Engineering Technical Communications 06-85-519-02 Inter/Summer 2018 Improvements in Healthcare facilities of Windsor Team 16 Parth Patel

Engineering Technical Communications
06-85-519-02
Inter/Summer 2018
Improvements in Healthcare facilities of Windsor
Team 16
Parth Patel (104947005)
Sairam Bezawada (104947465)
Nimitkumar Rana (104933088)
Venkatesh Gaddam (104711059)

Prepared for
Dr. Donald Bourne
Date: 14/08/2018
Executive Summary
Windsor is the southernmost city of Canada. It is mainly driven by education and tourism sector. The population of the city is increasing due to the arrival of international students. The population of the city is increased by 3 percent in the last five years. The number of hospitals and specialist doctors in the city are not ample to provide sufficient medical facilities to students and the people of Windsor. They primarily depend upon 3 main hospitals and 19 walk-in clinics. In Canada, Physicians and Dermatologists play a crucial role in the medical field, but the number of doctors per thousand people in Canada is less compared to other developed countries. Average wait time to meet dermatologists is around 2 months in the Windsor city.

The aim of this project is to improve the medical facilities of the city of Windsor by providing separate health facilities to students and making few changes in the current process of treatment. The team decided to improve the infrastructure of Sandwich Community Health of Windsor to provide quality health care to students and by limiting services given by the center to students only. In addition to that, time spent per patient or queries solved per visit should be limited to treat more patients in a day. However, patient visit time cannot be limited in every treatment process related to health issues. In addition, an increase in the office hours and the number of specialists at Student Health Services of the University of Windsor can be beneficial as well. Separate hospital for students can rectify the problem of long waiting time in hospitals for students as well as for the people of Windsor. This hospital will support the government to reduce rush at local clinics, and management of the system will be easy. There will be some problems related to the project funding, which can be resolved by the donation. The project is beneficial for students and the people of Windsor, which will eventually increase the reputation and health standards of the country.

The Project implementation is expected to cost around 195,000 Canadian dollars and will take around 7 to 8 months to finish. Implementation of the project will take place during the summer for convenience in construction.
Table of Contents Page Numbers
List of Figuresiv
List of Tablesv
Introduction1
Background and Literature Review3
Requirements and Criteria4
Requirements4
Criteria4
Proposed Design/Solution5
Sandwich Community Health6
Regulate the Patient visit time7
Student Health Services8
Strengths8
Limitations9
Cost Analysis10
Timeline11
Conclusions and Recommendations12
Conclusions12
Recommendations12
References13
Appendix14

List of Figures Page Numbers
REF _Ref522037761 h * MERGEFORMAT Figure 1Sandwich Community Health with Staff members5
REF _Ref522041451 h * MERGEFORMAT Figure 2Sandwich Community Health6
REF _Ref522038166 h * MERGEFORMAT Figure 3The general layout of Emergency ward7
REF _Ref522038337 h * MERGEFORMAT Figure 4Student Health Services8
List of Tables Page Numbers
REF _Ref522038785 h * MERGEFORMAT Table 1Project Cost10
REF _Ref522038878 h * MERGEFORMAT Table 2Project Implementation Timeline11
Introduction
Windsor is located on the southern shore of the Detroit River. According to the 2016 Census survey taken on May 10, the population of Windsor city increased by 3.1 percent in the last 5 years and reach to 217,888CITATION Census l 16393 1. According to the survey, the combined population of the Windsor metropolitan area was 329,144 in 2016 CITATION Census l 16393 1. The Population of Windsor is increasing day by day due to the facilities provided by Windsor City. Windsor is the most affordable city to live in Canada as property rates are exceptionally low. The people of Canada are migrating here due to warm weather and natural places of the Windsor. The city of Windsor offers various parks, gardens, trails, and Riverside to spend leisure time with family which makes this city prime location for retirees who want to live in CanadaCITATION Mar18 l 16393 2. The city of Windsor is the host of many activities during Summer time like Art in Park, annual Detroit River Fireworks, Summer- Fest, and many moreCITATION Mar18 l 16393 2.

