“Hospitals built in the 60s and 70s we now realize were built to spread infections,” says Dr. Michael Gardam, an infection control researcher at the Toronto General Hospital.
His statement was made in connection with the construction of the new billion dollar Humber River Hospital in Toronto, which is due to be completed in 2 years. The modern vision of patient care has changed based on hard lessons learned from the SARS outbreak in Toronto 10 years ago and from hospital outbreaks of drug resistant infections. From these hard-learned lessons a number of fundamental things about the design of the Humber River Hospital will be different. For example:
We’ll start with the big one – 80% of the rooms will be single-patient rooms thus minimizing patient-to-patient spread of disease. Dr. Gardam explains that multi-bed rooms and ICUs with bed after bed after bed separated only by a curtain are breeding grounds for disease and need to be done away with.
The ER and Outpatient Departments will be built on opposite sides of the hospital. That way ER patients who are contagious can be admitted by a special entrance away from everyone else. And outpatients will also have a short walk from their entrance to the clinic so they’re not exposed to anyone else.
We have robots! R2D2-looking things will be used to deliver supplies throughout the hospital thus minimizing human hand contact with those supplies. Apparently the robots are able to call and use elevators on their own, and will email you when the supplies you’ve ordered have arrived.
Additional features in the hospital will be a constant flow of fresh air so that none has to be recycled; mainly hard surfaces because they’re easier to disinfect, and; the strict separation of clean linen and other supplies from soiled linen and used supplies.
Two Canadian reports issued just last year underscore the real and important problem of hospital infections. The first one told us that 1 in 12 adults in Canadian hospitals are colonized or infected with the bacterial pathogens MRSA (the major culprit), VRE or C Difficile. And the second report from Canada’s Chief Public Health Officer issued just 2 months ago and told us that (1) there has been more than a 1,000% increase in Healthcare-Associated MRSA between 2005 and 2009 (the latest date for available figures), (2) more than 200,000 patients get infections every year while receiving healthcare in Canada, and (3) more than 8,000 of these patients die as a result.
So what Dr. Gardam is saying is huge – that in essence we humans, by our very own design (literally), have built-in a guaranteed institutional failure when it comes to the control of hospital infections. In other words, all those people in Canada who get infections each year, and all those people who die each year – it doesn’t have to be that way.
Which raises one other question: If hospital design is a fundamental flaw that in essence breeds infectious disease, what are we doing about all the improperly designed hospitals we have now?