Download RMH Pharmacy Expansion RMH-08-110

RMH Pharmacy Expansion RMH-08-110
RFP Project Manual
September, 2009
1.0 Background
Ridge Meadows Hospital (RMH) Pharmacy department provides pharmacy services for
residential care and acute care including both inpatient and outpatient populations.
The department has been developed in various phases dating back to 1956. Minor
renovations have been completed over the past 10 years but no major capital construction
has occurred since the early 1990's. The department was last renovated during the
introduction of the Unit Dose System in 1996. Since then, the consolidation of the
satellite pharmacy into one pharmacy occurred with a net loss of 9.29 m2 in space. The
current area on the second floor of the acute tower is 123.3 m2 and it is below the
standard of 0.46 m2 per bed for a 285 bed hospital. Apart from being undersized, the
pharmacy is located in a clinical zone and the space would be better utilized for patient or
acute programs.
It is proposed that the pharmacy relocate to the basement of the acute tower at RMH to a
246m2 area and renovate the space to suit their needs. This space is in the central core of
the hospital and it will be a beneficial location for serving residential, acute care and also
for receiving deliveries.
The space is intended to be as ‘flexible’ as possible, with minimal solid walls. Utilization
of wall systems and casework systems are seen as essential to the design. Managing
Consultants are expected to work with Herman Miller or approved equivalent systems in
the design process and coordinate their design with the furniture or wall system.
2.0 Space Moves
As part of the expansion to the basement of the acute tower at RMH, there are a number
of departments that need to be relocated by March or April of 2010. These space moves
are being handled internally by FHA staff, and are not to be a part of the Managing
Consultants scope of services.
3.0 Pharmacy Functional Programming
The functional program and high level fit test have been completed for this project,
indicating the operational and space needs for the pharmacy. In conjunction with the
functional program, a high-level block form fit test was completed for the space that
would allow the volunteer lounge to remain in its current location, but 2 offices external
to the main core are identified for pharmacy use as a result. Refer to the appendices for
the fit test example.
A ventilation specialist was brought in to determine some of the limitations or
opportunities for the BSC and fume hood in the new pharmacy space. Preliminary
options for the relocation of the BSC and fume hood are identified. The final location of
these components will be determined on the cost and functionality after the architect and
mechanical consultants are chosen and have completed further review.
The functional program, space list, ventilation letter and the fit test plan are attached as
appendices to this report.
4.0 Project Timeline
The key milestones for the pharmacy project include:
•
•
•
•
•
September 24, 2009 – Receive RFP for Managing Consultant Services.
October 2009 – Start Preliminary Design
March 2010 – Complete construction drawings/ project tender.
April 2010 – Begin construction.
February 2010 – Construction completion.
Appendices to Project Manual
i.
ii.
iii.
iv.
Pharmacy functional brief
Pharmacy space list
Pharmacy fit test
Ventilation specialist letter
Agency Name:
Ridge Meadows Hospital
Functional Program Brief,
Pharmacy Services
Prepared by:
Department of Facility Planning & Real Estate
Valerie Spurrell , Executive Director, RMH
Jason Gore, Pharmacy Manager, RMH
Mits Miyata, Director Pharmacy
Date:
June , 2009
Project Name
Project Number
Pharmacy Expansion
RMH 08-110
Final Draft
Name
Date
returned
Final Draft
FUNCTIONAL PROGRAM
Functional Description
Overview
Ridge Meadows Hospital (RMH) Pharmacy department provides pharmacy services for
residential care and acute care including both inpatient and outpatient populations.
The department has been developed in various phases dating back to 1956. Minor
renovations have been completed over the past 10 years but no major capital construction
has occurred since the early 1990's. The department was last renovated during the
introduction of the Unit Dose System in 1996. Since then, the consolidation of the satellite
pharmacy into one pharmacy occurred with a net loss of 9.29 m2 in space. The current area
is 123.3 m2 and is below the standard of 0.46 m2 per bed for a 285 bed hospital.
Context and Assumptions
Ridge Meadows Hospital has undergone an expansion of the Emergency Department and
Ambulatory Care department (2008). The additional programs and services are placing
increased demands on pharmacy services which are already undersized by 50% based on
current standards. In addition, Fraser North planning has identified the long term need for
additional beds and services in the north, including Ridge Meadows Hospital into the future.
