Nanaimo Regional General Hospital patients will have a new $33.85-million intensive care unit in 2021. It will replace what a 2013 Island Health report deemed the “worst” ICU in Canada.

“The money is there, we’re going forward. After a lot of years of inaction, we’ll be delivering for Nanaimo,” B.C. Health Minister Adrian Dix said. “This hospital is not just critical for Nanaimo, it’s critical for the whole region. This ICU will serve the people on Vancouver Island very well.”

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Construction is forecast to start early in 2020 and be completed by late 2021.

Nanaimo’s current nine-bed ICU was built in 1970. It cares for patients with life-threatening illnesses or injuries. The new ICU on the hospital’s second floor — south of the emergency department — will be three times bigger. It will have 12 private rooms, each with washrooms and hand-washing sinks. There will also be negative-pressure rooms for patients requiring high levels of infection control.

On the floor below, space will be allocated — to open at a future date — for patients who require less care than the ICU but more than on a general ward. The new ICU will also offer a private entrance and consultation rooms.

“I’m just thrilled the time has come,” said Dr. Ben Williams, Island Health’s executive medical director for a geographic area encompassing Nanaimo. “I think this is an incredibly exciting time at Nanaimo hospital. It’s really a chance after a challenging two or three years to reset and be forward looking about the kind of hospital our community needs going forward, and a new ICU is a really important part of that for our staff and our physicians but most importantly for our patients.”

A 2013 external review that looked at three of Island Health’s ICUs said the physical condition of the Nanaimo unit was “by far the worst ICU we have seen in Canada.”

“There are multiple factors that cause this area to be a risk to patients as well as staff: The limited size, layout and lack of storage space create numerous safety issues,” the review said. “This impacts the ability of the team to safely transport patients into and out of the ICU as well as within the unit.”

The report recommended replacement.

To compound challenges, a problem-plagued electronic health record system was implemented in March 2016, and the next year an independent report spoke of the toxic culture at the hospital.

Dr. David Forrest said when he came to work in Nanaimo’s ICU in 2004 it was already one of the worst physical plants in Canada, but there was the opportunity to expand with quality staff.

“This is a huge step forward that staff have the appropriate resources and infrastructure to provide the best quality care,” Forrest said.

His concern is whether the ICU is being built for today or future service demands for the central Island: “It needs to be built for future needs and that’s difficult to predict.”

By the end of 2018, about 2,500 patients will have been treated in the hospital’s intensive care unit, and that’s anticipated to grow by 30 per cent to 3,250 visits by 2033.

Dix made the announcement on Wednesday in Nanaimo, where Liberal candidate Tony Harris has promised voters a new ICU in his byelection campaign. Nanaimo-Ladysmith MP Sheila Malcolmson is the NDP candidate for the provincial Nanaimo seat, which is becoming vacant because the incumbent, NDP MLA Leonard Krog, was elected mayor of Nanaimo.

Harris, a board member with the Nanaimo and District Hospital Foundation, said the foundation has been pressing the government for a new ICU for over a year. “I just couldn’t be more pleased with the fact we’ve got this over the hill,” Harris said. “Of course the timing is interesting. We’ve been making a lot of noise about this lately and there’s a really important byelection coming up and Nanaimo is all of a sudden at the centre of attention for the province.

“It’s terrific for Nanaimo, it’s been overlooked for so long,” said Harris, adding a project of this magnitude requires a lot of people working together across the political spectrum.

Dix said he has long been interested in the issues at Nanaimo’s hospital, including the need for a new ICU. “Nothing had been done on the project until I became minister of health,” Dix said. “It became clear to me this project needed to be done and it was critical to the life of the hospital.”

Malcomson called it “deeply troubling” that the B.C. Liberals did nothing to fix the problem when they were in power.

Dix said a formal request was made by the Vancouver Island Health Authority in October 2017. “As capital projects go, this has been dealt with remarkably quickly,” he said.

The project is funded 60 per cent by the provincial government through Island Health and 40 per cent by the Nanaimo Regional Hospital District. The Nanaimo and District Hospital Foundation pledged last year to fundraise $5 million for medical equipment.

ceharnett@timescolonist.com