QH CIR-Volume 2.3 FDB Specifications, Design brief … Health Capital Infrastructure...

Queensland Health Capital Infrastructure Requirements Volume 2 Functional design brief

Section 3: Functional design brief specifications and example

Queensland Health Capital Infrastructure Requirements‐2nd edition

Volume 2 Functional Design Brief Section 3 – Specifications and Example

Queensland Health Capital Infrastructure Requirements manual Published by the State of Queensland (Queensland Health), June 2013

This document is licensed under a Creative Commons Attribution 3.0 Australia licence. To view a copy of this licence, visit www.creativecommons.org/licenses/by/3.0/au © State of Queensland (Queensland Health) 2013 You are free to copy, communicate and adapt the work, as long as you attribute the State of Queensland (Queensland Health). For more information contact: Health Infrastructure Branch, Office of the Director-General Department of Health GPO Box 48 Brisbane QLD 4001 Email: [email protected] Phone: 3006 2816

Queensland Health disclaimer Queensland Health has made every effort to ensure the Queensland Health Capital Infrastructure Requirements (CIR) are accurate. However, the CIR are provided solely on the basis that readers will be responsible for making their own assessment of the matters discussed. Queensland Health does not accept liability for the information or advice provided in this publication or incorporated into the CIR by reference or for loss or damages, monetary or otherwise, incurred as a result of reliance upon the material contained in the CIR. The inclusion in the CIR of information and material provided by third parties does not necessarily constitute an endorsement by Queensland Health of any third party or its products and services.



Version Author Version description Released date

Approved for release by

1.0 Health Planning and Infrastructure Division, Queensland Health

First public release 28 May 2012 Deputy Director-General (DDG) – Health Planning & Infrastructure Division

1.1 Health Infrastructure Branch

Name changed from Capital Infrastructure Minimum Requirements to CIR Approved

5 April 2013 DDG-System Support Services

2.0 Health Infrastructure Branch

Second public release. Updated information regarding Legionella, infection control and other minor edits.

3 September 2014

Deputy Director-General, Office of the Director-General



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Contents How to use this document ....................................................................................................... 1

Part 1: Design specifications ................................................................................................... 2

Part 2: Example functional design brief .................................................................................. 4

1. Strategic level introduction and overview ...................................................................... 4 1.1 Purpose and context of the functional design brief ............................................................ 4

1.2 Overview of the project ....................................................................................................... 4

1.3 Interpretation ....................................................................................................................... 4

1.4 Glossary .............................................................................................................................. 4

2. Project background ........................................................................................................ 6 2.1 Vision for the project ........................................................................................................... 6

2.2 Project objectives ............................................................................................................... 7

3. Project scope ................................................................................................................. 7

4. Strategic policy and direction ......................................................................................... 8 4.1 Facility or Hospital and Health Service overview ............................................................... 8

4.2 Strategic models of care ..................................................................................................... 9

5. Facility profile ............................................................................................................... 10 5.1 Demographics ................................................................................................................... 10

5.2 Activity projections summary ............................................................................................ 10

5.3 Bed and bed equivalent projections ................................................................................. 10

5.4 Summary of facility departments/units ............................................................................. 12

6. Key operational and design principles ......................................................................... 13 6.1 Facility design objectives .................................................................................................. 13

6.2 Operational principles and design .................................................................................... 13

6.3 Patient environment .......................................................................................................... 14

6.4 Staff environment ............................................................................................................. 14

6.5 Interior design ................................................................................................................... 14

6.6 Equity of access................................................................................................................ 14

6.7 Education and research .................................................................................................... 14

6.8 Future proofing flexibility and technology ......................................................................... 15

7. Facility wide approaches ............................................................................................. 16 7.1 Access and hours of operation/zones .............................................................................. 16

7.2 Admissions and discharges .............................................................................................. 17

7.3 Building services ............................................................................................................... 17

7.4 Car parking ....................................................................................................................... 17

7.5 Commercial and retail ....................................................................................................... 17

7.6 Disaster provision ............................................................................................................. 18

7.7 Environmental services .................................................................................................... 19



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7.8 Food services ................................................................................................................... 19

7.9 Infection prevention and control ....................................................................................... 19

7.10 Information communications and technology services ..................................................... 20

7.11 Linen ................................................................................................................................. 20

7.12 Mail ................................................................................................................................... 21

7.13 Medical imaging ................................................................................................................ 21

7.14 Medication management .................................................................................................. 21

7.15 Patient flow ....................................................................................................................... 21

7.16 Patient safety and quality ................................................................................................. 22

7.17 Pneumatic tube system .................................................................................................... 22

7.18 Room configurations and percentage of single rooms ..................................................... 22

7.19 Security ............................................................................................................................. 23

7.20 Shared space approaches ................................................................................................ 23

7.21 Staff amenities .................................................................................................................. 23

7.22 Telehealth ......................................................................................................................... 23

7.23 Transport and access of patients, staff and visitors ......................................................... 23

7.24 Visiting hours .................................................................................................................... 24

7.25 Waste management ......................................................................................................... 24

7.26 Occupational health and safety ........................................................................................ 24

7.27 Workstations and office accommodation .......................................................................... 25

8. Functional description and relationships ...................................................................... 27 8.1 Functional areas ............................................................................................................... 27

8.2 Nature of functional relationships ..................................................................................... 27

8.3 Specification of functional relationships ........................................................................... 27

9. Workforce .................................................................................................................... 30 9.1 Current and projected ....................................................................................................... 30

9.2 Clinical, clinical support and non-clinical workforce profile .............................................. 30

9.3 Impact on design .............................................................................................................. 31

10. Accommodation brief ................................................................................................... 32

11. Clinical Service Department/Unit Example .................................................................. 33

12. Adult surgical inpatient unit .......................................................................................... 34 12.1 Scope of service ............................................................................................................... 34

12.2 Model of care .................................................................................................................... 34

12.3 Workforce of the department/unit ..................................................................................... 35

12.4 Policies impacting on built environment ........................................................................... 36

12.5 Operational description ..................................................................................................... 36

12.6 Functional relationships .................................................................................................... 39

12.7 Staging of built capacity .................................................................................................... 42

12.8 Future service developments and innovations ................................................................. 42



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12.9 Specific design requirements ........................................................................................... 42

12.10 Schedule of accommodation ............................................................................................ 44

12.11 Summary of changes to model of care ............................................................................. 45

13. Clinical Support Service Department/Unit Example .................................................... 46

14. Medical imaging ........................................................................................................... 47 14.1 Scope of service ............................................................................................................... 47

14.2 Model of service delivery .................................................................................................. 47







14.9 Specific Design Requirements ......................................................................................... 54


14.11 Summary of changes to model of service delivery ........................................................... 58

15. Non-Clinical Services Department/Unit Example ........................................................ 59

16. Food services .............................................................................................................. 60 16.1 Scope of service ............................................................................................................... 60

16.2 Model of service delivery .................................................................................................. 60







16.9 Specific design requirements ........................................................................................... 64


16.11 Summary of changes to model of service delivery ........................................................... 65

Appendix A Referenced documents ................................................................................ 66

Appendix B Terms and definitions .................................................................................. 73

Appendix C Detailed workforce profile ............................................................................ 82

Appendix D Summary schedule of accommodation ........................................................ 85



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Figures

Figure 1: Functional design brief H HS organisational chart ................................................... 8

Figure 2: Whole-of-site relationships .................................................................................... 29

Figure 3: Relationship of areas/units external to the surgical inpatient unit .......................... 40

Figure 4: Relationship of areas within the surgical inpatient units ........................................ 41

Figure 6: Internal relationships (macro)—medical imaging ................................................... 52

Figure 7: Internal relationships (micro)—medical imaging .................................................... 53

Figure 8: External relationships—food services .................................................................... 62

Figure 9: Internal relationships—food services ..................................................................... 63

Tables Table 1: Acronyms .................................................................................................................. 5

Table 2: Current and projected inpatient activity 2007–08 to 2026–27 ................................. 10

Table 3: Bed and bed alternative requirements FDB facility 2007–08 to 2026–27 ............... 10

Table 4: Proposed FDB facility services and Clinical Services Capability Framework level . 12

Table 5: Hours of operation by zones ................................................................................... 16

Table 6: FDB facility operating days and hours by functional space .................................... 17

Table 7: FDB facility workstation and office provisions ......................................................... 25

Table 8: Functional relationship classifications, symbols and definitions ............................. 28

Table 9: FDB facility clinical, clinical support and non-clinical workforce profile ................... 31

Table 10: FDB facility accommodation brief ......................................................................... 32

Table11: Current and projected workforce requirements for surgical IPU ............................ 36

Table 12: Surgical inpatient unit schedule of accommodation .............................................. 44

Table 13: FDB facility medical imaging modality requirements ............................................ 47

Table 14: FDB facility medical imaging workforce requirements .......................................... 48

Table 15: Medical imaging department schedule of accommodation ................................... 57

Table 16: FDB facility food service workforce requirements ................................................. 61



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HOW TO USE THIS DOCUMENT This section of the Capital Infrastructure Requirements (CIR) suite of documents has two parts. Part 1: Design specifications, explains Queensland Health’s approach to design specifications and describes where to find health facility design specifications. Part 2: is example text for each of the sections in a strategic and full functional design brief. The purpose of providing this example text is to give an idea of the type of content and level of detail to include when completing the functional design brief template for a project. The scope for capital infrastructure projects will vary widely, covering many kinds of clinical, clinical support and non-clinical services. Provided here is a: • completed example of a strategic level functional design brief which assumes that the

project is for a new facility. The strategic level functional design brief sections are: − introduction and overview − project background − project scope − strategic policy and direction − facility profile − key operational and design principles − facility wide approaches − functional description and relationships − workforce − accommodation brief.

• completed example of a clinical service which would be provided for a full functional design brief

• completed example a clinical support service which would be provided for a full functional design brief

• completed example of a non-clinical service which would be provided for a full functional design brief.

When finalised for a project, the full functional design brief will have a section for each of the functional units covered by the scope of the capital project. Note that while an example of each type of service is provided here, in some cases a project may only have services of a single type. For example the project may be a new kitchen and hotel services block so there will not be any clinical services included.



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Part 1: Design specifications Design specifications in the context of the functional design brief relates to the Australasian Health Facility Guidelines (AusHFG). Queensland Health has endorsed the AusHFG as the recommended source of information on health facility design and specifications. All health capital projects in Queensland are required to use the AusHFG as the basis of department and room planning and design. This includes Queensland reviewed AusHFG available from the Queensland Health policy site. The AusHFG are used because they enable planners and designers of health facilities throughout Australasia to use a common set of guidelines and specifications for the base elements of health facilities. Their use will save time and resources as well as maximise the quality and effectiveness of design1. The AusHFG contains detailed information on capital planning processes and enables health facilities to use a common set of base elements to inform their planning, design and construction. The AusHFG provides a: • best practice approach to health facility planning • standard spatial components • flexible planning tool responsive to the dynamic changes in health. Facility planners, architects and engineers using the AusHFG are still required to ensure the health facility complies with relevant legislation, other building and design standards and codes and that facilities are designed to balance maximum efficiency with minimum asset management and maintenance costs. The main aims of the AusHFG are to: • provide general guidance to designers seeking information on the special needs of

typical healthcare facilities • promote the design of healthcare facilities with due regard for the safety, privacy and

dignity of patients, staff and visitors • maintain public confidence in the standard of healthcare facilities • achieve affordable solutions for the planning and design of healthcare facilities • eliminate design features that result in unacceptable practices • eliminate duplication between various existing guidelines • minimise recurrent costs and encourage operational efficiencies2

1 AusHFG v4 2010, accessed 10 January 2012 at www.healthfacilityguidelines.com.au

2 ibid



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The AusHFG is divided into the following parts: • Part A: Introduction and Instructions for use • Part B: Health Facility Briefing and Planning , including standard components and

specific hospital planning unit (HPU) sections • Part C: Design for Access, Mobility, OHS and Security • Part D: Infection Prevention and Control • Part E: Building Services and Environmental Design • Part F: Project Implementation, including furniture, fittings and equipment (FFE) and

operational commissioning. Applicable to New South Wales only, but available to other jurisdictions as a reference.

• Enclosures: generic room data sheets (RDS) and generic room layout sheets (RLS). The AusHFG website has extensive information and resources for health facility design specifications, including a library of guidelines covering most types of health facilities, a reference library, links to other Australian websites and the latest guideline updates. The guidelines are based on the HPU which is defined as:

All the rooms, spaces and internal circulation that make up a particular health service department and that are necessary for that department to function3. The standard components are a range of standard rooms that make up a department.

The guideline library has a number of PDFs ready for download which provide extensive detail on health planning units and their standard components, including for example, room types, recommended room layouts and equipment and specialised provisions, such as infection prevention and control, and technical requirements of rooms and spaces. The design specifications accessible through AusHFG website are not replicated in this document as they are constantly being updated. The AusHFG website should be accessed when design specifications are required to ensure their currency.

3 AusHFG v4 2010, accessed 12 May 2014 at www.healthfacilityguidelines.com.au



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Part 2: Example functional design brief The examples provided in this functional design brief do not contain as much detail as might be provided if actually undertaking a brief for a genuine project. The content is by way of example only and provides information for a strategic level and full functional design brief.

1. STRATEGIC LEVEL INTRODUCTION AND OVERVIEW

1.1 Purpose and context of the functional design brief The HHS Health Service Plan 2011–2026 was prepared and approved in 2011. It sets out the health service and facility infrastructure requirements for the population over that period. A HHS model of care document was prepared in 2011. It included descriptions of contemporary HHS strategic and service level models of care and models of service delivery. This functional design brief describes the scope of a new HHS health facility based on future projections for health service delivery demand as well as the methods or models for its delivery as they translate into built space form. The design detail provided in this brief will be used to inform the site’s strategic infrastructure assessment, concept planning and facility infrastructure. It will also be used in the development of the project assurance framework’s strategic assessment business case documents. 1.2 Overview of the project Stage one of the functional design brief for a facility describes the design requirements for a new purpose built standalone XXX bed secondary facility which will service the HHS. The scope of the project includes a XXX bed facility, standalone XX bed mental health unit, a central energy facility, child care centre and public and staff car parking. These new facilities are designed to meet the HHS level of health services projections to 2026–27. The design approach for the new facilities will reflect contemporary practice as well as providing future proofing and flexibility of use for changing models of care. 1.3 Interpretation The functional design brief must be read and interpreted in its entirety. The individual parts of the functional design brief are not stand alone or exhaustive provisions as to their subject matter and must be considered in light of and within the context of the other parts of the functional design brief. Floor area calculations should be undertaken in accordance with CIR, Volume 1, Overview, and instructions on how to measure drawings. 1.4 Glossary Commonly used acronyms used throughout this brief are summarised in Table 1. A full list of terms and definitions is provided in CIR, Volume 1, Overview.



