Finalist 2023

Victorian Heart Hospital

Conrad Gargett / Wardle

Architecture, interiors, facility and clinical planning consider the impact of the built environment on the health and wellness of users.

The Victorian Heart Hospital (VHH) is the southern hemisphere’s first dedicated cardiac hospital, providing a range of world-class clinical cardiology services, research and education. The architecture, interiors, facility and clinical planning consider the impact of the built environment on the health and wellness of users. The design and planning was guided by strong clinical and patient voices. This is a valuable place within the university campus and wider community with its capacity to save and change lives.

Design Brief:

The VHH was announced by Victorian Premier Daniel Andrews mid-2016, it was created to be the centrepiece of the Victorian Cardiac Design, Service and Infrastructure Plan (the Victorian Cardiac Plan), a bold vision for the future of Victoria’s health system. The scope of the project was to combine a centre of excellence with integrated clinical and scientific resources, facilitate world-class clinical research, advanced models of education and training and translating these developments into new, innovative models of care. The co-location of research infrastructure and biomedical engineering creates a hub for innovations around medical technologies and commercial partnerships. A shared vision for clients and stakeholders was the importance of design on the human experience for patients, visitors and staff, an empathetic design approach was undertaken. The VHH now co-locates important cardiac services such as the Victorian Heart Institute, the Monash Cardiovascular Research Centre and Monash Health’s Training, Education and Research programs.

This project was developed by:

Design Process

Key members of the design team, with Monash Health, visited cardiac hospitals in Singapore, Canada, the United States and the United Kingdom, for insights into the successes and shortcomings of these facilities.

Experiencing other heart hospitals allowed the team to challenge the norm of traditional hospital design and how to do things according to Australasian Health Facility Guidelines in the pursuit of innovation.

The design process was initiated with a project-wide design visioning workshop facilitated by former Harvard professor, Sarah Williams Goldhagen, an award-winning writer and lecturer on architecture and landscapes, cities and urban design, and infrastructure and public art. This workshop unified the clients, stakeholders and design advisors in a design vision that has led to a highly successful project outcome.

To ensure the vision was carried through to the built outcome stakeholder workshops, user group sessions and a design control group all had regular and rigorous involvement during the design stages. Design review presentations to a range of stakeholders were undertaken throughout the life of the design process. Regular Project Control Group reports and presentations ensured final design and relevant new information was incorporated into the project.

A complete journey has been embedded into the VHH, from admission to discharge. The design contributes to the wellbeing of all and aids patient recovery through its spatial qualities, amenity and materiality. The design provides spaces clinical in function and non-clinical in environment.

Landscaping within a health and wellness setting has well established clinical benefits. To sustain and extend the human experience of the VHH, the building has a large central courtyard—the ‘gravitational heart’—maximising opportunities for engagement with the outdoors and surrounding landscape.

The design incorporates an effective pathway for future staging and development, to unlock the opportunity potential for the Clayton Campus.

Design Excellence

Upon arrival at the VHH there is a sense of openness – the impression of a civic place rather than a hospital. The carefully crafted, warm interior palette incorporates natural timbers and earthy tones, drawing inspiration from the colours and textures of the surrounding landscape including the historic Matheson Tree – a grand 400+ year old River Red Gum that stands proudly at the main entrance.

The hospital’s design allows the working day’s activities to be seamless, its organisation is clear and legible. Equally important are the spatial, material, and ambient qualities which define the hospital’s character. Circulation corridors, both public and clinical, frame views of the courtyard, along with the outlook to the neighbouring sports fields and the Dandenong Ranges beyond, enhancing connections to nature and daylight. These are recognised as important factors in the recouperation of patients in hospitals.

A key factor in the planning of the hospital was the experience for staff ensuring that their needs were met for the range of work functions and non-work related, down-time situations. Such as quiet places to make calls or undertake study. The hospital reports that staff have responded extremely positively to the new work environment since opening.

A range of forms, colours and finishes imbue the exterior with a robust appearance that strives to be welcoming and reassuring. The progressive journey through the building gradually increases a sense of tranquillity in the clinical spaces, creating a calm, comfortable environment.

