Burwood Hospital Redevelopment - Safety in Design Case Study

1. Burwood Hospital Redevelopment - SiD The Christchurch Earthquake in Feb 2011 meant that CDHB urgently needed a new hospital to replace The Princess Margaret Hospital which was severely damaged and not economic to repair

2. Burwood Hospital Redevelopment. S.I.D Case Study In Mar 2013 Cabinet decided to fast track the construction of a major hospital expansion of the Burwood Hospital. The expansion has 29,400m² of new building area, and includes: • 230 new inpatient beds • 1100m² radiology department with 160m² shell for future expansion • 2500m² outpatient and procedural area • 2400m² clinical administration and community teams area • new main entry atrium with information centre, retail and cafeteria • new kitchen and back of house support areas • general older adults assessment treatment and rehabilitation wards • a specialist stroke ward • adult rehabilitation ward catering for brain injury and under 65 rehabilitation

4. Design Principles & Safety in Design • Health Planners and Design Consultants were appointed, design and functional briefs were prepared. • 7 Overarching Design principles were established to guide the design process e.g., patient focused design • One of these Principles was health and safety in all aspects of design • User Groups were established to review every aspect of design and to map the patient journey • The average age of patients was 75 years old

5. Design and User Group Process https://youtu.be/Mhb_dDug8n0

6. Design and User Group Process https://youtu.be/Mhb_dDug8n0 The Design Lab is opening the doors to patient-centred health care.  It's a space where clinicians, engineers, architects and user groups are rethinking how health services are provided.

7. Safety in Design Considerations • Patient safety – Fall reduction, Infection Control, Patient monitoring, Nurse call, Nurse Stations Visibility • Patient Health – nutritious food, fresh air, sunshine and sleep • Public Safety – Seismic, Fire, Security • Staff Safety – Access control ,CCTV, Duress alarm, patient lifting tracks • Safety in Construction – Early Contractor Involvement, site inductions, close monitoring, audits • Safety in Service and Maintenance - FM , Eng. were involved in Detailed design and Briefing e.g., access panels, isolation valves, catwalks, ladders, roof top controls.

8. Design and User Group Process • Clinical Teams and Health Planners map the patient journey in detail • Process design improvements ideas captured in working groups • Layout options presented by Design team to address issues • Options pro’s and con’s were evaluated • Test design proposals via prototyping and life size carboard mock up • High fidelity of preferred options– real prototype with real materials and fittings • Staff ,Patient and public surveys conducted to give feedback • Plans and specifications were updated • DHB Signoff to proceed with design & procurement.

9. Design and User Group Process

10. Risk registers were established

11. Risk registers were established

12. SiD Examples- Prevent Falls • New Beds were purchased with adjustable bed heights to make it easier to get in and out of bed • Grab rails were put every where so that patients always could steady and support themselves • Patient lifting tracks were installed in every second room • Non Slip vinyl was specified • Nurse stations had good visibility so they could supervise any patients out of bed.

13. SiD Examples- Prevent Infection • An Infection control lens was put across every detail – joints in showers, floor vinyl coving, lift buttons • More single rooms and isolation rooms were incorporated into the design to isolate sick patients from others • Hand basins and hand sanitised were put in all rooms and public circulation areas • Large windows to let natural light to kill germs • Windows were openable to let fresh air in • Ventilation had Hepa filtration to extract 99.9% particles and germs • Taps and hand basins were anti splash and water temp was hot enough to kill germs but not too hot to scold • Floor vinyl was anti static and easy to clean

14. Burwood Hospital Redevelopment. S.I.D Case Study The expansion has 29,400m² of new building area, and includes: • 230 new inpatient beds

15. SiD Prevent Harm from EarthquakePartitions and ceilings were all braced to prevent damage or collapse via track lock systemSecondary steel bracing was installed to support all in ceiling servicesLight fittings over 5 kg were tethered to prevent fallingPrimary structure was IL3 Low damage designBMS and control systems were enhanced to monitor performance of building in earthquake More isolation and shut down valves were included in design so that repairs and maintenance was easier to effect.

16. The results speak for themselves • Reduce fall by 22% - 120 less per year • Reduced rate of infection compared with TPMH • No damage nor injuries in 5.9 Earthquake

18. Lessons learnt • It is important to engage with end users in identifying issues & solutions • Sid did not significantly add cost to the project – value for money was still achieved • The benefits of SiD continue to be realised well beyond construction • The reduction in harm can be significant

19. Question time?