GOULBURN HOSPITAL &

HEALTH SERVICES REDEVELOPMENT

ARCHITECTURAL DESIGN STATEMENT

19th September 2019 Rev E

EXECUTIVE SUMMARY The demand for healthcare services in the Goulburn Mulwaree LGA is expected to increase markedly in response to evolving healthcare needs of the community. The Goulburn Hospital within the Southern NSW Local Health District is at capacity and a number of the existing assets neither support nor have the capacity to be repurposed to support contemporary models of care. The current facilities require expansion to meet the health service demand of the local population. The primary focus of this project is to deliver a new 4 storey acute clinical services building at the Goulburn Hospital campus, with appropriate linkages to the existing hospital assets including Goulburn Base Hospital, Bourke Street Health Service and Kenmore Hospital in order to create a seamless campus. The project will also require refurbishment and re-development of interface services and building elements.

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Design Process Summary

Following a Peer Review engagement to review the approved Architect’s Design Development documentation, STH were asked to submit a proposal to become the new Principal Consultant / Architect for the project. STH reviewed the functional relationships and identified numerous efficiencies that could be offered to ensure that the proposed development met the brief. Following these peer review meetings and an initial presentation to the NSW HI, SENSW LHD and the Project Managers, STH were engaged to undertake a complete review of the Schematic Design for the project. Following numerous Schematic Design User Group consultations, which allowed the SENSW LHD and key Users explain the rationale and functional relationships of the design, STH developed a scheme that met the brief and reduced the overall size of the building. Some of the key changes were as follows:

• Raising the Level LG floor plate by 300mm to minimize ramps and excavation works

• Rotating the Service/Bed Lifts to provide a clear Service/Bed corridor traffic flow separate from the Public flow

• Provided a new Sterile Supply Unit (SSU) and Mortuary within the new Building footprint to provide optimal access and workforce efficiencies

• Reducing the overall bulk and scale of the proposed building by maximizing efficiencies in clinical planning

• Providing a greater setback of the upper level building form The location and proposed siting of the new Acute Services building was also intensely reviewed and scrutinized. The hospital site features a large sloping topography, which falls from north to south-east. The location of the proposed modified scheme did not change from the approved scheme however the location of entries into the building were modified to ensure a clear separate access path for public from staff and logistics, which was achieved utilizing the existing street network surrounding the hospital campus and the natural topography of the site. Site access The main changes to site access (both vehicular and pedestrian) incorporate redesign of the main drop off, re-direction of traffic flow on the existing arched driveway and eliminating switchback ramps as pedestrian access. All public access points have been located from Goldsmith Street, with staff access provided from Faithfull Street (to the new Fleet carpark) and Clifford Street (to the existing Staff carpark). Logistics deliveries will be via Clifford Street in a one-way flow, exiting via Faithfull Street. There will be a dedicated Ambulance / Emergency Services vehicle access from Faithfull Street into a dedicated plaza with direct access into the building. Design rationale for the redesign of main forecourt (Goldsmith St) was to improve public access, provide more intuitive wayfinding, clearly separate main entry from public emergency entry, provide more pedestrian- friendly access from the street to main entry and increase landscape opportunities. Proposed scheme also leaves existing building #32 in-situ (it was proposed to be demolished). This helped realign the main entry point and provide a more direct visual and physical connection to lift core and vertical circulation. Changed shape and extension of the main drop off canopy over the driveway provides protection from various adverse weather conditions. This also helps to emphasize the main entry point and thus improves intuitive wayfinding. Re-direction of the vehicular flow on the existing arched driveway improved access to the new main entry point, with the drop off now being on the passenger side. Utilizing the existing topography to connect between the main entry and emergency levels helped eliminate the switchback ramps, provided more landscaping opportunities and minimized visual clutter with single stair connecting the 2 levels, which in turn makes unambiguous wayfinding choice.

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Changes to emergency carpark layout allowed creation of landscaped verge along the boundary. Changes to ambulance access, fleet car park allowed perimeter access to the building, giving access to hearse/mortuary which were not previously located in the new Acute Services Building

Approved Scheme.

Proposed Modified Scheme.

