PEACE ARCH HOSPITAL MASTER CONCEPT PLAN. White Rock, B.C. V4B 2R4. Prepared By: Funded in Partnership with:

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Project Number:

PAH-10-1010

Site Address:

15521 Russell Avenue White Rock, B.C. V4B 2R4

Prepared By: · Kasian Architecture Interior Design And Planning Ltd.

·

Resources Management Consultants (Alberta) Ltd.

·

Jim Bush and Associates

·

Consolidated Lower Mainland Facilities Management (LMFM)

Funded in Partnership with: · Peace Arch Hospital and Community Health Foundation

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN · TABLE OF CONTENTS INTRODUCTION .............................................................................................................................. 3 WHAT IS A MASTER CONCEPT PLAN ............................................................................................................................ 3 PURPOSE AND VALUE OF A MASTER CONCEPT PLAN ................................................................................................... 3 WHAT IS A MASTER PROGRAM.................................................................................................................................... 5 VISION, MISSION & PRINCIPLES ................................................................................................................................... 5 Vision ...................................................................................................................................................................... 5 Mission ................................................................................................................................................................... 5 Commitment ........................................................................................................................................................... 5 Core Principles ........................................................................................................................................................ 5 Guiding Principles .................................................................................................................................................... 6

PROPOSED SITE DEVELOPMENT SOLUTIONS ................................................................................ 53 Phase 1A - New Residential Care Building, Lot C South - By 2014 (Open)..................................................................... 53 Phase 3: Second Residential Building on Lot C (North) - Design (2016 - 2018)............................................................. 56 Phase 4: New Tower (2018 - 2030) ............................................................................................................................ 57

0 - 3 Year Cost Estimate – ............................................................................................................. 58 PHASE 1 DESIGN AND CONSTRUCTION SCHEDULE ....................................................................... 59

EXECUTIVE SUMMARY.................................................................................................................... 7 PEACE ARCH HOSPITAL MASTER CONCEPT PLAN ........................................................................... 8 Overview of the Chapter.......................................................................................................................................... 8 Demographic Profile of the Service Area. ................................................................................................................. 8 PAH FACILITY PROFILE INFORMATION (ROLE OF PAH) .................................................................................................10 MASTER PROGRAM PRIORITIES & PLANNING PARAMETERS........................................................................................13 Master Program Priorities.......................................................................................................................................13 MASTER PROGRAM PARAMETERS ..........................................................................................................................14 ADJACENCY MATRIX ...................................................................................................................................................15 FUNCTIONAL EVALUATION SUMMARY .......................................................................................................................16 PURPOSE OF SITE/BUILDING ASSESMENT ...................................................................................................................17 URBAN CONTEXT........................................................................................................................................................17 Topography of Sites ................................................................................................................................................17 ZONING AND LAND USE .............................................................................................................................................18 BUILDING HEIGHTS.....................................................................................................................................................19 SITE STATISTICS ..........................................................................................................................................................21 Setbacks .................................................................................................................................................................21 Maximum Site Coverage .........................................................................................................................................21 Allowable Density (FSR) ..........................................................................................................................................21 BREAKDOWN OF BUILDING / PARKING STATISTICS .....................................................................................................22 Building Floor Area * ..............................................................................................................................................22 Site Assessment......................................................................................................................................................22 Parking Stalls * .......................................................................................................................................................22 Building Age ...........................................................................................................................................................23 EXISTING FLOOR PLANS BY DEPARTMENT / USE .........................................................................................................24 BUILDING / SITE SECTIONS.........................................................................................................................................31 SITE PHOTOS ..............................................................................................................................................................32 URBAN PLANNING ANALYSIS ......................................................................................................................................39 EXISTING GREENSCAPE ...............................................................................................................................................41 SITE / COMMUNITY CHARACTER.................................................................................................................................42 SPACE SUMMARY (CURRENT & PROJECTED) ...............................................................................................................43 PLANNING PRINCIPLES ...............................................................................................................................................46

SITE OPPORTUNITIES .................................................................................................................... 47 SITE DEVELOPMENT STRATEGIES .................................................................................................. 50

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN INTRODUCTION WHAT IS A MASTER CONCEPT PLAN A Master Concept Plan (MCP) is an integration of clinical service planning, space programming, asset management, urban planning and site planning undertaken at a higher level to recognize the dynamic nature of the healthcare environment and planning information. It involves a process of assessment and analysis of current and future service needs and facility readiness (both actual and potential) to enable current and future service delivery through the development of short, medium and long term infrastructure projects. The MCP is an innovative variant of traditional Master Plans that are more appropriate for other sectors such as university sectors that have more stability in their facility and capital funding requirements. As a consequence traditional Master Plans commit more planning effort and resources to develop detailed functional plans down to the room level, project phasing plans for the campus with comprehensive capital and operating financial plans and procurement strategies for the phases. Like a Master Plan, the MCP does take a short, medium and long term perspective. But in such a dynamic environment as healthcare, the MCP takes a different approach that provides value over a traditional Master Plan process in two ways. First the MCP process matches the level of service and facility information, processes, resources and deliverables to what is needed to make transparent and defensible facility decisions. Conversely a Master Plan assesses clinical needs at a room detail level which is time consuming and expensive. The MCP process engages greater planning detail at the Business Case stage when there is greater probability of a priority project obtaining capital funding approval. Secondly the MCP focuses on achieving the approval and financing of short term priority projects that mitigate high consequence facility deficiencies impacting care access, quality, efficiency and continuity. Large capital projects are pursued where they represent an appropriate response to facility needs and where there is a reasonable probability of the project being approved. Taken together the MCP provides enhanced stewardship of the Health Authority’s planning funds while providing a context to advance project approval and implementation.

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

The MCP is one of a suite of three plan typologies that the LMFM Group undertakes for its sites. The two other plan typologies that are commonly undertaken are the Site Opportunity Plan and the Site Development Plan. Both of these plan typologies are really subsets of the Master Concept Plan. The Site Opportunity Plan’s focus is primarily on the capacity of the site and siting Project Capital / Operational Approval opportunities to accommodate additional building area. The Project Implementation emphasis is on the site and urban Increased Planning planning elements found in the Project Business Case Effort MCP. The Site Development Plan Project Concept Brief (Service & Value) extends the focus to consider what the density, massing and Priority Projects built form of development on the Priority Needs site would look like based on high level space projections of selected Site Master Concept Plan (Projects / Capital) clinical and operational elements Site Development Plan (Density / Massing / Infrastructure) such as inpatient beds that inform Site Opportunities Plan (Capacity) the overall size of the future facility. It does not take a more extensive view of considering the service role of the site within a regional system or look at opportunities for service realignment and partnerships or look for opportunities to improve the utilization of space by programs. Nor does a Site Opportunity Plan or Site Development Plan set out to identify short term priority projects to advance them to the Project Brief or Business Case stage for funding approval.

PURPOSE AND VALUE OF A MASTER CONCEPT PLAN The MCP creates a long term vision for a facility to inform optimal short term & long term site infrastructure decisions and focuses on generating value for site users and health service providers in four key areas ·

Service alignment, quality and operational productivity

·

Asset lifecycle value

·

Asset highest and best utilization & synergy with surrounding community

·

Identification and configuration of phasing of priority projects to address facility issues having high consequence for care access, quality, efficiency and sustainability. in a way that maximizes financing approval and project initiation

Service Alignment, Quality and Operational Efficiency: The MCP process provides an opportunity to understand the site’s current and future service plan alignment within a regional context, service requirements on the site and assumptions that drive the current and future capacity and functional requirements of the facility infrastructure. This review provides the basis for understanding where the facility infrastructure is misaligned with current and future patient and service needs or creates obstacles to operational efficiency and care quality. Page 3

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Asset Lifecycle Value: Hospital facilities have an economic life that reflects both the physical lifecycle of the facility and its building components and the functional usefulness of facility systems and spaces to accommodate current and future patient and operational needs. The physical lifecycle starts with the construction of a new facility at which time it is at its physical and functional prime. Subsequent investments in preventative maintenance, replacement or upgrades of building components, renovations or even re-purposing of the facility combat the obsolescence caused by age, weather, wear and tear and the pervasive changes in healthcare service demand, clinical practices and technology. A replacement facility is sometimes required when the costs to renew the economic life of the facility approach the costs of building a new facility. The decision to renew, de-commission or replace a facility can be a complex one and requires periodic assessment and planning within a site and even regional context to develop a coherent and optimal facility investment strategy. Without a Master Concept Plan that identifies the economic lifecycle and role of facilities within a broader and longer term context, facility users and the health organization can fail to realize the full benefits of facility investments.

capital needs, strategic options analysis and solution delivery strategy for capital assets such as facilities as a means of ensuring that capital requests to the provincial treasury have considered non-capital solutions to address capital asset deficiencies and obsolescence and considered non-provincial capital financing solutions for capital projects that are required. The MCP demonstrates that the projects identified for a site have emerged from a process that meets the expectations of the CAMF.

