Children’s Hospital of Saskatchewan: Our Journey to Opening Day

It was November 2011. Lori Chartier remembers clearly presenting the information technology vision for Children’s Hospital of Saskatchewan (CHS) to a packed warehouse in northern Saskatoon.

“We had been asked to think about how we could create a facility for the future by ensuring our information flow was seamless,” explains Chartier, Saskatoon Health Region’s operational director for eHealth and Health Information.

Chartier and some of her team were part of a group of more than 100 staff, physicians and family tasked with creating the early design for the new maternal and children’s hospital during two week long events called 3P (production preparation process).

November 2011 – Lori Chartier presents IT vision during one of two early design events. Click here to watch what happened during these events.

November 2011 – Lori Chartier presents IT vision during one of two early design events. Click here to watch what happened during these events.

“We were told to be innovative and future-focused. Every day, we can see the how the power of technology transforms patient care. Our information technology vision for the new hospital embraced that concept.”

 The early design of the hospital was based on a state of the art digital design. Teams for each clinical area created physical space and clinician workflows with the assumption the hospital would be fully supported by an electronic health record, which resulted in minimal storage space within the facility for patient charts.

 “It was so exciting, but we also knew we had a long and complex journey ahead of us to get to an electronic health record. We knew it wouldn’t happen overnight,” says Chartier.

Adding in the IT details to design

In the months that followed, even larger teams of staff, physicians and patient advisors created detailed designs for each of their areas in the new hospital. These details built on the transformational concepts from the early design phase and included determining where the bedside terminals for electronic charting should be placed in a patient room and even the less-glamourous details of physical IT connection points within patient rooms and team touch-down spaces.

Meanwhile, Chartier’s team began working and planning for how to would bring the hospital’s IT vision to life.

September 2012 – Detailed design mock-up of a beside terminal.

September 2012 – Detailed design mock-up of a beside terminal.

“We have a few challenges we are working through. We are a paper-heavy system. We have patients and families coming from across the province for care today in our hospitals, and eventually Children’s Hospital of Saskatchewan as well. We also have an extensive provincial network of physicians and caregivers who have their own private clinics and own systems, some paper-based and some using electronic charting. This very complex network of care and technology has to come together and work together not only for our Saskatoon hospitals, but provincially. Children’s Hospital of Saskatchewan will be one component of this and we need to build it with that eventual provincial network in mind,” says Chartier.

This means bringing the vision for a digital hospital to life through a staged-approach. First, in spring 2013, the teams started outlining what they “must have” in place for opening day to support the hospital design, and what infrastructure will be built in to support the technology that can be implemented after opening day.

This first phase of “must have” decisions used the overarching principle that whatever information technology infrastructure is critically necessary to ensure patient safety, support patient care and improved clinician work flow needed to be in place for when the doors open.

“We had to be forward thinking,” says Chartier. “By imaging a digital hospital during the design phase, by imagining the technology advancements we will need to have in place over the next five to 10 years, we had the opportunity to put in place the vital infrastructure in a way that is cost-effective. Once the ceilings and walls are closed in this hospital, any changes to IT infrastructure become far more costly and require additional construction.”

Building the ‘spine’ today for tomorrow

It’s that backbone of vital infrastructure that Alex Morgun’s team is focused on getting in place. Morgun is the operational director for Information Technology (IT) Services for Saskatoon Health Region. His team is charged with maintaining and developing the Region’s IT network today and for the future.

“In medical terms, IT infrastructure is the ‘spine’ that protects and delivers the nerve pathways to the brain,” explains Morgun. “It’s one thing for the emergency department to have a workstation on wheels, equipped with computers and specialized monitors that allow them to document within an electronic health record and provide bedside registration and triage. But without a robust wireless infrastructure to enable those mobile carts and without a data network that enables the use of swipe cards for log in and mobile printing of patient armbands, those carts and that vision are rendered useless. And more importantly, the benefit to patient care isn’t realized.”

The infrastructure for CHS will include having a secure and reliable data and voice network designed, built, tested, and fully functional, as well as clinical and non-clinical systems and applications assessed, planned, configured, tested, and fully implemented for opening day.

Making sure purchases today work for the future

The tricky part is ensuring that any equipment or systems purchased today will interact with these future networks and can be moved over to the new hospital.

“It means ensuring clinical areas are not purchasing and planning for equipment without working with IT and other support areas. To move towards a digital age, clinical equipment requires a collaborative approach for purchasing and installing equipment and bringing this into a network. This will ensure investments in clinical applications and equipment today can be transferred into the new hospital,” says Morgun.

So, aside from building a hospital with needed IT infrastructure for the future, Chartier’s and Morgun’s teams are also working to ensure Region systems today can be expanded to support the new hospital as it’s brought on board. Chartier’s team is also partnering with eHealth Saskatchewan to coordinate some of the important work underway provincially.

“For example, we have started introducing a new integrated nurse call system that alerts a caregiver to the patients’ request directly through a mobile device,” says Morgun, referring to a system that has already been put in place in 4th floor surgery in St. Paul’s Hospital. “The same requirement was designed for Children’s Hospital of Saskatchewan. We will be working to maximize standardization of systems in the Region for ease of maintenance and interaction as well as ensuring they can handle expansion to the new hospital.”

Other applications planned for CHS that are already being used in other areas in Saskatoon’s hospitals include staff-to-staff communication. This means overhead paging will be eliminated along with the noisy patient signaling systems we have today, which should lower patient stress. Then there’s the less glamourous side of technology being considered through building infrastructure – creating centralized systems in the hospital that will be able to monitor airflow to steam generation, all requiring access to the backend systems and interacting with Royal University Hospital systems as needed.

What’s behind the walls will transform care in the new hospital

“There’s been a lot of focus on the clinical and interior design of the hospital. But it’s important to realize that there is also a large group of people who have been focused on designing and creating the IT and building support systems needed to operate the hospital and support the care being planned,” says Chartier. “We are so proud to have been part of this planning since the beginning. Saskatoon Health Region is committed to building Children’s Hospital of Saskatchewan for the future. We know it’s vital to get the foundation elements right so we have the hospital our patients and families have asked for and are expecting. We know we have a lot to do during the next three years.”

Want to learn more about what is underway today to move towards the hospital’s IT vision? Next week, we explore Scanning and Forms on Demand Management. The name might not grab you, but this project is a must-have for opening day and will bring changes to the units by end of May!

IT Infrastructure Principles for CHS Opening Day

  • Electronic patient scheduling in pediatric outpatients
  • Electronic order management system maintained and upgraded as required
  • Sufficient end-user devices (terminals, laptops etc.) would be in place to ensure clinicians can view results for lab and diagnostic imaging (including results from other regions), patient history and demographics as well as access any dictated or scanned documentation from anywhere in the building
  • All planned technology (including bedside monitors, workstations) will be in place. This means the physical space must accommodate a hybrid environment of technology and paper charts.
  • Support emergency department’s goal of improving patient flow by implementation of electronic clinical documentation in Sunrise Clinical Manager (SCM) by registered nurses and physicians (This work is underway. Read more in this article: “New Technology Launched in Saskatoon hospitals”)
  • Decentralize registration with satellite locations for check-in as was originally designed
  • Critical upgrades (SCM, Enovation, lab, pharmacy) must occur as planned
  • Critical ITS infrastructure work must be completed as planned

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