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Table 1: Acronyms Acronym Term AS Australian Standard AusHFG Australasian Health Facility Guidelines ATSI Aboriginal and Torres Strait Islander BCA Building Code of Australia BIM Building information modelling BPE Building performance evaluation CIR Capital infrastructure requirements CPTED Crime prevention through environmental design CRG Community reference group DD Design development DDA Disability Discrimination Act 1992 EBD Evidence based design ESD Environmentally sustainable design FDB Functional design brief FECA Fully enclosed covered area FFCP Fitness for current purpose FFNP Fitness for new purpose FPU Functional planning unit GFA Gross floor area GDA Gross departmental area HSP Health service planning HHS Hospital and Health Service HHS Hospital and Health Service Board ICT Information and communication technology MOC Model of care MOS Model of service MP Master planning NDA Net department area NZS New Zealand Standard PDP Project Definition Plan PCG Project control group PSC Project steering committee QH Queensland Health RDS Room data sheet SD Schematic design WH&S Work health and safety



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2. PROJECT BACKGROUND The healthcare needs and medical care of Queensland’s population are changing. Queensland has a growing, ageing, decentralised and diverse population; demand for health services is increasing; there is a limited healthcare workforce supply; continuous technological and pharmacological developments are likely to impact on the way services are delivered and located. In recognition of changing healthcare needs, Queensland Health has two main objectives in reforming Queensland’s health system: the first objective is to improve access to safe and sustainable health services, and the second is to better meet people’s needs across the health continuum4. The HHS Health Service Plan 2011–2026 indicates that a new facility is required to expand the HHS’s range and capacity of clinical services to meet the growing and increasingly complex healthcare needs of its population. The HHS is located in the south east corner of the state where there is rapid population growth across all age groups. Investing in a new facility will assist in meeting the objectives of Queensland’s health system reform. The new facility services will include: • clinical services: emergency department, overnight and short stay medical services,

overnight and day stay surgical services, sub-acute care and rehabilitation, maternity, paediatrics, critical care, mental health and ambulatory care

• clinical support services: radiology and pharmacy • non-clinical support: central energy plant, child care centre, staff and patient car park.

The facility’s patient centred model of care will strengthen the partnerships with other facilities across the HHS and with agencies and sectors across Queensland’s healthcare system. The model of care will improve efficiency by better meeting people’s needs across the health continuum. In 20XX a master plan was completed for the entire facility site. On the basis of the findings of that master plan, a short design brief was prepared for this facility the same year and submitted to the HHS executive. Elements of this functional design brief are based on the findings of that master plan and the 20XX design brief. 2.1 Vision for the project The facility will deliver high quality health services in a modern setting which maximises its surroundings to the benefit of all patients and staff. The facility will support innovation and implementation of the elements of the state wide health reform process for the HHS. The facility will continue to be actively involved with health faculties of associated universities by providing undergraduate and postgraduate education for health and related disciplines as well as playing a role in the vocational and educational training sector. The facility will emphasise research in the design and delivery of care to the HHS community by including the concepts of the healing environment and advanced technology together with



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high quality medical care. The focus on patient-centred care will be embedded in the planning and design. The facility will be designed as a healing environment that incorporates the use of gardens, water features, natural light, colour, artworks and views in its design while also providing for quiet and privacy. The high quality environment throughout the grounds and the facility will be conducive to teamwork and help the HHS to attract and retain staff. The facility will attract XXX number of staff, treat XXX number of outpatients per year and will provide overnight care to approximately XXX number of inpatient admissions per year. 2.2 Project objectives The project objectives are to: • meet the health needs and expectations of the local planning catchment population • develop health services in line with the objectives within the HHS and the state wide

strategic health services plans • complete stage one redevelopment of functional design brief facility • provide an expanded facility by increasing the bed capacity to XXX beds, increasing the

range of clinical, clinical support and non-clinical support services, and increasing the level of clinical services capability of the existing services

• provide a contemporary healthcare facility that is designed to support the delivery of patient-centred evidence based care in an environment that promotes healing and supports staff to deliver efficient and effective healthcare services.

These objectives will be achieved using the health service planning outcomes, relevant benchmarks, best practice, the design guidelines and technical information outlined in this brief.

3. PROJECT SCOPE The scope of the project includes stage one development of the functional design brief facility that includes a XXX bed facility, a new central energy plant, a XX bed standalone mental health and ambulatory service buildings, child care centre and a new staff and visitor car park. Stage one development does not include development of the rehabilitation services building. Rehabilitation services will form part of the stage two development.



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4. STRATEGIC POLICY AND DIRECTION 4.1 Facility or Hospital and Health Service overview 4.1.1. Hospital and Health Service health service planning The HHS covers an area of 4847 square kilometres in the south east corner of Queensland. The majority of the HHS is classified as metropolitan and regional with no areas classified as rural and remote. HHS health service planning undertaken in 2011 indicates a 25 per cent increase in the network’s overall population by 2026. The HHS’s population will increase across all age groups with the most significant growth in the over 65 year age group. Nearly a fifth of the population within the HHS area (18.9 per cent) were born overseas. Nine percent of the HHS population speak a language other than English at home. Indigenous Australians make up 1.6 per cent of the network’s population which constitutes 8.7 per cent of Queensland’s total Indigenous population. 4.1.2. Organisational chart The HHS has a governing board to which a Health Service Chief Executive and other HHS executives service and other employees report. The HHS reporting structure is summarised in Figure 1. Each of the facilities and services are governed by an executive director who has a reporting relationship to the Health Service Chief Executive. Figure 1: Functional design brief H HS organisational chart

Source: HHS Health Service Plan 2011–2026

4.1.3. Hospital and Health Services The HHS will continue to provide a range of services including: • acute and subacute services • residential aged care services • primary healthcare services



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• an integrated mental health service, including community and acute facility care • state wide super specialty services • major role in research, education and training. 4.2 Strategic models of care The HHS health facilities and services operate under a clinical network governance structure. A range of services are provided across the HHS supported by, and functioning in collaboration with the specialist facilities and services. Collaboration also includes primary and community sectors such as local general practitioners and private health services, and other government and non-government services. State wide outreach clinical services are provided to regional centres by specialists from metropolitan services. The HHS promotes and supports integrated models of care ensuring that patients receive quality, coordinated care, and that gaps, duplication and fragmentation in the provision of services are minimised. The future vision of the HHS facilities is an integrated healthcare approach where the primary focus continues to shift to the patient, rather than a system which focuses on the health service provider and health delivery setting. Patients will move seamlessly within the primary and secondary setting depending upon their health condition and its severity. This healthcare approach will not be limited to patient-care based on treatment and rehabilitation. Integration of care will also include activity between services, such as those provided by other Queensland Health services, with external providers and partners, and consumers, collaborating to deliver illness prevention and health promotion. The key focus areas of the HHS strategic models of care include: • prevention and promotion • early detection and intervention • integration and continuity of care • self management.



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5. FACILITY PROFILE 5.1 Demographics Health service planning for the local planning catchment was undertaken as part of the HHS health service planning in 2011. Population analysis for the catchment indicates that the population is projected to increase by 80 000 persons, an overall population increase of 51 per cent by 2026. The age profile increases for all groups with the most significant increase in the over 65 years age group. These trends are similar to that of general population trends across Australia, suggesting an overall ageing population. 5.2 Activity projections summary This section summarises the projected activity for functional design brief facility based on the service planning undertaken in 20XX. This activity data is the basis on which the facility is planned. However actual activity, length of stay and bed occupancy rates are likely to differ from what is predicted as demand for services alters over time with population changes and the introduction of new models of care. Table 2: Current and projected inpatient activity 2007–08 to 2026–27

Summary of projected inpatient activity 2007–08

2016–17

2021–22

2026–27

Adult separations Same day Overnight

Paediatric separations Same day Overnight

Total same day and overnight separations

Overnight occupied bed days Adult

Paediatric Total overnight occupied bed days

Source: FDB Facility Health Service Plan 20XX

5.3 Bed and bed equivalent projections Bed requirements for the functional design brief facility were calculated using endorsed Queensland Health service planning benchmarks. Where no endorsed service planning benchmarks are available, benchmarks have been drawn from various sources, including Queensland Health state wide health service plans, Victorian Capital Planning Benchmarks and Australian College for Emergency Medicine. Current models of care, referral patterns and admission practices were applied. Based on the projected demand for services, the facility bed and bed alternatives required are summarised in Table 3.The projections estimate that the facility’s bed/bed alternative numbers will need to increase to XXX by 2026–27. Table 3: Bed and bed alternative requirements FDB facility 2007–08 to 2026–27

Item Current capacity

2016–17

2021–22

2026–27

Category A: Beds A1. Overnight beds Medical Surgical



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Item Current capacity

2016–17

2021–22

2026–27

Obstetrics (maternity) Paediatric Emergency department short stay–adult Emergency department short stay–paediatric

ICU/PICU/HDU CCU Neonatal (Neonatal Intensive Care Unit/Special Care Nursery)

Mental health–acute Mental health–non-acute aged care Sub and non-acute–palliative care Sub and non-acute–rehabilitation Sub and non-acute–geriatric evaluation management

Total overnight beds A2. Same day beds Medical Surgical Obstetrics Paediatrics Sub and non-acute

Total same day beds A3: Bed alternatives Chemotherapy chairs/trolleys Ante natal day assessment unit chairs

Renal dialysis chairs/trolleys Surgical (including stage 2: recovery bays–adult)

Stage 2: recovery bays–paediatrics Total bed alternatives

Totals for Category A Total A1 Overnight beds Total A2 Same day beds Total A3 Bed alternatives

Total overnight, same day beds and bed alternatives

Category B: Emergency Department treatment spaces Total emergency department treatment

spaces

Category C: Operating/intervention rooms Medical imaging–CT scan Medical imaging–fluoroscopy Medical imaging–general X-ray Medical imaging–mammography Medical imaging–ultrasound Medical imaging–MRI Delivery suite Operating suite Endoscopy/bronchoscopy rooms Radiation oncology Cardiac catheter laboratory Category D: Consultation/treatment/procedure rooms Outpatient/ambulatory care unit clinics

Source: FDB facility health service pan 20XX



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5.4 Summary of facility departments/units The functional design brief facility will provide the following services at the Clinical Services Capability Framework (CSCF) level detailed below. Table 4: Proposed FDB facility services and Clinical Services Capability Framework level

Department/unit Type Brief description Proposed CSCF level

Surgical unit 4a clinical 30 bed inpatient unit 4-5 Surgical unit 4b clinical 30 bed inpatient unit 4-5 Medical unit 3a clinical 30 bed inpatient unit 4-5 Medical unit 3b clinical 30 bed inpatient unit 4-5 Renal unit clinical 16 chair unit 4 Mental health unit clinical 30 bed inpatient unit 5 Maternity unit clinical 30 bed inpatient units 4 Neonatal unit clinical 12 bed inpatient unit 4 Paediatric unit clinical 30 bed inpatient unit 4 Emergency department

clinical 24 treatment spaces 5

Operating room suites

clinical 12 operating rooms 5

Intensive care unit clinical 10 bed inpatient unit 4 Oncology unit clinical 30 bed inpatient unit 4 Medical imaging clinical support diagnostic and

interventional service 4-5

Pathology clinical support 4-5 Anaesthetic unit clinical support 4-5 Pharmacy clinical support inclusive of production 5 Food services non-clinical production kitchen Security non-clinical

Source: FDB facility health service plan 20XX



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6. KEY OPERATIONAL AND DESIGN PRINCIPLES

6.1 Facility design objectives The key design objectives for this facility are: • safe, high quality patient-centred care • equity of access • efficient and effective care • a spatial environment that is contemporary, salutogenic, flexible and adaptable • teaching and research that is integral to the facility’s service, governance and models of

care • attraction and retention of a high quality workforce • facilitation of new best practice models of care • effective working relationships with other healthcare providers. 6.2 Operational principles and design A primary objective in the planning and design of this project is that services should be safe, of high quality and patient-centred. The overarching principles that underpin this objective are: • that high quality care is supported by leadership, organisational culture, research,

systems and processes as well as the physical environment • design of physical form should be a balance of staff, patient and operational needs • design must facilitate:

− evidence based separation of flows − efficient patient, staff and services flows − privacy and dignity for all patients − avoidance of healthcare associated infection − accurate identification of patients, staff, equipment and medications − avoidance of medication errors − collaborative efficient and effective clinical handover − timely access of services − prevention of falls and adverse events − minimised travel time for staff − patient safety, and ensure high indoor environment and safe water − quality.

• evidenced based design based on the following: − overall spatial planning that supports standardisation of the configuration and fit-out

of clinical areas − integration of ergonomic principles into design − clear visual connection between patients and staff − connectivity to external environment − control over natural and artificial light by staff and patients − design features that facilitate safe and effective care for people with disabilities and

behavioural issues. • design that is salutogenic, that is, is a cause of good health and maximises use of

positive elements related to natural light, colour, images of nature, access to fresh air, visual arts and music, and ‘spiritual’ spaces

• spaces should have visual connectivity with pleasant views.



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6.3 Patient environment Specific design of patient bedrooms is covered by the AusHFG and in following sections on clinical inpatient units. General design considerations in relation to the patient environment are: • all patient areas both inpatient and ambulatory to have access to the outdoors • windows and doors are located to balance privacy with need for clinical observation • access to private space for patients, carer and staff discussion • facilitate patient safety, and ensure high indoor environment and safe water quality • inclusion of spaces for assembly of groups of family and friends both inside and outside

the building • maximum features that allow patient control of their environment:

− variety of lighting options appropriate for all times of the day and year − control of lighting on a room by room basis − treatments that include or exclude light − easily operated doors − minimisation of unwanted noise.

6.4 Staff environment Design features to be incorporated to facilitate a positive experience of working in the facility to ensure that: • the facility is an attractive place to work • collaboration opportunities are enhanced • a sense of community is engendered • staff are easily able to supervise and observe patients • staff are safe and not unnecessarily isolated during their shift • all work and break spaces are designed to have windows or reference to natural light • access to external pleasant views • access to non patient spaces in break times • circulation routes both inside departments and throughout the facility are easy to

navigate and understand and minimise travel time • patient safety is facilitated , and ensure high indoor environment and safe water quality. 6.5 Interior design The interior design must ensure that spaces are clearly and intuitively organised, arranged in a pattern or hierarchy that promotes individuals’ privacy and at a scale and proportion that complements the activity they contain. 6.6 Equity of access Design will comply with the Disability Discrimination Act 1992. Health facilities are visited and used by people from across the entire community. Special consideration needs to be given to ease of access to the facility for the elderly, parents with children, people with a range of disabilities. Access design should specifically address the purpose of the facility which is to assist those who are unwell and may be less able to easily negotiate facilities and organisations. 6.7 Education and research Teaching and research are integral to the governance and delivery of patient-care. All staff throughout the facility are encouraged and supported to participate in teaching and research activities. The overarching policy in relation to use of space is that meeting rooms and teaching spaces will be shared to maximise flexibility and promote access to a variety of



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learning modes. Education, research and meeting spaces across the facility will be bookable and have flexibility in their use. The design principles to support this facility wide approach include: • spaces must be developed to meet the education and research needs of staff and

students (both undergraduate and postgraduate) and the organisations to which they belong

• a centralised skills, academic and research centre with a range of space types • decentralised education and research spaces within or adjacent to individual units • multipurpose meetings rooms throughout the facility • spaces in patient areas, such as consulting rooms and patient bedrooms to undertake

education and research in the clinical setting.

6.8 Future proofing flexibility and technology Design must incorporate 25 per cent overall shell space for future configuration. This may be provided as a block area or through provision of additional non specified spaces adjoining a department or unit. In selected areas a buffer of 10 per cent should be provided to allow for changes in models of care, new technologies and adaptability of use over the long-term.



