommodated in the general work areas or within specified teaching spaces.
Scope of Research Functions
2.1.4.1
Staff and students working in the inpatient units will, from time-to-time, be engaged in
research. The nature and extent of research functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities within the
General Medical/Surgical Inpatient Unit.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 2.2
2.2.1
IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
OPERATIONAL DESCRIPTION
LEAN Planning Standards
2.2.1.1
2.2.2
Staff Access to Supplies and Equipment
2.2.1.1.1
The placement of equipment and supplies stores will promote the concept of
reducing travel time/distance for staff to/from a patient. Minimal volumes of
commonly used items are stored either in the patient bedroom or at the Care
Hub for that neighbourhood. More highly rationed items shall be stored close
to the neighbourhood or close to the Collaboration Centre shared by two
neighbourhoods. Unique or “one of” items will be generally stored in the
Equipment Depot (See OS-STL.08) unless an item’s use will be confined to
an inpatient unit or neighbourhood.
2.2.1.1.2
Planning assumes Facility-wide reliance on radio frequency identification
(RFID) system for most equipment enabling immediate locating capability.
Electronic requests for an item will be received in the Equipment Depot
where portering services staff will locate the item, retrieve it or a comparable
item, and deliver it to the requesting site.
Hours of Operation
2.2.2.1
The General Medical/Surgical Inpatient Units are staffed and in operation:
2.2.2.1.1
2.2.3
24 hours-a-day, 7 days-a-week
People Management Systems
2.2.3.1
Patients admitted through the Facility’s “front door” will generally access their inpatient
bed through the Central Patient Registration, Diagnostic Intake and Specimen
Collection component (See OS-GP.06) where all final registration and admitting
procedures will be completed. From here, medical admissions will normally proceed
directly to their assigned inpatient unit and to the unit clerk based in that inpatient unit
for the purposes of final documentation and room assignment. Same-day-admission
surgical patients will follow generally follow a path through the Surgical Day Care
component (See AC.03), the Surgical Services component (See DT.04) and then to the
General Medical/Surgical Inpatient Units following a recovery period in the postanesthetic recovery room (PARR).
2.2.3.2
Patients admitted through the ED (See AC.01) will typically be documented (registered
and admitted) while in the ED and transported directly to their assigned room.
2.2.3.3
Patients requiring mobility assistance will be either escorted or transported in a
wheelchair by staff from the Facility’s portering services (See OS-STL.08).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.2.3.4
2.2.4
All visitors to an inpatient unit will have access through a securable entrance under the
direct visual supervision of staff based in a Collaboration Centre. This centre will
typically support the operations of two neighbourhoods.
Materiel Management Systems
2.2.4.1
2.2.4.2
Consumable Supplies
2.2.4.1.1
Inventories of consumable supplies will be maintained close to point of use
on each inpatient unit. Items shall be maintained with minimum inventory
levels triggering a re-ordering process. Most supplies will be stored either in
bins or on top-up carts. Decentralized supplies must not be accessible to the
public to prevent cross- contamination, and any linen stored in an inpatient
room will be dedicated to that patient.
2.2.4.1.2
Use of a 2-bin system will enable staff to draw from one bin while the other
waits in reserve. Emptying the first bin will trigger an electronic ordering
process while inventories in the reserve bin are drawn.
2.2.4.1.3
Inventories on top-up carts will be generally maintained according to
prescribed delivery schedules by either Environmental Services (See OSSTL.03) or Materiel Management (See OS-STL.05).
2.2.4.1.4
Supply ordering will be sent electronically to and processed through the
Materiel Management component.
2.2.4.1.5
On demand supplies will be delivered to Care Hubs via pneumatic tubes.
Linen
2.2.4.2.1
All clean linen used for patient care will be stored close to point of use. A
clean utility room in the neighbourhood will accommodate inventories of
commonly used items for immediate, emergency access. All inventories will
be managed according to a minimum 3-days supply reorder level, and will be
resupplied using a top-up system.
2.2.4.2.2
Laundry processing will occur off site at the regional laundry located in
Cumberland. Soiled linen will be collected in room in small hampers,
temporarily staged in the neighborhood and consolidated in the On Floor
Holding space prior to removal to the Environmental Services component for
off-site transfer. Clean linen returning from the regional laundry will be
delivered to central receiving facilities in the Environmental Services
component before being sorted onto exchange/top-up carts and delivered to
the General Medical/Surgical Inpatient Care Units.
2.2.4.3
Pharmaceutical Products
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.2.4.4
2.2.4.5
2.2.4.3.1
Automation will be used in the inventory management and dispensing of
patient medications. Medication rooms will be located within the
neighbourhood’s Care Hub, Stations located close to the inpatient bedrooms,
will be stocked with unit doses of patients’ medications and dispensed
according to prescribed schedules. Pharmacy personnel will be responsible
for inventory management of the medication areas/stations, whereas nursing
personnel will deliver medications from the stations to the bedside.
Integrated medication carts will be stored, docked and charged in medication
rooms. Integrated medication carts will be used by nursing staff to distribute
medications to patients by nursing staff.
2.2.4.3.2
Unstable products will be prepared in the Pharmacy component (see DT.06),
and then delivered to the inpatient unit either according to a prescribed
schedule or upon request. Product delivery will rely on a pneumatic tube
system, unless size, fragility or stability issues require manual transport. In
these latter circumstances, pharmacists or pharmacy technicians from the
Pharmacy will be responsible for product transportation.
2.2.4.3.3
Anticipate select STAT medications will be delivered to Care Hubs via
pneumatic tubes.
Food Services
2.2.4.4.1
Food services will include a patient focused meal service approach providing
patients with the ability to make selections prior to service.
2.2.4.4.2
Food Services personnel will facilitate orders at least twice per day, typically
an hour or two in advance of lunch and supper with next day breakfast
selection facilitated along with supper selection in the mid-afternoon. Meals
will be assembled from the central kitchen or from pantries located on each
floor. Once assembled, meals will be distributed to patient units and
delivered to patients at bedside by Food Services personnel and/or to the
inpatient unit’s dining room, as specified.
2.2.4.4.3
Following each meal service, all carts, trays and service ware will be
returned to the central kitchen for ware washing and sanitation.
Waste Management
2.2.4.5.1
Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations. On
each inpatient unit, waste management is understood to begin in the
individual patient bedrooms with collection and temporary holding in the
soiled utility room located on each neighbourhood. Each administrative area
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
will also accommodate segregation of the types of waste products typically
generated in these types of spaces.
2.2.4.5.2
2.2.5
Segregation of wastes will accommodate the following categories of
products:
2.2.4.5.2.1
General garbage
2.2.4.5.2.2
Sharps (including potentially biohazardous items)
2.2.4.5.2.3
Infectious or contaminated wastes (excluding sharps)
2.2.4.5.2.4
Clean paper and cardboard
2.2.4.5.2.5
Clean metal (tin and aluminum)
2.2.4.5.2.6
Clean recyclable plastics
2.2.4.5.2.7
Compostable materials
Information Management Systems
2.2.5.1
It is anticipated that electronic technology will be used to manage more aspects of each
patient’s care. Electronic checking of patient information (e.g., wrist band bar code), for
example, will be used to validate the match between patient and a prescribed
treatment, procedure or medication. This manner of linking the patient to the
information management infrastructure will require reliable and secured wireless
access throughout the Facility.
2.2.5.2
All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, located close to each patient’s bedside and at key staff workstations, and
mobile pads. Access to the EMR will be controlled electronically with varying levels of
security clearance determining a person’s access to different sections and their ability
to enter/edit data.
2.2.5.3
Staffing information will be a managed corporate service. Scheduling, including
providing for sick and vacation relief will be conducted centrally, and off-site. Notices to
individual staff regarding their schedules will be communicated electronically.
2.2.5.4
The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authority’s strategic investment in Cerner and other
clinical and business systems.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.2.5.5
The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
2.2.5.5.1
Integrated Medication Carts
2.2.5.5.2
Medication Dispense Cabinets
2.2.5.5.3
Mobile and Fixed Computer Devices – Desktop and Wall mounted
2.2.5.5.4
Mobile and Fixed Label Printers
2.2.5.5.5
Mobile and Fixed Barcode Scanners
2.2.5.5.6
Handheld Computer Devices
2.2.5.5.7
Glucometers with Docking Stations
2.2.5.5.8
Tracking Monitors – Patient, Staff, and Resource Tracking
2.2.5.5.9
Clinical Dashboards
2.2.5.5.10 Smart Beds
2.2.5.5.11 Smart Pumps
2.2.5.5.12 Device Integration for real –time clinical assessment and physiological data
documentation
2.2.5.5.13 Digital Room Signage and Way-finding
2.2.5.5.14 Interactive Patient Station
2.2.5.5.15 Location Awareness
2.2.5.5.16 Device Connectivity
2.2.5.5.17 Multifunction Communication Devices with integration to systems
2.2.5.5.18 Telehealth and Virtual Team Capabilities
2.2.5.5.19 Real Time Location System
2.2.5.5.20 Staff Safety and Duress
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 2.3
2.3.1
IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
DESIGN CRITERIA
LEAN Planning Standards
2.3.1.1
Standardization of Inpatient Rooms
2.3.1.1.1
[Intentionally left blank]
2.3.1.1.2
All patient bedrooms will be configured according to a “like-handed” design.
2.3.1.1.3
Each neighbourhood, its associated central communication centre and the
physical organization linking the neighbourhood’s Care Hub to its central
communication centre shall be designed and configured to a common
physical plan. The intent of this requirement is to facilitate staff moving
between neighbourhoods without having to reorient themselves with respect
to commonly accessed features like clean/soiled utility rooms, automated
medication dispensing carts/cabinets (ADC), collaborative team space and
individual charting spaces.
2.3.1.2
[Intentionally left blank]
2.3.1.3
Multi-Purpose Use of Purpose-Built Space
2.3.1.3.1
Specified bedrooms in this component will be designed, configured and
furnished for bariatric patients. Maximizing the utility of these bedrooms will
require special features and services that accommodate other patient
populations when not in use by bariatric patients. For the purposes of these
specifications, each inpatient bed room identified as “bariatric” will also be
utilized by palliative patients (acute episode management only) and by
Aboriginal patients. Requirements to address the former (palliative) patient
group will be accommodated using standards for bariatric bedrooms (e.g.,
family rooming in), but the Aboriginal group will require that these bed rooms
be vented to the outside and, like other inpatient bedrooms, have operable
windows to accommodate Aboriginal “Ceremony”. Bariatric rooms will also
be equipped with two headwalls and two complete sets of medical gases.
The bariatric bedrooms must be configured in such a way as to typically
accommodate 2 patients.
2.3.1.3.2
For each semi-private room, two complete headwalls will be provided. Each
headwall will include all mandatory medical gases for the anticipated patient
population.
2.3.1.3.3
Cubicle curtains are required in all patient bed rooms to provide privacy;
curtains must provide privacy from the hallway into the patient room, even
when the door to the patient room is open. Curtains must not interfere with
clinical activities.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.2
Proximity Relationships
2.3.2.1
The General Medical/Surgical Inpatient Units component’s location relative to other
components, or other areas of the Facility, and the nature of circulation used to move
between different components/areas are illustrated in the diagram below. Proximities
are listed according to rank; higher priorities appear above lower priorities (Refer to
Section 1.4.1 for Definitions).
General Medical/ Surgical IPU Main Horizontal/ Vertical Circulation General Medical/ Surgical IPU Surgical Services General Medical/ Surgical IPU Pharmacy 2.3.2.2
Provide Convenient Access by General
Circulation to major non-public circulation.
Personnel, patients, visitors and supplies will
move frequently to/from this component and
other components in the Facility.
2.3.2.3
Provide Convenient Access by General
Circulation via non-public circulation to the
Surgical Services component for the
movement of patients and staff.
2.3.2.4
Provide Convenient Access by General
Circulation to the Pharmacy component for the
movement of staff and pharmaceutical
products.
2.3.3
Internal Design Criteria
2.3.3.1
General Internal Layout
2.3.3.1.1
The design and layout of the Medical/Surgical Inpatient Units at the
Authority’s Royal Jubilee Hospital Patient Care Centre is an example of a
layout that meets the Authority’s operational needs. Project Co is
encouraged to consider providing a similar general layout in the Facility. The
component shall be organized into 4 major areas as follows:
2.3.3.1.1.1
Inpatient bedroom clusters
2.3.3.1.1.2
Decentralized professional support facilities (Care Hub)
2.3.3.1.1.3
Centralized professional support facilities (Collaboration
Centre)
2.3.3.1.1.4
Centralized general/public support facilities (Common
Support Space)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.3.2
Royal Jubilee Hospital Patient Care Centre Operations Manual
2.3.3.2.1
2.3.3.3
Typical Inpatient Unit Organization
2.3.3.3.1
2.3.3.4
Each inpatient unit is serviced by a single central Collaboration Centre. Each
inpatient unit is further subdivided into two neighbourhoods which operate as
two parts of the whole. Each neighbourhood contains a variety of support
areas, including equipment storage, utility rooms, a quiet work area and a
medication room, as well as a Care Hub work area for the completion of
professional duties.
Central Collaboration Centre
2.3.3.4.1
2.3.3.4.2
The Authority intends that the clinical operations in the medical/surgical
inpatient units will be carried out in a similar manner to clinical operations in
the medical/surgical inpatient units of the Authority’s Royal Jubilee Hospital
PCC. The Authority’s clinical operations manual (dated March 2011) for the
PCC outlines how the Authority conducts clinical operations in the PCC.
Project Co is encouraged to consider the general clinical operational
concepts outlined in this manual and shall use those concepts to design the
medical/surgical inpatient units in the Facility. A copy of this manual has
been made available to Project Co.
The Central Collaboration Centre will act as each inpatient unit’s
communication hub, and will accommodate a variety of functions. Its
primary function is to support the multi-disciplinary collaboration between
all care givers, including nursing, physicians, allied health personnel and
students. On the Medical/Surgical Inpatient Units, the Centre will be in an
enclosed space and will not be open to the public to promote
confidentiality. The primary functions of this space are:
2.3.3.4.1.1
Dictating and reviewing charts, diagnostic images and test
results
2.3.3.4.1.2
Conducting private telephone conversations
2.3.3.4.1.3
Conducting multi-disciplinary care team discussions
2.3.3.4.1.4
Accommodation of teaching and collaboration space for
University of B.C. (UBC) Faculty of Medicine
2.3.3.4.1.5
Providing access to computer workstations and business
equipment and business supplies for the unit
2.3.3.4.1.6
Providing on-unit space for nursing management activities
2.3.3.4.1.7
This space is not intended for use by patient, families or the
public.
The Central Collaboration Centre will include the following areas:
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GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.3.4.2.1
A Central Care Team station immediately outside of the
Collaboration Centre will act as the control point for the unit,
and will be highly accessible to patients and visitors.
2.3.3.4.2.2
A Business Centre will be located in close proximity to the
Central Reception/Unit Clerk desk while providing the
appropriate segregation of business equipment for staff safety
and noise reduction within the Collaboration Centre.
2.3.3.4.2.3
The following functions will be accommodated in the enclosed
private area of the Central Collaboration space:
2.3.3.4.2.3.1 A central Conference/Huddle Area where
professional staff can conduct business and
collaborate.
2.3.3.4.2.3.2 Six (6) individual workstations will be provided
for use by clinical staff. These workstations will
be in the central, open area of the Collaboration
Centre co-located with the Conference/Huddle
Area to promote collaboration.
2.3.3.4.2.3.3 One office for each neighbourhood will be
located directly off of the central area. During a
pandemic or the need to isolate the entire
neighbourhood, the office will function as the
access point into the neighbourhood. A handwashing sink is required in each office
functioning as the Pandemic/ Isolation access
point into the neighbourhood
2.3.3.4.2.3.4 Collaborative Teaching Spaces and a Teaching
Room that will accommodate UBC staff. 1
workstation for use by UBC staff/trainees will be
provided in the central, open area of the
Collaboration Centre. The Teaching Room will
be a private space directly off of the central
area.
2.3.3.4.3
Close proximity between the Collaboration Centre, the Care Hubs and the
Common Support Spaces is required. The dual need for front line nurses to
be close to their patients in the neighbourhood and to be able to participate
in the Collaboration Centre must be considered in this design.
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GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.3.4.3.1
2.3.3.5
2.3.3.6
2.3.3.7
The ability for staff to visualize the care team hubs from the
huddle area of the Collaboration Centre is a beneficial
aspect of enhanced patient care and staff communication.
Visibility will be provided from the Collaboration Centre into
the Neighbourhoods. Ideally visibility will be provided from
the Collaboration Huddle Area to the Care Team substations. There is a strong preference that visibility between
the Collaboration Centre, Neighbourhoods, and Care Team
stations is not into public areas – visibility between the
huddle area and the care team hub should only be between
staff/ non-public areas.
Neighbourhood Care Hubs
2.3.3.5.1
Care Hubs are to be provided within each neighbourhood to provide front
line staff with access to required supplies and services without leaving their
neighbourhood. The design of the medication area needs to ensure easy
access to the room and incorporate doors which facilitate movement of
medication carts, into and out of the room (Refer to Schedule 3 for
medication room technical requirements).
2.3.3.5.2
Close proximity between the Collaboration Centre, the Neighbourhood Care
Hubs and the Common Support Spaces is required.
2.3.3.5.3
Care Hubs must be designed to support physician rounding, clinical
education, during peak hours the Care Hubs must accommodate all peak
staff, and multiple clinicians documenting simultaneously.
Unobstructed Site Lines between Nursing Staff and Patient Beds
2.3.3.6.1
The goal of the Authority is to provide staff with an unobstructed line of site
to the patient rooms. The line of site must be provided from the hallways of
the unit to the head of the patient. Louver blinds built into double-glazed
windows in doors and/or walls will be used for this purpose.
2.3.3.6.2
A mandatory aspect of the design for the patient rooms will be direct visibility
for care team staff to the door of the patient room within 15m of a Care Team
Hub workstation.
Family Zones in Inpatient Bedrooms
2.3.3.7.1 Family involvement in care is encouraged by the Authority. Accommodation
within the inpatient bedroom must be provided to allow a family member to
sleep in the patient bedroom. Locked drawer storage shall be provided to
enable family member to securely store a small number of belongings.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.3.7.2 It is important that the accommodation for the family be created in a specific
zone within the inpatient bedroom which minimizes the possibility of any
interference in the provision of care to the patient.
2.3.3.8
Reduction of Hallway Clutter and Equipment and Supply Storage
2.3.3.8.1
2.3.3.9
The inpatient unit design must consider mechanisms to ensure the
elimination of hallway clutter. Equipment room, and supply room storage
and alcoves will be designed to ensure easy access to all items stored there
to prevent the movement of these items into the hallway for access.
Electrical outlets must be provided in equipment rooms, supply room storage
and alcoves and be positioned at a height which promotes ease of access
without unnecessary bending.
Segregated Patient and Visitor Flows
2.3.3.9.1
Separate points of access/exit shall be provided for patients being
transported to/from other destinations in the Facility and for visitors.
Wayfinding signage shall clearly identify the “public” point of access/egress
and the preferred route for visitors to access the inpatient bedrooms.
2.3.3.10 Component Security
2.3.3.10.1 Access to this component must be controllable at all times, but visitors shall
have unrestricted access during regular visiting hours. This area must be
accessible to authorized personnel 24 hours-a-day, 7 days-a-week.
2.3.3.10.2 The component’s design must avoid creation of “blind corners” and must
provide adequate lighting throughout to protect staff, patients and visitors
from unexpected violence. Work areas must not place staff in isolation, and
staff must have the capability of summoning help. Areas subject to limited
visual access must be video monitored and supplied with ceiling-mounted
mirrors enabling staff to view the area prior to entry.
2.3.3.10.3 “Staff only” rooms must have windows incorporated into doors enabling staff
to assess the area outside of the room for traffic and security issues.
2.3.3.10.4 All dimensions of counters and desks must act as a barrier and provide
adequate protection from violent or threatening behaviour.
2.3.3.10.5 Staff facilities, including toilets and change rooms, must be separate from
patient areas to reduce the risk of staff being isolated with a patient or visitor.
2.3.3.11 Lighting
2.3.3.11.1 There will be a variety of lighting options in this component, each suited to
the functions accommodated in a specified space.
2.3.3.11.2 Each inpatient bedroom must have access to natural lighting and views to
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
the outside.
2.3.3.11.3 Each inpatient bedroom requires an exam light to provide enhanced lighting
during intravenous insertions, wound care, etc.
2.3.3.11.4 Artificial lighting throughout the inpatient units shall follow a general standard
of providing “non direct” lighting. This specification implies fixtures that reflect
light upwards, away from direct eye contact, and especially in those areas
where patients will be either in bed or transported on stretchers.
2.3.3.11.5 Artificial lighting in each inpatient bedroom must be variable to provide
different levels of lighting and for different purposes. At night time, patients
will have the ability to read while in their bed. In the case of double
occupancy rooms, this specification requires that lighting at one bed not
substantially affect lighting conditions at the other. Lighting in the patient
bedroom must also accommodate staff’s ability to monitor the patient during
the night without affecting the patient’s ability to sleep.
2.3.3.11.6 Artificial lighting in the administrative and support areas must be variable to
accommodate different levels of ambient lighting commensurate with the
functions ongoing at any one time in that space. Individual workstations must
be provided with task lighting.
2.3.3.11.7 The family zone within each inpatient bedroom requires a reading light, with
controls able to be reached from the sleeping accommodation.
2.3.3.12 Operable Windows
2.3.3.12.1 Each inpatient bedroom must have windows that provide access to exterior
views, and preferably to views of predominantly landscape versus buildings.
2.3.3.12.2 The intent of this requirement is to respect multicultural attitudes and beliefs.
In some cultures, immediate exterior access from interior spaces is a
requirement for both in-life and after-life experiences. An additional benefit of
this feature is allowing patients a choice in environmental condition that they
would ordinarily enjoy in their own homes.
2.3.3.12.3 All inpatient rooms with the exception of Airborne Isolation and Protective
Isolation inpatient rooms will have operable windows akin to the RJH Patient
Care Centre. At least a portion of each window must be operable providing
access to fresh, outdoor air.
2.3.3.13 Ergonomics for an Aging Workforce
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.3.13.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff is required to
use. Ease of access will be among the key criteria. In the inpatient
bedrooms, this specification will be reflected in electrical outlets being
located both a floor level for low pull items e.g. power for beds, specialty
mattresses, etc., plus electrical outlets located for easy access above the
floor surface (approximately 3 feet) for high pull items such as intravenous
pumps. The type and number of electrical devices used in the rooms is
expected to increase, and the combination of outlets at floor surface and
elevated outlets will minimize repetitive bending, while assisting with
electrical cable management.
2.3.3.13.2 The patient lift system will allow patient pick up from all areas of the room
including the bathroom for toileting, showering and to the sink (refer to
Schedule 3 for technical requirements).
2.3.3.13.3 For each patient bed room, a headwall is required for each patient bed,
provide two complete sets of medical gases and suction on each headwall
(Refer to Schedule 3 for the specific Medical gas requirements for each
headwall).
2.3.3.14 Accommodation of Bariatric Patients
2.3.3.14.1 Numbers of bariatric patients admitted to hospital are projected to increase.
Managing these patients will require features enabling for both patients and
staff. Doorways and circulation spaces must be sufficiently wide to
accommodate large people, many of whom will be relying on mobility
assistance including motorized chairs and scooters. Doorways must be a
minimum of 1500 mm (approximately 59”) in width. The reference to
circulation spaces applies especially in confined rooms like water closets.
2.3.3.14.2 Bariatric patients often require assistance getting into and out of bed. The
patient lift system will allow patient pick up from the bathroom, including the
toilet, sink and shower (refer to Schedule 3 for technical requirements).
2.3.3.15 Inducements for Patient Ambulation
2.3.3.15.1 Patient recovery, especially in cases of orthopaedic surgery, has been
shown to benefit the sooner patients become mobile and the more they
engage in gentle exercise like simple walking. Features will be incorporated
throughout the inpatient unit that encourages ambulation either with or
without assistance.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.3.15.1.1 Handrails must be installed around the perimeter of
each inpatient room and within the toilet room, providing
grab support during movement within the room and to
the toilet. A single handrail will guide the patient from
the bedside to the washroom. Corridors typically
accessed by inpatients will have handrails installed on
both sides. Short breaks between handrails are
permissible to allow for doorways, fire extinguishers,
etc. Handrail heights will be 860 – 920 mm
(approximately 3’) above floor surface.
2.3.3.15.1.2 Folding grab rails will be installed on both sides of each
patient toilet, and the door leading separating the
ensuite water closet from the rest of the inpatient room
must be a “barn door” style door installation, as
opposed to swing.
2.3.3.15.1.3 Corridors typically accessed by patients shall provide
opportunities for brief rest. Chairs of varying height will
be placed in recessed alcoves in the walls along one
side of the hallway created for this purpose, located at
intervals of not more than 9000 mm (approximately 30’).
2.3.3.15.1.4 “Wandering loops” will be incorporated within the unit to
support ambulation by for all patients, to support the
care needs of patients with dementia. The concept of
“wandering loops” is required on all inpatient floors.
“Wandering loops” with dead end corridors will not be
permitted; the design must accommodate the
“wandering loops” within the required racetrack design
of the inpatient unit.
2.3.3.15.2 Designated therapy spaces and general patient/public lounges shall be
inviting and accessible by all patients at any time. Natural lighting, views to
the outside and opportunities for light recreation and entertainment shall be
considered as these features can provide motivation for patients to leave
their rooms. Electrical outlets at both floor surface level and at about 3 feet
above the floor surface are to be provided to support power requirements of
intravenous pumps and other electrical devices patients must utilize while in
these rooms.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.3.16 Infection Control Features
2.3.3.16.1 Hand hygiene sinks will be installed in each area where physical contact with
patients occurs. Sinks should be located in the entry to every patient room
with clear sight lines to head of patient bed. Sinks must be orientated to
prevent inadvertent splashing onto nearby equipment. Hand hygiene sinks
should be of hands free operation.
2.3.3.16.2 Each neighbourhood will be supplied with 2 automatic bedpan
flusher/washer/disinfectors in the associated soiled utility room. The location
of the bedpan washers in the soiled utility room, must be located in such a
way as to not obstruct entry in to the room, especially when the bed pan
washer is in use. The location of the bed pan washer must not interfere with
any other functional requirements to be conducted in the room
2.3.3.16.3 Installation of hand sanitizer dispensers should be placed on either side of
patient bed to support the Authority’s hand hygiene policy.
2.3.3.16.4 All furniture, fixtures and equipment used in this component should be
fabricated using smooth, non porous materials that are capable of being
decontaminated with hospital grade disinfectants. Their shapes should allow
for easy cleaning around all sides and should be free of inaccessible spaces.
2.3.3.16.5 A nourishment station located in this component must be capable of being
closed during and outbreak or contamination event. A separate hand
hygiene sink must be supplied in addition to a utility sink.
2.3.3.16.6 Increases electronic technology increases the number of interfaces between
patients and technical devices. All equipment used in this component that
comes into contact with patients must be able to withstand frequent and
consistent cleaning using hospital-grade products.
2.3.3.17 Isolation Capabilities
2.3.3.17.1 Cabinetry and equipment used in inpatient units must be able to withstand
frequent and consistent cleaning using hospital-grade products. Each
neighbourhood will be designed to provide negative pressure for the entire
neighbourhood in the event of a pandemic or outbreak.
2.3.3.17.2 Patients admitted to hospital can have needs for isolation. The nature of this
isolation can either prevent against the spread of airborne infections,
requiring a room with negative airflow/pressurization, or protect those with
compromised immune systems, requiring positive airflow/pressurization.
Isolation-capable rooms will require 2 separate points of access/exit; 1 from
the main circulation corridor in the patient care area which could be locked
down when isolation is required, and a second access/egress point directly
to/from the ante room.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.3.17.3 All ante rooms shall be to the side of each patient bedroom and not in front
of the patient bedroom. Ante rooms shall not form a vestibule in front of the
patient bedroom. The patient entrance to each isolation room shall be
directly onto the corridor. There shall be a window from the ante room into
the isolation patient bedroom.
2.3.3.18 Opportunities for Specialty Services
2.3.3.18.1 Design and configuration of each neighbourhood will allow for development
of specialty services to accommodate distinct patient cohorts. Ideally, this
development will centralize around the semi-private inpatient rooms and
nearby support space allowing for activities in the patients’ rooms and in
joint-use/group space.
2.3.3.18.2 All neighbourhoods must be designed to be “elderly friendly” by incorporating
features for patients with compromised mobility and/or cognitive functioning.
These features will include, but are not limited to: 1) lights being “off centre”
relative to circulation corridors, 2) “wander guard” type protection being
incorporated into each access/exit point specified for this component, 3)
minimal design of “blind corners” where the cognitively impaired can become
confused and distressed, 4) extensive use of visual stimulation that enables
easy identification of different areas on each neighbourhood. 5) features that
diminish the visual identification of exit doorways, enabling patients to remain
within their designated inpatient unit.
2.3.3.19 Entrance-Focused Amenities
2.3.3.19.1 An alcove immediately inside each patient bedroom must be located to
accommodate features considered to be universal requirements. The
alcoves will contain the following items:
2.3.3.19.1.1 Hand wash sink for use of staff and visitors entering or
leaving the room
2.3.3.19.1.2 Patient server cabinets for en-suite storage of supplies,
clean linen and waste/soiled linen receptacles
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 2.3.4
IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
Component Functional Diagram
2.3.4.1
The areas making up this component shall be organized as illustrated in the following
diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
2.3.5
Space Table
2.3.5.1
The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM ID
(RID)
ROOM TYPE
IP.01 General Medical/Surgical Inpatient Units
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
Floor/Unit Entrance/Common Support Area - 1 Typical Area - Provides support to 1, 17/18-bed nursing sub-unit
combinations
01 Seating/Reception/ Waiting
Seating for up to 4-6. 1 room
12.0
1.0
12.0
02
Toilet, Public, Male/Female
6.0
1.0
6.0
Collaboration Area
Central Reception/Unit Clerk
Two workstations
4.0
2
8.0
04
Business Centre
Accommodates business equipment
and supplies, Locate Adjacent to
Collaboration Area
4.0
1
4.0
05
Conference/ Huddle Area
Open area, provide within Collaboration
Centre
8.0
1
8.0
06
07
Workstations, Care Team
[RID intentionally left blank]
3.0
-
6
-
18.0
-
08
Teaching Room, UBC
12.0
1
12.0
09
Collaborative Teaching/ UBC
Space - Trainee Workstations
2.0
1
2.0
10
Office, First Line
10.0
1
10.0
11
Office, Private, Unassigned
10.0
1
10.0
12
13
14
[RID intentionally left blank]
Staff/Lounge
Toilet, Staff
20.0
6.0
1
1
20.0
6.0
16.0
1
16.0
30.0
1
30.0
36.0
1
36.0
6.0
4.5
6.0
1
1
1
6.0
4.5
6.0
03
Includes Conference Table, UBC
Teaching Space, will function as quite
room
Carrel w/ computer terminal
Locate Adjacent to Central Care Team,
will function as Isolation Ante Room
Locate Adjacent to Central Care Team,
will function as Isolation Ante Room
Include standard Kitchenette
Unit Support
15
On Floor Holding
16
Activation Space
17
On Floor Food Service/Galley
18
19
20
Toilet, Male/Female
Systems Room
Housekeeping Room
Holding for large Totes and Bins
Open plan w/ rehabilitation assessment
and treatment stations - Hand hygiene
station - Therapy Room IN PCC
Drawings
Low Voltage systems
Subtotal, Floor/Unit Entrance/Common Support Area - 1 Typical Area
214.5
Patient Care Area - 1 Typical Nursing Sub-Unit (18 beds)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
COMOX VALLEY HOSPITAL
ROOM ID
(RID)
ROOM TYPE
IP.01 General Medical/Surgical Inpatient Units
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
20.0
12
240.0
6
1
6.0
6
12
72.0
30
2
60.0
6
2
12.0
30
2
60.0
6
2
12.0
16.0
1
16.0
21
Patient Bedroom, Private
1 patient bed w/ wardrobe, supply
cabinet and hand washing sink at
entrance - Isolation capability - Sized to
allow for family participation/ visiting, 1
room negative pressure for isolation
22
Anteroom, Isolation
Entry alcove for gowning - Counter w/
hand washing sink
23
Toilet/Shower Room
24
Patient Bedroom, Private,
Bariatric
25
Toilet/Shower Room
26
Patient BedRoom, SemiPrivate
27
Toilet/Shower Room
Include overhead lift system
Note: To be located adjacent to one
another - 2 patient beds w/ wardrobe,
supply cabinet for each bed and hand
washing sink at entrance - Sized to
allow for family participation/visiting.
For 1 Semi-private bed room on 1 unit,
provide a single headwall, instead of
two headwall, to achieve the bed
demand of 153 total beds.
TOTAL
SIZE
(nsm)
28
Sun Room
Multipurpose, when available will
function as a meeting room
29
Alcove, Equipment
Alcoves for equipment storage, include
power and data outlets in alcoves
1.5
4
6.0
Standard workstation
3.0
4
12.0
8.0
1
8.0
12.0
1
12.0
Workstation Care Hub
30
Workstation, Care Team
31
Quiet Work Area
32
Medication Room
33
Utility Room, Soiled
Includes dictation stations each w/
PACs viewing capability
Accommodates automated dispensing
cabinet (ADC) and medication
preparation - Counter w/ sink Lockable cabinets
11.0
1
11.0
18.0
1
18.0
34
Utility Room, Clean
Accommodation for up to 3 carts Counter - Separate linen holding area
35
Nourishment Station
Ice machine - Counter w/ sink,
microwave oven - Half size refrigerator
- Storage cabinetry
3.0
1
3.0
36
Equipment Storage
Include multiple power and data outlets
in storage room
10.0
1
10.0
37
Closet, Soiled Holding
2.0
7
14.0
Patient Care Area - 1 Typical Nursing Sub-Unit (18 beds)
572.0
Patient Care Area - 1 Typical Nursing Sub-Unit (17 beds)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
COMOX VALLEY HOSPITAL
ROOM ID
(RID)
ROOM TYPE
38
Patient Bedroom, Private
39
Toilet/Shower Room
Patient Bedroom, Private,
Bariatric/ Isolation
40
41
Anteroom, Isolation
42
Toilet/Shower Room
43
Patient Bedroom, SemiPrivate
44
[RID intentionally left blank]
45
Toilet/Shower Room
46
Sun Room
47
Alcove, Equipment
IP.01 General Medical/Surgical Inpatient Units
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
1 patient bed w/ wardrobe, supply
cabinet and hand washing sink at
entrance - Isolation capability - Sized to
allow for family participation/ visiting
20.0
12
240.0
6
12
72.0
30
1
30.0
6
1
6.0
6
1
6.0
30
2
60.0
Include overhead lift system
Entry alcove for gowning - Counter w/
hand washing sink - Can be left open
when isolation not required
Note: To be located adjacent to one
another - 2 patient beds w/ wardrobe,
supply cabinet for each bed and hand
washing sink at entrance - Sized to
allow for family participation/visiting
1 assisted WC, 1 sink, 1 assisted
shower
Multipurpose, when available will
function as a meeting room
Alcoves for equipment storage, include
power and data outlets in alcoves
TOTAL
SIZE
(nsm)
-
-
-
6
2
12.0
16.0
1
16.0
1.5
4
6.0
3.0
4
12.0
8.0
1
8.0
12.0
1
12.0
Workstation Care Hub
48
Workstation, Care Team
49
Quiet Work Area
50
Medication Room
51
Utility Room, Soiled
Standard workstation
Includes dictation stations each w/
PACs viewing capability
Accommodates automated dispensing
cabinet (ADC) and medication
preparation - Counter w/ sink Lockable cabinets
11.0
1
11.0
18.0
1
18.0
52
Utility Room, Clean
Accommodation for up to 3 carts Counter - Separate linen holding area
53
Nourishment Station
Ice machine - Counter w/ sink,
microwave oven - Half size refrigerator
- Storage cabinetry
3.0
1
3.0
54
Storage, Equipment
Include multiple power and data outlets
in storage room
10.0
1
10.0
55
Closet, Soiled Holding
2.0
7
Patient Care Area - 1 Typical Nursing Sub-Unit (17 beds)
14.0
536.0
Subtotal, Patient Care Area - 1 Typical Sub-Unit 18 beds
572.0
Subtotal, Patient Care Area - 1 Typical Sub-Unit 17 beds
536.0
Subtotal, Patient Care Area - 1 Typical Nursing Unit, 35 beds
1,322.5
Subtotal, Patient Care Area - 3 Typical Nursing Units (105 Beds)
3,967.5
TOTAL NSM, ALL AREAS
3,967.5
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQIREMENTS: EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
CAMPBELL RIVER HOSPITAL
IP.01 General Medical/Surgical Inpatient Unit
ROOM
NUMBER
TOTAL
SIZE
OF
SIZE
(nsm)
ROOMS
(nsm)
Floor/Unit Entrance/Common Support Area - 1 Typical Area - Provides support to 1, 17/18-bed nursing sub-unit
combinations
1
01 Waiting Area/ Reception
Seating for up to 4-6
12.0
12.0
ROOM
ID (RID)
02
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Toilet, Public
6.0
1
6.0
Collaboration Area
03
Central Reception/Unit Clerk
two workstations
4.0
2
8.0
04
Business Centre
Accommodates business equipment
and supplies, Locate Adjacent to
Collaboration Area
4.0
1
4.0
05
Conference/ Huddle Area
Open area, provide adjacent to
Collaboration Area
8.0
1
8.0
06
07
Workstations, Care Team
[RID intentionally left blank]
3.0
-
6
-
18.0
-
08
Teaching Room, UBC
Includes Conference Table, UBC
Teaching Space, will function as quite
room
12.0
1
12.0
09
Collaborative Teaching/ UBC
Space - Trainee Workstations
Carrel w/ computer terminal
2.0
1
2.0
10
Office, First Line
10.0
1
10.0
11
Office, Private, Unassigned
10.0
1
10.0
12
13
Staff/Lounge
Toilet, Staff
Include standard Kitchenette
20.0
6.0
1
1
20.0
6.0
Holding for large Totes and Bins
Open plan w/ rehabilitation assessment
and treatment stations - Hand hygiene
station - Therapy Room IN PCC
Drawings
Standard food service galley
16.0
1
16.0
30.0
Standard workstation
Locate Adjacent to Central Care Team,
will function as Isolation Ante Room
Locate Adjacent to Central Care Team,
will function as Isolation Ante Room
Unit Support
14
On Floor Holding
15
Activation Space
1
30.0
16
17
18
19
On Floor Food Service/Galley
36.0
1
Toilet, Male/Female
6.0
1
Systems Room
Low Voltage systems
4.5
1
Housekeeping Room
6.0
1
Subtotal, Floor/Unit Entrance/Common Support Area - 1 Typical Area
36.0
6.0
4.5
6.0
214.5
Patient Care Area - 1 Typical Nursing Sub-Unit (18 beds)
1 patient bed w/ wardrobe, supply
cabinet and hand washing sink at
20 Patient Bedroom, Private
entrance. Sized to allow for family
participation/ visiting. 1 room with
isolation capability
Entry alcove for gowning - Counter w/
21 Anteroom, Isolation
hand washing sink
22 Toilet/Shower Room
Patient Bedroom, Private,
23
Include overhead lift system
Bariatric
24 Toilet/Shower Room
20.0
12
240.0
6
1
6.0
6
12
72.0
30
2
60.0
6
2
12.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.01
GENERAL MEDICAL/SURGICAL INPATIENT UNITS
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
25
Patient Bedroom, Semi-Private
26
Toilet/Shower Room
27
Sun Room
28
Alcove, Equipment
IP.01 General Medical/Surgical Inpatient Unit
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
30
2
60.0
6
2
12.0
16.0
1
16.0
Alcoves for equipment storage, include
power and data outlets in alcoves
1.5
4
6.0
Standard Workstation
3.0
4
12.0
8.0
1
8.0
12.0
1
12.0
11.0
1
11.0
18.0
1
18.0
3.0
1
3.0
10.0
1
10.0
2.0
7
Subtotal, Patient Care Area - 1 Typical Sub-Unit 18 beds
14.0
572.0
Subtotal, Patient Care Area - 1 Typical Nursing Unit, 36 beds
1,358.5
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
To be located adjacent to one another 2 patient beds w/ wardrobe, supply
cabinet for each bed and hand washing
sink at entrance - Sized to allow for
family participation/visiting
1 assisted WC, 1 sink, 1 assisted
shower
Multipurpose, when available will
function as a meeting room
TOTAL
SIZE
(nsm)
Workstation Care Hub
29
Workstation, Care Team
30
Quiet Work Area
31
Medication Room
32
Utility Room, Soiled
33
Utility Room, Clean
34
Nourishment Station
35
Storage, Equipment
36
Closet, Soiled Holding
Includes dictation stations each w/
PACs viewing capability
Accommodates automated dispensing
cabinet (ADC) and medication
preparation - Counter w/ sink Lockable cabinets
Accommodation for up to 3 carts Counter - Separate linen holding area
Ice machine - Counter w/ sink,
microwave oven - Half size refrigerator
- Storage cabinetry
Include multiple power and data outlets
in storage room
Subtotal, Patient Care Area - 2 Typical Nursing Units (72 Beds)
2,717.0
TOTAL NSM, ALL AREAS
2,717.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
This specification outlines the functional, operational and physical requirements for the Intensive Care
Unit/Telemetry Unit (ICU/TU) functional component.
3.1
3.1.1
3.1.2
FUNCTIONAL DESCRIPTION
Statement of Purpose
3.1.1.1
The ICU/TU exists for the purposes of providing continuous medical, nursing and allied
health care to the most acutely ill or injured patients requiring a higher level of nursing
care and/or life support, which will not be provided on the General Medical/Surgical
Inpatient Units (See IP.01). “At risk” patients requiring continuous monitoring of vital
signs will also be accommodated here.
3.1.1.2
The Facility’s telemetry monitoring functions for any inpatient, regardless of where they
will be accommodated will be centralized here as well.
3.1.1.3
Measures to prevent infection and/or control the spread of infection are an expectation
of safe care.
3.1.1.4
The intent is to provide as home-like an atmosphere as possible, with attention given to
providing the necessary services in as unobtrusive way as possible. Sub-units within
the inpatient unit will be referred to as “neighbourhoods” and inpatient rooms as
inpatient “bedrooms”.
Scope of Services
3.1.2.1
Functional Content
3.1.2.1.1
The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
3.1.2.1.1.1
Receiving patients either through the Facility’s Emergency
Department (ED – See AC.01), Surgical Services component (See
DT-.04), another inpatient care area in this Facility or direct
admissions from another Health Care Facility (HCF), followed by a
holistic model of assessing and monitoring each patient’s condition
3.1.2.1.1.2
Providing mechanical life support including mechanical ventilation
and dialysis (continuous renal replacement therapy – CRRT)
3.1.2.1.1.3
Production of conditioned water, using portable equipment,
required by specialized equipment (e.g., purified water produced
using reverse osmosis technology for CRRT) requires plumbing
provided at patient bedside. Bedside dialysis capacity and
functional requirements are required in all ICU and Telemetry
rooms.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.1.2.1.1.4
Centralized telemetry monitoring of all TU patients, as well as
monitoring of patients attached to a telemetry monitor, being cared
for on any General Medical/Surgical Inpatient Unit (See IP.01).
3.1.2.1.1.5
Conducting bedside consultations between patients and members
of their interdisciplinary health care team
3.1.2.1.1.6
Conducting symptom management, including minor procedures
and emergent endoscopy services requiring support by
anaesthetists
3.1.2.1.1.7
Facilitating patients’ access to diagnostic and treatment services
located elsewhere in the Facility
3.1.2.1.1.8
Delivering medications according to each patient’s scheduled or
immediate needs
3.1.2.1.1.9
Conducting discharge planning including activation focusing on
returning the patient to their highest level of functioning
3.1.2.1.1.10 Conducting shift reports and participating in interdisciplinary team
conferences
3.1.2.1.1.11 Documenting each patient’s progress and health status using an
electronic medical record (EMR)
3.1.2.1.1.12 Addressing each patient’s nutritional needs by providing meals at
the bedside and nutritional consultations
3.1.2.1.1.13 Educating patients and lay members of their support network
3.1.2.1.1.14 Providing assistance to patients’ personal needs as necessary
(e.g., feeding and maintaining hygiene)
3.1.2.1.1.15 Accommodating participation by lay members of a patient’s
support network in providing care
3.1.2.1.1.16 Providing respite and relaxation opportunities for both patients and
their visitors
3.1.2.1.1.17 Accommodating in-service education, demonstration and practice
for new staff, and recurrent training for existing staff on safe patient
handling protocols
3.1.2.1.1.18 Managing all functions conducted in the unit including scheduling
and managing staff, controlling inventories of consumable
supplies, scheduling rounds, conducting service quality
evaluations, maintaining standards of maintenance and cleanliness
in all areas of the unit and communicating with staff on facility-wide
and professional topics.
3.1.2.2
Exclusions
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.1.2.2.1
3.1.2.3
3.1.2.2.1.1
Routine nursing care provided to telemetry monitored
patients on a General Medical/Surgical Inpatient Unit
(See IP.01 General Medical/Surgical Inpatient Units)
3.1.2.2.1.2
Central production of purified water
3.1.2.2.1.3
Large and/or formal educational lectures
3.1.2.2.1.4
Long term palliative care
Anticipated Trends in Service Delivery
3.1.2.3.1
The following list specifies functions either related to or supportive of
services accommodated in the ICU/ TU, but are understood to occur
in other functional components in the Facility or outside of the Facility:
The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these
trends shall be reflected in the component’s design.
3.1.2.3.1.1
Inpatient bedrooms must be capable of accommodating
a range of acuity levels or a single patient’s changing
acuity level with little or no changes to the room’s
configuration or supplies/equipment content. This
feature will reduce the need for in-hospital patient
transfers.
3.1.2.3.1.2
The decentralization of more diagnostic and treatment
services to the inpatient units is predicted as equipment
becomes smaller and more mobile.
3.1.2.3.1.3
The number of bariatric patients admitted to hospital is
predicted to increase.
3.1.2.3.1.4
The mean age of patients admitted to hospital is
predicted to increase as is the incidence of co-morbidity
and patients with complex health issues.
3.1.2.3.1.5
The mean age of staff working on the inpatient units is
predicted to increase.
3.1.2.3.1.6
Shortages of key staff positions are predicted to
increase, including staff in the highly trained,
specialized professions.
3.1.2.3.1.7
Infection control will remain a high priority in all areas of
the Facility
3.1.2.3.1.8
Food services will become more responsive to each
patient’s needs as opposed to provision on a fixed
schedule.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.1.2.3.1.9
3.1.3
Scope of Education Functions
3.1.3.1
3.1.4
3.2.1
Medical and nursing students and students in the allied health professions from
technical colleges and universities will receive practical skills training through
internships and co-op programs. All teaching and supervision functions will be
accommodated in the general work areas, or within specified teaching spaces.
Scope of Research Functions
3.1.4.1
3.2
Staff and students working in the ICU/TU will, from time-to-time, be engaged in
research. The nature and extent of research functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
OPERATIONAL DESCRIPTION
LEAN Planning Standards
3.2.1.1
Staff Access to Supplies and Equipment
3.2.1.1.1
To accommodate future changes in patient acuity, the
Telemetry unit will be designed identical to the Intensive
Care unit, specifically the visibility from the care team
hubs to the head of the patient is mandatory for all
Telemetry patients. A mandatory aspect of the design
for the patient rooms will be direct visibility for care
team staff to the door of the patient room, and for ICU
and Telemetry patients to the head of the patient, within
15m of a care team hub workstation.
The placement of equipment and supplies stores will promote the
concept of reducing travel time/distance for staff to/from a patient.
Minimal volumes of commonly used items are stored either in the
patient bedroom or at the Care Hub for that neighbourhood. More
highly rationed items shall be stored close to the neighbourhood or
close to the collaborative centre. Unique or “one of” items will be
generally stored in the Facility’s Equipment Depot (See OS-STL.08)
unless an item’s use will be confined to a inpatient unit or
neighbourhood
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.2.1.1.2
3.2.2
Hours of Operation
3.2.2.1
The ICU/TU at this Facility will be staffed and in operation:
3.2.2.1.1
3.2.3
3.2.4
24 hours-a-day, 7 days-a-week
People Management Systems
3.2.3.1
Most patients admitted to this component will arrive via the Facility’s ED (See AC.01) or
from another inpatient care area in the Facility. ED admissions will be typically
documented (registered and admitted) while in the ED and transported directly to their
assigned room.
3.2.3.2
Patients on stretchers or requiring mobility assistance will be either escorted or
transported in a wheelchair by staff from the Facility’s portering services (See OSSTL.08) and may or may not be accompanied by a physician, a nurse or another allied
health professional
3.2.3.3
All visitors to this component will have access through a securable entrance.
Materiel Management Systems
3.2.4.1
Planning assumes Facility-wide reliance on radio frequency
identification (RFID) system for most equipment enabling immediate
locating capability. Electronic requests for an item will be received in
the Equipment Depot where portering services staff will locate the
item, retrieve it or a comparable item, and deliver it to the requesting
area. Access to the RFID tracking system is required from all the
Collaboration Centre, Care Team Hubs and all nursing stations.
Consumable Supplies
3.2.4.1.1
Inventories of consumable supplies will be maintained close to point
of use on each inpatient unit. Items shall be maintained with minimum
inventory levels triggering a re-ordering process. Most supplies will be
stored either in bins or on top-up carts.
3.2.4.1.2
Use of a two-bin system will enable staff to draw from 1 bin while the
other waits in reserve. Emptying the first bin will trigger an electronic
ordering process while inventories in the reserve bin are drawn.
3.2.4.1.3
Supplies stores will be inaccessible to patients and to the public.
3.2.4.1.4
Inventories on top-up carts will be generally maintained according to
prescribed delivery schedules by either Environmental Services staff
(See OS-STL.03) or Materiel Management staff (See OS-STL.05).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.2.4.2
3.2.4.3
3.2.4.4
3.2.4.1.5
Most supply ordering will be sent electronically to and processed
through the Facility’s Materiel Management component.
3.2.4.2.1
All clean linen used for patient care will be stored close to point of
use. A clean utility room at the neighbourhood level will accommodate
inventories of commonly used items for immediate, emergency
access. All inventories will be managed according to a minimum 3days supply reorder level, and will be resupplied using a top-up
system.
3.2.4.2.2
Laundry processing will occur off site at the regional laundry located
in Cumberland. Soiled linen will be collected into small hampers
within each inpatient bedroom and then transferred into foot pedalactivated totes, located in soiled utility rooms. Soiled linen will be
temporarily held pending removal to the Environmental Services
component for off-site transfer. Clean linen returning from the regional
laundry will be delivered to central receiving facilities in the
Environmental Services (See OS-STL.03) component before being
sorted onto exchange/top-up carts and delivered to the ICU/TU.
Linen
Pharmaceutical Products
3.2.4.3.1
Automation will be used in the inventory management and dispensing
of medications. Medication rooms will be stocked with unit doses of
patients’ medications and dispensed according to prescribed
schedules or as necessary. The Pharmacy will be responsible for
inventory management of the medication areas/automated stations
and integrated medication carts, whereas nursing personnel will
deliver medications from the stations.
3.2.4.3.2
Unstable products will be prepared in the Facility’s Pharmacy
component (see DT.06), and then delivered to the inpatient unit either
according to a prescribed schedule or upon request. Product delivery
will rely on a pneumatic tube system, unless fragility or stability issues
require manual transport. In these latter circumstances, pharmacists
or pharmacy technicians from the Pharmacy will be responsible for
product transportation.
3.2.4.3.3
Select medications will be delivered via pneumatic tube to the unit.
Food Services
3.2.4.4.1
Food services will include a patient focused meal service approach
providing patients with the ability to make selections prior to service.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.2.4.5
3.2.4.4.2
Food Services personnel will facilitate orders at least twice a day,
typically an hour or two in advance of lunch and supper with next day
breakfast selection facilitated along with supper selection in the midafternoon. Meals will be assembled from the central kitchen or from
pantries located on each floor. Once assembled, meals will be
distributed to patient units and delivered to patients at bedside by
Food Services personnel.
3.2.4.4.3
Following each meal service, all carts, trays and service ware will be
returned to the central kitchen for ware washing and sanitation.
Waste Management
3.2.4.5.1
Waste products will be managed according to a system of
segregation at point of origin and sequential consolidation. Operation
of this system relies on appropriate containment facilities for each
type of waste product beginning at where the waste is generated
followed by similar, but progressively larger, containment facilities at
key collection locations. In the ICU/TU, waste management is
understood to begin in the individual patient bedrooms with a central
collection and temporary holding station. Each administrative area will
also accommodate segregation of the types of waste products
typically generated in these types of spaces.
3.2.4.5.2
Segregation of wastes will accommodate the following
categories of products:
3.2.4.5.2.1
General garbage
3.2.4.5.2.2
Sharps (including potentially biohazardous
items)
3.2.4.5.2.3
Infectious or contaminated wastes
(excluding sharps)
3.2.4.5.2.4
Confidential Paper
3.2.4.5.2.5
Clean paper and cardboard
3.2.4.5.2.6
Clean metal (tin and aluminum)
3.2.4.5.2.7
Clean recyclable plastics
3.2.4.5.2.8
Compostable materials
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 3.2.5
IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
Information Management Systems
3.2.5.1
It is anticipated that electronic technology will be used to manage more aspects of each
patient’s care. Electronic checking of patient information (e.g., wrist band bar code), for
example, will be used to validate the match between patient and a prescribed
treatment, procedure or medication. This manner of linking the patient to the
information management infrastructure will require reliable and secured wireless
access throughout the Facility.
3.2.5.2
All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, located close to each patient’s bedside and at key staff workstations, and
mobile pads. Access to the EMR will be controlled electronically with varying levels of
security clearance determining a person’s access to different sections and their ability
to enter/edit data.
3.2.5.3
Staffing information will be a managed corporate service. Scheduling, including
providing for sick and vacation relief will be conducted centrally, and off-site. Notices to
individual staff regarding their schedules will be communicated electronically.
3.2.5.4
The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authority’s strategic investment in Cerner and other
clinical and business systems.
3.2.5.5
The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
3.2.5.5.1
Integrated Medication Carts
3.2.5.5.2
Medication Dispense Cabinets
3.2.5.5.3
Mobile and Fixed Computer Devices – Desktop and Wall mounted
3.2.5.5.4
Mobile and Fixed Label Printers
3.2.5.5.5
Mobile and Fixed Barcode Scanners
3.2.5.5.6
Handheld Computer Devices
3.2.5.5.7
Glucometers with Docking Stations
3.2.5.5.8
Tracking Monitors – Patient, Staff, and Resource Tracking
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.2.5.5.9
Clinical Dashboards
3.2.5.5.10 Smart Beds
3.2.5.5.11 Smart Pumps
3.2.5.5.12 Device Integration for real –time clinical assessment and
physiological data documentation
3.2.5.5.13 Digital Room Signage and Way-finding
3.2.5.5.14 Interactive Patient Station
3.2.5.5.15 Location Awareness
3.2.5.5.16 Device Connectivity
3.2.5.5.17 Multifunction Communication Devices with integration to systems
3.2.5.5.18 Telehealth and Virtual Team Capabilities
3.2.5.5.19 Real Time Location System
3.2.5.5.20 Staff Safety and Duress
3.3
3.3.1
DESIGN CRITERIA
LEAN Planning Standards
3.3.1.1
Standardization of Inpatient Bedrooms
3.3.1.1.1
The intent of this requirement is to facilitate staff moving from roomto-room without having to reorient themselves with respect to
frequently accessed key features like hand wash sinks/stations,
supplies storage, medical gases and suction, call annunciator cancel
buttons, ceiling lift controls, ceiling lift sling storage and transfer belts.
3.3.1.1.2
Telemetry neighbourhood: Each Inpatient bedroom will be designed,
configured, equipped and furnished to a common standard and
design and with the design conforming to that of the inpatient
medical/surgical unit bedrooms.
3.3.1.1.3
Telemetry patient bedrooms will be configured according to a “likehanded” design, where the foot of each bed is oriented in the same
direction (all toes pointed in the same direction).
3.3.1.1.4
All Intensive care unit rooms will be standardized to a common
design.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.1.2
Priority Access to Patients and to Collaborative Functions
3.3.1.2.1
3.3.2
Proximity Relationships
3.3.2.1
The ICU component’s location relative to other components, or other areas of the
Facility, and the nature of circulation used to move between different
components/areas are illustrated in the diagram below. Proximities are listed according
to rank; higher priorities appear above lower priorities.
Intensive Care Unit Emergency Department Intensive Care Unit Surgical Services Intensive Care Unit Pharmacy Intensive Care Unit Main Horizontal/ Vertical Circulation 3.3.3
3.3.2.2
Provide Direct Access by General
Circulation to the Emergency Department
(ED) component for the movement of
patients and staff.
3.3.2.3
Provide Direct Access by General
Circulation to the Surgical Services
component for the movement of patients
and staff.
3.3.2.4
Provide Convenient Access by General
Circulation to the Pharmacy component for
the movement of staff and pharmaceutical
products.
3.3.2.5
Provide Convenient Access by General
Circulation to the Facility’s main public
corridor/elevator system for the movement
of patients and visitors.
Internal Design Criteria
3.3.3.1
General Internal Layout
3.3.3.1.1
Locating staff support facilities central to inpatient bedrooms will
enable staff to maintain direct visual contact with patients in their
bedrooms. This scheme provides for collaborative functions to occur
without removing nursing and other interdisciplinary staff from close
proximity to patients under their care.
The component shall be organized into 4 major areas as follows:
3.3.3.1.1.1
ICU inpatient bedroom cluster, including decentralized
professional support facilities
3.3.3.1.1.2
TU inpatient bedroom cluster, including decentralized
professional support facilities
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.3.2
3.3.3.1.1.3
Professional support facilities (Including a
Collaboration Centre and associated shared support)
3.3.3.1.1.4
General/public support facilities
Unit Organization
3.3.3.2.1
ICU and Telemetry are two neighbourhoods making up one inpatient
unit. The ICU neighbourhood is a high intensity care area, while the
Telemetry Unit provides less intensive care, but a higher level of care
than found on a general medical surgical unit.
3.3.3.2.2
The ICU and Telemetry neighbourhoods have individual Care Hubs,
but share the support elements of the unit including the Collaborative
Centre, medication rooms, utility rooms, etc.; therefore the two
neighbourhoods must be co-located and adjacent. There must be
specific attention within the design of this unit to ensure the shared
support areas are easily accessible to both neighbourhoods.
3.3.3.2.3
The Telemetry bedrooms shall be designed to match the patient
bedrooms on the general medical/surgical units (IP.01).
3.3.3.2.4
The ICU patient bedrooms must be designed to provide a higher
intensity of care. The care of ICU patients frequently involves many
types and numbers of medical equipment and the design must
minimize obstruction of movement of personnel within these rooms by
equipment. Workflow and clear-space requirements will drive design
decisions.
3.3.3.2.5
To protect patient privacy, room design that limits obtrusive sightlines
during care or procedures is required. Consideration must be given
in the room design to ensure privacy for the patient who cannot be
mobilized to use the toilet.
3.3.3.2.6
The door system must be sized and designed to permit rapid
movement of patients, bariatric beds, equipment, and personnel into
or out of patient rooms in the event of a crisis.
3.3.3.2.6.1
Cubicle curtains are required in all patient bed rooms
to provide privacy; curtains must provide privacy from
the hallway into the patient room, even when the door
to the patient room is open. Curtains must not
interfere with clinical activities.
3.3.3.2.6.2
Patient room doors will accommodate bariatric beds
and oversized beds (refer to Section 3.3.3.14.3 for
detail regarding patient bedroom doors).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.3.2.7
3.3.3.3
3.3.3.4
Unobstructed Site Lines
3.3.3.3.1
Unobstructed site lines must be provided between a Care Hub and
each of the patient bedrooms. A mandatory aspect of the design for
the patient rooms will be direct visibility for care team staff to the door
of the patient room within 15m of a care team hub workstation.
3.3.3.3.2
Provide a window no smaller than 1000mm wide between ICU patient
bedrooms. Provide measures to ensure privacy for the windows
between ICU patient bedrooms. No ICU patient bedroom shall be
without a window into an adjacent patient bedroom. Control of privacy
measures must be available within patient room and outside patient
room. Staff must be able to control privacy measures without entering
the patient room.
Collaboration Centre
3.3.3.4.1
The design must consider the optimum location of the
seating/reception area and the family consultation/grieving room.
Family members will tend to cluster immediately outside the patient’s
room or within the unit if the lounge is perceived to be too far from the
ICU. Provide positive distraction ceilings in the waiting room
(skyscape ceiling art or views of nature).
The Central Collaboration Centre will act as each inpatient unit’s
communication hub, and will accommodate a variety of functions. Its
primary function is to support the multi-disciplinary collaboration
between all care givers, including nursing, physicians, allied health
personnel and students. On the ICU/ TU, the Centre will be in an
open space, but acoustical attenuation and privacy is required. The
Center will not be open to the public to promote confidentiality. The
primary functions of this space are:
3.3.3.4.1.1
Dictating and reviewing charts, diagnostic images and test
results
3.3.3.4.1.2
Conducting private telephone conversations
3.3.3.4.1.3
Conducting multi-disciplinary care team discussions
3.3.3.4.1.4
Accommodation of teaching and collaboration space for
University of B.C. (UBC) Faculty of Medicine
3.3.3.4.1.5
Providing access to computer workstations and business
equipment and business supplies for the unit
3.3.3.4.1.6
Providing on-unit space for nursing management activities
3.3.3.4.1.7
This space is not intended for use by patient, families or the
public.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.3.4.2
The Central Collaboration Centre will include the following areas:
3.3.3.4.2.1
A Central Reception/Unit Clerk desk immediately outside of
the Collaboration Centre will act as the control point for the
unit, and will be highly accessible to patients and visitors.
3.3.3.4.2.2
A Business Centre will be located in close proximity to the
Central Reception/Unit Clerk desk while providing the
appropriate segregation of business equipment for staff
safety and noise reduction within the Collaboration Centre.
3.3.3.4.2.3
The following functions will be accommodated in the
enclosed private area of the Central Collaboration space:
3.3.3.4.2.3.1 A central Conference/Huddle Area where
professional staff can conduct business and
collaborate.
3.3.3.4.2.3.2 Four (4) individual workstations will be provided
for use by clinical staff. These workstations will
be in the central, open area of the Collaboration
Centre co-located with the Conference/Huddle
Area to promote collaboration.
3.3.3.4.2.3.3 Within the ICU/TU, the Collaboration Centre will
be open design, yet have areas within the
Collaboration Centre designed to provide
acoustically private areas where professional
staff can conduct business
3.3.3.4.2.3.4 Collaborative Teaching Spaces and a Teaching
Room that will accommodate UBC staff. 1
workstation for use by UBC staff/trainees will
be provided in the central, open area of the
Collaboration Centre. The Teaching Room will
be a private space directly off of the central
area.
3.3.3.4.3
Close proximity between the Collaboration Centre, the Care Hubs and the
Common Support Spaces is required. The dual need for front line nurses to
be close to their patients in the neighbourhood and to be able to participate
in the Collaboration Center must be considered in this design.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.3.4.3.1
The ability for staff to visualize the care team hubs from the
huddle area of the collaboration center is a beneficial aspect of
enhanced patient care and staff communication. Provide
visibility from the collaboration centre into the neighbourhood
pods, visibility will be provided from the collaboration huddle
area to the care team sub-stations. Prefer visibility between
the collaboration centre, neighbourhood pods, and care team
stations is not into public areas, visibility between the huddle
area and the care team hub should only be between staff/ nonpublic areas.
3.3.3.5
Patient Bedroom Isolation Capability
3.3.3.5.1
Patients admitted to hospital can have needs for isolation. The nature
of this isolation can either prevent against the spread of airborne
infections, requiring a room with negative airflow/pressurization, or
protect those with compromised immune systems, requiring positive
airflow/pressurization. Isolation-capable rooms will require 2 separate
points of access/exit; 1 from the main circulation corridor in the patient
care area which could be locked down when insolation is required,
and a second access/egress point directly to/from the ante room.
There will be one (1) negative pressure isolation room for ICU and
two (2) isolation rooms for TU – one positive pressure for protective
isolation and one negative pressure.
3.3.3.5.2
All ante rooms shall be to the side of each patient bedroom and not in
front of the patient bedroom. Ante rooms shall not form a vestibule in
front of the patient bedroom. The patient entrance to each isolation
room shall be directly onto the corridor. There shall be a window from
the ante room into the isolation patient bedroom.
3.3.3.5.3
Each neighbourhood will be supplied with 2 automatic bedpan
flusher/washer/disinfectors in the associated soiled utility room and
1bedpan flusher/washer/disinfector in each ICU bedroom. The
location of the bedpan washers must be located in such a way as to
not obstruct entry in to the room, especially when the bed pan washer
is in use. The location of the bed pan washer must not interfere with
any other functional requirements to be conducted in the space.
3.3.3.6
Family Zones in Inpatient Bedrooms
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.3.6.1
Family involvement in care is encouraged by the Authority.
Accommodation within the inpatient bedroom must be provided to
allow a family member to sleep in the patient bedroom. Locked
drawer storage shall be provided to enable family member to securely
store a small number of belongings. A reading light, controllable from
the Family zone, will be provided in the family zone.
3.3.3.6.2
It is important that the accommodation for the family be created in a
specific zone within the inpatient bedroom which minimizes the
possibility of any interference in the provision of care to the patient.
3.3.3.6.3
All furniture in the family zone must be moveable, and if required can
be easily moved out of the room, during clinical emergencies.
3.3.3.6.4
A family shower is required on the ICU/ Telemetry unit
3.3.3.7
3.3.3.8
Reduction of Hallway Clutter and Equipment and Supply Storage.
3.3.3.7.1
The inpatient unit design must consider mechanisms to ensure the
elimination of hallway clutter. Equipment room supply room storage
and alcoves will be designed to ensure easy access to all items
stored there to prevent the movement of these items into the hallway
for access. Electrical outlets must be provided in equipment rooms,
supply room storage and alcoves and be positioned at a height which
promotes ease of access without unnecessary bending.
3.3.3.7.2
For equipment items stored in the equipment storage room, electrical
outlets must be positioned at a height which promotes ease of access
without unnecessary bending.
Segregated Patient and Visitor Flows
3.3.3.8.1
Separate points of access/egress shall be provided for patients being
transported to/from other destinations in the Facility and for visitors.
Wayfinding signage shall clearly identify the “public” point of
access/exit and the preferred route for visitors to access the inpatient
bedrooms.
3.3.3.8.2
Patient room numbers must be clearly marked. Directional signage
within the unit must be easy to read, understand, and follow.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.3.9
Component Security
3.3.3.9.1
Access to this component must be controllable at all times. This area
must be accessible to authorized personnel and visitors (subject to
restrictions) 24 hours-a-day, 7 days-a-week.
3.3.3.9.2
The component’s design must avoid creation of “blind corners” and
must provide adequate lighting throughout to protect staff, patients
and visitors from unexpected violence. Work areas must not place
staff in isolation, and staff must have the capability of summoning
help. Areas subject to limited visual access must be video monitored
and supplied with ceiling-mounted mirrors enabling staff to view the
area prior to entry.
3.3.3.9.3
“Staff only” rooms must have windows incorporated into doors
enabling staff to assess the area outside of the room for traffic and
security issues.
3.3.3.9.4
All dimensions of counters and desks must act as a barrier and
provide adequate protection from violent or threatening behaviour.
3.3.3.9.5
Staff facilities, including toilets and change rooms, must be separate
from patient areas to reduce the risk of staff being isolated with a
patient or visitor.
3.3.3.10 Lighting
3.3.3.10.1 There will be a variety of lighting options in this component, each
suited to the functions accommodated in a specified space.
3.3.3.10.2 Each telemetry and ICU bedroom must have access to natural
lighting and views to the outside.
3.3.3.10.3 Artificial lighting throughout the inpatient units shall follow a general
standard of providing “non direct” lighting. This specification implies
fixtures that reflect light upwards, away from direct eye contact, and
especially in those areas where patients will be either in bed or
transported on stretchers.
3.3.3.10.4 Artificial lighting in each inpatient bedroom must be variable to
provide different levels of lighting and for different purposes. At night
time, patients will have the ability to read while in their bed. Lighting in
the room must also accommodate staff’s ability to monitor the patient
during the night without affecting the patient’s ability to sleep.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.3.10.5 Artificial lighting in the administrative and support areas must be
variable to accommodate different levels of ambient lighting
commensurate with the functions ongoing at any one time in that
space. Individual workstations must be provided with task lighting.
3.3.3.11 Ergonomics for an Aging Workforce
3.3.3.11.1 The expected increase in the average age of workers in all
professions will require greater attention to equipment and devices
that staff are required to use. Ease of access will be among the key
criteria. In the inpatient bedrooms, this specification will be reflected in
electrical outlets being located both a floor level for low pull items e.g.
power for beds, specialty mattresses, etc., plus electrical outlets
located for easy access above the floor surface (approximately 3 feet)
for high pull items such as intravenous pumps. The type and number
of electrical devices used in the rooms is expected to increase, and
the combination of outlets at floor surface and elevated outlets will
minimize repetitive bending, while assisting with electrical cable
management.
3.3.3.11.2 Refer to the Technical Specifications and Medical Gas Matrix for
specific requirements of ICU and TU rooms.
3.3.3.11.3 The patient lift system will allow patient pick up from all areas of the
room including the bathroom for toileting, showering and to the sink
(refer to Schedule 3 for technical requirements).
3.3.3.12 Accommodation of Bariatric Patients
3.3.3.12.1 Numbers of bariatric patients admitted to hospital are projected to
increase. Managing these patients will require features enabling for
both patients and staff. Doorways and circulation spaces must be
sufficiently wide to accommodate large people, many of whom will be
relying on mobility assistance including motorized chairs and
scooters. Doorways must be a minimum of 1120 mm (approximately
3’ 8”) in width. The reference to circulation spaces applies especially
in confined rooms like water closets.
3.3.3.12.2 Bariatric patients often require assistance getting into and out of bed.
The patient lift system will allow patient pick up from all areas of the
room including the bathroom for toileting, showering and to the sink
(refer to Schedule 3 for technical requirements).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.3.12.3 Observation Alcove
3.3.3.12.3.1 There is no better way of monitoring a patient than by
direct visualization as there is a link between poor
visualization of patients by nursing staff and physicians
and patient mortality. Each of the patient bedrooms will
have direct visibility from an observation alcove to the
head of each patient. For safety reasons, each head of
the patient must also be visible from the ICU corridor.
3.3.3.12.3.2 The observation alcove windows will have integral blinds
operable from both sides. Each workstation at each
observation alcove shall have 1400mm of countertop
space. The computer station shall not block the view to the
patients head. The observation window shall be large
enough to view more than 3/4ths of the patient bedroom.
The Observation alcove shall be standing height with a
foot rest at its base.
3.3.3.13 Patient Bedroom Sanitation
3.3.3.13.1 Each patient bedroom will be supplied with an enclosed bathroom
and a bedpan flusher/washer/disinfector. The patient toilet doors in
the ICU shall be double swing (the door swings in but is able to swing
out for patient safety). The bathroom door will be either a double
swing or barn door style. The final decision will be made in
conjunction with the Clinical User Group to maximize clinical
functionality and safety. Patient showers are required in all telemetry
rooms.
3.3.3.14 ICU Patient Bedrooms
3.3.3.14.1 Pleasant surroundings for patients and staff promote increased
comfort, and in some cases, improved patient outcomes. Color
schemes can affect mood and stress levels. Pictures and artwork can
be selected and placed appropriately for patients, families, and
caregivers. For bed-ridden patients, the ceiling is most often what is
seen. The design must address implementation of positive
distractions, such as a selection of images that can be incorporated
into ceilings.
3.3.3.14.2 Provide space for a family recliner chair that does not disrupt nursing
operations when the chair is fully extended. Ensure that the TV is
mounted such that it aligns with the patient bed for comfortable
viewing by the patient. Ensure that the door entrance width into the
room is not obstructed by the sink. Provide space for a large cart
storage area that does not disrupt clinical operations.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.3.14.3 All doors into patient rooms will be large three panel glass doors that
provide an opening that is 2/3rds of the room width. The doors will
include a breakaway function. The glass doors shall be 2/3rds frosted
to provide privacy. There shall be handles on both sides of all patient
room doors.
3.3.3.14.4 Cubicle curtains are required in all patient bed rooms to provide
privacy; curtains must provide privacy from the hallway into the
patient room, even when the door to the patient room is open.
Curtains must not interfere with clinical activities.
3.3.3.14.5 Each ICU patient bedroom will have a minimum width of 4.2 metres.
3.3.3.15 Noise Reduction
3.3.3.15.1 Materials and finishes can help to create a healing environment by
controlling noise. Critically ill patients are more sensitive to noise than
staff and increased noise levels disrupt sleep and increase perception
of pain. Alarms, movement of equipment and chairs, and other unit
clinical and business activities, and conversations are often disturbing
to patients. Materials used in the ICU unit must minimize noise, not
only in patient’s rooms, but also throughout the neighbourhood.
3.3.3.16 Infection Control
3.3.3.16.1 Materials and finishes can help to create a healing environment by
reducing the spread of pathogens. While this is of importance in all
areas of the hospital, it is of particular concern in the ICU
neighbourhood given the vulnerable nature of this population.
3.3.3.16.2 To enhance infection control, materials and finishes throughout both
the ICU and Telemetry neighbourhoods must be easy to and maintain
and clean, and deter the growth and spread of pathogens.
EXECUTION COPY Nortth Island Hospittals Projject SCHED
DULE 3: DESIGN AND CONSTRUC
CTION SPECIFICA
ATIONS APP
PENDIX 3A: CLIN
NICAL SPECIFICA
ATIONS ______________
_____________
______________
____________________________________________________________ __________
IP.02
INTEN
NSIVE CARE UNIT/TELEME
ETRY UNIT (IC
CU/TU)
3.3.3.17 Com
mponent Fun
nctional Diagram
3.3.3.17.1.1 The areas
s making up th
his componen
nt shall be org
ganized as
illustrated in the followiing diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
3.3.4
Space Table
3.3.4.1
The schedule accompanying this document illustrates rooms, and their respective
sizes, that combine to make up this functional component. Refer to the respective
space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
IP.02 Intensive Care Unit/Telemetry Unit (ICU/TU)
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Inpatient Bedroom Cluster - Intensive Care Unit (8 beds)
01
Patient Bedroom, ICU
Patient bed w/ wardrobe, supply cabinet and hand
washing sink at entrance, bedpan
flusher/washer/disinfector - Sized to allow for family
participation/ visiting
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
25.0
7
175.0
01.01
Patient Bedroom, ICU, Private,
Isolation (Negative Pressure)
Patient bed w/ wardrobe, supply cabinet and hand
washing sink at entrance, bedpan
flusher/washer/disinfector - Sized to allow for family
participation/ visiting
25.0
1
25.0
02
03
Toilet
Anteroom, Isolation
Within patient bedrooms
Adjacent to ICU Isolation Room. Entry alcove for
gowning - Counter w/ hand washing sink
4.5
6.0
8
1
36.0
6.0
Standard Workstations
3.0
4
12.0
8.0
1
8.0
2.0
4
8.0
3.0
2.0
6.0
2
4
1
6.0
8.0
6.0
Workstation Care Hub
04
Care Hub Workstations
05
Quiet Work Area
06
Alcove, Observation
07
08
09
Alcove, Equipment
Alcove, Linen
Toilet, Staff
Includes dictation stations each w/ PACs viewing
capability
Include computer for Documentation, provide 1 for
every 2 ICU rooms
Linen Hamper
Subtotal, Intensive Care Unit
290.0
Inpatient Bedroom Cluster - Telemetry Unit (10 beds)
10
Patient Bedroom, Private
Patient bed w/ wardrobe, supply cabinet and hand
washing sink at entrance - Sized to allow for family
participation/ visiting
20.0
7
140.0
11
Patient Bedroom, TU, Private,
Isolation (1 Negative Pressure,
1 Positive Pressure)
Patient bed w/ wardrobe, supply cabinet and hand
washing sink at entrance, bedpan
flusher/washer/disinfector - Sized to allow for family
participation/ visiting
20.0
2
40.0
12
Anteroom
Adjacent to TU Isolation Room. Entry alcove for
gowning - Counter w/ hand washing sink
4.0
2
8.0
13
Patient Bedroom, Private,
Bariatric
Patient bed w/ wardrobe, supply cabinet and hand
washing sink at entrance, bedpan
flusher/washer/disinfector - - Sized to allow for family
participation/ visiting
30.0
1
30.0
14
Patient Toilet/Shower Room
Within patient bedrooms
6.0
10
60.0
Workstation Care Hub
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
15
16
ROOM TYPE
Workstation, Care Team
Quiet Work Area
17
Nourishment Centre
18
19
20
Alcove, Equipment
Toilet, Staff
Alcove, Soiled Holding
IP.02 Intensive Care Unit/Telemetry Unit (ICU/TU)
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Standard Workstation
Includes dictation stations each w/ PACs viewing
capability
Ice machine - Counter w/ sink, microwave oven - Half
size refrigerator - Storage cabinetry
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
3.0
4
12.0
8.0
1
8.0
2.0
1
2.0
3.0
6.0
2.0
2
1
4
6.0
6.0
8.0
Subtotal, Telemetry Unit
General/Public Support Facilities
21
On Floor Food Service/Galley
22
23
Toilet, Male/Female
Family Consultation/Grieving
Room
23.01
Family shower
Supports food services for the full nursing unit Electrical service for food service delivery carts or
microwave ovens (Contingent upon food service
delivery model adopted)
Locate inside unit
TOTAL
SIZE
(nsm)
320.0
18.0
1
18.0
6.0
20.0
1
1
6.0
20.0
4.0
1
4.0
Subtotal, General/Public Support Facilities
48.0
Professional Support Facilities
Collaboration Area/ Communication Zone
24
Waiting Area/ Reception
Seating for 4-6 people -Television viewing area,
fireplace, outside of dept
12
1
25
26
4.0
4.0
2
1
8.0
4.0
Business Centre
two workstations
Accommodates business equipment and supplies,
Locate Adjacent to Care Team Central Station
Conference/ Huddle Area
Open area, provide adjacent to central care team
area
8.0
1
8.0
Standard Workstation
3.0
27
28
29
Collaboration Centre
Workstations, Care Team
[RID intentionally left blank]
30
Teaching Room, UBC
31
32
33
34
35
Collaborative Teaching/ UBC
Space - Trainee Workstations
Alcove, Resuscitation
Equipment
Office, First Line Leader
Storage, Equipment
Storage, Ventilators
12.0
4
-
-
12.0
-
Includes Conference Table, UBC Teaching Space,
will function as quite room
12.0
1
12.0
Carrel w/ computer terminal
2.0
1
2.0
2.0
1
2.0
10.0
11.0
1.0
1
1
6
10.0
11.0
6.0
Include power and data outlets
Storage for 6 Ventilators
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
36
Medication Room
37
IP.02 Intensive Care Unit/Telemetry Unit (ICU/TU)
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
Preparation and storage of controlled substances,
floor stocks - Counter w/ sink
12.0
1
12.0
Utility Room, Clean
Accommodation for up to 3 carts - Counter - Separate
linen holding area
18.0
1
18.0
38
Utility Room, Soiled
Accommodation for up to 6 garbage and linen totes Includes sink, bed pan flusher/washer/sanitizer,
counter w/ sink, garbage cart and recycling cart Separate hand hygiene sink w/ adjacent storage for
PPE containers
11.0
1
11.0
39
Housekeeping Room
1 floor sink, standard wall-mounted sink, storage
cabinetry - Accommodates housekeeping cart storage
6.0
1
6.0
40
41
Staff/Lounge
Toilet, Male/Female
Included in floor support
1 assisted WC, 1 sink
20.0
6.0
1
1
20.0
6.0
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Subtotal, Stores Area
TOTAL NSM, ALL AREAS
TOTAL
SIZE
(nsm)
160.0
826.0
818.0
CAMPBELL RIVER FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
IP.02 Intensive Care/Telemetry Unit (ICU/TU)
ROOM
SIZE
(nsm)
NUMBE
R OF
ROOMS
Inpatient Bedroom Cluster - Intensive Care Unit (6 beds)
01 Patient Bedroom
1 patient bed - Open plan room with utility cabinet,
bedpan flusher/washer/disinfector - Sized to allow for
family participation/visiting
25.0
5
125.0
01.01
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Patient Bedroom, ICU, Private,
Isolation (Negative Pressure)
Patient bed w/ wardrobe, supply cabinet and hand
washing sink at entrance, bedpan
flusher/washer/disinfector - Sized to allow for family
participation/ visiting
25.0
1
25.0
02
Toilet
Within patient bedrooms
4.5
6
27.0
03
Anteroom, Isolation
Adjacent to ICU Isolation Room. Entry alcove for
gowning - Counter w/ hand washing sink
6.0
1
6.0
3.0
4
12.0
Workstation Care Hub
04 Care Hub
05
Quiet Work Area
Includes dictation stations each w/ PACs viewing
capability
8.0
1
8.0
06
Alcove, Observation
Include computer for Documentation, provide 1 for
every 2 ICU rooms
2.0
4
3
8.0
6.0
07
08
Alcove, Equipment
Alcove, Soiled Holding
4.0
2.0
2
3
8.0
6.0
6.0
1
6.0
08.01
TOTAL
SIZE
(nsm)
Toilet, Staff
Include Linen Hamper
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
IP.02 Intensive Care/Telemetry Unit (ICU/TU)
NUMBE
R OF
ROOMS
TOTAL
SIZE
(nsm)
Subtotal, Intensive Care Unit
231.0
229.0
CONTENTS/KEY FEATURES/DESIGN CRITERIA
ROOM
SIZE
(nsm)
Inpatient Bedroom Cluster - Telemetry Unit (7 beds)
09
Patient Bedroom, Private
1 patient bed w/ wardrobe, supply cabinet and hand
washing sink at entrance . Sized to allow for family
participation/visiting
20.0
4
80.0
Patient Bedroom, TU, Private,
Isolation (1 Negative Pressure,
1 Positive Pressure)
Patient bed w/ wardrobe, supply cabinet and hand
washing sink at entrance, bedpan
flusher/washer/disinfector - Sized to allow for family
participation/ visiting
20.0
2
40.0
10
Anteroom, Isolation
Adjacent to TU Isolation Rooms. Entry alcove for
gowning - Counter w/ hand washing sink Can be left
open when isolation not required
6.0
2
12.0
11
12
Toilet/Shower Room
Patient Bedroom, Private,
Bariatric
6.0
30.0
6
1
36.0
30.0
13
Toilet, Bariatric Room
Within patient bedrooms
1 patient bed w/ wardrobe, supply cabinet and hand
washing sink at entrance, bedpan
flusher/washer/disinfector - Sized to allow for family
participation/visiting - Accommodates bariatric
patients
Within patient bedroom
6.0
1
6.0
Standard workstation
3.0
4
12.0
8.0
1
8.0
2.0
1
2.0
09.01
Workstation Care Hub
14 Care Hub
15
Quiet Work Area
Includes dictation stations each w/ PACs viewing
capability
Ice machine - Counter w/ sink, microwave oven - Half
size refrigerator - Storage cabinetry
16
Nourishment Centre
17
Alcove, Equipment
4.0
2
8.0
18
Alcove, Soiled Holding
2.0
3
6.0
Subtotal, Telemetry Unit
General/Public Support Facilities
19 On Floor Food Service/Galley
Supports food services for the full nursing unit Electrical service for food service delivery carts or
microwave ovens
240.0
18.0
1
18.0
20
Toilet, Male/Female
6.0
1
6.0
21
Family Consultation/Grieving
Room
20.0
1
20.0
Family shower
4.0
1
4.0
21.01
Subtotal, General/Public Support Facilities
48.0
Professional Support Facilities
Collaboration Area/ Communication Zone
22 Waiting Area/ Reception
Seating for 4-6 people Television viewing area,
fireplace
12.0
1
12.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.02
INTENSIVE CARE UNIT/TELEMETRY UNIT (ICU/TU)
CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
23
24
Collaboration Centre
25
26
27
28
Conference/ Huddle Area
Workstations, Care Team
[RID intentionally left blank]
29
Collaborative Teaching/ UBC
Space - Trainee Workstations
Alcove, Resuscitation
Equipment
30
Business Centre
Teaching Room, UBC
IP.02 Intensive Care/Telemetry Unit (ICU/TU)
ROOM
SIZE
(nsm)
NUMBE
R OF
ROOMS
two workstations
Accommodates business equipment and supplies,
Locate Adjacent to Collaboration Area
4.0
4.0
2
1
8.0
4.0
Open area, provide adjacent to collaboration
Standard workstation
8.0
3.0
1
4
Includes Conference Table, UBC Teaching Space,
will function as quite room
12.0
1
8.0
12.0
12.0
Carrel w/ computer terminal
2.0
1
2.0
2.0
1
2.0
10.0
11.0
1.0
12.0
1
1
6
1
10.0
11.0
6.0
12.0
CONTENTS/KEY FEATURES/DESIGN CRITERIA
-
-
TOTAL
SIZE
(nsm)
31
32
33
34
Office, First Line Leader
Storage, Equipment
Storage, Ventilators
Medication Room
35
Utility Room, Clean
Accommodation for up to 3 carts - Counter - Separate
linen holding area
18.0
1
18.0
36
Utility Room, Soiled
Accommodation for up to 6 garbage and linen totes Includes sink, bed pan flusher/washer/sanitizer,
counter w/ sink, garbage cart and recycling cart Separate hand hygiene sink w/ adjacent storage for
PPE containers
11.0
1
11.0
37
Housekeeping Room
1 floor sink, standard wall-mounted sink, storage
cabinetry - Accommodates housekeeping cart storage
6.0
1
6.0
38
39
Staff/Lounge
Toilet, Male/Female
15.0
6.0
1
1
15.0
6.0
Include power and data outlets
Storage for 6 Ventilators
Preparation and storage of controlled substances,
floor stocks - Counter w/ sink
Subtotal, Stores Area
TOTAL NSM, ALL AREAS
155.0
674.0
672.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
This specification outlines the functional, operational and physical requirements for the Maternity,
Newborn and Paediatric Inpatient Unit functional component.
4.1
4.1.1
4.1.2
FUNCTIONAL DESCRIPTION
Statement of Purpose
4.1.1.1
The Maternity, Newborn and Paediatric Inpatient Unit exists for the purposes of
providing continuous medical, nursing and allied health perinatal care to expectant
mothers and immediate, short term postpartum care to neonates.
4.1.1.2
Facilities located in this component also accommodate specialized care services for
paediatric patients; for planning purposes, paediatric will be defined as any child aged
17 years less a day.
Scope of Services
4.1.2.1
Functional Content
4.1.2.1.1
The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
4.1.2.1.1.1
Receiving patients either through the Facility’s “front door” or the
emergency department (ED) followed by a holistic model of triage
and follow-up assessment and monitoring of each patient’s
condition
4.1.2.1.1.2
Initial and ongoing assessment of patients presenting with
symptoms of infection and prompt initiation of precautions and/or
isolation of those patients
4.1.2.1.1.3
Maternal/newborn patient care conducted according to a “family
Centered care” model that accommodates continuous rooming for
the patient, her newborn and other family members
4.1.2.1.1.4
Paediatric patient care conducted according to a “family centered
care” model that accommodates continuous rooming in of a
parent/guardian
4.1.2.1.1.5
Delivering babies vaginally using a model of single room,
labour/delivery/recovery/post-partum (LDRP) care, and supported
either by physicians or midwives
4.1.2.1.1.6
Recovering mothers post-operatively following C-section deliveries
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.1.2.1.1.7
Caring for some neonates in a Level 1 nursery setting offering
respite care; compassionate care for neonates being given up for
adoption; and enhanced nursing care and resuscitation capability.
4.1.2.1.1.8
Conducting outpatient programs and services including: non-stress
testing, pre-operative teaching for elective patients (Part of a
Healthy Beginnings program)
4.1.2.1.1.9
Paediatric inpatient care accommodating children suffering from a
variety of clinical conditions including, but not limited to, respiratory
illness, gastro-intestinal disorders, fractures, ear nose and throat
and other childhood illnesses.
4.1.2.1.1.10
Paediatric outpatient care including post anesthetic recovery (PAR)
care for surgical daycare and some specialized medical day
procedures such as therapeutic phlebotomy, transfusions,
catheterizations, circumcisions, preoperative assessment, etc.
4.1.2.1.1.11
Conducting bedside consultations between patients and members
of their interdisciplinary health care team
4.1.2.1.1.12
Conducting symptom management including minor procedures
requiring support by anaesthetists
4.1.2.1.1.13
Conducting fetal assessments (non-stress testing using fetal
monitors)
4.1.2.1.1.14
Facilitating patient access to diagnostic and treatment services
located elsewhere in the Facility
4.1.2.1.1.15
Delivering medications according to each patient’s scheduled and
immediate needs
4.1.2.1.1.16
Conducting discharge planning including activation focusing on
returning the patient to their highest level of functioning, and
specifically for maternity patients, education/support related to
breast feeding and neonatal care.
4.1.2.1.1.17
Paediatric rooms when not required for paediatric patients will also
provide flexibility for over census support for maternity patients;
gynaecological admissions subject to room availability; and/or over
census support for the medical/surgical units.
4.1.2.1.1.18
Providing outreach services using traveling professionals/teams
and telemedicine as a means of bridging north island communities
and the Facility
4.1.2.1.1.19
Conducting shift reports and participating in interdisciplinary team
conferences
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.1.2.2
4.1.2.1.1.20
Documenting each patient’s progress and health status using an
electronic medical record (EMR)
4.1.2.1.1.21
Addressing each patient’s nutritional needs by providing meals at
the bedside and nutritional consultations
4.1.2.1.1.22
Educating patients and lay members of their support network
4.1.2.1.1.23
Providing assistance to patients’ personal needs as necessary
(e.g., feeding and maintaining hygiene)
4.1.2.1.1.24
Accommodating participation by lay members of a patient’s
support network in providing care
4.1.2.1.1.25
Providing respite and relaxation opportunities for patients and their
visitors and for staff
4.1.2.1.1.26
Managing all functions conducted in the unit including scheduling
and managing staff, controlling inventories of consumable
supplies, scheduling rounds, conducting service quality
evaluations, maintaining standards of maintenance and cleanliness
in all areas of the unit and communicating with staff on facility-wide
and professional topics
4.1.2.1.1.27
The Campbell River Hospital Maternity, Newborn and Paediatric
Unit will include the Centre for Excellence in Maternity Care for
Aboriginal Women and Families (CFEMAW). The CFEMAW
program will require specific aboriginal design features in all
LDRPs in Campbell River but specifically in the two LDRP rooms
designated as aboriginal LDRPs (Refer to Sections 1.1 and 4.3.3
for additional detail regarding incorporation of aboriginal design
throughout the Facility).
Exclusions
4.1.2.2.1
The following list specifies functions that involve either patients or staff
normally present on the Maternity, Newborn and Paediatric Inpatient Unit,
but are understood to occur in other functional components in the Facility
or outside of the Facility:
4.1.2.2.1.1
Large and/or formal educational lectures
4.1.2.2.1.2
Births by Caesarean section (C-section)
4.1.2.2.1.3
Supportive housing for at risk mothers/families arriving from
remote communities
4.1.2.2.1.4
Specialized paediatric outpatient clinics and procedures (e.g.
paediatric endoscopy) (Refer to AC.02 Ambulatory Care/Day
Programs and DT.04 Surgical Services).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.1.2.3
4.1.2.2.1.5
Pre-natal classes
4.1.2.2.1.6
Drop-in breast feeding support program facilitated by the Healthy
Beginnings Nurse
Anticipated Trends in Service Delivery
4.1.2.3.1
4.1.3
The use of inpatient bedrooms capable of accommodating a range
of acuity levels or a single patient’s changing acuity level with little
or no renovation to the room. This feature will reduce the need for
in-hospital patient transfers.
4.1.2.3.1.2
The decentralization of more diagnostic and treatment services to
the inpatient units is predicted as equipment becomes smaller and
more mobile.
4.1.2.3.1.3
The number of bariatric patients admitted to hospital is predicted to
increase.
4.1.2.3.1.4
The mean age of staff working on the inpatient units is predicted to
increase.
4.1.2.3.1.5
Shortages of key staff positions are predicted to increase, including
staff in the highly trained, specialized professions.
4.1.2.3.1.6
Infection control will remain a high priority in all areas of the Facility
4.1.2.3.1.7
Food services will become more responsive to each patient’s
needs as opposed to provision on a fixed schedule.
Medical and nursing students and students in the allied health professions from
technical colleges and universities will receive practical skills training through
internships and co-op programs. All teaching and supervision functions will be
accommodated in the general work areas, and will not require specialized or dedicated
facilities in this component.
Scope of Research Functions
4.1.4.1
4.1.2.3.1.1
Scope of Education Functions
4.1.3.1
4.1.4
The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
Staff and students working in this component will, from time-to-time, be engaged in
research. The nature and extent of research functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 4.2
4.2.1
IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
OPERATIONAL DESCRIPTION
LEAN Planning Standards
4.2.1.1
4.2.2
Staff Access to Supplies and Equipment
4.2.1.1.1
The placement of equipment and supplies stores will promote the concept
of reducing travel time/distance for nursing staff to/from a patient.
Commonly used items that are abundant in number will generally be stored
either in the patient room or adjacent to the room’s entrance. More highly
rationed items will be centrally stored close to the Collaborative Centre
space. Unique or “one of” items will be generally stored in the Facility’s
Equipment Depot (See OS-STL.08) unless an item’s use will be confined to
an inpatient unit or neighborhood.
4.2.1.1.2
Planning assumes facility-wide reliance on a radio frequency identification
(RFID) system for most equipment enabling immediate locating capability.
Electronic requests for an item will be received in the Equipment Depot
where portering services staff will locate the item, retrieve it or a
comparable item, and deliver it to the requesting area.
Hours of Operation
4.2.2.1
The component at the Facility will be staffed and in operation:
4.2.2.1.1
4.2.2.2
4.2.3
The Maternity, Newborn component will accommodate rooming in by the mother’s
spouse, partner or support caregiver. These people and other visitors will have
controlled access to the component at any time. The Paediatric component will
accommodate rooming in by the parent or caregiver during the period of hospitalization.
People Management Systems
4.2.3.1
24 hours-a-day, 7 days-a-week
Patients admitted through the Facility’s “front door” may first register with the Facility’s
booking and registration personnel (See OS-GP.06 Central Patient Registration,
Diagnostic Intake and Specimen Collection). Patients will next proceed directly to
personnel based in this unit for the purposes of final documentation and room
assignment. If clinically appropriate, patients may also proceed directly to the unit for
assessment and will be registered on the unit. Maternity patients arriving after hours
will enter the Facility through the afterhour’s entrance and proceed directly to the unit
for registration and assessment. Patients admitted through the Facility’s ED will
typically be registered/documented while in the ED and transported directly to their
assigned room.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.2.3.2
4.2.4
4.2.3.2.1
Observation following resuscitation
4.2.3.2.2
Stabilization of newborns awaiting transfer to a higher level care facility
4.2.3.2.3
Treatment and monitoring when sepsis is suspected
4.2.3.2.4
Thermoregulation
4.2.3.2.5
Blood sugar monitoring
4.2.3.2.6
Premature neonates transferred-in from a higher level care facility
preparing for discharge home
4.2.3.2.7
Neonates being given up for adoption
4.2.3.3
On the Paediatric subcomponent a family-centred approach will be taken. Parents and
caregivers will be encouraged to participate in the care of the child.
4.2.3.4
All visitors to the inpatient unit will have access through a securable entrance that will
have direct visual access from a central reception area.
