Woods Bagot Melbourne Health Sector Leader Megan Hendy says health precincts have the potential to give back to the community, both physically and socially, through flexible amenity, public resource, and sensitivity to the diverse needs of community.
Almost everyone will experience a healthcare environment at some point in their lives. According to Megan Hendy, the opportunity for architects is in helping to positively influence this experience through considered design.
“What continues to interest me about the healthcare sector is the inherent social value,” says Hendy. “You’re designing for people’s best and worst days. All public buildings potentially have that opportunity, but it’s even more pronounced in a healthcare environment. People are receiving, and delivering, life-altering news, care, and procedures in these spaces.”
As models of care evolve, so too does our understanding of the role of the hospital within the community. “There is so much infrastructure associated with the hospital; for example, in a regional city like Ballarat, the health service is the largest employer,” says Hendy. “It’s not only what a building is doing, but what it can offer back. How can we make it more welcoming, less institutional, and integrated with the fabric of the community it sits within?”
According to Hendy, one of the major shifts impacting healthcare is designing with Country. “It’s making these institutions that have been historically alienating, traumatising, and uncomfortable places for First Nations People – and people with diverse ethnic backgrounds – safe, welcoming and inclusive,” says Hendy.
As a sector, health requires a balance of controlled, technical and clinical requirements with the need for imaginative, creative, and empathetic design solutions. Within her own practice, Hendy and her team are investigating ways to hold health conversations outside. “How can we create environments that allow for that comfort of connection to Country?” she offers.
Wathaurong Aboriginal Co-operative will offer healthcare services in culturally safe environments, with spaces based on traditional yarning circles that provide infrastructure for community gathering.
“Something that we should consider in all of our urban environments is creating a novel place-based experience by drawing on the things that make it unique,” Hendy says. This means locating the design within its community, engaging with stories and cultural knowledge of place, and situating the building within its specific ecosystem.
The work of the designer is to identify where functional requirements must be adhered to, and where the boundaries of innovation can be stretched.
“I’m an advocate for using less white in patient areas,” says Hendy. “Ideally, we have lots of natural light, good circulation, natural finishes and outdoor connections, but just avoiding the sterile white-box approach is a basic step to alleviating patient stress.”
Uniform and monotonous white spaces, Hendy says, can be so under-stimulating that they cause psychological distress. “White still has its place – I think clinical areas can look clinical – but in bedrooms, waiting areas, and potentially high-anxiety spaces, it’s a simple step to ensure those areas are more comfortable and human-centred.
“There are a lot of evidenced-based design principles for supporting healing, both cognitive healing and physical healing, which include access to natural light and systems, as well as having a clean, healthy environment.”
The majority of hospitals designed in the late-twentieth century prioritised functionality, infection control and technology at the expense of the human experience. But research has demonstrated that the deprivation of natural light, surfaces and systems can increase stress for patients and their families, as well as the hospital staff themselves. Inversely, Edwina Bennett says good design can support recovery and promote healing, and consequently, the hospital environment should not be regarded as separate to treatment, but a fundamental part of it.
The environment can provide aesthetic and cognitive nourishment to patients, which can reduce their experience of pain and discomfort. Good design, says Hendy, is a balancing act between generating enough curiosity and stimulation to engage the user, without the introduction of factors that are likely to overwhelm.
“We know that creating spaces that are interesting for the brain will promote cognitive healing,” says Hendy. “But it’s important that these spaces are not so complex that they are confusing. It’s about finding that balance with a space that’s not boring – that has that level of interest that promotes thinking and imagination – but not so much that you become overwhelmed or confused.”
Hendy says that this concept is supported by principles of “positive distraction” – that is, environmental features that introduce positive feelings by diverting attention from anxious thoughts and high-stress situations.
“One source could be public art – and that doesn’t have to be physical objects; it could be sound art or another way to create positive distractions from any difficult decisions or conversations that might be coming up,” says Hendy.
“Hospitals can be quite noisy and filled with alienating sounds, like beeping and whirring,” she continues. “How can we consider the whole environment, all of the senses, and how we can soften those and make it a more positive environment?”
For healthcare infrastructure to have an enduring positive impact on our communities, embedding flexibility into the design is a core principle of effective and resilient buildings and precincts. “Trends, technologies, models of care – all those things change. How do we keep adapting our buildings to keep up with healthcare?”
This could mean designing open, contiguous floorplates, designing for electrification, and accommodating space to allow for future expansion and growth, as well as considered material selections and operational efficiencies.
Flexibility and sustainability can also create a good neighbour in healthcare infrastructure. “As much as possible, I would like to see Front of House spaces be spaces that community can use,” Hendy continues. “If there’s an education department within a hospital that includes a lecture theatre or event space, can that be used by the community and booked out for other events?”
The New Women’s and Children’s Hospital will provide ample connection to nature and the parklands, incorporating a “nature play” area for children and their families.
Finally, Hendy says, good healthcare design includes innovation and preventative care, which can be delivered through precinct models that combine patient care and cutting-edge research.
“Our need for healthcare is growing exponentially, faster than we can build hospitals,” says Hendy. “So, the other aspect of healthcare is preventative: how do we prevent people from needing acute hospital care? How do we make sure that we’re investing money and smarts in at-home care, early intervention, or other alternative health delivery, so that acute hospitals are only for the really, really sick?”
Hendy adds that co-locating hospitals with research institutes within innovation precincts will help to ensure their ongoing relevance and best practice.
“The healthcare system has two modes: on the one hand, there is all this cutting-edge research and technological innovation, but on the other, healthcare delivery is very risk adverse. It’s about connecting the dots between that research and practice. That’s where innovation precincts come into play, which encourage that cross-pollination of research and application, so we are enriching our care environments with the most relevant thinking.”
Woods Bagot designed the Australian Bragg Centre (ABC), home to the continent’s first proton therapy unit. The project is located adjacent to the Woods Bagot-designed South Australian Health and Medical Research Institute (SAHMRI) within Adelaide’s Biomedical Precinct. With the addition of the ABC, the precinct will deliver end-to-end care, from research through to treatment.
Health precincts have the potential to give back to the community, both physically, through flexible amenity and public resources, as well as socially and culturally, by being sensitive to the diverse needs of community though considered salutogenic design and meaningful stakeholder engagement.
“People-centric design means taking the time to understand all of your stakeholders,” she says. “How can we ensure that we think about the people who aren’t always represented in the room, and ensure their voice is still taken into account?”
“A meaningful engagement process is one where community can see where they have influenced the building and feel proud of it as well,” Hendy continues. “That is the biggest achievement.”
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