Wednesday, February 24, 2016

Blacktown Hospital Tour

On Monday 15 February Darlene Cox, Kerry Snell and I drove to Sydney to visit the new Blacktown Hospital expansion. Peter Rophail the transition manager for Western Sydney Local Health District organised and provided the tour just two days before the new building was to be handed over. This meant there was lots of activity throughout the building. We are very thankful of the time Peter gave us for the tour.

Blacktown Clinical Services Building

Co Design
The project won a gold medal, in the co-design category at the APAC Forum - Asia Pacific’s premier healthcare conference. Western Sydney Local Health District identified that there was a need for strong community engagement in the planning of the hospital. They were wanting the people of Blacktown to own it. Throughout the planning hundreds of consumers where involved through the many methods such as master planning, user groups, focus groups, and getting out to the community and talking to people about what they want.

Consumer engagement was difficult at the beginning as there was not a strong culture of community involvement. Once models were developed to better involve consumers things improved. They learnt by trailing approaches. They were clear about the need for consumer input and were open to making change along the way. For example, while they started out with a single consumer representative on a user group through the process they found that it was better if there was two or three consumers involved in one user group.

How did consumers influence the design?
·         Adequate number of free parking spots for patients undergoing cancer treatment
·         A significant proportion of their inpatient rooms have a carer zone so that carers can stay overnight with adult patients
·         Attractive images on the ceiling for patients in radiation therapy
·         Provision of easily accessible interpreter services for non -English speaking patients
·         Toilets to accommodate patients with intravenous drip stands
·         Consumer was on the panel that selected the 25 large print photographs for the walls throughout the hospital

Core Values
The project included core values that whenever a decision was made the team would referred to the core values and how it supported them. These values are:
·         Mutual Respect
·         Accountability
·         Integrity
·         Teamwork
·         Trust
·         Quality
·         Consumer involvement


Furniture Colour for Wayfinding

The new clinical service building uses colour for wayfinding. This is cleverly integrated into the build. This was in response to consumer feedback. One of the consumers said: “a hospital space does not need to be white and sterile”. Every room and every ward had their own colour to improve way finding. The intent is to assist with orientation to wards and inpatient rooms. Their research informed this design decision and it will help patients and visitors to find their rooms. We really liked this approach. The only thing that could be improved is placing a coloured tile next to the sign with the room number. These wayfinding methods are proven to improve the experience for the consumer and it will be good to see how it goes when the building is open.

The Hospital also related all its wayfinding colours to the external colouring of the building, this brightened up the whole space and again made it feel less clinical.

Community Arts Program 
Blacktown Hospital engaged a Canberra based art company called Health Arts Research Centre to improve community engagement in the design, selection and creation of art within the building. This includes an 80 m mosaic, with 13 different works designed by community groups such as Indian elderly and Arabic community groups. There is also involvement from local aboriginal artists Leanne Tobin, who designed The Call Of Home, which is a suspended sculpture of more than 80 unique hand blown glass eels.

The art project also included a photo completion where people could submit their own photos with a chance to be displayed throughout the hospital. The selection panel was a consumer, art specialist and the General Manger. You can find further information on the Arts & Cultural Program here.

The Call Of Home by Leanne Tobin to be
installed in the foyer of the Blacktown Hospital

Example of the large scale photos in public areas
Hospital Street
The main entrance into the new Blacktown clinical services building comes into a long open corridor called Hospital Street. A lot of contemporary health facilities include a hospital street. This layout makes the environment feel less clinical and more welcoming. It is also very effective way to connect the existing hospital with the new building.

Main Reception
The volunteers will be located at the main reception desk, to better include them within the hospital. This decision was made after feedback form volunteers that they wanted to feel part of a team and be more involved in assisting patients and families.

Off the main reception was lifts and clearly mark stars to the outpatients and inpatient spaces, making for easy wayfinding.

Inpatient Unit
The design includes an additional 180 beds for acute inpatients. These inpatient beds included 65 single bed rooms, three four bedded rooms and the rest being two bedded rooms. The bathrooms where out bound with double doors. All inpatient rooms had glass windows for better line of sight. This was one of the design principles of to see and be seen.

Convertible couch to bed
Eight rooms per ward provided a carers zone where family and carers could stay the night on a couch that converted into a bed and the two bedded room had reclining chairs that converted into beds to sleep on. This meant visiting hours where revised to allow for flexibility. This was feedback from the multicultural community.

Even though the outbound bathrooms reduced light the room it still felt very bright and welcoming.

Patient entertainer system included internet, free to air TV and their Electronic Medical Records (EMR). The TV is on an arm located above the bed, and could recode clinical information such as observations.

Inpatient Single Bed Room

This was to improve line of sight, with the ability to draw a curtain across for privacy.

