JOINT IHEEM NI AND ROI 2022 CONFERENCE
challenges for patients as elsewhere’. “However,” Brendan Smyth said, “you walked in and it was an absolute oasis of calm. People were able to be treated in their bedrooms and individual spaces with dignity, and the staff there were treating people that otherwise would have been in an HDU or ICU facility.” The medical gases and space standards were sufficient to allow this. He remembered much debate initially about whether the provision of 100% single rooms was ‘excessive’ He said: “The answer was absolutely not. We could see the positive outcomes of that, in that we could facilitate family visits to patients at end of life, simply because of the built environment and layout here.
The difference a high-quality estate makes “That’s the actual difference that a good quality estate like this can make, so this is what we have to strive for and demand; that investment is accelerated. Certainly in Northern Ireland over the last number of years, that real estate investment has dropped from what it was 10 years ago, and I think that we have to lobby to get back to that level of investment.” Next showing some slides of the other
new ward block at Ulster Hospital – the Acute Services Block, with its specialist wards, an Emergency Department, and most of the imaging functions, Brendan Smyth said the reason for showing them was to highlight ‘those elements of learning from previous projects – of detailed attention to good design – such as the transparency between the patient bedroom and the staff area, affording full visibility for patients and staff’. He elaborated: “From the patient handset control – and the image in the centre at the top – you can see that the patient has complete control of whether they want that ‘connectivity’ with staff walking up and down the ward, or whether they want privacy, and to turn those blinds down. That’s all patient-controlled, as are the blinds externally.” Meanwhile, he noted, the en-suite
bathrooms feature an easily cleaned, seamless Corian finish, ‘with no hidden surfaces to harbour infection’. He said: “Yesterday, Mark Kane (the Assistant National Director, HSE Capital & Estates – New Construction Methods, Strategy, Risk and Sustainability), discussed Modern Methods of Construction – something we toiled with for a long time, with the design
‘‘
At the new Acute Services Block, ‘there’s always a connection to the outside and to nature, via heavily landscaped courtyards’.
team and the contractor trying to engage with industry. On this block alone, there are 288 bathrooms, all pretty much identical, and we wanted to see if we could develop them in some volumetric modular form and insert that in.”
Not economically viable at the time While ‘a huge amount’ of work had gone into this, at the time it had not proven economically viable, although today Brendan Smyth reckoned ‘that might be a different scenario – because the marketplace has changed’. He said: “We did manage to achieve exceptional quality through a traditional approach, but I think the way forward is for such en-suite facilities to be inserted, fully finished, or fully finished as far as possible, up to the connections.” He told delegates: “So, these facilities were designed and achieved a BREEAM ‘Excellent’ standard, but we have been questioning ourselves as to the effectiveness of that as a rating system. Is it more about a design and commissioning element, or is it really effective in an operational sense, and how do you track this an operational issue, and changes in behaviour?” Consequently, he and his team had been investigating other systems to see what might provide the best measure and data as to how they are actually performing.
Brendan Smyth: “We did manage to achieve exceptional quality through a traditional approach, but I think the way forward is for such en-suite facilities to be inserted, fully finished, or fully finished as far as possible, up to the connections”
‘Non-technical’ spaces ‘squeezed out’ He added: “Pete Sellars talked yesterday about an attempt to ‘squeeze out’ some of the ‘non-technical’ spaces. These,” he said, showing slides, “are images of the canteen area in the Acute Services block, the circulation spaces, and their little breakout areas.” While very often in hospitals, ‘by their very nature’, the circulation spaces were dark and dreary, with the users losing a sense of orientation, here the team had developed courtyards right down into lower levels. So,” Brendan Smyth said, “there’s always a connection to the outside and to nature, via heavily landscaped courtyards.” This had ‘made an enormous difference’ to the sense of well-being of people travelling through the building. “Staff told us the breakout spaces – particularly in response to the COVID pandemic – were invaluable,” the speaker explained, “saying they could nip out there for 10 minutes in a controlled environment, de-escalate, and come down from the stress of dealing with really difficult situations, and then go back to work, refreshed and reinvigorated.” He continued: “So, again, I think you cannot underestimate this; it’s just simple basic things, such as the integration of art into the corridor or the circulation spaces, the sense staff get that they are valued. That, in turn, leads to better staff retention, which results in a more sustainable system. All of these things are interdependent.
An investment with a ‘legacy value’ “The last point I’d like to make about this Acute Services Block – in terms of Northern Ireland’s response to the COVID pressures – is that we didn’t build a big exhibition-type facility with hundreds of beds. Instead we accelerated a couple of
October 2022 Health Estate Journal 25
Courtesy of Donal McCann Photography / Avanti Architects
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124
