In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.
Kyle Basilius is a senior associate and healthcare planner at Parkin Architects (Vancouver, British Columbia, Canada). Here, he shares his thoughts on a net-zero future, new project delivery models, and healthcare’s role in Aboriginal reconciliation.
Sustainable building certifications
Following a record-shattering heat wave and raging wildfires in British Columbia this year, the province has indicated the need to reduce greenhouse gas emission by 45 percent in the next eight years. In response, all new hospital projects in Canada are now required to meet LEED Silver or Gold certification. The South Niagara Hospital project (Niagara Falls, Canada), expected to open in 2026, is working toward being the first WELL-certified healthcare facility in Canada, designed to promote the health and well-being of its occupants.
Canada has committed to reaching net-zero carbon emissions by 2050—a goal that is already impacting the healthcare sector. Newfoundland’s new Corner Brook Acute Care Hospital, opening in 2023, will have the largest geothermal heating and cooling system in the Canadian healthcare system. The system adds higher capital costs to the project, but significantly reduces the facility’s electrical consumption and demand, providing for significant financial savings over the life of the facility. In British Columbia, the mandated specifications for new healthcare projects have indicated that net-zero design, and construction solutions will be given higher scoring over traditional building design methods during the competition stage of future capital projects. This will ensure that the design and construction industry change its design strategies on future, provincially funded projects.
New project delivery model
Since its introduction to the market in the early 2000s, the private-public partnership (P3) model has been the traditional project delivery method for all publicly financed hospital projects across Canada. While this model has been successful in reducing the risk for governments, often lower pricing has led to compromises. Recently, the British Columbia government implemented the alliance delivery model, which has been successfully used in Australia and the U.K., for infrastructure projects. Under an alliance contract, the government agencies, contractor, architect, and any designated consultants are equal partners in sharing project risks and gains. This new model looks to resolve the pitfalls of the P3 model where the contractor and price dictate design outcomes and instead give equal voice to all signees of the alliance contract. This relationship-style model will be used for the first time to deliver a hospital project on Vancouver Island and, if successful, could become the preferred method in delivering future healthcare projects nationwide.
There’s a growing push for hospitals to aid in reconciliation with Indigenous populations to help educate and facilitate the repair of past cultural damage. Thoughtful, educated, and humble design; nods to historical geographical landmarks; use of natural materials; and planning indigenous health programs can help to break down discriminatory biases attached to the way healthcare systems have treated indigenous and marginalized populations in the past. Cultural awareness training by the entire project team and thoughtful engagement with the local Indigenous community are also essential from project inception to completion to give these populations both ownership and a forum to voice their cultural needs when receiving healthcare services.
Due to the pandemic outbreaks of SARS and H1N1 in Canada in the mid-2000s, Canada’s hospitals and healthcare workers were more prepared than most when COVID-19 arrived. Mandated outbreak zones were programmed into various departments as part of a holistic isolation response for future epidemic and pandemic events. Projects planned prior to COVID-19 dictated that a 16-bed pod of a 32-bed inpatient unit, including many intensive care units, have an outbreak zone on every floor. In the front-line emergency department (ED), designating the critical decision unit as an outbreak zone, using the walk-in entrance vestibule as a triage space, and outfitting the ambulance garage with headwalls are standard practice now. Since COVID-19, we’re now seeing rural hospitals get creative in their responses, such as placing ambulatory clinics adjacent to the ED to allow for overflow into standardized clinic rooms that function as a satellite unit when the departments are at full capacity. As a result, infection control has been improved and the number of hospital-acquired infections has been reduced.
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