Healthcare planning for an uncertain future: Adaptability

It’s no secret demands placed on health facilities are constantly changing, which means the services provided need to be flexible.

So can you really plan and forecast the needs of the Australian population?

There are a few strands that emerged during the round table discussion recently held for Australian Healthcare Week 2014 . Stuart Moore (Epworth Healthcare) referred to the analytical information Epworth use during the development stages of projects and how this can help with mapping provisions: “We look at data in terms of trends in clinical areas of all sides, public and private, across Australia. We use this data to try to map out growth areas across Victoria (the market in which we operate). That information directly impacts the development projects for our existing sites. We also look at Greenfield opportunity sites in Geelong.

“That information is used alongside the figures we get from Government forecasting such as funding models etc.”

There’s a whole range of information available from the Government that can be incorporated into plans. Anna Morgan (Southern Health) uses information based on areas of growth to gain a better understanding of the timing for expected growth in particular areas when mapping out services.

“The growth catchment predictions impact decisions made in our area quite heavily. We have a lot of older established areas that we currently serve, but in the outer regions there are identified nominated growth areas. We have to understand what the time frames are for that growth so we can incorporate them into our plans.”

The fluctuating population growth rates and behaviour predictions of those people have certainly been a challenge for health facilities in the past.

Leonie Hobbs (Carramar Consulting) has first-hand experience in Queensland, where unexpected population growth led to a long term design predicament: “We closed many beds because we had huge facilities at the time. Then something happened that we weren’t expecting: we had a huge population influx. We hadn’t designed to manage that. That’s the dilemma we are still stuck with now. The population modelling was done correctly, it was the provision of services themselves that we got wrong – we were hearing people would use more ambulatory services and therefore need less bed days, but we still needed the beds.”

So how can we really predict population? Ultimately, modelling can never be exact, but the message is to use the data sources available to make the most informed decisions.

The workforce challenge

Of course, the adaptability challenge extends beyond the build of facilities to occupy surrounding communities; the service itself needs to be just as flexible.

Two themes tie into the debate: the provision of services themselves and the location.

Perhaps one of the most interesting pieces of research happening currently is in Queensland around contestability. Leonie explained: “With the potential of outsourcing public work, there’s becoming a trend in QLD, NSW and WA where we are seeing more of a ‘Fee for Service’ model provided by the private sector. This may be something on the landscape for the future.”

Time will tell how much of an impact outsourcing and contestability will have. Projections produced by HWA in the ’Health Workforce 2025’ report make it pretty clear that without major reform in the pattern of health service delivery, Australia faces huge shortfalls in the nursing and related workforce nationwide, and in the supply of general practice and many specialities outside inner metropolitan areas.

There are considerations that should be made during the design and development to start to tackle this challenge.

The first is around staff and the experience they have. If we make our facilities a better place to be, we’re more likely to retain staff. The roundtable participants discussed how the biggest asset to any facility is the people who work within it, they therefore need to also be at the centre of the design.

We looked at several examples, ranging from the layout of facilities to providing open spaces for staff to relax and research.

The second consideration is around how we’re providing the service itself and a question that was raised by Arch Fotheringham (Brookfield Multiplex): “Are we taking the person to the facility or the facility to the person?”

Location based health

As mentioned earlier, the Government growth reports are one tool for forecasting. Arch suggests that it’s important not to reduce options when providing services in these expanding areas: “It’s easy to say there’s a growth area but you need to look at how you get people out to where that facility is. A good example is if you look at the Western Melbourne area, where a large percentage travel to Central Melbourne for treatment because it’s not available in that area. It extends beyond buildings…”

Anna spoke of a recent project in Dandenong, where they experienced similar location issues. The team are in the process of building new and improved facilities at Dandenong Hospital to ensure continued access to the highest quality of care for the community.

The work redevelops a number of community and ambulatory care services provided in disparate locations, bringing them into one central precinct. It’s an approach that extends existing services rather than builds new ones.