The city of Windsor offers quality education at St Clair College and the University of Windsor. These are one of the most significant academic institutes in Canada, which offer quality education at moderate fees. The University of Windsor offers 190 undergraduates programs to 12,780 students and 65 graduate programs and 6 professional programs to 2,794 part-time and full-time studentsCITATION Fas181 l 16393 3. Among them, 17 percent are international studentsCITATION Fas181 l 16393 3. The University of Windsor has become the first choice for international students due to its prime location and moderate fees. There is a decent chance of an increase in these numbers for the fall intake as it is the most preferable intake for study by international students. The number of students at St Clair College is increased by 12 percent compared to last yearCITATION Enr17 l 16393 4. The current number of students at St Clair College is around 10,500 and it will be increased by around 1,200 in fall intakeCITATION Enr17 l 16393 4.

The City of Windsor primarily depends upon 3 hospitals named Windsor Regional Hospital (WRH), Hotel-Dieu Grace Healthcare and the Erie Shore Health Care to provide all kinds of medical services to the people of Windsor. The WRH has two Campus in Windsor. WRH is the 3rd largest teaching community hospital of Ontario and the 11th largest medical Hospital of CanadaCITATION 18Ju l 16393 5. Hotel-Dieu Grace Health Care offers facility related to mental health and addictionsCITATION 18Ju l 16393 5. Erie Shores Health Care is fully-accredited Hospital, which offers the broadest range of specialties including Anesthesia, Emergency Medicine, Surgery, and many moreCITATION 18Ju l 16393 5. The city of Windsor also has around 19 small Walk-in Clinics to provide medical facilities.

However, these hospitals are not ample to provide medical facilities for an excessive number of people. This problem is increasing day by day due to the arrival of a number of students. The average wait-time to contact specialists of a particular field is increasing. So that the people of Windsor travel to the nearest major cities like Toronto to acquire medical facilities by a specialist. This problem can be extremely critical in the cases related to skin problems and physical problems which require instant treatments.

According to research conducted by The Canadian Institute for Health Information (CIHI), only 43 percent of Canadians are able to get a same or next-day appointment at their nearest clinic and around 20 percent of Canadians wait for more than 7 days to contact doctorCITATION Car17 l 16393 6. According to Canadians, they get an appointment after almost a month to see a specialist which is very large compared to the international average wait time to see a specialistCITATION Car17 l 16393 6. In an emergency situation, Canadians have to wait for around 4 hours to see a doctorCITATION Car17 l 16393 6. Canadians also have to wait for the longest time for surgery compared to other countries peopleCITATION Car17 l 16393 6.

The aim of this project is to improve the current healthcare system by conducting research and analysis. This project report describes the possible solutions to the problem. The Team is looking forward to improving this scenario by implementing essential changes in the current process of treatment and by providing separate medical facilities to students. These solutions have been proposed after various research and reviewing articles and existing projects related to the topic. The team thinks this is the best time to implement these solutions as the number of International students is increasing and its critical move to spread positive review about Canada and Windsor in front of the World by improving the most essential healthcare facilities given to the international students. The report also describes a detailed budget, timeline, and conclusions and recommendations for the project.

Background and Literature Review
For any country, the most common need of people is access to quality healthcare services. The citizens have full rights to demand comprehensive and quality health care services from their Government. Its duty and responsibility of the government of a country to provide basic health care facilities to people. The most common barriers to health services include the high cost of medicines and lack of availability of servicesCITATION Acc18 l 16393 7. These barriers can lead to problems like unmet health needs, delays in receiving appropriate care and financial burden to the GovernmentCITATION Acc18 l 16393 7.

