Ukraine inflation and fallout pose new hurdles for children’s hospital as structure takes shape

THE NEW NATIONAL CHILDREN’S HOSPITAL is now firmly entrenched in the Dublin landscape, but soaring inflation and global supply chain issues pose new development challenges.

Construction of the long-awaited National Children’s Hospital, located next to St James’ in Dublin 8, is well underway.

The structure has reached its final height, more than 95% of the required concrete has been poured and many services are within walking distance and are close to being ready for the installation of equipment and furniture.

However, factors like Brexit and Russia’s war on Ukraine which increased the cost of materials are another hurdle in a project whose cost has steadily increased since its inception.

The newspaper visited the site of the new hospital and its office in Rialto, where demonstration areas have been designed to show what the patient rooms will look like when completed.

Staff behind the development described the latest reasons for rising costs and new hospital features, as well as what the transition from existing hospitals will entail and how sustainability has been built into the construction.

National Children’s Hospital Development Board (NPHDB) project director Phelim Devine said there are “huge cost pressures and people are aware of that”.

In 2017, the project was expected to cost 983 million euros. The following year, Taoiseach Leo Varadkar told the Dáil that it would cost €1.4 billion.

That amount rose again to €1.73bn in 2019, while an opposition TD said he thought it was ‘highly unlikely’ the total cost would be less than €2bn euros.

NPHDB’s Devine pointed out that the project had accounted for inflation of around 4% – but this year inflation soared to 7% as consumer prices rose at their fastest pace in nearly 22 years old.

“There will be additional costs associated with inflation. There are other external pressures beyond our control, Devine said.

“Covid impacted the project; it delayed the project and there will be costs associated with that,” he said.

The other pressure is that there is a shortage of resources in the industry. The industry is at its peak, you can’t attract people, and obviously there’s the big impact of Brexit, Covid and the war in Ukraine.

“In a way, we are lucky, because we were reasonably advanced on certain things, like the facade, everything was built, [so] as Covid impacted the program was delayed, but at least we had the materials.

Today, globally, Russia’s war on Ukraine has led to increased fuel costs and complications with international shipping, triggering a construction domino effect.

“Steel went through the roof, plasterboard went up. Everything, every material went up, because of the logistics, the cost of fuel, the cost of transporting it – everything comes from different countries. These are the pressures with which we are faced.

The entrance to the new hospital

Source: Lauren Boland/TheJournal

Before the opening

Despite the added pressure on costs and supplies, the project still aims to complete construction by the end of 2023 and open in 2024.

Before taking off, the hospital will have to manage the complicated process of moving patients, staff and equipment from existing children’s hospitals in Crumlin, Tallaght and Temple Street.

Medical director Dr Emma Curtis explained that the move will involve an ‘operational commissioning’ process, which involves staff entering the hospital, finding their way around and getting used to the new building and facilities .

“For this hospital, it will be about a six-month period,” Dr. Cutis said.

“Then the process of moving everyone is called clinical migration. It happens over a shorter period of time and there is an enormous amount of planning that goes into it,” she said.

You are trying to reduce the number of your hospitalized patients. You can control your planned activity – if someone is going to have a complex operation, you wouldn’t do it the week before the move, you would do it two months before the movie or you would leave it a month after.

“You can’t control that sick people are sick, so there will be a certain cohort of patients. We will move one hospital at a time. We are currently working on this sequence.

While one hospital is relocating, other hospitals will need to be able to cover any shortfalls.

“And then once you’re in, you’re up and running. Once the door opens, people know we’re there, so we need to be ready to deliver whatever comes up on opening day. It’s tough, but we’re going to do it and we’re going to do it well.

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Main hall sections

Source: Lauren Boland/TheJournal

4525 C11 Atrium Seat Steps Night Shot - Opt Warm (Stage-05)

A projection of how the space will look when completed

There are child-centric touches throughout the building, from colorful floor markings and eye-level windows in the doors to a tablet installed at each bed that can be used for entertainment, education and ordering food.

Most of the rooms have a private bathroom and are equipped with a convertible sofa that the parents can use as a bed.

The decision to focus on single rooms rather than shared rooms was debated earlier in the planning process, but ultimately came as a source of relief when the pandemic underscored the importance of being able to give patients their own space. if necessary.

Each section of the building has an outdoor play area in an interior courtyard, and the fourth floor will be planted with an expansive rooftop garden and windows that will illuminate the main lobby.

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An example of a room

Source: Lauren Boland/TheJournal

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An example of a door

Source: Lauren Boland/TheJournal

Clinically, all health records will be processed through an electronic system instead of paper documents in the hope that electronic records will make access to patient information faster and easier.

And in a first for Ireland, some materials will be transported through the hospital by small robots which will make around 1,400 trips a day on material corridors separate from patients and visitors.

“We’re going to have robotics transporting material flows through the building. They will activate the automated doors, they will also activate the elevators,” explained Tony O’Rourke, director of estates, facilities management and sustainability.

“It is a small rectangular unit running on wheels. It has an elevator, so it would walk under, say, a laundry cage, lift it, and drive off to its destination. It has its own predetermined paths,” O’Rourke described.

“The hospital is designed around robotics. He’ll walk up his hallway, enter the elevator, go up to the ward where he’s supposed to go, there’s a clean hub to drop off, and he’ll head to disposal to pick up trash returns and head back down to the dock.”

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Part of the roof garden under construction

Source: Lauren Boland/TheJournal

Sustainability

Across the health service, the HSE is due to publish a plan (due to be published in March) outlining how it intends to decarbonize its infrastructure.

Buildings’ energy needs for electricity, heating and cooling add up to produce significant greenhouse gas emissions and the HSE has recognized that its infrastructure needs to become more energy efficient.

The new children’s hospital has been awarded a BREEAM Excellent rating for design, a marker of sustainability in buildings, and governing body Children’s Health Ireland intends to work towards achieving a BREEAM rating for operations in the hospital.

Compared to existing children’s hospitals, the energy consumption of the new NCH is expected to be 60-70% lower per square meter.

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“Hospitals are very energy-intensive,” said project director Phelim Devine.

He said sustainable decisions were implemented “where we had the slightest opportunity”.

“Take the rooms on levels five and six, we have a hybrid ventilation system there. It’s mostly natural ventilation with a backup for days when we might put in some cooling, but it’s usually natural ventilation.

“[It’s] the same in all ambulatory rooms. Those who don’t need special air because of the patients, they are naturally ventilated, just open the windows. We’ve modeled all of this through CFD analysis to make sure people don’t get too hot.

“We have a combined heat and power unit, so it’s gas. It produces electricity to reduce tariffs.

He said “there were a few things we weren’t allowed to do because it’s a hospital”, like using boreholes to draw water directly from the ground.

“It could have been a little more, but there are rules that we have to respect. We are as efficient as possible.

One measure that has not been implemented, but could be a possibility in the future, is solar power.

“We looked at PV panels, but they just didn’t stack up the price-performance ratio,” Devine said.

“Because we have a helipad, the largest roof area we have is level four, but there are downdrafts from the helicopters,” he said.

“There may still be an opportunity in the Meadow Garden in the future to do a little more about solar power, because solar power is getting better and better, but when we designed the hospital, it just wasn’t working.”

NCH ​​antennas

Aerial images of the site at the start of construction (top) and in April 2022 (bottom)

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