“As we continue forward, we’re about to do master planning in a growth area to do a very similar thing to what we’ve done in Dandenong. It’s about community services, medical consulting, allied health consulting and referring back to our main bases in adjacent areas where the tertiary services are. Understand the services you already have, look at how you can build on them.”

We couldn’t look at location services without discussing at least part of the rural health challenge. We have an ageing population; a large number of people are retiring and moving out to more rural areas where there aren’t as many accessible sub-acute services. They currently have to gravitate back into the capitals.

The population will still also continue to be dispersed – inner city health facilities are run off their feet whilst rural facilities are much quieter and come with their own workforce challenges.

Australia can’t continue to be so metro-centric.

Leonie confirmed, “The models of care are changing rapidly. We design to a model of care and it quickly changes. Take cancer care: we used to bring patients in for treatment and get great outcomes and survival rates. We’re now seeing the day ambulatory oncology unit gets just as good outcomes. Another example is around physiotherapists. I’m consulting with a facility at the moment that has a strong Allied Health background, the whole structure needs to change as we’re now moving into therapy aids. There will be fewer physios and more aids, more groups and less individual spaces. I’m learning people will require less cube rooms and bigger group spaces. We have to be flexible enough to change models of care.”

Solutions need to be found and they’re expected to be driven through design innovations, extended workforce training and technology.

Next week we’ll cover ‘Part Two:  Funding’ or download the full report here: www.austhealthweek.com.au

Government Organisations tasked with risky business…

Times are changing for government organisations, and for many it’s going to come as quite a shock. When it comes to risk, we haven’t seen anything that’s actually required government agencies to set up a framework that really aligns to processes. The framework is aimed to fully manage risk and proactively put tools in place to mitigate any potential outcomes.

By the 1st July, under new guidelines, it’s time for organisation to progress beyond compliance.

Rod Farrar, Director of Paladin Risk Management Services has been working with organisations for years, helping them to develop and implement risk management frameworks for their business. He explained how in many organisations, if risk management is done at all, it is in a token manner and is mainly seen as a compliance exercise – it does not add value to the organisation in any way. Even with the introduction of the PGPA, there is a danger that Government Agencies will do just enough to be compliant but it’s time to start looking at the wider strategic and operational picture. If embraced fully, in the long term, there’s huge potential to achieve the national objective of doing ‘more with less’.

It’s time for change

What needs to happen between now and July 1st? According to Rod, organisations need to embrace the true benefits of ERM to achieve their full potential: “Many Government organisations are in a situation where they spend more time crisis managing than they do on risk management. If they start to see risk management as more than a compliance activity, one which is fully integrated into their other organisational programs, then huge efficiencies are to be gained.

“There are some key areas that need to change, and it has to start with a culture shift driven from within. To manage risk effectively, we need to be working in a no blame culture, where we learn from our mistakes.”

“When you have a culture that embraces open discussion around mistakes, people are more encouraged to prevent it happening again and therefore adapt new processes. There’s absolutely no capability of a risk framework succeeding if there is a blame culture.”

For many organisations, this would require a big shift in culture, with support needed from top to bottom

“Everyone is accountable for driving a positive culture, management need to lead through open communication, but all tiers need to embrace change in order to switch from re-active to pro-active. There needs to be a transition from ‘doing risk management’ to ‘managing risk.’

“I look around the public service now and government agencies have to come up with efficiency dividends. This is usually done by reducing staff numbers. If we managed risk properly, however, efficiency dividends may not be needed.

Where the benefits can be seen

It seems clear there are some real benefits to be had for the entire business when risk management is seen as more than just a compliance exercise. Rod described the knock on effect that has seen many organisations dramatically improve operations:

“Organisations are currently spending too much time managing a crisis. It’s been shown that managing crises costs more than proactively managing risk.

“What risk management will do – if it’s integrated properly with strategic and business planning, compliance, performance management and internal audit is reduce the amount of work an organisation is required to do and will significantly reduce expenditure.   “Risk management has also been shown to improve objectives, planning and relationships with stakeholders.

