chatham-kent health alliance

Chatham-Kent Health Alliance

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Sydenham and Public General buildings are outdated and do not meet code in many areas, (i.e. building, medical gas, fire codes, etc.)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

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 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