Materiel Management Systems
4.2.4.1
Following delivery, patients and their spouse/partner will be encouraged to care for
neonates in that patient’s room, and according to the LDRP model (Labor, Delivery,
Recovery and Postpartum room). In this model, the mother can remain in the same
room throughout the birthing experience and into the postpartum period and care for
her infant within her room. A nursery will be provided for occasions when mothers
require respite from their babies or neonatal monitoring is required. This nursery will
also accommodate neonates requiring:
Consumable Supplies
4.2.4.1.1
Inventories of consumable supplies will be maintained close to point of use
on each inpatient unit. Most supplies will be stored either in bins or on topup carts, and will be inaccessible to the public to prevent cross
contamination.
4.2.4.1.2
Use of a two-bin system will enable staff to draw from 1 bin while the other
waits in reserve. Emptying the first bin will trigger an electronic ordering
process while inventories in the reserve bin are drawn.
4.2.4.1.3
Inventories on top-up carts will be generally maintained according to
prescribed delivery schedules by either Environmental Services staff (See
OS-STL.03) or Materiel Management staff (See OS-STL.05).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.2.4.2
4.2.4.1.4
Most supply ordering will be sent electronically to and processed through
the Facility’s Materiel Management component, but provision will be made
for staff to work directly through approved vendors on securing specialty or
infrequently ordered items.
4.2.4.1.5
Supplies not immediately available on the unit will be delivered via
pneumatic tube.
Linen
4.2.4.2.1
All clean linen used for patient care will be stored close to point of use. A
clean utility room by the Care Hub will accommodate inventories of
commonly used items for immediate, emergency access. All inventories
will be managed according to a minimum 3-days supply reorder level, and
will be resupplied using a top-up system.
4.2.4.2.2
Laundry processing will occur off site at the regional laundry located in
Cumberland. Soiled linen will be collected in room in small hampers,
temporarily staged in the neighborhood and consolidated in the On Floor
Holding space prior to removal to the Environmental Services component
for off-site transfer. Clean linen returning from the regional laundry will be
delivered to central receiving facilities in the Environmental Services
component before being sorted onto exchange/top-up carts and delivered
to all Inpatient Units.
4.2.4.3
Pharmaceutical Products
4.2.4.3.1
Automation will be used in the inventory management and dispensing of
patient medications. Medication rooms located within the neighbourhood
Care Hub, Stations located close to the inpatient bedrooms, will be stocked
with unit doses of patients’ medications and dispensed according to
prescribed schedules. Pharmacy personnel will be responsible for
inventory management of the medication rooms/stations, whereas nursing
personnel will deliver medications from the room/stations to the bedside.
Each LDRP will accommodate self administration of medication by mothers
in the immediate post partum period.
4.2.4.3.2
Unstable products will be prepared in the Facility’s Pharmacy component
(see DT.06), and then delivered to the inpatient unit either according to a
prescribed schedule or upon request. Product delivery will rely on a
pneumatic tube system, unless size, fragility or stability issues require
manual transport. In these latter circumstances, pharmacists or pharmacy
technicians from the Pharmacy will be responsible for product
transportation.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.2.4.3.3
4.2.4.4
Select pharmaceuticals not immediately available on the unit, will be
delivered by pneumatic tube.
Food Services
4.2.4.4.1
Food services will include a patient focused meal service approach
providing patients with the ability to make selections prior to service.
4.2.4.4.2
Food Services personnel will facilitate orders at least twice per day,
typically an hour or two in advance of lunch and supper with next day
breakfast selection facilitated along with supper selection in the midafternoon. Meals will be assembled from the central kitchen or from
pantries located on each floor. Once assembled, meals will be distributed
to inpatient units and delivered to patients at bed side by Food Services
personnel.
4.2.4.4.3
Following each meal service, all carts, trays and service ware will be
returned to the central kitchen for ware washing and sanitation.
4.2.4.4.4
Provision for after hour meals is required on the Maternity unit. Select
items will be stored on the unit and will be provided to patients following
delivery or upon request.
4.2.4.4.5
The unit must support family members who choose to bring their own food
for patients. The ability to store food in the LDRPs is required.
4.2.4.5
Waste Management
4.2.4.5.1
Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations. On
each inpatient unit, waste management is understood to begin in the
individual patient bedrooms with collection and temporary holding stations
being located on each neighbourhood (see Internal Design Criteria, “B.
Typical Inpatient Unit Organization”). Each administrative area will also
accommodate segregation of the types of waste products typically
generated in these types of spaces.
4.2.4.5.2
Segregation of wastes will accommodate the following categories of
products:
4.2.4.5.2.1
General garbage
4.2.4.5.2.2
Sharps (including potentially biohazardous items)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 4.2.5
IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
Infectious or contaminated wastes (excluding sharps)
4.2.4.5.2.4
Confidential paper
4.2.4.5.2.5
Clean paper and cardboard
4.2.4.5.2.6
Clean metal (tin and aluminum)
4.2.4.5.2.7
Clean recyclable plastics
4.2.4.5.2.8
Compostable materials
Information Management Systems
4.2.5.1
4.2.5.2
4.2.4.5.2.3
Patient Information System
4.2.5.1.1
It is anticipated that electronic technology will be used to manage more
aspects of each patient’s care. Electronic checking of patient information
(e.g., wrist band bar code), for example, will be used to validate the match
between patient and a prescribed treatment, procedure or medication. This
manner of linking the patient to the information management infrastructure
will require reliable and secured wireless access throughout the Facility.
4.2.5.1.2
All patient related information will be maintained on the electronic medical
record (EMR) system. Wireless technology will enable data entry using a
combination of fixed terminals, located close to each patient’s bedside and
at key staff workstations, and mobile pads. Access to the EMR will be
controlled electronically with varying levels of security clearance
determining a person’s access to different sections and their ability to
enter/edit data.
4.2.5.1.3
The ability to access and manage Electronic Fetal Monitoring (EFM) and
physiological monitoring is required at the unit’s Collaboration Centre and
at the Maternal/Newborn Care Hub, as well as in the nursing zone of each
LRDP. Monitoring capabilities must extend in to all areas of the unit,
including accessible outdoor areas.
4.2.5.1.4
Staffing information will be a managed corporate service. Scheduling,
including providing for sick and vacation relief will be conducted centrally,
and off-site. Notices to individual staff regarding their schedules will be
communicated electronically.
The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authority’s strategic investment in Cerner and other
clinical and business systems.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.2.5.3
The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
4.2.5.3.1
Integrated Medication Carts
4.2.5.3.2
Medication Dispense Cabinets
4.2.5.3.3
Mobile and Fixed Computer Devices – Desktop and Wall mounts
4.2.5.3.4
Mobile and Fixed Label Printers
4.2.5.3.5
Mobile and Fixed Barcode Scanners
4.2.5.3.6
Handheld Computer Devices
4.2.5.3.7
Glucometers with Docking Stations
4.2.5.3.8
Tracking Monitors – Patient, Staff, and Resource Tracking
4.2.5.3.9
Clinical Dashboards
4.2.5.3.10 Smart Beds
4.2.5.3.11 Smart Pumps
4.2.5.3.12 Device Integration for real –time clinical assessment and physiological data
documentation
4.2.5.3.13 Digital Room Signage and Way-finding
4.2.5.3.14 Interactive Patient Station
4.2.5.3.15 Location Awareness
4.2.5.3.16 Device Connectivity
4.2.5.3.17 Multifunction Communication Devices with integration to systems
4.2.5.3.18 Telehealth and Virtual Team Capabilities
4.2.5.3.19 Real Time Location System
4.2.5.3.20 Staff Safety and Duress
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.2.5.4
Inpatient Room Management System
4.2.5.4.1
4.2.5.5
Staffing
4.2.5.5.1
4.3
4.3.1
LEAN Planning Standards
Standardization of Inpatient Bedrooms
4.3.1.1.1
Each inpatient bedroom will be designed, configured, equipped and
furnished to a common standard and design. The intent of this requirement
is to facilitate staff moving from room-to-room without having to reorient
themselves with respect to frequently accessed key features like hand
wash sinks/stations, supplies storage, medical gases and suction, call
annunciator cancel buttons, ceiling lift controls, ceiling lift sling storage and
transfer belts. The inpatient patient rooms in the paediatric neighborhood
will match the design of the medical./surgical patient rooms. The LDRP
patient rooms will be standardized.
Proximity Relationships
4.3.2.1
Staffing information will be a managed corporate service. Scheduling,
including providing for sick and vacation relief will be conducted centrally,
and off-site. Notices to individual staff regarding their schedules will be
communicated electronically.
DESIGN CRITERIA
4.3.1.1
4.3.2
Infection control will be a high priority in this component’s operation. This
will require electronic scheduling between this and the Environmental
Services (See OS-STL.03) components. Each time a mother leaves an
LDRP room, terminal cleaning of that room will be required. This will apply
in cases where mothers are sent to the Surgical Services component (See
DT.04) for C-section delivery unless they are returned to the same LDRP
room. For the inpatient paediatric subcomponent, terminal cleaning of the
bedroom will be required upon discharge of the patient.
The Maternity, Newborn and Paediatric Inpatient Unit component’s location relative to
other components, or other areas of the Facility, and the nature of circulation used to
move between different components/areas are illustrated in the diagram below.
Proximities are listed according to rank; higher priorities appear above lower priorities.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.2.2
Provide Direct Access by Internal Circulation
to the Surgical Services component for the
movement of expectant mothers requiring Csection deliveries and for the movement of
mothers and neonates post procedure.
Maternity shall not be located on the main
entrance floor.
4.3.2.3
Provide Convenient Access by General
Circulation to the Pharmacy component for
the movement of staff and pharmaceutical
products.
4.3.2.4
Provide Convenient Access by General
Circulation to major public and non-public
circulation. Personnel, patients, visitors and
supplies will move frequently to/from this
component and other components in the
Facility.
Surgical Services Maternity and Newborn IPU Maternity and Newborn IPU Pharmacy Main Horizontal/ Vertical Circulation Maternity and Newborn IPU 4.3.2.5
4.3.3
A path of travel that does not cross major public zones from the Heliport to the
Maternity/Newborn Unit must be provided. Mothers and newborns are frequently
transferred out of the Facility via helicopter to alternate sites of care.
Internal Design Criteria
4.3.3.1
General Internal Layout
4.3.3.1.1
4.3.3.2
4.3.3.1.1.1
Inpatient bedroom cluster and a triage/observation/procedure area
for maternity patients will decentralized professional and general
support facilities for maternity and newborn inpatient care
4.3.3.1.1.2
Inpatient bedroom cluster and a small paediatric outpatient
treatment area, with decentralized professional and general
support facilities for paediatric care
4.3.3.1.1.3
Centralized professional support facilities, including the nursery
and a Collaboration Centre.
Inpatient Unit Organization
4.3.3.2.1
The component should be organized into 3 major areas as follows:
Planning assumes a physical organization of two physically separated
neighbourhoods; maternity and paediatrics. The nursery shall be located in
the maternity neighbourhood.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.3
4.3.3.2.2
All bedrooms will be single occupancy and will accommodate rooming in by
a spouse/partner or parent in the case of paediatric bedrooms.
4.3.3.2.3
At the Campbell River Hospital site, two (2) LDRP rooms in this component
will be designed and configured specifically for aboriginal mothers and their
newborn children. Features incorporated into these rooms will be respectful
of Aboriginal culture and will reflect their values and beliefs. When not
required for aboriginal patients, this room will be open to all maternal
admissions. These Aboriginal birthing rooms will also be used to support
bariatric patients when required.
4.3.3.2.4
At the Comox Valley site, one (1) LDRP room will be configured for use by
Bariatric Patients. The design of the designated bariatric spaces will follow
the VIHA standards for the design of Bariatric inpatient rooms.
LDRP Patient Bedrooms
4.3.3.3.1
The layout and design details of the LDRP patient bedrooms in the
Authority’s Nanaimo General Hospital is an example of a design that meets
the Authority’s operational needs. Project Co will provide a similar design
for the LDRP's in this Facility as in NRGH LDRP.
4.3.3.3.2
Four “zones” will be provided within the design of the LDRP.
4.3.3.3.2.1
A nursing zone located next to the patient bedside along the
headwall. This zone requires cabinetry and space to support
the nursing functions, including monitors, a charting
workstation, space to accommodate paper and electronic
documentation, and immediately accessible supplies.
4.3.3.3.2.2
A patient zone with built in cabinetry that conceals the
headwall, medical gases, monitors, and equipment on both
sides of the patient bed with foldaway doors. The headwall
cabinetry shall have be full height and contain full height
storage with shelves and drawers. The headwall cabinetry
shall incorporate the nursing functions (monitors and
workstation). Provide lockable full height patient belongings
storage cabinetry in each room. Provide birthing lights at the
foot of the patient bed. Align the television with the patient
bed.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.4
4.3.3.3.2.3
An infant zone with a fold down infant isolette and warmer
into cabinetry located at the footwall of the LDRP. The
isolette area shall have medical gases and sufficient space
to record observations. Provide no less than 1900mm
between the foot of the patient bed and the footwall.
Adequate space is needed to allow for a patient bed to pass
by the infant bassinet and warmer when it is folded down.
4.3.3.3.2.4
A family zone large enough for a full sized sleeper sofa and
recliner chair, with storage for a few family belongings. The
family zone in all LDRPs needs to accommodate more than
one family member. The layout and design of this area within
the Aboriginal rooms to be determined in consultation with
the User Consultation Group. A reading light, controllable
from the family zone, is required in each patient and delivery
room.
4.3.3.3.3
The handwash sink shall not block the entrance vestibule to a smaller
width than the entrance door. Provide a standing countertop no less than
1500mm in length in the room.
4.3.3.3.4
Provide a tub that is open on one side. In the Aboriginal LDRP washrooms
(Campbell River Facility), provide a tub that is open on three sides that
meets the clinical requirements for water births. Provide full height
cabinetry storage in the washroom for birthing supplies. The sink in the
washroom shall be mounted to a countertop. Provide a large edge-to-edge
mirror in the washroom above the sink countertop. Provide task lighting for
all countertops. Provide a floor drain in each LDRP toilet room. Provide
medical gases in the LRDP washrooms.
Nursery
4.3.3.4.1
Provide a large viewing window from outside the nursery for family and
visitors. Ensure that this window can be closed with integrated window
blinds for privacy. Provide independent lighting and controls for each
isolette bay. Two isolette bays shall be provided for sick babies awaiting
transport, including medical gases and a headwall. Each isolette area shall
accommodate a rocker adjacent to the isolette. Each isolette bay shall
have a privacy curtain. Provide an area accessible to the nursery for
equipment storage. Provide an area adjacent to each isolette suitable for
wall mounted equipment and accessories.
4.3.3.4.2
Designated space is required in the nursery to accommodate
respite/boarding bassinettes for all other infants in the Maternity/Newborn
neighbourhood.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.4.3
4.3.3.5
4.3.3.6
Paediatric Patient Bedrooms
4.3.3.5.1
Provide a suite of patient bedrooms that have finishes suitable for
paediatrics. Provide, in the entire suite, playful design features that create
positive distraction of patients. This area shall contain multiple colours, art
and interactive features that entertain paediatric patients. The paediatric
patient bedrooms shall be designed to match the medical/surgical patient
bedrooms. The intent is to operate them in a similar fashion.
4.3.3.5.2
The Authority intends that clinical operation of the paediatric unit will be
carried out by the Authority in a similar manner to clinical operations in the
medical/surgical inpatient units of the Authority’s Royal Jubilee Hospital
Patient Care Centre (PCC). The Authority’s clinical operations manual
(dated March 2011) for the PCC outlines how the Authority conducts
clinical operations in the PCC. Project Co is encouraged to consider the
general clinical operational concepts outlined in this manual and use those
concepts to inform the design of paediatric inpatient neighbourhood in the
Facility. A copy of this manual has been made available to Project Co.
4.3.3.5.3
For each patient bed room, a headwall is required for each patient bed,
provide two complete sets of medical gases and suction on each headwall.
Refer to Schedule 3 for the specific Medical gas requirements for each
headwall.
4.3.3.5.4
Cubicle curtains are required in all patient bed rooms to provide privacy;
curtains must provide privacy from the hallway into the patient room, even
when the door to the patient room is open. Curtains must not interfere with
clinical activities.
Paediatric Treatment Bays
4.3.3.6.1
4.3.3.7
The paediatric treatment bays shall match the patient bays in the post
anaesthetic recovery rooms PARR.
Family Zones in Inpatient Bedrooms
4.3.3.7.1
Provide four sitting/standing workstations inside the nursery. Provide a
large baby bath sink with no less than 1500mm of countertop adjacent to
the sink. Provide upper cabinets above the countertop space with
dimmable task lighting. Provide full height storage cabinets with shelves
and doors suitable for supply storage and chart storage.
Family involvement in care is supported. Accommodation within the
inpatient bedroom must be provided to allow a family member to sleep in
the patient bedroom. Locked drawer storage shall be provided to enable
family member to securely store a small number of belongings.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.7.2
4.3.3.8
It is important that the accommodation for the family be created in a
specific zone within the inpatient bedroom which minimizes the possibility
of any interference in the provision of care to the patient.
Collaboration Centre
4.3.3.8.1
4.3.3.8.2
The Central Collaboration Centre will act as the Maternity/Paediatric Unit’s
communication hub, and will accommodate a variety of functions. Its
primary function is to support the multi-disciplinary collaboration between
all care givers, including nursing, physicians, allied health personnel and
students. On the Maternity/Paediatric Unit, the Centre will be in an open
space, but acoustical attenuation and privacy is required. The Center will
not be open to the public to promote confidentiality. The primary functions
of this space are:
4.3.3.8.1.1
Dictating and reviewing charts, diagnostic images and test
results
4.3.3.8.1.2
Conducting private telephone conversations
4.3.3.8.1.3
Conducting multi-disciplinary care team discussions
4.3.3.8.1.4
Accommodation of teaching and collaboration space for
University of B.C. (UBC) Faculty of Medicine
4.3.3.8.1.5
Providing access to computer workstations and business
equipment and business supplies for the unit
4.3.3.8.1.6
Providing on-unit space for nursing management activities
4.3.3.8.1.7
This space is not intended for use by patient, families or the
public.
The Central Collaboration Centre will include the following areas:
4.3.3.8.2.1
A Central Reception/Unit Clerk desk immediately outside of
the Collaboration Centre will act as the control point for the
unit, and will be highly accessible to patients and visitors.
4.3.3.8.2.2
A Business Centre will be located in close proximity to the
Central Reception/Unit Clerk desk while providing the
appropriate segregation of business equipment for staff safety
and noise reduction within the Collaboration Centre.
4.3.3.8.2.3
The following functions will be accommodated in the Central
Collaboration space:
4.3.3.8.2.3.1 A central Conference/Huddle Area where
professional staff can conduct business and
collaborate.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.8.2.3.2 Four (4) individual workstations will be provided
for use by clinical staff. These workstations will
be in the central, open area of the Collaboration
Centre co-located with the Conference/Huddle
Area to promote collaboration.
4.3.3.8.2.3.3 Within the Maternity/Newborn and Paediatric
Inpatient Unit, the Collaboration Centre will be
open design, yet have areas within the
Collaboration Centre designed to provide
acoustically private areas where professional
staff can conduct business.
4.3.3.8.2.3.4 Collaborative Teaching Spaces and a Teaching
Room that will accommodate UBC staff. 1
workstation for use by UBC staff/trainees will be
provided in the central, open area of the
Collaboration Centre. The Teaching Room will
be a private space directly off of the central
area.
4.3.3.8.3
Close proximity between the Collaboration Centre, the Care Hubs and the
Common Support Spaces is required. The dual need for front line nurses to
be close to their patients in the neighbourhood and to be able to participate
in the Collaboration Centre must be considered in this design.
4.3.3.8.3.1
The ability for staff to visualize the care team hubs from the
huddle area of the collaboration Centre is a beneficial aspect
of enhanced patient care and staff communication. Visibility
will be provided from the Collaboration Centre into the
Neighbourhoods. Visibility will be provided from the
Collaboration Huddle Area to the Care Team sub-stations.
There is a strong preference that visibility between the
Collaboration Centre, Neighbourhoods, and Care Team
stations is not into public areas – visibility between the
huddle area and the care team hub should only be between
staff/ non-public areas.
4.3.3.8.4
The Collaboration Centre will be adjacent to the Maternity Care team hub.
4.3.3.8.5
The dual need for front line nurses to be close to their patients and to be
able to participate in the Collaboration Centre must be considered in this
design.
4.3.3.8.6
[Intentionally left blank]
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.8.7
Provide modular systems furniture for the unit’s Collaboration Centre,
including accessories and storage. The area behind all care stations shall
be suitable for business centre functions such as large printers, storage,
chart storage, and countertop space. As the Maternity/Newborn and
Paediatric inpatient unit’s Collaboration Centre has a generally open plan,
the business centre functions must be designed in a way that allows for
acoustic privacy.
4.3.3.8.8
The area shall be equipped with modular systems furniture and
accessories necessary to facilitate clinical operations.
4.3.3.8.9
Priority Access to Patients and to Collaborative Functions
4.3.3.8.9.1
4.3.3.9
Locating staff support facilities central to inpatient bedrooms will
enable staff to maintain direct visual contact with patients in their
bedrooms. This scheme provides for collaborative functions to
occur without removing nursing and other interdisciplinary staff
from close proximity to patients under their care.
Unobstructed Site Lines Between Nursing Staff and Patient Beds
4.3.3.9.1
The Collaboration Centre will be designed to support private conversations
between staff and dictation while preserving visibility to the Maternity Care
Hub. Unobstructed site lines must be provided between the Maternity Care
Hub and each LDRP. Unobstructed site lines must be provided between
the Pediatric Care Hub and the paediatric patient bedrooms and paediatric
treatment bays. Site lines will be from the hallway to the patient head.
4.3.3.9.2
The nursery (including critical care/holding and respite/boarding nursery
must have direct visual access to all positions from the maternity Care
Hub.
4.3.3.9.3
The goal of the Authority is to provide staff with unobstructed site lines from
the hallway to the head of the patient bed. Louver blinds built into doubleglazed windows in doors and/or walls shall be considered for this purpose.
4.3.3.9.4
A mandatory aspect of the design for the patient rooms will be direct
visibility for care team staff to the door of the patient room within 15m of a
Care Team Hub workstation.
4.3.3.10 Segregated Patient and Visitor Flows
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.10.1 Separate points of access/exit shall be provided for patients being
transported to/from other destinations in the Facility and for visitors.
Wayfinding signage shall clearly identify the “public” point of access/egress
and the preferred route for visitors to access the inpatient bedrooms.
4.3.3.11 Reduction of Hallway Clutter and Equipment and Supply Storage.
4.3.3.11.1 The inpatient unit design must consider mechanisms to ensure the
elimination of hallway clutter. Equipment room and supply room storage
will be designed to ensure easy access to all items stored there to prevent
the movement of these items into the hallway for access. For equipment
items stored on the unit, and in the equipment storage room, electrical
outlets must be positioned at a height which promotes ease of access
without unnecessary bending.
4.3.3.12 Component Security
4.3.3.12.1 Access to the Maternity, Newborn and the Paediatric subcomponents must
be controllable at all times, but visitors shall have unrestricted access
during regular visiting hours. This area must be accessible to authorized
personnel 24 hours-a-day, 7 days-a-week. At each point of exit from this
component, doors will automatically lock upon approach by anyone other
than people in possession of the appropriate security device (e.g.,
electronic card or fob). All neonates shall be equipped with alarm
technology to prevent unauthorized removal from this component.
Paediatric patients must be accompanied by healthcare worker, custodial
parent/guardian or authorized caregiver when leaving the inpatient unit.
4.3.3.12.2 Staff safety shall be considered during the design of this unit. The
component’s design must avoid creation of “blind corners” and must
provide adequate lighting throughout. Work areas must avoid staff isolation
and/or being equipped with appropriate call mechanisms for staff being
able to summon help. Staff facilities, including staff lounge, toilets and
change rooms shall be separate from patient areas to afford staff privacy
and to reduce the risk of staff isolation.
4.3.3.13 Non-Institutional Environment
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.13.1 All patient accessible spaces in this component, and especially the LDRP
rooms, shall be designed, finished and furnished to reflect a home-like
environment. Furniture fixtures, and equipment will have a similar aesthetic
appearance as items provided in the patients home. The experience
conveyed to patients accommodated here shall be one of “hoteling” as
opposed to being institutionalized. Achieving this criterion will require:
4.3.3.13.1.1
Application of contemporary wall colours, floor finishes and
window treatments that will also comply with infection control
specifications
4.3.3.13.1.2
Display of artwork that will be relevant to the patient
population (i.e., mothers and children) and to their families
4.3.3.13.1.3
Installation of residential-type furniture as opposed to officelike or technical furniture, and the installation of furniture
scaled for children where applicable
4.3.3.13.1.4
Views to the outside and to natural landscapes and the
installation of operable windows are required in each patient
room.
4.3.3.13.1.5
Opportunities for patients and their families to move from
inpatient bedrooms to other amenities (e.g., lounge space)
without having to transit technical space or space that is
obviously devoted to medical/surgical procedures.
4.3.3.13.1.6
Opportunities for patients to choose the extent to which they
will integrate or segregate from the rest of the patient
population.
4.3.3.13.1.7
Provide Convenient Access to an outdoor area or shared
courtyard for maternity and paediatric patients. A dedicated
Maternity courtyard/outdoor space may be developed in the
future, however immediate access to a courtyard/outdoor
area is required. A door is required from the maternity unit
to any future courtyards which may be developed to support
the Maternity component.
4.3.3.14 Paediatric-Friendly Environment
4.3.3.14.1 All designated ‘paediatric’ spaces in this component must be designed,
configured and scaled for children. Furniture will be sized to for the
spectrum of ages to be accommodated here, ranging from infants to
teenagers. Wall treatments and displayed artwork must be appealing to
children and help in creating a non-institutional or homelike environment.
4.3.3.14.2 Strategic use of alcoves, cabinetry and closet will reduce the visibility of
technology which can be intimidating to children.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.15 Lighting
4.3.3.15.1 There will be a variety of lighting options in this component, each suited to
the functions accommodated in a specified space.
4.3.3.15.2 Each inpatient room must have access to natural lighting and views to the
outside.
4.3.3.15.3 Each inpatient bedroom requires an exam light to provide enhanced
lighting during intravenous insertions, wound care, etc.
4.3.3.15.4 Artificial lighting throughout the inpatient units shall follow a general
standard of providing “non-direct” lighting. This specification implies fixtures
that reflect light upwards, away from direct eye contact, and especially in
those areas where patients will be either in bed or transported on
stretchers.
4.3.3.15.5 Artificial lighting in each inpatient room must be variable to provide different
levels of lighting and for different purposes. At night time, patients will have
the ability to read while in their bed. In the case of double occupancy
rooms, this specification requires that lighting at one bed not substantially
affect lighting conditions at the other. Lighting in the room must also
accommodate staff’s ability to monitor the patient during the night without
affecting the patient’s ability to sleep.
4.3.3.15.6 Obstetric lights must be located above each patient bed in each LDRP.
These lights must be adjustable/articulated, of variable intensity and
located towards the foot end of the bed.
4.3.3.15.7 Artificial lighting in the administrative and support areas must be variable to
accommodate different levels of ambient lighting commensurate with the
functions ongoing at any one time in that space. Individual workstations
must be provided with task lighting.
4.3.3.15.8 The family zone within each inpatient bedroom requires a reading light,
with controls able to be reached from the sleeping accommodation.
4.3.3.16 Sound Proofing
4.3.3.16.1 Noise containment will be a priority in this component. The maternity and
newborn portion must be acoustically isolated from the paediatric portion.
In the maternity and newborn area, each LDRP must be acoustically
isolated from each other and from the adjoining corridors.
4.3.3.17 Operable Windows
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.17.1 Each inpatient room must have windows that provide access to exterior
views, and preferably to views of predominantly landscape versus
buildings. A portion of each window in each patient room must be operable
providing access to fresh, outdoor air, the ability to conduct Aboriginal
ceremonies, especially end of life ceremonies.
4.3.3.17.2 The intent of this requirement is to respect multicultural attitudes and
beliefs. In some cultures, immediate exterior access from interior spaces is
a requirement for both in-life and after-life experiences. An additional
benefit of this feature is allowing patients a choice in environmental
condition that they would ordinarily enjoy in their own homes.
4.3.3.18 Rooming In
4.3.3.18.1 Planning assumes that at least one other person, in addition to mothers
and neonates, will occupy each LDRP for a portion of the mother’s stay.
Within the Aboriginal LDRP’s (Campbell River Facility), space is required to
accommodate more than one person supporting the birthing process. The
size of the family zone will be determined during User Consultation Group .
Accommodation of the supporting person’s “hotel” needs will be met using
combination sofa/fold-out bed furniture. Inpatient bedrooms will be sized to
accommodate this flexible arrangement.
4.3.3.19 Inpatient Room Utilities
4.3.3.19.1 Each inpatient room in this component will be supplied with the standard
set of medical gases, suction. Nitrous oxide will be included in the LDRPs.
To promote a homelike atmosphere, the medical gases will be enclosed in
the LDRP bedrooms.
4.3.3.20 Ergonomics for an Aging Workforce
4.3.3.20.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff is required to
use. Ease of access will be among the key criteria. In the inpatient
bedrooms, this specification will be reflected in electrical outlets being
located both a floor level for low pull items e.g. power for beds, specialty
mattresses, etc., plus electrical outlets located for easy access above the
floor surface (approximately 3 feet) for high pull items such as intravenous
pumps. The type and number of electrical devices used in the rooms is
expected to increase, and the combination of outlets at floor surface and
elevated outlets will minimize repetitive bending, while assisting with
electrical cable management.
4.3.3.21 Accommodation of Bariatric Patients
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.21.1 Numbers of bariatric patients admitted to hospital are projected to increase.
Managing these patients will require features enabling for both patients and
staff. Doorways and circulation spaces must be sufficiently wide to
accommodate large people, many of whom will be relying on mobility
assistance including motorized chairs and scooters. Doorways must be a
minimum of 1120 mm (approximately 3’ 8”) in width. The reference to
circulation spaces applies especially in confined rooms like water closets.
The design of the unit must follow the VIHA standards for Bariatric patient
rooms and associated services.
4.3.3.21.2 Bariatric patients often require assistance getting into and out of bed. The
patient lift system will allow patient pick up from all areas of the room
including the bathroom for toileting, showering and to the sink (refer to
Schedule 3 for technical requirements).
4.3.3.22 Inducements for Patient Ambulation
4.3.3.22.1 Early patient discharge has been shown to benefit the sooner patients
become mobile and the more they engage in gentle exercise like simple
walking. Features shall be incorporated throughout the component that
encourages ambulation either with or without assistance. Handrails must
be installed around the perimeter of each paediatric bedroom and within
the toilet room, providing grab support during movement within the room
and to the toilet.
4.3.3.22.2 Folding grab rails will be installed on both sides of each patient toilet, and
the door leading separating the ensuite water closet from the rest of the
inpatient room must be a “barn door” style door installation, as opposed to
swing.
4.3.3.22.3 Corridors typically accessed by inpatients will have handrails installed on
both sides. Short breaks between handrails are permissible to allow for
doorways, fire extinguishers, etc. Handrail heights will be 860 – 920 mm
(approximately 3’) above floor surface.
4.3.3.22.4 Corridors typically accessed by patients shall provide opportunities for brief
rest. Chairs of varying height will be placed in recessed alcoves in the
walls along one side of the hallway created for this purpose, located at
intervals of not more than 9000 mm (approximately 30’).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.22.5 General patient/public lounges located in this component shall be inviting
and accessible by all patients at any time. Natural lighting, views to the
outside and opportunities for light recreation and entertainment shall be
considered as these features can provide motivation for patients to leave
their rooms. Electrical outlets at both floor surface level and at about 3 feet
above the floor surface are to be provided to support power requirements
of intravenous pumps and other electrical devices patients must utilize
while in these rooms.
4.3.3.23 Isolation Capabilities
4.3.3.23.1 Some patients admitted to hospital will have needs for isolation. The nature
of this isolation can prevent against the spread of airborne infections,
requiring a room with negative airflow/pressurization. At least 1 LDRP
bedroom and 1 paediatric bedroom must have full airborne isolation
capabilities. Isolation rooms will be serviced by an anteroom supplied with
hand hygiene sink, PPE dispenser and garbage containment.
4.3.3.23.2 All ante rooms shall be to the side of each patient bedroom and not in front
of the patient bedroom. Ante rooms shall not form a vestibule in front of the
patient bedroom. The patient entrance to each isolation room shall be
directly onto the corridor. There shall be a window from the ante room into
the isolation patient bedroom.
4.3.3.24 Infection Control Features
4.3.3.24.1 Hand hygiene sinks will be installed in each area where physical contact
with patients occurs. Sinks should be located in the entry to every patient
room with clear sight lines to head of patient bed. Sinks must be orientated
to prevent inadvertent splashing onto nearby equipment. Hand hygiene
sinks should be of hands free operation.
4.3.3.24.2 Installation of hand sanitizer dispensers should be placed on either side of
patient bed to support VIHA’s hand hygiene policy.
4.3.3.24.3 All furniture, fixtures and equipment used in this component should be
fabricated using smooth, non porous materials that are capable of being
decontaminated with hospital grade disinfectants. Their shapes should
allow for easy cleaning around all sides and should be free of inaccessible
spaces.
4.3.3.24.4 Cabinetry and equipment used in inpatient units must be able to withstand
frequent and consistent cleaning using hospital-grade products.
4.3.3.24.5 A nourishment station located in this component must be capable of being
closed during and outbreak or contamination event. A separate hand
hygiene sink must be supplied in addition to a utility sink.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.3.24.6 Increases electronic technology increases the number of interfaces
between patients and technical devices. All equipment used in this
component that comes into contact with patients must be able to withstand
frequent and consistent cleaning using hospital-grade products.
4.3.3.25 Entrance-Focused Amenities
4.3.3.25.1 An alcove immediately inside each patient room must be located to
accommodate features considered to be universal requirements. The
alcoves will include the following items in these alcoves:
4.3.3.25.1.1
Hand wash sink for use of staff and visitors entering or leaving the
room
4.3.3.25.1.2
Patient server cabinets for en-suite storage of supplies, clean linen
and waste/soiled linen receptacles
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 4.3.4
IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
Component Functional Diagram
4.3.4.1
The areas making up this component shall be organized as illustrated in the following
diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
4.3.5
Space Table
4.3.5.1
The schedule accompanying this document illustrates zones, rooms, and their
respective sizes, that combine to make up this functional component. Refer to the
respective space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM ID
(RID)
ROOM TYPE
IP.03 Maternity and Newborn Inpatient Unit
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
Floor/Unit Entrance/Common Support Area - 1 Typical Area - Provides support to 1, 17/18-bed nursing sub-unit
combinations
01 Waiting Area/ Reception
Seating for up to 4-6, Television viewing
12.0
1
area, Fireplace
02 Sun Room
Multipurpose when available will function
15.0
1
as a meeting room- Locate adjacent to
Public Corridor
03 Toilet, Public, Male/Female
6.0
1
Collaborative Centre
04 Care Team Station - Central
05 Care Hub Workstations
06 Conference / Huddle 07 UBC Teaching Area
08 Collaborative Teaching/ UBC
Space - Trainee Workstations
09
Business Centre
10
[RID intentionally left blank]
11
Office, First Line Leader
12
Office, Healthy Beginnings
Unit Support
13 On Floor Holding
14
On Floor Food Service/Galley
15
Staff/ Lounge
16
17
Toilet, Staff
Housekeeping Room
One Workstation
Standard workstations
TOTAL
SIZE
(nsm)
12.0
15.0
6.0
4.0
3.0
8.0
12.0
2.0
1
4
1
1
1
4.0
12.0
8.0
12.0
2.0
6.0
1
6.0
-
-
-
10.0
1
10.0
10.0
1
10.0
12.0
1
12.0
18.0
1
18.0
15.0
1
15.0
6.0
6.0
1
1
6.0
6.0
Common Floor Support Area
154.0
Carrel w/ computer terminal
Accommodates business equipment and
supplies, - Temporary chart holding area
Multipurpose work area, files storage Accommodates meetings with up to 2
people
Healthy Beginnings Program
On floor holding for trash, soiled linen and
recyclables
Supports food services for 1, Electrical
service for food service delivery carts or
microwave ovens (Contingent upon food
service delivery model adopted)
Seating for up to 10 people - Kitchenette
w/ counter, sink, microwave oven, half
size refrigerator
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage - Shared by 1,
17/18-bed sub-unit combinations
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
COMOX VALLEY HOSPITAL
ROOM ID
(RID)
ROOM TYPE
Maternity and Newborn Patient Care Area
18 Triage/Observation/
Examination Room
19
Labour/Procedure Room
20
Nurse Sub-Station/ Observation
Alcove
21
22
23
Toilet Room, Patient
Alcove, Clean Linen
Patient Room, LDRP
24
Vestibule/Anteroom
25
Toilet/Shower/Tub Room,
Patient
26
27
Patient Room, LDRP
Toilet/Shower/Tub Room,
Patient
Care Team Hub
28
29
30
Care Hub Workstations
Medication Room
Utility Room, Clean
31
32
Utility Room, Soiled
Nourishment Station
33
Alcove, Equipment
34
35
36
Alcove, Equipment
Respite/ Boarding Nursery
Critical Care/ Holding Nursery
Paediatric Patient Care Area
37 Treatment Bays
38 Procedure Room
39
Toilet Room, Patient
IP.03 Maternity and Newborn Inpatient Unit
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
11.0
1
11.0
11.0
1
11.0
3.0
1
3.0
6.0
2.0
30.0
1
1
8
6.0
2.0
240.0
6.0
1
6.0
7.0
8
56.0
32.0
8.0
1
1
32.0
8.0
3.0
12.0
12.0
4
1
1
12.0
12.0
12.0
12.0
3.0
1
1
12.0
3.0
2.0
4
8.0
1.0
3.0
4.0
2
5
2
2.0
15.0
8.0
Subtotal, Maternity and Newborn Patient Care Area
459.0
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Enclosed room w/ 1 patient position Counter w/ sink - Storage cabinetry Direct visual access from Nurse SubStation
Accommodates fetal non-stress testing
(NST) - Includes area for stretcher or 2
recliners, counter w/ sink
ROOM
SIZE
(nsm)
Supports Triage/ Observation bays
1 patient bed - Isolation capability for 1 Sized to allow for family
participation/visiting - Counter w/ sink Area for neonate stabilization - rooms to
be serviced for negative pressure isolation
Entry alcove for gowning - Counter w/
hand washing sink - Can be left open
when isolation not required
1 assisted WC, 1 sink, 1 assisted
shower/tub unit - Showers to use handheld shower heads w/ adjustable jets
Bariatric Room
Locate directly adjacent to Collaborative Centre
Standard workstations
Accommodation for up to 3 carts - Counter
- Separate linen holding area
Ice machine - Counter w/ sink, microwave
oven - Half size refrigerator - Storage
cabinetry
Procedure Carts- Epidural Cart, Neonatal
Cart, Airway/ Resuscitation Cart
Baby Warmer, Baby Scale
Patient holding/ Observation bays
Include med-gases, locate adjacent to
observation bays
1 assisted WC, 1 sink
7.0
12.0
2
1
14.0
12.0
6.0
1
6.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
COMOX VALLEY HOSPITAL
ROOM ID
(RID)
40
IP.03 Maternity and Newborn Inpatient Unit
Patient Bedroom
41
Anteroom Isolation
42
Toilet/Shower Room
ROOM
SIZE
(nsm)
20.0
NUMBER
OF
ROOMS
6
TOTAL
SIZE
(nsm)
120.0
6
1
6.0
6
6
36.0
Standard workstations
Holding space only, different size and
functions than standard room
3.0
8.0
4
1
12.0
8.0
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
1 patient bed w/ wardrobe, supply cabinet
and hand washing sink at entrance Isolation capability - Sized to allow for
family participation/ visiting - 1 room to be
serviced for negative pressure isolation
Entry alcove for gowning - Counter w/
hand washing sink - Can be left open
when isolation not required
1 assisted WC, 1 sink, 1 assisted shower
Care Team Hub
43 Care Hub Workstations
44 Medication Room
45
Utility Room, Clean
Holding space only, different size and
functions than standard room
8.0
1
8.0
46
Utility Room, Soiled
Holding space only, different size and
functions than standard room
8.0
1
8.0
47
Nourishment Station
2.0
1
2.0
48
49
Alcove, Equipment
Multipurpose Room, Paediatric
Play Area
Ice machine - Counter w/ sink, microwave
oven - Half size refrigerator - Storage
cabinetry
Portable equipment
Education/play area for paediatric
inpatients
2.0
10.0
2
1
4.0
10.0
Subtotal, Paediatric Patient Care Area
246.0
Administrative and Staff Support Area
50 Alcove, Resuscitation
Equipment
51 Storage , Equipment
52 On-Call Room
53
Toilet, Staff
55
Shower
One Adult and One Peds
2.0
2
4.0
15.0
9.0
6.0
2.0
1
1
1
1
15.0
9.0
6.0
2.0
Subtotal, Administrative and Staff Support Area
36.0
TOTAL NSM, ALL AREAS
895.0
1 standard bed w/ side tables - Lockable
1 assisted WC, 1 sink
Assisted
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM ID
(RID)
ROOM TYPE
IP.03 Maternity and Newborn Inpatient Unit
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
Floor/Unit Entrance/Common Support Area - 1 Typical Area - Provides support to 1, 17/18-bed nursing sub-unit
combinations
01 Waiting / Reception
Seating for up to 4-6, Television viewing
12.0
1
area, Fireplace
02 Sun Room
Multipurpose when available will function
15.0
1
as a meeting room- Locate adjacent to
Public Corridor
03 Toilet, Public, Male/Female
6.0
1
Collaborative Centre
04 Care Team Station - Central
05 Care Hub Workstations
06 Conference / Huddle
07 UBC Teaching Area
08 Collaborative Teaching/ UBC
Space - Trainee Workstations
09
Business Centre
10
[RID intentionally left blank]
11
Office, First Line Leader
12
Office, Healthy Beginnings
Unit Support
13 On Floor Holding
14
On Floor Food Service/Galley
15
Staff/ Lounge
16
17
Toilet, Staff
Housekeeping Room
Maternity and Newborn Patient Care Area
18 Triage/Observation/
Examination Room
19
Labour/Procedure Room
One Workstation
Standard workstations
TOTAL
SIZE
(nsm)
12.0
15.0
6.0
4.0
3.0
8.0
12.0
2.0
1
4
1
1
1
4.0
12.0
8.0
12.0
2.0
6.0
1
6.0
-
-
-
10.0
1
10.0
10.0
1
10.0
12.0
1
12.0
18.0
1
18.0
15.0
1
15.0
6.0
6.0
1
1
6.0
6.0
Common Floor Support Area
154.0
Carrel w/ computer terminal
Accommodates business equipment and
supplies - Temporary chart holding area
Multipurpose work area, files storage Accommodates meetings with up to 2
people
Healthy Beginnings Program
On floor holding for trash, soiled linen and
recyclables
Supports food services for 1, Electrical
service for food service delivery carts or
microwave ovens
Kitchenette w/ counter, sink, microwave
oven, half size refrigerator
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage - Shared by 1,
17/18-bed sub-unit combinations
Enclosed room w/ 1 patient position Counter w/ sink - Storage cabinetry Direct visual access from Nurse SubStation
Accommodates fetal non-stress testing
(NST) - Includes area for stretcher or 2
recliners, counter w/ sink
11.0
1
11.0
11.0
1
11.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
CAMPBELL RIVER HOSPITAL
ROOM ID
(RID)
ROOM TYPE
20
Nurse Sub-Station/ Observation
Alcove
21
22
23
Toilet Room, Patient
Alcove, Linen
Patient Room, LDRP
24
Anteroom Isolation
25
Toilet/Shower/Tub Room,
Patient
26
27
28
Patient Room, LDRP- Aboriginal
Aboriginal Family Room
Toilet/Shower/Tub Room,
Patient
Care Team Hub
29 Care Hub Workstations
30 Medication Room
31 Utility Room, Clean
32
33
Utility Room, Soiled
Nourishment Station
34
Alcove, Equipment
35
36
37
Alcove, Equipment
Respite/ Boarding Nursery
Critical Care/ Holding Nursery
Paediatric Patient Care Area
38 Treatment Bays,
39 Procedure Room
40
41
Toilet Room, Patient
Patient Bedroom
42
Anteroom Isolation
43
Toilet/Shower Room
IP.03 Maternity and Newborn Inpatient Unit
ROOM
SIZE
(nsm)
3.0
NUMBER
OF
ROOMS
1
TOTAL
SIZE
(nsm)
3.0
6.0
2.0
30.0
1
1
5
6.0
2.0
150.0
6.0
1
6.0
7.0
5
35.0
32.0
5.0
8.0
2
2
2
64.0
10.0
16.0
Locate directly adjacent to Collaborative Centre
Standard workstations
3.0
12.0
Accommodation for up to 3 carts - Counter
12.0
- Separate linen holding area
4
1
1
12.0
12.0
12.0
12.0
3.0
1
1
12.0
3.0
2.0
4
8.0
1.0
3.0
4.0
2
5
2
2.0
15.0
8.0
Subtotal, Maternity and Newborn Patient Care Area
398.0
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Supports Triage/ Observation bays
1 patient bed - Isolation capability for 1 Sized to allow for family
participation/visiting - Counter w/ sink Area for neonate stabilization - rooms to
be serviced for negative pressure isolation
Entry alcove for gowning - Counter w/
hand washing sink - Can be left open
when isolation not required
1 assisted WC, 1 sink, 1 assisted
shower/tub unit - Showers to use handheld shower heads w/ adjustable jets
Aboriginal Cultural Support for Births
1 assisted WC, 1 sink, 1 assisted
shower/tub unit - Showers to use handheld shower heads w/ adjustable jets
Ice machine - Counter w/ sink, microwave
oven - Half size refrigerator - Storage
cabinetry
Procedure Carts -Epidural Cart, Neonatal
Cart, Airway/ Resuscitation Cart
Baby Warmer, Baby Scale
Patient holding/ Observation bays
Include med-gases, locate adjacent to
observation bays
1 assisted WC, 1 sink
1 patient bed w/ wardrobe, supply cabinet
and hand washing sink at entrance Isolation capability - Sized to allow for
family participation/ visiting - 1 room to be
serviced for negative pressure isolation
Entry alcove for gowning - Counter w/
hand washing sink - Can be left open
when isolation not required
1 assisted WC, 1 sink, 1 assisted shower
7.0
12.0
2
1
14.0
12.0
6.0
20.0
1
3
6.0
60.0
6
1
6.0
6
3
18.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.03
MATERNITY, NEWBORN AND PAEDIATRIC INPATIENT UNIT
CAMPBELL RIVER HOSPITAL
ROOM ID
(RID)
ROOM TYPE
Care Team Hub
44 Care Hub Workstations
45 Medication Room
IP.03 Maternity and Newborn Inpatient Unit
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
Standard workstations
Holding space only, different size and
functions than standard room
3.0
8.0
2
1
6.0
8.0
46
Utility Room, Clean
Holding space only, different size and
functions than standard room
8.0
1
8.0
47
Utility Room, Soiled
Holding space only, different size and
functions than standard room
8.0
1
8.0
48
Nourishment Station
2.0
1
2.0
49
50
Alcove, Equipment
Multipurpose Room, Paediatric
Play Area
Ice machine - Counter w/ sink, microwave
oven - Half size refrigerator - Storage
cabinetry
Portable
Education/play area for paediatric
inpatients
2.0
10.0
2
1
4.0
10.0
2.0
2
4.0
12.0
9.0
6.0
2.0
1
1
1
1
12.0
9.0
6.0
2.0
Subtotal, Administrative and Staff Support Area
TOTAL NSM, ALL AREAS
195.0
747.0
Administrative and Staff Support Area
51 Alcove, Resuscitation
Equipment
52 Storage , Equipment
53 On-Call Room
54
Toilet, Staff
55
Shower
One Adult and One Peds
Include power and data outlets
1 standard bed w/ side tables - Lockable
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
This specification outlines the functional, operational and physical requirements for the Psychiatry
Inpatient Unit functional component at the Comox Valley Facility.
5.1
5.1.1
5.1.2
FUNCTIONAL DESCRIPTION
Statement of Purpose
5.1.1.1
The Psychiatric Inpatient Unit exists for the purposes of patient-centered care for those
in the Authority’s north island catchment area with mental illness and/or addiction, and
who require admission to a specialized acute psychiatric care environment. The unit
will focus on providing the highest quality of individualized care possible, using the
Authority’s values each and every step along the way. Measures to prevent infection
and/or control the spread of infection are an expectation of safe care.
5.1.1.2
The intent is to provide as home-like an atmosphere as possible, with attention given to
providing the necessary services in as unobtrusive way as possible. Sub-units within
the inpatient unit will be referred to as “neighbourhoods” and inpatient rooms as
inpatient “bedrooms”.
Scope of Services
5.1.2.1
Functional Content
5.1.2.1.1
5.1.2.1.1.1
An Psychiatric Inpatient unit (PIU) with 11 open unit beds, and two
non census seclusion rooms
5.1.2.1.1.2
A Psychiatric Intensive Care Unit (PICU) with 4 beds, each bed
meeting current seclusion room standards.
5.1.2.1.2
Functionally, this component has two distinct patient care areas, each
having locked access and each with significant focus on the safety and
security of both patients and staff:
The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
5.1.2.1.2.1
Receiving patients either through the facility’s “front door” or the
ED (AC.01) followed by a holistic model of assessing and
monitoring each patient’s condition from a physical, functional and
psychiatric perspective
5.1.2.1.2.2
Use seclusion when assessed as necessary for clients of this
service
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
5.1.2.1.2.3
Diagnosing, stabilizing and providing intensive behavioural health
treatment for acutely ill adult or adolescent individuals, most of
whom suffer from major mental disorders, and prepare them for
discharge to a community setting
5.1.2.1.2.4
Providing intensive behavioural care for the most acutely ill
patients in a designated PICU
5.1.2.1.2.5
Accommodating for adolescent admissions using facilities and
processes allowing for segregation from the main patient
population
5.1.2.1.2.6
Conducting consultations and therapy sessions between patients
and family members, as appropriate, and members of their
interdisciplinary health care team
5.1.2.1.2.7
Enabling large and small group work to occur simultaneously
5.1.2.1.2.8
Providing individual and group therapy, pharmacotherapy, ECT
(this therapy is provided in Surgical Services (DT.04)),
occupational, physiotherapy and recreational therapy
5.1.2.1.2.9
Facilitating patients’ access to diagnostic and treatment services
located elsewhere in the Facility
5.1.2.1.2.10
Refeeding therapy with nutritional support, including nasogastric
feeding
5.1.2.1.2.11
Delivering medications orally, topically, intravenously or by
injection, according to each patient’s scheduled or immediate
needs.
5.1.2.1.2.12
Conducting discharge planning including activation focusing on
returning the patient to their highest level of functioning and
assembling the appropriate set of community-based and outpatient
resources to enable continuity in care beyond hospitalization
5.1.2.1.2.13
Conducting shift reports and participating in interdisciplinary team
conferences
5.1.2.1.2.14
Documenting each patient’s progress and health status using an
electronic medical record (EMR)
5.1.2.1.2.15
Addressing each patient’s nutritional needs by providing meals in a
residential, family-style dining setting in each patient care area,
and by providing nutritional counselling
5.1.2.1.2.16
Educating patients and lay members of their support network
5.1.2.1.2.17
Providing design and specific supports to ensure the control of
infection
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
5.1.2.2
5.1.2.1.2.18
Providing assistance to patients’ personal needs as necessary
(e.g., feeding and maintaining hygiene)
5.1.2.1.2.19
Laundering of patients’ personal clothing
5.1.2.1.2.20
Accommodating participation by lay members of a patient’s
support network in providing care
5.1.2.1.2.21
Providing respite and relaxation opportunities for both patients and
their visitors
5.1.2.1.2.22
Managing all functions conducted in the unit including scheduling
and managing staff, controlling inventories of consumable
supplies, scheduling rounds, conducting service quality
evaluations, maintaining standards of maintenance and cleanliness
in all areas of the inpatient unit and communicating with staff on
facility-wide and professional topics
5.1.2.1.2.23
Supporting administrative functions of a Mental Health Team
whose role may include delivering non-crisis support to patients in
any part of the Facility, and who are experiencing acute episodes
of mental health or addictions problems
5.1.2.1.2.24
Conducting private interviews in space separate from the patients’
bedrooms
Exclusions
5.1.2.2.1
5.1.2.3
The following list specifies functions that involve either patients or staff
normally present on the PIU, but are understood to occur in other
functional components in the facility or outside of the facility:
5.1.2.2.1.1
Pediatric psychiatry
5.1.2.2.1.2
Electro-convulsive therapy – (DT.04 Surgical Services)
5.1.2.2.1.3
Clients with dementia complicated by other medical issues (IP.01
Medical Surgical Inpatient Units)
5.1.2.2.1.4
Short term secured holding of emergency patients (AC.01
Emergency Department)
5.1.2.2.1.5
Activities of daily living (ADL) kitchen assessment and training
(DT.05 Therapy Services)
5.1.2.2.1.6
Forensic psychiatry
5.1.2.2.1.7
Large and/or formal educational lectures (OS-GP.01 Central
Education and Conference Facilities)
Anticipated Trends in Service Delivery
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
5.1.2.3.1
5.1.3
5.2.1
Increasing numbers of patients with addictions and mental
disorders (concurrent disorders)
5.1.2.3.1.2
Increasing patient acuity and complexity and potential for
aggression (e.g. brain injured younger people from trauma or
substance abuse)
5.1.2.3.1.3
Increasing numbers of bariatric patients admitted to hospital is
predicted to increase.
5.1.2.3.1.4
Increasing mean age of staff working on the inpatient units is
predicted to increase.
5.1.2.3.1.5
Increasing shortages of key staff positions are predicted to
increase, including staff in the highly trained, specialized
professions.
5.1.2.3.1.6
Continuing need to focus on infection control is predicted to remain
an ongoing challenge in all areas of the facility.
5.1.2.3.1.7
Increasing recognition of need for informed care
5.1.2.3.1.8
Redesigning service delivery to meet the needs of aboriginal and
metis patients
Medical and nursing students and students in the allied health professions from
technical colleges and universities will receive practical skills training through
internships and co-op programs. All teaching and supervision functions will be
accommodated in the general work areas, and will not require specialized or dedicated
facilities in this component.
Scope of Research Functions
5.1.4.1
5.2
5.1.2.3.1.1
Scope of Education Functions
5.1.3.1
5.1.4
The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
Staff and students working in the inpatient units will, from time-to-time, be engaged in
research. The nature and extent of research functions will be accommodated in the
general work areas.
OPERATIONAL DESCRIPTION
Hours of Operation
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
5.2.1.1
The component at this facility will be staffed and in operation:
5.2.1.1.1
5.2.1.2
The component will have regular visiting hours:
5.2.1.2.1
5.2.2
5.2.3
24 hours-a-day, 7 days-a-week
0900 – 2100, 7 days-a-week
People Management Systems
5.2.2.1
Most patients admitted to this component will arrive from the ED (AC.01). Patients will
be admitted under the Hospital Act or the Mental Health Act. The typical patient will be
ambulatory, and will be escorted by family members, care givers or, in extreme cases,
by police or protection services personnel. For patients held in the ED’s secure holding
facilities prior to their arrival here, registration and documentation will have been started
or completed in the ED. All other patients will be documented upon arrival. Arrival will
also coincide with medical and nursing assessments to determine the appropriate level
of care required. Admission will be to either the PICU or the PIU. Once admitted each
patient’s movements will be monitored and exit from the component will be restricted.
Depending on the needs of the patient and the staff, there may be a need to control or
restrict inpatient activity.
5.2.2.2
All visitors to the PIU will have access through a securable entrance that has direct
visual control from the component’s main Collaboration Centre.
Materiel Management Systems
5.2.3.1
The design of the unit shall minimize the need for support and maintenance staff to
access patient areas. The flow of support services and patients and clinical staff shall
be separated to the greatest extent possible. Support services, staff processes and
space shall have adequate safety and security to ensure patients cannot access
harmful materials or objects.
5.2.3.2
Consumable Supplies
5.2.3.2.1
Inventories of consumable supplies will be maintained within the Common
Support Area. . Items shall be maintained with minimum inventory levels
triggering a re-ordering process. Most supplies will be stored either in bins
or on top-up carts.
5.2.3.2.2
All supplies stores will be inaccessible to patients and to the public.
5.2.3.2.3
Inventories on top-up carts will be generally maintained according to
prescribed delivery schedules by either Environmental Services (OSSTL.03) or Materiel Management (OS-STL.05).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
5.2.3.2.4
5.2.3.3
5.2.3.4
5.2.3.5
Most supply ordering will be sent electronically to and processed through
the Facility’s Materiel Management component, but provision will be made
for staff to work directly through approved vendors on securing specialty or
infrequently ordered items.
Linen
5.2.3.3.1
Inventories will be managed according to a minimum 3-days supply reorder
level, and will be resupplied using a top-up system.
5.2.3.3.2
Laundry, for patients’ non-personal items, processing will occur off site at
the regional laundry located in Cumberland. Soiled linen will be collected in
room in small hampers, temporarily staged in the neighborhood and
consolidated in the On Floor Holding space prior to removal to
Environmental Services for off-site transfer. Clean linen returning from the
regional laundry will be delivered to central receiving facilities in
Environmental Services (OS-STL.03) before being sorted onto
exchange/top-up carts and delivered to the PIU.
5.2.3.3.3
Linen will include items specific to this population- such as Velcro house
coats/pajamas, etc.
5.2.3.3.4
On unit laundry facilities, consisting of a heavy-duty domestic type washer
and dryer to use for laundering personal clothing is considered essential.
Pharmaceutical Products
5.2.3.4.1
Automation will be used in the inventory management and dispensing of
patient medications. The medication room for this inpatient unit shall be
located within the Collaboration Centre and must be easily accessible by
both PIU and PICU staff. The medication room will contain medication
carts which will be stocked with unit doses of patients’ medications and
dispensed according to prescribed schedules or as required. Pharmacy
personnel will be responsible for inventory management of the medication
rooms and their associated medication carts, whereas nursing personnel
will deliver medications from the medication room to the patient.
5.2.3.4.2
Unstable products will be prepared in Pharmacy (DT.06), and then
delivered to the PIU either according to a prescribed schedule or upon
request. Product delivery will rely on a pneumatic tube system, unless size,
fragility or stability issues require manual transport. In these latter
circumstances, pharmacists or pharmacy technicians from Pharmacy will
be responsible for product transportation.
Food Services
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5.2.3.6
5.2.3.5.1
Food services will include a patient focused meal service approach
providing patients with the ability to make selections prior to service. Food
will be assembled from the food service galley on each floor and once
assembled will be set out for “family style dining” by Food Services
personnel or, in the case of patients in PICU or in seclusion, delivered by
psychiatry unit staff to inpatient bedrooms.
5.2.3.5.2
Following each meal service, all carts, trays and service ware will be
returned to the central kitchen for ware washing and sanitation.
Waste Management
5.2.3.6.1
Waste products will be generally managed according to a system of
segregation at point of origin and sequential consolidation. Operation of
this system will rely on appropriate containment facilities for each type of
waste product beginning at where the waste is generated followed by
similar, but progressively larger, containment facilities at key collection
locations. In the PICU and the PIU, waste management is understood to
begin in the individual inpatient bedrooms with collection and holding
stations located in the common support area. Administrative areas will
also accommodate segregation of the types of waste products typically
generated in these types of spaces.
5.2.3.6.2
Segregation of wastes will accommodate the following categories of
products:
5.2.3.6.2.1
General garbage
5.2.3.6.2.2
Sharps (including potentially biohazardous items)
5.2.3.6.2.3
Infectious or contaminated wastes (excluding sharps)
5.2.3.6.2.4
Confidential paper
5.2.3.6.2.5
Clean paper and cardboard
5.2.3.6.2.6
Clean metal (tin and aluminum)
5.2.3.6.2.7
Clean recyclable plastics
5.2.3.6.2.8
Compostable materials
5.2.3.6.3
5.2.4
A secure soiled utility room, for the containment of soiled items and trash
will be required on the unit. The soiled utility room will be accessible by
staff only.
Information Management Systems
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5.2.4.1
All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, at staff workstations in the common support area, and mobile pads. Access
to the EMR will be controlled electronically with varying levels of security clearance
determining a person’s access to different sections and their ability to enter/edit data.
5.2.4.2
To meet requirements of the Mental Health Act; each client will be required to have
some paper based health records. Storage for theses records will be provided within
the unit, in a secured area only accessible by the appropriate staff.
5.2.4.3
The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authorities strategic investment in Cerner and other
clinical and business systems.
5.2.4.4
The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
5.2.4.4.1
Integrated Medication Carts
5.2.4.4.2
Medication Dispense Cabinets
5.2.4.4.3
Mobile and Fixed Computer Devices – Desktop and Wall mounta
5.2.4.4.4
Mobile and Fixed Label Printers
5.2.4.4.5
Mobile and Fixed Barcode Scanners
5.2.4.4.6
Handheld Computer Devices
5.2.4.4.7
Glucometers with Docking Stations
5.2.4.4.8
Tracking Monitors – Patient, Staff, and Resource Tracking
5.2.4.4.9
Clinical Dashboards
5.2.4.4.10 Smart Beds
5.2.4.4.11 Smart Pumps
5.2.4.4.12 Device Integration for real –time clinical assessment and physiological data
documentation
5.2.4.4.13 Digital Room Signage and Way-finding
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5.2.4.4.14 Interactive Patient Station
5.2.4.4.15 Location Awareness
5.2.4.4.16 Device Connectivity
5.2.4.4.17 Multifunction Communication Devices with integration to systems
5.2.4.4.18 Telehealth and Virtual Team Capabilities
5.2.4.4.19 Real Time Location System
5.2.4.4.20 Staff Safety and Duress
5.3
5.3.1
DESIGN CRITERIA
LEAN Planning Standards
5.3.1.1
Standardization of Inpatient Bedrooms
5.3.1.1.1
Each inpatient room will be designed, configured, equipped and furnished
to a common standard and design. The intent of this requirement is to
facilitate staff moving from room-to-room without having to reorient
themselves with respect to frequently accessed key features like hand
wash sinks/stations, call annunciator cancel buttons, etc.
5.3.1.1.2
All patient rooms are to have a standard orientation; the configuration and
layout within each patient room will be standardized to facilitate immediate
orientation for staff. A standard room orientation may be accommodated
via a “like-handed” design - namely clusters of same handed rooms as per
the Royal Jubilee Hospital PCC. Room clusters can be mirrored per the
PCC however. A mandatory aspect of the design for the patient rooms will
be direct visibility for care team staff to the door of the patient room within
15m of a care team hub workstation.
5.3.2
Proximity Relationships
5.3.2.1
The PIU’s location relative to other components, or other areas of the facility, and the
nature of circulation used to move between different components/areas are illustrated
in the diagram below. Proximities are listed according to rank; higher priorities appear
above lower priorities.
5.3.2.2
The PIU may be located on any floor.
5.3.2.3
The PIU will be directly adjacent to a healing garden, access and exit from the healing
garden is limited to from within the department.
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5.3.2.4
The healing garden must be visible to staff at all times and video monitoring of the
healing garden is required.
5.3.2.5
The healing garden shall be shielded from visibility to public and staff outside of the
PIU.
Psychiatry Inpatient Unit Secured Outdoor Therapy Area Psychiatry Inpatient Unit Emergency Department Psychiatry Inpatient Unit Pharmacy 5.3.2.6
Provide direct access by internal circulation
to a secured outdoor area for the
movement of patients, visitors and staff.
The PICU and the PIU will have separate,
dedicated secure outdoor areas.
5.3.2.7
Provide convenient access by general
circulation from the Emergency Department
for the movement of patients and
security/protective services personnel.
5.3.2.8
Provide convenient access by general
circulation from the Pharmacy Department
for movement of medications.
5.3.2.9
Provide convenient access by general
circulation to major public and non-public
circulation. Personnel, patients, visitors and
supplies will move frequently to/from this
component and other components in the
Facility.
Main Horizontal/ Vertical Circulation Psychiatry Inpatient Unit 5.3.3
Internal Design Criteria
5.3.3.1
General Internal Layout
5.3.3.1.1
The component shall be organized into 3 major areas as follows, A general
inpatient bedroom cluster (PIU); an intensive care bedroom cluster (PICU);
centralized common support facilities (including Collaboration Centre and
shared support spaces).
5.3.3.1.2
The PIU and the PICU shall share the same corridor system that are
divided by secure doors. That is, the corridor system between the units
shall share the same “racetrack” design with unit division provided by
doors.
5.3.3.1.3
The PICU bed area shall have an adjacent room designed for gradual
reintegration of patients into the larger unit. This room must be suitable for
a table and chairs.
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5.3.3.1.4
5.3.3.2
5.3.3.3
Unit Organization
5.3.3.2.1
All patient bedrooms will be designed to recognize the environmental risk
factors for the patient population. Design requirements will accommodate a
range of acuity levels for this population.
5.3.3.2.2
Planning assumes unit operations will be coordinated from the
Collaboration Centre.
5.3.3.2.3
Provide a sally port entrance vestibule into the department. The sally port
will have secure access for all doors associated with the port. Provide
visibility into the sally port from all entrances. Provide doors from the sally
port into the PIC and the PICU. The sally port shall be large enough for a
stretcher.
5.3.3.2.4
Locate the food service area directly adjacent to the Group Actives/Dining
Area.
Central Collaboration Centre
5.3.3.3.1
A centrally located secured storage area for patient’s personal belongings
will be provided on the unit. The secure storage area will be accessible
only by staff and must have appropriate ventilation and be equipped with
15 full sized storage lockers, with additional space for additional storage of
belongings. The secure storage room will be located off a staff-only
corridor; patients and visitors will not have access to the patient belongings
storage area.
The Collaboration Centre will act as the unit’s communication centre, and
will accommodate a variety of functions. Its function is to support the
interdisciplinary collaboration between all caregivers, including nursing,
physicians and allied health personnel. There must be visibility at all times
from the Collaboration Centre to the patient care areas on the inpatient
unit. There shall be provision for a closed, acoustically private area within
the Collaboration Centre to undertake confidential and frequently highly
sensitive discussions including:
5.3.3.3.1.1
Dictating and reviewing charts, diagnostic images and test
results
5.3.3.3.1.2
Conducting private telephone conversations
5.3.3.3.1.3
Conducting multi-disciplinary care team discussions.
5.3.3.3.1.4
Accommodation of teaching and collaboration space for
University of B.C. (UBC) Faculty of Medicine
5.3.3.3.1.5
Providing access to computer workstations and business
equipment and business supplies for the unit
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5.3.3.3.1.6
Providing on-unit space for nursing management activities
and transfer of control conferences at shift change
5.3.3.3.1.7
This space is not intended for use by patient, families or the
public.
5.3.3.3.2
The Central Collaboration Centre will include the following areas:
5.3.3.3.2.1
A Central Care Team station immediately outside of the
Collaboration Centre will act as the control point for the unit.
5.3.3.3.2.2
A Business Centre will be located in close proximity to the
Central Reception/Unit Clerk desk while providing the
appropriate segregation of business equipment for staff safety
and noise reduction within the Collaboration Centre.
5.3.3.3.2.3
The following functions will be accommodated in the enclosed
private area of the Central Collaboration space:
5.3.3.3.2.3.1 A central Conference/Huddle Area where
professional staff can conduct business and
collaborate.
5.3.3.3.2.3.2 Workstations will be provided for use by clinical
staff. These workstations will be in the central,
open area of the Collaboration Centre colocated with the Conference/Huddle Area to
promote collaboration.
5.3.3.3.2.3.3 One office for each neighbourhood will be
located directly off of the central area. During a
pandemic or the need to isolate the entire
neighbourhood, the office will function as the
access point into the neighbourhood. A handwashing sink is required in each office
functioning as the Pandemic/ Isolation access
point into the neighbourhood.
5.3.3.3.3
5.3.3.4
Close proximity between the Collaboration Centre, the Care Hubs and the
Common Support Spaces is required. The dual need for front line nurses to
be close to their patients in the neighbourhood and to be able to participate
in the Collaboration Centre must be considered in this design. Visual
access between the public and private areas will be required. Staff must be
able to directly enter both units from the common support area. Staff must
be able to speak to patients from the Collaboration Centre area without
opening a window or a door.
Expansion Potential
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5.3.3.4.1
5.3.3.5
5.3.3.6
Patient Screening
5.3.3.5.1
Upon arrival in the component, patients require an initial assessment to
identify accommodation requirements and the beginning of a care plan.
Patients are also checked for drugs, weapons, etc. upon arrival to the unit.
Anti-concealment strategies shall be provided. Unit design will promote
risk assessment, while ensuring privacy and safety.
5.3.3.5.2
All rooms will be capable of responding to patients with different levels of
acute symptoms. Operationally, the PIU will follow a procedure of admitting
higher acuity patients closer to the component’s Collaboration Centre. On
the PIU, patients will be provided with an appropriate area within their
bedroom for personal effects that, if lockable, can be opened by staff.
Ability to Accommodate Adolescent Admissions
5.3.3.6.1
5.3.3.7
The PIU shall be designed and configured to allow for horizontal
expansion. The focus of this expansion would be to accommodate an
increase in the number of inpatient beds. Consideration shall be given to
be able to convert the rooms to semi-private rooms if required.
The component shall be designed to meet the needs for immediate
psychiatric intervention in supporting adolescents will be accommodated in
this component. Design and configuration of the PIU portion must allow for
at least two inpatient bed rooms and an activity area to function
independently from the others allowing for segregation from the general
inpatient population. This segregation of adolescent patients must not
occur as a result of total confinement and must provide options for degrees
of integration with other psychiatric inpatients.
Patient Security and Safety
5.3.3.7.1
Safety shall be a high planning and design priority. The design of this
component shall meet or exceed Government of British Columbia’s
Minister of Health standards for mental health facilities.
5.3.3.7.2
Patient safety shall be provided for in all locations e.g. by providing antiligature breakaway design features and avoidance of ligature attachment
points.
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5.3.3.7.3
The design to include, but is not limited to items which are non-loopable or
designed to release under a load of 20 kilograms and meet either the load
release or non-loopability ligature release tests outlines in the Door and
Hardware Federations Technical Specifications DHF-TS-001: Door
mounted anti-ligature devices for safety and security purposes: November
05. These features need to be incorporated on all items, objects, systems
and fixtures incorporated into the mental health areas including, but not
limited to:
5.3.3.7.3.1
Door hardware
5.3.3.7.3.2
Sprinklers
5.3.3.7.3.3
Showerheads
5.3.3.7.3.4
Lavatories
5.3.3.7.3.5
Faucets
5.3.3.7.3.6
Lavatory valves
5.3.3.7.3.7
Shower actuators
5.3.3.7.3.8
Toilet seats
5.3.3.7.3.9
Toilet operator valves
5.3.3.7.3.10
Plumbing traps and piping covers
5.3.3.7.3.11
Fire extinguisher and hose cabinets
5.3.3.7.3.12
Medical gas enclosures
5.3.3.7.3.13
HVAC terminal devices and covers
5.3.3.7.3.14
Access doors
5.3.3.7.3.15
Light fixtures
5.3.3.7.3.16
Electrical outlets
5.3.3.7.3.17
Thermostats
5.3.3.7.3.18
Fire alarm system components
5.3.3.7.3.19
Grab bar – not filled in
5.3.3.7.3.20
Handrails
5.3.3.7.3.21
Crash rails
5.3.3.7.3.22
Rub rails
5.3.3.7.3.23
Clothes hooks
5.3.3.7.3.24
CCTV devices
5.3.3.7.3.25
Security and tracking devices and antennas
5.3.3.7.3.26
Hanger rods
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5.3.3.8
5.3.3.7.3.27
Toilet partitions
5.3.3.7.3.28
Mirrors
5.3.3.7.3.29
Bulletin Boards
5.3.3.7.3.30
Artwork hanging systems
5.3.3.7.3.31
Window treatments
5.3.3.7.4
Tamper resistant fasteners will be used in patient areas. Drop ceilings are
not to be used. Furniture, fittings and equipment shall be selected to
reduce the risk of patient self-harm, harm to other patients and staff, and
property damage. Durable, secured covers are needed for items
accessible to patients in unsupervised areas to reduce the risk of
tampering, removed or unapproved operation.
5.3.3.7.5
The design will include anti-barricade measures including out-swinging or
doors equipped with pivot hinges and emergency hospital stops. This
applies especially to doors at bedrooms and washrooms, but may apply to
other patient treatment areas such as offices. Provide bedrooms,
bathrooms and shower rooms with doors that can be locked by staff, but
not by the patient.
5.3.3.7.6
Patient containment strategies, such as “fail secure” design (e.g.
maglocked doors remain locked in the event of a power failure) and
“moveable perimeter” concepts (i.e. variable secure perimeter location)
shall be implemented by the Authority.
5.3.3.7.7
The component’s design will support staff safety (e.g., by providing a clear
path to the door or two doors and by providing a staff alarm system);
provide good visibility of patient activity areas (e.g., good sightlines); and
avoid blind corners.
5.3.3.7.8
The Collaboration Centre requires two points of entrance/exit to avoid staff
entrapment. The design will provide a high level of privacy and
confidentiality for patients and staff.
Staff Safety
5.3.3.8.1
A main reception station, which controls access to the unit, will be
provided. It will not be located on the public access side of the sally–port.
5.3.3.8.2
A visitor lounge will be provided on the unit; locate the visitor lounge
outside the secure area of the unit.
5.3.3.8.3
Provide a single entrance into the secure unit; locate the reception stations
directly adjacent to the unit entrance.
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5.3.3.9
5.3.3.8.4
The Collaboration Centre shall be designed as a secure area and may
include glass.
5.3.3.8.5
A staff lounge will be provided and will be located within the Collaborative
Centre to reduce the risk of staff being isolated with a patient or visitor. A
toilet will be provided adjacent to the staff lounge; the toilet will not open
directly into the staff lounge.
Emergency Response
5.3.3.9.1
Facilities shall be planned to minimize staff response time in emergencies.
Emergency equipment (i.e. suction, oxygen, crash cart, etc.) will be
portable and stored, when not in use, in a nearby, locked equipment
storage room, located proximal to the Collaboration Centre.
5.3.3.10 Operable Windows
5.3.3.10.1 Each inpatient bedroom must have windows that provide access to exterior
views, and preferably to views of predominantly landscape versus
buildings. At least a portion of each window must be operable providing
access to fresh, outdoor air. Ensure that the windows are lockable by staff
such that patients are prevented from opening windows unauthorized.
5.3.3.11 Unobstructed Site Lines Between Nursing Staff and Patient Beds
5.3.3.11.1 To the extent practicable, unobstructed site lines shall be provided
between the Collaboration Center and the PIU and PICU. The head of
each inpatient bed needs to be visible to caregivers from the hallway
outside of the room. Louver blinds built into double-glazed windows in
doors and/or walls shall be considered for this purpose.
5.3.3.12 Segregated Patient and Visitor Flows
5.3.3.12.1 Provide a separate point of access for patients being transported to PICU
from the ED or coming into the unit as a direct admission.
5.3.3.13 Component Security
5.3.3.13.1 Access to this component must be controllable at all times. Door activation
technology will be in accordance with existing health legislation and will be
integrated with Facility-wide security systems. The doors must have
manual backup in case the facility wide system fails.
5.3.3.13.2 The component must be accessible to authorized personnel 24 hours-aday, 7 days-a-week.
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5.3.3.13.3 All lockable patient care rooms, including group and interview rooms, in
this component must be serviced by non-accessible audio-video
surveillance and monitoring equipment. Monitoring stations will be located
at the component’s Collaboration Centre and at the Protection Services
desk located in the ED (AC.01).
5.3.3.13.4 The component’s design must provide adequate lighting throughout to
protect staff, patients and visitors from unexpected violence. Work areas
must not place staff in isolation, and staff must have the capability of
summoning help. Areas subject to limited visual access must be video
monitored and supplied with ceiling-mounted mirrors enabling staff to view
the area prior to entry.
5.3.3.13.5 Storage areas, supply/utility and medications rooms shall be secure from
patient access and include a lockable cupboard for housekeeping/cleaning
supplies.
5.3.3.13.6 “Staff only” rooms must have windows incorporated into doors enabling
staff to assess the area outside of the room for traffic and security issues.
Allow for a space to where staff can retreat when their safety is at risk. All
dimensions of counters and desks must act as a barrier and provide
adequate protection from violent or threatening behavior.
5.3.3.13.7 There shall be no recesses, alcoves or places where patients can hide.
5.3.3.13.8 Secure Rooms
5.3.3.13.8.1
Secure (seclusion) rooms must have one point of access through a
secured doorway. The area that houses the seclusions rooms
must have multiple access points including one leading directly to
the Collaboration Centre. Similarly, interview rooms must have a
secondary point of access/egress to the Collaboration Centre.
5.3.3.13.8.2
Secure room design must meet or exceed, if new information is
available, the standards for psychiatric secure room section of
“Standards: Hospital Based Psychiatric Emergency Services:
Observation Units” published by the Ministry of Health and include:
special treatment of fixtures, absence of handles; tamper-proof
fixtures; solid ceilings; water control shut-off from the nursing
station; sound proofing; observation windows in each secure room;
internal blinds on external windows; doors that swing in both
directions; and configuration such that the general population could
readily use the rooms, when they are not being utilized as secure
rooms. Secure rooms must not have any raised platforms or
ledges, and must not have any sharp edges or corners.
5.3.3.14 Therapeutic Environment
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5.3.3.14.1 Patient spaces will be designed to reduce anxiety and fear. The design
shall enhance the psychological effect of colour and décor. Where
possible, use familiar and non-institutional materials with cheerful and
varied colours and textures. Avoid items, colours and patterns that can be
disturbing or disorienting to patients e.g. patterns with spots, etc.
Approaches to minimize noise will be included including reducing noise
from other patients, toilet noises, mechanical noises, etc. Give patients as
much visual privacy and control over it, as is consistent with the need for
supervision.
5.3.3.14.2 Design features to assist patient orientation, such as direct and obvious
travel paths, avoidance of glare, avoidance of unusual configurations and
excessive corridor lengths. Make spaces easy to find, identify and use
without asking for help.
5.3.3.14.3 Provide a smaller space for activities/activation room for use by adolescent
patients when admitted on unit and by all patients for individual activities
not requiring the larger group space.
5.3.3.14.4 Space will be provided for patient access to a computer. The space must
be observable from the Collaboration Center
5.3.3.14.5 The design shall ensure the ability to view into the seclusion rooms at night
and when the natural daylight is darker. The design shall also ensure that
visitors and staff from outside the unit are not able to view into the unit from
outside during the day or at night
5.3.3.14.6 The design shall be non-institutional and as home-like as possible and
conducive to wellness. This includes the inclusion of elder-friendly design
to address such features as signage, lighting, colours and floor services.
5.3.3.15 Access to outdoor Therapy Space
5.3.3.15.1 The PIU and the PICU parts of this component will have a direct
connection with a secured and separate outdoor spaces (Therapy Spaces).
Location must provide privacy from other hospital areas and from visitors.
5.3.3.15.2 These spaces will be designed for therapeutic functions and shall include
features that provide a variety of calming stimulation. It shall be a healing
garden with water features (e.g., streams, cascades), plants, pathways and
seating benches shall be incorporated into this space. No less than 10
garden seating places shall be provided. The outdoor space shall have
areas that are covered from the elements for shade and protection from
the rain.
5.3.3.15.3 PIU and PICU patient populations are different, but part of a common
continuum of care. Generally the two are segregated and opportunities for
coincident access to common space must be controlled at all times. Needs
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for segregation highlight a requirement to keep the two secured outdoor
areas apart from one another, and to the extent that patients in one area
cannot communicate by any means with those in the other. The outdoor
space shall have an exterior wall around its entire perimeter. The exterior
walls must be un-scalable to prevent patient escape. The exterior walls
must be safe. There shall be a covered area that is away from the entrance
that isolated as a smoking area. The smoking area shall be observable
from the Outdoor Space door. The smoking area shall have a minimum of
four covered places to sit. Provide smokeless ashtrays and other
accessories for odour, ventilation and trash issues.
5.3.3.16 Lighting
5.3.3.16.1 There will be a variety of lighting options in this component, each suited to
the functions accommodated in a specified space.
5.3.3.16.2 Each inpatient bedroom must have access to natural lighting and views to
the outside. Window sills shall be low, close to the floor. Windows shall be
large to provide a connection with outside grounds and to avoid
perceptions of a “closed in” and confining environment. Exterior and
interior windows need to be impact resistant to appropriate standards, with
secure glazing and frames, which will withstand high impact. Windows,
with the exception of secure and convertible rooms, shall be operable to
the exterior to access fresh air, offer appropriate light, but also privacy.
The windows must prevent patients from throwing things out of the window.
5.3.3.16.3 Artificial lighting throughout the component shall follow a general standard
of providing “non direct” lighting. This specification implies fixtures that
reflect light upwards, away from direct eye contact, and especially in those
areas where patients will be either in bed or transported on stretchers.
5.3.3.16.4 Artificial lighting in each inpatient bedroom must be variable to provide
different levels of lighting and for different purposes. At night time, patients
will have the ability to read while in their bed. Lighting in the room must
also accommodate staff’s ability to monitor the patient during the night
without affecting the patient’s ability to sleep. Lighting to patient bedrooms
shall be controlled from the hallways as well as from the patient bedside
(by the patient).
5.3.3.16.5 Artificial lighting in the administrative and support areas must be variable to
accommodate different levels of ambient lighting commensurate with the
functions ongoing at any one time in that space. Individual workstations
must be provided with task lighting.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
5.3.3.16.6 Surfaces, including walls and floors, throughout this component shall avoid
the use of highly reflective materials. Reflected light shall be muted.
5.3.3.17 Ergonomics for an Aging Workforce
5.3.3.17.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff are required to
use. The type and number of electrical devices used in the rooms is
expected to increase, and elevated outlets will avoid stress associated with
repetitive bending.
5.3.3.18 Accommodation of Bariatric Patients
5.3.3.18.1 Numbers of bariatric patients admitted to hospital are projected to increase.
Managing these patients will require features enabling for both patients and
staff. Doorways and circulation spaces must be sufficiently wide to
accommodate large people, many of whom will be relying on mobility
assistance including motorized chairs and scooters. The reference to
circulation spaces applies especially in confined rooms like water closets.
5.3.3.18.2 Ceiling lifts will not be installed in this component. Mechanical assistance
required for moving bariatric patients will rely on 1 mobile lift that services
the entire component. When not in use, this mobile unit will be kept in a
locked equipment storage room.
5.3.3.19 Inducements for Patient Ambulation
5.3.3.19.1 Activation spaces on the inpatient unit, including designated therapy
spaces, activity rooms and general patient/public lounges, shall be inviting
with natural lighting, views to the outside and opportunities for light
recreation and entertainment such as gaming consoles with TVs which
have exercise programs and various games.
5.3.3.20 Infection Control
5.3.3.20.1 The design shall include the selection of finishes and fixtures that maximize
ability to reduce infection and disease transmission and the safe placement
of hand hygiene stations and clean/soiled utility rooms.
5.3.3.20.2 One inpatient bedroom on the PIU will be equipped with negative pressure
capabilities to be used as an isolation room, if required.
5.3.3.21 Pneumatic Tube Station
The Collaboration Centre will be equipped with a pneumatic tube station for
the transport of documents, specimens and small supply/equipment items.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
5.3.4
Space Table
5.3.4.1
The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM ID (RID)
ROOM TYPE
IP.04 Psychiatric Inpatient Unit
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
1.5
10
15.0
1.0
2.0
6.0
4.0
0.2
1
1
1
1
10
1.0
2.0
6.0
4.0
2.0
30.0
Entrance and Reception
01
Patient/Visitor Lounge/Waiting
Area
02
03
04
05
06
Alcove, Telephone
Alcove, Vending Machine
Toilet, Male/Female
Workstation, Reception
Lockers, Visitors
Seating for up to 10 w/ variety of seating
configurations - Television viewing area,
Fireplace
Storage of Items precluded from unit
Entrance and Reception Sub-Total
Patient Reception and Intake
07
Entrance Vestibule
08
Provides secured access to either the
PIU or the PICU - Controlled from the
Central Communication Centre. Include
Sally-Port
Interview, Exam Room
10.0
1
10.0
11.0
1
11.0
21.0
Patient Reception and Intake
Central Communication and Care Team
09
Workstation, Care Team
10
Office, Touchdown
Include (3) dictation stations
Pharmacist/ Patient Care Coordinator/
Social Worker/ Physical Therapy
3.0
3.0
8
3
24.0
9.0
11
Conference / Huddle
Open work area, include conference
table, Care Team Planning
8.0
1
8.0
12
Workstation, Staff
Quiet Work Areas - Care Planning and
Consultation, Requires private room
10.0
1
10.0
13
Office, Private, First Line
Leader
10.0
1
10.0
14
Business Centre
6.0
1
6.0
15
[RID Intentionally left blank]
-
-
-
16
Storage, Patient Belongings,
Secured
Include ventilation, open shelving, full
height lockers
1.0
15
15.0
17
Medication Room
Counter w/ sink - Secured storage
cabinetry - Accommodates medication
ADC - Includes hand hygiene sink
12.0
1
12.0
18
Storage, Equipment
Secured room
15.0
1
15.0
Photocopier, facsimile machine, printer,
stationery supplies - Temporary chart
holding area
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
COMOX VALLEY HOSPITAL
ROOM ID (RID)
ROOM TYPE
IP.04 Psychiatric Inpatient Unit
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
19
Storage, Bed & Mattress
Include in secure storage room
2.0
2
4.0
20
Storage, Equipment
Include in secure storage room, include
power storage, data outlets
2.0
4
8.0
Central Communication Centre Sub-Total
Patient Care Support
21
Patient Education Room
22
Patient Education Room
121.0
Small Group and 1:1 Counseling
Include telehealth Equipment for telehealth
Video monitoring of Patient
Education Rooms
Group Room
12.0
12.0
1
1
12.0
12.0
3.0
1
3.0
24.0
1
24.0
Multi-media, multi-purpose room. Used
for communal dining room - Provide
direct access between this room and the
on-floor food service galley
32.0
1
32.0
23
Workstation, Observation
24
Family Education/Counselling
Room
25
Group Activities/Activation
Room- Noisy Activities
26
Exercise Room
15.0
1
15.0
27
Equipment Storage, PT/OT
6.0
1
6.0
28
On Floor Food Service/Galley
18.0
1
18.0
29
Utility Room, Clean
Secured Area. Supports food services for
PICU and PIU - Electrical service for food
service delivery carts or for microwave
ovens - Provide direct access between
this room and Group Activities/ Activation
Rooms
Secured Areas. Accommodation for up to
2 carts - Shelving for clean linen separate
from other storage - Counter
10.0
1
10.0
30
Utility Room, Soiled
Secured Room
10.0
1
10.0
31
Laundry, Personal Clothing
Commercial washer and dryer - Counter
w/ sink
4.0
1
4.0
32
Housekeeping Room
1 floor sink, standard wall-mounted sink,
6.0
1
storage cabinetry - Accommodates
housekeeping cart storage
Unit Support Sub-Total
Staff Support
33
Staff / Lounge
34
Toilet, Staff
35
Office, Unassigned
Seating for up to 6 people - Kitchenette
w/ counter, sink, microwave oven, half
size refrigerator
Quiet Work Area
6.0
152.0
18.0
1
18.0
6.0
1
6.0
10.0
1
10.0
Staff Support Sub-Total
34.0
Psychiatry Inpatient Unit (PIU) - 11 Beds
36
Patient Bedroom
37
38
Vestibule/Anteroom
Toilet, Patient
1 patient bed w/ toilet/shower room,
wardrobe, supply cabinet and hand
washing sink at entrance - 1 room with
Isolation capability - All rooms sized to
allow for family participation/visiting
Provide (1) Airborne Isolation
1 assisted WC, 1 sink
20.0
11
220.0
6.0
6.0
1
11
6.0
66.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ IP.04
PSYCHIATRY UNIT
COMOX VALLEY HOSPITAL
ROOM ID (RID)
39
ROOM TYPE
Seclusion Room
IP.04 Psychiatric Inpatient Unit
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Standards as per MOH Hospital-Based
Psychiatric Emergency Services:
Observation Units
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
12.0
2
Subtotal, PIU - 11 Beds
Psychiatry Intensive Care Unit (PICU) - 4 Beds
40
Secured Re-Integration /
Multipurpose Area
41
Patient Room, Seclusion
42
Shower Room
TOTAL
SIZE
(nsm)
24.0
316.0
Secured Vestibule area for PICU
patients, secured from PIU. Include
Secure furniture. Design in consultation
with Clinical users group
Provide security cameras for observation
from Central care team. Requires visual
monitoring from central care team.
25.0
1
25.0
20.0
4
80.0
Toilet/shower. Lockable from outside only
7.0
1
7.0
Subtotal, PICU - 4 Beds
112.0
TOTAL NSM, ALL AREAS
786.0
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
This specification outlines the functional, operational and physical requirements for the Emergency
Department (ED) functional component.
6.1
6.1.1
6.1.2
FUNCTIONAL DESCRIPTION
Statement of Purpose
6.1.1.1
The ED accommodates the unscheduled arrival of patients presenting with suspected
or confirmed illnesses or injuries. Patients’ conditions are either resolved in the ED or
referred elsewhere for care. Patients may be discharged to their normal place of
residence, to an inpatient unit or to another health care facility (HCF).
6.1.1.2
During times outside of the hospital’s normal hours of business operation, a separate
doorway in the vicinity of the ED will become the Facility’s point of access/exit for
visitors. The intent of this doorway will be to enable access to other parts of the Facility
while bypassing the ED, and while providing monitoring and control of public traffic by
Protection Services personnel stationed in the ED.
Scope of Services
6.1.2.1
Functional Content
6.1.2.1.1
The following list specifies the minimum set of functions that must be
accommodated within the functional component’s spaces:
6.1.2.1.1.1
Reception of all patients and staff arriving from both
outside and from within the Facility requiring emergency
or urgent medical attention or first aid
6.1.2.1.1.2
Registration of patients after the Facility’s daytime
hours of operation (conducted by Admitting personnel
accommodated in this component)
6.1.2.1.1.3
Completion of paperwork by emergency medical staff
(EMS) and police accompanying patients to the ED
6.1.2.1.1.4
Monitoring of all arrivals and building systems by
Protection Services personnel who will provide security
services to the Facility in general and to patients,
visitors and staff in this component when the ED
becomes the Facility’s front door
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.1.2.1.1.5
Triage, documentation and registration of all patients
and assignment to the appropriate treatment or waiting
area or to another area of the Facility (e.g., IP.03
Maternity Newborn and Pediatric Inpatient Unit and
DT.04 Surgical Services) or to another HCF
6.1.2.1.1.6
Decontamination of people arriving with suspected or
confirmed hazardous materials covering their clothes or
skin
6.1.2.1.1.7
Isolation of arrivals suspected or confirmed as
presenting with an infectious condition
6.1.2.1.1.8
Stabilization of patients in preparation for transport to
another HCF
6.1.2.1.1.9
Secured holding of behaviourally disruptive people
pending transfer to the Facility’s psychiatric inpatient
care services Psychiatric Inpatient Care Services(See
IP.04) or transfer to another HCF
6.1.2.1.1.10 Specialized care streams for children, eye
injuries/diseases, ENT cases, fractures and obstetrical/
gynaecological health issues
6.1.2.1.1.11 Patient and escort waiting pending availability of
medical or nursing staff (low acuity cases) or escort
waiting pending resolution of a patient’s condition
6.1.2.1.1.12 Providing emergency care in the event of a local
disaster event or large scale disease outbreak, and
coordinated with other response resources
6.1.2.1.1.13 Treatment of groups of patients according to the
Canadian Triage and Acuity Scale (CTAS) that rates
patients from 1 (most serious) to 5 (least serious)
6.1.2.1.1.14 Immediate treatment of high acuity and trauma cases,
including multiple, complex trauma and including
provision for child-focused trauma care
6.1.2.1.1.15 Short-term observation of patients with unresolved
conditions
6.1.2.1.1.16 Imaging of body parts and structures using portable
digital general radiography equipment
6.1.2.1.1.17 Procurement of tissue and fluid specimens for
laboratory analyses
6.1.2.1.1.18 Storing and inventory control of standard
pharmaceutical stocks
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.1.2.1.1.19 Storing and inventory control of standard consumable
supply stocks
6.1.2.1.1.20 Collection and recording of patient information either
from the patient or their escort
6.1.2.1.1.21 Conducting confidential interviews/consultations with
patients, their escorts or with both
6.1.2.1.1.22 Respite for staff, including preparation of snacks and
light meals, relaxation, reading and conversation
6.1.2.1.1.23 Segregated storage of all wastes generated in the
functional component, and including general waste,
recyclable materials, sharps and infectious wastes
6.1.2.2
Exclusions
6.1.2.2.1
6.1.2.3
The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
6.1.2.2.1.1
Scheduled visits including scheduled clinics and single
patient/physician encounters
6.1.2.2.1.2
Imaging of body structures beyond those that can be
captured using portable digital general radiography
6.1.2.2.1.3
Treatment of patients requiring the services of a
designated trauma centre beyond initial stabilization for
transport
Anticipated Trends in Service Delivery
6.1.2.3.1
The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of functions
accommodated within this component. Effects of these trends shall be
reflected in the component’s design.
6.1.2.3.1.1
[Intentionally left blank]
6.1.2.3.1.2
Rationalization of resources will argue for non-urgent
patients (CTAS Level 5 – See below) receiving
referrals to other primary HCFs for their care.
6.1.2.3.1.3
Continued attention on infection control measures will
promote screening and immediately isolating patients at
the component’s entrance.
6.1.2.3.1.4
Increases in the average acuity level and in the
numbers of patients arriving with complex issues will be
anticipated due to aging population.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.1.2.3.1.5
Point of care testing will bring more technology into the
ED and into closer proximity to the patient contact
spaces.
6.1.2.3.1.6
The number of bariatric patients will be expected to
increase.
6.1.2.3.1.7
The electronic medical record (EMR) will accommodate
data entry and retrieval using wireless technology and a
combination of fixed computer terminals and hand-held
devices.
6.1.2.3.1.8
Privacy and confidentiality regulations will promote
development of more private, acoustically isolated
patient care areas and health care worker areas.
6.1.2.3.1.9
Increasing the efficiency of emergency care will require
rapid and less resource-intensive protocols for dealing
with ED patients falling into the lowest acuity (CTAS
Level 5) category.
6.1.2.3.1.10 More technology will continue being incorporated to the
bedside reducing the needs for ED patient transfers to
other diagnostic areas of the Facility and allowing for
remote monitoring of patients’ conditions.
6.1.2.3.1.11 Security for patients, visitors and staff will continue
being a priority issue as the risk for workplace violence
persists.
6.1.3
Scope of Education Functions
6.1.3.1
6.1.4
Medical and nursing students and students in the allied health professions from
colleges and universities will receive practical skills training through internships and coop programs. All teaching and supervision functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
Scope of Research Functions
6.1.4.1
Staff and students working in the ED will, from time-to-time, be engaged in research.
The nature and extent of research functions will be accommodated in the general work
areas, and will not require specialized or dedicated facilities in this component.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2
6.2.1
OPERATIONAL DESCRIPTION
LEAN Planning Standards
6.2.1.1
6.2.2
Consumable Supplies Management
6.2.1.1.1
To the extent practicable, consumable supplies stored in treatment areas
will be organized and stored in a common order and configuration. The
intent of this standard is to enable efficient locating of each supply item
without staff first having to reorient themselves to a new room configuration
and to avoid long travel distances between supplies storage and point of
use.
6.2.1.1.2
STAT supplies not maintained on the unit will be delivered via pneumatic
tube.