Improving health care services means to increase access to the public to the medical facilities by increasing the number of hospitals and reducing the cost of the medical facilities. The government has to focus on Timeliness which includes waiting time to see a doctor in a clinic and emergency departments as well as the availability of appointmentsCITATION Acc18 l 16393 7. The average wait time to see a doctor should be minimized to provide a quality healthcare facility to everyone. Delays in getting health care can decrease the patient satisfaction as well as the number of patients who leave without getting treatment can increase significantlyCITATION Acc18 l 16393 7.

According to the public of Canada, the healthcare facility of Canada is very good as 74 percent of Canadian people rates the medical facility given to them as “very good” or ‘excellent”CITATION Car17 l 16393 6. Even most people can afford the healthcare facility of Canada as only 1 out of 10 Canadians skipped a dose because of costCITATION Car17 l 16393 6. However, for dental care, 28 percent of Canadians do not visit a dentist’s clinic as they couldn’t afford itCITATION Car17 l 16393 6. “Most of the Canadians are satisfied with the quality of health care they are receiving from their doctors”CITATION Car17 l 16393 6.

The team studied various reports and articles to find required healthcare facilities and needs of International students and public of Windsor. The team researched current projects on which government is working to improve medical facility in Canada. The team found that students most commonly suffered from skin diseases, physical health problems, and mental issues. So, the team searched for the reasons behind these problems and worked on solutions to these problems. The team also searched and compared various facilities provided by the current hospitals in the City. In this research team found that the Sandwich Community Health is the best place to implement this solution.

According to the director of the school’s student counseling center, the number of students who faced mental problems increased from 300 to 830 in the recent yearsCITATION 8 l 16393 8. Currently, students are under immense pressure because they have to juggle between their full-time study and part-time jobsCITATION 8 l 16393 8. According to the survey of more than 25,000 students who attends Ontario colleges and Universities, the rate of anxiety, depression, suicidal thoughts, and suicide attempts are increased compared to the last survey of 2013CITATION 8 l 16393 8. This survey was conducted by the Ontario University and College Health AssociationCITATION 8 l 16393 8. A load of the study also affects the sleeping habits of students known as Sleep deprivation. A larger study of 1,125 students found that more than half of the students had poor sleep habitsCITATION 9 l 16393 9. Students start taking sleeping tablets which can affect their physical and psychological healthCITATION 9 l 16393 9. Currently, tuition fees for colleges and Universities are very higher than ever. So, students worried more about the financial burden, which leads to problems like anxiety, stress, and sleeping problemsCITATION 9 l 16393 9. According to the research conducted by the Lewis Katz School of Medicine at Temple University psychological stress are associated with skin diseasesCITATION 10 l 16393 10.

Requirements and Criteria
Requirements
To improve the infrastructure of Windsor City, the team researched and surveyed various areas in which improvements are required. The team considered modifying the current healthcare facilities provided by the government as one of the main requirements of Windsor. In addition to that, the team needs to focus on the Timeliness of the treatment process. According to that, reduce waiting time to see a doctor in a clinic as well as in the emergency departments, and increase the availability of the appointments of specialists. Even there is a need to recruit the number of specialists at Student Health Services of the University of Windsor. The most common health problems faced by students relate to depression, anxiety, and stress. Physical health problems and Skin diseases are also common to students. So, the new system should be designed to fulfill these requirements. The proposed solution implementation cost should be minimized for the success of the project.

Criteria
To implement the proposed solution, the team performed deeply research about the current medical facilities provided by hospitals in Windsor. The team gathered various data from hospitals in Windsor and compare their advantages and disadvantages. To find an optimum place to implement the solution, the team followed particular criteria and found the Sandwich Community Health Center is the perfect place to implement the proposed solution. To ensure the optimization of the proposed solution following criteria were considered.

Initial costs: The team tried finding the proposed solution which requires the least amount of initial cost. The team has two options. One is to construct a new Separate hospital for students and the second one is to modify health facility provided by existing hospital and restrict its services to students only. The team has chosen the second option as it requires the less initial cost to implement the solution.

Convenient location: This includes efforts required to reach the location. The team selected the location where everyone can reach easily. The location of the Sandwich Community Health Center is on the bus route so; it is easy to reach there. In addition to that, this hospital is very near to the University of Windsor which makes it a prime location for students.

