Sebastian R. Freiku
5 November 2008
Kumasi — AFTER TWO years of hard work by GERTECH of Germany, the 74 million euro Ultra Modern National Accident and Emergency (A&E) Centre, the biggest and one of the best health facilities to be put in place by the government at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, has been completed, and would be commissioned by President J. A. Kufuor on Saturday November 8, this year, hospital sources have disclosed.
The world class 200-bed A&E Centre, the first of its kind in the West African sub-region, consists of operating theatres, accident units, consulting rooms, X-ray units, a pharmacy, recovery wards, a mortuary with separate cubicles for 208 bodies, as well as a helipad, where helicopters can take off and land.
The project comes to supplement other health delivery facilities, including 20 government hospitals in the region. The project design of the A&E Centre has all the clinical areas on the ground and first floors, while the Administration, Central Command and Education facilities are on the second floor.
Hospital sources say the ground floor would accommodate the A&E Department, Clinical Decision Unit - 24 beds - split into 3 No 8-bed wards - one each for male, female and children, Medical Records, Radiography, Pharmacy, Laboratories and Blood Bank, Dental Unit - attached to main A&E treatment area, Mortuary - for overnight storage, Central Stores and Materials Management, Central Housekeeping and Central Staff Changing area.
The first floor, Ashanti File, learnt would accommodate Wards - 66 beds - made up of 22 beds each for males, females and children; Intensive Care Unit - 8 beds made up of 2 No singles and 1 No 6 bedded area, Isolation Unit - 3 single beds, Burns Unit - 3 single beds, Operating Theatres, Sterile Supply Department, Renal Dialysis - Two bed spaces equipped for mobile dialysis equipment.
A total of 104 beds, 24 observation beds on the ground floor and 80 beds on the first are thus provided. The second floor accommodates the Administration areas and Education facilities. It also includes a Command Centre for the overall operational control and co-ordination of emergencies.
Plant rooms are directly over the 'high use' areas, such as the Operating Theatres, ICU, Isolation units and Burns Units. The helipad is on the roof over the Administration and Education areas - with ramp access to the first and ground floors.
A separate National Disaster area has been provided at a large space located adjacent to the A&E building. It is envisaged that this will be used, under normal conditions, as a multi-purpose hall and vacated in an emergency, to provide accommodation for emergency services.
This is located adjacent to the new A&E building, and has links to the existing military hospital.
Although there are separate clinical departments within this building, it is primarily a major Accident and Emergency Centre, which will require close working relationships across the traditional clinical barriers.
This co-operation would be a very important issue in a major emergency. In this building there are many small specialist departments, such as the Burns Unit (3 beds) and Isolation Unit (3 beds) and Intensive care (8 beds), where staff facilities, administration, reception, teaching/seminar/meeting facilities are located for convenient shared use across those departments.
Working practices may require review to fully integrate the separate clinical departments into a fully co-ordinated Accident and Emergency Centre.
Vertical circulation will be via two ramps - one primarily serving patients and visitors, and the other serving staff, supplies and materials distribution. These are at opposite ends of the building for operational and fire escape purposes. Stairs are provided between ground and first floor - located centrally - to reduce the travel distance between floors for staff, visitors and ambulant patients. Lifts are also provided between the floors.
The hospital sources said new roads had been provided around all sides of the new A&E building, to provide easy access to the building, and much flexibility of use as possible.
The road access points lead directly to the main A&E entrances for 'walking-in wounded' and visitors. Separate entrances are provided for accident cases arriving by private cars or taxis and for ambulances.
There is a secondary entrance on the north-west boundary, to be used for staff. Supplies and materials management will use a dedicated goods entrance, located near the link to the existing hospital.
There is a new road access to this point, for materials delivery and waste removal. This is also the point where the building connects to the existing hospital walkways.
In the concept design, emergencies arriving by helicopter will use the helipad on the roof of the building. This is located with close access by ramp to the major treatment areas, and to operating theatres directly below. All relatives of patients and visitors are directed to the main A&E Entrance, from where they will be directed to other departments such as the observation ward on the same level, and to the wards on the floor above.
Three categories of traffic, namely patients, relatives and visitors and supplies, are important for the A&E Centre, and must function smoothly under emergency conditions. Where possible, the level of 'overlapping' and 'crossovers' are kept to a minimum, but some are inevitable.
The design concentrates the patients in the main A&E department, Radiography and Clinical Decision Unit (CDU) areas. The remaining departments on this floor are generally for staff only. Patients requiring the first floor will use the lifts or stairs nearby.
Supply routes are concentrated at the link to the existing hospital, and a separate goods entrance with road access. Catering and laundry will link into the existing hospital. Supplies can come either from the existing hospital, or via the new goods entrance. Waste disposal will use this area - as will the mortuary with a screened loading area.
Vertical distribution will be via the 'supplies' ramp.
Relatives and visitors will have access to the main A&E department, and the plan encourages them to remain in that area. Visitors will have access located near the main wait area to the Clinical Decision Unit. Visitors will have access to the first floor wards, and view patients in the ICU, Burns Unit and the Isolation Wards.
Catering for patients and staff will be provided from the existing catering facilities within the hospital, while laundry will be provided from the laundry at the basement of the building.
Engineering and equipment maintenance services will be provided by the main contractor, GERTECH of Germany, through a 5-year maintenance agreement, as part of the contract.
According to the management of the hospital, efforts would be made to facilitate technology transfer to in house technical staff, to continue with Planned Preventive Maintenance of the Centre and equipment, after the five (5) years, official hospital sources indicated.
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