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Chatham-Kent Health Alliance. Facility Renewal and Capital Infrastructure Needs Tri Board Meeting October 26, 2010. Facility Renewal and Capital Infrastructure Needs October 2010.

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Chatham-Kent Health Alliance

Facility Renewal and Capital Infrastructure Needs

Tri Board Meeting

October 26, 2010


Facility Renewal and Capital Infrastructure NeedsOctober 2010

  • Chatham-Kent Health Alliance is a partnership of 3 hospital corporations: Public General ( PGH), St. Joseph’s Hospital ( SJH) and Sydenham District Hospital (SDH).

  • Request to review current state and capital needs for facility upgrades

  • PGH – dates back to 1954

  • SDH – dates back to 1955

  • Both facilities have reached a critical point in their life expectancy and are in need of major investment to maintain patient and staff safety.


Facility Renewal and Capital Infrastructure NeedsOctober 2010

  • !magine redevelopment project is 10 plus years away

  • Inadequate resources available over the years to support infrastructure upgrades

  • Sydenham and Public General buildings are outdated and do not meet code in many areas, (i.e. building, medical gas, fire codes, etc.)


Facility Renewal and Capital Infrastructure NeedsOctober 2010

  • Costs are estimates

  • Many upgrades cannot be done in isolation of one another

  • Any changes to current systems will require all code upgrades

  • Significant capital facility upgrades will require Ministry approval

  • Cannot bring certain systems up to code given building structure limitations

  • Does not include capital needs for the SJC or offsite properties, i.e. 47 Emma, MHA, adjacent houses.

  • Multi-year coordinated plan and dedicated annual resources required to proceed with any upgrades


Facility Renewal and Capital Infrastructure NeedsOctober 2010

  • References used:

  • Cohos Evamy Facility Audit Report July 2009

  • Honeywell Energy and Facility Renewal Report 2009

  • Emergency Department Hay Study 2009 (LHIN study)

  • Asbestos Audits – Advanced Environmental Corporation 2007

  • Stantec Facility Audit Report SDC 2005

  • Applied Building Sciences LTD Facility Audits – 2002 & 2004 PGC and SDC

  • Additional Inspections, i.e. Medical Gas, Fire Marshall, HIROC, Roofing Inspections, etc.

  • External Contractors and CKHA Engineering Staff


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus


Roofing

Cost Estimate $1,000,000

Multi-Year project will be complete 2010-2011

$ not included in total request

Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusRoof Replacement Plan


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Windows

  • Cost Estimate $ 1,500,000

  • Connected to envelope deterioration project

  • Add: Building Envelope

  • Asbestos Abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusExterior Window


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusInterior Window


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Building Envelope

  • Cost Estimate $ 1,500,000 +

  • Connected to Window deterioration project

  • Add: Window Replacement

  • Asbestos Abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusHeat Loss from Building Envelope


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusHeat Loss from Building Envelope


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Balconies

  • Cost Estimate $330,000

  • Deterioration to the point of unsafe

  • Do not meet code

  • Currently locked for safety, no access

  • Add: Building Envelope repair if balconies need to be removed


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusExterior Balcony


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusExterior Balcony


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

Fire System Upgrade

  • Cost estimate $ 1,000,000

  • Does not meet code

  • Currently equipped with smoke and heat detectors

  • Must bring up to code when doing any renovation (only 2 sprinklers at present time)

  • Add: Structural changes (Ceiling heights)

  • Asbestos abatement

  • Electrical upgrade


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Elevators Upgrade

  • Cost Estimate $ 250,000

  • Interior Upgrades 2010 – floors, walls, lighting

  • Control Systems need complete upgrade

  • Only one elevator accommodates a stretcher

  • Add: Electrical system upgrade

  • Asbestos abatement


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham CampusElevator Mechanical Room


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusElevator Control Panels


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Ventilation System Upgrade

  • Cost Estimate $5,000,000 - $7,000,000

  • End of life, does not meet code

  • Current ceiling heights do not allow for proper replacement to meet code

  • Add: Structural Changes (ceiling heights)

  • Electrical upgrade

  • Fire system upgrade

  • Medical gas system upgrade

  • Asbestos abatement


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham CampusOperating Room Air Handler

  • Manual controlled, No humidification – original unit


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusGeneral Air Supply – East Wing

  • Dampers are not working, over 15 years ago 35% of coils were removed do to coils were leaking (frozen), no humidification

  • Never reinstalled


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Medical gas system upgrade

  • Cost Estimate $ 500,000

  • System does not meet code, any changes to the system will require the entire system be brought up to code

  • Add: Structural changes (walls and ceilings)

  • Asbestos abatement


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

Asbestos Abatement

  • Cost estimate $ 2,000,000

  • Must be factored in to any and all changes to SDC

  • Add: Structural changes (walls and ceilings)


