Hospitals in KW

[ac3r]

I still think The Aud would be a great location. It's huge, near the LRT (and you could always run a new line down Ottawa in the future, has various bus routes, access to the highway and various arterial roads. But using that would require The Aud to move which I'm not sure they would do. I don't know where else they could put it that would still be central enough and transit friendly.

[panamaniac]

If they are seriously looking for 60 acres, is there really any likely site in the developed areas of K-W? Would the Charles/Ottawa/Schneiders Creek/Borden block be big enough?

[KevinL]

I still don't get the 60 acres number. Can anyone name ANY major hospital with that large a footprint?

[bravado]

I still don't get the 60 acres number. Can anyone name ANY major hospital with that large a footprint?

There was a twitter thread today explaining that even Hamilton, the biggest Ontario hospital re: beds, is 5 hectares. If they truly are looking for 25 hectares, it doesn’t make sense. Unless it’s 20 hectares of parking lot.

[panamaniac]

I still don't get the 60 acres number. Can anyone name ANY major hospital with that large a footprint?

The new Windsor hospital (60 acres) and the new Ottawa Hospital (50 acres).  In  Windsor's case, I gather that it's out in the burbs.  In Ottawa's case, the GofC made Experimental Farm land available.  Edit, I haven't seen an explanation of why the GofO is insisting on such big sites - perhaps to accomodate other medical-related developments down the road?

[ijmorlan]

I still don't get the 60 acres number. Can anyone name ANY major hospital with that large a footprint?

The new Windsor hospital (60 acres) and the new Ottawa Hospital (50 acres).  In  Windsor's case, I gather that it's out in the burbs.  In Ottawa's case, the GofC made Experimental Farm land available.  Edit, I haven't seen an explanation of why the GofO is insisting on such big sites - perhaps to accomodate other medical-related developments down the road?

There is no conceivable reasonable justification for insisting on such a large site.

I mean obviously, ceteris paribus (“all other things being equal”), a bigger site is better, but the real estate market is about as far from ceteris paribus as you can get — a large site is almost certainly out in the boonies, so by specifying that up front they are pre-determining another variable, and pre-determining it wrong.

As an example of how this could go wrong in the other direction, imagine they understood that it’s important for hospitals (specifically, emergency departments, among other parts of the hospital I can think of) to be centrally located. So they specify “within 500m of Kitchener City Hall”. That would force an unreasonable expense for vacant land or require an extreme downsizing of the hospital or probably both.

Unfortunately, we still live in a society where building some huge thing way out in car-only land still isn’t immediately obviously a big fail to most people, so this will probably go forward with a huge site in the middle of nowhere.

Actually, it occurs to me that a lot of our problems, especially around cars, stem from the same sort of consideration. I would argue that, ceteris paribus, it’s obviously good for stores, offices, etc. to have good road access and lots of parking. And that can justify modern zoning, parking regulations, freeways, and suburb design. But this particular “ceteris paribus” is doing a lot of work, and understanding that turns this argument on its head; here in the real world, none of those things are “ceteris paribus”; everything costs a lot to build, it encourages car dependence, causes pollution, and ends up raising costs even more than it initially appears while making it harder for those who choose or want to choose differently. So in reality it’s better to allow and even encourage development that does not cater to motor vehicles or does so to a lesser extent.

[panamaniac]

For reference,  Kitchener's Woodlawn Cemetery is about 50 acres.  I think the K-W Hospital would be on less than 25 acres, not counting ancillary buildings beyond the main site.

I was doing a bit of reading about the new Ottawa Hospital and it seems that new trends, specifically one patient per room and reducing movements between floors are two elemenst contributing to larger hospital sites (ie. the buildings have larger footprints).  There must be other factors as well, but the total land "ask" still seems very high.  And it's not just about parking (the new Ottawa Hospital will have a huge parking garage but relatively little surface parking).

[nms]

London's Health Services Campus is about 40 acres plus another 40 acres for longer-term residential programs. The site includes the main hospital building (really an agglomeration of the main hospital and the children's hospital plus various additions). The surrounding campus includes surface and structured parking, the helipad, and supporting buildings.

[ijmorlan]

London's Health Services Campus is about 40 acres plus another 40 acres for longer-term residential programs.  The site includes the main hospital building (really an agglomeration of the main hospital and the children's hospital plus various additions).  The surrounding campus includes surface and structured parking, the helipade, and supporting buildings.