CAMF

Asset Highest and Best Use: The projects that are required for the timely renewal or replacement of hospital facilities have a significant lead time for planning, approvals, financing, design and construction. Advanced planning is critical to accommodating this lead time so that the right facility environments are available at the right time, place and cost. Hospital sites often have multiple buildings each with a different economic lifespan and with functional interdependencies that adds to the complexity of making decisions that optimally position the site and its facilities to support the short, medium and long term requirements of patients, clinicians and operations. Site and facility decisions must also take into account that a hospital site has development opportunities and constraints created by the existing site area, shape, infrastructure, zoning and regulatory policies, surrounding land uses and neighbours. In this context, the site itself is a valuable asset from a utility and market perspective. But it has practical limits on its ability to accommodate the current and future space requirements of health services and do so in a way that achieves the siting of services necessary for effective and efficient access to care and delivery of care services. Planning of facility projects in the absence of a Master Concept Plan can diminish the long term utility and value of the site by misusing site area suitable for higher and better uses. Identification of Short Term High Priority Project Solutions that Are More Readily Achievable: The MCP focuses on driving the approval and financing of short term priority projects to mitigate high consequence facility deficiencies impacting care access, quality, efficiency and continuity. However the MCP process looks for opportunities to improve facility and operational conditions that are right sized for financing. Large capital projects are pursued where they represent an appropriate response to facility needs and where there is a reasonable probability of the project being approved for funding. Importantly the MCP provides the longer term vision of the site within which decision makers and potential funders can understand how individual projects fit into the long term development and investment strategy of the site. This reduces the financial risks of a project. The availability of capital and operational financing for facility projects is linked to the priorities and policies of government, health authorities, regional hospital districts and foundations. One such policy, the Capital Asset Management Framework (CAMF) sets the Provincial Government’s expectations as to the rigour of the service plan,

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN WHAT IS A MASTER PROGRAM

·

Exceptional customer service;

The Master Program is the key program/service input into the development of the Master Concept Plan. It describes in words and component areas the program requirements for the 31 program components identified for master programming at PAH.

·

Linking with community care providers and hospitals in order to actively integrate the delivery of care;

·

Each Master Program includes a description of the current and projected scope of service for each program, and their corresponding functional, operational, spatial and relationship requirements. It incorporates the projected program space for the next 10-15 years and informs the Master Concept Plan for PAH.

Creating an atmosphere that embraces healthy lifestyles, facilitates healing, and reflects the diverse needs of the community;

·

Being on the leading edge of health care delivery through continuous quality improvement, innovation, and a commitment to achieving optimum results;

VISION, MISSION & PRINCIPLES

·

Operational efficiency; and

The development of the PAH Master Concept Plan was guided by the vision, mission and planning principles for Fraser Health as presented below.

·

Creating an environment where care providers and staff are proud and happy to work.

·

Strives for Excellence (Best in Health Care). The Facility should facilitate excellence in clinical and support services and a healthy workplace environment.

Core Principles Vision For Fraser Health, the "vision" is the mental concept or image of what the organization is seeking. The general vision is “Better Health, Best in Health Care”.

Fraser Health has identified six “core principles” that it has concluded will assist to establish effective care delivery models, clinical support and design: ·

Patient-Centered. The Facility should facilitate the delivery of patient-centered care that seeks to optimize the overall experience of patients and their families.

·

Forward-Thinking (Future-Oriented). The Facility should be designed to accommodate future care delivery trends, technologies, and service needs.

·

Efficient Use of Resources. The Facility should be designed to maximize the value of each health care dollar spent to in Design and Construction and after Service Commencement.

·

Integrated Care Delivery and Knowledge Transfer. The Facility should facilitate the involvement of all appropriate care providers in the diagnosis and treatment of patients and facilitate access by care providers and patients to complete and timely health information.

·

Optimized Health Outcomes (Better Health). The design of the Facility should promote healthy lifestyles and optimize health outcomes for patients.

Mission ·

·

To deliver high-quality, culturally-sensitive, health care services; and To improve the health and well-being of the people in our community.

Commitment In carrying out the mission, it is critical that the spirit and intent of the Facility is not lost during the planning, implementation, or operational phases of the Project. To this end, a series of commitments has been made by staff members, physicians, and planners. These commitments are set out below. Fraser Health is committed to: ·

The seamless integration of services into the continuum of care;

·

Providing inter-disciplinary primary and chronic care;

·

A patient-centered approach to health care delivery;

·

Evidence-based best practice and design;

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Guiding Principles

·

Incorporate state of the art technology.

·

Use technologies as a tool to improve health outcomes.

From the core principles set out above, Fraser Health has developed a more detailed set of “guiding principles” that can be used to develop service strategies. These guiding principles essentially create a framework for assessing service strategy decisions against the stated vision, mission, and core principles. These should serve as the common foundation for all planning, design and operation decisions as the development of the Project proceeds.

·

Be proactive in thinking and embrace innovation.

·

Models of care and design will be evidence-based.

·

Improve environmental impact through “green” or “sustainable planning” design, construction, operations and maintenance.

·

Promote healthy living.

·

Quality and safety will be the paramount features of the clinical and non-clinical work environments.

·

Provide staff with the physical facilities necessary to allow them to excel in a safe and multi-functional environment.

Efficient Use of Resources ·

Build and promote partnerships that improve effectiveness and efficiency.

Patient Centered ·

Design with the patient’s perspective in mind.

·

Maximize cost effectiveness and the use of available resources.

·

Develop and maintain a healing and aesthetically pleasing environment that is inviting, comfortable and sensitive to diversity.

·

Use technologies as a tool to improve cost effectiveness.

·

Maximize space through efficient design and shared usage.

·

Utilize an optimal performance approach such as LEAN Healthcare.

·

Improve indoor environmental quality through sustainable design.

·

Design care processes that optimize patient, client and family satisfactions.

·

Design so that diversity is not a barrier to health care.

·

Design parking to provide easy access to the Facility.

Forward Thinking ·

Create a flexible and adaptable design to accommodate future structures, processes, care delivery systems and technological needs.

·

Minimize impact on the natural and physical environment.

·

Strive to be on the leading edge of health care delivery.

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Strive for Excellence (Best in Health Care) ·

Foster a safe, comfortable and productive healthy workplace environment that promotes recruitment, retention and satisfaction.

·

Maintain the individual identities of the Authority while sharing resources and providing seamless services.

·

Adopt best practices and aspire to be leaders.

·

Open to new ideas and creative solutions.

·

Remain patient focused and have the courage to do what is necessary to achieve the Facility’s mission, vision and core principles.

Integrated Care Delivery and Knowledge Transfer ·

Develop and apply integrated resources to enable:

·

Seamless and sustainable care and support for patents and families;

·

Effective exchange of information;

·

Sharing of technology and services; and

·

Ongoing learning and development of new knowledge.

Optimized Health Outcomes (Better Health)

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN EXECUTIVE SUMMARY Overall Purpose of Master Concept Planning • • • • •

Define the hospital’s role within the network of acute and community services in FH and the Lower Mainland context Align capacity planning to the overall capacity planning in Fraser Health and Lower Mainland Anticipate emerging service requirements Prioritize service enhancements and required capital investments Provide support for funding requests and allocation

Immediate priorities identified in the next five years are: 1. Expansion of Peace Arch Hospital’s Emergency Department 2. Expansion of Residential Care Capacity 3. Redevelopment of OR & Surgical Inpatient Program Future Priorities over next six to 20 years include:

Goals • • • • •

Produce a 10 year plan that includes a 20 year vision Review current and future scope of clinical services Indicate opportunities for improved clinical operations & efficiency related to space and design Identify key operational requirements Identify expansion areas on the site

Background In 2011 Peace Arch Hospital and Community Health Foundation and Fraser Health jointly funded a Master Concept Plan for Peace Arch Hospital (PAH). The plan is based on high level service demand projections, assumed future service mix and aligned with the hospital typology project. The purpose of the plan is to guide future facility investment decisions as well as provide a framework for ongoing facility planning. Peace Arch Hospital (169 funded beds1) is a community Hospital with a 24/7 Emergency Department that primarily serves the communities of South Surrey and White Rock (SS/WR) with some inflow from other communities (Delta, Tsawwassen, Ladner and Langley). The 2011 population of the Peace Arch catchment area is approximately 87,752 and in the next ten years will grow by 14.7% to 100,670. 2 By 2030, 30% of the SS/WR population will be seniors 65 and older and while enjoying good health and longer life expectancy the high prevalence of seniors in this community is expected to significantly impact health service requirements. The campus includes two Complex Residential Care facilities, Dr. Al Hogg Pavilion and Weatherby Pavilion (234 beds).

1. New ICU 2. New Acute Care tower

Findings To accommodate priority requirements various development scenarios were considered with the most viable option presented below. 1. An opportunity has been identified to develop a complex care residential facility on the PAH Foundation owned property on the North West corner of 156th street and 16th Avenue. Potentially a new facility could be developed within two year to support approximately 200 beds. 2. Phase 1a: Decant 80 beds from the Weatherby Pavilion into the new residential facility (excluding Oceanside – Tertiary Mental Health program). 3. Phase 1b: Decant Berkeley Pavilion, Vine Avenue and Russell Unit as well as some areas from the main floor of the Acute building to the Weatherby Pavilion. 4. Phase 2: Renovate and expand the existing Emergency Department, minor O/R and surgical outpatient areas. 5. Phase 3: Demolish Berkeley Pavilion, Vine and Russell buildings for development as interim parking lot until construction of a new tower.

Past reviews of Peace Arch Hospital programs identified several areas that are struggling to provide a high level of service due to expanding volumes, increasing complexity and lack of space. Overall growth projections indicated that the current site could grow to a range of 348 – 362 beds 3 by 2030. Additionally, the Emergency Department was identified as a priority for grow to 46 treatment spaces from the current 10 treatment spaces based on increasing visit volumes.

