COVID-19 Update: New outbreak declared

C-Ward, ICU outbreaks declared over

Today, HHS Infection, Prevention and Control (IPAC), in consultation with Niagara Public Health, has declared a COVID-19 outbreak on B Ward at West Lincoln Memorial Hospital (WLMH). Less than five patients have tested positive for COVID-19 in relation to the outbreak.

Additional patient and staff point prevalence testing is underway. The earliest this outbreak can be declared over is January 12, 2022.

The previous outbreaks on C Ward and ICU were declared over on December 29. C Ward is open to admissions.

A message to the WLMH community

Last year, we started this message off by noting how remarkable a year 2020 was.

It’s safe to say that 2021 has followed a similar path.

Over the past 12 months, our teams across Hamilton Health Sciences, including those at West Lincoln Memorial Hospital (WLMH), have continued to demonstrate resilience, dedication, and courage serving patients with unwavering compassion in the most challenging of times. Staff and physicians continue to rise to each occasion and meet every difficult endeavour head on.

At WLMH, we saw many staff bring their highly specialized skills to other hospital sites, helping out in the hardest hit patient care areas, and others volunteering their skills at vaccination sites. Some programs at the site saw twists and turns as the hospital followed the government’s direction in response to the unrelenting virus, changing the way our providers deliver and patients receive care.

All of that turbulence did not stop progress on major WLMH initiatives.

For the first time in the site’s almost 75-year history, patients can now get timely and critical computed tomography (CT) scans in West Niagara. This momentous achievement was the result of many years of work by many hands – in the hospital, the Foundation, the community and at Queen’s Park. The site is now also home to two new x-ray machines and a new mammography suite, allowing more opportunity for preventative screening close to home.

As we head into 2022, we are just months – yes, months – away from construction being able to start on the new hospital. Getting here has taken immense effort, energy and emotional investment. It has been a long road travelled, but when shovels finally break ground on this long-overdue project, we think we will all agree that it was time well spent.

On behalf of Hamilton Health Sciences, we would like to wish our staff, physicians, volunteers, families, donors, community and supporters a very happy, healthy and safe holiday season, and what promises to be a very exciting New Year.

Rob MacIsaac, President and CEO, Hamilton Health Sciences

Leslie Gillies, VP, Community Medicine & Population Health, & Exec Site Lead, WLMH – Hamilton Health Sciences

This message was originally drafted for the West Lincoln Memorial Hospital Foundation annual Trees of Healthy Wishes campaign.

Teams submit technical RFPs for new WLMH

Financial submissions due January 2022

The West Lincoln Memorial Hospital (WLMH) Redevelopment project moved a little closer to becoming a reality as the technical Request for Proposals (RFP) period closed.

Technical submissions include individual plans for the design, layout and execution of the future facility. Hamilton Health Sciences (HHS) and Infrastructure Ontario (IO) will now begin a rigorous evaluation of the technical submissions.

The financial component of the RFP is expected to close in January 2022, after which time HHS and IO will be able to select a preferred proponent and negotiate a contract with that team.

“As we turn the corner into the New Year, we will very soon be able to determine and share who will build the new West Lincoln Memorial Hospital and what it will look like,” said Kelly Campbell, Vice-President, Corporate Services & Capital Development at HHS. “We thank each of the teams for the time, effort and energy they have invested into developing their technical proposals for this project. Very soon, we will have the exciting yet challenging task of selecting one winner from the high-quality and unique submissions.”

It is anticipated the successful team will be announced in spring 2022, and construction will begin shortly thereafter.


The RFP was posted at the end of June 2021. The three shortlisted teams – which were determined through an open Request for Qualifications (RFQ) process earlier this year – were invited to respond to the RFP for the new hospital. The RFP package included more than 5,500 technical requirements set by HHS, in partnership with the Ministry of Health and IO, which each team must satisfy in its submission.

“This is an exciting next step towards the build of the new West Niagara hospital the community has been working towards for many years,” said Sam Oosterhoff, Niagara West MPP. “This legacy community healthcare infrastructure will provide care and treatment to many patients in our community for years to come, and I wish to thank all those who have worked so hard to get the new build to this point. The Government of Ontario is committed to working with Hamilton Health Sciences and the whole community in getting the new hospital built as soon as possible.”

Q&A: Leadership lessons learned

For the last four-plus years, Cindy MacDonald has been the Director of Community Programs and Site Administrator at West Lincoln Memorial Hospital. She recently announced her retirement which is set for the end of December 2021. She graciously (and humbly) agreed to sit down for a Rapid Fire Q&A session to share some of insights from her career and advice for younger health-care workers looking to take the leap into management.

(Dear Reader, please note that the feature photo shared with this story was taken long before the COVID-19 pandemic. Cindy, like all members of our team, diligently follow public health guidelines, including masking and physical distancing.)

Q. Best piece of advice you’ve been given about leadership?

A. My mentor told me a long time ago: “surround yourself with bright lights,” meaning other people who are committed to excellence and kindness. Bright lights bring people together and help others grow and evolve.