Hospitals have many uses which relate to each other to different extents. Emergency, maternity, surgery, outpatient, and long term care and others are all distinct functions which have varying degrees of interconnection. They do not need to be all at the same site. It’s more important to have multiple emergency locations accessible to different parts of the city than to have everything in the same building.

I would go further and suggest that resilience requires that the hospital be at multiple sites. Combined with the transport requirements, it simply does not make sense to insist on one huge site. If they really need 60 acres, build 4 hospitals at different locations with different functions (except maybe Emergency at all of them).

And that is before even considering the fact that by using multiple floors you can put a shocking amount of floor space on an existing parking lot. The new hospital does not have to be built like a suburban strip mall.

[SF22]

There's no way this land parcel is as big as they are asking for, but I think the empty area around Hagey Blvd next to the R&T ION stop is worth looking into. It's on the Laurel Trail, there are a few bus lines close by that could easily be rerouted to provide even more direct service, and most of its neighbours are businesses in the technology park (less disruption to residences, although the folks on Corrie Cres might not be super pleased). It's not right on the highway, but neither is GRH or St Marys. Definitely a weirdly-shaped plot of land, but a hospital campus is likely to have a number of buildings that could be arranged to make the most of it. Plus, there is some greenspace surrounding it, and there are studies showing that patients recover faster when they are able to look out over nature from their rooms. If you want to keep traffic off of Bearinger, you could cut through an entrance to Westmount.

[danbrotherston]

There's no way this land parcel is as big as they are asking for, but I think the empty area around Hagey Blvd next to the R&T ION stop is worth looking into. It's on the Laurel Trail, there are a few bus lines close by that could easily be rerouted to provide even more direct service, and most of its neighbours are businesses in the technology park (less disruption to residences, although the folks on Corrie Cres might not be super pleased). It's not right on the highway, but neither is GRH or St Marys. Definitely a weirdly-shaped plot of land, but a hospital campus is likely to have a number of buildings that could be arranged to make the most of it. Plus, there is some greenspace surrounding it, and there are studies showing that patients recover faster when they are able to look out over nature from their rooms. If you want to keep traffic off of Bearinger, you could cut through an entrance to Westmount.

I mean, the R&T park is already a joke of a suburban office strip...so why not put a suburban hospital there.

I do think you would have difficulty connecting to Westmount, as that is an environmentally sensitive area, but there is no reason the access can't be off Bearinger. It has direct access to Westmount, and more, they are insisting on widening Bearinger because our regional staff are incompetent at transportation planning, so if they wanted less traffic that ship has already sailed.

That being said, to ijmorlan's comment, there is actually a huge benefit to having facilities co-located in a hospital, the point is to share common facilities, like labs, imaging, and other services. While it's easy for staff to move between facilities, it's very hard for patients to move between facilities. I can see the value in co-locating the facilities, but it doesn't change that the land requirement is totally absurd. The land requirement is driven by parking and nothing else.

FWIW: Amersfoort has a brand new large hospital built here, it is the only one in town (they demolished the old one). It is at the edge of the city, accessible by bike and bus, but still very remote and far, most people arrive by car. It has a ton of parking including multiple parking structures. Even including all the surface parking, accessory buildings and gardens (yes, it includes gardens), the site only takes up 24 acres.

[ijmorlan]

That being said, to ijmorlan's comment, there is actually a huge benefit to having facilities co-located in a hospital, the point is to share common facilities, like labs, imaging, and other services. While it's easy for staff to move between facilities, it's very hard for patients to move between facilities. I can see the value in co-locating the facilities, but it doesn't change that the land requirement is totally absurd. The land requirement is driven by parking and nothing else.

Those are good points. I’m not sure it really says that long-term cancer, say, really needs to be co-located with maternity, but I agree there are benefits to having things together.

I would dispute that the land “requirement” is driven by parking. The main parking lot at Pearson Airport Terminal 1 is on about 5ha or 12 acres. It holds 9000 vehicles. Just how many patients are they expecting at this new hospital?

I believe the land requirement is just picked to be ample, with no consideration of the consequences. To be fair, this is normal for car infrastructure: it would be “nice” if there were space for everybody to park when they go to the store, so we have parking minima for commercial buildings, and it’s handy to have a place to park at home, so we have parking minima there too; those of us who question this clearly do not possess the degree of expertise possessed by our credentialed planners.

