Healthcare Design - April 2020 - 14

R

OYAL MELBOURNE HOSPITAL in Parkville, Victoria,
Australia, had been delivering stroke care in an aging
hospital ward with semiprivate rooms and decentralized care services that weren't up to today's standards.
Furthermore, the space didn't provide the right setting for delivering a new treatment, endovascular
clot retrieval (ECR), which involves removing blood
clots within 24 hours of stroke onset and getting patients into high-intervention rehabilitation treatment to enhance blood
flow and stimulate the brain to make new connections. ECR has achieved
greater independence and fuller recoveries in those who receive it, but
the key to its success is getting stroke patients up and active as quickly as
possible-something that was difficult to provide in Royal Melbourne's
existing setting. "They lost potential recovery time in transit to other
departments for therapies like rehabilitation," says Mark Parsons, professor and director of neurology and head of the new stroke unit at Royal
Melbourne Hospital.
In 2017, ClarkeHopkinsClarke Architects (Collingwood, Victoria, Australia) began working with the hospital to design a new 31-bed stroke and
neurology unit designed to support ECR, renovating shell space on a floor
of the hospital's main building into the new 13,993-square-foot unit. The
goal was to create a space that allowed patients to increase their activity incrementally through varied rehabilitation activities that stimulate
blood circulation, brain activity, and overall recovery. The project team
proposed a central activity "racetrack" with wide corridors where patients could build up their stamina walking under the supervision of staff,
with subtle wall and floor markers to help monitor progress. Upholstered
seating areas around the racetrak provide place for rest as well as meetings or one-on-one therapy sessions.
A rehab zone and clinical and caregiver support areas are now centralized in the hub of the racetrack, housing therapies like playing Nintendo Wii to build up hand-eye coordination and exercising using gym
equipment. Patient rooms are located along the perimeter of the unit to
maximize access to natural light, which also helps stimulate brain activity. Because clear sight lines were imperative throughout since stroke pa-

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ABOVE: Staff reception is
designed to provide clear
sight lines through the
unit to allow unobtrusive
monitoring of the central
racetrack and rehab areas.
BELOW: Comfortable,
curved benches and
seating nooks around the
track offer spaces for rest.
These areas also support
interaction with staff or
family members and offer
surfaces to play therapeutic
card games or complete
puzzles.

tients are at high risk for falls, extensive glazing
is used in patient rooms and staff areas and can
be switched to opaque when privacy is required.
Decentralized staff workstations positioned
outside patient rooms also allow constant but
unobtrusive monitoring of the unit while improving staff communication and collaboration.
Guided by biophilic design principles, designers incorporated softly curved forms that mimic
natural shapes in the walls, seating nooks, bulkheads and flooring patterns to further promote
an active environment. "Hard right angles are
subconscious stop points," says Justin Littlefield, architect and healthcare leader at ClarkeHopkinsClarke Architects. "Curved walls and
fluid forms encourage patients to keep moving."
A color palette of deep blue, teal, and warm
grays for the upholstery and walls contribute a sense of calm to help keep the environment from becoming overstimulating,
which can bring on another stroke in recovering patients, says Nicholas Simmonds,
project architect at ClarkeHopkinsClarke
Architects. "It's a balancing act," he says. "We
used a very simple palette of materials, and the
forms with punches of color start to give a little
bit of stimulus back to patients without overstimulating them."
The new unit marked its one-year anniversary in February and is having a "massive" impact
on patient recovery, Parsons says. "More stroke
patients are being discharged directly home
who would previously have had to go on to rehabilitation," he says. "For the same length of
stay, patients have a much better level of function than they did previously."-Anne DiNardo,
executive editor

RHIANNON SLATTER

MONITOR

HCDMAGAZINE.COM
http://www.HCDMAGAZINE.COM
Healthcare Design - April 2020

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