Facilities – Physical Space Constraints

Service: Risk Management
Subject: Facilities

Physical space constraints can impede workflow and patient care needs, impact strategic planning and organizational growth. As a result, this creates risks in the form of increased operational costs, patient safety issues, fire hazards, privacy breaches and reputational loss. This document contains information entered by HIROC Subscriber healthcare organizations (acute and non-acute) in the Risk Register application to help you in your assessment of this risk.

Key Controls/Mitigation Strategies

  • Strategic Planning/Budgeting:
    • Develop space allocation/budget process to ensure needs are evaluated and in-line with the budget cycle
    • Master planning
    • Immediate and annual space needs assessment and plan
    • Evaluate off-site locations, as needed
    • Continue to evaluate additional space solutions
  • Internal Policies and Processes:
    • Process in place through Facilities Department/Committee to:
      • Document and track current occupancy
      • Receive requests for space allocation (decisions made are based on request need and availability) 
      • Catalogue all additions
    • “Hotel” office space use (i.e. shared desks)
    • Controls to enhance storage space:
      • Walkarounds to eliminate unneeded items
      • Auctioning off unused items 
      • Donation of items to medical companies and regular disposal runs
  • External Relationships:
    • Contracts/Memorandum of Understanding (MOU) and strong relationships with partner hospitals to mitigate care deficits (i.e. critical patient needs)
    • Federal, provincial, and local politicians engaged in requests for redevelopment
  • Temporary Workarounds for Space Constraints due to Public Health Measures: 
    • Temporary modular spaces
    • Space Planning Workgroup reviews all space requests for renovation and relocation, as well as provides a proactive outlook on short-term (<24 months) and medium-term (<5 years) space requirements
    • Relocation of staff through:
      • Work from home strategy
      • Convert existing areas to functional workspaces
    • Facilities Department calculates maximum capacity within rooms to meet social distancing requirements
    • Added portable physical barriers to waiting areas
    • Adjusted appointment times to reduce the number of people in the waiting area at one time
    • Reduced the number of visitors accompanying patients in waiting areas
    • Some services moved off-site


  • Master list/catalogue of all space and current use
  • Ongoing identification of internal efficiencies and benchmarking stage approval
  • Space Constraints due to Public Health Measures: 
    • Number of space requests
    • Patient volume information
    • Changes in program needs and requirements
    • Infection Prevention and Control (IPAC) monthly audits in areas