1

Includes all acute & 8 palliative beds based on April 2011 information Source BC Stats, People 36 projections & FH Population Health Profile 2010 3 Data to determine this growth was prepared by FH Decision Support Services, using CIHI DAD 2009/10, 2006 ACCI methodology with refined service group mix. 2

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN PEACE ARCH HOSPITAL MASTER CONCEPT PLAN STRATEGIC CONTEXT, SERVICE REVIEW & HOSPITAL PROFILE Overview of the Chapter This section of the report presents demographic information for the PAH service area, master plan priorities and key planning parameters that directed the development of the plan. The service planning information was used to project workload and staffing which are the key space drivers. The chapter also includes information on bed projections, planning parameters for each master program, and the space summary based on the master programs.

The following information is taken from the Population Health Profile 2010 for the South Surrey/White Rock (SS/WR) Local Health Area (LHA) document prepared by Fraser Health: · In SS/WR, 24% of the population are seniors 65‐years and older, giving SS/WR the largest proportion of seniors among Fraser Health LHAs. The aging population is a significant driver of demand because the need for health services rises dramatically with age. In 2006/07 people over 65 made up 14 per cent of the B.C. population, but used 33 per cent of physician services, 48 per cent of acute care services, 49 per cent of PharmaCare expenditures, 74 per cent of home and community care services and 93 per cent of residential care services. The following graphically illustrates this point, i.e. seniors are significant users of health services.

Demographic Profile of the Service Area. Peace Arch Hospital (PAH) is located in the Lower Mainland of BC in the City of White Rock. The following table presents the demographic information for the White Rock / South Surrey area (Source: BC Stats, BC Ministry of Labour & Citizens’ Services, P.E.O.P.L.E. 35 projections). Area

2008

2010

2015

2020

White Rock / South Surrey %é

82,287 -

86,013 5% é

93,177 8.5% é

99,460 7% é

Observations - Demographic Profile Information The population increased by 5% between 2008 and 2010. It is projected to increase by another 8.5.0% by 2015, and another 7% by 2020. · The seniors population (age 65 plus) is a significant population. The SS/WR population is older than Fraser Health overall with more seniors 65+ than children ≤16 as seen in the inverted pyramid shape in the age‐sex distribution graph. A popular retirement community with our lowest birth rate, SS/WR is home to one of the largest concentrations of seniors in our region. The following map shows the South Surrey/White Rock Local Health Area (LHA) boundaries (Note: Patients from outside the White Rock / South Surrey area access PAH for health services but the primary service area is White Rock / South Surrey).

· · · · ·

·

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

By 2030, 30% of the SS/WR population will be seniors 65 and older. Low‐income is less prevalent in SS/WR than in many of our other LHAs. SS/WR has the highest average family income in Fraser Health and one of the highest median incomes. Cancer, depression/anxiety, and dementia in seniors are major causes of illness, with higher rates than Fraser Health or BC overall. About 17% of Fraser South residents smoke, a major risk factor for cardiovascular disease and lung cancer, two of the leading causes of death in SS/WR. Older adults can be heavy users of our healthcare system and their healthcare needs are generally more diverse and more complex than those of younger age groups. While a growing seniors’ population could increase demand in our health care resources and other services, this age group also has much to offer society through volunteerism, civic participation, and community involvement. Fraser Health can help to protect this resource and reduce the anticipated demand on healthcare utilization by encouraging seniors to adopt healthy, active lifestyles and by providing supports for optimal aging. Health Status: In general, South Surrey/White Rock residents enjoy good health and have long life expectancies. However, South Surrey/White Rock has higher incidence rates for cancer and prevalence rates for dementia among the elderly and depression/anxiety compared to the Fraser Health and BC averages. The prevalence rates for a number of chronic diseases are on the rise and a cause for concern and some health practices can also be further improved. For example, less than 40% of Fraser South residents eat the recommended five daily servings of fruits and vegetables. In addition, 17% of residents smoke, and smoking remains the single most significant preventable risk factor for cardiovascular disease and a number of different types of cancer. Cardiovascular disease remains one of the leading causes of hospitalization among men age 25‐64 and among men and women age 65 and older in South Surrey/White Rock, and is the leading cause of death as well. Cancer is also a significant cause of death. In fact, chronic diseases contribute to 9 out of 10 of the leading causes of death in South Surrey/White Rock. Page 8

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN PAH FACILITY PROFILE INFORMATION (ROLE OF PAH) A primary role of the PAH is to provide secondary acute services and fulfill the role of a community hospital.

h ig h

C O M P L E X IT Y O F C A R E

R E G IO N A L H O S P IT A L

lo w

C O M M U N IT Y H O S P IT A L

Hospitals Defined: A Classification of Regional and Community Roles Fraser Health’s integrated care network contains “regional” and “community” hospitals. Within regional and community hospitals a range of services are provided based on proximity to other sites, their specific clinical function, historical referral patterns, integrated service delivery models and the health needs of the population served. The following table articulates the general functional characteristics of regional and community hospitals. As outlined, all Fraser Health hospitals have variable components of non-referral services, referred services and academic teaching and research elements.

R o y a l C o lu m b ia n H o s p ita l S u r re y M e m o r ia l H o s p ita l A b b o t s fo r d R e g io n a l H o s p ita l a n d C a n c e r C e n t re

Table 1 – Fraser Health Hospital Classifications Regional Hospitals

B u r n a b y H o s p it a l R id g e M e a d o w s H o s p it a l L a n g le y M e m o ria l H o s p ita l

Non–referral services

C h illiw a c k G e n e ra l H o s p ita l P e a c e A r c h H o s p ita l

E a g le R id g e H o s p ita l

Primary

Primary

- 24/7 Emergency - Some GP services Secondary

- 24/7 emergency - Some GP services Secondary

- Primary care/community practitioner refers patient and specialists may provide care

D e lta H o s p ita l M is s io n M e m o r ia l H o s p it a l F ra s e r C a n y o n H o s p ita l

Referral Services Tertiary In order to provide sustainable, high quality health care (from prevention to end-of-life care) throughout the region, Fraser Health continues work to integrate services and care processes across the continuum. From a patient safety and quality of care perspective, continuity of care between hospitals and between hospital and community services is paramount. Transitioning patients from specialized care at one of Fraser Health regional centres to care at a community hospital will be medically appropriate, efficient and effectively utilize Fraser Health resources to better serve patients, families and communities. To pursue Fraser Health’s future vision of a seamless, integrated, high quality network of services, Fraser Health – in collaboration with academic and community partners – has undertaken a number of extensive planning exercises. One such exercise, the Acute Care Capacity Initiative (ACCI), included a systematic literature review in regards to hospital roles and functions within an integrated system. The hospital roles contained in this section are grounded in the literature and provide the foundation for future planning and resource allocation.

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

- Highly specialized acute care services that require multiple medical specialties, specialized technology and multi-disciplinary care team

Academic health care network

Community Hospitals

- Designated referral centre for selected specialized services, serving the entire region. Active participation in medical education / residency programs and clinical teaching. University designated “Clinical Academic Campus.”

- Primary care / community practitioners manage majority of care, refer patients to specialists when required. At some sites specialists may be primary care giver. - May include “area of specialty focus.” Tertiary - Tertiary services are not provided at Fraser Health’s community hospitals.

May participate in medical residency programs & clinical teachings

Potential clinical teaching sites

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN The next series of table present service utilization information for PAH. This information further substantiated the \key program pressure areas and in particular acute care capacity requirements for the Emergency Department and acute beds at the site. The following table presents the number of PAH Cases by Service & Patient Residence LHA for 2009/10. LHA

Cardiac

Medicine

Surgery

Neurosc.

Paeds.

Maternity

Psych.

Other

TOTAL

The following table presents the PAH Percentage Occupancy of Inpatient Services. Program/Unit

2006/07

2007/08

2008/09

2009/10

2010/11

ICU

85.1%

82.1%

83.6%

87.8%

90.2%

Medicine

106.6%

105.6%

102.6%

101.1%

113.9%

Rehabilitation

99.1%

99.2%

106.4%

106.9%

227.7%

103.5%

108.0%

104.5%

Abbotsford

1

5

10

1

0

4

1

0

22

Agassiz

0

0

1

0

0

0

0

0

1

Burnaby

4

2

11

1

0

3

4

0

25

Maternity

68.6%

72.2%

75.1%

69.4%

67.5%

Chilliwack

0

4

6

2

0

2

2

0

16

Surgery

85.6%

87.7%

95.8%

98.8%

97.8%

Coquitlam

3

7

11

1

0

6

5

0

33

Psychiatry

94.5%

98.4%

102.1%

104.8%

108.1%

Delta

9

34

72

3

2

117

15

4

****256

Hope

0

0

0

0

0

0

1

0

1

Langley

25

65

101

5

1

117

17

5

***336

Maple R

3

3

5

2

0

0

0

0

13

Mission

0

3

2

0

0

0

2

0

7

New West

3

2

6

1

0

2

0

0

14

WR/SS

875

1603

1492

297

23

699

316

158

*5463

Surrey

132

318

487

34

7

559

70

17

**1624

VCHA

8

19

23

6

0

5

5

1

67

Other

21

45

55

8

0

9

11

1

150

1084

2110

2282

361

33

1523

449

186

8028

ACE

-

-

The red font indicates over 100% occupancy. The recommended target bed % occupancy for Fraser Health is 85% occupancy. The only inpatient service that is within the recommended target is the Maternity unit. This information supports the requirement for additional acute beds at PAH. The next table presents the Average Length of Stay (ALOS) at PAH.