The actual number is not known at this time.
Both internal and external factors contribute to the space issues. Internal factors include the
addition of staff, to expanded programs, from 4 FTE in the 1980s to the current 12 FTE
within the same allotted workspace. Changes in practice, including use of the unit dose
system and the Central Intravenous Admixture Programs, are placing additional demands on
space to house the equipment ,supplies and personnel, necessary for this distribution
system.
External factors include changes in clinical practice models and the involvement of
pharmacists in therapeutic medication monitoring, patient care rounds, and provision of drug
information to patients and care providers, Changes in the patient populations, such as an
increase in severity of illness , increases the demands upon the drug delivery system and an
increasing number of medications are ordered for immediate administration. Hospitals with
outpatient programs require an area for confidential counseling and monitoring in close
adjacency to the pharmacy.
Because of ongoing expansion of the clinical programs involving pharmacy mandates (DVT
outpatient program, oncology patient care, Home IV, patient counseling) a solution to the
space deficiency is needed in order to meet the service demands for patient care at Ridge
Meadows Hospital
1
Program Goals
To improve pharmacy services workspace by relocating to a larger footprint and redesigning
the internal processes to efficiently increase the ability to safely store, prepare and dispense
medications, improve workflow processes and to support the area to move toward a different
clinical service model. (Point of Use).
Objectives:
•
To enlarge the footprint of the current department by relocating it to the lower level
•
Improve the generic space allocation for the functions within the pharmacy service
•
Improve workflow processes through redesign of the discreet functions within the
pharmacy including
o
Inventory storage both non refrigerated and refrigerated
o
Narcotics management
o
IV Formation
o
Manufacturing and prepackaging area
o
Inpatient dispensing
o
Drug information and patient teaching services
o
Preparation of space to provide a change to point of use dispensing (ADC)
Operating Description
Organization and Management:
Pharmacy services will operate under the leadership of the Site Manager. Pharmacy Services
reports to the Director of Pharmacy Services, Acute Care.
Hours of Operation:
Pharmacy will operate from 0730 hours to 2000 hours Monday to Friday. Clinical services are
available 7.5 hours Monday to Friday. Weekend hours are Saturday and Sunday 08:30 until
16:30. (Includes Stats)
Implementation of the ADCs will result in the Night cupboard becoming redundant in the future
during afterhours.
Workflow
Purchasing & Inventory Control
Purchasing of pharmaceuticals will be coordinated by the PDDC in Langley. RMH staff will
establish minimum and maximum par levels for inventory replenishment. All inventory orders
will be recorded in the computer system and communicated electronically to the PDDC. A
2
hand held bar coding system will be implemented to scan and download stock levels at a
future date. Eventually, a bar code system will be implemented Inventory shipments will be
received in the Pharmacy by the technician staff, verified, and stocked in the appropriate
storage area. Inventory shipments from PDDC will be received in pharmacy by the
technician staff, verified and stocked in the appropriate storage area.
Manufacturing & Packaging
Current State: Unit dose system is the current method utilized and will transition easily
to the ADC/POU methodology.
Future State: Most items will be purchased in a manufactured form. Manufacturing of
ointments, creams and other topical applications will be prepared in the Pharmacy (if
not available commercially) on an as-needed basis.
All oral doses will be prepackaged off-site at the PDDC and stored in the RMH
Pharmacy. A two-week inventory of pre-packaged items will be held on-site.
Medication Order Processing & Administration
Current state is paper based and includes the following flow
MD writes order -> order faxed to pharmacy-> order inputted by technician-> order
checked by pharmacy against patient profile-> medication packaged for patient with
label -> transported to unit.
Future state
The new point-of-use (POU) medication management system combines bar-coding and
wireless technologies to link physicians, nurses and the pharmacy at the point of care
(i.e., at the bedside). Through the use of hand-held mini-computers, computer
networks and computerized medication dispensing units, patients will be administered
medication including narcotics through the POU system.
Once the new POU system is introduced, the workflow for the order processing and
administration functions are anticipated as listed below.
