Developing a design for a new hospital

Ms. Siobhán Bonham described how, over the past two years, staff at the National Rehabilitation Hospital engaged in a programme of stakeholder engagement to enable them to create better and more user friendly design for the first phase of their new hospital.

Siobhán Bonham
Ms. Siobhán Bonham

The National Rehabilitation Hospital (NRH) is located on the outskirts of Dublin near Dun Laoghaire. The hospital provides complex specialist rehabilitation services at a national, regional and community service level for inpatient and outpatients who have acquired a physical or cognitive disability as a result of an accident, illness or injury and require complex specialist medical rehabilitation services.

This new building will be comprised of fit for purpose 120 single rooms with ensuite facilities, programme specific integrated therapy spaces on each ward, living and social spaces and ward clinical ancillary facilities.

The National Rehabilitation Hospital was delighted to welcome the announcement in May 2012, made by then Tánaiste, Eamon Gilmore T.D. and the Minister for Health, Dr. James Reilly, confirming a significant capital development on the campus of the existing hospital.

The brief for this project is to construct the first phase of a new hospital through the provision of ward accommodation with integrated therapy spaces. This new building will be comprised of fit for purpose 120 single rooms with ensuite facilities, programme specific integrated therapy spaces on each ward, living and social spaces and ward clinical ancillary facilities. Submission of a planning application was made with An Bord Pleanala in October 2014 under the strategic infrastructure development legislation. Following the successful grant of planning permission, a main building contractor will be appointed in 2015 and will construct the building with a target completion date of late 2017.

As a publically funded hospital the NRH operates on the ethos of providing high quality care and treatment to patients irrespective of background or status, but on the basis of clinical need. The hospital in partnership with the patients and families endeavors to achieve health and social gain through effective treatment and education of patients who following illness or injury, require dedicated interdisciplinary rehabilitation services.

One of the fundamental responsibilities of the NRH as an internationally accredited rehabilitation facility is to effect positive change in functional ability and independence and self-reliance across environments, while protecting and promoting the rights of patients. The new hospital design endeavors to create that environment, specifically to facilitate rehabilitation and its related service processes, delivered by an integrated team which includes the patient. Therefore the design of this development is patient centered and based on the principles of empowerment, dignity, privacy, confidentiality and choice.

The design of this development is patient centered and based on the principles of empowerment, dignity, privacy, confidentiality and choice.

Stakeholder Engagement

Key to developing a design which embeds customer quality into the building is through a process of continuous and wide ranging stakeholder engagement. The NRH health planning team has endeavored to understand what is important to our customers from a healthcare building perspective. Our customers are our patients both past and present, their families, our staff, external agencies and disability advocacy groups. Essentially, we have come to view a customer as any individual who will use the new building.

Over the past two years in preparation for designing the new building we embarked on a journey of learning. This required us to shift our thinking from viewing stakeholder engagement as a “requirement” and toward embracing stakeholder engagement as a step that will enable us to create a better and more user friendly design, inevitably leading to higher customer satisfaction.

Effective participation of stakeholders in the process requires meaningful engagement. We found that individuals will participate more effectively when presented with physical mock up environments which reflect the proposed design. Through the use of physical and visual representations of concepts it is easier for non-technical individuals to understand technical data such as size of rooms and configuration of equipment and assist with developing new workflows for operational processes.

Stakeholder engagement is a complex iterative process and creativity needs to be applied to the process of gaining insights and designing solutions together. There are challenges in obtaining quality information from stakeholders. An issue worth noting is that one stakeholder viewpoint is not representative, and in our experience, we have found that different stakeholders of the same ‘type’ have different perspectives.

Healthcare workers tend to become expert in stakeholder engagement, as it is required as part of their daily working practice. However, it would appear to be a skillset usually developed over time with experience rather than formally taught as part of initial professional education. Stakeholder Engagement is viewed in project management as a critical success factor for many projects or initiatives, as such a vast repository of literature and specific stakeholder management courses are now widely available for those interested in further developing their knowledge and skills in this area.

14 Easy Steps to improving your Skills for Successful Engagement:

  • Ability to listen without judgment
  • Ability to put your own perspective aside
  • Ability to show respect for opinions of others, even when they disagree with you
  • Comfort dealing with conflict
  • Belief that groups working together are smarter than individuals working alone
  • Open to feedback about self
  • Openness
  • Ability to balance participation of stakeholders with achieving results
  • Active listening
  • Flexibility
  • Ability to synthesise large amounts of diverse input
  • Ability to summarise
  • Knowledge of group processes
  • Ability to structure meeting to allow participants to focus on the substance of issue

Siobhán Bonham M.Sc RN, Project Manager, Health Planning Team, National Rehabilitation Hospital, Rochestown Avenue, Dun Laoghaire, Co. Dublin.