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7. FACILITY WIDE APPROACHES 7.1 Access and hours of operation/zones Access—public Public access will be between the normal hours of 6 am and 10 pm, seven days, via the main entrance, emergency department and mental health unit. Access after hours will be from 10 pm to 6 am and only via the emergency department and security monitored and access into the birthing unit. All other external doors and access points must be capable of being closed and locked after hours. In general, design must facilitate and control after hours access by authorised persons, through systems that are linked to staff bases. Staff must control entry and be able to identify the person prior to allowing entry. Design must provide for central monitoring and after hours access to all buildings on the facility site. Control of access to all building areas will be centralised, using networked electronic systems and will be the responsibility of security staff. Access—staff Design must enable staff access through public entrances as well as dedicated staff access points controlled by security staff. A separate staff entry away from public view must be provided in the emergency department, which will be used by all after hour’s rostered staff. Design must allow for casual and agency staff to access the facility after hours. Areas that staff will have access to after hours include: the library, café, staff amenities, car park and bike lockers. Staff will have access to clinical and non-clinical areas based on need. Design must provide for safe passage from car parking to the staff entrance at all hours. There must be secure after hours parking for on call staff. Hours of Operation Hours of operation are divided into three zones for the purposes of their design and management. While areas within each zone may be used and accessed ‘out of hours’, the design that supports occupation, use, management and control of these zones will be based on their designated hours of operation as detailed in Table 5. Table 5: Hours of operation by zones

Zone Departments/units Hours of operation 1 Administration and management, education and

training, non-clinical, supply 9 am to 5 pm, Monday to Friday

2 Reception/main entrance, ambulatory units, pharmacy, catering, housekeeping/facilities management

7 am to 7 pm, Monday to Friday

3 Emergency, inpatient units, operating room suite, pathology, medical imaging

24 hours, seven days



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The operating days and hours by functional or clinical areas are summarised in the following table. Table 6: FDB facility operating days and hours by functional space

Functional space Operating days Operating hours Clinical Areas Emergency Every day At all times Inpatient units Every day At all times Technical suites Monday to Friday 8 am to 6 pm Outpatient areas Monday to Friday 8 am to 6 pm Day areas Monday to Saturday 7 am to 7 pm Clinical Support Areas All clinical support areas (unless specified below)

Monday to Saturday 7 am to 7 pm

Central sterilising department Every day At all times Equipment pool Every day 7 am to 7 pm Imaging–emergency Every day 7 am to 7 pm Imaging–outpatient areas Monday to Saturday 7 am to 7 pm Imaging–inpatient areas Every day 7 am to 7 pm Pathology Every day At all times Pharmacy Every day At all times Multi faith centre Every day 7 am to 7 pm Non-clinical support areas Main entry Every day At all times Amenity Monday to Saturday 7 am to 7 pm Research Monday to Friday 8 am to 4 pm

7.2 Admissions and discharges Admissions and discharges are managed as per the HHS policies and procedures. All admissions and discharges will be managed centrally and through a networked electronic information system. The emergency department and day of surgery admission centre will admit and discharge patients within the whole of facility management process. 7.3 Building services Building services will be monitored and managed through an integrated information system. Services on the system include electric power, illumination, HVAC, security and access, fire alarms, lifts, other mechanical and electrical building systems. 7.4 Car parking Car parking will be provided for staff, patients and visitors to the facility. Reference should be made to the Queensland Health Car Park Infrastructure Policy, V2 2011 and the Queensland Health Car Park Implementation Standard V1, 2011 as well as HHS policy. Design of car park will include consideration of the following: • ease and safety of access to the site and facilities on the site • dedicated parking for patients adjacent to ambulatory services, such as renal dialysis

chairs and other ‘frequent flyer’ services • location of clinical staff parking in accordance with Queensland Health and HHS policy • safety within the car park and surrounds and transit path to and from the facility • provision of excellent visibility, transparency and lines of sight • provision of all weather access to the car park from the facility. 7.5 Commercial and retail A variety of functions may be provided by the commercial or retail sector. These include:



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• food outlets • café • retail pharmacy • post facilities • florist/gifts/toys • private doctor's rooms • private pathology • concessions for mobile vendors • car parking. There are some Queensland Health guidelines and policies on functional and design requirements: • Queensland Health, Food Safety Program: Tool for the Development of a Food Safety

Program for Catering and Retail Premises (2008) • Queensland Health, Laws Banning the Retail Display of Smoking Products in

Queensland, Requirements for Retailers (2011) • design approach and considerations required for commercial and retail spaces • location to be in a publicly accessible area • security of individual premises to be separate while being within overall context of facility • design not to include internal fit-out—shell space only will be supplied • services provision for ICT, power, air conditioning and water supply as per functional

requirements of the space type, for example a café requires exhaust vents • flexibility of future configuration of space, such as combining two areas into one • adjacency to outside areas is essential • location to be based on hours of operation, such as after hours café accessible to public • provision for naming rights or signage • provision for delivery of mail. 7.6 Disaster provision This facility will have a role in the disaster and post disaster management for the HHS and local government area. That role in relation to incidents and disaster management will be determined and agreed during project planning. Minimum facility design requirements to support disaster management are: • a designated emergency operations centre in a large meeting room no less than 40m2 • a designated backup emergency operations centre in an alternative location

− capacity to manage contaminated patients and staff outside the emergency department prior to being moved into the facility as per AusHFG

• surge capacity to triage and treat patients outside the emergency department • ability to lock down the emergency department for a chemical, biological or radiological

event • emergency vehicle access to the facility site especially the emergency department • a landing area to provide air access to the site, such as helipad or car park area • capacity to operate autonomously for 48 hours. Provide detail of how essential services

including water quality will be maintained in the event of a disaster. Features of the emergency operations centre to include: • capacity to satisfy Australian Emergency Management requirements • ability to directly access communications and bed management systems for the whole

facility • be adjacent to office areas and staff amenities, centrally located within the building and

above ground floor level



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• high level of redundancy for data and voice communications with two dedicated and switchboard independent outside lines

• data and voice ports to be pre-configured and labelled for use • storage for communications equipment, fax and copying facilities, stationery and up to

date copies of the relevant disaster plans for the HHS. 7.7 Environmental services The environmental services department will provide all facility cleaning services with the exception of periodic deep clean of designated areas and cleaning of retail and commercial areas. 7.8 Food services The food service will provide food and beverages to inpatients and outpatients of the facility. The food service will be a combination of fresh and frozen meals. Retail outlets will provide hot and cold food and beverages to staff and visitors to the facility. 7.9 Infection prevention and control Infection prevention and control requirements are as per the Queensland Health Prevention and Control of Healthcare Associated Infection (HAI) Policy, the HHS policy and procedures and the AusHFG infection control requirements. The specific design elements that are required to facilitate these infection prevention and control practices must include: • providing safe water quality including sufficient residual disinfectant to prevent microbial

contamination in the water supply systems • sensor taps are to be provided in clinical areas as well as at the entries to

units/departments • hand basins are to be provided as per the AusHFGs as follows:

− ‘clinical’ standard hand basins defined as have non-touch electronic taps and minimum splash design, to be located in all bedrooms, utility rooms and treatment spaces

− clinical hand basins to be located at entrances of units and in corridors with a small shelf above to place items while cleaning hands

− hand basins not to be fitted with overflow valves • use of visual prompts/signs/aids to remind and direct staff and visitors to hand basins • personal protective equipment (PPE) dispensers to be placed next to all hand basins • non-detergent hand hygiene rub dispensers must be provided in all clinical units where

there is patient contact and clinical area interfaces • the AusHFG, Part D: Infection Prevention and Control, as well as the Australian

Standards HB 260–2003 Hospital acquired infections – Engineering down the risk guide to requirements for isolation rooms

• requirement for control of contagion and infection control is supported by use of standard single rooms with dedicated ensuite, as well as by use of positive and negative pressure isolation rooms. All standard and special single bedrooms as defined by the AusHFGs can function as Class S isolation rooms

• Class P positive isolation rooms are single rooms with a dedicated ensuite. They are designed to reduce the risk of airborne transmission of infection to susceptible patients are profoundly immune compromised such as allogenic bone marrow transplant recipients. This room would be used for oncology and transplant patients. Class P positive pressure rooms must operate at a pressure higher than the surrounding rooms. Air exhausted from these rooms does not require filtration



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• Class N rooms are single rooms with an anteroom, clinical basin for staff in both bedroom and anteroom, and access to a dedicated ensuite. Class N rooms are provided for patients who require airborne droplet nuclei isolation such as varicella or tuberculosis, through negative pressure isolation.

7.10 Information communications and technology

services ICT services changes rapidly and the design process must acknowledge continuous development of policy and the impact it may have on implementation. Reference should be made to Queensland Health, Health Services Information Agency. Relevant policy and standards must be applied. Examples of the whole-of-facility approaches relating to ICT services include but are not limited to: • extent of wireless coverage inside and outside buildings and other infrastructure on site

including tunnels • pneumatic tube system configuration, design and security requirements • capacity to use passive, active and semi active radio frequency identification (RFID) with

consideration to environmental compatibility and safety issues • ceiling mounted pendants to house services and medical equipment, their type,

configurations, locations and design requirements • integrated nurse call system. Consider whether it must be the same system across the

facility and all buildings on site • audiovisual services—digital or analogue, level of integration throughout facility, range of

uses for example, Telehealth, • non-clinical/management software applications, such as central booking and scheduling

of space and patient attendances, automated admissions • digital and automated information displays and wayfinding • workforce technologies can assist staff to undertake their work safely and in a manner

that also supports their skills and knowledge base. Technologies can assist in the provision of safe care to our patients by avoiding rework, as well as automating routine tasks or reassigning them to alternate staff

• the information technologies to be applied facility wide include software for the following: − drug calculation, dispensing, distribution − order entry − access to results − general distribution and storage systems including goods and services − just in time supply chain system to the point of use.

Change management strategies are being developed both across Queensland Health and at HHS level to maximise the opportunities presented by the new facility. 7.11 Linen All facility linen is supplied and managed through the central linen service with the exception of specific requirements of some clinical units, such as paediatric inpatients, mental health and the dementia unit. A limited on site facility laundry will be provided for the needs of these units. One patient and family access laundry with one washing machine and dryer will be provided.



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7.12 Mail Incoming and outgoing mail will be managed centrally by administrative services from a mail room on ground floor which has ease of access. Provision will be made for retailers to receive their mail separately. 7.13 Medical imaging Most medical imaging services will be provided from one centralised location with the addition of two satellite services, one in the emergency department and one in the operating theatre suite. Services include: general x-ray, ultrasound, fluoroscopy, computed tomography and magnetic resonance imaging. Mobile x-ray units will be located in the intensive care unit (ICU), operating theatre suite and in one medical inpatient unit, to provide a mobile service where required. A networked radiology information system and picture archiving and communication system will manage data collection, retrieval and reporting throughout the facility. X-ray film viewing screens are only to be provided in medical imaging (MI) reporting rooms and one in the emergency department. All x-ray films will be converted to digital media immediately on presentation at the facility. 7.14 Medication management The medication management model for the HHS requires a consistent and standardised comprehensive management approach to be applied throughout the facility. The medication management service will include the following: • electronic information systems to manage procurement, storage, medication knowledge,

prescribing • centralised management of medications • imprest system in all clinical units in the clean utility including storage of medication

trolleys • storage of patient medications in individual bedside or other in room lockers • provision for the safe storage and easy access by patient to their own medications • both in-ward discharge dispensing and private space for discharge medication training at

pharmacy to facilitate pharmacist involvement throughout the patient stay • capacity for future pharmacy automation systems. 7.15 Patient flow The following principles apply to the whole-of-facility patient flows: • provide access to patients and members of the public without disrupting workflow of

clinical and operational staff • separate patient and public flows in all clinical units and give preference to separation of

patient and public when transiting between clinical units • provide a dedicated lift for hotel services including delivery of goods and removal of

waste and dirty linen, and delivery of food and clean linen • no access for patients and public to any back of house areas • preference to be given for ‘back of house’ pathway for the deceased • for specialist units:

− interventional suite requires separation of dirty and clean flows − provide a peripheral area for arrival and de-boxing of goods for interventional suite − provide a dedicated staff entry to units including: interventional suite, intensive care,

coronary care, medical imaging and emergency department dedicated entry.



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7.16 Patient safety and quality The design of the facility will support patient safety and quality through the following: • use of modular design • standardised location of equipment, technology, supplies and room layout • reduce ambient and specific noise sources • visibility of patients to staff • design to minimise patient falls, such as unobstructed corridors and space around

patient bed • immediate accessibility to information particularly that needed for decision making, close

to the point of service • use of adaptive systems that will allow introduction of future technology and ICT systems • ensure high indoor environment and safe water quality.

7.17 Pneumatic tube system The facility is to include a pneumatic tube system (PTS) to enable cylindrical containers to be propelled through a series of tubes to key locations around the facility. Small bore PTS (around 160–300mm diameter) will distribute pharmaceutical goods, specimens and the like. All clinical and clinical support departments/units will have stations. The following units must have dedicated point to point transfer: • emergency to pathology • intervention suite to pathology • intensive care unit to pathology • birthing suite to pathology. 7.18 Room configurations and percentage of single

rooms The minimum target percentages for general acute and sub-acute (non-specialist) inpatient room configurations are as follows: Single rooms 60 per cent Double rooms 20 per cent or as clinically required Quad rooms 20 per cent or as clinically required. The percentage of single rooms includes positive and negative pressure isolation rooms. Each single room will have a dedicated ensuite and will be designed to facilitate: • patient privacy and dignity both physical and communication • patient control of viewing windows • acoustic privacy • reduced incidence of hospital acquired infections • reduced incidence of patient falls through ease of direct access to the ensuite, space for

two staff to assist a patient to the ensuite, provision of adequate space around the bed for transfer and a direct line of sight from the bed to the ensuite

• ease of access from both sides of the bed when up to four people may be in the room • capacity for family and carers to stay overnight where appropriate • capacity to provide treatment and therapy at the bedside • visibility of the patient’s head from the corridor • access to outdoor spaces • ability to turn double rooms into single rooms.



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7.19 Security While the philosophy of the HHS is that both management and staff must take joint responsibility for protecting themselves and others, the design approach and built environment plays an important role in safety of staff, visitors and patients. A security risk assessment process must be applied to this project using ‘security by environmental design considerations’ and crime prevention through environmental design principles and other methodologies. Functional areas that have specific requirements for security services and secure design features are: • emergency • helipad • mental health unit • pharmacy • operating room suite • women’s and children’s services • mortuary • aged acute (psychogeriatric) mental health unit.

7.20 Shared space approaches There are instances where taking a communal or shared approach to the use of space, is more efficient and promotes better use of space overall. A communal approach is one in which the spaces are not owned by a specific department or unit, and may be used by any unit that would normally occupy similar spaces. This is facilitated by using a central booking system. The following are types of spaces which will be shared in the facility: • waiting and reception areas for ambulatory services • ambulatory consult and treatment rooms • education and teaching rooms, facilities and spaces • meeting and conference rooms • staff amenities with the exception of units secured on a 24 hour, seven day basis, such

as operating theatre suite. 7.21 Staff amenities In general, staff amenities will be co-located as much as possible to avoid duplication and inefficiency. Access to staff amenities including toilets, showers, change rooms and lockers will be supplied as per the regulatory requirements and on the basis of Queensland Health policy for all staff. Notwithstanding provisions of industrial agreements, lockers will be provided on a shift share basis and will not be allocated to individuals. 7.22 Telehealth The facility network will be designed to provide for use of Telehealth technologies throughout the facility in a variety of settings. Telehealth equipment and operation will be managed as part of the ICT service and will be available to all services and units as required. 7.23 Transport and access of patients, staff and visitors Design will give consideration to facilitating the easiest pathway and wayfinding from public transport to the main entry and emergency department. In the driveway outside the main entry and emergency department, provision must be made for:



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• drop-off and pickup short term parking • volunteer patient transport services, both car and minivan, short-term parking • taxis. 7.24 Visiting hours Visiting hours for the facility will be X to X in the morning and X to X in the afternoon/evening. Clinical units that may vary visiting hours on an as needs basis are intensive care unit, special care nursery, maternity and paediatric inpatient units. Design must always provide the capacity to manage visitors on the basis of patient condition and preference. Generally visitors will have the ability to stay overnight. However intensive care unit, special care nursery, and maternity and paediatric inpatient units will have dedicated, but limited facilities for visitor overnight stay. Alternative non-facility provided overnight stay arrangements will be available. 7.25 Waste management All aspects of waste throughout the facility will be managed by the HHS operational services department within policy, standards and procedures. The following principles apply to waste management: • preference for ‘back of hours’ routes for all waste removal including clean, contaminated,

and hazardous wastes • provision is made for removal, transit and storage of hazardous wastes using specialist

equipment. 7.26 Occupational health and safety Occupational health and safety (OHS) requirements are outlined in Queensland Health policies including the Occupational Health and Safety Policy (2012) and Implementation Standard for Occupational Health and Safety Risk Management (2012). In addition, there are numerous Queensland Health guidelines, protocols and implementation standards as well as HHS policy and procedures. Design must have the safety of staff and patients as a prime objective. Specific design requirements include: • integration of OHS outcomes into all aspects of design to minimise illness, injury and

damage to property • incorporation of a risk management approach to design, through hazard identification

and reduction, risk assessment and control processes • design features that specifically mitigate known risks including:

− falls, slips and trips − hazardous materials handling − needle stick and body fluid exposure − radiation hazards − patient handling − manual handling − violence within facility boundaries − occupational stress − shift work and fatigue.



