Edmonton’s main public health provider realized almost all of its renovation and construction goals in 2002.
The one exception was with long-term care expansion, which came in a little behind schedule due to some funding hiccups, since resolved.
“We have noticed an increase in (construction) prices, but we haven’t had a problem with getting contractors,” says Brent Skinner, chief planning officer for the Capital Health Authority (CHA), giving credit to the loyalty of the subtrades to the CHA’s chosen construction managers.
Local companies are given priority in bidding for all CHA projects, and those employed throughout 2002 have almost all been from within the province.
The stand-out exception is the American firm contracted to design the Alberta Heart Institute, which is in its preliminary stages at the University of Alberta Hospital. The $125-million project is a joint venture between local engineering firm Stantec and North Carolina heart hospital design experts KMD.
Capital Health has recently completed the functional program work on the cardiac centre and is awaiting approval to go into active design. The first physical signs can be expected late in 2003.
“A lot of people are on the wait list waiting for heart surgery, and this will allow us to increase capacity and serve more Albertans,” says Skinner.
The $47.2-million ambulatory care project at the Royal Alexandra Hospital is the weightiest endeavour in the construction phase.
Work includes renovation of the active treatment centre (large spaces in the lower levels of the main hospital building) and will allow for more day surgery, scope testing (endoscopy, for the medically inclined) and day medicine.
Emergency patients will also have the option of being moved into the new space while waiting for a bed.
It is no mistake that funds earmarked for construction are being funnelled into day-service facilities as they are efficient and cost effective for the health-care system when compared to the expansion of overnight bed facilities.
When feasible, the improved and expanded day-service area will encourage patients to recover in their own homes rather than in the hospital.
“It’s not abandoning people. We provide great home care/followup care,” says Skinner. The surgical suite redevelopment at the U of A Hospital weighs in at $24.5 million and, like the Alex, is about half completed. It should be finished sometime in 2005, while the Alex’s completion is targeted for late 2004.
Capital Health is recognizing the demographics shift toward the aged, and is working to meet the ever-increasing demands for more nursing homes.
Nursing-home projects built in the last couple of years have fallen under public/private partnership scenarios. Rather than appealing for a grant to access funds for construction, competitions are offered to the private sector. Those companies willing and able to build and operate nursing homes for a 30-year contract are considered.
A portion of the funding still comes from government, but the private company awarded the contract takes care of the design and planning, adhering to the general guidelines articulated by the health authority.
In return, CHA guarantees to buy the facility’s beds for the duration of the contract, channeling seniors from regional wait lists into those beds.
The competition structure has allowed a variety of successful ownership types, including solely private companies, church-owned not-for-profit organizations and publicly owned subsidiaries.
The first two rounds of contracts, valued at $37.8 million (276 beds) and $50 million (371 beds) respectively and encompassing a number of projects apiece, are in progress. A third round is anticipated. Round one, which started more than two years ago, is nearing completion and round two will wind down in late 2004.
“It’s a new concept and a new way of building facilities, so both the private sector and Capital Health have had to learn a lot about the process,” says Skinner.
“We’ve had to learn to step back a bit from our normal ways of doing things. (The private companies) have also had to step in and understand that they have different responsibilities than the traditional model.” The continuing-care centres are located around Edmonton and the surrounding area.
The not-for-profit Allen Gray Continuing Care Centre, which opened in March, and the 120-bed Devonshire Care Centre in Riverbend (run by the private company Summit Care) are examples of nursing homes built in large aging-in-place campuses, with lots of seniors’ housing being built up around them.
The clustering of facilities with varying levels of care will allow individuals to move from extended care to full-fledged nursing care without moving across town. The end result should mean less disruption for the aged.
The overall feel of the buildings no longer screams “nursing home” as the trend continues to move from institutionalization towards personal dignity.
“People today have much higher expectations of the system than they did 20 years ago, and people and their families expect a better ambiance and more choice in their lives,” says Skinner.