Hours of Operation
6.2.2.1
The component at the Facility will be staffed and in operation:
6.2.2.1.1
6.2.3
24 hours-a-day, 7 days-a-week
People Management Systems
6.2.3.1
1.7.1 Canadian Triage Acuity Scale (CTAS)
6.2.3.1.1
There are five categories of emergency services based on the Canadian
Triage Acuity Scale (CTAS). This division will be one of the criteria used in
determining how patients are segregated and then treated. The scale is:
6.2.3.1.1.1
CTAS 1 – Resuscitation conditions that are threats to
life or limb, or at imminent risk of deterioration, and
require immediate aggressive intervention
6.2.3.1.1.2
CTAS 2 – Emergent conditions that are a potential
threat to life, limb or function, and require rapid medical
intervention or delegated acts
6.2.3.1.1.3
CTAS 3 – Urgent conditions that could potentially
progress to a serious problem and require emergency
intervention. These conditions may be associated with
significant discomfort or affected ability to function at
work or in activities of daily living
6.2.3.1.1.4
CTAS 4 – Semi-urgent conditions that relate to patient
age, distress, or potential for deterioration or
complications that would benefit from intervention or
reassurance within 1-2 hours
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2.3.1.1.5
6.2.3.2
CTAS 5 – Non-Urgent conditions that may be acute but
non-urgent, as well as conditions which may be part of
a chronic problem with or without evidence of
deterioration. The investigation or intervention for some
of these illnesses or injuries could be delayed or
referred to other areas of the hospital or health care
system
Patient Streams
6.2.3.2.1
All ambulance and walk-in arrivals at the ED will be received through triage
by a health professional and categorized as to the appropriate care stream.
Patients may be pediatric or adult and will be immediately directed into an
appropriate care stream for diagnosis and treatment. The component will
accommodate three (3) major streams of care aimed at providing the
highest quality of care in the most timely manner, and organized into
discrete zones. Each zone will be equipped to expedite the disposition of
patients and to maintain capacity for new arrivals. Immediately upon arrival,
patients will be streamed into one zone, and patient transfers between
zones will be minimized. Patient care zones will be:
6.2.3.2.1.1
Adult and Pediatric Resuscitation/Major
Trauma/Stabilization (CTAS 1) – This patient category
will typically arrive by ambulance and will require direct
and immediate attention. The majority of these cases
will be non-traumatic arrest or critical medical pre-arrest
patients. Complex trauma cases arriving at the Facility
will be stabilized for transport to the nearest appropriate
site of care.
6.2.3.2.1.2
Urgent and Emergent Care Zone (CTAS 2 and 3) - This
area will be used for acute care cases in which patients
will typically arrive by ambulance. These cases will
require direct and immediate attention, but will be
second in priority to any CTAS 1 patient. Processing
tasks such as registration and admitting will be
secondary to diagnosis and stabilization.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2.3.2.1.3
6.2.3.3
Streaming Zone (CTAS 3, 4 and 5) – This zone will be
further subdivided into ambulatory and non-ambulatory
streams. Patients processed through these streams will
typically arrive by private vehicle or on foot. Upon
arrival, and assuming available space in the designated
area, patients will be assessed and sent to either the
streaming waiting area, a streaming recliner or stretcher
area to await further assessment by the emergency
physician. A child-sensitive flow will be incorporated into
this zone. Staff first aid will also be incorporated into
this stream.
Patient Intake and Registration
6.2.3.3.1
Patients will arrive by ambulance or as walk-ins; the latter may be alone or
escorted. The ambulance entrance will be removed from public areas;
registration functions will be accommodated at the triage station or at the
bedside for these patients.
6.2.3.3.2
The walk-in entrance will be adjacent to a vehicle drop-off/short-term
parking area and will automatically direct patients and visitors to a reception
or triage service. After normal daytime working hours, the ED will
accommodate entrances for emergency patients and their escorts and for
staff and all other hospital visitors. A staff/visitor entrance will be controlled
by Protection Services staff, whereas the patient/escort entrance will be
jointly controlled by Protection Services staff and
triage/admitting/information personnel.
6.2.3.3.3
Upon arrival, ED patients and their escorts will be directed to a
reception/triage area where they will be assessed by the Triage Nurse.
Preliminary assessment of the patient's condition will establish nature of the
urgency and extent of required treatment. Patients waiting to be triaged will
wait in an area where they can be easily observed by the Triage Nurse.
6.2.3.3.4
A single triage nurse will be responsible for providing triage of walkin/ambulatory patients and patients arriving via ambulance. The triage
station is required to be able to directly support and visually monitor the intake of ambulance patients and ambulatory/ walk-in patients.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2.3.4
6.2.3.3.5
Processes for documenting all ED patients will be coordinated from the
Central Patient Registration, Diagnostic Intake and Specimen Collection
component (See OS-GP.06). Generally, personnel from this component will
be present in the ED to document each patient who does not have an active
patient file. Information will be obtained either from the patient or from their
escort(s) at an appropriate time and prior to the patient leaving the Facility.
Should an inpatient admission from the ED become necessary, patient
placement functions will identify infection control issues and initiate a
care/discharge plan prior to the patient’s transfer to an inpatient unit.
6.2.3.3.6
Upon arrival, Facility staff/workers reporting for first aid will be directed to a
first aid station where they will be assessed, treated, and/or referred for
medical treatment for injuries considered serious or beyond the scope of the
first aid attendant; this latter referral may include directing them to the ED’s
triage service.
Satellite Diagnostic, Treatment and Support Services
6.2.3.4.1
Services accommodated in other components in the Facility will have a
smaller scale presence in the ED. These satellite services will include:
6.2.3.4.1.1
Crisis Intervention - Mental health and addictions staff will
provide services on a referral basis. Assessments and
treatments will be conducted at the bedside or in a secure
holding room.
6.2.3.4.1.2
Medical Imaging - ED patients will often require immediate
access to imaging services. Imaging capability within the ED
component will include:
6.2.3.4.1.3
6.2.3.4.1.2.1
General digital radiography (using portable
radiography equipment)
6.2.3.4.1.2.2
Ultrasound (bedside procedures using portable
equipment)
6.2.3.4.1.2.3
Other imaging procedure requirements will be
met within the main Medical Imaging
component (See DT.02).
Laboratory Services - Specimen collection will be performed
by laboratory technologists and assistants who will travel to
the ED upon request. Provision will be made in this
component for point of care testing, but immediate planning
criteria assumes the majority of specimen testing will be
performed in the Facility’s Laboratory (See DT.03).
Specimens will generally be transported by pneumatic tube.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2.3.5
6.2.3.4.1.4
Respiratory Therapy - Respiratory Therapists will provide
care to emergency patients as required. Testing of blood
gases will not be accommodated in the ED, but in the
Facility’s Laboratory (See DT.03). Specimens will generally
be transported by pneumatic tube.
6.2.3.4.1.5
Rehabilitation Services - Occupational therapy,
physiotherapy, and speech and language pathology (SLP)
services will be provided on a referral basis. Assessments
and treatments will be conducted at the bedside.
6.2.3.4.1.6
Sexual assault intervention – A multidisciplinary approach will
be used addressing the patients physical and psycho-social
needs.
6.2.3.4.1.7
Social Work - Social workers will provide therapeutic clinical
counselling services to patients and families, including
detection and assessment of child protection, family violence,
and chemical dependency issues presenting to the ED.
Social workers will conduct interviews at the bedside or in
consult/interview rooms. Discharge planning and other
necessary resource information will be compiled in an office
setting, as will be most interdisciplinary and community
partner interactions.
6.2.3.4.1.8
Interpreter Services - Professional interpreter services will be
available through Provincial Language Services.
6.2.3.4.1.9
Volunteer Services - Volunteers will provide support to
patients and family as appropriate. Volunteers will reflect the
diversity of the community, and will respond to each
individual’s cultural needs.
Protection Services
6.2.3.5.1
Protection Services staff will provide a front-line, primary entrance presence
in the component and will attend to all issues related to visitor, staff, and
patient security. Security staff will monitor and manage all access points into
the ED component including the ability to visually monitor the “after hours”
Facility entrance and the ED walk-in and ambulance entrances.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2.4
Materiel Management Systems
6.2.4.1
Consumable Supplies
6.2.4.1.1
6.2.4.2
Reusable Equipment and Supplies
6.2.4.2.1
6.2.4.3
6.2.4.4
Inventories of consumable supplies will be maintained close to point of use
throughout the ED. Items shall be maintained with minimum inventory levels
triggering a re-ordering process. Most supplies will be stored either in bins
or on top-up carts. Inventories on top-up carts will be generally maintained
according to prescribed delivery schedules by either Environmental
Services staff or Materiel Management staff.
Processing of all used equipment and reusable supplies will be
accommodated in the Facility’s MDRD (See OS-STL.09).
Used/contaminated items will be consolidated in soiled utility rooms and
then manually transported to MDRD for processing. Processed items will be
returned from MDRD to clean utility rooms close to point of use.
Linen
6.2.4.3.1
All clean linen used for patient care will be stored close to point of use. The
clean utility rooms in this component will accommodate inventories of
commonly used items for immediate, emergency access. All inventories will
be managed according to a minimum 3-days supply reorder level. Separate
linen storage will be provided for BC Ambulance Services (BCAS) needs.
6.2.4.3.2
Laundry processing will occur off site at the regional laundry located in
Cumberland. Soiled linen will be consolidated at a central location in the
component, and temporarily held pending removal to the Environmental
Services component (See OS-STL.03) for off-site transfer. Clean linen
returning from the regional laundry will be delivered to central receiving
facilities in the Environmental Services component before being sorted and
delivered to the ED.
Pharmaceutical Products
6.2.4.4.1
Automation will be used in the inventory management and dispensing of
patient medications. Stations located close to the patient care areas will be
stocked with commonly used medications and dispensed as required.
Pharmacy personnel will be responsible for inventory management of the
automated stations, whereas nursing personnel will deliver medications
from the stations to the bedside.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2.4.4.2
6.2.4.5
6.2.4.6
During times when the Facility’s Pharmacy (See DT.06) is open and in
operation, unstable products will be prepared in the Pharmacy, and then
delivered to the ED either according to a prescribed schedule or upon
request. After hours, when the Pharmacy is closed, these products will be
prepared in the ED. All refrigerators used for medications or sensitive
products will be alarmed.
Food Services
6.2.4.5.1
Nourishment stations for ED patients will be stocked and maintained with
beverages and light snacks by Food Services personnel (See OS-STL.06).
All food and utensils will be dispensed in a manner that prevents cross
contamination. The nourishment station located in this component must be
capable of being closed during an outbreak or contamination event. A
separate hand hygiene sink must be supplied in addition to a utility sink.
6.2.4.5.2
Needs for full meals will be communicated electronically to the Food
Services component, where meal trays will be prepared and then delivered
to the ED by Food Services personnel. All used mealware will be returned to
Food Services for processing.
6.2.4.5.3
Provide an alcove for 3 full sized vending machine areas just off the family
waiting area. The vending machines shall be recessed into an alcove.
Waste Management
6.2.4.6.1
Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations.
Throughout the ED, waste management is understood to begin at the
individual patient contact locations with centralized collection and temporary
holding stations being located in a general support area. Each
administrative area will also accommodate segregation of the types of waste
products typically generated in these types of spaces.
6.2.4.6.2
Segregation of wastes will accommodate the following categories of
products:
6.2.4.6.2.1
General garbage
6.2.4.6.2.2
Sharps (including potentially biohazardous items)
6.2.4.6.2.3
Infectious or contaminated wastes (excluding sharps)
6.2.4.6.2.4
Pharmaceuticals
6.2.4.6.2.5
Confidential paper
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2.5
6.2.4.6.2.6
Clean paper and cardboard
6.2.4.6.2.7
Clean metal (tin and aluminum)
6.2.4.6.2.8
Clean recyclable plastics
6.2.4.6.2.9
Compostable materials
6.2.4.6.3
Each patient care area in the ED where patients may present with limited
mobility and may be confined to a stretcher will be supplied with at least one
automatic flusher/washer/disinfector (e.g., Meiko Topline appliances) for
convenient and close waste disposal and processing of bedpans.
6.2.4.6.4
Personnel from Environmental Services (See OS-STL.03) will be
responsible for general cleaning and disinfecting of all surfaces throughout
the ED. They will also be responsible for cleaning all rolling stock (e.g.,
stretchers, wheelchairs and IV poles), transfer of waste to soiled holding
rooms and terminal cleaning of patient positions between cases.
Information Management Systems
6.2.5.1
It is anticipated that electronic technology will be used to manage more aspects of each
patient’s care. Electronic checking of patient information (e.g., wrist band bar code), for
example, may be used to validate the match between patient and a prescribed
treatment, procedure or medication. This manner of linking the patient to the
information management infrastructure will require reliable and secured wireless
access throughout the Facility.
6.2.5.2
All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, located close to each patient’s bedside and at key staff workstations, and
mobile pads. Access to the EMR will be controlled electronically with varying levels of
security clearance determining a person’s access to different sections and their ability
to enter/edit data.
6.2.5.3
Provision will be made for temporary reversion to a paper-based information
capture/recording system in the event of an electronic information management
systems failure.
6.2.5.4
Staffing information will be a managed corporate service. Scheduling, including
providing for sick and vacation relief will be conducted centrally, and off-site. Notices to
individual staff regarding their schedules will be communicated electronically.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2.5.5
The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support the Authority’s strategic investment in Cerner and other clinical
and business systems.
6.2.5.6
The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space
requirements of:
6.2.5.6.1
Integrated Medication Carts
6.2.5.6.2
Medication Dispense Cabinets
6.2.5.6.3
Mobile and Fixed Computer Devices – Desktop and Wall mountable
6.2.5.6.4
Mobile and Fixed Label Printers
6.2.5.6.5
Mobile and Fixed Barcode Scanners
6.2.5.6.6
Handheld Computer Devices
6.2.5.6.7
Glucometers with Docking Stations
6.2.5.6.8
Tracking Monitors – Patient, Staff, and Resource Tracking
6.2.5.6.9
Clinical Dashboards
6.2.5.6.10 Smart Beds
6.2.5.6.11 Smart Pumps
6.2.5.6.12 Device Integration for real –time clinical assessment and physiological data
documentation
6.2.5.6.13 Digital Room Signage and Way-finding
6.2.5.6.14 Interactive Patient Station
6.2.5.6.15 Location Awareness
6.2.5.6.16 Device Connectivity
6.2.5.6.17 Multifunction Communication Devices with integration to systems
6.2.5.6.18 Telehealth and Virtual Team Capabilities
6.2.5.6.19 Real Time Location System
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.2.5.6.20 Staff Safety and Duress
6.3
6.3.1
DESIGN CRITERIA
LEAN Planning Standards
6.3.1.1
Physical Relationships between Zones
6.3.1.1.1
6.3.1.2
The ED’s design will accommodate the ability for one zone to flex into
another zone to meet the demands depending on changes in workload.
Specific requirements for each zone include:
6.3.1.1.1.1
Adult and Pediatric Resuscitation/Major Trauma Zone The resources of this zone will be reserved for major
trauma, resuscitation, cardiac arrests and loss of
consciousness, including CTAS 1 adult and pediatric
patients as defined above. The staff to patient ratio will
be the highest in this zone. After stabilization, patients
will be transferred to the Surgical Services component
(See DT.04), the Intensive Care/ Telemetry Unit (See
IP.02), a general medical surgical inpatient ward (See
IP.01), to the Acute Care Zone in this component or, if
deceased, to the Morgue and Autopsy component (See
DT.03.01). This zone requires direct visibility from the
Acute Care Zone care station
6.3.1.1.1.2
The location of the Helipad must follow all regulations,
codes, guidelines and recommendations associated
with the Emergency Health Services BC Ambulance
guidelines.
Non-Urgent Care Area
6.3.1.2.1
An area will be provided to allow for patients to be assessed quickly by the
physician and then released. This zone will have a separate waiting area
and accommodates minor procedures under the following categories:
6.3.1.2.1.1
Minor lacerations and wound care
6.3.1.2.1.2
Eye problem diagnosis and treatment
6.3.1.2.1.3
Ear, nose and throat problem diagnosis and treatment
6.3.1.2.1.4
Bone fracture and dislocation reduction
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.2
Proximity Relationships
6.3.2.1
The ED will be located on the first floor, the same floor as the main hospital entrance.
6.3.2.2
The ED will be located adjacent to the Medical Imaging Department.
6.3.2.3
Provide a staff only corridor to the Psychiatric IPU (in CVH). The goal is to transport
patients from the ED along a corridor that does not cross a family/public corridor.
6.3.2.4
The ED component’s location relative to other components, or other areas of the
Facility, and the nature of circulation used to move between different
components/areas are illustrated in the diagram below. Proximities are listed according
to rank; higher priorities appear above lower priorities.
Emergency
Department
Medical
Imaging
Emergency
Laboratory
6.3.2.5
Provide Direct Access by Internal Circulation
to the Medical Imaging component, especially
to the general radiography modality area, for
the movement of patients and staff.
6.3.2.6
Provide Direct Access (via vertical or
horizontal adjacency) by General Circulation
to the Laboratory component for the
movement of technical staff following
specimen procurement (vertical separation
possible).
6.3.2.7
Provide Direct Access (via vertical or
horizontal adjacency) by General Circulation
to the Surgical Services component for the
movement of patients requiring surgical
procedures. Path of travel must be nonpublic.
6.3.2.8
Provide Convenient Access by General
Circulation to the Intensive Care Unit
component for the movement of patients and
staff. Path of travel must be non-public.
Department
Emergency
Surgical
Department
Services
Emergency
Intensive Care Department
Unit 6.3.3
Internal Design Criteria
6.3.3.1
General Internal Layout
6.3.3.1.1
The component shall be organized into 5 major areas as follows:
6.3.3.1.1.1
Reception/Triage including waiting and admitting
functions
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.3.2
6.3.3.3
6.3.3.1.1.2
Trauma/Resuscitation
6.3.3.1.1.3
Emergent/Urgent Care
6.3.3.1.1.4
Non-Urgent Care including streaming
6.3.3.1.1.5
Administrative and Staff Support
Creating a Healing and Accommodating Environment
6.3.3.2.1
Creating an environment conducive to patient healing and comfort must
take precedence in the design, configuration and operation of this
component.
6.3.3.2.2
Furniture, features and finishes must be non-institutional, comfortable, nontechnical, possibly with music and/or television as a diversion (particularly in
waiting areas). Design waiting areas into clusters for those watching TV, for
reading and quiet waiting, and for children play. Natural light exposure, high
ceilings and access to fresh air shall be maximized to support patient and
staff well-being and orientation.
6.3.3.2.3
Features promoting local Aboriginal culture shall appear throughout the ED.
6.3.3.2.4
Alcoves shall be distributed throughout the component to keep equipment
and supplies out of the direct view of patients and their escorts.
6.3.3.2.5
Patient, staff and visitor use areas must be designed to allow easy access
by those persons with physical or cognitive disabilities.
6.3.3.2.6
Ensure that all patient occupied spaces are designed for disabled access
and assistance by nursing staff.
6.3.3.2.7
Toilets, washing facilities and corridors must be provided with handrails.
6.3.3.2.8
Public washrooms shall not open directly on the family waiting area. The
washrooms shall be behind a vestibule or in an adjacent corridor.
Emergency Entries
6.3.3.3.1
Three entrances will continue to be provided, one for ambulances/ stretcher
patients, one for private vehicle/walk-in patients and one from the main
hospital circulation system. The entrances will be large enough to
accommodate stretcher movement for critically ill patients that arrive by car.
All entrances will be weather-protected with a canopy and will be serviced
by air curtains.
6.3.3.3.2
Provide a public corridor that connects the Emergency Walk-in entrance
and/or family waiting area to the main lobby of the hospital.
6.3.3.3.3
Provide outside seating at the walk-in entrance adjacent to the vehicular
drop off. Provide exterior lighting for this seating.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.3.4
6.3.3.5
6.3.3.3.4
Provide a large feature wall in the emergency department walk-in vestibule
or family waiting area. This feature wall shall promote the core values of the
Authority.
6.3.3.3.5
Unloading of ambulance vehicles and some private vehicles will occur within
a separate enclosed ambulance shelter. This separation will ensure that
critically ill patients can be transferred, without hindrance, directly from an
ambulance or a private vehicle to the trauma/resuscitation room. Ensure
that the space behind the ambulance (the patient unloading or loading area)
is directly adjacent to the ambulance entrance vestibule. Provide a visual
barrier between the distressing aspects of certain ambulance arrivals and
the non-critical patients' walk-in entry.
6.3.3.3.6
The ambulance entrance must also provide direct access from the Facility’s
exterior into decontamination spaces. Patients accessing these spaces will
do so prior to triage. The space immediately outside the emergency
decontamination space shall be covered by the ambulance shelter.
6.3.3.3.7
Traffic flow from the ambulance and walk-in entrances shall not cross one
another. However, while providing the above degree of separation, both
entrances shall be visible/easily accessible from the reception/triage desk. A
security kiosk shall be located adjacent to these entrances.
After Hours Facility Entrance
6.3.3.4.1
After hours (2100h to 0630h), the main entry to the Acute Care Facility will
be locked and a secondary entrance adjacent to the ED shall be provided
for general access to the Acute Care Facility without traversing the ED.
Protection Services personnel will monitor access and screen traffic.
6.3.3.4.2
The layout of circulation corridors will need to allow for ambulance deliveries
to the Acute Care Facility, other than those destined for the ED to discreetly
bypass interior portions of the ED. Triage and reception functions in the ED
will not provide general information services.
Access and Parking
6.3.3.5.1
The walk-in entrance must accommodate short-term parking. A designated
“emergency parking only” area shall be located in close proximity to the
drop-off bay.
6.3.3.5.2
Provide a canopy over the walk-in entrance and drop off area suitable to
provide weather protection for the entire drop off vehicle and patient entry
process.
6.3.3.5.3
Provide a covered vehicle drop off area that is wide enough for two vehicles
to drop off simultaneously.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.3.6
6.3.3.7
6.3.3.8
6.3.3.9
Draft and Exhaust Free Entrances
6.3.3.6.1
Waiting and triage areas located close to the walk-in entrance must not be
exposed to drafts and transient temperature changes with the opening and
closing of doors.
6.3.3.6.2
Exhaust fumes from ambulances and private vehicles must not be allowed
to enter the building.
Triage and Patient Intake Functions
6.3.3.7.1
Workstations provided for triage, including triage nurse and unit clerk, and
for patient registration/documentation shall be located close together. This
proximity will enable an efficient flow of patients away from and immediately
after entering the ED, and will accommodate simultaneous triage and
admitting functions. There shall be a hidden panic button at the triage
location. There shall be a secure exit door from the back of the triage
station.
6.3.3.7.2
The triage area will have direct visibility to the walk-in entrance and the
entire depth of the entrance vestibule will be visible.
6.3.3.7.3
The reception/triage area will have visibility over the entire family waiting
area.
6.3.3.7.4
The registration clerk area and triage area shall be in the same integrated
multi station work area. The triage area will have lockable cabinets.
Identification and Segregation of Cases
6.3.3.8.1
The patient triage function will be located in close proximity to the
emergency walk-in entry and the ambulance entry, with visual access to
both. Ambulance cases must have direct access to the trauma/resuscitation
area immediately upon entry without crossing the route taken by walk-in
patients.
6.3.3.8.2
Visibility of the patients in urgent care from the Collaboration Centre is
highly desirable to facilitate prompt “patient symptom recognition” by
nurses/doctors.
Open Plan Allowing for Care Zone Definition
6.3.3.9.1
Although co-locating different patient groups is desirable for organization of
different care requirements and levels of care, a general concept of
openness and flexibility will be followed. These features will allow space use
to change based on immediate needs, and whenever surplus resources are
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
available. Visibility of all patient care zones by nursing and medical staff will
be promoted and inappropriate patient isolation will be avoided. A plan
emphasizing the importance of a single patient care space with potential for
segregation will be followed, enabling care for all patients with a single care
team.
6.3.3.9.2
The design of the ED must accommodate daily peaks in patient volumes, as
well as the ability to allow the ED staff to consolidate services to minimize
staffing during non-peak patient volume periods. The design of the ED will
allow for the consolidation of minimal staff to a single area, while
maintaining all mandatory proximity and zoning relationships, and
established visibility requirements. The preferred design will maximize staff
visibility and access to treatment rooms, from a care team hub
6.3.3.10 Proximity to Medical Imaging
6.3.3.10.1 Circulation must allow for immediate transport of patients, many of whom
will be on stretchers, between the ED and Medical Imaging (See DT.02).
Upon arrival in Medical Imaging, the primary access requirement will be for
the general radiography imaging modality.
6.3.3.10.2 Clear and intuitive wayfinding is required to allow ED patients to self-direct
from triage, streaming, and treatment bays to General
Radiography/Fluoroscopy Rooms within the Medical Imaging component.
6.3.3.10.3 The CT Scanner and General Radiology rooms will be the closest
modalities to the Emergency Department to facilitate high volume and time
sensitive cases.
6.3.3.11 Design of Patient Treatment Spaces
6.3.3.11.1 Partitioning must be accomplished by using either solid walls or, in cases
where visual access between patient contact spaces is necessary, glazing.
6.3.3.11.2 The design of the Treatment Rooms containing stretchers, is modeled off
the Emergency Treatment Rooms that were constructed in the Emergent
Area in the Emergency Department at Nanaimo Regional General Hospital.
All doors into Treatment Rooms will be large three panel glass doors that
provide an opening that is 2/3rds of the room width. The doors will have a
breakaway function. The glass doors shall be 2/3rds frosted to provide
privacy. There shall be handles on both sides of all patient room doors.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.3.11.3 The recliner bays in the streaming zone will be designed in conjunction with
the User Consultation Group. Provide floor-to-ceiling walls extending out 1.5
m from the headwall. Provide glazing for the remaining wall length. The goal
is to enclose patient cubicles on 3 sides but maintain some visibility. Sliding
glass breakaway doors with 2/3 glazing will be used to create a private
room/cubicle.
6.3.3.11.4 There will be two isolation rooms. Each isolation room will be designed to
match the Treatment Rooms. Each isolation patient room will be designed
with the ante room to the side of the patient room and will not be positioned
as an vestibule into the patient room. The ante room will also have a
window into the isolation room.
6.3.3.11.5 The decontamination room will be positioned adjacent to one isolation room
and shall have a door into the isolation room. The isolation room adjacent to
the decontamination room shall have a window (with integral blinds) for
direct visibility into the decontamination room.
6.3.3.11.6 Selected patient care spaces will accommodate special care, purpose-built
rooms including obstetrics/gynecology/ sexual assault assessment and
treatment, minor procedures, EENT and paediatrics.
6.3.3.11.7 There shall be an office directly adjacent to the secure holding room.
6.3.3.11.8 All secure holding rooms will have direct access to a washroom. Access to
the washroom from the secure room will be controlled by the ED staff.
Patients will not be required to enter the corridor to access the washroom. A
stainless steel toilet is required in the toilet room (Refer to Diagram 3:
Secure Rooms).
6.3.3.11.9 One Treatment Room shall be designated as a Suture Procedure room.
This room shall have appropriate full height storage cabinets, storage for
suture carts and storage for restraining gear.
6.3.3.11.10 Provide an area with secured access for patient belongings for those
patients held in the secure rooms.
6.3.3.11.11 One Treatment room in the ED will be capable of accommodating bariatric
patients. This will include bariatric-capable furniture, storage facilities for
portable lifts (including accessories like belts and slings) and installation of
ceiling mounted lift tracking systems (e.g., above each of the trauma
resuscitation bays).
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.3.11.12 The two Trauma rooms will be adjacent. Each Trauma room will have its
own patient entrance. The corridor wall of both Trauma rooms (that corridor
facing the care station and/or the corridor) shall be all glazing. The doors
from the corridor into each trauma bay will be large three panel glass doors
that provide an opening that will accommodate movement of patients, team
members and required equipment into and out of the trauma bays. The
doors will include a breakaway function. The glass doors shall be 2/3rds
frosted to provide privacy. There will also be a full length cubicle curtain on
the inside of each trauma door opening into the corridor. This will provide
multiple levels of patient privacy
6.3.3.11.13 Provide a full wall between each trauma room, include a sliding- door
opening between the trauma rooms, provide a viewing panel in the sliding
door. The door opening needs to be large enough to accommodate
movement of equipment such as portable X-ray and emergency equipment.
6.3.3.11.14 Provide a work/ charting station in the trauma room, ensure the charting
station orientation allows for visibility of the patient head. Orient charting
station at the foot of the patient.
6.3.3.11.15 Provide a minimum depth of 6 m in the trauma rooms.
6.3.3.11.16 The Trauma area shall be incorporated into the Emergent Area and not
separated as an isolated suite. The design must ensure that when any of
the Trauma room doors are opened, patients and visitors are not able to see
into the trauma room.
6.3.3.11.17 Provide in each secure/seclusion room a floor drain, a stainless steel toilet
and stainless steel sink (Refer to Diagram 3: Secure Rooms).
6.3.3.12 Infection Control Features
6.3.3.12.1 The following outlines a list of the infection prevention and control
considerations for the ED:
6.3.3.12.1.1 Provide one hands free sink and hand sanitizer per
examination/patient room and any area where patients
are treated.
6.3.3.12.1.2 All wall mounted soap, paper towel, and disinfectant
dispensers shall have automatic dispensing systems
6.3.3.12.1.3 [Intentionally left blank]
6.3.3.12.1.4 Provide a minimum of two patient washrooms in the
'emergent zone'.
6.3.3.12.1.5 Hygiene stations with adjacent PPE dispensers and
with mats to protect flooring shall be located in all
waiting rooms and triage areas
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.3.12.1.6 Provide 1 sink per 3 beds in open areas
6.3.3.12.1.7 All lighting and furniture must have surfaces that can be
easily disinfected and cleaned
6.3.3.13 Collaboration Centre
6.3.3.13.1 The Collaboration Centre shall be central to all patient examination and
treatment areas in order to facilitate nursing, physician and clerical
interaction. Planning shall strive to provide nurses in this station with visual
contact of as many of the care stations as possible.
6.3.3.13.2 The ability for staff to have direct visibility between the Collaboration Centre
and the care team hubs is a beneficial aspect of care delivery, the design of
the ED to the extent possible will provide visibility from Collaboration
Stations to Care Team Hubs.
6.3.3.13.3 An acoustically private area will be required in the Collaboration Centre,
where professional staff can conduct business that will include:
6.3.3.13.3.1 Dictating and reviewing charts, diagnostic images and
test results
6.3.3.13.3.2 Conducting private telephone conversations
6.3.3.13.3.3 Conducting care team discussions
6.3.3.14 Concentration of Patient Care Activity
6.3.3.14.1 Workloads will vary greatly at different times of the day. Organization of
patient care areas shall allow concentration of patient care activity in one
area, at times of low workload, and allow the zone of activity to expand as
workload increases. The design of the ED must accommodate the ability to
concentrate staff to a single area during low workload activities.
6.3.3.15 Monitoring Capability
6.3.3.15.1 All patient positions in the emergent/urgent care area must have physiologic
monitoring capability. All stretcher bays in streaming area must have
physiologic monitoring capability. Portable physiologic monitors must be
readily available to deploy to any patient position. Confirm specific
monitoring needs with User Consultation Group.
6.3.3.16 Obstetrics/Gynaecology/Sexual Assault Assessment and Treatment room
6.3.3.16.1 Diagnostic procedures conducted in this room will employ ultraviolet (UV)
light sources. Blackout conditions must be created whenever this
technology is in use.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.3.16.2 There shall be a washroom with shower immediately adjacent to this room
accessed by an internal door.
6.3.3.17 Patient Privacy, Confidentiality and Noise Control
6.3.3.17.1 Design features will ensure that noise transference generally is kept to a
minimum throughout the ED, and that adjacent spaces are sound
attenuated and/or visually screened to achieve the required degree of
privacy. This will apply especially to staff workspaces, triage admitting
cubicles, care stations, physician dictation areas, staff phones and computer
monitors (protected from patient view).
6.3.3.17.2 Cubicle curtains are required in all patient bed rooms to provide privacy;
curtains must provide privacy from the hallway into the patient room, even
when the door to the patient room is open. Curtains must not interfere with
clinical activities.
6.3.3.17.3 Comfortable and appropriate spaces will be available for families to meet
their needs for information, privacy and support, including spaces to meet
with staff, and have access to a phone (in privacy) during times of stress or
grief.
6.3.3.18 Safety and Security
6.3.3.18.1 Access to the component for emergency patients and visitors shall be
through the main emergency entrance only. Planning and design shall
provide the means to minimize theft. Closed circuit television must be
incorporated.
6.3.3.18.2 The layout and design of the component must address the dangers to staff
inherent in the services provided (e.g., from violent patients). A staff “escape
route” from the triage area must be provided to protect staff from aggressive
or violent patients.
6.3.3.18.3 Design staff workstations to avoid staff isolation, especially those used by
staff at night. There shall be no blind corners. A safe will be available for
secure storage of patient’s valuables, sized to manage valuables at
department’s peak volume.
6.3.3.19 Quiet Room
6.3.3.19.1 A grieving/quiet room will be provided for family members of critically ill or
deceased patients. , This room shall be in close proximity to the
trauma/resuscitation area. The function of the grieving room is to provide a
temporary refuge for distressed family/friends; it is not intended for
prolonged use. It must be acoustically and visually private. The quiet room
will be in proximity to the crisis nurse office
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.3.19.2 This room shall be provided with access to natural light and shall have
operable windows enabling access to fresh air.
6.3.3.20 Educational Materials
6.3.3.20.1 Waiting areas shall be used as venues for educating the public.
Consideration shall be given to strategically locating printed materials and
interactive computer/television screens throughout the ED. All televisions
shall be tamper proof and controlled by staff only.
6.3.3.21 Disaster Response Capability
6.3.3.21.1 In addition to being planned for normal day-to-day provision of emergency
services, the examination/treatment areas shall be planned to allow for
increased numbers of casualties generated by a major disaster. This could
be achieved by means of the following:
6.3.3.21.1.1 Adjacency to, and ease of use of other open spaces
(e.g., hospital corridors, waiting areas, "soft"
examination/treatment areas in other ambulatory care
areas; and the main lobby spaces) that could be also
used for accommodating additional stretchers
6.3.3.21.1.2 Protected and alternative access routes from the
exterior to the exam/treatment areas to enhance and
guarantee accessibility during a disaster
6.3.3.21.1.3 Potential to convert protected exterior areas into triage
and/or stretcher holding.
6.3.3.22 Decontamination Capability
6.3.3.22.1 A decontamination room will be located along the component’s periphery.
The access point leading into/out of the decontamination room must
accommodate full isolation when containment protocols are in effect. The
degree of connection and the risks attached to contamination of adjacent
ED areas will require careful consideration.
6.3.3.22.2 A vestibule accessible from the Ambulance shelter is
required. Containment receptacles will be located here for secure storage
of contaminated items. The vestibule will lead to a decontamination
room/stretcher/shower area.
6.3.3.22.3 A vestibule, for the direct entrance of a contaminated patient, is required.
The vestibule is required to directly access the decontamination room.
Ambulance access, for the drop off of patients, to the vestibule is required.
However, it is permissible for the entry vestibule to the decontamination
room to be accessed from outside of the ambulance shelter.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.3.22.4 All parts of the room will be designed to be lined with a disposable
polythene liner.
6.3.3.22.5 It is assumed that radiation containment will not be required. However, a
catchment sump under the shower drainage and ambulance bay wash
down area shall be provided.
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.4
Component Functional Diagram
6.3.4.1
The areas making up this component shall be organized as illustrated in the following
diagrams:
6.3.4.1.1
Diagram 1: Department Organization Diagram
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.4.1.2
Diagram 2: Isolation Room and Decontamination Rooms
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.4.1.3
Diagram 3: Secure Rooms
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
6.3.5
Space Table
6.3.5.1
The Functional Space Requirement illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID (RID)
AC.01 Emergency Department (ED)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
Reception/Triage/Public Support Area
01
02
Entrance from ambulance bays w/
automatic doors
Vestibule, Ambulance Bay
Enclosed room exhausted to exterior Serviced w/ water, deluge shower, eye
wash station - Hamper for containment of
bio hazardous items/garments - Direct
access from building's exterior with
vestibule
Decontamination Room
Requires access for Ambulances
8.0
1
8.0
10.0
1
10.0
6.0
1
6.0
02.01
Entrance, Vestibule Contaminated
Patient
03
Vestibule, Public/Walk-In Entrance
Automatic doors - Provides draft control
from exterior
6.0
1
6.0
Triage Infection Screening
Requires visibility to Main entrance,
requires barrier between triage nurse and
public to maintain infection control
protocols. Triage Screening area to be
combined with Triage station
4.0
2
8.0
04
Triage Station
2 multipurpose wrkstn w/ computer
terminal, counter w/ sink - Visual access to
separate ambulance and public entrances
6.0
2
12.0
05
Workarea, Protection Services
Officer
6.0
2
12.0
06
Workstation, Volunteer/Admitting
13.5
1
13.5
07
Wheelchair/Stretcher Alcove
2 wrkstn w/ computer terminal, portable
radio charging station, Locate in ED
4.0
1
4.0
08
Ambulance/Police Room
2 multipurpose wrkstns w/ computer
terminal - Secured supplies storage
9.3
1
9.3
09
Waiting Area, Patient/Escort
Allowance for segregation of seating Television viewing area, Include fire-place
30.0
1
30.0
10
Alcove, Telephone
1.0
2
2.0
04.01
Capacity for 2 wheelchairs
Allowance for 3 machines including 1 ATM
11
Alcove, Vending Machine
3.0
1
3.0
12
Toilet, Male/Female
6.0
2
12.0
Subtotal, Reception/Triage/Public Support Area
135.8
Trauma/Resuscitation Area
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
AC.01 Emergency Department (ED)
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
45.0
35.0
1
1
45.0
35.0
10.0
1
10.0
8.0
12.0
1
1
8.0
12.0
7.0
1
7.0
Subtotal, Trauma/Resuscitation Area
117.0
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
13
14
Trauma/Resuscitation Cubicle
Trauma/Resuscitation Cubicle
15
Alcove, Supplies
16
17
Alcove, Equipment
Quiet Room
Locate proximal to Crisis Room Office
18
Care Sub-Station/Charting/
Medications
2 wrkstns - Counter w/ sink - Medication
automatic dispensing cabinet (ADC)
Accommodates medical/surgical equipment
cart, linen cart, blanket warmer, blood
refrigerator
Non-Urgent Care Area
19
Streaming Area
20
Paediatric Play Area
21
Toilet, Male/Female
22
Cubicle, Treatment, Wheelchair/
Recliner Chair
1 sink, 1 assisted WC
Enclosed (stub walls/glazing) cubicle Includes counter w/ sink, computer
terminal, equipment and supplies storage Monitoring capability
23
Cubicle, Treatment, Stretcher
Enclosed (stub walls/glazing) cubicle Includes counter w/ sink, computer
terminal, equipment and supplies storage Examination lamp - Serviced w/ medical
gases and suction - Monitoring capability
24
Cast Sink
Provide in one treatment room
25
Examination Room, EENT
Accommodates stretcher - Counter w/
shampoo sink, slit lamp - Provide good
access from Emergent/Urgent Care Area
26
Alcove, Equipment
27
Work Room, Laboratory Technician
1 wrkstn - Work bench
Care Team Hub
28
Distributed Care Sub-Station
29
Workstation, PACS
30
Medication Room
30.0
1
30.0
6.0
1
6.0
5.0
2
10.0
4.0
7
28.0
12.0
6
72.0
0.5
1
0.5
12.0
1
12.0
2.0
1
2.0
4.5
1
4.5
4.0
4.0
12.0
3
1
1
12.0
4.0
12.0
31
Utility Room, Clean
Accommodation for up to 2 carts - Shelving
for clean linen - Counter w/ sink
11.0
1
11.0
32
Utility Room, Soiled
Holding for soiled items
18.5
1
18.5
Alcove, Stretcher Storage, First Aid
Station
Used in stand-by mode for employee first
aid response - Locate w/ direct access off
circulation corridor and internal point of
access/egress for this component
8.5
1
8.5
Nourishment Station
Include Storage, Refrigerator, Ice machine,
Sink, Coffee machine
33
33.01
3.0
1
3.0
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
AC.01 Emergency Department (ED)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
Subtotal, Non-Urgent Care Area
234.0
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
ROOM
SIZE
(nsm)
Emergent/Urgent Care Area
34
Patient Room, Isolation
Directly accessible from ambulance and
public entrances - 1 room to be serviced w/
negative pressure - 1 stretcher position w/
450 mm deep counter w/ sink behind bed
head
35
Anteroom, Isolation
Includes hand wash sink, supplies and
garbage and linen hampers - Attach to 1
Patient Room to accommodate full isolation
capability
8.0
1
8.0
36
Isolation Toilet
1 sink, 1 assisted WC
6.0
2
12.0
37
Secure Holding Room
12.0
1
12.0
4.0
1
4.0
12.0
2
24.0
Secure toilet
Adjacent to secure holding room.
Toilet/shower.
Office, Private, Nurse, Crisis
Intervention/ Psychiatric Assessment
1 wrkstn w/ computer terminal - Visual
supervision over Secure Holding Rooms
10.0
1
10.0
Treatment Room, General
1 stretcher position w/ 450 mm deep
counter w/ sink behind bed head - Medical
gases and suction - Overhead articulated
examination lamp - bedpan flusher/washer/
sanitizer
12.0
11
132.0
Toilet, Male/Female
1 sink, 1 assisted WC
6.0
3
18.0
40
Patient Room, Sexual Assault/ ObGyn Examinations
1 stretcher position/pelvic table, 1500 mm
of counter w/ sink - Overhead exam lamp Locked storage cabinet for wood’s lamp
and camera - Locked evidence cabinet Direct access to washroom - Includes
family/escort area within room
14.0
1
14.0
41
Toilet, Male/Female
GYN Toilet and Shower area
6.0
1
6.0
42
Utility Room, Clean
Linen and medical/surgical carts - Counter
w/ sink
11.0
1
11.0
43
Medication Room
ADC, refrigerator - Dispensing counter w/
sink. Secured medication disposal
12.0
1
12.0
44
Alcove, Resuscitation Equipment
1.0
1
1.0
45
Utility Room, Soiled
18.5
1
18.5
3.0
5
15.0
10.0
1
10.0
37.01
38
39
39.01
Collaboration Center
46
Workstation, Care Team/ Physicians
47
Conference/Huddle
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
AC.01 Emergency Department (ED)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
48
49
Workstation, PACS
Workstation, Unit Clerk
50
Alcove, Equipment
Distributed among patient care positions in
this area
Care Team Hub
51
Distributed Care Sub-Station
52
Workstation, PACS
53
Toilet, Staff
Clinical Decision Unit
54
Care Sub-Station
55
Cubicle, Treatment, Stretcher
56
1 sink, 1 assisted WC
Enclosed (stub walls/glazing) cubicle Includes counter w/ sink, computer
terminal, equipment and supplies storage Examination lamp - Serviced w/ medical
gases and suction - Monitoring capability
Includes shower
Toilet, Male/Female
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
4.0
3.0
2
1
8.0
3.0
2.0
3
6.0
3.0
3.0
4.5
4
2
3
12.0
6.0
13.5
6.0
12.0
1
6
6.0
1
6.0
72.0
6.0
Subtotal, Emergent/Urgent Care Area
440.0
Administrative/Staff Support Area
Centralized storage for Cast Cart,
Resuscitation Equipment, Procedures Cart
and Ultrasound Card, Telehealth Cart
57
Cart Storage
58
Storage, Equipment
2.0
5
10.0
Accommodates stretchers, IV poles/pumps,
seizure pads, transfer boards, neck collars,
blanket warmer, l, clothes storage (donated
clothing storage), fluid warming cupboard,
portable blood pressure machine, transfer
monitors/suction/drug/resp box, commodes,
hard collars, O2 bottles, linen cart, IV fluid
cart, paper storage, burn cart, procedures
trays, ECG machines, incubator,
orthopaedic and general equipment
supplies
Storage for 1 Vent in ED
30.0
1
30.0
1.0
1
1.0
59
Storage, Ventilator
60
Office, Private, Shared, Site Chief
and Nurse Manager
2 wrkstns - Meeting area for up to 3 people
14.0
1
14.0
61
Office, Private, Transient Medical
and Allied Health Staff
Multipurpose work area - Meetings with 1-2
people
10.0
1
10.0
62
Business Centre
Business equipment and supplies
6.0
1
6.0
63
On-Call Room
Locate adjacent to Lounge, Lockers and
Showers
9.0
1
9.0
64
Staff / Lounge
Counter w/ sink, storage cabinetry,
microwave oven, coffee station, full size
refrigerator - Seating for up to 4 people,
staff lockers for 30 staff
20.0
1
20.0
65
66
Lockers, Staff
Toilet, Male
1 assisted WC, 1 sink
0.3
6.0
30
1
9.0
6.0
67
Shower Stall, Male
Assisted - Includes change area
4.0
1
4.0
71
68
Toilet, Female
Shower Stall, Female
2 sinks, 3 WC (1 assisted)
Assisted - Includes change area
6.0
4.0
2
1
12.0
4.0
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
69
AC.01 Emergency Department (ED)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
ROOM
SIZE
(nsm)
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
Housekeeping Room
NUMBER
OF
ROOMS
6.0
TOTAL
SIZE
(nsm)
1
6.0
Subtotal, Administrative/Staff Support Area
141.0
1,062.8
1,067.8
TOTAL NSM, ALL AREAS
CAMPBELL RIVER FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
AC.01 Emergency Department (ED)
ROOM
SIZE
(nsm)
NUMBER
OF ROOMS
Entrance from ambulance bays w/
automatic doors
8.0
1
8.0
Decontamination Room
Enclosed room exhausted to exterior Serviced w/ water, deluge shower, eye
wash station - Hamper for containment of
bio hazardous items/garments - Direct
access from building's exterior with
vestibule
10.0
1
10.0
02.01
Entrance, Vestibule Contaminated
Patient
Requires access for Ambulances
6.0
1
6.0
03
Vestibule, Public/Walk-In Entrance
Automatic doors - Provides draft control
from exterior
6.0
1
6.0
04
Triage Station
2 multipurpose wrkstn w/ computer
terminal, counter w/ sink - Visual access
to separate ambulance and public
entrances
6.0
2
12.0
Triage Infection Screening
Requires visibility to Main entrance,
requires barrier between triage nurse and
public to maintain infection control
protocols. Triage Screening area to be
combined with Triage station
4.0
2
8.0
13.5
2
27.0
ROOM
ID (RID)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
Reception/Triage/Public Support Area
01
Vestibule, Ambulance Bay
02
04.01
TOTAL
SIZE
(nsm)
05
Workstation, Volunteer/Admitting
06
07
Wheelchair/Stretcher Alcove
Work-area, Protection Services
Officer
Capacity for 2 wheelchairs
2 wrkstn w/ computer terminal, portable
radio charging station, Locate in ED
4.0
6.0
1
2
4.0
12.0
08
Ambulance/Police Room
2 multipurpose wrkstns w/ computer
terminal - Secured supplies storage
9.3
1
9.3
09
Waiting Area, Patient/Escort
Allowance for segregation of seating Television viewing area, Include fire-place
30.0
1
30.0
1.0
3.0
2
1
2.0
3.0
6.0
2
12.0
10
11
12
Alcove, Telephone
Alcove, Vending Machine
Allowance for 3 machines including 1
ATM
Toilet, Male/Female
Subtotal, Reception/Triage/Public Support Area
149.3
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
AC.01 Emergency Department (ED)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
Trauma/Resuscitation Area
13
Trauma/Resuscitation Cubicle
14
Trauma/Resuscitation Cubicle
15
Alcove, Supplies
16
17
18
Accommodates medical/surgical
equipment cart, linen cart, blanket
warmer, blood refrigerator
Alcove, Equipment
Quiet Room
Care Sub-Station/Charting/
Medications
Locate proximal to Crisis Room Office
2 wrkstns - Counter w/ sink - Medication
automatic dispensing cabinet (ADC)
ROOM
SIZE
(nsm)
NUMBER
OF ROOMS
45.0
35.0
10.0
1
1
1
45.0
35.0
10.0
8.0
12.0
7.0
1
1
1
8.0
12.0
7.0
Subtotal, Trauma/Resuscitation Area
Non-Urgent Care Area
19
Streaming Area
20
Paediatric Play Area
21
Toilet, Male/Female
22
Cubicle, Treatment, Wheelchair/
Recliner Chair
Enclosed (stub walls/glazing) cubicle Includes counter w/ sink, computer
terminal, equipment and supplies storage
- Monitoring capability
TOTAL
SIZE
(nsm)
1
117.0
30.0
6.0
4.5
4.0
1
2
6
30.0
6.0
9.0
24.0
23
Cubicle, Treatment, Stretcher
Enclosed (stub walls/glazing) cubicle Includes counter w/ sink, computer
terminal, equipment and supplies storage
- Examination lamp - Serviced w/ medical
gases and suction - Monitoring capability
12.0
5
60.0
24
25
Cast Sink
Examination Room, EENT
Provide in one treatment room
Accommodates stretcher - Counter w/
shampoo sink, slit lamp - Provide good
access from Emergent/Urgent Care Area
0.5
12.0
1
1
0.5
12.0
26
27
Alcove, Equipment
Work Room, Laboratory Technician
Include power and data outlets
1 wrkstn - Work bench
2.0
4.5
1
1
2.0
4.5
4.0
4.0
12.0
11.0
3
1
1
1
12.0
4.0
12.0
11.0
Care Hub
28
29
30
31
32
33
33.01
Distributed Care Sub-Station
Workstation, PACS
Medication Room
Utility Room, Clean
Accommodation for up to 2 carts Shelving for clean linen - Counter w/ sink
Utility Room, Soiled
Alcove, Stretcher Storage, First Aid
Station
Holding for soiled items
Used in stand-by mode for employee first
aid response - Locate w/ direct access off
circulation corridor and internal point of
access/egress for this component
18.5
8.5
1
1
18.5
8.5
Nourishment Station
Include Storage, Refrigerator, Ice
machine, Sink, Coffee machine
3.0
1
3.0
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
AC.01 Emergency Department (ED)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
ROOM
SIZE
(nsm)
NUMBER
OF ROOMS
Subtotal, Non-Urgent Care Area
Emergent/Urgent Care Area
34
Patient Room, Isolation
TOTAL
SIZE
(nsm)
217.0
Directly accessible from ambulance and
public entrances - 1 room to be serviced
w/ negative pressure - 1 stretcher position
w/ 450 mm deep counter w/ sink behind
bed head
12.0
2
24.0
35
Anteroom, Isolation
Includes hand wash sink, supplies and
garbage and linen hampers - Provide (2)
Isolation vestibules
8.0
1
8.0
36
Isolation Toilet
1 sink, 1 assisted WC, Include Transom
shower and floor drain
6.0
2
12.0
12.0
4.0
2
1
24.0
4.0
10.0
1
10.0
1 stretcher position w/ 450 mm deep
counter w/ sink behind bed head - Medical
gases and suction - Overhead articulated
examination lamp - bedpan
flusher/washer/ sanitizer
1 stretcher position/pelvic table, 1500 mm
of counter w/ sink - Overhead exam lamp
- Locked storage cabinet for wood’s lamp
and camera - Locked evidence cabinet Direct access to washroom
12.0
9
108.0
14.0
1
14.0
GYN Toilet and Shower area
Require direct access from General
Treatment Rooms (RID 39) to a toilet
room.
Linen and medical/surgical carts - Counter
w/ sink
6.0
6.0
1
3
6.0
18.0
11.0
1
11.0
12.0
1
12.0
1.0
18.5
1
1
1.0
18.5
3.0
5
15.0
10.0
4.0
3.0
2.0
1
2
1
3
10.0
8.0
3.0
6.0
3.0
4
12.0
37
37.01
Secure Holding Room
Secure Holding Toilet
Shared between two secure holding
rooms (RID 37)
1 wrkstn w/ computer terminal - Visual
supervision over Secure Holding Rooms
38
Office, Private, Nurse, Crisis
Intervention/ Psychiatric
Assessment
39
Treatment Room, General
40
Patient Room, Sexual Assault/ ObGyn Examinations
40.01
41
Toilet, Male/Female
Toilet, Male/Female
42
Utility Room, Clean
43
Medication Room
44
45
Alcove, Resuscitation Equipment
Utility Room, Soiled
ADC, refrigerator - Dispensing counter w/
sink - Secured medication disposal
Collaboration Center
46
Collaboration Centre
47
48
49
50
Conference/Huddle
Workstation, PACS
Workstation, Unit Clerk
Alcove, Equipment
Distributed among patient care positions
in this area, requires data and power
outlets
Care Team Hub
51
Distributed Care Sub-Station
EXECUTION COPY North Island North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS AC.01
EMERGENCY DEPARTMENT (ED)
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
52
53
AC.01 Emergency Department (ED)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
Workstation, PACS
Toilet, Staff
Clinical Decision Unit
54
Care Sub-Station
55
Cubicle, Treatment, Stretcher
56
Enclosed (stub walls/glazing) cubicle Includes counter w/ sink, computer
terminal, equipment and supplies storage
- Examination lamp - Serviced w/ medical
gases and suction - Monitoring capability
Includes shower
Toilet, Male/Female
ROOM
SIZE
(nsm)
NUMBER
OF ROOMS
3.0
4.5
2
3
6.0
13.5
6.0
12.0
1
4
6.0
48.0
6.0
1
Subtotal, Emergent/Urgent Care Area
Administrative/Staff Support Area
57
Cart Storage
TOTAL
SIZE
(nsm)
6.0
404.0
58
Storage, Equipment
59
Storage, Ventilator
60
Office, Private, Shared, Site Chief
and First Line Leader
Centralized storage for Cast Cart,
Resuscitation Equipment, Procedures
Cart and Ultrasound Card, Telehealth
Cart
Accommodates stretchers, IV
poles/pumps, seizure pads, transfer
boards, neck collars, blanket warmer, l,
clothes storage (donated clothing
storage), fluid warming cupboard, portable
blood pressure machine, transfer
monitors/suction/drug/resp box,
commodes, hard collars, O2 bottles, linen
cart, IV fluid cart, paper storage, burn cart,
procedures trays, ECG machines,
incubator, orthopaedic and general
equipment supplies
Storage for 1 Vent in ED, include in
Trauma Bay
2 wrkstns - Meeting area for up to 3
people
61
Office, Private, Transient Medical
and Allied Health Staff
Multipurpose work area - Meetings with 12 people
10.0
1
10.0
62
63
Business Centre
On-Call Room
6.0
9.0
1
1
6.0
9.0
64
Staff / Lounge
Business equipment and supplies
Locate adjacent to Lounge, Lockers and
Showers
Counter w/ sink, storage cabinetry,
microwave oven, coffee station, full size
refrigerator
18.0
1
18.0
65
66
67
68
69
70
Lockers, Staff
Toilet, Male
Shower Stall, Male
Toilet, Female
Shower Stall, Female
Housekeeping Room
2.0
5
10.0
30.0
1
30.0
1.0
1
1.0
14.0
1
14.0
0.3
30
1 assisted WC, 1 sink
6.0
1
Assisted - Includes change area
4.0
1
2 sinks, 2 WC (1 assisted)
6.0
2
Assisted - Includes change area
4.0
1
1 floor sink, standard wall-mounted sink,
6.0
1
storage cabinetry - Accommodates
housekeeping cart storage
Subtotal, Administrative/Staff Support Area
9.0
6.0
4.0
12.0
4.0
6.0
139.0
TOTAL NSM, ALL AREAS
1,026.3
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
This specification outlines the functional, operational and physical requirements for the Ambulatory Care/
Medical Day Units functional component.
7.1
FUNCTIONAL DESCRIPTION
7.1.1
NOTE: All patients deserve high quality care. Patients need to be treated in an atmosphere
which focuses on them as an individual presenting with a medical condition. Designing a new
hospital for the communities provides an opportunity to re-examine the environment and the ways
that health care services are provided to meet the needs of all residents of northern Vancouver
Island seeking health care, with particular focus on the needs of the elderly and with sensitivity to
the cultural and healing practices of the Aboriginal community. What is needed is an environment
where all members of the health care team, whether they are employees, physicians or
volunteers, can work collaboratively in promoting health and wellness.
7.1.2
Nowhere in a hospital are the changes resulting from progress in care delivery approaches and
advances in technology more apparent than in ambulatory care. Hospital admission, the most
costly form of care, may be avoided or their length reduced by effective ambulatory care service
delivery. Ambulatory care provides a bridge following hospital discharge and helps reduce the
potential for readmission for the same problem. Growth in ambulatory care services is
anticipated in response to a growing and aging population and from an ongoing shift from
inpatient to outpatient service delivery as treatment and technologies evolves and become more
appropriate for delivery in the outpatient setting.
7.1.3
The shift to outpatient service provision is of great benefit to patients as it is the least disruptive to
their personal lives. Significant numbers of patients will access these ambulatory clinics and it is
important that the design promote safe, quality health care and provide an environment which
considers patients’ needs. The design also must enhance access, care coordination and needs
to be address accessibility and movement of patients between services.
7.1.4
Care which is responsive to patients’ needs is particularly important among vulnerable and
disadvantaged populations such as the elderly or those from culturally diverse backgrounds, such
as Aboriginal people. There must be consideration of their specific needs in the development of
this space.
7.1.5
The key functional elements of this area are:
7.1.5.1
Medical Day Care
7.1.5.1.1
Medical Day Care will provide care for patients which cannot be provided
outside of the hospital environment (e.g. blood transfusions, IV therapies,
infusions, etc).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.1.5.2
7.1.5.3
Chemotherapy
7.1.5.2.1
Chemotherapy will provide care for oncology patients who are potentially
immunosuppressed which cannot be provided outside of the hospital
environment e.g. blood transfusions, IV therapies, chemotherapy, etc.
7.1.5.2.2
Chemotherapy patients are a unique group of ambulatory patients. These
patients are at a time when their lives are highly stressful due to their
diagnosis and they must spend prolonged periods of time in the treatment
area. Providing comfort and support for patients in all stages of
chemotherapy treatment, from the newly diagnosed with cancer to the
patient going through the final outpatient treatment must be a priority.
Areas to address include the provision of natural lighting and views to the
outdoors, with low sills so patients are able to enjoy the view while seated
or lying down; addressing privacy concerns; providing opportunities for
patients to read, watch television and play video games; and minimizing
noise and traffic through the treatment area.
General Ambulatory Care
7.1.5.3.1
7.1.5.4
The General Ambulatory Care clinics will provide a full array of ambulatory
services, including clinics focused on chronic disease management, as
well as transient specialty and subspecialty clinics (Refer to 7.1.8 for
detail).
Aboriginal Health Program (AHP)
7.1.5.4.1
This component will allow for the care of ambulatory patients of aboriginal
descent and non-aboriginal descent
7.1.5.4.2
The AHP will be designed in such a way so as to acknowledge the
historical, cultural history of the people of Vancouver Island. The
Ambulatory Care space will be designed to integrate cultural practices. It
will be visually distinctive and include the use of wood and incorporation
of multiple languages. The final design will be in consultation with the
Aboriginal Working Group.
7.1.5.4.3
Aboriginal health staff will be co-located within the Ambulatory Care
Component. These staff will provide clinical ambulatory services (e.g.
assessments, counseling, clinical visits, etc.) to Aboriginal people as well
as administrative support for the overall Aboriginal Health Program at the
Facility.
7.1.5.4.4
At the Campbell River Facility, staff for the Centre For Excellence in
Maternal Aboriginal Health for Women (CFEMAW) will be accommodated
in the Ambulatory Care Centre.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.1.5.4.5
The AHP area of the Ambulatory Care component will include dedicated
office space, exam rooms, a group exam room, a teaching kitchen, and
access to the Paediatric Play area and procedure rooms
7.1.5.4.6
A teaching kitchen is required as part of the Aboriginal Health Program.
The teaching kitchen will be used for large group demonstrations,
nutritional counseling, in addition to teaching. The kitchen will be utilized
by patient and family to produce and prepare traditional aboriginal
medicines. The teaching kitchen will be adjacent to the group medical
visit/ education room.
7.1.6
The planning for this new Facility provides an opportunity to explore innovative new ways to
organize the delivery of these services. At this time, the specific details of how the space will be
organized and designed are not identified. The space estimates contained here allow for the
delivery of Medical Day Care services and Chemotherapy services, and a designated block of
space to be designed for current clinics which host a combination of permanent, daily-run
services, as well as transient services that require space for brief periods of time. These Clinical
Specifications are intended as a plan capable of accommodating different types of clinics and
configuration of ambulatory services and specific allocations of space to the individual
components will be identified in subsequent stages of planning, design and construction of this
space. Concepts of space design and layout, with easily modified mechanical and electrical
systems and options to modify physical layout will be utilized to ensure the space is able to meet
current and adapt to future needs.
7.1.7
Statement of Purpose
7.1.7.1
The Ambulatory Care component will accommodate scheduled visits by patients requiring
consultations and minor procedures with medical, nursing or allied health professionals. Patient
encounters accommodated here will be highly variable in terms of the nature and scope of each
visit and the professionals involved. The range of functions conducted here will include:
7.1.7.1.1
One-on-one consultative clinics
7.1.7.1.2
Group learning sessions
7.1.7.1.3
Group demonstration sessions
7.1.7.1.4
Medical Day Care services
7.1.7.1.5
Chemotherapy services
7.1.7.1.6
Minor procedures and non-invasive treatments, including ophthalmology laser
7.1.7.1.7
Group medical visits
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.1.8
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
Scope of Services and Functional Content
The following list specifies the minimum set of functions that must be accommodated within the functional
component’s spaces:
7.1.8.1
Patient-Focused Programs and Services
7.1.8.1.1
Comox Valley Services:
7.1.8.1.1.1
Medical Day Care including:
7.1.8.1.1.1.1 IV therapy
7.1.8.1.1.1.2 IV antibiotics
7.1.8.1.1.1.3 Biological infusions
7.1.8.1.1.1.4 Transfusions
7.1.8.1.1.1.5 Wound therapy
7.1.8.1.1.2
Chemotherapy services including:
7.1.8.1.1.2.1 Chemotherapy
7.1.8.1.1.2.2 IV therapy
7.1.8.1.1.2.3 IV antibiotics
7.1.8.1.1.2.4 Biological infusions
7.1.8.1.1.2.5 Oral Chemotherapy administration
7.1.8.1.1.2.6 Transfusions
7.1.8.1.1.3
Chronic disease management organized according to disease or
condition, for example:
7.1.8.1.1.3.1 Diabetes Program
7.1.8.1.1.3.2 Heart Health Program
7.1.8.1.1.3.3 Pain Clinic (Including palliative pain)
7.1.8.1.1.4
Integrated Health Networks
7.1.8.1.1.5
Transient specialty and subspecialty clinics targeting patient cohorts
including:
7.1.8.1.1.5.1 Arthritis
7.1.8.1.1.5.2 Endocrinology
7.1.8.1.1.5.3 General medical/surgical consultation clinics
7.1.8.1.1.5.4 Geriatrics (Including Psychogeriatrics)
7.1.8.1.1.5.5 Gynaecology
7.1.8.1.1.5.6 Infectious diseases
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.1.8.1.1.5.7 Ophthalmology including laser procedures
7.1.8.1.1.5.8 [Intentionally left blank]
7.1.8.1.1.5.9 Ostomy care
7.1.8.1.1.5.10 Paediatrics
7.1.8.1.1.5.11 Psychiatry
7.1.8.1.1.5.12 Renal
7.1.8.1.1.5.13 North Island Liver Clinics (outreach clinic)
7.1.8.1.1.5.14 Stroke Clinic (outreach clinic)
7.1.8.1.1.6
7.1.8.1.1.7
Outpatient dietary counseling providing support to all of the
programs/services listed above
Aboriginal Health Program
7.1.8.1.1.8
Telehealth capabilities in support of the programs and services listed
above
7.1.8.1.1.9
Diabetes Education and Counseling
7.1.8.1.2
Campbell River Services:
7.1.8.1.2.1
Medical Day Care including:
7.1.8.1.2.1.1 IV therapy
7.1.8.1.2.1.2 IV antibiotics
7.1.8.1.2.1.3 Biological infusions
7.1.8.1.2.1.4 Transfusions
7.1.8.1.2.1.5 Wound therapy
7.1.8.1.2.2
Chemotherapy services including:
7.1.8.1.2.2.1 Chemotherapy
7.1.8.1.2.2.2 IV therapy
7.1.8.1.2.2.3 IV antibiotics
7.1.8.1.2.2.4 Biological infusions
7.1.8.1.2.2.5 Oral Chemotherapy administration
7.1.8.1.2.2.6 Transfusions
7.1.8.1.2.3
Chronic disease management organized according to disease or
condition for example:
7.1.8.1.2.3.1 HIV Program
7.1.8.1.2.3.2 Diabetes Program
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.1.8.1.2.3.3 Heart Health
7.1.8.1.2.3.4 Pain Clinic (Including palliative pain)
7.1.8.1.2.3.5 North Island Liver Clinics
7.1.8.1.2.3.6 Stroke Clinic
7.1.8.1.2.4
Integrated Health Networks
7.1.8.1.2.5
Transient specialty and subspecialty clinics targeting patient cohorts
including:
7.1.8.1.2.5.1 Arthritis
7.1.8.1.2.5.2 Cardiology
7.1.8.1.2.5.3 Endocrinology
7.1.8.1.2.5.4 General medical/surgical consultation clinics
7.1.8.1.2.5.5 Geriatrics (Including Psychogeriatrics)
7.1.8.1.2.5.6 Gynaecology
7.1.8.1.2.5.7 Infectious diseases including HIV clinic
7.1.8.1.2.5.8 Ophthalmology including laser procedures
7.1.8.1.2.5.9 Ostomy care
7.1.8.1.2.5.10 Paediatrics
7.1.8.1.2.5.11 Plastic surgery clinic
7.1.8.1.2.5.12 Psychiatry outreach
7.1.8.1.2.5.13 Renal
7.1.8.1.2.5.14 Wound care
7.1.8.2
7.1.8.1.2.6
Outpatient dietary counseling
7.1.8.1.2.7
Aboriginal Health Program
7.1.8.1.2.8
Telehealth capabilities in support of the programs and services listed
above
7.1.8.1.2.9
Diabetes Education and Counselling
Clinic Patient Support
7.1.8.2.1
Centralized scheduling services for all visits conducted in this component
7.1.8.2.2
Check-in and arrival confirmation
7.1.8.2.3
Waiting
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.1.8.3
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
Exclusions
7.1.8.3.1
7.1.8.4
The following list specifies functions that will occur in other functional components in
the Facility or outside of the Facility:
7.1.8.3.1.1
Services provided by a Orthopedic Clinic (See AC.02.01)
7.1.8.3.1.2
Minor procedures and scope based procedures (e.g., minor plastic
surgery, cataract removal, bronchoscopy, cystoscopy and colposcopy)
(See AC.04) Outpatient Procedural Care
7.1.8.3.1.3
Surgical procedures, bronchoscopy, gastro-intestinal endoscopy and
electro-convulsive therapy (ECT) (See DT.04 Surgical Services)
7.1.8.3.1.4
Specimen procurement of any kind (See OS-GP.06 Central Patient
Registration, Diagnostic Intake and Specimen Collection)
7.1.8.3.1.5
Specimen analyses (See DT.03 Laboratory)
Anticipated Trends in Service Delivery
7.1.8.4.1
The following lists trends expected within the planning horizon of this project that are
expected to affect the nature and/or extent of functions accommodated within this
component. Effects of these trends shall be reflected in the component’s design.
7.1.8.4.1.1
Chronic disease management programs will continue becoming more
interdisciplinary as patient groups seldom present with a single medical
condition.
7.1.8.4.1.2
Continued increases in outpatient clinic visits, as the population ages
and with the continued shift to outpatient services.
7.1.8.4.1.3
Acuity and complexity of patients managed in an outpatient setting will
continue to increase.
7.1.8.4.1.4
Evolution of the electronic medical record (EMR) will enable patients to
move efficiently between programs and services as their health needs
will be communicated with the appropriate professionals almost
immediately.
7.1.8.4.1.5
Telehealth and telemedicine will continue allowing more outpatient
encounters to occur remotely, and without needs for a patient visiting a
clinic or hospital.
7.1.9
Scope of Education Functions
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.1.9.1
Medical and nursing students and students in the allied health professions from colleges and
universities will receive practical skills training through internships and co-op programs. All
teaching and supervision functions will be accommodated in the general work areas, and will
not require specialized or dedicated facilities in this component.
7.1.10 Scope of Research Functions
7.1.10.1 Staff and students working in the Ambulatory Care Component will, from time-to-time, be
engaged in research. The nature and extent of research functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this component.
7.2
OPERATIONAL DESCRIPTION
7.2.1
7.2.1.1
LEAN Planning Standards
Patient Flows
7.2.1.1.1
7.2.1.2
Utilization Efficiency
7.2.1.2.1
7.2.1.3
The operation of this component will focus on efficiency in patient flows. A centrally
located reception/registration station, shared with Outpatient Procedural Care, (See
AC.04), will help orient patients immediately upon arrival, and will provide a onestop location for completing all outstanding needs. Beyond reception, scheduling
strategies will promote directing scheduled patients directly to their point of care,
unless a patient has arrived early or their care room is not ready. Waiting will be
accommodated in this component, but patients faced with prolonged delays
between arrival and their consultation will be encouraged to access other Facilitybased components (e.g., OS-GP.04 Public Support Services) or other nearby
amenities.
Planning assumes that Facility operations will include a fully integrated
booking/scheduling system in which all Facility-based services participate. The
intent of this specification is to allow patients to move between multiple, same-day
appointments seamlessly, with few delays and short wait times and without need to
continuously revisit the Patient Registration, Diagnostic Intake and Specimen
Collection component (See OS-GP.06).
Patient-Centered Care
7.2.1.3.1
To the extent practicable, ambulatory services will be designed around the patient.
This scheme implies use of mobile multi-disciplinary teams that travel to the patient
as opposed to a patient having to schedule several visits, which may or may not be
consecutive.
7.2.1.4
Consumable Supply Management
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.2.2
7.2.2.1
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.2.1.4.1
To the extent practicable, consumable supplies stored in treatment areas will be
organized and stored in a common order and configuration. The intent of this
standard is to enable efficient locating of each supply item without staff first having
to reorient themselves to a new room configuration and to avoid long travel
distances between supplies storage and point of use.
7.2.1.4.2
All ordering, purchasing, receiving, checking and delivering of supplies will be
conducted through the Facility’s Materiel Management component (See OSSTL.05).
7.2.1.4.3
All ordering, purchasing, receiving, checking and delivering of supplies will be
conducted through the Facility’s Materiel Management component (See OSSTL.05).
Hours of Operation
The component at the Facility will be staffed and in operation:
7.2.2.1.1
7.2.3
7.2.3.1
People Management Systems
Patient Streams
7.2.3.1.1
7.2.4
7.2.4.1
0700 – 1700, 5 days a week
Most patients accessing this component will arrive according to a scheduled
appointment. Upon entering the Facility patients will proceed directly to the
component’s main reception/registration area where appointments will be confirmed
as will any other diagnostic procedures scheduled for the same visit. All patient
waiting will be accommodated close to reception/registration area or in the Facility’s
lobby area (See OS-GP.04 Public Support Services). Planning assumes that patient
location technology will be part of the Facility’s infrastructure, enabling patients to be
located and notified electronically that an appointment is about to begin.
Materiel Management Systems
Consumable Supplies
7.2.4.1.1
Inventories of consumable supplies will be maintained close to point of use in this
component. Items shall be maintained with minimum inventory levels triggering a reordering process. Most supplies will be stored either in bins or on top-up carts.
Inventories on top-up carts will be generally maintained according to prescribed
delivery schedules by either Environmental Services staff (See OS-STL.03) or
Materiel Management staff (See OS-STL.05).
7.2.4.1.2
STAT supplies not maintained on the unit will be delivered via pneumatic tube.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.2.4.2
7.2.4.3
7.2.4.4
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
Linen
7.2.4.2.1
All clean linen used for patient care will be stored close to point of use. Clean
storage areas in this component will accommodate inventories of commonly used
items for immediate, emergency access. All inventories will be resupplied using a
top-up system.
7.2.4.2.2
Laundry processing will occur off site at the regional laundry located in Cumberland.
Soiled linen will be collected at a central location in small hampers, temporarily
staged and consolidated prior to removal to the Environmental Services component
(See OS-STL.03) for off-site transfer. Clean linen returning from the regional laundry
will be delivered to central receiving facilities in the Environmental Services
component before being sorted and delivered to the Ambulatory Care/ Medical Day
Care component.
Pharmaceutical Products
7.2.4.3.1
Pharmaceutical products used in this component will be stored in automated
dispensing carts/cabinets (ADC), which will be provided in secured medication
rooms. Supplies of commonly used products will be maintained in the ADC by
Pharmacy personnel, and replenished on a scheduled basis. Dispensing from the
ADC will be conducted by personnel working in this component; electronic security
technology will restrict dispensing capability to authorized staff.
7.2.4.3.2
STAT needs for products not contained in the ADC will be communicated
electronically to the Pharmacy (See DT.06). STAT deliveries will be conducted by
pneumatic tube, unless the product is fragile or unstable.
7.2.4.3.3
Chemotherapy agents administered to cancer day patients will be prepared in the
Facility’s Pharmacy (See DT.06). These products will be delivered to the appropriate
patient care area by Pharmacy personnel, and just prior to their administration.
Food Services
7.2.4.4.1
There will be minimum food requirements given the nature of services
accommodated in this component. Planning assumes that appropriate mechanisms
to support these requirements will be developed during operational planning.
7.2.4.5
Waste Management
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.2.5
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.2.4.5.1
Waste products will be generally managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies on
appropriate containment facilities for each type of waste product beginning at where
the waste is generated followed by similar, but progressively larger, containment
facilities at key collection locations. Throughout this component, waste management
is understood to begin at the individual patient contact locations with centralized
collection and temporary holding stations being located in a general support area.
Each administrative area will also accommodate segregation of the types of waste
products typically generated in these types of spaces.
7.2.4.5.2
Segregation of wastes will accommodate the following categories of products:
7.2.4.5.2.1
General garbage
7.2.4.5.2.2
Sharps (including potentially biohazardous items)
7.2.4.5.2.3
Infectious or contaminated wastes (excluding sharps)
7.2.4.5.2.4
Cytotoxic and chemotherapy agents
7.2.4.5.2.5
Confidential paper
7.2.4.5.2.6
Clean paper and cardboard
7.2.4.5.2.7
Clean metal (tin and aluminum)
7.2.4.5.2.8
Clean recyclable plastics
Information Management Systems
7.2.5.1
Efficiency in this component’s operation will rely, in part, on a fully integrated booking and
scheduling system in which all Facility-based services participate. The intent of this specification
is to allow patients to move between multiple, same-day appointments seamlessly, with few
delays and short wait times and without needs to continuously revisit the central
reception/registration service based in this component or the Central Patient Registration,
Diagnostic and Specimen Collection component (See OS-GP.06). Planning assumes that all
registration staff working in the Facility will utilize a common system, regardless of their
workstation location.
7.2.5.2
All patient related information will be maintained on the electronic medical record (EMR)
system. Wireless technology will enable data entry using a combination of fixed terminals,
located close to each patient’s bedside and at key staff workstations, and mobile pads. Access
to the EMR will be controlled electronically with varying levels of security clearance determining
a person’s access to different sections and their ability to enter/edit data.
7.2.5.3
The clinical unit and patient care spaces will optimize care delivery through the design and build
of facilities and work spaces which emphasize the blend of workflow, care processes,
automation of practice, and interoperability between medical and business technologies in
support of the Authority’s strategic investment in Cerner and other clinical and business
systems.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.2.5.4
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
The intent is to enable clinicians and staff to take advantage of the technologies and resultant
optimal care environment with respect to communication, access to the Electronic Health
Record, documentation, mobility, monitoring, tracking, and care processes and best practices
supported by technology. The space will accommodate the technology devices and medical
equipment required to deliver care in an automated environment including mounting, storage,
charging, and space requirements of:
7.2.5.4.1
Integrated Medication Carts
7.2.5.4.2
Medication Dispense Cabinets
7.2.5.4.3
Mobile and Fixed Computer Devices – Desktop and Wall mounted
7.2.5.4.4
Mobile and Fixed Label Printers
7.2.5.4.5
Mobile and Fixed Barcode Scanners
7.2.5.4.6
Handheld Computer Devices
7.2.5.4.7
Glucometers with Docking Stations
7.2.5.4.8
Tracking Monitors – Patient, Staff, and Resource Tracking
7.2.5.4.9
Clinical Dashboards
7.2.5.4.10 Smart Beds
7.2.5.4.11 Smart Pumps
7.2.5.4.12 Device Integration for real –time clinical assessment and physiological data
documentation
7.2.5.4.13 Digital Room Signage and Way-finding
7.2.5.4.14 Interactive Patient Station
7.2.5.4.15 Location Awareness
7.2.5.4.16 Device Connectivity
7.2.5.4.17 Multifunction Communication Devices with integration to systems
7.2.5.4.18 Telehealth and Virtual Team Capabilities
7.2.5.4.19 Real Time Location System
7.2.5.4.20 Staff Safety and Duress
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.3
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
DESIGN CRITERIA
7.3.1
7.3.1.1
LEAN Planning Standards
On-Stage versus Off-Stage Areas
7.3.1.1.1
7.3.1.2
Medical and technical personnel will be better able to perform their work when
free from distractions. Patient contact areas shall be considered as on-stage
and the site where personnel will focus on providing service to the patient.
Functions accommodated in technical support and professional office space
shall be distraction-free and considered off-stage. No patient contact shall
occur in these latter areas.
Supply Access
7.3.1.2.1
Each patient contact site will accommodate inventories of commonly used
supplies, with each inventory being designed to address that space’s
functions. Clean supply rooms will be provided in the ambulatory clinics for
the storage of supplies. Decentralized supplies must not be accessible to the
public to prevent to minimize the risk of cross contamination. The clean supply
room will be a secured room, with access limited to appropriate personnel.
7.3.1.3
Standardization of Space
7.3.1.3.1
Maximizing the use of all areas in this component will require that each space
be able to accommodate a variety of functions. This will enable services to
move among eligible locations depending upon space availability. The
process of moving among locations will be facilitated by designing and
configuring rooms and/or groups of rooms (e.g., examination/treatment rooms
and associated support space) to a common plan. Under this scheme, users
will not be faced with needs to reorient themselves with respect to supply
inventory location, electrical power outlet location, audio-visual equipment,
etc. each time they are booked into a different location.
7.3.1.3.2
The ambulatory clinics will be built on a clinical module concept, with all
patient encounter rooms (exam rooms and consult rooms), being designed to
a universal room design. Each exam room will be equipped and fit out based
upon the anticipated clinical use of the exam room, however final
determination of the type and location of equipment within the exam and
consult rooms will be decided upon consultation with the clinical champions.
7.3.1.3.3
Dedicated bariatric and special needs patient exam rooms will be provided in
the ambulatory clinical suites. The bariatric/ special needs patient exam
rooms will be provided directly adjacent to the main complement of exam
rooms.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.3.1.3.4
7.3.2
7.3.1.3.4.1
MOHS procedural suite and required support areas (CRH only)
7.3.1.3.4.2
Adhere to all confirm and adhere to all mechanical, electrical
and plumbing requirements for the MOHS procedural room
(CRH only)
7.3.1.3.4.3
Ophthalmology Laser procedural suites (confirm and adhere to
all mechanical, electrical and plumbing requirements for the
ophthalmology lased with the clinical champion
7.3.1.3.4.4
Ophthalmology Laser procedural suites will require the ability to
achieve complete black-out status
7.3.1.3.4.5
Adhere to all safety and notification requirements for the laser
procedural room
Proximity Relationships
7.3.2.1
The ambulatory clinics require direct ground floor access.
7.3.2.2
[Intentionally left blank]
7.3.2.3
Ambulatory parking is required proximal to the main Ambulatory Care/Medical Day Unit
entrance.
7.3.2.4
The Ambulatory Care clinics will be located directly adjacent to the orthopaedic clinic.
7.3.2.5
The Ambulatory Care clinics will be located proximal to main patient registration and
patient check-in
7.3.2.6
The Ambulatory Care clinics will be located proximal to the medical imaging component.
7.3.2.7
Dedicated waiting will be provided for the Ambulatory Care clinics, to be shared with the
Outpatient Procedural Care area.
7.3.2.8
Locate the Ambulatory Care adjacent to the following areas:
7.3.2.9
Dedicated procedural rooms will be required in the ambulatory clinic spaces
and will be located proximal to the main exam and consult rooms. The
following dedicated procedural rooms will be provided:
7.3.2.8.1
Cast Clinic
7.3.2.8.2
Cardio-Pulmonary Clinic
The following procedure rooms will be provided within the ambulatory care program:
7.3.2.9.1
Ophthalmology procedural laser
7.3.2.9.2
MOHS Procedural Suite (CR only)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.3.2.10 The Pharmacy component is required to be located proximal to the Medical Day Unit.
The proximity is required to minimize the transport distance and time for chemotherapy
and other infusion drugs. Direct vertical transport is acceptable to minimize transport
time and to reduce travel distances between the components.
7.3.2.11 A physical separation is required between chemotherapy patients receiving infusion
services and non-oncology infusion patients, but the Medical Day Unit will remain a
contiguous department, located directly adjacent to the ambulatory clinics.
Ambulatory Care/ Medical Day Units Public Support Services, Registration, ED, Ortho Clinic
Ambulatory Care/ Medical Day Units Outpatient Procedural Care Ambulatory Care/ Medical Day Units Pharmacy Ambulatory Care/ Medical Day Units Medical Imaging Emergency Department Ambulatory Care/ Medical Day Units 7.3.3
7.3.2.13 Provide Direct Access by General
Circulation to the Outpatient Procedural
Care for shared use of Central Reception
and Waiting Room space.
7.3.2.14 Provide Convenient Access by General
Circulation to the Pharmacy component for
the movement of chemotherapy agents and
for the movement of patients accessing
pharmaceutical consultations.
7.3.2.15 Provide Convenient Access by General
Circulation to the Medical Imaging
component for the movement patients and
their escorts.
7.3.2.16 Provide Direct Access by Internal Circulation
to the Emergency Department component
allowing Ambulatory Clinic rooms to be
utilized to support the Emergency
Department during peak periods.
Internal Design Criteria
7.3.3.1
General Internal Layout
7.3.3.1.1
7.3.2.12 Provide Direct Access by General
Circulation from the Facility’s main lobby for
the movement of patients and their escorts
immediately after arriving on site.
The components shall be organized as follows:
7.3.3.1.1.1
Reception, central/shared administrative area
7.3.3.1.1.2
Shared support areas
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.3.3.1.1.3
Clinical Modules (Refer to 7.3.4.1.1 Diagram 1: Typical Clinical
Module)
7.3.3.1.1.3.1 Two (2) General Exam
7.3.3.1.1.3.2 One (1) Chemotherapy Services and Medical Day
Care – co-located but with distinct care spaces to
segregate patients.
7.3.3.1.1.3.3 One (1) Aboriginal Health Program
7.3.3.1.1.3.4 One (1) Orthopaedics Clinic (Refer to Section
AC.02.02)
7.3.3.1.2
7.3.3.2
The Chemotherapy and Medical Day Care areas have the following
requirements:
7.3.3.1.2.1
Direct observation of all Chemotherapy and Medical
Day Care treatment bays is required from the
associated care team work areas.
7.3.3.1.2.2
Provide accommodation for family members within each
Chemotherapy and Medical Day Care treatment bay
7.3.3.1.2.3
Provide personal television and multi-media devices in
each Chemotherapy and Medical Day Care treatment
bay
7.3.3.1.2.4
Provide visual and auditory privacy for each
Chemotherapy and Medical Day Care treatment bay
7.3.3.1.2.5
Provide the quiet work area directly adjacent to the care
team work area.
7.3.3.1.2.6
Minimize the horizontal or vertical distance from the
Pharmacy to the Chemotherapy and Medical Day Care
for the safe transport of prepared chemo therapeutics.
7.3.3.1.2.7
Chemotherapy Services requires access to the private
exam rooms located within the other modules for use by
clinical staff when examining chemotherapy patients.
Patient Information Confidentiality
7.3.3.2.1
Patients presenting at the unit clerk station at the front of the unit must be able to
provide their personal information without the risk of patients/visitors overhearing
the discussion. Seating/ waiting areas must be sufficiently removed from 1-on-1
registration kiosks to provide acoustic isolation. Kiosks shall be spaced sufficiently
far apart preventing discussions being overheard in the adjacent kiosk. Include
provision for future use of self-service patient registration kiosks.
7.3.3.2.2
Provide for acoustic and visual privacy for patients in examination, treatment and
procedure areas.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.3.3.2.3
All staff workstations, including clinical documentation stations, with the exception
of central reception/registration, require a non-public, acoustically private area to
accommodate the following functions:
7.3.3.2.3.1
Private and confidential patient phone calls
7.3.3.2.3.2
Clinical documentation and charting
7.3.3.2.3.3
Collaboration and interaction with peers
7.3.3.3
7.3.3.4
Infection Control Features
7.3.3.3.1
Hand hygiene sinks will be installed in each area where physical contact with
patients occurs.
7.3.3.3.2
Provide a minimum of one hand-washing sink in each exam and procedure room.
7.3.3.3.3
Provide a minimum of one hand-washing sink, in all areas where patients are
treated.
7.3.3.3.4
Sinks must be oriented to prevent inadvertent splashing onto nearby equipment. In
the case of open areas with multiple patient contact points, consideration shall be
given to installing hand sanitizer dispensing stations at each point. These stations
would be in addition to a centrally located hand hygiene sink.
7.3.3.3.5
Equipment and machines used in this component shall be fabricated using smooth,
non-porous and chemical resistant materials. Their shapes shall allow for easy
cleaning around all sides, and shall be free of inaccessible recessed spaces.
7.3.3.3.6
Inventories of consumable supplies will be physically separated from
soiled/contaminated holding.
7.3.3.3.7
With the exception of endoscopes used in this component, reusable medical
devices and parts will be transported to the MDRD (See OS-STL.09) for
reprocessing. Endoscopes will be processed using purpose-built equipment and
space located close to the point of use.
Flexibility in Space Use
7.3.3.4.1
Outpatient programs and services tend to organize according to a disease or injury
type. As patients age, their conditions typically become more complex and
associated with co-morbidity. Chronic disease intervention recognizes this trend and
will continue becoming more multidisciplinary in dealing with patients’ complex
needs. As programs and services evolve, the space they occupy will also need to
adapt. Use of open plans and modular workstations will enable changes in a
space’s use over time with minimal or no needs for renovations.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.3.3.5
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.3.3.4.2
Flexible examination and treatment space will be designed to adapt to long term
growth, changes in treatment approaches and changes in workload. Modular
concepts of design and layout of the physical space and the use of modular furniture
which can be easily moved and reconfigured will be used to maximize future
flexibility. Plan to include consideration for opportunities for future expansion.
Easily modifiable electrical and mechanical systems are required to support the
reconfiguration of this space in the future
7.3.3.4.3
Standard room sizes and configuration will be utilized except when there are
specific clinical indications warranting an exception.
Internal Circulation
7.3.3.5.1
Routine high volume clinics will be located closest to the patient entry/reception
point.
7.3.3.5.2
The circulation system will be designed to allow efficient movement of ambulatory
and wheelchair patients.
7.3.3.5.3
A minimum of one dedicate clean supply room will be provided for both the
Ambulatory Care clinics and the Medical Day Unit.
7.3.3.5.4
A minimum of one dedicated soiled holding room will be provided for both the
Ambulatory Care clinics and the Medical Day Unit.
7.3.3.5.5
A minimum of one dedicates medication storage room will be provided for both the
Ambulatory Care clinics and the Medical Day Unit.
7.3.3.5.6
7.3.3.6
7.3.3.5.5.1
Automated medication distribution rooms will be stored in the
medication storage rooms. Confirm number and size of automated
medication rooms upon consult with the User Consultation Group.
7.3.3.5.5.2
Upon consultation with the User Consultation Group, ensure the
medication storage room is sufficient size to accommodate the
functional needs of Ambulatory Care clinics and Medical Day Units.
Provide a teaming area centrally located in the clinic module that has countertop
space for all required workstations. (Refer to 7.3.4.1.1 Diagram 1: Typical Clinical
Module).
Environment
7.3.3.6.1
Create an environment conducive to patient comfort
7.3.3.6.2
The Ambulatory component will provide a comfortable, non-institutional environment.
7.3.3.6.2.1
Public washroom shall not open directly on the family waiting area. The
washrooms shall be behind a vestibule or other in an adjacent corridor.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.3.3.6.3
7.3.3.7
7.3.3.8
7.3.3.6.2.2
Provide a canopy over the walk-in entrance and drop off area suitable to
provide weather protection for the entire drop off vehicle and patient
entry process.
7.3.3.6.2.3
Provide a covered vehicle drop off area that is wide enough for two
vehicles to drop off simultaneously.
7.3.3.6.2.4
Staff break and respite area will be provided proximal to the
Ambulatory Care / Medical Day Unit clinical and patient encounter
areas. The staff lounge will be located “off-stage” from the main patient
care areas.
The Ambulatory Care/Medical Day Unit component will experience high patient
volumes daily. There will be peak traffic periods, but constant activity throughout a
workday shall be anticipated.
Furniture and Finishes
7.3.3.7.1
Walls in circulation corridors shall be supplied with guards that will double as hand
rails. Door frames shall be supplied with guards to prevent chipping and denting
caused by mobility aids, delivery carts, stretchers and cleaning machines.
7.3.3.7.2
Flooring shall consist of smooth, non-porous, anti-skid and anti-static material that is
resilient to high traffic, dropped objects and repeated exposure to cleaning
chemicals.
7.3.3.7.3
Furniture used throughout the component shall be modular and/or mobile to allow
fast and efficient conversions to different floor plans. Meeting/interview rooms shall
include several smaller tables that can be either combined or used separately
depending upon the number of groups desired. All furniture shall be comfortable and
easy to clean.
7.3.3.7.4
All televisions shall be tamper proof and controlled by staff only.
Universal Access
7.3.3.8.1
Many of this component’s users will have compromised mobility. The presence of
mobility aids, including canes, crutches, walkers, wheelchairs and motorized
chairs/scooters will be anticipated in all areas where patient contact will occur.
Hallways shall be sufficiently wide to accommodate simultaneous passage of 2
motorized chairs/scooters. Doorways shall also be wide enough to permit passage
of a motorized chair/scooter with at least one escort accompanying at their side.
7.3.3.8.2
Door handles must be of the lever type and consideration shall be given to installing
mechanical opening systems on doorways into key rooms.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.3.3.9
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.3.3.8.3
Floors must be at a common grade, and all floor finishes must be smooth, nonporous, anti-static, non-skid and resilient to heavy traffic. Consideration shall be
given to incorporating visual aids into flooring (e.g., colour used to identify a pod of
rooms) to assist in user orientation and way finding.
7.3.3.8.4
The AHP will be designed to acknowledge the historical, cultural history of the people of
Vancouver Island. The design will integrate cultural practices, use of local finishes, products
e.g. wood. Final determination of the design will be reviewed in consultation with the
Aboriginal Working Group.
7.3.3.8.5
This component will allow for the care of ambulatory patients of aboriginal descent and nonaboriginal descent.
[Intentionally left blank]
7.3.3.10 Disaster Response Resource
7.3.3.10.1 In the event of a major disaster event or pandemic, the ED may become
overwhelmed by the volume of patients. Since the Ambulatory Care/Medical Day
Unit component will be designed and equipped to provide direct patient care,
consideration shall be given to seconding this space for ED overflow. This
transitional role would require ambulance access and a main reception/waiting area
with associated storage that could function as a triage station.
7.3.3.11 Pneumatic Tube Station
7.3.3.11.1 A pneumatic tube station will be installed in this component’s business centre. This
conveyance system will be used to transport documents, small parts/items and
STAT medications and supplies.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 7.3.4
7.3.4.1
AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
Component Functional Diagrams
The areas making up this component shall be organized as illustrated in the following diagrams,
the overall design of the Ambulatory Care Component will be composed of multiple modules, all
contiguously aligned to a single area.
7.3.4.1.1
Diagram 1: Typical Clinical Module – Individual Module
EXECUTION COPY Nortth Island Hospittals Projject SCHED
DULE 3: DESIGN AND CONSTRUC
CTION SPECIFICA
ATIONS APP
PENDIX 3A: CLIN
NICAL SPECIFICA
ATIONS ______________
_____________
______________
____________________________________________________________ __________
AC.02
AMBULATO
ORY CARE/ME
EDICAL DAY U
UNITS
7.3.4.1.2
Diagram
D
2: Ty
ypical Clinical Module – Mu
ultiple Module
es
7.3.4.1.3
Diagram
D
3: Ty
ypical Clinical Module – Mu
ultiple Module
es and Suppo
ort
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
7.3.5
7.3.5.1
Space Table
The Functional Space Requirements illustrates rooms, and their respective sizes, that combine
to make up this functional component. Refer to the respective space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
AC.02 Ambulatory Care/Day Programs
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
4.0
2
8.0
4.0
2
8.0
4.0
6.0
24.0
1
1
1
4.0
6.0
24.0
6.0
10.0
2
1
12.0
10.0
Subtotal, Reception, Central/Shared Administrative Area
72.0
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Reception, Central/Shared Administrative Area
01
Workstation, Clerical,
2 wrkstns each w/ computer terminal - Open design
Information
- Information and way finding services - Volunteer
wrkstn
02
Workstation,
Amb. Clinic and Outpatient procedure scheduling
Clerical/Registration
and registration
03
04
05
Wheelchair Alcove
Business Centre
Waiting Area, Patient/Escort
06
07
Toilet
Office, First Line Leader
Ambulatory Clinic
Capacity for 2 wheelchairs
Business equipment and supplies
Seating for up to 10-15 people, Locate adjacent to
lobby
1 assisted WC, 1 sink
Multipurpose work area, files storage Accommodates meetings with up to 2 people
Design to be determined - Modular concepts of space and design to be utilized with
easily modified electrical and mechanical services and ability to modify physical
layout
08
09
10
11
Exam Room
Group medical visit exam room
Paediatric Play Area
Procedure Room/ Special
Needs Exam
Provide Video Conferencing
Locate adjacent to Aboriginal Health module
Bariatric and procedure room
11.0
18.0
6.0
15.0
26
3
1
3
286.0
54.0
6.0
45.0
12
13
14
Procedure Room, Laser
Alcove, Intake
Workstation, RN/MA
Ophth Procedural Laser
Private area to record patient height, weight
Workstation for Clinic Staff, including dictation
13.0
4.0
4.0
1
4
6
13.0
16.0
24.0
15
16
17
18
19
20
21
Office, Unassigned
Office, Diabetes Education
Utility Room, Clean
Medication Room
Utility Room, Soiled
Storage, Equipment
Toilet, Patient
Quiet Work Area
10.0
10.0
10.0
6.0
6.0
10.0
6.0
2
2
2
1
2
2
2
20.0
20.0
20.0
6.0
12.0
20.0
12.0
41
Teaching Kitchen
Fully Functional kitchen, including stove,
refrigerator, sink, dishwasher
6.0
1
6.0
42
Offices, Aboriginal Health
Program
3 offices must be located together
10.0
3
30.0
Storage for Clinics supplies
locate adjacent to patient intake, include pass
through window
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
AC.02 Ambulatory Care/Day Programs
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
43
Workstations, Unassigned
4.0
3
12.0
44
Workstations, Unassigned
4.0
5
20.0
Subtotal, Ambulatory Clinics
622.0
Design to be determined - Modular concepts of space and design to be utilized
with easily modified electrical and mechanical services and ability to modify physical
layout
Medical Day Care and Cancer
Outpatient Care Areas
22
Treatment Bay, Open- Day
Area
Infusion Bay, three walled treatment area, include
space for family member in infusion bay, include
storage for patient valuables
8.0
6
48.0
23
Treatment Bay, Open- Chemo
Infusion Bay, three walled treatment area, include
space for family member in infusion bay, include
storage for patient valuables
8.0
7
56.0
24
Treatment Bay, Private
12.0
2
24.0
25
MDC Observation, Work Area
2.0
4
8.0
26
Cancer Care Workstation,
Care Team
Private Room for infusions, and Patient Consult,
Provide one dedicated for Chemo Infusions, One
for Medical Day Unit Infusions.