 “Simply relying on risk champions within your organisation to be the focus of the risk management effort will not work – the organisation as a whole needs to embrace the program within a well-structured risk management framework.”

Join the Masterclass

During Enterprise Risk Management 2014, we’ll be holding a brand new one day masterclass: Governance, Risk and Compliance. Not sure whether it’s for you? Find out more

It’s time to think outside the box for funding.

Monash Health are currently in the process of building new and improved facilities at Dandenong Hospital to ensure continued access to the highest quality of care for the community.

The work will redevelop a number of community and ambulatory care services which are provided in disparate locations and to bring them into one central precinct in central Dandenong.

As with many other projects one of the key challenges has been funding. With funding increasingly becoming a barrier to development, I had a chat with the Capital Planning Manager at Monash Health; Anna Morgan to get an insight on the innovative approaches used to get funding.

Five years ago Monash worked with the Department of Health to develop business cases for funding. However, they were unsuccessful in bids for funding from State and Federal Government. The conditions of the buildings housing the health services that were being provided were becoming critical, another set of business cases and another source of funding solution had to be found.

The solution came from internal funding; Monash acquired long term leasehold of a property and then arranged for the landlord to fit out the building in accordance with their design, over the ten year lease period, Monash will pay back the landlord for those fit out works.

The project is currently well into design, closing off schematic design and into design and documentation with the aim of going out to tender by the end of July, and engaging a key contractor in August.

Anna explained how there’s a need for a new form of thinking in Victoria: “ We are having to get a bit smarter with our funding and make it stretch a lot further, we’re not getting the same sort of funding. We need to think outside the box if we want to keep resourcing our facilities, so not just looking to government for funding. Look to inside your organisation, sponsorship and other support methods, it’s a key way to get funding to renew services and renew facilities. There are some health services in Victoria that are starting to do that, but many that still aren’t looking beyond the main stream.”

We also have to be a lot smarter in the way we’re using the budgets, it’s coming through to a much smaller level. In the past we might have got two or three million for a project, now we’re expected to achieve a small refurb with a million dollars instead. It’s a huge challenge to prioritise the key aspects of a development rather than doing the full project”.

Interested in hearing more expert insights on how to tackle some of Australia’s biggest health challenges, check out http://www.austhealthweek.com.au

New Generation Learning Spaces: The essentials

Thinking back to my classroom experience, our weekly highlight was re-vamping the small notice board in the corner. The rest of the room (and most of the other classrooms for that matter) housed square desks and chairs facing the teacher at the front.

Those days are gone. We’re going through a huge transformation; classrooms are being reinvented as studios to suit the new ways in which we both learn and teach.

The future is technology and collaborative based and our educational facilities are adapting accordingly.

Architects are having a field day (excuse the pun) with designs, encompassing innovative buildings, bright colours and new technologies to create truly inspirational and educational experiences. I’ve collected insights, tips and tricks from around the web and spoken to our New Generation Learning Spaces panel to share the best with you:

Immerse yourself

One of the key drivers behind re-imagining the learning space is collaboration. When you think of immersing yourself, you might be thinking it’s something you already do; reading up on the latest teaching methods and so on; but are you physically immersing yourself in the classroom?

There’s no need for the teacher to stand at the front of the room to teach anymore, don’t be afraid to move your desk around, surround yourself with students and have a 360 view of the classroom.

This was a key feature of a recent Third Teacher+ transformation, check out the video of the journey as well as some key highlights from the project here:

http://www.edutopia.org/blog/8-tips-redesign-your-classroom-david-bill

Utilise natural light

Insight from Sean Coleman, Lead – Learning Spaces, Better Learning and Teaching Team, Office of the Pro-Vice Chancellor (Learning and Teaching) at Monash University:

“Natural light is hugely important to learning spaces; we’re seeing it more and more in tertiary educational spaces. We’re doing a huge refurbishment at one of our lecture theatres currently and the designs feature some huge windows that started to get smaller and smaller during the PCG. You have to push back and keep them as big as possible.