Future scope: The location should be selected in a way that it can meet the future scope of the project. There is an ample space available near the Sandwich Community Health for future developments.

Proposed Design/Solution
The team conducted a comprehensive study of the vital medical problems faced by students. The team found that in the most of the cases student suffered from physical health issues, skin diseases, and mental problems. Hence, the team searched for the reasons behind that and gathered detail on that. According to our research, the Sandwich Community Health Center is the ideal place for the implementation of the proposed solution. REF _Ref522037761 h * MERGEFORMAT Figure 1 shows the Sandwich Community Health with the staff members working thereCITATION 11 l 16393 11.

1333503242310Figure SEQ Figure * ARABIC 1: Sandwich Community Health with Staff members
Figure SEQ Figure * ARABIC 1: Sandwich Community Health with Staff members
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The Sandwich Community Health Center is located at the corner of College Avenue and Brock Street in Windsor. The health center provides primary care services to the people of Essex country and Windsor. “It has a team which consists of physicians and nurse practitioners supported by RN’s, RPN’s, and medical receptionists”CITATION 11 l 16393 11. The Health Center offers medical facilities related to the laboratory, ECG, and provides home visits for patients who cannot reach the CenterCITATION 11 l 16393 11. They also provide placements and learning opportunities for students and also provide free counseling services up to 12 sessionsCITATION 11 l 16393 11. Counselors of Sandwich Community Health assist public of Windsor in solving metal issues like stress, anxiety, work-related stress, and many moreCITATION 11 l 16393 11. The team proposed the following three solutions to improve the medical facility of Windsor.

Improve the infrastructure of Sandwich Community Health of Windsor to provide quality health care to students and restrict the services given by the center for students only.

To serve more patients in a day, time spends per patient limiting to 15 minutes or number of queries solved per visit limiting to 2 in the cases of physical health issues and skin diseases.

Increase the office hours at Student Health Services.

Sandwich Community Health:
The Sandwich Community Health provides treatment to the mental problems of the people of Windsor and students. Therefore, the team decided to improve the infrastructure of the Center in such an able manner that, is able to provide treatment of physical problems, skin diseases, and emergency health services to students of Windsor. To provide these facilities, the team decided to build one more floor on the existing building which will require construction in around 6,300 square foot area. This amount of construction will be ample to accommodate medicine, emergency, orthopedics, and dermatology facilities in the center which are the most common requirements of students. In addition to this, it will be ample to provide emergency block services with 2 beds and a pathology lab. Each required medical facilities by students described below in details. REF _Ref522037914 h * MERGEFORMAT Figure 2 shows the image of Sandwich Community Health captured by the team member.

Figure SEQ Figure * ARABIC 2: Sandwich Community Health
Emergency services: To treat the emergency services, qualified medical staff will be required to handle any emergency services. The Emergency block consists of the waiting room, triages, arrival gate for an ambulance as well as by own means, consulting rooms, and treatment zone. To fulfill the required criteria, four qualified doctors can be appointed at the center. REF _Ref522038166 h * MERGEFORMAT Figure 3 shows the most basic layout of the Emergency ward of a hospital.

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Figure SEQ Figure * ARABIC 3: The general layout of Emergency ward
Physical and Dermatology Facilities: In Canada, skin diseases are extremely common. To accommodate physical and dermatology-related facilities in the center, two qualified doctors per facility will be required, who can work on rotating shifts to accommodate more patients in a day. In these medical streams, doctors do not require large and costly equipment. So, physical and skin related health issues could be solved in a small room.

In addition to the above services, the health center will consist of laboratory services. Laboratory services play a crucial role in the diagnosis and treatment of diseases. The improved Health center will also consist service equipment like lift, fire-fighting equipment, and air conditioning system for the convenience of patients. For inventory control, the team will introduce computers in the Center.