Q. What would you say to someone who wants to get into health-care management?

A. First thing I would ask is “why”? What do you want to achieve in your career? What’s your definition of leadership? If you’re coming into a leadership role for any other anything other than wanting to provide leadership to those around you and support patients and the organization, you may not be successful. Leadership is not about you as an individual but how you can support others to be successful. It can be a very challenging at times and you have to be in it for the right reasons. If your heart is at the bedside, you can be a leader in compassionate and evidence based care, teamwork, advocacy – there is a need for bedside leadership as well.

Q. Most important skills health-care leaders should have to be successful?

A. Communication is very important. The challenge of communicating in a digital world is that email isn’t always the best way to get a message across. How do you ensure people are informed and have what they need to do their job? How to you bring information to people as opposed to thinking they’ll seek it out on their own?

Q. Best piece of advice about being staying grounded in a management role?

A. Part of being a good leader is reflecting and learning, but you’ll never achieve everything you want to do in a role. It’s about doing the best job you can do and making positive change for those around you.

Q. Any leadership myths you’d like to dispel?

A. People sometimes think when you take on leadership positions that you need to change, but you don’t. What you do need to be is authentic and stay true to yourself.

Q. Best part about your time at WLMH?

A. The team who come in every day and provide the best care possible for patients. I’m thankful for the opportunity to work in a community hospital for the first time in my career. I’m honoured to be of service to the community, and grateful for being part of the exciting conversations about the new hospital.

Q. Plans for retirement?

A. Lots. But after 36 years of working full time in health care, I’m looking forward to what life wants to show me next.

“Perfect time” to get screened

New WLMH mammography machine up and running


The latest upgrade to diagnostic services at Hamilton Health Sciences’ (HHS) West Lincoln Memorial Hospital (WLMH) is new state-of-the-art mammography equipment that provides routine 2D mammography as well as 3D imaging, also called tomosynthesis.


Mammography technologists at WLMH started using the new machine — a GE model called the Pristina — earlier this month. It replaces the hospital’s aging mammography machine, and is part of upgrades through Managed Equipment Services (MES).


The HHS Juravinski Hospital and Cancer Centre’s CIBC Breast Assessment Centre (BAC) in Hamilton received three of the same model of machines.


“WLMH now has a top-of-the-line mammography machine with all the bells and whistles to perform screening mammograms, diagnostic studies in people with breast concerns and tomosynthesis,” says Dr. Kavita Dhamanaskar, an HHS radiologist with expertise in breast imaging. Dhamanaskar was part of the MES team that was instrumental in bringing the new machines to WLMH and the BAC.


The new machines provide traditional 2D digital mammography for routine breast screening as well as leading-edge 3D technology. With 2D mammography, two x-ray images are taken – one from the top of the breast and one from the side. The 3D mammography provides a more detailed look by obtaining a set of breast images at different angles.
Radiologists recommend tomosynthesis views when a person is recalled for further evaluation of abnormal findings on routine mammogram. This more advanced 3D scan can also be used for screening people with dense breasts.


Improved experience for patients and staff


Until this month, WLMH patients needing detailed assessment or extra views were sent to the BAC. “Now these patients can have complete diagnostic assessment right here in Grimsby instead of travelling into Hamilton,” says WLMH clinical manager Bethany Hancocks, whose responsibilities include diagnostic imaging.


Patients have shared that they’re pleased with the new machine, which is designed to provide a more comfortable experience, says WLMH mammography technologist Natasha Brandel. It’s also more user friendly for technologists, provides higher-quality scans than its predecessor, and is faster.


It has been a big year for diagnostics at WLMH, with a new CT scanner added in summer and now the new mammography machine. It’s all part of a plan to replace and upgrade most of the site’s diagnostic imaging fleet.


Ontario Breast Screening Program


WLMH is home to an Ontario Breast Screening Program (OBSP) site, serving West Niagara and Hamilton residents. The OBSP offers free mammograms to people ages 50 to 74 as part of their routine health care. It’s recommended that most women in this age group get a mammogram every two years since early detection can catch breast cancer when it’s small and is easier to treat.


Anyone in the 50 to 74 year age group who’s due or overdue for a mammogram is encouraged to book their own appointment by phone at an OBSP site that’s most convenient for them. A referral is not necessary, although appointments can also be booked through a person’s primary care provider.


This year, due to delays caused by the pandemic, women aged 75 can also book their own appointment. Outside of the provincial breast screening program, women over 75 and under 50 can book through their primary care provider if screening is deemed necessary due to personal circumstances such as a family history.


“Now is the perfect time for people who are due or overdue to book their mammogram,” says Dhamanaskar.

WLMH welcomes Dr. Mosher, OBGYN

For Dr. Andrea Mosher, coming to West Lincoln Memorial Hospital is a bit of a homecoming.

“This opportunity at WLMH is somewhat full circle for me,” said Dr. Mosher, WLMH’s newest obstetrician and gynecologist. “I grew up in Niagara Falls, did my undergrad at Queens University, went to medical school in Calgary, and took my residency in Hamilton. I am excited for this opportunity to come back to the Niagara community.”

At a young age, Dr. Mosher set her sights on a career in medicine. Influenced by a family friend who was a physician practicing obstetrics in a low-risk birthing environment, she started considering a similar path for herself.

“Being a doctor was always a dream of mine. When I was in medical school I did rotations in obstetrics and I was then matched into the residency program. It’s an honour to be part of families’ birthing experiences and help them welcome a new life into their family and world,” she said.

