Designing healthcare for regional communities

Unlike any other state or territory in the country, most Queensland residents live in regional areas. To support this decentralised population, regional communities demand the same standard of critical care and services that is provided in any major city.

Fulton Trotter Architects has been working in regional health and community projects in Western Queensland for 70 years and has recently been appointed to redesign Clermont Hospital’s new aged care facility. Director Paul Trotter* shares his learnings in continuing the practice’s legacy in rural architecture.

The most important lesson I’ve learnt working in rural Queensland is that things are done differently in the bush.

Australia’s identity is forged from the bush and strong ties exist between urban and rural communities. But there is a chasm in the values and outlook that is reflected in our politics and our whole way of life.

The passion for community and a rural way of life translates to consultants who work in these areas, and they must share or understand these values if they are to gain the trust and friendship from these communities.

When we’re designing rural hospitals, we must balance the competing needs to design 21st century, clinically efficient facilities with the need to satisfy the location’s distinctive atmosphere and ‘spirit of place’. We are building more than a hospital.

Rural healthcare facilities, including hospitals and aged care, are often the cornerstone of their communities. Though they’re one of the pillars that support and enhance rural life — alongside the local state school, police station, courthouse and the post office — they’re often so poorly serviced that they cannot support the community’s needs.

Connecting a community can be an immense challenge at the best of times; however, the task becomes that much harder when that community is in fact multiple communities joined by kilometres of rugged landscape.

As with any healthcare project, the challenge is to understand the processes and model of care specific to that centre. The model of care and patient flow dictates the relationship between different departments, which essentially informs the overall layout of the hospital.

Unsurprisingly, there are vast differences in the models of care associated with metropolitan and regional health centres — primarily dictated by scale and the range of medical services supported.

Very few towns, for example, can support their own renal dialysis department or even their own operating ward. This means the centre — and importantly its staff — must be able to accommodate a wider range of services under the one roof. This integrated approach in regional hospitals fosters a more intimate and relaxed environment and informs their design.

Understanding the climatic variation in regional areas is fundamental. Particularly in Western Queensland, it can get very hot in summer and very cold in winter. Rain doesn’t come frequently, but when it arrives, it rains hard, and for a long time. These are elementary design considerations that you must understand to make provisions for materials, lighting, landscaping and ventilation.

Working in regional areas also requires consideration of labour and material availability. We use local trades and services whenever we can and our buildings are specified using locally available materials and systems, for easy ongoing maintenance.

In smaller regional towns, hospitals play a very significant role in the community, as the key stakeholders — the staff, patients and their families — are almost always locals. They have a personal investment in the community, so it is vital to listen and understand their needs and create architecture that reflects the ‘spirit of place’.

*Paul Trotter is an architect and Director of Fulton Trotter Architects. Paul is recognised with numerous awards for his work throughout Queensland and particularly extensive involvement with regional communities.

Top image caption: Clermont Hospital, Qld. Photographer: Richard Stringer.