In this series, Healthcare design Ask leading healthcare design professionals, companies, and owners to tell us what caught their attention and share some thoughts on the topic.

Kyle Basilius is a senior assistant and healthcare planner Parkin Architect (Vancouver, British Columbia, Canada). Here, he shared his views on the Net Zero Future, new project delivery models, and the role of healthcare in the reconciliation of indigenous peoples.

  1. Sustainable Building Certification

Following this year’s record heatwave and wildfires in British Columbia, the province said it needs to reduce greenhouse gas emissions by 45% over the next eight years. In response, all new hospital projects in Canada must now meet LEED Silver or Gold certification. The South Niagara Hospital Project (Niagara Falls, Canada) is expected to open in 2026. It is working hard to become the first WELL-certified medical institution in Canada to promote the health and well-being of its residents.

  1. Net zero future

Canada has pledged to achieve net zero carbon emissions by 2050-a goal that has already affected the healthcare industry. The new Corner Brook Acute Care Hospital in Newfoundland will open in 2023 and will have the largest geothermal heating and cooling system in Canada’s healthcare system. This system adds a higher capital cost to the project, but significantly reduces the power consumption and demand of the facility, thereby saving a lot of money during the entire life cycle of the facility. In British Columbia, the mandatory specifications for new healthcare projects indicate that in the competitive phase of future capital projects, net-zero design and construction solutions will receive higher scores than traditional architectural design methods. This will ensure that the design and construction industry changes its design strategy for future provincial-funded projects.

  1. New project delivery model

Since its introduction into the market in the early 2000s, the public-private partnership (P3) model has been the traditional project delivery method for all public hospital projects in Canada. Although this model succeeds in reducing the government’s risk, usually lower pricing leads to compromises. Recently, the British Columbia government has implemented an alliance delivery model, which has been successfully applied to infrastructure projects in Australia and the United Kingdom. Under the alliance contract, government agencies, contractors, architects and any designated consultants are equal partners who share the risks and benefits of the project. This new model aims to solve the shortcomings of the P3 model, that is, the contractor and the price determine the design result, but to provide an equal voice for all signatories of the alliance contract. This relational model will be used for the first time to deliver hospital projects on Vancouver Island. If successful, it will become the preferred method of delivering healthcare projects nationwide in the future.

  1. reconciliation

Hospitals are increasingly promoting reconciliation with indigenous peoples to help educate and promote the restoration of past cultural destruction. Thoughtful, educated, and humble design; paying tribute to historical and geographic landmarks; using natural materials; and planning indigenous health plans can help break discriminatory prejudices related to the past treatment of indigenous and marginalized populations by healthcare systems. From the beginning to the completion of the project, the cultural awareness training of the entire project team and the thoughtful participation with the local indigenous communities are also essential, so that these people have ownership and a forum to express their cultural needs when receiving healthcare services.

  1. Pandemic response

Due to the SARS and H1N1 pandemics that broke out in Canada in the mid-2000s, when COVID-19 arrived, Canadian hospitals and medical staff were better prepared than most hospitals and medical staff. As part of the overall quarantine response to future epidemics and pandemic events, prescribed outbreak areas are grouped into various departments. The project planned before COVID-19 stipulated that a 16-bed pod in a 32-bed inpatient ward (including many intensive care units) had an outbreak area on each floor. In the frontline emergency department (ED), it is now standard practice to designate key decision-making units as outbreak areas, use walk-in entrance foyer as triage space, and equip ambulance garages with roof walls. Since COVID-19, we now see rural hospitals becoming creative in their responses, such as placing mobile clinics near emergency rooms so that they can overflow into standardized clinic rooms that are satellite units when the department is full. As a result, infection control has been improved and the number of hospital-acquired infections has decreased.

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