The striking weathered steel façade establishes the VHH as a landmark building on the Monash campus, gently nesting within the tree-lined landscape and providing protection from the sun. The perforated steel screen, which will weather over time, reduces the heat load to the building and minimises glare while still permitting views out. The diffuse natural light softens and calms the interior.

Design Innovation

The VHH has a clear agenda – the overlap of learning, teaching and research with clinical activities to foster a significant degree of collaboration. Strong vertical linkages between research and clinical levels foster collaborations between Monash Health and its research programs with Monash University. Colocation of the specialist research institutions at the hosptial provides extensive opportunity for medical entrepreneurship. The potential exists to identify a health need, create a solution, and commercialise it - all under the one roof.
One important advance is the ability from within the facility for students to observe live operations and clinical procedures from meeting rooms or lecture theatres and take this into teaching areas to debrief. Simulation of interventional procedures is another important teaching tool that is enabled at VHH.

As a place of work and treatment the design contributes to the wellbeing of patients, clinicians and staff and aids patient recovery through its spatial qualities, amenity and materiality. The design puts patients and staff needs at the forefront. Natural light permeates through the building, softening and calming the interior.

It's possible for cardiac monitored patients to move around inside and outside the building, which is unique and encouraged. Fresh air, natural light and engagement with the elements all contribute to recuperation. The building’s radial geometry, embracing the garden and punctuating the otherwise rectilinear planning also means the occupants can experience transition of day to night - something that some patients struggle to comprehend in traditional hospital settings.

The VHH will deliver life-saving diagnosis and treatment to thousands of patients each year. Patients will have access to clinical trials, expert care, and advice through the latest telehealth technology. Embedded cardiac research, education and training within clinical services will provide patients with cutting edge treatments of a global standard.

Design Impact

With an investment of $577m, the VHH employed 1700 construction jobs and it's expected that there will be 2150 cardiac surgeries and 108,000 consultations taking place in the next year. The hospital employs more than 850 people in clinical care and research. Patients have access to cutting-edge treatments thanks to the Monash Victorian Heart Institute hub for cardiac research, specialist training and patient clinical trials co-located within the hospital.

Ambulance Victoria data shows that every day around 19 Victorians suffer a cardiac arrest outside a hospital setting, and only one in 10 survive. The recently opened helipad will allow regional patients timely access to treatment.

The Department of Health estimates more than 300,000 Victorians live with heart disease – and with a growing and ageing population, this number is set to increase.

Embedding research and teaching in a state-of-the-art facility means patients will have access to cutting-edge treatment sooner. This is done by bringing researchers closer to patients and clinicians, enabling researchers to make discoveries and innovations sooner. The impact of these innovations is that they will be bought to clinic and/or market faster. This is of huge benefit to the community, state and Australia’s health outcomes.

The environmental impact of this facility was deeply considered. Using first principles such as passive design and selection of appropriate materials has created resilient and energy-efficient heating and cooling systems within the facility.

The hospital will attract the best cardiac health professionals in the world which will be a huge driver of success for the VHH. It will be a teaching and training hub for the country and offers places to 300 under grads, 260 post grads and 20 PhD’s across a range of healthcare disciplines. There are 206 beds for patient care. The VHH is a place that will change and save lives.

Circular Design and Sustainability Features

The energy efficiency and insulation performance of the hospital envelope has been designed to exceed the minimum requirements. Chilled beams have been adopted for conditioning of non-clinical spaces where possible as an energy saving and air quality initiative. This high performing envelope contributes positively to the thermal comfort of the occupants and is a key component of the project’s passive design approach.

The VHH has extensive in-ground tanks for rainwater harvesting, re-use and landscaping irrigation. Including an in-ground water detention tank integrated into the stormwater system that enables the design to meet best practice water quality pollutant removal. The design of the building is rotated to fit within the tree lines and to avoid excavation and removal of existing trees.

The materials palette for the hospital was selected with an emphasis on robustness. Importantly for the design was for the materials to display natural patina and weathering characteristics. Weathering steel was adopted for the perforated shading screen to reduce heat load and to minimise the use of energy intensive materials such as aluminium or zinc. Terracotta panels are integrated into the curtain wall system to maximise insulating properties and material content with a lower embodied carbon.

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