The design of the nurse station is very open and a significant move away from the fortress we see in most wards. It will invite communication.
Nurses station in the inpatient areas
Nurses station in the inpatient wards

The floor design is to help with dementia and cognitive decline. This is done by guiding people through the space with visual cues as marked out on the floor to help with wayfinding.
QR Code

Defects Liability for the Building
There was throughout the building QR codes that could be used by NSW Health to note any issues with the building before handover. This meant that you could simply use the QR Code in each room to log any issues with the room and it would go on their data base.

Computers on Wheels (COWs)
We went to have a look at a medical ward in the older clinical tower with a 28 bed ward that included six COWs per ward with fourteen charging bays through the ward. The inclusion of an Electronic Medical Record was a key success to the integration and use of COWs. Other new builds that we have previously visited have had issues with COWs and where not used to the full extent.
Computer on Wheels

Paper light
Blacktown Hospital is one of the first hospitals in NSW to go paper light. What this means is that the use of paper documentation for inpatients is reduced and more information is logged electronically, such as the Electronic Medical Records. Currently the inpatient unit at Blacktown is using one page per person per a day, this is expected to reduce even further with the introduction of a closed loop medication system which is coming in August.

The tour provided some fantastic information on new hospital design and how the community is involved in the planning of their hospital. We have taken lots away from the tour and again would like to thank Peter Rophail for the tour and providing use with so much great information.

Nick Wales
Project Officer

Sunday, February 14, 2016

Book Review: An Insiders Guide to Getting the Best out of the Health System – Author Kate Ryder

This is an interesting resource, written by a Registered Nurse turned health advocate, who has also worked as a complaints officer at the Office of the Health Care Complaints Commission. The book does not shy away from looking at issues, risks and problems you run across as a health consumer.

Some of the language I think is a little simplistic, and one section goes as far to say that if you treat your health team poorly it is your own fault if they treat you badly and your health suffers as a consequence. I found this a bit concerning. For the most part I think the book is full of really useful checklists, examples and ideas about how to keep yourself safe in the health care system. Well worth a read. I really liked the section about writing a medical history to take to appointments or hospital admissions that you can update.  We have a copy of the book here in the office should you be interested.

Eleanor Kerdo
Policy Officer 

Monday, February 8, 2016

Update - University of Canberra Public Hospital

Invitation to the event
On Monday 8 February HCCA staff attended the smoking ceremony and sod turning for the University of Canberra Public Hospital, the new rehabilitation hospital which is being built on the grounds of the University of Canberra

HCCA has been very involved with this project. Our involvement dates back to 2010 when we first proposed a sub-acute hospital to the then Minister for Health, Katy Gallagher.

Since that time we have undertaken plenty of research, reading articles, attending conferences, talking to consumers about their experience, and visiting similar facilities in other places. All of this informs the positions we take when we advocate for design of the building - including car parks - as well as the way care will be delivered. 

Yelin Hung, Darlene Cox and Nick Wales at the site of UCPH.

Consumer representatives have participated in User Groups to date. These are groups that bring together consumers and clinicians to consider planning issues. User groups have been focussed on many aspects of the design, including the main foyer, hydrotherapy, pharmacy, equipment loans, medical imaging inpatient rooms, rehabilitation day services and pathology.

An important aspect of the event was a smoking ceremony, to cleanse and refresh the land before construction begins.
Duncan Smoth from Wiradjuri Echoes conducting the smoking ceremony

Minister for Health, Simon Corbell
Following the smoking ceremony, both Andrew Barr MLA, the Chief Minster and Simon Corbell MLA, the Minister of Health spoke, outlining the role the University of Canberra Public Hospital will play in helping improve access to health services for the ACT. The Chief Minister also stated that health is the Government's number one priority

Finally to mark the official start to construction of the University of Canberra Public Hospital Andrew Barr MLA, Simon Corbell MLA, Meegan Fitzharris MLA, Chris Bourke MLA and Vice Chancellor Professor Stephen Parker turned the first sod on the site. And yes, there were a few jokes about how many Minsiters and Vice Chancellors it takes to turn a sod.

Handshakes all round for the sod turning.

Work is expected to start in the coming weeks, with the fence up around the site on the corner of Aikman and Ginninderra Drives in Bruce. The site is clearly marked with a banner on the whole external fence.

Work is also continuing on the Final Sketch Plan for the hospital with great involvement from consumer representatives. Last week the consumer representatives that will be involved in the User Groups came along to and induction to have a look at the current plans and what will be involved in the User Groups. It’s fantastic to have so much involvement from our members to help improve the design.

The current date for completion and opening of University of Canberra Public Hospital will is early 2018.

There is more information online, including this video.

Darlene Cox
Executive Director