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7.27 Workstations and office accommodation Workstations and office accommodation will be provided as per the Queensland Health Workplace and Office Accommodation Guidelines. Core facility wide administrative functions, such as general, nursing and medical administration, finance and human resources will be co-located in one location with all necessary support services. Provision will be made for centralised general administrative functions, workstations and offices in one location for clinicians who work across the facility and to provide flexibility of use into the future. Office accommodation will not be provided more than once per eligible individual. For identified clinical staff, workstations and offices will be located within or adjacent to clinical areas where possible. The primary design objective, however will remain as the efficiency of clinical departments. Offices will be provided as summarised in Table 7. Table 7: FDB facility workstation and office provisions

Office resident Configuration Office size

Board chair Dedicated 18m2

Health Service Chief Executive and senior executive of HHS

Dedicated 18m2

Executive member of HHS Dedicated 15m2

Service director Dedicated 12m2

Pathologist offices, includes 3m2 for microscope

Dedicated 12m2

Staff specialists/senior clinician including medical department heads

Dedicated 9m2

Nursing directors Dedicated 9m2

HHS senior nurses Dedicated 9m2

Nurse unit managers with supervisory responsibilities

Dedicated 9m2

Business managers with supervisory responsibilities

Dedicated 9m2

Various shared office Shared 2 persons 12m2

Shared 3 persons 15m2

Shared 4 persons 20m2

Open plan workstations Dedicated workstation

5m2

Hot desks Shared workstation

4m2

NB: Table contents are example only



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7.27.1. Design considerations Design of workstations and offices will be modular and repeatable, meaning that there will be one set of options available for application across the entire facility. Open plan workstations will be provided where possible. Where open plan areas are provided, adjacent meeting rooms must be provided. Maximum access to natural light and windows must be afforded to all open workstation and office residents. Office support functions such as multifunction devices must be located within easy reach of all staff. Non-installed window treatments must not be used. Where hot desks are located, easy access to lockers must be provided.



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8. FUNCTIONAL DESCRIPTION AND RELATIONSHIPS

8.1 Functional areas Functional areas or zones are all of the areas within a health planning unit, clinical support or non-clinical support service, such as a health planning unit may include the following: • main entry, reception, clerical area • assessment, procedural area • staff offices, administrative and management area • staff amenities area • inpatient area, including outdoor areas. 8.2 Nature of functional relationships Functional relationships are defined throughout the brief to describe the co-dependencies and interdependencies of areas within the facility as a whole, and of individual functional planning units, clinical support and non-clinical support services. Certain relationships are required to determine the configuration of the facility. Key functional relationships to services and units are provided to describe the internal and external physical relationship of functions and the flow of movement. The basic form of the facility includes the following functions: • inpatient functions • outpatient, ambulatory functions • diagnostic and treatment functions • administrative functions • service functions, such as food and supply • research and teaching functions. 8.3 Specification of functional relationships The specification of the flows and access for functional relationships has been classified using the terms, symbols and definitions summarised in Table 8.



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Table 8: Functional relationship classifications, symbols and definitions

Access Line Type Definition Immediate (<1 minute)

Indicates a required adjacency, being the shortest direct, horizontal route.

The route must be an unimpeded.

Door to door travel time between the two areas or services identified as having an ’immediate’ functional relationship must not exceed one minute.

Direct

(<2 minutes)

Being a direct horizontal or vertical route.

The route must be an unimpeded.

Door to door travel time between the two areas or services identified as having a ‘direct’ functional relationship must not exceed two minutes and there must be minimal corner turns between the two areas or services.

Ready

(<5 minutes)

Being a horizontal or vertical route.

Door-to-door travel time between the two areas or services identified as having a ’ready’ functional relationship must not exceed five minutes.

Routine

(5 or > minutes)

Being a horizontal or vertical route.

Door-to-door travel time between the two areas or services identified as having a routine functional relationship with access five minutes or greater.

The terms in the table have the following meanings: • horizontal means on the same floor of the facility • vertical means via a lift or stairs within the facility • travel time means the travel time achievable at an average walking pace of 5 km per

hour • unimpeded route means travel between areas or discrete services are not obstructed by

security doors; do not require travel through busy or crowded areas, do not require movement between different buildings; allow for unrestricted movement of a critical patient, biomedical equipment and accompanying staff.

Whole-of-site functional relationships are summarised in Figure 2.



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Figure 2: Whole-of-site relationships



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9. WORKFORCE 9.1 Current and projected As of 20XX the total current workforce for the facility is XXX staff representing XXX FTE. Future staffing numbers will change dependent on the model of care, increasing number and configuration of beds and other patient spaces. The HHS is aware of the need for redesign of health workforce roles and has participated in role redesign implementation, such as advanced nursing roles, physician assistants, anaesthetic assistants and lifestyle coordinators. The key focus of the HHS model of care is the patient-centred approach. To support the implementation of the patient-centred approach the facility design must facilitate a greater staff focus on direct patient-care and less on the administrative tasks that take them away from the patient. To enable greater patient focus: • the management of documentation and records must be able to be undertaken in or near

the patient bedroom • requirements for patient-care, such as information, test results, order entry, medication,

linen and general supplies must be available in the patient bedroom or be stored in a manner that does not take clinical staff away from the patient

• physical design must also allow for staff-staff interaction as well as patient-staff interaction as clinical team interaction is crucial to the provision of appropriate and safe care.

Workforce planning is predicated on the application of new technologies that will assist staff to undertake their work safely in a manner that supports their skill and knowledge base. To meet health service activity projections, it is estimated that the workforce will need to grow over the next XX years (or between 2012 and 20XX) as follows: • Administrative, management XX% • Facility management XX% • Health practitioners XX% • Medical XX% • Nursing XX% • Operational XX% • Technical XX% 9.2 Clinical, clinical support and non-clinical workforce

profile The current and projected whole-of-facility workforce profile by FTE and number of people is summarised in detail in Table 9.



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Table 9: FDB facility clinical, clinical support and non-clinical workforce profile Whole of facility Staff Profile

Type Classification Current FTE

Current no

people

Projected FTE 20XX

Projected no people

20XX Nursing Grade 12 1.00 1

Sub total Medical Senior staff specialist

L29

Staff specialist L26 Senior registrar L13 Registrar L4 Resident medical officer

L2

Intern L1 Subtotal

Health practitioner Subtotal

Professional stream Subtotal

Technical stream Subtotal

Operational stream Subtotal

Dental Subtotal

Building engineering and maintenance HBEA Engine driver Apprentice

Subtotal Management/administrative

Subtotal Non Queensland Health service providers Ambulance officers

Police officers Volunteers

Subtotal TOTALS 106.80 150

9.3 Impact on design Provision must be made for the projected increased workforce FTE and staff numbers in terms of the following: • Car parking • staff amenities—at unit level and overall throughout the facility • security—access management • sign on areas.



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10. ACCOMMODATION BRIEF The following table is a summary of area requirements for each of the departments/units provided in example chapters. Allowance is made for associated functional units and spaces such as outdoor enclosed areas which might be included in scope. Table 10: FDB facility accommodation brief Service area Room/space type Number Inpatient areas

General surgery Inpatient Unit (IPU)

High acuity and acute recovery beds 30 ICU/CCU/NICU beds - Mental health beds -

Total Emergency service Diagnostic assessment unit–patient bays -

Trauma and resuscitation–patient bays - Observation–patient bays - Treatment area–patient bays -

Total Perioperative Operating rooms -

Procedure rooms - Recovery bays - Interventional imaging–cardiac catheter - Interventional imaging–MRI - Endoscopy procedure rooms -

Total Outpatients Generic consulting rooms -

Generic treatment rooms - Specialist rooms -

Total Day areas General day beds -

Renal beds - Cancer beds - Day surgery -

Total Imaging modalities General X-ray and fluoroscopy 5

CT 2 MRI 1 Ultrasound 4 OPG 1 Gamma cameras - Mobile X-ray 5 Cardiac catheter laboratory 1 Vascular procedure room 1

Total

Functional unit Input parameter Production kitchen 350 [email protected]% occupancy x 3 meals/day Car park–basement, covered and uncovered N/A Central energy facility N/A Childcare centre N/A Outdoor enclosed space 400m2



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11. CLINICAL SERVICE DEPARTMENT/UNIT EXAMPLE

The following clinical service department/unit content is by way of example only.



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12. ADULT SURGICAL INPATIENT UNIT The primary purpose of the surgical inpatient unit is to provide suitable accommodation for the delivery of healthcare services by multidisciplinary teams to admitted patients. Healthcare services include diagnosis, surgical interventions, treatment, care and education. The unit also provides a suitable working environment for staff and amenities for families, carers, visitors, staff and students. 12.1 Scope of service The unit is a 30 bed adult surgical inpatient unit offering a range of surgical specialties at CSCF level 4–5. The unit will cater for patients 18 years and older and requiring an overnight stay in an inpatient environment. The surgical services provided on the unit include:

Specialty/sub specialty CSCF level • General surgery 4 • Upper gastro-intestinal tract

4

• ENT 4 • Orthopaedics 4-5 • Vascular 4 • Urology 4–5

Clinical networking arrangements with other HHS facilities enable access to specialty surgical services not available on-site. The following networking arrangements have been established for specialist services: • neurosurgery, cardiovascular and spinal surgery will be provided at the HHS specialist

facility • plastics, reconstructive and ophthalmology services will be provided at the HHS general

facility. Patients assessed as requiring urgent advanced surgical management above the CSCF level of the service are transferred in accordance with HHS medical retrieval arrangements—either to the specialist facility or wherever an intensive care unit bed is available. Patients requiring rehabilitation will be referred to the rehabilitation inpatient unit. Access to rehabilitation beds is currently limited and often results in patients spending increased days in acute inpatient areas. The rehabilitation inpatient unit is planned for the stage two development.

12.2 Model of care The unit will provide multidisciplinary case management for acute surgical care for booked and emergency adult patients. Patients will come from the local planning catchment and from bordering planning catchments by referral. The patients admitted to the unit will require a minimum overnight stay with the average length of stay being 2.58 days. The unit on most occasions will be dedicated for surgical patients. On some occasions medical patients may need to be accommodated in the unit depending on demand. When possible, medical patients will be allocated to a dedicated area within the unit. Male and



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female patients will be accommodated and separated through single rooms. Multi-bedrooms will accommodate patients of the same gender where possible. A patient centred approach will be provided and will require: • the inclusion of patients and their family/significant other in the planning and delivery of

care. Care planning and patient and family education will commence at pre-admission • admissions will generally be on day of surgery, with a small number of patients requiring

admission the night before surgery. For example, in cases where there is a pre-existing medical condition or long travel distances,

• focussing care services around the patient and within their bed area • providing treatments or therapies either at the patient’s bed or in the unit’s treatment

and/or therapy room • holistic multidisciplinary care involving integrated healthcare teams including medical,

nursing, allied health, operational and administrative staff • tailored nursing models of care to suit the needs of the patient and/or cohort of patients • an integrated model of care across both teams within the facility and primary care

settings, such as emergency department, general practitioners and community settings. This will include follow up care of patients at high risk of readmission with a focus on prevention and early intervention to minimise risk

• clinical handover at the bedside, involving the patient in the care process and assisting to minimise clinical error

• discharge planning for all booked admissions will commence at pre-admission prior to the day of surgery.

12.3 Workforce of the department/unit Workforce requirements are detailed in Table11.



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Table11: Current and projected workforce requirements for surgical IPU

Department/Functional Unit Staff Profile


Current No People

Projected FTE 20XX

Projected No People

20XX Nursing Nurse practitioner

Grade 8 1.00 1 1.00 1

Nurse unit managers/CNC

Grade 7 1.00 1 1.00 1

Clinical nurses Grade 6 5.00 7 5.00 7Registered nurses

Grade 5 12.00 24 12.00 24

Enrolled nurse Grade 3 15.00 20 15.00 20Undergraduate nurse

Grade 2 2.00 3 2.00 3

Assistants in nursing

Grade 1 1.00 1 1.00 1

Sub total 37.00 57 37.00 57Professional stream L4 1.00 1 1.00 1

Subtotal 1.00 1 1.00 1Operational stream OO4 1.00 1 1.00 1

Subtotal 1.00 1 1.00 1Management/administrative L3 1.00 2 1.00 2

Subtotal 1.00 2 1.00 2Non Queensland health service providers Volunteers N/A 4

Subtotal TOTALS 40.20 65 40.2 65Legend FTE Fulltime equivalent FT Full-time PT Part-time N/A Not applicable

12.4 Policies impacting on built environment All facility wide policies impact on the surgical inpatient unit and there are no other specific policies that impact directly on the surgical inpatient unit. 12.5 Operational description The design of the inpatient unit will facilitate the operational practices of the facility. These are detailed below. Hours of operation The inpatient unit remains open 24 hours per day, 365 days of the year. Elective surgery ceases for four weeks over the Christmas period, resulting in reduced activity in the inpatient unit. The surgical inpatient unit activity is directly impacted by the hours of operation in the operating theatre suite, as outlined below: • operating theatres are open 24 hours per day, 365 days of the year • elective surgery 7 am–4 pm, Monday to Friday • emergency surgery 4 pm–12 am



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• on-call emergency surgery 12 am–7 am • weekends 7.30 am–12 pm. Hours of operation impacting upon the inpatient unit are likely to expand, due to an increase number of operating theatres, and growth in operating theatre and procedural activity. Access The unit will have two access points, one for staff and one for visitors. After hours access to the unit will be controlled through proximity swipe cards. Patients Admissions will be via the following: • booked admissions will mostly be through the day of surgery admissions unit (DOSA) on

the day of surgery • direct ward admissions will be limited to transfers from other facilities • admissions will be accepted from emergency department • transfers from intensive care unit will occur on a routine, urgent or emergency basis. Patients will be allocated a bed based on clinical need. Patient care will be provided within the patient’s bedspace in most instances. A high proportion of patients will be aged 65 years or older, many of whom will have co-morbidities and some may be confused or have dementia. The inpatient environment also needs to support the management of patient who may be confused or wandering. Patients will have access to a shared lounge area within the unit. The unit will have therapy/consultation and treatment spaces for unit patients. Staff There will be a central reception and staff station next to the unit entrance from which dedicated unit administration staff will work. Administration staff will provide overview of the unit entrance, reception duties, records management, patient admission and discharge processes and filing. Dedicated unit staff will require a secure property bay area for storage of personal belongings behind a staff controlled perimeter. Staff change rooms will be centralised within the facility. The nurse unit manager will have an office in the unit for accessibility to staff, visitors and patients. While the nursing model may change over time, at opening it is planned that nursing staff will be allocated to a group of patient rooms throughout their shift. Nursing shifts will be a combination of 8.5, 10 and 12 hours. Visiting staff to the unit, such as medical and allied health will work across the entire unit and will need access to collaboration space and a temporary workspace. Allied health staff will use the therapy room frequently throughout their shifts primarily between 7.30 am and 6 pm. Wards persons assisting in patient care, and technical staff providing equipment maintenance, will routinely access the unit.