“If there’s too much light, you can always retrofit blinds or window treatments, but let’s just get as much light as we can and provide students with a connection to the outside world.

“It aids in the connection and engagement of the teaching staff and the students, especially if you can see the changes in the season – letting light into what would normally be a dark room.”

Don’t get tripped up by technology

Insights from Barbara White, Senior Lecturer in Information Technology, Charles Darwin University:

“Technology plays a central role when considering the design for a new learning space and this can bring new challenges and opportunities for education providers. I can see in lots of places that teaching students how to use communication technologies as a knowledge practice, as opposed to an entertainment or communication practice, is where some of the issues still are. Learning spaces are certainly providing an opportunity for those things to happen.”

Hon Steve Maharey, Vice-Chancellor, Massey University (New Zealand):

“You need to invest heavily in future-proofing our buildings because the demand for technology is going to rise exponentially. Our new building is set to evolve along with the demand by students and staff for more digital capacity.”

Peter Lippman, Associate Director from EIW Architects:

“There have been a lot of lessons learned about technology and spaces, but we have to understand very clearly that technology is a tool. We have to start with how people learn and think about how we’re going to support that. 

“We have to think about what is good and what is appropriate for the kinds of spaces we’re creating. For example, if you’re just going to do PowerPoint presentations, then all you need is a lap top and a connection to mount it into a projector so you can do your presentation. How different is that from just a blackboard or building in a projector and putting a movie on the screen?

“We need involve all people from all around the university and pull IT engineers out of their caves, because there are many people who have wonderful ideas and should become part of the stakeholder conversation.”

Break down the classroom wall

Insight from Mark Freeman, on his experience designing the Kangan Institute Automotive Centre of Excellence (Stage 2).

“This unique inner city campus was envisaged as a catalyst to assist in transforming all aspects of automotive skills training and research, and automotive component and vehicle testing.

“Previously, all of the different automotive skills units were, to some extent, delivered in isolation, in individual buildings on an older campus. Now, for the first time, all of the skill units are brought together in the one building, and not just in the one building, but also in the same workshop space.

“There’s a lot more collaboration between the workshop skills managers. There’s a lot more day to day negotiation of space and the utilisation of equipment that’s there.

“One of the key benefits is that the students are exposed to a lot more things. Previously they might have existed in the one building for half the day, and then in the other building in another, and effectively those were, to some extent, closed spaces.

“In this particular building the students are exposed to everything that’s happening on a daily basis. There is industry coming in and doing workshops (they’re running seminars, running vehicle and product launches), so the students come into contact with industry. There is industry participation in terms of sponsorship and maintenance of aspects of the facility as well.

 “It’s a lot more of a collaborative environment. It’s a lot more of a transparent environment, and the building as a whole, is a good place to be in. It’s not dark, it’s not damp, and it’s not dirty. It’s light, it’s bright, and it’s a healthy environment.

“It has really lifted everyone’s spirits in terms of the students who are in the building, and also visitors to the building. It has transformed their attitude towards coming to campus.”

A few practical tips:

When you do have walls, write on them.

First came the transition from chalkboards to whiteboards, but why limit the space? Walls are often filled with clutter, or just left as wasted space. Why not integrate whiteboards across your entire wall space. Not only will this utilise the space in your classroom, but by opening up the room you’ll be helping to encourage spontaneous collaboration.

Finally, get yourself some quick (and fun) wins.

We couldn’t finish without talking about all those neat little storage tricks out there. Storage is one of the key ways that space can be created, from something as simple as adding cushions to your stable cabinets to use as chairs, through to rebuilding your entire cabinet range to fit smartly within the confines of your walls.