Ordering:
Patients will receive a bar-coded identification bracelet, which stores information such
as their condition, diagnosis, attending physician, client's weight, and height and body
surface area. At the bedside or through secure log-in, patient care staff enters the
medication order into the POU system, which monitors for drug interactions, allergies,
duplicate therapy and dosage. The information system alerts the patient care staff
member if the selected drug is not a formulary drug and offers formulary suggestions.
Verification:
The order is instantly transmitted to the pharmacy terminals (centralized and decentralized) for
verification. STAT orders are queued to the top of the list of drugs ready for verification. It is
anticipated that a significant percentage of orders will be immediately verified. Once verified the
POU system will advise the pharmacist if the items is available in the ADC. Items not stored in the
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ADC will be dispensed in the pharmacy and delivered to the patient care unit by the pharmacy
porter, pneumatic tube, or by other means. The POU system will instantly update the patient's
record and the nurse's hand-held unit.
Administration:
Using the hand-held unit and scanning the bar code on the client's ID bracelet, the nurse confirms
the client, medication, dosage and time of drug administration. Once receiving a request from the
nurse, the ADC opens the correct drawer and directs the nurse to the bin containing the correct
medication. The nurse then scans the bar-coded medication to confirm the information. The
nurse scans the client's bracelet and his/her tag for added security, ensuring once again that the
right client is receiving the proper medication. The medication is administered and documented on
the on-line Medication Administration Record (MAR).
Intravenous (IV) medication
Orders will also be entered into the POU system. Labels will be generated in the anteroom outside
the sterile admixture room in the Pharmacy. Intravenous medications (first dose) will be prepared
by Pharmacy in the IV room. Prepared product will be delivered by the Pharmacy staff on a
scheduled basis. Prepared product will be stored in the medication room on each Patient Care
Unit in refrigerated and non-refrigerated storage areas.
ADC Replenishment
All of the medications, stocked on the Units, will be stored in cassettes in the ADCs. Medications
will be filled with fill lists generated through the POU Information System and distributed to the Units
using totes and a master replenishment cart. The technicians will fill all medications, placing them
into the totes with a record of dispensing, using bar coding technology. These are then brought to
the floors and replenished on a scheduled basis by Pharmacy technician staff. In the longer term
replenishment of ADCs may be done directly by the PDDC which will eliminate the requirement for
inventory in the Pharmacy. However, as the timing is unknown, for planning purposes, inventory
stock will be housed in the RMH Pharmacy.
Supplies
Office and other supplies will be requisitioned from Materiel Management and distributed by
Materiel Management staff to the user area daily or as required, Monday through Friday
Cleaning & Waste Removal
Housekeeping staff will continue to provide general cleaning services on a regular basis.
Housekeeping will also collect waste material from the user area and deliver it to the point of
removal from the Hospital for either land fill or for recycling. Soiled linen and waste will be bagged
and coded as necessary for removal, treatment, storage, and disposal.
Enabling Technologies
Information Systems
The pharmacy information system will be connected to the hospital-wide information network for
order entry, review and record keeping. Applications available will include: MAR, order entry,
4
ADT/CPI, formulary management, purchasing and administrative/managerial applications, and
other clinical applications The Information System needs to be ubiquitously available throughout all
patient care areas, potentially through handheld devices. It is anticipated that the system will
accommodate order entry and order review to occur in all patient care areas.
Eventually, the system will be integrated with the electronic health record. Handheld devices will
also be used for processing orders, accessing the electronic medical record and reviewing drug
information literature from downloaded or external sources. Handheld devices will also be used for
processing orders, accessing the electronic medical record and reviewing drug information
literature from downloaded or external sources. A wireless infrastructure will be available to support
bedside charting and the use of handheld devices.