PAH ALOS

2006/07

2007/08

2008/09

2009/10

8.3 days

8.3 days

9.1 days

9.2 days

Notes: Year to date for 2010/11: 8.6 days (excl. newborns)

TOTAL

The following table presents the Current and Projected Number of Surgical Cases at PAH showing both day patients and inpatient surgical cases at PAH. Patient Type 2008/09 2009/10 5-7 years 10-15 years Day Patients

6,296 (73%)

6,265 (73.3%)

6,798

7,274

Inpatients

2,319 (27%)

2,282 (26.7%)

2,516

2,692

8,615

8,547

9,314

9,966

Notes: WR/SS = White Rock / South Surrey As shown above, the largest number of cases were from White Rock / South Surrey (highlighted in red font), the second largest number of cases were from Surrey (green font), the third largest number from Langley (blue font), and then Delta (orange font). This information confirms that the primary clients of PAH are residents of the White Rock / South Surrey area.

TOTAL

Notes: The projected number of surgical patients by patient type applied the same percentage as current practice, i.e. 73% day patients and 27% inpatients.

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 11

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN The next table presents the historical number of PAH Emergency Department (ED) Visits by CTAS Level (Level 1 is the highest acuity and Level 5 the lowest acuity). 2006/07 ED Visits

2007/08

32,640

2008/09

33,877

2009/10

37,760

38,407

PAH Bed Requirements The following table provides an overview of the current beds and future bed requirements. It is important to note that projected bed range of 348-362 beds was reviewed and agreed upon by the clinical program directors. A Summary of Current & Projected Acute Care Beds at PAH UNIT NAME

CTAS % CTAS #1

0.2%

0.4%

0.2%

0.2%

CTAS #2

3.6%

10.1%

10.9%

11.3%

CTAS #3

43.1%

CTAS #4

48.4%

36.4%

CTAS #5

31.8%

5.4%

Unknown

40.8%

11.3%

34.3%

12.0%

3.8%

AVAILABLE BEDS

MASTER PROGRAM BED ALLOCATION

COMMENTS

82

84

136-150 Master program assumes up to 5 30-bed units

0

0

12 Currently 8 beds included in Medical bed count

Surgical Beds

25

29

75 Master program assumes up to 3 25-bed units

Mental Health Beds

11

12

26

Maternity Beds

7

8

Critical Care

7

8

ACE Beds

17

17

25 Master program assumes 1 25bed unit

General Rehabilitation Beds

12

30

25 Master program assumes 1 25bed unit

0

0

25 Will be a regional service – new unit

161

188

8

10

Telemetry – Future Allocation

36.9%

30.5%

5.5%

Medical Beds

CURRENT FUNDED BEDS

8 Status quo 16

13.2%

5.6%

4.1%

As shown above, the number of ED visits continues to rise, with the largest number of ED patients classified as CTAS Level 3 (highlighted in red font) and the second largest group CTAS 4 (green font).

Geriatric Rehabilitation Beds – Future Allocation The Projected Number of Visits for the PAH Emergency Department is presented next. TOTAL 2010 Actual

2015

2020

2030 Palliative Care Beds

ED Visits

41,592

45,150

50,011

348-362

60,760

10 A 10-bed hospice plan included in End of Life master program

Notes: Notes: Projections prepared by Fraser Health Decision Support Unit

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

1. 10-bed hospice included in the End of Life master program is over and above the projected acute care bed numbers of 348-362. 2. Excludes the 3 infant spaces in the nursery on the Maternity Unit.

Page 12

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Residential Care Beds at PAH Residential Care beds at PAH are located in two buildings – the Weatherby Pavilion and the Al Hogg Pavilion. There are a total of 234 beds. The projected number of residential care beds for White Rock/South Surrey is presented in the table below:

White Rock/Surrey Additional Beds

Current Beds 814

# of Beds by 2015 895

# of Beds by 2020 1,125

# of Beds by 2025 1,531

# of Beds by 2030 2,096

TOTAL

-

(+81)

(+230)

(+406)

(+565)

(+1282)

2,096

The residential care space in both the Weatherby and Al Hogg Pavilions do not meet the complex care space requirements, i.e. the recommended ‘neighbourhood’ size is 24-28 residents not 42-50 residents, 95% of the rooms should be single room accommodation, all rooms should have ceiling lifts, no shared bathrooms, etc. The program leads did indicate that residential care does not need to be located on the PAH campus.

MASTER PROGRAM PRIORITIES & PLANNING PARAMETERS

•

Interim Bed Expansion – As shown in the projected bed table on page 2-6, additional beds are required and there is significant pressure on medical beds. – The suggested strategy is to use vacated space (once the Critical Care Tower that will accommodate the three program listed above is built) to create additional acute care bed capacity.

The rationale used to establish priorities were: • Mitigate risk —regulatory non-compliance or health safety issues • Enhance operational efficiency • Improve space utilization • Improve patient access/satisfaction • Build future capacity • Renew/retool physical plant (New Program Technology) • Facilitate donor/partner funding Key Planning Parameters The following high level planning parameters were used to develop and evaluate the site development options. Physical Parameters

This section of the chapter presents the master program priorities and planning parameters including highlights from the 31 master programs.

Master Program Priorities The master program priorities that emerged from this planning work are as follows:

· · · · ·

The site will offer an open, friendly, well lit, cheerful and inviting environment. The space will be designed in a flexible manner to accommodate current and future service requirements. The Emergency Department (ED), Surgical Services and Critical Care will be developed in new space and the vacated space will accommodate other outpatient services and interim acute care inpatient beds. Direct convenient access from parking facilities to the main entrance and high volume ambulatory programs is essential. Minimize the number of internal moves and renovations required to accommodate program space needs, appreciating the operational impacts and disruption to existing services.

•

Emergency Department – Require additional treatment space (46 appropriate spaces) to support the projected 60,000+ visits per year. – Require improved ambulance area. •

•

Surgical Suite – The current 3 operating theatres (OR’s) and support space built in the 1950’s are not adequate to support the type of caseloads and current and projected workload at PAH. – The area requires 8 OR’s and support space for the projected volume of surgical cases. Critical Care (ICU) – The current unit does not meet best practice clinical and space standards, i.e. enclosed private room, infection control needs, family & staff support space, etc. – There are 8 ICU beds and the projected need is for 16 beds.

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Operational Parameters · · · · · · ·

Program and service space will be designed to support a family-centred care model. Needs of special patient populations must be reflected in design, e.g. elderly patients and bariatric patients. Where ever possible, reception and waiting space will be a shared resource. Meeting space will be a shared resource in the facility. Ambulatory Care services including the ED with strong functional affinities with the Diagnostic and Treatment services (DI and Lab in particular) should be located nearby to maximize operational efficiencies. There will be restricted access in treatment and staff areas. As much as possible, outpatient programs and services will be located together to maximize operational efficiencies.

Page 13

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Component

MASTER PROGRAM PARAMETERS Component 1. Administration & Staff Facilities 2. Auxiliary & Volunteer Res. 3. Biomedical 4. Cardiology

5. Critical Care 6. Emergency

7. End of Life Program 8. EPI - Early Psychosis Intervention

Highlights ü Level 2 area could be modified to increase work spaces ü Additional meeting and staff amenity space projected ü Future volunteer lounge and additional retail and storage area included in the master program ü Increased staff projected based on expansion of acute care, and therefore additional work area and storage space projected ü Ambulatory care clinic space planned ü A potential change in reporting relationship Nuclear Medicine/ Cardiology program which could impact future service directions ü Project the need to increase the number of ICU beds from 8 to 16 beds ü Projected space based on best practice space guideline ü Project the need for 46 treatment spaces to support the projected volume of approximately 60,000 visits/year by 2030; currently have 30 spaces which includes 8 chairs ü Ambulance bay requirement (including a suggested 2 unit enclosed area that could also double as an disaster response area) included in master program ü Preferred direction to locate the 10-bed hospice and the Hospice Society Supportive Care Unit on the PAH campus ü Prefer to locate program in community rather than at PAH ü Additional space projected to support program growth

16. Laboratory

17. Maternity Program

18. Medical Imaging

19. Medicine Program (includes needs of Ambulatory Care)

20. Mental Health & Substance Use

21. Older Adults 9. Food & Nutrition

ü Opportunity to relocate kitchen to Level 0 ü Additional staff work space included in master program

10. Foundation

ü Current location accessible to public ü Located in recently renovated space that is adequate to support future requirements ü Projected space based on the Gameplan space plan report ü There are patient coordination and staff integration benefits of locating Home Health on PAH campus ü Housekeeping and linen services contracted ü Laundry area in Level 0 of the residential care wing does personal items only ü Any new space will incorporate housekeeping closets ü A new loading dock would include waste/soiled holding space ü The projected space requirement as per the previous Kasian master plan report

22. Paediatrics

11. Home Health

12. Housekeeping, Laundry & Waste

13. IMIT 14. Infection Control

ü Project additional IC staff and therefore additional work space projected

15. In-Hospital Replenishment

ü Additional space to be determined with the projected expansion space ü An improved loading dock required to support future site expansion

