A new building is often seen as a solution for the updated delivery of health care.
It’s true they usually reduce energy costs. If designed correctly and collaboratively, they can also contribute to higher operational efficiency.
Ontario invested heavily in new hospital buildings under former Premier Dalton McGuinty. At one point we counted about 100 major hospital infrastructure projects in the works – about a third developed as public-private partnerships.
Many of these buildings are now open or will be shortly. After moving in, administrators and staff are discovering the shortcomings that often aren’t evident in the planning stage.
One of them is Waypoint Centre for Mental Health Care in Penetanguishene. Waypoint moved both medium and maximum security units into its new $474 million building in May.
The only high security forensic hospital in Ontario, it has had an almost flawless record in preventing maximum security elopements over its long history – the last escape was about 40 years ago.
The new building has been open for less than four months and already a maximum security patient has been able to elope, traversing three chain link fences to make his escape. He has since been returned to hospital, but now many questions are being asked about security at the new building. That includes questions posed by staff who feel more vulnerable as new health and safety issues take a back seat to other priorities.
The Atrium building appears to be modelled on a series of new mental health facilities popping up across the province. Some have been quite good – including the new Southwest Centre for Forensic Mental Health Care in St. Thomas. Built with much input from the union local, St. Thomas is generally considered successful in its design – not that there haven’t been problems or unanticipated issues.
Just because a building design works in one place doesn’t mean it will work everywhere. Waypoint is not like the other mental health facilities, foremost because its patients are not like the others. When a patient is disruptive and other facilities can no longer cope, they often send him to Waypoint (there are no women in the maximum security unit).
Nor has Waypoint paid particular attention or sought extensive input from front line staff in the design. That’s a shame.
Several of the new patient rooms have already been trashed by their occupants at Waypoint, the debris used as a weapon against staff trying to restore calm. It seems self-evident that more input and thought should have been placed into the design of these rooms.
The design of the new facility gives much more freedom of movement to the patients – as it should – however neither the staffing levels nor training has kept pace with the requirements and risks of this new environment.
Waypoint is not going to rebuild its new building.
The fact that it is a P3 makes new physical adjustments that much more difficult to negotiate. Any material changes get multiplied by the long-term costs and slowed by the negotiation process.
The Royal Ottawa Mental Health Centre experienced elopements from its new exercise yard in 2006 after it was found that initial security was also insufficient. That resulted in protracted negotiations between the hospital and the P3 consortium over who was responsible for paying for the fix.
Waypoint has promised the community that high security elopements will not happen again. They have also promised a “full investigation by Waypoint officials” into the incident.
That investigation should include significant input from front line staff and its findings made public.
Health and safety concerns are not necessarily linked exclusively to the new building.
Last November the Ministry of Labour issued 10 orders to the hospital to reduce the risk of workplace violence. That’s six months before the move to the new building.
The more discretionary approach the hospital is taking to disclosure of incidents that impact the workplace frustrates Waypoint’s unionized employees. If the hospital wishes to foster trust, it should make transparency its mantra.
A new building is always a challenge. Waypoint could do much better in navigating issues in these early days.
Correction: In our interview with CBC Radio early this morning, we said that the elopement was for two days. In fact we have since been told the patient was found and returned to the hospital in less than two hours on Saturday night.
It must be embarrassing to the “powers that be” when time after time it’s made obvious that the nursing staff know significantly more about how to create a safe and therapeutic environment than they did!!Over and over design flaws where pointed out to no avail.It mystifies me why the expert opinion of people doing the job would be ignored unless you factor in egos,insecurities and arrogance.I certaintly hope that’s not the case because a lot of lives have been put needlessly at risk.Patients,staff and apparently the public and police.
Ya, the internal review is be done by management, the same people that approved the current design. These management type with several letters behind their name should stick to what they know and thats healthcare. Not designing a secure facility. Here would be a suggestion, get rid of your current security VP and get someone who actually has a security background.
My dad was one of the construction labourer’s at the new building. With 40+ years experience in building he was able to point out key flaws to his bosses. These flaws were always ignored. The issues they are having now, and the many other issues that will arise in the near future, are things that could have been avoided if they had only listened to people’s safety concerns on the layout of the building and grounds.
Unfortunately most staff are unable to verbally comment to the public because of the confidentiality page sign but most who are working there are becoming very stressed about the future. We’re not even talking about some serious injuries that happening.
2 hours or 2 days. Waypoint is located in a residential neighborhood. Nearby residents were not made aware of the “elopement” until it was on the local news the next day. ANYTHING could have happened. Changes need to be immediate to ensure this NEVER happens again!
I would like to thank Rick for his comments and ongoing support through out this elopement concern. I would like to add that many staff have contacted me personally since the opening of the New Building and have expressed their safety concerns on an ongoing basis. I have had numerous conversations with Senior Management about these concerns and have felt that I have had no choice but to involve the MOL on a few different occasions for third party intervention related to safety. On behalf of many Waypoint Staff, I would encourage Waypoint leadership to further open up lines of communication with the Union, the Health and Safety Committee and to take the safety concerns expressed by front line staff more seriously. I most often find out about safety issues by receiving a call or email from frontline workers and although I welcome these notifications, I struggle with the fact that even when Management is aware, they often choose to leave me in the dark. This is how I found out about the Elopement. Frontline staff informed me before receiving the official notification from Management on Sunday. I have been told by Senior Management that they will use their discretion as to when they need to let the Union know about safety issues unless they are required to according to the OH&S Act or other legislation. Once again, I feel that the minimum legal reporting requirements under the law should not be the standard set by the Organization, but rather should strive to exceed minimum expectations in order to ensure staff safety. I am aware of an SIU investigation at this time and have seen the Media releases by the Employer ensuring an internal investigation, but since being notified on Sunday, I have been provided with no updates nor has the Union been asked to participate in any investigation.
I would like to point out that the fencing in the High Security Provincial Forensics Division is inadequate. It is slanted inward at the top, but no razor wire or other High security climbing deterrents.
In closing, my goal for any media that I am involved in and this comment, is to make Waypoint Centre a safe place for all staff. The only way for this to happen is to have open, honest communication between Management, the Union and Frontline Staff and for any input arising to be valued and carefully considered.
President OPSEU Local 329
Many are aware of the movement by hospital administration, in recent years, to shed the Maximum Security label that the previous Oak Ridge building represented, in favour of a new facility with a more “therapeutic” environment. The fact that Oak Ridge has already been demolished could testify to that. This was a Maximum Security hospital, meaning that, for many years, the public could reasonably expect that patients would be safely contained there while being treated, long and short term. Because of its design, staff could do their job with a higher degree of safety. Now, we have a very expensive new facility that does not appear to be as secure, or as safe, as Oak Ridge. I am at a loss to understand why public, staff, and patient safety seems to have been compromised, apparently because of very poor planning and lack of consultation from those who could have contributed valuable input. It all means nothing if lives are put at risk.