With much anticipation, the new Glen site of the McGill University Health Centre (MUHC) finally opened its doors in April 2015. The MUHC, located in Montreal (Canada), is one of the world’s foremost academic health centres, affiliated with the Faculty of Medicine of McGill University, and comprises four locations including the Glen site, which brings together the Montreal Children’s Hospital, the Royal Victoria Hospital, the Montreal Chest Institute, the Cedars Cancer Centre and the Research Institute.

We spoke to Elizabeth McPhedran, Communications Officer with the MUHC, to find out more about how the creation of this new super hospital presented a perfect opportunity to design for better health outcomes.


Q: How did the idea of the Glen site first come about?

Over twenty years ago the leadership team started to brainstorm and think about what the future of Montreal healthcare would look like. Because all the staff were accustomed to working in turn-of-the-century buildings where medical practices had outgrown the space in which they were performed, they were looking to build a very modern but also a very centralized and consolidated patient centric facility. The primary objective was to provide quality tertiary and quaternary care* services across the age spectrum, which is why we included the children’s hospital and the adult hospital in one building. And the whole idea was to bring all our services together to meet the present and the future needs of healthcare, so the building has room to grow at the same time as being able to provide quality healthcare right now.

They chose the Glen site because of accessibility. It’s much more accessible than say, the Royal Victoria Hospital that was downtown, and also because of its sheer size. So there’s room for expansion in the future. In 2020 we’re bringing over the Montreal Neurological Hospital, so that as well will be consolidated within the Glen site.


Q: Having children and adults together was a strategic move?

The idea of having the children and adults in the same building is to consolidate care across the age spectrum—we call it cradle to grave healthcare. A child is born at one hospital and is followed throughout their youth by doctors and then instead of having to go to a new facility they are followed in the exact same building. It’s a lot easier for physicians to collaborate with one another. We’re also consolidating a lot of our services now so staff can work together. For example, all of the operating suites are on the third floor, so the adults are right next to the children. This allows us to do things like for example a couple of months ago when we had our first mother-daughter kidney transplant at the new site. This consolidation of the adult and children hospitals allowed us to simply wheel the organ down the hall instead of having to harvest the organ at one hospital and transport it across town for surgery.


Q: Can you tell us about the multi-disciplinary team that designed the new site? What kinds of expertise were required? How did they work together?

There were many different teams that came together to build the site. As you can imagine, designing a building of this size is a bit of a Herculean endeavor. Hospital designers spent years before even designing meeting with experts to understand the options of the different spaces they could design. This was done in order to ensure the new space met with the latest standards in hospital care and scientific research. Among the different experts, 800 MUHC employees (clinicians, academics, researchers) from different departments were consulted in order to make sure that their new space reflected the environment that they needed to optimize work in their own departments in the new building. The architecture and urban planning team met with these clinicians to make sure that staff felt at home in their new environment. It was also an exercise in reflection and cooperation for different interdisciplinary groups to work together. The new building really has that MUHC touch, since it was designed personally by our clinicians to ensure that the space is a reflection of what they need to provide quality care.


Q: Can you give us a few concrete examples of design choices made specifically to improve patient health?

I think the biggest example at the Glen site is that we’re entirely made up of single-patient rooms. That’s 500 single-patient rooms—154 rooms on the paediatrics side and 346 on the adult side. This is leaps and bounds better for the patient and for the staff. The rooms are very spacious and each one has a large window that lets in a lot of natural light and has a beautiful view. Each room also has its own private bathroom, which means a lot more privacy. There is also a reclining sofa and chair in each room so that visitors can stay overnight more comfortably. The rooms are big enough to bring in medical equipment, instead of having to move patients to different floors for testing, which is a plus. And, the most important part is that studies show that single-patient rooms decrease the risk of nosocomial† infections spreading.

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Everything was designed with the patient experience in mind.

We’ve also divided the hospital so that there are separate elevators and hallways designated for different uses. This is also a huge help in stopping the spread of nosocomial infections. So for example, in public areas of the hospital you have elevators that are only used by members of the public to go visit different clinics and the hallways either lead directly to a reception desk or patient rooms—in short, only places that the public can access. We’ve put the back of house elevators and hallways in completely separate areas, accessible only by electronic key card. So we really have that division between public and private in the hospital.