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Building Massing and Envelope Design Changes

In general, the approved scheme and the proposed modified scheme share largely the same siting and building mass. Refer to the S.455 modification application plans and sections which show the extent and location of the building’s reduction and expansion in further detail. These diagrams clearly show a largely neutral variation on all levels. Fundamentally the U-shape of the building remains the same with the only noticeable difference being the external stair wells now located inbound. The building also remains a 4-level building and as such no additional impact on the surrounding environment is envisaged. Changes between the two schemes include a setback to the level 3 perimeter, to reduce perceived bulk and scale from the building from public domain. The following is an outline of amendments and improvements to mitigate any negative visual or physical impacts.

North-South Section, Approved Scheme

North-South Section, Proposed Modified Scheme The overall floor area has been reduced in the proposed modified scheme: Fully Enclosed Covered Area + Links in the approved scheme are approx. 12,072m2 vs the proposed modified scheme at 11,744m2, difference of approx. 328m2 The Physical scale of the building is reduced with the height of the roof over the roof plantroom which has been reduced by 800mm, to achieve an RL of 674.810 (21.285 meters from the natural ground level RL653.525). The approved scheme has an RL value of 675.610 at their roof plant level (22.085 meters from the natural ground level of RL653.525). The height of the top of parapet for the approved scheme

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is estimated at RL670.060 (17.30 meters) at the roof fascia (perceived as the top of façade). The modified scheme is captured at RL669.290 (16.53 meters), resulting in a reduction of 770mm. As the building internal planning was amended from the approved scheme, to allow for updated layouts the building envelope has undergone some redesign, which include a reduction to the overall bulk and scale. Shape and location of roof plantroom was changed to face greater setback from Goldsmith Street, being the main public “face” of the Hospital. Proposed Roof forms were selected to be visually sympathetic to existing Hospital buildings for better visual coherency. Proposed roof forms also resulted in the deletion of perimeter parapets, in turn reducing the visual bulk as well as reducing overshadowing of the south wing of the new bulging and ambulance plaza below. Façade material selection was changed to include porcelain tiles, which not only have desired visual qualities and reference to the existing surrounding historic building materials but offer an improvement in durability and life cycle. These adjustments to the building’s façade and materials undertook a review by the government architect NSW and well received with recommendations to maintain the pursuit of harmonistic site and material qualities. A new colonnade, connecting the new main entry to Existing Pavilion Building, acts not only as a visual tie reinforcing unified Hospital campus appearance, but also provides weather protection to the drop off spaces. The link providing a connection to Existing campus Back of House and Logistics area has been modified to reduce the overall length and provide a more direct route into the new building. This creates courtyard space on the west side of the new building (between existing and new) which will be used by staff and give visual amenity to the main public entry and lobby.

North View, Approved Scheme

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North View, Proposed Modified Scheme

Goldsmith Street Ciew, Approved Scheme

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Goldsmith Street View, Proposed Modified Scheme The following Concept summary offers design intent and rationale for the proposed envelope design and massing: The design response is establishing architectural language for the Hospital campus to create a coherent overall presentation to the public domain. Brick is the predominate building material in the precinct and brick buildings (to a degree) predetermine the aesthetics, colour, modularity and grain for the Hospital campus. Certain architectural elements represented are typical across multiple buildings (vertical windows, frame elements, and colonnades) establishing proportion and rhythm of the façade break up with fine-grain details and layering. The challenge is connecting a modern state of the art facility to the existing heritage building and creating one singular, coherent hospital precinct. An elevation study reveals that there are visual datums that could connect the buildings - in this case with the use of similar colour material. The upper and the lower parts of the new extension would be executed in a different materiality and play a secondary role, giving the opportunity for the 2 mid-levels to visually connect the hospital forecourt.

2-storey datum, strategy to establish connectivity to existing and reduce visual bulk and scale.