Check out this list of ’35 Money-Saving  DIY tricks for teachers on a budget’:

http://www.buzzfeed.com/peggy/money-saving-diys-for-the-classroom

Classroom architect is a great resource that allows you to virtually redesign your exact room:

http://classroom.4teachers.org/

Finally, for some inspiration, these two Pintrest boards have some great examples of before and after classroom transformations:

http://www.pinterest.com/mrsbartteaches/before-after-classroom-makeovers/

http://www.pinterest.com/kmp444/classroom-transformations/

Find out more by visiting www.designforlearning.com.au

[Exclusive interview] Building powerful partnerships at Queensland’s new Lady Cilento Children’s Hospital

The new 359-bed hospital will be the biggest public children’s hospital in Australia, and the central hub of an enhanced state-wide network of children’s health services.

The Lady Cilento Children’s Hospital merges staff and expertise of the Royal Children’s Hospital and the Mater Children’s Hospital

It is part of a $1.5 billion program of work, including an adjacent academic and research facility, the refurbished headquarters of the Children’s Hospital Foundation; land to accommodate families within the precinct; improved road access and a new Adolescent Drug and Alcohol Withdrawal Service building.

Developing Queensland Children’s Hospital has been no easy feat. The overarching challenge: bring together two old (but long-standing) children’s hospitals and win people’s hearts…

Ahead of their presentation at Australian Healthcare Week 2014 in March, I caught up with some of the people tasked with steering the project from concept to completion: Dr Peter Steer, Chief Executive, Children’s Hospital and Health Services, Bruce Wolfe, Project Director at the project’s architect, Conrad Gargett Lyons, and Tim Treby, Project Director for the managing contractor, Lend Lease.

Could you outline your involvement in the Lady Cilento Children’s Hospital and where your focus lies?

Peter Steer: I’m the Chief Executive of the Children’s Health Queensland Hospital and Health Service that will be running and managing the facility at the end of the day. I’ve been involved for five years now, and my focus is to ensure that we deliver a contemporary design that delivers against our vision and mission, which is a really patient- and family-focused healthcare service.

Bruce Wolfe: This was something of the ultimate architectural prize so, initially, my involvement was bidding on the project; then Master Planning and developing the building concept with the design team, health planners and client. In many ways my role involved managing the complex relationships on the project and that is my focus now as the building nears completion

Tim Treby: I have been involved in project for over 6 years, from commencement of the Master Planning phase as Building Consultant initially, and then as Managing Contractors representative.  I am responsible for delivering the building to meet the expectations of the client and the many other project stakeholders.

The success of the project relies heavily on effective collaboration and communication. What would you say is key to getting this right?

Peter Steer: The relationship between the principals on the project. We were very fortunate with the appointed architectural team and the managing contractor as those relationships are critical. The other critical communication issue in health is the quality of stakeholder engagement and, in particular, user group engagement.

We learned through the project that you can’t over-communicate in the context of these complex designs. The healthcare professionals using the facility feel very strongly about their services.   There’s a significant education element around that stakeholder and user group engagement. It was one of the things we got better at as the project progressed.

I’ve been involved in a number of significant projects before and am continually surprised at how difficult it is to bring people along. Some clinicians have strong opinions and their expectations are very high, and not always contextually appropriate for the capital build. There are real challenges in managing stakeholder user groups. We took the communication and listening process very seriously. We went back repeatedly to review and subsequently did some significant schematic re-design work because we were keen to ensure people felt listened to.

Bruce Wolfe: Time spent listening is always valuable; listening to both ideas and criticisms. It’s crucial to moving forward collectively.

Tim Treby: I agree that the success of any project relies heavily on effective collaboration and communication.  The larger and more complex the project, the more challenging this becomes, and the more important it is.  This project has been extremely challenging in virtually all aspects of the development process, and the toughest issues to overcome, in hindsight, have been those where communication and collaboration have been lacking in some form.  We are fortunate to have a client who recognises the importance of this and we are able to communicate openly and resolve potential issues early. 

What preconceptions did you bring to the project and were they reinforced or altered?