Regulate the Patient visit time:
According to the current treatment policy, doctors are able to meet an only limited number of patients in a day. Due to this, the average wait time to see a specialist is increasing. This condition will become the worst as many doctors are retiring and many shutting downs their practices because they cannot afford itCITATION 12 l 16393 12. The number of required doctors and beds are almost halfCITATION 12 l 16393 12. To solve this problem patient visit time can be limited to 15 to 20 minutes or solve the maximum two queries of patients on a visit in case of physical health issues and skin diseases. There are some adverse effects of implementing this solution as it conveys the wrong message to the public that the government is unable to provide quality healthcare facility to patients. It is even impossible to implement in every medical facility as some treatments require time to consult and solve. However, it is the optimum way to provide medical facility to every patient and reduce average waiting time to see a doctor. This implementation can play a crucial role in the improvement of the medical facility of Ontario.

Student Health Services:
Student Health Services at the University of Windsor provides comprehensive health care and counseling services to the students of the University of Windsor. They only provide services by the appointments through phone calls. The office hours of the center are from 9:00 am to 12:00 pm and 1:00 pm to 4:00 pm from the Monday to Friday. They only provide 6 hours of services for 5 days of the week. So, they should increase the number of office hours to the 12 hours a day and provide health care on the weekends also. They should provide health care related to the emergency situations and start to provide walk-in healthcare facility. In addition to that, they should recruit a number of specialist doctors. REF _Ref522038337 h * MERGEFORMAT Figure 4 shows the Student Health Services at the University of Windsor.

Figure SEQ Figure * ARABIC 4: Student Health Services
Strengths
Advantages of implementation of the project can:
Lower initial and constructing cost compared to other possible solution.

Average wait time to get appointments of specialists will reduce.

The standard of the medical facility providing by the government will increase.

Rush at walk-in clinics will reduce, which is beneficial for the people of Windsor.

The number of international students in Windsor will increase.

Limitations
Limitations of implementation of the project can:
Patient visit time cannot be limited in every treatment process related to health issues.

Cost Analysis
The team made an estimation of how much it will cost to build the second floor at the Sandwich Community Health, buying equipment cost and other costs like transportation. The team had a meeting with a civil engineer of the private company named EverJonge Homes Ltd. and the team is sourcing the project cost according to their estimation. To implement this solution, firstly the team has to move the current location of the Sandwich Community Health and need to rent a new location for a temporary set-up which will cost around 15,000 CAD. The Construction cost related to the project will be around 120,000 CAD. In addition to that, it will cost around 60,000 CAD to purchase medical equipment and the additional facilities like furniture, beds, and electronics items. REF _Ref522038785 h * MERGEFORMAT Table 1 describes the cost associated with the project implementation details.

Table SEQ Table * ARABIC 1: Project Cost
S.N. Description Cost (in CAD)
1. Cost related to temporary set-up 15,000
2. Cost related to building 6,300 square foot medical facility 120,000
3. Cost of medical equipment required for emergency ward 20,000
4. Cost related to the additional facilities (Elevator, Medical furniture, Electronic items like TVs and Computers, and Hospitals beds and Counters) 40,000
Total cost 195,000
Therefore, the total cost to implement the proposed solution is around 195,000 CAD, which is negligible when compared to the benefits it provides for students and the public of Windsor.

Timeline
After the project has been approved by the healthcare department, the team will follow the particular timeline to implement the proposed solution. To implement the project summertime is appropriate. The implementation plan is divided into 4 phases. According to the team, it will take around 20 days for preliminary approval of the project. In the pre-installation stage, the team will formalize the plane layout which will take around 15 days, and it will take around two weeks to finalize the vendor. For construction, it will take around 5 months and the team will purchase and install the required equipment during the final stage which will take around a month. REF _Ref522038878 h * MERGEFORMAT Table 2 describes the timeline and different stages of the implementation.

