Surrey Memorial Hospital Critical Care Tower Emergency Department opens

On October 1, 2013, the new Emergency Department at Surrey Memorial Hospital (SMH) opened for patients. The new ER is the first completed phase of the SMH Critical Care Tower Expansion and Redevelopment Project, designed by CEI Architecture and Parkin Architects. With a capital cost of $512 million, the Critical Care Tower represents the single-largest capital investment in health care in the history of British Columbia. In addition to the ER, the completion of the first phase includes the main entry for the new facility and a link to existing buildings on the SMH campus. The remainder of the new Critical Care Tower will open in the spring of 2014.

The new Emergency Department features the latest technologies and approaches to patient-centred care. It is five times the size of the previous ER, which was the busiest in the province. The new ER includes separate Pediatric and Adult Emergency spaces for tailored care. The Pediatric Emergency has its own entrance, check-in, treatment rooms and family room. The mental health area provides a safe environment with privacy and seclusion when needed.

The state-of-the-art ER has many innovative design features informed by the latest evidence-based design principles: registration and triage stations located at the walk-in entry that can direct patients, based on the seriousness of their illness or injury, directly to treatment spaces; a fast-track zone immediately adjacent to the triage area designed to rapidly assess and treat non-life-threatening illness or injuries and allow for discharge without entering the other treatment spaces for seriously ill patients; private treatment rooms with walls (not curtains) and glass fronts so health-care professionals can monitor patients from team-care stations; dedicated family spaces in treatment rooms enables family support to patients during their stay; a dozen isolation treatment rooms for patients with infectious diseases with their own filtered air supply, sinks and bathrooms; white boards in every room so patients and their families can have interactive communication with health-care teams; a medical imaging unit close to the trauma area where an anticipated 70,000 tests will be done each year; an all-concrete, six-ambulance holding garage area that can be converted into a disaster command and treatment centre; a decontamination suite for patients that may have been exposed to dangerous chemicals allows for treatment of multiple casualties with an external shower, a separate exterior entrance, internal showers and an anteroom where health-care staff can put on protective clothing, gloves and masks; the acute care treatment spaces are uniquely segregated into diagonal pods each with dedicated team-care stations, medication rooms and access to supplies to reduce walking distances for staff and increase efficient patient care and treatment; within the tower, attention to reducing noise from ceiling tiles to flooring will provide for a quieter environment for patients, family and staff.

On approach, visitors to the new Critical Care Tower are presented with a structure that responds to the cultural diversity of its community and displays an expression appropriate for a state-of-the-art facility providing the latest in patient- and family-centred care. The façade massing combines four strong and durable building elements – wood, glass, ceramic and stone. These elements are woven throughout the facility as textures and details, creating a warm atmosphere that softens the institutional nature of a hospital and emphasizes personal healing and care.

Evidence-based design research has shown that the presence of visual wood surfaces has a positive impact on physiological stress responses. CEI and Parkin incorporated many visible wood elements, structural and decorative, into the design of the Surrey Memorial Hospital Critical Care Tower, resulting in a warm, natural aesthetic that supports the form and function of a facility dedicated to healing. The roof structure of the main 20-metre by 20-metre public entry pavilion is supported by internal “trees,” each consisting of four thick glulam wood “branches,” which extend from floor to ceiling. Wood structural elements are also incorporated into the link between the new Critical Care Tower and the existing hospital to reinforce the connection and emphasize wood as a natural wayfinding element.

The Critical Care Tower’s six-storey glass façade is veiled by a three-dimensional ceramic frit pattern. This theme is also expressed and reinterpreted throughout the interior design and provides a context for the hospital’s wayfinding system. The glass inpatient tower is echoed by the distinctly articulated stone circulation tower that is separate but adjacent to the tower.

The rest of the new Critical Care Tower will open in the spring of 2014. The addition of the tower and renovations to parts of the existing hospital will result in a net gain of 151 beds for Surrey Memorial Hospital, bringing its total to 650 beds. The majority of private inpatient rooms in the tower have been located on the perimeter of the building to allow access to daylight and views of nature – a major influence on positive patient outcomes in evidence-based research.

Besides the ER, the tower will include: 48 private rooms in a Neonatal Centre of Excellence, with an adjacent Pediatric Pharmacy; an embedded in-hospital Ronald MacDonald House space near the Neonatal Intensive Care Unit to provide space for families to remain close; 26 intensive care beds; 26 beds for seriously ill patients in the High Acuity Unit; two 36-bed in-patient floors with specialized areas for neurological, cardiac and kidney disease patients; an expanded laboratory with the latest in automation; a rooftop helipad with a dedicated elevator directly linked to the emergency and all-inpatient floors; and additional space for SMH’s clinical academic campus.

With the added academic space, SMH will be able to provide postgraduate medical training as a satellite campus of the UBC School of Medicine, helping address the shortage of doctors in BC. Internal renovations will upgrade the hospital’s north entrance, family birthing unit, pharmacy, linens and logistics, sterile processing and supply, and the kitchen.