Workstation for Clinics Staff proximal to treatment
bays
RN and Provider Work Area, Cancer Care
3.0
3
9.0
27
28
29
30
31
32
33
34
35
36
37
[RID intentionally left blank]
Work Area, Private
Nourishment, Station
Utility Room, Clean
Medication Room
Utility Room, Soiled
Storage, Equipment
Toilet, Patient
Alcove, Equipment
Alcove, Wheelchair
Alcove, Resuscitation
Equipment
6.0
8.0
10.0
14.0
10.0
10.0
6.0
1.0
2.0
2.0
1
1
1
1
1
1
2
1
1
1
6.0
8.0
10.0
14.0
10.0
10.0
12.0
1.0
2.0
2.0
Subtotal, Medical Day Care and Cancer Outpatient Care Areas
220.0
Quiet Work Area
Storage for supplies
Blanket Warmer
Shared Support Area
38
Housekeeping Room
39
Staff / Lounge
40
Toilet, Staff
1 floor sink, standard wall-mounted sink, storage
cabinetry - Accommodates housekeeping cart
storage
Counter w/ sink, storage cabinetry, microwave
oven, coffee station, full size refrigerator - Seating
for up to 4 people
6.0
1
6.0
18.0
1
18.0
6.0
2
12.0
Subtotal, Shared Support Area
36.0
TOTAL NSM, ALL AREAS
950.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUREMENTS: AC.02 Ambulatory Care/Day Programs
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Reception, Central/Shared Administrative Area
01
Workstation, Clerical,
2 wrkstns each w/ computer terminal - Open design
Information
- Information and way finding services - Volunteer
wrkstn
02
Workstation,
Amb. Clinic and Outpatient procedure scheduling
Clerical/Registration
and registration
03
04
05
Wheelchair Alcove
Business Centre
Waiting Area, Patient/Escort
06
07
Toilet
Office, First Line Leader
Capacity for 2 wheelchairs
Business equipment and supplies
Seating for up to 10-15 people, Locate adjacent to
lobby
Multipurpose work area, files storage Accommodates meetings with up to 2 people
ROOM
SIZE
(nsm)
NUMBE
R OF
ROOMS
4.0
2
8.0
4.0
2
8.0
4.0
6.0
24.0
1
1
1
4.0
6.0
24.0
6.0
10.0
2
1
12.0
10.0
Subtotal, Reception, Central/Shared Administrative Area
Ambulatory Clinic
TOTAL
SIZE
(nsm)
72.0
Design to be determined - Modular concepts of space and design to be utilized with
easily modified electrical and mechanical services and ability to modify physical
layout
11.0
20
220.0
Provide Video Conferencing
18.0
2
36.0
08
09
Exam Room
Group medical visit exam
room
10
11
Paediatric Play Area
Procedure Room/ Special
Needs Exam
Locate adjacent to Aboriginal Health module
Bariatric and procedure room
6.0
15.0
1
2
6.0
30.0
12
13
14
15
16
17
18
19
20
21
22
23
Procedure Room, Laser
Procedure Room, MOHS
Alcove, Dermato-Path
Alcove, Intake
Workstation, RN/MA
Office, Unassigned
Office, Diabetes Education
Utility Room, Clean
Medication Room
Utility Room, Soiled
Storage, Equipment
Toilet, Patient
Ophth Procedural Laser
13.0
14.0
3.0
4.0
4.0
10.0
10.0
10.0
6.0
6.0
10.0
6.0
1
1
1
4
6
2
2
2
1
2
2
2
13.0
14.0
3.0
16.0
24.0
20.0
20.0
20.0
6.0
12.0
20.0
12.0
6.0
1
6.0
10.0
5
50.0
Include Microscope for specimen review
Private area to record patient height, weight
Workstation for Clinic Staff, including dictation
Quiet Work Area
Storage for Clinics supplies
Locate adjacent to patient intake, include pass
through window
41
Teaching Kitchen
Fully Functional kitchen, including stove,
refrigerator, sink, dishwasher
42
Offices, Aboriginal Health
Program
5 offices must be located together
43
Workstations, Unassigned
4.0
3
12.0
44
Workstations, Unassigned
4.0
5
20.0
Subtotal, Ambulatory Clinics
560.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02
AMBULATORY CARE/MEDICAL DAY UNITS
AC.02 Ambulatory Care/Day Programs
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
Medical Day Care and Cancer
Outpatient Care Areas
CONTENTS/KEY FEATURES/DESIGN CRITERIA
ROOM
SIZE
(nsm)
NUMBE
R OF
ROOMS
TOTAL
SIZE
(nsm)
Design to be determined - Modular concepts of space and design to be utilized
with easily modified electrical and mechanical services and ability to modify physical
layout
Infusion Bay, three walled treatment area, include
8.0
6
48.0
space for family member in infusion bay, include
storage for patient valuables
24
Treatment Bay, Open- Day
Area
25
Treatment Bay, OpenChemo
Infusion Bay, three walled treatment area, include
space for family member in infusion bay, include
storage for patient valuables
8.0
6
48.0
26
27
Treatment Bay, Private
MDC Observation, Work
Area
Cancer Care Workstation,
Care Team
Private Room for infusions, and Patient Consult
Workstation for Clinics Staff proximal to treatment
bays
RN and Provider Work Area
12.0
2.0
2
4
24.0
8.0
3.0
3
9.0
6.0
8.0
10.0
14.0
10.0
10.0
6.0
1.0
2.0
2.0
1
1
1
1
1
1
2
1
1
1
6.0
8.0
10.0
14.0
10.0
10.0
12.0
1.0
2.0
2.0
Subtotal, Medical Day Care and Cancer Outpatient Care Areas
212.0
28
29
30
31
32
33
34
35
36
37
38
39
[RID Intentionally left blank]
Work Area, Private
Nourishment, Station
Utility Room, Clean
Medication Room
Utility Room, Soiled
Storage, Equipment
Toilet, Patient
Alcove, Equipment
Alcove, Wheelchair
Alcove, Resuscitation
Equipment
Quiet Work Area
Storage for supplies
Blanket Warmer
Shared Support Area
40
Housekeeping Room
41
Staff / Lounge
42
Toilet, Staff
1 floor sink, standard wall-mounted sink, storage
cabinetry - Accommodates housekeeping cart
storage
Counter w/ sink, storage cabinetry, microwave
oven, coffee station, full size refrigerator
6.0
1
6.0
18.0
1
18.0
6.0
2
12.0
Subtotal, Shared Support Area
36.0
TOTAL NSM, ALL AREAS
880.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02.01
ORTHOPAEDIC CLINIC
This specification outlines the functional, operational and physical requirements for the Orthopaedic Clinic
functional component.
8.1
8.1.1
FUNCTIONAL DESCRIPTION
Statement of Purpose
8.1.1.1
8.1.2
The Orthopedic Clinic component will accommodate scheduled visits by patients
requiring assessment, treatment and follow-up of orthopedic conditions. The focus of
component operations will be on assessment of the healing process, remediation of
healing issues and planning and implementation of later-stage healing processes,
including the fabrication and application of custom splints.
Scope of Services
8.1.2.1
Functional Content
8.1.2.1.1
8.1.2.2
The following list specifies the minimum set of functions that must be
accommodated within the functional component’s spaces:
8.1.2.1.1.1
Removal of previously applied casts and orthotics
8.1.2.1.1.2
Orthopedic consultations regarding stage of healing and needs for
continued orthopedic application or fracture re-setting and new
orthopedic application
8.1.2.1.1.3
Completion of referrals to the Medical Imaging component (See
DT.02) for assessment of healing
8.1.2.1.1.4
Application of new casts and orthotics
Exclusions
8.1.2.2.1
The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
8.1.2.2.1.1
8.1.2.3
Anticipated Trends in Service Delivery
8.1.2.3.1
The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of functions
accommodated within this component. Effects of these trends shall be
reflected in the component’s design.
8.1.2.3.1.1
Scheduling and registration services (See OS-GP.06 Central
Patient Registration, Diagnostic Intake and Specimen Collection)
The nature of cast clinic functions will continue being noise intense
and characterized by short duration, high patient volumes.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 8.1.3
AC.02.01
ORTHOPAEDIC CLINIC
Scope of Education Functions
8.1.3.1
8.1.4
Scope of Research Functions
8.1.4.1
8.2
8.2.1
Medical and nursing students and students in the allied health professions from
colleges and universities will receive practical skills training through internships and coop programs. All teaching and supervision functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
Staff and students working in the Orthopaedic Clinic component will, from time-to-time,
be engaged in research. The nature and extent of research functions will be
accommodated in the general work areas, and will not require specialized or dedicated
facilities in this component.
OPERATIONAL DESCRIPTION
LEAN Planning Standards
8.2.1.1
8.2.1.2
Consumable Supply Management
8.2.1.1.1
To the extent practicable, consumable supplies stored in treatment areas
will be organized and stored in a common order and configuration. The
intent of this standard is to enable efficient locating of each supply item
without staff first having to reorient themselves to a new room configuration
and to avoid long travel distances between supplies storage and point of
use.
8.2.1.1.2
All ordering, purchasing, receiving, checking and delivering of supplies will
be conducted through the Materiel Management component (See OSSTL.05).
Utilization Efficiency
8.2.1.2.1
Although small in size, this component will experience large volumes of
daily patient visits. The small size will limit the amount of infrastructure that
can be reasonably assigned to support its functions (e.g., waiting area).
Efficiency in patient scheduling will be a key factor in the success of this
component’s operations, achieving a balance between having assurances
of a continuous flow of patients without creating backlogs and prolonged
wait times.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02.01
ORTHOPAEDIC CLINIC
8.2.1.2.2
8.2.2
Hours of Operation
8.2.2.1
The component at this facility will be staffed and in operation:
8.2.2.1.1
8.2.3
8.2.4
0730 – 1700, Monday to Friday
People Management Systems
8.2.3.1
Most patients seen in this component will arrive according to a scheduled appointment.
Upon entering the Facility patients will proceed directly to the Central Patient
Registration, Diagnostic Intake and Specimen Collection component (See OS-GP.06)
where appointments will be confirmed, as will any other diagnostic procedures
scheduled for the same visit. All patient waiting will be accommodated close to the
Central Patient Registration, Diagnostic Intake and Specimen Collection area or in the
Facility’s lobby area (See OS-GP.04 Public Support Services). Planning assumes that
patient location technology will be part of the Facility’s infrastructure, enabling patients
to be located and notified electronically that an appointment is about to begin.
8.2.3.2
Include provision for future use of self-service patient registration kiosks.
8.2.3.3
After a clinic visit, patients will typically be discharged from the Facility.
Materiel Management Systems
8.2.4.1
Consumable Supplies
8.2.4.1.1
8.2.4.2
Inventories of consumable supplies will be maintained close to point of use.
Items shall be maintained with minimum inventory levels triggering a reordering process. Most supplies will be stored either in bins or on top-up
carts. Inventories on top-up carts will be generally maintained according to
prescribed delivery schedules by either Environmental Services (See OSSTL.03) or Materiel Management (See OS-STL.05).
Linen
8.2.4.2.1
Planning assumes that Facility operations will include a fully integrated
booking/scheduling system in which all Facility-based services participate.
The intent of this specification is to allow patients to move between multiple,
same-day appointments seamlessly, with few delays and short wait times
and without needs to continuously revisit the Central Patient Intake and
Specimen Collection component (See OS-GP.06).
All clean linen used for patient care will be stored close to point of use.
Inventories of commonly used items for immediate, emergency access will
be maintained within the component. All inventories will be managed using
a top-up system.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02.01
ORTHOPAEDIC CLINIC
8.2.4.2.2
8.2.4.3
Pharmaceutical Products
8.2.4.3.1
8.2.4.4
Section not applicable to this component
Waste Management
8.2.4.4.1
Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations.
Throughout this component, waste management is understood to begin at
the individual patient contact locations with centralized collection and
temporary holding stations being located in a general support area.
8.2.4.4.2
Segregation of wastes will accommodate the following categories of
products:
8.2.4.4.2.1
General garbage
8.2.4.4.2.2
Sharps (including potentially biohazardous items)
8.2.4.4.2.3
Infectious or contaminated wastes (excluding sharps)
8.2.4.4.2.4
Clean paper and cardboard
8.2.4.4.2.5
Clean metal (tin and aluminum)
8.2.4.4.2.6
Clean recyclable plastics
8.2.4.4.3
8.2.5
Laundry processing will occur off site at the regional laundry located in
Cumberland. Soiled linen will be collected at a central location in small
hampers, temporarily staged and consolidated prior to removal to the
Environmental Services component (See OS-STL.03) for off-site transfer.
Clean linen returning from the regional laundry will be delivered to central
receiving facilities in the Environmental Services component before being
sorted and delivered to this component.
All sink and floor drains in this component will have plaster traps
incorporated into their installation.
Information Management Systems
8.2.5.1
All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, and mobile pads. Access to the EMR will be controlled electronically with
varying levels of security clearance determining a person’s access to different sections
and their ability to enter/edit data.
8.2.5.2
Diagnostic images that are part of a patient’s EMR will be available to authorized
personnel on monitors located in the Orthopedic Clinic procedures room.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02.01
ORTHOPAEDIC CLINIC
8.2.5.3
The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authorities strategic investment in Cerner and other
clinical and business systems.
8.2.5.4
The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
8.2.5.4.1
Integrated Medication Carts
8.2.5.4.2
Medication Dispense Cabinets
8.2.5.4.3
Mobile and Fixed Computer Devices – Desktop and Wall mounta
8.2.5.4.4
Mobile and Fixed Label Printers
8.2.5.4.5
Mobile and Fixed Barcode Scanners
8.2.5.4.6
Handheld Computer Devices
8.2.5.4.7
Glucometers with Docking Stations
8.2.5.4.8
Tracking Monitors – Patient, Staff, and Resource Tracking
8.2.5.4.9
Clinical Dashboards
8.2.5.4.10 Smart Beds
8.2.5.4.11 Smart Pumps
8.2.5.4.12 Device Integration for real –time clinical assessment and physiological data
documentation
8.2.5.4.13 Digital Room Signage and Way-finding
8.2.5.4.14 Interactive Patient Station
8.2.5.4.15 Location Awareness
8.2.5.4.16 Device Connectivity
8.2.5.4.17 Multifunction Communication Devices with integration to systems
8.2.5.4.18 Telehealth and Virtual Team Capabilities
8.2.5.4.19 Real Time Location System
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02.01
ORTHOPAEDIC CLINIC
8.2.5.4.20 Staff Safety and Duress
8.3
8.3.1
DESIGN CRITERIA
LEAN Planning Standards
8.3.1.1
8.3.1.2
Patient-Focused Care
8.3.1.1.1
A philosophy of patient-focused care applied in this component will mean
that medical, nursing and rehabilitation personnel travel to the patient as
opposed to patients scheduling and moving to different components. One
exception to this policy will be requirements for diagnostic images that will
be accommodated in a nearby Medical Imaging component (See DT.02).
8.3.1.1.2
Shall a clinic visit coincide with needs for images to be taken beforehand,
patients will normally proceed to Medical Imaging before their Orthopedic
Clinic visit. Both of these encounters will have been scheduled allowing time
for the images to be available at the time of the clinic visit.
8.3.1.1.3
Unanticipated needs for diagnostic images that become apparent during a
clinic visit will prompt an unscheduled imaging procedure. Planning
assumes that general digital radiography services conducted in the Medical
Imaging component will have sufficient flexibility and capacity to
accommodate these patients.
Supply Access
8.3.1.2.1
8.3.2
Proximity Relationships
8.3.2.1
Ortho Clinic Each patient contact site will accommodate inventories of commonly used
supplies, with each inventory being designed to address that space’s
functions.
The Orthopaedic clinic requires direct adjacency to the ambulatory care clinics, medical
imaging and patient registration.
8.3.2.2
Medical Imaging Provide Direct Access by General
Circulation to the Medical Imaging
Component for the movement of patients
requiring imaging procedures.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02.01
ORTHOPAEDIC CLINIC
Provide Direct Access by General
Circulation to the Central Patient
Registration, Diagnostic Intake and
Specimen Collection and the Ambulatory
Care components for the movement of
patients accessing this clinic.
8.3.2.4
Provide Direct Access by General
Circulation to the Public Support Services
for the movement of patients accessing this
clinic.
Central Patient Registration, Diagnostic Intake & Specimen Collection, Ambulatory Care Ortho Clinic Public Support Services Ortho Clinic 8.3.3
8.3.2.3
Internal Design Criteria
8.3.3.1
General Internal Layout
8.3.3.1.1
8.3.3.2
The component shall be organized into 2 major areas as follows:
8.3.3.1.1.1
Reception and administrative area (shared with Central Patient
Registration, Diagnostic Intake and Specimen Collection
OS.GP.06)
8.3.3.1.1.2
Procedures and support area
General Design Criteria
8.3.3.2.1
Provide storage cabinets in each cast room
8.3.3.2.2
Provide a plaster trap sink in each cast clinic treatment room
8.3.3.2.3
Provide appropriate ventilation and sound attenuation in each treatment
room. This includes providing acoustic separation of the Casting Room from
the rest of the component and acoustic separation of the stretchers within
the Casting Room from one another. The intent of this requirement is that
casting saws and other equipment can be in use in one stretcher bay while
not disturbing individuals in the second stretcher or the rest of the Clinic.
8.3.3.2.4
Provide a sink in each treatment room
8.3.3.2.5
Each treatment room is required to accommodate a stretcher
8.3.3.2.6
Provide storage in each treatment room for the cast cart.
8.3.3.3
Environmental Control
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02.01
ORTHOPAEDIC CLINIC
8.3.3.4
8.3.3.5
8.3.3.3.1
Application and removal of casts will be associated with the generation of
noise and aerosolized dust. Air handling in the procedures and support area
shall generate down-draft circulation with exhaust inlets located near the
floor. Air shall generally flow from the reception and administrative areas
towards the procedures and support areas before being exhausted to the
exterior. Exhausted air must be filtered.
8.3.3.3.2
The component as a whole must be noise insulated to prevent noise
contamination of adjacent components and spaces. Interior spaces shall
also be noise insulated allowing for acoustic separation between the
reception/administrative functions and casting procedures.
8.3.3.3.3
All floor and sink drains in this component will be equipped with plaster
traps.
Interior Finishes and Features
8.3.3.4.1
Finishes and fixtures used in this component will be designed to minimize
the continual build-up of dust. Horizontal surfaces will be kept to minimum
sizes and will be constructed of smooth, non-porous materials. Finishes are
required to be durable and will last multiple cleaning and harsh chemicals.
8.3.3.4.2
No exposed shelving will be used in this component and all cabinetry will be
capable of being hermetically sealed.
Pediatric-Friendly Environment
8.3.3.5.1
8.3.3.6
Natural Lighting and Exterior Views
8.3.3.6.1
8.3.4
Children will be frequently present in this component. Some features
incorporated into its interior will be scaled for smaller users. Opportunities
for distraction will also help reduce anxiety produced by exposure to loud
noises. Participation by at least one parent during the clinic visit will be
anticipated.
The component’s relatively small size will have the potential of creating the
impression of a confined space. Exterior views and use of glazing will help
promote an open environment. These same features will provide relief for
staff who will spend prolonged periods of time working in this component.
Space Table
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02.01
ORTHOPAEDIC CLINIC
8.3.4.1
The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
AC.02.01 Orthopaedic Clinic
ROOM
SIZE
(nsm)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
Reception and Administrative Area
01
Workstation, Clerical/
Registration
02
03
[Intentionally left blank]
Waiting Area, Patient/Escort
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
3.0
1
3.0
12.0
1
12.0
Subtotal, Reception and Administrative Area
15.0
Seating for up to 6 people
Procedures and Support Area
04
Casting Room
2 stretcher positions - Partitioned for privacy and
acoustic separation between stretchers - Floor
drain w/ plaster trap - Ventilated to exhaust dust
- Acoustically insulated room
16.0
1
16.0
05
Alcove, Equipment
Accommodates 2 cast carts - Counter w/ sink,
plaster trap - Cabinetry for supplies - Clean linen
cart
9.0
1
9.0
06
07
Alcove, Soiled Holding
Housekeeping Room
Accommodates 2 totes
1 floor sink, standard wall-mounted sink, storage
cabinetry - Accommodates housekeeping cart
storage
3.0
6.0
1
1
3.0
6.0
Subtotal, Procedures and Support Area
34.0
TOTAL NSM, ALL AREAS
49.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.02.01
ORTHOPAEDIC CLINIC
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROO
M ID
(RID)
ROOM TYPE
AC.02.01 Orthopedic Clinic
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBE
R OF
ROOMS
TOTAL
SIZE
(nsm)
Reception and Administrative Area
01
Workstation, Clerical/
Registration
02
03
[Intentionally left blank]
Waiting Area, Patient/Escort
Procedures and Support Area
04
Casting Room
05
Alcove, Equipment
06
07
Alcove, Soiled Holding
Housekeeping Room
3.0
1
3.0
12.0
1
12.0
Subtotal, Reception and Administrative Area
15.0
2 stretcher positions - Partitioned for privacy and
17.0
1
acoustic separation between stretchers Floor
drain w/ plaster trap - Ventilated to exhaust dust
- Acoustically insulated room
Accommodates 2 cast carts - Counter w/ sink,
9.0
1
plaster trap - Cabinetry for supplies - Clean linen
cart
Accommodates 2 totes
3.0
1
1 floor sink, standard wall-mounted sink, storage
6.0
1
cabinetry - Accommodates housekeeping cart
storage
Subtotal, Procedures and Support Area
17.0
TOTAL NSM, ALL AREAS
50.0
Seating for up to 6 people
9.0
3.0
6.0
35.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
This specification outlines the functional, operational and physical requirements for the Surgical Day Care
functional component.
9.1
9.1.1
9.1.2
FUNCTIONAL DESCRIPTION
Statement of Purpose
9.1.1.1
The Surgical Day Care component exists for the purposes of preparing and final stage
recovering of patients admitted to the Facility for a surgical procedure. Both day
patients and “same day admission” patients will be cared for here; following a
procedure patients will be either returned to this component prior to discharge from the
Facility or will be admitted to an inpatient bed directly from the post anesthetic recovery
room (PARR) of the Surgical Services component (See DT.04)
9.1.1.2
No procedures will be conducted here. Patients will be transferred to the Surgical
Services component for anesthetic induction, procedures and first stage recovery.
Scope of Services
9.1.2.1
Functional Content
9.1.2.1.1
The following list specifies the minimum set of functions that must be
accommodated within the functional component’s spaces:
9.1.2.1.1.1
Receiving patients, completing final documentation and confirming
pre-procedure requirements have been met
9.1.2.1.1.2
Patient changing into gowns and then waiting in either a seated
area or in a bed
9.1.2.1.1.3
Secured storing of patients’ personal belongings
9.1.2.1.1.4
Preparing patients for their procedure (e.g., pre-operative
medication administration)
9.1.2.1.1.5
Conducting final nursing and medical consultations immediately
prior to a procedure
9.1.2.1.1.6
Patient support including changing out of street clothes and secure
storing of personal property
9.1.2.1.1.7
Coordination with Portering Services for transporting patients
between this component and the Surgical Services component
(See DT.04)
9.1.2.1.1.8
Discharge planning including post procedure/wound care
requirements and plans for follow-up visits and consultations
9.1.2.1.1.9
Providing light snacks, beverages and toilet facilities for post
procedure patients awaiting discharge orders
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
9.1.2.2
9.1.2.1.1.10
Final post-operative and post procedure recovery prior to
discharge from the Facility
9.1.2.1.1.11
Overcapacity management of inpatients, as required
Exclusions
9.1.2.2.1
9.1.2.3
9.1.2.2.1.1
Initial greeting, screening and documenting of arriving patients
(See OS-GP.06 Central Patient Intake and Specimen Collection)
9.1.2.2.1.2
Care for patients undergoing scope-based procedures described in
Outpatient Procedural Care (See AC.04)
9.1.2.2.1.3
Long term holding of post procedure patients (Requirements for
stays past 2100 will be assumed to warrant an inpatient admission)
9.1.2.2.1.4
Procedures (See DT.04 Surgical Services and AC.04 OP
Procedural Care)
Anticipated Trends in Service Delivery
9.1.2.3.1
9.1.3
9.1.2.3.1.1
Advances in technology and pharmaceuticals will continue
enabling more invasive-types of procedures to be conducted either
as day surgery or as a day procedure/treatment.
9.1.2.3.1.2
Improvements in anesthetic agents and increasing use of sedation
as opposed to general anesthesia will shorten the post-operative
recovery duration.
Medical and nursing students and students in the allied health professions from
colleges and universities will receive practical skills training through internships and coop programs. All teaching and supervision functions will be accommodated in the
general work areas, or within specified teaching spaces.
Scope of Research Functions
9.1.4.1
The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
should be reflected in the component’s design.
Scope of Education Functions
9.1.3.1
9.1.4
The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
Staff and students working in the Surgical Day Care component will, from time-to-time,
be engaged in research. The nature and extent of research functions will be
accommodated in the general work areas, and will not require specialized or dedicated
facilities in this component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 9.2
9.2.1
AC.03
SURGICAL DAY CARE
OPERATIONAL DESCRIPTION
LEAN Planning Standards
9.2.1.1
9.2.1.2
Consumable Supply Management
9.2.1.1.1
To the extent practicable, consumable supplies stored in treatment areas
will be organized and stored in a common order and configuration. The
intent of this standard is to enable efficient locating of each supply item
without staff first having to reorient themselves to a new room configuration
and to avoid long travel distances between supplies storage and point of
use.
9.2.1.1.2
Wherever practicable, inventories of consumable supplies will rely on a 2bin system. Under this system, stock will be drawn first from a top/front bin.
When the last item has been removed, an electronic tag will be placed on a
monitoring board which will trigger the reordering process. The empty bin
will be replaced with the one previously being held as standby. Two (2)
tags on a monitoring board from the same type of storage bin will trigger a
STAT order and delivery process.
9.2.1.1.3
All ordering, purchasing, receiving, checking and delivering of supplies will
be conducted through the Facility’s Materiels Management component
(See OS-STL.05).
Utilization Efficiency
9.2.1.2.1
This component will experience large volumes of daily patient visits. It will
also experience peak workflow periods. The first peak period is at the
beginning of each work day as patients begin arriving for procedures, and
then again at the end of the day when patients are returning from their
initial stage recovery.
9.2.1.2.2
The component’s small size will limit the amount of infrastructure that can
be reasonably assigned to support its functions (e.g., waiting area).
Efficiency in patient scheduling will be a key factor in the success of this
component’s operations, achieving a balance between having assurances
of a continuous flow of patients without creating backlogs and prolonged
wait times.
9.2.1.2.3
Planning assumes that Facility operations will include a fully integrated
booking/scheduling system in which all Facility-based services participate.
The intent of this specification is to allow patients to move seamlessly, with
few delays and short wait times. Close coordination will be required
between functions occurring in the Surgical Day Care, Surgical Services,
Pre-admission Clinics, Central Patient Registration, Diagnostic Intake and
Specimen Collection and OR Booking components.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 9.2.2
AC.03
SURGICAL DAY CARE
Hours of Operation
9.2.2.1
9.2.3
The component at this facility will be staffed and in operation:
9.2.2.1.1
0630 – 2200, Monday through Friday
9.2.2.1.2
0700 – 2000, Saturday and Sunday
People Management Systems
9.2.3.1
Patient Streams
9.2.3.1.1
All requests for bookings for use of this component will be received
electronically, and at a central booking/scheduling station in the OR
Booking Office (See DT.04 Surgical Services).
9.2.3.1.2
Upon arrival at this component, patients will report to the Central Patient
Registration, Diagnostic Intake and Specimen Collection component where
any outstanding information will be collected. Include provision for future
use of self-service patient registration kiosks.
9.2.3.1.3
Surgical Day Care and same day admission patients will be directed
immediately to a stretcher/change area where they will exchange street
clothes for a hospital gown. All personal property will be stored in a
secured area. Pre-operative medications will be administered by nursing
personnel based in the component or by the Facility’s mobile IV Team.
Patients will then wait in either a bed or recliner chair pending transfer
notification.
9.2.3.1.4
Once notification is received that a patient’s operating/procedure room and
care team are ready, Portering Services will be notified and the patient will
be transferred to the Surgical Services component (See DT.04). Patient
transit will be accomplished walking, in a wheelchair or on a stretcher. In all
cases, a porter escort will be required.
9.2.3.1.5
Initial stage post-operative recovery will occur in the post anaesthetic
recovery room (PARR), which will be part of the Surgical Services
component. Patients designated for discharge either home or to another
HCF will return to the Surgical Day Care component for discharge
planning. Patients designated for inpatient admission will be transferred to
their room directly from the PARR without returning to the Surgical Day
Care component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ 9.2.4
AC.03
SURGICAL DAY CARE
Materiel Management Systems
9.2.4.1
Consumable Supplies
9.2.4.1.1
9.2.4.2
9.2.4.3
9.2.4.4
Linen
9.2.4.2.1
All clean linen used for patient care will be stored close to point of use. A
central stores area in this component will accommodate inventories of
commonly used items for immediate, emergency access. All inventories
will be managed according to a minimum 3-days supply reorder level, and
will be resupplied using a top-up system.
9.2.4.2.2
Laundry processing will occur off-site at the regional laundry located in
Cumberland. Soiled linen will be collected at a central location in small
hampers, temporarily staged and consolidated prior to removal to the
Environmental Services component (See OS-STL.03) for off-site transfer.
Clean linen returning from the regional laundry will be delivered to central
receiving facilities in Environmental Services before being sorted and
delivered to the Surgical Day Care component.
Pharmaceutical Products
9.2.4.3.1
Automation will be used in the inventory management and dispensing of
patient medications. Automated dispensing carts/cabinets (ADC) located
close to a central nurse/communication area will be stocked with unit doses
of commonly used and prescribed medications and dispensed as needed.
Pharmacy personnel will be responsible for inventory management of the
automated stations, whereas nursing personnel will deliver medications
from the stations to the bedside.
9.2.4.3.2
Unstable products will be prepared in the Facility’s Pharmacy component
(see DT.06), and then delivered to the Surgical Day Care component either
according to a prescribed schedule or upon request.
Food Services
9.2.4.4.1
Inventories of consumable supplies will be maintained close to point of use
in this component. Items shall be maintained with minimum inventory levels
triggering a re-ordering process. Most supplies will be stored either in bins
or on top-up carts. Inventories on top-up carts will be generally
maintained according to prescribed delivery schedules by either
Environmental Services (See OS-STL.03) or Materiel Management (See
OS-STL.05).
There will be minimum food requirements given the nature of services
accommodated in this component. Planning assumes that appropriate
mechanisms to support these requirements will be developed during
operational planning.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
9.2.4.5
9.2.5
Waste Management
9.2.4.5.1
To the extent practicable, waste products will be generally managed
according to a system of segregation at point of origin and sequential
consolidation. Operation of this system relies on appropriate containment
facilities for each type of waste product beginning at where the waste is
generated followed by similar, but progressively larger, containment
facilities at key collection locations. Throughout this component, waste
management is understood to begin at the individual patient contact
locations with centralized collection and temporary holding stations being
located in a general support area. Each administrative area will also
accommodate segregation of the types of waste products typically
generated in these types of spaces.
9.2.4.5.2
Segregation of wastes will accommodate the following categories of
products:
9.2.4.5.2.1
General garbage
9.2.4.5.2.2
Sharps (including potentially biohazardous items)
9.2.4.5.2.3
Infectious or contaminated wastes (excluding sharps)
9.2.4.5.2.4
Clean paper and cardboard
9.2.4.5.2.5
Clean metal (tin and aluminum)
9.2.4.5.2.6
Clean recyclable plastics
Information Management Systems
9.2.5.1
It is anticipated that electronic technology will be used to manage more aspects of each
patient’s care. Electronic checking of patient information (e.g., wrist band bar code), for
example, will be used to validate the match between patient and a prescribed
treatment, procedure or medication. This manner of linking the patient to the
information management infrastructure will require reliable and secured wireless
access throughout the Facility.
9.2.5.2
All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, located close to each patient’s bedside and at key staff workstations, and
mobile pads. Access to the EMR will be controlled electronically with varying levels of
security clearance determining a person’s access to different sections and their ability
to enter/edit data.
9.2.5.3
Staffing information will be a managed corporate service. Scheduling, including
providing for sick and vacation relief, will be conducted centrally, and off-site. Notices to
individual staff regarding their schedules will be communicated electronically.
9.2.5.4
The clinical unit and patient care spaces will optimize care delivery through the design
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authorities strategic investment in Cerner and other
clinical and business systems.
9.2.5.5
The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
9.2.5.5.1
Integrated Medication Carts
9.2.5.5.2
Medication Dispense Cabinets
9.2.5.5.3
Mobile and Fixed Computer Devices – Desktop and Wall mounta
9.2.5.5.4
Mobile and Fixed Label Printers
9.2.5.5.5
Mobile and Fixed Barcode Scanners
9.2.5.5.6
Handheld Computer Devices
9.2.5.5.7
Glucometers with Docking Stations
9.2.5.5.8
Tracking Monitors – Patient, Staff, and Resource Tracking
9.2.5.5.9
Clinical Dashboards
9.2.5.5.10 Smart Beds
9.2.5.5.11 Smart Pumps
9.2.5.5.12 Device Integration for real –time clinical assessment and physiological data
documentation
9.2.5.5.13 Digital Room Signage and Way-finding
9.2.5.5.14 Interactive Patient Station
9.2.5.5.15 Location Awareness
9.2.5.5.16 Device Connectivity
9.2.5.5.17 Multifunction Communication Devices with integration to systems
9.2.5.5.18 Telehealth and Virtual Team Capabilities
9.2.5.5.19 Real Time Location System
9.2.5.5.20 Staff Safety and Duress
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
9.3
DESIGN CRITERIA
9.3.1
LEAN Planning Standards
9.3.1.1
9.3.2
Supply Access
9.3.1.1.1
Each patient contact site will accommodate inventories of commonly used
supplies, with each inventory being designed to address that space’s
functions.
9.3.1.1.2
Use of radio frequency identification (RFID) technology will enable on-line
and immediate locating of required pieces of equipment. Once a required
item has been located, Portering Services personnel will be responsible for
retrieving the item and delivering it to its point of use.
9.3.1.1.3
The decentralized inventories and RFID strategies are designed to reduce
the amount of time that medical and nursing staff spend looking for and
retrieving equipment and supplies.
Proximity Relationships
Surgical Day Care Provide Direct Access by Internal Circulation
to the Surgical Services component for the
movement of patient’s pre and postprocedure. Provide direct access to the
PARR department.
9.3.2.2
Provide Convenient Access by General
Circulation to the Central Patient
Registration, Diagnostic Intake and
Specimen Collection component for the
movement of patients and their escorts.
Surgical Services, PARR Central Patient Registration, Diagnostic Intake & Specimen Collection Surgical Day Care 9.3.3
9.3.2.1
Internal Design Criteria
9.3.3.1
General Internal Layout
9.3.3.1.1
The component should be organized into 2 major areas as follows:
9.3.3.1.1.1
Patient intake/nursing/ administrative area
9.3.3.1.1.2
Patient care area
9.3.3.2
Surgical Day Care Organization
9.3.3.2.1
The Surgical Day Care Unit will be configured as an open plan with
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
unobstructed sight lines between a central nurse station and each of the
patient positions. The Surgical Day Care shall be directly adjacent to the
PARR Department. The Surgical Day Care shall be designed to share a
“race-track” loop with PARR to facilitate patient bay overflow capability.
Provide automatic doors with hold opens between PARR and Surgical Day
Care. Where two curtains tracks meet the tracks shall overlap by 200mm
for privacy. This means that the curtain tracks shall run parallel for 200mm
such that there is no gap where the curtains meet. Provide one handwash
sink for every two patient bays. Provide artwork and patient positive
distraction features in the Surgical Day Care Area. Provide a wayfinding
sign that is unique to each bay such that it is visible from the corridor when
the curtains around a patient bay are closed.
9.3.3.3
9.3.3.2.2
No Surgical Day Care patient bay or private room shall be less than
3,300mm wide measured from the inside of the space in the direction of
the sides of the patient. There shall be no less than 800mm at the foot of
the patient bed or privacy curtain bays or 1800mm for private rooms.
9.3.3.2.3
Provide task lighting at the Surgical Day Care team care station. Provide
modular systems furniture for the care station including accessories and
storage. The area behind all care stations shall be suitable for business
centre functions such as large printers, storage, chart storage, and
countertop space. The area shall be equipped with modular systems
furniture and accessories necessary to facilitate clinical operations.
Surgical Day Care Entrance to Surgery
9.3.3.3.1
9.3.3.4
Surgical Waiting Area
9.3.3.4.1
Provide a patient door between Surgical Day Care and the Surgery “racetrack” corridor system. Ensure that the Surgical Day Care patient door into
surgery is central and suitably located for high volumes of patient traffic.
Ensure that the corridor leading into and out of Surgical Day Care has few
corners. All Surgical Day Care patient entrances shall be automatic doors
with push plates on both sides.
Furniture, features and finishes must be non-institutional, comfortable, nontechnical, possibly with music and/or television as a diversion. Design the
waiting area into clusters for those watching TV, for reading and quiet
waiting, and for children playing. Natural light exposure, high ceilings and
access to fresh air should be maximized to support patient and staff wellbeing and orientation. Features promoting Aboriginal culture should appear
throughout the Surgical Day Care. Public washroom shall not open directly
on the family waiting area. The washrooms shall be behind a vestibule or
other in an adjacent corridor. The check-in desk shall have feature lighting
over the desk. Provide stand up height countertop and wheelchair
accessible locations. Provide signage on or above the desk for wayfinding
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
and branding. Provide a status board in the waiting room.
9.3.3.5
Patient Privacy and Confidentiality
9.3.3.5.1
9.3.3.6
9.3.3.7
Achieving an open plan (See Criterion B), while providing privacy for each
patient, will be possible through the use of floor-to-ceiling walls extending
out 1.5 m from the headboard end of the room. Use of glazing for the
remaining span of the 2 side walls will enable patient cubicles that are
enclosed on 3 sides. Breakaway doors can be used to create a private
room/cubicle.
Natural Lighting and Views to the Exterior
9.3.3.6.1
Research has demonstrated the benefits that natural light and views of
natural surroundings offer to recovering patients. Staff satisfaction and
power conservation are additional reasons for including this feature in
patient care areas.
9.3.3.6.2
This component should have access to exterior views. If all component
spaces cannot be offered this exposure, priority will be given to the patient
care areas.
Family Centered Care
9.3.3.7.1
Participation by at least one family member in a patient’s care will be
anticipated. This will be common both prior to the patient leaving the
component for their procedure and again, when the patient returns from
their procedure. The size of patient cubicles and furniture installed with
each cubicle will reflect this occupancy.
9.3.3.8
[Intentionally left blank]
9.3.3.9
Services and Utilities
9.3.3.9.1
Medical gases and suction will service each patient cubicle headboard.
9.3.3.9.2
Monitors at each patient position will fulfill a variety of functions. Staff will
use them to display electronic medical record (EMR) information and to
receive notifications about a patient’s status (e.g., ready for
transport/discharge). Patients will use these same devices for personal
needs including entertainment and receiving post-procedure care
instructions.
9.3.3.10 Assistance for Bariatric Patients
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
9.3.3.10.1 Bariatric patients will often require assistance getting into and out of bed.
Ceiling mounted lift/transfer rail systems will be installed above all patient
positions. Refer to Schedule 3 for detailed weight capacity requirements.
9.3.3.11 Ergonomics for an Aging Workforce
9.3.3.11.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff are required to
use. Ease of access will be among the key criteria. In the patient care
areas, this specification will be reflected in electrical outlets being located
approximately 900 mm (approximately 3’) above floor surface. The type
and number of electrical devices used in the rooms is expected to
increase, and elevated outlets will avoid stress associated with repetitive
bending.
9.3.3.12 Lighting
9.3.3.12.1 There will be a variety of lighting options in this component, each suited to
the functions accommodated in a specified space
9.3.3.12.2 Each patient position must have access to natural lighting and views to the
outside.
9.3.3.12.3 Artificial lighting should follow a general standard of providing “non direct”
lighting. This specification implies fixtures that reflect light upwards, away
from direct eye contact, and especially in those areas where patients will
be either in bed or transported on stretchers.
9.3.3.12.4 Artificial lighting at each patient care position must be variable to provide
different levels of lighting and for different purposes. Lighting must also
accommodate staff’s ability to monitor the patient during the night without
affecting the patient’s ability to sleep.
9.3.3.12.5 Artificial lighting in the administrative and support areas must be variable to
accommodate different levels of ambient lighting commensurate with the
functions ongoing at any one time in that space. Individual workstations
must be provided with task lighting
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
9.3.4
Space Table
9.3.4.1
The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
AC.03 Surgical Day Care
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
NUMBER
OF ROOMS
22.5
5.0
1
2
22.5
10.0
3.7
6.0
1
2
3.7
12.0
Subtotal, Nursing/Administrative Area
48.2
Patient Intake/Nursing/Administrative Area
01 Waiting Area, Patient/Escort
02 Workstation,
Check-in and greeter station
Clerical/Registration
03
Alcove, Wheelchair
04 Toilet
1 assisted WC, 1 sink
Patient Care Area
05 Preparation/Holding Area Stretcher Cubicle
1 stretcher position w/ allowance for change
area and storage of personal items
8.0
11
88.0
12.0
7
84.0
6.0
3
18.0
4.0
12.0
11.0
11.0
4
1
1
1
16.0
12.0
11.0
11.0
2.0
11.0
1
1
2.0
11.0
2.0
1
2.0
6.0
1
6.0
06
Preparation/Holding Area Private Room
1 stretcher position w/ allowance for change
area and storage of personal items
07
Toilet
1 assisted WC, 1 sink - Provides support to all
patient holding cubicles/rooms
Collaboration Centre
08 Collaboration Centre
09 Medication Room
10 Storage, Equipment
11 Utility Room, Clean
12
13
Alcove, Linen
Utility Room, Soiled
14
Nourishment Station
15
Housekeeping Room
TOTAL
SIZE
(nsm)
ROOM SIZE
(nsm)
Accommodation for up to 2 carts - Shelving
for clean linen - Counter w/ sink
Accommodation for up to 4 totes - Includes
sink, hopper, bed pan
flusher/washer/sanitizer, counter w/ sink,
garbage cart and recycling cart
Ice machine - Counter w/ sink, microwave
oven - Half size refrigerator - Storage
cabinetry
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
Subtotal, Patient Care Area
261.0
TOTAL NSM, ALL AREAS
309.2
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.03
SURGICAL DAY CARE
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
AC.03 Surgical Day Care
ROOM
SIZE
(nsm)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Patient Intake/Nursing/Administrative Area
01
Waiting Area, Patient/Escort
02
Workstation,
Check-in and greeter station
Clerical/Registration
03
Alcove, Wheelchair
04
Toilet
Patient Care Area
05
Preparation/Holding Area Stretcher Cubicle
06
07
1
2
22.5
8.0
3.7
6.0
1
2
3.7
12.0
Subtotal, Nursing/Administrative Area
46.2
1 stretcher position w/ allowance for change
area and storage of personal items
8.0
1 stretcher position w/ allowance for change
area and storage of personal items
Toilet
1 assisted WC, 1 sink - Provides support to all
patient holding cubicles/rooms
12
13
Alcove, Linen
Utility Room, Soiled
14
Nourishment Station
15
Housekeeping Room
TOTAL
SIZE
(nsm)
22.5
4.0
Preparation/Holding Area Private Room
Collaboration Centre
08
Collaboration Centre
09
Medication Room
10
Storage, Equipment
11
Utility Room, Clean
NUMBER
OF
ROOMS
Accommodation for up to 2 carts - Shelving
for clean linen - Counter w/ sink
Accommodation for up to 4 totes - Includes
sink, hopper, bed pan
flusher/washer/sanitizer, counter w/ sink,
garbage cart and recycling cart
Ice machine - Counter w/ sink, microwave
oven - Half size refrigerator - Storage
cabinetry
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
8
64.0
4
48.0
6.0
2
12.0
4.0
12.0
11.0
11.0
3
1
1
1
12.0
12.0
11.0
11.0
2.0
11.0
1
1
2.0
11.0
2.0
1
2.0
6.0
1
6.0
12.0
Subtotal, Patient Care Area
191.0
TOTAL NSM, ALL AREAS
237.2
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.1 PURPOSE AND BACKGROUND
10.1.1 All patients deserve high quality care. Patients need to be treated in an atmosphere which
focuses on them as an individual presenting with a medical condition. Designing a new hospital
provides an opportunity to re-examine the environment and the ways that health care services
are provided to meet the needs of all residents of northern Vancouver Island seeking health care,
with particular focus on the needs of the elderly and with sensitivity to the cultural and healing
practices of the Aboriginal community. What is needed is an environment where all members of
the health care team, whether they are employees, physicians or volunteers, can work
collaboratively in promoting health and wellness.
10.1.2 Nowhere in a hospital are the changes resulting from progress in care delivery approaches and
advances in technology more apparent than in ambulatory care. Hospital admission, the most
costly form of care, may be avoided or their length reduced by effective ambulatory care service
delivery. Ambulatory care provides a bridge following hospital discharge and helps reduce the
potential for readmission for the same problem. Growth in ambulatory care services is
anticipated in response to a growing and aging population and from an ongoing shift from
inpatient to outpatient service delivery as treatment and technologies evolves and become more
appropriate for delivery in the outpatient setting.
10.1.3 The shift to outpatient service provision is of great benefit to patients as it is the least disruptive to
their personal lives. Significant numbers of patients will access these ambulatory clinics and it is
important that the design promote safe, quality health care and provide an environment which
considers patients’ needs. The design also must enhance access, care coordination and needs
to be address accessibility and movement of patients between services.
10.1.4 Care which is responsive to patients’ needs is particularly important among vulnerable and
disadvantaged populations such as the elderly or those from culturally diverse backgrounds, such
as Aboriginal Peoples
10.1.5 The planning for this new facility provides an opportunity to explore innovative new ways to
organize the delivery of these services. Concepts of space design and layout, with easily
modified mechanical and electrical systems and options to modify physical layout will be utilized
to ensure the space is able to meet current and adapt to future needs.
10.1.6 This specification outlines the functional, operational and physical requirements for the Outpatient
Procedural Care functional component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.2 FUNCTIONAL DESCRIPTION
10.2.1 Scope of Services
10.2.1.1 The Outpatient Procedural Care component will accommodate scheduled visits by
patients, both adult and paediatric, undergoing minor surgical procedures not requiring
the advanced support of the Surgical Services area; scope-based procedures; and
procedure recovery of patients undergoing an interventional Medical Imaging
procedure.
10.2.1.2 Functional Content
10.2.1.2.1 Patient –focused Programs and Services
10.2.1.2.2 The following list specifies the minimum set of functions that must be
accommodated:
10.2.1.2.2.1
Minor surgical procedures including but not limited to:
12.1.1.1.1.1.1
Ophthalmology; cataracts and laser procedures
12.1.1.1.1.1.2
Minor plastic surgery
12.1.1.1.1.1.3
General surgery/orthopaedic minor procedures
10.2.1.2.2.2
Medical Imaging post interventional procedure recovery
10.2.1.2.2.3
Scope-based procedures including but not limited to:
12.1.1.1.1.1.4
Bronchoscopy
12.1.1.1.1.1.5
Colposcopy
12.1.1.1.1.1.6
Colonoscopy
12.1.1.1.1.1.7
Cystoscopy
12.1.1.1.1.1.8
Gastroscopy
10.2.1.2.2.4
Endoscopic specimen procurement
10.2.1.2.2.5
Patient Preparation and holding pre-procedure
10.2.1.3 Clinic Patient Support
10.2.1.3.1 Centralized booking and scheduling services for all visits conducted in this
component
10.2.1.3.2 Final registration and documentation (shared with AC.02 Ambulatory
Care/Medical Day Care)
10.2.1.3.3 Waiting (shared with AC.02 Ambulatory Care/Medical Day Care)
10.2.1.4 Exclusions
10.2.1.4.1 The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.2.1.4.1.1
Minor procedures and non-invasive medical day treatments (See
AC.02 Ambulatory Care/Medical Day Care)
10.2.1.4.1.2
Surgical Day procedure recovery (See AC.03)
10.2.1.4.1.3
Laparoscopic endoscope procedures (See DT.04)
10.2.1.4.1.4
Day program group learning or education sessions (See AC.03
Ambulatory Care/Medical Day Care)
10.2.1.4.1.5
Medical Imaging pre-interventional procedure care (See DT.02)
10.2.1.4.1.6
Surgical procedures or electro-convulsive therapy (ECT)(See
DT.04)
10.2.1.4.1.7
Specimen analysis (See DT.03 Laboratory Services)
10.2.1.4.1.8
Services provided by the Orthopaedic Clinic (See AC.02.01)
10.2.1.5 Anticipated Trends in Service Delivery
10.2.1.5.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
should be reflected in the component’s design
10.2.1.5.1.1
Evolution of technology resulting in increased numbers and types
of less invasive interventions appropriate for performance in an
Outpatient Procedure area or in Medical Imaging
10.2.1.5.1.2
Growth in ambulatory care in response to a growing and aging
population
10.2.1.5.1.3
Higher levels of patient acuity managed in ambulatory areas
10.2.2 Scope of Education Functions
10.2.2.1 Medical and nursing students and students in the allied health professions from
colleges and universities will receive practical skills training through internships and coop programs. All teaching and supervision functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
10.2.3 Scope of Research Functions
10.2.3.1 Staff and students working in the Ambulatory Procedural Care component will, from
time-to-time, be engaged in research. The nature and extent of research functions will
be accommodated in the general work areas, and in designated teaching spaces.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.3 OPERATIONAL DESCRIPTION
10.3.1 LEAN Planning Standards
10.3.1.1 Patient Flows
10.3.1.1.1 The operation of this component will focus on efficiency in patient flows. A
centrally located reception/registration station shared with Ambulatory
Care/Medical Day Care (AC.02) will help orient patients immediately upon
arrival, and will provide a one-stop location for completing all outstanding
needs. Beyond reception, scheduling strategies will promote directing
scheduled patients directly to their point of care, unless a patient has
arrived early or their care room is not ready. Waiting will be accommodated
in this component (shared with AC.02 Ambulatory Care/Medical Day Care)
Programs, but patients faced with prolonged delays between arrival and
their consultation will be encouraged to access other Facility-based
components (e.g., OS-GP.04 Public Support Services) or other nearby
amenities.
10.3.1.2 Utilization Efficiency
10.3.1.2.1 Planning assumes that Facility operations will include a fully integrated
booking/scheduling system in which all Facility-based services participate.
The intent of this specification is to allow patients to move between
multiple, same-day appointments seamlessly, with few delays and short
wait times and without needs to continuously revisit the central patient
registration area (See OS-GP.06 Central Patient Registration, Diagnostic
Intake and Specimen Collection).
10.3.1.3 Patient-Centered Care
10.3.1.3.1 To the extent practicable, ambulatory services will be designed around the
patient.
10.3.1.4 Consumable Supply Management
10.3.1.4.1 Inventories of consumable supplies will be maintained close to point of use
in this component. Items shall be maintained with minimum inventory levels
triggering a re-ordering process. Most supplies will be stored either in bins
or on top-up carts. Inventories on top-up carts will be generally
maintained according to prescribed delivery schedules by either
Environmental Services (See OS-STL.03) or Materiel Management (See
OS-STL.05).
10.3.1.4.2 All ordering, purchasing, receiving, checking and delivering of supplies will
be conducted through the Materiel Management component (See OSSTL.05).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.3.2 Hours of Operation
10.3.2.1 The component at this facility will be staffed and in operation:
10.3.2.1.1 0700 – 1700, 5 days a week
10.3.3 People Management Systems
10.3.3.1 Patient Streams
10.3.3.1.1 Most patients accessing this component will arrive according to a
scheduled appointment. Upon entering the Facility patients will proceed
directly to the component’s main reception/registration area where
appointments will be confirmed as will any other diagnostic procedures
scheduled for the same visit. All patient waiting will be accommodated
close to reception/registration area or in the Facility’s lobby area (See OSGP.04 Public Support Services). Planning assumes that patient location
technology will be part of the Facility’s infrastructure, enabling patients to
be located and notified electronically that an appointment is about to begin.
10.3.3.1.2 After a clinic visit, patients will typically be discharged from the Facility.
10.3.4 Materiel Management Systems
10.3.4.1 Consumable Supplies
10.3.4.1.1 Inventories of consumable supplies will be maintained close to point of use
in this component. Items shall be maintained with minimum inventory levels
triggering a re-ordering process. Most supplies will be stored either in bins
or on top-up carts. Inventories on top-up carts will be generally
maintained according to prescribed delivery schedules by either
Environmental Services (See OS-STL.03) or Materiel Management (See
OS-STL.05).
10.3.4.1.2 All orders will be sent electronically to the Materiel Management
component (See OS-STL.05) for processing.
10.3.4.2 Linen
10.3.4.2.1 All clean linen used for patient care will be stored close to point of use. A
central clean utility area in this component will accommodate inventories of
commonly used items for immediate, emergency access. All inventories
will be managed according to a minimum 3-days supply reorder level, and
will be resupplied using a top-up system.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.3.4.2.2 Laundry processing will occur off site at the regional laundry located in
Cumberland. Soiled linen will be collected at a central location in small
hampers, temporarily staged and consolidated prior to removal to the
Environmental Services component (See OS-STL.03) for off-site transfer.
Clean linen returning from the regional laundry will be delivered to central
receiving facilities in the Materiel Management component before being
sorted and delivered to the Ambulatory Care/Medical Day Care
component.
10.3.4.3 Pharmaceutical Products
10.3.4.3.1 Pharmaceutical products used in this component will be stored in
automated dispensing carts/cabinets (ADC). Supplies of commonly used
products will be maintained in the Outpatient Procedural Care by
Pharmacy personnel, and replenished on a scheduled basis. Dispensing
from the Outpatient Procedural Care will be conducted by personnel
working in this component; electronic security technology will restrict
dispensing capability to authorized staff.
10.3.4.3.2 STAT needs for products not contained in the OPC will be communicated
electronically to the Pharmacy (See DT.06). STAT deliveries will be
conducted by pneumatic tube, unless the product is fragile or unstable.
10.3.4.3.3 Chemotherapy agents administered to cancer day patients will be prepared
in the Pharmacy component (See DT.06). These products will be delivered
to the appropriate patient care area by Pharmacy personnel, and just prior
to their administration.
10.3.4.4 Food Services
10.3.4.4.1 Provide a nourishment station.
10.3.4.5 Waste Management
10.3.4.5.1 Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations.
Throughout this component, waste management is understood to begin at
the individual patient contact locations with centralized collection and
temporary holding stations being located in a general support area. Each
administrative area will also accommodate segregation of the types of
waste products typically generated in these types of spaces.
10.3.4.5.2 Segregation of wastes will accommodate the following categories of
products:
10.3.4.5.2.1
General garbage
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.3.4.5.2.2
Sharps (including potentially biohazardous items)
10.3.4.5.2.3
Infectious or contaminated wastes (excluding sharps)
10.3.4.5.2.4
Cytoxic and chemotherapy agents
10.3.4.5.2.5
Confidential paper
10.3.4.5.2.6
Clean paper and cardboard
10.3.4.5.2.7
Clean metal (tin and aluminum)
10.3.4.5.2.8
Clean recyclable plastics
10.3.5 Information Management Systems
10.3.5.1 Efficiency in this component’s operation will rely, in part, on a fully integrated booking
and scheduling system in which all Facility-based services participate. The intent of this
specification is to allow patients to move between multiple, same-day appointments
seamlessly, with few delays and short wait times and without needs to continuously
revisit the central reception/registration service based in this component or the Central
Patient Registration, Diagnostic Intake and Specimen Collection component (See OSGP.06). Planning assumes that all registration staff working in the Facility will utilize a
common system, regardless of their workstation location It is anticipated that electronic
technology will be used to manage more aspects of each patient’s care. Electronic
checking of patient information (e.g., wrist band bar code), for example, will be used to
validate the match between patient and a prescribed treatment, procedure or
medication. This manner of linking the patient to the information management
infrastructure will require reliable and secured wireless access throughout the Facility.
10.3.5.2 All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, located close to each patient’s bedside and at key staff workstations, and
mobile pads. Access to the EMR will be controlled electronically with varying levels of
security clearance determining a person’s access to different sections and their ability
to enter/edit data.
10.3.5.3 The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authorities strategic investment in Cerner and other
clinical and business systems.
10.3.5.4 The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.3.5.4.1 Integrated Medication Carts
10.3.5.4.2 Medication Dispense Cabinets
10.3.5.4.3 Mobile and Fixed Computer Devices – Desktop and Wall mounta
10.3.5.4.4 Mobile and Fixed Label Printers
10.3.5.4.5 Mobile and Fixed Barcode Scanners
10.3.5.4.6 Handheld Computer Devices
10.3.5.4.7 Glucometers with Docking Stations
10.3.5.4.8 Tracking Monitors – Patient, Staff, and Resource Tracking
10.3.5.4.9 Clinical Dashboards
10.3.5.4.10 Smart Beds
10.3.5.4.11 Smart Pumps
10.3.5.4.12 Device Integration for real –time clinical assessment and physiological data
documentation
10.3.5.4.13 Digital Room Signage and Way-finding
10.3.5.4.14 Interactive Patient Station
10.3.5.4.15 Location Awareness
10.3.5.4.16 Device Connectivity
10.3.5.4.17 Multifunction Communication Devices with integration to systems
10.3.5.4.18 Telehealth and Virtual Team Capabilities
10.3.5.4.19 Real Time Location System
10.3.5.4.20 Staff Safety and Duress
10.4 DESIGN CRITERIA
10.4.1 LEAN Planning Standards
10.4.1.1 On-Stage versus Off-Stage Areas
10.4.1.1.1 Medical and technical personnel, will be better able to perform their work
when free from distractions. Patient contact areas should be considered as
on-stage and the site where personnel will focus on providing service to the
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
patient. Functions accommodated in technical support and professional
office space should be distraction-free and considered off-stage. No patient
contact should occur in these latter areas.
10.4.1.2 Supply Access
10.4.1.2.1 Each patient contact site will accommodate inventories of commonly used
supplies, with each inventory being designed to address that space’s
functions.
10.4.1.2.2 Use of radio frequency identification (RFID) technology will enable on-line
and immediate locating of required pieces of equipment. Once a required
item has been located, Portering Services personnel will be responsible for
retrieving the item and delivering it to its point of use.
10.4.1.2.3 The decentralized inventories and RFID strategies are designed to reduce
the amount of time that medical and nursing staff spend looking for and
retrieving equipment and supplies.
10.4.1.3 Standardization of Space
10.4.1.3.1 Maximizing the use of all areas in this component will require that each
space be able to accommodate a variety of procedures. This will enable
services to move among eligible locations depending upon space
availability. The process of moving among locations will be facilitated by
designing and configuring rooms to a common plan. Under this scheme,
users will not be faced with needs to reorient themselves with respect to
supply inventory location, electrical power outlet location, audio-visual
equipment, etc. each time they are booked into a different location.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.4.2 Proximity Relationships
Outpatient Procedural Care Medical Imaging Outpatient Procedural Care Ambulatory Care/Day Program Ambulatory Procedural Care MDRD Ambulatory Procedural Care Surgical Services Ambulatory Procedural Care 10.4.2.1 Provide Direct Access by Internal Circulation
to the Medical Imaging component for the
movement of patients and their escorts.
10.4.2.2 Provide Direct Access by General Circulation
from the Ambulatory Care/Day Programs
component for the sharing of Reception and
Waiting Room space.
10.4.2.3 Provide Direct Access by General Circulation
from the MDRD for the processing of
equipment and scopes. Equipment carts
must be closed and secured for transport.
Central Patient Registration, Diagnostic Intake and Specimen Collection 10.4.2.4 Provide Direct Access by General Circulation
to Surgical Services for movement of staff,
equipment and supplies.
10.4.2.5 Provide Direct Access by General Circulation
from the Central Patient Registration,
Diagnostic Intake and Specimen Collection
Component for the movement of patients and
their escorts.
10.4.3 Internal Design Criteria
10.4.3.1 General Internal Layout
10.4.3.1.1 The component should be organized into 5 major areas as follows:
10.4.3.1.1.1
Reception, central/ shared administrative area (shared with AC.02/
Ambulatory Care/Medical Day Care)
10.4.3.1.1.2
Patient Preparation and Holding Area
10.4.3.1.1.3
Procedure Rooms
10.4.3.1.1.4
Post Procedure Recovery
10.4.3.1.1.5
Shared Support
10.4.3.1.2 Area must be able to accommodate both adult and pediatric patients.
10.4.3.2 Changing Area
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.4.3.2.1 The changing area shall be separate from the waiting area and the gowned
waiting area by doors. Each changing room shall have a door that reaches
the floor but is no more than 1900mm tall (i.e not a full height door). Each
changing stall shall be lockable from the inside with an outside safety
release. Each changing stall shall be large enough for a wheelchair. Each
changing stall shall have room for a bench. Each changing stall shall have
a light, full height mirror and a coat hook on each wall. Each changing stall
shall have a nurse call pull. Provide full height lockers in this area.
10.4.3.3 Gowned Waiting
10.4.3.3.1 The gowned waiting area shall be private from all other waiting areas,
change areas and other traffic. There shall be a TV mounted in this area.
There shall be multiple seating clusters with dividers for privacy.
10.4.3.4 Patient Bays and Chairs
10.4.3.4.1 The patient Holding/Recovery bays (including the private room) shall match
the patient bays in Surgical Day Care (See AC.03). Each bay or private
room shall match the design and layout including configuration, equipment
layout and organization and infrastructure provided. All patient bays and
chairs shall have direct visibility from the care station. Provide one hand
wash sink for every two patient bays. Provide artwork and patient positive
distraction features in the Recovery area. Provide a way finding sign that is
unique to each bay such that it is visible from the corridor when the
curtains around a patient bay are closed.
10.4.3.5 Care Team Workstation
10.4.3.5.1 Provide task lighting at the care team station. The area behind all care
stations shall be suitable for business centre functions such as large
printers, storage, chart storage, and countertop space. The area shall be
equipped accessories necessary to facilitate clinical operations. This area
shall be acoustically private to provide staff with a space for confidential
conversations and a quiet work environment.
10.4.3.6 Procedure Rooms
10.4.3.6.1 All procedure rooms shall have stainless steel work surfaces and storage.
Provide full height storage with glass windows in the doors. Provide a
standing height staff workstation. Provide task lighting at all workstations.
Provide wall support for large wall hung monitors. Provide room for scope
cabinets.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.4.3.6.2 The Ophthalmology and General Procedure Rooms are considered
“clean/sterile” procedure rooms and require access to a Scrub Sink. The
Minor Procedure Room and Cystoscopy/Colposcopy rooms are non-sterile
procedures and require access to a hand-washing sink, not a dedicated
scrub sink.
10.4.3.7 Patient Information Confidentiality
10.4.3.7.1 Patients checking in at a central reception/registration station must be able
to provide their personal information without the risk of patients/visitors
overhearing the discussion. Seating/ waiting areas must be sufficiently
removed from 1-on-1 registration kiosks to provide acoustic isolation.
Kiosks should be spaced sufficiently far apart preventing discussions being
overheard in the adjacent kiosk. Include provision for future use of selfservice patient registration kiosks.
10.4.3.7.2 Acoustic and visual privacy is required for patients in prep/holding areas,
procedure rooms and post procedure recovery areas.
10.4.3.8 Infection Control Features
10.4.3.8.1 Hand hygiene sinks will be installed in each area where physical contact
with patients occurs. Sinks must be oriented to prevent inadvertent
splashing onto nearby equipment. In the case of open areas with multiple
patient contact points, consideration should be given to installing hand
sanitizer dispensing stations at each point. These stations would be in
addition to a centrally located hand hygiene sink.
10.4.3.8.2 Equipment and machines used in this component should be fabricated
using smooth, non-porous and chemical resistant materials. Their shapes
should allow for easy cleaning around all sides, and should be free of
inaccessible recessed spaces.
10.4.3.8.3 Inventories of consumable supplies will be physically separated from
soiled/contaminated holding.
10.4.3.8.4 Endoscope and broncoscopy suites will meet CSA HVAC standards for air
exchange and pressurization.
10.4.3.8.5 If patients are required to be recovered outside of bronchoscopy suite a
dedicated negative pressure room will be available.
10.4.3.8.6 Reusable medical devices and parts will be transported to the Medical
Device Reprocessing Department (See OS-STL.09) for reprocessing.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.4.3.9 Flexibility in Space Use
10.4.3.9.1 Flexible treatment space will be designed to adapt to long-term growth,
changes in treatment approaches and changes in workload. Modular
concepts of design and layout will be used to maximize future flexibility.
Plan to include consideration for opportunities for future expansion.
10.4.3.10 Internal Circulation
10.4.3.10.1 Routine high volume clinics will be located closest to the patient
entry/reception point.
10.4.3.10.2 The circulation system will be designed to be sufficiently wide to allow
efficient movement of ambulatory, stretcher, and wheelchair patients.
10.4.3.11 Supervision of Patients
10.4.3.11.1 Visual supervision is needed from the nursing station and work alcoves of
all patients who have undergone some form of preparation for procedures
and patients recovering from procedures.
10.4.3.12 Environment
10.4.3.12.1 Create an environment conducive to patient comfort. Consideration needs
to be given to traffic flows to reduce noise and confusion. As much as
possible, provide a comfortable, non-technical type of environment
10.4.3.13 Lighting
10.4.3.13.1 Specialized lighting appropriate for procedure rooms will be incorporated
into the endoscopy/ procedure rooms.
10.4.3.14 Furniture and Finishes
10.4.3.14.1 The Outpatient Procedural Care component will experience high patient
volumes daily. There will be peak traffic periods, but constant activity
throughout a workday should be anticipated.
10.4.3.14.2 Walls in circulation corridors should be supplied with guards that will
double as hand rails. Door frames should be supplied with guards to
prevent chipping and denting caused by mobility aids, delivery carts,
stretchers and cleaning machines.
10.4.3.14.3 Flooring should consist of smooth, non-porous, anti-skid and anti-static
material that is resilient to high traffic, dropped objects and repeated
exposure to cleaning chemicals.
10.4.3.14.4 Furniture used throughout the component should be modular and/or mobile
to allow fast and efficient conversions to different floor plans. All furniture
should be comfortable and easy to clean.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.4.3.15 Universal Access
10.4.3.15.1 Many of this component’s users will have compromised mobility. The
presence of mobility aids, including canes, crutches, walkers, wheelchairs
and motorized chairs/scooters will be anticipated in all areas where patient
contact will occur.
10.4.3.15.2 Floors must be at a common grade, and all floor finishes must be smooth,
non-porous, anti-static, non-skid and resilient to heavy traffic.
10.4.3.16 Disaster Response Resource
10.4.3.16.1 In the event of a major disaster event or pandemic, the ED may become
overwhelmed by the volume of patients. Since the Outpatient Procedural
Care component will be designed and equipped to provide direct patient
care, this component may be seconded to ED in the event of a disaster.
10.4.3.17 Pneumatic Tube Station
10.4.3.17.1 A pneumatic tube station will be installed in this component’s business
centre. This conveyance system will be used to transport documents, small
parts/items and STAT medications.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
10.4.4 Space Table
10.4.4.1
The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIRMENTS:
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
ROOM TYPE
AC.04 Outpatient Procedural Care
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Patient Intake/Nursing/Administrative Area
01 Workstation, Clerical/
2 multipurpose wrkstns each w/ computer
Registration
terminal
02
Alcove, Wheelchair
03
Toilet, Male/Female
04
Waiting Area, Patient/Escort
Patient Care Area
05 Preparation/ Changing Area
ROOM
SIZE
(nsm)
3.0
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
2
6.0
2.0
1
2.0
6.0
1
6.0
1.5
8
12.0
Subtotal, Nursing/Administrative Area
26.0
1 assisted WC, 1 sink
1 chair for starting IV's - Includes counter w/
sink - Purse lockers for secured storage of
personal items
4.0
4
16.0
06
Holding Area, Gowned
Patients
2.0
4
8.0
07
Holding/ Recovery, Chair
4.0
5
20.0
08
Holding/ Recovery, Stretcher
8.0
6
48.0
09
Private Holding/ Recovery
12.0
1
12.0
6.0
3
18.0
4.0
3
12.0
-
-
-
12.0
1
12.0
14.0
1
14.0
4.0
1
4.0
10
Toilet, Male/Female
11
Collaboration Centre
12
[Intentionally left blank]
13
Medication Room
14
Storage, Equipment
15
Alcove, Equipment
1 assisted WC, 1 sink - Provides support to all
patient holding cubicles/rooms
Emergency Endoscopy Cart (to be used in
ICU) storage, include in Equipment storage
16
Utility Room, Clean
Accommodation for up to 3 carts - Shelving for
clean linen - Counter w/ sink
11.0
1
11.0
17
Utility Room, Soiled
Accommodation for up to 4 totes - Includes
sink, hopper, bed pan
flusher/washer/sanitizer, counter w/ sink,
garbage cart and recycling cart
12.0
1
12.0
18
Nourishment Station
2.0
1
2.0
Subtotal, Patient Care Area
189.0
Procedures Area
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
19
Minor Procedures Room Negative Pressure (Endoscopy
& Bronch)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Supports minor scope procedures
ROOM
SIZE
(nsm)
25.0
NUMBER
OF
ROOMS
2
TOTAL
SIZE
(nsm)
50.0
20
Anteroom, Isolation
2.0
1
2.0
21
Procedure Room Ophthalmology
30.0
1
30.0
22
Alcove, Microscope
23
General Procedure Room,
Plastics & Others ( Positive
Pressure)
24
Minor Procedures Room Cystoscopy/ Colposcopy
25
26
ROOM TYPE
AC.04 Outpatient Procedural Care
Locate in Ophth. Procedure room
1 patient position - Overhead boom system
equipped w/lighting, video monitor, medical
gases and suction - Portable shelving and
cabinetry - Clean linen alcove - Work counter
- 1 double sink for general cleaning - 1 sink
for contaminated equipment - Automated door
for patient entry
Scrub Station
Configured to allow each scrub room to
support 2 Procedure Rooms
Alcove, Linen
1 cart
27
Scope Processing/
Decontamination
28
Workstation, Care team
29
[Intentionally left blank]
Physician Touchdown, Dictation
4.0
1
4.0
25.0
1
25.0
35.0
1
35.0
2.0
1
2.0
2.0
1
2.0
40.0
1
40.0
2.0
2
4.0
-
-
-
Subtotal, Procedures Area
194.0
TOTAL NSM, ALL AREAS
409.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIRMENTS:
CAMPBELL RIVER HOSPITAL
AC.04 Outpatient Procedural Care
ROOM
ID (RID)
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Patient Intake/Nursing/Administrative Area
01 Workstation, Clerical/
2 multipurpose wrkstns each w/ computer
Registration
terminal
02
Alcove, Wheelchair
03
Toilet, Male/Female
04
Waiting Area, Patient/Escort
Patient Care Area
05 Preparation/ Changing Area
3.0
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
2
6.0
2.0
1
2.0
6.0
1
6.0
1.5
8
12.0
Subtotal, Nursing/Administrative Area
26.0
1 assisted WC, 1 sink
1 chair for starting IV's - Includes counter w/
sink - Purse lockers for secured storage of
personal items
4.0
4
16.0
06
Holding Area, Gowned
Patients
2.0
4
8.0
07
Holding/ Recovery, Chair
4.0
5
20.0
08
Holding/ Recovery, Stretcher
8.0
6
48.0
09
Private Holding/ Recovery
12.0
1
12.0
10
Toilet, Male/Female
6.0
3
18.0
11
Collaboration Centre
3.0
3
9.0
12
[Intentionally left blank]
-
-
-
12
Alcove
2.0
1
2.0
1 assisted WC, 1 sink - Provides support to all
patient holding cubicles/rooms
13
Medication Room
12.0
1
12.0
14
Storage, Equipment
14.0
1
14.0
4.0
1
4.0
15
Alcove, Equipment
Away/ Emergency Endoscopy Cart storage,
Include in Equipment storage
16
Utility Room, Clean
Accommodation for up to 3 carts - Shelving for
clean linen - Counter w/ sink
11.0
1
11.0
17
Utility Room, Soiled
Accommodation for up to 4 totes - Includes
sink, hopper, bed pan
flusher/washer/sanitizer, counter w/ sink,
garbage cart and recycling cart
12.0
1
12.0
18
Nourishment Station
2.0
1
2.0
Subtotal, Patient Care Area
186.0
25.0
2
50.0
3.0
1
3.0
30.0
1
30.0
Procedures Area
19 Minor Procedures Room Negative Pressure (Endoscopy
& Bronch)
20
21
ROOM
SIZE
(nsm)
Anteroom, Isolation
Procedure Room Ophthalmology
Supports minor scope procedures
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ AC.04
OUTPATIENT PROCEDURAL CARE
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
22
Alcove, Microscope
23
General Procedure Room,
Plastics & Others ( Positive
Pressure)
24
Minor Procedures Room Cystoscopy/ Colposcopy
25
26
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Locate in Ophth. Procedure room
1 patient position - Overhead boom system
equipped w/lighting, video monitor, medical
gases and suction - Portable shelving and
cabinetry - Clean linen alcove - Work counter 1 double sink for general cleaning - 1 sink for
contaminated equipment - Automated door for
patient entry
ROOM
SIZE
(nsm)
4.0
NUMBER
OF
ROOMS
1
TOTAL
SIZE
(nsm)
4.0
25.0
1
25.0
35.0
1
35.0
2.0
1
2.0
Scrub Station
Alcove, Linen
27
Scope Processing/
Decontamination
28
Workstation, Physician/ Care
team
29
ROOM TYPE
AC.04 Outpatient Procedural Care
[Intentionally left blank]
1 cart
2.0
1
2.0
40.0
1
40.0
2.0
2
4.0
-
-
Physician Touchdown, Dictation
-
Subtotal, Procedures Area
190.0
TOTAL NSM, ALL AREAS
402.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
This specification outlines the functional, operational and physical requirements for the Cardio-Pulmonary
Diagnostic Services functional component.
11.1 FUNCTIONAL DESCRIPTION
11.1.1 Statement of Purpose
11.1.1.1 The Cardio-Pulmonary Diagnostic Services component will accommodate testing and
assessment of functioning of the heart, circulatory and respiratory systems. Services
will be provided to both inpatients and to outpatients.
11.1.2 Scope of Services
11.1.2.1 Functional Content
11.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
11.1.2.1.1.1
Reception and final documentation of ambulatory outpatients that
will occur in the Central Patient Registration, Diagnostic Intake and
Specimen Collection component (See OS-GP.06)
11.1.2.1.1.2
Patient support including change and toilet facilities
11.1.2.1.2 Comox Valley Cardiac Diagnostic Services:
11.1.2.1.2.1
Cardiac ultrasound (Echocardiography)
11.1.2.1.2.2
Electrocardiogram (ECG)
11.1.2.1.2.3
Cardiac stress testing, including as part of MIBI (methoxy-isobutylisonitrile) test protocol
11.1.2.1.2.4
Holter monitoring (Equipment fitting and results analyses)
11.1.2.1.2.5
Implantable cardiac defibrillator (ICD) resetting
11.1.2.1.2.6
24-hour blood pressure monitoring
11.1.2.1.3 Campbell River Cardiac Diagnostic Services:
11.1.2.1.3.1
Cardiac ultrasound (Echocardiography)
11.1.2.1.3.2
Stress Echocardiography testing
11.1.2.1.3.3
Electrocardiogram (ECG)
11.1.2.1.3.4
Cardiac stress testing
11.1.2.1.3.5
Holter monitoring (Equipment fitting and results analyses)
11.1.2.1.3.6
Implantable cardiac defibrillator (ICD) resetting
11.1.2.1.3.7
24-hour blood pressure monitoring
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.1.2.1.3.8
Pacemaker Clinic
11.1.2.1.4 Campbell River and Comox Valley Pulmonary Diagnostic Services:
11.1.2.1.4.1
Plethysmography (Body box)
11.1.2.1.4.2
Aerosol therapy
11.1.2.1.4.3
Spirometry
11.1.2.1.4.4
Sleep studies (Equipment fitting and results analyses)
11.1.2.1.4.5
Walk testing
11.1.2.1.4.6
Bronchial challenges
11.1.2.1.4.7
Arterial blood gas specimen procurement
11.1.2.1.5 Administrative and technical support functions for cardiac technicians and
for the Facility’s respiratory therapy (RT) services
11.1.2.1.6 Segregated storage of gas cylinders and all wastes generated in the
functional component, and including general waste, recyclable materials,
sharps and infectious wastes
11.1.2.2 Exclusions
11.1.2.2.1 The following list specifies functions conducted by Cardio-Pulmonary
personnel that are understood to occur in other components in the Facility
or outside of the Facility:
11.1.2.2.1.1
Bronchoscopy (See AC.02 Ambulatory Care/Day Programs)
11.1.2.2.1.2
Cardioversions (See DT.04 Surgical Services)
11.1.2.2.1.3
MIBI image acquisition (See DT.02 Medical Imaging)
11.1.2.3 Anticipated Trends in Service Delivery
11.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
11.1.2.3.1.1
Calibrating and troubleshooting of devices, including mechanical
ventilators, will be conducted by Cardio-Pulmonary personnel.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.1.3 Scope of Education Functions
11.1.3.1 Technology students from technical colleges and universities will receive practical skills
training through internships and co-op programs. All teaching and supervision functions
will be accommodated in the general work areas, and will not require specialized or
dedicated facilities in this component.
11.1.4 Scope of Research Functions
11.1.4.1 Medical and technology personnel and students will, from time-to-time, be engaged in
research. The nature and extent of research functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
11.1.5 OPERATIONAL DESCRIPTION
11.1.6 LEAN Planning Standards
11.1.6.1 Consumable Supply Management
11.1.6.1.1 To the extent practicable, consumable supplies stored in treatment areas
will be organized and stored in a common order and configuration.
Decentralized supplies must not be accessible to the public to prevent
cross- contamination, and any linen stored in an inpatient room will be
dedicated to that patient. The intent of this standard is to enable efficient
locating of each supply item without staff first having to reorient themselves
to a new room configuration and to avoid long travel distances between
supplies storage and point of use.
11.1.6.1.2 All ordering, purchasing, receiving, checking and delivering of supplies will
be conducted through the Materiel Management component (See OSSTL.05).
11.1.6.2 Utilization Efficiency
11.1.6.2.1 Although small in size, this component will experience large volumes of
daily patient visits. The small size will limit the amount of infrastructure that
can be reasonably assigned to support its functions (e.g., waiting area).
Efficiency in patient scheduling will be a key factor in the success of this
component’s operations, achieving a balance between having assurances
of a continuous flow of patients without creating backlogs and prolonged
wait times.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.1.6.2.2 Planning assumes that Facility operations will include a fully integrated
booking/scheduling system in which all Facility-based services participate.
The intent of this specification is to allow patients to move between
multiple, same-day appointments seamlessly, with few delays and short
wait times and without needs to continuously revisit the Central Patient
Registration, Diagnostic Intake and Specimen Collection component (See
OS-GP.06).
11.1.7 Hours of Operation
11.1.7.1 The Cardio-Pulmonary Diagnostic Services component will be staffed and in operation:
11.1.7.1.1 0700 to 2200, Monday through Friday
11.1.7.2 Respiratory Therapy services will be available:
11.1.7.2.1 0700 to 1900, Monday through Friday
11.1.7.3 Outside the routine hours of operation listed above and depending upon the nature of
service(s) required, RT services will be available on-call locally or by using telehealth
linkages with personnel located off-site.
11.1.8 People Management Systems
11.1.8.1 Most patients seen in this component will arrive according to a scheduled appointment.
Upon entering the Facility patients will proceed directly to the Central Patient
Registration, Diagnostic Intake and Specimen Collection component (See OS-GP.06)
where appointments will be confirmed as will any other diagnostic procedures
scheduled for the same visit. All patient waiting will be accommodated close to the
Central Patient Intake area or in the lobby area (See OS-GP.04 Public Support
Services). Planning assumes that patient location technology will be part of the
Facility’s infrastructure, enabling patients to be located and notified electronically that
an appointment is about to begin.
11.1.8.2 Access into this component will be controlled at all times, although provision will be
made to receive unscheduled walk-in patients. Patients will be under the attention of a
technical staff member for the duration of their stay.
11.1.8.3 After a clinic visit, patients will typically be discharged from the Facility.
11.1.9 Materiel Management Systems
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.1.9.1 Consumable Supplies
11.1.9.1.1 Inventories of consumable supplies will be maintained close to point of use.
Items shall be maintained with minimum inventory levels triggering a reordering process. Most supplies will be stored either in bins or on top-up
carts. Inventories on top-up carts will be generally maintained according
to prescribed delivery schedules by either Environmental Services (See
OS-STL.03) or Materiel Management (See OS-STL.05).
11.1.9.2 Linen
11.1.9.2.1 All clean linen used for patient care will be stored close to point of use.
Linen will be gathered in foot controlled bins until transported to a central
location within Environmental Services (See OS-STL.03) for removal.
11.1.9.2.2 Laundry processing will occur off site at the regional laundry located in
Cumberland. Soiled linen will be consolidated at a central location in the
component, and temporarily held pending removal to the Environmental
Services component (See OS-STL.03) for off-site transfer. Clean linen
returning from the regional laundry will be delivered to central receiving
facilities in the Environmental Services component before being sorted and
delivered to this component.
11.1.9.3 Pharmaceutical Products
11.1.9.3.1 Provide a secured area for minor routine medications. A crash cart located
in the component will contain a standard inventory of pharmaceutical
products. Responsibility for maintaining this inventory and for ensuring that
medications have not passed their expiry date will be assumed by
Pharmacy personnel.
11.1.9.4 Food and Nutrition Services
11.1.9.4.1 Section not applicable to this component
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.1.9.5 Waste Management
11.1.9.5.1 To the extent practicable, waste products will be generally managed
according to a system of segregation at point of origin and sequential
consolidation. Operation of this system relies on appropriate containment
facilities for each type of waste product beginning at where the waste is
generated followed by similar, but progressively larger, containment
facilities at key collection locations. Throughout the Cardio-Pulmonary
Diagnostic Services component, waste management is understood to
begin at the individual patient contact locations with centralized collection
and temporary holding stations being located in a general support area.
Each administrative area will also accommodate segregation of the types
of waste products typically generated in these types of spaces.
11.1.9.5.2 Segregation of wastes will accommodate the following categories of
products:
11.1.9.5.2.1
General garbage
11.1.9.5.2.2
Sharps (including potentially biohazardous items)
11.1.9.5.2.3
Infectious or contaminated wastes (excluding sharps)
11.1.9.5.2.4
Clean paper and cardboard
11.1.9.5.2.5
Clean metal (tin and aluminum)
11.1.9.5.2.6
Clean recyclable plastics
11.1.10 Information Management Systems
11.1.10.1 All patient related information, including diagnostic test results, will be maintained on
the electronic medical record (EMR) system. Wireless technology will enable data entry
using a combination of fixed terminals, and mobile pads. Access to the EMR will be
controlled electronically with varying levels of security clearance determining a person’s
access to different sections and their ability to enter/edit data.
11.1.10.2 Include provision for future use of self-service patient registration kiosks
11.1.10.3 The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authorities strategic investment in Cerner and other
clinical and business systems.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.1.10.4 The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
11.1.10.4.1 Integrated Medication Carts
11.1.10.4.2 Medication Dispense Cabinets
11.1.10.4.3 Mobile and Fixed Computer Devices – Desktop and Wall mounta
11.1.10.4.4 Mobile and Fixed Label Printers
11.1.10.4.5 Mobile and Fixed Barcode Scanners
11.1.10.4.6 Handheld Computer Devices
11.1.10.4.7 Glucometers with Docking Stations
11.1.10.4.8 Tracking Monitors – Patient, Staff, and Resource Tracking
11.1.10.4.9 Clinical Dashboards
11.1.10.4.10 Smart Beds
11.1.10.4.11 Smart Pumps
11.1.10.4.12 Device Integration for real –time clinical assessment and physiological
data documentation
11.1.10.4.13 Digital Room Signage and Way-finding
11.1.10.4.14 Interactive Patient Station
11.1.10.4.15 Location Awareness
11.1.10.4.16 Device Connectivity
11.1.10.4.17 Multifunction Communication Devices with integration to systems
11.1.10.4.18 Telehealth and Virtual Team Capabilities
11.1.10.4.19 Real Time Location System
11.1.10.4.20 Staff Safety and Duress
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.2 DESIGN CRITERIA
11.2.1 LEAN Planning Standards
11.2.1.1 On-Stage versus Off-Stage Areas
11.2.1.1.1 Medical and technical personnel will be better able to perform their work
when free from distractions. Patient contact areas shall be considered as
on-stage and the site where personnel will focus on providing service to the
patient. Functions accommodated in technical support and professional
office space shall be distraction-free and considered off-stage. No patient
contact shall occur in these latter areas.
11.2.1.2 Consumable Supplies Stations
11.2.1.2.1 A key requirement in the component’s design and configuration will be
features that reduce the amount of time technology staff spend travelling to
retrieve supplies and equipment. Technical workspaces in the respective
cardiac and pulmonary areas will incorporate storage and holding space for
inventories of commonly used supplies. To the extent practicable, these
supply stations will be standardized with respect to location and the
organization of supplies that are common between disciplines. Specialized
or unique items will also be standardized in storage location.
11.2.2 Proximity Relationships
11.2.2.1 The Cardio-Pulmonary Diagnostic Services component’s location relative to other
components and the nature of circulation used to move between two components are
illustrated in the diagram below. Proximities are listed according to rank; higher
priorities appear above lower priorities.
11.2.2.1.1 Provide directly adjacent to Medical Imaging
11.2.2.1.2 Provide direct access from the Ambulatory Care Clinics
11.2.2.1.3 Provide direct access to the ED
11.2.2.1.4 Provide directly adjacent to Central Patient Registration component
11.2.2.1.5 Provide proximal access to the Inpatient Care areas, either horizontally or
vertically
Cardio‐Pulmonary Diagnostic Services Diagnostic Imaging 11.2.2.2 Provide Direct Access by Internal Circulation
to the Diagnostic Imaging component for the
movement of patients accessing a shared
reception/registration service and other
diagnostic procedures.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
Cardio‐Pulmonary Diagnostic Services Inpatient Care Areas 11.2.2.3 Provide Direct Access by General
Circulation to the inpatient care areas of this
Facility for the movement of RT staff and
equipment.
11.2.3 Internal Design Criteria
11.2.3.1 General Internal Layout
11.2.3.1.1 The component shall be organized into four major areas as follows:
11.2.3.1.1.1
Cardiac diagnostic area
11.2.3.1.1.2
Pulmonary diagnostic area
11.2.3.1.1.3
Common administrative and technical support area
11.2.3.1.1.4
Dedicated storage for ventilators, including clinical work area
11.2.3.1.2 Treatment areas require emergency call system to summon help in case of
an emergency situation.
11.2.3.2 Access to Public and Non-Public Circulation
11.2.3.2.1 Patients accessing this component will, on occasion, be required to
conduct a 6-minute walk test. This procedure will be difficult to conduct
within the confines of the component’s interior spaces. Convenient access
to this component off a major public corridor will enable walking for the
required time, and in a relatively controlled environment.
11.2.3.2.2 Staff transiting between this component and the inpatient care areas to
deliver ECG testing will require convenient access to non-public/service
circulation.
11.2.3.3 Lighting
11.2.3.3.1 Ceiling mounted light fixtures shall cast light upwards to avoid the shadows
created by direct ambient lighting.
11.2.3.3.2 Spaces assigned to Holter monitor testing must be supplied with task
lighting.
11.2.3.3.3 The room accommodating echocardiography must not have any installed
windows and will have the ability to be rendered completely dark.
11.2.3.3.4 “Testing in Progress” annunciators will be installed immediately next to the
entrances of the respective cardiac and pulmonary diagnostic areas to
prevent inadvertent entry.
11.2.3.4 Component Security
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.2.3.4.1 Access to this component must be controlled at all times. Patients will
proceed from the Central Patient Registration, Diagnostic Intake and
Specimen Collection component (See OS-GP.06) or directed to the Cardio
Pulmonary Department.
11.2.3.4.2 There will be a single point of access/egress off a public circulation
corridor/route for this component. While working with patients or
conducting administrative work, technology staff may not have direct visual
access to this doorway which will be locked at all times. An intercom
system shall be installed outside of this component, and next to its main
entrance. This system shall be connected with voice receivers located in
each of the diagnostic areas close to the technical workstations.
11.2.3.5 Environmental Control
11.2.3.5.1 Patients undergoing cardiac stress testing can become heated by physical
exertion. Room temperature control in the cardiac testing area must be
adjustable enabling creation of a comfortable (by the patients’ standards)
environment within 2 minutes.
11.2.3.5.2 Pulmonary function equipment is very sensitive to environmental
conditions. Constant monitoring of environmental conditions (barometric
pressure, temperature, and relative humidity) will be required for calibration
and quality assurance.
11.2.3.6 Gas and Utility Service Requirements
11.2.3.6.1 Cardiac stress testing, cardiac ultrasound and pulmonary diagnostics areas
must be equipped with the following:
11.2.3.6.1.1
Medical gases
11.2.3.6.1.2
Compressed air
11.2.3.6.1.3
Suction
11.2.3.6.2 All clinical areas within the component need sufficient electrical outlets to
support all planned and anticipated treatment and therapeutic services.
11.2.3.7 Telehealth Technology
11.2.3.7.1 The ability to provide telehealth from the Cardio Pulmonary Department is
required; provide telehealth capability in the procedure, treatment rooms.
11.2.3.8 Natural Lighting and Exterior Views
11.2.3.8.1 The component’s relatively small size will have the potential of creating the
impression of a confined space. Exterior views and use of glazing will help
promote an open environment. These same features will provide relief for
staff who will spend prolonged periods of time working in this component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.2.3.9 Medical Supervision Accommodation
11.2.3.9.1 Clinicians will, on occasion, be in attendance while patients are undergoing
testing. Workstations will be oriented providing direct visual access to a
testing station while, at the same time, allowing the physician to complete
other work.
11.2.3.10 Code Response Station
11.2.3.10.1 Patients undergoing cardiac stress testing and methacholine challenges
will be at risk during the procedure. A crash cart and automatic electronic
defibrillator (AED) will be permanently stored close to the location where
stress tests will be performed. An alarm activation button will installed at
this same location and will be used to summons the “Code Team”.
11.2.3.11 Infection Control Features
11.2.3.11.1 Hand hygiene sinks will be installed in each area where physical contact
with patients occurs. Sinks must be oriented to prevent inadvertent
splashing onto nearby equipment. In the case of open areas with multiple
patient contact points, consideration shall be given to installing hand
sanitizer dispensing stations at each point. These stations would be in
addition to a centrally located hand hygiene sink.
11.2.3.11.2 Equipment and machines used in this component shall be fabricated using
smooth, non-porous and chemical resistant materials. Their shapes shall
allow for easy cleaning around all sides, and shall be free of inaccessible
recessed spaces.
11.2.3.11.3 Inventories of consumable supplies will be physically separated from
soiled/contaminated holding.
11.2.3.11.4 Reusable medical devices and parts will be initially cleaned in this
component, but will be transported to the MDRD (See OS-STL.09) for
reprocessing.
11.2.3.11.5 Cough-inducing procedures conducted on some pulmonary patients will
require that the pulmonary diagnostic area meets the ventilation
specifications for airborne infection control.
11.2.3.11.6 Bronchial challenge testing will require the Pulmonary Function Test room
to be equipped with a ventilation system that provides at least two room air
changes per hour, and without causing a large draft in the vicinity of the
plethysmograph or the patient. The room must be sheltered from outside
air pressure (i.e., need for at least two doors of separation between the
Pulmonary Function Test room and any outside doors).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.2.3.11.7 Upon consultation with clinical champions, ensure all infection control
protocols and requirements are satisfied for all patient treatment areas and
staff work areas.
11.2.3.12 Pneumatic Tube Station
11.2.3.12.1 A pneumatic tube station dedicated to this component. This conveyance
system will be used to transport specimens, small parts/items and STAT
medications.
11.2.4 Component Functional Diagram
11.2.4.1 The areas making up this component shall be organized as illustrated in the following
diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
11.2.5 Space Table
11.2.5.1
The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
DT.01 Cardio-Pulmonary Diagnostic Services
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
2.0
6
12.0
2.0
1
2.0
Sized for assisted changing
4.0
2
8.0
Storage of personal items, valuables
Standard workstations
0.5
6.0
2.0
6
1
3
3.0
6.0
6.0
Storage of personal items, valuables
Business equipment and supplies storage -
0.5
6.0
6
1
3.0
6.0
Subtotal, Reception, Central/Shared Administrative Area
46.0
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Reception, Central/Shared Administrative Area
01 Waiting Area,
Patient/Escort
02
Stretcher/Wheelchair
Alcove
03
04
05
06
Change Room,
Male/Female
Locker, Patient
Toilet, Male/Female
Workstation, Care Team
07
08
Locker, Staff
Business Centre
Cardiac Diagnostic Area
09 Echocardiogram
10
Patient Room, ECG/ Holter
11
Treadmill Room
12
13
14
Stress, MIBI
Alcove, Crash Cart
Holter Monitor
Workstations
Holter, Workroom and
Equipment Storage
15
16
17
14.0
2
28.0
1 patient position - Counter w/ sink, storage
cabinetry
Include two treadmills, potentially open bay, Include
(2) Stretchers
11.0
3
33.0
14.0
1
14.0
28.0
2.0
3.0
1
1
3
28.0
2.0
9.0
4.0
1
4.0
6.0
2.0
2
1
12.0
2.0
Subtotal, Cardiac Diagnostic Area
132.0
3 computer wrkstns - Records management area
Accommodates outfitting of all ambulatory
monitoring equipment - Equipment storage
Toilet, Male/Female
Alcove, Linen
Pulmonary Diagnostic Area
18 Workstation, Tech
19 Testing/Treatment RoomSpecial
Serviced w/ medical gases and suction, 1 room
equipped for telemedicine/teleradiology
20
21
Alcove, Linen
Sleep Apnea Work Area/
Storage
22
Ventilator, Work Area
Includes 1 Testing Booth and 1 spirometry patient
station - High air exchange and pressure controlled
room
2 technical wrkstns - Accommodates equipment
setup for sleep study patients. Equipment storage
6.0
15.6
1
1
6.0
15.6
2.0
8.0
1
1
2.0
8.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
23
24
25
ROOM TYPE
Utility, Soiled
Utility, Clean
Storage, Clean
Supplies
DT.01 Cardio-Pulmonary Diagnostic Services
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Soiled work area for vent decontam
Work area for build of clean vents
Vents supply storage, vents to be stored in ICU
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
10.0
8.0
2.0
1
1
1
10.0
8.0
2.0
Subtotal, Pulmonary Diagnostic Area
51.6
TOTAL NSM, ALL AREAS
229.6
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: DT.01 Cardio-Pulmonary Diagnostic Services
CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
2.0
2.0
6
1
12.0
2.0
Standard workstations
4.0
0.5
6.0
2.0
2
6
1
3
8.0
3.0
6.0
6.0
Storage of personal items, valuables
Business equipment and supplies storage -
0.5
6.0
6
1
3.0
6.0
Subtotal, Reception, Central/Shared Administrative Area
46.0
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Reception, Central/Shared Administrative Area
01 Waiting Area, Patient/Escort
02
Stretcher/Wheelchair
Alcove
03
04
05
06
07
08
Change Room, Male/Female
Locker, Patient
Toilet, Male/Female
Workstation, Care Team
Locker, Staff
Business Centre
Cardiac Diagnostic Area
09 Echocardiogram
Serviced w/ medical gases and suction, 1 room
equipped for telemedicine/teleradiology
14.0
2
28.0
10
Patient Room, ECG/ Holter/
Pacemaker
1 patient position - Counter w/ sink, storage
cabinetry. Room must accommodate stretcher
11.0
4
44.0
11
Treadmill Room
Include two treadmills, potentially open bay,
Include (2) Stretchers
14.0
1
14.0
12
13
14
15
Echo/Stress Testing Room
Alcove, Crash Cart
Holter Monitor Workstations
Holter, Workroom and
Equipment Storage
Includes Echo, Treadmill
28.0
2.0
3.0
4.0
1
1
3
1
28.0
2.0
9.0
4.0
16
17
Work area, Pacemaker Clinic
Toilet, Male/Female
8.0
6.0
1
2
8.0
12.0
18
Alcove, Linen
2.0
1
2.0
Subtotal, Cardiac Diagnostic Area
151.0
Pulmonary Diagnostic Area
19 Workstation, Tech
Sized for assisted changing
Storage of personal items, valuables
3 computer wrkstns - Records management area
Accommodates outfitting of all ambulatory
monitoring equipment - Equipment storage
1 assisted WC, 1 sink - Accessible to users of
other nearby areas
6.0
1
6.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.01
CARDIO-PULMONARY DIAGNOSTIC SERVICES
CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
20
ROOM TYPE
Testing/Treatment RoomSpecial
21
22
Alcove, Linen
Sleep Apnea Work Area/
Storage
23
Ventilator, Work Area
24
25
26
Utility, Soiled
Utility, Clean
Storage, Clean Supplies
DT.01 Cardio-Pulmonary Diagnostic Services
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Includes 1 Testing Booth and 1 spirometry patient
station - High air exchange and pressure
controlled room
2 technical wrkstns - Accommodates equipment
setup for sleep study patients. Equipment storage
Soiled work area for vent decontamination
Work area for build of clean vents
Vents supply storage, vents to be stored in ICU
ROOM
SIZE
(nsm)
15.6
NUMBER
OF
ROOMS
1
TOTAL
SIZE
(nsm)
15.6
2.0
8.0
1
1
2.0
8.0
10.0
8.0
2.0
1
1
1
10.0
8.0
2.0
Subtotal, Pulmonary Diagnostic Area
51.6
TOTAL NSM, ALL AREAS
248.6
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
This specification outlines the functional, operational and physical requirements for the Medical Imaging
(MI) functional component.
