Natural healing: Fiona Stanley Hospital

A flagship facility for Western Australia’s health reform program, the Fiona Stanley Hospital employs evidence-based design principles to make tangible contributions to patients’ wellbeing and recovery.

The acceleration in the upgrading and renewal of healthcare systems and services in Australia has substantially increased investment in large-scale, integrated health facilities. These facilities advance healthcare capabilities, achieve efficiencies of scale and benefit from the rapid pace of innovation in medical technology. The Fiona Stanley Hospital in Perth is one of the latest and among the very largest of the nation’s comprehensive health and hospital projects. With a budget of $2 billion, it is Western Australia’s largest single building project and the flagship of the state’s health reform program. The range of design and medical planning services required by the size, nature and location of the project led to the selection and appointment of architecture firms Hassell, Hames Sharley and Silver Thomas Hanley working jointly as the Fiona Stanley Hospital Design Collaboration (FSHDC). Construction commenced in 2009 and practical completion was achieved on schedule in December 2013. Subsequently, however, the complexities of commissioning such a large entity and enterprise have caused the opening of the hospital to be rescheduled as a series of stages commencing in October 2014.

By necessity, those major hospitals that provide comprehensive tertiary and quaternary care rely on a broad spectrum of clinical and health-related disciplines. Further, they increasingly stand to benefit from the rapid take-up of proven medical and technical advances through translational research partnerships and from the integrated education of clinicians, nurses and medical support staff. They are large, complex organizations governed and managed with a focus on the effective and efficient delivery of healthcare. As hospitals have become larger and more centralized, there has been some concern that operational management and clinical systems would subordinate the patients’ needs to those of the institution – a concern that has stimulated an increased focus on the patient experience.

The Education Building, located to the west of the Main Building.

The Education Building, located to the west of the Main Building.

Image: Robert Frith

As the current generation of hospitals and healthcare facilities has evolved, so too the delivery of healthcare services has been recast to embrace patient-centric practices that position the patient as an active participant in the healthcare journey. This is strongly aligned with the adoption of team-based healthcare tailored to the individual needs and situation of each patient. Evidence-based design has further enhanced traditional, hospital-based medicine and clinical care: essentially, research into the moderating effects of the physical environment has found that the nature and quality of the environmental experience make tangible contributions to patients’ wellbeing and to their rate of recovery. Such factors as the quality of light, privacy within ward settings, views of green space, access to outdoor space, the ease of wayfinding and clear orientation, among others, have been demonstrated to improve recovery. Evidence-based design strongly influenced the development and design of the Fiona Stanley Hospital through a sharpened focus on the relationship with the natural environment, the generation of comprehensive strategies for effective wayfinding and a significant increase in the number of inpatient beds provided in sole-occupancy rooms to over 80 percent of the total.

Located on a 32-hectare, greenfield site at Murdoch to the south of Perth’s CBD, the Fiona Stanley Hospital is the location of not just core healthcare services but also medical research, medical education and a range of allied specialist entities including the state centre for rehabilitation services and a major mental health unit. Co-location with neighbouring institutions including Murdoch University, the private St John of God Murdoch Hospital and the Harry Perkins Institute of Medical Research offers potential synergies for the further enhancement of Western Australia’s healthcare program. It is envisaged that the increase in the critical mass of health resources will foster a step change in the urban growth and development of the precinct and the region.

The 32-hectare site is a flagship project of Western Australia’s heath reform program and includes allied services such as the State Rehabilitation Service.

The 32-hectare site is a flagship project of Western Australia’s heath reform program and includes allied services such as the State Rehabilitation Service.

Image: Peter Bennetts

The primary physical arrangement of the hospital and its supporting units is as a low plateau or plinth of functional entities ordered by a grid that integrates the main circulation spaces and the linking courts, terraces and public parks. The flexibility of the underlying planning strategies provides for future growth and for future developments in the delivery of healthcare. The planning approach also enables co-located services to articulate their separate identities within a unifying framework and to draw from shared planning principles and a common palette of materials. Differences in expression of the various service units and disciplines are governed by a vocabulary of colour, materials, finishes and ordering rhythms drawn from a detailed analysis and abstraction of the colours, textures and forms of the adjacent native bushland, including spatial analogies to clearings, density, canopy and growth. There are instances of spatial drama, including the void of the main pedestrian spine as it cuts through the Education and Pathology Buildings and the atrium that links the various levels of the cancer treatment centre, but otherwise the architectural resolution is one of discreet composition with changes in function and purpose revealed by relatively subtle changes in expressive treatment.

The five levels of the principal inpatient, acute care wards stand above the podium of the main hospital building and provide a crowning expression of the patient-centric approach to healthcare. The pleated planes of the diamond-patterned wall panels and their intersection with the undulating chevrons of the window hoods to the east, north and west provide a series of dynamic forms and surfaces further articulated by shade and shadow. Influenced by a study of native banksia seed pods, the strength of the elevation treatment is in its articulation of the primacy of the care of individual patients. Locating the wards at these higher levels provides all inpatients with views across the landscaped roofs of the podium and beyond to the wider landscape.

The Main Building, viewed from the State Rehabilitation Service. The two facilities are separated by a pedestrian link through the landscape.

The Main Building, viewed from the State Rehabilitation Service. The two facilities are separated by a pedestrian link through the landscape.

