Gold Award: Humber River Hospital

Faced with significant financial and bureaucratic constraints, but willing to set lofty goals nonetheless, hospital officials in Toronto met their once-in-a-lifetime challenge with award-winning results.

The gold medal in the 31st annual Modern Healthcare Design Awards goes to the new Humber River Hospital and architectural firm HDR of Omaha, Neb.

The 656-bed hospital, which opened last fall, was built with its own triple aim: Lean, green and high-tech.

Hospital planners used Lean Six Sigma methodologies, including a pre-construction workflow analysis, to identify and create labor-saving design features, such as a layout that significantly reduced staff footsteps.

Leaders also committed to using energy-saving devices such as low-flow plumbing fixtures and lighting strategies to maximize the use of daylight with the goal of achieving the U.S. Green Building Council's Leadership in Energy and Environmental Design Silver-level standard.

And finally, to create an “all-digital hospital,” leaders deployed the latest versions of Meditech's electronic health record systems, self-guided robots and a text-messaging system that can update a relative when a loved one gets out of surgery.

“I was captured by the final results of this hospital,” said judge Agnessa Todorova, director of integration at Aditazz, a Brisbane, Calif., construction and design firm.

“The art pieces on the front façade, a colorful representation of trees—that was definitely very inviting,” Todorova said. “The use of robots for materials management frees up a lot of time and resources that can be dedicated to being more patient-friendly. I think that balance between being very friendly and technologically savvy is what made me put it at the top of my list.”

Fellow judge Cecilia DeLoach Lynn, of Practice GreenHealth, said she was impressed with the building's “incredible operational efficiency,” noting that Humber River's design reduced anticipated energy consumption by 41.8%.

“We recognized this as a once-in-a-lifetime opportunity,” said Humber River CEO Barbara Collins. The new hospital, with about 80% single-patient rooms, replaces three sets of hospital buildings from the 1940s, '50s and '70s that had mostly double rooms and wards.

Under Canada's healthcare system, the local hospital was eligible for a package of funding to build the new hospital. But the government doesn't pay for computers, equipment or a parking garage, Collins said.

“You have to be very thorough, very wise and very careful about not overbuilding,” Collins said. “So, they expect business cases. And we really did flood them with business cases.”

It fell to the hospital to raise $225 million to fill the shortfall. That meant preparing more business cases and “lots of publicity explaining” why more money was needed, she said.

During pre-construction, planners tracked staff movement in the old hospital buildings.

“They determined in a typical 12-hour shift, a nurse would have to walk 5.4 kilometers (3.3 miles) to do what they had to do,” said Jerry Jeter, vice president and principal with HDR. “If they upsized those rooms, it would more than double that to 11.8 kilometers (7.3 miles).”

Jeter, his design colleagues and members of the Humber River staff went to work, creating a layout that cut travel distances by 18.3%. How?

“A lot of it had to do with how and where we located main circulation paths and centralized services,” Jeter said. “Then it became a little game—how could we cut that. We spent a lot of time being very rational about how things were laid out and mindful of the orientation of rooms."