Health services planner sheds light on health centre design process
Margaret Garthwaite is a health services and facilities planner with Peddle Thorp architects, the company designing Golden Bay’s integrated family health centre.
Her career has included periods of clinical service delivery as an occupational therapist; service manager of a paediatric and child mental health community team; operational management of a large mental health service during and after closure of an inpatient psychiatric unit; quality and risk management of a women’s health and paediatrics service, and leadership of a number of process re-engineering projects.
“I’ve been through this kind of process before, but on the other side of the table from the health planners,” she said. “The Golden Bay project is going very well and we have been especially delighted with the positive feedback we’ve been getting from the clinical leadership group.”
The GB Weekly spoke to Margaret about the planning process, where the project is at the moment and what we can expect to see at the upcoming open days.
“When I first became involved in the project, it was a matter of understanding the model of care that had been developed and making sure that the planning process took careful notice of the way the practitioners want to deliver services,” said Margaret. “I reviewed the work that had been done and decided whether what they had in writing was what they still wanted. It was important that the model of care document said what it thought it said, in case there were questions or challenges later. Our job was to start describing what a facility that delivered that model of care would look like.”
During January and February the design brief was developed.
“It’s the document that describes to an architect what the facility is meant to do. It tells the story of what is going to happen in the building and describes the physical relationship between the different rooms. For example, where is reception in relation to the doctors’ rooms? Where should we place the activities room? The model of care said that everyone was going to be using it, so what does that mean for its placement? Once we’d agreed on the brief, the architect picked up his pen and started drawing the concept.”
About 90 per cent of the rest-home and hospital rooms, are of standard size. In the case of the rest-home rooms that standard is 17 square metres. This is determined by the Australasian Health Facility Guidelines, which have been adopted by New Zealand’s Ministry of Health and, says Mrs Garthwaite, “If you want to vary the size, you have to put up a very good case.”
The next step of the process involved the architect starting to put the blocks of area into relation with each other in the way the design brief describes. The process is called “bulk and location”.
The resulting plan was then tabled that with the clinical leadership group. This consists of 17 people representing the three organisations who will provide services at the facility, the hospital, the rest home and the PHO.
The group also includes Margaret Garthwaite, the architect, Chris Hill from the property-owning trust, and a St John representative—Stu Chalmers or his nominee. The group had also added Heather Cole, to represent the families of residents and patients.
“The debate about detail started there,” said Margaret. “Some of the things that the clinical leadership group has shown an interest in include sustainable features like the provision of natural fresh air and shade, instead of totally mechanically managed hot and cold air.”
In all, five different layouts were presented to the clinical leadership group and the interim management group. In early March the concept design was signed off by both groups.
“After we got sign-off, we started on the preliminary design, showing progressively finer details like showers, basins and doors. While he’s checking to make sure everything’s going to fit, the architect is also starting to look at the outside of the building in three dimensions,” explained Margaret.
“At this stage of the process, we also need an estimate of the cost of all the equipment and furniture that has to be either bought or moved.”
At the open day on May 16, people will be able to see more detailed drawings of some of the rooms—a rest-home room, a hospital room, a birthing room, and a consultation room.
“We may also bring the 3D drawings of the roof-lines showing what happens when you join the new building to the existing one.”
Speaking about the way the facility will work from a user’s point of view, Margaret said, “You want to be confident that the architect and planner have taken into account the staff’s working experiences with patients and residents. Things like the distances that staff have to walk and what’s important to them about the spaces they work in.”
Margaret spoke about the whanau aspect of the facility’s design.
“The facility is not just for patients and residents but also the families who care for them. It’s especially important in a rural facility that people can be on hand when they need to be. There will be an overnight room where a person or a family could stay if they need to. They would then be able to use the activities room or a patient could be wheeled to them there. Also both of the separate dining rooms have tea-making facilities. You have to put yourself in the situation of the residents, patients and their families. If my mother was a resident there, I’d want to be able to make her a cup of tea when I visited her.”
There will also be a children’s play area in the primary health area, said Margaret.
“There won’t be an area called a waiting room. They’re known as ‘hospitality areas’. People shouldn’t arrive with the expectation of a lengthy wait.”
What of the future of the integrated health facility? Have the planners thought about possible future changes to people’s needs?
“We did have to think about the future world as well as the present,” said Margaret. “You don’t want to landlock an area that might need to be expanded itself or used to access an expanded area. The plan shows dotted lines around the areas that can be expanded in the future. Future-proofing was an early value that the clinical leadership group wanted to stress along with sustainability, adaptability and a quality living environment.”
For details of the integrated family health centre’s open day on Monday 16 May, refer to the display ad on page 5.
Neil Wilson