[ac3r]

The new Windsor hospital (60 acres) and the new Ottawa Hospital (50 acres).  In  Windsor's case, I gather that it's out in the burbs.  In Ottawa's case, the GofC made Experimental Farm land available.  Edit, I haven't seen an explanation of why the GofO is insisting on such big sites - perhaps to accomodate other medical-related developments down the road?

There is no conceivable reasonable justification for insisting on such a large site.

I mean obviously, ceteris paribus (“all other things being equal”), a bigger site is better, but the real estate market is about as far from ceteris paribus as you can get — a large site is almost certainly out in the boonies, so by specifying that up front they are pre-determining another variable, and pre-determining it wrong.

As an example of how this could go wrong in the other direction, imagine they understood that it’s important for hospitals (specifically, emergency departments, among other parts of the hospital I can think of) to be centrally located. So they specify “within 500m of Kitchener City Hall”. That would force an unreasonable expense for vacant land or require an extreme downsizing of the hospital or probably both.

Unfortunately, we still live in a society where building some huge thing way out in car-only land still isn’t immediately obviously a big fail to most people, so this will probably go forward with a huge site in the middle of nowhere.

Actually, it occurs to me that a lot of our problems, especially around cars, stem from the same sort of consideration. I would argue that, ceteris paribus, it’s obviously good for stores, offices, etc. to have good road access and lots of parking. And that can justify modern zoning, parking regulations, freeways, and suburb design. But this particular “ceteris paribus” is doing a lot of work, and understanding that turns this argument on its head; here in the real world, none of those things are “ceteris paribus”; everything costs a lot to build, it encourages car dependence, causes pollution, and ends up raising costs even more than it initially appears while making it harder for those who choose or want to choose differently. So in reality it’s better to allow and even encourage development that does not cater to motor vehicles or does so to a lesser extent.

Ugh.

Yes there is. I know the car lives rent free in the minds of a lot of you on this website, but the size of the property/project they're seeking has nothing to do with cars. Will it be built in an area that is not well serviced by public transportation (at least at present)? It's possible, but them wanting a significant acreage is unrelated to this. The directors of GRH are not sitting there with a whiteboard on the wall with a big list starting with "1. Hospital must have as much parking as possible"

They want to build a hospital that will be able to handle hundreds of thousands of citizens without having people sleeping on stretchers in the hallways as they frequently do now. Given the extremely rapid population growth of Waterloo Region, this is perfectly understandable. Through the company I work for and through my partner providing me information about the hospital's needs as she is an employee there, I've been able to have an understanding on what GRH is aiming for with this hospital. They are looking to build an extremely top of the line healthcare centre for Waterloo Region and beyond - while also future proofing everything so it can evolve.

I mean what do you guys expect? A hospital with absolutely no parking which you can only access with bike lanes?

[bravado]

I guess we expect a hospital that’s actually close to the people it’s supposed to serve, mostly.

If the location is picked to maximize road access and cheaper land for surface parking but not actually be near any humans, then that seems like a loss. We’ll have to wait and see.

[ac3r]

Most people don't walk/bike/whatever to hospitals, though. Of course I would love the new hospital to be as central in the region as possible with as much transportation access that can be achieved. But the reality is most people who are going there are driving. If you're going to get chemotherapy, you're not roller blading to the appointment. If you've cut open your arm at work or fell off a ladder, you're not going to be biking to the emergency room. If you're an employee - an ICU doctor on call, an oncology nurse, a housekeeper, a receptionist - you're likely driving so you can be there on time, not biking and sweating like a pig on the way there so you are forced to shower and get changed. Or risking being late to care for your patients because your train couldn't handle 2 millimeters of freezing rain. Let's not forget many of the staff work 12 hours a day in an unfathomably challenging job as well. The last thing my partner would want to do after working a 12 hour shift with people dying or losing their mind is to ride a bike home. She relies on the LRT and bus to get to work and that has got her written up and disciplined numerous times because it is so damn unreliable. That sort of nonsense doesn't fly in healthcare.

I'm no fan of the automobile but there are still lots of valid reasons why people either prefer to or are obligated to drive to one.