Why size matters for Ottawa's new Civic hospital

Two issues loomed large at Monday night's long-awaited information session on plans for a new Civic campus of The Ottawa Hospital: concern — and in some quarters outright opposition — over the possibility the hospital could be built on a 60-acre chunk of the Central Experimental Farm; and skepticism that it really needs that much space.

That folks were upset about the possible use of the Experimental Farm wasn't a huge surprise. The preferred location for a new hospital on a key research field on the farm — a National Historic Site and the location of the second-oldest research agricultural land in the world  —  has become increasingly controversial ever since former MP John Baird handed the land to the hospital in 2014, a decision made behind closed doors.

The federal government has since told the hospital to re-evaluate the options for relocating the Civic, and to consider the impact on research at the farm.

But three of the four shortlisted sites are still on the Experimental Farm — a fact that has upset supporters of the heritage site. The fourth option is Tunney's Pasture.

Meeting criteria

Why just these four locations? They are the only ones that meet the criteria for a new Civic, according to hospital officials. Those criteria include:

• 60 acres of available land.
• Proximity to the Queensway a​nd public transit (although of the four shortlisted locations, only Tunney's Pasture is easily accessible to rapid transit).
• Proximity to the downtown core.
• And the cost to tear down pre-existing structures on the site.

The current Civic sits on 23 acres of land. Officials are now looking for a new home that's more than twice as large — the equivalent of about 1.5 Lansdowne Parks, or two Bayshore Shopping Centres.

But it was clear from some of the questions at Monday's meeting that some are skeptical about why the hospital needs so much space. 

Hospital officials concede they haven't done a great job explaining why they're looking for so much more land, or what a new campus might look like.

Up to 10 storeys

For one thing, the hospital isn't going to be some sort of two- or three-storey, sprawling, ranch-like structure. Some buildings will likely be eight, nine or even 10 storeys, said chief operating officer Cameron Love in an interview this week.

Here are some of the key reasons why hospital officials are asking for 60 acres for the Civic:

• Single rooms, more beds: New hospitals have all private rooms for patients with individual washrooms. This leads to more restful care, and keeps infections from spreading. A unit in the current Civic that has 40 beds would only be able to accommodate 15 beds in the new, one patient-one room configuration. A new hospital would also have between 700 and 800 beds, an increase over the current 600, which includes spaces at the Heart Institute.
• Efficient layout: Today, a patient taken to emergency at the Civic may have to be moved to different floors for various tests or treatments, wasting precious time. But a new hospital might have the emergency room ICU, operating rooms and a trauma centre all on one floor, explained Love. Locating services on one level would be more efficient, but would also take up more space.
• More "healing" spaces: These would include gardens and gardening plots, walking paths and other indoor and outdoor "reflection" areas "intended to enhance the patient experience and assist with recovery," according to a hospital report.
• Out-patient clinics: In new hospitals, out-patient services are often run as their own separate units (for example, a colonoscopy clinic). Some clinics are even housed in separate buildings. But they need to be on the hospital campus so that out-patients can avail themselves of tests like MRIs or CT scans at the same time as their clinic appointments, said Love. As well, doctors practising at the clinic, such as neurologists, may also have patients in the main hospital.
• Separate research areas and patients: Some of the Civic's most highly regarded specialists also have research mandates, which require labs and research centres. For a number of reasons — including the fact that research often includes animals — the labs need to be in a separate building, again increasing the need for horizontal space.

Love added that Ontario's Ministry of Health and Long-Term Care's guidelines call for new hospitals to be built on a minimum of 50 acres, although he concedes the guideline is not an "edict." A prime example would be the new hospital opened in Oakville, Ont., at the end of last year. It was built on 50 acres, has 457 beds and serves a community of 180,000 people.

Comparison confusing

To underscore the argument that modern hospitals need more space, the hospital provides a list of recently-built health facilities with their corresponding acreage. And yet, even that was a little confusing.

For example, it lists the 862-bed New Parkland hospital in Dallas, opened in August 2015 on 64 acres — about the size of what the Civic is planning.

But the Dallas-Fort Worth metropolitan area has a population of roughly 7 million. Does Ottawa and its one million residents really need a hospital that size?

That comparison is misleading, said Love. Hospitals have to be understood as part of a regional health care plan. (It turns out Dallas has at least 10 regional hospitals, including one even larger than the New Parkland.)

While Monday's was the first of many planned community consultations, the public will not get the final say on where the new Civic will be built. The federal government will decide that. 

A decision on a location for the Civic should be made later this year. Wherever it goes, though, Love said that the hospital has "committed 100 per cent that we will not go beyond the bounds of 60 acres" for the "next 50 to 100 years."

 "We've been very conscious of the fact that if it's on the farm — or no matter where it is — that after we get it built, 10 years later we're not asking for another 20 acres," said Love.