22 October 2012 — In this colourful and detailed expose of a new medical facility project in Adelaide, we’re led on the journey from initial thinking, the collaboration, the technology, the sustainable outcomes – including the first 5 star Green Star design and as built for healthcare – and on the hugely important impact this facility has on the people who will use it. By Paula Nagel and Richard Evans, on behalf of Woodhead.

Head 20 minutes due south of Adelaide CBD towards the beaches and you’ll pass a large hospital and university on the left. The first thing the driver will notice though is a stand-out, other-age building, all glass and timbers, fronting out to the main road and the sea.

The real stand out though lies inside, in the make-up of the Flinders Centre for Innovation in Cancer, and the fostering of something new in the fight against a scourge of this century and others.

And like a lot of innovations, it begins with a group of colleagues and a cup of coffee…

Like many good ideas, it was a long time in the making.

Ten years to be exact, from vision to completion, but the brief to come up with an iconic building to house, and showcase, Australia’s first integrated cancer care and research facility, is promising to be more than worth the wait.

Stunning at a glance, four storeys tall with a curved glass and copper coloured aluminium facade, it’s in the use of space at the Flinders Centre for Innovation in Cancer in suburban Adelaide, that the possibilities really kick in.

Informality is everywhere, public places light and uncluttered, but the real intrigue is upstairs, where a coterie of researchers, academics and more will sit down daily across a coffee table and, quite literally, set about finding a cure for cancer.

Which is something of a stereotyping conundrum… researchers, though historically left alone in their daily endeavours, are largely outgoing types and keen to talk about their work, says FCIC director Professor Ross McKinnon.

And thus, the change afoot at Flinders.

Ross McKinnon

“My favourite parts of the new building are the open plan areas on levels three and four,” McKinnon says. “There’s a break out area at the end. Where there’s an informal space people can head to, they will do. It’s where the best ideas come from.”

Openness is all here and the FCIC has been put together with the idea of everyone mixing in.

“We’re taking integration to another level. Medical staff now see the people they are treating around the building in general, there’s a continual public interface,”  McKinnon says.

The plan is simple. Through its iconic design the FCIC hopes to become a byword for first rate grants and first rate staff.

It’s all about cancer prevention, early intervention and survivorship here – around half of all cancers can be dealt with if they’re found early enough says the FCIC. And having a wondrous, state-of- the-art facility will do no harm in attracting the money to feed the ideal. A public relations, marketing and fundraising hit, all in one.

“We want to find new techniques to detect cancer earlier, whether improving uptake in bowel screening or behavioural aspects to cancer, looking at what drives peoples choices and habits,”  McKinnon says.

In which vein he’d be happy to let his researchers chat ad infinitum, caffeine fuelled and enthused by the context and company. But should the mocha or cappuccino run dry, the exit is not to the dingy, rear of the hospital, and mind, billets of old.

Transparency and visibility rule – back to the desk post coffee means a workbench within a vast open plan laboratory, all light and white, or a seat in an adjoining  open work area where PhD students can hot desk and hi-five with senior medical staff should the mood take them.

“A lot of the oncologists weren’t visible before,” says McKinnon. “The new work area breaks down all the hierarchical barriers, you don’t have to make an appointment as you’re often seeing them every day. You don’t see a lot of open planning, this takes it to another level.”

Don’t be fooled by the apparent casualness of it all, is the subtext. Detail is everywhere and much sharpened over time.

It all kicked off pre millennium when Woodhead was working on complementary projects at the Flinders Medical Centre just metres away. Ideas were thrown around and shared with the university and hospital foundation.

Angelo Di Marco

Woodhead chief executive officer Angelo Di Marco was on board from the start and while the idea and intent was there for the FCIC, the money wasn’t.

Nor was the initial design.

“It was all was about making a lot out of very little,” Di Marco says.

“The site was fraught with problems, backing onto an ambulance ramp didn’t aid the new plans, a car park needed shifting and the hospital helipad needed rehousing.”

Head inside today and the integration is an experience in itself, the sole staircase, wide and timber, snaking up and around the four floors, a navigation aid and tour of almost everything the centre has to offer.

There’s a giant glass meeting room slap bang in the centre of the upper floors and, downstairs, a T-bar franchise with all profits given over to the FCIC. A lecture hall next door doubles as a yoga suite. Wellness facilities will soon be on the menu too.

Colours count – the timber seeps a healing effect, white walls neutral but calming, subtle graphic design everywhere, amalgams of spots dotted around representing cancer cells and the fight all are united against.

The Infusion Suite – cancer’s nemesis and the battleground of bravery and anguish for 1200 unique patients each month – is a layer of complexity masked by simplicity. Individual bays can be reshaped for need or simply for change’s sake – it can be a long six or seven hours here at a stretch and the same again a day or two later.

There’s a touch of the sci-fi even here and, 2001: A Space Odyssey, in its look and feel – a nice synchronicity too, 2001 was the year the then projected $10M project really got going.

Today it stands finished, just shy of 6000 square metres and at a cost of $29 million all told.

Official and indigenous welcome ceremonies marked its opening in April this year – a decorative, two-metre high Indigenous shield, built by local artist Karl Telfer stands in front of the atrium – but the work is just now really fitting its mould and shaping up.

Moving the helipad from atop the car park across the road for example was a master stroke of pragmatism – the previous journey from landing to theatre previously involved a complex and long winded shuttle across much of the hospital. Now, it’s land on the FCIC roof, down one level in a lift, along a corridor and you’re where you need to be.

It’s not only efficient but almost un-noticed too, sound and vibration stabilisers unsettling neither patient nor research. You might hear it occasionally, says Professor McKinnon, but you won’t feel a thing. Detail as ever.

