How to reinvigorate Sydney by improving hospital design

The poor financial performance and subsequent closure of 20 rural hospitals in the United States in 2020 was a wake-up call for hospitals around the world – many of which are facing similar challenges around staffing, budgets, and supply chains.

However for architectural company, HDR, the trend also invited an opportunity: to investigate the impact of design on organisational performance.

A study, documented in the book Rural Resolve, led HDR architects to ask the question, ‘What small changes can make a big impact to how hospitals perform financially – and better serve the communities in which they operate?’.

In answering this question, they generated eight ideas that Managing Principal Cate Cowlishaw says have important takeaways for cities around the world.

“Our research showed how, in a post pandemic environment, health facilities can play a key role in the creation of vibrant local centres, and inspire healthier, more fulfilled communities,” she said.

Ahead of The Sydney Morning Herald Sydney 2050 Summit, Ms Cowlishaw breaks these ideas down.

1. Reimagine Main Street

Situating hospitals in lively town centres will inevitably attract more pedestrian traffic, but it could also encourage other businesses to base themselves in the vicinity.

In turn, hospitals could be both a stimulus for, and a beneficiary of, population density – a key driver for their success, Ms Cowlishaw highlights.

“Relocating critical access facilities from the outskirts of town and turning them into a ‘civic anchor’ could give private hospitals increased financial security,” she said, ahead of her speech at the conference.

“With this method, hospitals are taking a broader, longer term view: seeing their role in the creation of a new, more energised town centre, from which they can also benefit from added custom.”

2. Redefine healthcare

Co-locating hospitals with fitness centres, yoga studios, and pharmacies can provide an attractive hub for people who are interested in wellness. In turn, it can also redefine people’s perception of the hospital experience and encourage usage.

“This approach is premised on the idea of the ‘whole being greater than the sum of its parts’,” Ms Cowlishaw said.

“Placing hospitals in wellness hubs encourages an association to be made between hospitals and wellness – a much more attractive proposition than a building associated with illness.”

3. Revisit outdoor amenities

Adjoining a park to a healthcare facility – or placing one on site – will reinforce this undertone of wellness, Ms Cowlishaw highlights.

“Access to high-quality parks and recreation spaces is associated with healthier living. Having them on site or in close proximity to hospitals will also improve patient experience,” she said.

4. Rethink indoor amenities

Introducing shared community spaces, such as auditoriums, meeting or theatre rooms, swimming pools, and basketball courts will boost community engagement with the hospital facilities and further fuel pedestrian traffic.

Ms Cowlishaw says this approach can also make resources go further.

“Hospitals could develop shared user agreements, enabling them to pool resources with schools, community non-profits and faith based organisations – a sensible strategy for those with constrained budgets,” she suggested.

5. Repurpose existing infrastructure

Prohibiting traffic on surrounding streets and repurposing the outdoor space could further energise the local area and encourage usage of the hospital.

“We started to see this trend emerging during COVID-19 and, in some areas, it had a really positive impact on local businesses.

“I think it’s a tradition that should stay. It would make hospitals appear more accessible to the community and attract greater volumes of people, as more flock to the surrounds,” Ms Cowlishaw said.

6. Refocus on education and tourism

Inviting guest lecturers to give educational talks – either in the hospital or other local facilities – could help position the area as an educational centre.

In turn, this could attract talent and entrepreneurialism, re-energising the local area and fuelling population growth.

“Densely populated areas inevitably mean more custom and greater economy of scale – so even indirect approaches like this can be highly effective,” Ms Cowlishaw argued.

7. Reinforce intergenerational connections

Improving access to hospitals for elderly citizens is a key way to encourage usage.

Where possible, Ms Cowlishaw recommends situating the hospital adjacent to, or in close proximity to, senior homes and retirement villages. Alternatively, improving access to transport networks that connect the two.

“This could improve the quality of life for thousands of residents and generate renewed activity for the hospital,” she said.

8. Reconsider what constitutes a healthcare facility

Leveraging the high community engagement that exists in places of worship and other public spaces is a great way to foster connection between local residents and hospital services.

Ms Cowlishaw says these places could be used as platforms for health education and screening.

“Places of worship are often thriving community spaces. Making use of these environments to share information on disease prevention, and promote and undertake vital health tests will mutually benefit the community and the hospital,” she said.

About HDR

With 11,000 employees across more than 250 locations, HDR is ranked #5 among the world’s design firms and #1 in healthcare design. In Australia, the Architecture Business specialises in Health, Education, Science, Civic, Justice and Defence and designs and delivers projects across a multitude of sectors at every scale, whether that be state-of-the-art laboratories, paradigm-shifting hospitals or healthy cities that act as antidotes to loneliness.

Within the practice, the Health sector has transformed hospitals from conventionally monolithic closed systems to major infrastructure and precincts, the Science sector has delivered highly adaptable education and laboratory research facilities that cultivate knowledge-transfer, and the Education team has democratised learning environments to deliver student-centred outcomes underpinned by diversity, equity and inclusion.

Key projects include Westmead Health Precinct Redevelopment, University of Sydney and Health Infrastructure NSW’s Sydney Biomedical Accelerator, CSIRO’s Australian Centre for Disease Preparedness, Chris O’Brien Lifehouse, Sunshine Coast University Hospital, University of Sydney’s Life, Earth & Environmental Sciences Building, Wollongong Central, and the Australian Defence Force Academy Redevelopment.

About Cate Cowlishaw – Managing Principal, HDR

Cate has over two decades of experience serving in leadership roles with global, national and boutique architectural practices. Having spent much of her career focused on business development and practice leadership, she has deep industry knowledge and extensive client networks across numerous markets. She was previously the Studio Director and Head of Business Development at Bates Smart before joining HDR as the Managing Principal. A member of the Australian Institute of Architecture, Cate belongs to the NSW chapter’s Gender Equity Taskforce and is passionate about designing high-performance buildings, delivering smart infrastructure and building strong communities.

Hear more from Cate Cowlishaw at The Sydney Morning Herald Sydney 2050 Summit. This year’s event will be held 15th May 2023 at the Sofitel Darling Harbour.

Joining Ms Cowlishaw on stage is the NSW Productivity Commissioner and CEO for Committee of Sydney. Learn more and register.