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D E C E M B E R 2 0 2 1 | 63 Langley Memorial Hospital – Emergency Department Expansion P H OTO G R A P H Y BY A N D R E W L AT R EI L L E /CO U RT E S Y K I R S T EN R EI T E A RC H I T EC T U R E I N C . LANGLEY MEMORIAL HOSPITAL – EMERGENCY DEPARTMENT EXPANSION by NATALIE BRUCKNER M ay 4, 2021 is a day the com- munity of Langley will forever remember: Langley Memorial Hospital opened the doors to a long-awaited, new state-of-the-art Emergency Department and wel- comed in its first patient. Gone was the old ER built in 1986 and in its place stands a beautiful two- storey building that is three times the size of the original and designed to meet the needs of the fast-grow- ing community and its surroundings. The redevelopment sees an increase in treatment spaces from 31 to 49, as well as a separate pediatric waiting area and treatment rooms. Trauma bays have increased from one to two, and a decontamination suite and two isolation rooms have been added. In addition, there is a separate space for people with mental health and sub- stance use concerns so their needs can be addressed privately in a way that best supports the care they require. "Even though our community has been talking about the needs of the Langley Emergency Department [ED] for many years, we first validated the need for redevelopment of the Emergency Department through the High Level Master plan effort in 2015 and worked through the business case starting fall 2016," explains George Cawdry, senior project manager at Fraser Health. The City and Township of Langley was noted as the fifth largest munic- ipality in Metro Vancouver. "It was projected that compared to 2015 the population of Langley would grow by 21 percent to 2025 and by 40 percent to 2035; this translated to about 46,000 visits to the ED in 2015/16 and pro- jected that the demand will increase to 55,000 visits by 2025. All these num- bers become important when you learn that the original ED was built to accom- modate 25,000 visits," says Cawdry. It was time for an overhaul! Once the project was approved, design started in the fall of 2017 and EllisDon began construction in early 2019. "The site was originally a parking lot and a small ambulance drop off area with a concrete canopy, which we set about demolishing. We had some issues with soil contamination due to the high iron content and removed the con- taminated material." Site logistics were of course a chal- lenge as the existing hospital was still operational, but the team strategically rerouted the public and staff through the various stages of construction to minimize disruption. As the building started to go up, it was evident this would be no ordi- nary ED, and for that credit goes to the vision of Kirsten Reite Architecture (KR A), Cawdry and Fraser Health, the Langley Memorial Hospital Foundation, and the many stakehold- ers (including doctors, other direct care providers, and staff). "When we saw Langley Memorial Hospital it was clear we had a chance to do something to assist the future vision of the hospital. We were lucky enough that our project was right in front of the existing hospital, so we were able to become front and cen- tre. It gave us the opportunity to tie it all together and bring some cohesion to the identity of the site," explains Kirsten Reite, lead architect. With the existing hospital clad in mostly brick, KR A designed the new building with a combination of cementitious panel on the ground floor and brick above to tie it all together. On the Ombrae wall surrounding the ambulance bay, a photograph taken by Jen Newman, one of the nurses, of McMillian Island area along the Fraser River was used that adds a real state- ment to the building. The emergency entrance, which acts as the hospital's front door after hours (and is one of three entrances to the new building extension), was given a tremendous amount of thought and attention to ensure it would not only meet the many layers of constraint from a functional point of view, secu- rity, ease of wayfinding and drop off, but would also create opportunity for pause, reflection, and beauty through natural light and views. Inside, the building has been divided into different zones. "When you enter you are directed to the red, yellow, green, or blue zones depend- ing on your clinical need. We worked closely with the Foundation to ensure visitors and staff can easily identify each zone. Each has its own identity, even featuring hand wash sinks with backsplashes in the selected colour, but is all interconnected," explains Julie Verville, associate principal at KR A. The main corridor that runs down the middle, or "Main Street" as Cawdry calls it, is double-height and features clerestory windows that bring in natural light and provide a posi- tive experience. With the zones being on the perimeter of the building, KR A was able to design the building so that natural light would stream into every angle of the building; a stark contrast to the old emergency department. Efficiency in work and patient flow was paramount in the design, and a great deal of thought was given to create a clean and simple design that could evolve over time. Instead of built-in millwork, carts on wheels were chosen that could be easily transported from place to place. Also, the team opted for workstations on wheels (WOWs), so that computer work stations can be moved around as nec- essary. "There's this one doctor who I have never seen without a WOW," laughs Cawdry. EllisDon was tasked with tying in many of the systems, including the hospital's nurse call, public address, fire alarm, security, and DDC moni- toring. As the ED expansion relies on several services from the existing hos- pital there were several mechanical balancing issues, electrical tie-in chal- lenges, and fire alarm tie-in issues, too. But nothing that couldn't be overcome. Modifications were made to HVAC system design and routing in back-of- house to avoid drawing air from the existing hospital (preventing the risk of airborne contamination/COVID-19 concerns). "The isolation rooms were interesting as we had to make those rooms air tight and pressurized. They had to be on a separate system. In addition, we had several significant changes issued to us as the project progressed, but we worked through these collaboratively with Fraser Health and the consultants to ensure that the schedule didn't blow out and we were still able to deliver the May 4 opening date for patients to begin using the new ED," explains Sam Whitehurst at EllisDon. The connectivity to the existing plant services systems also presented several challenges to mechanical con- sultants Rocky Point Engineering. "With FHA Facilities Maintenance and Operations, FMO, a series of mechanical service pathways needed to be discov- ered and implemented within existing functional clinical areas," says Mark Swain, VP, Rocky Point Engineering. Swain adds that in addition a new buried trench system containing mechanical services was provided and installed within the service ring road which surrounds the campus. "The potential impact of health-care goods and services being delivered daily was limited with phasing and construction co-ordination," explains Swain. Considering the extent and size of the project, as well as the numer- ous challenges that COVID presented, the project was a huge success, and everyone involved credits the team, their vision, and passion for the proj- ect. As for the staff's reaction, Cawdry couldn't have said it better: "The feed- back has been fantastic; one of the doctors does a happy dance every time we pass in the hall." A LOCATION 22051 Fraser Highway, Langley, B.C. OWNER /DEVELOPER Fraser Health Authority / Langley Memorial Hospital Foundation ARCHITECT/INTERIOR DESIGN Kirsten Reite Architecture Inc. GENER AL CONTR ACTOR EllisDon Corporation STRUCTUR AL CONSULTANT Bush, Bohlman & Partners LLP MECHANICAL CONSULTANT Rocky Point Engineering Ltd. ELECTRICAL CONSULTANT WSP Canada Group Limited L ANDSCAPE ARCHITECT Bearmark Design & Landscape Ltd. BUILDING ENVELOPE CONSULTANT RJC Engineers CIVIL CONSULTANT R.F. Binnie & Associates Ltd. TOTAL SIZE 2,700 square metres TOTAL COST $39 million 10:41 AM 2:59 PM