Healthcare Design: St Stephen’s Hospital

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On completion, St Stephen’s Private Hospital in Queensland’s regional centre of Hervey Bay will be the first fully integrated digital hospital in Australia. Australian Hospital and Healthcare Bulletin spoke with architect David Peters about the project, and how this hospital is inspiring the direction for future healthcare developments.

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What is the scope of St Stephen’s Hospital? How many beds and what services does it offer the local community?
St Stephen’s Hospital offers a number of services to the community including inpatient (medical and surgical), day surgery, renal and oncology, and various practitioner services. The current development provides 96 inpatient beds and five operating theatres, as well as supporting and related services, with the potential for further expansion.
What was the design brief for St Stephen’s Hospital?
[caption id="attachment_6638" align="alignright" width="355"] Ariel Shot, St Stephen's Private Hospital[/caption]
As well as being a sophisticated regional hospital for the Fraser Coast Region, one of the most important aspects of the building design is the way it presents to the public and contributes to the local environment. As a commercial building it must have an inviting frontage and become something of a landmark.
Importantly however, this hospital was designed to be Australia’s first fully integrated digital hospital. It will be truly paperless, with all patient records being digital. There are no exceptions to this rule, to the extent that there will not be any facilities for the storage of paper records, or for the processing of paper documents (other than scanning). As part of the move to a fully digitised environment, UnitingCare Health (UCH) is committing resources to digitise all existing patient records.
The brief called for the building to be designed not only for staff and patient flow, but to allow various services to be offered by external providers in standalone service modules. The provision of spaces for external providers allows the services to alter over time to meet changing requirements in the district. It also affords the facility owner the most efficient method of service delivery. The combined Oncology and Renal Dialysis facility is an example of a service which could be used and set up as either a single or dual service provider.
The future expansion of the building has been an integral component of all planning and design of this project. The provision of ‘soft spaces’ and corridors will accept expansion without disrupting existing facilities. The final stage will offer the Fraser Coast community a facility comprising eight operating theatres, 180 inpatient beds, specialist facilities including a sleep centre, Renal and Oncology facilities plus a number of auxiliary facilities like a pathology and pharmacy.
While the building can be expanded in multiple stages, the data centre and other plant spaces have been designed for future capacity to avoid the disruption that often accompanies these changes.
Who was involved in the design and construction of St Stephens?
The hospital team from St Stephens Hospital and the UCH management were very much part of the design process. The Conrad Gargett Riddel (CGR) design team was led by David Peters and Rebecca Moore with a support team including Grant Buglar and Katherin Khoo. The initial first stage delivered by CGR in February 2006 was designed to be expanded upon with the current development representing stage two of a master plan for the site. All master planning, urban design, architecture, interior design and landscape architecture for the project have been undertaken by CGR.
The following companies and individuals comprise the consultancy team, client and user groups for this project. All have contributed to the investigations, discussions and decision making required in the preparation of this report.
 

Client
UnitingCare Health

Users
St Stephen's Hospital (Maryborough and Hervey Bay)

Project Manager
APP

Quantity Surveyor Architecture/
Interiors
Slattery Australia Pty Ltd

Landscaping
Conrad Gargett Riddel

Structural/
Civil Engineering
Cardno

Mechanical/
Electrical/
Communications/
Medical Gases/
Lift Engineering/
Fire
Wood & Grieve Engineers

Ehealth
UnitingCare Health / ICT

Hydraulics Engineering
Opus

Acoustics
ASK Consulting Engineers

Kitchen Consultant
FSD Australia

Building Surveyor
McCarthy Consulting Group

Programmer
RTM (Rowles Time Management)

Town Planning
KHA Development Managers

Fire Engineer
Omni Engineering

Access Consultant
Eric Martin and Associates

Safety in Design
Hughes Health & Safety

Cockram Construction
was awarded the current
contract at the beginning of 2013

How long will the project take to construct from planning through to opening? 
This current stage of the overall development was 18 months in the planning and the building program will be approximately 18 months with completion in August 2014. There will be a relatively short commission program following this prior to the full facility being operational.