Workload
Table 1.0 Workload volumes by year and category
2007/08
2008/09
% growth
from
06/07
Proj
2020
%
growth
to 2020
New RX
Inpatient
57422
66350
15.5%
89280
34.5
Outpatient
573
499
-12.9%
650
23%
Chemo
compound
N/A
N/A
N/A
N/A
N/A
Chemo
intravenous
1547
1551
-.02%
1700
10%
Chemo oral
641
629
0.2%
700
1%
Iv
compounded
244
307
20.5%
630
51%
Iv large
volume
165
162
0
7374
7940
7.1%
13600
71%
6
8
33%
250
389
35.7%
1390
72%
45390
51876
12.5%
64860
20.%
N/A
N/A
NC
331060
(-9%)
Iv Sm vol
Other IV
TPN
Ward stock
LOA
1
Refills
291424
327804
11%
Total units
1
457151
39%
405036
Data source: Pharmacy Services at Ridge Meadows
5
Staffing & General Support
Table: 2.0 Calculation of FTE’s per Bed /Service
Service
Bed numbers 09/10
Pharmacist
Technicians
Total
Rx/Tech
Mental Health/Psych
20
0.05
0.06
1.0/1.2
Critical Care
7
0.13
0.09
0.91/0.63
ER
11
0.08
0.09
0.88/0.99
General Medicine
51
0.04
0.08
2.04/4.08
General Surgery
22
0.04
0.08
0.88/1.76
Residential Care
148
0.01
0.02
1.48/2.96
Sub-acute Care
25
0.06
0.08
1.5/2.0
Hospice
10
0.03
0.06
0.3/0.6
total
8.99/14.22
2.1 Department personnel by FTE and category
Position
Typical
daily
staffing
DAYS
EVES
Nights
Manager
1.0
N/A
N/A
Admin
support
N/A
N/A
N/A
Position
DAYS
EVES
NIGHTS
Pharmacists
3.0
1.0
N/A
Technicians
7.0
1.0
N/A
Dispensary
2.0
1.0
N/A
Unit based
clinical
2.0
N/A
N/A
Total count
15
3
0
6
Design Criteria
External relationships:
Pharmacy should be housed in a secure area with reasonable access to the vertical circulation of
the building for transportation of medications, as well as staff access to the patient care units.
Internal Relationships Concepts:
Pharmacy should be subdivided into the following zones:
o
Receiving and breakout inventory storage this area should be separated and secured
from the production zone.
o
Sterile IV formations,
o
Manufacturing and prepackaging area and unit of use dispensing replenishment, which
includes order entry, verification and product checking.
The planning and design of these areas is contingent on the equipment selected for storage and
production. Areas allocated in the space table included in this document reflect general areas
included in the production pharmacy. Specific planning will be required to address integration of
information systems, modular storage and inventory units, narcotic storage and security,
distribution carts with the flow of staff and production with in the pharmacy.
Space and Equipment Requirements
In support of the Region’s role and service goals, the RMH Pharmacy will introduce
changes to its methods of operation. These initiatives which are the basis of the
Region’s automation plan for Pharmacy Services will include:
•
Implementation of a new point-of-use (POU) drug distribution system. This will
include automated drug dispensing cabinets (ADC) on patient care units for the
majority of doses including first doses in addition to ward stock and narcotic
inventories. Of note, some bulk and refrigerated items will not be stored in the ADC
unit
•
Packaging of all adult oral doses with few exceptions (e.g., special access
medications) at the Central Production Centre in Langley (referred to as PDDC).
•
Preparation of patient specific IV admixture refill doses and batch doses at the
PDDC with the exception of TPN, chemotherapy and narcotic infusions requiring
mixing, which will all be done on-site. All first doses up to 36 hours will be
prepared on-site.
•
Centralized purchasing will be done at PDDC. Inventory control will be done by the
RMH Pharmacy on-site.
Incoming supplies will be inspected scanned and reconciled with orders in receiving.
7
Items will be removed from shipping containers and the corrugated cardboard
containers removed for recycling. This area should be separated and secured from the
production zone. Inventory storage is a secured room containing two weeks of
inventory on-hand, replenished daily.
Requirements for storage of narcotics and controlled drugs should meet the
provincial/federal requirements.
IV formation Areas
IV formation will be conducted in a biological safety and laminar flow cabinets. Cabinet
dimensions should determine room sizes. The operation of these units is influenced by
internal air circulation into and within the room. This sterile room will be contiguous to a
changing area and an ante room. The ante room will be connected with the IV formation
room via a pass through window. A pass through refrigerator will connect the inventory
storage area and the ante room.
Entry
Two entrances will be required, depending on layout and footprint. The main entrance
will serve as public reception to the Department; this area should also contain a small
area with 2 cubicles for patient information and dispensing of outpatient medications. A
second entrance will serve as a receiving entrance from outside vendors and PDDC and
serve as the exit for medication delivery to the ADC units. The administrative /clinical
space which includes the drug information area should be accessible from the entrance
w/o penetrating the dispensing and manufacturing room.
