For many of us, moving involves some boxes, bubble wrap, maybe some friends, and a truck. But when it comes to relocating an entire hospital, there are considerations most of us could never dream of.
Well before sunrise on the morning of December 4th, 2021 in the northern Alberta city of Grande Prairie, Alberta Health Services (AHS) launched the largest coordinated patient move in the organization’s history, beginning the delicate task of relocating about a hundred patients from the old Queen Elizabeth II (QEII) Hospital and the new Grand Prairie Regional Hospital (GPRH).
“I believe that this is the first time in Alberta, likely in Canada and possibly even in North America where the “lift and shift” approach was taken to move a hospital—and all the patients—in a single day. It was an amazing, well-coordinated, team-work based success,” says Darren Sandbeck, Senior Provincial Director and Chief Paramedic, at Alberta Health Services EMS.
Planning for the relocation started well before that morning and contingencies were made to move nearly two hundred patients, if necessary. All would require transport by EMS—and it would all need to happen in a single day so that the entire operation of the hospital could be fully operational at the new site.
“Paramedics are very accustomed to fast and large responses to incidents such as floods and fires, but the difference with this event was we had time on our side, as we had a number of months to plan for this move,” says Rob Barone, Associate Executive Director, AHS EMS North Zone. “Patient needs ranged from minimal medical attention to complex care requirements – including some patients on mechanical ventilators. We would need to move all patients safely, and as quickly as possible, seven kilometers to the new Grande Prairie Regional Hospital. We did a lot of planning for every eventuality – matching each patient’s needs with the appropriate level of EMS care team.”
Logistics and planning included AHS, EMS, and all hospital departments including protective services, pharmacy staff and equipment, porters, contracting, procurement and supply management.
“When you’re moving a hospital patient, there’s additional considerations, and that’s why EMS was so important to the move. We needed to ensure specific medications and specialized equipment were available and brought along, and that anyone who needed ongoing care would receive it, uninterrupted, while in the care of EMS,” explains Barone. “But there were plenty of other important things to consider, like having Personal Protective Equipment available for everyone involved, plus equipment decontamination, since we were pulling this off during a global pandemic.”
The patient care teams and GPRH planners stayed in constant contact with both sites and with EMS to feed information back and forth to all teams involved in the move.
“I am always impressed by the way multiple disciplines and departments come together to work through any significant event that impacts AHS,” shares Dallas Pierson, Special Operations Supervisor, AHS EMS North Zone. “We were constantly managing changing circumstances; keeping tabs on how many patients had been moved and how many more were still to come, and each of their conditions through the entire transport process. It was a real team effort between EMS and hospital staff and I couldn’t have been any prouder in terms of how everyone got it done—and done safely for our patients.”
EMS needed to plan for a number of factors including estimating how long it would take to ready, load and drive each patient, particularly when each one might have different or more acute care needs. Timing also included donning and doffing of PPE for EMS paramedic crews, plus including the need for proper documentation of each patient and handing them off to nursing staff at the new hospital.
The plan also required extensive “what if” contingency planning.
”We started that planning by taking the full hospital capacity number of 187 patients and dividing it by an 18 hour time frame, just in case we needed that much time. We knew this could mean we might have to move 10 patients every hour—that sounds way better than a patient every six minutes!” Pierson explains. “That was the maximum capacity that we were ready for.”
The night before the move, EMS staff from across the province began arriving in Grande Prairie, along with support staff and spare ambulances. In total, 87 EMS staff and paramedics volunteered for this herculean assignment, ready to make history. They were part of the 1,192 total AHS staff members involved in the move, along with 24 physicians and 95 volunteers.
While an influx of patients on that Friday night could have altered logistics and planning for the move the following day, the numbers remained largely static, and by go-time 99 patients were awaiting transport. As the day progressed, the relocation teams took to calling the mission ‘Operation 99 – the great one day move,’ a nod to hockey great Wayne Gretzky’s number and nickname, ‘the great one’.”
At 6 A.M. EMS transport teams arrived at the old QEII hospital to take the first patient, Kelsi Ching, and her newborn to GPRH by ambulance. Paramedics Crystal Cartwright and Kyla Mosenko did the honours.
“The exceptional teamwork made the day go seamlessly from our perspective”, says Kyla Mosenko, an Advanced Care Paramedic with AHS EMS.
Teams of porters, hospital staff, EMS support staff and leadership watched as Ching and her child arrived in the very first ambulance, then entered the hospital to the sound of bagpipes.
“It took a full eleven hours to transport all the patients,” according to Phillip Tautchin, Deployment Manager, AHS Northern Communications Centre. “This was definitely a solid example of communication and collaboration between staff and departments regardless of different fields or backgrounds. It’s definitely helpful when you are a part of a dynamic group and to see everyone roll up their sleeves and just get things done!”
“There was a bit of a bittersweet feeling over at the QEII on move day,” says Stacy Greening, senior operating officer for Grande Prairie. “A hospital is just a building until there are people in it. To see the patients and the staff here now in all of the hustle and bustle — the site has really come alive.”
The QEII emergency department is now permanently closed. Anyone in need of emergency medical care should go to the new GPRH site, located at 11205 110 Street in Grande Prairie.