For many hospital design and general medical building designs, the benefits of ‘hindsight’ are seen to be a somewhat regretful and costly oversight. Nonetheless, there are some great lessons to be learnt in construction ‘hindsight’.
For a study in how costs can start to add up when designing for hospitals and medical facilities, let's look at the new and yet to be opened Royal Adelaide Hospital.
The $2.3 billion Royal Adelaide Hospital has earnt the accolade of the world’s third most expensive building (after New York’s One World Trade Centre and Bucharest’s Palace of the Parliament). It's set to be Australia’s first paperless hospital, delivering state-of-the-art healthcare, with private rooms and lush gardens. Since the building was commissioned in 2011, its construction costs alone have nearly doubled, from $244.7 million to more than $417 million.
The defects and delays come on top of a looming safety crisis, amid concerns that the electronic patient record system for the paperless hospital will not be ready. Shockingly, the ward floors will not be strong enough to withstand the weight of paper records!
The weight of ordinary items is usually very low in priorities in most applications, such as around your home and in office spaces. And certainly, the weight of paperwork in the new Royal Adelaide Hospital's case is quite extraordinary.
Doors are another element which may not cross your mind. Yet it's important to note that Coldshield swing doors are up to 50% lighter than typical solid timber doors. Yet due to the one-piece polymer door panel which has been high density filled with non-CFC urethane foam, Coldshield swing doors have been manufactured for maximum durability.
Download the brochure on Hospital Theatre Doors.
It's not uncommon to forget about the importance of hospital swing doors, but they are often referred to as 'crash doors' thanks to the punishment they are subjected to. The three major factors that make weight an important consideration for hospital door selection are:
There is however, a more crucial factor; the way people navigate the doors. In a lot of cases when nurses are wheeling beds, wheel chairs and trolleys through hospital doors they travel backwards using their shoulder or backside to push through the door. Travelling forward opening a heavy door while also pushing or towing something else can be very difficult.
Strain injury could become a major concern with traditional, heavy timber doors and time off work due to strain is a huge issue in the workplace. This shows that what may seem a minor concern, can become a massive roadblock to the effectiveness of a hospital.
The new futuristic 800-bed Royal Adelaide hospital, on a 10-hectare site, will work to maximise lean management practices by using robots to deliver food and equipment. All beds will be single patient suites with private bathroom facilities. There will be 40 large identical operating suites built to the world's best standards, each measuring 65m2.
The RAH will be Australia's most technologically advanced hospital, with the aforementioned fleet of automated robotic vehicles helping to move supplies, meals and equipment around the hospital, and a tailor made patient electronic medical record (EMR).
Other technology features include patient weighing beds, wireless technology and equipment tracking capability, and intelligent information systems such as bedside entertainment and meal ordering for patients. For hospital staff, amenities will be supplemented by a commercial precinct including a crèche, mini-mart, restaurant, cafes and gymnasium.
New technology has allowed companies to make leaps in what were once quite ordinary everyday products to then create time-saving products which offer a lean-management approach to everyday tasks such as the patient weighing beds. If lean management consists of reducing the amount of time it takes to complete a job and reducing time-consuming regular tasks, reducing the time taken to get from one area to another efficiently is contributing towards lean management.
Consider going one step further with automated sliding hospital doors which utilises sensors to open and close hospital doors whilst offering all the benefits of the 4500 Swing Door range. Now your staff could have one less delay with bumping through doorways, nor have to handle sensitive equipment and patients as well as hold open heavy doors.
An alternative to heavy timber doors; one-piece polymer doors with high-density foam cores such as the 4500 Series high impact hospital theatre swing door offer a lightweight, strong, insulated (R-value of 3) and durable option. This means that hospital theatre swing doors could do their part to save on air conditioning and heating bills throughout the hospital, on top of increasing efficiency and safety.
Following on from saving energy as discussed in the last paragraph of point number 2 above - large amounts of waste are generated by hospitals. It was previously reported by Issues Magazine <source> that Victoria’s public hospital sector produces the waste equivalent of 200,000 householders and spends about $10 million annually disposing of this waste. For an idea of how much waste this accounts to - a hospital mentioned by Issues Magazine reported a rate of around 5 kg of waste per patient per day, but this certainly varies considerably according to the “intensity” of the hospital.
The Royal Adelaide Hospital has set a target of 50 per cent reduction in greenhouse gas emissions compared to other hospitals. Although many issues are being faced by the new site ahead of its opening, we should give the designers their due in considering the future requirements, not only only of the hospital itself but for the greater good of environmental issues. By considering what the site will require in the future and being empathetic to the environment, not just tomorrow, we can save much more than just dollars by making better decisions from the outset.
Of course sourcing local products is not always feasible but where it is an option, sourcing local products not only helps the local economy but also could reduce costs later down the line due to suitability to local conditions and servicing and parts are more readily available locally. Not to mention the fact that manufacturing standards differ across the world. An example of this is the $1.2bn Perth Children’s Hospital which is under the microscope, with WA Auditor General Colin Murphy investigating its building contracts. This build is at least one year behind schedule and asbestos was found in roof panels which had been imported from China.
Hospitals are one case in point where repairs are often required urgently and broken equipment can become a critical issue. Broken-down theatre equipment for example could delay urgent theatre operations; broken access doors could result in issues to access certain areas of the hospital.
What's more, if equipment has originally been sourced overseas, then the transport time should be factored into delivery times as well as the fact that time zones and language barriers may contribute to significant frustration in a high pressure situation.
Remax 4500 Series High Impact Doors are manufactured in Australia to Australian standards for Australian conditions.
Not every hospital has the same layout or the same budget. That is why it is important that the products chosen has some of its features as add ons. Below are four key extra features you should be looking at.
Hopefully your doors already meet those design criteria and if not you are looking at ways to optimise your doors to be more hygienic and efficient. If you would like to learn more about swing doors follow this link.
Remax Doors can help with the ideal swing door for your hospital. For more information on setting up doors for hospitals, contact us online or to speak with the Remax Doors team immediately, call us on 1800 010 221.