When Dr. John Conly took over the Department of Medicine at the University of Calgary and Calgary Health District in 2002, the renovation of a medical ward at Calgary's Foothills Hospital was one of the biggest items on his agenda.
The idea of doing something other than a routine renovation came up in a conversation with Andrea Robertson, the hospital's director of inpatient nursing, Dr. Conly says.
They decided to take advantage of expertise in the university's engineering faculty.
The Calgary Health Region was receptive. "It was apparent to us that even though the cost of renovating the ward would be significantly greater, the anticipated benefits would be tremendous," recalls Dr. Sid Viner, the region's executive medical director.
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The result is the Medical Ward of the 21st Century, a unique 36-bed facility filled with innovations such as wireless communication and advanced patient monitoring technology, which could improve health care and serve as a prototype for future hospitals.
Unit 36, as it is also called, was designed with extensive input from caregivers. "We sat down as a clinical group and designed this unit," says Sonya Morrison, patient care manager on the ward. "We wanted to design an environment that was pleasant to work in and pleasant to be a patient in."
The goal was not just to build a better medical ward, adds Shandra Kimpton, project manager. "As much as it's a high-tech ward, we've got a really strong research agenda as well."
That design includes more private rooms — 28 of 36 beds are private — more equipment at the bedside and computers scattered throughout the ward so doctors and nurses can spend more time with patients, and facilities like strategically placed sinks and one toilet per patient to reduce the spread of infection.
This is already proving successful. Infections like clostridium dificile, Vancomycin-Resistant Enterococcus (VRE) and Methicilin Resistant Staphylococcus Aureus (MRSA) are constant problems in hospitals. In Unit 36, says Dr. Conly, C. Dificile and MRSA have dropped by 80 per cent, and there has not been a single case of VRE in 18 months.
Multiple computers throughout the ward give doctors and nurses convenient access to information rather than forcing them to queue at terminals at a central nursing station, notes Dr. William Ghali, a physician and health services researcher at Foothills.
The ward's wireless data network gives physicians and nurses immediate access to information using a laptop computer on a cart during rounds, Ms. Kimpton says. Nurses will soon use handheld computers to check patient-care instructions and drug information and share information more easily between shifts, Ms. Morrison says.
And the wireless network will support future projects such as smart cameras for patient monitoring. Dr. Barry Baylis, clinical co-leader of the Ward of the 21st Century project, says University of Calgary engineers are helping create this system, which should be ready for pilot testing early next year.
Rather than watching patients constantly, he explains, staff can set its custom software to alert them to certain movements that might be dangerous or a sign of trouble, while ignoring others. Nurses might want to know if one patient appears agitated. In another case they might just want to be alerted if the patient starts getting out of bed.
Another project focuses on wireless monitoring of patients' vital signs. Jim Haslett, a University of Calgary electrical engineering professor who is working on this project, says the present prototype is about the size of a thick Band-Aid and can transmit a patient's temperature reading wirelessly. Next Mr. Haslett hopes to monitor heart rate and blood-oxygen level. His team is also working on ways to draw energy from the environment, thus eliminating the battery and making the device even smaller.
Patient monitoring, designed to spot signs of trouble and promote earlier treatment, is just beginning to take off in Canada, says Scott Myers, managing director for the Canadian health and life sciences practice of consulting firm Accenture in Toronto.
Work is under way on a tool to give community health care providers better access to information about hospital stays after their patients are discharged, Ms. Kimpton says, and the ward is in the forefront of the region's plans for electronic health records. Mr. Myers says integrating health information is one area where Canada leads the U.S.
Dr. Viner says the Calgary Health Region sees the ward as a prototype for new hospital facilities. Because of the city's growth a new hospital is planned and all three existing hospitals will be expanded. Dr. Viner says the new facilities will adopt many design features from the Ward of the 21st Century.
The team is now awaiting word on a Canada Foundation for Innovation grant to help take the project to the next stage. On a disused smoking patio adjoining the ward, they want to build a research facility that would include a simulation centre, test labs, interview rooms and other facilities for researchers working on ward projects. "It makes it a little more of a living laboratory," Ms. Kimpton says.
The project will cost about $20-million, Dr. Ghali says. The hoped-for CFI grant would cover a third of that, another third is being sought from the province and the balance would come from the REACH program - a fund-raising partnership of the university and the Calgary Health Region - and other local sources.
