Flexible design and stakeholder input are important for innovation in aged care facility design. With government investment in aged care and an increasing elderly population, facilities must be designed to provide happy environments for years. A collaborative approach is critical for the best outcomes, as no single person has all the answers. Involving a variety of specialists can improve staff workflow, productivity and safety. Flexible designs allow facilities to adapt to future changes in care models and technology over their 50-year lifespan.

1. Flexible design and fresh stakeholders lead to
innovation in aged care facility design
Q&A with Bill Duncan, Director of Care 4
Aged Care Facility Design and Development
Australian Healthcare Week 2011
With the government investing $47billion for aged care and community
services over the next four years and $10.8billion in 2010-11, there has been
huge pressure on the sector. Alzheimer’s Australia estimates that there will
279,000 elderly Australians without a bed in 2050, so it is imperative that aged
care facilities are built and designed in a way that will cater for the elder
generation and provide happy environments for years to come.
Health IQ: When looking outside your organisation for help, what kind
of tools or vendors should you us? Can you take us through your
selection criteria?
Bill: Our program doesn’t have any very specific selection criteria and one
of the reasons for that is that most of the people in the organisation do have a
passion I guess for delivering aged care and providing better care to residents.
There are many so called ‘aged care experts’ out there or specialists who
tend to have a very, very fixed view on only a single way of working or specific
solutions that they might be promoting. And this even occurs within in the
design and construction side of the industry.
But my view is if we are really focused on delivering better care, then we need
to be innovative, we need to be forward-thinking and we need to look outside
the squares. If you look around at the different providers providing such great
care, all of them have a slightly different way of doing things, despite the fact
that they’re providing the same levels of care, or types of care.
So I really look for those people who can think a bit differently to everyone
else; and some of the best people that I find with this type of thinking actually
don’t have an aged care background. I’m working with architects at the
moment who are relatively new into the aged care industry, but it is that
newness gives them their inquisitiveness and their questioning of the status
quo. They’re uncovering and discovering more about aged care. They tend to
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2. ask questions that those of us who have been here a little bit longer no longer
ask.
This gives us a fresh perspective on what we’re doing. For me, I believe is
true progress towards innovation and better care.
Health IQ: So now can you predict what will work into the future by
designing out obsolescence?
Bill: Predicting the future, if I had the crystal ball, I probably wouldn’t have
to work! But my view on designing out obsolescence is not actually about
predicting what will work in the future. We really don’t have to know what’s
going to come in the future. We just need to know the things that are going to
change, and I think that’s a pretty essential caveat.
If we allow flexibility within our design and within our buildings – we then
create the ability to incorporate future developments - whatever they may be.
Because after all, the things that we can’t predict that will actually most shape
our future. A building’s lifespan should be at least 50 years, possibly more,
and we can be confident that there will be major developments during that
time – medically, socially, and technologically.
So what we really need to do is rather than trying to predict what the future
holds, we need to put in place the things that allow us to change the building
as it grows and it develops. We should stay away from those things that are
hard to change without major cost or hassle. I guess if I can give you a
specific example of this, designing a frame and insular structure for a new
facility, actually allows the ability to reconfigure the rooms in to the future.
So where we might have a whole facility at the moment with its single rooms
with private room suites. Designing it rather in masonry heavy brick and
heavy materials that are hard to change make it difficult to move the walls
around. If we do it in concrete frame structure with lightweight insular which is
certainly possible, it allows us look down the track and when we get to the
point of 10, 20 or 30 years times, to be able to say, this configuration now will
assist us, and we can actually change it around.
Now, it might seem like an unlikely need, but if we look backwards just 10
years ago in this industry, we wouldn’t really have thought that single
bedrooms with private room suites would make up by far the majority of the
new market. So that’s just an indication of how quickly things can change and
it’s really that creating that flexibility in design construction that allows us to
take advantage of.
Health IQ: So can facilities ensure they’re responsive to new and
emerging patient centre model of care then?
Bill: This is a bit related to the last question. This is because patient-
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3. centred models of care, and all models of care, stem from the face-to-face
caring side of every facility and every business in this industry.
As design and property professionals, our responsibility actually exist in
ongoing development of better care for provision of the best possible
environment in which the care is delivered.
So the real challenge that we have in allowing facilities and giving facilities the
opportunity to be responsive to this emerging models, is the different
timeframes we work in, as I said, a typical building once it’s constructed will
last 50 years or more. While care models can change from one year to the
next, they have the ability to change much more quickly than the building
does.
So again, our understanding of the speed of their transition is critical in our
ability to create flexible facilities which allow for that ongoing change and
development of care models; and that’s a specific example of the future-
proofing that I mentioned earlier.
The other issue that is currently being looked at in terms of patient-centred
models of care obviously, making facilities get much more sunlight, getting
away from institutional nature of facilities of the past. That’s very much a
focus that will remain and that’s brought down to the details when we’re
getting to the detail design and development, but it really leads to being
having a lot of flexibility at the big picture which means we can keep up-to-
date with whatever the care models are showing us into the future.
Health IQ: So you talked about the big picture, so how important is a
collaborative approach when designing and constructing new facilities
then?
Bill: I believe it’s absolutely critical to get the best outcome and the true
delivery of better care. The bottom line (and the truth) is that of all the people
involved in the development of any aged care facility from the provider
through to the architect and other consultants, project managers, all the
people that surround that new development, no one has all the answers; and
the true value is only created by putting a lot of people in the project at the
right time; and what I find is that right time is actually much earlier than most
people think.
Most people think that the team really starts up quite small and build over time
as you get further down the path towards, specifically towards construction.
But I believe we need to be much more collaborative right up front. The
decisions made at the earliest stage of the project are the ones that impact
heavily upon the final outcome. To change those at the later stages are really
costly and it’s actually less effective than getting them right in the first out, that
having the right people around the table and make those good quality
decision up front, just adds enormous value.
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4. So, as an example, the value of having a builder to the project team - even
during the design stage - which not too many people do. The value will be
created many, many times over what it cost to have the builders form the
project team because of the efficiencies and the strategic vision they can
bring to nearly the construction stage of the project.
One of the other aspect that I’m saying just recently is the input of a range of
specialist backgrounds and viewpoints, which can have an enormous impact
on a finished facility; and there is an organisation I work with that’s looking in
integrating people of occupational therapist as part of the design team, and
really looking, measuring, and analysing and creating staff work here from the
design team that are as effective as possible and exactly suit the work flow
that the staff will perform in that facility on a daily basis.
Now, the output of having someone like that on the team is that it directly
leads to reduced possibility of injuries, increased productivity and improved
morale. So, I believe you can’t collaborate too much… collaboration is
absolutely critical to make sure at the end of the day we’re delivering the best
care possible to the residents, which is the only outcome we should be
interested.
Bill Duncan will be presenting at the Aged Care Facility Design and
Development. The Australian Healthcare Week combines five essential health
events in to one big week. For more information on this particular stream visit
www.aushealthweek.com.au/agedcare, alternatively you can call our
enquiries team on 02-9229-1000 for more information. .
Health IQ asks Bill Duncan, Director of Care4: Can
you tell us a bit about yourself and your
involvement in aged care facility design and
development
I’ve been in the aged care industry for about 5 or 6
now; my background was actually in architecture and
design of property. I got into aged care while I was
working with a builder, I fell in love with the industry, I
think it’s a fantastic industry and it does such a good
job, such an important job, in our society that I just
developed a passion for it and I plan to be here for a
lot more years.
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