Image: Peter Bennetts

For any large hospital, clear orientation and lucid wayfinding are essential to minimize confusion and stress and to reduce delays, especially for those in need of immediate care. On approach to the Fiona Stanley Hospital, large beacons integrated with the facade and form of the podium signal the key arrival points. Most pedestrian movement will be channelled from the principal entry forecourt and plaza into and through the Main Building via the pedestrian spine of the main concourse. This ground-level, double-height space provides an open-ended, continuous, linear armature with primary access to most of the key functions, including the various reception areas, retails outlets, pharmacy and cafes. To the west it stretches across the entry plaza and connects, via an upper-level bridge, to the Education and Pathology Building and to the Harry Perkins Institute of Medical Research. Natural light filters in from above and the length of the concourse is broken by rest points and by shifts in colour and material treatment. The location of the primary public stair and lifts is signalled by the serpentine coils of a major artwork by Stuart Green incorporating timber harvested from the hospital’s site. Fittingly titled Around and in Between , the work also marks the entry to the Main Court and to the adjacent public and staff cafes. The Main Court provides an inviting and sustaining public space and landscaped garden at the heart of the hospital. It is generous enough to be both an active space with open terraces for the main cafes and a place of retreat and reflection for patients and visitors seeking privacy and solace. The landscape planting, though yet to mature, employs species native to the immediate region, with much of the plant stock generated from seeds and plants collected from the site prior to construction.

Gardens and external courtyards help provide a variety of outlooks and breakout spaces throughout the hospital. A linked series of courtyards and terraces at different levels forms a green “valley” running parallel to the main concourse through the podium levels. These valley spaces provide external light and views of an exterior setting to enliven the internal spaces of the deep plan of the podium levels.

Wards – positioned above the main podium – provide inpatients with views of the Main Court, the planted roofs of the podium and the landscape beyond.

Wards – positioned above the main podium – provide inpatients with views of the Main Court, the planted roofs of the podium and the landscape beyond.

Image: Peter Bennetts

Green roofs are used across the complex for a further extension of the hospital’s natural setting, giving additional visual relief – where visible – from internal spaces. Continuity with the landscape beyond the hospital is reinforced by a series of linked public parks integral to the hospital precinct and open to public and patients alike. The principal linear park aligned north–south from the north-east corner of the precinct provides a green lung and parkway route separating the State Rehabilitation Service unit and the Mental Health unit from the main hospital building. To the south, across Robin Warren Drive, is the public Lake Park formed as part of the remediation of the wetlands and adjacent conservation area. Planting extends out and across the various surface car parks to further strengthen landscape continuity.

The Fiona Stanley Hospital has yet to receive its first patients and to be tested by the intense activity that it has been designed to support. Even so, it is already clear that the stage is set for what promises to be a new benchmark for hospital-based healthcare in Australia. The complex politics and the machinations of the funding and delivery of major capital projects such as hospitals often suppress or weaken the architectural resolution of the design. The vision framed in the masterplan for the Fiona Stanley Hospital included an objective to create “a distinguished work of architecture that contributes positively to its surroundings, the environment and the community.” Although such a review as this – conducted well before the hospital has welcomed its first patients – may be premature, it is apparent that the integration of evidence-based design principles in the planning and design of the hospital has ensured that the patient experience will be enhanced through clearly ordered planning, well-defined circulation and wayfinding and thorough provision of physical and visual amenity. It is to the credit of all involved that the initial ambition for the architectural quality and effectiveness of the overall project has been sustained and answered with distinction and without compromise.

Credits

Architect
Fiona Stanley Hospital Design Collaboration
Consultants
Accessibility consultant O’Brien Harrop Access
Acoustics Gabriels Environmental Design
Alpolic SGI Architectural
Audio consultant CHW Consulting
BCA Ian Lush and Associates
Bicycles Department of Transport WA
Building maintenance equipment SafetyLink
Communications consultant Mills Wilson Communication Consultants
Design hardware Lorient Australia
Drafting Atlas Industries
Drainage consultant BG&E
Electrical engineer Wood & Grieve Engineers
Environmental consultant Strategen
Evidence-based design Robert Ulrich
Facade consultant BG&E
Fire engineer Norman Disney Young
Fire protection Norman Disney Young
Geotechnical Coffey Projects
Graphics Last Pixel
Helicopter operations Meinhardt Group
Hydraulics Sinclair Knight Merz
ICT IBMS Group
Irrigation CADsult
Lift services Wood & Grieve Engineers
Mechanical engineer AECOM
Model maker John Belviso
Physicist Sean Geoghegan, Royal Perth Hospital
Quantity surveyor Ralph Beattie Bosworth Pty Ltd
Safety in design John Massey Group
Security Sinclair Knight Merz
Specification writer Davis Langdon
Structural and civil engineer BG&E
Sustainability BESTEC
Waste management consultant FCA Online
Waterproofing Bonaldi (Australia)
Wayfinding Minale Tattersfield Australia
Wind consultant Cermak Peterka Petersen
Site Details
Location Perth,  WA,  Australia
Project Details
Status Built
Category Health, Public / commercial

Source

Project

Published online: 6 Oct 2014
Words: Michael Keniger
Images: Peter Bennetts, Robert Frith

Issue

Architecture Australia, September 2014

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