Peter Steer: My preconception was that it was going to be a very complex capital build and that there would be issues around our workforce merger, given that this was bringing two hospitals together.  They’ve been reinforced – it’s a very complex project that is now going well, I’m not sure there’s been anything like it in this country before.

Bruce Wolfe: At the interview for the project, we talked about a very different type of hospital, open and “permeable”. I actually wondered whether this may have been too big a move for Queensland Health but it the opposite was true, the client was keen to embrace innovation and bring new ideas to the planning including the concept of a more open and community connected hospital. The site was also challenging and involved a broad review and evaluation of the urban context. This was fundamental to the success of the project and in reality was every bit as complex as imagined.

Tim Treby: This was always going to be a technically challenging project; a heavily serviced hospital including an energy facility on brownfield site bounded by major arterial roads, bus tunnel, schools, hospitals, residences and a telephone exchange. Having been involved in many hospital developments before the LCCH this was understood, and has been reinforced many times over during the life of the project.   The project has traversed several cycles, including economic, political, industrial, corporate and stakeholders which have all had to be negotiated.  I knew that the project team would have to be tenacious to overcome the challenges that would and have come, and also that we would be all be justifiably proud of the end product.  It is a fantastic result.

QCH was not a public-private partnership. Do you see any benefit of using this new PPP style?

Peter Steer: We benefited from not being a PPP, primarily because the site was complex and had some major design challenges, along with the organisational merger; engagement was critical. And certainly the procurement process and the choice of managing contractor versus a PPP allows a lot more user and stakeholder engagement. That was the advantage for us.

In terms of Public-Private Partnership, given the challenges for government finding injections of capital money, PPPs will become more attractive. PPPs will be a mechanism (and not an unreasonable one) to deliver these big projects that otherwise will simply not get off the ground. PPPs certainly have their place and their advantages, but I don’t think there’s a perfect methodology. The mechanism of procurement really does need to fit the purpose and context.

Bruce Wolfe:  Shortly after the design of QCH, CGR won the commission to master plan and provide the design of the Reference Project of the Sunshine Coast University Hospital, a PPP project on a large scale. One of the difficulties in the PPP process is getting sufficient client and user-group contact with the competing design teams. I think that was well handled in that project but it remains a difficult aspect of PPPs. The benefits are in relation to the capital cost savings for government and allowing the health experts concentrate on delivering their core expertise.

Tim Treby: They appear to be desirable from a public funding point of view, however I think that the cost to industry to bid for PPP tenders is excessive and unsustainable.  There must be a more equitable procurement methodology that can be developed.  I would question whether they are sufficiently client focussed for particularly complex projects.

How is the project responding to a change in customer demands?

Peter Steer: Things have changed enormously over the last seven years.  To be both accurate and give praise where it’s due, the architects in their design have designed a facility that maximises flexibility.

As our understanding of service models has matured, we have had to make changes. We’ve obviously had to draw a line in the sand, but we were fortunate with a flexible design in the first place that has allowed us to survive well with adaptation over that long period of time between design and delivery.

Bruce Wolfe:  Our customer for QCH was Queensland Health. In the long delivery of such a project there are inevitably changes in their demands that impact on planning. The versatility and flexibility of the design was tested during that six year period from master planning to completion.

Tim Treby:  I think that when the Hospital opens people will be impressed with this building.  It is a facility that has the welfare of its young patients and their families firmly in mind, as well as the needs of staff and visitors.  There has been future flexibility built in, and much work done by the client, design and contractors teams to ensure the latest technology is provided in the facility, considering the lead times which have had to be managed.

What have been some of the biggest challenges you faced throughout the development of the project? Are there any lessons learnt?

Peter Steer: It’s critical in any healthcare design, particularly given the context of our merger and bringing two organisations into one, to get that engagement right. The other opportunity is getting stakeholders to understand there may be design solutions and technology solutions to some of our service delivery challenges at the moment.

