By Barb Collins
Chief Operating Officer, Humber River Hospital

Having the opportunity to build a new hospital, from the ground up, on a greenfield site is rare. When Humber River Hospital's redevelopment plans were approved, it presented a unique opportunity to push the envelope for the planning, design and construction phases. The result: the first fully digital hospital in North America, with cutting-edge technology to help the hospital reinvent patient care delivery.

From the start of the planning process for the new Humber River Hospital, the work needed to be exemplary. The hospital had to be planned and designed in a way that will still be relevant 30 years from now, rather than just a bigger version of yesterday's model. The new building had to be adaptable to new work flows as well as future technologies. The core design question became "Will this design element enhance care and service for patients and families both now and in the future?" If yes, it stayed. If the answer was no, or maybe, it was tossed aside.

Following a great deal of discussion on how to best answer our design question, three vision elements were established to guide us:

• Lean: Maximize clinical design efficiency to enable high quality, cost-effective care.
For example, we developed a design test called 'sneaker time' – the distance a nurse has to walk to deliver patient care during a typical shift. At our hospital's current site, sneaker time is 5.4 kilometres. At our future site, sneaker time has been reduced by over 18 per cent.
• Green: Minimize the environmental impact of the new facility wherever possible.
The new Humber River Hospital will be the most energy-efficient acute care hospital in North America according to ASHRAE standards, achieving more than a 40 per cent reduction in energy consumption over current models. The savings will be reinvested into Humber River's patient care programs.
• Digital: Develop an affordable, fully integrated and interoperable digital hospital, using the best possible technology to deliver safe, high-quality, patient-centred care.
We looked for ways to use technology or equipment to reduce 'non-value added tasks' for staff and physicians. Instead of scribbling blood pressures on a scrap of paper and then walking back to the nursing station to chart it, data is downloaded at the bed side automatically, in real time. This saves nurses steps, and time – time now available to spend talking with the patient about his or her care.

Many supply deliveries will be made using robots. These automated guided vehicles receive orders by wireless communication and prioritize them. Once a delivery has been completed, they automatically send a message to the handheld device of whoever placed the order. If along the way, someone is blocking their path, the robot politely asks that individual to allow them to pass. We will save more than 160 kilometers of staff sneaker time every day by using automation for 75 per cent of all deliveries in the new hospital.

Just as customers can use their smartphones to check in for a flight, patients at Humber River will be able to use it to register at the hospital before they're even there. Once in an inpatient room, patients can turn on the bedside terminal: email, menu, room climate controls, medical records – all this and more will be available. When a health care provider walks in, his or her name and photo will appear on the screen – one of the security features on the hospital's ID badges.

The terminal also allows patients to see their complete health record, with test results, images and notes about their progress. All this information is also available to the care team on any connected device. And the videoconference feature lets patients communicate with friends, family or the care team members.

This project is not about technology for technology's sake. It's about maximizing the use of technology to advance high-quality, efficient, safe patient care. It's about designing an efficient, affordable facility that complements patient care delivery workflows. Most of all, it's about putting the patient at the centre of their care in a real and meaningful way.

Lean, green and digital: the new Humber River Hospital.

A display of the new Humber River Hospital design will be featured in a special exhibit at HealthAchieve 2013 taking place this November 4, 5 and 6 at the Metro Toronto Convention Centre. Visit www.healthachieve.com for more information.