October 2008 issue
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Feature
Edmonton’s Big Heart
The stunning Mazankowski Alberta Heart Institute has more than good looks on its side. The challenging project is designed as a top-of-the-line testament to the city’s reputation as a leader in cardiac care
BY GAIL HELGASON
Freelance Writer
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CARDIAC CONTOURS |
One of the mandates is that this building is going to be state-of-the-art for Alberta. That means bringing in the latest technology for medical equipment, and that technology and equipment are changing fast. When
the equipment changes, the basic requirements of the room change — facilities, power, water.
- Paul Forgues, R.E.T.
EllisDon Operations Manager
The shimmering glass structure rises above the University of Alberta campus at 112th Street and 84th Avenue, an imposing symbol of the state-of-the-art cardiac care it will provide across Western Canada. The Mazankowski Alberta Heart Institute is on its way to becoming fully equipped for the most complex of heart cases, including transplant surgery and the implanting of pumps called ventricular assist devices, which allow the heart to rest while it takes over.
Indeed, a lot of heart — not to mention expertise, careful planning and financial commitment — goes into a structure as stunning and complex as this one.
“This was a tough project to build,” says Paul Forgues, R.E.T., operations manager for London, Ont.-based EllisDon, the construction manager. “The project site was so confined that, logistically, we could only deliver materials to the site that could be set into place, as no lay-down areas were possible.”
Construction involved, for example, lifting 900-kilogram structural steel columns over an active health-care site. “We actually closed down a room for 10 minutes while we moved the columns,” Mr. Forgues says. “In five years, we only had to close down the emergency centre once, to accommodate transfer of the base building electrical service.”
Phase 1, representing a total investment of $180 million, officially opened in the spring, and the plan is to admit the first patients this fall. Phase 2, announced in August, will bring the tally to $217 million and complete the shelled-in floors built in Phase 1. Detailed design for Phase 2 begins this year, with construction set to follow next year.
Why Edmonton?
The institute, the first of its kind in Western Canada, is envisioned as a centre for excellence in heart disease prevention, treatment, rehabilitation and research. It builds on the city’s reputation for stellar cardiac care — Canada’s first successful open-heart surgery was performed in Edmonton in 1956.
And it’s named after Don Mazan-kowski, the former deputy prime minister of Canada. He’s a heart attack survivor and a health-care champion.
This will also be one of the few heart institutes in Canada equipped to handle pediatric and adult patients under one roof. The institute will open with 132 beds with shelled space for future capacity. It has 600,000 square feet of space, with half dedicated to clinical uses. The other half contains interstitial spaces for all the building’s mechanical and electrical services.
Among its other features are
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five adult operating rooms
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a dedicated pediatric operating room
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two adult cardiac catheterization labs
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one pediatric cardiac catheterization lab
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three electrophysiology labs
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a cardiac MRI
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virtual reality technology
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a “hybrid” operating room.
The hybrid room allows both non-surgical and surgical cardiac treatments in the same location. Surgeons can’t always know which approach will work best until they’re already in a room, says Deb Maerz, director of projects and planning for Capital Health. “This offers them much more flexibility.”
Virtual reality technology will, in Phase 2, allow surgeons to view holographic images of a patient’s heart, blood vessels and abnormalities, before operating.
The Best Examples
All of this began taking shape in 2001, when the Alberta Government charged Capital Health, in partnership with the University of Alberta, to develop a cardiac centre of excellence. At the start, Capital Health arranged tours of leading cardiac centres in North America, including the Cleveland Clinic and the Texas Heart Institute.
Construction under EllisDon started in October 2003. The firm’s credits range from Canary Wharf in London to the Olympic Village in Atlanta, and also include numerous hospitals, including the Royal Alexandra North Treatment Centre. Stantec Architecture undertook the design work, along with the U.S. firm KMD Architects.
The structure even contains a research hospital, the Alberta Cardiovascular and Stroke Research Centre. “The intent of the Mazankowski Institute was always that it was a hospital within a hospital,” explains John Webster, leader of Stantec’s architectural team.
The completed structure will be part of the existing Walter C. MacKenzie Health Sciences Centre, which already houses the University of Alberta Hospital and the Stollery Children’s Hospital. It is, nevertheless, “an individual building,” distinct from the other structures, Mr. Webster notes.