A classic example of such an opportunity was in our outpatient design – we had our clinicians absolutely horrified that there was very little waiting space within this hospital for clinics etc. When you think about it, at first, a patient might think, why don’t we have larger waiting areas? But, the principle about being patient- and family-centric with this children’s health service is not to have people wait, and to design a facility that would enable waiting makes no sense.

You can create tension by your design, your intent and your vision for the organisation, and through technology, make a real difference to a design solution. There’s a major change agenda, a service change opportunity, with these big design projects, it’s difficult to grab them.

The other challenge is that on a really big, long project, the team changes. You have changes in personnel, particularly in the public sector, in the bureaucracy with whom you’re interfacing, and often have government changes. Managing that change can be a challenge.

Bruce Wolfe:  This was a complex and testing project and there were really no areas that were not a challenge.  A difficult brown-field site, two separate and very different organisations coming together, a highly visible project politically and a turnover of client project directors during the course of the project. The challenge was to stay focussed on the architecture and the building and the problems that were in a domain where we could be most effective.

Tim Treby:  As I have already mentioned there has been no shortage of challenges on the project.  The site location provided many technical and logistic challenges, and the form of the building required a lot of planning to develop methodologies to safely construct it, and it did drive innovation.

The clarity and alignment of expectations for the user group approval of the developed design was challenging, and exacerbated by external criticism and lack of continuity of some participants.   The importance of external stakeholder engagement was recognised and managed well.

There has already been a lot of interest in this project from a design perspective. What has been your impression from that commentary?

Peter Steer: This project (and certainly the design that’s put on the table) is centred on creating a green and healing environment.

This vision has permeated everything with extraordinary attention in design, designing to minimise use of electricity, having our atria and major thoroughfares in the hospital, open to the environment.

There’s also a community vision where the intent of the architects has lived true, they’ve ensured the hospital is open to the community. There are major ‘windows’ that allow people both to see in and see out from this facility, which not only helps with finding context about time of day and place, space and time, but also builds community connections. For a children’s hospital, this is critical.

Bruce Wolfe:  The building occupies the site quite powerfully which has generated discussion both for and against. As the building is revealed, the gestures of opening the building façade and connecting the inside spaces to the outside is more apparent and helps in the scale of what is a very large building. There is more of the ground plane also given to the public.

We have been pleased with the comments as the scaffolding has come down and surrounding buildings removed to reveal the civic domain.

It was also pleasing to be the first Australian hospital to win the Academy of Design and Health Award for Best Future Hospital

Once it’s open and people get to experience it, as opposed to looking at pictures, I am sure the impact will be much, much more significant.

Tim Treby: The external appearance tends to be polarising, and it certainly has people talking.  The finished product being delivered is true to the brief and design intent, and will provide fantastic facilities.

The project has clearly seen lots of innovation. Have you any examples of how it’s acted as a catalyst for change for other hospitals?

Peter Steer: There’s little doubt that our emphasis on service planning and patient flow as a result of this process is influencing ambulatory care delivery across Queensland. We’ve been innovative in terms of our ambulatory clinic not just design, but service. We’ve got some great feedback and interest from health services across the State. It’s that interface between service design informing building design that has been the advantage.

Bruce Wolfe: I think it is probably too soon to tell but I think that since the design of this building was revealed in early 2008, there is a renewed emphasis in hospitals on intuitive way finding and creating public spaces in the building that link to form a network of volumes rather than of corridors and passageways. There have been planning innovations as well but these would be tested in practice before being adopted more broadly.

Tim Treby: The have been many innovations implemented during the construction phase, which will no doubt be used on future projects.

Hear more from Peter Steer, Bruce Wolfe and Tim Treby during their exclusive presentation at Australian Healthcare Week:  ‘Queensland Children’s Hospital: The New Look PPP’s: Powerful Precinct Partnerships’ This project case will focus on the new Children’s Hospital Project, demonstrating a strong collaborative process adopted by the client, architect and contractor which has ultimately acted as a catalyst for change