Dr. Mosher is currently practicing at St. Joseph’s Healthcare Hamilton. She officially starts at WLMH on October 1. The community medical model in place at West Lincoln will be a change, but a welcomed opportunity to practice in a different care environment with new colleagues.

“The model is unique as it allows you to interact with many other providers from the hospital and community. This presents a great opportunity for continued collaboration and growth because it always keeps you learning and encourages experience sharing with each other. It’s very important to me that I’m always advancing but also helping others advance as well,” noted Dr. Mosher.

In addition to her expert clinical skills and experience, she brings another personal yet critical element to her practice which enhances her interaction with patients during their journey to parenthood.

“I’m a mother of two young boys. This is an important piece of who I am but also how I engage with my patients. Having my children let me learn what it was like from a patient’s perspective and where appropriate, I bring this into my work. While it’s definitely not a requirement for practicing obstetrics, personally, I feel like it helps me connect with new and expecting moms and parents,” she explains.

Dr. Mosher is also a practicing gynecologist and will continue this work at WLMH. Through her appointment at McMaster University, Dr. Mosher’s current research focuses on endometriosis – a common but underdiagnosed condition where endometrial tissue grows outside the uterus – with the goal of expanding knowledge of the symptoms toward earlier diagnosis and treatment.

When asked if she had a preference between her two specialties, she gave a considered chuckle before responding.

“I like to say: I came to the specialty for the obstetrics and stayed for the gynecology,” she said. “I really love them both and I think they complement each other well. I am excited to see that gynecology has significant [operating room] time allocated at WLMH and it will be great to get in there work through some of the backlog caused by the pandemic. Being able to help fill a clinical need for a community is humbling.”

The obstetrics program has been temporarily redirected to Niagara Health following a provincial directive earlier in the year which paused scheduled care and facilitated the redeployment of hospital staff to critical care and other clinical areas hard hit by the COVID-19 pandemic. WLMH staff who contributed to this response have since returned to the site.

Separately, in the past year, two of the site’s three obstetricians have departed to pursue professional opportunities abroad. Dr. Nwachukwu [ChuChu] Nwebube who leads WLMH’s obstetrics and gynecology department has remained steadfast in his role and has been the sole obstetrician/gynecologist on site for a number of months.

From an operations perspective, there are three essential pieces needed to run an obstetrics and gynecology program: operating room (OR) staff and OR availability, obstetrics staff, and obstetricians/gynecologists. Dr. Mosher’s arrival is a big step toward fulfilling the physician complement and resuming obstetrical care at the site starting October 5.

“We’re grateful to staff who took on different roles to help out across Hamilton Health Sciences sites during the pandemic, but we’re also really glad to have them back at the site,” said Cindy MacDonald, director of community programs and WLMH site administrator. “Our OR and obstetrical staffing has been stabilized. Dr. Mosher is passionate to work in the community and her arrival is an opportunity to rejuvenate the program. We’re excited for her to start, and at the same time we’re all incredibly thankful to Dr. Nwebube for his dedication and commitment to our patients and the program.”

Arguably, no one at WLMH is more eager for Dr. Mosher’s arrival than Dr. Nwebube.

“Over the last year, we’ve worked through the loss of two obstetricians and it’s very promising to welcome Dr. Mosher to the team,” he said. “She brings great expertise and talents to the program and to our patients. Her contributions will be important as we serve patients in the current building, but also as we transition to the new hospital and restore the program to its former glory and beyond. In addition to her clinical practice, she’s also an accomplished researcher and we’re looking forward to her bringing this important element to the care we provide.”

With the birthing program set to resume, consideration needs to be given that the COVID-19 pandemic is still very unpredictable in the community and the government-driven response which may be needed in the coming months is yet unknown. However, most people at the site are now looking a little farther down the road; to the opening of the new hospital.

“The promise of the new hospital holds a lot of potential,” said Dr. Mosher, who noted the prospect of a rebuilt WLMH played into her decision to accept this role. “It’s exciting to have the opportunity to work in a new facility which is being built with community growth in mind and patient care at the centre of everything. Also, the new hospital will let us further grow the obstetrics program and provide long-term stability for patients in the community.”

The WLMH redevelopment is currently in Stage 4 of the planning process, with the Request For Proposals (RFP) currently out to tender. Shovels are looking to hit the ground in June 2022.

Obstetrics services resuming October 5

Obstetrics services at WLMH will resume starting October 5, supporting deliveries from Tuesday morning to Friday afternoon.

Outside of these hours of operation, women in labour or requiring assessment will be redirected to deliver at the St. Catharines site of Niagara Health (NH).

This is the same model that was in place prior to the provincial directive earlier this year which temporarily paused scheduled care to allow hospital staff and physicians to support clinical areas hardest hit by the COVID-19 pandemic.

Our obstetricians and family physicians will retain their privileges at both hospitals, allowing continuity of care for patients. In situations where WLMH physicians are not able to attend a delivery, the patient will be under the care of the NH obstetrician on call


Midwifery care will be provided at NH only.

EXPECTING FAMILIES: this handout is for you.


Once again, the obstetrics service resumption will be assessed on an ongoing basis to determine if and how it can be extended. The goal is to provide as many hours of obstetrics services as possible, as long as its sustainable from a staffing and resourcing perspective to do so.

