Flexible design and fresh stakeholders lead to          innovation in aged care facility design            Q&A with Bill D...
ask questions that those of us who have been here a little bit longer no longerask.This gives us a fresh perspective on wh...
centred models of care, and all models of care, stem from the face-to-facecaring side of every facility and every business...
So, as an example, the value of having a builder to the project team - evenduring the design stage - which not too many pe...
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Flexible design and fresh stakeholders lead to innovation in aged care facility design


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Health IQ’s interview with Bill Duncan, Director of Care4. In this exclusive interview, Bill explains how to create flexible design in aged care facilities and what can external (and sometimes, unexpected) stakeholders can bring to such designs. He argues the need to involve new stakeholders to question existing aged care facility models to bring innovation to a new level.

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Flexible design and fresh stakeholders lead to innovation in aged care facility design

  1. 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 2011With the government investing $47billion for aged care and communityservices over the next four years and $10.8billion in 2010-11, there has beenhuge pressure on the sector. Alzheimer’s Australia estimates that there will279,000 elderly Australians without a bed in 2050, so it is imperative that agedcare facilities are built and designed in a way that will cater for the eldergeneration and provide happy environments for years to come.Health IQ: When looking outside your organisation for help, what kindof tools or vendors should you us? Can you take us through yourselection criteria?Bill: Our program doesn’t have any very specific selection criteria and oneof the reasons for that is that most of the people in the organisation do have apassion I guess for delivering aged care and providing better care to residents.There are many so called ‘aged care experts’ out there or specialists whotend to have a very, very fixed view on only a single way of working or specificsolutions that they might be promoting. And this even occurs within in thedesign and construction side of the industry.But my view is if we are really focused on delivering better care, then we needto be innovative, we need to be forward-thinking and we need to look outsidethe squares. If you look around at the different providers providing such greatcare, all of them have a slightly different way of doing things, despite the factthat 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 everyoneelse; and some of the best people that I find with this type of thinking actuallydon’t have an aged care background. I’m working with architects at themoment who are relatively new into the aged care industry, but it is thatnewness gives them their inquisitiveness and their questioning of the statusquo. They’re uncovering and discovering more about aged care. They tend to 1
  2. 2. ask questions that those of us who have been here a little bit longer no longerask.This gives us a fresh perspective on what we’re doing. For me, I believe istrue progress towards innovation and better care.Health IQ: So now can you predict what will work into the future bydesigning out obsolescence?Bill: Predicting the future, if I had the crystal ball, I probably wouldn’t haveto work! But my view on designing out obsolescence is not actually aboutpredicting what will work in the future. We really don’t have to know what’sgoing to come in the future. We just need to know the things that are going tochange, and I think that’s a pretty essential caveat.If we allow flexibility within our design and within our buildings – we thencreate the ability to incorporate future developments - whatever they may be.Because after all, the things that we can’t predict that will actually most shapeour 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 thattime – medically, socially, and technologically.So what we really need to do is rather than trying to predict what the futureholds, we need to put in place the things that allow us to change the buildingas it grows and it develops. We should stay away from those things that arehard to change without major cost or hassle. I guess if I can give you aspecific example of this, designing a frame and insular structure for a newfacility, 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 roomswith private room suites. Designing it rather in masonry heavy brick andheavy materials that are hard to change make it difficult to move the wallsaround. If we do it in concrete frame structure with lightweight insular which iscertainly possible, it allows us look down the track and when we get to thepoint of 10, 20 or 30 years times, to be able to say, this configuration now willassist us, and we can actually change it around.Now, it might seem like an unlikely need, but if we look backwards just 10years ago in this industry, we wouldn’t really have thought that singlebedrooms with private room suites would make up by far the majority of thenew market. So that’s just an indication of how quickly things can change andit’s really that creating that flexibility in design construction that allows us totake advantage of.Health IQ: So can facilities ensure they’re responsive to new andemerging patient centre model of care then?Bill: This is a bit related to the last question. This is because patient- 2
  3. 3. centred models of care, and all models of care, stem from the face-to-facecaring side of every facility and every business in this industry.As design and property professionals, our responsibility actually exist inongoing development of better care for provision of the best possibleenvironment in which the care is delivered.So the real challenge that we have in allowing facilities and giving facilities theopportunity to be responsive to this emerging models, is the differenttimeframes we work in, as I said, a typical building once it’s constructed willlast 50 years or more. While care models can change from one year to thenext, they have the ability to change much more quickly than the buildingdoes.So again, our understanding of the speed of their transition is critical in ourability to create flexible facilities which allow for that ongoing change anddevelopment 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-centredmodels of care obviously, making facilities get much more sunlight, gettingaway from institutional nature of facilities of the past. That’s very much afocus that will remain and that’s brought down to the details when we’regetting to the detail design and development, but it really leads to beinghaving 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 acollaborative approach when designing and constructing new facilitiesthen?Bill: I believe it’s absolutely critical to get the best outcome and the truedelivery of better care. The bottom line (and the truth) is that of all the peopleinvolved in the development of any aged care facility from the providerthrough to the architect and other consultants, project managers, all thepeople that surround that new development, no one has all the answers; andthe true value is only created by putting a lot of people in the project at theright time; and what I find is that right time is actually much earlier than mostpeople think.Most people think that the team really starts up quite small and build over timeas you get further down the path towards, specifically towards construction.But I believe we need to be much more collaborative right up front. Thedecisions made at the earliest stage of the project are the ones that impactheavily upon the final outcome. To change those at the later stages are reallycostly and it’s actually less effective than getting them right in the first out, thathaving the right people around the table and make those good qualitydecision up front, just adds enormous value. 3
  4. 4. So, as an example, the value of having a builder to the project team - evenduring the design stage - which not too many people do. The value will becreated many, many times over what it cost to have the builders form theproject team because of the efficiencies and the strategic vision they canbring 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 ofspecialist backgrounds and viewpoints, which can have an enormous impacton a finished facility; and there is an organisation I work with that’s looking inintegrating people of occupational therapist as part of the design team, andreally looking, measuring, and analysing and creating staff work here from thedesign team that are as effective as possible and exactly suit the work flowthat 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 directlyleads to reduced possibility of injuries, increased productivity and improvedmorale. So, I believe you can’t collaborate too much… collaboration isabsolutely critical to make sure at the end of the day we’re delivering the bestcare possible to the residents, which is the only outcome we should beinterested.Bill Duncan will be presenting at the Aged Care Facility Design andDevelopment. The Australian Healthcare Week combines five essential healthevents in to one big week. For more information on this particular stream visitwww.aushealthweek.com.au/agedcare, alternatively you can call ourenquiries 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. 4