Transfer of 203 patients is accomplished without a hitch
After a decade of planning, years of construction, months of painstaking preparation, weeks of simulation exercises and a day of extremely intense activity, Pavilion K is now the new home of Intensive Care, Coronary Care, Neonatal Intensive Care, the Family Birthing Centre, the operating rooms and numerous other units and services.
The largest, most ambitious and most complicated expansion project in the 81-year history of the JGH reached a climax on January 24, with the transfer of 203 patients to their new rooms over a period of just 5½ hours.
Dawn was a couple of hours away when staff began arriving in the Atrium and prepared for the move from the main hospital building to Pavilion K. By 5:30 a.m., dozens had gathered for a hot breakfast and to pick up colour-coded t‑shirts imprinted with the names of their respective teams.
The air of excitement and anticipation was palpable as Dr. Lawrence Rosenberg, President and CEO of West-Central Montreal Health, told staff they were experiencing “what the founders of the original hospital must have felt when they first opened the doors to patients back in 1934.”
Alan Maislin, Chair of the Board of Directors of West-Central Montreal Health, urged members of staff to “take advantage of this new institution and use it as the launching point to provide the best possible care.”
The impending move was described by Johanne Boileau, Director of Nursing, as “a great voyage from the past to the future, and I feel very privileged to be part of this team.”
Finally, Joanne Côté who, as Director of Transition, had overseen the extensive preparations for the move, acknowledged that some employees would miss their old units. “It’s okay to have mixed feelings as you leave an area of work with so many good feelings to cherish,” she said. “But today you are starting a new chapter.”
Then came the moment that so many had been awaiting for so long—the move of the first patient, at 7:00 a.m., out of the Family Birthing Centre on the fifth floor of Pavilion B.
As the patient was readied for transport, Marie-Josée Bourassa, the Centre’s Head Nurse, described the atmosphere as “a real adrenalin rush,” while Paul Lao, a member of the Transport Team, felt he was “participating in history in the making.”
From there, and for every successive patient, it was a matter of following the steps in a carefully predetermined scenario:
- Wheel the stretcher through the halls of the legacy unit and across a link to the new building.
- Take an elevator to the appropriate floor in Pavilion K.
- Check in with a reception team to confirm the identity and destination of the arriving patient.
- Wheel the patient to his or her new room and make the connections to monitors or other equipment.
“It was very nice, very smooth, very well done,” said Chantal Piché, an expectant mother, who was among the first in the new Family Birthing Centre. “Everybody seemed really well prepared and they let me know everything that was going on.”
Over and over, patients arrived at a steady rate of one every 2½ minutes, except for those in critical condition who were moved every five minutes.
Numerous precautions were also taken. For example, Toula Trihas, Chief of Respiratory Therapy and Anesthesia, explained that when infants were moved between the NICUs, their incubators were attached to special shuttles equipped with back-up systems for the respirator and the respirator’s battery. Also on board were tanks of oxygen and air for resuscitation, as well as the means to monitor the baby’s vital signs.
Silvana Perna, Coordinator of Infection Prevention and Control, and her colleagues had arrived especially early that morning to determine whether any new patients had been put into isolation overnight because of infections.
During the move, a member of Ms. Perna’s team was assigned to the Red Track (critical-care patients) and one to the Blue Track (other patients) to ensure the proper transport of patients in isolation. “At the end of the move,” Ms. Perna said, “we’re going back to Pavilion K to make sure they were properly isolated and the proper precautions were put in place.”
Relatives of the transported patients also got kid-glove treatment. According to Lyne Charbonneau, a Nurse Clinician and Patient Coordinator, NICU personnel met with the infants’ parents two days before the move to brief them on what to expect.
“We went with them to Pavilion K and showed them where their baby would be moved to,” Ms. Charbonneau said. “They know they need to wait, and as soon as we settle all the babies, we will call them and reassure them that, yes, their baby is in the new location.”
For Dr. Apostolos Papageorgiou, Chief of Pediatrics and Neonatology, the move was his fourth at the JGH, and by far, the most hopeful and exciting. Incubators were now arranged in groups of six, with each group assigned to a single large room (known as a pod) where serenity reigned. This was a far cry from the old NICU, where more than 30 incubators had been crammed into one room that bustled with constant noise and activity.
“This is an extraordinary event,” enthused Dr. Papageorgiou. “You can imagine my emotions. It’s a wonderful improvement for the families and for the babies. Finally, it’s modern neonatology.”
Doctors were also looking forward to significant improvements in patient care. “They’re going to be in a unit with less noise, more sunlight and more privacy,” said Dr. Denny Laporta, a staff physician in Intensive Care. “We hope that environment will be more conducive to healing and communication. Ultimately, we hope patients will feel they can heal better and faster.”
Dr. Richard Sheppard, a staff physician in Cardiology, said he was anticipating a decrease in the spread of infection, since all patients would have their own room. “Patient confidentiality will certainly be a big plus in those private rooms. For critically ill patients, we’ll also have a lot more space to bring in machines that would previously have taken up a lot of room.”
By 12:32 p.m., it was done. The big move—203 patients, 61 of them in critical condition—had been completed without incident, leaving staff to provide care in the new environment.
“I’m very pleased with how it went,” said Ms. Boileau, pausing for a breather after the final patient had been moved. “I’m especially happy there were no incidents. Patient transport is a high-risk activity, but nothing happened. Everything went smoothly. I’m very pleased and very relieved.”
What happens to all of that empty space?With the relocation of so many units to Pavilion K, the legacy building finds itself with an abundance of vacant space. So far, however, the only confirmed plans involve renovating and transforming the old Emergency Department (vacated in 2014) into a hemodialysis unit.
According to Johanne Boileau, Director of Nursing, suggestions have been made to move beds from some of the oldest areas to legacy units that were renovated relatively recently. This would be complemented by rearranging the space to create a greater number of private and semi-private rooms.
However, Ms. Boileau says these sorts of plans would not be funded by the government. For this reason, discussions are ongoing to determine how to best use the empty space and how to finance any necessary renovations.
A post-script: At 3:17 p.m., nearly three hours after the move was completed, Cynthia Dahan and David Ohayon became the proud parents of a daughter, the first baby to be delivered in Pavilion K.