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FEBRUA RY 2016 | 63 PHOTOGRAPHY BY DAN SCHWALM/COURTESY HDR ARCHITECTS INC. Humber River Hospital Humber River Hospital by YVAN MARSTON A irports and hospitals play host to the full spectrum of life's emotions – from interminable boredom, to high anxiety, sadness and elation. Moving through these spaces efficiently can ease tensions, assuage fears and ultimately help people get to where they must be; whether it's a journey of care or an actual journey. At Humber River Hospital's new 1.8-million-square-foot facility in western Toronto, a patient's journey is designed to be intuitive and precise. Many will start on the building's south end where a 180-metre-long concourse draws on the notion of an airport's long, open spaces and passenger drop- off zones to form the main entrance. Traditional hospitals have two main entrances, one formal and the other for emergencies. And both are apt to form bottlenecks in terms of enabling patient flow. Here, patients can be dropped off at two northern entries, one for emergency and one for dialysis, or at one of the five entry points along the south drop off road depending on the care they require, explains Jeff Churchill, VP of HOK Toronto, the firm that wrote the specifications for this P3 project. Called portals of care, each uses signage and wayfinding to direct a patient from curbside to clinic. "It's a concept we've used in our health care work in the U.S. and Humber really liked the idea. Particularly that the clinics are just 30-feet from the entry and how convenient that is for someone dropping off a patient and knowing that they are where they are supposed to be," he says, adding that he doesn't often use the airport analogy because "we think of it as friendlier than an airport." It's a solution that makes a large hospital into a small convenient experience, Churchill adds. As the project's compliance architects, HOK represented Humber's interests and provided thought leadership behind many of the innovations inherent in the final hospital. But bringing ideas such as the portals of care into the final design and incorporating the elements and materials that underpin the hospital's character – like the exterior's large graphic glass mural of the aspen grove – is the work of HDR, the designers working for the Plenary Group, which was awarded the $1.75-billion design-build- finance-maintain (DBFM) contract. As Ontario seeks to modernize its health care infrastructure, this new $1-billion facility does more than replace three older sites (one continues as a primary care centre). It stands as a current example of state-of-the-art, patient-centred health care delivery. "This is the 32nd hospital project we delivered with success. Humber River Hospital, which is our largest hospital project ever, was not only delivered on time and on budget, it also represents the most technologically advanced health- care facility in Canada," says Angelo Gismondi, senior VP at Infrastructure Ontario in project delivery for the justice and education portfolios. Achieving substantial completion in June 2015 and opening in October, Humber is also Toronto's largest regional acute care hospital. Its expansive podium consists of five levels and the patient tower climbs to 14 storeys. It sits in a busy northwest corner of the GTA to serve a catchment area with a population of more than 850,000. To do this, it has enhanced services including medical ambulatory clinics, paediatric clinics, specialized geriatric outpatient services, mental health programs and women's clinics. It also has a geriatric rehabilitation inpatient program as well as cardiology and respiratory clinics. And its expanded ambulatory services will see a steady stream of outpatients move on and off the site each day. One of the new hospital's guiding principles was a dedication to become North America's first fully digital hospital. For this 656-bed facility, that meant the extensive automation and digitization of systems to improve care. Now, 75 per cent of all deliveries in the hospital are done using eight automated guided vehicles (AGVs) to wheel about linens and supplies. A pneumatic tube system moves clean supplies, medicine and specimens through a network of 69 PTS stations using 288 carriers travelling at an average speed of 25 feet per second. Special pneumatic tubes are also used for waste removal and dirty linen. Patients have bedside touchscreen terminals where they can access their health records, connect with family, control room elements like lighting and order from food menus. And diagnostic images such as MRI scans can be charted immediately so that specialists can review them sooner and patients can check-in using self- serve kiosks that will notify care teams that their patient has arrived. "It's a remarkable hospital in terms of the integration of digital technology and automation. All of these things have been done in other hospitals – but never in one place and never as Humber has done it," says HOK's Churchill. "The most important thing Humber offers is its opportunity for interoperability between systems; so that systems can talk to each other without being prompted." That its systems speak to each other is what makes the hospital a remarkable digital solution, but the space itself contributes to important patient care gains, explains Norman Fisher of HDR Architecture. The HDR team used LEAN principles as another guiding force when assembling its proposal for this DBFM project. This meant examining how to improve physician-patient interface as well as trying to find efficiencies in the overall layout of the project, says Fisher, explaining that the portals of care in the south concourse serve as an example of the building addressing the concept of LEAN in a meaningful way. The two-storey, 30-foot-wide concourse's south wall features floor- to-ceiling glass that floods the space with natural light. It runs the full LOCATION 1235 Wilson Ave, Toronto, Ontario AGENCY RESPONSIBLE Infrastructure Ontario CLIENT Humber River Hospital ARCHITECT OF RECORD HDR Architecture Associates Inc. COMPLIANCE ARCHITECT HOK DESIGN BUILD FINANCE MAINTAIN CONTRACTOR PCL Constructors Canada STRUCTURAL CONSULTANTS WSP (formerly Halsall) MECHANICAL/ ELECTRICAL CONSULTANTS Smith + Andersen LANDSCAPE ARCHITECT Quinn Design Associates FOOD SERVICE CONSULTANT Trend Foodservice Design & Consulting TOTAL SIZE 1.75 million square feet TOTAL COST $1.75 billion 8:49 AM

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