ST. THOMAS, Ontario, Canada — The St. Thomas Elgin General Hospital (STEGH) celebrated its grand opening earlier this year for what’s being dubbed by the project team as the “Great Expansion.” The addition includes a completely new emergency room, surgery and central processing departments and a new 17-bed Mental Health unit in a design created to help with efficiency and wayfinding.

Milwaukee-based Kahler Slater partnered with the Toronto architectural firm Montgomery-Sisam on this Ministry of Health–approved Redevelopment Project, breaking ground on the $98 million expansion in 2015. The project was financed by raised funds including $16 million, comprised of 10 percent of construction costs and 100 percent of the cost of the new equipment. The county of Elgin and city of St. Thomas paid $3.5 million each with the rest made by community donors.

The lustrous design holds new, state-of-the-art equipment and provides two separate entryways including the “front of the house” entrance for patients accessing emergency, surgical and outpatient services, and another back entrance for arriving ambulances. The expansion also includes the conversion of the basement into a sterile processing unit and wider hallways.

According to a statement from Kahler Slater, an emphasis was placed on bolstering both patient experience and staff efficiencies by improving adjacencies and lessening footsteps. Kahler Slater’s team led staff through a process to develop a functional and clinical design for the project while concentrating on merging the addition with the existing facility to improve wayfinding for public and staff flows.

The project’s two key goals were to ensure healthcare providers spend 80 percent of their time caring for patients and that every patient entering the emergency department requiring admittance could be checked in within 60 minutes.

Before the expansion, the facility was designed to hold roughly 20,000 patients while the number of patients reached up to 52,000. The emergency department, located on the ground floor, is now geared toward high-volume patient accommodations and lowering wait times, with rooms designed under a regulatory method to reduce the chance of errors.

Prior to the expansion, the hospital also had issues with their paging system caused by temporary connectivity issues. Now, STEGH replaced its operating paging system with Vocera Voice and integrated Vocera with other technologies at the hospital, including the Medworxx Bed Board bed optimization system (BOS). The BOS provides a data repository and graphical representation of all the beds in a hospital unit and the status of those beds. Consequently, this has helped improve bed turnover rates and decreased the length of patient stays.

A statement from Kahler Slater explained that the recent advancement capitalizes on current operational improvement work that reduces emergency wait times and improved workflow. By implementing a “front of house” entrance design for patients arriving, they separate the experience from the emergency vehicle entrance, which was previously joined. The design with the back- and front-of-house spaces help ensure patient dignity, privacy and comfort within the facility.

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MILTON, Ont. — Toronto-based PCL Constructors Canada Inc. recently announced the final phase of the Milton District Hospital (MDH) project expansion in December 2017, signifying the project’s completion. The $512 million expansion began June 2015 and achieved substantial completion in April 2017, with Halton Healthcare providing patient care in the new space as early as Oct. 1, 2017.

A major challenge was allowing the remaining MDH to continue to serve the community during construction, which was key to the success of the expansion. It was built to meet the increasing care needs of one of Canada’s fastest growing communities and to accommodate new technology. PCL Toronto District Manager Kelly Wallace explained how the efficiency of this project demonstrates exemplary collaborative success, according to a statement.

“Milton District Hospital expansion project is a case study for design-build excellence,” said Wallace. “Achieving total completion within seven months of substantial completion on a project of this scope speaks volumes about the collaboration and respect exhibited by all partners, which was a critical success factor in achieving this tremendous outcome for the people of Milton.”

With an air-tight, 25-month design-build schedule executed on an active hospital site, more than 40 PCLers influenced an outstanding safety culture that sent more than 600 tradespeople home safely every day, with more than 1.2 million hours worked without a lost time injury (LTI).

The MDH project brings expanded emergency and surgical services, medical/surgical inpatient units, critical care, maternal newborn and diagnostic imaging, and support services to the community. The hospital’s capacity increased from 63 to 129 inpatient beds, including 80 percent single-patient rooms for improved infection prevention and control and increased patient privacy in a quieter healing environment. A level 2A Special Care Nursery with capacity for eight bassinets in the Maternal Newborn Unit is included as well as the hospital’s first Magnetic Resonance Imaging (MRI) machine.