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

Sanitary and Storm drain piping

  • Cost Estimate $ 3,000,000

  • Does not meet code (Asbestos piping)

  • Current piping is all cracked

  • Requires major demolition to access prior to any potential repair

  • Add: Structural changes (walls and ceilings)

  • Asbestos abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusPlumbing Stack – Deteriorated Sewer Piping


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusDeteriorated/ Cracked Piping

  • all located in brick pipe chase


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusDiscovery of Sewer Piping Installation, after leak investigation


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

Waterlines

  • Cost Estimate $ 2,000,000

  • Does not meet code (galvanized piping)

  • Current piping is corroding

  • Risers are located in brick pipe chases

  • Add: Structural changes (walls and ceilings)

  • Asbestos abatement


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham CampusHot Water Supply Line Corrosion


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham CampusHot Water Supply Line Corrosion


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham CampusDiscovered During Recent Repair - Laundry


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

Boilers - Replacement

  • Cost Estimate $ 200,000

  • End of life

  • RFP issues September 2010 for replacement of one boiler

  • Add: Electrical upgrade

  • Asbestos abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusSteam and Hot Water Boilers


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusDeteriorated Boiler Tubing


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Chiller Replacement

  • Cost Estimate $ 275,000

  • End of life

  • Supplies only the OR

  • Add: Electrical upgrade

  • Asbestos abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusOperating Room Chiller


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Heating system upgrade (Radiant heating)

  • Cost Estimate $ 210,000

  • End of life

  • Add: Structural changes (walls and ceilings)

  • Asbestos abatement

  • There is an in-floor heating system on the first floor in part of the emergency, ambulatory care department and both side of the hallway in the West wing.

  • Source of leak cannot be located as system is buried in concrete. This system is shut down and not in use.


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Electrical system upgrade

  • Cost Estimate $ 1,000,000

  • System is obsolete

  • Does not meet code

  • Switched are no longer manufactured

  • Add: Structural changes (ceilings and walls)

  • Asbestos abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusOld Electrical Panels


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

OR Upgrades

  • Cost Estimate $ 1,000,000

  • Does not meet current code and standards

  • Consideration should be given to closing this section if continues to function as regular OR

  • Add: Electrical upgrade

  • Medical air systems upgrade

  • Ventilation system upgrade

  • Structural changes (walls and ceiling)

  • Asbestos abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Installation of negative pressure rooms

  • Cost Estimate $ 500,000

  • Currently no negative pressure room

  • Safety risk for airborne illness

  • Current patients transferred to Chatham

  • Add: Electrical system upgrade

  • Medical air system upgrade

  • Plumbing system upgrade

  • Ventilation system upgrade

  • Structural changes (walls and ceiling)

  • Asbestos abatement


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

Removal of Sewer tank

  • Cost Estimate $ 40,000 – $ 50,000

  • Current Emergency Department partly build on a sewer holding tank

  • 2010-2011 Capital plan – drain and connect to municipal line


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

Structural/Building reinforcements upgrade

  • Cost Estimate $ 2,000,000

  • Any changes in use or modification to the floor layout of the 1967 structure will require reinforcement of the structural system below the affected area.

  • (Cohos pg. B-3)


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

Renovation to patient rooms

  • Cost Estimate $ 4,000,000

  • Current rooms do not meet code

  • Washrooms are small and inaccessible

  • Do not meet Infection Control standards – sinks are located outside of washroom

  • Add: Plumbing upgrade

  • Electrical system upgrade

  • Ventilation system upgrade

  • Medical air system upgrade

  • Structural changes (walls and ceiling)

  • Asbestos abatement


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham CampusPatient Washroom & Outside Sink


Facility Renewal and Capital Infrastructure Needs October 2010 – Sydenham Campus

ED Renovations

  • Cost Estimate $ 500,000

  • Emergency Department LHIN Hay study - physical plant is inadequate by current standards


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus

Accessibility

  • Accessibility for Ontarians with Disabilities Act, 2005 (AODA)

  • Unable to determine cost at this point

  • Add: Structural changes (walls and ceilings)


Facility Renewal and Capital Infrastructural NeedsOctober 2010 – Sydenham Campus

  • We require an investment of approximately $27,000,000- $30,000,000 to maintain this facility in an acceptable state

  • Costs are construction related costs only. Relocation, moves, temporary set ups etc. needs to be factored into to overall project

  • Additional Engineering study required if direction is to proceed with only sections of the building upgraded as systems are interconnected

  • Recommendation – dedicated resources to maintain facility while proceeding to fast track cost of a new facility


