Edmontons Royal Alexandra Hospital is Building for the Future, as its slogan goes, with a $210 million multi-phased project over five years. The current $51 million phase, now nearing completion, includes the redevelopment of the Ambulatory Care Area.

The Ambulatory Care Area redevelopment is centred on the basement and sub-basement levels of the existing Active Treatment Centre (ATC) of the Royal Alexandra Hospital at 10240 Kingsway Avenue. The renovations constitute a complex retrofit of the existing ATC basement spaces, comprising 6,500 square metres of renovations and new construction.

The largest component includes 10 operating rooms with pre and post operation support for short stay surgeries, a large Scoping Suite, Neurological Diagnostic Services, Respiratory Therapy and Pulmonary Function, Pre Admissions Clinic, Orthopedic Clinics and two Diagnostic Imaging Procedure Rooms. Other work is also being completed to a Patient Registration area.

Sean Hamelin, project manager for PCL-Maxam, compares the work, carried out as the facility kept functioning, to sliding a new seat under a person as they are driving down the highway. The phasing and staging of the work was key to keep the hospital operational and control noise and dust. Coordination between the trades and the users was essential.

Design work was completed by Royal Alexandra Hospital Redevelopment Architects (RAHRA), a Joint Venture Project that involved Edmontons Hamilton Filipowicz Architects and O'Neill O'Neill Procinsky Architects. The cornerstone of the planning and design process was a need for efficient patient access and flow patterns and easy to understand visitor circulation and orientation, says J. Bruce Elliott, design architect with RAHRA and ONeill ONeill Procinsky Architects.

Efficiency of operations, including movement of patients, staff and ready access to services, were guiding principles. Ease of staff and services movement was crucial, as was the creation of a pleasing environment that diminishes patient anxiety, Elliott says.

Working within a fixed structural columns grid, the design team devised ways to situate complementary programs and functions adjacent and established applicable fits and integration with the buildings structural, mechanical and electrical systems. A dedicated design studio was established for this project, including an on-site office which proved an enormous benefit to answer the complex demands of the renovation work, says Christopher Filipowicz, principal with Hamilton Filipowicz Architects.

This is a facility that has seen several renovations over its more than 40 year life. We needed to shift some HVAC elements to a new service space outside the building to meet the demands for improved air exchange and building code requirements, Filipowicz says.

A new entrance to the basement level improves overall ambulatory patient circulation and provides more direct access from the parking areas. A Patient Registration area, centrally located between two existing elevator cores and close to the stairs, provides convenient connections with other components.

The renovations have retained the vertical connections (elevator and staircase) with the rest of the facility. The convenient adjacency of the existing enclosed inter-site ambulance transfers drop-off area was maintained and several connections with the existing food court provide ready access to concessions and services. Other sub-basement level areas included in the renovations are Central Rehabilitation Services and Central Services Reprocessing, both areas that support the site. The existing configuration of the sub-basement allowed the design and construction team to accommodate rehabilitation programs with few compromises.

The new location offers convenient outpatient and staff access. Security considerations are reflected in design through layout improvements and will be enhanced by modified operational procedures. The renovations to Central Services allow instrument reprocessing on site to be centralized.

Challenges included floor-to-ceiling space limitations of the existing structure, with larger structural support columns and existing HVAC and plumbing systems which were retained, replaced or reconfigured. There were only moderate changes to existing ceiling heights and lighting systems and fixtures were carefully chosen to provide the necessary illumination while recognizing both practical and aesthetical considerations of the limited clearances.

Other renovations in separate buildings were also completed as part of this phase of development. They include the Emergency Trauma Administration, Northern Health Services Network, Medicine Clinics, Kingsway Emergency Physicians offices and Clinical Nutrition functions on levels five and six of the Community Services Centre. At the Childrens Centre, the Child Ambulatory Health Clinic, on level two, and Human Resources and Occupational Health and Safety departments, both on level four, were renovated.

Within Capital Health, the Royal Alexandra Hospital plays many important roles but the key role is being the service engine for our region and as such it was important during the redevelopment that we were able to continue to provide full services, says Joanna Pawlyshyn, Chief Operating Officer at the hospital. Its a credit to the creativity and sensitivity of our consultants that we could do this. This redevelopment is critical in ensuring the hospital continues its key role in Albertas health system and in providing specialized health services to Canadas northwest.

The next phase of the project, the renovation of Level One of the North Wing of the Active Treatment Centre, has commenced and is to be completed next spring. It includes the expansion of the hospitals busy Emergency Department with the addition of 19 new observation beds including two airborne isolation rooms.

Additional phases will include the construction of the just named Lois Hole Hospital for Women, a new six-storey building to be completed in 2008. It will be home for the Womens Health and Cardiac Services programs and additional inpatient beds.

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