With these additions, patients will have increased access to healthcare services, with a unit layout that puts equipment, supplies and staff closer to the patient, enabling more direct care time with patients. MDH facilities will also encourage the participation of family and friends, including pull-out sleeper beds inside patient rooms to allow a family member to stay overnight with their loved one, along with available room-service delivery on most inpatient units that enables patients to order meals by telephone from their hospital room.

The expansion comes along with the implementation of new technological systems, including an electronic patient tracking system to manage each patient’s records from the moment they arrive as well as wireless handheld devices that allow staff to communicate with both systems and people. The hospital will now use reliable networks to support clinical, communications, security, environmental, building and back office systems. The hospital is pursuing its LEED Silver certification with a sustainable building strategy, holding a mechanical design of the hospital optimizes energy usage by incorporating energy-efficient design and maximizing equipment efficiency.

Key partners of the project included Halton Healthcare (owner); Plenary Group (project sponsor, equity investor, financial arranger); PCL Constructors Canada Inc. (design-builder; Toronto); Johnson Controls (facilities manager); B+H Architects and RTKL Associates (architect); Smith and Andersen (mechanical/electrical consultant); and WSP (structural consultant). MDH was constructed using Infrastructure Ontario’s Alternative Financing and Procurement model.

“Reaching final completion demonstrates another significant milestone for the Milton District Hospital project. Plenary remains incredibly proud of the collaborative working relationship we have with all the project partners, and we look forward to participating in the ongoing success of this facility,” said Angela Clayton, Plenary’s group head, Buildings Division, according to a statement.

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The Louisville office of Messer Construction will manage the project, which is expected to begin in spring 2016. This is not Messer’s first time working on a project for Norton Healthcare Inc. In fact, the company has worked on the Norton Brownsboro Hospital in Louisville, and a $70 million renovation project at Kosair Children’s Hospital, also in Louisville, according to a statement by Erin Rasinen, Louisville region business development executive for Messer.

The renovation will include building a two-story addition to support 74 private patient beds, remodeling existing patient rooms, and upgrading and expanding the emergency department, intensive care until and open heart unit, according to an article by Louisville Business First.

Louisville Business First also reported that three operating rooms will be added during the construction, and one of the existing operating rooms will be renovated. In addition, the hospital will have a new entrance, a retail pharmacy, a café and a gift shop.

According to a statement made to Louisville Business First by Jon Cooper, chief administrative officer for the hospital, the entire project will take around three and a half years to complete.

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The new 182-bed facility will include 118 beds for surgery and mental health, a 30-bed spinal cord injury/disorder center and a 30-bed nursing home community living center, in addition to a four-bed blind rehab facility, research building and parking structures.

The medical center will create about 6,300 jobs during construction, employ about 2,000 people when built and will serve 83,000 veterans.

“This new medical center will not only help provide veterans with the care they have earned, it will create good-paying construction jobs that invest in the local economy,” said Secretary of Veterans Affairs Eric Shinseki.

All of the remaining construction options, totaling $580.2 million, were awarded to Englewood-Colorado-based Kiewit-Turner Joint Venture on Nov. 17, the department reported.

The facility will be designed to LEED Silver certification to make the most of renewable energy initiatives and is expected to be completed in early 2015.

The Department of Veteran Affairs also announced that the office has narrowed its choices for a replacement hospital in the Louisville, Ky. area down to two site options: a site on Brownsboro Road is the preferred site, and undeveloped land at St. Joseph/Factory Lane is also an option.

The veteran affairs office considered five site options: three undeveloped sites, reconfiguration of the existing medical center, or a downtown location adjacent to the University of Louisville Hospital.

In addition to financial, environmental and historic preservation studies, the Veterans Affairs office will solicit input from veterans while working towards the acquisition of one of the properties.

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