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Staff meal breaks will be taken outside the unit in the staff amenity area or commercial facilities. Visitors Visiting hours will generally be between 8 am and 8 pm but will be extended to 24 hours for relatives and careers of critically ill or dying patients. At all times visiting will be in accordance with patient condition, preference and unit safety. Visitors will not have access to any staff areas within the unit. All visitors will take universal infection control precautions, including hand washing and use of disinfection products in all patient rooms including isolation rooms. Education Provision needs to be made for access to continuing education and relevant professional development for medical, nursing, allied health, administrative, support staff and students. A multipurpose meeting room with access to a phone, computer and video screen functionality is required within the department for the following activities: • staff meetings, training and education • student education room • patient education. Information and communications technology Trained staff will access integrated clinical information systems, including imaging, pathology, and electronic health record systems at the bedside, write-up bays, staff station, staff base and clinical handover/staff collaboration room. Nursing staff will utilise a clinical handover/collaboration room for shift handover. The total number of staff at shift handover will be equal to that of the two shifts For example the afternoon handover will comprise of staff on the morning shift and the afternoon shifts. The clinical handover/collaboration room will be equipped for education and training and in-service activities. The nurse call system will be integrated into the facility network. Clinical support services Pathology The unit must have access to a pneumatic tube system for clinical samples and blood products. The visiting phlebotomy service to the unit will use the pneumatic tube system. Pharmacy Patient medications will be stored in a dedicated lockable storage unit in close proximity to their bedroom area. Other medications will be secured in a lockable clean utility room with secure card access. Non-clinical support services Individual patient meals will be received directly to the unit on trolleys. Space to store food trolleys during meal times is required. Drinks and snacks will be accessible from a beverage bay throughout the day and evening. A small kitchenette will have provisions for storage of snacks and beverages.



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Equipment and materials A large proportion of the ward medical equipment will be accessible from the centre equipment store located outside of the unit. Storage for general and equipment stores will be required within the unit as per the AusHFG standards. Consumables supply will be delivered by supply staff directly to the unit into the allocated store room. Information and communication Telemetry from the surgical inpatient unit to the intensive care unit for cardiac monitoring is required. There is to be provision for one fixed PC per two beds and a fixed PC in the clean utility/medication room. There is to be one mobile PC per four beds and full wireless connectivity in treatment and office areas. There needs to be an increase in printers to allow patient education/patient information on discharge to be provided. Printers need to be accessible from each patient pod on the unit. Waste Provision for separate general, contaminated and recycled waste needs to be made in each room/multi-bedroom. 12.6 Functional relationships The 30 bed surgical inpatient unit configuration will be as follows: • 18 single bedrooms with non-shared ensuite comprising of:

− one single class N isolation room with anteroom − two single bariatric rooms − 15 standard single bedrooms

• two double bedrooms with shared ensuite • two quadruple bedrooms with shared ensuite. Figure 3 sets out the key external relationships for the surgical inpatient unit. The unit must achieve the functional relationships set out below.



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External relationships Figure 3: Relationship of areas/units external to the surgical inpatient unit



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Internal relationships Figure 4: Relationship of areas within the surgical inpatient units



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12.7 Staging of built capacity The surgical inpatient unit must have convenient access to a covered patient drop off area for ambulances and the public for when patients are being admitted and discharged. 12.8 Future service developments and innovations Future service developments and innovations to be accommodated include: • provision for eHealth integration. This includes patient point of care terminals in each

single room and one for each bed in a multi-bedroom • provision for scanning devices to be accessible throughout the unit • hand held devices that require docking stations, GPOs and data points • capacity for future patient bedside access to the internet. 12.9 Specific design requirements The design will be consistent with the elements described in the AusHFG with specific design considerations as summarised below. General The design of the surgical inpatient unit is to convey a patient centred healing environment with welcoming surrounds. The unit is to be designed for patient and staff safety, bariatric care and be an ‘elder friendly’ environment. The requirements include: • continuous coloured floor coverings • non-slip floor coverings in wet areas • a nurse call system with ease of operation • low level lighting in corridors • large font clocks • hand basins in ensuites to be at a height to accommodate wheelchairs/shower chairs • space for walking aids around bed areas • communal spaces to be used for patients to socialise, a meal area and patient lounge. Natural light and views from patient rooms to be maximised. The design of the unit is to be standardised with the other inpatient units throughout the facility to assist staff to orientate to the clinical environment. The design of each pod within the unit is to support flexibility of nursing allocation and bed management to enable clear visibility when working across two areas. This will ensure areas can • be managed efficiently during periods of low activity • accommodate medical patients in a designated area in times of high demand. One negative pressure (Class N) isolation room is required in the unit with clear patient visibility into the room from the corridor and also the anteroom. The patient bed area must provide appropriate space for the carers and relatives. Patient privacy must be achieved and balanced with maximum visibility into the patient bedrooms from the corridors and nursing/staff stations. Architectural and building



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Mobile equipment, linen and resuscitation bays must be located in the unit and positioned in the same layout as other IPUs throughout the facility. Ceiling mounted lifting devices are to be included in the isolation room and specialling rooms within the unit. They are to be capable of lifting 350 kg. The ceiling tracks must be positioned over the bed and into the ensuite. Bedrooms, bedhead and ensuites • The unit consists of two multi-bedrooms accommodating four patients with the remaining

configuration of beds contained within single rooms. • All beds require direct access to an ensuite shower/toilet or separate shower and toilet

compartment. • Larger super ensuites are provided for bariatric patients. • There will be a standard bedhead with services such as nurse-call, light and telephone

accessible to patients on one side. There will also be services such as medical gases and emergency call accessible to staff only on the other.

Infection control • Infectious patients or those requiring protective isolation will be nursed in single rooms. • One (Class N) negative pressure isolation room will be located within the unit with PPE

area and ensuite. • All patient-care and utility rooms will be equipped with general staff hand basins (Type

B). Generally staff should not be more than 10 –12 metres from a hand basin. • Gel and glove dispensers will be located in all patient-care areas and utility rooms. • Materials used in the furnishings of the unit must meet infection control standards. Building and information and communication technology services • An audiovisual intercom must be provided for after hours access to the unit. The system

is to be linked to all staff bases to enable communication with the public and to provide remote access into the unit through an automatic release door mechanism.

• Videoconferencing service capability is required in the staff collaboration/education rooms.

Communication and security • Card operated telephones will be beside each patient bed. Telephones for staff will be

located at all staff bases and administrative areas as well as offices on the wards. • Clinical information systems will be accessible from all staff bases, offices, treatment

areas, interview rooms and education/meeting rooms. In the future, access will be via patient entertainment systems and mobile devices.

• Patient call system will provide the following call components: patient to staff, staff to staff and emergency to staff. The call points will be at every patient bed, ensuite, treatment room and patient lounge.

• Staff working in the unit are to have access to duress alarms at all workstations. Waste • A dirty utility room will be required in an accessible location away from public and

administration areas. • Waste management should be in accordance with AS/NZS 3816 and as detailed in

AusHFG, Part D. An outdoor enclosed area is required for recreational and therapeutic purposes. This area will be shared with four other inpatient units.



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12.10 Schedule of accommodation The following table summarises the surgical inpatient schedule of accommodation. This is not a comprehensive summary and is by way of example only. Table 12: Surgical inpatient unit schedule of accommodation

Room tag

Room code

Room name Standard room

Briefed area m2

No of rooms

Subtotal of briefed area m2

Occupancy

Functionaldescription

Comments

3000 1 BR-ST 1 bedroom–standard

Y 15 x 15 = 270 1 patient, 1-2 staff, 1-2 visitors

see standard room nil

30010 1 BR-IS-N 1 bedroom –isolation – negative pressure

Y 15 x 1 = 15 1 patient, 1-2 staff, 1 visitor


30012 ANRM anteroom Y 6 x 1 = 6 1-2 staff see standard room nil 30050 ENS-ST ensuite – standard Y 5 x 15 = 60 1 patient, 1-2

staff see standard room nil

30006 1 BR-SP-A 1 bedroom –special Y 18 x 2 =36 1 patient, 1-2 staff

see standard room bariatric room

30065 ENS-SP ensuite –super Y 6 x 2 =12 1 patient, 1-2 staff

see standard room bariatric ensuite

30014 2 BR-ST 2 bedroom Y 25 x 2 =50 1 patient, 1-2 staff


30016 4 BR-ST 4 bedroom Y 42 x 2 =84 1 patient, 1-2 staff


30020 BBEV-OP bay beverage Y 4 x 1 = 4 1-2 staff see standard room open bay includes ice machine

30039 DTUR-12 dirty utility Y 12 x 1 = 12 2 staff see standard room dual access 30043 OFF-S9 office – single

person NUM Y 9 x 1 = 9 1 staff see standard room NUM office plus

clinical personnel 30046 STEQ store – equipment Y 20 x 1 = 20 4 staff see standard room size depends on

equipment stored and no. of bays

Total xxx.0 m2



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12.11 Summary of changes to model of care There are no significant changes to the model of care in stage one development that will impact on design. Relevant facility wide approaches will apply to the surgical inpatient unit and need to be considered.


Section 3 – Specifications and Example

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13. CLINICAL SUPPORT SERVICE DEPARTMENT/UNIT EXAMPLE

The following clinical support service department/unit content is by way of example only.



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14. MEDICAL IMAGING 14.1 Scope of service The medical imaging service will be a CSCF level 5 service and will provide a tertiary referral service to other facilities within the HHS. This service will provide radiology including diagnostic and interventional services for inpatients and outpatients of all facility departments and units as well as some external referrers. The service will provide 24-hour reporting on diagnostic tests. Services will be provided on both an elective planned and emergency basis. The medical imaging department will require the following modalities Table 13: FDB facility medical imaging modality requirements

Modality Number General x-ray 4 Ultrasound–general and doppler 4 Computed tomography 2 Magnetic resonance imaging 1 Fluoroscopy 1 OPG 1 Mobile x-ray–ICU, emergency department, one IPU, operating room suite plus one

5

Cardiac catheter laboratory–in the operating room suite 1 Vascular procedure room–in the operating room suite 1

14.2 Model of service delivery The medical imaging department (MI) will operate as the primary centre for the HHS, supporting services at all other HHS facilities. While the majority of services will be provided in the department, a mobile service will also be provided to the intensive care unit, inpatient units, operating theatre suite, mortuary and antenatal clinics. A satellite services will operate in the emergency department and the interventional suite within the operating theatre suite. It is anticipated that MI will act as a primary centre to the whole HHS for radiology reporting services. Interventional radiology procedures will be undertaken in the interventional suite. The following services are provided: • radiography including mobile imaging and procedures • magnetic resonance imaging • computed tomography • ultrasound • fluoroscopy • dental scanning • clinical photography • picture archive and communication system (PACS) • cardiac angiography • vascular angiography. Exclusions from the medical imaging service include:



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• mammography • paediatric CT/MRI requiring anaesthesia. Activities undertaken for training and research are detailed in the education and research section. 14.3 Workforce of the department/unit The workforce calculations are based on the following assumptions: • medical staff numbers include directors, consultants, registrars, residents and interns

providing both direct and indirect care • nursing staff numbers include nurse managers, educators, clinical facilitators, equipment

nurses, research and data nurses • health practitioners includes radiographers and sonographers • administration staff dedicated to the department • operational staff includes wards persons who are dedicated to the department • students include medical, nursing and health practitioners on placement • staff located in satellite imaging areas are included in the workforce table. Staff both current and future projected to 20XX is detailed in Table 14. Table 14: FDB facility medical imaging workforce requirements

Department/Functional Unit Staff Profile: Imaging


Current No People

Projected FTE 20XX

Projected No People

20XX

Nursing Nurse unit managers/Clinical nurse consultants

Grade 7 1.00 1 1.00 1

Clinical nurses Grade 6 3.00 5 3.00 5Registered nurses Grade 5 12.00 16 12.00 16Enrolled nurses Grade 3 12.00 15 12.00 15Undergraduate nurse

Grade 2 1.00 3 1.00 3

AINs Grade 1 3.00 1 3.00 1Sub total 32.00 41 32.00 41

Medical Staff specialist L26 5.00 5 5.00 5Staff specialist L22 12.00 12.00 12.00 12

Subtotal 17.00 17 17.00 17Health practitioner HP6.2 1.00 1 1.00 1 HP5.4 10.00 10 10.00 10 HP4.3 25.00 30 25.00 30 HP3.2 12.00 15 12.00 15 HP2.1 10.00 10 10.00 10

Subtotal 56.00 67 56.00 67Operational stream OO4 10.00 10 10.00 10 OO5 5.00 6 5.00 6

Subtotal 15.00 16 15.00 16Management/administrative L6 1.00 1 1.00 1 L4 3.00 3 3.00 3



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Department/Functional Unit Staff Profile: Imaging


Current No People

Projected FTE 20XX

Projected No People

20XX

L3 10.00 15 10.00 15Subtotal 14.00 19 14.00 19Non-Queensland Health service providers Students 3.00 3 3.00 3

Subtotal 3.00 3 3.00 3TOTALS 137.00 163 137.00 163

Legend FTE Fulltime equivalent FT Full-time PT Part-time N/A Not applicable

14.4 Policies impacting on built environment There are a range of policies, standards and legislation impacting on the medical imaging built environment. Some of these include and are not limited to: • Relevant legislation includes the Queensland Radiation Safety Act 1999, Radiation

Safety (Radiation Safety Standards) Notice 2010 and Radiation Safety Regulation 2010. Queensland Health Occupational Health and Safety (OHS) Policy, and Implementation Standard for Security Risk Management and Asset Protection.

14.5 Operational description The operational practice of the medical imaging department and satellite services will be as follows: Hours of operation Radiology reporting service to emergency department and intensive care unit will be provided on a 24-hour, seven days a week. Medical imaging department will operate from 7 am to 7 pm. The satellite service to the interventional suite will operate from 8 am to 6 pm, Monday to Friday and on an emergency basis. Mobile services to inpatient units and outpatients clinics will operate from 8 am to 8 pm, Monday to Friday. A limited after hour’s service will be provided between 7 pm to 7 pm. Patient flow All inpatients will be registered by reception. Inpatients may arrive on beds, trolleys, wheelchairs or on foot through the inpatient only entrance. Inpatients will be accompanied by a clinical staff member. Inpatients will be taken directly to the modality sub waiting area or to the scanning room dependent on their condition and urgency of procedure.



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Inpatients on trolleys and beds will always travel on a separate pathway to the general public and be placed in an area with privacy screening. Outpatients will arrive via the reception area and will either wait in the general waiting room or once directed to a modality waiting area. After hours all patients will be escorted within the department. Staff flow Staff will arrive in the medical imaging department through dedicated secure staff entries which includes at least one entrance with direct access to staff amenities and adjacent offices. Staff providing mobile services will be stationed within medical imaging department and will travel to and from the department as required. Satellite service staff will have the medical imaging department as their primary base and will be rostered to the satellite as required. Visitor flow Visitors will be restricted to the reception and general and sub wait areas. Parents and carers of paediatric patients will be allowed to enter clinical areas under supervision. Other flows Clinical and non-clinical support services and flows are as per the AusHFG. Equipment must be capable of being maintained, repaired and replaced without undue interruption to service delivery. In particular, large equipment items such as MRIs must be able to be moved without damage to structures and other assets.