Q: That just seems to make a lot of sense, doesn’t it?

Well, it does, exactly! And I always give the example of the Royal Victoria Hospital, where at any given time in an elevator you could have a flower-carrying visitor, a patient on a stretcher and a housekeeper with a load of dirty laundry. We don’t have that anymore. We have public elevators, we have patient transfer elevators, and we have logistics elevators. The patient elevators are only used for transferring patients from floor to floor, which not only helps for privacy for patients and stopping the spread of infectious diseases, but it also reduces the number of users taking the elevators so that they are available much more quickly in the case of emergency. The logistics elevators are dedicated solely either for moving clean or soiled materials throughout the hospital. So if you have a housekeeper who’s going to be collecting garbage or collecting dirty linens, they’ll only be using the soiled material elevators. And if you have food staff bringing up the lunches for patients into the in-patient units, they use another dedicated elevator that’s only for clean materials.


Q: Many of these examples deal with trying to stop the spread of infections within the hospital, which I guess is a serious issue.

Well, yes, that definitely, but it also improves patient privacy, which is very important. It’s a big improvement to travel flow in the hospital as well. There’s a natural way in which the public is directed towards where they need to go, with people getting less lost, even though the Glen is much bigger than any of the previous hospitals. That’s because there’s logic to how it was designed.

Each of the sub-sites has a specific colour assigned to help people navigate through the Glen site. For example, the Royal Victoria Hospital is dark blue, and the Montreal Children’s Hospital is turquoise, while the Montreal Chest Institute is orange

 

Q: We’re guessing a lot of thought went into where the different departments would be located. Can you give us an example of how this leads to a better patient experience?

As mentioned before in the operating room example, the Glen site was built to combine many interdisciplinary departments in strategic areas. The sixth floor of the hospital houses all departments that are related to women and newborn care; the breast clinic, gynecology and obstetrics, the birthing centre, and the post-partum maternity care unit are all located on the same floor. Once a woman has given birth she stays in the post-partum maternity care unit, which is on one side of the birthing centre. On the other hand, if the pregnancy has not gone to plan, right down the hall there are two caesarian operating rooms, and behind that you have the NICU, the neonatal intensive care unit. Compare this to the Royal Victoria Hospital, where all these departments were on different floors and maybe even in different buildings. You had to be transported between each. Now we’re all consolidated on one floor.

So yes, everything was designed with the patient experience in mind.

Because the MUHC is an academic health centre, the site was also conceived so that our academics and our professionals would be able to work more closely together. We’re a teaching and a research hospital, we have a lot of academics who come and do tests. Now it’s a lot easier for physicians and for staff to talk to one another between the paediatric and the adult side. Moving forward we’re hoping for a lot more collaboration between our teams, and that was a big part of it as well.


Q: Speaking of patient experience, were patients involved in co-designing the new site?

We consulted the MUHC Patient Committee, which is made up entirely of patients. We collaborated closely with them and they were consulted throughout the entire design process. Not only that, we also collaborated with experts in elderly care, experts with limited vision and limited accessibility. As many experts as possible were brought in to the design of the Glen— we were very mindful of building a space that was accessible for all sorts of different patient populations.


Q: Now located at the Glen site, the Royal Victoria Hospital opened in 1893 and was considered at the time one of the best-designed hospitals in North America. Over the years it developed an international reputation for teaching, clinical care and pioneering research. What aspirations does the new Glen site have with respect to its future legacy?

As we were saying before, the Glen site consolidates three of these legacy hospitals—the Royal Victoria, the Montreal Children’s and the Montreal Chest Institute—that have cumulatively been providing 350 years of renowned experience independently throughout Montreal. We’ve taken all that expertise and put it together under one roof, but in modern facilities with cutting-edge technology. We will no doubt continue to build on this reputation of excellence in healthcare and research and teaching, but we’ll do so from within one of the most innovative academic health centres in North America.

*Tertiary and quaternary care is care that requires hospitalization, complex surgery, emergency care or specialized treatment.

†A nosocomial infection is any infection acquired within a healthcare environment.

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