Special Considerations
An open floor design is best suited for most areas of the Department. In general most
fixtures should be of modular design thus enabling easy movement and reconfiguration
as the pharmacy design changes.
The physical configuration and planning of the Pharmacy will support efficient
production, and meet industry requirements for quality control in all drug production
areas.
All production areas are subject to protocols for asepsis and sterile production.
The IV formation area should be walled off from the rest of the Pharmacy and its storage
areas with an anteroom located at the entry. The chemotherapy hood must be vented to
the outside. The IV formation area including the IV admixture room, anteroom and
change room shall comply with USP<797> standards for design, including specific HEPA
filter and HVAC requirements.
Pharmacy design shall conform to the regulations of the professional and government
authorities having jurisdiction. Confer with Canadian Society of Hospital Pharmacists,
Health Canada guidelines and the BC Pharmaceutical Association.
Security
Access to all pharmacy areas will be subject to strict security control.
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Codes & Standards
In addition to the above criteria, the facility must conform to recognized national,
provincial, and local building codes and standards as they may relate to safety and
accessibility for patients, staff, and visitors.
Production/Storage Area
Storage shelving and refrigerated storage will be provided for bulk inventory and PDDC
pre-packaged medications. Approximately 10 days of inventory (600 linear feet) will be
maintained on six 9’ double-sided mobile shelving units, 6’ in height. Space for 2
hematology refrigerators will be provided to store inventory. A workstation to assemble
ward stock medications will also be provided.
Manufacturing/Compounding
An area having a counter of no less than 6' plus a sink, will be provided for compounding
and limited manufacturing. Equipment will include a packaging & product labeling
machine. Above and below the counter will be a system of flexible shelving for storage
of supplies.
Drug Dispensing and Order-Entry Area
There will be 4 (four) workstations, each equipped with computer terminals provided for
order-entry and verification functions. The workstations will be utilized by Pharmacists
and Technicians. Space will also be provided for 2 printers/scanners. An area for future
installation of a pneumatic tube station will be required.
This Order entry area should be acoustically protected as a quiet area were staff can
maintain concentration on order processing.
One large picking station will be required for assembly and replenishment of ADC
medications. The station is best designed as a “horse-shoe”, using gravity flow shelving,
which minimizes walking and enables quick retrieval. The medications will be stored in
alphabetical sequence.
Space will be provided nearby for storing totes and distribution carts.
Controlled Substance Storage
Conveniently placed within the footprint will be a narcotics vault with a work counter for
assembling and preparing narcotic medications.
IV Formation
Based on current USP<797> guidelines, the IV formation area will consist of two
separate spaces; an anteroom and IV admixture room. The anteroom will accommodate
two order assembly stations equipped with a computer terminal, storage shelving units
on casters, a hand wash sink, a double-door pass-thru refrigerator and 2 (two) IV carts.
The IV admixture room will be a sterile room that will accommodate one - 6’ clean filed
cabinets (laminar flow hoods), a work counter and holding space for a daily supply
storage cart. All admixture jobs will be setup outside in the anteroom and transferred
through an airlock/pass-thru. This room will be positive pressure
9
Chemotherapy preparations
A separate room will be provided for preparation of antineoplastic medications
prescribed for all oncology patients of the Hospital. The chemotherapy preparation room
(clean room) and anteroom shall comply with USP <797> standards for design including
specific HEPA and HVAC requirements.
The chemotherapy preparation room will accommodate a biological safety cabinet and
shall allow for 100% total exhaust of the safety cabinet, using separate ducting and fan
returns for each cabinet. Low wall mounted returns are to be ducted to the outside wall.
This room will be negative pressure.
Access to the chemotherapy preparation room shall only be through the anteroom.
Access from the anteroom into the chemotherapy preparation room shall be by a handsfree door made of glass and aluminum appropriate to clean room design.
The change area will be shared between the IV admixture room and the chemotherapy
preparation room. This area is used to gown and scrub prior to entering the prep areas.
The change area will then have access to either of the ante rooms and then into the
preparation areas.