“Another unseen and unexpected variance came indirectly, with the implementation of a change management process,” adds  Di Marco.

Hot desking for consultants, haematologists, psychologists and all manner of clinicians amid an open plan workplace was questioned at first but the Flinders medical world is now firmly wedded to contemporary business in outlook and practice. Not an easy win but rooted in a design that works and looks good – the practical outcome always.

The case for BIM

The Flinders Centre for Innovation in Cancer was built by Hindmarsh, with Aurecon  environmental and structural engineer. Project manager was PM Connect and mechanical contractor/consultant was Watson Fitzgerald and Associates.

A BIM [building information management] case study paper produced by Woodhead said the Flinders Centre for Innovation in Cancer allowed the company “to leverage the tool beyond the single model use”. Highlights from the paper said:

“It is only recently that the broader community of consultants have begun to embrace the potential of the BIM authoring suites and the model integration and coordination processes which can follow.

“The potential of leveraging through model sharing and model integration was now a possibility. This is in spite BIM deliverables not being a requirement or a contracted item for the FCIC project.

Woodhead sought to have the project stakeholders agree to a selected set of BIM objectives.

“Recognising the project and implementation of BIM is only as good as the weakest link, the objectives were required to be based on the skill sets and strengths within the respective project teams.

“A Project Protocols document was drafted by Woodhead and issued to the project team establishing workflow, model and data sharing with also the BIM objectives defined.”

“In summary, the BIM objectives for the FCIC Project were identified as:

  • Architectural and engineering consultants were required to utilise BIM authoring suites for the purpose of building modelling and the production of documentation
  • Models generated were required to integrate into a single master model to facilitate coordination between disciplines
  • BIM coordination software was to be used to facilitate coordination of services with structure and architecture.

“The project team agreed to have a mechanical contractor/consultant appointed to assist in achieving budget compliance and working more closely with the design team.

“The modelling responsibilities for mechanical services therefore shifted from services consultant to the mechanical contractor/consultant.

“An integrated model was generated comprising the architectural, electrical and structural design models with the mechanical contractor/consultant chain supply model.”

The case study says lessons learned included:

  • Technology is only part of the story. BIM is ultimately a process with efficiencies available through planning of clear workflow practices and procedures.
  • Modelling does incur more up-front costs.
  • The integrated model can provide a greater level of control all round.
  • There is value in working with contractors as consultants. However not all procurement processes can support this.
  • Getting the right team is an issue for all projects. With BIM implementation this is especially the case as BIM is only as effective as the most ineffective link.
  • The level of service is greater than traditionally provided and therefore of greater value to the client.

The brief, based on earlier masterplanning studies, identified a range of functional issues to be addressed. The major issues were focussed on deficiencies with the L3 “hot” floor which included operating theatres, emergency department and intensive care.

A collaborative procurement strategy was engaged that saw the client, the design team and the constructor working together to prioritise and deliver a redeveloped health facility that addressed all the client objectives.

As the project included a high percentage of refurbished space, options for sustainability were at times limited by the existing conditions.

The new components of the redevelopment have been designed to maximise daylighting and views whilst incorporating passive design elements to reduce heat gains.

(And) as a health facility there are many mandatory requirements including infection control and space standards.  This project assisted with setting new standards at Flinders Medical Centre and statewide.

The recently completed four-storey “New South Wing” has been designed and constructed with a focus on ecologically sustainable development principles.

This Healthcare V1 is the first health building in Australia to be awarded a 5 Star Green Star rating by the Green Building Council of Australia for both “as designed” and “as built” categories.

Sustainability is of paramount importance to the design. Woodhead has installed what we understand to be the largest solar hot water system in South Australia. In an effort to reduce greenhouse gas emissions by 1100 tonnes annually and cut around $200,000 in energy costs, a 286 hot water panel system was included in the centre’s total redevelopment work.

It is anticipated that once completed the Flinders Medical Centre will cut greenhouse gas emissions by 4200 per year and save 60 million litres of water through use of rainwater harvesting and greywater diversion.

Innovative inclusions were

  • Installation of a displacement ventilation system- a first in South Australian hospital context. It allowed generous provision of natural ventilation to the patient rooms: This system was incorporated into the customised bed head joinery allowing minimal impact on the space
  • A sustainable Procurement Guide developed through the NSW project is now utilised on other SA Health projects. This guide provides valuable ESD benchmarks for the complex procurement process.
  • Validation of materials selections let to the education of suppliers and manufacturers, of products specific to Healthcare markets, regarding the additional ESD/ Greenstar criteria.
  • Stringent performance criteria applicable to healthcare environments, including long term durability and maintainability and infection control procedures limited the available material choices.

All specified materials complied with formaldehyde and VOC limits.  Despite the majority of flooring being PVC the environmental credentials of the supplier Armstrong Nylex allowed two of the available three points to be achieved in the flooring credit.  GECA certified carpet tiles, ceiling tiles and board products for joinery aids were also incorporated. Loose furniture was also Greenstar compliant.  Typical joinery was designed on a modular basis to reduce waste and facilitate relocation and reuse.

The Flinders Medical Centre redevelopment project has set the standard for a more sustainable built environment with the achievement of the first, and so far only, healthcare facility 5 Star Greenstar “as designed”.

Project Information

Client:                           Flinders Medical Centre Foundation

Location:                     Adelaide, SA, Australia

Project Start Date:     November 2007

Project End Date:      June 2012

Architect:                    Woodhead Pty Ltd

Scope of Work:           Masterplanning, Architecture, Interior Design

Project Value:             (AU)$163 million

ESD Certified Rating: Healthcare V1 5 Star Green “as designed” and “as built”.