Rouge Valley Health System

Staying out of the redSenior director of capital planning Rick Gowrie tells Jenn Monroe how Rouge Valley Health System builds a healthier future for its community. Renovation projects are rarely convenient, but the Rouge Valley Health SystemÔÇÖs capital projects and facilities staff has found a good way to stay focused. ÔÇ£IÔÇÖm a planner by background and education,ÔÇØ says Rick Gowrie,┬áÔÇ£and the focus of our group is the end resultÔÇöthe improvement to patient care and service delivery. That keeps us focused and allows us to deal with the frustrations that are inherent with construction programs.ÔÇØ Rouge Valley Health System comprises two campusesÔÇöCentenary and AjaxÔÇöin the greater Toronto metropolitan area. Thus far, its current $100-plus million capital upgrade has been relatively frustration-free, but with its challenges. It recently completed a new two-story townhouse complex at its Centenary campus to provide housing and round-the-clock treatment for 30 seriously mentally ill residents. While the facility may become a permanent home for some residents, it will provide transitional accommodation to others who will learn basic life skills, such as banking and cooking, designed to reintegrate them into the community. Also at the Centenary campus, Rouge Valley Health is closing in on completing a new Birthing & Newborn Center. This $21 million project will include advanced obstetrics services, advanced levels of patient care and significant infrastructure and technology upgrades. It will provide expectant families with a comfortable, home-like environment for low-risk, uncomplicated births, while providing all the equipment and expertise needed to handle more complicated high-risk deliveries. Construction is slated to be finished in August, with the facility up and running by October.At the Ajax campus, a $90-plus million redevelopment project is under way. When complete, this site will feature a new emergency department and related services amounting to about 140,000 square feet of new or renovated space and services. ÔÇ£We see 45,000 emergency visits in an 8,500-square-foot space right now,ÔÇØ Gowrie says, ÔÇ£and weÔÇÖll see 60,000 visits in a 21,000-square-foot space.ÔÇØ Other features of the Ajax campus project are new or renovated facilities for diagnostic imaging; more cardiac diagnostic services; and new or renovated facilities for mental health, complex continuing care, ambulatory care and laboratory. While the projects differ, they all stem from community need. ÔÇ£The birthing center need was identified through a child health study by the Child Health Network,ÔÇØ Gowrie explains. ÔÇ£The Ajax campus project is in response to the need to bring or deliver more diagnostic services. Our key focus is on enhancing it to the level of a community general hospital.ÔÇØ Getting to that level has created a few challenges at the Ajax campus, but Gowrie says the organization is learning as it goes along. ÔÇ£WeÔÇÖre at full capacity in terms of physical space,ÔÇØ he explains, ÔÇ£so weÔÇÖve had to move some areas during the construction. For example, our diabetes education program is in a trailer on site.ÔÇØ Parking also has been a challenge. ÔÇ£WeÔÇÖve had to ask for voluntary participation to allow patients to park in the closest spaces,ÔÇØ Gowrie notes. Generally, good communication, with both staff and patients, is the key to keeping perceived inconvenience at a minimum. ÔÇ£The honeymoon period was very short,ÔÇØ Gowrie jokes. ÔÇ£There is a long-term benefit for patients and staff, but we tend to forget about that in the midst of construction.ÔÇ£WeÔÇÖre sharing the time line so the staff and the community are aware of whatÔÇÖs going on,ÔÇØ he continues, ÔÇ£and we need to do a better job with interim signage.ÔÇØWhat tends to make the most difference is the completion of different phases of construction. ÔÇ£The opening up of the new admitting and registration area carried a lot of goodwill,ÔÇØ Gowrie says.Rouge Valley Health System wonÔÇÖt just be bringing state-of-the-art care to its patients through these projects. It also is planning ahead for any type of major epidemic. The projects were in the planning stages during the SARS scare in Canada, and Rouge Valley Health saw the experience as an opportunity.ÔÇ£The two projects were on the books for a significant amount of time,ÔÇØ Gowrie says, ÔÇ£and we were in the right place to make changes. We learned that we had limited ability to remain operational after shutting down areas, so we started to look at how we would need to redesign our space.ÔÇØThey started with the birthing center and designed in negative pressure areas for labor, birthing, delivery and postpartum recovery. There also are a number of maternal and newborn spaces that are separation or segregation rooms. Exit and entry into the center also was rethought. ÔÇ£We still needed to be able to deliver care without access through the main hospital building,ÔÇØ Gowrie explains.Rouge Valley Health went through a similar planning exercise with the Ajax project. ÔÇ£In addition to a number of isolation rooms, we structured the emergency department with an isolation zone. We have direct access to it, and it can be shut down from the rest of the emergency department,ÔÇØ Gowrie says. ÔÇ£ItÔÇÖs accessed through the ambulance bay and includes a decontamination area. This is the most significant design improvement we made.ÔÇØAnother challenge at the Ajax campus was moving from the east side to the west side without going through the center of the hospital. To remedy this, Rouge Valley Health designed a ring road that connects and separates emergency department traffic from the general public moving in and out of the hospital. How does Rouge Valley Health System keep all the projects moving? A scheduling consultant works with Gowrie and his staff, conducting status interviews every month and then creating an executive summary. ÔÇ£They use a traffic-light scenario,ÔÇØ Gowrie says. ÔÇ£Green is everything moving along, yellow is a risk or remediation, and redÔÇöwell, red we want to stay away from.ÔÇØ (In addition, on the Ajax job the projectÔÇÖs co-sponsor, Infrastructure Ontario, also provides ongoing project oversight and project management support.)Keeping everything in the ÔÇ£greenÔÇØ takes a combination of Rouge Valley Health projects and facilities staff and outside contractors, as well as a management strategy that makes use of multi-site directors and teleconferencing, among other communication tools. ÔÇ£We rely on our people,ÔÇØ Gowrie says. ÔÇ£ThereÔÇÖs nothing really magical about it.ÔÇØ┬á