Hamilton Health Sciences is grateful for our ongoing partnership with NH and its team who continue to make this service arrangement possible until obstetrics services can fully resume at WLMH. We also appreciate the flexibility and professionalism our staff and physicians have demonstrated during this period of transition.

“Exciting part of the development process”

Work continues on rebuild project

The Request for Proposals (RFP) was issued at the very end of June, meaning the three teams vying for the project have all of the requirements needed to complete their bids.

For the redevelopment team which has been working furiously throughout the planning phases to get this project over the finish line, it’s a chance to take stock of all their efforts.

“This is an exciting part of the development process,” said Bart DeVries, director of redevelopment at Hamilton Health Sciences. “Our team has spent the better part of two years consulting and planning for the new hospital. Now we’re at the stage where we get to see that hard work materialize in the plans being developed by the design-build teams competing to win the project.”

Working behind-the-scenes

While this is a relatively quiet period in terms of public milestones and updates, lots of work is happening behind the scenes.

“Together with Infrastructure Ontario, we meet with each bid team on almost a weekly basis. Some of these meetings are a few hours in duration to cover their progress on schedules, IT and equipment planning, etc. In August, September, and October there are all-day meetings with each team where they share their current design iterations and walk us through their plans at each stage,” said DeVries, noting that each meeting is attended by an impartial “fairness monitor” to ensure that any information provided by the hospital to one bidder is shared equally with the others.

These meetings are an important part of the development process. They allow each design-build team to receive feedback on its designs in real time and have dialogue with the hospital. The meetings also provide the opportunity to raise red flags if there are potential issues or concerns on either side of the table.

“The RFP includes over 5,500 specific and unique requirements associated with the project. Documentation is provided to the bid teams after each design presentation session outlining which requirements have been satisfactorily met, and those that have not. As you can imagine, many questions come up throughout the process. Between regular meetings with the bidders, and request for information (RFI) requests, all parties have the ability to interact with our requirements and ultimately identify solutions, even though their design is unique from others. Where warranted, we revise some of our requirements to respond to innovations and other changes that will benefit the project,” said DeVries.

“With all projects, especially those which move as fast as the WLMH rebuild is moving, it’s always better to address matters up front so that teams can progress their designs quickly and allow us to minimize what needs to be resolved in the end,” he added.

Building relationships

The regular dialogue also lets the hospital’s team get to know each of the potential design-build teams. The new hospital will take between two and three years to build. It’s important to start building relationships and understanding each team’s dynamics.

“The relationship between the design-build team and the hospital and its planning, design and conformance (PDC) team is critical for the success of any project. Building rapport starts on day one and it’s nice for both sides to get to know each other early on,” noted DeVries.

Meetings with design-build teams will continue until late October 2021. Technical (“design”) submissions for the RFP are due at the end of November 2021. RFP financial (“cost”) submissions are due early January 2022. Evaluation of each will take place and the successful proponent will be announced sometime in March 2022. Shovels are expected to hit the ground by June 2022.

More diagnostic imaging upgrades on the way

Summer is in full swing, and so is construction on the WLMH mammography and x-ray rooms.

The current machines have been well used and have now reached the end of their useable lifespan. Upgrades are needed to the rooms before the updated, top-of-the-line equipment can be installed.

Construction is well underway on the mammography room. The room is on-track to receive the machine the first week of September, with it being ready for patients by the end of September.

Demolition is also taking place on the first of the two x-ray rooms, to allow for continuity of service. X-ray machines use and produce more radiation than mammography, so the construction will follow a similar path as the computed tomography (CT) suite preparation. The first room will be open early October and work will start on the second at that time, reopening later this year.

These machines are being purchased through Hamilton Health Sciences’ Managed Equipment Services (MES) agreement with Siemens Healthineers. The same one which supported the purchase of the CT.

We’ll have more to share on these developments in the coming weeks and months.

HHS, IO Issue RFP for WLMH Redevelopment

Today, Infrastructure Ontario (IO) and Hamilton Health Sciences have invited three teams to respond to a request for proposals (RFP) to design, build and finance the West Lincoln Memorial Hospital redevelopment project.

The three teams were prequalified based on criteria identified in a request for qualifications process that began in November 2020. Selection criteria included design and construction capability, experience, qualified personnel and financial capacity to undertake a project of this size and scope.

“With the posting of the RFP, the three teams who were previously shortlisted now have everything they need to develop their bids,” said Kelly Campbell, HHS vice-president of corporate services and capital development. “We are excited by the caliber of the teams and are confident each submission will bring a unique vision for the rebuilt hospital. Together with our partners at Infrastructure Ontario, we look forward to working with each team over the coming months, and ultimately choosing the group who will deliver the hospital for the community.”

The prequalified teams and their prime team members are:

AMICO SACYR ALLIANCE
• Applicant Lead: Amico Design Build Inc. (50%), Sacyr Construction S.A (50%)
• Design Team: IBI Group Architects Canada
• Construction Team: Amico Design Build Inc. (50%), Sacyr Construction S.A (50%)
• Financial Advisor: Operis Business Engineering Limited


ELLISDON INFRASTRUCTURE HEALTHCARE
• Applicant Leads: EllisDon Corporation
• Design Team: Parkin Architects Limited
• Construction Team: EllisDon Corporation
• Financial Advisor: EllisDon Capital Inc.


