Jane Carthey

Adapting Australian health facilities to cope with climate‐related extreme weather events

Purpose – The purpose of this paper is to discuss the current state of FM preparedness required to deal with the risks to healthcare delivery posed by climate change‐related extreme weather events.Design/methodology/approach – Selected stakeholders were invited to participate in targeted focus groups that, using the ROMS methodology, explored the status of current knowledge and preparedness of the NSW health system to deal with the expected demands imposed by increasing incidences of extreme weather events. Findings are summarised and discussed in terms of the key stakeholder objectives identified. Further areas of required research are then discussed.Findings – The key objectives of the stakeholders were readily agreed, however a lack of information regarding the quantifiable impacts forecast to be associated with climate change constrained the development of other than generic strategies for dealing with these impacts. Further areas of research included assessment of changing demand for health services,...

Post Occupancy Evaluation: Development of a Standardised Methodology for Australian Health Projects

Abstract Post Occupancy Evaluation (POE) is considered an important stage of the implementation loop for health projects in Australia, allowing for feedback of evaluation results and consequent lessons into the planning stages of future projects. Although the use of POE is on the increase, the lessons learnt are not always adequately communicated or used for the purposes intended. There are many reasons for this including the lack of a commonly agreed methodology for conducting evaluations within and between different health jurisdictions in Australia. The results of this lack of standardisation include inconsistencies in data collection (type and format), in the analysis of the collected data and in the reporting of conclusions in a format useful for feeding back into the planning process. The research project described in this paper involved a review of current POE processes used in Australia together with examples from overseas. The reasons for conducting POEs were identified and a manual titled ‘The New South Wales Standard POE Methodology’ was developed for a range of project sizes, types and locations. The resulting methodology was issued in draft form for testing on New South Wales (NSW) Health projects that occurred in late 2004. This testing was conducted by a major industry organisation who recommended that, subject to further clarification of assessment criteria and fine tuning of the methodology, NSW Health should adopt the methodology as a standard for use on all its capital projects. Ultimately the intention is to share this methodology with the rest of Australia and New Zealand, and in the first instance, to agree to the use of an Australasian Post Occupancy Evaluation Methodology for evaluation of all health capital projects across that region. There is no logical reason why the methodology cannot be used in other countries in addition to that for which it was initially developed.

Reinterpreting the Hospital Corridor: “Wasted Space” or Essential for Quality Multidisciplinary Clinical Care?:

The planning of New South Wales (NSW) and other Australian health facilities is guided by the Australasian Health Facility Guidelines (AHFG), which prescribe allowances for circulation (corridors and similar areas for movement between spaces) of between 10% and 40% of functional floor areas. A further allowance of up to 28% for Travel and Engineering is then assumed (University of NSW & Health Capital Asset Managers Consortium, 2005). Therefore the “circulation” and “travel” space manifested as the corridors and similar movement spaces within health facilities is both extensive and expensive. Consequently, such space often becomes regarded as a necessary evil and, in the name of efficiency, is often minimized wherever possible. This paper revisits the view that corridor space allocations (circulation) must always be minimized to achieve design or functional efficiencies. Minimizing circulation or travel inevitably assumes that the realized space savings will then be reallocated to “more important” areas of the facility. Yet the corridors and other movement spaces also are very important to the functioning of multidisciplinary clinical teams and the quality of care delivery. Ultimately, inflexibly reducing the space allocated to such spaces may be regarded as a false economy.

Climate change risks and opportunities in hospital adaptation

Purpose – The future of healthcare delivery will depend in part on the adaptive capacity of hospital infrastructure required to respond to the predicted physical and health‐related impacts of climate change. The purpose of this paper is to assess the vulnerabilities and opportunities of existing hospital facilities faced with climate‐related extreme weather events and to identify adaptive strategies that will enable existing hospital facilities to assist rather than hinder healthcare continuity and quality during these events.Design/methodology/approach – Four major hospitals in Australia and New Zealand, significantly exposed to climate change‐associated extreme weather event risks, were selected as case studies. A risk management workshop was conducted for each case study using the risk and opportunity management system methodology.Findings – The preliminary findings identified several key objectives associated with responding to the impact of extreme weather events on healthcare infrastructure. Assumin...

Flexibility: Beyond the Buzzword—Practical Findings from a Systematic Literature Beview

Objective: The goal was to identify practical, cost-effective, design-related strategies for “future-proofing” the buildings of a major Australian health department. Background: Many health buildings become obsolete before the end of their effective physical lives, requiring extensive reconfiguration or replacement. This study sought to move beyond the oft-used buzzword flexibility to seek effective strategies to accommodate future change (future-proofing) that could be further explored in Australia and other developed countries. Methods: A systematic literature review compiled definitions of flexibility and adaptability from a range of sources. Nineteen case studies were identified that illustrated various future-proofing strategies. A matrix was developed to classify different approaches to flexibility and then used to assess the case studies. Results: Analysis was hampered by inconsistent use of terminology and limited availability of quantifiable methods for assessing the long-term success of approaches to future-proofing. Several key strategies were identified, classified, and discussed in terms of their relevance and application. Conclusions: More rigorous definitions of flexibility, adaptability, and related terms are needed to enable more useful comparisons of the strategies implemented to future-proof health projects. Local conditions often affect both the strategies adopted and the degree to which they can be considered successful. Many of the case studies analyzed in this research were not operational long enough to enable assessment of their claims of being future-proofed. Therefore, review of lifetime facility costs, including the service life periods of major facility components, should be considered, and some older projects should be evaluated in terms of these criteria.