12.1 FUNCTIONAL DESCRIPTION
12.1.1 Statement of Purpose
12.1.1.1 The MI component accommodates the imaging of internal organs, bones and system
functioning. Different imaging modalities will be used for diagnostic, and in some cases,
interventional purposes. Component operations will support both scheduled and
unscheduled visits from the ED (See AC.01), inpatient care areas, and outpatient care
areas.
12.1.2 Functional Content – Scope of Services
12.1.2.1 The following list specifies the minimum set of functions that must be accommodated
within the functional component’s spaces:
12.1.2.1.1 Reception, final documentation and any pre-procedure assessment of
ambulatory outpatients following check-in at the Central Patient
Registration, Diagnostic Intake and Specimen Collection component (See
OS-GP.06)
12.1.2.1.2 Reception, triage, holding (including isolation of infectious patients) and
preparation (conscious sedation if required) of patients arriving from the
ED, the inpatient care areas and outpatient procedures
12.1.2.1.3 Imaging using the following modalities:
12.1.2.1.4 Comox Valley:
12.1.2.1.4.1
General Radiography
12.1.2.1.4.2
Fluoroscopy
12.1.2.1.4.3
Magnetic Resonance Imaging (MRI), Adherence to all MR safety
zone requirements is required.
12.1.2.1.4.4
Mammography (Organized as Breast Health Centre
accommodating screening mammography, diagnostic
mammography, stereotactic mammography and ultrasound)
12.1.2.1.4.5
Computed Tomography (CT)
12.1.2.1.4.6
Ultrasound
12.1.1.1.1.1.1
Nuclear Medicine, including the specialized containment
for handling of radioactive isotopes and management of
Nuclear Medicine patients
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
12.1.2.1.4.7
Interventional Radiography (Single Plane)
12.1.2.1.5 Campbell River:
12.1.2.1.5.1
General Radiography
12.1.2.1.5.2
Fluoroscopy Mammography (Organized as Breast Health Centre
accommodating screening mammography, diagnostic
mammography, stereotactic mammography and ultrasound)
12.1.2.1.5.3
Computed Tomography (CT)
12.1.2.1.5.4
Ultrasound
12.1.2.1.5.5
Interventional Radiography (Single Plane)
12.1.2.1.5.6
Bone mineral densitometry
12.1.2.1.6 Patient support including change, waiting and toilet facilities distributed
amongst the modalities
12.1.2.1.7 Processing and interpretation of images including diagnoses of remotely
located patients through the use of telehealth
12.1.2.1.8 Staff support
12.1.2.1.8.1
Maintenance and repair of imaging equipment
12.1.2.1.8.2
Segregated storage of all wastes generated in the functional
component, and including general waste, recyclable materials,
sharps and infectious wastes
12.1.2.2 Exclusions
12.1.2.2.1 The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
12.1.2.2.1.1
Cardiac Ultrasound (Echocardiography – See DT.01 CardioPulmonary Diagnostic Services)
12.1.2.2.1.2
Imaging procedures conducted by MI personnel, but in other
components including: ED (See AC.01), Ambulatory Care/ Medical
Day Care Unit (See AC.02), Surgical Services (See DT.04),
Outpatient Procedural Care (See AC.04) and inpatient care units
(See IP.01 General Medical Surgical Inpatient Units, IP.02
Intensive Care Unit and IP.03 Maternity, Newborn and Pediatric
Inpatient Unit) which will have imaging equipment stored near
point of care
12.1.2.2.1.3
Prolonged monitoring of patients post interventional procedure
(Assumed to be accommodated in AC.04 Outpatient Procedural
Care)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
12.1.2.3 Anticipated Trends in Service Delivery
12.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
12.1.2.3.1.1
Increases in interventional procedures will result in additional
needs for post-procedural recovery and monitoring capacity.
12.1.2.3.1.2
Telehealth technology will continue expanding to provide more
services to remotely located patients and will expand to include
more of the imaging modalities.
12.1.2.3.1.3
The mix of purely diagnostic and interventional imaging procedures
will continue and will increase the average procedure time per
patient.
12.1.2.3.1.4
Demands for breast health services will continue growing as the
number of breast cancer cases continues increasing.
12.1.3 Scope of Education Functions
12.1.3.1 Medical and nursing students and students in the allied health professions from
colleges and universities will receive practical skills training through internships and coop programs. All teaching and supervision functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
12.1.4 Scope of Research Functions
12.1.4.1 Staff and students working in the MI component will, from time-to-time, be engaged in
research. The nature and extent of research functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
12.2 OPERATIONAL DESCRIPTION
12.2.1 LEAN Planning Standards
12.2.1.1 Patient Streaming
12.2.1.1.1 The operation of this component will focus on efficiency in patient flows. A
shared (with other components) and centrally located Patient Registration,
Diagnostic Intake and Specimen Collection component (See OS-GP.06)
will help orient patients immediately upon arriving at the Facility, and will
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
provide a one-stop location for completing initial check-in, registration and
schedule confirmation. Integrated electronic scheduling strategies will
promote streaming patients directly to their point of care with minimal time
spent waiting between successive, multiple appointments. Waiting will be
accommodated in this component, but patients faced with prolonged
delays between arrival and their procedure will be encouraged to access
other Facility-based components (e.g., OS-GP.04 Public Support Services)
or other nearby amenities.
12.2.1.1.2 Scheduling efficiencies in this component will rely on two key patient
streams. Segregating outpatient traffic, scheduled and walk-in from the ED
and inpatient traffic will allow streamlined processing of the high volume,
high turnover cases while keeping some capacity for emergency cases.
Cases arriving from the inpatient areas need to be separated from
outpatient/general public due to infection control and privacy concerns.
12.2.1.2 Consumable Supply Management
12.2.1.2.1 To the extent practicable, consumable supplies stored in treatment areas
will be organized and stored in a common order and configuration. The
intent of this standard is to enable efficient locating of each supply item
without staff first having to reorient themselves to a new room configuration
and to avoid long travel distances between supplies storage and point of
use.
12.2.1.2.2 All ordering, purchasing, receiving, checking and delivering of supplies will
be conducted through the Materiel Management component (See OSSTL.05). Provision will be made for direct ordering of unique/specialty
items by component personnel with approved vendors of these products.
12.2.2 Hours of Operation
12.2.2.1 The component at this facility will be staffed and in operation:
12.2.2.1.1 24 hours-a-day, 7 days-a-week
12.2.3 People Management Systems
12.2.3.1 Patient Streams
12.2.3.1.1 Ambulatory patients arriving for imaging procedures will proceed directly to
a central check-in area to complete any outstanding documentation and to
confirm that any pre-procedure instructions/preparations have been
followed. Once these screening functions are complete, patients will be
directed/escorted to the appropriate modality area inside the MI component
which may include a requirement for the patient to change and/or receive
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
additional preparation. Unscheduled ambulatory arrivals will be registered
assuming the patient has the necessary requisition. Unscheduled and
undocumented ambulatory arrivals will generally be directed to the ED for
assessment or back to the patient’s primary health care practitioner.
12.2.3.1.2 Following a procedure, ambulatory patients will retrieve any personal items
and then be discharged from the component, unless short-term post
procedure monitoring is warranted. Patients requiring post procedure
monitoring will be moved to Outpatient Procedural Care (SeeAC.04).
Patients booked for successive diagnostic tests in a single visit will be
directed to the Central Patient Registration, Diagnostic Intake and
Specimen Collection component (See OS-GP.06) or to their next
destination inside the Facility.
12.2.3.1.3 Some patients from the ED and from various inpatient care areas in the
Facility will typically arrive on stretcher where they will be prepared and
then held, pending availability of an imaging room. Following their
procedure, this group of patients will be returned to their point of origin
unless post procedure monitoring is warranted. Needs for post procedure
monitoring will occur in the patient recovery facilities located in the
Outpatient Procedural Care component (See AC.04).
12.2.4 Materiel Management Systems
12.2.4.1 Consumable Supplies
12.2.4.1.1 Inventories of consumable supplies will be maintained close to point of use.
Items shall be maintained with minimum inventory levels triggering a reordering process. Most supplies will be stored either in bins or on top-up
carts. Inventories on top-up carts will be generally maintained according
to prescribed delivery schedules by either Environmental Services (See
OS-STL.03) or Materiel Management (See OS-STL.05).
12.2.4.2 Linen
12.2.4.2.1 All clean linen used for patient care will be stored close to point of use and
away from public access to minimize the potential of cross contamination.
A clean utility room in this component will accommodate inventories of
commonly used items for immediate, emergency access. All inventories
will be managed according to a minimum 3-days supply reorder level.
12.2.4.2.2 All furniture, fixtures and equipment used in this component should be
fabricated using smooth, non porous materials that are capable of being
decontaminated with hospital grade disinfectants. Their shapes should
allow for easy cleaning around all sides and should be free of inaccessible
spaces.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
12.2.4.2.3 Increases electronic technology increases the number of interfaces
between patients and technical devices. All equipment used in this
component that comes into contact with patients must be able to withstand
frequent and consistent cleaning using hospital-grade products.
12.2.4.2.4 Laundry processing will occur off site at the regional laundry located in
Cumberland. Soiled linen will be consolidated at a central location in the
modality suites in foot activated totes, and temporarily held pending
removal to the Environmental Services component (See OS-STL.03) for
off-site transfer. Clean linen returning from the regional laundry will be
delivered to central receiving facilities in the Environmental Services
component before being sorted and delivered to the modality areas.
12.2.4.3 Pharmaceutical Products
12.2.4.3.1 All pharmaceuticals used in this component will be managed through
Pharmacy (See DT.06). Automated dispensing cabinets (ADC) located in a
secure location within the MI component will be stocked with routinely used
items. Pharmacy personnel will be responsible for replenishing ADC
stocks, and MI personnel will be responsible for delivering medications to
patients.
12.2.4.3.2 Unstable products will be prepared in the Pharmacy component (See
DT.06), and then delivered to the MI component either according to a
prescribed schedule or upon request.
12.2.4.3.3 Comox Valley Nuclear Medicine:
12.2.4.3.3.1
A “hot laboratory” will be included with other Nuclear Medicine
space for the preparation and administration of radioactive
isotopes. Radioactive products will not be processed through the
Pharmacy, but will be delivered directly to the MI component. The
“Hot Lab” will be provided directly adjacent to the nuclear medicine
gamma cameras.
12.2.4.3.3.2
An injection room will be provided directly adjacent to the Nuclear
Medicine imaging rooms
12.2.4.3.3.3
Dedicated “Hot” patient waiting will be provided directly adjacent to
the Nuclear Medicine rooms
12.2.4.3.3.4
A secure storage area for radioactive decay storage is required in
the Hot Lab.
12.2.4.3.3.5
A technician work-area is required directly adjacent to the Hot Lab
and the nuclear medicine cameras
12.2.4.4 Waste Management
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
12.2.4.4.1 Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations.
Throughout the Medical Imaging component, waste management is
understood to begin at the individual patient contact locations with
centralized collection and temporary holding stations being located in a
general support area. Each administrative area will also accommodate
segregation of the types of waste products typically generated in these
types of spaces.
12.2.4.4.2 Segregation of wastes will accommodate the following categories of
products:
12.2.4.4.2.1
General garbage
12.2.4.4.2.2
Sharps (including potentially biohazardous items)
12.2.4.4.2.3
Biohazardous (infectious or contaminated) wastes (excluding
sharps)
12.2.4.4.2.4
Radioactive waste (CV site only)
12.2.4.4.2.5
Confidential paper
12.2.4.4.2.6
Clean paper and cardboard
12.2.4.4.2.7
Clean metal (tin and aluminum)
12.2.4.4.2.8
Clean recyclable plastics
12.2.5 Information Management Systems
12.2.5.1 It is anticipated that electronic technology will be used to manage more aspects of each
patient’s care. Electronic checking of patient information (e.g., wrist band bar code), for
example, will be used to validate the match between patient and a prescribed
treatment, procedure or medication. This manner of linking the patient to the
information management infrastructure will require reliable and secured wireless
access throughout the Facility.
12.2.5.2 All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, and at key staff workstations, and mobile pads. Access to the EMR will be
controlled electronically with varying levels of security clearance determining a person’s
access to different sections and their ability to enter/edit data.
12.2.5.3 Universal application of picture archiving and communication systems (PACS) will be
applied to all imaging modalities accommodated in this Facility. All images will be
processed and stored digitally. Needs for film processing and retention of hard copy
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
images will not be anticipated.
12.2.5.4 Staffing information will be a managed by supervisors responsible for each imaging
modality.
12.2.5.5 The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authorities strategic investment in Cerner and other
clinical and business systems.
12.2.5.6 The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space
requirements of:
12.2.5.6.1 Integrated Medication Carts
12.2.5.6.2 Medication Dispense Cabinets
12.2.5.6.3 Mobile and Fixed Computer Devices – Desktop and Wall mounta
12.2.5.6.4 Mobile and Fixed Label Printers
12.2.5.6.5 Mobile and Fixed Barcode Scanners
12.2.5.6.6 Handheld Computer Devices
12.2.5.6.7 Glucometers with Docking Stations
12.2.5.6.8 Tracking Monitors – Patient, Staff, and Resource Tracking
12.2.5.6.9 Clinical Dashboards
12.2.5.6.10 Smart Beds
12.2.5.6.11 Smart Pumps
12.2.5.6.12 Device Integration for real –time clinical assessment and physiological data
documentation
12.2.5.6.13 Digital Room Signage and Way-finding
12.2.5.6.14 Interactive Patient Station
12.2.5.6.15 Location Awareness
12.2.5.6.16 Device Connectivity
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
12.2.5.6.17 Multifunction Communication Devices with integration to systems
12.2.5.6.18 Telehealth and Virtual Team Capabilities
12.2.5.6.19 Real Time Location System
12.2.5.6.20 Staff Safety and Duress
12.3 DESIGN CRITERIA
12.3.1 LEAN Planning Standards
12.3.1.1 Tiered Patient Access into the Component
12.3.1.1.1 This component’s organization shall respond to typical volumes incurred by
the various imaging modalities. High volume, high turnover procedures
shall be located close to the component’s entrance. Lower volume, more
complex and more time-consuming procedures shall be located further into
the component’s space.
12.3.1.2 On-Stage versus Off-Stage Areas
12.3.1.2.1 Imaging personnel, including medical and technical, will be better able to
perform their work when free from distractions. Patient contact areas shall
be considered as on-stage and the site where personnel will focus on
providing service to the patient. Privacy and confidentiality issues will drive
many of the design and configuration features in the on-stage area.
Functions accommodated in technical support and medical staff office
space shall be distraction-free and considered off-stage. No patient contact
shall occur in these latter areas.
12.3.2 Proximity Relationships
12.3.2.1 A staff lounge will be provided within Medical Imaging,
12.3.2.2 Staff toilets will be provided adjacent to the staff lounge; toilets will not open on to main
public work areas or directly into the staff lounge. Toilets will be accessible to staff
without having to exit the Medical Imaging department
12.3.2.3 A check-in and reception station will be provided within the department; the check-in
and reception station will be provided directly adjacent to the imaging department’s
waiting area.
12.3.2.4 A segregated women’s waiting and changing area will be provided adjacent to the
mammography and ultrasound imaging rooms.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
12.3.2.5 Segregated gowned waiting will be provided for men and women within the department
12.3.2.6 Patient lockers will be provided in the department, for the storage of patients personal
belongings.
12.3.2.7 A patient holding area will be provided in the department for the observation of patients
awaiting imaging services.
12.3.2.7.1 Provide medical gases at each patient observation station
12.3.2.8 Medical gases are required in each imaging room
12.3.2.9 A soiled workroom will be provided in the department for the decontamination of
medical imaging probes. Provide appropriate ventilation to ensure staff safety in the
soiled workroom.
12.3.2.10 Patient toilets will be provided directly adjacent to the following modalities:
12.3.2.10.1 Fluoroscopy
12.3.2.10.2 Ultrasound – Patients receiving ultrasound studies must be able to access
a washroom while gowned from the ultrasound room without walking
through public or general circulation space.
12.3.2.11 Radiologist reading stations/ rooms will be provided in the department. The reading
rooms will be sound and light attenuated. Dimmable lighting will be provided in the
reading rooms. The reading rooms will have no windows or outside light.
Medical Imaging Emergency Department Medical Imaging Outpatient Procedural Care Medical Imaging Medical Imaging Cardio‐ Pulmonary Diagnostic Services Central Patient Registration, Diagnostic Intake & Specimen Collection
12.3.2.12 Provide Direct Access by Internal Circulation
to the ED component for the movement of
patients requiring imaging procedures.
12.3.2.13 Provide Direct Access by Internal Circulation
to the Outpatient Procedural Care component
for the movement of patients requiring post
procedural recovery.
12.3.2.14 Provide Direct Access by Internal Circulation
to the Cardio-Pulmonary Diagnostic Services
component for the movement of patients
accessing a shared reception/registration
service and other diagnostic procedures.
12.3.2.15 Provide Direct Access by General Circulation
to the Central Patient Registration, Diagnostic
Intake and Specimen Collection component
for the movement of patients and their escorts.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
12.3.3 Internal Design Criteria
12.3.3.1 General Internal Layout
12.3.3.1.1 The component shall be organized into 4 major areas as follows:
12.3.3.1.1.1
Receiving/marshaling area
12.3.3.1.1.2
Imaging modalities and associated technical support area,
excluding Nuclear Medicine
12.3.3.1.1.3
Nuclear Medicine area
12.3.3.1.1.4
Administrative and staff support area
12.3.3.1.1.5
Each patient treatment area requires an emergency call system to
summon assistance in the case of a medical emergency.
12.3.3.2 Segregated Entrances
12.3.3.2.1 Separate entrances into this component shall allow for both physical and
visual separation of two arriving patient types. The vast majority of this
component’s users will be ambulatory outpatients. The entrance for this
group shall be easily visible and accessible from the Central Patient
Registration, Diagnostic Intake and Specimen collection component (See
OS-GP.06). This entrance will be characterized by high volume, transient
traffic. Consideration shall be given to a separate point of exit for this high
volume group of users. Separating incoming from outgoing traffic will
reduce the chances for short term congregating which can be distracting to
staff at nearby workstations.
12.3.3.2.2 A second entrance will be used for arriving and departing emergency
patients, ambulance transported patients and inpatients. Planning assumes
a strong affinity between the Facility’s ED (See AC.01) and this MI
component, and dedicated internal circulation linking the 2 will be part of
this criteria. Cases arriving from the ED can be unsettling to the general
public; physical, visual and acoustic isolation from the more public parts of
the component will be required. The holding area for the patients arriving
from the ED must be equipped with medical gases and a patient call
system.
12.3.3.2.3 A third major source of the component’s users will come from the various
inpatient care units. Inpatient arrivals must be accommodated through the
emergency patient entrance. Circulation routes used to access this point
must be sufficiently large to accommodate stretchers and patient beds.
They must also avoid public circulation routes.
12.3.3.3 Unit Organization
12.3.3.3.1 Medical Imaging will be designed around a “race-track” circulation system.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
Imaging Modalities shall be located around a technical support core.
Locate Nuclear Medicine and the MRI in separate and independent suites
that share a corridor system with the overall “race-track” organizational
concept.
12.3.3.4 Emergency Department (ED) Affinity
12.3.3.4.1 A key criteria promoting affinity between the ED and MI is providing
convenient access for emergency patients to computed tomography (CT)
and general radiography. Consideration must be given to locating the CT
procedures and interventional rooms and associated technical support in
close proximity to the entrance used for emergency patients and inpatients.
12.3.3.5 Radioactivity Precautions for Comox Valley
12.3.3.5.1 Accommodation of Nuclear Medicine at the Facility will require special
features for the safe handling of radioactive materials and patients who
have been injected with radioactive contrast media.
12.3.3.5.2 A “hot laboratory” will be required for the storage of radioactive isotopes
and for the preparation of injectable contrast media. A lead-lined fume
hood will be used in media preparation and will also function as the storage
for contaminated sharps pending natural decay of the isotopes.
12.3.3.5.3
[Intentionally left blank]
12.3.3.5.4 Note: Canadian standards for Nuclear Medicine services are specified in
the document Canadian Nuclear Safety Commission/Atomic Energy
Control Board Regulatory Document GD-52 – Design Guide for Basic and
Intermediate Level Radioisotope Laboratories.
12.3.3.6 Internal Circulation and Accessibility
12.3.3.6.1 Some patients will be transported to this component on stretchers and in
hospital beds. Corridors and doorways must be sufficiently wide to permit
transit with a staff member/escort on at least 1 side of the stretcher/bed.
Corridors must be sufficiently wide to permit 2 hospital beds to pass
unimpeded.
12.3.3.7 Environmental Control
12.3.3.7.1 Imaging equipment will generate heat when in operation. Air handling in
this component will be organized into zones enabling independent
temperature regulation in different functional areas.
12.3.3.8 Radiology Reading Environment
12.3.3.8.1 Reading and interpreting diagnostic images will require high resolution (5
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
megapixels) video technology and the environment to support this function.
Reading desks must be back lit, capable of accommodating at least 3
monitors and must be height adjustable.
12.3.3.8.2 Some lighting conditions can degrade the on-screen appearance of
images. Reading rooms must allow for a variety of lighting levels ranging
down to black-out conditions.
12.3.3.8.3 Reading rooms must be removed from the general patient flow and must
be acoustically insulated to accommodate dictation of confidential patient
information and consultations with referring physicians. Voice recognition
technology will be incorporated into each reading room to support dictation
functions.
12.3.3.9 Internal Staff Circulation
12.3.3.9.1 Maximizing staff utilization will encourage a practice of cross-training
imaging technologists for more than 1 imaging modality. Functionality of
these multi-skilled professionals will be enhanced if they are able to easily
move among the various technical work areas while maintaining some
visual contact with their “primary” work area.
12.3.3.10 Lighting
12.3.3.10.1 There will be a variety of lighting options in this component, each suited to
the functions accommodated in a specified space.
12.3.3.10.2 Consideration shall be given to providing staff support and administrative
areas with natural lighting and views to the outside.
12.3.3.10.3 Artificial lighting throughout the component shall follow a general standard
of providing “non direct” lighting. This specification implies fixtures that
reflect light upwards, away from direct eye contact, and especially in those
areas where patients will be either in bed or transported on stretchers.
12.3.3.10.4 Artificial lighting in the administrative and support areas must be variable to
accommodate different levels of ambient lighting commensurate with the
functions ongoing at any one time in that space. Individual workstations
must be provided with task lighting.
12.3.3.10.5 Surface colours used throughout the component must be compatible with
these lighting specifications.
12.3.3.11 Acoustic Privacy
12.3.3.11.1 Every imaging/procedure room, interview room and radiology reading room
must be acoustically insulated to provide confidentiality.
12.3.3.12 Patient Privacy and Confidentiality
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
12.3.3.12.1 Due to the nature of mammography examinations, space assigned to this
modality needs to accommodate private space where patients and their
partners can meet with staff. Change and waiting areas will also need to be
isolated from general traffic/waiting occurring elsewhere in the component.
12.3.3.13 [Intentionally left blank]
12.3.3.14 Impact-Resistant Finishes
12.3.3.14.1 Floors in this component must be durable, non-skid, anti-static and able to
accommodate frequent stretcher/ bed movement from the
emergency/inpatient entrance to the imaging/procedure rooms. All flooring
must facilitate the movement of rolling equipment including mobility aids.
The latter will be commonly used by elderly patients who are prone to
shuffling. Floor finishes must protect against tripping by providing
continuous, smooth and contrasting surfaces.
12.3.3.14.2 Walls and doorways must be equipped with guards to protect against
impact from stretchers, beds, wheelchairs and motorized chairs.
12.3.3.15 Infection Control Features
12.3.3.15.1 Hand hygiene stations shall be placed at each of the following locations:
12.3.3.15.1.1 At each place where contact between patient and staff occurs
12.3.3.15.1.2 At entrances to all imaging and procedure rooms
12.3.3.15.1.3 All imaging rooms must have hand washing sinks
12.3.3.15.1.4 Rooms accommodating procedures must have 2 utility sinks to
allow for separation of clean and dirty items
12.3.3.15.2 Separate facilities will be provided for holding of clean supplies and
equipment and containment of soiled/contaminated items.
12.3.3.16 Patient Security
12.3.3.16.1 All patient toilets in this component will have an emergency call system
installed.
12.3.3.17 Ceiling Lift System
12.3.3.17.1 With the exception of MRI imaging rooms. Refer to Schedule 3 for detailed
specifications and weight capacity requirements.
12.3.3.17.2 A ceiling lift and straight tracking system will be used to accommodate
transfers for the MRI room.
EXECUTION COPY Nortth Island Hospittals Projject SCHED
DULE 3: DESIGN AND CONSTRUC
CTION SPECIFICA
ATIONS APP
PENDIX 3A: CLIN
NICAL SPECIFICA
ATIONS ______________
_____________
______________
____________________________________________________________ __________
DT.02
MED
DICAL IMAGING (MI)
12.3.4 Component
C
Functional
F
Diiagram
12
2.3.4.1 The areas making
g up this com
mponent shall be organized
d as illustrated
d in the follow
wing
diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
12.3.5 Space Table
12.3.5.1 The schedule accompanying this document illustrates rooms, and their respective
sizes, that combine to make up this functional component. Refer to the respective
space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIRENTS: COMOX VALLEY HOSPITAL
ROOM
ID (RID)
ROOM TYPE
Central Reception, Administrative Area
01 Workstation, Clerical/
Registration
02
03
04
05
06
07
[RID Intentionally left blank]
Wheelchair Alcove
Business Centre
Waiting Area, Patient/Escort
Toilet, Male/Female
Holding Area, Stretcher Patients
08
Alcove, Resuscitation
Equipment
Storage Room, Personal/
Valuable Items
09
10
11
12
Change Booth, Standard
Change Booth, Assisted
Toilet, Male/Female
DT.02 Medical Imaging (DI)
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
4.0
4
16.0
4.0
6.0
22.5
6.0
36.0
1
1
1
2
1
4.0
6.0
22.5
12.0
36.0
2.0
1
2.0
Secured room accommodating up to 20 halfhigh, full-width lockers configured 2 banks of
2 tiers
5.5
1
5.5
1 Male, 1 female
1 Male, 1 female
2.0
4.0
6.0
2
2
1
4.0
8.0
6.0
Subtotal, Central Reception, Administrative Area
122.0
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Registration and Scheduling stations
Capacity for 2 wheelchairs
Business equipment and supplies storage
Separate from ambulatory entrance Accommodates up to 4 stretchers and
accompanying porters/staff - Serviced w/
oxygen and suction - Counter w/ sink
Imaging and Technical Support Area
13 Computed Tomography (CT)
Room
14
15
16
17
18
19
20
21
Post Processing Room
Probe Cleaning Room
Toilet Room
22
General Radiography/
Fluoroscopy Room
23
24
Tech Work Core
Office, Private, Network/
PACs Support
25
Generator/Control Room
Post Processing Room
Server Room
Ultrasound Room, Large
Ultrasound Room, Standard
Toilet Room
2 wrkstns
Serviced w/ medical gases and suction
Serviced w/ medical gases and suction, 1
room equipped for telemedicine/teleradiology
6 wrkstns - Acoustically isolated room
Discrete access to/from Ultrasound room
required
Includes control alcove
1 multipurpose wrkstn, files/reference
storage
37.2
1
37.2
18.6
7.4
7.4
16.0
11.0
1
1
1
2
4
18.6
7.4
7.4
32.0
44.0
16.0
7.5
6.0
1
1
2
16.0
7.5
12.0
35.0
3
105.0
3.0
10.0
1
1
3.0
10.0
6.0
1
6.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
ROOM TYPE
DT.02 Medical Imaging (DI)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
26
General Radiography,
Interventional Room
Counter w/ sink, storage cabinetry for
supplies and catheters
46.5
1
46.5
27
Post Processing/Control
Room
Provides service to Interventional Room
15.0
1
15.0
28
Magnetic Resonance Imaging
Room
46.5
1
46.5
29
30
31
32
33
34
Control Room
Equipment Room, MR
MR Safety Zones
Mammography Room
Breast Ultrasound Room
Change Booth, Standard
10.0
8.0
10.0
18.0
16.0
2.0
1
1
1
1
2
2
10.0
8.0
10.0
18.0
32.0
4.0
35
Change Booth, Assisted
4.0
1
4.0
36
Toilet, Female
6.0
1
6.0
37
Waiting, Gowned Patients
1.5
4
6.0
Subtotal, Imaging and Technical Support Area
512.1
Includes control alcove
Provides support to all mammography
services
Provides support to all mammography
services
1 sink, 1 assisted WC - Provides support to
all mammography services
Seating for 4 patients - Provides support to
all mammography services
Nuclear Medicine Area
38 Nuclear Medicine, Scanning
Room
39
40
Storage, Equipment
Control Room
41
Patient Injection Room
42
Patient Waiting, Post Dose
Administration
43
44
Toilet, Patient, Assisted
Hot/Radiopharmaceutical
Laboratory
45
46
47
Radioactive Decay Storage
Technician's Work Area
Housekeeping Room
37.2
2
74.4
9.3
13.9
1
1
9.3
13.9
1 patient position, chair or stretcher Counter w/ sink
9.3
1
9.3
Maximum capacity of 6 patients in
chairs/wheelchairs or fewer people using a
combination of chairs and stretchers
2.0
6
12.0
6.0
14.0
2
1
12.0
14.0
5.0
1
5.0
4.0
6.0
1
1
4.0
6.0
Subtotal, Nuclear Medicine Area
159.9
Computer consoles - View into both
Scanning Rooms
Radioactive material preparation and
storage, counter w/ sink - Pass through into
Patient Injection Room
Containment in lead-lined drums - 2 drums
planned at 32 Imp. Gallons each
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
Administrative and Shared Technical Support Area
48 Office, Private, Radiologist
1 multipurpose wrkstn, files/reference
storage 49 Office, Private
1 multipurpose wrkstn - Viewing terminals
50 Office, Private, Lead
1 multipurpose wrkstn - Meetings with 1
Technologist
person
ROOM
SIZE
(nsm)
12.0
5
60.0
12.0
10.0
1
1
12.0
10.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.02
MEDICAL IMAGING (MI)
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
DT.02 Medical Imaging (DI)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
TOTAL
SIZE
(nsm)
Office, Shared, Technologist
2 multipurpose wrkstns - Common
work/meeting area
4.0
2
8.0
52
Server Room
Environmentally controlled - May be located
w/ imaging rooms
9.0
1
9.0
53
54
Medication Room
Business Centre
12.0
6.0
1
1
12.0
6.0
55
56
Alcove, Equipment
Utility Room, Clean
Mobile Imaging
Accommodation for up to 2 carts - Shelving
for clean linen - Counter w/ sink
3.0
12.0
3
1
9.0
12.0
57
Utility Room, Soiled
Accommodation for up to 4 totes - Includes
sink, hopper, bed pan
flusher/washer/sanitizer, counter w/ sink,
garbage cart and recycling cart
11.0
1
11.0
58
Housekeeping Room
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
6.0
1
6.0
Subtotal, Administrative and Shared Technical Support Area
155.0
60
NUMBER
OF
ROOMS
51
Business equipment and supplies storage
Technical Staff Support
59 Staff/Lounge
ROOM
SIZE
(nsm)
Kitchenette/pantry w/ seating for up to 10
people
Toilet, Staff
25.0
1
25.0
6.0
1
6.0
Subtotal, Technical Staff Support
TOTAL NSM, ALL AREAS
31.0
980.0
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MEDICAL IMAGING (MI)
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
Central Reception, Administrative Area
01
Workstation, Clerical/ Registration
DT.02 Medical Imaging (DI)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Registration and Scheduling stations
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
4.0
4
16.0
4.0
6.0
1.5
6.0
8.0
1
1
12
2
3
4.0
6.0
18.0
12.0
24.0
2.0
1
2.0
02
03
04
05
06
07
[RID Intentionally left blank]
Wheelchair Alcove
Business Centre
Waiting Area, Patient/Escort
Toilet, Male/Female
Holding Area, Stretcher Patients
08
Alcove, Resuscitation
Equipment
Storage Room, Personal/ Valuable
Items
storage of patients and visitors personal
items
5.5
1
5.5
Change Booth, Standard
Change Booth, Assisted
Toilet, Male/Female
1 Male, 1 female
1 Male, 1 female
1 sink, 1 assisted WC
2.0
4.0
6.0
2
2
1
4.0
8.0
6.0
Subtotal, Central Reception, Administrative Area
105.5
09
10
11
12
Business equipment and supplies storage
Separate from ambulatory entrance - include
medical gases
Imaging and Technical Support Area
13
Computed Tomography (CT) Room
14
Generator/Control Room
15
16
17
18
Post Processing Room
Server Room
Ultrasound Room, Large
Ultrasound Room, Standard
19
20
Post Processing Room
Probe Cleaning Room
21
Toilet Room
37.0
1
37.0
2 separate rooms - Environmental controls in
Generator Room
18.0
1
18.0
2 wrkstns
7.4
7.4
16.0
11.0
1
1
2
4
7.4
7.4
32.0
44.0
16.0
7.5
1
1
16.0
7.5
6.0
2
12.0
35.0
3
105.0
3.0
10.0
1
1
3.0
10.0
6.0
46.5
1
2
6.0
93.0
Provides service to Interventional Room
18.0
2
36.0
Includes control alcove
8.0
18.0
1
1
8.0
18.0
Serviced w/ medical gases and suction
Serviced w/ medical gases and suction - 1
room equipped for
telemedicine/teleradiology
6 wrkstns - Acoustically isolated room
Processing equipment - Counter w/ 2 sinks,
storage cabinetry - Serviced w/ negative
pressure
Discrete access to/from Ultrasound room
required
Includes control alcove
22
General Radiography/ Fluoroscopy
Room
23
24
Tech Work Core
Office, Private, Network/ PACs
Support
1 multipurpose wrkstn, files/reference
storage
25
26
Toilet Room
General Radiography, Interventional
Room
Counter w/ sink, storage cabinetry for
supplies and catheters
27
28
29
ROOM
SIZE
(nsm)
Post Processing/Control Room
Storage, Equipment
Mammography Room
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MEDICAL IMAGING (MI)
CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
30
31
32
33
Breast Ultrasound Room
Bone Mineral Densitometry
Workstation, PACS
Change Booth, Standard
34
Change Booth, Assisted
35
36
Toilet, Female
Waiting, Gowned Patients
DT.02 Medical Imaging (DI)
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
16.0
14.0
2.0
2.0
2
1
1
2
32.0
14.0
2.0
4.0
4.0
1
4.0
6.0
1.5
1
4
6.0
6.0
Subtotal, Imaging and Technical Support Area
528.3
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Locate adjacent to Bone Densitometry
Provides support to all mammography
services
Provides support to all mammography
services
Seating for 4 patients - Provides support to
all mammography services
Administrative and Shared Technical Support Area
37
Office, Private, Radiologist
Reading stations (4), 1 to support
Mammography
12.0
4
48.0
10.0
1
10.0
38
Office, Private, Lead Technologist
1 multipurpose wrkstn - Meetings with 1
person
39
Office, Shared, Technologist
2 multipurpose wrkstns - Common
work/meeting area
4.0
2
8.0
40
Server Room
Environmentally controlled - May be located
w/ imaging rooms
9.0
1
9.0
41
42
43
44
Medication Room
Business Centre
Alcove, Equipment
Utility Room, Clean
12.0
6.0
3.0
12.0
1
1
2
1
12.0
6.0
6.0
12.0
45
Utility Room, Soiled
Accommodation for up to 4 totes - Includes
sink, hopper, bed pan
flusher/washer/sanitizer, counter w/ sink,
garbage cart and recycling cart
11.0
1
11.0
46
Housekeeping Room
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
6.0
1
6.0
Subtotal, Administrative and Shared Technical Support Area
128.0
Business equipment and supplies storage
Mobile Imaging
Accommodation for up to 2 carts - Shelving
for clean linen - Counter w/ sink
Technical Staff Support
47
Staff/Lounge
48
Toilet, Staff
Kitchenette/pantry w/ seating for up to 10
people
20.0
1
20.0
6.0
1
6.0
Subtotal, Technical Staff Support
TOTAL NSM, ALL AREAS
26.0
787.8
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SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
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DT.03
LABORATORY
This specification outlines the functional, operational and physical requirements for the Laboratory
functional component.
13.1 FUNCTIONAL DESCRIPTION
13.1.1 Statement of Purpose
13.1.1.1 The Laboratory component accommodates the accessioning and analyzing of
specimens obtained from outpatients, inpatients and patients undergoing surgery. This
component also receives specimens from other HCFs for testing and prepares
specimens for transportation when off-site testing is required. Reporting on all testing,
whether performed on-site or off-site is accommodated in this component.
13.1.2 Scope of Services
13.1.2.1 Functional Content
13.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the functional component’s spaces:
13.1.2.1.1.1 Receipt of specimens from the Central Patient Registration,
Diagnostic Intake and Specimen Collection component (See OSGP.06), Surgical Services (See DT.04), the ED (See AC.01),
Outpatient Procedural Care (See AC.04), all inpatient and
ambulatory care areas and from sources outside of the Facility
13.1.2.1.1.2 Specimen accessioning
13.1.2.1.1.3 Specimen processing and analyzing under the following laboratory
specialties:
13.1.2.1.1.3.1 Core Laboratory Services
13.1.2.1.1.3.2 Core Support Laboratory Services
13.1.2.1.1.3.3 Transfusion Medicine Laboratory (TML is also known as the
Blood Bank.)
13.1.2.1.1.3.4 Microbiology
13.1.2.1.1.3.5 Histology – frozen section, grossing of anatomical pathology
specimens, and interpretation of anatomical pathology slides
in both sites. Processing of AP specimens into slides will
occur in CVH only.
13.1.2.1.2 TML, Haematology and Chemistry form the “Core” laboratory and manual
process for these specialties form the Core Support area.
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13.1.2.1.3 TML functions accommodated on-site include routine testing only (On-site
testing includes initial stage antibody testing with later stages being sent
off-site)
13.1.2.1.4 Histology functions accommodated on-site include gross anatomic
pathology, tissue processing into wax blocks, microtomy, staining/coverslipping of slides, including frozen section analyses in support of surgical
services Specimen preparation for off-site transport and testing
13.1.2.1.5 Medical staff support
13.1.2.1.6 Technical staff support for work-related and personal needs
13.1.2.1.7 Production of treated water required by some testing procedures using
dedicated reverse osmosis (RO)
13.1.2.1.8 Glassware washing
13.1.2.1.9 Storage of blood products for transfusion
13.1.2.1.10 Storage of documents, specimens (room temperature, refrigerated and
frozen), chemicals/reagents and dry ice
13.1.2.1.11 Segregated storage of all wastes generated in the functional component,
and including general waste, confidential paper, recyclable material,
infectious waste and biohazardous waste
13.1.2.2 Exclusions
13.1.2.2.1 The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
13.1.2.2.1.1 Specimen collection (OS-GP.06 Central Patient Registration,
Diagnostic Intake and Specimen Collection; AC.01 ED; AC.04
Outpatient Procedural Care; and DT.04 Surgical Services)
13.1.2.2.1.2 Equipment sterilization (See OS-STL.09 MDRD)
13.1.2.2.1.3 Storage and Viewing of Bodies (See DT.03.01 Morgue and
Autopsy)
13.1.2.3 Anticipated Trends in Service Delivery
13.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
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APPENDIX 3A: CLINICAL SPECIFICATIONS
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LABORATORY
13.1.2.3.1.1 Telehealth and point of care (POC) technology will continue
expanding to provide more laboratory services to remotely located
patients. POC testing provided in remote facilities will be monitored
and this site will continue to have oversight responsibility for this
type of remote testing.
13.1.2.3.1.2 Technology, technical capacity and POC testing will continue
increasing space needs in the Laboratory component.
13.1.2.3.1.3 Laboratory services represent a source of revenue for the Authority.
Attention will continue focusing on streaming patients making it both
convenient and efficient to access these on-site services.
13.1.2.3.1.4 Attracting qualified medical and technical staff to laboratory
medicine will be an ongoing challenge.
13.1.2.3.1.5 Automation, including robotics will enable “walk-way” technology
giving technical staff the option of attending to other functions while
specimen analyzing and reporting is being conducted.
13.1.3 Scope of Education Functions
13.1.3.1 Medical and laboratory technology students from colleges and universities will receive
practical skills training through internships and co-op programs. All teaching and
supervision functions will be accommodated in the general work areas, and will not
require specialized or dedicated facilities in this component.
13.1.4 Scope of Research Functions
13.1.4.1 Staff and students working in the Laboratory component will, from time-to-time, be
engaged in research. The nature and extent of research functions will be
accommodated in the general work areas, and will not require specialized or dedicated
facilities in this component.
13.2 OPERATIONAL DESCRIPTION
13.2.1 LEAN Planning Standards
13.2.1.1 Specimen Transport
13.2.1.1.1 While Laboratory staff will continue to collect specimens through the facility
it is anticipated the some travel requirements will be reduced by use of a
pneumatic tube system. This system will be designed to accommodate
rapid delivery of specimens and hard copy documents to/ from stations
located with Accessioning and Core Laboratory functions.
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APPENDIX 3A: CLINICAL SPECIFICATIONS
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LABORATORY
13.2.1.2 Consumable Supply Management
13.2.1.2.1 The majority of Laboratory consumable supplies will be ordered and
delivered directly to the component. Dry and refrigerated storage must be
located as close as possible to the areas serviced. Many consumables are
time sensitive so rotational storage capacity will be required to allow for
ease of access and to ensure maximum utilization of supplies. Frequent
direct deliveries to the Laboratory will require temporary holding facilities
pending staff’s availability to sort items into storage areas.
13.2.1.2.2 Common stock supplies will be ordered, purchased, checked and delivered
by the Materiels Management component (See OS-STL.05)
13.2.2 Hours of Operation
13.2.2.1 The component at this facility will be staffed and in operation:
13.2.2.1.1 Core and Core Support Laboratory
13.2.2.1.1.1 24 hours-a-day, 7 days-a-week
13.2.2.1.2 Histology
13.2.2.1.2.1 0700 – 1700, Monday - Friday
13.2.2.1.3 Microbiology
13.2.2.1.3.1 0800 – 1800, 7 days-a-week
13.2.3 People Management Systems
13.2.3.1 Patients and members of the public will not have access to this component.
13.2.3.2 Controlled points of access/exit will restrict access to the component’s interior to
authorized staff. Staff will often be working alone so only authorized access is
acceptable. A pick-up window incorporated into the TML portion of the Laboratory will
enable other hospital staff and couriers for access to TML for pick up or drop off of
blood products without crossing the component’s secured perimeter. Access to the
accessioning area for courier drop off and pick up of samples will be required. The
accessioning area will need to be on the exterior of the Laboratory and accessible from
public space.
13.2.3.3 Provision will be required for Materiel Management delivery of special orders (multiple
deliveries per day) with space available for delivering supplies and temporary storage
until laboratory staff can properly store all supplies in appropriately temperature
controlled storage.
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LABORATORY
13.2.4 Materiel Management Systems
13.2.4.1 Equipment
13.2.4.1.1 Laboratory functions will rely on an increasing prevalence of automated,
mechanical and electrical equipment. This equipment will require routine
maintenance as well as periodic repair. To the extent practicable, routine
maintenance will be performed without moving the item from its normal
place of operation. Some bench space will be available in shared support
space that could accommodate minor technical work. External service
engineers or laboratory staff will perform virtually all repairs and
maintenance on the laboratory equipment on site within the Laboratory.
Biomedical Engineering will be involved in small general equipment only.
Refrigerators for blood products require secondary monitoring to ensure
that temperature standards are maintained.
13.2.4.2 Consumable Supplies
13.2.4.2.1 Inventories of common consumable supplies will be maintained close to
point of use throughout the Laboratory. Items shall be maintained with
minimum inventory levels triggering a re-ordering process.
13.2.4.2.2 Most Laboratory supplies will be speciality items ordered directly from the
vendor by Laboratory staff. These items will be received by Materiel
Management and delivered to the Laboratory on an agreed upon regular
schedule. Inventories on top-up carts will be generally maintained
according to prescribed delivery schedules by either Environmental
Services (See OS-STL.03) or Materiel Management (See OS-STL.05).
13.2.4.2.3 Provide appropriate secure and temperature control for storage of
laboratory reagents. Ensure the security and temperature control systems
provided in the laboratory achieve functional requirements for temperature
and security monitoring. Confirm requirements, type and location with the
clinical laboratory user champions.
13.2.4.3 Linen
13.2.4.3.1 Laundry processing will occur off site at the regional laundry located in
Cumberland.
13.2.4.3.2 Soiled linen will be consolidated at a central location in the component, and
temporarily held in foot controlled laundry totes. Filled totes will be moved
to the Environmental Services component (See OS-STL.03) for off-site
transfer. Clean linen returning from the regional laundry will be delivered to
central receiving facilities in Environmental Services before being sorted
and delivered to the Laboratory where it will be centrally stored.
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13.2.4.4 Processed Specimen Retention
13.2.4.4.1 Processed specimens including specimen tubes, urines, fluids, swabs,
stools, blocks, slides and wet specimens, will be stored centrally in the
Laboratory for up to one year. Long term storage (20 years for adults and
50 years for children) of processed specimens will be accommodated offsite.
13.2.4.5 Waste Management
13.2.4.5.1 Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations.
Throughout the Laboratory component, waste management is understood
to begin at the individual workstations with centralized collection and
temporary holding stations being located in a general support area. Each
administrative area will also accommodate segregation of the types of
waste products typically generated in these types of spaces.
13.2.4.5.2 Segregation of wastes will accommodate the following categories of
products:
13.2.4.5.2.1 General garbage
13.2.4.5.2.2 Confidential paper
13.2.4.5.2.3 Sharps (including potentially biohazardous items)
13.2.4.5.2.4 Infectious or contaminated wastes (excluding sharps)
13.2.4.5.2.5 Flammables
13.2.4.5.2.6 Chemicals (including residues)
13.2.4.5.2.7 Clean recyclable paper and cardboard
13.2.4.5.2.8 Clean metal (tin and aluminum)
13.2.4.5.2.9 Clean recyclable plastics
13.2.5 Information Management Systems
13.2.5.1 All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, and at key staff workstations, and mobile pads. Access to the EMR will be
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APPENDIX 3A: CLINICAL SPECIFICATIONS
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LABORATORY
controlled electronically with varying levels of security clearance determining a person’s
access to different sections and their ability to enter/edit data.
13.2.5.2 Electronic order entry with decision support capability and reporting will enable
physicians to requisition tests and receive results from any computer terminal or
wireless device. Electronic security protocols will control all access to requisitioning and
reporting functions.
13.2.5.3 Laboratory reporting will interface with the EMR, and will eliminate needs for hard copy
test reports.
13.3 DESIGN CRITERIA
13.3.1 LEAN Planning Standards
13.3.1.1 Consumable Supplies Stations
13.3.1.1.1 A key requirement in the Laboratory’s design and configuration will be
features that reduce the amount of time technical staff spend travelling to
retrieve supplies. Each laboratory testing station will be accompanied by
inventories of commonly used supplies. To the extent practicable, these
supply stations will be standardized with respect to location and the
organization of supplies that are common between disciplines. Specialized
or unique items will also be standardized in storage location.
13.3.1.1.2 In addition to decentralized supply stations, a central supply area will be
organized according to a system that makes sense to the key users (e.g.,
alphabetical, by laboratory discipline or most commonly used to least
commonly used).
13.3.1.2 Space Use Flexibility
13.3.1.2.1 The use of modular furniture, mobile furniture and adjustable height
tables/benches will enable workstations to respond to the needs of each
user. Floor drains will be installed at intervals of not more than 2.5 linear
metres (approximately 8 feet) throughout all technical work areas. These
features will enable timely and efficient changes to work spaces on either a
short term or more permanent basis.
13.3.2 Proximity Relationships
13.3.2.1 A staff lounge will be provided within the laboratory, staff will not be required to leave
the laboratory to access the staff lounge.
13.3.2.2 Staff toilets will be provided in the laboratory. Toilets will not open on to main public
work areas or directly into the staff lounge. Toilets will be accessible to staff without
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LABORATORY
having to exit the secure areas of the laboratory.
13.3.2.3 The Administrative offices, including the First Line Leader’s office will be provided
within the secure area of the laboratory.
Emergency
Department
Laboratory
Laboratory
Laboratory
Central Patient
Registration,
Diagnostic
Intake &
Specimen
Collection
Inpatient Care
Units
Laboratory
Surgical
Services
13.3.2.4 Provide Direct Access by General
Circulation to the ED component for the
movement of specimens and technical staff
(Core laboratory access) (vertical
separation).
13.3.2.5 Provide Direct Access by General
Circulation to the Central Patient
Registration, Diagnostic Intake and
Specimen Collection component for the
movement of technical staff and specimens.
13.3.2.6 Provide Convenient Access by General
Circulation to all inpatient care areas for the
movement of staff and specimens.
13.3.2.7 Provide Convenient Access by General
Circulation to the Surgical Services
component for the movement of staff and
specimens.
13.3.3 Internal Design Criteria
13.3.3.1 General Internal Layout
13.3.3.1.1 The component shall be organized into 5 major areas as follows:
13.3.3.1.1.1 Accessioning
13.3.3.1.1.2 Core Laboratory consisting of Haematology and Chemistry major
instrumentation
13.3.3.1.1.3 Core Support to Haematology and Chemistry including minor
instrumentation and manual analytical areas.
13.3.3.1.1.4 Transfusion Medicine (TML)
13.3.3.1.1.5 Histology area
13.3.3.1.1.6 Microbiology area
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13.3.3.1.1.7 Administrative and staff support area
13.3.3.2 Zoning According to Flexibility
13.3.3.2.1 In addition to the functional zones described above, the Laboratory
component shall be organized into three zones ranging from highly flexible
to least flexible space. The resulting spatial organization will include:
13.3.3.2.1.1 Highly flexible zone including Accessioning and those disciplines
that are heavily reliant on automation (Haematology and Chemistry)
- This zone will accommodate high workload volumes and will be
the most susceptible to workflow and equipment changes.
13.3.3.2.1.2 Semi-flexible zone for more specialized and/or manual testing (Core
Support, Microbiology and Histology)
13.3.3.2.1.3 Least flexible zone for offices and staff support facilities
13.3.3.2.2 The arrangement of these three zones must allow for the component’s
boundaries to expand and contract in response to service demands and
technology-driven space requirements. Consideration shall be given to
locating the least flexible zone at the centre or at the least accessible
portion of the Laboratory with the highly flexible zone being located at the
periphery or at the most accessible portion of the Laboratory. The latter’s
ability to expand and contract cannot be limited by spaces that are more
fixed in location or more difficult to relocate.
13.3.3.3 Remote Location of Histology Functions
13.3.3.3.1 Histology functions will be closely aligned with services provided through
the Surgical Services component (See DT.04) and Outpatient Procedural
Care (See AC.04). The benefit of this option is that frozen sections could
be transported and analyzed with less risk to the specimen or the timeline.
Pathologists would also be more immediately available to Surgeons for
consultation.
13.3.3.4 Segregation of Accessioning Functions
13.3.3.4.1 Functions occurring in the Accessioning area will require separation
between “clean” activities (clerical, data entry and administrative) and
specimen handling. Centrifuge machines supporting the latter will be
equipped with biohazard containment.
13.3.3.4.2 Accessioning for Histology will be performed in the space allocated to this
discipline.
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13.3.3.5 Expansion and Adaptability Potential
13.3.3.5.1 The Laboratory’s infrastructure will accommodate the initial installation of
equipment and workstations upon the Facility’s Service Commencement.
The grid used to deliver services shall provide for multiple connection
points for electrical, mechanical, HVAC and exhaust systems enabling
convenient relocation of workstations which will also be flexible through the
use of modular work benches and storage cabinets. Distilled and treated
water supply and drains must also be part of the flexible services delivered
to this component.
13.3.3.5.2 Ongoing needs for routine and preventive maintenance will require easy
access to laboratory equipment. Whenever possible servicing will be
conducted with the machine left in place. External service engineers or
laboratory staff will perform virtually all repairs and maintenance on the
laboratory equipment on site within the Laboratory. Biomedical will be
involved in small general equipment only.
13.3.3.5.3 Millwork (wood products) shall not be used as modular systems furniture.
13.3.3.5.4 Provide modular systems furniture throughout the lab. The modular
systems furniture shall be suitable for lab usage. The modular systems
furniture in this area will include throughout the lab: utility spines,
countertops, upper and under counter storage components (including
suspended storage cabinets), drawers, sliding shelves, height adjustable
workstations, locking hardware (doors, shelves and drawers), full height
storage components and all/any systems furniture accessories required for
normal and efficient lab operations. This includes any storage areas and
workstations/cubicles. Provide lab sinks required for lab operations where
necessary. The modular systems furniture shall meet or exceed the
requirements of the Scientific Equipment and Furniture Association
(SEFA).
13.3.3.5.5 All lab sinks shall be resistant to chemical products and staining. Sink
dimensions shall be suitable for efficient lab usage and task requirements.
Provide pivoting gooseneck spout.
13.3.3.5.6 Provide medical gases to each workstation and analyser as needed for
efficient lab operations.
13.3.3.5.7 The entire laboratory water system shall be designed and installed to
ensure the satisfactory operation of all tasks, equipment and systems in
the laboratory.
13.3.3.5.8 Provide reverse osmosis purified water flow systems that operate in a
continuous production process. Storage tanks are not acceptable.
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
13.3.3.5.9 Fume hoods shall contain the following: variable air, compressed air, cup
sink, electrical outlets, low velocity alarm, gooseneck water faucet,
vacuum, “monkey bar” mounting system.
13.3.3.5.10 Multiple countertops shall be stainless steel to be determined during the
Clinical User Group process.
13.3.3.5.11 Provide a sufficient quantity of electrical and data outlets directly adjacent
to laboratory equipment. Confirm location and height of electrical and data
outlets with laboratory Clinical User Group and the manufactures
specifications.
13.3.3.5.12 Provide all necessary flammable chemical storage and “lab units” as
required by lab chemical use and chemical generation operations. Precise
chemical and flammable chemical quantities and storage locations shall be
directed by lab operations and staff. Provide a room with no less than 600
litres of flammable chemical storage in the laboratory. Assume that a large
quantity (a quantity suitable for efficient lab operations) of flammable
chemicals shall be openly used in the lab. Provide vented storage cabinets
as required by lab operations. Provide vented tables (downdraft or
backdraft) as required by lab operations. Provide transaction windows
where necessary by lab operations. Ensure that any transaction windows
can be secured and locked. Provide after hours privacy on the transaction
windows.
13.3.3.5.13 Provide alarmed and monitored refrigerators and freezers required by lab
operations.
13.3.3.6 Lines of Sight
13.3.3.6.1 Technology staff working in each of the laboratory disciplines will be
conducting different tests at different workstations simultaneously. Sight
lines between workstations, especially within a single discipline, shall be
unobstructed allowing for distant monitoring.
13.3.3.7 Air Quality Control
13.3.3.7.1 Generation of fumes, noxious odours and heat from equipment and light
fixtures will require enhanced ventilation compared with that throughout the
rest of the Facility. Clinical Laboratory Institute Design Standards must be
incorporated into the design of this component. Air turnover rated at up to
16 changes per hour will be required. Different ventilation features (e.g.,
bench level, hepa filter, biohazardous and laminar flow hoods) will be
incorporated to address the needs of each workstation. Passive ventilation
will be required for some supplies, such as acids.
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
13.3.3.7.2 Consideration shall be given to incorporating operable windows providing a
source of fresh air to the laboratory workstations part of this component.
13.3.3.7.3 Biosafety cabinets will be required in any area where open specimens will
be present.
13.3.3.8 Noise Insulation
13.3.3.8.1 Some large equipment items will produce noise while operating. Noise
attenuating technologies must be incorporated into rooms built to
accommodate these types of items or into surrounding enclosures if they
are built-in. Core and Core Support need to be adjacent. Attention must
be placed on noise attenuation between these two areas.
13.3.3.9 Workstation Lighting
13.3.3.9.1 Staff working at the technical workstations will benefit from exposure to
natural lighting. Views to the outside as well as task lighting shall be
provided to adapt to functions occurring at workstations, which will vary
from moment-to-moment.
13.3.3.9.2 Task lighting for Microbiology will require integrated magnifying glasses.
13.3.3.10 Staff Safety
13.3.3.10.1 Prevalence of heat generating equipment and chemicals will create risks
for staff working in this component. Fire suppression systems, emergency
deluge showers, plumbed emergency eye wash stations and first aid
stations shall be strategically located throughout the technical work areas.
Flooring used in the technical work areas shall be smooth, non-porous,
skid resistant and resistant to electrostatic build-up. Floor areas around
deluge showers must be supplied with drains.
13.3.3.10.2 Personal protection equipment (PPE) stations will be strategically located
throughout the component.
13.3.3.10.3 Spill kits will be strategically located throughout the component in key
areas where transportation of dangerous goods will be a common
occurrence.
13.3.3.10.4 Upon consultation with the laboratory Clinical User Group, provide a
sufficient number of hand-washing stations, in the appropriate locations.
The laboratory Clinical User Group will have final input and confirmation of
the location and quantity of hand-washing stations required.
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
13.3.3.10.5 Upon consultation with the laboratory Clinical User Group, provide a
sufficient number of emergency eye wash stations, in the appropriate
locations. The laboratory Clinical User Groupwill have final input and
confirmation of the location and quantity of eye-wash stations required.
13.3.3.10.6 Upon consultation with the laboratory Clinical User Group, confirm the
need and location or locations for deluge showers. Do not locate electrical
equipment or sensitive laboratory equipment within the deluge shower
splash zone; do not provide and electrical outlet within the deluge shower
splash zone.
13.3.3.10.7 Provide a secure drainage system is required to prevent contamination of
water streams.
13.3.3.11 Component Security and Confidentiality
13.3.3.11.1 Couriers will routinely access the accessioning area to drop off and pick up
packages for delivery. The Authority will rely on a variety of companies,
ranging from professional couriers (e.g., UPS) to taxi companies for this
function. An area for the temporary holding of packages, envelopes and
insulated containers must be conveniently located close to one of the
Facility’s service entrances. Couriers must be able to access this
temporary holding area without entering into any of the Accessioning or
any laboratory workspaces. Space for laboratory specimen transport must
be close to the laboratory and handled by laboratory staff due to nature of
specimen stability.
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
13.3.4 Space Table
The Functional Space Requirements illustrates rooms, and their respective sizes, that combine
to make up this functional component. Refer to the respective space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTINAL SPACE REQUIREMENTS:
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
DT.03 Laboratory
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
4.0
1
4.0
-
-
-
18.0
1
18.0
Central Specimen Accessioning Area
01
Receiving/Sorting Workstation
02
[Intentionally left blank]
03
Data Entry Workstation
4 computer wrkstns w/ associated bench
space, label printer
04
Primary Processing
Workstation
Bench space accommodating 2 centrifuge
machines
5.0
1
5.0
05
Biosafety Hood/Cabinet
Workstation
6" Biosafety cabinet
2.8
1
2.8
06
Counter w/ 1 "dirty" sink
1.9
1
1.9
Referral/Send-Out
Workstation
Storage/Temporary
Holding
1 wrkstn w/ computer, printer, label printer
4.5
1
4.5
Insulated containers of various sizes Supplies storage
11.0
1
11.0
09
Storage/Temporary
Holding - Cold
walk in refrigerator
10.0
1
10.0
10
Storage/Temporary
Holding - Frozen
1 full-size freezer
1.9
1
1.9
11
Inpatient Phlebotomy/ECG
9.0
1
9.0
12
Alcove, Clean
1 wrkstn w/ supplies storage, alcove holding
area for up to 4 phlebotomy carts and 2 ECG
machines
clean hand washing sink and eyewash station
3.0
1
3.0
Subtotal, Central Specimen Accessioning Area
71.1
07
08
Utility Area
1 computer wrkstn w/ associated bench space
Core Laboratory Area
13
Workstation, Automated
(Major)
Chemistry/immunochemistry - Free standing
instrument + computer workstation w/ access
on all sides - Free standing counter
15.0
1
15.0
14
Core Lab, Processing
Benches
Workstation, Automated
(Minor)
Workstations, Analyzers, Storage, Freezers
50.0
1
50.0
Chemistry/immunochemistry - Free standing
instrument w/ access on all sides - Free
standing counter
2 free-standing instruments with free-standing
computer workstation
10.0
1
10.0
6.0
1
6.0
15
16
Analyzer, Haematology
17
18
Analyzer, Coagulation
Workbench, Sample/STAT
Preparation
2 bench top instruments (on moveable tables)
2 benches, each w/ small centrifuge machine
- Includes counter w/ "dirty" sink
5.0
4.0
1
1
5.0
4.0
19
Storage/Temporary Holding Cold
1 double-door laboratory refrigerator
2.0
1
2.0
20
Workstation, Computer
3.7
2
7.4
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
DT.03 Laboratory
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
Subtotal, Core Laboratory Area
TOTAL
SIZE
(nsm)
99.4
Core Support Area
21
22
Workstation, Microscope
Workstation, Teaching
Microscope
Microscope w/ computer wrkstn
Teaching Microscope w/ computer wrkstn
3.0
4.0
2
1
6.0
4.0
23
24
Slide Stainer
Workstation, Minor Instrument
bench top
Blood gas analyzer, Point of Care
instruments, cytospin, osmolality instrument
and other small instruments
1.9
9.0
1
1
1.9
9.0
25
Workstation, Urinalysis
7.0
1
7.0
26
Workstation, Staff
Includes counter, microscope, computer
workstation, centrifuge, shelving, w/ utility sink
(dirty utility)
files storage - Accommodates meetings with
up to 1 person
4.5
1
4.5
27
Biosafety Hood/Cabinet
Workstation
biosafety cabinet 6"
2.8
1
2.8
28
29
Storage/Temporary Holding
Storage/Temporary Holding Frozen
shelving reagents room temp
1 full-size freezer
5.0
1.9
2
1
10.0
1.9
30
Alcove, Clean Holding
1 clean hand wash sink with eyewash, clean
linen
3.0
1
3.0
Subtotal, Core Laboratory Area
50.1
Microbiology Area
31
Workstation, Specimen Intake
2 computer wrkstns with label printers Specimen data entry
6.0
1
6.0
32
Workstation, Automated
(Major)
Blood culture machine with printer
3.5
1
3.5
33
Workstation, Automated
(Minor)
Table top analyzers with computer and printer
5.0
1
5.0
34
Workstation, Manual
Gram stains, dirty sink, rapid kit testing and
culture setups (performed inside 2 x 6"
biosafety cabinets), centrifuge computer
workstation
Microscope w/ computer wrkstn
Sized to accommodate up to 6 stacking
incubators - Includes 1 large room air, 1 large
carbon dioxide and 3 small room air
incubators
Supplies - Counter /shelves
Plate reading, ID and antibiotic susceptibility
testing - with computer workstation
12.0
1
12.0
2.5
6.7
2
1
5.0
6.7
10.0
4.0
1
3
10.0
12.0
5.0
4.0
1
1
5.0
4.0
10.0
1
10.0
1.9
1
1.9
35
36
Workstation, Microscope
Workstation, Incubator
37
38
Storage Area
Workstation
39
40
Workstation, Microscope
Storage/Temporary
Holding
Includes multi-head teaching microscope
Insulated containers of various sizes Supplies storage
41
Storage/Temporary
Holding - Cold
walk in refrigerator
42
Storage/Temporary
Holding - Frozen
1 full-size ultra low freezer
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
43
ROOM TYPE
DT.03 Laboratory
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
Storage/Temporary
Holding - Frozen
1 full-size freezer
1.9
1
1.9
44
Workstation, Staff
files storage - Accommodates meetings with
up to 1 person
4.5
1
4.5
45
Alcove, Clean
1 clean hand wash sink with eyewash, clean
linen
3.0
1
3.0
Subtotal, Microbiology Area
90.5
Transfusion Medicine Laboratory Area
46
Dispensing Window
47
Workstation, Manual
48
49
Sink
Workstation, Sterile
Processing
Workstation, Plasma Thawer,
Platelet Incubator/Rocker
50
1 computer wrkstn + printer w/ counter and
shelving - Securable providing restricted
access to remainder of this area. Workstation
will also flex to be used as a manual
workbench during peak workload.
Counter w/ 4 table-top centrifuge,
microscope, computer terminal; shared dirty
sink
Counter w/ 1 clean sinks
1 wrkstn w/ laminar flow hood or biosafety
cabinet 4"
1 counter and shelving
1
4.0
4.0
2
8.0
1.9
2.8
1
1
1.9
2.8
4.0
1
4.0
4.0
1
4.0
1.9
1
1.9
51
Storage/Temporary Holding
52
Storage/Temporary Holding Cold
53
Storage/Temporary Holding Cold
1 full-size couple door blood bank specialized
refrigerator - Monitored and integrated w/
other building alarms
3.7
2
7.4
54
Storage/Temporary Holding Frozen
1.9
2
3.8
55
Workstation, Staff
1 full-size blood bank specialized freezer Monitored and integrated w/ other building
alarms
files storage - Accommodates meetings with
up to 1 person
4.5
1
4.5
56
Alcove, Clean
1 clean hand wash sink with eyewash, clean
linen
3.0
1
3.0
Subtotal, Transfusion Medicine Laboratory Area
45.3
Histology Area
57
Tissue Reception/Holding,
Histology/cytology
58
59
Workstation, Embedding
Workstation, Cutting
60
61
Workstation, Grossing
Workstation, Manual
62
Workstation, Microscope/
Computer
63
64
65
Workstation, Special Stains
Workstation, Fume Hood
Workstation, staff
blood boxes from CBS, shelving for room
temp product
combo fridge and freezer for specimens
4.0
3.0
3
9.0
manual embedding station
1 computer wrkstn w/ printer - Microtome,
water bath, cold plate
2.8
3.0
5
5
14.0
15.0
`
Special staining - Reagent preparation and
clean up
3.0
3.7
1
1
3.0
3.7
5.6
1
5.6
3.0
2.8
4.0
1
1
1
3.0
2.8
4.0
Counter w/ sink - Localized exhaust to outside
4" fume hood - reagent prep and use
files storage - Accommodates meetings with
up to 1 person
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
66
ROOM TYPE
Histology Support
DT.03 Laboratory
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Combined work area including autostainer w/
tempered/adjustable water supply, cover
slipper, refrigerator, freezer, still, sink, floor
drain
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
15.0
1
15.0
4.6
12.0
-
1
1
-
4.6
12.0
-
67
68
69
Storage, Supplies
Storage, Blocks/Slides
[Intentionally left blank]
70
71
Tissue Processing
Cytology Support
equipment - Local exhaust to outside
Combined work area including autostainer,
cover slipper, storage
5.6
5.6
1
1
5.6
5.6
72
Workstation, Surgical
Processing/Gross Dissection
1 integrated grossing station w/ integrated
garbage container/dictation system Ventilated
Scale, monitor, microscope, cryostat,
refrigerator
Accommodates 3-month's volume - Ventilated
bone marrow - fine needle cart storage
1 clean hand wash sink with eyewash,
emergency shower with drain, clean linen
5.0
1
5.0
5.5
1
5.5
4.5
1.5
2.0
1
1
1
4.5
1.5
2.0
Subtotal, Histology Area
121.4
73
General Support Area
74
75
76
Storage, "wet "Specimens
Alcove
Alcove, Clean
Common Laboratory Support Area
Accommodate 1-year's volume
77
Storage/Temporary Holding Flammable Material
1 cabinet - Rooms may be distributed
throughout technical work areas - Segregated
for acids, bases, flammables
1.9
5
9.5
78
Room temperature storage
room
Shared by entire lab for reagents, disposable
products, linen
15.5
1
15.5
79
Fume Hood Workstation
4" fume hood - 1 wrkstn w/ associated bench
space, sink, shared
2.8
1
2.8
80
Storage/Temporary Holding Central
Non-hazardous, non-flammable general
stores - Consumable supplies common to
most areas
4.0
1
4.0
81
82
83
Glassware washing
Spill Response cart
Storage/Temporary Holding Central
3.0
2.0
4.0
1
2
1
3.0
4.0
4.0
84
Utility Room, Soiled
Accommodation for up to 4 totes - Includes
sink, R/O water production unit, counter w/
sink, garbage cart and recycling cart
9.5
1
9.5
85
86
Utility Room, Soiled
Alcove, Clean
Temporary storage of chemicals for disposal
1 clean hand wash sink with eyewash,
emergency shower with drain, clean linen
2.0
4.0
1
1
2.0
4.0
87
Housekeeping Room
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
4.5
1
4.5
Subtotal, Common Laboratory Support Area
62.8
Staff/Administrative Support Area
Alcove - Shared by all technical work areas
Biohazard/sharps waste- Negative pressure
room
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
88
ROOM TYPE
Office, Private, Pathologist
DT.03 Laboratory
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
Multipurpose work area, files storage Accommodates meetings with up to 2 people
- Locate close to Histology
4-6 Station Microscope
12.0
4
48.0
6.0
1
6.0
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
TOTAL
SIZE
(nsm)
89
Work Area, Multi-Headed
Microscope
90
91
Office, Private, Transient Staff
Workstation, Clerical,
transcription staff
Multipurpose work area
Multipurpose work area, files storage - 1
person
10.0
3.0
1
3
10.0
9.0
92
93
94
Office, First Line Leader
Business Centre
Staff/Lounge
Manager's Office
Business equipment and supplies storage
Kitchenette w/ pantry including counter w/
sink, microwave oven, refrigerator - Includes
seating for up to 20 and racks for storage of
outer clothing/shoes
1 assisted WC, 1 sink
8.0
5.0
25.0
1
1
1
8.0
5.0
25.0
4.5
2
9.0
Subtotal, Shared Support Area
120.0
TOTAL NSM, ALL AREAS
660.6
95
Toilet, Staff
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
CAMPBELL RIVER HOSPITAL FUNCTINAL SPACE REQUIREMENTS:
CAMPBELL RIVER HOSPITAL
ROOM
IDENTIFIER
(RID)
ROOM TYPE
Central Specimen Accessioning Area
01 Receiving/Sorting Workstation
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
1 computer wrkstn w/ associated bench
space
DT.03 Laboratory
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
4.0
1
4.0
1.9
13.0
1
1
1.9
13.0
8.0
1
8.0
3.5
1
3.5
02
03
[Intentionally left blank]
Data Entry Workstation
04
Primary Processing Workstation
05
Biosafety Hood/Cabinet
Workstation
06
07
08
Utility Area
Referral/Send-Out Workstation
Storage/Temporary Holding
Counter w/ 2 sinks
1 wrkstn w/ computer, printer
Insulated containers of various sizes Supplies storage
2.5
4.0
22.0
1
1
1
2.5
4.0
22.0
09
Storage/Temporary Holding
- Cold
Walk-in refrigerator
15.0
1
15.0
10
Storage/Temporary Holding
- Frozen
1 full-size freezer
1.9
1
1.9
11
Inpatient Phlebotomy
1 wrkstn w/ supplies storage, holding
area for up to 5 phlebotomy carts
10.0
1
10.0
12
Alcove, Clean
clean hand washing sink and eyewash
station
3.0
1
3.0
Subtotal, Central Specimen Accessioning Area
88.8
86.9
Core Laboratory Area
13 Workstation, Automated (Major)
14
Core Lab, Processing Benches
15
16
17
Analyzer, Hematology
Analyzer, Coagulation
Workbench, Sample/STAT
Preparation
18
Workstation, Computer
Core Support Area
19 Workstation, Microscope
20
Slide Stainer
21 Workstation, Minor Instrument
22
23
Workstation, Manual
Workstation, Urinalysis
24
Workstation, Core Laboratory
Supervisor
25
Storage/Temporary Holding
4 computer wrkstns w/ associated bench
space, label printer
Bench space accommodating 4
centrifuge machines
Chemistry/immunochemistry - Free
standing instrument w/ access on all
sides - Free standing counter
Workstations, Analyzers, Storage,
Freezers
2 free-standing machines
2 machines
2 benches, 1 w/ centrifuge machine
12.0
1
12.0
63.0
1
63.0
5.0
4.0
4.0
1
1
1
5.0
4.0
4.0
3.7
1
3.7
Subtotal, Core Laboratory Area
91.7
Microscope w/ computer wrkstn
Blood gas analyzer, Point of Care
instruments, osmolality w/ computer
wrkstn
Includes counter w/ utility sink (dirty
utility)
1 computer wrkstn w/ printer
4.0
1.9
5.0
1
1
1
4.0
1.9
5.0
5.0
7.0
1
1
5.0
7.0
4.0
1
4.0
12.0
1
12.0
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
CAMPBELL RIVER HOSPITAL
ROOM
IDENTIFIER
(RID)
ROOM TYPE
26
Storage/Temporary Holding Frozen
27
28
Alcove, Clean Holding
Eye Wash/Emergency Deluge
Station
Microbiology Area
29 Workstation, Specimen Intake
30 Workstation, Automated (Major)
31
Workstation, Automated (Minor)
32
Workstation, Manual
33
34
Workstation, Centrifuge
Workstation, Incubator
DT.03 Laboratory
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
1.9
1
1.9
3.0
1.9
1
1
3.0
1.9
Subtotal, Core Laboratory Area
45.7
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
1 full-size freezer
Serviced w/ floor drain below shower
head
TOTAL
SIZE
(nsm)
1 wrkstns - Specimen intake
Blood culture machine
3.0
3.5
1
1
3.0
3.5
Table top analyzers w/ computer wrkstn
5.0
1
5.0
Gram stains, rapid antigen testing Computer wrkstn w/ microscope
5.0
3
15.0
0.8
5.7
1
1
0.8
5.7
5.0
4.5
1
2
5.0
9.0
1.9
1.9
3.7
15.0
1
1
1
1
1.9
1.9
3.7
15.0
Sized to accommodate up to 6 stacking
incubators
Supplies - Counter
Includes counter-top fume hood
(biological safety cabinet - 1 wrkstn for
specimen preparation, 1 wrkstn for
additional testing set-up
35
36
Storage Area
Workstation, Enclosed
37
38
39
40
Workstation, Microscope
Workstation, Slide Staining
Workstation, Computer
Storage/Temporary Holding
- Cold
41
Storage/Temporary Holding Frozen
1 full-size freezer
1.9
1
1.9
42
Storage/Temporary Holding Hazardous Waste
Negative pressure room
9.3
1
9.3
43
44
Workstation, Supervisor
Alcove, Clean
4.5
3.0
1
1
4.5
3.0
45
Eye Wash/Emergency Deluge
Station
1.9
1
1.9
Subtotal, Microbiology Area
90.1
Transfusion Medicine Laboratory Area
46 Dispensing Window
1 computer wrkstn w/ printer
Walk-in refrigerator
1 clean sink w/ eyewash - 1 clean line
cart
Serviced w/ floor drain below shower
head
1 wrkstn w/ counter - Securable
providing restricted access to remainder
of this area
Counter w/ 4 table-top centrifuge,
microscope, computer terminal
1.5
1
1.5
5.6
1
5.6
1.9
4.5
9.3
3.7
1
1
1
1
1.9
4.5
9.3
3.7
1.9
1
1.9
47
Workstation, Manual
48
49
50
51
Sink
Workstation, Testing
Storage/Temporary Holding
Storage/Temporary Holding Cold
Counter w/ 2 sinks
52
Storage/Temporary Holding Frozen
1 full-size freezer - Monitored and
integrated w/ other building alarms
1 full-size refrigerator - Monitored and
integrated w/ other building alarms
EXECUTION COPY
North Island Hospitals
Project
SCHEDULE 3: DESIGN AND CONSTRUCTION
APPENDIX 3A: CLINICAL SPECIFICATIONS
_____________________________________________________________________________________________
DT.03
LABORATORY
CAMPBELL RIVER HOSPITAL
ROOM
IDENTIFIER
(RID)
53
ROOM TYPE
57
58
Histology Support Area
Frozen Section Laboratory
Handwash Sink
Storage, Specimens
Common Laboratory Support Area
59 Storage/Temporary Holding Flammable Material
60
Storage/Temporary Holding Central
61
Spill Response Cabinet
62
Utility Room, Soiled
63
Housekeeping Room
Staff/Administrative Support Area
64 Office, Private, Pathologist
65
Workstation, Transcription
66
Office, Private, Transient Staff
67
Office, Private, Chief
Technologist
68
69
70
Office, Private, Point of Care
Workstation, Student
Business Centre
71
Staff Lounge/Break Room
72
NUMBER
OF
ROOMS
3.0
1
3.0
Subtotal, Transfusion Medicine Laboratory Area
31.4
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Alcove, Clean
Histology Area
54 Workstation, Surgical
Processing/Gross Dissection
55
56
DT.03 Laboratory
ROOM
SIZE
(nsm)
Toilet, Staff
1 wrkstn w/ fume hood, sink
TOTAL
SIZE
(nsm)
15.5
1
15.5
15.0
8.0
1
1
15.0
8.0
1.0
5.0
1
1
1.0
5.0
Subtotal, Histology Area
44.5
1 computer wrkstn w/ printer - Counter w/
sink
1 clean sink w/ eyewash
1 cabinet - Rooms may be distributed
throughout technical work areas
1.9
3
5.7
Non-hazardous, non-flammable general
5.0
1
stores - Consumable supplies common
to most areas
May be distributed throughout the
1.9
2
technical work areas
Accommodation for up to 4 totes 10.0
1
Includes sink, R/O water production unit,
counter w/ sink, garbage cart and
recycling cart
1 floor sink, standard wall-mounted sink,
4.5
1
storage cabinetry - Accommodates
housekeeping cart storage
Subtotal, Common Laboratory Support Area
5.0
3.8
10.0
4.5
29.0
Multipurpose work area, files storage Accommodates meetings with up to 2
people
1 multipurpose wrkstn, files storage
12.0
3
36.0
7.0
1
7.0
Multipurpose work area Accommodates meetings with up to 1
person
Multipurpose work area, files storage Accommodates meetings with 1 person
10.0
1
10.0
7.5
1
7.5
1 multipurpose wrkstn, files storage
Touchdown wrkstn/carrel
Business equipment and supplies
storage
Kitchenette w/ pantry including counter
w/ sink, microwave oven, refrigerator Includes seating for up to 10
10.0
4.5
6.0
1
1
1
10.0
4.5
6.0
20.0
1
20.0
4.5
2
9.0
Subtotal, Shared Support Area
110.0
531.2
529.3
1 assisted WC, 1 sink
TOTAL NSM, ALL AREAS
EXECUTION COPY
North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
This specification outlines the functional, operational and physical requirements for the Morgue and
Autopsy Suite functional component.
14.1 FUNCTIONAL DESCRIPTION
14.1.1 Statement of Purpose
14.1.1.1 The Morgue and Autopsy Suite exists for the purpose of receiving bodies of deceased
patients and for the performance of post mortem examinations. While the attending to,
and grieving with deceased inpatients will be accommodated in the various inpatient
care areas, there will continue to be a need for this centralized holding function as
some arrivals at the Facility will be dead-on-arrival (DOA), and will not have been
admitted to either the ED nor to an inpatient care area.
14.1.1.2 This component will also be the Facility’s site for secured holding of forensic
specimens. Chain of custody protocols will be enabled by features incorporated here.
14.1.2 Scope of Services
14.1.2.1 Functional Content
14.1.2.1.1
The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
14.1.2.1.1.1
Receiving and temporary cold storage of cadavers arriving from
the:
12.1.1.1.1.1.1
Emergency Department
12.1.1.1.1.1.2
Intensive Care Unit
12.1.1.1.1.1.3
General Medical/Surgical Inpatient Units
12.1.1.1.1.1.4
Maternity, Newborn Pediatric Inpatient Unit
14.1.2.1.1.2
Privacy for family and friends attending the body
14.1.2.1.1.3
Secured storage of specimens from sexual assault cases treated
in the ED, and in accordance with “chain of custody” requirements
14.1.2.1.1.4
Receiving of mortuary attendants for transferring the body to local
funeral homes
14.1.2.1.1.5
Performing post mortem examinations to establish cause of death
or for teaching purposes
14.1.2.1.1.6
Audio-visual recording of autopsy procedures, and with
telemedicine capability
14.1.2.1.1.7
Staff changing and showering
14.1.2.2 Exclusions
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
14.1.2.2.1
The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
14.1.2.2.1.1
Forensic autopsies
14.1.2.2.1.2
Preparing cadavers for burial or cremation
14.1.2.2.1.3
Collection and storage of anatomical specimens, with the
exception of specimens relating to sexual assault cases (Note:
Chain of custody protocols must be maintained to accommodate
this function)
14.1.2.3 Anticipated Trends in Service Delivery
14.1.2.3.1
The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
should be reflected in the component’s design.
14.1.2.3.1.1
As hospitals’ teaching roles increase, the need for autopsies as a
teaching encounter will become more common.
14.1.2.3.1.2
More grieving for deceased inpatients will be conducted in the
various inpatient care areas. These cadavers will leave the Facility
directly without first accessing the Morgue and Autopsy
component.
14.1.3 Scope of Education Functions
14.1.3.1 Teaching encounters based on autopsies will be accommodated in this component.
Education of this nature will rely on general service space, and needs for specialized
teaching facilities are not required.
14.1.4 Scope of Research Functions
14.1.4.1 Clinicians and students will occasionally use autopsies for research opportunities. The
nature and extent of research functions will be accommodated in the general work
areas, and will not require specialized or dedicated facilities in this component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
14.2 OPERATIONAL DESCRIPTION
14.2.1 Hours of Operation
14.2.1.1 The component at this Facility will not be staffed, but will be accessible to authorized
staff and escorted family/friends:
14.2.1.1.1.1
24 hours-a-day, 7 days-a-week
14.2.2 People Management Systems
14.2.2.1 Staff and Visitor Management
14.2.2.1.1
Access to this component will be secured at all times. Authorized medical
staff, and authorized students will have access to this component 24hours-a-day, 7 days-a-week with access being controlled by the electronic
screening system adopted for Facility-wide security (e.g., I.D. card, finger
print and/or retinal scan).
14.2.2.1.2
All visitors to this component will be granted access by, and accompanied
by an escort with entrance authorization.
14.2.2.2 Cadaver Management
14.2.2.2.1
Cadavers will arrive at this component from anywhere in the Facility. Cases
arriving DOA will be transported via the ED (See AC.01).
14.2.2.2.2
Cadavers leaving the Facility will depart the Facility via a separate and
discrete exit adjacent to the main loading dock. The path of travel from the
Morgue will be a non-public circulation route and one that does not involve
transit through the Materiel Management component (See OS-STL.05).
14.2.2.2.3
All cadaver transport within the Facility will be conducted using sealed
transport carts. Transport of bariatric cadavers will be accommodated
throughout this Facility.
14.2.3 Materiel Management Systems
14.2.3.1 Consumable Supplies
14.2.3.1.1
Inventories of consumable supplies will be maintained close to point of use.
In this component, this standard will require supplies stores in close
proximity to the autopsy area. Generally, a minimum 3 day supply of each
item will be maintained with minimum inventory levels triggering a reordering process. All orders will be sent electronically to the Materiel
Management component (See OS-STL.05) for processing.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
14.2.3.1.2
If required, STAT supplies not maintained in the morgue will be delivered
via pneumatic tube.
14.2.3.2 Equipment Management System
14.2.3.2.1
Equipment used in this component will consist primarily of stretchers, fixed
autopsy tables and small equipment items used in autopsies. Stretchers
will include fully enclosed capsules for the discrete transportation of
cadavers. All moveable equipment will be cleaned, processed, and
maintained in the Equipment Depot component (See OS-STL.08).
14.2.3.2.2
See also Information Management Systems below.
14.2.3.3 Waste Management
14.2.3.3.1
To the extent practicable, waste products will be generally managed
according to a system of segregation at point of origin and sequential
consolidation. Operation of this system relies on appropriate containment
facilities for each type of waste product beginning at where the waste is
generated followed by similar, but progressively larger, containment
facilities at key collection locations. In this component, waste management
is understood to begin at the autopsy station.
14.2.3.3.2
Segregation of wastes will accommodate the following categories of
products:
14.2.3.3.2.1
General garbage
14.2.3.3.2.2
Sharps (including potentially biohazardous items)
14.2.3.3.2.3
Infectious or contaminated wastes (excluding sharps)
14.2.3.3.2.4
Confidential paper
14.2.3.3.2.5
Clean paper and cardboard
14.2.3.3.2.6
Clean metal (tin and aluminum)
14.2.3.3.2.7
Clean recyclable plastics
14.2.4 Information Management Systems
14.2.4.1 Equipment inventory management will rely on electronic order processing and tracking.
All approved purchase orders for new equipment will be processed through the Materiel
Management component (See OS-STL.05). New equipment arriving on site will be
delivered from central receiving in Materiels Management after being confirmed against
outstanding purchase orders.
14.2.4.2 Upon delivery to the Equipment Depot, each item will be either tagged with an
electronic locating tag (Radio Frequency Identification – RFID) or bar coded with an
adhesive label. The item will then be transported to this component to be put in use.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
14.2.4.3 Requests for equipment delivery or retrieval will be submitted electronically from this
component. Upon receiving a delivery request in the Equipment Depot, the item will be
picked from inventory, scanned indicating its destination and then delivered. If a
requested item is not in inventory, portering staff will use the electronic tracking system
to locate items potentially not in use, and then contact the user to determine the item’s
status. Repeated shortages of requested equipment will typically generate purchase
requests for additional items.
14.3 DESIGN CRITERIA
14.3.1 Proximity Relationships
14.3.1.1 The Morgue and Autopsy component’s location relative to other components, or other
areas of the Facility, and the nature of circulation used to move between different
components/areas are illustrated in the diagram below. Proximities are listed according
to rank; higher priorities appear above lower priorities.
Central Staff Facilities Morgue and Autopsy Morgue and Autopsy Main Building Circulation System Morgue and Autopsy Loading Dock 14.3.1.2 Provide Direct Access by General
Circulation to the Central Staff Facilities for
the movement of staff accessing toilet,
shower, change and locker facilities.
14.3.1.3 Provide Convenient Access to non-public
circulation. Personnel, visitors and supplies
will move frequently to/from this component
and other components in the Facility
14.3.1.4 Provide Convenient Access via non-public
circulation to the Loading Dock.
14.3.2 Internal Design Criteria
14.3.2.1 General Internal Layout
14.3.2.1.1
The component should be organized into two major areas as follows:
14.3.2.1.1.1
Viewing/Visiting/Grieving area
14.3.2.1.1.2
Autopsy and cadaver storage area
14.3.2.2 Component Security
14.3.2.2.1
Access to this component must be controllable at all times as only
authorized staff will have access. This area must be accessible to
authorized personnel 24 hours-a-day, 7 days-a-week.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
14.3.2.3 Component Access and Egress
14.3.2.3.1
Visitors to this component will be periodic and unpredictable in their timing.
Sensitivities around family and friends of deceased arriving at the same
time as a cadaver cannot be under emphasized. Regardless of the
anticipated frequency of visitor access, this component will include 2
separate points of access/egress. One (1) point will be reserved for family
and friends arriving to visit with deceased persons, and the other will be
reserved for the receiving and discharging of cadavers. Visitors of
deceased will not travel through the autopsy area to gain access to the
viewing area.
14.3.2.4 Internal Circulation
14.3.2.4.1
Spaces designated for cadaver holding and autopsy procedures must be
physically, visually and acoustically separate from a grieving/viewing area.
A secured doorway must be provided enabling movement of cadavers from
the holding area to the grieving/viewing area.
14.3.2.4.2
Space provided for autopsy procedures must have the autopsy table
centrally located enabling 360° circulation to access/view any portion of the
cadaver.
14.3.2.5 Segregated Cadaver Viewing
14.3.2.5.1
A viewing area for family and friends visiting with the deceased should
allow for physical contact with the deceased; a requirement in many
cultures. An access door is to be provided to allow for this physical contact.
The door is to be controlled by the electronic screening system adopted for
Facility-wide security. Some cadavers, however, will be in various stages of
decay, and may present infection control issues. For these latter cases, a
main visiting/ viewing area must also provide visual access to an
environmentally separate screening room. Glazing separating these two
areas must be coverable from the cadaver-holding side to control visual
access into this area.
14.3.2.6 Lighting
14.3.2.6.1
Artificial lighting in all parts of this component must be variable to
accommodate different levels of ambient lighting commensurate with the
functions ongoing at any one time in that space. Individual workstations in
the autopsy area must be provided with task lighting.
14.3.2.6.2
Lighting above an autopsy table will be comparable to that of an operating
theatre; articulated and of variable intensity.
14.3.2.6.3
All lighting used in this component must allow for accurate colour rendition.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
14.3.2.7 Environmental Control
14.3.2.7.1
Cadavers kept in this component will be in various stages of decay, and
odour/vapour control will be a primary consideration. Air exchanges per
hour must be sufficient to prevent the buildup of offensive odours and
harmful vapours. Airflow patterns should be such that air flows away from
visitors and towards the cadaver. This specification implies a horizontal
circulation of internal air handling. In the case of autopsy procedures, the
airflow should be away from the “alive” and towards the “deceased”. This
specification implies a “downdraft” airflow pattern in which air flows from
the ceiling to the floor in the vicinity of the autopsy table and grossing
bench.
14.3.2.7.2
Separate temperature regulation should be provided between the viewing
area and the autopsy/ cadaver storage area. Whereas a viewing area will
require temperatures comfortable for people seated for prolonged periods,
the autopsy area will require cooler temperatures to accommodate medical
and allied health staff working under intense (heat generating) lighting and
dispensing heat generated by cooling (cadaver storage) facilities.
14.3.2.8 Cleaning and Infection Control Features
14.3.2.8.1
Features in this component will promote the safe handling of (potentially)
infectious materials and will prevent transmission of infections from
cadavers to staff and the public.
14.3.2.8.2
All work surfaces shall be non-porous, chemical resistant and self-coved
for cleaning. Surface joints and corners/angles must avoid creating
crevices and concealed spaces that are difficult to clean.
14.3.2.8.3
Hand hygiene stations shall be located at each point of access/egress.
14.3.2.8.4
The Autopsy Suite regularly deals with cases that present tuberculosis
bacterium and other airborne pathogens which will require some level 3
containment elements as per the Health Agency of Canada, The
Laboratory Biosafety Guidelines: 3rd Edition 2004. The Morgue and
Autopsy Suites are to be designed to fully achieve the conditions required
by CSA Z317.02 which support management of airborne pathogens. The
most significant implications of complying with CSA Z317.02 are that a
dedicated anteroom/vestibule will be required to the Autopsy Suite and
HEPA filtration of exhausted Morgue/Autopsy air to achieve Level 3
Containment will be required.
14.3.2.8.5
The autopsy area will be equipped with an eye wash station and an
emergency deluge shower. This part of the component will be serviced by
floor drains. Drains will be in compliance with standards for biosafety and
disposal of bio-hazardous fluids.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
14.3.2.9 Acoustic Isolation
14.3.2.9.1
All areas in this component must be acoustically isolated from the rest of
the Facility.
14.3.2.10 Ergonomics for an Aging Workforce
14.3.2.10.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff are required to
use. Ease of access will be among the key criteria. In all areas throughout
this component, this specification will be reflected in electrical outlets being
located approximately 900 mm (approximately 3’) above floor surface. The
type and number of electrical devices used in the rooms is expected to
increase, and elevated outlets will avoid stress associated with repetitive
bending.
14.3.2.10.2 The autopsy table will accommodate height adjustment to accommodate
personal preferences for standing or sitting while conducting autopsies.
14.3.2.11 Provisions for Bariatric Cadavers
14.3.2.11.1 Moving bariatric cadavers to/from refrigerated storage will require
installation of a ceiling mounted lifts system. Lifts must have a maximum
rated capacity of not less than 450 kg. (approximately 1,000 lbs.), and must
be fully operable by a single person.
14.3.2.11.2 Sealed bariatric transport carts will be used to transport bariatric cadavers.
14.3.2.12 Pneumatic Tube Station
14.3.2.12.1 The autopsy area of this component will be equipped with a pneumatic
tube station for the transport of specimens, documents and small
supply/equipment items.
14.3.3 Component Functional Diagram
14.3.3.1 The areas making up this component should be organized as illustrated in the following
diagram:
EXECUTION COPY Nortth Island Hospittals Projject SCHED
DULE 3: DESIGN AND CONSTRUC
CTION SPECIFICA
ATIONS APP
PENDIX 3A: CLIN
NICAL SPECIFICA
ATIONS ______________
_____________
______________
____________________________________________________________ __________
DT
T.03.01
MORGUE AN
ND AUTOPSY S
SUITE
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
14.3.4 Space Table
14.3.4.1
The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: DT.03.01 Morgue and Autopsy
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
15.0
1
15.0
Subtotal, Grieving/Viewing Area
15.0
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Grieving/Viewing Area
01
Family/Grieving Room
Accommodation for up to 10 people - Allowance for
some visitors to be in wheelchairs
Cadaver Storage and Autopsy Area
02 Workstation, Staff
1 multipurpose wrkstn w/ computer terminal, files
storage
03
04
[RID intentionally left
blank]
Cadaver Preparation/
Viewing Room
05
Autopsy Station
06
07
08
Alcove, Linen
Utility Room, Soiled
Storage,
Biohazardous Waste
09
Storage, Cadaver
10
Toilet/Shower/Change
Room
1 stretcher position - Coverable glazing providing
controlled visual access from Family/Grieving Room
Adjustable height autopsy table - Counter w/ sink,
scales - Securable supplies and equipment storage Ceiling mounted lift system linked with cadaver
storage area. Ante room that meets Level 3 Biosafety
requirements.
Cart storage
Accommodates up to 2 laundry totes
Need storage for 8-9 body holding, provide Crypt
storage, requires lift system
3.0
1
3.0
-
-
-
9.0
1
9.0
32.5
1
32.5
2.0
5.0
4.0
1
1
1
2.0
5.0
4.0
9.5
1
9.5
6.0
1
6.0
Subtotal, Cadaver Storage and Autopsy Area
76.0
TOTAL NSM, ALL AREAS
86.0
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.03.01
MORGUE AND AUTOPSY SUITE
CAMPBELL RIVER
HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
DT.03.01 Morgue and Autopsy
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
15.0
1
15.0
Subtotal, Grieving/Viewing Area
15.0
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Grieving/Viewing Area
01
Family/Grieving Room
Cadaver Storage and Autopsy Area
02 Workstation, Staff
03
04
[RID intentionally left
blank]
Cadaver Preparation/
Viewing Room
Accommodation for up to 10 people - Allowance for
some visitors to be in wheelchairs
1 multipurpose wrkstn w/ computer terminal, files
storage
3.0
1
3.0
-
-
-
1 stretcher position - Coverable glazing providing
controlled visual access from Family/Grieving Room
9.0
1
9.0
32.5
1
32.5
2.0
5.0
4.0
1
1
1
2.0
5.0
4.0
9.5
6.0
1
1
9.5
6.0
05
Autopsy Station
Adjustable height autopsy table - Counter w/ sink,
scales - Securable supplies and equipment storage Ceiling mounted lift system linked with cadaver
storage area - Audio-video recording/telemedicine
technology incorporated into this area. Ante room
that meets Level 3 Biosafety requirements.
