The University of Ottawa Heart Institute’s improvement project reaches Phase 3

The expansion of the University of Ottawa Heart Institute gives the facility some of the most advanced surgical technology available, but a focus on a state-of-the-art working environment is almost as important.

Inaugurated in the Spring, the Life Support Tower – “The Tower,” to its staff – marks the completion of Phase 3 of the planned hospital improvement project, says Dr. Tim Zakutney, Vice-President, Medical Equipment and Chief Medical Technology Officer.

The five-story building, three years in construction, adds 145,000 square feet, 27 critical care beds, nine cardiac catheterization and electrophysiology (EP) labs, and six cardiac operating rooms.

One room is a 1,000-square-foot hybrid OR, featuring robotic and image-guided surgical equipment. (Another room is shelled in for a future use hybrid OR.)

The hybrid OR is home to the hospital’s da Vinci Surgical System, produced by surgical robotics manufacturer Intuitive Surgical Inc. of Sunnyvale, Calif.

Da Vinci is a surgeon-helmed robot that allows less invasive surgical procedures, minimizing danger and recovery time. The Institute has one of the world’s largest installations of Azurion image guided therapy equipment from Philips, which helps perform complex procedures more consistently and efficiently.

In fact, surgeons could perform various procedures – open heart, robotic and image-guided – simultaneously in the hybrid OR, says Dr. Thierry Mesana, President and Chief Executive Officer of the Institute.

The Institute performs about 12,000 surgical and non surgical procedures a year, about 80 percent of them complex operations – such as open heart surgery, coronary bypasses, heart transplants – that can only be done in a handful of Ontario hospitals, says Mesana.

It’s the cardiac referral hospital for 14 others in the Champlain Local Health Integration Network (LHIN), which serves about 1.2 million people.

“We need very specialized operating room procedures,” Mesana says. Much of the Institute’s infrastructure dates back to its 1976 opening, and “needed updating,” he says.

The redevelopment began in 2014 with new cardiac magnetic resonance imaging (MRI) and computed tomography (CT) facilities. They were bumped up in the schedule, a sort of “pre-Phase 1” project, according to Zakutney.

“We needed to address that immediately for our patients, so we moved that ahead,” Zakutney says.

Phase 4 will see a new cardiac imaging centre (to open in the first quarter of 2019), new general radiology and gamma photography equipment, and the relocation of stress and CT labs. It will be 2020 before the five-phase redevelopment is complete, Zakutney says.

“It’s about creating more space, safer space for staff and patients, and having space to expand,” Zakutney says.

Perhaps nowhere is this theme more obvious than the relocated surgical intensive care unit (ICU), its beds moved from a windowless room in the basement of the Institute to the top floor of the new tower. The spacious rooms include a nursing station for a one-to-one patient-nurse ratio; importantly, they’re brighter and quieter.

“Being in the basement for so long (a post-surgical stay) was traumatic to patients,” Mesana says. And it could be demoralizing to staff as well. “The wellness of our staff is very important,” he says. The effect of the new environment has been “invigorating”, he observes. “The staff is much happier.”

The ceilings lift for more headroom. Articulated arms can position patients to allow them a window view. There’s even a balcony for chronic care patients. “The windows we had downstairs were something you’d see in your own basement,” Zakutney says.

One ICU room is dedicated to morbidly obese bariatric patients, but the other four can be adapted to accommodate them as well. And new monitoring equipment is designed to integrate with the hospital’s coming electronic health records (EHR) system.

Zakutney and Mesana are monitoring a number of metrics to validate the performance improvement at a hospital that already ranks well below the Canadian average in post-operative mortality rate and 30-day readmissions, according to a three-year study by the Canadian Cardiovascular Society and the Canadian Institute for Health Information. The Institute also boasts a 98 percent patient satisfaction rate.

“The bar was pretty high already,” Mesana says.

Mesana has already seen a 10- to 15-percent volume increase in treatments, shortened wait lists and wait times; he’s expecting a drop in wait times to two to three weeks for non-emergency patients from the current six weeks.

Zakutney says the opening of another shelled floor in the tower will have “a dramatic impact” on patient volume. Better heating and ventilation systems should reduce infection rates and more non-invasive surgical procedures, using robotics and image-guided technology, should lead to shorter hospital stays.

More imaging equipment will help shorten patient wait times, and the centralization of imaging disciplines will allow closer collaboration and the selection of the best imaging options for each patient.

Zakutney stresses that while the construction of the Life Support Tower was funded to the tune of $135 million by Crown agency Infrastructure Ontario, the local share, which included all medical equipment, was funded through community donations to the University of Ottawa Heart Institute Foundation, which provided an additional $63 million for the project.