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“… this hospital was designed to be Australia’s first fully integrated digital hospital. It will be truly paperless, with all patient records being digital. There are no exceptions to this rule, to the extent that there will not be any facilities for the storage of paper records or for the processing of paper documents …”

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Was the budget adhered to? If not, where did it differ and why? 
Apart from an allowance for the costs associated with the high level of technology required for a fully digital hospital, the costs are very much in line with expectations. The project is currently within budget and on program.
St Stephen’s is recognised as the first hospital in Australia designed as a Himms 7 level digital hospital. What does this entail and what are the potential benefits this system will offer staff and community? 
A ‘fully digital’ hospital defined as: “From the time of arrival to the time of departure all of the data relating to a patient’s stay at the hospital will be collected, recorded and accessed digitally.  This means that doctors, nurses and support staff will not record or fill out any paperwork in relation to the medical record or support services.”
All hospital devices will be fully integrated to allow complete access to digital records with ‘connectivity engines’ to enable old technology to talk to new technology.
Each patient bedroom will have a touch-screen “patient station” with all relevant services and entertainment, including meal ordering, internet, television, and information pertinent to their medical requirements.  Staff will similarly have access to all digital records via a clinical station within each bedroom.
All medical devices can be linked to the system via hardwire data connections or  wirelessly from anywhere within the hospital.  Devices and patients can be tracked using the real-time tracking system which will be of great benefit, not only to staff but also to relatives, who will have the ability to ‘follow’ their loved ones as they progress through the hospital system.
The hospital systems can also be linked via smart applications to tablets and computers. This allows care providers and patients to share information in real-time, all the while allowing medical records to be continually updated. All hospital management processes will also be carried out digitally.  This includes, among many other processes, ordering patients’ meals and goods, BMS requirements and staff records.
Wayfinding will also be digital, with a touch screen at the front entry to provide any assistance required for direction. The screen will also be used as an interactive centre, identifying key environmentally sustainable design (ESD) initiatives throughout the building.
What are some of the unique features of St Stephen’s Hospital that will inspire the direction for future health design projects? 
On arrival at St Stephen’s Hospital, the airy light-filled main entry foyer is a large volume of space that is broken into smaller areas to ensure human scale is considered and that individuals feel comfortable.
The form of the new building is directly determined by the location and occupation of the existing facility, the new work essentially “wraps and extends” around three sides of the day surgery, enveloping it to make a whole.
With strong exposure to the north and south, the building’s layout lends itself to the integration of courtyards. From all aspects of the facility, it is possible to view the surrounding landscape. Users are able to understand the passage of time throughout the day and have a connection to the exterior while the resulting penetration of daylight plays an important role in creating a welcoming environment. The capacity to see the exterior allows users and visitors to orientate themselves and easily navigate through the building.
In addition to spatial and departmental planning, the characteristics of the interiors were also designed to facilitate users’ cognitive mapping process for way-finding, to reduce stress and enhance their experience in the building.
The building is also expandable and adaptable. This is crucial for healthcare facilities of the future where demographics, models of care, types of treatment, nature of disease, equipment and technology may change at a rapid rate.
What were some of the biggest challenges in delivering the Hospital to the point it is now?
The coordination and development of the design with the complexities of developing the concept and requirements of the ’digital hospital’, particularly as digital technology is constantly evolving.
Managing the design and planning while still maintaining the design intent and budget with an evolving brief.

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[caption id="attachment_6646" align="alignleft" width="175"] David Peters, Director,
Conrad Gargett Riddel
DipArch, AIA, BOA 1996[/caption]
David Peters has delivered major innovative design projects across the commercial, institutional, government, and residential and health sectors. During his 30 year career he has developed a speciality niche in hospital design, and as a result heads up Conrad Gargett Riddel’s health division. His understanding of health regulations have resulted in the creation of many projects which have surpassed client expectations.
David’s strength in spatial planning is supported by his in-depth knowledge of construction processes. Through the application of clever design within constraints, coupled with a strong knowledge of process planning, David manages to continually create engaging and highly functional environments. David also has the ability to drive a team to create user friendly designs which incorporate a vision for future development.
David recently authored “Going the Extra Mile” a paper on the key role health facilities need to play in the social and economic life of regional and remote communities, published in Australian Healthcare Design 2000-2015, published by the International Academy for Design and Health 2013.