One of the first significant state projects that the OVGA was involved with when it was established was the development of the new Royal Children’s Hospital (RCH). With a capital expenditure of $1 billion, the project was the largest hospital redevelopment ever undertaken by the State. A lot was at stake and expectations were high.
‘The Minister for Health said to me “I want the new Royal Children’s Hospital to be an iconic building” and my first thought was no you don’t – perhaps you want great architecture, a memorable building, to lead the world in terms of hospital care for children or advanced ESD – but not iconic!’
Semantics aside, the personal interest shown by the Minister for Health (now the Premier of Victoria) in the quality of the new RCH set the tone and demonstrates what we know to be true – behind every great building is a great (smart) client! A photograph of the new hospital hangs on the wall of the Premier’s office, ‘a proud achievement’1 of his time in this important portfolio.
This early experience with one of Victoria’s most important health projects has shaped much of the OVGA’s thinking around how to best support quality outcomes in the procurement of public infrastructure and projects. The RCH is featured as one our procurement case studies on Public Private Partnerships. Lessons learned have been adapted to current involvements with other major health projects such as the Victorian Comprehensive Cancer Centre and new Bendigo Hospital both being delivered as Public Private Partnerships.
We know it’s in the earliest stages of a project’s lifecycle that expectations around quality and processes need to be articulated and embedded to secure the best outcomes. The vision components of the RCH briefing documents were critical to the procurement process and remained a focus of the design team to ensure that aspirations were met. The determination of all parties to ensure a quality outcome was also a critical aspect of the project’s success.2
At the Design Speaks: Health Care/Health Design forum held in March 2015, both client/stakeholder (Christine Kilpatrick, Chief Executive Officer, RCH) and architects (including ShereeProposch, formerly Director at Bates Smart, now Principal at Hassell as well as Ron Billard, Director at BillardLeece) teamed up to present and discuss the thinking that shaped the development and design of RCH.
Major design influences included an emphasis on patient and family centre care, workforce culture and the integration of education, research and clinical care. The designers responded with a focus on the comfort of patients, family and staff and the quality and nature of their surroundings. Design elements included an emphasis on single rooms with access to natural light and outlook for patients and their families; access to activity and play; an efficient and enjoyable workplace; the integration of artwork to create way finding; and community partnerships leading to the introduction of initiatives such as the meerkat enclosure and the aquarium – adding richness to the design. An eloquent account of the achievement is included in the Institute’s project citation when it received the Victorian Architecture Medal in 2012, quoted in part as follows:
‘Nature as a way of healing permeates every aspect of the building… Natural light is in abundance. At its centre an internal high street creates an informal village environment replete with promenades, courtyards and intimate spaces that promote human values over technological ones.’3
That human values might be an important consideration in the design of health care facilities might sound rather obvious but a strange thing happened in health design in the mid-twentieth century with an increased ‘reliance and awe of medical technology’4 and a change ‘in focus from patient to the disease; from healing to diagnosis and treating’.5
It is easy to get caught up in technology and the complexity of functional area requirements, therefore losing sight of people and the fundamentals of health, wellness and healing. Maintaining a sense of connection to the natural environment (with access to natural light, fresh air and outlook); staying connected to a supportive community network; creating delight – these are some of the foundation principles of design that translate across all building scales and typologies.
Broader discussions taking place at a national level are interrogating the nature and cost of our health system. There is much to do to broaden our understanding of what it might mean to enhance health and wellbeing in our society in an effort to reduce the cost implications of poor health. The research and evidence points to a need for more, not less, investment in the integration of care and on prevention.6 Karen Hitchcock’s sobering essay, ‘Dear Life: Caring for the Elderly’ maps out a way forward with examples of complex and integrated community-based models of holistic health care and design being developed in Japan and Denmark.
In the meantime our hospitals will continue to play an important role in our society. ‘Our hospitals…are not shops or hotels; they are precious public institutions; they are ours. They need help if they are to become more humane…’7
Sophie Patitsas, Principal Adviser, Urban Design and Architecture
With thanks to:
Jill Garner, Acting Victorian Government Architect
David Islip, Principal Adviser, Urban Design and Architecture
2. Case Study: Royal Children’s Hospital, Parkville, OVGA Procurement Case Study: Public Private Partnerships, 2013
3. Victorian Architecture Awards 2012, Architect Victoria, p18
4. E.M. Sternberg, Healing Spaces: The Science of Place and Well-Being, Cambridge, Massachusetts and London, England: The Belknap Press of Harvard University Press, 2009, p 4
6. Karen Hitchcock, ‘Dear Life: On Caring for the Elderly’, Quarterly Essay, 2015, 57: 1-79. Black Inc., p 30
7. Ibid. p 59