Administrative Office/Drug Information/ Wicket
Offices/workstations will be provided for the following positions:
o
Site Manager
All other work space will be as per Fraser Health Integrated workspaces for integrated
workplaces.
An area with 4 cubicles with computer stations with internet access to on-line drug
information will reside in the pharmacist work area.
An adjacent education space will be shared for staff meetings, conferencing etc for up to
8-10 people on a pre booking basis.
Patient information area will have up to 3 cubicles to provide privacy during counseling..
This area should also be utilized as the internal storage for transport carts, until they can
be taken into the main pharmacy area. A glass wicket is required in this area to allow for
pass through of medication to staff and for outpatient pick up.
Staff Area
An n area will be provided for storing coats and belongings. Cube lockers, 20 in total will
be provided for secured storage.
10
11
RMH Pharmacy Space list
RMH Pharmacy Space Needs
Production /Storage area
Unit area
units
net area
Notes
decasing area standin ht island or
counter and waste holder
1
Receiving breakdown area
- decanting area
-inventory control desk
- waste holding
5.7
3.7
2
0
1
5.7
2
Bulk Storage
-non refrigerate
- refridg storage 0.71m3
-freezer storage 0.71m2
8.2
0
5.6
2.6
1
8.2
3
Active storage14days inventory
- storage mobile shelves 2,3
-- mobile carts
11.9
11
0.9
1
11.9
4
Controlled Substance storage
-narcotic vault
7.7
4
1
7.7
-workstation
3.7
5
Manufacturing and compounding
-work counter
-sink station
-supplies storage
- packaging/product labeling station
-packaging cadette
11.6
4.6
1.9
4.6
2.8
1
11.6
work counter,sink,supplies
storage,pkging labelling,station
6
Emergency eye station
1.4
1
1.4
wall mounted eye wash
Unit area
units
46.5
net area
Notes
lab pharmaceutical grade fridge
lab pharmaceutical grade fridge
1 narcotic cart, 1 lab/pharm grade
fridge
wall mounted flat screen and key board
with seat
subtotal
Dispensing/ADC Replenishment Area
3 shelving units /double sided,
work station power/data
1 mobile cart
7
Order entry review stations
-order processing workstations
-printers
20.2
18.4
1.8
8
ADC Replenishment Picking stations
9.3
1
9.3
U shaped shelving with gravity flow
standin ht counters label printer
9
Cart totes holding area
13.9
1
13.9
distribuion cart
10
housekeeping closet
0
1
0
delete and use existing
11
Pneumatic tube station
1.9
1
1.9
Unit area
units
net area
Notes
Ante-room (ISO 8)
-order assembly and verification
-sink station
-pass through refrig 1.6m3
-supplies storage
-transfer cart
-clothes storage and gowning
19
3.7
1.9
2.8
4.6
1.4
4.6
1
19
eye wash sink station,
power,data sink shelving
IV admixture room(ISO 7)
14
1
IV FORMATION STATION
12
13
-clean field cabinet-large(ISO 5)
-daily storage holding
-work counter/supplies storage
-pass through refrigerator 1.6m3
Fraser Health Authority Confidential
5.6
1.9
3.7
2.8
05/08/2009
1
20.2
power,data quiet area
4 stations
2 hi capacity printers and fax
Shared space with the chemo area.
14
power
1 class IIA laminar flow hood, cart
holding,workcounter/supplies
storage label printer,positive
pressure
Page 1
RMH Pharmacy Space list
Chemotherapy Formation Area
Unit area
units
net area
Notes
order assembly eyewash sink,refrig,
pass thru from bulk storage/iv cart
holding
14
Ante room (ISO7)
-order assembly and verification
-medication storage
-pass thru refrigerator 0.8m3
-eye wash station
-scrub sink
10.8
10.8
3.7
1.9
1.9
1.4
1.9
1
10.8
15
Chemotherapy Sterile Room (ISO7)
-class ii biosafety cabinet(ISO5)
-pass thru refrig 0.8m3
-daily storage cart
8.9
8.9
5.6
1.9
1.4
1
8.9
Incl class IIB biosafety cabinets,
room to be neg pressure
work counter/supplies storage printer
Unit area
units
net area
Notes
Administration Area
16
17
Admin support (recep)
-workstation
-file/record storage
-wicket Area
office equipment
-copy/fax
-work counter
18
office manager
19
Alcove pyxis controller
20
Resource area
this area to be incorporated into #21
21
Pharmacists Work area( central staff)
-cubicles
storage
Pateint counselleing cubilcles/delivery
cart storage.2,3 counselling cubicles.