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Shadow Analysis The Autodesk Revit software platform was used to generate the shadow projections for both approved and modified schemes. The approved scheme’s 3D REVIT model was located initially at a height of 0 meters above AHD instead of the nominated ground level of RL 656.910. The plans below show the approved scheme location and the proposed modified scheme comparisons for an accurate depiction of the shadow projections. 23 September, 9am

23 September, 12pm

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23 September, 3pm

22 June, 9am

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22 June 12pm

22 June, 3pm

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22 December, 9am

22 December, 12pm

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22 December, 3pm

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Functional Planning

Following the endorsement of the revised Schematic Design drawings, the design team worked with the SENSW LHD and Goulburn Hospital User Groups to develop the detailed Design Development layouts for the proposed design. These meetings were held with key personnel from all the clinical departments and a specific Whole of Hospital group. The proposed Acute Services Building consists of the following: Lower Ground Floor Patient Flow & Triage & Emergency Care Service (TECS) The Patient Flow and TECS departments are located to the west of the Lower Ground floor, directly opposite the Emergency Department. The layout allows for a series of Offices around the perimeter of the department and a central Workstation area with access to photocopying facilities. There is a dedicated Staff Room which has views out onto the new landscaped area adjacent the existing Pathology building. There is a dedicated Disaster Control Meeting Room which has been arranged as a control centre in the event of an emergency in the local area. This room has dedicated phone lines, television screens for arrivals and media and has the ability to page staff and doctors across the facility to attend specific presentations as a result of the emergency.

Emergency Department The Emergency Department is located directly from Goldsmith Street via a dedicated ED drop-off and short-term parking area. There is a dedicated Triage Nurse and space for 2 dedicated Clerks to meet all patients presenting to the ED. There are 6 Acute cubicles including one dedicated Paediatric enclosed cubicle and an Isolation cubicle, 2 Resuscitation cubicles, a 4 cubicle Short Stay Unit and a 4 place Ambulatory / Fast Track Unit. There are 3 Consulting rooms, with consideration for Sexual Assault and Ophthalmology presentations. There is also a dedicated Safe Assessment Room (SAR) for patients with mental health, alcohol or drug affected symptoms. There is a revised Ambulance plaza, which is accessed from Faithfull Street, for 4 Ambulances, 1 Bariatric Ambulance, 3 Patient Transport Ambulances and Emergency Services / Correctional vehicles. There is a dedicated access into the ED from the plaza for typical ambulance presentations and access directly into the SAR room for patients requiring safe assessment.

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Medical Imaging The Medical Imaging department has been located on the western side of the Lower Ground floor, with access from the main airlock adjacent to the Emergency Department and from Goldsmith Street. The department features 3 Ultrasound rooms with dedicated ensuites, 2 General X-Ray rooms, Fluoroscopy and CT scanning rooms. There is a 4 place Holding and Recovery area for patients transferred from Inpatient Units or from the Emergency Department. There is a dedicated Reporting area interlinked to the X-Ray, Fluoroscopy and CT rooms and access to a Staff Room. There is a dedicated Cold Shell space to the south-western corner which has been future proofed for a MRI facility. There has been forward planning to allow for this cold shell to be fitted out in the future with minimal disruption to the existing operations of the hospital.

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Mortuary The new Mortuary has been located to the south-eastern corner of the Lower Ground floor, with direct access from the Service road via Clifford Street. The Mortuary allows for 12 bodies in standard mortuary refrigerators, 2 bodies in specialist bariatric refrigerators and 3 bodies in a dedicated freezer. These are all accessed with a ceiling mounted hoist system which allows for movement within the Mortuary and to the Hearse Bay. There is a dedicated Waiting Room with Viewing facility for families. This department will be relocated from the lower level of the existing Pathology building which removes the requirement for a vehicular access route through the new enclosed link to the existing Back of House / Loading Dock area.

Back of House / Enclosed Link to existing Building / Engineering Services There is an enclosed link from the new facility to the existing Back of House / Kitchen / Loading Dock facilities. This will provide direct access for logistics, food, waste and linen from the Loading Dock and delivery area around the hospital. There is a dedicated Sterile Supply Unit (SSU) loading dock area which allows for the delivery and pick up of loan equipment which has been treated in the new facility. The large Engineering Services plant area for Mechanical plant, Medical Gas, Main Switchroom, Main UPS and Communications Room and the meter rooms (Gas and Water) allows for direct access from the service road via Clifford Street. There is access into specific rooms from within the facility as requested by the hospital. This was relocated from the eastern side of the building which had limited access which would have also been shared with the Ambulance plaza area. Ground Floor Front of House / Non-Clinical Support / Link to existing buildings The revised Main Entrance to the Goulburn Hospital will be from Goldsmith Street, with a dedicated patient drop-off and short-term parking area. There will be a direct link through from the new facility into the existing Hospital via the existing Pathology building, which will be turned into a gallery space to showcase specific arts and heritage items.