06
07
08
Alcove, Linen
Utility Room, Soiled
Storage,
Biohazardous Waste
Cart storage
Accommodates up to 2 laundry totes
09
10
Storage, Cadaver
Toilet/Shower/Change
Room
Subtotal, Cadaver Storage and Autopsy Area
71.0
TOTAL NSM, ALL AREAS
86.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
DT.04
SURGICAL SERVICES
This specification outlines the functional, operational and physical requirements for the Surgical Services
functional component.
15.1 FUNCTIONAL DESCRIPTION
15.1.1 Statement of Purpose
15.1.1.1 The Surgical Services component exists for the purposes of accommodating invasive
and minimally invasive procedures during which patients will require either anesthesia
or sedation. Following each procedure, patients will be recovered before being
transferred to an inpatient bed or to the Surgical Day Care component (See AC.03).
Services of the OR Booking Office and the Pre-Admission Clinic (PAC) will be
accommodated here as well.
15.1.2 Scope of Services
15.1.2.1 Functional Content
15.1.2.1.1
The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
15.1.2.1.1.1 Coordinating next day’s booking schedules with the MDRD (See
OS-STL.09) in preparing surgical packs and case carts
15.1.2.1.1.2 Receiving of patients following their initial preparation in either the
Surgical Day Care component or on one of the inpatient care units,
and then confirming patients’ identity according to the procedure
for which they are scheduled and their destination in the
component
15.1.2.1.1.3 Identification and segregation of infectious patients
15.1.2.1.1.4 Induction of patients, including general anesthesia, spinal blocks
and regional block administration by anesthesiologists
15.1.2.1.1.5 Conduct of surgical procedures, including some pediatric surgery,
and in the following surgical specialties:
12.1.1.1.1.1.1
General
12.1.1.1.1.1.2
Dental
12.1.1.1.1.1.3
EENT
12.1.1.1.1.1.4
Obstetrical/Gynecological including C-sections
12.1.1.1.1.1.5
Orthopedic
12.1.1.1.1.1.6
Plastic
12.1.1.1.1.1.7
Urologic
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15.1.2.1.1.6 Conducting some scope based procedures (e.g., some
cystoscopies for tumor removal, laparoscopy, arthroscopy)
15.1.2.1.1.7 Continuous ventilation and monitoring of patients vital signs by
anaesthetists during surgical procedures
15.1.2.1.1.8 Performing diagnostic imaging procedures during surgical
procedures
15.1.2.1.1.9 Procuring and transferring tissue/fluid samples during surgical
procedures
15.1.2.1.1.10 Post procedure recovery to a state where patients are awake and
alert
15.1.2.1.1.11 Conducting electroconvulsive therapy (ECT)
15.1.2.1.1.12 Conducting Cardioversions
15.1.2.1.1.13 Patient scheduling including coordinating surgical suite availability
with surgeons schedules and coordinating with pre-admission
clinics and services
15.1.2.1.1.14 Conducting pre-operative assessments in a consultative clinic
setting (PAC)
15.1.2.1.1.15 Coordinating with the Facility’s patient portering service
15.1.2.1.1.16 Coordinating the transfer of clean and dirty equipment, supplies
and case carts
15.1.2.1.1.17 Managing inventories of consumable supplies
15.1.2.1.1.18 Performing routine maintenance on ventilators and anaesthetic
equipment
15.1.2.1.1.19 Performing routine cleaning of operating rooms between cases
and terminal cleaning at the end of each day
15.1.2.1.1.20 Flash sterilization of urgently needed surgical instruments. Flash
sterilizers should not be used in a surgical theater.
15.1.2.1.1.21 Personal facilities for staff working in the component, including
toilets, showers, lockers, change and lounge facilities
15.1.2.2 Exclusions
15.1.2.2.1
The following list specifies functions supporting surgical services or
involving minor invasive procedures, and requiring either local anesthesia
or sedation, but are understood to occur in other functional components in
the facility or outside of the facility:
15.1.2.2.1.1 Ophthalmological surgery (See AC.04 Outpatient Procedural Care)
15.1.2.2.1.2 Minor scope based procedures e.g., G.I. endoscopy,
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bronchoscopy, cystoscopy and colposcopy (See AC.04 Outpatient
Procedural Care)
15.1.2.2.1.3 Cardiac surgery
15.1.2.2.1.4 Neurosurgery
15.1.2.2.1.5 Thoracic surgery
15.1.2.2.1.6 Frozen section tissue assays
15.1.2.2.1.7 Cleaning of surgical equipment
15.1.2.3 Anticipated Trends in Service Delivery
15.1.2.3.1
The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
15.1.2.3.1.1 Advances in technology and procedures will continue increasing
the volumes of minimally invasive procedures
15.1.2.3.1.2 The mean age of staff working in this component is predicted to
increase.
15.1.2.3.1.3 Shortages of key staff positions are predicted to increase, including
staff in the highly trained, specialized professions.
15.1.2.3.1.4 Infection control will remain a high priority in all areas of the
Facility.
15.1.2.3.1.5 The shift from inpatient to ambulatory/same day and less invasive
procedures will continue. This trend will require enhanced
registration and processing procedures, accommodation for new
equipment and technology as well as amenities for family
members and escorts.
15.1.2.3.1.6 More efficient use of the ORs will mean that, regional block
anesthetics will become more prevalent arguing for a separate
induction room (block room) to support orthopedic and plastic
procedures.
15.1.2.3.1.7 Increased numbers of bariatric patients will be anticipated.
15.1.3 Scope of Education Functions
15.1.3.1 Medical and nursing students and students in the allied health professions from
technical colleges and universities will receive practical skills training through student
rotations, residency rotations and co-op programs. All teaching and supervision
functions will be accommodated in the general work areas, and will not require
specialized or dedicated facilities in this component.
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15.1.4 Scope of Research Functions
15.1.4.1 Staff and students working in the Surgical Services component will, from time-to-time,
be engaged in research. The nature and extent of research functions will be
accommodated in the general work areas, and will not require specialized or dedicated
facilities in this component.
15.2 OPERATIONAL DESCRIPTION
15.2.1 LEAN Planning Standards
15.2.1.1 Consumable Supplies Management
15.2.1.1.1
To the extent practicable, consumable supplies stored in different areas in
this component will be organized and stored in a common order and
configuration, with each item having a standardized storage location. The
intent of this standard is to enable efficient locating of each supply item
without staff first having to reorient themselves to a new room configuration
and to avoid long travel distances between supplies storage and point of
use.
15.2.1.1.2
Materiel management will rely on automation. Consumption, reordering
and resupplying will rely on a combination of bar-coding and automated
tracking as supplies are withdrawn from inventories.
15.2.1.1.3
Disposable as opposed to reusable items will be the preferred option in this
component. A key result of this choice will be reflected in the nature of
clean and soiled holding areas. Disposable items tend to be lighter and
smaller than their reusable counterparts, but they also tend to be retained
for longer periods after use before removal for disposal. The net effect will
be a reduction in clean utility holding areas and an increase in soiled utility
holding areas.
15.2.2 Hours of Operation
15.2.2.1 The component at this facility will be staffed and in operation:
15.2.2.1.1
0700 – 1530, Monday to Friday for elective procedures
15.2.2.1.2
1500 – 2300, 7 days-a-week for urgent and emergent procedures
15.2.2.1.3
2300 – 0700, 7 days-a-week for emergent procedures
15.2.3 People Management Systems
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15.2.3.1 The facility’s portering staff will transfer all patients arriving at and leaving the
component. At an appropriate lead-time prior to the availability of each patient’s
scheduled surgical suite, a porter will be dispatched to transfer the patient. This
process will be reversed once patients are sufficiently recovered and ready for transfer
out of post-anaesthetic recovery. Transfers to and from this component will generally
originate from one of the following:
15.2.3.1.1
Emergency Department (See AC.01)
15.2.3.1.2
General Medical Surgical Inpatient Units (See IP.01)
15.2.3.1.3
Intensive Care Unit (See IP.02)
15.2.3.1.4
Maternity, Newborn and Pediatric Inpatient Unit (See IP.03)
15.2.3.1.5
Surgical Day Care (See AC.03)
15.2.3.2 Arriving patients will first have their identity confirmed against their scheduled
procedure and any pre-procedure requirements. Any requirements for a final preanesthetic consultation will be coordinated at this time. Patients will next be moved to a
holding area pending any final consultations and availability of their scheduled
operating room.
15.2.3.3 Post procedure unconscious patients will be moved immediately to the PARR for
recovery. Once achieving a state of consciousness and awareness indicating that
further close monitoring is not required, patients will be either returned to the Surgical
Day Care component or to the appropriate inpatient care unit. Patients receiving
regional anesthesia may go to PARR or may go directly to the Surgery Day Care
Component.
15.2.4 Materiel Management Systems
15.2.4.1 Consumable Supplies
15.2.4.1.1
Inventories of consumable supplies will be maintained centrally in the
Surgical Services component. Commonly used items requiring immediate
access will be stored de-centrally in each of the surgical suites and in the
post anaesthetic recovery area. Generally, a three day supply of each item
will be maintained with minimum inventory levels triggering a re-ordering
process.
15.2.4.1.2
Planning assumes electronic tracking supporting a two bin inventory
maintenance system. Under this system, two bins will be filled with
identical supply items. Once the first bin is depleted of inventory that bin’s
tag will be placed on an electronic monitoring board which will
automatically trigger a reordering process. Two (2) tags from the same bin
appearing on the electronic monitoring board will trigger a request for “fast
track” delivery. All orders will be sent electronically to the Materiel
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Management component (See OS-STL.05) for processing.
15.2.4.2 Laundry and Linen
15.2.4.2.1
Linen services address two major product streams. The first of these
includes linens used during procedures. These will be a mix of disposable
and reusable sterile items processed through the MDRD. In this case,
clean linen will be delivered by the Facility’s regional laundry (towels) and
by outside suppliers (disposable drapes, gowns, etc.) to a clean holding
area in the MDRD if the item is to be incorporated into case carts. Items
will be picked, assembled into closed case carts, sterilized and then
transported to a sterile holding area in this component. Stocks of loose
items will be similarly processed, delivered directly to Surgical Services
component and stored in designated clean linen holding areas. A laundry
cart of clean, reusable linen (towels and isolation gowns used during
endoscopic procedures) will be delivered directly to the procedures room.
15.2.4.2.2
Soiled disposable linen will be deposited into lined waste containers
located in each of the operating rooms. Reusable linens will be discarded
into totes. Between cases, Environmental Services will remove the
liners/hampers and consolidate these in a contaminated holding area.
Consolidated waste will be removed daily for off-site disposal via the
Environmental Services component (See OS-STL.03). Totes will be
returned to the regional laundry.
15.2.4.2.3
The second major product stream addresses OR staff uniforms. Stocks of
uniforms will be kept in clean holding areas in each of the male/female
change rooms; inventory levels will be maintained using a top-up system
directly from the regional laundry. Environmental Services will access
clean inventories maintained in the Laundry component at regular intervals
to replenish the number and sizes of each garment stored in the OR
change facilities.
15.2.4.2.4
Soiled uniforms will be consolidated in totes located in each of the
male/female change rooms. Totes will be removed daily by Environmental
Services during routine cleaning and transported to the off-site Laundry.
15.2.4.3 Specimens and Laboratory Testing
15.2.4.3.1
Tissue and fluid specimens will be obtained during some surgical
procedures. Regardless of the urgency in testing requirements, all
specimens will be transported to the Laboratory component (See DT.03)
for processing and analysis, unless on site analysis is required. Specimen
transport will be conducted by pneumatic tube, unless a specimen’s
stability or fragility requires manual transport. In the latter case, laboratory
technicians will be responsible for transporting specimens from operating
rooms to the Laboratory. Specimen collection protocols will enable
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Laboratory staff access to specimens without entering a sterile area; staff
working in a sterile area must also not be required to exit into a clean or
contaminated area.
15.2.4.3.2
Laboratory test results will be communicated back to the operating room
electronically, and on video displays.
15.2.4.4 Diagnostic Images
15.2.4.4.1
Diagnostic images required during a surgical procedure generally will be
conducted using digital general radiography and/or fluoroscopy. Portable
imaging machines kept in the Surgical Services component will be used to
capture images. Provision will also be made for the use of portable
ultrasound machines during surgical procedures. Storage requirement for
imaging equipment will be in accordance with Canadian Standards
Association (CSA) Z8000-11 standards for orthopedic or specialty rooms.
15.2.4.5 Pharmaceutical Products
15.2.4.5.1
Automation will be used in the inventory management and dispensing of
patient medications. Centrally located automated stations close to the
surgical suites and to the post anaesthetic recovery area will be stocked
with medications and dispensed when and as needed. Pharmacy
personnel will be responsible for inventory management of the automated
stations, whereas clinicians and nursing personnel will deliver medications
from the stations to the patients.
15.2.4.5.2
Unstable products will be prepared in the Pharmacy component (see
DT.06), and then delivered to the Surgical Services component either
according to a prescribed schedule or upon request.
15.2.4.5.3
Pharmaceutical agents used to support anesthetic procedures will be
maintained on anesthetic carts by anesthetists or anesthesia technologists.
All pharmaceuticals will be ordered through and delivered by the
Pharmacy. Inventory management will be electronically monitored.
15.2.4.5.4
All narcotics used in surgical procedures will be maintained in secure
rooms located in this component, and in close proximity to the ORs and the
recovery area. Removal of a narcotic from inventory will be recorded
electronically.
15.2.4.6 Food Services
15.2.4.6.1
Patients experiencing prolonged stays in the PARR will, on occasion,
require snacks or light meals. These will be ordered electronically by PARR
staff and delivered to the component by Food Services (See OS-STL.06).
Provision will be made for teletracking or similar system to confirm patient
location and linkages to pharmacy and food services.
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15.2.4.6.2
Beverages and snack items will be maintained in kitchenette facilities
located with staff lounge facilities. Food Services will be responsible for
replenishing snack/beverage items on a daily basis.
15.2.4.7 Waste Management
15.2.4.7.1
To the extent practicable, waste products will be generally managed
according to a system of segregation at point of origin and sequential
consolidation. Operation of this system relies on appropriate containment
facilities for each type of waste product beginning at where the waste is
generated followed by similar, but progressively larger, containment
facilities at key collection locations. In this component, waste management
is understood to begin in the individual surgical suites and at each post
anaesthetic recovery bed site with collection and temporary holding
stations being centrally located in a general support area of this
component.
15.2.4.7.2
Biohazardous waste will not be sent off-site for disposal, but will be
accommodated on-site. Any fluids allowed by local regulations into the
sewer system will be pre-treated by a sanitizing disposal system (e.g.,
Neptune system).
15.2.4.7.3
Segregation of wastes will accommodate the following categories of
products:
15.2.4.7.3.1 General garbage
15.2.4.7.3.2 Sharps (including potentially biohazardous items)
15.2.4.7.3.3 Infectious or contaminated wastes (excluding sharps, but including
disposable products that touch a patient)
15.2.4.7.3.4 Clean paper and cardboard (including disposable wraps that do
not touch the patient)
15.2.4.7.3.5 Clean metal (tin and aluminum)
15.2.4.7.3.6 Clean recyclable plastics
15.2.5 Information Management Systems
15.2.5.1 All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, located close to each patient’s bedside and at key staff workstations, and
mobile pads. Access to the EMR will be controlled electronically with varying levels of
security clearance determining a person’s access to different sections and their ability
to enter/edit data.
15.2.5.2 Surgical procedures will be supported by interfaces with diagnostic images (PACS) and
laboratory results (LIS). Planning assumes that video monitors in each operating room
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will have the capability to display these diagnostic tools in addition to real-time patient
vital statistics.
15.2.5.3 The OR booking process will begin with an electronic request from a surgeon’s office
that will be prioritized with all other requests to compile an updated wait list. Prior to
being scheduled for surgery, a sequence of events will be initiated that will trigger a
preadmission clinic visit and an equipment order requisition, including any require loan
items. All of this data will then be fed back into the booking procedure which will be
used to compile the “day before” slate.
15.2.5.4 Staffing information will be a managed corporate service. Scheduling, including
providing for sick and vacation relief will be conducted centrally, and off-site. Notices to
individual staff regarding their schedules will be communicated electronically.
15.2.5.5 The clinical unit and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authorities strategic investment in Cerner and other
clinical and business systems.
15.2.5.6 The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
15.2.5.6.1
Integrated Medication Carts
15.2.5.6.2
Medication Dispense Cabinets
15.2.5.6.3
Mobile and Fixed Computer Devices – Desktop and Wall mounta
15.2.5.6.4
Mobile and Fixed Label Printers
15.2.5.6.5
Mobile and Fixed Barcode Scanners
15.2.5.6.6
Handheld Computer Devices
15.2.5.6.7
Glucometers with Docking Stations
15.2.5.6.8
Tracking Monitors – Patient, Staff, and Resource Tracking
15.2.5.6.9
Clinical Dashboards
15.2.5.6.10 Smart Beds
15.2.5.6.11 Smart Pumps
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15.2.5.6.12 Device Integration for real –time clinical assessment and physiological data
documentation
15.2.5.6.13 Digital Room Signage and Way-finding
15.2.5.6.14 Interactive Patient Station
15.2.5.6.15 Location Awareness
15.2.5.6.16 Device Connectivity
15.2.5.6.17 Multifunction Communication Devices with integration to systems
15.2.5.6.18 Telehealth and Virtual Team Capabilities
15.2.5.6.19 Real Time Location System
15.2.5.6.20 Staff Safety and Duress
15.3 DESIGN CRITERIA
15.3.1 LEAN Planning Standards
15.3.1.1 Points of Access/Egress and Patient Circulation
15.3.1.1.1
Patient flow through this component will be developed around one-way
flow in a scheme where inbound and outbound patients do not cross paths.
This will likely require two entrances; a patient access point that could also
function as the staff entrance, and a patient egress point that is
functionally, physically and visually separate from the entrance.
15.3.1.1.2
The intent of this standard is to avoid congestion that can occur when two
patient streams are forced to converge. A second objective is to allow
patient care areas and care team expertise to focus on each patient’s
needs at key points as they journey through the component (e.g., preprocedure care and assessment, during procedure and post procedure).
15.3.1.2 Separation of Clean and Dirty Transport
15.3.1.2.1
Separate vertical conveyances between this component and the MDRD
(See OS-STL.09) will enable preservation of the sterile core and
transportation of contaminated items while providing the highest infection
control standards. Planning assumes the installation of two dedicated
elevators linking MDRD to the Surgical Services component.
15.3.1.2.2
The intent of this standard is to reduce the amount of time, materials and
protocols required to accommodate the transportation of clean/sterile
products versus soiled/contaminated products. A dual (clean versus dirty)
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system implies less equipment, fewer protocols and less opportunity for
cross contamination.
15.3.2 Proximity Relationships
15.3.2.1 The Surgical Services component’s location relative to other components, or other
areas of the facility, and the nature of circulation used to move between different
components/areas are illustrated in the diagram below. Proximities are listed according
to rank; higher priorities appear above lower priorities.
Surgical Services Medical Device Reprocessing Department 15.3.2.2 Provide Direct Access by Internal Circulation
to the MDRD for the movement of case carts
and clean/dirty surgical equipment and for
maintenance of a sterile core.
Surgical Services Mat/Newborn & Pediatric Inpatient Unit 15.3.2.3 Provide Direct Access by Internal Circulation
to the Maternity, Newborn and Pediatric
Inpatient Unit for the movement of mothers
requiring C-section delivery and for the
movement of mothers and neonates post
procedure.
Surgical Day Care Surgical Services Surgical Services Surgical Services Surgical Services 15.3.2.4 Provide Direct Access and General Circulation
to the Surgical Day Care component for the
movement of patients post procedure
Emergency Department 15.3.2.5 Provide Direct Access and General Circulation
to the ED for the movement of critically ill or
injured patients.
Intensive Care Unit 15.3.2.6 Provide Direct Access and General Circulation
to the (horizontal separation only) to the
Intensive Care Unit component for the
movement of patients pre and post procedure.
Outpatient Procedural Care 15.3.2.7 Provide Direct Access and General Circulation
to the Outpatient Procedural Care Unit
(vertical circulation possible) for the movement
of staff, equipment and supplies.
Medical Staff/UBC 15.3.2.8 Provide Convenient Access by General
FoM Academic Circulation to the Medical Staff/UBC FoM
Teaching Facilities Academic Teaching Facilities component for
Surgical Services the movement of medical staff accessing
resource/meeting/lounge facilities.
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15.3.3 Internal Design Criteria
15.3.3.1 Functional Zoning
15.3.3.1.1
The component shall be organized into 3 major zones that define
restrictions on access and different levels of cleanliness:
15.3.3.1.1.1 A Public Zone accessed from a public corridor for patients
requiring pre-operative assessment and for OR Booking function.
15.3.3.1.1.2 An Unrestricted Zone represents the component’s main staff and
patient entrance. It is the point beyond which only authorized
personnel and patients will be allowed to proceed. Traffic
monitoring and controlling will be key functions associated with this
zone.
15.3.3.1.1.3 A Semi-Restricted Zone accommodates support facilities including
clean/sterile holding areas, technical work areas, and staff support
rooms. The Post-operative Recovery component is part of this
zone.
15.3.3.1.1.4 A Restricted Sterile Zone represents the component’s sterile core.
15.3.3.2 Component Access and Security
15.3.3.2.1
Access to the Semi-Restricted and Restricted Zones will be restricted to
authorized personnel; all points of access are controlled electronically (e.g.,
electronic reader for key card, finger print or retinal scanning). Access
technology at the main patient entrance will be connected to automatic
doors enabling porters to maneuver stretchers, bariatric beds, and
wheelchairs easily. This doorway will be of sufficient width to allow
passage of a bariatric bed accompanied by one person on each side.
15.3.3.2.2
Access to the Pre-Admission Clinic and Anesthetic Consultation
offices/rooms will require direct access of a public corridor, patients and
their escorts will not use the component’s main entrance to access these
spaces. Each of these rooms must also be supplied with a second point of
entrance/exit allowing staff to enter without having to go through a public
corridor. Provide direct access from the OR to OR Booking Clinic space.
15.3.3.3 Communication Technology
15.3.3.3.1
Each of the operating rooms, staff lounges and change rooms will have a
means of communicating with the control station located in the Unrestricted
Zone.
15.3.3.3.2
Networked computer terminals will be located in each of the operating
rooms and will provide immediate communication to key hospital areas
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including the Laboratory (test results), Medical Imaging (digitized images)
and the Pharmacy (stat medication orders).
15.3.3.3.3
Paging in this component will rely on hands-free, voice activated
technology
15.3.3.3.4
Light annunciators located outside of each operating room will be used to
alert Environmental Services and Portering when procedures are complete
and patients are about to be discharged.
15.3.3.4 Environmental Control
15.3.3.4.1
Each of the operating rooms will be sealed to achieve specific ventilation
(air exchange) requirements, controlled air quality and airflow direction
(positively pressurized for infection control).
15.3.3.4.2
Each of the operating rooms, the pre-operative holding area and the PARR
area will have separate temperature and humidity controls. Temperatures
in the operating rooms will be capable of being adjusted rapidly to
accommodate heat generated by surgical equipment.
15.3.3.4.3
Exhaust systems incorporated into each operating room will be capable of
immediately removing smoke that may be generated during a surgical
procedure.
15.3.3.4.4
In terms of internal air handling and requirements for number of “air
changes per hour”, areas of the Surgical Services component will be
ranked from highest to lowest as follows:
15.3.3.4.4.1 Operating rooms
15.3.3.4.4.2 Restricted Zone and Semi-Restricted Zone
15.3.3.4.4.3 Soiled or contaminated holding area
15.3.3.4.4.4 Pre-operative and PARR area
15.3.3.4.4.5 Pre-Admission Clinic, OR Booking, Staff support facilities, private
offices and administrative work areas
15.3.3.4.5
Utilities
15.3.3.4.5.1 All gas outlets in the operating theatres will be boom-mounted.
15.3.3.4.5.2 Compressed air, suction and nitrogen (equipment power source)
for dental surgery will also be provided for in each of the operating
rooms.
15.3.3.4.5.3 Medical gases and suction will be delivered to each workstation in
the operating rooms using an articulating, boom-mounted system
capable of adapting to different orientations of an operating room
table or a patient stretcher.
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SURGICAL SERVICES
15.3.3.4.5.4 With the exception of water used for hand washing in scrub sinks,
all water used in this component will be conditioned.
15.3.3.5 Video Technology
15.3.3.5.1
Each of the operating rooms will be equipped with at least three flat screen
video monitor(s) capable of displaying patient-related information,
diagnostic images, laboratory test results and real-time images of
procedures in progress. This monitor will be fixed-mounted and located in
a position capable of being viewed from any location in the operating room.
The location of the video monitors will be done in consultation with the user
group champions.
15.3.3.5.2
In addition to fixed-mounted video monitors, a second bank of 3 video
monitors in each operating room will be mounted on an articulating boom
system for use by the surgeon/physician during a surgical procedure.
15.3.3.5.3
Each patient position in the PARR will be equipped with a flat screen
monitor capable of displaying patient-related information including vital
statistics, diagnostic images and laboratory test results.
15.3.3.6 Surgery Unit Organization and the Restricted Zone (Sterile Core)
15.3.3.6.1
The surgical suite shall be designed around the “race-track” model. The
operating rooms shall be located around the sterile core. Each operating
room shall have two doors. One staff door leading into the sterile core and
one large patient door leading to the “race-track” patient circulation
corridor. There shall be only one sterile core room. Provide an area inside
the sterile core next to each operating room door such that four case carts
can be queued simultaneously. Provide two exits from the sterile core, one
at each side of the surgical race-track. Provide 4 workstations in the sterile
core. Provide an elevator that connects MDRD to the sterile core, this
elevator shall open directly into the sterile core room. Provide a large open
area directly in front of the clean elevator for marshalling of clean case
carts. Provide controlled access into the sterile core room. Provide a wall
mounted phone in the sterile core.
15.3.3.6.2
Provide equipment rooms that open onto the “race-track” corridor. Ensure
equipment rooms have close and immediate access to the majority of
operating rooms. Provide no less than two staff washrooms in the “racetrack” that are distributed around the operating room “race-track”.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
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15.3.3.6.3
Provide a surgery control desk that has visibility to the surgical “race-track”.
The control desk shall be located to have visibility to the Surgical Day Care
entrance and shall be positioned to have awareness of all surgical patient
traffic. The control desk shall be millwork with a standing height transaction
counter on the approach side. The nurse side shall be sitting height with no
less than 4500mm of continuous work counter. The control desk shall be
adjacent to the inpatient holding area. The control desk shall observe and
provide nursing for the inpatient holding area. The inpatient holding patient
bays shall match the patient bays in the Surgical Day Care and PARR. The
inpatient holding patient bays shall not be in an enclosed room, they shall
be immediately adjacent to the surgical “race-track”. Provide the Front Line
Leader office directly adjacent to the control desk. Provide task lighting at
the surgery control desk. Provide status boards distributed around the
surgical unit. Ensure the surgery control desk, PARR, Surgical Day
Surgery and surgery waiting have a status board.
15.3.3.6.4
The patient circulation corridors in the Restricted Zone will be sufficiently
wide to accommodate side-by-side passage of 2 beds. Soft chamfered
corners (45 degree soft corners) shall be incorporated into all high traffic
corridors and stretcher/bed transportation routes. During surgical
procedures, stretchers will be stored immediately outside of the operating
room. Corridors in the vicinity of an operating room entrances will be
sufficiently wide to accommodate this temporary storage without impeding
circulation.
15.3.3.7 Operating Rooms:
15.3.3.7.1
No operating room shall have a width less than 7300mm measured inside
from wall to wall. Provide a sitting height stainless steel workstation with no
less than 1500mm in length of countertop space. Provide wall backing for
multiple flat panel monitors. Provide a patient lift in the ceiling. Refer to
Schedule 3 for specifications regarding patient lifts.
15.3.3.8 Universality of Function
15.3.3.8.1
All operating rooms will be equally capable of supporting all types of
surgical procedures conducted at the Facility. Achieving this flexibility in
room use will mean:
15.3.3.8.1.1 All operating rooms are equipped with floor drains in support of
urologic surgery. Drains are equipped with filters, traps, 1-way
valves and any other technology or device necessary to achieve
compliance with infection control standards for operating rooms.
15.3.3.8.1.2 Sinks installed in the operating rooms are equipped with plaster
traps in support of orthopedic surgery.
15.3.3.8.1.3 Location and rating of electrical power outlets, medical gas and
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
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suction delivery systems, lighting, video monitors, communication
technology is standardized as much as practicable enabling staff to
adopt common practices regardless of the operating room to which
they are assigned. The placement of these items will be
determined in discussion with the Surgical Services Clinical User
Group.
15.3.3.8.1.4 All operating rooms are capable of accommodating the installation
of ceiling-mounted diagnostic imaging equipment.
15.3.3.9 C-Section OR:
15.3.3.9.1
At least two (2) operating rooms shall be capable of performing C-Sections.
These operating rooms shall have an infant resuscitation area with
appropriate gases and space. One of the C-Section operating rooms shall
be the closest operating room to the Maternal Newborn/Pediatric Unit.
15.3.3.10 Scrub Sinks:
15.3.3.10.1 Provide a scrub sink adjacent to each operating room patient door or the
stretcher bay. Provide a window with integral blinds (controlled on both
sides) from the scrub sink into each operating room with visibility to the
patient table. Provide a stainless steel shelf above the length of the scrub
sink no less than 200mm deep. The scrub sink shall be in an alcove such
that users of the sink shall not be standing in the circulation corridor.
Provide wing walls around the scrub sink for mounting accessories and
splash protection.
15.3.3.11 Decontamination Room:
15.3.3.11.1 The decontamination room shall be located directly adjacent to the “racetrack”. The decontamination room shall contain the soiled elevator to the
MDRD. Provide an open area in front of the elevator door to allow for cart
marshalling. The door to the decontamination room shall be automatic with
two push plates on either side of the door such that it can be opened no
matter which direction it is approached. 15.3.3.12 PARR Surgery Entrance
15.3.3.12.1 Provide a patient door between PARR and the Surgery “race-track”
corridor system. Ensure that the PARR patient door into surgery is central
and suitably located for high volumes of patient traffic. Ensure that the
corridor leading into and out of the PARR has few corners. All PARR
patient entrances shall be automatic doors with push plates on both sides.
15.3.3.13 PARR Unit Organization
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
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SURGICAL SERVICES
15.3.3.13.1 The PARR will be configured as an open plan with unobstructed sight lines
between a central nurse station and each of the patient positions. The
PARR shall be directly adjacent to both the Operating Room on one side
and the Surgical Day Care component on the other side. The PARR shall
be designed to share a “race-track” loop with Surgical Day Care to facilitate
patient bay overflow capability. Provide automatic doors with hold opens
between PARR and the Surgical Day Care component. Privacy partitions
or curtains around each position will be accommodated, but their use will
not obstruct views to any of the other patient positions. Privacy between
most PARR recovery bays will be provided by the use of privacy curtains.
Where two curtain tracks meet, the tracks shall overlap by 200mm for
privacy. This means that the curtain tracks shall run parallel for 200mm
such that there is no gap where the curtains meet. Provide one handwash
sink for every two patient bays. Provide artwork and patient positive
distraction features in the PARR. Provide a wayfinding sign that is unique
to each bay such that it is visible from the corridor when the curtains
around a patient bay are closed. This sign may hang from the ceiling.
15.3.3.13.2 Provide task lighting at the PARR care station. Provide modular systems
furniture for the care station and other work areas, including accessories
and storage, to facilitate current and future operations of this area.
15.3.3.13.3 The area behind all care stations shall be suitable for business centre
functions such as large printers, storage, chart storage, and countertop
space. The business centre functions shall be designed to be minimize
noise.
15.3.3.14 OR Booking
15.3.3.14.1 The OR Booking Office is permanently assigned space that will be
occupied daily. The nature of activity occurring in this space will require
periods of focused concentration and collaboration among booking staff.
The OR booking office shall be located in the Public Zone of Surgical
Services but away from public waiting areas and away from areas where
staff congregate for either work-related or leisure functions. Provide 5
Individual workstations. These workstations shall be partitioned on 3 sides
to provide some privacy while providing opportunities for collaborative
working. The OR Booking Office must be accessible through internal
corridors to other areas of the Surgical Suite and be located in the SemiRestricted Zone.
15.3.3.15 Pre-Admission Clinic
15.3.3.15.1 This clinic sees patients prior to admission for surgery to provide direction
on preparation of a patient for a surgical procedure and/or assessment of
patients with other medical conditions that could influence the outcome of
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
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SURGICAL SERVICES
the surgery. Patients attend this area in the days or weeks before their
surgery. This clinic will be located in the Public Zone of Surgical Services.
The consultation room shall have direct access to the day surgery waiting
room.
15.3.3.16 Staff Support Areas
15.3.3.16.1 There shall be a vestibule or sally port from the surgical “race-track” to the
staff lounge and change rooms. The staff lounge shall be accessible
without traveling through a change room. Provide an area for a wallmounted monitor in the staff lounge. Provide an area in the staff lounge for
a cluster of comfortable reclining seating that includes a sofa.
15.3.3.16.2 The staff washrooms shall be accessed from the change rooms and shall
not open directly onto the staff lounge. Provide privacy for the change room
entrance/exit doors for those changing. Provide benches and areas for
linen hampers. Provide full height mirrors in all change rooms and adjacent
to the vestibule door into the surgical “race-track”.
15.3.3.16.3 Staff using the staff support areas will have direct access to both the SemiRestricted Zone and the Restricted Zone, (not the Sterile Core) and
doorways leading from male/female change areas will provide access to
the Restricted Zone. Staff should be able to access the change area from
both the Semi-Restricted Zone and the Restricted Zone. Staff arriving and
leaving for work will require access to the staff support areas, from outside
the semi-restricted and restricted zones, access the male and female
change areas and locker rooms is from a non-public corridor.
15.3.3.17 Natural Lighting
15.3.3.17.1 The opportunity to bring natural lighting into each of the operating rooms is
a desirable feature as. Operating room staff often spend prolonged
periods confined to a single room. Natural light also provides a safety
feature in the event of a power loss and any delay in auxiliary/emergency
power coming on-line; in this situation, staff will avoid temporary black-out
conditions.
15.3.3.18 Patient Privacy and Isolation
15.3.3.18.1 One patient position in each of the pre-operative holding and PARR areas
will be a private room providing both acoustic and visual privacy and will be
negatively pressurized relative to the surrounding space. The intent of this
space is to accommodate:
15.3.3.18.1.1 confidential patient/physician/nurse consultations
15.3.3.18.1.2 physical examinations including teaching sessions
15.3.3.18.1.3 isolation of infectious patients
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
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15.3.3.19 Entrance/Exit – Operating Rooms
15.3.3.19.1 The operating room doorway shall be automated and sufficiently wide to
permit the passage of a bariatric patient bed and attending staff on either
side.
15.3.3.20 Ergonomics for an Aging Workforce
15.3.3.20.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff are required to
use. Ease of access will be among the key criteria. In all areas where
electrical devices will be prevalent, this specification will be reflected in
electrical outlets being located approximately 900 mm (approximately 3’)
above floor surface. The type and number of electrical devices used in the
rooms is expected to increase, and elevated outlets will avoid stress
associated with repetitive bending.
15.3.3.20.2 All ceiling-mounted boom systems must have electrical outlets and be both
horizontally and vertically mobile.
15.3.3.21 Accommodation of Bariatric Patients
15.3.3.21.1 Numbers of bariatric patients admitted to hospital are projected to increase.
Managing these patients will require features enabling for both patients and
staff. Doorways and circulation spaces must be sufficiently wide to
accommodate bariatric beds (minimum of 1150 mm.).
15.3.4 Space Table
15.3.4.1 The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
DT.04 Surgical Services
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
Pre-Admission/ Anaesthesia Clinic and OR Scheduling
01 Office, Private, Consultation
Supports functions of Pre-Admission Clinic Accommodation for clinician, nurse and
pharmacist
02
Anaesthetic Consultation
Room
Locate directly adjacent to Consult Offices
03
Workstation, Care Team
3 multipurpose wrkstns each w/ computer
terminal - includes Wall shelving for references
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
10.0
3
30.0
10.0
1
10.0
3.0
3
9.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
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SURGICAL SERVICES
COMOX VALLEY HOSPITAL
ROOM
ID
ROOM TYPE
(RID)
Surgery Scheduling
04 Workstation, OR Booking
Clerk
05 Business Centre
DT.04 Surgical Services
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
Standard workstations
3.0
5
15.0
Photocopier, printer, scanner, facsimile machine
- Counter w/ supply cabinetry. Share with PreAdmission Clinic
6.0
1
6.0
Subtotal, Patient Intake, Reception and Administrative Area
Patient Holding and Procedure Support Areas (Semi-Restricted Zone)
Pre-Procedure Holding Area
06 Inpatient Holding
Privacy partitions around 3 sides - Direct access
to Restricted Zone
70.0
8.0
4
32.0
07
OR Control Desk
Include status board, OR Scheduling system
4.0
5
20.0
08
Alcove, Equipment
Masks, Shoe and Head covers, Provide bench
1.0
1
1.0
Subtotal, Pre-Procedure Holding Area
53.0
Post Anaesthetic Recovery Room (PARR) Area
09 Stage I, Recovery
Privacy curtains around 3 sides - Direct access
from Restricted Zone
8.0
4
32.0
10
Stage II, Recovery Open
3 Walled cubicles, monitored station
8.0
4
32.0
11
Stage II, Recovery Private
3 Walled cubicles, monitored station
12.0
2
24.0
12
13
14
Recovery, Isolation Room
Anteroom, Isolation
Collaboration Centre
12.0
6.0
3.0
1
1
4
12.0
6.0
12.0
15
16
17
18
3.0
12.0
2.0
3
1
1
9.0
12.0
2.0
19
[Intentionally left blank]
Dictation Station
Medication Room
Alcove, Resuscitation
Equipment
Utility Room, Clean
Accommodation for up to 3 carts - Shelving for
clean linen - Counter w/ sink
12.0
1
12.0
20
Utility Room, Soiled
Accommodation for up to 4 totes - Includes sink,
2 bed pan units, counter w/ sink, garbage cart
and recycling cart
11.0
1
11.0
49
Patient Toilet
6.0
1
6.0
21
Nourishment Station
2.0
1
2.0
Subtotal, Post-Anaesthetic Recovery Room Area
172.0
3 Workstations
Ice machine - Counter w/ sink, microwave oven Half size refrigerator - Storage cabinetry
Staff Support Area
22 Staff/Lounge
30.0
1
30.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
DT.04
SURGICAL SERVICES
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
23
DT.04 Surgical Services
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
Kitchenette
24
Workstation, Care Team
25
Entry Alcove/Vestibule, Male
Facilities
26
Locker/Change Room
Include in Staff Lounge
Capacity for up to 20-30 full-width/ configuration
w/ bench
ROOM
SIZE
(nsm)
7.0
NUMBER
OF
ROOMS
1
TOTAL
SIZE
(nsm)
7.0
2.0
1
2.0
3.0
1
3.0
20.0
1
20
27
Toilet, Male
2 sinks, 2 WC (1 assisted), 2 urinals
6.0
2
12.0
28
Shower Stall
Includes change area
2.0
2
4.0
3.0
1
3.0
30.0
1
30.0
6.0
2.0
3
2
18.0
4.0
10.0
1
10.0
10.0
1
10.0
Subtotal, Staff Support Area
153.0
29
Entry Alcove/Vestibule Female Facilities
30
Locker/Change Room
Capacity for up to 40 full-width lockers
31
32
Toilet, Female
Shower Stall
2 sinks, 3 WC (1 assisted)
Includes change area
33
Office, First Line Leader
34
Office, Physician Chief's
Anaesthesia and Surgeon
Locate directly adjacent to First Line Leader
Operating Rooms and Support Area (Restricted Zone)
35 Operating Room, Standard
Spaced to accommodate future technologies
Size/ Configuration- Ortho
including robotics, imaging equipment - Capable
of accommodating higher acuity cases
65.0
1
65.0
55.0
5
275.0
2.0
2
4.0
10.0
3.0
1
3
10.0
9.0
2.0
8
16.0
36
Operating Room, Standard
Size/ Configuration
37
Infant Resuscitation
Include in a minimum of 1 OR
38
39
Induction/ Swing Room
Scrub Station
Include medical gases in induction room
Configured to allow each scrub room to support
up to 2 Operating Rooms
40
Alcove, Stretcher &
Equipment
Storage, Distributed, Clean
Equipment
Locate directly adjacent to OR's, Blanket
Warmers, Bear Huggers
10.0
3
30.0
42
Technical Support/ Workroom
- Anaesthesia
Counter - Shelving for inventories of consumable
supplies and reusable equipment
18.0
1
18.0
43
Storage Equipment
Centrally located to support entire OR
40.0
1
40.0
44
Storage Room, Sterile Core
Case cart marshalling area - Equipment supplies
storage including sterile orthopaedic equipment,
storage for a minimum of 12 case carts.
54.0
1
54.0
4.0
1
4.0
41
45
Alcove - Sterilizer
Supports all Operating Rooms - Flash
sterilization
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
DT.04
SURGICAL SERVICES
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
46
DT.04 Surgical Services
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
Housekeeping Closet
1 floor sink, standard wall-mounted sink, storage
cabinetry - Accommodates housekeeping cart
storage
47
Decontamination Room
Gross decont., soiled holding area
48
Holding, Soiled Case Carts
Locate directly adjacent to soiled elevator
ROOM
SIZE
(nsm)
6.0
NUMBER
OF
ROOMS
1
TOTAL
SIZE
(nsm)
6.0
10.0
1
10.0
1.0
8
8.0
Subtotal, Shared Support Area
549.0
TOTAL NSM, ALL AREAS
997.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
DT.04
SURGICAL SERVICES
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
DT.04 Surgical Services
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Pre-Admission/ Anaesthesia Clinic and OR Scheduling
01 Office, Exam/ Consultation
Supports functions of Pre-Admission Clinic Accommodation for clinician, nurse and pharmacist
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
10.0
3
30.0
10.0
1
10.0
02
Anaesthetic Consultation
Room
Locate directly adjacent to Consult Offices
03
Workstation, Care Team
3 multipurpose wrkstns each w/ computer terminal includes Wall shelving for references
3.0
3
9.0
Standard workstations
3.0
3
9.0
Photocopier, printer, scanner, facsimile machine Counter w/ supply cabinetry. Share with Pre-Admission
Clinic
6.0
1
6.0
Surgery Scheduling
04 Workstation, OR Booking
Clerk
05
Business Centre
Subtotal, Patient Intake, Reception and Administrative Area
Patient Holding and Procedure Support Areas (Semi-Restricted Zone)
Pre-Procedure Holding Area
06 Inpatient Holding
Privacy partitions around 3 sides - Direct access to
Restricted Zone
64.0
8.0
3
24.0
07
OR Control Desk
Include status board, OR Scheduling system
4.0
5
20.0
08
Alcove, Equipment
Masks, Shoe and Head covers, Provide bench
1.0
1
1.0
Subtotal, Pre-Procedure Holding Area
Post Anaesthetic Recovery Room (PARR) Area
09 Stage I, Recovery
Privacy curtains around 3 sides - Direct access from
Restricted Zone
45.0
8.0
4
32.0
10
11
12
13
14
15
Stage II, Recovery Open
Stage II, Recovery Private
Recovery, Isolation Room
Anteroom, Isolation
Collaboration Centre
[Intentionally left blank]
3 Walled cubicles, monitored station
3 Walled cubicles, monitored station
8.0
12.0
12.0
6.0
3.0
-
3
1
1
1
3
-
24.0
12.0
12.0
6.0
9.0
-
16
17
18
2 Work stations
3.0
12.0
2.0
2
1
1
6.0
12.0
2.0
19
Dictation Station
Medication Room
Alcove, Resuscitation
Equipment
Utility Room, Clean
Accommodation for up to 3 carts - Shelving for clean
linen - Counter w/ sink
11.0
1
11.0
20
Utility Room, Soiled
Accommodation for up to 4 totes - Includes sink, 2 bed
pan units, counter w/ sink, garbage cart and recycling
cart. Includes alcove with power and data outlets
11.0
1
11.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
DT.04
SURGICAL SERVICES
CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
DT.04 Surgical Services
ROOM TYPE
49
Patient Toilet
21
Nourishment Station
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Ice machine - Counter w/ sink, microwave oven - Half
size refrigerator - Storage cabinetry
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
6.0
1
6.0
2.0
1
2.0
Subtotal, Post-Anaesthetic Recovery Room Area
145.0
Staff Support Area
22
Staff/Lounge
24.0
1
24.0
7.0
2.0
1
1
7.0
2.0
3.0
1
3.0
20.0
1
20.0
6.0
2.0
3.0
2
2
1
12.0
4.0
3.0
Capacity for up to 40 full-width lockers
25.0
1
25.0
2 sinks, 3 WC (1 assisted)
Includes change area
6.0
2.0
10.0
10.0
2
2
1
1
12.0
4.0
10.0
10.0
Subtotal, Staff Support Area
136.0
23
24
Kitchenette
Workstation, Care Team
25
Entry Alcove/Vestibule, Male
Facilities
26
Locker/Change Room
Capacity for up to 20-30 full-width/ configuration w/
bench
27
28
29
Toilet, Male
Shower Stall
Entry Alcove/Vestibule Female Facilities
2 sinks, 2 WC (1 assisted), 2 urinals
Includes change area
30
Locker/Change Room
31
32
33
34
Toilet, Female
Shower Stall
Office, First Line Leader
Office, Physician Chief's
Anaesthesia and Surgeon
1 computer wrkstn w/ PACS viewing capability.
Located in Lounge
Locate directly adjacent to First Line Leader
Operating Rooms and Support Area (Restricted Zone)
35 Operating Room, Standard
Spaced to accommodate future technologies including
Size/ Configuration- Ortho
robotics, imaging equipment - Capable of
accommodating higher acuity cases
36 Operating Room, Standard
Size/ Configuration
1
65.0
55.0
3
165.0
2.0
2
4.0
10.0
3.0
1
2
10.0
6.0
37
Infant Resuscitation
38
39
Induction/ Swing Room
Scrub Station
40
Alcove, Stretcher &
Equipment
Include power and data outlets
2.0
6
12.0
41
Housekeeping Closet
1 floor sink, standard wall-mounted sink, storage
cabinetry - Accommodates housekeeping cart storage
6.0
1
6.0
42
Storage, Equipment
Locate directly adjacent to OR's, Blanket Warmers,
Bear Huggers…
10.0
2
20.0
Include in 2 OR's capable of performing C-sections
65.0
Configured to allow each scrub room to support up to 2
Operating Rooms
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS
DT.04
SURGICAL SERVICES
CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
DT.04 Surgical Services
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
43
Technical Support/ Workroom
- Anaesthesia
Counter - Shelving for inventories of consumable
supplies and reusable equipment
18.0
1
18.0
44
Storage Room, Equipment
Centrally located to support entire OR
35.0
1
35.0
45
Storage Room, Sterile Core
Case cart marshalling area - Equipment supplies
storage including sterile orthopaedic equipment,
storage for a minimum of 12 case carts..
35.0
1
35.0
Supports all Operating Rooms - Flash sterilization
3.0
1
3.0
18.0
1.0
1
6
18.0
6.0
46
47
48
49
Alcove - Sterilizer
Decontamination Room
[Intentionally left blank]
Holding, Soiled Case Carts
Gross decontame, soiled holding area
Subtotal, Operating Rooms and Support Area
403.0
TOTAL NSM, ALL AREAS
793.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
This specification outlines the functional, operational and physical requirements for the Therapy Services
functional component.
16.1 FUNCTIONAL DESCRIPTION
16.1.1 Statement of Purpose
16.1.1.1 The Therapy Services component will accommodate non-invasive and invasive (SLT
scopes) assessment and treatment of conditions that affect patients’ abilities to function
at their maximum physical and mental potential. Goals of therapy will be to either
restore function or to slow down further deterioration of function.
16.1.2 Scope of Services
16.1.2.1 Functional Content
16.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the functional component’s spaces:
16.1.2.1.1.1
Reception and registration of ambulatory outpatients and reception
of inpatients
16.1.2.1.1.2
Assessment of each patient’s needs and capabilities and then
development of a holistic care plan around these parameters
16.1.2.1.1.3
Care organized by therapy discipline and often delivered in an
inter-professional approach with involvement in specialized or
focused programs as follows:
16.1.1.1.1.1.1
Physiotherapy (PT) will be responsible for maintaining
and/or improving patients’ physical capacities and work
in an inter-professional collaborative approach with other
allied health professionals.
16.1.1.1.1.1.1.1
Pre and post-surgical consultations and
treatments
16.1.1.1.1.1.1.2
Hand Program (Campbell River Facility only)
16.1.1.1.1.1.1.3
Neurological programs including, but not,
limited to stroke, multiple sclerosis (MS) and
Parkinson’s Disease
16.1.1.1.1.1.1.4
Intensive outpatient rehabilitation
16.1.1.1.1.1.1.5
Amputee and wound care (Collaborative with
nursing personnel)
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THERAPY SERVICES
16.1.1.1.1.1.1.6
Chronic Disease Management (CDM)
16.1.1.1.1.1.1.7
Lymphedema management
16.1.1.1.1.1.2
Occupational Therapy (OT) will be responsible for
maintaining and/or improving patients’ functional
capacity; OT works in inter-disciplinary collaboration with
PT, Speech Language Pathology (SLP), and Social
Work (SW) in the following:
16.1.1.1.1.1.2.1
Pre-operative joint teaching for elective joint
replacements, but excluding post-operative
care for elective total joints
16.1.1.1.1.1.2.2
Neurological programs including, but not,
limited to stroke, ABI, multiple sclerosis (MS)
and Parkinson’s Disease
16.1.1.1.1.1.2.3
Hand Therapy program (Campbell River
Facility only)
16.1.1.1.1.1.2.4
Seating assessments (temporary seating to
address mobility and positioning)
16.1.1.1.1.1.2.5
Assessment and treatment for arthritis patients
16.1.1.1.1.1.2.6
Burns and scars management
16.1.1.1.1.1.2.7
Lymphadema education
16.1.1.1.1.1.2.8
Splint fabrication and modification, including
custom splinting to support referrals from the
Orthopaedic Clinic (AC.02.01) on a walk in
basis
16.1.1.1.1.1.2.9
Functional assessments including Activities of
Daily Living (ADL) assessments
16.1.1.1.1.1.3
Social Work will support patients in need of developing
social coping skills and in discharge planning:
16.1.1.1.1.1.3.1
16.1.1.1.1.1.4
Most consultations will be conducted outside
of this component, and at locations close to
the patient
Speech Language Pathology (SLP) will be responsible
for assessing and treating conditions affecting patients’
language, voice, speech and swallowing by supporting
the following:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
16.1.2.1.1.4
16.1.1.1.1.1.4.1
Complex neurological assessments –
Swallowing Clinic
16.1.1.1.1.1.4.2
Parkinson’s Disease patients – Voice therapy
16.1.1.1.1.1.4.3
Aphasia treatment
16.1.1.1.1.1.4.4
Cancer patient (head and neck) post-surgical
treatment
Segregated storage of all wastes generated in the functional
component, and including general waste, recyclable materials,
sharps and infectious wastes
16.1.2.2 Exclusions
16.1.2.2.1 The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
16.1.2.2.1.1
Most inpatient encounters will be accommodated in activation
(therapy) space located within each General Medical/Surgical
Inpatient Unit (IP.01). However, there may be instances in which
an inpatient will receive therapy services within this component.
16.1.2.2.1.2
Intensive outpatient rehabilitation programs delivered using multidisciplinary care teams and chest therapy (AC.02 Ambulatory
Care/Medical Day Care Unit)
16.1.2.2.1.3
Audiology services will not occur within the Facility
16.1.2.2.1.4
Laundry for specialized and heat-sensitive items (OS-STL.03
Environmental Services)
16.1.2.3 Anticipated Trends in Service Delivery
16.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
16.1.2.3.1.1
Therapy services are one of the key strategies used to minimize
inpatient stays or avoid inpatient admission altogether. They also
target those at risk for institutionalization by allowing them to live
as independently as practical for as long as possible. Demands for
these services are expected to grow, and especially in response to
an aging population that often presents with multiple health and
functioning issues.
16.1.2.3.1.2
The therapist’s role will continue shifting towards proportionately
more outpatient care as opposed to inpatient care, although many
outpatient care plans will originate with the latter.
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THERAPY SERVICES
16.1.2.3.1.3
Demands for therapy services will promote introduction of
extended hours and weekend operations as opposed to larger
facilities as a means of increasing capacity.
16.1.2.3.1.4
Emphasis will continue being placed on group encounter therapy
sessions as opposed to one-on-one.
16.1.3 Scope of Education Functions
16.1.3.1 Students in all of the therapy professions from colleges and universities will receive
practical skills training through internships and co-op programs. All teaching and
supervision functions will be accommodated in the general work areas, and will not
require specialized or dedicated facilities in this component.
16.1.4 Scope of Research Functions
16.1.4.1 Staff and students working in the Therapy Services component will, from time-to-time,
be engaged in research. The nature and extent of research functions will be
accommodated in the general work areas, and will not require specialized or dedicated
facilities in this component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
16.2 OPERATIONAL DESCRIPTION
16.2.1 LEAN Planning Standards
16.2.1.1 Patient Streaming
16.2.1.1.1 Effective operation of this component will rely on efficiencies in patient
flows. A centrally located patient reception will help orient patients
immediately upon arrival, and will provide a one-stop location for
completing all outstanding needs. Waiting will be accommodated in this
component, but patients faced with prolonged delays between arrival and
their appointment will be encouraged to access other Facility-based
components (e.g., OS-GP.04 Public Support Services) or other nearby
amenities.
16.2.1.2 Consumable Supply Management
16.2.1.2.1 To the extent practicable, consumable supplies stored in treatment areas
will be organized and stored in a common order and configuration. The
intent of this standard is to enable efficient locating of each supply item
without staff first having to reorient themselves to a new room configuration
and to avoid long travel distances between supplies storage and point of
use.
16.2.1.2.2 All ordering, purchasing, receiving, checking and delivering of supplies will
be conducted through the Materiels Management component (See OSSTL.05).
16.2.2 Hours of Operation
16.2.2.1 The component at this facility will be staffed and in operation:
16.2.2.1.1 0800 – 1600, Monday through Friday
16.2.2.2 [Intentionally left blank]
16.2.3 People Management Systems
16.2.3.1 Patient Streams
16.2.3.1.1 Ambulatory patients arriving for therapy appointments will proceed directly
the Therapy Services component to check in for their appointment and to
complete any outstanding documentation. Unscheduled ambulatory
arrivals will be seen within the department assuming the patient has the
necessary requisition.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
16.2.3.1.2 Inpatients accessing this component will be portered to the area to be seen
by their inpatient therapist if their needs are greater than can be met on the
inpatient unit.
16.2.3.1.3 Include provision for future use of self-service patient registration kiosks.
16.2.3.1.4 Patients arriving at the Facility for Therapy Services will either proceed
directly to the Therapy Services component or they will stop at the Main
Registration desk prior to arriving at Therapy Services. The intent of the
Authority is to minimize the travel distances for patients accessing this
component wherever possible.
16.2.4 Materiel Management Systems
16.2.4.1 Consumable Supplies
16.2.4.1.1 Inventories of consumable supplies will be maintained close to point of use.
Items shall be maintained with minimum inventory levels triggering a reordering process. Most supplies will be stored either in bins or on top-up
carts. Inventories on top-up carts will be generally maintained according
to prescribed delivery schedules by either Environmental Services (OSSTL.03) or Materiel Management (OS-STL.05).
16.2.4.2 Linen
16.2.4.2.1 All clean linen used for patient care will be stored close to point of use in
linen storage/alcoves. Laundry processing will occur off site at the regional
laundry located in Cumberland. Soiled linen will be collected at the point of
use in foot activated linen totes and temporarily held pending removal to
the Environmental Services component (OS-STL.03) for off-site transfer.
Clean linen returning from the regional laundry will be delivered to central
receiving facilities in the Environmental Services component before being
sorted and delivered to Therapy Services.
16.2.4.3 Pharmaceutical Products
16.2.4.3.1 Section not applicable to this component
16.2.4.4 Food and Nutrition Services
16.2.4.4.1 The Food Services component (OS-STL.06) will not be involved with the
production and delivery of meals to Therapy Services.
16.2.4.4.2 Food and beverage products used to support functions of an ADL kitchen
will be sourced from the Nutrition Services component. Electronic
requisitions initiated by Therapy Services will be processed by food service
workers who will pick items from centralized dry, refrigerated and frozen
stores. Products will be delivered to Therapy Services by Food Services
staff.
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THERAPY SERVICES
16.2.4.5 Environmental Services
16.2.4.5.1 Cleaning of all floors, walls, window treatments, furniture and pieces of
major/fixed equipment, including items in the ADL suite, will be conducted
by Environmental Services (See OS-STL.03).
16.2.4.5.2 Requirements for reusable equipment reprocessing will be accommodated
in the MDRD (OS-STL.09).
16.2.4.6 Waste Management
16.2.4.6.1 Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations.
Throughout the Therapy Services component, waste management is
understood to begin at the individual patient contact locations with
centralized collection and temporary holding stations being located in a
general support area. Each administrative area will also accommodate
segregation of the types of waste products typically generated in these
types of spaces.
16.2.4.6.2 Segregation of wastes will accommodate the following categories of
products:
16.2.4.6.2.1
General garbage
16.2.4.6.2.2
Sharps (including potentially biohazardous items)
16.2.4.6.2.3
Infectious or contaminated wastes (excluding sharps)
16.2.4.6.2.4
Confidential Paper
16.2.4.6.2.5
Clean paper and cardboard
16.2.4.6.2.6
Clean metal (tin and aluminum)
16.2.4.6.2.7
Clean recyclable plastics
16.2.5 Information Management Systems
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
16.2.5.1 All patient related information will be maintained on the electronic medical record
(EMR) system. Wireless technology will enable data entry using a combination of fixed
terminals, and at key staff workstations, and mobile pads. Access to the EMR will be
controlled electronically with varying levels of security clearance determining a person’s
access to different sections and their ability to enter/edit data.
16.2.5.2 Staffing information will be a managed corporate service. Scheduling, including
providing for sick and vacation relief will be conducted by supervisors based in this
component as will staff coordination between the two sites.
16.2.5.3 The clinical units and patient care spaces will optimize care delivery through the design
and build of facilities and work spaces which emphasize the blend of workflow, care
processes, automation of practice, and interoperability between medical and business
technologies in support of the Authorities strategic investment in Cerner and other
clinical and business systems.
16.2.5.4 The intent is to enable clinicians and staff to take advantage of the technologies and
resultant optimal care environment with respect to communication, access to the
Electronic Health Record, documentation, mobility, monitoring, tracking, and care
processes and best practices supported by technology. The space will accommodate
the technology devices and medical equipment required to deliver care in an
automated environment including mounting, storage, charging, and space requirements
of:
16.2.5.4.1 [Intentionally left blank]
16.2.5.4.2 [Intentionally left blank]
16.2.5.4.3 Mobile and Fixed Computer Devices – Desktop and Wall mount
16.2.5.4.4 Mobile and Fixed Label Printers
16.2.5.4.5 Mobile and Fixed Barcode Scanners
16.2.5.4.6 Handheld Computer Devices
16.2.5.4.7 [Intentionally left blank]
16.2.5.4.8 Tracking Monitors – Patient, Staff, and Resource Tracking
16.2.5.4.9 Clinical Dashboards
16.2.5.4.10 Smart Beds
16.2.5.4.11 Smart Pumps
16.2.5.4.12 Device Integration for real –time clinical assessment and physiological data
documentation
16.2.5.4.13 Digital Room Signage and Way-finding
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
16.2.5.4.14 Interactive Patient Station
16.2.5.4.15 Location Awareness
16.2.5.4.16 Device Connectivity
16.2.5.4.17 Multifunction Communication Devices with integration to systems
16.2.5.4.18 Telehealth and Virtual Team Capabilities
16.2.5.4.19 Real Time Location System
16.2.5.4.20 Staff Safety and Duress
16.3 DESIGN CRITERIA
16.3.1 LEAN Planning Standards
16.3.1.1 On-Stage versus Off-Stage Areas
16.3.1.1.1 Medical and technical personnel will be better able to perform their work
when free from distractions. Patient contact areas shall be considered as
on-stage and the site where personnel will focus on providing service to the
patient. Functions accommodated in technical support and professional
office space shall be distraction-free and considered off-stage. No patient
contact shall occur in these latter areas.
16.3.1.2 Supply Access
16.3.1.2.1 Each patient contact site will accommodate inventories of commonly used
supplies, with each inventory being designed to address that space’s
functions.
16.3.2 Proximity Relationships
Therapy Services Ambulatory Care/ Day Programs Therapy Services Inpatient Care Areas 16.3.2.1 Provide Convenient Access by General
Circulation to the Ambulatory Care/Day
Program component for the movement
of staff participating in collaborative
programs.
16.3.2.2 Provide Convenient Access by General
Circulation to all inpatient care areas in
the Facility for the movement of
inpatients and staff.
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THERAPY SERVICES
Therapy Services 16.3.2.3 Provide Convenient Access by General
Circulation to the Orthopedic Clinic
component for the movement of patients
and their escorts.
Orthopedic Clinic Therapy Services Central Patient Registration 16.3.2.4 Provide Convenient Access by General
Circulation to the Central Patient
Registration area for the movement of
patients and staff.
Therapy Services Main Horizontal/Vertical Circulation
16.3.2.5 Provide Convenient Access by General
Circulation for the movement of patients
and staff.
16.3.3 Internal Design Criteria
16.3.3.1 General Internal Layout
16.3.3.1.1 The component shall be organized into 8 major areas as follows:
16.3.3.1.1.1
Central reception/administrative area
16.3.3.1.1.2
Shared Professional and Technical Support Area
16.3.3.1.1.3
Gymnasium and Physiotherapy area
16.3.3.1.1.4
Occupational Therapy assessment and treatment area
16.3.3.1.1.5
Hand Therapy area (Campbell River Facility only)
16.3.3.1.1.6
Speech Language Pathology assessment and treatment area
16.3.3.1.1.7
SW office area
16.3.3.1.1.8
Administrative and therapist documentation and work areas
16.3.3.1.2 Provide the component areas administrative functions and therapist work
areas, and documentation areas directly contiguous to the patient
treatment areas and gym area of the component. Therapists require the
ability to visually and audible observe the gym and treatment areas from
the administrative zones of the component.
16.3.3.2 Ground Floor Location and Component Access
16.3.3.2.1 Convenient access by large numbers of outpatients will require this
component being located on the same floor as vehicular drop off and public
elevators. It must be easily accessible from an exterior vehicle drop-off bay
with nearby patient/visitor parking.
16.3.3.2.2 All doors used by patients in accessing this component must be
automatically activated, sliding doors. Assuming the component is
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
accessed from inside the host building, as opposed to having its own,
dedicated exterior access/egress point, this specification will require
installation of automatic doors at the building’s and the component’s
entrances.
16.3.3.3 “Front Door” Amenities
16.3.3.3.1 Upon entering the component, users will encounter a reception/orientation
desk. The intent of this station will be to complete all documentation and
pre-visit requirements before the patient proceeds to their assessment or
treatment area. Once undergoing assessment/treatment, patients will not
be required to access this reception area except to leave the component at
the end of their appointment.
16.3.3.3.2 Chairs provided for patient waiting must be height-adjustable.
16.3.3.3.3 Rehabilitation equipment storage will be located close to the component’s
point of entrance/exit.
16.3.3.4 Open Plan Configuration
16.3.3.4.1 The PT assessment and treatment area shall be configured according to
an open plan with minimal partitioning. Individual treatment stations are
large and require 360° circulation. An open plan will assist in monitoring
patients while therapists attend to other stations, and will allow for
equipment to be moved as reorganizations become necessary. The
gymnasium/exercise area shall be located on an exterior wall with large
windows. The equipment storage area shall be adjacent to the
gymnasium/exercise area. All therapy stations within the
gymnasium/exercise area shall be visible (have line of sight) from the
registration area.
16.3.3.4.2 Provide secure storage for patient valuables in the component area.
16.3.3.5 Occupation Therapy Area
16.3.3.5.1 The Occupational Therapy area shall be contained in a separate suite that
is apart from the PT open plan area. Access to a washroom is required.
16.3.3.5.2 An ADL treatment area will be provided in the OT area. The ADL area will
resemble a standard kitchen, apartment and toilet room, including shower.
All services will be functional.
16.3.3.6 Speech Therapy
16.3.3.6.1 Dedicated treatment rooms will be provided for speech therapy. The
speech therapy rooms will be sound attenuated.
16.3.3.6.2 A procedure room will be provided in the speech therapy area, the
procedure room will accommodate an endoscope. Dimmable lighting and
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medical gases are required in the procedure room.
16.3.3.7 Ergonomics for an Aging Workforce
16.3.3.7.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff are required to
use. Ease of access will be among the key criteria. In the therapy treatment
spaces, this specification will be reflected in electrical outlets being located
approximately 900 mm (approximately 3’) above floor surface. The type
and number of electrical devices used in the rooms is expected to
increase, and elevated outlets will avoid stress associated with repetitive
bending.
16.3.3.7.2 Numbers of bariatric patients are projected to increase. Managing these
patients will require features enabling for both patients and staff. Doorways
and circulation spaces must be sufficiently wide to accommodate large
people, many of whom will be relying on mobility assistance including
motorized chairs and scooters. Doorways must be a minimum of 1500 mm
(approximately 59”) in width. The reference to circulation spaces applies
especially in confined rooms like water closets.
16.3.3.7.3 Bariatric patients often require assistance getting into and out of bed.
Ceiling mounted lift tracking/transfer rail systems will be installed above all
treatment spaces accommodating recumbent patients and within the
gymnasium area. Lifts must have a maximum rated capacity of not less
than 450kg (approximately 1000lbs).
16.3.3.7.4 A storage alcove must be provided for a portable lift system enabling staff
to respond to a fallen patient anywhere in the component.
16.3.3.8 Floor Finishes
16.3.3.8.1 Patients accessing this component may have compromised mobility.
Frequent use and presence of mobility aids including canes, crutches,
walkers, wheelchairs and motorized chairs/scooters will be anticipated.
Patient ambulation may involve shuffling as opposed to stepping. Patients
will also have varied levels of visual acuity.
16.3.3.8.2 Flooring installed throughout this component must facilitate mobility.
Finishes must avoid posing tripping hazards, allow for unimpeded
movement of wheeled equipment and contain no raised joints. As well the
finish must be low glare for those with low vision. Surfaces must be nonskid, anti-static and resilient to heavy traffic and cleaning chemicals.
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16.3.3.9 Internal Circulation
16.3.3.9.1 Patients accessing the SLP and SW assessment and treatment areas will
not be required to pass through the PT and OT gymnasium and
assessment/treatment areas.
16.3.3.10 Natural Lighting and Views
16.3.3.10.1 Personnel and patients will often spend prolonged periods in this
component. Natural lighting and views to the outside will provide
distractions from activities that can be highly repetitive. Connections with
outdoor spaces will also provide incentives for patients to engage in further
activities outside of the component.
16.3.3.10.2 In addition to the therapeutic benefits of natural light, this feature offers
energy conservation benefits by reducing the needs for artificial lighting
during periods of bright daylight.
16.3.3.11 Artificial Lighting
16.3.3.11.1 There will be a variety of lighting options in this component, each suited to
the functions accommodated in a specified space.
16.3.3.11.2 Artificial lighting throughout the component shall follow a general standard
of providing “non direct” lighting. This specification implies fixtures that
reflect light upwards, away from direct eye contact, and especially in those
areas where patients will be either in bed or transported on stretchers.
16.3.3.11.3 Artificial lighting in the administrative and support areas must be variable to
accommodate different levels of ambient lighting commensurate with the
functions ongoing at any one time in that space. Individual workstations
must be provided with task lighting.
16.3.3.11.4 Surface colours used throughout the component must be compatible with
these lighting specifications.
16.3.3.12 Infection Control Features
16.3.3.12.1 Hand hygiene sinks will be installed in each area where physical contact
with patients occurs. Sinks must be oriented to prevent inadvertent
splashing onto nearby equipment. In the case of open areas with multiple
patient contact points, consideration shall be given to installing hand
sanitizer dispensing stations at each point. These stations would be in
addition to a centrally located hand hygiene sink.
16.3.3.12.2 Equipment and machines used in this component shall be fabricated using
smooth, non-porous and chemical resistant materials. Their shapes shall
allow for easy cleaning around all sides, and shall be free of inaccessible
recessed spaces.
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16.3.3.12.3 Inventories of consumable supplies will be physically separated from
soiled/contaminated holding.
16.3.3.13 Acoustic Isolation
16.3.3.13.1 The Speech Language Pathology area will require acoustic isolation from
the rest of the component to accommodate testing and assessment
procedures.
16.3.3.13.2 The Occupational Therapy Splint grinding room requires acoustic isolation
from the rest of the component.
16.3.3.13.3 A privacy area must be provided with the reception function enabling
patients to speak with component staff about confidential information.
16.3.3.13.4 All rooms accommodating patient/family interviews must be acoustically
isolated.
16.3.3.14 Environmental Control
16.3.3.14.1 Patients engaged in physical activity will have different heating/cooling
requirements than those engaged in more passive sessions. Air handling in
this component will be organized into zones enabling independent
temperature regulation in different functional areas.
16.3.3.14.2 Fabrication of splints and orthotics relies on chemicals and processes that
generate strong and potentially hazardous odours. The room(s) where this
fabrication occurs must be enclosed, supplied with a high air exchange and
exhausted to the exterior.
16.3.3.15 Patient Security
16.3.3.15.1 All patient toilets in this component will have an emergency call system
installed. Emergency call systems are required in all treatment areas.
16.3.3.15.2 All patient rooms with lockable doors will be un-lockable from the outside
as well enabling staff access to patients who may require assistance and
who may not be able to operate the locking mechanism.
16.3.4 Component Functional Diagram
16.3.4.1 The areas making up this component shall be organized as illustrated in the following
diagram:
EXECUTION COPY Nortth Island Hospittals Projject SCHED
DULE 3: DESIGN AND CONSTRUC
CTION SPECIFICA
ATIONS APP
PENDIX 3A: CLIN
NICAL SPECIFICA
ATIONS ______________
_____________
______________
____________________________________________________________ __________
DT.05
TH
HERAPY SERV
VICES
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
16.3.5 Space Table
16.3.5.1 The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
DT.05 Therapy Services
ROOM
SIZE
(nsm)
NUMBE
R OF
ROOMS
Reception, Central/Shared Administrative Area
01
Workstation, Clerical/
2 wrkstns each w/ computer terminal
Registration
4.0
2
8.0
02
03
Wheelchair Alcove
Business Centre
4.0
6.0
1
1
4.0
6.0
04
Waiting Area, Patient/Escort
Seating for up to 10 people
20.0
1
20.0
05
Demonstration/Group Room
Capacity for up to 20 people - Accommodates
flexible seating arrangements/some wheelchairs
40.0
1
40.0
06
Washroom
6.0
1
6.0
Subtotal, Reception, Central/Shared Administrative Area
84.0
ROOM TYPE
Administrative & Charting Area
07
Office, First Line Leader
08
Workstation, Care Team
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Capacity for 2 wheelchairs
Photocopier, facsimile machine, printer, stationery
supplies - Temporary chart holding area
1 wrkstn - Accommodates meetings with up to 2
people
10.0
1
10.0
3.0
8
24.0
Administrative & Charting Area
34.0
Cubicle Space for All Therapists
GYM & Physiotherapy Area
09
Exercise/ GYM Area
10
11
Charting/Work Area
Supply Storage/Workroom
12
13
Alcove, Linen
Alcove, Soiled Linen
140.
0
2.0
7.0
1
140.0
2
1
4.0
7.0
2.0
6.0
1
1
2.0
6.0
6.0
2
12.0
48.0
1
48.0
4.5
4
18.0
Subtotal, GYM Physiotherapy Area
237.0
2 Workstations
Ice Machine, Wraps.
14
Toilet, Male/Female
15
Treatment, Area Open
Include standard and Bariatric Table
16
Treatment, Private
Include Physiatrist's Exam Room
Occupational Therapy Area
17
Assessment/Consultation Room
1 assisted WC, 1 sink
Capacity for up to 4 people - Counter w/ sink,
storage cabinetry
TOTAL
SIZE
(nsm)
3.0
4
12.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
COMOX VALLEY HOSPITAL
ROOM
ID
(RID)
18
19
DT.05 Therapy Services
ADL Kitchen/Dining/Bed/Toilet
Area
NUMBE
R OF
ROOMS
30.0
1
30.0
8.0
1
8.0
25.0
4.0
10.0
1
1
1
25.0
4.0
10.0
Subtotal, Occupational Therapy Area & Orthotics
89.0
Flexibility to accommodate assistance pole station
w/ 1 bed
Supply Storage/Workroom
Splint and Orthotics Room
20
Work Area, Splinting
21
Workbench, Sewing
22
Room, Workbench Grinding
Includes Storage
Include ventilation hood
Speech Language Pathology Area
23
Office, Private, Speech
Language Pathologist
24
ROOM
SIZE
(nsm)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
Examination/Treatment Room
Social Work Area
25
Office, Private, Social Worker
2 wrkstns w/ computer terminal, telephone,
printer, files storage - Open plan
10.0
1
10.0
1 patient position - Counter w/ sink, storage
cabinetry - Directed lighting - Accommodates
endoscopy procedures - Serviced w/ suction
14.0
1
14.0
Subtotal, Speech Language Pathology Area
24.0
Multipurpose work area, files storage Accommodates meetings with up to 2 people
10.0
2
Subtotal, Diabetes Day Care Area
TOTAL
SIZE
(nsm)
20.0
20.0
Shared Professional/Technical Support Area
26
Storage, Equipment
Accessed from component's main entrance
50.0
1
50.0
27
20.0
1
20.0
Staff /Lounge
Kitchenette w/ pantry including counter w/ sink,
microwave oven, refrigerator - Staff Lockers
Subtotal, Shared Professional/Technical Support Area
70.0
TOTAL NSM, ALL AREAS
558.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: DT.05 Therapy Services
CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Reception, Central/Shared Administrative Area
01
Workstation, Clerical/
2 wrkstns each w/ computer terminal
Registration
TOTAL
SIZE
(nsm)
4.0
2
8.0
4.0
6.0
1
1
4.0
6.0
Wheelchair Alcove
Business Centre
04
Waiting Area/, Patient/Escort
Seating for up to 10 people
20.0
1
20.0
05
Demonstration/Group Room
Capacity for up to 20 people - Accommodates
flexible seating arrangements/some wheelchairs
30.0
1
30.0
06
Washroom
6.0
1
6.0
Subtotal, Reception, Central/Shared Administrative Area
74.0
08
Workstation, Care Team
1 wrkstn - Accommodates meetings with up to 2
people
10.0
1
10.0
3.0
8
24.0
Administrative & Charting Area
34.0
Cubicle Space for All Therapists
GYM & Physiotherapy Area
09
Exercise/ GYM Area
10
11
Charting/Work Area
Supply Storage/Workroom
12
13
Alcove, Linen
Alcove, Soiled Linen
2 Workstations
Ice Machine, Wraps..
1
100.0
2
1
4.0
7.0
2.0
6.0
1
1
2.0
6.0
6.0
2
12.0
12.0
Toilet, Male/Female
15
Treatment, Area Open
Include standard and Bariatric Table
12.0
1
16
Treatment, Private
Include Physiatrist's Exam Room
12.0
2
24.0
Subtotal, GYM Physiotherapy Area
167.0
18
19
Include hand treatment table
Whirlpool
Storage, Equipment
Occupational Therapy Area
20
Assessment/Consultation Room
21
1 assisted WC, 1 sink
100.
0
2.0
7.0
14
Hand Therapy
17
Treatment Area, Hand Therapy
NUMBER
OF
ROOMS
02
03
Administrative & Charting Area
07
Office, First Line Leader
Capacity for 2 wheelchairs
Photocopier, facsimile machine, printer, stationery
supplies - Temporary chart holding area
ROOM
SIZE
(nsm)
ADL Kitchen/Dining/Bed/Toilet
Area
Capacity for up to 4 people - Counter w/ sink,
storage cabinetry
Flexibility to accommodate assistance pole
station w/ 1 bed
4.0
2
8.0
4.0
8.0
2
1
8.0
8.0
3.0
4
12.0
30.0
1
30.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.05
THERAPY SERVICES
DT.05 Therapy Services
CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
22
ROOM TYPE
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
8.0
1
8.0
25.0
4.0
10.0
1
1
1
25.0
4.0
10.0
Subtotal, Occupational Therapy Area & Orthotics
113.0
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Supply Storage/Workroom
Splint and Orthotics Room
23
Work Area, Splinting
24
Workbench, Sewing
25
Room, Workbench Grinding
Includes Storage
Include ventilation hood
Speech Language Pathology Area
26
Office, Private, Speech
Language Pathologist
27
Examination/Treatment Room
Social Work Area
28
Office, Private, Social Worker
10.0
1
10.0
14.0
1
14.0
Subtotal, Speech Language Pathology Area
24.0
1 patient position - Counter w/ sink, storage
cabinetry - Directed lighting - Accommodates
endoscopy procedures - Serviced w/ suction
Multipurpose work area, files storage Accommodates meetings with up to 2 people
1
10.0
Subtotal, Diabetes Day Care Area
10.0
Shared Professional/Technical Support Area
29
Storage, Equipment
Accessed from component's main entrance
30
Staff/Lounge
TOTAL
SIZE
(nsm)
10.0
1
1
35.0
20.0
Subtotal, Shared Professional/Technical Support Area
55.0
TOTAL NSM, ALL AREAS
477.0
35.0
20.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
This specification outlines the functional, operational and physical requirements for the Pharmacy
functional component.
17.1 FUNCTIONAL DESCRIPTION
17.1.1 Statement of Purpose
17.1.1.1 The Pharmacy exists for the purposes of procuring, controlling inventories of, preparing
and distributing medications and narcotics, teaching patients and other health care
providers about medications, training new pharmacists and pharmacy technicians,
applying medication knowledge collaboratively with physicians and other health care
providers and delivering drug order review and therapeutic drug therapy management
decisions within defined scope of practice criteria defined by the College of
Pharmacists of BC and Health Authority Policy.
17.1.2 Scope of Services
17.1.2.1 Functional Content
17.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
17.1.2.1.1.1
Ordering, receiving and inventory controlling of medications and
narcotics
17.1.2.1.1.2
Dispensing and distributing medications and narcotics to various
user sites throughout the Facility using a unit-dose system and
direct deliveries to patients
17.1.2.1.1.3
Preparing/compounding, including sterilized preparation, of
specialized products including admixture preparation in
accordance with the USP Pharmaceutical Compounding – Sterile
Products Guidelines (797) and the Canadian Society of Hospital
Pharmacists Guidelines for the Preparation of Sterile Products in
Pharmacies for:
17.1.1.1.1.1.1
IV therapy
17.1.1.1.1.1.2
Cytotoxic and chemotherapy agents
17.1.1.1.1.1.3
Injectable IV medications
17.1.1.1.1.1.4
Home IV therapy programs
17.1.1.1.1.1.5
Total parenteral nutrition (TPN)
17.1.1.1.1.1.6
Clinical drug trial medications and documentation
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.1.1.1.1.1.7
Occasional biological may be compounded in the sterile
prep room, e.g. prolastin injection.
17.1.2.1.1.4
CR Pharmacy will prepare and store medications for off-site
delivery to residential, hospital/acute care, and health centres
listed in 17.1.1.2.
17.1.2.1.1.5
Storage and temporary holding of unused and discarded
medications and narcotics for off-site disposal
17.1.2.1.1.6
Meeting with pharmaceutical representatives to discuss existing
and new medications
17.1.2.1.1.7
Consulting with staff on medication administration and safety
17.1.2.1.1.8
Consulting one-on-one with inpatients and outpatients regarding
drug administration, therapeutic drug monitoring, possible side
effects and contraindications (some of this function occurs outside
of this component while the majority occurs within this component
(e.g., counseling cancer care patients, medication reconciliation –
See Exclusions below – Reference: Health Professions Act,
Bylaws, Schedule F and Pharmacy Operations and Scheduling Act
Bylaws regarding legislative requirements for pharmacist/patient
consultation and outpatient counseling space)
17.1.2.1.1.9
Providing clinical pharmacy on-call support to this Facility and to
remotely located HCFs through the use of telehealth.
17.1.2.1.1.10 Providing pharmaceuticals and patient oriented pharmacy
practices such as drug order review and therapeutic drug
monitoring to remotely located HCFs
17.1.2.1.1.11 Provision for training of new Pharmacists and Pharmacy
Technicians
17.1.2.2 Exclusions
17.1.2.2.1 The following list specifies functions conducted by Pharmacy personnel
that are understood to occur in other components in the Facility or outside
of the Facility:
17.1.2.2.1.1
Consulting with patients and staff in the following components:
17.1.1.1.1.1.8
All inpatient units (IP.01 General Medical/Surgical
Inpatient Units, IP.02 ICU and IP.03 Maternal/Newborn
Inpatient Unit)
17.1.1.1.1.1.9
Emergency Department (AC.01)
17.1.1.1.1.1.10 Ambulatory Clinics/Medical Day Care Unit (Including
Chemotherapy and Anti-Coagulation Program – AC.02)
17.1.1.1.1.1.11 Surgical Day Care (AC.03)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.1.1.1.1.1.12 Pre-Admission Clinic (DT.04 Surgical Services)
17.1.2.2.1.2
Dedicated pharmacist workspace/workstation for inpatient units
17.1.2.2.1.3
Maintaining minimum stock levels at various user sites throughout
the Facility
17.1.2.2.1.4
Providing in-service training to medical, nursing, pharmacy and
allied health professionals
17.1.2.3 Anticipated Trends in Service Delivery
17.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
17.1.2.3.1.1
The increasing use of telemedicine in providing services from this
Facility to remote locations will continue.
17.1.2.3.1.2
The increasing use of automation and technology in the ordering
and in the dispensing of medications and narcotics will continue.
17.1.2.3.1.3
The profession will continue increasing its use of pharmacy
technicians in the professional workforce.
17.1.2.3.1.4
Pharmacists will be increasingly mobile, working remotely from a
collaborative care spaces distributed throughout the patient care
areas.
17.1.3 Scope of Education Functions
17.1.3.1 Pharmacy students from technical colleges and universities will receive practical skills
training through post-graduate residencies, internships and co-op programs. All
teaching and supervision functions will be accommodated in the general work areas,
and will not require specialized or dedicated facilities in this component.
17.1.4 Scope of Research Functions
17.1.4.1 Pharmacy personnel and students will, from time-to-time, be engaged in research. The
nature and extent of research functions, which may include dispensing investigational
drugs or preparing medications for clinical trials, will be accommodated in the general
work areas, and will not require specialized or dedicated facilities in this component.
17.1.4.2 Upon consultation with User Consultation Group, confirm the need for dedicated and
secure storage for clinical trials and/ or research protocols.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.2 OPERATIONAL DESCRIPTION
17.2.1 LEAN Planning Standards
17.2.1.1 Consumable Supply Management
17.2.1.1.1 Consumable supplies stored in treatment areas will be organized and
stored in a common order and configuration. The intent of this standard is
to enable efficient locating of each supply item without staff first having to
reorient themselves to a new room configuration and to avoid long travel
distances between supplies storage and point of use.
17.2.1.1.2 The Materiel Management and Pharmacy components will establish a
receiving and delivering system for incoming and outgoing pharmaceutical
products to ensure that all such activities are timely, reduce the need to
carry out unnecessary handoffs, provide required chain of control including
cold chain processes, and that pharmaceutical products are stored as per
manufacturer’s recommendations and are kept secure.
17.2.1.1.3 Pharmaceuticals will be delivered directly to the pharmacy, provide a nonpublic access corridor to allow the transfer of pharmaceutical supplies to
the main pharmacy. The transport corridor must not cross a public
corridor.
17.2.1.1.4 A dedicated staging/ holding area will be provided in the main pharmacy,
located directly off a non-public corridor, for the delivery of pharmaceutical
supplies.
17.2.1.1.5 Confirm the final requirements for security systems to be provided in the
main pharmacy upon consultation with the User Consultation Group.
Provide at a minimum a secured access door and video monitoring of all
areas of the pharmacy.
17.2.2 Hours of Operation
17.2.2.1 The Pharmacy component at this Facility will be staffed and in operation:
17.2.2.1.1 0730 to 1700, Monday through Friday
17.2.2.1.2 0800 to 1630, Saturday and Sunday
17.2.2.2 Outside the routine hours of operation listed above, and depending upon the nature of
service(s) required, pharmacy services will be available on-call locally or by using
telehealth linkages with personnel located off-site. The Pharmacy components are not
to lose space to accommodate a night cupboard outside of pharmacy.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.2.2.3 An automated night cabinet will be located outside this component and will be
accessible by authorized personnel at times when the Pharmacy is closed. The night
cabinet is to be in a secure room outside of Pharmacy and close to the Emergency
Department component (AC.01) but not inside the ED component. The night cabinet
shall be obscured from public view.
17.2.3 People Management Systems
17.2.3.1 Pharmacy personnel will have unrestricted, but controlled, access to this component at
all times. Unauthorized personnel will not have access to this component’s interior
space.
17.2.3.2 The component will serve as a “home base” for personnel and students at which to
conduct informal meetings, training sessions and assignment briefings.
17.2.4 Materiel Management Systems
17.2.4.1 Pharmaceutical Products
17.2.4.1.1 All orders for pharmaceutical products, including those originating from
other user sites, will be submitted and processed electronically through the
Pharmacy component.
17.2.4.1.2 All orders for pharmaceutical products, including those originating from
other user sites, will be submitted and processed electronically through the
Pharmacy component.
17.2.4.1.3 Pharmaceutical products arriving during regular Pharmacy hours of
operation will be delivered directly to the Pharmacy where they will be
received. Pharmaceutical products, arriving when the Pharmacy is closed,
destined for the Pharmacy component will be received in Materiel
Management. Orders will be left “as received” and delivered immediately to
the Pharmacy where boxes will be unpacked, contents checked against
purchase and packing orders and then taken into inventory. Some orders
will be delivered by couriers directly to the Pharmacy.
17.2.4.1.4 Dispensing medications within the Facility will generally follow two streams.
The medication system will provide a “patient-specific stream” and a
“wardstock stream” and will utilize unit dose medications in both streams.
The wardstock stream maybe contained in an ADC or traditional
medication cupboard. The patient-specific stream will be dispensed from
pharmacy and supplied to the patient care area for administration. The
patient specific stream may utilize PacMed and PacVision technologies. In
both streams pharmacy personnel will transport the medications to the
patient care area.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.2.4.1.5 Dedicated storage will be provided in the pharmacy for the pharmacy
distribution/ medication carts. The cart storage is for pharmacy carts only.
Cart storage in CR and CV Pharmacies will not accommodate medication
cart storage that are used in the nursing areas.
17.2.4.1.6 As per ISMP’s Guidance on the Interdisciplinary Safe Use of Automated
Dispensing Cabinets
(https://www.ismp.org/tools/guidelines/ADC_Guidelines_Final.pdf) “the
physical environment in which the ADC is placed can have a dramatic
effect on medication errors.” The guidelines for the location and number of
ADCs are:
17.2.4.1.6.1
Purchase a sufficient quantity of ADCs, depending on their
intended use (e.g., limited narcotic and unit stock versus
total drug distribution), and install them in areas that are
easily accessible to staff and in close proximity to patients in
order to reduce excessive walking and workarounds by staff.
17.2.4.1.6.2
Locate ADCs in an isolated “sterile cockpit” environment or
an area of limited foot traffic, where a minimal number of
distractions would be the norm.
17.2.4.1.6.3
Locate ADCs in close proximity to IV tubing, supplies, and
refrigerated medications.
17.2.4.1.6.4
Ensure sufficient space around ADCs to allow for the
opening of access doors to the medication area and
medication drawers in the cabinet. Provide space for the use
of medication administration records (MARs) and patient
charts, and for the movement of staff without encumbrances.
17.2.4.1.6.5
Ensure adequate ventilation and temperature control of the
area or room where ADCs are placed to avoid overheating of
the electronic systems and to maintain proper storage
temperature for medications.
17.2.4.1.6.6
Provide sufficient overhead lighting to allow for easy reading
of the ADC screen, medication label, and MAR. Auxiliary
lighting shall be available day or night. Even on low-light
units, there shall be the ability to brighten the medication
areas around ADCs for short periods to prepare and
dispense medications.
17.2.4.1.6.7
Ensure ADCs are placed in locations that are secure when
cabinets are not being used.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.2.4.1.7 A third “product stream” of select pharmaceutical products that require
special handling and or storage will occur. This third “product stream” will
include injectable medications compounded in pharmacy and will require
storage in medical grade refrigerators with temperature monitors. Some
injectable compounded medications, such as chemotherapy, may be
stored for short periods at room temperature in a secure location in the
patient care area. Transportation will be provided by pharmacy.
17.2.4.1.8 Pharmaceutical products returned to the Pharmacy in the same sealed
containers as dispensed may be reused; products will be disposed if there
is any indication of broken packing seals.
17.2.4.2 Waste Management
17.2.4.2.1 Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations.
Throughout the Pharmacy, waste management is understood to begin at
the individual workstations with centralized collection and temporary
holding stations being located in a general support area. Each
administrative area will also accommodate segregation of the types of
waste products typically generated in these types of spaces.
17.2.4.2.2 Segregation of wastes will accommodate the following categories of
products:
17.2.4.2.2.1
General garbage
17.2.4.2.2.2
Sharps (including potentially biohazardous items)
17.2.4.2.2.3
Cytotoxic and chemotherapy agents
17.2.4.2.2.4
Narcotics (Rendered unusable then temporarily held in
secure storage)
17.2.4.2.2.5
Medications
17.2.4.2.2.6
Confidential paper
17.2.4.2.2.7
Clean paper and cardboard
17.2.4.2.2.8
Clean metal (tin and aluminum)
17.2.4.2.2.9
Clean recyclable plastics
17.2.4.2.3 Unused medications originating from various patient care areas will
generally be returned to the Pharmacy where they will be either returned
into inventory or discarded. Pharmaceutical waste will be kept secure in all
storage locations outside of this component until pick-up for off-site
disposal.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.2.5 Information Management Systems
17.2.5.1 Most “active” information used in this component will be stored and managed
electronically. Component personnel will enter purchase/receipt orders, production
records, dispensing records and personnel work records at local terminals. Pharmacy
staff engaged in work and training functions on the patient care areas will be deployed
with wireless computing technology used to access the patient care system and
teaching resources.
17.2.5.2 Although planning assumes eventual transition to a “paperless” system, provision will
be made initially for retention of hard copy prescriptions and medication dispensing
requisition. Hard copy records will be deemed “active” for a 6-month period during
which they will be maintained in this component. After this initial holding period, records
will be transported off-site and stored for a further 30 months.
17.2.5.3 Component personnel will maintain a library of hard copy product manuals.
17.3 DESIGN CRITERIA
17.3.1 Proximity Relationships
17.3.1.1 The Pharmacy component’s location relative to other components and the nature of
circulation used to move between two components are illustrated in the diagram below.
Proximities are listed according to rank; higher priorities appear above lower priorities.
17.3.1.1.1 A staff lounge will be provided within the pharmacy, staff will not be
required to leave the secure area of the pharmacy to access the staff
lounge.
17.3.1.1.2 Staff toilets will be provided in the pharmacy, toilets will not open on to
main public work areas or directly into the staff lounge. Toilets will be
accessible to staff without having to exit the secure areas of the pharmacy.
17.3.1.1.3 A reception station will be provided and will act as the main access point
into the pharmacy.
17.3.1.1.4 The Administrative offices, including the First Line Leader’s office will be
provided within the secure area of the pharmacy.
Pharmacy Ambulatory Care/ Medical Day Care Programs 17.3.1.1.5 Provide Direct Access (vertical or
horizontal adjacency) via a non-public
corridor to the Ambulatory Care/Medical
Day Care component for the movement of
chemotherapy products.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
Pharmacy Patient Care Areas Pharmacy Materiel Management 17.3.1.1.6 Provide Convenient Access by General
Circulation to all inpatient and outpatient
components in this Facility for the
movement of patients, staff and
pharmaceutical products. Ambulatory
patients will access the pharmacy,
convenient access is required for
outpatients requiring consults or for
patients obtaining medication from the
main pharmacy
17.3.1.1.7 Provide Convenient Access by General
Circulation to the Materiel Management
component for the movement of
pharmaceuticals and waste products.
17.3.2 Internal Design Criteria
17.3.2.1 General Internal Layout
17.3.2.1.1 The component shall be organized into three major areas as follows:
17.3.2.1.1.1
Administrative work area including reception counter, private
consultation area and general workspace for teaching and training
17.3.2.1.1.2
Technical work area including product receiving/processing area
and technical workstations.
17.3.2.1.1.3
Sterile Preparation area with sterile preparation/laminar flow hoods
and chemotherapy safety cabinet workrooms
17.3.2.1.2 The sterile preparation area will be organized into two separate zones; one
for chemotherapy drug preparation and one for general sterile preparation.
Both zones will be independent of each other including their respective
anterooms. Anteroom countertops will be stainless steel counter tops, to
promote ease of cleaning. Each room will also require a dedicated
production preparation space to prepare all ingredients for production in
the room and to validate production work before submitting finished
product into distribution (USP 797). The chemotherapy drug preparation
room and the sterile preparation room will use a single anteroom where a
scrub sink is located for “Gloving” and an adjoining preparation anteroom
that services both chemo and sterile prep rooms with pass-through doors.
The hoods will meet ISO 5 requirements. The Proponent will consult with
the Pharmacy Services User Consultation Group to ensure the design of
the sterile preparation area meets professional standards and provides an
efficient and effective workflow.
17.3.2.1.3 Provide a scrub sink in the change room, gloving room and anteroom.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.3.2.1.4 The change room will provide personnel in scrubs a place to store
footwear, bonnets, face masks and wash hands and glove prior to entering
either chemotherapy or sterile prep room.
17.3.2.1.5 The anteroom will be used for product organization/prepping prior to being
moved into prep rooms via pass-through for compounding in the hoods,
then back through pass-through for checking.
17.3.2.1.6 Provide one pass through for chemotherapy prep room and one pass
through for sterile prep room that adjoin the anteroom where
organizing/preparing product for compounding in the two types of prep
rooms occur.
17.3.2.2 Proximity to Ambulatory Care/Medical Day Care (Cancer Outpatient Care)
17.3.2.2.1 Chemotherapy agents, which are classified as hazardous materials, will be
produced in the Pharmacy component and then manually transported to
the Ambulatory Care/ Medical Day Care Unit (AC.02). In order to reduce
risks associated with this transport; these two components must be located
close together and ideally on the same building level. Circulation routes
used for transporting chemotherapy agents must not involve high-traffic,
public corridors.
17.3.2.3 Open Plan
17.3.2.3.1 Administrative and technical work areas shall be segregated, but organized
within a common, open floor plan. Staff must be able to move easily
between technical workbenches and administrative workstations and with
minimal disruption to others occupying other workstations.
17.3.2.3.2 The reception/consultation counter shall serve as a boundary between
pharmacy personnel and other authorized HCF personnel accessing this
component for pharmacy consultations or for product pick-up. Provide
picking wall storage, half height and full height.
17.3.2.3.3 Provide modular systems furniture in this area, including under counter
storage components, full height storage components and accessories as
required for functionality. This includes any drug dispensing/picking/storage
areas and workstations/cubicles.