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Roofing

  • Cost Estimate $ 500,000

  • Multi year roofing plan in place

  • HIRF investment planned for 2010


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Ventilation system upgrade

  • Cost Estimate $ 4,000,000

  • End of life

  • Does not meet code

  • Current ceiling heights do not allow for proper replacement to meet code

  • Add: Asbestos abatement

  • Electrical system upgrade

  • Structural changes (walls and ceiling)


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusObsolete Air Handling Unit

  • PG.A43 Induction unit, Perimeter heating and cooling

  • Dampers not working (manual controlled)


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusObsolete Air Handling Unit

  • PG.A45 Part of Maternity SE/SW


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Fire system and wiring upgrade

  • Cost Estimate $ 295,000

  • Some PGC is already done from previous renovations

  • Other does not meet code, must bring system up to code when doing any renovations

  • Add: Structural changes (ceiling heights)

  • Asbestos abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Building Envelope

  • Cost Estimate $ 1,500,000

  • Moisture penetration from outside walls

  • Repairs were done on South and South East walls

  • Add: Asbestos Abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusExterior Pillar


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusExterior Concrete Wall


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Medical gas systems upgrade

  • Cost Estimate $ 500,000

  • Some upgrades were done with previous renovations

  • Does not meet code

  • Any changes to the system will require the entire system be brought up to code

  • Add: Structural changes (walls and ceilings)

  • Asbestos abatement

  • required system shutdown for changes


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Elevator upgrades

  • Cost Estimate $ 1,000,000

  • 2 Elevators on the West wing

  • 3 Elevators in the Centre

  • 1 Elevator in centre is completely shutdown

  • Add: Electrical system upgrade


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusCenter Elevator Mechanical Room


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusWest Elevator Mechanical Room


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Asbestos Abatement

  • Cost Estimate $ 2,000,000

  • Must be factored in to any and all changes to PGC

  • Some areas amount and content is undetermined due to triple ceilings


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusWest Mechanical Room – Interior Asbestos Walls


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Structural/Building reinforcement upgrades

  • Cost Estimate $ 2,000,000

  • Any building expansion or changes, the existing foundations will need to be under pinned and enlarged to accommodate the additional loads


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Electrical system upgrade

  • Cost Estimate $150,000

  • Replacements of obsolete panels

  • Some areas were upgraded under previous renovations


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusElectrical Panels


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusElectrical Panels


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Sanitary and storm sewer piping

  • Cost Estimate $ 3,000,000

  • Current underground piping is deteriorated

  • All underground piping repair need extensive construction to access (few have been done)

  • Add: Asbestos abatement

  • Structural changes (walls and ceilings)


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusStarting of Corrosion – Sewer Piping PGC


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Sinks and toilet fixtures

  • Cost Estimate $ 125,000

  • Infection controls issue as identified (overflow drains do not meet code)


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Heating system upgrade (radiant heat)

  • Cost Estimate $ 250,000

  • End of life

  • Add: Asbestos abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General CampusObsolete Terminal Induction Units - Patient Rooms – Original System 1969


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Installation of additional Negative pressure room

  • Cost Estimate $ 100,000

  • Infection control and safety risk for patient and staff

  • Add: Structural changes (walls and ceiling)

  • Electrical upgrade

  • Medical air system upgrade

  • sprinkler system upgrade

  • Ventilation system upgrade

  • Asbestos abatement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Medicine A/B, Patient room and washrooms accessibility

  • Cost Estimate $ 300,000

  • Small, limited accessibility, patient and staff safety

  • Changes needed to get patient beds into rooms

  • Identified as safety issue at Executive Leadership Council Safety inspection


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Accessibility

  • Accessibility for Ontarians with Disabilities Act, 2005 (AODA)

  • Unable to determine cost at this point

  • Current building does not meet code under Accessibility legislation


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

  • We require an investment of approximately $16,000,000 to maintain this facility in an acceptable state

  • Costs are construction related costs only. Relocation, moves, temporary set ups etc. needs to be factored into to overall project

  • Additional Engineering study required if direction is to proceed with only sections of the building upgraded as systems are interconnected


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Recommendation:

  • Dedicated capital resources needed annually for next 5-10 years to maintain building to acceptable levels

  • Continue to proceed with Master Program/ Master Planning costing out complete renewal replacement


Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus

Next Steps

  • Priority list – safety issues and required capital

  • Site visit with Engineers from Cohos Evamy October 28, 2010. Additional assessment and recommendations of capital projects as it relates to future development

  • Clear vision of Sydenham site

  • Contingency plans

  • Dedicated capital


Facility Renewal and Capital Infrastructure NeedsOctober2010 – Sydenham Campus and Public General Campus

  • This report was prepared by:

  • Beth Hall Director, Support Services

  • Harrie Bos Manager, Engineering Services


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