From Clinical Walks to Preboard Walks: Enhancing Patient-Centered Spaces through Multidisciplinary On-Site Reviews
“These walks are more than just quality checks—they’re a collaborative effort to ensure every space is functional, efficient, and patient-centered. Through teamwork, continuous learning, and a shared commitment to excellence, the project Alliance is shaping a hospital that truly serves its community.” — Melinda Lobo, Associate and Healthcare Planner at Parkin.
The Nuts’a’maat Alliance’s journey toward improving quality assurance and quality control (QA/QC) at the Cowichan District Hospital Replacement Project began with clinical walks bringing together representatives from Island Health, Parkin, and EllisDon at the rough-in stage. These walkthroughs focused on assessing key design elements—doors, windows, stud walls, plumbing rough-ins, and ceiling rough-ins—to ensure the intended clinical flow while proactively identifying potential concerns.
As the process evolved, clinical walks transformed into preboard walks conducted before drywall installation. These detailed reviews focused on Medical Equipment & IT devices, equipment locations, wall backing for mounted items, plumbing rough-ins, and ceiling elements. With subject matter experts from Parkin, Island Health, and EllisDon on-site, every detail is meticulously checked, ensuring the highest standards of functionality and patient care is met before final sign-off.
Beyond Walks: Building a Collaborative Culture
What truly sets these walks apart is the culture of collaboration they have fostered. The team includes representatives from Island Health, the client, Parkin (the architect), EllisDon (the construction team), and key champions from Infection Prevention & Control, Occupational Health & Safety, Electrical and InformationManagement and Information Technology (H.H. Angus and Houle), and Security. This diverse group works seamlessly together, meeting at least once a week—sometimes twice—depending on the boarding schedule.
Our commitment to continuous improvement is exemplified by our recent “Lessons Learned Workshop,” where we reflected on successes and explored opportunities for growth using the “Even Better If” approach. The insights gained from this workshop are already being implemented, further enhancing this culture of open communication and learning, further strengthening our collaborative efforts.
Real-Time Problem-Solving: Agility in Action
A standout example of our approach occurred during a walkthrough of a fluoroscopy treatment room. While simulating clinical flow, we discovered that staff would be using the sliding doors in the opposite direction. Instead of delaying the project with lengthy coordination efforts, the team acted immediately—heading straight to the construction trailer to check the fabrication status of the door frames. Since they were still in production, the issue was corrected within an hour, saving both time and money and supporting optimal patient care workflow.
By proactively identifying issues early and resolving them, the Alliance team can create a more efficient and successful QA/QC process.
Shaping the Future of Healthcare Spaces
Through collaboration, continuous learning, and agile real-time problem-solving, our integrated team is not just reviewing spaces—we’re shaping them. These clinical and preboard walks have revolutionized QA/QC at the Cowichan District Hospital Replacement Project, ensuring that every detail contributes to a top quality, patient-centered environment.
As the Cowichan District Hospital Replacement Project Alliance team continues this journey, we remain committed to refining our approach, leveraging technology like Fieldwire for real-time deficiency tracking, and strengthening the collaborative spirit that drives our success. One walk at a time, we are setting a new standard for QA/QC in healthcare construction.