The second of three week-long 3P (Production, Preparation, Process) Lean capital planning sessions was held the week ending Aug. 2 in North Battleford regarding replacement of the province's only psychiatric rehabilitation and forensic hospital. The process involved Saskatchewan Hospital patients and staff, Prairie North senior leaders and board members, architects, mental health consultants, Ministry of Health and Ministry of Justice officials and other key partners.
The goal of the 3P process is to reach consensus on a building design that will provide a better service for clients in a new Saskatchewan Hospital by identifying improvements that can be made in programs, services and the environment, to improve flow in the continuum of mental health services delivery for patients. The designs move away from the traditional custodial model of care toward a rehabilitation model.
Prairie North CEO David Fan, speaking on the final day of the design marathon, said the process was not about the building itself, which will replace the existing century old building, it's about the design.
"A well designed, efficient, effective building in the long term, in the next hundred years, will save us a lot of money," said Fan, adding it's worth taking the time to "do it right."
This was really a second round of planning, said Fan. The first round was done in the "old traditional way" the 3P process moves away from.
"I, like some of you, was not happy with having to do it all over again, but now we see the power of thinking and the end result is that it's going to give us a much better facility that will serve us and our patients well, serve the province well for the next 100 years."
Planning a new hospital goes back to 2002, when Prairie North Health Region was one of 12 regional health authorities established by The Regional Health Services Act.
Fan said, "The board at the time came to the realization that 'we've got to do something about Saskatchewan Hospital.' That's when we started to do our homework."
In 2004, a health region study recommended a new facility be constructed to replace the aging structure.
In February of 2006, Saskatchewan Health, under an NDP government, announced plans to rejuvenate Saskatchewan Hospital with some new construction and some demolition.
Prairie North's annual report for 2005-06 said, "The government has set aside nearly two-thirds of the projected $59 million dollar cost for the new facility. Planning has begun, with construction to start in 2008 and completion set for 2010. Prairie North continues to promote eventual replacement of BDCC (Battlefords District Care Centre) in conjunction with Sask Hospital redevelopment." (BDCC was originally built as part of the Saskatchewan Hospital.)
In its 2006-07 annual report, the region said the planning was 50 per cent complete with a final report to be ready by August 2007. Construction continued to be expected to start in 2008, with completion set for 2010. Prairie North continued to promote eventual replacement of BDCC in conjunction with SHNB redevelopment."
The annual report also said " A further significant pressure for Prairie North Health Region surrounds the provincial Forensic Program at Saskatchewan Hospital. Our ability to meet the growing demand for clinical forensic services is contingent on adequate resources. Prairie North has the opportunity in pending redevelopment of Saskatchewan Hospital to plan for current and future needs of the Forensic Program. In the meantime, the region must look at ensuring adequate resources to manage workloads and needs." (The forensic unit, the only one in the province, was added to SHNB in 1996.)
In 2007, the redevelopment plan calling for construction of a 204-bed, $60 million hospital, increasing forensic beds from 22 to 28, plus 32 reintegration spaces in the Battlefords was presented to residents and staff, then to the public. The overall target was for a 2008 construction start with completion slated for 2010.
The end of the year saw a new government under the Sask. Party.
Prairie North's 2007-08 annual report referred to a difficult fiscal year for the region.
"Government changes in Alberta and Saskatchewan influence Prairie North Health Region's planning for capital projects to redevelop Lloydminster Hospital and replace Saskatchewan Hospital North Battleford. The new administrations need time to review and revise such capital projects to align with their visions and priorities."
As to SHNB, it said, "Functional programming and concept design for the replacement of Saskatchewan Hospital North Battleford is 98 per cent complete. A final functional program and concept design report is expected in the summer of 2008. Ministry approval is required to proceed to the next phase of planning which is detailed design work. PNHR expects to be able to proceed with that phase in early fall 2008. The project is roughly one year behind schedule with completion targeted at 2012 rather than the initial goal of 2011.
The 2008-09 annual report said, "Functional programming and concept design for the replacement of Saskatchewan Hospital North Battleford was completed in December 2008. Ministry approval is required to proceed to the next phase of planning."
By the time of the 2009-2010 annual report, plans were changing again. The region had submitted its completed functional program and concept design to the government in December 2008, however, discussions with the Ministry of Health had "resulted in new parameters for the project and the re-scoping."
In 2009, the Ministry of Health had announced it would provide Prairie North Health Region with $450,000 for further capital planning to clarify the scope of work needed to replace the hospital, and the estimated costs.
The parameters included a new hospital at approximately SHNB's existing size of 156 beds, capable of serving current clients, forensic patients, and complex needs cases. The project would also include community-based residential resources located in regional health authorities to facilitate increased access to Saskatchewan Hospital and timely discharge of patients when rehabilitation service is complete.
"Re-scoping will include working with a steering committee to plan modifications to the physical design proposed in December 2008, said the 2009-10 annual report. "Consultations are to occur with various regional health authorities and community groups to plan the community-based residential resources. The project is also to include advice on best practice models of combining facility-based and community-based treatment from North America. Re-scoping is to begin in June 2010."
In December of 2010, the board of Prairie North Regional Health Authority announced it had approved revised plans for replacement SHNB. The revised plan called for construction of a new 186-bed hospital, plus development of a total 120 post-Saskatchewan Hospital residential support spaces in North Battleford and other communities in the province.
Prairie North Health Region said the re-scoped Saskatchewan Hospital Replacement Project has broadened to become more of a provincial strategy for psychiatric mental health rehabilitation across the continuum of services, and recognizes the demand for mental health services is increasing. In addition to the need for a new psychiatric rehabilitation facility, a key consideration included the changing approach in mental health toward a recovery model of patient care, with as much care available as close to home as possible.
The proposed size of the new facility was re-evaluated in concert with program requirements, said the health region, however the intended location was reviewed and reaffirmed. The proposed location for the new Saskatchewan Hospital remained as recommended in 2007: on the current Saskatchewan Hospital site, slightly northwest of the existing buildings on a 30-acre plot North Battleford City council had resolved to sell to Prairie North Health Region for the nominal sum of one dollar so a new hospital could be built.
On Aug. 18, 2011, Premier Brad Wall announced the province was providing $8 million immediately so Prairie North Health Region could begin work on detailed planning for a new facility to house 188 patients for rehabilitation, forensic appraisal and monitoring.
In May of 2013, Prairie North Health Region said it fully supports development of a mental health and addictions action plan for the province, as announced by the government of Saskatchewan.
"We applaud the decision to move forward with a comprehensive, strategic and collaborative approach to better serve the needs of some of the most vulnerable people in our communities," said Fan, noting the announcement commits to building upon the care and services already in place.
"This includes Saskatchewan Hospital," Fan stated, "and is consistent with the recommendations Prairie North put forward in its December 2010 report to government and Saskatchewan residents." The report is titled 'Charting a New Course for Mental Health's Most Vulnerable: A Provincial Approach to Replace Saskatchewan Hospital and Address Complex Needs Care'.
Fan adds, "We see Saskatchewan Hospital as continuing to play a critical role in that continuum of integrated mental health services, as it has for the past 100 years."
