Disaster Preparedness

(a) Include within the design of the Building an Emergency Operations Centre (EOC) in accordance with the BCERMS and the FHERMS requirements. Communications devices

in the EOC will include, but not be limited to, satellite TV and satellite telephone. The EOC is to be located in the largest conference room at ground level.

(b) Provisions for Disaster:

(1) The design of the Facility will provide adequate seismic restraint for equipment and non-structural items in accordance with CSA S832-01 Guidelines for Seismic Risk Reduction of Operational and Functional Components.

(2) Where appropriate and cost effective, consider the concept of “mitigation” (design concepts that enhance occupant safety during seismic events) as it applies to security and emergency preparedness in the planning and design of the Facility.

(3) The structural design of the Facility will be to the post disaster standard and will be in accordance with the following:

(A) seismic design will address the parts and portions of the Facility including architectural appendages and the restraint of mechanical and electrical items attached to the Facility; and

(B) the importance factor used in the calculation of seismic forces on these parts will be in accordance with the Building Code

requirements for a post disaster structure.

The balance of the design of the Facility is not required to be to a post disaster standard.

(4) The Facility will provide for:

(A) a domestic water inlet connections on the exterior of the Building for supply of water through tanker truck connections;

(B) a sanitary sewer pump out connection on the main sewer line leaving the Building for removal of sanitary sewer material by pump-out trucks;

(C) seismically protected bulk storage tanks and piping for medical oxygen and nitrous oxide, or a gas truck inlet connection for oxygen at the Building wall; and

(D) fuel oil inlet connections on the exterior of the power plant for fuel oil tanker truck connection.

4.8 Infection Control

(a) Project Co will utilize Good Industry Practice for the purpose of achieving a safe environment for all patients, staff and visitors in the Building.

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1543463.20 Schedule 3 – Design and Construction Specifications (Surrey) EXECUTION COPY (b) General Criteria:

(1) Provide Design, planning, material selection and Construction to take account of and facilitate infection control in accordance with Good Industry Practice, including consideration of the infection control guidelines and policies which the Authority has identified below:

(A) Guidelines for Design and Construction of Health Care Facilities, AIA, 2006;

(B) CSA Z317.13-03 Infection Control during Construction or Renovation of Health Care Facilities;

(C) Infection Prevention and Control Best Practices for Long Term Care, Home and Community Care including Health Care Offices and Ambulatory Clinics June, 2007;

(D) Best Practices for cleaning, disinfecting and sterilization in all health care settings, 2006;

(E) Construction Related Nosocomial Infection in Health Care Facilities, 2001;

(F) Guidelines for Environmental Infection Control in Health Care Facilities, CDC/MMWR, 2003;

(G) Role of Infection Control during Construction in Health Care Facilities, APIC, 2000;

(H) CSA Special requirements for plumbing installation in Health Care facilities (R2002) Z317.1.99;

(I) CSA Warehousing, Storage, and transportation of clean and sterile medical devices Z314.15.03 (2003);

(J) ORNAC Recommended standards and guidelines for perioperative practice 2003;

(K) Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005;

(L) Infection Control Construction Agreement; and

(M) Communique #2007-01 Reprocessing of Medical Devices & Patient Care Equipment.

(1) Negative Pressure Rooms (as per applicable CSA standards) will be

incorporated into the design and constructed on each level of the Building to handle clinical needs as well as emergency situations. Project Co will provide the following rooms unless agreed otherwise by the Authority:

(A) Level 1 – one Negative Pressure Room in either the Respiratory Diagnostics/Rehab area or the Medical Day Care area.

(B) Level 2 – one Negative Pressure Room in the Diagnostic Imaging Centre, preferably a room that is located close to the perimeter. If possible, the room should be one that does not have diagnostic equipment (i.e., prep room or holding area would be preferable). (C) Level 3 – one Negative Pressure Room in any of the clinics except

Perinatal. The designated room should be one of the Exam Rooms and should not have diagnostic equipment associated with it, such as EEG or EMG.

(D) Level 4 – One Negative Pressure Room in the Surgery/Procedure Centre; specifically in the PACU (post anesthetic care unit –stage 1). (E) In addition, to the requirement of having one Negative Pressure

Room on each level, as described above, all Bronchoscopy rooms throughout the Building are to have negative pressure capacity (typically, these will all be located on Level 4).

(d) Handwashing Sink Standards

To optimize hand hygiene and reduce the risk of microbial contamination and biofilm buildup, the Design of sinks will meet the following minimum standards:

(1) Taps:

(A) Sinks primarily used by staff in patient care areas should be hands free (no hand contact required with taps). This could be

accomplished by electronic eye, knee or foot controls.

(B) Patient and public washrooms will have sensor operated taps. (C) If electronic eye is used, the activation area should be nearer the

base of the faucet and not close to water outflow area.

(D) The activation mechanism should provide consistent and reliable service.

(E) In areas where temperature control is required, manual taps are acceptable.

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1543463.20 Schedule 3 – Design and Construction Specifications (Surrey) EXECUTION COPY (2) Faucets

(A) No aerators on faucets. Aerators can easily become contaminated by external sources and quickly develop a build up of biofilm. A gooseneck faucet is preferred. Avoid the use of low profile faucets which may result in hand contact with underside of faucet and subsequent contamination.