POMERLEAU HEALTHCARE PARTNERS
• Applicant Lead: Pomerleau Inc.
• Design Team: Cumulus Architects Inc, WalterFedy
• Construction Team: Pomerleau Inc.
• Financial Advisor: Pomerleau Inc.

“The release of the RFP for WLMH is a key milestone towards the new build,” said Sam Oosterhoff, MPP, Niagara West. “This is great news for West Niagara, and the speed with which we have arrived at this point from the initial commitment to a new build being made in October 2018, testifies to the huge desire to see this new build in the community. I have appreciated working with HHS, Minister Elliott, and the community on this key community infrastructure project, and it is exciting to see us get to this place. West Niagara has been waiting for a long time to see our new hospital, and today’s release of the RFP is very good news.”


Teams will now begin preparing proposals that detail how they will deliver the project. Once technical submissions are received by the end of November 2021, Infrastructure Ontario and Hamilton Health Sciences will evaluate the proposals, select a preferred team and then negotiate a final contract. A successful bidder is expected to be announced in spring 2022.

Photo essay: Building the CT suite

Pictures are worth a thousand words. We’ve taken many opportunities over the past 9 months to capture different stages of the development – from office space to CT suite. Check out this stunning transformation.

Original floor plan when it was used as office space
Office space
And just in case you didn’t believe us that this was formerly an office space, here’s another blurry pic to prove it
CT suite floor plan
Demo day! Out with the old…
…preparing for the new
After demolition, construction crews rebuild the suite and line walls with lead panels to contain the radiation
Welding overhead mounts for equipment
Structure is built outside of the suite to house the CT “chiller”
At long last, the CT is delivered into….
…the brand new CT suite!
Patient waiting area with nature-print dividers
IV insertion and patient monitoring area
Details matter. This overhead panel provides a calming view for patients while receiving a scan
Finally, here’s the CT in its natural habitat!

Introducing…a palliative care nurse clinician

Sarah Romeril has held a variety of roles across her 11 years of nursing practice. She started her career working at the Hamilton General Hospital site before moving to a position in the Emergency Department (ED) at Joseph Brant Hospital all the while working at Carpenter Hospice in Burlington. When a nurse clinician position opened up with the Niagara West Palliative Care Team (NWPCT) in 2018, she saw a wonderful opportunity. For Romeril, who holds a Masters of Nursing degree and is specialty certified, the holistic, patient-centred nature of palliative care drew her practice toward this speciality. Sarah is an Assistant Clinical Professor in the School of Nursing at McMaster University and an Associate Member of the Division of Palliative Care hosted by Department of Family Medicine which serves the whole Faculty of Health Sciences at McMaster University. She is also a member of palliative care nursing associations regionally, provincially and nationally.

What led you to pursue a career in palliative care?

I held student placements during my undergraduate studies and remember feeling like palliative care is an area which deserved more system-level focus and improvement. Patients come to the ED with complex illnesses, some with multiple admissions and struggle to navigate the system. Over time there can be real sense of a loss of identity within standardized care. I felt there were opportunities to improve the care experience for patients, particularly with earlier integration of palliative care. Practicing palliative care gives me the privilege to care for patients and families across all age groups, with varieties of illnesses, to help personalize their end-of-life journeys and improve their quality of life.

Tell us about the Niagara West Palliative Care Team, how it operates and the services it provides:

The NWPCT is a population-based shared care model providing comprehensive palliative care to patients with life-limiting illnesses. We’re an interprofessional team of two physicians, the nurse clinician role, a navigator, two counsellors, and home and community care coordinators; we are a teaching team providing educational opportunity and support to learners. We believe in meeting the patient where they are at and we work across care settings throughout West Niagara. This means we follow patients across their journey including hospital, home, long-term care, retirement homes and/or hospice. We are well partnered and integrated within the system locally and regionally.

The NWPCT model is integrated within other health-care models delivered at West Lincoln Memorial Hospital, which focuses on primary care capacity building. We partner with primary care physicians and nurses to help them grow their palliative care skills and provide customized support.

What does a day in the life of a palliative care nurse clinician look like?

No two days are the same. We work together as a team to ensure we have holistically met the needs of patients and families. Clinically, we spend a lot of time in the community consulting with and caring for patients. Our work involves providing comprehensive clinical services such as pain and symptom management. It involves system navigation, making patients aware of available services and helping connect them with what they need. We help patients and their families with advance care planning to determine their end-of-life needs and wishes. We also offer psycho-spiritual support to patients to help them and their families through the journey, including bereavement support. It’s an honour to be able to help people fulfil their end-of-life goals, while being there to support the family through the process as well.

This role also includes opportunity to integrate principles of advance practice nursing through innovation, education and facilitate systems level advocacy and support.

What’s your philosophy toward palliative care?

Every person should have access to palliative care to support their journey with a life-limiting illness. Early integration of high-quality, comprehensive palliative care is critical to achieving this vision. Evidence shows that early integration can improve outcomes and quality of life. It also helps to removes the burden of navigating the health care system while personalizing the patient’s care.