17.3.2.4 Component Security and Confidentiality
17.3.2.4.1 Access to this component must be controlled at all times. This area must
be accessible to authorized personnel 24 hours-a-day, 7 days-a-week. A
staff safety alarm system built into each workstation will communicate
directly with the Facility’s protection services.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.3.2.4.2 The ceiling installed in this component must be solid and not be of the
drop-down variety. All of the component’s exterior walls must extend from
the floor to the base of the overlying slab to prevent unauthorized access
through interstitial or crawl spaces.
17.3.2.4.3 All areas in this component will be under video surveillance and recording.
This criterion will be especially important for the unused narcotics storage
area. This will be the location where narcotics that have been rendered
unusable will be temporarily held pending removal for off-site destruction.
17.3.2.4.4 Refrigerators will be monitored and alarmed. In the event of a refrigerator’s
failure, annunciators in the building monitoring system will alert
maintenance staff and initiate a maintenance response.
17.3.2.4.5 Secured storage areas and rooms shall not be located on an exterior wall
of the building. Space dedicated for clinical drug trial inventory and
associated trial documentation will be segregated and secure from general
access within the internal design.
17.3.2.5 Environmental Control
17.3.2.5.1 Equipment and products accommodated in these rooms will generate heat
and odours. Compounding rooms in this component must be supplied with
independent controls for varying temperature and air quality.
17.3.2.5.2 Medication production and bulk storage spaces, in addition to appropriate
lighting, will require controlled temperature and humidity environments to
maintain integrity of medications within approved product monograph
specifications. This specification will apply to both refrigerated and nonrefrigerated spaces.
17.3.2.6 Emergency Power
17.3.2.6.1 Essential equipment in this component will require connections to delayed
vital power which must be restored within two minutes of an electrical
power failure. Essential equipment will include refrigerators, freezers,
computers and video systems supporting telehealth functions.
17.3.2.6.2 Laminar flow fume hoods and biohazard cabinets must be supplied by an
uninterruptable power source (UPS).
17.3.2.7 Natural Lighting and Exterior Views
17.3.2.7.1 Research has demonstrated the benefits that natural light and views of
natural surroundings offer to the accuracy and quality of work performed in
vital areas. Areas in this component where products are mixed or
packaged for dispensing shall be provided with windows and views to the
exterior.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.3.2.7.2 Exposure to natural lighting shall not compromise the component’s security
by providing direct views from the outside into key work and storage areas.
Some products are also light sensitive and consideration shall be given to
locating some workstations away from spots that could receive direct
sunlight.
17.3.2.8 Lighting
17.3.2.8.1 There will be a variety of lighting options in this component, each suited to
the functions accommodated in a specified space.
17.3.2.8.2 Artificial lighting shall follow a general standard of providing “non-direct”
lighting. This specification implies fixtures that reflect light upwards, away
from direct eye contact.
17.3.2.8.3 Artificial lighting in the administrative and technical work areas must be
variable to accommodate different levels of ambient lighting commensurate
with the functions ongoing at any one time in that space. Individual
workstations must be provided with task lighting.
17.3.2.9 Staff Support Areas
17.3.2.9.1 A staff lounge will be provided within the pharmacy, staff will not be
required to leave the secure area of the pharmacy to access the staff
lounge, including staff lockers. Staff toilets will be provided without staff
having to exit the secure areas of the pharmacy. Toilets will not open on to
main public work areas or directly into the staff lounge.
17.3.2.9.2 A reception station will be provided which will act as the main access point
into the pharmacy. Security cameras will be provided at all pharmacy
access and exit points and within the main pharmacy stores and narcotics
storage areas.
17.3.2.9.3 The Administrative offices, including the First Line Leader’s office will be
provided within the secure area of the Pharmacy.
17.3.2.10 Ergonomics for an Aging Workforce
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.3.2.10.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staffs are required
to use. Ease of access will be among the key criteria. In the patient care
areas, this specification will be reflected in electrical outlets being located
approximately 900 mm (approximately 3’) above floor surface. The type
and number of electrical devices used in the rooms is expected to
increase, and elevated outlets will avoid stress associated with repetitive
bending. Work stations where individuals will work for extended periods of
time will require the ability to accommodate both sitting and standing
positions. Height adjustable tables will be required in all preparation and
dispensing areas.
17.3.2.11 Staff Safety
17.3.2.11.1 A plumbed emergency eye wash station (tempered with thermostatic
mixing values to prevent eye scalding) and emergency deluge shower will
be installed in the Pharmacy. The final location of eye wash stations and
emergency shower will require consultation with the Pharmacy clinical
champions. A floor drain must be installed with each deluge shower.
17.3.2.11.2 The receiving and storage areas will also require a hand wash sink.
17.3.2.11.3 Upon consultation with the User Consultation Group, provide a sufficient
number of hand-washing, in the appropriate locations. The Clinical User
Group will have final input and confirmation of the location and quantity of
hand-washing stations required.
17.3.2.11.4 Upon consultation with the User Consultation Group, provide a sufficient
number of emergency eye wash stations, in the appropriate locations. The
pharmacy champions will have final input and confirmation of the location
and quantity of eye-wash stations required.
17.3.2.11.5 Upon consultation with the User Consultation Group, confirm the need and
location or locations for deluge showers. If deluge showers are provided
ensure a secure drainage system is provided to prevent contamination of
water streams.
17.3.2.12 Infection Control Features
17.3.2.12.1 Hand wash stations will be located at each workstation where medications
are prepared. In the compounding area, a single station in the anteroom
will be sufficient. The location of all hand wash stations shall prevent
against accidental spills and splashes from contacting nearby medications.
17.3.2.12.2 All furniture, fixtures and equipment used in this component should be
fabricated using smooth, non porous materials that are capable of being
decontaminated with hospital grade disinfectants. Their shapes will allow
for easy cleaning around all sides and will be free of inaccessible spaces.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.3.2.12.3 Increases electronic technology increases the number of interfaces
between patients and technical devices. All equipment used in this
component that comes into contact with patients must be able to withstand
frequent and consistent cleaning using hospital-grade products.
17.3.2.12.4 All flooring in this component must be smooth, non-porous, skid and slip
resistant and anti-static.
17.3.2.13 Automated Night Cabinet
17.3.2.13.1 An automated night cabinet will be located outside this component and will
be accessible by authorized personnel at times when the Pharmacy is
closed. The night cabinet is to be in a secure room outside of Pharmacy
and close to the Emergency Department component (AC.01) but not inside
the ED component. The night cabinet shall be obscured from public view.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.3.3 Component Functional Diagrams
17.3.3.1 The areas making up this component shall be organized as illustrated in the following diagram
17.3.3.1.1 Diagram 1: Pharmacy Services Diagram
EXECUTION COPY Nortth Island Hospittals Projject SCHED
DULE 3: DESIGN AND CONSTRUC
CTION SPECIFICA
ATIONS APP
PENDIX 3A: CLIN
NICAL SPECIFICA
ATIONS ______________
_____________
______________
____________________________________________________________ __________
DT.06
PHARM
MACY
17
7.3.3.1.2 Diagram 2: Sterile Compoun
nding & Chem
motherapy Pre
eparation Fun
nctional and
elationship Diagram
Re
Ch
hange Room
R
An
nte Ro
oom
Stterile P
Prep
Glo
oving A
Area
CH
HEMO P
Prep
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
17.3.4 Space Table
17.3.4.1 The Functional Space Requirements illustrates rooms, and their respective sizes, that
combine to make up this functional component. Refer to the respective space program
for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID (RID)
ROOM TYPE
Office/Administrative Area
01 Waiting Area/ Reception
02 Counseling Room
03 Office, First Line Leader
04
Office, Professional
Staff/Student
Pharmacy Work Area
05 Storage Room, Night
Cabinet/ADC
06
Workstation, Administrative
07
08
Reception/Staging
Dispensing Station, Unit
Dose
Dispensing Station,
Multidose
[RID intentionally left blank]
Hand washing Sink
Workstation, Pharmacy
Technician
09
10
11
12
13
14
25
Storage Room, Active Drugs
Compounding Room,
Topical and Oral
Pharmaceuticals
Gloving Room
DT.06 Pharmacy
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Standard workstation
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
4.0
10.0
10.0
1
1
1
4.0
10.0
10.0
15.0
1
15.0
Subtotal, Office/Administrative Area
39.0
1 wrkstn w/ computer terminal - Meeting w/ 1-2
people - Accommodates telehealth functions
2 wrkstns w/ computer terminal - Meeting w/ 12 people - Accommodates telehealth functions
The night cabinet is to be in a secure room
outside of Pharmacy and close to the
Emergency Department component (AC.01)
but not inside the ED component.
1 wrkstn w/ computer terminal - Order entry
and order entry verification
10.0
1
10.0
4.5
8
36.0
Securable area w/ shelving
Dispensary UD picking station for patient
specific first doses.
PacMed & PacVision UD for patient specific
batch refill and UD prep.
15.0
19.0
1
1
15.0
19.0
17.0
1
17.0
0.9
13.5
2
1
1.8
13.5
30.0
7.5
1
1
30.0
7.5
3.0
1
3.0
3 wrkstns for charging out
medications/narcotics
Includes work bench w/ sink, scales and
storage cabinetry
15
Compounding Room, Sterile
Products
Includes room w/ 2 horizontal flow hoods Ventilated for air quality and heat dissipation Supports IV admixture - Positively pressurized
(Specifications as per USP 797)
16.5
1
16.5
16
Compounding Room,
Chemotherapy Agents
Includes room w/ 2 biological safety cabinets Ventilated for air quality and heat dissipation Supports IV admixture - Negatively pressurized
(Specifications as per USP 797)
16.5
1
16.5
17
Change Room, Sterile
Compounding
Staff Change Area, located adjacent to Ante
Room
7.0
1
7.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
18
Ante Room
Dedicated to Compounding Room.
19
Storage Room, Prepared IV
Products
20
21
22
23
24
DT.06 Pharmacy
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
4.0
2
8.0
Accommodates up to 20 carts - Includes
computer terminal, label printer.
15.0
1
15.0
Storage Room, Narcotics
Storage Area, Refrigerated
Staging, Medication Cart
Storage
Secured storage area
10.0
5.0
1.0
1
1
10
10.0
5.0
10.0
Staff/Lounge
Kitchenette w/ pantry including counter w/ sink,
microwave oven, refrigerator - Includes seating
for up to 4 and up to 10-12 purse-size wall
mounted lockers
15.0
1
15.0
6.0
1
6.0
Toilet, Staff
Floor Units Cart storing/ Staging
1 assisted WC, 1 sink
Subtotal, Technical Workshop Area
261.8
TOTAL NSM, ALL AREAS
300.8
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
Office/Administrative Area
01 Waiting Area/ Reception
02 Counseling Room
03 Office, Clinical Pharmacists
04
Office, First Line Leader
Pharmacy Work Area
05 Storage Room, Ante Room,
Night Cabinet/ADC
06
Workstation, Administrative
07
08
Receiving/ Staging Area
Dispensing Station, Unit
Dose
Dispensing Station,
Multidose
[RID intentionally left blank]
Handwashing Sink
Workstation, Pharmacy
Technician
09
10
11
12
13
14
Storage Room, Active Drugs
Storage Area, North Island
Clinic Pharmaceuticals
15
Compounding Room,
Topical and Oral
Pharmaceuticals
Gloving Room
26
DT.06 Pharmacy
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Standard workstation
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
4.0
6.0
14.0
1
1
1
4.0
6.0
14.0
10.0
1
10.0
Subtotal, Office/Administrative Area
34.0
2 wrkstns w/ computer terminal - Meeting w/ 12 people - Accommodates telehealth functions
1 wrkstn w/ computer terminal - Meeting w/ 1-2
people - Accommodates telehealth functions
The night cabinet is to be in a secure room
outside of Pharmacy and close to the
Emergency Department component (AC.01)
but not inside the ED component.
1 wrkstn w/ computer terminal - Order entry
and order entry verification
10.0
1
10.0
4.5
8
36.0
Securable area w/ shelving
Dispensary UD picking station for patient
specific first doses.
PacMed & PacVision UD for patient specific
batch refill and UD prep.
15.0
19.0
1
1
15.0
19.0
17.0
1
17.0
0.9
13.5
2
1
1.8
13.5
20.0
5.0
1
1
20.0
5.0
Includes work bench w/ sink, scales and
storage cabinetry.
7.5
1
7.5
.
3.0
1
3.0
3 wrkstns for charging out
medications/narcotics
Storage area for pharmaceuticals distributed
to North Island clinics
16
Compounding Room, Sterile
Products
Includes room w/ 2 horizontal flow hoods Ventilated for air quality and heat dissipation Supports IV admixture - Positively pressurized
(Specifications as per USP 797)
16.5
1
16.5
17
Compounding Room,
Chemotherapy Agents
Includes room w/ 2 biological safety cabinets Ventilated for air quality and heat dissipation Supports IV admixture - Negatively
pressurized (Specifications as per USP 797)
16.5
1
16.5
18
Change Room, Sterile
Compounding
Staff Change Area, located adjacent to ante
room
7.0
1
7.0
19
Ante Room
Dedicated to Compounding Room.
3.7
2
7.4
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ DT.06
PHARMACY
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
DT.06 Pharmacy
ROOM
SIZE
(nsm)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
20
Storage Room, Prepared IV
Products
Accommodates up to 20 carts - Includes
computer terminal, label printer.
15.0
1
15.0
21
22
23
Storage Room, Narcotics
Storage Area, Refrigerated
Staging, Medication Cart
Storage
Secured storage area
10.0
5.0
1.0
1
1
10
10.0
5.0
10.0
24
Staff/Lounge
Kitchenette w/ pantry including counter w/
sink, microwave oven, refrigerator - Includes
seating for up to 4 and up to 10-12 purse-size
wall mounted lockers
15.0
1
15.0
6.0
25
Floor Units Cart storing/ Staging
Toilet, Staff
1
6.0
Subtotal, Technical Workshop Area
251.7
TOTAL NSM, ALL AREAS
285.7
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.01
BIOMEDICAL ENGINEERING
This specification outlines the functional, operational and physical requirements for the Biomedical
Engineering functional component.
18.1 FUNCTIONAL DESCRIPTION
18.1.1 Statement of Purpose
18.1.1.1 Biomedical Engineering involves the use of technology, including hardware and
software, to keep vital clinical equipment and medical devices fully operational to
support the work of clinicians. Functions occurring in this component are responsible
for the safe design, testing, calibration, repair, maintenance and application of medical
devices that are applied to patients.
18.1.2 Scope of Services
18.1.2.1 Functional Content
18.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
18.1.2.1.1.1
Receiving, recording and temporary holding of all biomedical
devices delivered to the component, including new devices
requiring assembly, set-up, calibration and/or testing and existing
devices requiring maintenance or repair
18.1.2.1.1.2
Receiving, recording and organized storing of all equipment and
supplies used in the assembly, set-up, calibration and testing of
biomedical devices
18.1.2.1.1.3
Disassembling, assembling, setting-up, calibrating and testing new
and existing biomedical devices
18.1.2.1.1.4
Cleaning (not sterilizing) biomedical devices and components as
required; all sterilizing functions will be accommodated in the
Medical Device Reprocessing Department component (See OSSTL.09)
18.1.2.1.1.5
Maintaining a library of reference manuals, warranties and service
records of all biomedical devices used in the Facility; storage of
both electronic and hard copy media will be accommodated in this
component
18.1.2.1.1.6
Receiving/preparing biomedical devices for off-site servicing, and
receiving/preparing devices for return to use following off-site
servicing
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.01
BIOMEDICAL ENGINEERING
18.1.2.1.1.7
Providing “first line” diagnoses and trouble-shooting services for
equipment located in other components, especially in technologyintensive components like Medical Imaging, Laboratory and
Surgical Services
18.1.2.1.1.8
Coordinating on-site work of private service contractors
18.1.2.2 Exclusions
18.1.2.2.1 The following list specifies functions conducted by Biomedical Engineering
personnel that are understood to occur in other components in the Facility
or outside of the Facility:
18.1.2.2.1.1
Direct contact with inpatients and outpatients
18.1.2.2.1.2
Servicing of equipment covered under a vendor’s warranty
18.1.2.3 Anticipated Trends in Service Delivery
18.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
18.1.2.3.1.1
More calibrating and troubleshooting of biomedical devices at
point-of-use, and using hardwired or wireless connections with
technical staff located in the Biomedical Engineering component or
off-site
18.1.2.3.1.2
Increasing involvement of Biomedical Engineering personnel in
selecting/purchasing, moving, repairing and maintaining
equipment, and decreasing involvement of private service
contractors
18.1.2.3.1.3
Increasing use of technology in maintaining health and combatting
diseases
18.1.2.3.1.4
Increasing “smart” technology incorporated into devices
18.1.2.3.1.5
Increasing interfaces between the patient, monitoring devices and
the electronic medical record
18.1.3 Scope of Education Functions
18.1.3.1 Biomedical Engineering students from technical colleges and universities will receive
practical skills training through internships and co-op programs. All teaching and
supervision functions will be accommodated in the general work areas, and will not
require specialized or dedicated facilities in this component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.01
BIOMEDICAL ENGINEERING
18.1.4 Scope of Research Functions
18.1.4.1 Biomedical Engineering personnel and students will, from time-to-time, be engaged in
research. The nature and extent of research functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
18.2 OPERATIONAL DESCRIPTION
18.2.1 LEAN Planning Standards
18.2.1.1 Efficiency in Circulation
18.2.1.1.1 Biomedical Engineering personnel will frequently travel to other
components to trouble-shoot and/or repair equipment. Urgent requests and
needs for STAT services will require that this component be located
strategically within the Facility to respond to requests.
18.2.1.2 Hours of Operation
18.2.1.2.1 The Biomedical Engineering component at this HCF will be staffed and in
operation:
18.2.1.2.1.1
0800 - 1600, Monday through Friday
18.2.1.2.2 Outside the routine hours of operation listed above and depending upon
the nature of service(s) required, biomedical services will be available via a
call-back service or by using telehealth linkages with personnel located offsite.
18.2.2 People Management Systems
18.2.2.1 Biomedical Engineering personnel will have unrestricted, but controlled access to this
component at all times. Unauthorized personnel will not have access to this
component’s interior space.
18.2.2.2 The component will serve as a “home base” for personnel and students at which
informal meetings, training sessions and assignment briefings will be conducted.
18.2.3 Materiel Management Systems
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.01
BIOMEDICAL ENGINEERING
18.2.3.1 Equipment Management
18.2.3.1.1 All orders for new equipment will be submitted and processed
electronically. Orders for new equipment originating in other components
will be sent initially to the Biomedical Engineering component for
compliance with existing standards. All approved orders will be forwarded
to the Facility’s Materiel Management component (See OS-STL.05) for
processing.
18.2.3.1.2 Equipment and supplies arriving at the Facility, and destined for the
Biomedical Engineering component will be received and checked against
purchase/shipping orders in the Materiel Management component (See
OS-STL.05). Boxes containing more than 1 item will generally not be
broken down in Materiel Management, but will delivered intact to the
Biomedical Engineering component where they will be unpacked,
confirmed against packing slips and taken into inventory.
18.2.3.2 Waste Management
18.2.3.2.1 To the extent practicable, waste products will be generally managed
according to a system of segregation at point of origin and sequential
consolidation. Operation of this system relies on appropriate containment
facilities for each type of waste product beginning at where the waste is
generated followed by similar, but progressively larger, containment
facilities at key collection locations. In the Biomedical Engineering
component, waste management is understood to begin at the technical
workstations. An administrative area will also accommodate segregation of
the types of waste products typically generated in these types of spaces.
18.2.3.2.2 Segregation of wastes will accommodate the following categories of
products:
18.2.3.2.2.1
General garbage
18.2.3.2.2.2
Sharps (including potentially biohazardous items)
18.2.3.2.2.3
Infectious or contaminated wastes (excluding sharps)
18.2.3.2.2.4
Clean paper and cardboard
18.2.3.2.2.5
Clean metal (tin and aluminum)
18.2.3.2.2.6
Clean recyclable plastics
18.2.4 Information Management Systems
18.2.4.1 Most “active” information used in this component will be stored and managed
electronically. Service records, purchase/receipt orders, equipment dispatch records
and personnel work records will be entered at local terminals by component personnel.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.01
BIOMEDICAL ENGINEERING
18.2.4.2 Component personnel will maintain a library of hard copy equipment manuals, but this
function will diminish as manuals and technical information become accessible through
company web sites and electronic libraries.
18.3 DESIGN CRITERIA
18.3.1 LEAN Planning Standards
18.3.1.1 Accommodating Large Items
18.3.1.1.1 Efficiencies in moving and manoeuvring large pieces of equipment will
require wide hallways and wide doorways throughout the Facility. A
mechanical lift in this component’s technical work area will also contribute
to these efficiencies. The lift must have a minimum capacity of 450 kg.
(approximately 1,000 lbs.).
18.3.2 Proximity Relationships
18.3.2.1 The Biomedical Engineering component’s location relative to other components and the
nature of circulation used to move between 2 components are illustrated in the diagram
below. Proximities are listed according to rank; higher priorities appear above lower
priorities.
18.3.2.2 Provide direct access to the biomedical engineering department via a non-public
corridor, access to the depart will not cross public corridors.
Biomedical Engineering Main Horizontal/ Vertical Circulation Biomedical Engineering Surgical Services 18.3.2.3 Provide Convenient Access by General
Circulation to major non-public circulation.
Biomedical Engineering personnel and
pieces of large equipment will move
frequently to/from this component and other
components in the Facility, mainly those
involved in direct patient care.
18.3.2.4 Provide Convenient Access by General
Circulation to the Surgical Services
component. Pieces of large equipment and
supplies will frequently move between these
2 components.
18.3.3 Internal Design Criteria
18.3.3.1 General Internal Layout
18.3.3.1.1 The component shall be organized into 3 major areas as follows:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.01
BIOMEDICAL ENGINEERING
18.3.3.1.1.1
Receiving/marshalling area
18.3.3.1.1.2
Administrative work area
18.3.3.1.1.3
Technical work area including technical workbenches and
laboratory area accommodating supplies storage and reference
libraries
18.3.3.2 Open Plan
18.3.3.2.1 Administrative and technical work areas shall be segregated, but organized
within a common, open floor plan. Staff must be able to move easily
between technical workbenches and administrative workstations and with
minimal disruption to others occupying other workstations. A private office
for the First Line Leader/ Supervisor will be provided in the biomedical
engineering component area.
18.3.3.2.2 Biomedical engineering will be provided proximal to the non-public main
vertical access point in the building the technical work area must be
adjacent to the receiving/marshalling area enabling convenient movement
of large equipment.
18.3.3.2.3 Dedicated and secure storage will be provided in the Biomedical
engineering department. Electrical power and data will be provided in all
storage areas within Biomedical engineering. Confirm type and location of
electrical and data requirements upon consultation with the Biomedical
Engineering User Consultation Group.
18.3.3.3 Component Security
18.3.3.3.1 Access to this component must be controlled at all times. The
receiving/marshalling area serves as the component’s main entrance, and
may be accessed by other authorized Facility personnel for equipment
drop-off or pick-up. This area must be accessible to authorized personnel
24 hours-a-day, 7 days-a-week.
18.3.3.3.2 Access to the administrative and technical work areas will be reserved for
biomedical technologists or for Facility personnel accompanied by
component personnel. All aspects of the biomedical engineering
component programs will be provided in a contiguous and consolidated
suite.
18.3.3.3.3 Provide an industrial sink, confirm type and requirements and required
location with biomedical engineering User Consultation Group. Provide
medical gases directly adjacent to the industrial sink, at a minimum provide
air and vacuum. A workbench or counter is required adjacent to the
industrial sink.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.01
BIOMEDICAL ENGINEERING
18.3.3.4 Lighting
18.3.3.4.1 Focused viewing of biomedical devices will benefit from a combination of
natural and task lighting. Ceiling mounted light fixtures shall cast light
upwards to avoid the shadows created by direct ambient lighting. Adequate
task lighting will be required for the technical workspaces and some lighting
must be on delayed vital power.
18.3.3.5 Electrical Power Requirements
18.3.3.5.1 Workbenches located in the technical work area must be supplied with one
appropriate electrical capacity and outlets. Confirm final requirements with
biomedical user group champions
18.3.3.5.2 Each technical workstation must be equipped with a minimum of two (2)
115 VAC electrical circuits. Each circuit to have 6 outlets supplied in a
power strip configuration. At least 50% of the 115 VAC outlets in this
component must be on a delayed vital power source.
18.3.3.6 Gas Service Requirements
18.3.3.6.1 At a minimum, each technical workstation must be equipped with the
following, confirm final quantity and allocation based upon consultation with
Biomedical Engineering user group champions
18.3.3.6.1.1
Oxygen
18.3.3.6.1.2
Nitrous Oxide
18.3.3.6.1.3
Suction
18.3.3.6.1.4
Anesthetic Gas Scavenging
18.3.3.6.1.5
Medical Air
18.3.3.7 Communication Technology
18.3.3.7.1 Network connections will be required at each workbench and an access
point for wireless communication must be in the vicinity of this component.
18.3.3.8 Lift Assist Systems
18.3.3.8.1 The technical work area in this component must be serviced by a ceiling
mounted lift system enabling lifting of heavy items to each of the work
benches or to the appropriate height for the technician. Confirm
requirements, specification and location of the lift system with the
Biomedical engineering champions.
EXECUTION COPY Nortth Island Hospittals Projject SCHED
DULE 3: DESIGN AND CONSTRUC
CTION SPECIFICA
ATIONS APP
PENDIX 3A: CLIN
NICAL SPECIFICA
ATIONS ______________
_____________
______________
____________________________________________________________ __________
OS-S
STL.01
BIOMEDIC
CAL ENGINEE
ERING
18.3.4 Component
C
Functional
F
Diiagram
18
8.3.4.1 The areas making
g up this com
mponent shall be organized
d as illustrated
d in the follow
wing
diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.01
BIOMEDICAL ENGINEERING
18.3.5 Space Table
18.3.5.1 The schedule beginning on the following page illustrates rooms, and their respective
sizes, that combine to make up this functional component. Refer to the respective
space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENT: COMOX VALLEY HOSPITAL
ROOM
ID (RID)
OS-STL.01 Biomedical Engineering
Receiving/Marshalling Area
01 Receiving/Equipment
Marshalling/ Storage Room
02
Secured room
06
07
2.0
1
2.0
Subtotal, Receiving/Marshalling Area
30.0
28.0
28.0
1
28.0
-
-
-
2.0
1
2.0
35.0
1
35.0
2.0
1
2.0
Subtotal, Technical Work Area
67.0
[Intentionally left blank]
Counter w/ 2 sinks & drying area
Work Area/ Holding, Parts
Storage Service Manual
Storage
Includes reference library, data entry station,
spare parts inventory and testing/calibration
equipment
Workstation, Staff
Include in parts holding/ staging work area
Administrative Work Area
08 Office, First Line Leader
TOTAL
SIZE
(nsm)
1
Open plan w/ 3 work benches, each serviced as
per specifications in Interior Design Criteria
section of this component's description
Washing/Preparation Counter
NUMBER
OF
ROOMS
28.0
Work Counter
Technical Work Area
03 Technical Work Room
04
05
ROOM
SIZE
(nsm)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
Chief Technologist - 1 desk w/ computer terminal
- Meeting area for up to 3 people
10.0
1
10.0
Subtotal, Administrative Work Area
10.0
TOTAL NSM, ALL AREAS
107.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.01
BIOMEDICAL ENGINEERING
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENT: CAMPBELL RIVER HOSPITAL
ROOM
ID
(RID)
ROOM TYPE
Receiving/Marshaling Area
01 Receiving/Equipment
Marshaling/ Storage Room
02
07
ROOM
SIZE
(nsm)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Secured room
[Intentionally left blank]
Washing/Preparation Counter
TOTAL
SIZE
(nsm)
1
2.0
1
2.0
Subtotal, Receiving/Marshaling Area
30.0
Open plan w/ 3 work benches, each serviced as
per specifications in Interior Design Criteria
section of this component's description
28.0
28.0
1
28.0
2.0
1
2.0
35.0
1
35.0
2.0
1
2.0
Subtotal, Technical Work Area
67.0
Work Area/ Holding, Parts
Storage Service Manual
Storage
Counter w/ 2 sinks & drying area
Includes reference library, data entry station,
spare parts inventory and testing/calibration
equipment
Workstation, Staff
Include in parts holding/ staging work area
Administrative Work Area
08 Office, First Line Leader
NUMBER
OF
ROOMS
28.0
Work Counter
Technical Work Area
03 Technical Work Room
04
05
06
OS-STL.01 Biomedical Engineering
Chief Technologist - 1 desk w/ computer terminal
- Meeting area for up to 3 people
10.0
1
10.0
Subtotal, Administrative Work Area
10.0
TOTAL NSM, ALL AREAS
107.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.03
ENVIRONMENTAL SERVICES
This specification outlines the functional, operational and physical requirements for the Environmental
Service functional component.
20.1 STATEMENT OF PURPOSE
20.1.1 Environmental Services (EVS) will encompass housekeeping, waste management and
laundry/linen. Operational scope and standards will be in accordance with Schedule 4E,
Housekeeping and Waste Management Services.
20.1.2 Scope of Services
20.1.2.1 EVS will be responsible for the cleaning of interior building surfaces throughout the
Hospital and Clinical Support Building and in accordance with the Service
Specifications Outlined in Schedule 4E. This program component will accommodate
the spaces required to support EVS central administrative, clerical, communications
and storage functions as well as decentralized housekeeping supply rooms will be
provided throughout the facility.
20.1.2.2 EVS will manage the Waste Management process and will ensure standards are
maintained throughout the new Hospital. Waste Management will begin at the point-ofuse, therefore holding rooms for trash, recyclables, shredded confidential paper,
regulated medical waste containers, and sharps containers will be provided at strategic
points throughout the facility.
20.1.2.3 Housekeeping will be responsible for moving selected portions of the waste stream
from points-of-use, and from soiled utility/holding rooms to the soiled dock area. The
major portions of the waste stream including; soiled linen, non-infectious trash, and
mixed recyclables, will be transported in carts and totes.
20.1.2.4 Laundry functions will be facilitated off-site. A a 65 lbs commercial washer and a 75
lbs dryer will be maintained on site for laundering of any specialty or incidental items.
Housekeeping will be responsible for the collection, retrieval, distribution and
management of linen and laundry items.
20.1.2.5 Additional miscellaneous services will include room setups for lecture/training/class
rooms/display areas, reporting facility conditions that affect the cleaning operation or
present as a safety hazard and collect and deliver lost and found articles to Protection
Services.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.03
ENVIRONMENTAL SERVICES
20.2 OPERATIONAL DESCRIPTION
20.2.1 Hours of Operation
20.2.1.1 Environmental services will be staffed on a 24/7 basis.
20.2.1.2 Inpatient care areas will be primarily cleaned and serviced from 8:00am to 4:00pm, or
as agreed. Linen service and delivery to units will also occur during these times, or as
agreed. Supplemental cleaning of inpatient areas, clinics, offices and ancillary
departments, operating rooms and emergency will occur from 4:00pm and midnight,
and as necessary throughout the day. Housekeeping services will also be provided
between midnight and 8:00am for 24/7 areas such as operating rooms and emergency.
Waste management/collection will occur as necessary, from 7:00am to 11:00pm.
20.2.2 Staff Workflow
20.2.2.1 Continuous Quality Improvement (CQI) initiatives will be supported within
Environmental Services.
20.2.2.2 Staff will be assigned to specific areas of the hospital to provide cleaning services.
Staff will sign-in/log-in centrally. The storage, maintenance and charging of large pieces
of cleaning equipment (e.g. auto scrubbers, burnishers, floor finishing/ stripping
machine, etc.) will be accommodated centrally, as will the storage of bulk cleaning
supplies.
20.2.2.3 Satellite storage for selected floor care equipment, such as ride-on scrubbers, wetvacs, and floor fans, will be provided strategically in areas such as the main and
emergency entrances.
20.2.2.4 Traditional housekeeping closets as well as soiled and clean housekeeping and
laundry rooms will be developed to efficiently service the needs of patient care and
treatment areas of the hospital. The housekeeping closets will accommodate a floor
sink, burnisher, vacuum, housekeeping cart, cleaning and paper supplies.
20.2.2.5 The various forms of soiled material handling/waste management will be addressed as
follows:
20.2.2.6 General Non-infectious Trash will be collected on the patient care units from individual
patient rooms, treatment areas, soiled utility, and soiled holding rooms. EVS staff will
transport trash carts located throughout the hospital directly to central waste holding
area adjacent to the soiled docks and/or directly into trash compactor. The waste
holding area will be required to hold waste transport equipment, waste containers for
washing and drip drying purposes. The space needs to be adjacent to the loading dock
and waste compactor.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.03
ENVIRONMENTAL SERVICES
20.2.2.7 Recyclables as outlined in Schedule 4E will be collected manually, segregated and
stored in a central recycling area adjacent to the soiled docks, until the items are picked
up by a recycling company(s). All recyclables will be stored in bins off of the loading
dock.
20.2.2.8 Confidential paper waste will be stored in small totes located in alcoves throughout the
facility. Periodically, EVS staff will exchange full totes for empty totes. Staff will then
take the full totes to a secure holding room adjacent to the loading docks. An outside
contractor will remove the totes of confidential papers, and replace them with an equal
number of empty totes. The full totes will be taken off-site by the contractor for
destruction.
20.2.2.9 Regulated Medical Waste, including infectious waste and sharps will be collected at the
source and taken to the soiled holding area to be later transported by EVS staff to a
designated secure holding room adjacent to the soiled docks. The infectious waste
will be properly stored in refrigerated environment before being picked up by a licensed
contractor. Sharps containers will also be stored in a secure area, to await vendor
pick-up.
20.2.2.10 Hazardous Waste, small amounts will be stored in user areas, before the EVS staff
picks-up and transports the waste to a secure storage facility adjacent to the soiled
loading dock. A licensed carrier will pick-up and transport the accumulated hazardous
waste on a monthly basis. This may also include small amounts of radioactive waste.
20.2.2.11 Flammable Waste; any items in this category collected by EVS staff will be transported
as needed to specialized containment space located in the Materiel Management
component (See OS-STL.05).
20.2.2.12 Food Waste will be held in a refrigerator within the Food Service department. Food
Services will also use a pulper/digester, to process food waste. EVS will not be directly
involved with handling food waste within the Food Service department but rather will
empty and remove all containers within the garbage refrigerator within the kitchen and
transport them to a refrigerated holding room adjacent to the loading dock.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.03
ENVIRONMENTAL SERVICES
20.3 DESIGN CRITERIA
20.3.1 Proximity Relationships
20.3.1.1 The Environmental Services component’s location relative to other components and the
nature of circulation used to move between 2 components are illustrated in the diagram
below. Proximities are listed according to rank; higher priorities appear above lower
priorities.
ENVIRONMENTAL SERVICES ENVIRONMENTAL SERVICES MATERIELS MANAGEMENT MAIN HORIZONTAL/ VERTICAL CIRCULATION 20.3.1.2 Provide Direct Access by General
Circulation to the Materiel Management
component for the movement of staff and
materials and for the sharing of a common
loading dock.
20.3.1.3 Provide Convenient Access by General
Circulation to the Facility’s main circulation
system for the movement of staff, cleaning
carts and cleaning machines.
20.3.1.4 Loading Dock Requirements
20.3.1.4.1 Refer to Materiel Management (See OS-STL.05) for loading dock
specifications.
20.3.2 Flexibility and Adaptability
20.3.2.1 Provision for dedicated decentralized soiled and clean housekeeping and laundry
rooms and housekeeping closets.
20.3.3 Environmental Considerations
20.3.3.1 Natural light is preferred, wherever possible. Task lighting should be included in
selected work areas.
20.3.3.2 Appropriate air temperature and ventilation controls should be provided in work areas
for staff comfort and equipment sensitivities, i.e. floor care equipment (battery
charging), cleaning supplies, etc.
20.3.3.3 Appropriate flammable stores will be provided for centralized holding of flammable
cleaning products.
20.3.3.4 Sound attenuation systems/finishes will be used wherever possible to keep noise to
minimum levels.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.03
ENVIRONMENTAL SERVICES
20.3.3.5 To prevent floor equipment from damaging any sheet flooring, patterned floor covering
is recommended to hide imperfections to flooring and possible damage.
20.3.3.6 Bumper protection on walls and corners exposed to cart traffic or powered equipment.
Bumpers to project out from wall and to protect both upper and lower part of the wall.
20.3.4 Special Considerations
20.3.4.1 Room Requirements
20.3.4.1.1 Floor care equipment storage requires additional ventilation due to fumes
emitted during battery charging
20.3.4.1.2 Floor care equipment and all soiled holding rooms should have floor drains,
as well as wall faucets/hose bibs, and hand wash sinks
20.3.4.1.3 Ventilation in soiled holding rooms should provide ten (10) air changes
hourly
20.3.4.1.4 All EVS storage/holding rooms to have door openings at least 4 feet wide.
20.3.4.2 Other Considerations
20.3.4.2.1 Access to conference and training rooms for in-service and on-going
education for EVS staff.
20.3.5 Space Table
20.3.5.1 The schedule accompanying this document illustrates rooms, and their respective
sizes, that combine to make up this functional component. Refer to the respective
space program for each Facility.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.03
ENVIRONMENTAL SERVICES
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM ID
(RID)
OS-STL.03 Environmental Services
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Administrative Area
01
[RID Intentionally left
blank]
02
[RID Intentionally left
blank]
03
[RID Intentionally left
blank]
[NOTE: Space moved to OS-STL.05]
EVS Storage and Support Area
04 Storage, bulk supplies
05
Floor care equipment
holding area
Linen and Laundry Area
06 Clean linen holding and
cart make up room
07
Washer and dryer room
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
-
-
-
-
-
-
-
-
-
Subtotal
0.0
Floor care equipment holding area - Bulk storage of
paper products (toilet paper and paper towels) and
includes flammable products storage cabinet Vented to outside
15.0
1
15.0
Allowance for 5 housekeeping carts, btery charging
stations for 9 electric machines
25.0
1
25.0
Subtotal
40.0
Linen carts (9 exchange carts), linen carts (15 bulk
carts), cart make up area, bulk linen back up (i.e.
curtains, drapes), and workstation - Includes hand
washing sink
18.0
1
18.0
Accommodates in-house washing/drying of
specialized and heat - sensitive items - includes
washer, dryer, counter with sink - Pony wall to
separate the units, floor drain-floor sloping
13.0
1
13.0
Subtotal
31.0
15.0
1
15.0
15.0
1
15.0
Waste Management / Soiled Linen Area
08 Soiled linen holding
Accommodates 15 carts
(carts)
09 Compactor Loading Area
Waste removal/soiled holding for general garbage Provides access to manual/automatic compactors
located on building's exterior
ROOM
SIZE
(nsm)
10
Organic waste
Accommodates up to 12 totes - Refrigerated and
vented room
15.0
1
15.0
11
Biomedical waste
holding
Accommodates 12 totes - Serviced w/ negative
pressure and refrigeration
15.0
1
15.0
12
Confidential paper
holding
4.5
1
4.5
Subtotal
64.5
TOTAL NSM, ALL AREAS
135.5
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.03
ENVIRONMENTAL SERVICES
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: OS-STL.03 Environmental Services
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
ROOM
SIZE
(nsm)
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Administrative Area
01
[RID Intentionally left
blank]
02
[RID Intentionally left
blank]
03
[RID Intentionally left
blank]
EVS Storage and Support Area
04 Storage, bulk supplies
05
Floor care equipment
holding area
Linen and Laundry Area
06 Clean linen holding
and cart make up
room
07
Washer and dryer
room
Waste Management / Soiled Linen
Area
08 Soiled linen holding
(carts)
09 Compactor Loading Area
10
Organic waste
11
Biomedical waste holding
12
Confidential paper
holding
[NOTE: Space moved to OS-STL.05]
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
-
-
-
-
-
-
-
-
-
Subtotal
0.0
Floor care equipment holding area Bulk storage of paper products (toilet
paper and paper towels) and includes
flammable products storage cabinet Vented to outside
15.0
1
15.0
Allowance for 3 housekeeping carts,
battery charging stations for 6 electric
machines
25.0
1
25.0
Subtotal
40.0
Linen carts (6 exchange carts), linen
carts (10 bulk carts), cart make up
area, bulk linen back up (i.e. curtains,
drapes), and workstation - Includes
hand washing sink
15.0
1
15.0
Accommodates in-house
washing/drying of specialized and heatsensitive items - Includes washer,
dryer, counter with sink - Pony wall to
separate the units, floor drain - Floor
sloping to mops, slings, etc.
13.0
1
13.0
Subtotal
28.0
Accommodating 10 carts
15.0
1
15.0
Waste removal/soiled holding for
general garbage - Provides access to
manual/automatic compactors located
on building's exterior
Accommodates up to 12 totes Refrigerated and vented room
15.0
1
15.0
15.0
1
15.0
Accommodates 12 totes - Serviced w/
negative pressure and refrigeration
15.0
1
15.0
4.5
1
4.5
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.03
ENVIRONMENTAL SERVICES
OS-STL.03 Environmental Services
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
13
ROOM TYPE
Recycling Holding Area
ROOM
SIZE
(nsm)
CONTENTS/KEY FEATURES/DESIGN CRITERIA
Assumed accommodated on exterior
loading dock - Accommodates
segregation of paper, cardboard,
plastic, glass and metal - Assumes use
of Toter system
0.0
NUMBER
OF
ROOMS
0
TOTAL
SIZE
(nsm)
0.0
Subtotal
64.5
TOTAL NSM, ALL AREAS
132.5
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.04
INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY (IM/IT)
This specification outlines the functional, operational and physical requirements for the Information
Management/Information Technology (IM/IT) functional component.
21.1 FUNCTIONAL DESCRIPTION
21.1.1 Statement of Purpose
21.1.1.1 The IM/IT component will accommodate the Facility’s data centre and technical
personnel required to support the Facility’s information management and
communications systems.
21.1.2 Scope of Services
21.1.2.1 Functional Content
21.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the functional component’s spaces:
21.1.2.1.1.1
Maintenance of on-site centralized data management and
communication systems, and in accordance with policies
established by the Authority for corporate computing and
communication services
21.1.2.1.1.2
Receiving and staging of personal computers, printers and
wireless devices prior to delivery to the user
21.1.2.1.1.3
Conducting teleconferences and videoconferences providing IM/IT
support to remote locations
21.1.2.1.1.4
Segregated storage of all wastes generated in the functional
component, and including general waste and recyclable materials
21.1.2.2 Exclusions
21.1.2.2.1 The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
21.1.2.2.1.1
Maintenance of decentralized data closets and
teleconference/videoconference facilities
21.1.2.2.1.2
Consultations with users throughout the Facility on interfacing with
the VIHA-wide information network
21.1.2.2.1.3
Group training/demonstration sessions on the use of new
hardware, software and network technology (See OS-GP.01
Central Education and Conference Facilities)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.04
INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY (IM/IT)
21.1.2.3 Anticipated Trends in Service Delivery
21.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
21.1.2.3.1.1
Transition from a paper-based health record to a comprehensive
electronic medical record (EMR) will be assumed complete as at
the Facility’s opening date.
21.1.2.3.1.2
With very few exceptions, operating systems used throughout the
Facility will be supported by electronic information management
and communication technology (e.g., inventory tracking/ordering,
equipment tracking, patient data). Staff working in all areas will
require initial and recurrent training on systems applicable to their
functions.
21.1.2.3.1.3
Data and information related to the Facility’s operation, including
clinical and non-clinical support services, will continue becoming
more integrated. This will require more standardization in the way
information is captured, displayed and utilized. It will also require
that staff cross-train so that they become familiar with
information/data requirements outside of their (current) immediate
area of responsibility.
21.1.3 Scope of Education Functions
21.1.3.1 All teaching and supervision functions conducted by or for IM/IT staff will be
accommodated in the general work areas or in the Central Education and Conference
Facilities component (See OS-GP.01). A dedicated computer teaching laboratory will
be included in the Central Education and Conference Facilities’ component space.
21.1.4 Scope of Research Functions
21.1.4.1 Staff and students working in the IM/IT component will, from time-to-time, be engaged
in research. The nature and extent of research functions will be accommodated in the
general work areas, and will not require specialized or dedicated facilities in this
component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.04
INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY (IM/IT)
21.2 OPERATIONAL DESCRIPTION
21.2.1 LEAN Planning Standards
21.2.1.1 Efficiency in Circulation
21.2.1.1.1 IM/IT personnel will frequently travel to other components to trouble-shoot
and/or repair equipment. Urgent requests and needs for STAT services will
require that IM/ located strategically within the Facility to respond to
requests.
21.2.2 Hours of Operation
21.2.2.1 The component at this facility will be staffed and in operation:
21.2.2.1.1 0730 – 1800, Monday through Friday
21.2.2.2 On-call technical support will be available through the Authority’s 24-hour telephone
help service located off-site.
21.2.3 People Management Systems
21.2.3.1 Staff/Visitor Management
21.2.3.1.1 Access to this component will be controlled at all times. Security systems
will enable authorized staff to have temporary access to the training
laboratory. This authorization will be time limited and will automatically
expire when the scheduled access period ends.
21.2.3.1.2 Vendors will be present in this component, generally under the supervision
of a staff member.
21.2.3.1.3 Members of the public will not have access to this component.
21.2.4 Materiel Management Systems
21.2.4.1 Consumable Supplies
21.2.4.1.1 Inventories of consumable supplies will be maintained close to point of use
in this component. Generally, a 3 day supply of each item will be
maintained with minimum inventory levels triggering a re-ordering process.
All orders will be sent electronically to the facility’s Materiel Management
component (See OS-STL.05) for processing.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.04
INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY (IM/IT)
21.2.4.2 Waste Management
21.2.4.2.1 Waste products will be generally managed according to a system of
segregation at point of origin and sequential consolidation. Operation of
this system relies on appropriate containment facilities for each type of
waste product beginning at where the waste is generated followed by
similar, but progressively larger, containment facilities at key collection
locations. Throughout the IM/IT component, waste management is
understood to begin at the individual workstations with centralized
collection and temporary holding stations being located in a general
support area.
21.2.4.2.2 Segregation of wastes will accommodate the following categories of
products:
21.2.4.2.2.1
General garbage
21.2.4.2.2.2
Clean paper and cardboard
21.2.4.2.2.3
Clean metal (tin and aluminum)
21.2.4.2.2.4
Clean recyclable plastics
21.2.5 Information Management Systems
21.2.5.1 It is anticipated that electronic technology will be used to manage more aspects of each
patient’s care. This management function will involve more integration of different
information systems. Patient care, for example will require supplies (Materiel
Management), room/procedure bookings (e.g., inpatient care units, OR/PARR),
medications (Pharmacy) and staff (Staffing office). Each patient’s experience in the
Facility, therefore, will trigger a set of scheduling functions which will require full
integration to ensure resources are in place at the appropriate time.
21.2.5.2 Access to the information system infrastructure will be possible anywhere inside the
Facility using a combination of wireless and hard wire connections to networks.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.04
INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY (IM/IT)
21.3 DESIGN CRITERIA
21.3.1 Proximity Relationships
21.3.1.1 The IM/IT component’s location relative to other components and the nature of
circulation used to move between 2 components are illustrated in the diagram below.
Proximities are listed according to rank; higher priorities appear above lower priorities.
IM/IT IM/IT BIOMEDICAL ENGINEERING CENTRAL EDUC/ CONFERENCE FACILITIES 21.3.1.2 Provide Direct Access by General
Circulation to the Biomedical Engineering
component for the movement of staff and
equipment.
21.3.1.3 Provide Convenient Access by General
Circulation to the Materiel Management
component for the movement of staff and
equipment.
21.3.2 Internal Design Criteria
21.3.2.1 General Internal Layout
21.3.2.1.1 The component shall be organized into 2 major areas as follows:
21.3.2.1.1.1
Receiving/Equipment Storage area
21.3.2.1.1.2
Technical work area
21.3.2.1.2 Provide large double doors suitable for transporting loading dock pallets
into the Technical work area. Provide five work cubicles in the
administration area suitable to provide sound privacy. The cubicle work
countertops shall be no less than 800mm deep.
21.3.2.1.3 Provide three workbenches in the Technical Work Area. Benches are to be
bench height, a minimum of 800mm deep and 1500mm wide. The surface
of the workbench shall be suitable for computer maintenance.
21.3.2.2 Component Security
21.3.2.2.1 Valuable computer equipment will be stored in this component, and
terminals located here will have access to private/confidential information
and databases. Access to the component must be secured at all times.
Provide key card access. A separate secured room inside the component
will provide an additional level of security for stored equipment. All
doorways shall be alarmed and motion sensors shall be installed in the
equipment storage and main entrance area.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.04
INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY (IM/IT)
21.3.2.2.2 The component’s exterior walls shall extend from floor to ceiling, and the
use of drop ceilings in the component shall be avoided.
21.3.2.2.3 All computer terminals in this component will automatically lock whenever a
staff member leaves their workstation.
21.3.2.2.4 Component security will be enhanced by having a single point of
access/egress. All component users will enter/exit through this door. It will
also be the point through with arriving and departing computer equipment
and supplies pass.
21.3.2.3 Electrical Power Requirements
21.3.2.3.1 Workbenches located in the technical work area must be supplied with two
(2) 208 VAC electrical outlets, each rated at 50 amps.
21.3.2.3.2 Each technical workstation must be equipped with at least two (2) 115 VAC
electrical outlets. At least 50% of the 115 VAC outlets in this component
must be on a delayed vital power source; power to these outlets must be
re-established within 2 minutes of a power failure.
21.3.2.4 Communication Technology
21.3.2.4.1 Network connections will be required at each workbench and an access
point for wireless communication must be in the vicinity of this component.
21.3.3 Component Functional Diagram
21.3.3.1 The areas making up this component shall be organized as illustrated in the following
diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.04
INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY (IM/IT)
21.3.4 Space Table
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.04
INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY (IM/IT)
21.3.4.1 The schedule beginning on the following page illustrates rooms, and their respective
sizes, that combine to make up this functional component. Refer to the respective
space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
OS-STL.04 Information Management/Information Technology (IM/IT)
ROOM
ROOM
NUMBER
CONTENTS/KEY FEATURES/DESIGN
ID
ROOM TYPE
SIZE
OF
CRITERIA
(RID)
(nsm)
ROOMS
Administrative and Education Centre
01
Receiving/Equipment
Secured room
5.0
1
Marshalling/ Storage
Room
Subtotal, Administration and Education Centre
Technical Work Area
02
Workbench, Break/ Fix
Repair
10 Networks drops, sufficient power to charge
equipment is required.
03
Storage, Equipment
04
05
06
07
08
09
TOTAL
SIZE
(nsm)
5.0
5.0
3
3
9.0
Hot Swap Items, Computers, Monitors, printers.
Include power outlets, shelving, ensure
appropriate temperature and airflow
requirements. Room must be secured, with
limited access (e.g. key card access)
20
1
20.0
Workstation, Staff
Workstation, Staff
Workstation, Staff
IBM Contracted Staff
VIHA Desktop Staff
1 Telehealth, (2) SWING DESKS for visiting/
rotating staff
3.0
3.0
3.0
2
3
3
6.0
9.0
9.0
Workstation, Staff
Office, First Line Leader
Server Room, Computer
Clinical Informatics
3.0
2
Clinical Informatics Director/ IMIT
10.0
1
Environmentally controlled room w/ alarms tied
15.0
1
into FMO monitoring systems - Raised flooring
- Provided w/ emergency electrical power &
UPS. Requires Raised floor. Locate proximate
to IT work areas
Subtotal, Technical Work Area
6.0
10.0
15.0
TOTAL NSM, ALL AREAS
84.0
89.0
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.04
INFORMATION MANAGEMENT/INFORMATION TECHNOLOGY (IM/IT)
CAMPBELL RIVER HOSPITAL
ROOM
ID
ROOM TYPE
(RID)
Administrative and Education Centre
01
Receiving/Equipment
Marshalling/ Storage
Room
Technical Work Area
02 Workbench, Break/ Fix
Repair
OS-STL.04 Information Management/Information Technology (IM/IT)
ROOM
NUMBER
TOTAL
CONTENTS/KEY FEATURES/DESIGN
SIZE
OF
SIZE
CRITERIA
(nsm)
ROOMS
(nsm)
Secured room
5.0
1
5.0
Subtotal, Administration and Education Centre
5.0
10 Networks drops, sufficient power to charge
equipment is required.
3
2
6.0
03
Storage, Equipment
Hot Swap Items, Computers, Monitors, printers.
Include power outlets, shelving, ensure
appropriate temperature and airflow
requirements. Room must be secured, with
limited access (e.g. key card access)
20
1
20.0
04
05
06
Workstation, Staff
Workstation, Staff
Workstation, Staff
IBM Contracted Staff
VIHA Desktop Staff
1 Telehealth, (2) SWING DESKS for visiting/
rotating staff
3.0
3.0
3.0
2
2
2
6.0
6.0
6.0
07
08
09
Workstation, Staff
Office, First Line Leader
Server Room, Computer
Clinical Informatics
3.0
2
Clinical Informatics Director/ IMIT
10.0
1
Environmentally controlled room w/ alarms tied
15.0
1
into FMO monitoring systems - Raised flooring
- Provided w/ emergency electrical power &
UPS. Requires Raised floor. Locate proximate
to IT work areas
Subtotal, Technical Work Area
6.0
10.0
15.0
TOTAL NSM, ALL AREAS
80.0
75.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.05
MATERIEL MANAGEMENT
This specification outlines the functional, operational and physical requirements for the Materiel
Management functional component.
22.1 FUNCTIONAL DESCRIPTION
22.1.1 Statement of Purpose
22.1.1.1 The Materiel Management component will accommodate vendor selection and the
ordering, purchasing, receiving, processing and distributing of most items used in the
Facility. Incoming and outgoing mail will be processed through this area, as will most
outgoing equipment soiled/contaminated items and wastes.
22.1.2 Scope of Services
22.1.2.1 Functional Content
22.1.2.1.1
Functions occurring within this component will complement those
occurring in the Environmental Services component (See OS-STL.03).
Generally, incoming (to the Facility) items will flow through Materiel
Management, whereas outgoing items will flow through Environmental
Services. Provision will be made in both components for storage/holding
of items that will not be immediately transported to their point of use.
22.1.2.1.2
The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
22.1.2.1.2.1
Receiving of electronic purchase orders from all user components
in the Facility
22.1.2.1.2.2
Submitting purchase requisitions to the VIHA purchasing system or
directly to vendors
22.1.2.1.2.3
Receipt of incoming and outgoing items in the following categories
(includes checking against purchase orders/packing slips where
applicable):
22.1.1.1.1.1.1
Equipment (New incoming equipment and outgoing
equipment in need of maintenance or repair by
private/off-site vendors or being sent for disposal)
22.1.1.1.1.1.2
Consumable supplies, including medical/surgical
supplies (Combination of flow-through and bulk storage
functions)
22.1.1.1.1.1.3
Pharmaceuticals (Incoming purchases – Flow through
function only)
22.1.1.1.1.1.4
Cytotoxic/hazardous materials (Incoming purchases –
Flow through function only)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.05
MATERIEL MANAGEMENT
22.1.1.1.1.1.5
Food products (Incoming dry goods – Flow through
function only)
22.1.1.1.1.1.6
Mail (Incoming and outgoing)
22.1.2.1.2.4
Centralized storage of full and empty gas cylinders
22.1.2.1.2.5
Centralized storage of clean/usable and contaminated/un-usable
flammable substances
22.1.2.1.2.6
Centralized storage of inventory for the Auxiliary Gift Shop (See
OS-GP.04 Public Support Services)
22.1.2.2 Exclusions
22.1.2.2.1
The following list specifies functions conducted by Materiel Management
personnel that are understood to occur in other components in the
Facility, outside of the Facility or be conducted by other authorities:
22.1.2.2.1.1
Receipt of prepared foods and meals and raw ingredients
(Assumed delivered directly to OS-STL.06 Nutrition and Food
Services)
22.1.2.2.1.2
Inventory checking of pharmaceuticals (Receiving function only
with inventory control residing with the Pharmacy component (See
DT.06)
22.1.2.2.1.3
Large volume printing and copying services (Assumed
accommodated off-site by private vendors)
22.1.2.2.1.4
Flow through of cadavers leaving the Facility
22.1.2.2.1.5
Flow through of pharmaceutical products being sent off-site for
disposal
22.1.2.2.1.6
Management and operation of the Facility’s cylinder gas/tank farm
and medical gas manifold (Assumed located exterior to the
building and under the control of Project Co.)
22.1.2.2.1.7
Staff Support (See OS-GP.03 Central Staff Facilities
22.1.2.3 Anticipated Trends in Service Delivery
22.1.2.3.1
The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.05
MATERIEL MANAGEMENT
22.1.2.3.1.1
Inventory management in the Facility and in the individual
components will shift towards “just-in-time” management, reducing
the needs for centralized and decentralized bulk storage
requirements. Success of this system will depend upon a fully
automated inventory control system (i.e., no manual inventory
control), and an automated off-site warehousing facility.
22.1.2.3.1.2
As priority is given to accommodating clinical services on-site,
Materiel Management will take on more of a role of supply chain
management. This will mean more flow-through of goods and
services and less warehousing functions. Decentralized stores
areas will be accommodated in the Facility’s various components
as required.
22.1.3 Scope of Education Functions
22.1.3.1 Education conducted in this component will focus on in-service training and orientation
for new staff. These functions will be accommodated in the general workspace
provided, and there will be no need for dedicated or purpose-built teaching spaces.
22.2 OPERATIONAL DESCRIPTION
22.2.1 LEAN Planning Standards
22.2.1.1 Minimal Personnel Circulation
22.2.1.1.1
Materiel Management staff will spend substantial portions of each work
shift circulating between this component and all other areas of the
Facility. Efficiencies in circulation will require the location of this
component immediately accessible to major non-public vertical and
horizontal circulation routes to all areas of the Facility.
22.2.1.2 Reduced Materials Handling
22.2.1.2.1
Efficiency in processing of received items will rely on reduced steps of
processing. Wherever practicable, received goods will be transported
directly to the user component for inventory control. An overriding
guideline to this general principle will be needs for centralized (to the
Facility) storage of items.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.05
MATERIEL MANAGEMENT
22.2.1.3 Pneumatic Tube Distribution
22.2.1.3.1
Manpower and time spent distributing small items, often in response to
STAT requests, will be diminished by a Facility-wide pneumatic tube
system. Planning assumes that a tube station will be located close to
inventories of supplies that are eligible for mechanical transport (i.e.,
durable and required by user areas serviced by a tube station).
22.2.2 Hours of Operation
22.2.2.1 The Materiel Management component at this Facility will be staffed and in operation:
22.2.2.1.1
0600 to 2100, Monday to Friday
22.2.2.1.2
0900 – 1600, Saturday and Sunday
22.2.2.2 Outside the routine hours of operation listed above and depending upon the nature of
service(s) required, delivery services will be available on an on-call basis and provided
by personnel dispatched from the Equipment Depot component (See OS-STL.08).
22.2.3 People Management Systems
22.2.3.1 The component will serve as a “home base” for Materiel Management personnel in
which informal meetings, training sessions and assignment briefings will be conducted.
22.2.3.2 This component will be restricted to authorized employees and vendors only. No public
presence will be accommodated here, and controlled access shall be provided off a
major, non-public circulation route. Separate points of entrance/exit connecting to
circulation routes shall be provided for pedestrians and for carts, dollies and tugs used
in distributing materials.
22.2.4 Materiel Management Systems
22.2.4.1 Receiving and Distribution
22.2.4.1.1
All deliveries to the Facility, with the exception of all pharmaceuticals and
prepared/raw food products, will be conducted through this component.
Deliveries will generally coincide with reconciliation against purchase
orders and packing slips before items are delivered to the user
component. Order discrepancies and disputes between purchasers and
vendors will be referred back to this component for reconciliation.
22.2.4.1.2
Incoming processed linen, reusable items destined for the Medical
Device Reprocessing Department (See OS-STL.09) and mail will be
received in designated areas. Mail will be sorted and distributed from
Materiel Management, but linen and MDRD items will be transported to
their destinations with minimal holding time here.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.05
MATERIEL MANAGEMENT
22.2.4.1.3
All outgoing items will generally be prepared in the user component (i.e.,
Documentation and packaging) before being sent to Materiel
Management where shipping requisitions and arrangements will be
made.
22.2.4.1.4
The Facility’s portering services will be used to assure prompt handling
and delivery of time-sensitive items.
22.2.4.2 Waste Management
22.2.4.2.1
To the extent practicable, waste products will be generally managed
according to a system of segregation at point of origin and sequential
consolidation. Operation of this system relies on appropriate containment
facilities for each type of waste product beginning at where the waste is
generated followed by similar, but progressively larger, containment
facilities at key collection locations.
22.2.4.2.2
In the Materiel Management component, waste handling will focus on
designated holding areas to accommodate consolidated temporary
holding of the following product categories:
22.2.4.2.2.1
General garbage
22.2.4.2.2.2
Sharps (including potentially biohazardous items)
22.2.4.2.2.3
Infectious or contaminated wastes (excluding sharps)
22.2.4.2.2.4
Confidential paper
22.2.4.2.2.5
Clean paper and cardboard
22.2.4.2.2.6
Clean metal (tin and aluminum)
22.2.4.2.2.7
Clean recyclable plastics
22.2.4.2.2.8
Compostables
22.2.4.2.3
In addition to its role in waste management, this component will also
provide temporary holding of items for off-site transport. Categories will
include:
22.2.4.2.3.1
Soiled/contaminated linen
22.2.4.2.3.2
Processed items from MDRD destined for other HCFs
22.2.4.2.3.3
Mail
22.2.5 Information Management Systems
22.2.5.1 Purchasing and Inventory Control
22.2.5.1.1
Component personnel will maintain an electronic library of approved
vendors for selected items, especially those characterized by high
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.05
MATERIEL MANAGEMENT
volume and frequent ordering.
22.2.5.1.2
Requisitions from user areas will be submitted electronically into the
Authority’s purchasing system. Most purchased items will be delivered to
Materiel Management where orders will be checked against packing slips
and purchase orders. Some items will be taken into central warehousing
facilities, but the general trend will be to transport items directly to user
areas.
22.2.5.2 Consumable Supply Management
22.2.5.2.1
Wherever practicable, inventories of consumable supplies in user areas
will rely on a 2-bin system. Under this system, stock will be drawn first
from a top/front bin. When the last item has been removed, an electronic
tag will be placed on a monitoring board which will trigger the reordering
process in Materiel Management. The empty bin will be replaced with the
one previously being held as standby. Two (2) tags on a monitoring
board from the same type of storage bin will trigger a STAT order and
delivery process.
22.3 DESIGN CRITERIA
22.3.1 LEAN Planning Standards
22.3.1.1 Efficiencies in moving and manoeuvring large pieces of equipment will require wide
hallways and wide doorways throughout the Facility. Entrances to this component must
be sufficiently wide to accommodate large pieces of equipment including mobile pallet
trucks. All doorways installed in this component and which accommodate the
movement of goods arriving at or leaving the Facility must be a minimum of 2,440 mm.
(approximately 8’) wide and 3,050 mm. (approximately 10’) high.
22.3.2 Proximity Relationships
22.3.2.1 The Environmental Services component’s location relative to other components and the
nature of circulation used to move between 2 components are illustrated in the diagram
below. Proximities are listed according to rank; higher priorities appear above lower
priorities.
Materiel Management Environmental Services 22.3.2.2 Provide Direct Access by General
Circulation to Environmental Services for the
coordinated movement of items to/from the
Facility.
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Materiel Management MDRD Materiel Management Main Horizontal/ Vertical Circulation 22.3.2.3 Provide Convenient Access by General
Circulation to Medical Device Reprocessing
Department for movement of equipment,
supplies and staff.
22.3.2.4 Provide Convenient Access by General
Circulation to major public and non-public
circulation. Materiel Management personnel,
supplies and pieces of large equipment will
move frequently to/from this component and
all areas in the Facility.
22.3.3 Internal Design Criteria
22.3.3.1 General Internal Layout
22.3.3.1.1
The interior of this component shall be organized into 2 zones as follows:
22.3.3.1.1.1
Administrative work area
22.3.3.1.1.2
Industrial area including equipment and supplies marshalling and
shipping area and general inventory stores areas
22.3.3.2 Physical Relationship with Environmental Services
22.3.3.2.1
Functions occurring in this component will complement those occurring
in Environmental Services (See OS-STL.03). Achieving efficiencies in
the coordinated flow of items both coming onto and leaving the Facility
will require these 2 components sharing adjacent locations and access to
a common loading dock. The loading dock will be part of neither
component, but planning assumes designated areas along the dock’s
expanse that support functions of 1 component or the either. It is further
assumed that designated spaces will cluster near points of
access/egress for the appropriate component.
22.3.3.2.2
Planning assumes that Materiel Management and Environmental
Services will be adjacent components. There shall not, however, be any
internal circulation connections between the two; it is recommended that
a secured corridor be used as a partition. This corridor will have a
secured, monitored doorway leading from the loading dock, and
connecting directly with the Facility’s internal non-public circulation
system. There will be no direct connections off this corridor into either
Materiel Management or Environmental Services. The purpose of this
corridor will be to accommodate couriers arriving on-site to deliver/pickup items directly to/from other components in the Facility. Access to this
corridor may be unrestricted during normal, day-time business hours of
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operation, but will be monitored and controlled by Protections Services
personnel during off-hours. The monitoring station will be located in the
Emergency Department (See AC.01), and provision will be made for
continuous voice contact capability between the courier doorway
intercom system and Protection Services officers’ portable radios.
22.3.3.3 Secured Access:
22.3.3.3.1
Provide secured card access throughout the materials management
area. This area has complex security needs that will be provided in
consultation with the Authority.
22.3.3.4 Mail Room
22.3.3.4.1
Mailrooms at both facilities (Comox and Campbell River) will be the
same in construction, layout and equipment.
22.3.3.4.2
Mail describes the processing and movement of internal (throughout the
Authority), federal (Postage) and small parcels for inbound and outbound
items.
22.3.3.4.3
Mail stations within the facility will be in secured locations. Card access
to authorized employees only. Mail stations shall be behind glass walls.
Walls need not reach the ceiling.
22.3.3.4.4
Mail Centre shall be located near Receiving area.
22.3.3.4.5
Some mail will be sent via pneumatic tube system.
22.3.3.4.6
Physician mail will be delivered to the Physician’s lounge.
22.3.3.4.7
There shall be corridor access to the mailroom.
22.3.3.4.8
Mail Room Design Criteria
22.3.3.4.8.1
The mail room shall be approximately 4500mm square.
22.3.3.4.8.2
The floor shall be concrete with floor drains and is sealed with
waterproof sealant. Paint shall not be used on the floor in this area.
22.3.3.4.8.3
Walls shall be covered with a durable materiel. This shall be easy
to clean and resistant to cleaning chemicals.
22.3.3.4.8.4
The ceiling shall be 2400mm high with air exchange to provide
fresh air into the space.
22.3.3.4.8.5
Provide no less than six sets of Wall plugs. Plugs shall be
approximately 914mm above the finished floor.
22.3.3.4.8.6
Provide no less than three separate Data lines and outlets.
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22.3.3.5 Stores Area
22.3.3.5.1
Provide an electric pallet jack recharging station in the equipment room.
This recharging station shall be mounted to the wall and allow docking of
pallet jacks. This area shall include an eye wash station.
22.3.3.6 Bulk Storage Room
22.3.3.6.1
Provide an RFID system. Provide a stainless steel hand wash sink.
Provide an eye wash station. Provide workstations for business center
functions including a recharging station.
22.3.3.6.2
Provide secured steel pallet racking that is secured from lateral
(earthquake) forces. Provide a space that accommodates stores stacks
of 4800mm minimum height. Provide space for two refrigerators that are
centrally monitored. Provide no less than four full height lockers. Ensure
that the pallet racking does not cover the ceiling lights. The floors shall
have proper finishing allowing for extreme wear by pallets and heavy
equipment. Provide a cabinet work surface with storage cabinets below
that is no less than 1800mm in length and 914mm wide, close to the
primary corridor entrance door. Provide a wall phone on the loading dock
that connects the dock to the Bulk Storage area. Provide a large
industrial floor scale.
22.3.3.7 Warehouse Space Flexibility
22.3.3.7.1
Ceilings throughout the component must be a minimum of 4,270 mm.
(approximately 14’) in height to accommodate high-density, tiered
storage of consumable supplies.
22.3.3.7.2
Future needs for warehouse space will vary according to the model
adopted for on-site handling of materiel. Warehouse space designated in
the planning and design phases of this Facility must be located in an
area where conversion for other uses can be accomplished efficiently
and without disrupting other component operations. The potential for
conversion to accommodate clinical services would be ideal, but unlikely
due to the tendency for warehouse space to occupy “industrial” parts of a
building.
22.3.3.8 Infection Control
22.3.3.8.1
Arriving and departing items will include both the clean and soiled states.
While measures will be taken to segregate incoming from outgoing
streams, a second level of segregation will be used to separate clean
and soiled items (e.g., Outgoing MDRD processed items and outgoing
soiled linen).
22.3.3.8.2
Refrigerated and vented storage areas will be required for some
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contaminated, biohazardous items.
22.3.3.9 Flammable Storage Room
22.3.3.9.1
Separate rooms must be provided for incoming (clean) and outgoing
(used/contaminated) flammable products. These 2 rooms must be
physically distinct and separated from one another to avoid mixing of
usable versus non-usable products.
22.3.3.9.2
This room must have a minimum fire resistance rating of 1 hour.
22.3.3.9.3
A flammable storage room must be located with at least 1 wall being an
exterior building wall; this will have “blow-out” capability. The door to this
room must be automatically closing and must be hinged to swing out on
its vertical axis.
22.3.3.9.4
Flooring will be non-skid and anti-spark material. The floor will be
equipped with a drain connected to a dry sump. There will be liquid-tight
seals between interior walls and the floor. Any door opening which is not
part of an exterior wall will have a liquid-tight ramped sill.
22.3.3.9.5
The room will have passive ventilation created by the installation of
upper and lower gravity louvers in the exterior wall.
22.3.3.10 Options for Exterior Location
22.3.3.10.1
All spaces dedicated for materiel management do not require interior
space. Certain holding areas for soiled/contaminated items and waste
products, for example, may be stored in designated areas outside of the
building envelope. Benefits of using exterior space include less
expensive construction and fewer measures required for environmental
control (e.g., ventilation for odour control).
22.3.3.10.2
Compactors and recycled cardboard bins are obvious candidates for
outside accommodation, provided they are covered and protected from
precipitation. Other designated holding areas cited in this specification
shall be considered for locating outside, subject to being able to provide
adequate control, access and security. Possible choices are:
22.3.3.10.2.1 General waste holding
22.3.3.10.2.2 Compostable waste holding
22.3.3.10.2.3 Biohazardous waste holding
22.3.3.10.2.4 Gas cylinder storage
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22.3.3.11 Occupational Health and Safety
22.3.3.11.1
Spill kits, eyewash stations and an emergency deluge shower shall be
installed close to any chemical storage location. A floor drain shall be
installed below the shower outlet.
22.3.3.11.2
Flooring throughout the component must be non-slip and resilient to
chemicals, abrasion and damage from dropped objects.
22.3.3.11.3
The component’s overall configuration and devices installed/used in the
various areas shall be designed to minimize staff having to manually lift,
push, pull or carry objects.
22.3.3.12 Environmental Control
22.3.3.12.1
Exhaust gases from vehicles using the loading dock area must not be
allowed to enter the Facility either through passive air exchange or
through air intake and handling systems.
22.3.3.12.2
Interior areas immediately adjacent to the loading docks must be
provided with climate controls enabling heating and cooling
independently from other component areas.
22.3.3.13 Mezzanine
22.3.3.13.1
Provide a mezzanine in the Bulk Storage Room (RID 05 in Campbell
River and RID 05 in Comox Valley) that covers no less than half the floor
area. Provide standing height room in the mezzanine area of no less
than 2400mm in height. Provide standing height under the mezzanine
area of no less than 2400mm in height.
22.3.3.14 Pneumatic Tube Station
22.3.3.14.1
A pneumatic tube system will be used to transport specimens and small
parts/items.
22.3.3.15 Loading Dock Specifications
22.3.3.15.1
Full dimensions of the loading dock will be determined, in part, by the
design and configuration of this component and of the adjacent
Environmental Services component. At a minimum, the depth of the
loading dock platform, as measured from the wall surface forming the
curb of the truck docking area (pit wall) to the opposing exterior wall of
the Facility, must be 4,270 mm (approximately 14’). It shall be planned
as a continuous-run platform free of structural supports, changes in
grade, raised seems or feature that could impede movement of items,
many of which will be manually transported on dollies, carts and hand
trucks. Organize the loading dock as shown in Diagram 2. The loading
dock surface must be non-skid, non-porous and anti-static.
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22.3.3.15.2
The upper portion of the curb must be protected by a molded or
laminated rubber bumper of not less than 100 mm. (approximately 4”).
The intent of this feature is to protect both the building and trucks from
impact damage.
22.3.3.15.3
Ramps located at both extreme ends of the loading dock must be
installed to accommodate manual transport of items from the driveway
bed to the loading dock surface. The ramp may be either straight run or
curved, but must not be switch-backed. The ramp’s maximum grade will
be in compliance with prevailing WorkSafe BC (WSBC) standards for
these features.
22.3.3.15.4
A set of safety stairs must be installed in the vicinity of the doorway
leading to the corridor that separates Materiel Management from
Environmental Services. In addition to providing emergency
access/egress between the loading dock and driveway bed, this stairway
will also be used by couriers who will typically arrive in light duty (i.e., low
level) vehicles and who will not require the use of a ramp.
22.3.3.15.5
The loading dock area will not be enclosed, but must be covered by
overhanging portions (canopy) of the Facility. Minimum clearance
between dock surface and the canopy will be determined, in part, by the
depth of the driveway bed and the maximum dimensions of truck/trailers
that will arrive at this Facility. Clearance will be not less than 4,270 mm.
(approximately 14’). The horizontal run of the canopy, as measured
perpendicularly from the Facility’s wall towards the opposing driveway,
will extend to at least the pit wall (i.e., covering the entire loading dock
surface). Requirements for additional coverage must be considered
depending upon the loading dock’s orientation with respect to prevailing
winter storm directions. Maximum weather protection must be a planning
criterion.
22.3.3.15.6
Dimensions of the loading dock must provide for segregation of materiel
streams. There must be clear separation between incoming (typically
clean) items as opposed to outgoing (typically soiled, contaminated or
used and being sent for salvage) items. Ample space must be allowed
for the following:
22.3.3.15.6.1 General waste (trash) compactor
22.3.3.15.6.2 Cardboard compactor
22.3.3.15.6.3 Recycling totes (segregated for glass, metals, plastics/Styrofoam,
paper)
22.3.3.15.6.4 Compostable materials
22.3.3.15.7
Specifications for each of the preceding categories must be explored in
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detail with loading dock users prior to its design.
22.3.3.15.8
Radio frequency identification (RFID) sensors must be installed in the
ceiling of the canopy to record and track equipment items arriving at and
leaving the Facility.
22.3.3.15.9
The Facility wall forming the exterior limits of the loading dock surface
must be serviced by 115 VAC electrical outlets. Positioning of these
outlets will be determined, in part, by the Facility’s design, but installation
must be between 1,070 mm. and 1,370 mm. (approximately 42” and 54”)
above the dock’s surface. The maximum horizontal distance between
outlets shall not more than 4,570 mm. (approximately 15’).
22.3.3.15.10 The loading dock and driveway areas must be supplied with lighting for
safety and security purposes. Automatic sensors responding to ambient
light conditions must be installed near the top of the Facility, and not in
an area subject to shadows or reflected light. Automatic motion sensors
must provide surveillance over the entire loading dock surface, ramps,
stairwell and driveway. During daylight hours, the ambient light sensors
shall have priority and during hours between sunset and sunrise, the
motion sensors shall have priority.
22.3.3.15.11 The driveway must accommodate at least 2 truck berths. Subject to the
Facility’s design and configuration, consideration shall be given to
accommodating a third berth to achieve maximum efficiency in truck
arrivals and departures. One (1) berth must have a driveway surface
1,020 mm. (approximately 40”) below loading dock surface, and the
other berth(s) must have a driveway surface 1,400 mm. (approximately
55”) below loading dock surface. All truck berths must be not less than
4,000 mm. (approximately 13’) in width.
22.3.3.15.12 Each truck berth will be supplied with a recessed dock leveler capable of
achieving a maximum grade of 10% (downwards from truck to loading
dock). Final dimensions and capacities of the dock levelers will be
determined, in part, by the anticipated maximum truck size and transport
vehicle (i.e., forklift, hand truck, cart, and dolly) plus payload to be
accommodated. Materiel Management personnel must be consulted
prior to final selection of the levelling system to be installed. Controls for
each leveling system must be located away from the vicinity of the
leveler to avoid unintentional activation while in use.
22.3.3.15.13 Light duty vehicle parking spaces shall be incorporated into the
driveway’s design, and in the vicinity of the ramps and safety stairwell.
22.3.3.15.14 Design, configuration, orientation and maximum permissible grade of the
driveway will be determined, in part, by the Facility’s design and
configuration, choice of truck berth configuration (i.e., straight line or saw
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tooth), site grade/topography/availability and the maximum
dimensions/weight of vehicles anticipated to use the driveway.
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22.3.4 Component Functional Diagram
22.3.4.1 The areas making up this component shall be organized as illustrated in the following
diagrams:
22.3.4.1.1
DIAGRAM 1: Component Organization
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22.3.4.1.2
DIAGRAM 2: Loading Dock
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22.3.5 Space Table
22.3.5.1 The schedule accompanying this document illustrates rooms, and their respective
sizes, that combine to make up this functional component. Refer to the respective
space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY
ROOM
ID (RID)
OS-STL.05 Materials Management
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
23.0
TOTAL
SIZE
(nsm)
Post Receiving Area
01
Post Receiving Bay
Open area w/ scale - Directly connected to
exterior loading dock w/ mechanical dock to
accommodate truck beds of varying heights
1
23.0
02
03
Office, Private, Receiving
Staff Lounge
2 multipurpose wrkstns
15.0
1
Seating area, refreshments (coffee, microwave,
15.0
1
refrig., sink) - Staff check-in and assignment
with two (2) workstations, bulletin board, mail
slots and 80 purse lockers configured 4 rows
high
[NOTE: Space moved from OS-STL.03]
Subtotal, Post Receiving Area
15.0
15.0
1 multipurpose wrkstn w/ files storage - Meeting
with 1-2 people
Stores Area
04 Office, First Line Leader
05
06
Storage Room, Bulk
Storage Cubicle, Secured
Accommodates valuable items, temporary
holding of pharmaceuticals
07
08
09
Cart Marshalling Area
Decasing Area
Flammable Storage
Room, Clean
Space for 22 exchange/top-up carts
10
11
12
13
Retail Storage Area
Workstation, Clerical
Mail Room
Housekeeping Room
14
Flammable Storage Room,
Contaminated
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
See Internal Design Criteria, E. Flammable
Storage Room for specifications
15
Holding Room, Equipment
Short-term holding of outgoing equipment
See Internal Design Criteria, E. Flammable
Storage Room for specifications
1 multipurpose wrkstn
53.0
10.0
1
10.0
160.
0
6.0
1
160.0
1
6.0
50.0
16.0
20.0
1
1
1
50.0
16.0
20.0
4.5
4.5
23.0
6.0
1
1
1
0
4.5
4.5
23.0
0.0
15.0
1
15.0
16.0
1
16.0
Subtotal, Stores Area
325.0
TOTAL NSM, ALL AREAS
378.0
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CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
OS-STL.05 Materials Management
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
23.0
TOTAL
SIZE
(nsm)
Post Receiving Area
01
Post Receiving Bay
Open area w/ scale - Directly connected to
exterior loading dock w/ mechanical dock to
accommodate truck beds of varying heights
1
23.0
02
03
Office, Private, Receiving
Staff Lounge
1 multipurpose wrkstn
10.0
1
Seating area, refreshments (coffee, microwave,
15.0
1
refrig., sink) - Staff check-in and assignment
with two (2) workstations, bulletin board, mail
slots and 80 purse lockers configured 4 rows
high
[NOTE: Space moved from OS-STL.03]
Subtotal, Post Receiving Area
10.0
15.0
1 multipurpose wrkstn w/ files storage - Meeting
with 1-2 people
Stores Area
04 Office, First Line Leader
05
Storage Room, Bulk
48.0
10.
0
1
10.0
128
.0
6.0
1
128.0
1
6.0
06
Storage Cubicle, Secured
Accommodates valuable items, temporary
holding of pharmaceuticals
07
Cart Marshalling Area
Space for 15 exchange/top-up carts Medical/surgical supplies
30.
0
1
30.0
08
Decasing Area
1
12.0
09
Flammable Storage
Room, Clean
See Internal Design Criteria, E. Flammable
Storage Room for specifications
12.
0
20.
0
1
20.0
10
11
Retail Storage Area
Workstation, Clerical
1 multipurpose wrkstn
4.5
4.5
1
1
4.5
4.5
12
Mail Room
12.
0
1
12.0
13
[Intentionally left blank]
14
Flammable Storage Room,
Contaminated
See Internal Design Criteria, E. Flammable
Storage Room for specifications
15.
0
1
15.0
15
Holding Room, Equipment
Short-term holding of outgoing equipment
12.
1
0
Subtotal, Stores Area
12.0
254.0
TOTAL NSM, ALL AREAS
302.0
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FOOD SERVICES
This specification outlines the functional, operational and physical requirements for the Food Services
functional component at the Comox Valley Hospital and Campbell River Hospitals (the Facilities).
23.1 FUNCTIONAL DESCRIPTION
23.1.1 Statement of Purpose
23.1.1.1 Food Services will include a patient focused meal service approach providing patients
with ability to make selection prior to service and a retail program to support staff and
visitor meal service. The scope of food service will include in-patient meal service, outpatient meals, and retail / cafeteria food services, vending; and catering.
23.1.2 Scope of Services
23.1.2.1 Patient Food Services
23.1.2.1.1 The patient food system at each Facility will be predicated on a spoken
menu concept whereby food service personnel will facilitate patient meal
selection at bedside in advance of service.
23.1.2.1.2 Food Service personnel will facilitate orders at least twice per day (typically
an hour or two in advance of lunch and supper with next day breakfast
selection facilitated along with supper selection in mid afternoon).
23.1.2.1.3 Meal orders are entered into electronic tablet or hand held technology
which automatically transmits meal selection to the central kitchen.
Associates then return either to the central kitchen and assemble meals
using lean cell / pod assembly or plate from pantries located on each floor.
The facilities programmed will support the flexibility to accommodate either
a central or decentralized plating approach or combination of the two.
Once assembled, meals are then distributed to patient units and delivered
to patients at bed side, or in the case of Psychiatry Unit (IP.04) for “family
style” dining.
23.1.2.1.4 The model will be designed so as to allow for flexibility in production,
procurement and meal assembly.
23.1.2.1.5 Specifically, the production capabilities at each facility will be designed to
support alternate levels of in-house production versus food procurement
(that is the purchase of pre-prepared chilled and frozen bulk menu items
such as bagged soups and stews, casseroles, pre-cooked and
frozen/chilled meats, vegetables, chilled/frozen therapeutic diets and in
some instances pre-portioned entrée items).
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23.1.2.1.6 With respect to meal assembly, these functions will be designed to
accommodate hot meal assembly utilizing heat on demand technology and
cell assembly. However the assembly area should be flexible so as to
allow for accommodation of chilled meal assembly whereby items are
plated cold and reheated in advance utilizing combi-oven, retherm or
microwave technology. Cell assembly systems are to be used in either
application.
23.1.2.1.7 For meals assembled centrally, at minimum, a meal assembly cell will be
provided for every 100 to 125 beds. Once assembled, meal trays will be
placed in transport carts and delivered to patient units. Tray and cart
technology utilized will allow for proper holding of temperatures during
transport. Following meal service, all carts, trays and service wares will be
returned to the central kitchen for warewashing and sanitation.
23.1.2.1.8 For meals to be plated decentrally in on-unit pantries, individual meals
and/or meal components will be plated and packaged within the central
kitchen distributed to the pantries chilled and reheated within the pantry.
Retherm / reheating technology will be used to support reheat of meals
within pantries.
23.1.2.1.9 In addition to daily meals, patients will also be provided with daily
nourishments, snacks and supplements. Nourishments will be prepared
and delivered by Food Service personnel. Evening nourishments will be
stocked in on-unit ward kitchens along with snacks and supplements.
Nourishments and supplies will be single wrapped rather than bulk
dispensed to prevent cross contamination in this nourishment centres.
Food Service personnel will stock ward kitchens to specific par levels on a
daily basis.
23.1.2.2 Retail food services
23.1.2.2.1 Visitors, outpatients and staff food service will be provided from main
cafeteria / bistro. The cafeteria/ bistro will be located in a high staff and
visitor traffic area. Retail food service facilities will consist of a cafe
servery, dedicated back of house support space and seating area
(complete with condiment station). The back of house support area will
include storage, preparation/production and warewashing facilities.
Vending machines will be provided adjacent to the seating area to provide
beverage and grab and go items. Vending machines will be accessible 24
hours, 7 days per week. Hand hygiene sinks will be available in the
cafeteria area. At least 1 sink must be wheelchair accessible height.
23.1.2.2.2 Catering will be provided on a requisition basis. Catering will be provided
from the retail services support facilities.
23.1.2.3 Anticipated Trends in Service Delivery
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FOOD SERVICES
23.1.2.3.1 It is anticipated that in-patient and staff and visitor food service trends will
evolve during the course of the development and during the life of the new
facilities. As a result, flexibility has been built into the program herein so as
to allow for some alteration in the delivery model going forward including
but not limited to:
23.1.2.3.1.1
Altering production versus procurement mix;
23.1.2.3.1.2
Altering service delivery approach;
23.1.2.3.1.3
Ability to alter service delivery to meet each patient’s needs as
opposed to provision on a fixed schedule.
23.1.2.3.1.4
Allowance for both central and decentralized (on-unit) service
models; and
23.1.2.3.1.5
Allowance for in-house or third party operation of retail food
services.
23.1.2.4 27.2.4 Exclusions
23.1.2.4.1 Focus of Food Service will be delivery of in-patient, staff and visitor meals.
Community based programs such as meals on wheels, wheels to meals,
etc. will not be provided within the new hospitals and have not been
accounted for in this program.
23.2 OPERATIONAL DESCRIPTION
23.2.1 Hours of Operation
23.2.1.1 Food service functions at each facility will operate seven days per week, with hours to
support the provision of three meals and three nourishments per day.
23.2.1.2 Retail food service will be staffed and in operation over shift and a half, 7 days per
week or as demand warrants. Vending will be accessible 24 hours, 7 days per week.
23.2.2 Operational Process Description: Patient Food Service
23.2.2.1 All food products and other supplies will be specified and purchased by food services
personnel.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.2.2.2 Perishable and non-perishable food product and supplies will be obtained from
commercial and private purveyors regularly throughout the week Monday through
Saturday. All incoming goods will be removed from transport vehicles and placed onto
the receiving platform. Commercial food purveyors will transport the incoming goods
from the receiving platform to the kitchen. Food services staff will receive and verify
the shipment orders. Perishable food products will be decased, weighed, audited for
quantity. Patient food service menu items will then be moved directly to the kitchen
and placed in appropriate refrigerated, frozen and dry good storage rooms. These
items will be placed immediately on the food services inventory.
23.2.2.3 Paper and chemical supplies will be purchased, received and stored in the kitchen (to
support patient food service) or in the retail support kitchen (to support cafeteria/bistro
and catering operations).
23.2.2.4 On a daily basis, raw food products and semi processed food items will be removed
from appropriate refrigerated, frozen and dry goods storage rooms and moved to the
preparation and production areas. On-premise production capabilities will be provided
to support in-house conventional cooking of selected menu items. Conventional
production systems and blast chilling technology will be utilized in compliance with
HACCP (Hazardous Analysis Critical Control point) standards. In-house food
production will also be supplemented with selected items procured from private and
commercial purveyors.
23.2.2.5 For each meal, menu items will be assembled centrally (in accordance with patient
menu selections), placed in carts and distributed to patient at bed side. Ergonomically
friendly carts will be utilized. Food Service personnel will deliver fully assembled meal
trays to patients at bed side. Meal assembly will consist of pod/cell meal assembly
system rather than traditional belt line to maximize efficiency and effectiveness. Meals
will be either assembled hot prior to traditional meal times utilizing heat on demand
technology or assembled chilled and reheated utilizing retherm technology (i.e combioven, or microwave technology). Following meal assembly Food Service personnel will
deliver meals to patients at bed side.
23.2.2.6 In addition, on-unit pantries will also be provided to allow for flexibility to utilize a
decentralized service model for all or some of the units if desired. With the
decentralized model, individual meals will continue to be plated centrally however they
will be plated cold and sent to on unit pantries in a chilled format. Individual meal
components will be reheated utilizing retherm technology and full trays assembled
within the pantries and delivered to patients at bed side.
23.2.2.7 Patients will be offered a selective menu. Menu selections will be facilitated by Food
Service personnel in advance of service. Patients will be provided menus in
accordance with their diet profile. Wireless tablets will be used to facilitate meal
selection and transmit orders back to the central kitchen
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.2.2.8 After meal service, food service staff will be responsible for collecting soiled trays and
service wares from patient rooms and returning them to the main kitchen for
warewashing. Organic and inorganic waste will be collected in order to be decomposed
and/or digested within the warewashing room. Separate soiled tray return carts will be
maintained on the unit to allow for collection of soiled trays and service wares
throughout the day (including in-between meal periods). Cart closets will be provided
so that carts do not remain in the corridors.
23.2.2.9 Each unit will also contain ward kitchen for stock of nourishments and snacks. The
ward kitchen will contain ice machine, refrigerator, domestic toaster, coffee maker and
tea kettle.
23.2.2.10 Food service department will be responsible for cleaning all food related prep and
service areas.
23.2.3 Patient Menu
23.2.3.1 The menu will be based on a selective style approach whereby patients will be offered
choices of menu items daily. Orders will be facilitated through visitation from food
service staff on a room to room basis. Orders are then entered onto a handheld device
which communicates to the diet office.
23.2.3.2 The menu will be based on a cyclical menu. The menu offering will ensure variety to
account for patient allergy requirements, diet restrictions, ethnic and cultural diversity
and personal preferences.
23.2.4 Food Services Information Management System
23.2.4.1 VIHA currently utilizes a CBORD food service information management system. This
system will be maintained to support the operation of food services. The specific
device requirements and selection to support the service delivery have not been
determined at this date. Project Co will not be responsible to provide software or
handheld devices for the CBORD food service information management system.
23.2.4.2 Handheld devices with wireless interface to the Food Service information management
system will be used to enter patient orders prior to meal service.
23.2.5 Operational Process Description: Retail Food Service
23.2.5.1 Meal service for visitors, outpatients and staff will be provided from a cafeteria / bistro
and vending machines. Catering will be provided on a requisition basis. Products for
cafeteria, vending and catering operations will be received, stored, prepared,
assembled and produced within the bistro support area.
23.2.5.2 Menus for retail food services and catering will be developed to meet customers’
preferences and will vary based on seasonal availability.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.2.5.3 Automated point of sales system technology will be utilized in the retail food service
areas.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.2.6 KEY WORKLOAD INDICATORS
23.2.6.1 Projected food service workload for each hospital is projected as follows:
Comox Valley Hospital
In-Patient Beds
In-Patient Meal Days
Out-Patient Meal Days
Sub-Total - Meal Days
Cafeteria Volumes (Annual Transactions)
Campbell River Hospital
Projected
Projected
153
95
52,122
2,606
54,728
32,363
1,618
33,982
1
153,000
80,385
3
2
(1) Projected workload based on projected beds multipled by a rate of 2.8 meals per patient per day (to account for tube feeds, NPO, etc)
(2) Projected at a rate of 5% of the total patient meal volume or approximately 30 meals per weekday on average for CVH and 20 meals
per weekday for CRH.
(3) Projected based on generating revenues equivalent to 500 transactions per day at CVH and 250 per day at CRH
23.2.7 OCCUPANCY SCHEDULE
23.2.7.1 The following table illustrates the maximum number of people, by
category/classification, expected to occupy the component at any 1 time at Comox
Valley Hospital:
PERSONNEL
Manager
Food Service Supervisor
MAXIMUM ESTIMATED NUMBER OF PEOPLE
Day
1
Evening
1
1
Production Supervisor
1
Cook
2
Diet office Clerk
1
Food Service Worker 2
3
1
Food Service Worker 1
4-6
4
Cafeteria Service – Food Service Workers
2
1
Cafeteria Service – Short Order Cook
1
Total
15-17
Night
1
8
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.2.7.2 The following table illustrates the maximum number of people, by
category/classification, expected to occupy the component at any 1 time at Campbell
River Hospital:
PERSONNEL
MAXIMUM ESTIMATED NUMBER OF PEOPLE
Day
1
Evening
Food Service Supervisor
1
1
Cook
2
1
Diet office Clerk
1
Food Service Worker
5
4
Cafeteria Service – Food Service Workers
1
1
Total
11
7
Manager
Night
23.3 DESIGN CRITERIA
23.3.1 Proximity Relationships
23.3.1.1 The facilities for the main kitchen should be located at the same level as hospital
receiving with nearby access to major vertical and horizontal circulation routes for
delivery of patient meals.
23.3.1.2 The facilities for the Cafeteria/bistro including the seating area should be located in
high visitor and staff traffic areas such as the main lobby, outpatient areas, emergency,
etc.
23.3.1.3 Key adjacencies are as follows:
23.3.1.3.1 Adjacent: Direct Access by Internal Circulation
Area A Area B 23.3.1.3.1.1
For all functional areas within the main kitchen including storage,
production, assembly, warewashing and organic/inorganic
dehydrator/digesting area as one integral department and not
separated by corridors or general circulation.
23.3.1.3.1.2
Between the cafeteria / bistro servery and seating area
23.3.1.3.1.3
Beween cafeteria bistro server and bistro back of house support
kitchen
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FOOD SERVICES
23.3.1.3.1.4
Between the cafeteria / bistro and outdoor seating area (if
available)
23.3.1.3.2 Close: Direct Access by Non Public Circulation
Area A Area B 23.3.1.3.2.1
The main kitchen requires direct access to the main
receiving/loading dock for incoming products.
23.3.1.3.2.2
The main kitchen requires direct access to service elevators and
horizontal routes within the Hospital for delivery of patient meals.
Elevators must be dedicated during meal times.
23.3.1.3.2.3
Food services departmental administrative offices require direct
and convenient access to the main kitchen.
23.3.1.3.2.4
The main kitchen requires convenient access to staff washroom
and locker facilities.
23.3.1.3.2.5
Between the cafeteria servery and the main kitchen
23.3.1.3.2.6
Between the cafeteria servery and hospital loading / receiving dock
23.3.1.3.2.7
Between the cafeteria/bistro and General Horizontal and vertical
Circulation for major non-public circulation.
23.3.1.3.2.8
Between the cafeteria/bistro and Public Support Services for
movement of staff and food products
23.3.1.3.2.9
Between cafeteria/bistro and Materiel Management for the
movement of staff and food products
23.3.1.3.3 Convenient: Access by General Circulation
23.3.1.3.3.1
Between the cafeteria/bistro and public washrooms
23.3.1.3.3.2
Between the cafeteria/bistro and Central Staff Facilities for
movement of staff
23.3.1.3.3.3
Main kitchen and departmental administrative offices
23.3.1.3.3.4
Cafeteria and meeting spaces
23.3.1.3.3.5
Between the cafeteria/bistro and General Horizontal and Vertical
Circulation for movement of major public circulation
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.3.2 Internal Design Criteria
23.3.2.1 Main Kitchen
23.3.2.1.1 The functional areas within the main kitchen facilities will also be arranged
to accommodate a forward workflow of products and a reversing flow of
waste products.
