There has been plenty of buzz around the building of the Children’s Hospital of Saskatchewan (CHS) over the past few months. A ground-breaking ceremony was held in September, pilings are going into the ground, and soon construction beyond the foundation will begin.

Despite its name, this new hospital will not care for children only. It will also be the site of maternal services, which will move over from Royal University Hospital (RUH). And it will be the home of a new adult emergency department.

Architectural drawing of the entrance.

The design for the entrance into the emergency departments in the new Children’s Hospital of Saskatchewan.

It’s always been part of the plans for the new hospital to house both emergency departments – children and adult, indicated Dr. James Stempien, the head of emergency medicine, and Graham Blue, director of emergency services for Saskatoon Health Region.

“The adult emergency department will be on the first floor of the new pediatric hospital,” said Stempien, “with the pediatric emergency department as a separate entity.”

It makes sense for both adult and pediatric emergency departments to be in the same hospital, as they share doctors, nurses and other health care team members, as well as trauma specialists, who often treat both adults and children. It’s important to keep these specialists is one location, so they are available for adults or children who need them at any given time.

Moving both adult and pediatric emergency departments into the new hospital also makes sense, as it gives us a chance to redesign both spaces.

The pediatric emergency department is currently located at the end of the adult emergency department at RUH. The space wasn’t so much designed as carved out of the 1978 building when it was decided that a separate emergency department was necessary for children. As a result, the space is not set up in a way that is best suited to the care of our pediatric population.

The same can be said for the adult emergency department, which has been pieced together across two different buildings. Approximately 11 emergency beds are located in the 1955 portion of RUH, with the rest in the 1978 portion.

“It grew as our demographics grew,” Blue said. “It was meant to deal with about 20,000 patient visits per year. Approximately 55,000 are occurring every year now.”

The way the department is currently set up – with a very long physical footprint – presents a significant challenge for staff. It’s far too spread out for them to work in efficiently.

The new adult emergency department is going to contribute to better patient flow, and better staff flow, Blue believes, because of how it is designed.

The design process for the new department has included front line workers like nurses and physicians, maintenance and housekeeping staff, specialists and management.

“The people who organized the design team tried to include everyone they could think of,” Stempien noted. “No one who wanted to be involved was turned away, and their input was considered.”

Patients and families were also consulted, and the design reflects some of the changes they suggested due to their experiences in the current department.

When you walk in the doors of the new emergency department, going one direction will take you to the adult emergency room, and another the children’s emergency department.  Ambulances will come in a completely separate area and door from those walking in.

Instead of a long, narrow space, the new adult emergency space will be much wider, and will be split into cells, with patient beds grouped into areas for specific kinds of care. Each of those areas will have direct visibility to members of the medical team.

Plans for the new Saskatchewan Children's Hospital emergency departments.

The adult and children’s emergency departments will share a trauma zone and ambulance bay, but will otherwise be separate. The adult zone also includes a minor assessment and treatment area.

There are also special zones, including one for trauma and another for minor assessment and care. The trauma zone will include rooms that will be accessed easily from the ambulance entrance, and from both the adult and children’s emergency departments. The minor assessment and care area will allow medical staff to stream patients with minor injuries through more quickly, which should help with overall department wait times.

A portion of the diagnostic imaging department will be located right next to the emergency department, so the equipment and instrumentation that have become so important to the practice of medicine over past decades will be right at hand. This means that patients will no longer have to be moved to other parts of the building or up elevators to get an X-ray or a CT Scan.

Privacy will also be improved, as instead of separating beds with only curtains, which is the situation in the current space, patients will be in rooms with three walls and a set of doors that fit across the front.

“That will make it more private and a lot more comfortable for patients and their families,” Blue said.

The ambulance bay will also be larger than the one in the currently emergency department. The new one will fit four units and still have room to unload patients in a weather-protected area.

What happens to the space in RUH when the departments move out has yet to be determined.  One suggestion has been that the old ambulance entrance be used for those ambulances doing non-urgent patient transfers from the rural areas, and that the ward be used as a short-term space for patients awaiting beds in other units.

“There are lots of things that could be done with it,” Stempien said.  “It’s definitely an opportunity to improve patient flow and the patient experience.”