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

23. Pharmacy

Highlights ü Opportunity to increase core lab area with microbiology area vacated (and adjacent space potentially available for additional expansion area) if lab remains in current location ü Clinical program leads recommend the laboratory be located proximal to other clinical diagnostic services (e.g. Medical Imaging) and high volume program areas, i.e. Emergency, Surgical Suite and Critical Care ü Additional outpatient laboratory phlebotomy space included in the master program and increased body holding space in the morgue ü The inpatient service located in newly renovated space ü Adjacent space planned for Maternity Clinic (current location of clinic on Level 1 is under-sized) ü Important to main adjacency to the Emergency Department ü Additional diagnostic and support space identified to support future service volume; vacated Emergency Department space (when ED moves to new space) identified as the logical expansion area for Medical Imaging ü Require additional medicine beds to meet current and projected needs ü Master program includes 150 medical beds and 12 telemetry beds based on best practice space planning guidelines ü Additional space for an ambulatory care IV therapy service has been included (10 treatment spaces) ü 26 beds planned which is an increase of 15 beds from the current 11 beds in operation ü Projected space based on best practice space planning guideline ü Additional community mental health space projected ü A 25-bed ACE service projected which is an increase of 8 beds from the current 17 beds ü Projected space based on best practice space planning guideline ü Additional clinic space projected to support projected service needs ü 4-bed observation area included in master program ü The operational model is in development ü Additional work space projected ü Assumes Pharmacy will remain in current location

24. Plant Services

ü Additional space to be determined as part of expansion plan, e.g. a new tower will include appropriate Plant Services space

25. Protection Services & Parking

ü Additional space for security personnel include in the Emergency Department projected space allocation ü Will require a parking study to determine future parking stall requirements for the site ü Projected space based on the Gameplan space plan report ü There are patient coordination and staff integration benefits of locating Public Health on PAH campus ü Additional archival storage space included in master program ü Additional patient registration stations & support space projected to support projected service volume

26. Public Health

27. Records Management/ Patient Registration

Page 14

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

30. Respiratory Therapy 31. Surgical Services (includes Surgical Suite, OR Booking, Surgical Inpatient, Surgical & Medical Ambulatory Care, and SPD)

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Auxiliary & Volunteer Res

Biomecial

Cardiology

Critical Care

Emergency

End of Life Program

EPI - Early Psychosis Intervention

Food & Nutrition

Foundation

Home Health

Housekeeping, Laundry & Waste

IMIT

Infection Control

In-Hospital Replenishment

Laboratory

Maternity Program

Medical Imaging

Medicine Program

Mental Health & Substance Use

Older Adults

Paediatrics

Pharmacy

Plant Services

Protection Services & Parking

Public Health

Records Mgt/ Pt Registration

Rehabilitation Services

Residential Care

Respriatory Therapy

Surgical Services

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Project Components

3

The following chart presents the key adjacencies between program components. The red circle indicates a critical adjacency, the green circle a close adjacency requirement, and the grey circle a convenient adjacency.

Administration & Staff Facilities

29. Residential Care

ü 25-bed general rehab unit and a 25-bed geriatric rehab unit (regional resource) projected based on best practice space planning guidelines ü Additional storage space on Level 2 projected ü Assumes other functions not part of Rehabilitation Services (e.g. the space being used by Pre-Surgical Screening, Surgical Outpatients, OR Booking and the Dietitian) will be located elsewhere thereby providing additional required space for Rehabilitation Services ü Current facilities do not meet complex care space requirements, i.e. do not have single room accommodation, appropriate family and staff support space, etc. ü Residential care spaces onsite (234 beds) do not need to be located on acute care site ü Project additional 565 beds for area by 2030 (from current 814 spaces in White Rock/South Surrey) ü Additional space projected to support acute care service expansion ü Projected space based on previous Kasian master plan report ü Currently 3 OR’s designed in the 1950’s; projected workload to support 8 OR’s and support space including PACU ü OR Booking and PAC includes space needs related to projected staffing; colocation with Surgical Services recommended ü Project the need for 75 beds (3 25-bed units) based on best practice space planning guidelines ü Ambulatory Daycare requires additional treatment and support space ü SPD requires adjacency to Surgical Suite and space for assembly, case carts and improved scope cleaning

ADJACENCY MATRIX

2

28. Rehabilitation Services

Highlights

1

Component

1

Administration & Staff Facilities

2

Aux iliary & Volunteer Res.

3

Biomedical

4

Cardiology

l

5

Critical Care

l

6

Emergency

7

End of Life Program

8

EPI - Early Psy chosis Interv ention

9

Food & Nutrition

10

Foundation

11

Home Health

12

Housekeeping, Laundry & Waste

13

IMIT

14

Infection Control

15

In-Hospital Replenishment

16

Laboratory

17

Maternity Program

18

Medical Imaging

l l

19

Medicine Program

l

20

Mental Health & Substance Use

21

Older Adults

22

Paediatrics

23

Pharmacy

24

Plant Serv ices

25

Protection Serv ices & Parking

26

Public Health

27

Records Mgt/ Pt Registration

28

Rehabilitation Serv ices

29

Residential Care

30

Respiratory Therapy

l l

l

31

Surgical Serv ices

l l

l

l l l l l

l

l

l

l

l

l

l

l

l l l

l

l

l l l

l

l

l l l

l

l

l l l

l l l l l

l l

l l

l l l

l l l

l

l

l

l l

l

l

l l

l l

l

l l

l

l

l

Page 15

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Functional Evaluation Summary

FUNCTIONAL EVALUATION SUMMARY Legend:

Good

p

Fair

u

Poor

q

Functional Evaluation Summary

Location

Overall Layout

Room Sizes

Program Component

Meets Space Benchmarks

p

2. Auxiliary & Volunteer Resources

u

u

q

N/A

3. Biomedical

p

u

u

N/A

4. Cardiology

N/A

N/A

N/A

N/A

u

q

q

No

u

q

q

No

q

u

q

No

5. Critical Care 6. Emergency 7. End of Life Program 8. EPI - Early Psychosis Intervention

9. Food & Nutrition

10. Foundation

11. Home Health

q

u p u

p

u p u

p

p

u p q

N/A

N/A

N/A

u

u

N/A

13. IMIT

p

p

u

N/A

14. Infection Control

p

p

u

N/A

15. In-Hospital Replenishment

p

p

u

N/A

16. Laboratory

u

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Meets Space Benchmarks

17. Maternity Program

p

p

p

Yes

18. Medical Imaging

p

u

u

No

19. Medicine Program (includes needs of Ambulatory Care) 20. Mental Health & Substance Use Services

u

q

q

No

u

q

q

No

21. Older Adults

u

q

q

No

22. Paediatrics

N/A

N/A

N/A

N/A

23. Pharmacy

p

p

u

N/A

24. Plant Services

p

p

u

N/A

25. Protection Services & Parking

p

p

u

N/A

26. Public Health

u

u

q

N/A

27. Records Management/ Patient Registration

p

p

u

N/A

28. Rehabilitation Services

u

q

q

No

29. Residential Care

q

q

q

No

30. Respiratory Therapy

p

p

u

N/A

u

q

q

No

N/A

u

u

Room Sizes

N/A

12. Housekeeping, Laundry & Waste

q

Overall Layout

Program Component

1. Administration & Staff Facilities

p

Location

No

31. Surgical Services (includes Surgical Suite, OR Booking, Surgical Inpatient, Surgical Ambulatory Care, and SPD)

Page 16

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN EXISTING SITE ANALYSIS

PURPOSE OF SITE/BUILDING ASSESMENT A major focus of this work stream is to assess the state of the current site infrastructure and buildings, their state of maintenance and performance, their remaining life and replacement requirements and key areas of risk from unscheduled failure & shortened lifecycle of building components that require mitigation. These risks can manifest themselves in life safety, service continuity, service accreditation, collateral building damage, regulatory enforcement, high operating costs and major capital investments sooner than necessary. Together the physical condition assessment from this work stream and the functional assessment from the Master Program work stream determine the economic life of a building and the extent of its role at the site. The role of the building in response to its remaining economic life will influence the optimal long term use and investment strategy for the building and what the prudent short term maintenance investment strategy should be. This work stream is important to optimizing the asset and investment lifecycle that deliver the greatest value to the facility users and health authorities. The assessment reports will ensure the MCP is based on accurate existing site/building information. It is important to review all systems reports and historical data, as well as involve all knowledgeable personnel in a complete building assessment.

URBAN CONTEXT White Rock is bounded to the north, east and west by the City of Surrey, with Semiahmoo Bay to the south. White Rock has a total land area of 5.2 km2 representing less than 1% of the Metro Vancouver land area. Similarly, the population of White Rock in 2006, at almost 19,000, is less than 1% of that in Metro Vancouver. Peace Arch Hospital is located in the North Bluff East area of the City of White Rock. Its Lower Mainland location, in relation to nearby hospitals is illustrated on the right. The Peace Arch Hospital site is bounded by North Bluff Road/ 16th Avenue to the North, Finlay Street to the East, and Russell Avenue to the South. The Western portion of the Comprehensive Development Zone which the principle hospital resides in is bounded by Vine Avenue and Hospital Street. The site is in general surrounded by higher density residential to the West and North (including Peace Portal Lodge and Whitecliff Retirement Residence), and low density residential to the East and South. An electrical substation is located in the south east quadrant of the North Bluff Rd/Finlay St intersection.