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14.6 Functional relationships

External relationships Figure 5: External functional relationships—medical imaging



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Macro internal relationships Figure 6: Internal relationships (macro)—medical imaging



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Micro internal relationships Figure 7: Internal relationships (micro)—medical imaging



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14.7 Staging of built capacity There is no staging required for this department as all modalities will be part of one stage. 14.8 Future service developments and innovations Recent experience has shown that rapid and continuous change may be expected within the medical imaging modalities and service. Interventional and therapeutic options are growing and will continue to expand. This growth may require special consideration of infection control, monitoring, outpatients review and resuscitation. Design must consider future developments and provide flexibility for expansion or change of modality such as Positron Emission Technology or future MRI capacity. 14.9 Specific Design Requirements General The main department waiting area must be adjacent to and in full view of reception. It should include a children’s play area. The department layout scheme must provide for separation of patient and staff flows to protect privacy and confidentiality. Modalities are to be located adjacently by type. All procedure rooms will comply with relevant AusHFG requirements including specific infection control provisions. Adequate space and services must be provided for storage of mobile equipment bays throughout the department. Space for resuscitation trolley bays must be provided next to the patient holding space near to the staff station. The department must be designed to facilitate the maintenance and replacement of major imaging equipment items throughout their anticipated life span without disrupting service delivery or damaging assets by impacting on the building structure and services. Rooms housing such equipment must be located to allow easy access and include structural reinforcement along the routes of travel. Access from the exterior of the building must be provided for equipment replacement without the need for unplanned structural change. Provision for future proofing of building services must be considered. It must be possible to easily move and accommodate beds and trolleys and wheelchairs throughout the department. The whole department perimeter will be capable of being secured and controlled from the reception and staff station. Digital patient entertainment must be provided in wait areas and clinical rooms.



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Information and communication technology All patient data, reports and images will be stored on the radiology information system (RIS) and picture archiving system (PACS) servers. RIS and PACS servers are to be located in an ICT dedicated server room within the facility to assure uninterrupted data integrity and availability. RIS and PACS data will be available on a common network throughout the facility. Provision must be made for a mass storage server to facilitate direct link to three dimensional anatomical imaging. This server may be located in a server room elsewhere within the facility. The department must be capable of receiving external telecommunication downloads from other facilities and remote locations. High speed links to other HHS facilities, referring facilities in other HHSs and external referring doctors must be provided. The quality of monitors will be dependent on the primary purpose for accessing data. Diagnostic quality dual monitors are provided where qualified staff are usually based and the number will be based on maximum number of qualified staff working at any one time. At a minimum they are provided in MI department reporting rooms, one set in the emergency department and one set in ICU. All other monitors to be of sufficient standard to review and view images. Patient areas The patient holding area must include provision for sedated patients. Nursing staff must be able to observe all patients easily from a central workstation with uninterrupted views to all holding bays. Sub waits are required for general x-ray and fluoroscopy, CT and MRI with ultrasound sharing a wait area with the adjacent modality. General x-ray and fluoroscopy rooms Rooms must be sized appropriately for safe work practices and allow easy movement of staff and patients. Adjacency of patient toilet and change room is required for fluoroscopy. MRI and CT Rooms Cabling in all control rooms must be accessible throughout. MRI scanners will be a minimum of 3 Tesla. MRI and CT scanner room design must meet manufacturer and statutory requirements for the models being installed, including provisions for exclusion zones, radiation shielding and floor reinforcement, venting for gases, appropriate monitoring and alarms. Based on the model to be installed, the weight of individual MRIs must be taken into consideration in designing floor loads. MRI scanners rooms must include magnetic field shielding from other equipment. CT and MRI rooms require ceiling mounted shadowless lighting with dimmable lighting provided in all examination rooms.



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In MRI magnet rooms, one wall must be an external wall or adjacent to large enough circulation space for future replacement of the magnet. Noise attenuation is required for shared control rooms, as well as ability to direct voice to the correct room with minimal interference of background noise.



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14.10 Schedule of accommodation The following table summarises the medical imaging department schedule of accommodation. This is not a comprehensive summary and is by way of example only. Table 15: Medical imaging department schedule of accommodation

Room tag

Room code Room name Standard room

Briefed area m2

No of rooms


Occupancy

Functional description

Comments

61000 Wait-30 Waiting Y 35 x 1 = 35 25 people see standard room 25 seats/wheelchairs

61006 RECL-12 Reception Y 12 x 1 = 12 2 staff see standard room Reception and clerical area to be adjacent

61016 PACS Server room Y 12 x 1 = 12 see standard room 61022 GENXR General X-Ray Y 30 x 5 = 150 1 patient, 1

staff see standard room

61034 CHPT Change cubicle – Patient Y 2 x 4 = 8 1 patient see standard room 61036 ULTR Ultrasound Room Y 12 x 4 = 48 1 patient, 1

staff see standard room Non-interventional

procedures 61045 CTPR CT Scanning room Y 45 x 2 = 90 1 patient, 1

staff see standard room

61047 CTCR CT Control room Y 12 x 2 = 24 2 staff see standard room 61049 COEQ CT Computer room Y 12 x 2 = 24 2 staff see standard room 61053 PBTR-H-8 Patient bay – Holding Y 8 x 10 = 80 10 patients see standard room 61096 MEET-L-30 Meeting room - Large Y 30 x 1 = 30 6-8 staff see standard room 61104 BPTS bay – Pneumatic tube

station Y 1 x 1 = 1 see standard room

61097 SRM-20 Staff room Y 20 x 1 = 20 8 -10 staff Ssee standard room Total xxx.0 m2



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14.11 Summary of changes to model of service delivery A mobile service may be provided in the future to the antenatal clinic.



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15. NON-CLINICAL SERVICES DEPARTMENT/UNIT EXAMPLE

The following non-clinical support service department/unit content is by way of example only.



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16. FOOD SERVICES 16.1 Scope of service The food services department will provide food and beverages to facility inpatients and outpatients for a 350 bed facility and a limited event catering capacity. A commercial facility will be available within the facility for patients, staff, visitors and the public and for alternative event catering. 16.2 Model of service delivery Facility wide The facility will have a central food production kitchen on site which will prepare meals from both fresh and cooked frozen deliveries. Two hot meals per day, lunch and dinner, will be centrally hot plated for immediate distribution to wards on trolleys with thermal controls. All inpatient units with the exception of specified units will receive hot plated meals. The mental health unit, midwifery, psychogeriatric and paediatric IPUs will have hot serving of meals from bains marie or trolleys. Hot meals with special dietary requirements will be supplied to patients as required. Meals and sandwiches will be available to units not receiving a hot meal service. This includes units that holds patients over meal times and also provided to patients who have missed meal times. All inpatient units will have a pantry, stocked by food services, with items for mid meal beverages and snacks. Trolleys will be stored in the pantry for distribution of beverages. All central kitchen trolleys, food receptacles, food trays, water jugs, crockery and cutlery will be returned to the kitchen for cleaning. A menu management information system which manages all food and groceries procurement will be in use. The food service department will have the capacity to store on site meals and food requirements for the whole facility for a period of two days in case of post disaster. Production kitchen All hot meals are to be prepared in the central kitchen. The food service will use a variety of food types, including special diet items prepared off site and purchased in bulk as well as fresh foods. For inpatient units continental style breakfasts will be assembled in the kitchen. The exceptions to this are mental health unit, midwifery, psychogeriatric and paediatric IPUs which will prepare breakfasts in the unit. The kitchen will have the capacity for the preparation of sandwiches, snacks and meals. This includes: special events, units who don’t receive hot meals or for meals required outside of normal meal times. Event catering The food service department will cater to meetings, functions and events held on site.



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Facility staff are able to order catering food from either the central kitchen or alternative commercial suppliers. 16.3 Workforce of the department/unit Table 16: FDB facility food service workforce requirements

Department/functional unit staff profile: food services


Current no people

Projected FTE 20XX

Projected no people

20XX Health Practitioner HP5.4 1.00 1 1.00 1 HP4.3 5.00 7 5.00 7 HP3.2 1.00 2 1.00 2 HP2.1 1.00 2 1.00 2

Subtotal 8.00 12 8.00 12Operational stream OO9 1.00 1 1.00 1 OO7 2.00 3 2.00 3 OO6 3.60 5 3.60 5 OO5 5.00 5.00 OO3 15.00 20 15.00 20 OO2 5.00 6 5.00 6 OO1 12.00 20 12.00 20

Subtotal 43.00 55 43.00 55Management/Administrative L6 1.00 1 1.00 1 L4 2.00 3 2.00 3 L3 1.00 1 1.00 1

Subtotal 4.00 5 4.00 5TOTALS 55.00 72 55.00 72

16.4 Policies impacting on built environment Relevant legislation, policy and standards include: • Queensland Health, Occupational Health and Safety Policy 2012 • Queensland Health, Food and Nutrition Safety, Health Service Directive 2013. • Food Act 2006 • Australia and New Zealand Food Standards Code • Queensland Health food services directives and policy • Hazards Analysis Critical Control Point (HACCP). 16.5 Operational description Food services will operate from 6 am to 8 pm, 365 days. There will be three main meal times, breakfast, lunch and dinner and mid meal beverage times in the morning, afternoon and evening. An integrated bedside meal ordering system will be provided for patients to order meals, which will be managed from the central kitchen. A staff corridor will be provided for access to the central kitchen. A clean corridor will be provided for transport of meals to inpatient units.



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Materials and consumables will be supplied on imprest from the materials management service and stored in the food services store rooms on a ‘just in time’ basis. 16.6 Functional relationships

16.6.1. External relationships Figure 8: External relationships—food services



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16.6.2. Internal relationships Figure 9: Internal relationships—food services



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16.7 Staging of built capacity Once construction is complete this department will be fully operational from day one. 16.8 Future service developments and innovations Future capacity must be enabled through the integrated food management system, including ordering, invoicing, food safety and reporting functions. Capacity must be provided for bar code reading and automated data entry at each bed side using a wireless network. Smart cards will be supplied for staff to use at food and commercial outlets and vending machines. 16.9 Specific design requirements The following specific design requirements for food services are based on a fresh cook service solution: • design must allow for a functional, efficient operational flow incorporating receipt directly

off the food service dedicated loading dock into cold and dry storage areas. This should be in proximity of preparation, cooking and plating/tray line areas and separate wash-up area

• there must be sufficient circulation space for the movement of stores and trolleys • clean and dirty dedicated trolley areas with direct access to a trolley washing bay is

required • there must be single use packing and waste to be recycled with a minimum requirement

for dishwashing • there must be a trolley park area sufficient to hold all IPU trolleys at one time • a storage area with capacity for all meal trays is required • a number of segregated storage areas including refrigeration, freezer, dry goods and

chemicals are required • there must be separate storage areas for cooked and raw foods to support safe food

handling • specific temperature controls must be applied as per the use of certain areas of the

kitchen • a separate dietary formula area must be provided near the kitchen and will include areas

for preparation and storage. Special requirements include refrigeration and an ICT support area to print labels

• there must be efficient distribution routes from the kitchen to all patient areas • main kitchen must have appropriate storage, including cool rooms, freezers, separate

dry and chemical stores and area assembly washing areas. Waste processing must have ready access to the loading docks and service corridors

• access to a separate de-boxing room • storage for chemical and non food items as per regulations • design must comply with all current Queensland Health and food handling guidelines,

including HACCP • all temperature controlled rooms to have emergency power supply backup • freezers and cool rooms need to maintain temperature control and be monitored with

recording and alarm system connected to the Building Management System (BMS) • food production and delivery areas must have secured controlled access points by use of

proximity card or similar with authorised access only. This area must be capable of being overseen by staff

• support areas must include waste holding area, cleaner’s room and staff amenities.



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16.10 Schedule of accommodation The production kitchen schedule of accommodation will be undertaken by a specialist kitchen consultant. 16.11 Summary of changes to model of service delivery There are no specific changes to the model of service delivery.



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APPENDIX A REFERENCED DOCUMENTS Referenced standards The following standards have been grouped as ‘general’ or discipline specific. All designers are required to adhere to the requirements of the Australian Standards irrespective of whether these are listed as discipline specific standards or not. The grouping is provided to assist designers only as a ready-reference. Category Standard General • Building Code of Australia

• AS/NZS 1170:2011–Structural design actions–General principles • AS 1432:2004–Copper tubes for plumbing and drainage applications • AS/NZS 2107:2000–Recommended design sound levels and reverberation times for building interiors • 2021:2000–Acoustics–Aircraft noise intrusion–Building siting and construction • AS/NZS 2243.1:2005–Safety in laboratories–Planning and operational aspects • AS/NZS 2243.2:2006–Safety in laboratories–Chemical aspects • AS/NZS 2243.3:2010–Safety in laboratories–Microbiological safety and containment • AS 2243.4:1998–Safety in laboratories–Ionizing radiations • AS/NZS 2243.5:2004–Safety in laboratories–Non-ionizing radiations - Electromagnetic, sound and ultrasound • AS/NZS 2243.6:2010–Safety in laboratories–Plant and equipment aspects • AS 2243.7:1991–Safety in laboratories–Electrical aspects • AS/NZS 2243.8:2006–Safety in laboratories–Fume cupboards • AS/NZS 2243.9:2009–Safety in laboratories–Recirculating fume cabinets • AS/NZS 2243.10:2004–Safety in laboratories–Storage of chemicals • AS/NZS 2982:2010–Laboratory design and construction–General requirements • AS/NZS 3000:2007–Electrical Installations • AS/NZS 3013:2005–Electrical Installations–Classification of the Fire and Mechanical Performance of Wiring System Elements. • AS/ISO 31000 Risk Management • AS 3996:2006–Access covers and grates • AS/NZS 4187:2003–Cleaning, disinfecting and sterilizing reusable medical and surgical instruments and equipment, and maintenance of associated environments in healthcare facilities • AS 4260:1997–High efficiency particulate air (HEPA) filters–Classification, construction and performance • AS/NZS 4536:1999–Life Cycle Costing–An Application Guide • AS/NZS ISO 31000:2009–Risk Management–principles and guidelines • AS/NZS ISO 14644:2002–Cleanrooms and Associated Controlled Environments • HB 436:2004–Risk management guidelines • AS 4970-2009–Protection of trees on development sites

Discipline specific Communications • AS/NZS 3013:2005–Electrical installations–Classification of the fire

and mechanical performance of wiring systems elements • AS/NZS 3080:2003–Telecommunications installations–Generic



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Category Standard cabling for commercial premises • AS/NZS 3084:2003–Telecommunications installations–Telecommunications pathways and spaces for commercial buildings • AS/ACIF S009:2009–Installation requirements for customer cabling

Electrical • AS/NZS 1680.1:2006–Interior and workplace lighting–General principles and recommendations • AS/NZS 1768:2007–Lightning Protection • AS/NZS 2293.2:2008–Emergency Escape Lighting and Exit Signs for Buildings • AS/NZS 2500:2004–Guide to the safe use of electricity in patient-care • AS/NZS 3003:2011–Electrical installations–Patient treatment areas of hospitals, medical, dental practices and dialyzing locations. • AS/NZS 3009:1998–Electrical Installations–Emergency Power Supplies in Hospitals • AS/NZS 3017:2007–Electrical installations–Verification guidelines • AS/NZS 3439:2002–Low-voltage switchgear and control gear assemblies • AS/NZS CISPR 14.1:2010–Electromagnetic Compatibility or internationally recognized equivalent(s) • Standards Australia–Handbook on Electromagnetic Compatibility Standards and Regulation

