By Glen Korstrom
St. Paul’s Hospital executives are drafting a proposal for an 11-storey tower at the corner of Comox and Thurlow streets that would reinforce the 116-year-old hospital’s status as downtown Vancouver’s hospital.
City view corridors prohibit the tower from being any taller than 11 storeys, said the CEO of Providence Health Care, which operates St. Paul’s.
“We’re looking at something that’s definitely under $500 million and is probably closer to a $400 million target,” Dianne Doyle told Business in Vancouver. “That is just for this Phase 1.”
Future development phases would overhaul the hospital’s building that faces Burrard Street and other parts of the million-square-foot complex that are at the corner of Thurlow Street and a lane.
B.C. Health Minister Kevin Falcon told BIV in July that he wanted Providence to shelve plans to rebuild the hospital on an 18.5-acre False Creek Flats site that it bought in 2005 for $24 million.
“We have an option on those lands. We want to keep that available to us. That may make sense for government for other health-care options,” Falcon said. “I am persuaded that it makes more sense to do a modest but significant investment into the existing facility.”
Doyle said she plans in January to provide Falcon with what she called a “concept plan” for the hospital’s redevelopment. She anticipates that, assuming health ministry bureaucrats like the plan, Providence officials could draft a detailed business case for the project by mid-2012.
Shovels would then be in the ground by 2013, and the structure would be completed by 2016.
Doyle proposes to put the 200,000-square-foot tower at the corner of Thurlow and Comox streets because that would disrupt hospital operations least.
The tower would replace the Comox Building, which houses hospital offices and a small parking lot.
Doyle has said her hospital has an inefficient floor plan.
New purpose-built space can therefore replace more than 200,000 square feet in existing buildings.
“We’ll be able to redesign how we deliver ambulatory care,” Doyle said. “We have pieces spread throughout St. Paul’s Hospital right now. We will be able to redesign how the care is given so that it’s patient-focused – a one-stop shop.”
As an example, she pointed out that a patient might come to see a heart specialist on Monday and, unbeknownst to that team, might also have kidney problems that would require the patient to make a return trip to the hospital to see another medical team on another day.
“We will be able to streamline all that.”
Squeezing maximum productivity out of the emergency department operations has been a top priority at St. Paul’s for the past five years.
Success on that front has spurred visits from hospital representatives across Canada eager to see how the emergency room uses “lean” principles made famous by Japan’s Toyota Corp.
“One of the big things we’ve done is focus on what is of patient value to find what steps are not value-added,” said Lawrence Cheng, St. Paul’s physicians’ operations leader.
Patients used to have to wait in line to be registered. Then, they would wait in a second line for a quick initial assessment of what their emergency was.
Cheng said the two processes have since been combined into one.
“Patients used to wait for a nurse and then a doctor. Or wait for space and then the nurse and doctor. Now, we’ve created a rapid assessment zone. You’re essentially brought into a bed and seen by a nurse and doctor at the same time. That saves a lot of redundant storytelling. And it collapses a multi-step process into one.”
Other examples of St. Paul’s Hospital’s emergency room efficiency include:
- investments in technology that enable staff to determine how fast patients flow through X-rays, blood tests and other processes on an electronic tracking board;
- introducing dedicated procedure carts that have all anticipated supplies in one place and can be wheeled from station to station; and
- diagnostic treatment units, which house patients for an initial 24 hours.
The units use nearby doctors who are available 24 hours a day. That results in faster release times than if patients were transferred to an in-patient bed outside the emergency department.