23.3.2.1.2 The main kitchen will be designed to support a forward workflow from
receiving to preparation, production, assembly and distribution. The
functional areas within the main kitchen facilities will also be arranged to
accommodate a separate and non-crossing flow of waste and soiled carts
and service wares.
23.3.2.1.3 The two workflows should not cross to avoid contamination.
23.3.2.1.4 Hand hygiene sinks must be accessible within all areas of the kitchen
along work flow.
23.3.2.2 Retail Food Service / Cafeteria
23.3.2.2.1 A forward flow in and out of the cafeteria/bistro will be required. Adequate
circulation space will be required around all food stations to ensure
wheelchair accessibility
23.3.2.2.2 Sight lines from the cashier stations to the servery entrance will be needed.
23.3.2.2.3 Tray carts will also be provided throughout the seating area for soiled tray
drop off
23.3.2.2.4 The cafeteria seating area will be partitioned utilizing design elements that
are removable or flexible enough to accommodate large events. The
seating area should also be designed to allow it to remain open while the
cafeteria service area is closed.
23.3.2.2.5 Hand hygiene sinks available must be centrally located easily accessible to
the public.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.3.3 Component Functional Diagram
23.3.3.1 Main Kitchen
23.3.3.1.1 Conceptually, the following illustrates the internal relationships but is not
intended to represent a specific design.
Hospital Loading Dock
perishable & non perishable
goods & other supplies
waste removal
Main Kitchen Department Receiving
and Decasing
Refrigerated and
Frozen Storage
Dry Goods
and Non
Food
Storage
Warewashing,
Waste
Management
ICR
Preparation
Pot
Wash
Production /
Main Cooking
Compressor
Room
Staff
Facilities
Department
Administrative
Offices
Meal Assembly
soiled meal
service wares
Distribution of
patient meals
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.3.3.2 Retail Food Service / Cafeteria
23.3.3.2.1 Conceptually, the following illustrates the internal relationships but is not
intended to represent a specific design.
Natural Light and Link to Outdoor Seating (if possible)
High Staff and Visitor Traffic Area
Vending
Seating Area
Waste
Cafeteria
Servery
Bistro
Food and
beverage
products
Bistro Back
of House
Support Area
23.3.4 Flexibility and Adaptability
23.3.4.1 To the extent possible, mobile equipment will be used in the central kitchen so as to
allow for movement and repositioning in the future, easy replacement and ease of
cleaning.
23.3.4.2 A variety of mechanical and electrical sources including gas, electrical and steam will
be provided so as to ensure production and service capabilities during power loss.
23.3.4.3 Architectural provisions will be required to enable removal and replacement of large
food service equipment following the end of its useful life.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.3.5 HACCP (Hazardous Analysis Critical Control Point)
23.3.5.1 The main kitchen will be designed to support a HACCP program. Hazard analysis is
the process of identifying and assessing where hazards may enter the food processing
flow and effect food safety. Critical control points are operational procedures or
functions where identified hazards must be controlled and continuously monitored.
23.3.5.2 Central to the HACCP program will be the control of time temperature relationships
through the food processing flow. To support this effort, equipment such as walk in
refrigerators and freezers within the central receiving facility will include temperature
recorders and alarms.
23.3.5.3 Also, as part of the HACCP program, hand wash stations with soap dispensers and/or
automatic hand disinfectant stations will be provided in all work areas in the main
kitchen.
23.3.6 Information Technology Food Services Information Management system
23.3.6.1 Food Services will be supported with a Food services information management
software system which will aid with management of inventory and diet profiles and will
full interface with the hospital ADT system.
23.3.6.2 The Food services information management software system would be utilized to allow
for diet office, menu processing and inventory management.
23.3.6.3 The Food services information management software system will also allow for use of
wireless hand held technology to support bed side ordering.
23.3.6.4 VIHA currently utilizes a CBORD food service information management system. The
specific device requirements and selection to support the service delivery have not
been determined at this date. Project Co will not be responsible to provide software or
handheld devices for the CBORD food service information management system.
23.3.7 Room Finishes
23.3.7.1 Heavy duty non slip flooring will be provided throughout the Main Kitchen which is
washable, impervious to food acids and oils, suitable for rolling equipment with antimould / anti-fungi characteristics.
23.3.7.2 All corners between walls and floors within the Main Kitchen shall be coved.
23.3.7.3 General areas within the Main Kitchen will be gradually sloped to central floor drains for
general drainage to enable mechanical spray wash and chemical sanitation.
23.3.7.4 Wall finishes within the Main Kitchen shall be smooth, washable and durable and come
complete with protection from cart damage.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.3.8 Ventilation and Air Conditioning
23.3.8.1 Conditioned moderate velocity air in work areas will be provided within the Main
Kitchen. Slight negative pressure will be needed for odour control.
23.3.8.2 Special exhaust will be required above any cooking and dishwashing equipment to vent
grease, odours and humidity from the source.
23.3.8.3 All hoods utilized within the Main Kitchen must be compliant NFPA 96
23.3.8.4 The main kitchen, cafeteria / bistro support kitchen, cafeteria / bistro servery and
seating areas and on-unit plating pantries shall be air conditioned.
23.3.9 Shape and Critical Dimensions
23.3.9.1 Floor to Ceiling Heights: The Food Service Kitchen will require a clearance of 10 feet
from finished floor to finished ceiling. At minimum an additional 3-4 feet will be
provided above finished ceiling to accommodate ducting, mechanical systems, etc.
23.3.9.2 Kitchen Dimensions: Length and width of the kitchen to be configured at rate of no less
than 2:1 length time’s width.
23.3.9.3 Kitchen areas to be designed so as to avoid odd shapes, acute angles and nonfunctional corners.
23.3.10 Refrigerated and Frozen Storage Rooms
23.3.10.1 All temperature controlled storage rooms will be constructed of pre-fabricated insulated
walk-in panels. Panels shall be a minimum of 76mm thick.
23.3.10.2 Back loading walk in refrigeration and freezer units are desired so as to allow for
forward flow from Food Service departmental receiving areas to preparation production
areas.
23.3.10.3 Walk in units will come complete with bumpers and corner guards.
23.3.10.4 All temperature controlled rooms where internal air temperature is maintained by
blower type evaporator coils will be connected to room specific mechanical refrigeration
systems (condensing units) located either in the Main Kitchen or hospital mechanical
room.
23.3.10.5 All mechanical refrigeration systems will utilize CFC-free refrigerant and be designed
for heat reclaim.
23.3.10.6 Floor depressions will be provided in the floor slab underneath all walk in refrigerators
and freezers. This will avoid equipping walk-ins with insulated floors mounted on top of
the building slab requiring the use of interior ramp and also allow for flexibility to
convert units from coolers to freezers in the future if required.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.3.11 Emergency Power
23.3.11.1 At minimum, emergency power is required in the following areas:
23.3.11.1.1 The lighting, walk-in refrigerators and freezers, and 50 per cent of the
production equipment within the central kitchen and cafeteria / bistro
support kitchen.
23.3.11.1.2 To the dishwasher within the main kitchen.
23.3.11.1.3 To pantries located on the patient units
23.3.11.1.4 To coffee machines within the main kitchen and cafeteria bistro.
23.3.11.1.5 To the food service information management system which maintains
patient diet profiles is also required
23.3.12 Grease Traps
23.3.12.1 Pot sink, soiled dish tabling, dishwashing and pot washing equipment as well as any
work sink (i.e. tied to work table excluding hand wash sinks) within preparation and
production areas will be connected to a grease trap/interceptor unless otherwise stated
by local code or jurisdiction.
23.3.12.2 Floor drains within the kitchen will also be tied to grease trap/interceptor.
23.3.13 Safety and Security
23.3.13.1 All food service areas must support staff safety by incorporating features to control
hazards and minimize risk, consistent with current legislation, guidelines and best
practices (i.e. chemical, ergonomic, biological, physical).
23.3.13.2 Key elements to include the following:
23.3.13.2.1 Use of non-slip flooring materials within the main kitchen and back of
house cafeteria/ bistro support area.
23.3.13.2.2 Use of ergonomically friendly height adjustable equipment.
23.3.13.2.3 Use of security camera within all food service areas (with particular
emphasis in storage and retail service areas)
23.3.13.2.4 Cash stations within the cafeteria / bistro designed to allow visibility to
entrance of the Servery
23.3.13.2.5 Access restriction to the department and within departmental storage
areas.
23.3.13.2.6 Automated wash-down capabilities in hoods over cooking equipment.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
23.3.13.2.7 Temperature alarms for all refrigerators and freezers networked to a
computerized control system.
23.3.13.2.8 Proper in-kitchen safety apparel (i.e. supplies of hair nets/caps, gowns) at
all controlled entry points to the kitchen.
23.3.14 Natural Light and artificial lighting
23.3.14.1 To the extent possible, the main kitchen and on-unit pantries will be enhanced by
natural light. The cafeteria / bistro will have access to natural light. Appropriate
window covering will be required in all instances where natural light is provided. In
addition, the cafeteria bistro will have access to external / outdoor seating area.
23.3.14.2 In production areas, artificial lighting fixtures must be easily disassembled for cleaning
and sanitizing.
23.3.15 Space Table
23.3.15.1 The schedule accompanying this document illustrates rooms, and their respective
sizes, that combine to make up this functional component. Refer to the respective
space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID (RID)
ROOM TYPE
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
PATIENT FOOD SERVICE KITCHEN
Refrigerated Frozen and Dry Storage Area
01 Departmental Receiving
Area for sorting and segregation of food
and non-food products. Door wide enough
to accommodate a pallet.
02 Dry Stores Room
Based on 600 daily meals/meal equivalents
and 30% storage allocation for dry
ingredients
03 Refrigerated Store Room
Based on 600 daily meals/meal equivalents
and 40% storage allocation for refrigerated
product
04 Frozen Store Room
Based on 600 daily meals/meal equivalents
and 30% storage allocation for frozen items
at
05 Issue and Ingredient Control
Room
06 Non-Food Store Room
Laundry, paper, disposables, equipment
Food Production Area
07 Preparation and Portioning
08
Nourishment and Special
Individual temperature room to allow for
cold assembly
ROOM
SIZE
(nsm)
OS-STL.06 Food Services
NUMBER
TOTAL
OF
SIZE
ROOMS
(nsm)
8.0
1
8.0
18.0
1
18.0
10.0
3
30.0
16.0
1
16.0
6.0
1
6.0
8.0
1
8.0
Subtotal, Storage Area
86.0
20.0
1
20.0
10.0
1
10.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
COMOX VALLEY HOSPITAL
ROOM
ID (RID)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
09
Diets
Main Cooking (including
Bakery)
10
11
12
13
14
Housekeeping Room
Pot Washing Room
Blast Chilling
Prepared Food Holding
Meal Assembly
15
Cart Marshalling Room
1
40.0
6.0
12.0
5.0
5.0
60.0
1
1
1
1
1
6.0
12.0
5.0
5.0
60.0
18.6
1
18.6
Subtotal, Food Production Area
176.6
Assumes capacity for up to 10 carts and an
allowance of 1.86 nsm / cart
18.6
1
18.6
65.0
1
65.0
6.0
1
6.0
5.6
1
5.6
Minimum allowance
6.0
1
Garbage refrigerator to hold waste and
6.0
1
recylable items
Subtotal, Ware Washing Area
6.0
6.0
17
Dish and Flatware Washing
Room
Assumes small fligh dishwasher and
composter
18
Housekeeping Room
19
Clean Cart Holding
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
Assumes capacity for up to 6 carts and an
allowance of 1.86 nsm / cart
20
21
Cart Wash Area
Waste holding
Administrative/Support Area
22 Office, First Line Leader
23
24
25
Office, Supervisor
Office, Clinical Dietitian
Diet Office
26
27
Staff Locker Area
Toilet, Staff
OS-STL.06 Food Services
NUMBER
TOTAL
OF
SIZE
ROOMS
(nsm)
40.0
Minimum allowance
Roll in
Step in Cooler
Area to accommodate Lean cell assembly.
Temperature controlled room to allow for
cold assembly.
Assumes capacity for up to 10 carts and an
allowance of 1.86 nsm / cart
Ware Washing Area
16 Soiled Cart
Receiving/Sorting Room
ROOM
SIZE
(nsm)
1 computer wrkstn - Meeting area for 2-3
people
Clerical Suite with two stations - Diet Tech
and Clerk
Purse lockers
1 assisted WC, 1 sink
107.2
10.0
1
10.0
10.0
10.0
12.0
1
1
1
10.0
10.0
12.0
0.9
4.5
1
1
0.9
4.5
Subtotal, Administrative / Support Areas
47.4
TOTAL NSM, PATIENT FOOD SERVICE KITCHEN
417.2
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
OS-STL.06 Food Services
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM TYPE
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
PATIENT FOOD SERVICE KITCHEN
Refrigerated Frozen and Dry Storage Area
01
Departmental Receiving
02
Dry Stores Room
03
Refrigerated Store Room
04
Frozen Store Room
05
Storage, Ingredients Control
Room
06
Non-Food Store Room
Food Production Area
07 Preparation and Portioning
08
10
11
12
13
14
Nourishment and Special
Diets
Main Cooking (including
Bakery)
Housekeeping Room
Pot Washing Room
Blast Chilling
Prepared Food Holding
Meal Assembly
15
Cart Marshalling Room
09
Ware Washing Area
16 Soiled Cart
Receiving/Sorting Room
Area for sorting and segregation of food
and non-food products. Door wide enough
to accommodate a pallet.
Based on 600 daily meals/meal equivalents
and 30% storage allocation for dry
ingredients
Based on 600 daily meals/meal equivalents
and 40% storage allocation for refrigerated
product
Based on 600 daily meals/meal equivalents
and 30% storage allocation for frozen items
at
Laundry, paper, disposables, equipment
Individual temperature room to allow for
cold assembly
8.0
1
8.0
18.0
1
18.0
10.0
2
20.0
16.0
1
16.0
6.0
1
6.0
8.0
1
8.0
Subtotal, Storage Area
76.0
20.0
1
20.0
10.0
1
10.0
40.0
1
40.0
6.0
1
Minimum allowance
12.0
1
Roll In
5.0
1
Step in Cooler
4.5
1
Area to accommodate Lean cell assembly.
40.0
1
Temperature controlled room to allow for
cold assembly.
Assumes capacity for up to 6 carts and an
11.2
1
allowance of 1.86 nsm / cart
Subtotal, Food Production Area
6.0
12.0
5.0
4.5
40.0
Assumes capacity for up to 6 carts and an
allowance of 1.86 nsm / cart
11.2
148.7
2.0
6
12.0
50.0
6.0
1
1
50.0
6.0
17
18
Dishroom
Housekeeping Room
Assume Two Rack Machine and composter
1 floor sink, standard wall-mounted sink,
storage cabinetry - Accommodates
housekeeping cart storage
19
Clean Cart Holding
Assumes capacity for up to 6 carts and an
allowance of 1.86 nsm / cart
5.6
1
5.6
20
21
Cart Wash Area
Waste holding
Minimum allowance
Garbage refrigerator to hold waste and
recyclable items
6.0
6.0
1
1
6.0
6.0
Subtotal, Ware Washing Area
85.6
Administrative/Support Area
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.06
FOOD SERVICES
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
22
Office, First Line Leader
23
24
25
Office, Supervisor
Office, Clinical Dietician
Diet Office
26
27
Staff Locker Area
Toilet, Staff
OS-STL.06 Food Services
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
1 computer wrkstn - Meeting area for 2-3
people
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
10.0
1
10.0
10.0
10.0
12.0
1
1
1
10.0
10.0
12.0
0.9
4.5
1
1
0.9
4.5
Subtotal, Administrative / Support Areas
47.4
TOTAL NSM, PATIENT FOOD SERVICE KITCHEN
357.7
Clerical Suite with two stations - Diet Tech
and Clerk
Purse lockers
1 assisted WC, 1 sink
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.07
EQUIPMENT MAINTENANCE
This specification outlines the functional, operational and physical requirements for the Equipment
Maintenance functional component.
24.1 FUNCTIONAL DESCRIPTION
24.1.1 Statement of Purpose
24.1.1.1 The Equipment Maintenance component exists for the purpose of maintaining the
serviceability of all equipment and any building system(s) under the Authority’s scope
of responsibility.
24.1.1.2 Spaces accommodated in this component and included in the accompanying space
schedule support functions under the Authority’s scope of responsibility only. Spaces
required by the Facility operator (Project Co.) will be planned, configured, designed and
located separately from these Clinical Specifications.
24.1.2 Scope of Services
24.1.2.1 Functional Content
24.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
24.1.2.1.1.1
Maintaining electronic catalogues of all on-site equipment in
support of routine and preventative maintenance and repairs
24.1.2.1.1.2
Maintaining a complete set of “current” as-built drawings of the
Facility including schematics of all structural, mechanical,
electrical, HVAC and water systems
24.1.2.1.1.3
Conducting repairs and maintenance on all non contract VIHA
owned equipment, consisting mostly of portable/ wheeled
equipment
24.1.2.1.1.4
Maintaining inventories of spare/replacement parts and
maintenance supplies for high demand items (e.g., lubricants,
seals, casters)
24.1.2.1.1.5
Accepting deliveries of all new equipment and preparing these new
items for use
24.1.2.1.1.6
Scheduling and deploying maintenance engineers to work sites
throughout the Facility
24.1.2.1.1.7
Storage of maintenance carts and tools
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.07
EQUIPMENT MAINTENANCE
24.1.2.2 Exclusions
24.1.2.2.1 The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
24.1.2.2.1.1
Interior spaces required by Project Co. to operate the Facility
24.1.2.2.1.2
Repair and maintenance of electronic equipment serviced by
Biomedical Engineering (See OS-STL.01)
24.1.2.2.1.3
Repairs and maintenance to grounds, building structures and builtin equipment (Note: This general guideline will be refined
throughout the project as responsibilities are divided between
VIHA and Project Co.)
24.1.2.2.1.4
Locker, toilet, shower and change facilities for Maintenance
Engineers (See OS-GP.03 Central Staff Facilities)
24.1.2.3 Anticipated Trends in Service Delivery
24.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
24.1.2.3.1.1
The frequency with which Maintenance Engineers will be deployed
to provide service at point of care will continue increasing. As
members of a care team, Engineers will tend to work decentrally
as opposed to in a more traditional centralized workshop area.
24.2 OPERATIONAL DESCRIPTION
24.2.1 LEAN Planning Standards
24.2.1.1 Efficiency in Circulation
24.2.1.1.1 Maintenance personnel will frequently travel to other components to
deliver, retrieve, trouble-shoot and/or repair equipment. Urgent requests
and needs for STAT services will require that no component be located
more than the distance that can be traveled, assuming a reasonable
walking pace, in 5 minutes from the Equipment Maintenance component.
24.2.2 Hours of Operation
24.2.2.1 The component at this facility will be staffed and in operation:
24.2.2.1.1
07:00 19:00, Monday through Friday
24.2.2.1.2
08:00 16:00, Saturday and Sunday
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.07
EQUIPMENT MAINTENANCE
24.2.3 People Management Systems
24.2.3.1 Maintenance Engineers will be dispatched from this component. Electronic records of
work assignments and project status will be maintained here to coordinate personnel
with service demand volumes.
24.2.4 Materiel Management Systems
24.2.4.1 Consumable Supplies
24.2.4.1.1 Inventories of consumable supplies for use in the workshop will be
maintained in this component and conveniently located close to the
workbenches. Supply inventories will generally be maintained according to
minimum quantity reorder process or a 2-bin system in which depletion of
the first bin triggers a reorder while supplies are drawn from the second
bin.
24.2.4.2 Equipment Management System
24.2.4.2.1 Equipment used throughout the Facility will be maintained according to
standardized maintenance schedules. When servicing is required, the item
will be either brought to the workshop area by portering staff or serviced
close to point of use.
24.2.4.2.2 Needs for unscheduled maintenance or repairs will be prioritized and
addressed on a case-by-case basis.
24.2.4.3 Waste Management
24.2.4.3.1 To the extent practicable, waste products will be generally managed
according to a system of segregation at point of origin and sequential
consolidation. Operation of this system relies on appropriate containment
facilities for each type of waste product beginning at where the waste is
generated followed by similar, but progressively larger, containment
facilities at key collection locations. In this component, waste management
is understood to begin in the workshop area.
24.2.4.3.2 Segregation of wastes will accommodate the following categories of
products:
24.2.4.3.2.1
General garbage
24.2.4.3.2.2
Sharps (including potentially biohazardous items)
24.2.4.3.2.3
Infectious or contaminated wastes (excluding sharps)
24.2.4.3.2.4
Clean paper and cardboard
24.2.4.3.2.5
Clean metal (tin and aluminum)
24.2.4.3.2.6
Clean recyclable plastics
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.07
EQUIPMENT MAINTENANCE
24.2.4.3.2.7
Compostable materials
24.3 DESIGN CRITERIA
24.3.1 LEAN Planning Standards
24.3.1.1 Inventory Organization
24.3.1.1.1 The variety of equipment accommodated in this component will require
extensive inventories of small parts and consumable supplies. A stores
area must allow for a logical organization of all items enabling maintenance
personnel to easily locate and retrieve each item.
24.3.1.2 Internal Circulation
24.3.1.2.1 Equipment and personnel will be constantly entering and leaving this
component. Doorways must be sufficiently wide to allow simultaneous
passage of items as large as a bariatric hospital bed.
24.3.1.2.2 The internal flow of equipment shall clearly separate incoming from
outgoing items. The path including intake/receipt, processing,
repair/maintenance, holding and distribution shall be one-way, and shall
not cross at any point.
24.3.2 Proximity Relationships
24.3.2.1 The Equipment Maintenance component’s location relative to other components, or
other areas of the facility, and the nature of circulation used to move between different
components/areas are illustrated in the diagram below. Proximities are listed according
to rank; higher priorities appear above lower priorities.
Equipment Maintenance Equipment Maintenance Equipment Depot Main Horizontal/ Vertical Circulation 24.3.2.2 Provide direct adjacency to the Equipment
Depot component for the movement of staff
and equipment.
24.3.2.3 Provide convenient access by general
circulation to major non-public circulation.
Personnel, equipment and supplies will
move frequently to/from this component and
other components in the facility
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.07
EQUIPMENT MAINTENANCE
24.3.3 Internal Design Criteria
24.3.3.1 General Internal Layout
24.3.3.1.1 The component shall be organized into 2 major areas as follows:
24.3.3.1.1.1
Administrative area
24.3.3.1.1.2
Equipment service and storage area
24.3.3.2 Electrical Charging
24.3.3.2.1 Maintenance Engineers must be consulted on the number, location and
supply voltage of electrical outlets prior to this component’s design.
Equipment being serviced here will need to be fully operational, and all
work benches must have adequate power supply (volts/amps) for the items
to be serviced here.
24.3.3.3 Component Security
24.3.3.3.1 Access to this component must be controllable at all times as only
authorized staff will have access. This area must be accessible to
authorized personnel 24 hours-a-day, 7 days-a-week.
24.3.3.4 Lighting
24.3.3.4.1 Artificial lighting in the administrative and maintenance areas must be
variable to accommodate different levels of ambient lighting commensurate
with the functions ongoing at any one time. Individual workstations must be
provided with task lighting.
24.3.3.5 Ergonomics for an Aging Workforce
24.3.3.5.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff are required to
use. Ease of access will be among the key criteria. In all areas throughout
this component, this specification will be reflected in electrical outlets being
located approximately 900 mm (approximately 3’) above floor surface. The
type and number of electrical devices used in the rooms is expected to
increase, and elevated outlets will avoid stress associated with repetitive
bending.
24.3.3.5.2 Work bench surfaces must be sized to accommodate large pieces of
equipment like wheelchairs and motorized chairs. A ceiling-mounted X-Y
gantry lift and tracking system must be installed above the work bench to
assist in transferring heavy objects to a suitable work height. The ceiling
lift will require a minimum capacity of 450 kg. (approximately 1,000 lbs.).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.07
EQUIPMENT MAINTENANCE
24.3.3.5.3 The work bench will require 360° circulation, and must be of adjustable
height to accommodate access to different parts of an item without the
need for bending. The work bench must be height-adjustable by a single
person and must be rated to 450 kg. (approximately 1,000 lbs.) capacity.
24.3.3.6 Mezzanine
24.3.3.6.1 Provide a mezzanine in the Shop Space Room (RID 04 in Campbell River
and RID 08 in Comox Valley ) that covers no less than half the floor area.
Provide standing height room in the mezzanine area of no less than
2400mm in height. Provide standing height under the mezzanine area of
no less than 2400mm in height.
24.3.4 Component Functional Diagram
24.3.4.1 The areas making up this component shall be organized as illustrated in the following
diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.07
EQUIPMENT MAINTENANCE
24.3.5 Space Table
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.07
EQUIPMENT MAINTENANCE
24.3.5.1 The following schedule illustrates rooms, and their respective sizes, that combine to
make up this functional component. Refer to the respective space program for each
Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID
ROOM TYPE
(RID)
Administrative Area
01
Office, First Line Leader
02
03
Workstations, Staff
Office, Private, FMO
Equipment Service/Storage Area
04 Shop Space
OS-STL.07 Equipment Maintenance
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
Multipurpose work area, files storage 10.0
1
Accommodates meetings with up to 2
people
2 computer wrkstns
15.0
1
Multipurpose work area, files storage 10.0
1
Work space for visitors. Medical Gas
(A,O,V)
Subtotal, Administrative Area
TOTAL SIZE
(nsm)
10.0
15.0
10.0
35.0
Open plan - Includes counter w/ hand
60.0
1
wash sink and large laundry-type sink - 3
workbench stations each serviced w/
compressed air (cleaning and tool power
supply source) and 2 data ports - Single
electrical panel w/ 115 and 220 VAC
power supplies
Subtotal, Equipment Service/Storage Area
60.0
TOTAL NSM, ALL AREAS
95.0
60.0
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
Administrative Area
01 Office, First Line Leader
02
Workstations, Staff
03
Office, Private, FMO
OS-STL.07 Equipment Maintenance
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Multipurpose work area, files storage Accommodates meetings with up to 2
people
2 multipurpose computer wrkstns Hanging racks for hard copy plans and
drawings - Printer for production of
architectural and engineering drawings Layout table - Serviced by 2 data ports
Multipurpose work area, files storage Work space for visitors. Medical Gas
(A,O,V)
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL SIZE
(nsm)
10.0
1
10.0
15.0
1
15.0
10.0
1
10.0
Subtotal, Administrative Area
35.0
Equipment Service/Storage Area
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.07
EQUIPMENT MAINTENANCE
CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
04
ROOM TYPE
Shop Space
OS-STL.07 Equipment Maintenance
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
55.0
NUMBER
OF
ROOMS
1
TOTAL SIZE
(nsm)
Open plan - Includes counter w/ hand
wash sink and large laundry-type sink - 3
workbench stations each serviced w/
compressed air (cleaning and tool power
supply source) and 2 data ports - Single
electrical panel w/ 115 and 220 VAC
power supplies
Subtotal, Equipment Service/Storage Area
55.0
TOTAL NSM, ALL AREAS
90.0
55.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
This specification outlines the functional, operational and physical requirements for the Equipment Depot
functional component.
25.1 FUNCTIONAL DESCRIPTION
25.1.1 Statement of Purpose
25.1.1.1 The Equipment Depot exists for the purpose of managing inventories of large and/or
commonly used pieces of equipment.. Most equipment accommodated in this
component will be wheeled equipment, and all items will be generally eligible for use
anywhere in the Facility. A key planning objective supporting this component’s
development is the reduction of “clutter” that accumulates in hospital corridors, alcoves
and rooms.This space will be paper free and cleaned similar to the level of cleaning in
the clinical areas. No cardboard, wood crates or items that would be considered dirty
are permitted
25.1.2 Scope of Services
25.1.2.1 Functional Content
25.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
25.1.2.1.1.1
Organized storage of the following categories of equipment:
25.1.1.1.1.1.1
Large volumes of identical or similar items
25.1.1.1.1.1.2
Items used in many areas of the Facility, regardless of
inventory size
25.1.1.1.1.1.3
Items easily identifiable as a distinct unit (may or may
not have attachable accessories)
25.1.1.1.1.1.4
Valuable or unique pieces of equipment requiring
specialized maintenance and storage
25.1.2.1.1.2
Entering new pieces of equipment into inventory and applying the
appropriate tracking technology (either an electronic tag or bar
code label)
25.1.2.1.1.3
Removing broken, unneeded or obsolete equipment from inventory
and coordinating its disposal
25.1.2.1.1.4
Responding to requests for either dispatching or retrieving pieces
of equipment
25.1.2.1.1.5
Tracking and locating of tagged and/or logged equipment using
system similar to AeroScout RFID system.
25.1.2.1.1.6
Cleaning and routine mechanical maintenance of returned items
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
25.1.2.1.1.7
Maintaining hard copy and electronic copies of maintenance
manuals and records
25.1.2.1.1.8
Preparing and submitting requests for new supplies and
replacement equipment
25.1.2.2 Exclusions
25.1.2.2.1 The following list specifies functions that are understood to occur in other
functional components in the Facility or outside of the Facility:
25.1.2.2.1.1
Equipment loan service for discharged patients (Assumed
accommodated by charitable organizations based in the
community)
25.1.2.2.1.2
Maintenance and repair of biomedical devices (See OS-STL.01
Biomedical Technology)
25.1.2.2.1.3
This space is not used for storage. Only items belonging to the
depot inventory will be kept in this space.
25.1.2.3 Anticipated Trends in Service Delivery
25.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
25.1.2.3.1.1
More technology will be incorporated into equipment (e.g.,
“intelligent” patient beds) calling for more rigorous maintenance
standards for these devices.
25.1.2.3.1.2
The increased pace of technology will result in new generations of
equipment at more frequent intervals. Efficient equipment
management practices will require constant monitoring for
preferred options and replacement/disposal policies.
25.1.2.3.1.3
Demands for space will continue approaching or exceeding space
availability. Prior models of decentralized equipment storage will
be no longer acceptable as priorities address the need for “clinical”
space.
25.1.3 Scope of Education Functions
25.1.3.1 Equipment porters will require continual training on equipment Cleaning and new
Infection Control procedures.. Most of this training will be applied in nature and will
involve either self-study or training by supervisor. Teaching and practicing will be
conducted in general service space, and will not require specialized or dedicated
facilities in this component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
25.2 OPERATIONAL DESCRIPTION
25.2.1 Efficiency in Circulation
25.2.1.1 Porters will frequently travel to other components to deliver or retrieve, equipment
while also providing deliveries and pickup on behalf of Pharmacy, Lab, Health
Records,Stores and Blood Bank.. Urgent requests and needs for STAT services will
require that no component be located more than the distance that can be traveled,
assuming a reasonable walking pace, in 5 minutes from the Equipment Depot
component.
25.2.2 Hours of Operation
25.2.2.1 The component at this facility will be staffed and in operation:
25.2.2.1.1 24 hours daily, 7 days-a-week
25.2.3 People Management Systems
25.2.3.1 Porters and will have unrestricted, but controlled access to this component at all times.
Unauthorized personnel will not have access to this component’s interior space.
25.2.4 Materials Management Systems
25.2.4.1 Consumable Supplies
25.2.4.1.1 Inventories of consumable supplies will be maintained close to point of use
on. This standard will require conveniently located inventories of small
parts and cleaning/lubricating fluids in the technical work areas. Generally,
a 3 day supply of items will be maintained with minimum inventory levels
triggering a re-ordering process. All orders will be sent electronically to the
facility’s Materiels Management component (See OS-STL.05) for
processing.
25.2.4.2 Equipment Management System
25.2.4.2.1 See also Information Management Systems below.
25.2.4.2.2 Each dispatched piece of equipment will be delivered to the user area by
porters based in this component. When an item in use is no longer
required, the user will send an electronic request for pick-up and return to
the Equipment Depot. When portering staff return items to the component,
they will be inspected for general condition, cleaned and/or repaired as
necessary, and then returned to the appropriate storage location.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
25.2.4.2.3 Items that are returned broken will be assessed for salvage potential.
Generally, simple repairs will be accommodated by Facilities Maintenance
staff, whereas needs for more extensive work may be contracted out. If
repairs are deemed “not cost effective” or if an item is beyond its
serviceable life, it will be designated for salvage and disposed of through
Logistic Services.
25.2.4.3 Waste Management
25.2.4.3.1 Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations. In
this component, waste management is understood to begin in the
equipment cleaning area and at the maintenance workbench.
25.2.4.3.2 Segregation of wastes will accommodate the following categories of
products:
25.2.4.3.2.1
General garbage
25.2.4.3.2.2
Sharps (including potentially biohazardous items)
25.2.4.3.2.3
Infectious or contaminated wastes (excluding sharps)
25.2.4.3.2.4
Clean paper and cardboard
25.2.4.3.2.5
Clean metal (tin and aluminum)
25.2.4.3.2.6
Clean recyclable plastics
25.2.4.3.2.7
Compostable materials
25.2.5 Information Management Systems
25.2.5.1 Equipment inventory management will rely on electronic order processing and tracking.
All approved purchase orders for new equipment will be processed through the
Facility’s Materiels Management component (See OS-STL.05). New equipment arriving
on site will be delivered from central receiving facilities in Materiels Management after
being confirmed against outstanding purchase orders.
25.2.5.2 Upon delivery to the Equipment Depot, each item will be either tagged with an
electronic locating tag (Radio Frequency Identification – RFID) or bar coded with an
adhesive label. The item will then be placed into the appropriate storage location. This
component will serve as the central host site for electronic equipment tracking
technology, similar to the Aeroscout RFID system currently in use within VIHA.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
25.2.5.3 Requests for equipment delivery or retrieval will be submitted electronically from any
area in the Facility. Upon receiving a delivery request, the item will be picked from
inventory, scanned indicating its destination and then delivered.This technology would
be similar to the Teletracking system currently in use within VIHA Each staff member in
this area will have a PDA capable of receiving data as well as working as a telephone.
Internal antenna may be required to support wireless communications between porters
working in this area and the rest of the facility If a requested item is not in inventory,
portering staff will use the electronic tracking system to locate items potentially not in
use, and then contact the user to determine the item’s status. Repeated shortages of
requested equipment will typically generate purchase requests for additional items.
25.2.5.4 Staffing in this component will be conducted according to fixed and regular schedules.
Personnel will report to this component at the beginning and at the end of each work
shift, logging the shift electronically. Replacement staffing to accommodate illness or
vacation will be coordinated through the Authority’s corporate services (staffing office).
25.3 DESIGN CRITERIA
25.3.1 LEAN Planning Standards
25.3.1.1 Inventory Organization
25.3.1.1.1 The variety of equipment accommodated in this component will require
extensive inventories of small parts and consumable supplies. A stores
area must allow for a logical organization of all items enabling porters to
easily locate and retrieve each item.
25.3.1.2 Internal Circulation
25.3.1.2.1 Equipment and personnel will be constantly entering and leaving this
component. Doorways must be sufficiently wide to allow simultaneous
passage of items as large as a bariatric hospital bed.Doorways must be
controlled by proximity card access on hallway side and electronic door
openers on the inside.
25.3.1.2.2 The internal flow of equipment shall clearly separate incoming from
outgoing items. The path including intake/receipt, processing,
repair/maintenance, holding and distribution shall be one-way, and shall
not cross at any point.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
25.3.1.3 Proximity Relationships
25.3.1.3.1 The Equipment Depot component’s location relative to other components,
or other areas of the facility, and the nature of circulation used to move
between different components/areas are illustrated in the diagram below.
Proximities are listed according to rank, higher priorities appear above
lower priorities.
Equipment Depot Materiels Management Equipment Depot Central Staff Facilities Equipment Depot Main Horizontal/ Vertical Circulation 25.3.1.3.2 Provide Direct Access by Internal
Circulation to the Materiels Management
and Facilities,Maintenance and
Operations components for the movement
of new and discarded equipment.
25.3.1.3.3 Provide Convenient Access by General
Circulation to the Central Staff Facilities
component for the movement of staff.
25.3.1.3.4 Provide Convenient Access by General
Circulation to major non-public circulation.
Personnel, equipment and supplies will
move frequently to/from this component
and other components in the facility
25.3.2 Internal Design Criteria
25.3.2.1 General Internal Layout
25.3.2.1.1 The component shall be organized into 2 major areas as follows:
25.3.2.1.1.1
Administrative area
25.3.2.1.1.2
Equipment service and storage area
25.3.2.2 General Design Criteria
25.3.2.2.1 Flooring in the depot should be concrete sealed, not painted.
25.3.2.2.2 Internal antenna may be required to support wireless communications
between porters working in this area and the rest of the facility.
25.3.2.2.3 Storage Room Layout is ideally one large space with access to clean
room, hallway and administrative work space.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
25.3.2.2.4 Provide a mezzanine in the Storage Room (RID 08 in Campbell River and
RID 08 in Comox Valley) that covers no less than half the floor area.
Provide standing height room in the mezzanine area of no less than
2400mm in height. Provide standing height under the mezzanine area of
no less than 2400mm in height.
25.3.2.2.5 Doorways to cleaning room and hallway must be double doors with the
width to allow large pieces of equipment that are approximately 4-5 feet
wide. Allowances must be made on either side of the doorways for the
necessary turing radius required for longer equipment. Ideally, 6-8 feet are
required.
25.3.2.2.6 Computer outlets will be required in the storage portion of the depot as well
as the administrative area.
25.3.2.3 Tiered Storage Capacity
25.3.2.3.1 Subject to the Facility’s ultimate design, this component shall be built with
double-height ceilings. This configuration will enable horizontal portioning
of storage areas (e.g., mezzanine level addition) to accommodate growth
in the number and type of items stored here.
25.3.2.4 Electrical Charging
25.3.2.4.1 Equipment Maintenance personnel must be consulted on the number,
location and supply voltage of electrical outlets prior to this component’s
design. Equipment will be generally stored in segregated pods and items
with electrical storage capacity (e.g., infusion pumps, ceiling lifts, motorized
chairs) will require continual charging while being stored here. Organization
of electrical outlets (e.g., on columns or suspended pillars) will enable highdensity storage and simultaneous charging. 20-30 outlets are required to
power the equipment.
25.3.2.5 Component Security
25.3.2.5.1 Access to this component must be controllable at all times as only
authorized staff will have access. This area must be accessible to
authorized personnel 24 hours-a-day, 7 days-a-week. Doors need to be
controlled using proximity cards for access and have automatic door
openers for exit. Buttons for door openers shall be installed 5-6 feet away
from the doors.
25.3.2.6 Lighting
25.3.2.6.1 Artificial lighting in the administrative and storage areas must be variable
and adjustable in length to accommodate different levels of ambient
lighting commensurate with the functions ongoing at any one time.
Individual workstations must be provided with task lighting.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
25.3.2.7 Environmental Control
25.3.2.7.1 Cleaning of some equipment will require use of hot water. A wash bay area
must be sufficiently ventilated to control humidity build-up throughout the
rest of the component.
25.3.2.8 Ergonomics for an Aging Workforce
25.3.2.8.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff are required to
use. Ease of access will be among the key criteria. In all areas throughout
this component, this specification will be reflected in electrical outlets being
located approximately 900 mm (approximately 3’) above floor surface. The
type and number of electrical devices used in the rooms is expected to
increase, and elevated outlets will avoid stress associated with repetitive
bending.
25.3.2.9 Occupational Health and Safety Features
25.3.2.9.1 The wash bay must be of sufficient space to accommodate storage of
cleaning supplies, accumulation of unwashed items, and a drying area to
keep adjacent floor surfaces from getting wet and creating slipping
hazards.
25.3.2.9.2 A plumbed eye wash station must be included in the wash bay area.
25.3.2.9.3 The equipment cleaning area must include an elevated stainless steen two
basin (sink) for small items, and a large elevated basin and ramp for larger
items on casters, to reduce awkward posturing while manoeuvring heavy
items.A handwashing sink needs to be in the immediate area. High speed
ventilation is required to address the moisture and chemical vapours in this
room.
25.3.2.9.4 The exit from the wash bay must include a floor strip of “rubber sticky” to
capture any particles adhering to casters.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
25.3.3 Component Functional Diagram
25.3.3.1 The areas making up this component shall be organized as illustrated in the following
diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
25.3.4 Space Table
25.3.4.1 The following schedule illustrates rooms, and their respective sizes, that combine to
make up this functional component. Refer to the respective space program for each
Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID (RID)
ROOM TYPE
Administrative Area
01 Office, First Line Leader
OS-STL.08 Equipment Depot
ROOM
SIZE
(nsm)
NUMBE
R OF
ROOMS
Multipurpose work area, files storage - Accommodates
meetings with up to 4 people
10.0
1
10.0
CONTENTS/KEY FEATURES/DESIGN CRITERIA
TOTAL
SIZE
(nsm)
02
Plan Room
2 multipurpose computer wrkstns - Hanging racks for
hard copy plans and drawings - Printer for production
of architectural and engineering drawings - Layout
table
10.0
0
0.0
03
Workstation/Dispatch
Station, Porter
Multipurpose work area w/ 1 computer wrkstn Integrated w/ hospital-wide equipment tracking system
10.0
1
10.0
4.0
2
8.0
Subtotal, Administrative Area
28.0
04
Report, Work Area
Equipment Service/Storage Area
05 Receiving/Marshalling
Room
2 carrels
Capacity to accommodate 1 patient bed - Drop-off and
short term holding of items arriving at/leaving the
component - Secured entrance for adjoining exterior
non-public corridor
15.0
1
15.0
-
-
-
06
[Intentionally left blank]
07
Wash Bay
Equipped w/ floor drain, high volume air flow for quick
drying of large items - Storage of cleaning products
and supplies - Includes plumbed and tempered eye
wash station
20.0
1
20.0
08
Storage Room
Open plan w/ allowance for shelving along 3 perimeter
walls - Provision for designating space for specific
types of equipment. Includes Techinical Work Space (2
industrial work benches) and Supplies Storage
accessible from both work benches.
130.
0
1
130.0
09
10
[Intentionally left blank]
[Intentionally left blank]
-
-
-
Subtotal, Equipment Service/Storage Area
165.0
TOTAL NSM, ALL AREAS
193.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.08
EQUIPMENT DEPOT
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
Administrative Area
01 Office, Private, Site FMO
Supervisor/Manager
OS-STL.08 Equipment Depot
ROOM
SIZE
(nsm)
NUMBE
R OF
ROOMS
Multipurpose work area, files storage - Accommodates
meetings with up to 4 people
10.0
1
10.0
CONTENTS/KEY FEATURES/DESIGN CRITERIA
TOTAL
SIZE
(nsm)
02
Plan Room
2 multipurpose computer wrkstns - Hanging racks for
hard copy plans and drawings - Printer for production
of architectural and engineering drawings - Layout
table
10.0
0
0.0
03
Workstation/Dispatch
Station, Porter
Multipurpose work area w/ 1 computer wrkstn Integrated w/ hospital-wide equipment tracking system
9.0
1
9.0
04
Workstaion, Staff
2 carrels- Report Area
4.0
2
8.0
Subtotal, Administrative Area
27.0
Equipment Service/Storage Area
05 Receiving/Marshalling Capacity to accommodate 1 patient bed - Drop-off and short
Room
term holding of items arriving at/leaving the component Secured entrance for adjoining exterior non-public corridor
13.0
1
13.0
-
-
-
06
[Intentionally left
blank]
07
Wash Bay
Equipped w/ floor drain, high volume air flow for quick drying
of large items - Storage of cleaning products and supplies Includes plumbed and tempered eye wash station
20.0
1
20.0
08
Storage Room
Include Hoist and vertical storage, includes Techinical Work
Space (2 industrial work benches) and Supplies Storage
accessible from both work benches.
70.0
1
70.0
09
[Intentionally left
blank]
[Intentionally left
blank]
-
-
-
-
-
-
10
Subtotal, Equipment Service/Storage Area
103.0
TOTAL NSM, ALL AREAS
130.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
This specification outlines the functional, operational and physical requirements for the Medical Device
Reprocessing Department (MDRD) component.
26.1 FUNCTIONAL DESCRIPTION
26.1.1 Statement of Purpose
26.1.1.1 The Medical Device Reprocessing Department (MDRD) exists for the purposes of
cleaning, sterilizing and assembling supplies, equipment, packages and trays used in
the performance of minor and invasive procedures. The transfer of all dirty and
clean/sterilized items between the MDRD and destination components will be
coordinated by personnel based here.
26.1.2 Scope of Services
26.1.2.1 Functional Content
26.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
26.1.2.1.1.1
Receiving and decontamination of trays and carts used in the
transportation of sterile items
26.1.2.1.1.2
Receiving and decontamination of equipment and instruments
used in clinical procedures
26.1.2.1.1.3
Reprocessing equipment destined for off-site use
26.1.2.1.1.4
Cleaning of scopes used in the Ambulatory Care/Day Program
component (See AC.02 – cystoscopy and colposcopy procedures)
26.1.2.1.1.5
Quality control of reusable equipment and instruments (inspection
for condition and eligibility for re-use)
26.1.2.1.1.6
Waste segregation and disposal
26.1.2.1.1.7
Cart washing
26.1.2.1.1.8
Equipment reassembly
26.1.2.1.1.9
Instrument tray and pack assembly
26.1.2.1.1.10 Sterilization of trays, packs, individual pieces of equipment and
instruments
26.1.2.1.1.11 Assembly of closed case carts
26.1.2.1.1.12 Temporary holding of sterilized/reprocessed items pending
transportation to point of use or remote sterilized holding facilities
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.1.2.2 Exclusions
26.1.2.2.1 The following list specifies equipment processing functions that are
understood to occur in other functional components in the Facility or
outside of the Facility:
26.1.2.2.1.1
Processing of scopes used in performance of gastro-intestinal
endoscopic procedures and bronchoscopy procedures (See AC.04
Outpatient Procedural Care)
26.1.2.2.1.2
Processing of probes used in Medical Imaging (See DT.02)
26.1.2.3 Anticipated Trends in Service Delivery
26.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
shall be reflected in the component’s design.
26.1.2.3.1.1
Infection control is predicted to remain an ongoing challenge in all
areas of the facility.
26.1.2.3.1.2
Complexity of processing is increasing in response to introduction
of new technologies.
26.1.2.3.1.3
Ongoing introduction of enhanced approach and standards for
enhanced infection control.
26.1.3 Scope of Education Functions
26.1.3.1 New staff recruited to work in this component will require orientation and on-the-job
training. All teaching and supervision functions will be accommodated in the general
work areas, and will not require specialized or dedicated facilities in this component.
26.1.4 Scope of Research Functions
26.1.4.1 Research conducted in this component will support service quality initiatives including
studies in to infection control protocols and outcomes. This type of research will be
accommodated in the general work areas, and will not require specialized or dedicated
facilities in this component.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.2 OPERATIONAL DESCRIPTION
26.2.1 Hours of Operation
26.2.1.1 The component at this facility will be staffed and in operation:
26.2.1.1.1 24 hours-a-day, 7 days-a-week
26.2.2 People Management Systems
26.2.2.1 Access to this component will be controlled at all times, with electronic security
technology providing control (e.g., access card, retinal scans).
26.2.3 Materiel Management Systems
26.2.3.1 Consumable Supplies
26.2.3.1.1 Inventories of consumable supplies will be maintained close to point of use
on the inpatient unit. Generally, a 3 day supply of each item will be
maintained with minimum inventory levels triggering a re-ordering process.
All orders will be sent electronically to the facility’s Materiel Management
component (See OS-STL.05) for processing.
26.2.3.2 Processed Items Flow
26.2.3.2.1 The Facility will use a centralized model for decontaminating and sterilizing
items requiring the highest level of infection control. The MDRD’s primary
focus will be on reprocessing equipment, instruments and consumable
supplies used in surgical procedures. A secondary focus will be on
providing sterile instruments and supplies to other Facility components
including:
26.2.3.2.1.1
Medical Imaging (See DT.02)
26.2.3.2.1.2
Emergency Department (ED – See AC.01)
26.2.3.2.1.3
All Inpatient Care Units (See IP.01 General Medical/Surgical
Inpatient Unit, IP.02 Intensive Care Unit and IP.03 Maternity and
Newborn Inpatient Unit)
26.2.3.2.1.4
Ambulatory Care/Day Programs (See AC.02)
26.2.3.2.1.5
Outpatient Procedural Care (See AC.04)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.2.3.2.2 Reprocessing of all items will begin at the component’s point of receiving.
A centralized location will be designated for contaminated receiving and
marshalling of case carts arriving from the Surgical Services component. A
separate area will be designated for loose articles.
26.2.3.2.3 As each cart is opened, contaminated items will be removed and moved to
an initial processing area where any required disassembly will be
performed. Items will be washed/disinfected and inspected for condition,
dried and then reassembled, if required. Damaged items will be removed
and replaced from the component’s inventory of circulating instruments.
Carts and trays used in transporting items will be cleaned as well in this
stage of processing. Contaminated wastes will not be returned with case
carts, but segregated and disposed of in the Surgical Services component
(See DT.04).
26.2.3.2.4 Items leaving the contaminated area will be deemed to be clean and next
moved to an assembly area where MDRD personnel will pick from
inventories of equipment, instruments, supplies and disposable linen to
construct packs and trays. Peel packs, serving as containers for small
items will be assembled here and used in the construction of packs and
trays. Clean inventories will also be used to supply loose items destined for
inventory holding areas located in other components (e.g., AC.02
Ambulatory Care/Day Program spaces).
26.2.3.2.5 Assembled packs, linen, reusable supplies and loose instruments and
equipment will be next sterilized. Sterilization will use a method
appropriate for the item (i.e., fluid, sonic or steam).
26.2.3.2.6 In the last stage of reprocessing, sterilized items will be organized into
closed case carts or onto minor or major procedure trays in accordance
with schedules provided by the Surgical Services component (See DT.04)
and other areas where procedures and treatments are carried out.
Assembled carts, trays and loose equipment and instruments will be
temporarily held in a central sterile distribution area for pick-up and
transportation to the point of use or to a sterile holding area located
elsewhere in the Facility. Component will accommodate storage of supplier
“loaner” items until return of items is complete.
26.2.3.2.7 Transportation of items to and from the MDRD component will be
conducted by MDRD personnel.
26.2.3.2.8 Modalities used to decontaminate, clean and sterilize equipment,
instruments and supplies will include:
26.2.3.2.8.1
Steam
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.2.3.2.8.2
Fluid (e.g., plasma – hydrogen peroxide based biocide - to
accommodate sterilization of heat-sensitive items)
26.2.3.2.8.3
Automatic washing with disinfectants including case cart casher
26.2.3.2.8.4
Ultrasonic
26.2.3.2.9 Operations in this component will be equipment intensive. The modalities
listed above will involve the following pieces of equipment:
26.2.3.2.9.1
Autoclave
26.2.3.2.9.2
Automatic washer/disinfectant (small instruments)
26.2.3.2.9.3
Cart washer
26.2.3.2.9.4
Dryer (used in combination with pasteurizer)
26.2.3.2.9.5
Pasteurizer
26.2.3.2.9.6
Scope washer
26.2.3.2.9.7
Steripeel machine (manufacturing of peel packs)
26.2.3.2.9.8
Sterrad sterilizer (plasma/no heat method of sterilization)
26.2.3.2.9.9
Ultrasonic washer
26.2.3.2.10 The following table illustrates the organization of MDRD equipment
according to the stage of processing it supports.
MDRD EQUIPMENT
STATUS OF ITEMS
Before Processing
After Processing
Autoclave
Clean
Sterile
Cart Washer
Contaminated
Clean
Pasteurmatic Washer
Contaminated
Clean (Includes cycle through Dryer)
Scope Washer
Contaminated
Clean
Steripeel
Clean
Clean
Sterrad Sterilizer
Clean
Sterile
Ultrasonic Washer
Contaminated
Clean
Washer/Disinfectant (Automatic)
Contaminated
Clean
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.2.3.3 Linen
26.2.3.3.1 Laundry processing will occur off site at the regional laundry located in
Cumberland. Soiled linen will be consolidated at a central location in the
component, and temporarily held pending removal to the Environmental
Services component (See OS-STL.03) for off-site transfer. Clean linen
returning from the regional laundry will be delivered to central receiving
facilities in Environmental Services before being sorted and delivered to
MDRD.
26.2.3.4 Waste Management
26.2.3.4.1 Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system will
rely on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations. In
this component, waste management will begin at the individual
workstations with a centralized collection and temporary holding station.
26.2.3.4.2 Segregation of wastes will accommodate the following categories of
products:
26.2.3.4.2.1
General garbage
26.2.3.4.2.2
Sharps (including potentially biohazardous items)
26.2.3.4.2.3
Infectious or contaminated wastes (excluding sharps)
26.2.3.4.2.4
Clean paper and cardboard
26.2.3.4.2.5
Clean metal (tin and aluminum)
26.2.3.4.2.6
Clean recyclable plastics
26.2.4 Information Management Systems
26.2.4.1 All data regarding scheduled procedures and the inventory of processed equipment
required for each one will be communicated to this component electronically from the
OR Booking Office (See DT.04 Surgical Services). Terminals at final assembly
workstations will provide staff with immediate access to schedules of procedures and
associated processed equipment and supplies needs.
26.2.4.2 Staffing information will be a managed corporate service. Scheduling, including
providing for sick and vacation relief will be conducted centrally, and off-site. Notices to
individual staff regarding their schedules will be communicated electronically.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.3 DESIGN CRITERIA
26.3.1 LEAN Planning Standards
26.3.1.1 1-Way Flow Reprocessing Cycle
26.3.1.1.1 The organization of equipment and workstations in this component will
enable supplies and equipment to move in a single direction. As each item
clears a stage in the reprocessing cycle, it will move forward and not
retrace a previous path. The physical organization will also prevent paths
from crossing. This latter feature will be a key factor in separating clean
from contaminated items.
26.3.2 Proximity Relationships
26.3.2.1 The MDRD component’s location relative to other components, or other areas of the
Facility, and the nature of circulation used to move between different
components/areas are illustrated in the diagram below. Proximities are listed according
to rank; higher priorities appear above lower priorities.
MDRD Surgical Services 26.3.2.2 Provide Direct Access by Internal Circulation
to the Surgical Services component for the
movement of supplies and equipment and
for preservation of a sterile core. A
separation of more than one floor between
MDRD and Surgery, above or below, would
be considered acceptable.
MDRD Outpatient Procedural Care 26.3.2.3 Provide Direct Access by Internal Circulation
to the Outpatient Procedural Care
component for the movement of supplies
and equipment. Vertical integration possible
MDRD Emergency Department MDRD Mat/Newborn & Pediatric Inpatient Unit 26.3.2.4 Provide Direct Access by General
Circulation to the Emergency Department
component for the movement of supplies
and equipment.
26.3.2.5 Provide Direct Access by General
Circulation to the Maternity, Newborn and
Pediatric Inpatient component for the
movement of supplies and equipment.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.3.3 Internal Design Criteria
26.3.3.1 Functional Zoning
26.3.3.1.1 Space defined by this component will be organized into 3 discrete zones
that define restrictions on access and different levels of cleanliness.
26.3.3.1.1.1
A Contaminated Zone that represents the component’s central
receiving point. Returning pieces of equipment, instruments, linen
and waste will be transported to this site regardless of whether
they are being returned used or unused. Items will be segregated
here for disposal or for initial processing including disassembly (if
required) and cleaning/disinfecting.
26.3.3.1.1.2
A Clean Zone will accept items following initial processing in the
Contaminated Zone. Inventories of clean disposable linen and
consumable supplies will also be maintained here. Peel packs for
sterilized packaging of small items will be constructed in this zone.
Staff will then access the various inventories to construct packs
and trays or prepare loose items for delivery.
26.3.3.1.1.3
A Sterile Zone will accommodate the final stages of reprocessing.
Access to this area will be strictly controlled to prevent
contamination. Closed case carts will be assembled in this zone,
and all processed items will be held in this area prior to distribution
to point of use or sterile holding elsewhere in the Facility.
26.3.3.2 Circulation Patterns
26.3.3.2.1 The flow of items through this component will be one-way and progressive,
from dirty/contaminated through to sterile. As items work their way through
the reprocessing cycle, they will not reverse direction nor will they come
into contact with items at a lesser standard of cleanliness or sterility.
26.3.3.2.2 Items entering the MDRD that are processed elsewhere (e.g., new
consumable supplies) will be introduced into the component in the Clean
Zone.
26.3.3.2.3 All fixed equipment used in this component will be serviced in place.
Circulation space around each component will enable service personnel
access to all parts of a machine. Anchoring systems will be readily
accessible and simple to use in the event that a machine has to be moved
for servicing.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.3.3.3 Internal Design Criteria
26.3.3.3.1 Provide a pass-through window from the Contaminated zone to the Clean
zone.
26.3.3.3.1.1
Provide a cool-down area adjacent to the cart washer. Provide a
floor drain on the clean side of the cart washer.
26.3.3.3.1.2
Provide direct access from outside the department into a Loaner
Room. Provide access from the Loaner Room into the Sterile
Zone.
26.3.3.3.1.3
All countertops in the MDRD shall be stainless steel.
26.3.3.3.1.4
Provide floor drains in all zones.
26.3.3.3.1.5
Provide brackets for mounting multiple instrument tracking
monitors in all zones.
26.3.3.3.1.6
Provide a wall mounted phone in each zone.
26.3.3.3.1.7
Provide a drain adjacent to the cart washer exit on the clean side.
26.3.3.4 Component Entrance/Exit
26.3.3.4.1 Recognizing the circulation criteria cited above, there will be 2 points of
access and 2 points of exit for this component. Access points will lead into
the Contaminated Zone and Clean Zone with the latter serving as the
component’s main entrance. Entry into the Contaminated Zone will be
normally reserved for returning case carts and contaminated items.
26.3.3.4.2 Exit points will be located in the Clean Zone and Sterile Zone. The Clean
Zone again will function as the component’s main exit as well as the
departure point for items leaving the component directly from the point at
which they are cleaned (e.g., endoscopes). Sterile Zone egress will
normally be reserved for processed case carts and items waiting for
transport to either a point of use or the sterile holding area in the Surgical
Services component (See DT.04). Provide a handwash sink at the
entrance of the sterile zone.
26.3.3.5 Communication Technology
26.3.3.5.1 Workstations in the Clean Zone will have a means of communicating with
each of the operating rooms in the Surgical Services component (See
DT.04) to accommodate STAT requests.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.3.3.5.2 Networked computer terminals will be located in the Sterile Zone and will
provide immediate communication to the Surgical Services’ control station
for the receipt of future surgery schedules used to assemble packs and
trays. These terminals will also interface with other key areas in the
Facility including the ED (See AC.01), Ambulatory Care-Day Care (See
AC.02) and Ambulatory Care-Clinics (See AC.03). All of these areas will
share a common requirement for access to sterile items.
26.3.3.6 Infection Control
26.3.3.6.1 Each of the 3 zones will be isolated from the adjacent zone(s) by floor-toceiling walls and doors. Doors will be automatic sliding with touchless
controls. A pass-through washer/ disinfectant machine will form part of the
partitioning system separating the Contaminated Zone from the Clean
Zone.
26.3.3.6.2 All zones will be on a common air handling system, but the airflow will
generally be from cleanest to dirtiest (i.e., fresh air is introduced in the
Sterile Zone and exhausted out of the Contaminated Zone).
26.3.3.6.3 Hand wash stations will be located at the entrance/egress point for each of
the 3 zones. Hand washing facilities located in the Contaminated Zone will
include pedal-activated hot and cold water controls and air hand dryers.
26.3.3.6.4 Carts, tables, shelves, counters and drawers located throughout this
component will be constructed of metals that resist corrosion (e.g.,
stainless steel, aluminum). Inside corners on counters, shelving and in
drawers will be curved to facilitate cleaning and prevent dirt build-up. Use
of plastic and wood will be limited to finishes in private offices.
26.3.3.6.5 Unions between walls and floors will be curved to assist in cleaning and to
prevent dirt build-up in corners.
26.3.3.7 Decontamination Sinks
26.3.3.7.1 All Decontamination workstations and sinks shall be standardized. Provide
the following for all decontamination Sinks and workstations: Ample
counter space on either side of stainless steel sinks. Three basin stainless
steel sinks shall be no smaller than 24” X 17” X 10”. Provide an appropriate
sized stainless steel flat surface cover plate to place over sink to transition
to more counter space as needed. Provide a water gun that is tempered
and operates independently from faucets. Provide two faucets centered
between the three basins. Refer to Schedule 3 for specifications related to
water for the MDRD. Provide instrument grade air. Provide user regulated
suction (vacuum). Provide task lighting. Provide Electrical and data outlets
on both sides of counter space. Provide stainless steel shelving above
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
sinks that is at least as long as the sink assembly. Ensure the assembly is
capable of right to left one way operational work flow.
26.3.3.7.2 The decontamination work sinks and workstation must not be located along
walls. They may be placed in a back to back position with a wall between
them. These workstations must allow sufficient space to accommodate
staff working at the station (600mm minimum) as well as space for the flow
of materials and other staff (900mm minimum) between the work stations.
26.3.3.8 Assembly Workstations
26.3.3.8.1 Provide 6 workstations. Provide height adjustable assembly workstations.
Provide the following items for each workstation: One way flow, Medical
air, vacuum, power and data, Monitor/computer, Drawers, supply baskets
and Task lighting, Shelving, metal pegboards and rooms for carts on either
side. The assembly work surface shall be stainless steel.
26.3.3.9 Sterile Storage
26.3.3.9.1 In the sterile storage areas provide wire shelving (minimum 2400mm x
900mm). Ensure the shelving has adequate aisle room for two staff to
pass, each with a cart.
26.3.3.10 Site Lines
26.3.3.10.1 Recognizing the need for complete partitions between zones to preserve
levels of cleanliness, the use of glass in walls and doors will provide visual
access between staff working in different areas.
26.3.3.11 Environmental Control
26.3.3.11.1 Automatic cart washers will be in continuous use throughout a workday
and will produce substantial amounts of humidity. Air exchange in the
Contaminated Zone will be of sufficient volume to control humidity to a
range of 30% - 60% relative humidity.
26.3.3.11.2 Machinery used in the Contaminated Zone will produce high levels of
ambient noise. Safeguarding staff from potentially harmful effects of
prolonged exposure to these conditions will require noise attenuating
techniques including use of acoustic insulation around machines and noise
absorbing materials on walls and ceilings in this area.
26.3.3.11.3 Lighting around workstations will include a combination of fluorescent
ceiling lighting and task lighting located at each work site. Reflective
colours on walls, floors and ceilings will help create a bright environment
and reduce glare. Natural lighting and views to the exterior are desirable
for staff who will be confined to their workstations for prolonged periods.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.3.3.12 Ergonomics for an Aging Workforce
26.3.3.12.1 The expected increase in the average age of workers in all professions will
require greater attention to equipment and devices that staff will be
expected to use. Ease of access will be among the key criteria. Throughout
this component, this specification will be reflected in electrical outlets being
located approximately 900 mm (approximately 3’) above floor surface. The
type and number of electrical devices used in this component will continue
increasing, and elevated outlets will avoid stress associated with repetitive
bending.
26.3.3.12.2 Counters will be flat and entire work surfaces will be accessible without
needs for extensive reaching or for working into hard-to-access corners.
The latter create unusable spaces that can be difficult to clean.
26.3.3.12.3 Height adjustable counters must be installed in assembly area of MDRD.
26.3.3.13 Utilities
26.3.3.13.1 Refer to Schedule 3 for specifications related to water for the MDRD.
26.3.3.14 Workplace Safety
26.3.3.14.1 This component will be a closed component with access restricted to
authorized personnel. Electronic controls (e.g., access card finger print or
retinal scans) are used to control access, but exit will be unrestricted.
26.3.3.14.2 Scope washers located in the Contaminated Zone will produce fumes and
humidity. Ventilation ducts (exhaust air) located above each machine help
maintain air quality in the local environment.
26.3.3.14.3 Assembling packs, trays and carts will involve prolonged periods at a
worktable. Each table will be equipped with adjustable legs to
accommodate different working heights.
26.3.3.15 Surfaces and Finishes
26.3.3.15.1 Materials used to finish walls, ceilings and floor as well as coverings for
tables, counters and cabinets will be non-porous. Flooring throughout the
component will frequently be wet. A non-skid finish will protect staff
against slipping even under wet conditions.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.3.4 Component Functional Diagram
26.3.4.1 The areas making up this component shall be organized as illustrated in the following
diagram:
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
26.3.5 Space Table
26.3.5.1 The schedule accompanying this document illustrates rooms, and their respective
sizes, that combine to make up this functional component. Refer to the respective
space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONIAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM ID
(RID)
ROOM TYPE
OS-STL.09 Medical Device Reprocessing Department (MDRD)
CONTENTS/KEY
FEATURES/DESIGN CRITERIA
Contaminated Zone - Soiled Receiving and Decontamination Area
01
Holding Room - Contaminated
Returning case carts, equipment and
instruments - Accessed using
automated double-wide doors
w/electronic security
02
Holding Room - Waste
Segregated areas for general,
biohazardous, sharps and recyclable
waste products - Direct access to
circulation leading to Materials
Management
03
Work Area - Decontamination
1 wrkstn w/counter, sink, adjustable
height table - Separate hand washing
sink w/pedal activated hot/cold water
controls and air dryer
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
33.0
1
33.0
18.5
1
18.5
55.0
2
110.0
04
Alcove - Staff Gowning
Stocks of clean gowns, hats, gloves Hampers
5.5
1
5.5
05
Storage Room - Cleaning and
Disinfecting Products
Fixed shelving and cabinets for bulk
storage of liquids and solids Ventilated
14.0
1
14.0
06
Cart Washer
Pass-through type - Items exit into
Clean Zone
15.0
1
15.0
07
Washer/Disinfectant Machine
Automated pass-through type - Items
exit into Clean Zone
15.0
2
30.0
08
09
10
Ultrasonic Washer
Pasteurmatic Washer
Emergency Station - Eye Wash
and Shower
2.0
4.5
1.5
1
1
1
2.0
4.5
1.5
Subtotal, Contaminated Zone
234.0
Clean Zone - Preparation and Packaging Area
11
Alcove - Entry Vestibule
12
13
14
ROOM
SIZE
(nsm)
Alcove - Staff Gowning
Toilet, Staff
Preparation/Packaging Station
Includes hand washing station
Component's main entrance Controlled entrance w/scanner (key
card, finger print or retinal)
2.8
1
2.8
Stocks of clean gowns, hats, gloves Hampers - Adjacent to entrance into
Sterile Zone
5.5
1
5.5
1 assisted WC, 1 sink - Hand washing
station outside adjacent to doorway
4.5
2
9.0
80.0
2
160.0
6 wrkstn w/adjustable height table,
task lighting
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
COMOX VALLEY HOSPITAL
ROOM ID
(RID)
ROOM TYPE
OS-STL.09 Medical Device Reprocessing Department (MDRD)
ROOM
SIZE
(nsm)
CONTENTS/KEY
FEATURES/DESIGN CRITERIA
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
15
Storage Room - Clean
Instruments
Combination of wall mounted hanging
racks, shelves and cabinets
75.0
1
75.0
16
Office – First Line Leader
Multipurpose work area, files storage Accommodates meetings with up to 1
person
10.0
1
10.0
Subtotal, Clean Zone
262.3
Sterile Zone - Sterilization and Holding Area
17
Alcove - Entry Vestibule
18
19
20
21
Steam Sterilizer
Low Temperature/ Plasma
Sterilizer
Holding Room - Sterile
Assembly/Holding Area - Case
Carts
Automated doors separating Clean
and Sterile Zones
3.0
1
3.0
15.0
8.0
2
1
30.0
8.0
Loose instruments, packs, small
pieces of equipment
30.0
1
30.0
1 wrkstn w/adjustable height table,
task lighting - Holding area for up to 10
carts - Direct access to circulation
leading to OR (sterile core)
45.0
2
90.0
Subtotal, Sterile Zone
161.0
TOTAL NSM, ALL AREAS
657.3
Built-in unit e.g. Sterrad
CAMPBELL RIVER HOSPITAL FUNCTIONIAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM ID
(RID)
ROOM TYPE
OS-STL.09 Medical Device Reprocessing Department (MDRD)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBE
R OF
ROOMS
TOTAL
SIZE
(nsm)
Contaminated Zone - Soiled Receiving and Decontamination Area
01
02
Returning case carts, equipment and
instruments - Accessed using automated
double-wide doors w/electronic security
20.0
1
20.0
Holding Room - Waste
Segregated areas for general,
biohazardous, sharps and recyclable
waste products - Direct access to
circulation leading to Materials
Management
18.5
1
18.5
03
Utility Room - Decontamination
1 workstation w/counter, sink, adjustable
height table - Separate hand washing
sink w/pedal activated hot/cold water
controls and air dryer
55.0
1
55.0
04
Alcove - Staff Gowning
Stocks of clean gowns, hats, gloves Hampers
5.5
1
5.5
Fixed shelving and cabinets for bulk
storage of liquids and solids - Ventilated
14.0
1
14.0
05
Holding Room - Contaminated
Storage Room - Cleaning and
Disinfecting Products
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-STL.09
MEDICAL DEVICE REPROCESSING DEPARTMENT
(MDRD)
CAMPBELL RIVER HOSPITAL
ROOM ID
(RID)
ROOM TYPE
06
Cart Washer
07
Washer/Disinfectant Machine
08
09
Ultrasonic Washer
Pasteurmatic Washer
10
Emergency Station - Eye Wash and
Shower
OS-STL.09 Medical Device Reprocessing Department (MDRD)
ROOM
SIZE
(nsm)
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Pass-through type - Items exit into Clean
Zone
Automated pass-through type - Items exit
into Clean Zone
Includes hand washing station
NUMBE
R OF
ROOMS
TOTAL
SIZE
(nsm)
15.0
1
15.0
15.0
2
30.0
2.0
4.5
1
1
2.0
4.5
1.5
1
1.5
Subtotal, Contaminated Zone
166.0
Clean Zone - Preparation and Packaging Area
11
Alcove - Entry Vestibule
Component's main entrance - Controlled
entrance w/scanner (key card, finger
print or retinal)
2.8
1
2.8
12
Alcove - Staff Gowning
Stocks of clean gowns, hats, gloves Hampers - Adjacent to entrance into
Sterile Zone
5.5
1
5.5
13
Toilet, Staff
1 assisted WC, 1 sink - Hand washing
station outside adjacent to doorway
4.5
1
4.5
14
Preparation/Packaging Station
4 workstation w/adjustable height table,
task lighting
80.0
2
160.0
15
Storage Room - Clean Instruments
Combination of wall mounted hanging
racks, shelves and cabinets
75.0
1
75.0
16
Office – First Line Leader
Multipurpose work area, files storage Accommodates meetings with up to 1
person
10.0
1
10.0
Subtotal, Clean Zone
257.8
Sterile Zone - Sterilization and Holding Area
17
Alcove - Entry Vestibule
18
19
Steam Sterilizer
Low Temperature/ Plasma Sterilizer
20
Holding Room - Sterile
21
Assembly/Holding Area - Case
Carts
Automated doors separating Clean and
Sterile Zones
3.0
1
3.0
15.0
8.0
2
1
30.0
8.0
Loose instruments, packs, small pieces
of equipment - Separate area for items
waiting shipment to north island facilities
30.0
1
30.0
1 workstation w/adjustable height table,
task lighting - Holding area for up to 10
carts - Direct access to circulation
leading to OR (sterile core)
45.0
1
45.0
Built-in unit e.g. Sterrad
Subtotal, Sterile Zone
116.0
TOTAL NSM, ALL AREAS
539.8
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.01
CENTRAL EDUCATION AND CONFERENCE FACILITIES
This specification outlines the functional, operational and physical requirements for the Central Education
and Conference Facilities functional component.
27.1 FUNCTIONAL DESCRIPTION
27.1.1 Statement of Purpose
27.1.1.1 The Central Education and Conference Facilities component accommodates group
activities that vary in size for a variety of administrative, instructional and educational
functions. Also, it will accommodate functions associated with the Emergency
Operations Centre (EOC) in case of a major disaster event.
27.1.1.2 This component will be centrally managed as a Facility Resource and it will be open to
all the users from inside and outside of the Facility.
27.1.2 Scope of Services
27.1.2.1 Functional Content
27.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
27.1.2.1.1.1
Conducting meetings, instructional sessions, lectures,
presentations, demonstrations and workshops involving audiences
of varying sizes
27.1.2.1.1.2
Presenting the list of functions cited above using live presenters
and through the use of teleconference, videoconference and
telehealth technology
27.1.2.1.1.3
Hosting the community’s emergency operations centre (EOC) for
coordinating emergency services in response to a major disaster
27.1.2.1.1.4
The EOC will be a multi-purpose conference room and will be
dividable into a minimum of four rooms, each capable of
accommodating a minimum of twenty people.
27.1.2.1.1.5
Video-conferencing will be provided in the EOC and will be
available in all of the conference rooms when the EOC is divided
into smaller rooms.
27.1.2.1.1.6
A coat storage area will be provided in the component. The coat
storage area will accommodate a minimum of fifty coats.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.01
CENTRAL EDUCATION AND CONFERENCE FACILITIES
27.1.3 Exclusions
27.1.3.1 The following list specifies administrative, instructional and educational functions
conducted in other components in the Facility or outside of the Facility:
27.1.3.1.1 Instructional, educational and assessment functions requiring dedicated
and/or purpose built facilities (e.g., activities of daily living kitchen located
in DT.05 Therapy Services)
27.1.3.2 Anticipated Trends in Service Delivery
27.1.3.2.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
should be reflected in the component’s design.
27.1.3.2.1.1
Providing medical, nursing and allied health support to remote
communities will continue relying on telehealth medicine.
27.1.3.2.1.2
Demands for quality meeting accommodation will continue
exceeding availability of suitable rooms, especially during peak
utilization hours; needs for this component to operate under
extended hours, including evenings and on weekends will be
anticipated.
27.1.3.2.1.3
The EOC will be a multi-purpose conference room and will be
dividable into a minimum of four rooms, each capable of
accommodating a minimum of twenty people.
27.1.3.2.1.4
Video-conferencing will be provided in the EOC and will be
available in at least two of the conference rooms when the EOC is
divided into smaller rooms.
27.1.3.2.1.5
A coat storage area will be provided in the component. The coat
storage area will accommodate a minimum of fifty coats.
27.1.4 Scope of Education Functions
27.1.4.1 Functions accommodated in this component will support:
27.1.4.1.1 Continuing education for professionals
27.1.4.1.2 In-service education for hospital personnel
27.1.4.1.3 Orientation sessions for new staff
27.1.4.1.4 Demonstrations on the use of new technology and equipment
27.1.4.1.5 Lectures to learners enrolled in medical, nursing and allied health
programs
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.01
CENTRAL EDUCATION AND CONFERENCE FACILITIES
27.1.5 Scope of Research Functions
27.1.5.1 Functions accommodated in this component will support research activities of
investigators employed at the Facility and of visiting professionals. This support will be
in the form of:
27.1.5.1.1 Hosting presentations of research projects
27.1.5.1.2 Accommodating small group meetings of research staff engaged in
literature or data review
27.2 OPERATIONAL DESCRIPTION
27.2.1 LEAN Planning Standards
27.2.1.1 Component Utilization
27.2.1.1.1 Clerical and professional staff spends considerable time each work day
scheduling meetings and then searching for and booking appropriate
meeting space. Centralization of booking functions for all rooms in this
component will enable authorized users a convenient, on-line, real time
view of room availability and the technology supported in each room.
27.2.2 Hours of Operation
27.2.2.1 The Central Education and Conference Facilities component will be accessible to
authorized users during the following times:
27.2.2.1.1 0800 and 2100, 7-days-a-week
27.2.3 People Management Systems
27.2.3.1 Wayfinding
27.2.3.1.1 An electronic marquee located at the main entrance to this component will
inform arriving users of the location of their event, its scheduled time and a
floor plan guiding them to their destination. Descriptive services for
amenities like toilets, telephones, vending machines, food services and
bank machines (ATM) will also be provided by this technology.
27.2.4 Materiel Management Systems
27.2.4.1 Food Catering
27.2.4.1.1 Catering for events conducted in this component will be accommodated,
and will involve areas for setting up prepared foods, snacks and beverages
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.01
CENTRAL EDUCATION AND CONFERENCE FACILITIES
for self service. Electrical services will be required for small appliances like
coffee machines and hot plates.
27.2.4.1.2 Kitchenette facilities will be provided for cleaning of spills and initial
cleaning of plates, utensils and serving dishes. All final cleaning of these
items will be conducted elsewhere (e.g., OS-STL.06 Nutrition and Food
Services or off-site if catering is supplied by private vendors).
27.2.4.1.3 Food production will not be accommodated in this component.
27.2.4.2 Waste Management
27.2.4.2.1 Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations. In
this component, waste management will focus on disposal of discarded
paper, used food containers and disposable plates and utensils. All
collected wastes will be returned to designated holding areas located in
Environmental Services (See OS-STL.03).
27.2.4.2.2 Segregation of wastes in this component will accommodate the following
categories of products:
27.2.4.2.2.1
General garbage
27.2.4.2.2.2
Clean paper and cardboard
27.2.4.2.2.3
Clean metal (tin and aluminum)
27.2.4.2.2.4
Clean recyclable plastics
27.2.4.2.2.5
Compostables
27.2.5 Information Management Systems
27.2.5.1 See People Management Systems, above.
27.3 DESIGN CRITERIA
27.3.1 LEAN Planning Standards
27.3.1.1 Proximity Relationships
27.3.1.1.1 The Central Education and Conference Facilities component’s location
relative to other components and the nature of circulation used to move
between 2 components are illustrated in the diagram below. Proximities are
listed according to rank; higher priorities appear above lower priorities.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.01
CENTRAL EDUCATION AND CONFERENCE FACILITIES
Central Education and Conference Facilities Central Education and Conference Facilities Main Building Entrance Main Horizontal/ Vertical Circulation 27.3.1.1.2 Provide direct access by general
circulation to from the host building’s main
entrance for the movement of people
arriving from outside of the facility.
27.3.1.1.3 Provide convenient access by general
circulation to major public and non-public
circulation. Groups of varying sizes will
access this component frequently during
each day.
27.3.2 Internal Design Criteria
27.3.2.1 General Internal Layout
27.3.2.1.1 The interior of this component should be organized as follows:
27.3.2.1.1.1
Entrance, congregation and assembly area
27.3.2.1.1.2
Meeting room cluster area
27.3.2.2 Component Utilization and Security
27.3.2.2.1 Utilization of this component will be promoted by having convenient access
to users arriving from off-site. It will also require access outside of the
Facility’s routine hours of operation, and at a time when staffing will be
lower or absent in other components.
27.3.2.2.2 Satisfying these criteria will require a point of access/exit from nearby
vehicle drop-off and parking facilities. An interior point of access/exit will be
unlocked and opened during normal hours of operation, but otherwise
locked with access restricted to authorized users. Security throughout the
rest of the Facility must not be compromised by this component’s
operations during evenings and weekends.
27.3.2.2.3 The entire component must be on either vital power or back-up (generator)
power to accommodate full operation, especially that of the Emergency
Operations Centre (EOC), in the event of an electrical power failure.
27.3.2.3 Emergency Operations Centre (EOC)
27.3.2.3.1 The EOC’s primary function will be to serve as the community’s emergency
services coordination centre following a local major disaster. This will
require secured, permanent and immediately accessible storage of
emergency equipment and supplies (e.g., telephones, computers,
printers/plotters, VHF radios, first response kits, maps and printed
manuals).
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.01
CENTRAL EDUCATION AND CONFERENCE FACILITIES
27.3.2.3.2 This primary function, however, will also be an infrequent and relatively
short-lived role for the EOC. At all other times, it will be part of the Facility’s
inventory of bookable meeting space; this secondary function must not
inhibit immediate conversion from meeting room to EOC. This criterion will
require tables that can be either used in EOC operations or tiltable and
easily stored. Similarly, chairs must be either adaptable to EOC personnel
use or stacking/folding for convenient storage.
27.3.2.3.3 Electrical outlets must be in recessed and covered floor receptacles
located throughout the EOC. The location of electronic and electrical
equipment will vary according to the nature and extent of the event, and
the EOC’s setup configuration will require maximum flexibility.
27.3.2.3.4 Communications technology for the EOC must include, as a minimum, the
following services and features:
27.3.2.3.4.1
6 data drops for computers
27.3.2.3.4.2
6 drops for CISCO/VOIP telephones
27.3.2.3.4.3
6 drops for TELUS 1B telephones
27.3.2.3.4.4
Cable drops for VHF, UHF and Ham antennae (roof mounted)
27.3.2.3.4.5
Satellite antenna with cable drop and switch box in the, plus
satellite telephone storage (secured) to accommodate failure of the
TELUS 1B telephone system
27.3.2.4 Building Accommodation – Acute Care Building versus Clinical Support Building
27.3.2.4.1 The EOC described in the previous criteria must be accommodated in a
building built to post disaster standards. The entire component will be
located within the acute care building. The EOC will be provided with a
dedicated exterior exit for access to emergency vehicles.
27.3.2.5 New Employee Orientations and On-Line Learning Tasks
27.3.2.5.1 A minimum of one conference room will be dedicated for use as a
computer laboratory. This laboratory will contain a minimum of ten
temporary/ training workstations. A teaching/ control station will be
accommodated in the component. Secure storage will be provided in the
component for the storage of training equipment and materials.
27.3.2.5.2 The computer laboratory will be available for unsupervised use (e.g., selfpaced or supplemental training). Security systems will enable authorized
staff to have temporary access to the training laboratory. This authorization
will be time limited and will automatically expire when the scheduled
access period ends.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.01
CENTRAL EDUCATION AND CONFERENCE FACILITIES
27.3.3 Component Functional Diagram
27.3.3.1 The areas making up this component should be organized as illustrated in the following
diagram:
27.3.3.1.1 Diagram 1: Meeting Rooms and EOC Room
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.01
CENTRAL EDUCATION AND CONFERENCE FACILITIES
27.3.4 Space Table
27.3.4.1 The schedule beginning on the following page illustrates rooms, and their respective
sizes, that combine to make up this functional component. Refer to the respective
space program for each Facility.
COMOX VALLEY HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: COMOX VALLEY HOSPITAL
ROOM
ID (RID)
ROOM TYPE
OS-GP.01 Central Education and Conference Facilities
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL
SIZE
(nsm)
Entrance, Congregation and Assembly Area
01
Lobby/Entrance Vestibule
02
03
04
Alcove, Telephone
Toilet, Male/Female
Toilet/Shower Room,
Staff
Coat Room
05
Meeting Room Cluster Area
06 Meeting, Room Large
07
08
09
Video-Conferencing &
Communication
Equipment
Storage, Carts
Meeting Room, Small
10
Meeting Room, Medium
11
12
Kitchenette/Pantry
Housekeeping Room
Direct connection with exterior building
entrance w/ nearby vehicle drop-off and
patron parking
8.0
1
8.0
1.0
6.0
6
2
3
1
2.0
18.0
6.0
9.0
1
9.0
Subtotal, Entrance, Congregation and Assembly Area
43.0
Functions as the Emergency
80.0
1
Operations Command. Accommodation
for up to 30-60 people when set up as
EOC - Storage cabinetry for post disaster
response supplies and equipment Minimal use of glazing - Locate w/
dedicated doorway leading to outdoor
area - Dividable using floor-to-ceiling
sound insulating folding partitions Partition into 4 rooms accommodating up
to 20 people each room - Each partitioned
room serviced with teleconference
technology
Locate in 1 of the partitioned meeting
9.5
1
rooms - Serviced with videoconference
technology
EOC Supplies
2.0
4
Table w/ seating for up to 6 people 14.0
3
Serviced with teleconference and
videoconference technology
Table w/ seating for up to 12 people - 1
22.0
2
Room set up for computer training
sessions (10 teaching wrkstns, 1
teaching/demonstration wrkstn)
Provides support to all meeting rooms
9.0
1
1 floor sink, standard wall-mounted sink,
6.0
1
storage cabinetry - Accommodates
housekeeping cart storage
Subtotal, Education and Conference Area
80.0
198.5
TOTAL NSM, ALL AREAS
241.5
9.5
8.0
42.0
44.0
9.0
6.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.01
CENTRAL EDUCATION AND CONFERENCE FACILITIES
CAMPBELL RIVER HOSPITAL FUNCTIONAL SPACE REQUIREMENTS: CAMPBELL RIVER HOSPITAL
ROOM
ID (RID)
ROOM TYPE
OS-GP.01 Central Education and Conference Facilities
CONTENTS/KEY FEATURES/DESIGN
CRITERIA
Entrance, Congregation and Assembly Area
01
Lobby/Entrance Vestibule
Direct connection with exterior building
entrance w/ nearby vehicle drop-off and
patron parking
02
Alcove, Telephone
03
Toilet, Male/Female
1 assisted WC, 1 sink
04
Toilet/Shower Room,
1 assisted WC, 1 sink, 1 assisted shower
Staff
05
Coat Room
Meeting Room Cluster Area
06
Meeting, Room Large
07
08
09
Video-Conferencing &
Communication
Equipment
Storage, Carts
Meeting Room, Small
10
Meeting Room, Medium
11
12
Kitchenette/Pantry
Housekeeping Room
ROOM
SIZE
(nsm)
NUMBER
OF
ROOMS
TOTAL SIZE
(nsm)
8.0
1
8.0
1.0
6.0
6
2
2
1
2.0
12.0
6.0
6.0
1
6.0
Subtotal, Entrance, Congregation and Assembly Area
34.0
Functions as the Emergency
80.0
1
Operations Command. Accommodation
for up to 30-60 people when set up as
EOC - Storage cabinetry for post disaster
response supplies and equipment Minimal use of glazing - Locate w/
dedicated doorway leading to outdoor
area - Dividable using floor-to-ceiling
sound insulating folding partitions Partition into 4 rooms accommodating up
to 20 people each room - Each partitioned
room serviced with teleconference
technology
Locate in 1 of the partitioned meeting
9.5
1
rooms - Serviced with videoconference
technology
EOC Supplies
2.0
4
Table w/ seating for up to 6 people 14.0
3
Serviced with teleconference and
videoconference technology
Table w/ seating for up to 12 people - 1
22.0
2
Room set up for computer training
sessions (10 teaching wrkstns, 1
teaching/demonstration wrkstn)
Provides support to all meeting rooms
9.0
1
1 floor sink, standard wall-mounted sink,
6.0
1
storage cabinetry - Accommodates
housekeeping cart storage
Subtotal, Education and Conference Area
80.0
198.5
TOTAL NSM, ALL AREAS
232.5
9.5
8.0
42.0
44.0
9.0
6.0
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.02
CENTRAL MEDICAL STAFF/UBC FoM ACADEMIC TEACHING FACILITIES
This specification outlines the functional, operational and physical requirements for the Central Medical
Staff and UBC Faculty of Medicine (FoM) Academic Teaching Facilities functional component.
28.1 FUNCTIONAL DESCRIPTION
28.1.1 Statement of Purpose
28.1.1.1 The Authority recognizes the essential role fulfilled by physicians in providing patient
care, administrative support to their colleagues and training for undergraduate and
post-graduate medical learners. The Central Medical Staff Facilities will promote this
on-site participation while fostering a culture of collegiality among medical staff.
Adjacent facilities designated for UBC medical learners will fulfill similar roles for this
group while promoting communication and learning involving practitioners and learners.
28.1.2 Scope of Services
28.1.2.1 Functional Content
28.1.2.1.1 The following list specifies the minimum set of functions that must be
accommodated within the component’s spaces:
28.1.2.1.1.1
Research and study
28.1.2.1.1.2
Patient record review and dictation
28.1.2.1.1.3
Small group discussions
28.1.2.1.1.4
Mail receiving, consolidation of outgoing mail and posting of
notices (e.g., continuing medical education, up-coming
conferences, internal meetings)
28.1.2.1.1.5
Relaxation and light recreation
28.1.2.1.1.6
Dining (light snacks and beverages)
28.1.2.1.1.7
Refuge from the patient care environment
28.1.2.1.1.8
On-call coverage
28.1.2.2 Exclusions
28.1.2.2.1 The following list specifies functions similar to those accommodated in this
component, but are understood to occur in other components in the Facility
or outside of the Facility:
28.1.2.2.1.1
Administrative work conducted on behalf of medical staff with
privileges at the Facility
28.1.2.2.1.2
Administrative work conducted on behalf of the UBC FoM (See
OS-GP.05 Site Support and Business Services)
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.02
CENTRAL MEDICAL STAFF/UBC FoM ACADEMIC TEACHING FACILITIES
28.1.2.2.1.3
Collaborative teaching (See IP.01 General Medical/Surgical
Inpatient Units)
28.1.2.3 Anticipated Trends in Service Delivery
28.1.2.3.1 The following lists trends expected within the planning horizon of this
project, and that are expected to affect the nature and/or extent of
functions accommodated within this component. Effects of these trends
should be reflected in the component’s design.
28.1.2.3.1.1
Increasing involvement by medical learners in supporting patient
care promoting learners’ presence on-site and for prolonged
periods
28.1.2.3.1.2
Increasing average level of acuity among admitted patients
requiring more medical staff intervention at any time of day or night
28.1.3 Scope of Education Functions
28.1.3.1 Medical learners will receive practical skills training through rounds and small group
seminars, tutorials and discussions. All teaching and supervision functions will be
accommodated in the Facility’s general work areas, and in designated University of
British Columbia (UBC) FoM academic teaching and learning space forming part of this
component.
28.1.4 Scope of Research Functions
28.1.4.1 Medical staff and medical learners will, from time-to-time, be engaged in research. The
nature and extent of research functions will be accommodated in the general work
areas, and will not require specialized or dedicated facilities in this component. In
consultation with champions, determine if dedicated secure storage is required for
clinical research protocols and information.
28.2 OPERATIONAL DESCRIPTION
28.2.1 LEAN Planning Standards
28.2.1.1 Medical staff will use this component immediately before and after seeing their patients.
Ideally, these centralized facilities will be accommodated in a location that affords
convenient access to both inpatients and to those areas where large volumes of
outpatients concentrate. Strategic positioning will allow medical staff and medical
learners to move efficiently between this component and patient care sites.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.02
CENTRAL MEDICAL STAFF/UBC FoM ACADEMIC TEACHING FACILITIES
28.2.2 Hours of Operation
28.2.2.1 The Central Medical Staff/UBC FoM Academic Teaching Facilities component at this
Facility will be open for authorized access:
28.2.2.1.1 24 hours-a-day, 7 days-a-week
28.2.3 People Management Systems
28.2.3.1 Access to the Central Medical Staff/UBC FoM Academic Teaching Facilities component
will be restricted to authorized medical staff and medical learners. (See also Internal
Design Criteria, C. Component Security below) Visiting medical staff may also have
access, but continuous escort by an authorized medical staff member while in the
component is assumed.
28.2.4 Materiel Management Systems
28.2.4.1 Waste Management
28.2.4.1.1 Waste products will be managed according to a system of segregation at
point of origin and sequential consolidation. Operation of this system relies
on appropriate containment facilities for each type of waste product
beginning at where the waste is generated followed by similar, but
progressively larger, containment facilities at key collection locations. In the
Central Medical Staff/UBC FoM Academic Teaching Facilities component,
waste management is understood to begin at any workstation or in the oncall rooms.
28.2.4.1.2 Segregation of wastes will accommodate the following categories of
products:
28.2.4.1.2.1
General garbage
28.2.4.1.2.2
Confidential paper
28.2.4.1.2.3
Clean paper and cardboard
28.2.4.1.2.4
Clean metal (tin and aluminum)
28.2.4.1.2.5
Clean recyclable plastics
28.2.4.1.3 Environmental Services personnel will be responsible for cleaning all areas
of this component on a daily basis.
28.2.4.2 Food Services
28.2.4.2.1 A limited selection of beverages and light snack products will be provided
for medical staff. Inventories of food and beverages will be maintained by
Food Services personnel on a once-daily basis.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.02
CENTRAL MEDICAL STAFF/UBC FoM ACADEMIC TEACHING FACILITIES
28.2.5 Information Management Systems
28.2.5.1 Computer terminal and wireless pads will provide medical staff and medical learners
with access to the internet, The Authorities intranet and to the electronic medical record
(EMR) system. Security levels will be assigned to each authorized user controlling the
site(s) and document(s) to which they have access and to what extent they are allowed
to add, delete or alter data.
28.2.5.2 The Central Medical Staff/UBC FoM Academic Teaching Facilities component will
accommodate both hard-wired and wireless connectivity. For the UBC, Wi-Fi network
access is required based on UBC standards, to provide learners with access to
university learning resources including the library, online journal access, the learning
management system, video repositories and general internet access.
28.2.5.3 A television will be provided in the component.
28.2.5.4 Work carrels/ workstations and dictation stations will be provided. Each workstation will
include a minimum of two data and power outlets.
28.2.5.5 Staff physician mailboxes and student learner mailboxes will be provided.
28.2.5.6 Lockers for staff physicians will be provided. At a minimum twenty-four full size lockers
will be provided
28.2.5.7 A minimum of two washrooms will be provided; the washrooms will not open into a
public area or the main area of the component.
28.2.5.8 A shower and washroom will be provided for each on-call room.
28.2.5.9 On-call rooms will be sound and light attenuated and will be located off a non-public
corridor.
28.2.5.10 A clinical skills assessment room will be provided. An observation station will be
provided in the clinical skills assessment room. Confirm information systems
requirements and electrical requirements with clinical champions.
28.3 DESIGN CRITERIA
28.3.1 Proximity Relationships
28.3.1.1 The Central Medical Staff/UBC FoM Academic Teaching Facilities component’s
location relative to other components and the nature of circulation used to move
between 2 components are illustrated in the diagram below. Proximities are listed
according to rank; higher priorities appear above lower priorities.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.02
CENTRAL MEDICAL STAFF/UBC FoM ACADEMIC TEACHING FACILITIES
Central Medical Staff/UBC FoM Facilities Main Horizontal/ Vertical Circulation 28.3.1.2 Provide Convenient Access by General
Circulation to major non-public circulation.
Medical staff and medical learners will move
frequently to/from this component and other
components in the Facility, mainly those
involved in direct patient care.
28.3.2 Internal Design Criteria
28.3.2.1 General Internal Layout
28.3.2.1.1 The component will be organized initially into 2 distinct areas as follows:
28.3.2.1.1.1
The Authority Medical Staff Facilities
28.3.2.1.1.2
UBC FoM Academic Teaching Facilities
28.3.2.1.2 Within each of these primary divisions, The Authority Medical Staff
Facilities spaces should be generally organized into as follows:
28.3.2.1.2.1
Open plan and general relaxation/recreation (Lounge)
28.3.2.1.2.2
Quiet/study and small group meeting (Study, Work, Meeting)
28.3.2.1.2.3
On-call facilities (On-Call)
28.3.2.1.3 UBC FoM Teaching Facilities spaces should be generally organized into as
follows:
28.3.2.1.3.1
Teaching and Learning Area
28.3.2.1.3.2
Locker/On-call/Lounge Area
28.3.2.2 Separate Medical Staff and Medical Learners Spaces
28.3.2.2.1 Development of medical staff and medical learner’s facilities as a single
component will be promoted because of functional similarities. However,
while occupying contiguous space, the Authorities Medical Staff Facilities
and UBC FoM Academic Teaching Facilities will be physically separate
and secured from one another. Each will have its own single point of
access/exit.
28.3.2.2.2 A meeting/videoconference room forming part of the UBC FoM space will
serve as a collaborative focus between medical staff and learners. Secured
doorways will provide access from both Medical Staff Facilities and from
UBC FoM Academic Teaching Facilities, and security measures will be
used to unauthorized access of either side.
28.3.2.3 Purpose-Built Entrances
28.3.2.3.1 This component will be serviced by separate access/exit points for the
Medical Staff Facilities and for the UBC FoM Teaching Facilities portion.
EXECUTION COPY North Island Hospitals Project SCHEDULE 3: DESIGN AND CONSTRUCTION SPECIFICATIONS APPENDIX 3A: CLINICAL SPECIFICATIONS _______________________________________________________________________________________________________ OS-GP.02
CENTRAL MEDICAL STAFF/UBC FoM ACADEMIC TEACHING FACILITIES
28.3.2.3.2 A “main” entrance will be accessed by all component users. Clerical and
administrative staff will use this doorway to gain access to a mail roo