Wicket for drug pick up staff and
patients inside the admin pharmacy
area/cart storage area
combine with office equipment area
7
4.6
1.9
1.5
6.5
3.7
2.8
1
7
1
6.5
8
1
8
phone data
0.5
1
0.5
data drops,power
0
1
0
window with ledge
power data phone
Utilize education conf room adjac
22
1
22
5*3.3
4.6
dual screen pc, data power,phone
STAFF AREA
Unit area
units
net area
Notes
purse lockers
22
staff room
-cube lockers
-coat rack
11
4
7
1
11
23
Staff washroom
2.8
1
2.8
TOTAL NSM
Gross factor 1.20
TOTAL GROSS
202.3
242.76
all spoace to be verified by the architect.
Fraser Health Authority Confidential
05/08/2009
Page 2
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4021 West 31 Avenue
Vancouver, BC, V6S 1Y7
Phone 604- 822-9707
Fax: 822-9588
email: [email protected]
Ed Chessor & Associates
Angela Bennett (Toop)
Capital Project Planner
Fraser Health Facilities Planning & Real Estate
#300, 10233 - 153rd St., Surrey, BC V3R 0Z7
Dear Angela,
Subject: Ridge Meadows Hospital Pharmacy
I enjoyed meeting you yesterday and our tour of the present pharmacy, the lab on the
first floor and the basement area around the proposed new pharmacy.
This will summarize my observations:
The existing pharmacy seems crowded with equipment and materials, leaving
minimal room to move.
The room in which the IV bags are filled and antineoplastic drugs are prepared has a
Class 2 Type B2 hood for the antineoplastics and a biological safety cabinet for the
IV bags. These are side by side, and I will feel better about patient safety when they
are relocated into separate rooms.
Photo 1 – Antineoplastics hood on left, IV
Preparation hood on right
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August 9, 2009
Page 2 of 2
Ridge Meadows Pharmacy Relocation
The room also contains a refrigerator and several shelf units for drugs and related
materials in it’s 200 square feet of floor space. Like the rest of the lab, it is crowded.
The new facility should have the refrigerator for antineoplastics storage and storage
for equipment that may be contaminated with antineoplastics in the same room as
the hood used for preparing the antineoplastics. The room should be dedicated to
antineoplastics and kept under a slight negative pressure relative to adjacent spaces.
The existing hoods appear to be current technology and in good condition. They
appear suitable for relocation.
Hoods used for preparation of antineoplastic drugs require their own exhaust duct
and stack. I am not aware of any alternative to this.
We looked at the possibility of running a duct down the corridor from the new
pharmacy and out the wall near the loading dock. Unfortunately there is a beam in
the ceiling near the pharmacy that would need to be cored for this new duct.
We discussed the possibility of taking a duct straight up through the first floor,
through the roof, on up the wall to a new fan on the second floor roof. This would
be a much better option than going through the beam and down the corridor, as the
duct would be shorter by at least 80 feet and a few elbows might be eliminated.
We looked at a fume hood in the lab to evaluate the possibility of connecting the
antineoplastics hood to the duct that serves the lab hood. The hood in the lab is
narrower, and we only saw one so it is likely that the exhaust duct is smaller than the
one for the antineoplastics hood. Unless the duct is at least 16 inches in diameter it
would not be practical to move enough air through this duct to operate both hoods at
once. If it is smaller than the existing duct for the antineoplastics hood (12 or 14
inch diameter), it might not be adequate for that hood alone.
The best location for a stack is near the middle of the highest part of a building roof.
We looked at two portions of the storage room near the loading dock as potential
locations for antineoplastics preparation. Both seemed too small to me, and
although it would be easy to get ducts to the outside wall of the building from them,
taking the duct from there to the fan on the roof would still be a challenge.
Please call if you have questions about this letter.
Ed Chessor, P.Eng., MBA, CIH
Industrial Ventilation Engineer
Phone 604 822-9707; Cell 604 813-9707
Ed Chessor, MBA, CIH, P.Eng.