Fire • AS 1221:2003–Fire Hose Reels • AS 1603:1998–Automatic fire detection and alarm systems • AS 1670:2004–Fire detection, warning and intercom systems • AS 1668.3:2001–Smoke control systems for large single compartments or smoke reservoirs • AS 1690:1975–Rules for the safe design, construction and performance of domestic oil-fired appliances (withdrawn) • AS/NZS 1850:2009–Portable fire extinguishers–classification, rating and performance testing • AS 1851:2008–Maintenance of fire protection systems and equipment • AS 2118:2006–Automatic fire sprinkler systems • AS/NZS 2293:2008–Emergency evacuation lighting and exit signage for buildings • AS 2419:2007–Fire hydrant installations • AS/NZS 2441:2009–Installation of fire hose reels • AS 2444:2001–Portable fire extinguishers and fire blankets • AS 2941:2008–Fixed fire protection installations • AS 4118:1996–Fire Sprinkler system components • AS 4428:2002–Fire detection, warning, control and intercom systems - control and indicating equipment • AS ISO 14520 (various parts):2009–Gaseous fire-extinguishing systems–Physical properties and system design

Hydraulics • AS/NZS 1596:2008–The storage and handling of LP Gas • AS 3500:2003–Plumbing and drainage Set • AS 4032:2005–Water supply–Valves for the control of hot water supply temperatures • AS/NZS:2010 5601 Gas installations Set

Lifts • AS 1428:2009–Design for access and mobility; • AS 1735:2006–Lift, Escalators and moving walks • AS 4431:1996–Guidelines for safe working on new lift installations in new constructions • EN81.1 Safety Rules for the Construction and Installation of Lifts – Part 1 – Electric Lifts • EN115



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Category Standard • ASME A17.1 • CIBSE Guide D Transportation Systems in Buildings

Mechanical • AS 1324:2001–Air filters for use in general ventilation and air-conditioning • AS 1668.1:1998–The use of ventilation and air-conditioning in buildings: Fire and smoke control in multi-compartment buildings • AS 1668.2:2002–The use of ventilation and air-conditioning in buildings: Ventilation design for indoor air contaminant control • AS 1668.3:2001–The use of ventilation and air-conditioning in buildings: Smoke control systems for large single compartments or smoke reservoirs • AS 2639:1994–Laminar flow cytotoxic drug safety cabinets - Installation and use • AS 2686.1:1984 (withdrawn) • AS 2866.2:1985 (withdrawn) • AS/NZS 3666:2011–Air handling and water systems of buildings • AS 3892:2001–Pressure equipment-Installation • AS 4254:2002–Ductwork for air-handling systems in buildings • AS 4343:2005–Pressure equipment - Hazard levels • AS 4260:1997–High efficiency particulate air (HEPA) filters - Classification, construction and performance • AS 4426:1997–Thermal insulation of pipework, ductwork and equipment-Selection, installation and finish. • HB 260:2003– Hospital acquired infections–Engineering down the risk • Seismic Restraint Manual (Guidelines for Mechanical Services by SMACNA) • CIBSE Guides, particular Guide B for commissioning

Medical gases • AS 1210:2010 – Pressure vessels • AS 1894:1999 – The storage and handling of non-flammable cryogenic and refrigerated liquids • AS 4484:2004–Gas cylinders for industrial, scientific, medical and refrigerant use - Labelling and colour coding • AS 2030 (various)–Gas Cylinders (series). • AS 2120:1992–Medical suction equipment • AS 2120.3:1992–Suction equipment powered from a vacuum or pressure source • AS 2473.3-2007–Valves for compressed gas cylinders–Outlet connections for medical gases • AS 2568:1991–Medical gases—Purity of compressed medical breathing air. • AS 2896:2011–Medical gas systems—Installation and testing of non-flammable medical gas pipeline systems • AS 3840:1998–Pressure regulators for use with medical gases. • AS 3840.1:1998–Pressure regulators and pressure regulators with flow-metering devices • AS 4041:2006–Pressure piping • AS 4332:2004–The storage and handling of gases in cylinders • AS 4484:2004–Gas cylinders for industrial, scientific, medical and refrigerant use– Labelling and colour coding. • BS 5682 Specification for terminal units, hose assemblies and their connectors for use with medical gas pipeline systems

Security • AS/NZS 1158 Set:2010–Lighting for roads and public spaces Set • AS/NZS 2201.1:2007 to AS/NZS 2201.5:2008 - Intruder alarm systems • AS/NZS 2208:1999–Safety Glazing Materials in Buildings • AS 4485.1:1997–Security for Healthcare Facilities (Part 1: General



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Category Standard Requirements) • AS 4485.2:1997–Security for Healthcare Facilities (Part 2: Procedures Guide) • AS4083:2010–Planning for Emergencies; Healthcare Facilities

Referenced policies and implementation standards The following policies and implementation standards were referenced to inform this brief. Policies Office of Strategy and Government Business (1996) OHS Policy: P-21 Space Standards for office-based work environments Queensland Government (2011) Asbestos Management and Control Policy for Government Buildings Queensland Government, Department of Infrastructure and Planning, (2011), Project Assurance Framework Policy Overview Queensland Government, Department of Infrastructure and Planning, (2011), Project Assurance Framework Strategic Assessment of Service Requirement - Guidance Material Queensland Health (2010) Clinical Support Infrastructure Policy - Sterilisation Capacity Queensland Health (2011) Procedure for Building Performance Evaluation, V1.0 Queensland Health (2011) Third Party Infrastructure Partnership Policy Queensland Health, (2008) Integrated Risk Management Policy Queensland Health, (2010) Ecologically Sustainable Queensland Health Facilities Policy Queensland Health, (2011) Car Park Infrastructure Policy, v1 Queensland Health, Asset and Properties Services (2011) Asset Maintenance Policy v1.1 Queensland Health, Asset and Properties Services (2011) Asset Maintenance Policy, Protocol for Asset Maintenance Funding v 1.1 Queensland Health, Asset Management Unit (2007) Water Efficiency and Conservation Policy Queensland Health, Capital Works and Asset Management Branch (2008) Strategic Asset Management Policy, Asbestos Management and Control Policy Queensland Health, Capital Works and Asset Management Branch, (2008) Strategic Asset Management Policy, Helicopter Landing Sites Policy v1.7 Queensland Health, Capital Works and Asset Management Branch, (2008) Asbestos Management and Control Policy, v2 Queensland Health, Design Standards Unit (2008) Workplace and Office Accommodation Policy and Guidelines Queensland Health, Health Planning and Infrastructure Division (2010) Clinical Support Infrastructure Policy - Sterilisation Capacity Queensland Health, Health Planning and Infrastructure Division (2011) Capital Infrastructure Planning Policy, V3.0 Queensland Health, Health Planning and Infrastructure Division (2011) Wayfinding Policy, V1.1 Queensland Health, Health Planning and Infrastructure Division (2011) Capital Delivery Program Queensland Health, Health Planning and Infrastructure Division (2011) Capital Delivery Program, Procedure for Inducting User Group Representatives into the Capital Project Team at Project Initiation Stage Queensland Health, Integrated Communications Branch (2010) Signage Policy - Capital Works Projects, V1.0 Queensland Health, Integrated Systems and Process Improvement Unit (2010) Design Considerations and Summary of Evidence: Children's Emergency, Inpatient and Ambulatory Health Services



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Queensland Health, Policy Planning and Asset Services, (2011) Third Party Infrastructure Partnership Policy, V1.1



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Implementation standards Queensland Health (2011) Asset Maintenance funding Implementation Standard v1 Queensland Health (2011) Car Park Infrastructure Implementation Standard - Planning Queensland Health (2011) Ecologically Sustainable Queensland Health Facilities: Implementation Standard - Transport Queensland Health, (2008) Integrated Risk Management Implementation Standard Queensland Health, (2010) Ecologically Sustainable Queensland Health Facilities - Implementation Standard v1.1 Queensland Health, (2010), Signage - Capital Works Projects Implementation Standard v1.0 Queensland Health, (2011) Car Park Infrastructure Implementation Standard v1 Queensland Health, (2011) Occupational Health and Safety Management Systems, Implementation Standard v4.0 - Security Risk Management and Asset Protection Queensland Health, (2011) Third Party Infrastructure Partnership Implementation Standard for Investigation and Agreement in-Principle v1.2 Queensland Health, (2011) Third Party Infrastructure Partnership Implementation Standard for Project Delivery v1.2 Queensland Health, (nd) Capital Infrastructure Investigation Implementation Standard, v2 Queensland Health, (nd) Capital Infrastructure Proposal Implementation Standard v2 Queensland Health, Asset and Properties Services (2011) Asset Maintenance Policy Implementation Standard for Asset Maintenance Funding Queensland Health, Health Planning and Infrastructure Division (2011) Capital Infrastructure Investigation Implementation Standard v2.0 (DRAFT) Queensland Health, Health Planning and Infrastructure Division (2011) Wayfinding Implementation Standard v1.1 Queensland Health, Integrated Communications Branch (2010) Signage Policy - Capital Works Projects, Implementation Standard v1.0 Queensland Health, Planning Branch (nd) Implementation Standard for Capital Infrastructure Investigations v3 Queensland Health, Policy Planning and Asset Services (2011) Third Party Infrastructure Partnership Implementation Standard - Investigation and Agreement in-Principle v1.1 Queensland Health, Policy Planning and Asset Services (2011) Third Party Infrastructure Partnership Implementation Standard - Project Delivery v1.1



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Other referenced documents Other documents listed below were referenced to inform this brief. Australasian Health Facility Guidelines v4.0 17 December 2010 accessed at: http://www.healthfacilityguidelines.com.au/ Australian Commission on Safety and Quality in Healthcare, (2011) National Safety and Quality Health Service (NSQHS) Standards Australian Government, (1997) National Code of Practice for the Construction Industry accessed at: http://www.deewr.gov.au/WorkplaceRelations/Policies/BuildingandConstruction/Pages/default.aspx Australian Institute of Quantity Surveyors (AIQS) - Australian Cost Management Manual – Volume 1 Office of the Queensland Government Architect, (2010) Design Guidelines for Government Buildings Queensland Government, (2009) Adult Acute Mental Health Inpatient Unit Design Guidelines Queensland Government, (2010) Department of Infrastructure and Planning, Gateway review process overview Queensland Government, (2010) Strategic Asset Management Framework, Life-Cycle Planning Queensland Government, (2011) Asbestos Management and Control Policy for Government Buildings Queensland Government, (2011) Capital Works Management Framework Queensland Government, (2011) Project Assurance Framework, Policy Overview Queensland Government, (2011) Project Assurance Framework, Strategic Assessment of Service Requirement http://www.treasury.qld.gov.au/office/knowledge/docs/project-assurance-framework-guidelines/index.shtml Queensland Government, (2011), Maintenance Management Framework, policy for the maintenance of Queensland Government buildings, 2011. Queensland Health, (2006) Guidelines for Condition Assessments, V1.1 Queensland Health, (2007) Queensland Statewide Health Services Plan 2007-2012 Queensland Health, (2011) Occupational Health and Safety Management Systems, Better Practice Guidelines V2.0 - Security Risk Management and Asset Protection Queensland Health, (2011) Queensland Health Style Guide Queensland Health, (2011), Clinical Services Capability Framework v3.0, Fundamentals of the Framework Queensland Health, (2011), Queensland Health Strategic Plan 2011–2015 Queensland Health, (nd) Mackay Base Facility Redevelopment, Guidance for Developing a Security User Requirement Queensland Health, Asset Management Unit (2006) Guidelines for Condition Assessments, V1.1 Queensland Health, Design Standards Unit (2009) Employee Housing Design Standards and Guidelines Queensland Government – Guidelines for Managing Microbial Water Quality in Health Facilities 2013. Queensland Work Health and Safety Act - 2011 Western Australia Health, Facilities and Assets Branch (1998) A Private Facility Guidelines for the Construction Establishment and Maintenance of Private Facility and Day Procedure Facilities - 3rd Edition



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APPENDIX B TERMS AND DEFINITIONS Term Definition Accommodation brief The accommodation brief is a listing of the key functional rooms

and spaces and their number, which make up a department or facility. It is used at then strategic functional design brief stage.

Architect

An architect is trained in the planning, design and oversight of the construction of buildings and other structures.

Area (or space) A room, space or 'area' with a specific use. The area requirement may be enclosed or may be without walls as part of a larger area.

Area benchmark Prescriptive minimum or maximum areas. Building Code of Australia The regulation controlling construction of all building in Australia

and any subsequent or updates. Building performance evaluation A methodology developed to support the systematic evaluation

of health service buildings and facilities. Capital Infrastructure Requirements

Term used to describe the four volumes of requirements for Queensland Health Capital Infrastructure Planning and Design.

Capital infrastructure planning Determines the requirements of land, buildings, building services, equipment and site improvements (for example car parks) to support operational needs of health services now and in the future.

Circulation space The space required within a department or unit to enable movement and functionality between individual rooms/spaces for example the corridor that joins two rows of rooms or the entrance alcove to a room. Circulation space is nominated as a percentage of total usable floor area prior to the development of the design.

Clinical service units A service in the facility where clinical services are provided directly to patients. For example: • emergency • inpatient • interventional suites/perioperative • outpatients • ambulatory/day areas.

Clinical Services Capability Framework

A standard set of minimum capability criteria for service delivery and planning. The capability of any health service is recognised as an essential element in the provision of safe and quality patient-care.

Clinical support unit A service with specific design requirements that supports direct clinical care to the patient. For example: • medical imaging • nuclear medicine • pharmacy • pathology.

Commercial space The designated commercial areas of a site.



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Term Definition Commissioning – infrastructure There are two types of commissioning:

• Building commissioning – refers to the physical facility completion for occupation by the contractor. The activities include the successful running of all plant and equipment

• Operational commissioning – refers to activities undertaken leading up to handover of the building to the users. Typical activities include familiarisation of staff with safety, security and communications systems

• The main objectives of appropriately commissioning a facility are to: — ensure new facilities and equipment are ready for

occupancy and use, i.e. fit for purpose — ensure that the new equipment meets all government

legislative requirements — train staff in the operation of new equipment and safety

procedures — identify any minor defects which require rectification by

the contractor — receive all warranties and procedure manuals.

Commissioning - operational service

Operational service commissioning – refers to opening a service safely by Queensland Health staff.

Concept plan

The plan establishes the areas of a site/s where future development would occur (in line with service requirements). The plan incorporates: • service map with precincts identified for future development • service activity zones within a precinct for example

proposed uses, co-location proposals • main transport routes to the site and within the site • block drawings (at department level) of the proposed

buildings including scale and footprint. Condition assessment

The methodology employed to determine the condition of assets owned and maintained by an organisation or service. Accurate and standardised asset condition data enables asset managers to accurately target their limited maintenance funds to provide maximum user benefit.

Cost benchmark The cost model, based on real, similar facilities, used to evaluate project costs for a similar type of building.

Defect inspection An inspection that is undertaken to determine areas of non-compliance with the Building Code of Australia standards.

Design Development Design development includes: • completion of design in detail including architectural and

engineering design • confirmation that the design meets current government

policies. • confirmation of the cost estimate to demonstrate the project

is within budget • obtaining agreement or sign off from users.

Design principles The principles that govern how the elements of design are arranged within a composition for example facility.

Engineer

An engineer develops solutions for technical problems. They design materials, structures, machines and systems while considering the limitations imposed by safety, practicality and cost.

Expansion space An area nominated in the functional design brief to be included for future service delivery expansion.



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Term Definition Facility A complex of buildings, structures, roads and associated

equipment, such as a facility or healthcare facility that represents a single management unit for financial, operational maintenance or other purposes.

Feasibility Study

Evaluates options against a set of agreed criteria and presents : • a detailed analysis of a preferred facility development

strategya realistic estimate of the total project investment.