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The main Reception will be in a direct line of sight from the front entry and features a dedicated Admissions area adjacent. There will be a Volunteers / Concierge Information desk further into the entrance foyer on the pathway to the Public Lifts. The Non-Clinical Support area will be located behind the Reception and Admissions areas and features a series of Offices, Interview Rooms, Workstations and a Mail Room. There are public amenities, including a Parents room and Changing Places facility, located adjacent to the Public Lifts.

Level GR Front of House / Non-Clinical Support Areas

The Security office for the entire Hospital will be relocated into the Lower Ground floor opposite the Emergency department, which will also have direct vision to the ED drop-off and short-term parking area. This area will also feature CCTV capabilities to enable security to access and view all of the cameras located throughout the facility.

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Level LG Security

Maternal / Newborn / Paediatrics The Maternal / Newborn / Paediatrics unit is accessed directly from the new main entrance foyer. It features 2 Birthing LDR rooms, a Birthing Assessment room, 5 Post-natal Bedrooms and 6 Paediatric Bedrooms. There is a 2 place Special Care Nursery which is located centrally to the unit and adjacent the main Staff Bases and Clinical Workroom. The Birthing Rooms feature a custom-designed bedhead with storage and nurse write-up space, a day bed for family members, birthing bath and a dedicated ensuite. The Assessment Room is located adjacent the Birthing Rooms and will be used to assess patients in early stages of labour prior to requiring the Birthing Room. The Post-natal Bedrooms are located on the eastern side of the unit and feature a day bed for family members, dedicated ensuite and baby bathing facilities. The Paediatrics Bedrooms are located on the northern side of the unit and feature a day bed for family members and a dedicated ensuite. There is a Play area and external Terrace area which is accessible from the unit.

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Rehabilitation / GEM Inpatient Unit The 22 Bed Rehabilitation and GEM Inpatient Unit is located to the south of the Ground Floor and is accessed via the main entrance foyer. There is a mixture of single and two Bedrooms across the unit with a central Support Services core. There is direct access from the Service/Bed Lifts via the lift lobby which is separate from the public access corridor. There is a dedicated Gymnasium and ADL Lounge / Dining areas located within the unit. These are located adjacent the Services Lift Lobby and have direct access to an undercover Terrace space which overlooks the eastern side of the hospital site, directly over the Ambulance plaza.

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First Floor Surgical Inpatient Unit The 28 Bed Surgical Inpatient Unit is located to the north of the First Floor and is accessed via the Public lift lobby. There is a mixture of single and two Bedrooms across the unit with a central Support Services core. There is direct access from the Service/Bed Lifts via the lift lobby which is separate from the public access corridor.

Perioperative Services / Day Procedures Unit The Perioperative Services unit occupies the central and southern parts of the First Floor and is accessed via the Public lift lobby (into the Day Procedures Unit) or the Service/Bed lobby (into the Theatres area). The unit is split into the Day Procedures Unit (DPU), Recovery area and Operating Theatres. The Day Procedures Unit is accessed from the Public lift lobby and features a dedicated Admissions room and change area for patients presenting for day procedures. There is a 4 place Holding area, 6 bed Second Stage Recovery area and a 4 place Discharge Lounge (formerly Third Stage Recovery area). The DPU is located adjacent the Main First Stage Recovery area and shares the Support Services.