The NWPCT values and is grateful for its strong relationships with many partners, both local and across the region, which help ensure Niagara West residents’ needs are being met. This includes primary care, home and community care, McNally House Hospice, Rose Cottage, emergency services and WLMH. The community of care providers in West Niagara is amazing.

What are three things you feel people should know about palliative care?

  1. Patients live longer and better with early integration of palliative care.
  2. Palliative care should be available to all Canadians when facing life-limiting illness
  3. Palliative care is more than just end-of-life care and it includes a focus on quality of life and living well throughout an illness journey

WLMH is currently in the planning stages toward being rebuilt. Will the new WLMH enhance the NWPCT’s ability to serve patients?

Our team has been involved in the planning for the new hospital. We’re looking forward to new opportunities in the future hospital to further develop and create new partnerships with other care providers. The team is committed to new innovations and opportunities to meet emerging needs of the West Niagara community, which is home to one of the fastest-aging populations in Ontario.

We’re also looking forward to some of the technology that will be in place when the new hospital opens. Our team works out in the community and collaborates with a variety of care providers for each patient. Some of the new technologies being brought in like Odyssey (the initiative to operationalize HHS’ incoming hospital information system) will give increased access to real-time information, system access and communication with other care providers. Tools like this can enhance the way care providers work and the care we can provide to our patients.

Q&A: Update on the new WLMH

Q. The Stage 3 submission was sent to the Ministry of Health in late March for approval. Where does that currently stand?

A. Our team has been engaged in discussion with the Ministry about the submission. This is normal. Everyone is working toward the same goal of planning and building a great hospital. All parties are working as fast as possible to achieve that goal.

Q. When do we anticipate Stage 3 approval?

A. Approval is expected imminently.

Q. What happens after the Stage 3 submission is approved?

A. Refining the RFP documents has continued since the Stage 3 plan was submitted. The Stage 4A (Approval to Request for Proposal) was submitted to the Ministry on May 28. Final revisions and reviews will continue into mid-June, and we are also preparing for the tendering period.

Q. When will the RFP for the design-build team be posted?

A. Ministry direction is to post the RFP on June 28, which is almost a week earlier than originally scheduled.

GRAPHIC: Countdown to Construction

Q. What happens in Stage 4?

A. The three design-build team candidates will receive the tender documents on June 28. This launches us into formal design presentations from each team as they develop their proposals. Those presentations are followed up with design documents which will be checked for compliance and feedback, and then returned to the teams to progressively elaborate on their designs. This will continue until the proposals are received late fall 2021 at which point there is an extensive evaluation and negotiation process with the preferred proponent, leading to a contract to design-build-finance the project.

Q. What happens during the RFP period? Is there any contact between the hospital and the bidding teams?

A. There are regular touchpoints between the hospital, Infrastructure Ontario (IO) and the three individual teams while the RFP is posted. These conversations will inform the teams’ bids. The procurement process will be overseen by a third-party to ensure transparency and confidentiality are maintained.

Equipping the new WLMH for success

When people think about building a hospital, the shiny new building from a project’s renderings often come to mind. Construction-related comments like “shovels in the ground” or “opening the doors” are tossed around in casual conversation.


Less attention is paid to the thousands of critical items which make the hospital function. Operating tables, IV pumps, task chairs, stretchers, ultrasound machines, waiting room seating, scalpels. In the hospital sector, these items are referred to as furniture, fixtures and equipment, or commonly just “FF&E” and are absolutely essential for the care that’s provided.


Figuring out FF&E

Calculating the FF&E needed for a new hospital is complex, but is also similar to how a family would figure out the décor in their home.


“Think about your living room and all the items in it. You have a couch, chairs, coffee table, maybe a lamp or two, some shelves, possibly a TV, area rug, artwork, books. If you were to move, you’d look at your furnishing and based on their condition and the space in the new house, which should be kept or replaced. That’s essentially what needs to be done when planning for every room in a new hospital,” said Bart DeVries, HHS director of redevelopment.


Knowing what we’ll need starts with knowing what we currently have and what can be transferred to the new building. To help with this process, hospital redevelopment teams lean on industry experts.


“Our team went in last June and did a complete inventory of the existing assets. Each item was tagged, barcoded and logged so we could conduct an assessment for transferability to the new building. Each asset is evaluated individually looking at its age, service history, compatibility in the new space and its current condition,” said Larry Rook, an advisor from Colliers Project Leaders.


Did you know? Approximately 3,500 items were tagged in this process at WLMH.

Once the cataloguing and assessment is done, the team needs to determine what is missing and what needs to be purchased, taking into account the needs and spaces in the new hospital.


For example, the current WLMH has two operating rooms. The new hospital will have four. Even if every item from the existing operating rooms were transferred (and much of it is new so it will be) outfitting would be needed for the two new rooms regardless.

Other factors play into the decisions as well. Timing is a big one.


“You can’t move the contents of an entire hospital to a new building overnight. There will be a period of overlap when the new hospital opens and both hospitals are still operating. The emergency department, for example; if you arrive at 5:59 a.m. at the old site on ‘move day’ you are cared for there and then transferred to the new hospital later. The new site opens at 6:00 a.m. on move day so all patients after that time are seen there. The result is that some items will be bought new to ensure continuity of operations,” noted Rook.

