Project Information

• The Project Team
• Project Background
• Design Phases

Project Team:

The Wairau Hospital Redevelopment Project Team is made up of the following NMDHB staff:

Project Sponsor

Keith Rusholme

Project Director

Martin Ridgway

Internal Change Manager

Sue Morris

Project Administrator and Communications Coordinator

Susannah Findlay

Clinical Sponsor

Rick Wilson, Orthopaedic Surgeon

Wairau Liaison Manager

Ali Rendall

Onsite RDT Pacific Project Manager

David Hobern 

NMDHB Board Representative

Lynette Jones

The Project team is also supported by external consultants from around New Zealand: 

Health Planner

Peddle Thorp - Margaret Garthwaite

Architect

Aecom – Peter Wootton and Sara Antonievich

Quantity Surveyors

Maltbys – John Oscilowski and David Morriss 

Project Managers

RDT Pacific – Don Robertson and Peter Vause 

Mechanical and Electrical Engineers

Pacific Consultants – Malcolm Brown and Greig Blackler

Structural and Civil Engineers

Beca - Jonathan Barnett and Adam Moffat

Main Contractors

Hawkins Construction

Community Liaison Group

The Community Liaison Group was established to create connections between the community and the hospital; to be a channel for community interest in, and contribution to, the atmosphere and surroundings of the hospital; and to assist the community with establishing a sense of ownership of the hospital. Particular areas of focus include art and culture, memorials, landscaping, public waiting spaces, and the Chapel.

The Community Liaison Group is chaired by Tessa Anderson. Group members are Karen Fisher, Amanda Gibbs, Kaye Green, Jeremy Jones, Greg King, Rose Montgomery, Jenny Robertson, Francie Shagin, Joan Sorensen, Thelma Sowman, Mo Sutton, Sally Wadworth, Carolyn Ferraby, Shirley Hawtin and Pete Jerram.

Project Background:

Redevelopment Vision

“To create contemporary, collaboratively operated Hospital and Health Care Facilities that will provide optimised services for our community in settings designed and resourced to achieve that end, and of which all can be proud”.

The redevelopment project was based around five guiding principles:

• Patient/Client centered - Meet identified community and patient needs
• Staff Supportive - Promote a culture of learning and innovation
• Evidence based - Demonstrate effective integration across continuums of treatment and care
• System minded - Promote collaboration between health service providers and other agencies and sectors
• Funding Fit - Demonstrate financial accountability

The basic requirements of the site are that it:

• Promotes the clinical, patient, and efficiency-focused objectives of the service;
• Is adaptable to changes in “best practice” without costly alterations to the layout and fabric of structures.

Background and Development of the Business Case

Since 2004, a dedicated team of staff and consultants have been working on the redevelopment of the Wairau Site. In August 2006, the Business Case for the redevelopment was approved and the Ministry of Health allocated $36.6M for the new hospital and the Project Team lead by Martin Ridgway, Project Director was established. Since then, Architects and Health Planner, Quantity Surveyors, Project Managers, Structural, Civil, Electrical and Fire Engineers, Building Contractors, Change Managers, and Acoustic Consultants have joined the team.

The Architects and Health Planner worked closely with the Project Team and Senior Management to develop a Master Plan (facilities were represented by blocks to illustrate important co-locations, patient and public flows, and gave an aerial footprint for the new site) for the redevelopment using some of the existing buildings which was signed off by the Nelson Marlborough DHB (NMDHB) Board in February 2007.

Upon the completion of the Business Case and approval of the Master Plan, Architects and Health Planners worked closely with the DHB staff and 12 clinical user groups across the hospital covering all departments from Peri-Operative to Social Workers to Imaging.

The Master Plan which was agreed by the board was gradually turned into a hand drawn ‘Concept Plan’ by the Architect / Health Planner with user groups who focused on the internal configuration of their departments and identified where rooms and entrances would be located.  The user groups then moved into the Preliminary Design phase where more detail was added and the plan was converted into an electronic CAD format, doors and bed spaces were shown on the plan and the departments were drawn to scale. At this phase of the planning, the NMDHB provided a Preliminary Design Report to the Ministry to allow for the remaining funds to be released for the remaining project.

Need For Change

The Business Case for the redevelopment of the Wairau Hospital addressed the shortcomings in the existing outdated buildings and layout of the current facilities. The planned outcome of the project is to redevelop the core of Wairau Hospital and refurbish the remaining facilities to create a sustainable Hospital and Health Centre for Marlborough.

The current facilities at Wairau are aging and the site is fragmented and dispersed. The internal layout of the facilities is inappropriate for modern and efficient service delivery. Other issues are:

• Facilities have been added in the past on an 'as required' basis rather than through a systematic approach, which has resulted in a configuration that is inefficient in space utilisation, service delivery and ability to secure the premises.
• The age and condition of some buildings and the high cost of bringing these buildings up to building code compliance levels for electrical, fire, disabled access and earthquake.
• Age and type of construction means that some buildings are increasingly costly to maintain and operate, are inflexible and costly to upgrade.