Topography of Sites The Peace Arch Hospital site and the PAH Foundation Site A slopes approximately 8m down from west to east and is generally level north to south. The PAH Foundation Site B slopes approximately 2m down from west to east and also is generally level north to south.

Site circulation is principally accommodated by internal streets such as Weatherby Street, Hospital Street and Vine Avenue. Two adjacent sites shown as A & B on the diagram on the right are separately owned by PAH Foundation and currently used by PAH for parking.

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 17

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN ZONING AND LAND USE Any future development in the North Bluff east area, as described in the Official Community Plan (OCP), is intended to protect and enhance the quality of the natural and built environment and to promote a ‘West Coast or Sea Side Village’ building vernacular reflective of White Rock’s history and setting. The size and scale of the hospital should relate to adjacent development and provide a transition between the ‘Town Centre’ and ‘Apartment Areas' (both development areas as described in the OCP). The OCP designation for the hospital site is Public/Institutional/Utility. The Peace Arch Hospital falls into the Comprehensive Development Zone – 1 (CD-1) as described in the City of White Rock Bylaw 1591. The intent of this zone is to accommodate development of a full range of comprehensive public and semi-public hospital facilities. The legal titles of the sites are: Peach Arch Hospital

Lot 1, Plan LMP 15904, Section 11, Township 1, New Westminster Land District, & PLC A (BYLAW PL LMP21578) Plan

PAH Foundation A

LMP Parcels 15475, 15476, 15485, 15486 and 15496

PAH Foundation B

LMP Parcels 15562, 15563, 1627, 1637, 1647, 1661, 1662, 1673, 1687 an 1697

Uses: The following uses and no others are permitted in the CD-1 Comprehensive Development Zone; a) A hospital and related facilities provided or funded by a federal, provincial, regional, local government, or a non-profit society or organization; b) A health care facility provided by a not-for-profit society or organization c) An accessory off-street parking use; d) An accessory off-street loading use; e) Public and private open space and recreation areas The PAH Foundation Site A directly North-West of the Hospital site fall within Development Permit Area 2 – identified in the Official Community Plan (OCP) as Hospital Street. That area is flanked by Hospital Street, Vine Avenue, and North Bluff Road. Primarily higher density residential uses are permitted including medical and/or hospital related uses. New development must contribute to improvement of the visual image of the area. The PAH Foundation owned property B north of North bluff Road is within the City of Surrey jurisdiction and is designated RF (single family residential) except for LMP Parcel 15562 which is CD (comprehensive development).

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 18

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

BUILDING HEIGHTS Peace Arch Hospital has maximum building height elevations ranging from 105m, 124m and 135m above sea level, depending on the parcels identified in the CD-1. The elevation of existing main floor level of the hospital is approximately 103.4m. Refer to diagrams at right (from City of WhiteRock CD-1 Zoning By-laws).

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 19

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 20

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN SITE STATISTICS

Setbacks Vary from 1m to 16m, refer to Site Plan at right.

Maximum Site Coverage Refer to zoning diagrams

Allowable Density (FSR) Not specified.

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 21

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN BREAKDOWN OF BUILDING / PARKING STATISTICS Building Floor Area *

Bldg Name

Site Assessment Floor

Int. Gross Area (sm) Acute Care Building Level 0 5,323.87 Level 1 5,744.96 Level 2 3,473.42 Level 3 2,295.87 Level 4 2,234.93 Level 5 2,553.61 Level 6 2,571.16 Level 7 0.00 Level 8 1,233.90 Sub Total: 25,431.72 Berkley Pavilion Level 0 91.70 Level 1 1,873.08 Sub Total: 1,964.78 Dr Al Hogg Pavilion (originally Finlay Level 0 2,057.23 Pavilion) Level 1 2,232.09 Level 2 2,006.21 Level 3 2,005.02 Level 4 0.00 Sub Total: 8,300.55 Russell Unit Level 1 580.04 Vine Unit Level 1 127.37 Weatherby Pavilion Level 0 1,161.31 Level 1 1,552.35 Level 2 1,545.41 Level 3 1,522.75 Level 4 1,522.75 Sub Total: 7,304.57 Total: 43,709.03

External Gross Area (sm) 5,445.49 5,866.58 3,799.89 2,383.69 2,402.56 2,673.91 2,689.87 2,712.70 1,321.06 29,295.75 99.82 1,1969.99 2,069.81 2,166.85 2,352.68 2,149.62 2,093.62 2,093.62 10,856.39 593.93 133.30 1,660.94 1,624.90 1,613.99 1,589.12 1,589.12 8,078.70 51,027.88

The site areas are: · Peace Arch Hospital Site Area: · PAH Foundation Site A Area · PAH Foundation Site B Area

41,538m2 2,958m2 14,177m2

Parking Stalls * Lot A (Laneway) Lot A (Parking Lot)

Lot B (Main)

Outside of Weatherby Pavilion

47 Stalls 71 Stalls

292 Stalls

5 Stalls

#1-32 #1-51

Permit Holders Only Permit Holders Only

#1-3

H/C Parking

#4-7 #1-9 #64/65 #10-18 #1-94

Patient Pick Up and Drop Off Only H/C Stalls H/C Stalls Out Patient Stalls No Staff Parking 8am - 2pm Mon-Friday General Stalls Peace Arch Van Cross Hatched Bus & 10 Minute Pick Up Drop Off Only Emergency Physician Call Back Parking Surface / Gravel Emergency Parking H/C Parking General Stalls H/C Parking Service Vehicles Only Loading Trucks

#95-291 2 Stalls 3 Stalls 2 Stalls

Lot C (Staff Parking) Lot D (Foundation Lot)

400 Stalls 127 Stalls

Berkeley Pavilion

21 Stalls

Loading Zone

6 Stalls

400 Stalls 118 Stalls 9 Stalls #33-53 #38/39 4 Stalls 2 Stalls

Total Number of Stalls: 969

*Source: Fraser Health Authority

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 22

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Building Age The first building on the site was constructed and opened in 1954 as a 47 bed community hospital. The Berkley building was purchased in 1967 to serve as an extended care unit. The current six storey acute building, completed in 1968 raised the total acute beds to 155. An expansion of the diagnostic and support services was completed in 1993. The Weatherby Pavilion, opened in 1987, added 150 extended care beds and a further 150 extended care beds were provided in the Finlay Pavilion constructed in 1993. The latter building is now known as the Dr. Al. Hogg Pavilion. Various internal renovations have been undertaken over time and two temporary buildings (Vine Unit and Russell Unit) added. Peace Arch Hospital currently has 178 acute care beds and 343 extended care beds.

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 23

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN EXISTING FLOOR PLANS BY DEPARTMENT / USE

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 24

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 25

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 26

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 30

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN BUILDING / SITE SECTIONS

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 31

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN SITE PHOTOS

1.

Peace Arch Hospital - Panoramic View from Finlay Street

2.

Peace Arch Hospital - Emergency Entrance Panoramic View

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 32

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

3.

North Bluff Rd. / 16 Ave. @ Hospital Street

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

4.

North Bluff Rd. / 16 Ave @ Best Street

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Page 34

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

6.

5.

Peace Arch Hospital – Front Entrance

7.

Access from Finlay St. / Dr. Al Hogg Pavilion

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

8.

Dr. Al Hogg Pavilion view from Main Parking

9.

Front Entrance access from Finlay St.

Main Parking Entrance

Page 35

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

11. View from Finlay St. @ Russell Ave.

10. Russell Ave. looking West

12. Russell Ave. @ Weatherby St.

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

13. Access from Russell Ave.

14. Hospital & Russell Unit viewing from Russell Ave.

Page 36

PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

15. Parking Lot B Entrance

16. Berkeley Pavilion viewed from Russell Ave.

17. Berkeley Pavilion Entrance

18. Emergency access from Russell Ave.

19. Berkeley Pavilion view 1

20. Berkeley Pavilion view 2

21. Berkeley Pavilion 3

22. Berkeley Pavilion 4

23. White Rock Medical Associates parking

24. White Rock Medical Associates front view

25. Hospital viewed from Vine Ave. @ Best St.

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

26. Emergency & Berkeley Pavilion

27. Emergency viewed from Hospital St.

28. Vine Youth Clinic

29. Public Pay Parking

30. North Bluff Rd./16 Ave. residential building

31. Dr. Al Hogg Pavilion viewed from N. Bluff Rd./16 Ave.

32. McCracken Courtyard access from N. Bluff Rd./16 Ave.

33. McCracken Courtyard

34. Dr. Al Hogg Pavilion viewed from Off-site Parking

35. North Bluff Rd./16 Ave. @ 156 St. Off-site Parking

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN URBAN PLANNING ANALYSIS Access, Circulation and Parking Vehicular access to the site is from North Bluff Road, Russell Avenue, Finlay Street, and Vine Avenue. Parking is currently provided by the surface parking located at the South East corner of the site at Finlay Street and Russell Avenue. An objective the OCP is that all off-street parking should be below grade or enclosed within a building, with the exception of some visitor surface parking spaces. Transportation - Vehicular Bus service to Peace Arch Hospital is provided by multiple routes with stops adjacent to the campus. Bus routes include C50, C51, C53, 321, 354 and 375. Many staff and visitors to Peace Arch Hospital use these services.