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The Main First Stage Recovery has access direct from the Operating Theatres for recovering patients following procedures and into the Service/Bed lifts for transferring to Inpatient Units. There are 7 Recovery bed cubicles, which includes an enclosed cubicle for isolating patients if required. There are 4 Operating Theatres, which includes a Procedure Room that caters for Endoscopy cases. This Procedure Room has a dedicated Scope Processing room for the cleaning and storing of scopes. Each Operating Theatre features a dedicated Anaesthetic Induction room and each pair share a Scrub bay and Sterile Store. There is direct access from within the Operating Theatre area into the Sterile Supply Unit so that nurses can access sterilized equipment for their cases and drop off dirty instruments and equipment to be decontaminated and processed for re-use. Sterile Supply Unit The new Sterile Supply Unit replaces the existing non-compliant facility within the existing building. Located with access directly from the Service lobby and the Operating Theatre area, the new SSU features a Decontamination area with 4 Washer Disinfectors, a pass-through Drying Cabinet and Ultrasonic cleaning equipment adjacent height adjustable sinks. The central zone for Assembly and Packing caters for 6 packing tables, drying cabinet and access to the 3 main Sterilizers and single Low Temperature Sterilizer. The Sterilizer Cooling area has access into the Loans Set Holding room for Operating Theatre access and to the Dispatch room for Loans Equipment. The SSU will cater for Loans equipment from across the greater Goulburn region and has a dedicated Loading Dock on the Lower Ground floor with vehicular access via Clifford Street.

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Second Floor Intensive Care Unit The 10 bed Intensive Care Unit caters for patients requiring intensive care (ICU), high dependency care (HDU) and coronary care (CCU). There are 4 dedicated HDU / CCU cubicles and 4 dedicated ICU cubicles, along with a dedicated Bariatric and Isolation cubicle. All cubicles are enclosed behind glass doors. The central Support Services and Staff Bases are located in the central core and the unit is accessed via the Public lift lobby (family and visitors) and the Service/Bed lobby (patient transfers to other areas of the facility).

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Medical Inpatient Unit including Palliative Care The 28 Bed Medical Inpatient Unit, including a 4 Bed Palliative Care unit, is located to the south of the First Floor and is accessed via the Public lift lobby. There is a mixture of single and two Bedrooms across the unit with a central Support Services core. There is direct access from the Service/Bed Lifts via the lift lobby which is separate from the public access corridor. The 4 Palliative Care beds are located on the northern side of the unit and each have access to a dedicated terrace area and family lounge. The bedrooms feature a day bed for family members and a dedicated ensuite.

Third Floor Engineering Services Plant The rooftop plant will provide the facility with Mechanical ventilation via Air Handling Units (AHUs), Chilled and Heating Hot Water plant, RO plant and other building services equipment. This area is accessible via the Service lifts and the egress stairs.

Australasian Health Facility Guidelines (AusHFG) Variations

The new Goulburn Hospital Acute Services building has used the current AusHFG Room Layouts to provide a base point for the design. There have been a number of major and minor variations to these guidelines proposed throughout the Design Development phase during the PUG meetings. All of the major variations have been submitted for approval by NSW Health Infrastructure and their associated committees for endorsement. The major variations include:

• Schedule of Accommodation room area changes (submitted for endorsement)

• Bedroom configuration to provide a “proud” bedhead (submitted for endorsement)

• 2 Bedroom staggered configuration, with beds opposite each other rather than directly net to each other (submitted for endorsement, rejected by NSW HI)

• Day Procedures Unit (DPU) Admissions room (submitted for endorsement)

• Emergency Department Beverage facilities in Meeting Room and Interview Room (submitted for endorsement)

Minor variations to the AusHFG Room Layout Sheet configurations have been proposed and discussed throughout the Design Development process with the SENSW LHD, Goulburn user groups and NSW HI

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representative. These variations are minor in nature as they do not change the functionality of the room as depicted in the AusHFG Room Layout configurations but allow for flexibility of use and FF&E solutions. These minor variations include, but are not limited to, the layouts of the Clean Utility rooms (removal of fixed joinery in preference for a FF&E solution), Dirty Utility Rooms (preference for underbench Washer Disinfector rather than full size and deletion of flushing rim sink), Staff Rooms (use of banquette seating to maximise the number of seating spaces), Cleaners Rooms (to include a handwash basin and space for multiple cleaner trolleys) and Disposal Rooms (to provide a shelf for storage above the bins and space for empty gas cylinder storage).