Table SEQ Table * ARABIC 2: Project Implementation Timeline
Activities Time
Project Preliminary approval 20 Days
Pre-installation Stage
Formalization of Plane Layout – 15 Days
Quotation from vendors – 1 Week
Finalizing vendor – 5 Days 27 Days
Construction Stage
Migrate to Temporary Set-up – 1 Week
Construction Phase – Around 5 Months 5 Months
Final Stage
Purchase Required Equipment – 1 Week
Installation of Equipment – 2 Weeks
Final Inspection – 1 Week 1 Month
Overall, it will take around 7 to 8 months to complete the project.

Conclusions and Recommendations
Conclusions
The population of Windsor is increasing due to the arrival of International students. However, the medical facilities provided by the city is not ample to accommodate the high number of the population. Especially, the number of specialist doctors in Windsor is very less. The project’s main goal is to find a solution to improve medical facility provided to students which can aid students as well as the public of Windsor. This proposal gives an effective solution to the problem, which is to improve the infrastructure of Sandwich Community Health in such a way that it can fulfill desired criteria. The project will cost around 195,000 Cad and 7 to 8 months to implement.

RecommendationsThis project focuses on solving the problems related to health facilities. So, it is recommended that the government should do some surveys to solve the problem. In addition to that, the proposed solution can be implemented in every place where the number of students is high and not ample medical facilities available to treat health problems.

References BIBLIOGRAPHY
1 “Census data shows Windsor’s population has grown by 3 per cent,” CBC News, 8 February 2017. Online. Available: https://www.cbc.ca/news/canada/windsor/census-windsor-census-1.3971906. Accessed 10 July 2018.

2 M. Morrison, “About Windsor Ontario,” Mary Morrison Sales Representative, 2018. Online. Available: http://www.mywindsorontario.com/windsor-12/about-windsor-ontario. Accessed 10 July 2018.

3 “Fast Facts,” Daily News, Online. Available: http://www.uwindsor.ca/45/fast-facts. Accessed 10 July 2018.

4 “Enrolement At St. Clair College Reaches 10,000 – An All Time High!,” St. Clair College, 22 September 2017. Online. Available: http://www.stclaircollege.ca/news/2017/enrolment-reaches-all-time-high.html. Accessed 10 July 2018.

5 “Hospital Facilities,” Online. Available: https://www.citywindsor.ca/business/physician-recruitment/Work/Pages/Hospital-Facilities-.aspx. Accessed 10 July 2018.

6 C. Chai, “Canada has some of the longest wait times to see doctors, specialists,” Global News, 16 February 2017. Online. Available: https://globalnews.ca/news/3251833/canada-has-some-of-the-longest-wait-times-to-see-doctors-specialists-report/. Accessed 10 July 2018.

7 “Access to Health Services Heart Disease and Stroke | Healthy People 2020,” Online. Available: https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services. Accessed 10 July 2018.

8 “Students seeking mental health services spike at University of Windsor,” CBC News, 26 September 2017. Online. Available: http://www.cbc.ca/news/canada/windsor/students-seeking-mental-health-services-spike-at-university-of-windsor-1.3779964. Accessed 10 July 2018.

9 L. C. Roberts, “9 Ways Going to College Affects Your Health,” LiveScience, 03 September 2013. Online. Available: https://www.livescience.com/39366-how-college-affects-health.html. Accessed 10 July 2018.

10 “Association between stress levels, skin problems in college students,” ScienceDaily, 23 November 2015. Online. Available: https://www.sciencedaily.com/releases/2015/11/151123202212.htm. Accessed 10 July 2018.

11 “Sandwich Community Health,” Teen Health – Home, Online. Available: http://www.wechc.org/sch_about. Accessed 10 July 2018.

12 A. Seth, “Some Ontario physicians put time limit on patient visits to highlight government cuts,” Global News, 27 June 2016. Online. Available: https://globalnews.ca/news/2790203/ontario-physicians-limit-patient-visits-to-highlight-government-cuts/. Accessed 10 July 2018.

Appendix
Triage: Triage is an assessment to decide the degree of urgency to create the order of treatment of a large number of patients.