Appendix 3A - Clinical Specifications

530 Pages·2014·5.24 MB·English

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 0 Introduction 1
IP 01 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
DT 06 Pharmacy 17
OS-STL 01 Biomedical Engineering 18
OS-STL 02 This Component is Intentionally Blank 19
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

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:
 General Medical/Surgical Units
Inpatient Areas
 Intensive Care Unit/Telemetry Unit
 Maternity, Newborn, and Pediatric Unit,
o Centre for Excellence in Aboriginal Maternal Health (Campbell River)
 Psychiatry Unit (Comox Valley)
 Emergency Department
Ambulatory
Services  Ambulatory Care/Medical Day Care Programs
 Ambulatory Care – Orthopedic Clinic
 Surgical Day Care
 Outpatient Procedural Care
 Cardio-Pulmonary Diagnostic Services
 Medical Imaging
Clinical Services
 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
 Biomedical Engineering
Support Services
 Environmental Services
 Information Management/Information Technology
 Materials Management
 Equipment Maintenance
 Equipment Depot
 Medical Device Reprocessing Department (MDRD)
 Central Education and Conference Facilities
Support Areas
 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 The Maternity, Newborn, and Pediatric Unit
1.2.2.2 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.
1.2.3 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
1.2.3.1.1.2 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.
1.2.4 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 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:
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
1.2.6 Medication Rooms
1.2.6.1 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.
1.2.7 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 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.
1.2.9 Patient Lifts
1.2.9.1 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.
1.3 INFORMATION MANAGEMENT SYSTEMS
1.3.1 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