The Royal Ottawa Hospital Redevelopment

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The Writing on the Wall
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The Demand Wall
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The Supply Wall
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Key Points

• The supply and demand walls are in a state of
  dis-equilibrium
• Growing demands will not be resolved with the
  current supply framework unless Govts move to
  increase taxes and deficits (not)
• We need new options/new solutions

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Public Private Partnerships as an Option

• Capital acquisition
• Facility Management (non-core services)
• Creating, innovate (off the wall) solutions to
  current and future health care demands in these
  areas

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The Re-Development of the Royal Ottawa Hospital

• A Pilot P3 Project

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• The existing ROH site with century-old
  buildings, never designed for mental health care,
  and inefficient to run

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• Trying to Heal in Cramped Conditions

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Evolution of the ROH Pre-Health Care
Restructuring

• Royal Ottawa Health Care Group administered
• Acute,general psychiatric hospital, with
  psychiatric emergency services
• Regional Childrens Mental Health Centre
• The Rehabilitation Centre, Ottawa
• Catchment area Ottawa-Carleton region

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The Evolution of the ROH Post-Health Care
Restructuring

• Tertiary psychiatric center for most of Eastern
  Ontario
• Governance transfer of Brockville Psychiatric
  Hospital and transformation to Forensic
  Psychiatry Centre/Correctional Treatment facility
• World class focus on education and research
• Extensive shift in mandate to outreach and
  community partnerships
• Focus on specialized care for the severely
  mentally ill
• Emergency services now in acute general Hospitals

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Scope of the Shift in Mandate

• Pre HSRC
• 416 beds in the ROH and BPH combined
• Emphasis on inpatient programming and care
• 67 inpatient-related salaries
• 33 outpatient and outreach related salaries

• Post HSRC
• 232 beds in the ROH and BPH combined
• Enhanced/new emphasis on outpatient or
  client-centred model
• 47 inpatient-related
• 53 outpatient related
• Corrections Treatment Centre with 100 secure
  treatment beds 300 special care beds50 remand
  beds

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A New ROH Functional Program

• The ROH team completed a functional plan and
  capital requirement analysis based on
• Specific directions of the HSRC
• The new Mental Health Reform policy
• We began to question the feasibility of our
  surroundings to meet our new mandate

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Business Case Recommendation

• After much effort by our staff and our team of
  business analysts, we concluded that it was time
  to begin again
• Organizationally, for the ROH
• A focus on the Institute of Mental Health
  Research
• A focus on partnering, education, tele-health
  (mental health reform)
• The ROH facilities must
• Provide the right stage for the new mandate
• Create an image of what mental health care should
  be

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Comparison Renovation/Expansion to New

• Renovation Option
• 115 million capital and transition
• No operating efficiencies
• 7 years, ongoing disruption
• BPH divestment postponed

• New Facility
• 87 million capital and transition
• 4 M operational savings
• 2.5 years to complete
• BPH divests on schedule

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The Master Plan

• Old institutional model replaced with a highly
  flexible facility, a new focus on outpatient
  care, research and education