The institute has two main sections. A five-storey low-rise with a curved glass facade provides “phenomenal natural light” into the patient rooms. This section also has five interstitial, or between-floor, levels.
The second major section is a high-rise of eight storeys and another eight interstitial levels. It is topped by a helipad and a “megavator” — a large elevator capable of whisking patients to the existing emergency room on the first floor in just 26 seconds.
In the design, the goal was to maintain the overall image of the existing hospital but to change and improve the materials. “Because we were building over an existing building, we had to build a lighter structure to accommodate the structure already there,” says Mr. Webster. For example, the project incorporates a better, lighter wall system using metal instead of brick.
“We were challenged in some of the higher technical areas because the extent of the electrical/mechanical system is greater than was contem-plated in the 1970s,” he says.
Capturing the Technology
Representatives of EllisDon, Stantec Architectural and Capital Health all concur that one of the biggest challenges was keeping up with changing technology and patient-care standards.
“One of the mandates is that this building is going to be state-of-the-art for Alberta,” Mr. Forgues says. “That means bringing in the latest technology for medical equipment, and that technology and equipment are changing fast. When the equipment changes, the basic requirements of the room change — facilities, power, water.”
A review by a third party in the late phases of construction, for example, concluded that some design was no longer leading edge. That meant going back once again to revamp complex wiring and other systems. See sidebar, page 20. The many special health-care requirements, including infection control, demanded constant vigilance.
Before the project was put to tender, manufacturers were pre-qualified to ensure they understood the complex requirements. In total, EllisDon developed nine tender packages — site development, foundation, structural steel, major mechanical and electrical equipment, envelope, fit-out (interior), landscaping, security and medical equipment.
Also in the mix is that the hospital’s creators are aiming for a silver-level environmental certification under the trademarked LEED program. If successful, the Mazankowski Alberta Heart Institute will be among the first hospitals in Canada with the certification.
How will it get there? A recovery system, for one, will help by using giant air wheels to harvest otherwise waste heat from the building before it’s released. The system means far less traditional heating is needed, Mr. Webster says.
The People Quotient
The human side of the project was another huge challenge. On the labour front, the project hit it lucky, however.
About 350 trades personnel a day worked on the first phase. They began in 2003 and completed it “just under the rail” before Alberta’s major construction boom really heated up, says Mr. Forgues.
Luck may help, but Mr. Forgues credits much of the project’s success to good communication. “We have a very good relationship with Capital Health and all the user groups. Throughout construction, there were constant meetings at the high level and at the working level.”
Ms. Maerz of Capital Health was the interface among the users, designers and construction teams. “When you are building a leading-edge, state-of-the-art building, you really need to make sure you have that interface,” she says.
The people-focused design pays attention to allowing maximum staff efficiency. Surgical trays, for example, are suspended on ceiling booms to ensure easy movement in operating rooms and to streamline cleaning.
All in all, the project is truly memorable. “We started the process to develop a unique, state-of-the-art heart-care facility — one that would be a leading provider of heart care,” says Mr. Webster. “And I think that is what we have done.”
Focus on Patients Influences Design From windows to walls, the Mazankowski Alberta Heart Institute was designed and built with patient care the first priority. Take, for example, the patient area for the 20-bed cardiovascular intensive care unit. It was originally designed on an open concept, which was in keeping with the best-available knowledge when the project began in 2003. By last year, however, patient-care standards had changed. The most innovative facilities were now building enclosed patient spaces for all patient rooms, providing patients with more privacy — even though these are not quite as convenient for nurses. Redesign caused some delays, with patient admitting for Phase 1 set back from last spring to this fall. But it was worth the effort, says Deb Maerz, director of projects and planning for Capital Health. “Too often we design our facilities for the convenience of the caregiver, when really we should be focusing on the patient.” Each patient has a separate room, with a view of the Edmonton skyscape, a garden rooftop or an indoor garden. Each patient has a TV and access to Internet, which can be used to order meals. A towering curtain wall of glass curves around the institute’s south wall. The three-inch glass is designed to maintain heat and humidity as well as flood patient rooms with light. The facility’s theme of wellness is also evident in the stunning plant-filled Guru Nanak Dev Healing Garden, which spans two storeys. The heart institute’s walls are a visual feast of blues, greens, yellows and golds. “The idea is that they match the Alberta landscape,” explains Ms. Maerz. “Studies show that the ability to get natural light speeds patient recovery, even if the patient is in a coma.” |
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