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Transportation - Non - Vehicular

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN EXISTING GREENSPACE

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN SITE / COMMUNITY CHARACTER

This Site comprises areas near Hospital Street, Vine Avenue, and North Bluff Road. Primarily higher density residential uses are found here including medical and hospital related uses. This area is called North Bluff East. Peace Arch Hospital occupies the CD-1 Zone within the City of White Rock. The intent of this zone is to accommodate the development of a full range of comprehensive public and semi-public hospital facilities on a site of approximately 41,538 square metres (10.26 acres). (White Rock Zoning Bylaw 1591) Similarly across North Bluff Road in the City of Surrey, the neighbouring community character remains primarily higher density residential uses, with single family residences adjacent to these. According to the Official Community Plan (OCP) of White Rock, new developments should endeavour to contribute to the improvement of the visual image of the area. The size and scale of buildings should relate to adjacent development and provide a transition between the Town Centre and Apartment Areas. New developments should be designed to consider the compatibility with surrounding land uses, buildings and the physical environment. Roof lines, height, building mass, form, architectural character and outdoor spaces should complement adjacent buildings and spaces. Building materials should reflect the existing or planned character of the area, and the use of a variety of materials is encouraged in order to provide articulation and visually interesting design. Generally, buildings should be designed to appear to have limited frontage lengths and variations in façade treatment among different buildings. And the ground level treatment of development should enhance pedestrian interest through design, detailing and landscaping while maintaining necessary privacy and security for residents. These are but a few Development Permit Guidelines Applicable to the development of Peace Arch Hospital, respecting the character of the surrounding community. In conjunction with the OCP and CD-1 Zoning future plans should take into consideration how the City of White Rock views this site.

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN SPACE SUMMARY (CURRENT & PROJECTED) The following section presents the space summary table (current and projected) for the 31 master programs. PAH Component/Sub-Component

Current CGSM

Additional CGSM

Projected CGSM

Admin Offices - Level 2 Meeting Space

Comments Administration total projected space = 1,470.0 sqm

1. Administration 340.9 246.3

0.0 100.0

PAH Component/Sub-Component

0.0

48.0 Require improved location

Library

78.8

0.0

78.8 Require accessible location

Other Staff Office Space Level 0 Staff Lockers/Change Area/Lounge

73.3 246.2

Auxiliary Space Volunteer Space 3. Biomedical Engineering

4. Cardiology 5. Critical Care Unit 6. Emergency Department

65.0 On Level 0

71.5

Future space to support projected 144.8 expansion at PAH

200.0

On Level 0; future space to support 446.2 projected expansion Auxiliary/Volunteer Services total projected space - 325.7 sqm

2. Auxiliary/Volunteer Resources 131.7 48.0 49.2

0.0 264.4 763.7

Hospice

468.2

646.8

Supportive Care Centre

180.0

377.0

Projected space from Hospice Society 557.0 planning report

133.0

192.0

325.0 Does not need to be located at PAH

1,137.7

61.8

Current space includes coffee shop, cafeteria, kitchen and storage; add'l 1,199.5 space for offices

10. Foundation

192.0

0.0

Still need to meet with program to 192.0 confirm space needs

11. Home Health

611.2

600.0

Existing and projected space from 1,211.2 Gameplan report

9. Food & Nutrition

12. Housekeeping, Laundry & Waste

13. IMIT

80.0

Additional space for retail in Acute & 211.7 Residential Care plus storage

66.0

Additional space for 1 new office, 114.0 volunteer lounge & storage

15. In Hospital Replenishment

53.4

Add'l space requirement from Kasian 102.6 report

16. Laboratory Medicine & Pathology

80.0

Clinic space for mobile team; can be located with other ambulatory care 80.0 space

1,175.6

Projected space based on 16 beds @ 1,440.0 90 cgsm per bed

1,168.3

Projected space based on 46 1,932.0 treatment spaces

14. Infection Control

Lab - Level 2

Outpatient Lab - Level 1 Morgue - Level 0

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

Comments

1,115.0 Based on 10 hospice beds

346.3 Current space shown on Level 0

48.0

15.0

Projected CGSM

End of Life Program total projected space = 1,672.0 sqm

340.9

On call Space

50.0

Additional CGSM

7. End of Life Program

8. EPI (Early Psychosis Intervention)

Staffing Office

Current CGSM

0.0

Current space includes space on Level 0 of Al Hogg Pavilion and acute bldg; 290.8 future space TBD

14.5

Space taken from Kasian report; Still need to meet with program to confirm 354.7 space needs

12.0

12.0

1 additional work space for projected 24.0 staff increase of 1

960.1

0.0

960.1 Future space to be determined

0.0

Laboratory total projected space = 532.9 sqm Requires renovation to address space issues (vacated microbiology space and adjacent space available - test fit 366.0 required)

290.8

340.2

366.0

38.8 88.1

40.0 0.0

Additional exam room for FNAs, 2 add'l phlebotomy stns and support 78.8 space Overall space adequate; body holding 88.1 area requires renovation

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN PAH Component/Sub-Component

Current CGSM

Additional CGSM

Projected CGSM

Maternity Program total space = 1,190.0 sqm

17. Maternity Program Maternity Unit

Maternity Clinic

Comments

835.0

108.7

0.0

246.3

835.0 Recently renovated space Plan to move to vacated winter surge bed area on 3rd flr (355 sqm); currently in temporary space next to 355.0 ED on Level 1 Medical Imaging total projected space = 1,767.8

18. Medical Imaging

Add'l staff support space, patient waiting, fluoro rm, diag. mammo 1,081.2 suite, and 2 ultrasound rooms

Main MI - Level 1

879.2

202.0

Storage - Level 0

132.9

0.0

132.9

0.0

Located in newly developed space but 153.2 not adjacent to MI

MRI

153.2

PAH Component/Sub-Component

265.8

40.0

Additional CGSM

Projected CGSM

ACE - 5 South

657.7

1,092.3

Specialty Seniors Clinic

429.6

80.0

22. Paediatrics 23. Pharmacy 24. Plant Services 25. Protection & Parking Services

Projected space based on 25 beds x 1,750.0 70 cgsm/bed 509.6 Additonal clinic space required Projected space 4 paediatric observation spaces with family & 300.0 staff support space

0.0

300.0

520.2

30.0

1,731.7

0.0

1,731.7 Future space to be determined

8.2

12.0

20.2 Project 1 add'l space in ED

455.6

144.4

550.2 Add'l work space

Projected space from Gameplan 2009 600.0 report Records Mgt & Pt Regis. Program total projected space = 394.5 sqm

305.8 Add'l staff support space

27. Records Mgt & Patient Regist. Screening Mammography

94.7

0.0

Medicine Program total projected space = 11,640.0

19. Medicine Program Medical Daycare Program

Medicine Inpatient Beds

0.0

2,655.1

300.0

8,684.9

Inpatient Unit

498.8

1,321.2

Community MH Program

576.5

70.0

64.2

0.0

Group Therapy Program

300.0 Assumes 10 treatment spaces 5 units each at 30 beds x 70 cgsm/bed = 10,500 cgsm; Total bed count = 150 plus 12 telemetry beds @ 11,340.0 70 cgsm per bed Mental Health & Substance Use total projected space = 2,717.6

20. Mental Health & Substance Use

Geriatric Psychiatry

94.7 Currently located in Berkeley Pavilion

186.9

MASTER CONCEPT PLAN – DRAFT APRIL 12, 2012

0.0

Projected space based on 26 beds x 1,820.0 70 cgsm/bed 646.5 Add'l 3 clinician offices & med rm

Records Mgt

Comments

Older Adults Program total projected space = 2,259.6 sqm

21. Older Adults Program

26. Public Health Nuclear Medicine/Cardiology

Current CGSM

238.3

0.0

Archival Records Storage

51.6

18.6

70.2 Add'l space as per Kasian report

Patient Registration

51.0

35.0

2 add'l registration stations & 86.0 support space Rehabilitation Services total projected space = 3,812.4 sqm

28. Rehabilitation Services 5 North Geriatric Rehabilitation Unit Rehab Outpatient Department Social Work

238.3

1,190.0

200.0

0.0

1750.0

591.2

30.0

51.2

0.0

Assume unit remains with 25 beds; 1,390.0 add'l space for dining, gym 1,750.0 New 25-bed unit; a regional resource 621.2 Add'l equipment storage space 51.2 Located on Level 2

64.2 4 offices in the Berkeley bldg Located in renovated space on Level 0 186.9 of Weatherby Pavilion

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN PAH Component/Sub-Component

Current CGSM

Additional CGSM

Projected CGSM

Residential Care total space = 14,374.0 sqm

29. Residential Care Weatherby Pavilion

6,150.0

0.0

6,150.0

Al Hogg Pavilion

8,224.0

0.0

8,224.0

84.5

114.0

30. Respiratory Therapy

Comments

Located on Level 1 ; space as per 198.5 Kasian 2004 report Surgical Program total projected space = 8,749.3 sqm

31. Surgical Program

891.6

4,358.40

Surgical Program Outpatients and Surgical Daycare

471.0

124.0

OR Booking

12.5

7.5

Pre-Admission Clinic

44.3

40.0

Add'l space includes 4 offices and an 84.3 exam room Projected space based on 8 ORs including support space/physician & staff work space/PACU; 260 cgsm per 2,080.0 OR

586.3

1493.7

SPD

520.0

200.0

36,570.1

25,848.2

Total

•

Bed Planning Guidelines, New Zealand

•

Health Facility Planning Guidelines recently published from Australia

•

AIA Planning and Design Guidelines for Bariatric Healthcare Facilities and other AIA facility planning publications

