How can you get to 90% satisfaction when you never discuss 100% patient recovery? Unless of course you have bamboozled patients into accepting the tyranny of low expectations.
ClarkeHopkinsClarke's biophilic design at the heart of new stroke unit
Stroke is one of Australia’s major causes of death and disability, which is why an exciting new treatment called Endovascular Clot Retrieval (ECR) offered exclusively at the Royal Melbourne Hospital, is making news with its ground-breaking impact on patient outcomes.
ECR is a time-critical, technically challenging, high-intervention rehabilitation treatment that starts within 24 hours of clot removal, restoring the patient’s blood flow and getting short-term, high-needs patients up and active early.
Designed by ClarkeHopkinsClarke Architects, Royal Melbourne Hospital’s bespoke Stroke and Neurology Unit uses biophilic design features such as abundant natural light, soft curved forms, timber joinery and rug-like flooring, serene blue and warm grey seating upholstery and feature walls, and cosy nooks where staff, patients and visitors can interact and clinicians can observe incidental rehab activities or write up clinical notes.
According to project architect Nicholas Simmonds, the resulting calming, informal interior with elements of home naturally supports brain stimulation, physical activity and social connectivity.
“The environment needs to strike just the right balance in terms of stimulation,” says Simmonds. “If a stroke patient is over-stimulated that can send them into stroke again.”
Some of the design highlights of the new Stroke Unit include patient rooms located around the outside of the unit to capture natural light; previously decentralised rehabilitation services and new clinical and caregiver support facilities accomodated in a central hub; rooms and rehab linked by a wide circular walkway dubbed ‘The Racetrack’; and operable glazed walls and windows in High-Dependency Unit bedrooms switchable from clear to opaque when privacy is required.
The Racetrack is designed to create a light-filled, sociable space lined with deliberately non-clinical upholstered timber joinery seating. This space is very popular among staff, patients and visitors for all kinds of interactions, family visits and incidental rehabilitation.
The Racetrack gives staff clear sight lines and subtle wall - and floor-markers to help unobtrusively monitor patients’ progress, says ClarkeHopkinsClarke heath partner Justin Littlefield.
“Initially a patient might get up from a room opposite and just walk across the corridor. Later they might take shortcuts through the middle - there’s another seat on the opposite side of this central zone, so there’s another 20 steps or so that gets them to the next spot. Eventually they might go for a whole loop of one of these ends, which all vary in distance. We actually had a lot of fun designing for these changing needs.”
The design improves links to other departments, introduces teaching, training and research facilities that support patient care and staff development, and includes a higher proportion of single-bed patient rooms.
Commenting on the ‘massive’ impact of the design on patient recovery, RMH director of Neurology and head of the new Stroke Unit Professor Mark Parsons says, “We’re seeing patient satisfaction surveys of over 90 percent each month, and more stroke patients being discharged directly home who would previously have had to go on to rehabilitation. For the same length of stay patients have a much better level of function than they did previously. They’re able to go home and look after themselves rather than need further rehabilitation to get them to an independent level.”
According to Parsons, higher patient satisfaction and better recovery outcomes are producing huge savings for the hospital and the broader community.
“If you save one stroke patient from going to a nursing home you’re saving the community around $200,000 in the first year and $100,000 thereafter.”
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