St Thomas’ Critical Care unit
London, United Kingdom
Guy’s and St Thomas’ NHS Foundation Trust
The project, located on the 6th floor of St. Thomas' Hospital’s 13 storey East Wing building, creates 11 new critical care beds and ancillary clinical accommodation from former administration offices. The original ‘T’ shaped 1966 tower building had been over-clad and two triangular atria added in 2015.
Challenge & Solution
The existing ‘T’ shaped floor plate was limited in area and would not accommodate a more ideal racetrack type configuration with bedrooms clustered around staff bases nor facilitate all ancillary space and equipment requirements. It was essential to comply, as far as possible, with the latest DoH guidance and space standards for Critical Care bedrooms. The existing ribbed concrete floor construction would require strengthening.
Most of the internal partitions of the previous office accommodation were removed and the floorplate refurbished to form 7 open bed bays and 3 bedrooms (2 isolation) along the top of the ‘T’ with a central staff base. As storage limited – critical adjacency of stores to lifts and use of automated pharmacy cabinets ensured replenishment of consumables and waste disposal could be managed efficiently. Full height glazing (with interstitial blinds) between bed bays and in corridors within the clinical area was used to optimise staff visual supervision of patients. A full equipment list was provided, and each piece of equipment allocated on the CAD model allowing optimisation of equipment layouts relative to available space. Careful consideration was given to the length of staff journeys within the unit in planning accommodation adjacencies. As there was only one route for bed-bound critical care patients to access lifts to be evacuated, fire compartmentation was increased, and a mist suppression system introduced to provide additional protection. New steel structural components were carefully coordinated and slotted in between existing concrete floors ribs to support new services pendants.
Innovation & Added-Value
BMJ were able to apply specialist knowledge gained on previous CCU projects to briefing to ensure “Best practice” principles were agreed and fed back into the Critical Care design. Level-2 BIM methodology to PAS1192 was adopted by the design team to develop a federated 3-D BIM model. This was used to co-ordinate all equipment list components and services ensuring optimal fit within a limited spatial footprint and saved time and cost on site by allowing clashes in systems to be ironed out in the virtual world before creating any adverse impact on the site.