(3) Sinks:

(A) Size and depth of the sink basin are not directly correlated with splashing but rather a combination of factors such as drain location, faucet positioning, pressure of water, etc. may be more integral in determining amount of splash over to surrounding area. The basin should be at least 6 ¾ inches at the deepest part, e.g., no airplane or bar sinks.

(B) Depth from spout to drain needs to be such that the depth allows placement of hands under running water without contacting faucet or splash back from drain.

(C) A stand alone sink is preferred to minimize collection of standing water around the sink and microbial contamination of grout. (D) If a sink is to be inset in a counter ensure use of non-laminate

materials.

(E) Sinks are not to have overflows. (4) Miscellaneous:

(A) Trap location should be offset from drain to minimize splash back from under sink plumbing where biofilm development is most likely to occur.

(B) Placement of sink should provide convenient access to soap and paper towel dispensers.

(C) Patient disposal bedpan and urinal cleaning system are done by macerators, FHA standards are "Verna Care".

4.9 Retail

(a) General

(1) The purpose of the retail services component of the Building is to provide appropriate amenities at the Site to meet the needs of staff, visitors and patients of the Building. It is expected that the retail services will include (at a minimum) a retail outpatient pharmacy and coffee shop/food service outlet.

(2) All retail areas must be suitable for leasing to third parties, on usual commercial terms and conditions, including separate metering and mechanical/electrical connections.

(3) All retail areas, including dining areas, must be wheelchair accessible. (b) Retail Outpatient Pharmacy

(1) It is anticipated that the Building will have both a hospital pharmacy operated by the Authority (to provide support to the clinical programs) and a retail outpatient pharmacy operated by a third party retailer (to provide general community pharmacy services to staff and visitors as well as to provide a broad range of services to outpatients).

(2) Because of the limited hospital pharmacy capacity that will be available and because of the complex care needs of the patient population, the Authority anticipates the retail outpatient pharmacy will need to provide a broader scope of practice than is typical of a general community pharmacy.

(3) The retail outpatient pharmacy must be licensed by and designed in accordance with the requirements of the College of Pharmacists of British Columbia. The dispensing area must be separate from the retail area and able to be secured. An acoustically private area adjacent to the dispensing area must be provided for patient counselling. A securable storage area must be provided adjacent to the dispensing area.

(c) Coffee Shop/Food Service Outlet

(1) The coffee shop/food service outlet will be conveniently located off the main lobby and will include a seating/dining area to accommodate patrons. To minimize disturbance from food odours, the food service outlet will be somewhat removed from clinical areas.

(2) The seating area should be well lit and, to the extent possible, acoustically separated from the kitchen area. Tables and other furniture and fixtures must be appropriate for wheelchair users.

(3) The design should be conducive to self-service and encourage self-bussing of tables with soiled tray return bays at all exits.

(4) A separate staff entrance to the food storage/preparation area must be provided for supply delivery and waste removal.

(5) Appropriate kitchen facilities must be provided for food delivery, storage and preparation.

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1543463.20 Schedule 3 – Design and Construction Specifications (Surrey) EXECUTION COPY (6) Flooring must be appropriate for high traffic and wear areas and permit easy

movement of heavy equipment. Floors must be non-skid, impervious to moisture and grease, resistant to solvents, and durable.

(7) Walls must be washable, hard, smooth, and impervious.

(8) Sufficient storage space, separate and secured from public areas, must be provided for coffee shop/food service outlet supplies and equipment. (d) Vending Machines and ATMs

(1) Appropriate space must be allocated for one ATM in the lobby area and a minimum of three vending machines throughout the Building.

4.10 Other Spaces

(a) Customer Service Centre

It is anticipated that the Building will have a customer service centre located near the main entry to the Building that enables patient to “self register”, and cubicles located inside the customer service centre area to assist patients privately with a “Full” registration.

(b) Education Centre

It is anticipated that the Building will have an education centre with space for classes and seminars for both the patient population and the SMH residency program.

(c) Volunteer Centre

It is anticipated that the Building will have a fully equipped volunteer centre to support the services of volunteers. The Facility is expected to have between 75-100 volunteers that are expected to play a wide variety of roles including:

(1) wayfinding, patient/family support in the individual clinics; (2) peer support/education program support;

(3) volunteer support for the cardiology, diabetes and other clinics; (4) deliver the "Living with Chronic Disease" peer education program; (5) keep waiting areas stalked with magazines;

(6) provide spiritual support as necessary; and

(7) assist with the coordination of a patient education resource library.

The Facility will also host volunteers from other agencies accompanying or providing transportation for some patients.

(d) Administrative Office Suite

It is anticipated that the Building will have an administrative office suite with executive offices for staff supporting the Facility and a conference room that may also be used as the disaster command center if the need arises.

(e) Allied Patient Services Area

It is anticipated that the Building will have an allied patient services area with offices for social workers, pharmacists and nutritionists who will provide services to patients in the Facility but who are not part of the Authority’s multidisciplinary team.

1543463.20 Schedule 3 – Design and Construction Specifications (Surrey) EXECUTION COPY

5. QUALITY MANAGEMENT

5.1 Quality System

A “Quality System” means Project Co’s organizational structure, procedures, processes and resources necessary to implement a comprehensive, planned and systematic program, designed and implemented by Project Co pursuant to this Agreement, to ensure that the standards of quality control, quality

management and quality assurance required by this Agreement are achieved by Project Co in every material aspect of the Design and Construction.