•

SpaceMed Space Planning Guidelines 2008 publication (Cynthia Hayward - author)

•

Future of the Operating Room, Innovation Center, Washington, DC

•

RMC functional programming information from other health facility planning projects, e.g. Strathcona Community Hospital (Sherwood Park, AB), Misericordia Community Hospital and Grey Nuns Community Hospital (Edmonton, AB), Foothills Medical Centre (Calgary, AB), Edmonton Tertiary Level Ambulatory Clinic (not to mention the other health centres we have planned in Alberta)

•

RMC planning work undertaken in the Lower Mainland, e.g. Surrey Memorial Hospital, Royal Columbian Hospital (New Westminster), Burnaby Hospital and Langley Memorial Hospital

Assumes 3 units @ 25 beds per unit (70 cgsm per bed); Total bed count = 5,250.0 75

Surgical Inpatient Beds

Surgical Suite (includes PACU)

In regards to the benchmarks and peer hospital comparisons used to develop the master programs, RMC used the following:

595.0 Add'l space as per Kasian report 20.0 Add'l workstation space

Add'l space for assembly, case carts & 720.0 improved scope cleaning 62,418.3

Notes: New facilities will include required additional logistical support space - TBD CGSM = Component Gross Square Meters

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN PLANNING PRINCIPLES Development Assumption · Flexibility · expandability · adaptability · Parking · Retention of Existing FLEXIBILITY The given site allows for numerous design solutions that will provide a robust variety, accommodating much of the hospitals current and future uses. Depending on the preferred design option, the campus can be arranged to utilize both the underdeveloped areas as well the existing infrastructure and building. EXPANDABILITY The comprehensive development zone allows for a multitude of institutional activities, and hospital functions to be configured on the hospital site. With the adjacent Development Area – 2 (Hospital Street), it can be anticipated that these opportunities can be appropriated after engaging with the City of White Rock. The surface parking at the South-East corner of the campus already within CD-1 also provides opportunity for growth. As well the surface parking North-West of Comprehensive Development Zone 1 provides ideal area for growth. ADAPTABILITY With the already prescribed CD-1 and the DP-Area-2 (Hospital Street) a number of configurations can be realized. The hospital provides for current needs, and the site/zoning will allow the hospital to adapt to future requirements and needs as they arise. PARKING The site has two large surface lots that provide the majority of the sites needs. As development of the site increases, need for additional parking can be assumed. Off-Street parking is a requirement for developments such as the one found on site, any surface parking that is developed into hospital function, will need to be accommodated elsewhere. Below grade parking is certainly an option, as well as intensifying surface parking, into more efficient above grade structured parking. RETENTION OF EXISTING Though there will be significant rework of existing underdeveloped parcels within the CD-1 and adjacent DP-Area-2 in any one of the development options, there will be a concerted effort to leverage buildings and structures already on site. Healthcare facilities such as the Peace Arch Hospital, once opened remain operational 24/7, 365 days a year. Renovation and alteration of existing is a given, though a rigorous effort will be maintained to keep much of the existing for both operational, and fiscal motives.

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

SITE OPPORTUNITIES This section of the study provides an indication of land availability on both the Hospital and Foundation properties for future growth of hospital facilities. During this process 5 potential expansion zone sites were identified and considered for the most appropriate use related to expansion of hospital programs (departments) identified in the master program.

Expansion Opportunity 1 Location: · City of White Rock; west of Weatherby Pavilion and Emergency Department- known as Hospital Street. · Includes existing parking lot on PAH Foundation Property and Hospital Street Development Considerations: · Proximity to Emergency and Diagnostic Imaging Departments · Good Access to 16th Ave · No existing Structures · Existing underground services at the south side of this zone · Oxygen tank at south end of this zone · Facing high density residential on the north Recommended Use: South Side: Emergency Department Expansion North Side: Non Acute Care Use (Foundation)

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Expansion Opportunity 2 Location: · City of White Rock · Hospital property; west of main hospital tower and south parkade area · Currently site of Berkeley Pavilion Development Considerations: · Relocation of programs located in Berkeley Pavilion and Russell and Vine Unit · Demolition of Berkeley Pavilion, Russell and Vine Unit · Directly adjacent to Russell Avenue · Direct adjacency to inpatient tower · Facing single family residential zone on south Recommended Use: Development of future inpatient tower

Expansion Opportunity 3: Location: · City of White Rock · Existing main parking area east from main entrance between Weatherby Ct. and Finlay St. Development Considerations: · Direct adjacency to main entrance · Direct adjacency to Weatherby and Dr. Al Hogg Pavilions · Sloping site (two building floor levels) · Directly adjacent on east and south side to single residential zones · Largest zone available on hospital site Recommended Use: · ·

Site suitable for future replacement hospital with underground parking Hospice site

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Expansion Opportunity 4 Location: · City of White Rock · Existing parking lot, south of main inpatient tower Development Considerations: · Smallest zone on hospital site · Facing on south side single family residential Recommended Use · ·

Parking / Green Amenity Decant site

Expansion Opportunity 5: Location: · City of Surrey · North West corner of North Bluff Road and 156th Street · Foundation Property Development Considerations: · Direct adjacency to residential zones on north, east and west · Facing North Bluff Road and 156th Street · Currently gravel surface parking for hospital · Quiet zone · Bus stop and pedestrian crossing at North Bluff / 156th Street Corner Recommended Use: · ·

New residential care facilities Mixed Use

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN SITE DEVELOPMENT STRATEGIES Following the indicated site opportunities three strategies of site expansion were developed to indicate potential growth paths that are keeping within the design principles outlined above, and are illustrated below

•

Strategy 1 - Linear long east west concourse defining main pedestrian circulation through the site. Retaining existing hospital as part of the hospital campus and creating a new main entrance at Finlay Street.

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN •

Strategy 2 - Linear along east west concourse defining main pedestrian circulation through the site. Removing the oldest part of facility to create a new main entrance at Russell Avenue.

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN •

Strategy 3 - Main intersection concept defined by east-west and north south pedestrian paths. Main entrance located in the current parking area at Finlay Street. This strategy minimizes impact of hospital development on the adjacent single family residential zone.

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

PROPOSED SITE DEVELOPMENT SOLUTIONS The Master concept Plan establishes the scope of future clinical and non-clinical requirements related to the growth and profile of the population using the facility which is set in construction timeframe the outcome of which is defined by phased Site Development Solutions. These Site Development Solutions are based on following design/development assumptions: • • • • • • • • • • • • •

Single bed accommodation (80 %) Senior Clinic to be in community. Renovating emergency will allow future Medical Imaging Expansion. Critical that Emergency is a adjacent to MI Main Hospital is not going to be demolished. Berkeley and Russell buildings to be demolished. (Alternative solutions for current departments required) OR & Surgical Suite to be placed in new building. Review location of public entrance SPD/Material Management maybe located in new building. Flexibility, Adaptability and Expandability are critical drivers in development strategy. Sustainability. Additional Green Areas an objective Parking expansion and objective

Phase 1A - New Residential Care Building, Lot C (North) - By 2014 (Open) •

150 New residential care:

• •

Parking New hospice

80 beds from Weatherby 70 new beds

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Phase 1B - Decanting · Decant Vine and Mental Health (Berkeley Pavilion) to Weatherby - 2014 · Relocate Oxygen tank - anytime · Kitchen to new Residential Care - 2014 · Russell Unit Program to be relocated · Medical Records and Library to relocate to Weatherby Pavilion

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Phase 2: New Emergency Department (2012 - 2016) · · · ·

Expanded (2013-2014) Existing Emergency Department Renovation Redevelopment of Minor OR & Surgical Outpatient Program (2015-2016) Demolish Vine and Russell Unit

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN

Phase 3: Second Residential Building on Lot C (South) - Design (2016 - 2018) ·

200 - 250 new beds:

· · · ·

Al Hogg Redevelopment Berkeley Pavilion Demolition Berkeley Parking Lot Development New ICU - Level 2 - May require relocation of: o Admin to AL Hogg o Lab to Level 1

100 from Dr Al Hogg 100-150 New

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN Phase 4: New Tower (2018 - 2030)

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN 0 - 3 Year Cost Estimate – description

1 Decant Vine and Russel Relocate U/G Services Relocate Medical Records and Library to Weatherby Emergency expansion (ADDITION) Emergency renovation

2 Surgical Outpatient expansion (ADDITION) Relocation of food services (INCL. $1.5M EQUIP*)

3 Relocation Clinics to Weatherby (RENOV)

area (m2) 250.00 408.00 1168.00 764.00

271.00 1199.00

355.00

unit cost ($/m2)

total cost ($)

$ 2,212.50 allowance $ 1,327.50 $ 6,386.75 $ 4,026.75

$553,100 $250,000 $541,600 $7,459,700 $3,076,400

TOTAL

$11,880,800

$ 6,386.75 $ 5,276.04

$1,730,800 $6,326,000

TOTAL

$8,056,800

$ 3,023.75

$1,073,400

1+2+3 TOTAL

$21,011,000

(INCLUDES $1.5M FS EQUIP*) - Building Shell NIC (assume provided by 150 bed residential)

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PEACE ARCH HOSPITAL MASTER CONCEPT PLAN PHASE 1-3 DESIGN AND CONSTRUCTION SCHEDULE

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