Final Business Case

A comprehensive analysis of the relative merits (financial and socio-economic) of identified options to determine the preferred option. The Business Case Report forms the basis for government approval of the project and the allocation of capital and recurrent funding to construct and operate the facility.

Fittings Fixed items attached to walls, floors or ceilings that do not require service connections, such as curtain and IV tracks, hooks, mirrors, blinds, joinery, pin boards.

Fixed equipment Items that are permanently fixed to the building or permanently connected to a service distribution system.

Fixtures Fixed items that require service connection (for example electrical, hydraulic, mechanical) and includes basins, light fittings, clocks, medical service panels. Not to be confused with ‘fixed equipment’, such as theatre pendants.

Floor plans Floor plans define the room layouts on each level/area of a facility.

Functional Areas Areas or zones within a clinical, clinical support or non-clinical support service for example the functional area of a clinical service may include the following: • main entry/reception/clerical area • assessment/procedural area • staff offices/administrative and management area • staff amenities area • inpatient area including outdoor areas.

Functional design brief

A description of the functions to be accommodated and the relationships between functions for a proposed capital project. The functional design brief should identify how the project meets the objectives and policies of the organisation.

Functional relationships The co-dependencies and interdependencies of areas within the facility as a whole, and of individual clinical, clinical support and non-clinical support services.

Functional spaces

The key functional spaces within a facility being: • clinical areas • clinical support areas • non clinical support areas • staff administration areas • multipurpose outdoor space • commercial space • circulation space.



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Term Definition Furniture, fittings and equipment (FFE)

FFE that are additional to the basic building structure. As per the AusHFG, FFE is grouped into categories as follows: • Group 1: Items supplied and fixed by the contractor. These

are included in the construction contract. • Group 2: Items supplied by the client and fixed by the

contractor. These include items that are transferred but require installation by the contractor, or where the client chooses to buy a piece of equipment and give it to the contractor for installation.

• Group 3: Items supplied and installed by the client. These include all moveable items that can easily be transferred or installed by staff and major items of electromedical equipment that are purchased from the project budget, but are installed and commissioned by a third party.

• Group 4: Consumable items purchased and installed by the client outside the capital budget. This category includes bed linens, foodstuffs and disposable supplies.

Future proofing The future functionality of the facility will not be unduly compromised by changes in models of care or service delivery or the advent of new technology.

Guidelines A collection of recommendations that describe an acceptable level of facility provision.

Handover The act of relinquishing property or authority to another; as, the handover of a building/facility to the client.

Handover manuals A suite of documents detailing what has been installed, the commissioning outcomes for all systems and the operational and maintenance requirements for the facility. Documentation provided includes drawings, commissioning data, equipment technical literature, maintenance programs and key contractor contacts.

Health facility planner A health facility planner undertakes area wide planning for health facilities or planning of a particular unit on the basis of projected consumer/client need. This does not include facility design and construction or architectural plans.

Health planning unit All the rooms, spaces and internal circulation that make up a particular health service department and that are necessary for that department to function.

Health service plan

Health service plans provide information on the current and projected health needs of a population, contain evidence based service models, and outline a process for change, including defined service goals, objectives and strategies. The health service planning process aims to ensure that health services align and grow with changing patterns of need while making the most effective use of available and future resources. Service planning must precede and inform other types of planning - including capital infrastructure, workforce and information management.

Health service planner A health service planner leads or works in partnership to develop strategic directions and service developments for a corporate entity as a whole, a facility or a clinical stream or service.

Health service planning activities Service planning benchmarks are used to determine future requirements to deliver health services. The utilisation of a planning benchmark is linked to the CSCF level of service. Queensland Health endorsed benchmarks are used for planning.



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Term Definition Hot floor The floor/s of the facility on which the technical suites are

located. Ideally on one floor but not always possible in a large facility.

Infrastructure assessment

An assessment of the suitability of existing infrastructure in the delivery of health services. It incorporates the physical and functional aspects of buildings and building services and equipment and includes: • building condition assessment including strengths and

deficiencies • assessment of current function in delivering health services

(for example role in service activities) and issues with the asset in performing the required function

• current use and potential capacity to meet service requirements for example frequency of use, purpose, changes over time

• rectification costs where required. Interior designer

Interior designers plan and detail building interiors for effective use with particular emphasis on space allocation, traffic flow, building services, furniture, fixtures, furnishings and surface finishes. They consider the purpose, efficiency, comfort, safety and aesthetic of interior spaces to arrive at an optimum design.

Land assessment An assessment of potential sites for the acquisition of land for a health facility. This assessment includes: • future expansion areas • access to road networks and public transport • issues such as urban design, town planning and cultural

heritage. Maintenance plan A schedules of activities required to service and maintain plant,

equipment and facilities. The maintenance plan will include preventative maintenance, statutory maintenance and condition based maintenance activities.

Master plan

A thorough investigation of a feasible range of facility planning options which meet the services needs/gaps, resulting in confirmation of the site location and a recommended plan for the future development of the Health Service/Agency, within a prescribed timeframe and estimate

Master planning Identifies a preferred infrastructure development strategy for the site to meet future service requirements. The plan includes: • future health service requirements • building condition assessment and site assessment • infrastructure assessment • schedule of accommodation • local and state planning requirements • environmental impact assessments • determination of open space areas • assessment traffic and roads on and near the site

including public transport • car parking • geotechnical analysis of the site • site development options and the preferred option • staffing of proposed development • category 2 cost estimate of the preferred option • risk mitigation and management plan.

Model of care

A description of how care is managed and organised, providing the clinical and organisational framework for the service.



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Term Definition Model of service delivery A description of how non-clinical support services are managed

and organised, providing the organisational framework of the service.

Multipurpose space

A category of space which can accommodate a range of functions including group meetings (staff or patient), multi disciplinary meetings and patient therapy spaces.

Non-clinical support units A non-clinical unit is defined as ‘a service that has specific design requirements, is essential to the functioning of a health facility but has no clinical or clinical support role’. Examples include: • building engineering management • food services • hotel services • security • supply • waste management.

Operational policies A statement outlining the objectives, principal functions and modes of operation of facility, a department, particular service or activity at a non-HHS level. At HHS level there are operational briefs and local work instructions/procedures.

Operational training Training that develops, maintains, or improves the operational readiness of individuals or units.

Patient journey A component of the facility model of care and in general terms means the following stages of the patient pathway or patient flow through the healthcare system: • access • diagnosis • treatment and intervention • inpatient-care • discharge • outpatients.

Performance audit A suite of documents detailing what has been installed, the commissioning outcomes for all systems, and the operational and maintenance requirements for the facility. Documentation provided includes drawings, commissioning data, equipment technical literature, maintenance programs and key contractor contacts.

Pneumatic tube system (PTS) A system incorporating a series of tubes through which cylindrical containers are propelled. Small bore PTS distribute pharmaceutical goods and specimens. Large bore PTS distribute waste and dirty linen to a central location.

Pod A group of core spaces. PPE Personal protective equipment includes gloves, gowns, masks,

aprons, caps, shoe covers and goggles. Principal consultant/consultants In most projects the principal consultant will be the architect.

The principal consultant is responsible for leadership of the consultant team. Consultants are responsible to the project control group to provide specialist expertise and advice in management, planning, design and construction. For large or complex projects, a project manager or director will be responsible for leadership of the consortia of consultants and sub-consultants.



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Term Definition Project Assurance Framework (PAF)

The foundation framework for ensuring that project management is undertaken effectively across the Queensland public sector, and delivers value for money to the government from its significant investment in project activity. PAF is a whole-of-government project assessment process that establishes a common approach to assessing projects at critical stages in their lifecycle. Its aim is to maximise the benefits returned to government from project investments.

Project brief The project brief is a document initially prepared on completion of PDP which summarises the client needs. It defines all elements of the project, states project and budget objectives, service delivery outcomes and can be used as a benchmark to measure quality outcomes at the end of the project5. It may be updated throughout subsequent stages of the project. The project brief includes the design brief, project procurement strategy, ICT requirements, project program, cost estimates and Prequalification service risk rating for the project.

Project definition plan Clearly defines the scope of the building required to accommodate services to be provided by a new facility. The PDP details options for operational policies, models of care and accommodation requirements in the new facility.

Project design brief Part of the project brief, the project design brief outlines planning and design principles, and the functional requirements of the project.

Project manager The project manager works with the procurement manager in managing the project on behalf of the project owner. The project manager's responsibility is to manage the scope, time, cost, quality, resources, communications and risks aspects of the project.

Project director The project director Queensland Health capital infrastructure projects, is the person who has the authority to run the project on a day-to-day basis on behalf of the project board (steering committee). The project director brings together and manages all aspects of the program or project to deliver within budget, time and scope.

Quantity surveyor (Aust. Institute of Quantity Surveyors)

Quantity surveyors are employed predominantly on major building and construction projects to estimate and monitor construction costs, from the feasibility stage of a project through to the completion of the construction period. After construction they may be involved with tax depreciation schedules, replacement cost estimation for insurance purposes and, if necessary, mediation and arbitration

Refurbishment Standards Australia defines this as ‘work intended to bring an asset up to a new standard or to alter it for a new use.'

Role delineation or matrix of services at a facility

In Queensland, role delineation refers to levels of service provision as detailed in the CSCF.

Room data sheets A briefing document providing information on the minimum requirements for each room in the facility incorporating room details, room fabric, fittings and FFE with associated services.

5 Queensland Government, CWMF, Policy for managing risks in the planning and delivery of Queensland Government building projects.



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Term Definition Schedule of accommodation A schedule of accommodation specifies the number and size of

rooms that will be required, the relationships between rooms and groups of rooms, the finishes, equipment, furniture that will fit the room for its functional purpose and the environmental conditions that will assist the purpose. Environmental conditions might include temperature range, humidity, air movement and acoustic isolation.

Schematic design

Preparation of design briefs and layout, including key physical elements, areas, locations, and volumes including basic building services systems and cost estimate.

Site assessment

An assessment of land and other property related aspects of a site/s to identify future development opportunities. The assessment incorporates: • site access such as roads and parking • access to building services, such as power and water • proximity to other health services • social and cultural aspects of the site such as suitability of

the development in relations to surrounding uses and impacts on neighbouring developments such as noise and traffic

• natural environment, including features and design opportunities

• statutory impacts, for example zoning, flood levels • sustainability of services during redevelopment • size of site, for example collocation and commercial

opportunities and public open space and future expandability

• physical attributes, for example geology, gradient and climate

• financial costs, for example demolition of existing structures, site preparation, water upgrade

• economic analysis, for example other land use options, impact on services

Strategic Business Case

This provides a preliminary justification for the program or project based on a strategic assessment of business needs and a high level assessment of the program or project’s likely costs and potential for success.

Telehealth Telehealth is the transmission of health-related services or information over the telecommunications infrastructure. As such, Telehealth includes both telemedicine, which involves providing clinical services remotely, and non-clinical elements of the healthcare system, such as education.

Travel The space that is required for the circulation of people and goods both vertically and horizontally in a facility. Examples include ramps, lift wells, links, tunnels, main corridors and detached covered ways joining two buildings.

Treatment area The Building Code of Australia defines this as: 'an area within a patient-care area such as an operating theatre and rooms used for recovery, minor procedures, resuscitation, intensive care and coronary care from which a patient may not be readily moved.'

Universal design

A non-discriminatory design approach that provides increased usability for everyone without the need for adaption or specialised design.

User

A user is defined as ‘those people who have experienced services (staff member, contractor, patient, relative or friend) or who could potentially access services provided by Queensland Health in the future.’



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Term Definition Wayfinding

Wayfinding is a methodology of arranging indicators such as signs, light, colour, materials and pathways to guide people to their destinations. A successful wayfinding program is intuitive and self navigable and it protects the overall visual integrity of the site. Wayfinding is specific to its place and visitors.

Wayfinding scheme

A wayfinding scheme is the term used to describe a wayfinding master plan which is discreet and separate from a capital works Master plan. As such it includes the consideration and development of all four elements involved with wayfinding in a single facility, the built environment, pre-visit information, signage system and staff instruction.

Wayfinding signage

The sign system used for effective wayfinding, including visual, tactile and auditory signage, designed to provide organised and timely information at key points around a site in a manner that should be accessible to and understood by all users.

Wayfinding system

A wayfinding system is more than just signs; it encompasses architecture, landscape architecture, technology infrastructure, lighting, landmarks and orientation points.

Workspace A desk area used for the purpose of administration duties, education and research.



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APPENDIX C DETAILED WORKFORCE PROFILE Whole of facility staff profile


Current no

people

Projected FTE 20XX

Projected no people

20XXNursing Executive Director of Nursing Grade 12 1.00 1 HHS Director of Nursing Grade 11 Director of Nursing Grade 10 Assistant Director Nursing Grade 9 Nurse practitioner Grade 8 Nurse unit managers/CNC Grade 7 Clinical nurses Grade 6 Registered nurses Grade 5 EENs Grade 4 ENs Grade 2 AINs Grade 1

Sub total Medical Senior staff specialist L29 Senior staff specialist L28 Senior staff specialist L27 Staff specialist L26 Staff specialist L25 Staff specialist L24 Staff specialist L23 Staff specialist L22 Staff specialist L21 Staff specialist L20 Staff specialist L19 Staff specialist L18 Staff specialist L17 Staff specialist L16 Staff specialist L15 Staff specialist L14 Senior registrar L13 Senior registrar L12 Senior registrar L11 Senior registrar L10 Registrar L9 Registrar L8 Registrar L7 Registrar L6 Registrar L5 Registrar L4 Resident medical officer L3 Resident medical officer L2 Intern L1

Subtotal Health Practitioner HP6.2 HP6.1 HP5.2 HP5.1 HP4.4 HP4.3



Page 83

Whole of facility staff profile


Current no

people

Projected FTE 20XX

Projected no people

20XX HP4.2 HP4.1 HP3.8 HP3.7 HP3.6 HP3.5 HP3.4 HP3.3 HP3.2 HP3.1 HP3.0

Subtotal Professional stream L6 L5 L4 L3 L2 L1

Subtotal Technical stream L6 L5 L4 L3 L2 L1

Subtotal Operational stream OO9 OO8 OO7 OO6 OO5 OO4 OO3 OO2 OO1

Subtotal Dental DS2 DS1 L4 L3 L2 L1

Subtotal Building engineering and maintenance HBEA 3 HBEA 4 HBEA 5 HBEA 6 HBEA 7 HBEA 8 HBEA 9



Page 84

Whole of facility staff profile


Current no

people

Projected FTE 20XX

Projected no people

20XX HBEA 10 HBEA 11 HBEA 12 HBEA 13 Engine driver Apprentice

Subtotal Management/Administrative L8 L7 L6 L5 L4 L3 L2 L1

Subtotal Non Queensland Health Service Providers Ambulance officers N/A Police officers N/A Volunteers N/A

Subtotal TOTALS 106.80 150



Page 85

APPENDIX D SUMMARY SCHEDULE OF ACCOMMODATION

FDB facility development schedule of accommodation

Net briefed department area

m2

Target circulation % Gross briefed

Department area m2

Room type Total

briefed area m2

Total no. of rooms


Occupancy

Functionaldescription

Comments

Main entrance and Public spaces

x m2 x x = x m2

Emergency Department

x m2 x x = x m2

Critical Care x m2 x x = x m2 Operating Room Suite

x m2 x x = x m2

Inpatient units x m2 x x = x m2 Ambulatory care x m2 x x = x m2 Clinical support units

x m2 x x = x m2

Non-clinical units x m2 x x = x m2 Outdoor enclosed areas

x m2 x x = x m2

Plant and travel allowance

x m2 x x = x m2

Total xxx x m2 Carpark

x m2

Date post:	16-May-2018
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QH CIR-Volume 2.3 FDB Specifications, Design brief … Health Capital Infrastructure...

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