Designing minor illness and injury clinic for children

A new Minor Illness and Injury Clinic (MIIC), designed and delivered by the Australian architecture and design practice Conrad Gargett, will provide support to the Queensland Children’s Hospitals Emergency Department (ED) and also offer an alternative general practitioner (GP)-led model of care.

Like most hospitals across the world, the Queensland Children’s Hospital has experienced a surge in the volume and nature of presentations to its ED since the COVID-19 pandemic.

“It really challenged us to think about what different levels of care would look like as an adjunct to the Emergency Department,” said Perrin Moss, Integrated Care Program Manager at Children’s Health Queensland.

Around 40–50% of all presentations coming through EDs could be safely and effectively managed by a GP-led team outside the ED setting, according to literature at an international level, Moss said in a statement.

“Acknowledging patients are coming to us because a GP is not available — whether it be outside of business hours, or they are unable to get an appointment — led us to test a model where a GP would be accessible within close proximity to the Emergency Department.”

The hospital called on Conrad Gargett to explore a range of options and locations within the existing building for the new clinic, with the final outcome achieving over double the size and capacity to what was originally conceptualised to include four consultation rooms, a dual treatment space, telehealth room, kitchenette, clean and dirty utility rooms and an expansive waiting area.

“We looked at different areas within the building, from the ground floor right up to level 5, but what we went back to was the former convenience store space which was prime real estate that was underutilised, offered a really good connection to the Emergency Department, great crossflow and connection to the outside and central atrium,” said Paul Emmett, Principal at Conrad Gargett.

“Architecturally we worked that area really hard — we pushed it to make sure that we took full advantage of the engagement with the central atrium and existing large form artwork and made use of spaces that were underutilised, even outside of the clinic space.

“It has also added more engagement with the Main Reception — which, from our perspective, we always envisioned would be an activated space.”

Art was a major priority in the project, with Conrad Gargett working closely with esteemed senior art curator Lynne Seear, Manager of the Arts In Health Program at Children’s Health Queensland, to integrate art in the design.

“The decision was made at the beginning of the project to have the best art we could find — not to compromise on the quality that happens so often in healthcare facilities because some people have the impression it’s a luxury add-on — or there are cheaper ways to do it,” Seear said.

“What you have on the walls or floors should match in excellence the quality of care that is being delivered.”

Queensland Children’s Hospital recognises the importance of quality art and design in improving the patient and visitor experience. “It’s not just about making an aesthetically pleasing environment; it’s about creating an environment that makes people feel safe and comfortable. There is a huge degree of thoughtfulness required to put that environment together, which both subliminally and overtly communicates that we want them to have a good experience in the hospital,” Seear said.

“If people feel safe and comfortable, then their perception of the care that they receive is directly impacted for the better.

“Perception of care has a huge influence on how people will respond to clinicians, the kind of communications they have, whether they’re listening, whether they will trust the staff and be compliant with instructions and therefore whether the treatment will be successful and what the recovery will be.

The hospital has a commitment of having over 50% of art by Aboriginal and Torres Strait Islander artists. “Nine out of ten works are by First Nations artists. We can do that because First Nations’ art is fantastic — it’s really dynamic and diverse and it’s also an obvious a way to announce that a space is culturally inclusive; it doesn’t do the whole job, that’s up to people in their interactions and systems and processes, but it does some of the job,” Seear said.

“I like working with architects who from the beginning are thinking about what can we do to make the space habitable, to humanise it, to make people feel like we’ve really thought about how they’re going to be impacted on a sensory level and how are they going to use the space,” she added.

Since its opening in June 2022, the MIIC is said to have had success with an effective flow of the patients in and out of the space, according to Perrin.

“Once patients are referred to the clinic, it's between an 8- to 12-minute wait for them to be seen by a clinician in the Minor Illness and Injury Clinic, as opposed to what could be a number of hours waiting in ED, depending on how busy it is,” he added.

Conrad Gargett has a longstanding relationship with Queensland Children’s Hospital, having delivered the hospital with Lyons in 2014 and continued to be engaged for design services over the past eight years.

Images courtesy of Chris Wardle.