Covering the cost


FF&E for a new hospital can carry a hefty price tag. The multi-million dollar question becomes: who covers this cost? It depends on whether the items are considered “fixed or loose.”


“Generally, fixed items are anything that wouldn’t fall out of the building if you were to pick it up and turn it upside down. Ceiling-mounted surgical lights are a good example. Those are considered to be part of the building and are captured in the construction costs because structural supports need to be provided by the contractor and they have hard-wired electrical connections. Everything else that would shake out are considered loose and the Ministry doesn’t pay for those,” said DeVries.

Related: Take it to the Finish…Building a Healthy Community campaign website


The loose items are funded through the “local share of financing” for the new hospital. In Ontario, new hospitals are cost-shared between the Ministry of Health and the local community which the hospital serves. The local share is the portion the community is required to cover. For more on that, read this.

Related: Local share of financing lands at $50M


The more equipment that’s transferred means less will need to be bought new to open the hospital.


“FF&E costs are a big part of the local share of financing. For the WLMH redevelopment, we’ll be able to transfer almost 40 per cent of the total equipment required, which, compared to other hospital projects, is a considerable amount,” said DeVries, noting that all of the furniture in the new hospital will be bought new.

Three Teams on Shortlist to Build New WLMH


Process for full submissions opens in July, successful team will be announced spring 2022

Today, Infrastructure Ontario (IO) and Hamilton Health Sciences (HHS) announced that three teams have been prequalified to design, build and finance the West Lincoln Memorial Hospital (WLMH) redevelopment project.


Teams were prequalified based on criteria identified in a request for qualifications process that began in November 2020. Selection criteria included design and construction capability, experience, qualified personnel and financial capacity to undertake a project of this size and scope.

The prequalified teams and their prime team members are:


AMICO SACYR ALLIANCE
• Applicant Lead: Amico Design Build Inc. (50%), Sacyr Construction S.A (50%)
• Design Team: IBI Group Architects Canada
• Construction Team: Amico Design Build Inc. (50%), Sacyr Construction S.A (50%)
• Financial Advisor: Operis Business Engineering Limited


ELLISDON INFRASTRUCTURE HEALTHCARE

• Applicant Leads: EllisDon Corporation
• Design Team: Parkin Architects Limited
• Construction Team: EllisDon Corporation
• Financial Advisor: EllisDon Capital Inc.


POMERLEAU HEALTHCARE PARTNERS
• Applicant Lead: Pomerleau Inc.
• Design Team: Cumulus Architects Inc, WalterFedy
• Construction Team: Pomerleau Inc.
• Financial Advisor: Pomerleau Inc.


A request for proposals (RFP) is expected to be issued to these prequalified teams in summer 2021. Once submissions are received, IO and HHS Sciences will evaluate the proposals, select a preferred team and then negotiate a final contract. The successful team is expected to be announced in spring 2022. A fairness monitor will oversee the entire procurement process.

Quotes

“The WLMH RFQ generated interest from leading private-sector teams who want to bring this exciting project to life. Together with Infrastructure Ontario, we are encouraged by the quality of submissions received and look forward to seeing the full proposals from the shortlisted teams in the coming months. By this time next year, the successful design-build team will be selected; one of the final pieces before getting shovels into the ground.”
Kelly Campbell, VP Corporate Services and Capital Development, Hamilton Health Sciences

“The selection of three highly qualified teams to move on to the request for proposals stage is a significant project milestone. Through IO’s P3 process, we are confident these teams will submit competitive bids that will result in the delivery of a state-of-the-art hospital to serve West Niagara for years to come. We are delighted to once again partner with Hamilton Health Sciences as we set our collective sights toward breaking ground in spring 2022.”
Angela Clayton, President, Project Delivery, Infrastructure Ontario

“This is good news for Niagara West residents who have worked hard with HHS and WLMH team to ensure that this new facility moves forward. The Ontario government is committed to delivering this important project for Niagara West; and investing in healthcare across our region. My thanks goes to all who have put so much work into getting to this point, and my congratulations goes to those who have pre-qualified for this infrastructure build. I will keep supporting this build in any way I can!”
Sam Oosterhoff, MPP, Niagara West

Additional Resources


• Sign up for the monthly community newsletter to receive important news, updates and developments at the WLMH site.

SNEAK PEEK: New WLMH renderings

The WLMH redevelopment project once again entered unprecedented territory last week with the Stage 3 submission being sent to the Ministry of Health for approval: the final stage before the project is approved for tender in July!

This submission builds on the Stage 2 approval received in January and summarizes all the details required for the bidders to deliver a concept, design and price to construct the new hospital.

It also means we’re able to develop updated illustrative design renderings for the project! These renderings show what the hospital could look like, based on many of the requirements we’re putting forward to build teams to include in their bids for the project.

Bidders will apply their own innovations and solutions to meet the project’s needs, so these illustrations may still change somewhat.

Graphic: Evolution of Design-Build-Finance Project Design

The images illustrate the final plan with the former WLMH buildings removed; replaced with parks and parking. Due to the constraints on the site and robust specifications that will be in the tender package, it is very likely that the new WLMH will replicate many of the site and building characteristics shown in these renderings.

