The new Royal Adelaide Hospital: futuristic and state-of-the-art
The new Royal Adelaide Hospital (RAH), which opened in September 2017 in the city’s CBD, is arguably Australia’s most technologically-advanced hospital. From its fleet of robots (aka, Automated Guided Vehicles) that carry around supplies, food and equipment to its pneumatic tube automated internal delivery system, the 800 bed, environmentally-friendly hospital is a harbinger of the future of healthcare.
Article by: Judy Barouch
“Amazingly, in the past 50 years, only a handful of hospitals the size and complexity of the new RAH have been built from scratch,” says the Hon John Hill, who was South Australia’s Health Minister between 2005 to 2013 when the decision to build a new RAH was made.
“The old RAH was significantly rebuilt mid last century and adaptively renewed over time. Of necessity, facilities were added in ad hoc fashion, located where the site allowed. With this new purpose- built hospital, optimal design decisions were able to be made that allow for 30% improved efficiency,” he says.
In the new RAH, critical care areas have been “stacked” vertically for efficiency and to expedite what can potentially be life-saving time. On the western side, the Emergency Department is sited directly below floors housing pathology and blood transfusion, trauma and emergency theatres, the Intensive Care Unit and a helipad. Hot lifts connect these service areas. The ED features glass-enclosed, as opposed to curtained-off, cubicles.
Entry points and wayfinding
There are multiple entry points including the main entrance featuring a light-filled, two-storey glass atrium. Wayfinding touch screen kiosks at key locations provide maps and can print out directions. Their bent-knee design takes account of the wheelchair-bound. Additionally, the interior design employs different contemporary imagery and colours around lifts and adjoining public areas to provide points of reference; carried through vertically, each level is split into four or five distinct themes to aid visitors’ navigation.
Automated Guided Vehicles (AGVs)
Move over R2-D2 and BB-8: at the futuristic RAH, 25 stainless steel AGVs — measuring 1.7metres long x 0.62 wide x 0.34 high — transport supplies such as linen, pharmaceuticals and even meals along designated corridors. Inbuilt sensors allow them to avoid obstacles and they can “talk” to lifts. By reducing manual work and saving around 200 labour hours each day, they free up staff to spend more time on face-to-face patient interaction.
Automated pharmacy dispensing and the Pneumatic Tube System
The pharmacy dispensary is totally automated with Rowa robots loading,sorting and storing deliveries and boxing up medicines ready for delivery in order of expiry date. While checks on dosage/potential interactions are done electronically, pharmacists are on hand for double-checking.
The medications are delivered to biometrically-secured dispensing cabinets located in patient wings; nursing staff put in their ID and fingerprint for access. Whereas old- school hospitals store drugs in a stockroom with staff collecting the prescribed meds, this automated system helps eliminate human error in both manual dispensing and distribution.
In addition, medications and pathology samples are delivered from clinical areas to one of 74 stations. With 34 kms of tubing, items in the PTS travel at an astonishing six metres per second.
Items such as wheelchairs and blankets are tagged electronically so their whereabouts are instantly known. “In many hospitals, staff can’t easily locate equipment as it has been ‘hoarded’ in crammed storage areas,” Hill remarks. “Tagging prevents stockpiling and cuts down time wasted in the searching for items.” Even patients at risk of going AWOL can be electronically tagged and there is also a digital tracking system so medical instruments can be located quickly.
Total Lab Automation (TLA)
A fully automated microbiology lab for the processing of pathology and histopathology specimens is a game-changer. Samples are placed robotically into an incubator where they are photographed, and the results can be read digitally ensuring clinicians receive results around 40 percent more quickly.
Patient-centred and ‘green’ design
Most importantly, this state-of-the-art hospital contains no wards; all rooms feature a single bed with an ensuite, plus a daybed for a loved one. The single rooms are larger than is usual (18 to 21 metres) so that services such as mobile x-ray units, and health professionals, for example physiotherapists, can diagnose/treat in situ. This brings multiple benefits: privacy is ensured, potentially risky movement of patients is lessened and the possibility of infection is minimised.
At the design stage, care was given to optimising natural light throughout. Notably, patients’ rooms have windows that can open 30cm, with most rooms having an outlook across the hospital’s extensive gardens. With 70 internal courtyards, terraces and green spaces, including an Indigenous bush medicine garden, in tandem with the cutting-edge technology, it’s the nurturing, healing environment that very much sets the RAH apart.
Postscript: Best laid plans…
Despite high-tech bells and whistles, errors can still occur. On February 7th, during routine testing of the RAH generator system, a power outage lasting around 20 minutes affected two patients on the operating table and disrupted radiotherapy and dialysis treatments. At first, a single software fault was blamed but it now appears that the pump that feeds the fuel from the main tank into the smaller day tank that powers the generator, didn’t function correctly. Because of this, the day tank had insufficient fuel to complete the four-hour maintenance test and automatically switched to mains power. However, a second software glitch occurred at this point, with the generator unable to return to mains power, resulting in the outage. Evaluation of this failing is currently being investigated by an independent engineering firm.
You can find out more about managing blackout in the education session “What to do when the lights go out” and discover how technology is helping make buildings and facilities smarter at this year’s Total Facilities Expo at the Melbourne Convention Centre, 18-19 April 2018. Register online for free entry.
About the Author: Judy Barouch
Ever since she created her own pretend magazines as a girl, freelance journalist Judy Barouch has been passionate about writing. With a career spanning many years, Judy now specialises in authoring articles on residential, commercial and workplace architecture and design. She regularly contributes to leading newspapers such as the Sydney Morning Herald and The Age and their website sections including Domain and Executive Style. She also writes for national glossy magazines such as Australian House & Garden and Home Beautiful. And, as a self-confessed hypochondriac, she enjoys delving into health and wellness-related issues.