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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

Chatham-Kent Health Alliance

Facility Renewal and Capital Infrastructure Needs

Tri Board Meeting

October 26, 2010


Facility renewal and capital infrastructure needs october 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 needs october 20101

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  • Sydenham and Public General buildings are outdated and do not meet code in many areas, (i.e. building, medical gas, fire codes, etc.)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 needs october 20102

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 needs october 20103

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 needs october 2010 sydenham campus

Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham Campus


Facility renewal and capital infrastructure needs october 2010 sydenham campus1

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 sydenham campus2

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 needs october 2010 sydenham campus exterior window

Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusExterior Window


Facility renewal and capital infrastructure needs october 2010 sydenham campus interior window

Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusInterior Window


Facility renewal and capital infrastructure needs october 2010 sydenham campus3

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


Chatham kent health alliance

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 sydenham campus4

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 needs october 2010 sydenham campus exterior balcony

Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusExterior Balcony


Facility renewal and capital infrastructure needs october 2010 sydenham campus exterior balcony1

Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Sydenham CampusExterior Balcony


Facility renewal and capital infrastructure needs october 2010 sydenham campus5

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 needs october 2010 sydenham campus6

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


Chatham kent health alliance

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 sydenham campus7

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


Chatham kent health alliance

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

  • Manual controlled, No humidification – original unit


Chatham kent health alliance

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 needs october 2010 sydenham campus8

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 campus9

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 campus10

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


Chatham kent health alliance

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


Chatham kent health alliance

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

  • all located in brick pipe chase


Chatham kent health alliance

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 campus11

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


Chatham kent health alliance

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


Chatham kent health alliance

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 sydenham campus12

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


Chatham kent health alliance

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 sydenham campus13

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 sydenham campus14

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 needs october 2010 sydenham campus15

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 sydenham campus16

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 needs october 2010 sydenham campus17

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 campus18

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 campus19

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 campus20

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 sydenham campus21

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 needs october 2010 sydenham campus22

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 needs october 2010 sydenham campus

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 needs october 2010 public general campus

Facility Renewal and Capital Infrastructure NeedsOctober 2010 – Public General Campus


Facility renewal and capital infrastructure needs october 2010 public general campus1

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 needs october 2010 public general campus2

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)


Chatham kent health alliance

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)


Chatham kent health alliance

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 needs october 2010 public general campus3

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 needs october 2010 public general campus4

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


Chatham kent health alliance

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 public general campus5

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 needs october 2010 public general campus6

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


Chatham kent health alliance

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 public general campus7

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 public general campus8

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 needs october 2010 public general campus9

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


Chatham kent health alliance

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 public general campus10

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)


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 public general campus11

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 needs october 2010 public general campus12

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


Chatham kent health alliance

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


Facility renewal and capital infrastructure needs october 2010 public general campus13

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 needs october 2010 public general campus14

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 needs october 2010 public general campus15

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 needs october 2010 public general campus16

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 needs october 2010 public general campus17

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 needs october 2010 public general campus18

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


Chatham kent health alliance

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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