Stage 3 illustration of new WLMH: view from Main St.
Stage 3 illustration of new WLMH: view from current parking lot on east side of site.
Stage 3 illustration of new WLMH: aerial view of the proposed site (notice the proposed park space along Main St.!)

Reflecting on a remarkable year

What a remarkable year 2020 has been.

As a global pandemic took hold in the community, our team at West Lincoln Memorial Hospital (WLMH) has shown incredible resilience and dedication to keep the hospital open and our patients safe.

Inside the hospital, we’ve invested heavily to upgrade the aging mechanical systems to make the building safer, until we can open the new one. The most significant safety upgrade at the site occurred in the operating rooms and endoscopy reprocessing area. Our site team and the contractor worked tirelessly during the surgical shutdown that occurred in response to the pandemic in order to renovate and reopen the operating rooms on time.

We’re also further down the path than ever before to rebuild WLMH. This year started with the government approving a detailed service plan for the new hospital, which meant we could start designing how those services will function in a brand new building. At the end of October, that plan was sent to the Ministry of Health for review. We’re now looking for a team to design and build the future hospital. This project is moving at unprecedented speed. Our goal is to keep it going.

Through it all, our community, neighbours, families, patients, staff, physicians, volunteers, partners and donors have stood beside us. We thank you for your unwavering support and generosity this and every year. Because of you, WLMH’s future has never been brighter.

On behalf of Hamilton Health Sciences, we would like to wish you a very happy, healthy and safe holiday season.

Ten things to know about the Stage 2 submission

The last seven months were a whirlwind for those involved in WLMH rebuild planning. But, we got the Stage 2 plan done and sent off to the Ministry for review and approval…ahead of schedule!

It’s not a final document until the Ministry approves it, so we can’t say too much at this point. Though we’re too excited not to share some information about the plan. Here are 10 things to know about the WLMH Stage 2 submission:

  • The Stage 2 plan is submitted as part of the Government of Ontario’s five-stage process for building a hospital, with Infrastructure Ontario estimating construction on the new WLMH to begin in 2022.
  • The Stage 2 plan is based on planning details set by the Ministry about the services to be included in the new hospital. The Ministry of Health will make the final decision to approve or request changes to the plan.
  • The submission is not publicly accessible until the Ministry’s final approval is provided. This is anticipated early in 2021.
  • The submission includes:
    • a detailed list of the spaces within the new building;
    • a simplified “block planning” of how those spaces may be configured within the new hospital;
    • a site plan showing elements like parking, site access, landscape, etc.;
    • a list of all furniture and equipment needed for the facility;
    • and, a preliminary cost estimate.
  • Based on Ministry specs to assure accessibility, infection control and service delivery, the proposed hospital will be almost double the size of the current hospital – from 65,000 sq. ft. to roughly 120,000 sq. ft.
  • Approximately 150 staff members from across WLMH and HHS contributed their experience and expertise to this planning. This was on top of their daily duties of providing or supporting the delivery of excellent patient care. We’re incredibly thankful for their efforts to get this done. Particularly because…
  • Stage 2 planning kicked off the week before COVID-19 started showing up in our community. Almost every meeting was done virtually, but the stakeholder engagement was equally as robust as in-person sessions. “We got great questions, ideas and comments in all of our user group meetings. The engagement got even better as we progressed through the process. This was new for all of us, but it was a robust experience and that’s definitely reflected in the final plan,” said Bart DeVries, director of redevelopment.
  • The plan proposes to build the new hospital behind the existing building. Once the new hospital is open, the old hospital will be demolished. This will create a substantial set back from the street to the front door allowing for landscaping and additional parking. The details of what this looks like will be developed in Stage 3.
  • The plan includes four operating suites which is twice the number at the current WLMH. This is consistent with the Ministry’s direction, meaning more people can receive the surgical care they need at WLMH.
  • The plan includes space for a multi-faith room, where patients and families will be able to go for a quiet moment of reflection when they need it. The current site does not have a similar space.

    Want more content on the WLMH rebuild? Here’s the most recent video in our series with WLMH leaders involved in the rebuild, talking about what we’re planning and what we can expect moving forward.

What’s Up @ WLMH: September 2020

Much ado about (WLMH rebuild project) costing

Last week, Infrastructure Ontario (IO) released its fall Market Update report. The report reiterates the government’s commitment to rebuild WLMH, which we completely expected, but it’s always great news regardless. The report, however, noted for the first time that WLMH project is now included in the “$200 – $499 million” budget range, which is an increase…

Read the full story.

Launching expert video series: Ask Bart Anything

Building a hospital is not an everyday experience for many people, including those of us who work in the hospital! It comes with a whole bunch of lingo, jargon, roles, phrases, acronyms and processes. Luckily, we have an expert on our team who can clarify this stuff so we’re all on the same page about what’s happening in the rebuild.

See the first Ask Bart Anything video

Looking ahead to rebuilding WLMH

You may have seen this video floating around on your social media feeds recently. You know, the one comparing the future WLMH to be like “driving a Tesla!” Now that we’re getting close to submitting our Stage 2 plan to the ministry, we’ve asked some WLMH leaders to share their thoughts about what this hospital means to our community and maybe a sneak peek or two about what we’re planning.

Stay tuned for more to come!