Rebuild Juravinski Hospital: We’ve come a long way, but our buildings haven’t
Imagine health care in the early 1900s. Medicine has come a long way since then, but some of the buildings that make up Hamilton Health Sciences’ (HHS) Juravinski Hospital (JH) still echo this distant past. In 2012, we transformed sections of Juravinski Hospital into state-of-the-art spaces. Our mission isn’t complete. We need to bring the oldest sections into the 21st century, ensuring our patients and teams have access to the very best health facilities for decades to come. It’s time to rebuild Juravinski Hospital.
In this series, we’ll share our plans for the new hospital and how we’ll address these infrastructure challenges to ensure we are well-positioned to provide the highest quality health care for years to come.
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Infrastructure challenges
Like many hospitals, Juravinski Hospital and Cancer Centre (JHCC) is a collection of buildings, connected by a patchwork of hallways, walkways and tunnels. We call these separate buildings “wings.” Each wing was built in a different era and some are much older than others. The oldest wing still in use, M wing, was built in 1932 – almost 100 years ago. These outdated spaces make it very hard to provide the modern health care patients expect and deserve. We have made all the retrofits we can but the time has come to rebuild. Here’s why:
Rooms are too small
Most patient rooms are shared by four patients. These rooms are crowded and have limited space for staff to move around effectively, to appropriately place equipment, and to support visitors.
“Our four-patient rooms are similar to the size of private rooms at other hospitals,” says Karen Robinson, Director of Surgery, Rehabilitation and Specialty Cancer Services at Juravinski Hospital.
“Our four-patient rooms are similar to the size of private rooms at other hospitals.”
Equipment and supplies are often stored in the hallways.
Because of the small room size, standard medical equipment doesn’t fit at the bedside. With the complexity and size of modern equipment, staff “workstations on wheels” for bedside charting and barcode medication scanning often have to be used in the hallways to create a safe space.
It is challenging to get walkers, wheelchairs and stretchers in and out of these rooms. Transferring a stretcher-bound patient out of the room for a test, such as a CT scan, is very disruptive. Nursing and portering staff must pull back the curtains separating patients and physically move equipment and other patients in beds to support this movement.
In some rooms, the washroom door and the room door cannot both be open at the same time,
In addition, the lack of space affords no privacy for personal health care conversations or intimate conversations with loved ones. There are only curtains separating patients.
There aren’t enough rooms for the number of patients
Juravinski Hospital is caring for more patients than there is room.
Former public areas like lounges are now being used as makeshift patient rooms.
Public areas like family lounges, waiting areas, rehab spaces, and office spaces are now being used as makeshift patient rooms. This means there is typically no running water and no washrooms. These unconventional patient rooms also take away space that would otherwise be used by patients, families, visitors, and staff for other purposes including the safe storage of equipment.
“We have very little room for equipment and for our patients to be able to exercise and walk through the ward freely,” says Robinson. “We used to have a recreation room and a gym to be able to support patient rehabilitation. We’ve had to reconfigure this space to serve as a staff room and at times, to accommodate patient beds when units are full.”
The E/F4 cancer surgery wards originally supported 45 patient beds, and have now expanded to 73 beds in the same space.
“We are using every nook and cranny for patient beds.”
One of the old operating rooms is now called the “daily express unit” where patients from the emergency department who are waiting to be moved to an inpatient ward stay until space becomes available.
“This space is not ideal, with limited space to isolate patients if needed. The space only has one washroom for up to 14 patients who are waiting,” says Robinson. “We are using every nook and cranny for patient beds.”
Washrooms are limited
Patient washrooms are small and generally shared.
Patient washrooms are small and generally shared. On one unit, there is only one shower for more than 38 patients and this space if often needed for storage of equipment.
In other areas, four patients in a room must share one washroom. In some areas, two rooms share one washroom.
Washrooms are very small limiting nursing staff’s ability to support patients who need extra assistance and to bring required equipment such as walkers, wheelchairs and IV poles into the area.
Infrastructure does not meet patient needs
Critical infrastructure such as elevators are limited and in some cases not designed to meet the current patient care needs. Many wards lack air conditioning, making it very difficult in the summer to meet the comfort needs of patients.
Limited storage space creates issues with cleanliness and efficiencies
Storage space is limited for items such as IV pumps, walkers, wheelchairs and other necessary medical equipment.
The patient wards were designed decades ago before the introduction of modern medical equipment.
Storage space is limited for items such as IV pumps, walkers, wheelchairs and other necessary medical equipment. As a result, equipment clutters hallways and in some cases is stored in other areas of the hospital.
“Because we’re using storage space for patients, equipment isn’t readily available,” says Robinson. “We have to send staff to the storage area on the newer side of the hospital to find equipment, which is often hard to find.”
Looking ahead
The new hospital will result in all single-patient rooms with individual washrooms, escarpment views, and room for modern equipment and visitors.
Rebuilding the old hospital sections will result in all single-patient rooms with individual washrooms – the gold standard for infection prevention and control – and larger hallways, elevators and common areas to meet accessibility standards. We will have more capacity to support patients admitted to a medical, critical care, cancer care, surgical care and rehabilitation specialty.
This renewal will also include new heating, cooling, air conditioning, and air filtration systems.
State-of-the-art facilities will enable Hamilton to continue attracting the best doctors and clinicians, and further advance HHS’ world-leading excellence in research and innovation.
Which areas are being redeveloped?
Wings E and M (patient areas) as well as H and L (non-patient areas) will be knocked down and replaced with a new structure on the north side of the building overlooking the escarpment. F Wing, which includes the CIBC Breast Assessment Centre and other inpatient areas, will also be renovated. Demolition and construction will take place in phases, over several years. View our JHCC floor plan to see the current wings.
Redevelopment efforts will focus on patient areas that have not been updated since the mid-1900s. Construction will take place as we begin a phased demolition of the four oldest wings of the hospital and build new, modern patient care areas. The modernized facility will result in almost 70 per cent more room for care and will feature:
- All single-patient rooms
- 100+ brand new beds and replacing 400+ beds in newly constructed rooms
- Larger hallways and common areas to meet accessibility standards
- Inpatient units with anticipated bed growth include medicine, critical care, cancer surgery and rehabilitation