The redevelopment of Wairau hospital will allow NMDHB to implement the concept of “single specialty services across two hospitals” as the corner stone of service redevelopment. Developing this concept will require Models of Care that demand new collaborative approaches between departments, hospitals, and specialties, which incorporate the grouping of a number of services into clusters that allow NMDHB to provide appropriate services to their population.

Design Principles:

The Business Case has been based upon capacity needs to 2026, the current development building to 2013 capacity requirements. Buildings have been designed in a modular fashion, which will allow for expansion and/or alteration in the future, while minimising the costs or logistics of any required change. The models of care have informed the facilities planning process. This has resulted in a design solution that provides:

• Larger, more flexible units thus reducing the number of small inefficient units
• Better and closer co-locations with shared support areas
• Increased ambulatory capacity
• More effective utilisation of facilities and staff resources
• Reduce risks associated with small provincial Hospital
• Streamlined processes

Models of Care / Models of Service Delivery

As part of the physical site redevelopment, NMDHB has used this opportunity to update and revise the models of care/service delivery for each department. A standard approach to the Models of Care has been applied and this has been driven by iterative processes. The Models will continue to develop through the life of the project as staff gain experience and knowledge of process mapping techniques, and become more proficient at applying the principles of lean thinking to the patient pathway.

The Models of Care as specified in the Business Case have been developed and approved by the Project Steering Group. The footprint and the most appropriate shared spaces are being worked through with a process mapping exercises and facility design at the user group level. Where further Clinical Expertise is required, the changes are taken to the Clinical Reference Group for a recommendation that is then taken to the Project Steering Group for a decision.

The redevelopment includes a change in the Models of Care incorporating the grouping of a number of services into clusters that allow for appropriate service provision for our community. The key principals being:

• Larger, more flexible units thus reducing the number of small inefficient units
• Better and closer co-locations with shared support areas
• Increased ambulatory capacity
• More effective utilisation of facilities and staff resources
• Reduce risks associated with small provincial Hospital
• Streamlined processes

Impact of Change

The level of individual impact will vary across the hospital. For some staff, the impact will be primarily working from a new and better physical environment, whilst for others there will be substantial change in leadership, team members, processes, new technology and equipment, higher expectations regarding productivity, and for many nursing staff the need to expand clinical skills.

An organisational development work stream has been established to support the workforce redesign process.

• There is an expectation that all services will operate in an efficient and effective manner and will contribute to the financial viability and sustainability of the organisation.

• Training and development opportunities will be identified and implementation plans put in place to support and assist staff through any transitions. Retention of current staff and their skills, as well as the opportunity to learn new skills and recruit staff to new positions is important to Wairau Hospital and the community going forward.

• Developing systems and processes that ensure patient safety, and support health professionals to provide responsive care to patients, are recognised as strong incentives to recruitment and retention of staff.

• The provision of modern facilities should be used to enhance recruitment and retain current staff through the provision of a better work environment. The co-locations of departments and the design within departments are both informed by best practice, standards and staff experience and expertise

• The Wairau Hospital redevelopment has provided the unique opportunity to revisit and redefine the Models of Care within the services provided and within these to redefine the staffing models that support these services.

• It is anticipated that all systems and processes that are not building dependent will be implemented prior to moving into the new facilities. This will assist staff in managing the enormity of the facility changes and become accustomed to any new work practices prior to moving.

Design Phases:

Concept Design

This design phase generally involves the application of a design 'idea' to the practical provision of a facility. This design is usually a free hand drawn sketch.

The Concept Design phase may be used to define of verify the brief and may often involve the testing of different approaches/options. During this phase, ideas (concepts) are developed through open interaction by the team of the key elements of the project.

At the end of this phase, the basic building blocks of the project are defined in general terms and coordinated between design principles.

Preliminary Design

Preliminary Design generally involves the further refinement of the preferred concept to facilitate testing it against inputs from the team, including cost estimates and regulatory approval. The hand drawn sketch is transposed into a Computer Aided Design and exact measurements are included on the scheme.

During this phase the project concepts are developed into firm schemes, where the relationship and sizes of spaces and facilities are defined and coordinated between the design disciplines. At the end of this phase, the project should be clearly defined.

Developed Design

This is the phase where the scope of each component in the design is clearly defined and coordinated. This may involve production of detailed information including sketch details of all significant componentry and their interrelationships.

Developed design generally provides sufficient information for the client/user to clearly understand the aesthetics and functionality of the building, internal spaces and facilities.

Detailed Design

Detailed design generally provides a level of documentation that clearly defines the design, specification and extent of all building elements. The design should be comprehensively coordinated with other disciplines.

Rooms become more life like with doors, beds, sinks and curtain tracking and decisions are made around the color scheme and materials used within the facility.

Construction Design

This phase is where the requirements defined in detailed design documents are integrated with changes that may occur during the tender and contract process with the construction requirements such as site conditions, proprietary and performance design elements, erection requirements, and fabricated shop drawings to crease drawings that can be directly 'built' from.