Securing access to healthcare services for people in rural and remote communities

September 24, 2019 Derrick Lamb

How designers can create opportunities that connect isolated communities with compassionate care

 

The Government of Canada has long strove to provide its people with healthcare services that are both affordable and accessible. Since the 1960s, the country has offered its permanent residents’ free access to public health insurance. The aim? To provide universal and comprehensive healthcare to all Canadians. Yet, the biggest challenge for Canada’s healthcare system isn’t the price tag. It’s the access.

At almost 10 million square kilometres, Canada is the largest country in the western hemisphere and the second largest country in the world. The sheer size of our landmass lies in sharp contrast to the number of people who live here—Canada’s population consists of less than 40 million people.

In comparison to other developed countries, Canada’s population is incredibly sparse. And while we enjoy our physical freedom and open space, our scattershot approach to migration has resulted in cases of displacement as Canadians in remote communities can find themselves distanced from essential healthcare services. This is especially true in Saskatchewan, where some of the remote northern communities lack access to healthcare.

 

The Swift Current Long Term Care Centre offers compassionate care for residents and is the first completed P3 healthcare project in Saskatchewan.

 

_q_tweetable:Just like the Government of Saskatchewan, I believe in a patient-first approach into all the projects I work on._q_

Serving the northern communities of Saskatchewan

The City of Prince Albert, Saskatchewan, plays a unique role in Canada’s healthcare challenges. The community sits in the proverbial heart of Saskatchewan, north of the province’s two largest city centers—Regina and Saskatoon—and amongst a vast, reclusive stretch of extensive lake land and boreal forest.

The Prince Albert region serves northern Saskatchewan in a significant way. It provides healthcare needs to a service area of about 83,000 people, in addition to serving as the Regional Referral Centre for north central Saskatchewan—a role that offers specialized medical services pertaining to acute care, mental health, emergency medical services, and community service programs. 

Just like the Government of Saskatchewan, I believe in a patient-first approach into all the projects I work on. This is especially true in Saskatchewan, where I’ve spent most of my career working to understand the unique healthcare challenges that each community faces. The following examples demonstrate the work we’ve done at Stantec to not only remedy the situation—but to help change it.

 

A guide to alternative project delivery methods

The traditional model for project delivery practice is guided by a design-bid-build (DBB) process. But alternative project delivery (APD) methods have become increasingly attractive as of late. Why? Because APD methods offer the opportunity for innovation and the ability to deliver significant added value. APD methods can lead to:

  • Earlier project delivery.
  • Improved facility functionality.
  • Reduced environmental impacts.
  • Lowered capital and reduced operating costs.

APD isn’t right for every project, but there are many instances where it is well suited—such as the Dr. F.H. Wigmore Regional Hospital (FHWRH) in Moose Jaw, Saskatchewan. The FHWRH was the first hospital in Canada built using the integrated project delivery (IPD) model—a type of APD that’s becoming increasing popular.

Like the rethinking of healthcare delivery, the FHWRH project was an opportunity to design a facility that would truly improve healthcare delivery and client satisfaction. Again, the goal here was patient-first care. So, we collectively identified the significance of the project in the community and then outlined the goals and objectives of the region. Thanks to engaging everyone in the process, we delivered a hospital that worked to define the community’s legacy while providing compassionate care for patients.

Our key role in other healthcare projects in British Columbia—such as the $250-million Royal Columbian Phase 1 in New Westminster; the $505-million North Island Hospitals in Comox and Campbell River; and the $375-million Kelowna and Vernon Hospital—have provided invaluable insight and experience that we can apply to our local projects in Saskatchewan.

We can offer our clients a unique perspective into the process and design of these complex projects. And not only do we provide cost-effective options that have been engineered to maximize overall value through IPD processes, but we can also guide our clients through the framework of public-private partnerships (P3)—another APD model that’s been gaining momentum in Canada.

 

The FHWRH was the first hospital in Canada to be built using the integrated project delivery model.

 

Guiding a P3 project in Swift Current

P3 projects allow government agencies to initiate capital projects that would traditionally take more time to fund upfront costs. They allocate funding from multiple parties—in both the public and private sectors—to build community-based projects like schools, roads, and government infrastructure. P3 projects come with an additional set of arduous challenges, and require the following:

  • A strong team framework with consistent communication.
  • Economic and technical compliance.
  • A set scoring criterion that reduces the bid cost.
  • A variety of proven tools and processes, such as Revit, BIM, or virtual reality.

I’ve seen the P3 process work on multiple projects. Whether schools or roads, buildings or bridges, we’ve proven we can work with our partners to produce integral infrastructure for the communities we serve. Take the Swift Current Long Term Care Centre (SCLTC) in Saskatchewan, for example. It’s a P3 project that required true collaboration from all parties involved.

The uniqueness of the SCLTC site, the proposal requirements, and the authority’s lean P3 processes were the inspiration for the master plan and building design. Much of the P3 effort was spent on the design of the individual houses, which were brought together in a meaningful way to achieve the project objectives. The semi-circular organization created a simple and elegant solution and, more importantly, one focused on the needs of the residents.

Now, the innovative, 225-bed complex offers compassionate care for residents and is the first completed P3 healthcare project in Saskatchewan.

 

For the SCLTC project, the semi-circular organization created a simple and elegant solution.

 

Our experience in Saskatchewan

In addition to our tried and tested approach when navigating the P3 process, our team has a longstanding local presence with healthcare projects in Saskatchewan. Whether using traditional delivery methods or taking the APD approach, we have delivered several successful and significant healthcare projects, including:

  • The Southwest Integrated Healthcare Facility (Maple Creek), a $37-million, 8,000-square-metre facility that includes 48 long-term care beds, 24 inpatient beds, 2 trauma beds, 16 universal care platform clinic beds, and 4 universal care consulting rooms to deliver a comprehensive care package to hospital residents.
  • The Yorkton & District Nursing Home Addition (Yorkton), a $15-million, 93-bed addition built to accommodate the diverse needs of Yorkton residents, featuring bungalow style accommodations with long-term, palliative, and respite care services, as well as daycare and rehabilitation facilities.
  • The Centre for Mother Baby Care (Regina), a 6,500-square-metre renovation designed to upgrade a range of service areas—such as neonatal intensive care units—as well as create a family-focused facility and provide high-quality integrated treatment for mother and child, with additional support spaces and services for the entire family.

By being so actively involved in the larger Saskatchewan healthcare sector, our team keeps current with the advancements in hospital design as well as any changes to the delivery process. We employ a one-team approach that allows us to design hospitals as a holistic solution—the way hospitals should be conceived.

The Government of Saskatchewan believes in a patient-first mandate, and our approach supports that. When you design for something you believe in, there should be no limit to the effort you offer.

Our goal is always to increase our understanding of Canada’s healthcare needs. Right now, in Saskatchewan, that need is improving healthcare access for remote, northern communities. With a strategic approach and a healthy knowledge of the APD process, we’re excited to help our clients conceive, design, and construct enhanced care facilities for all.

About the Author

Derrick Lamb

Derrick Lamb is senior healthcare planner in Regina, Saskatchewan. For more than 20 years, he's focused on designing healthcare facilities, with the goal of incorporating the community's needs into each project.

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