[COM] New Royal Adelaide Hospital | $2.1b

[Waewick]

it is going to be very interesting what we end up with.

if the state coffers start to get a bit tight I wonder how quickly we lose the looks

[Amused]

Good to see the plans for the new hospital. All I can say is kudos for some of the design concepts. I have a couple of concerns but mostly I see the designs as quite good.

The duplication of the radiology services to include inpatient and outpatient is a great idea. Assuming we've the staff to staff all of the facilities, we will see a drop in waiting times from this alone. What many don't know is that much of the wait can be the lengthy ques for radiology services such as xray or CT. To split these services so that emergency patients aren't waiting for scheduled inpatient services to finish will be great.

I LOVE the splitting of psychiatric services from the emergency department. It appears that psyche services will be around the back, have 4 cool-down rooms and it's own ambulance access. There's nothing worse than dragging loud and abusive individuals through a department of sick people.

There appears to be a lot more high acuity emergency beds, none of which seem to double as other rooms such as negative pressure rooms, psyche rooms etc, which cut down on high acuity rooms when these special cubicles need to be used. So overall, this is a good thing and means more beds available for real sick people.
There seems to be included a Rapid Assessment area which is good but from the designs it appears that there won't be restricted access to the nurses stations or the department itself which worries me a bit.

My other concern is that whilst the amount of resuscitation cubicles in emergency has been doubled, there appears to be a curtain for privacy instead of the existing hard doors at the existing RAH. This makes me wonder whether there will be X-ray facilities in these cubicles as there should be. What we should be seeing is slide doors on the front of the cubicles, and access doors between them. Why? Because short of having an X-ray machine in each room (Hey I wouldn't complain if there were) they're usually on ceiling mounted runners that span across multiple cubicles. The machine can't go through the wall without a door.
I appreciate that there is a radiology department just across the corridor, but sometimes its just an unnecessary risk to move patients away from hi-tech equipment of the resus cubicles. Hopefully there's a revisit of this design a little down the track.

The other section of the emergency department is a little harder to decipher. I would assume it is the low acuity/quick treatment area. I'm praying the west most access door in the ambulance area is actually direct access to negative pressure rooms. I had to laugh when we'd get into all of this protective equipment to receive a highly contagious patient. Security would close down the hallways and restrict access, fire doors would be closed, but as soon as you got the patient into the department, you had to take them through the heart of the department, past numerous other cubicles, staff and patients, in order to get to the negative pressure rooms. It was beyond stupid. Fingers crossed it's a negative pressure room/quarantine area that we're looking at there.

I've already discussed the value of single rooms.

Separate lifts for staff/patients and visitors will be great for patient privacy instead of having half a dozen strangers standing in the lift looking at the patient (fingers crossed they're longer than the current ones)

Can't quite figure out what the third lift type is for. No doubt service lifts. Also, assuming they go ahead with the service robots, they'll need their own lifts so they'll probably use those.

I couldn't decipher the basement areas either. I was looking in particular for the pharmacy as the plan is to apparently use automated distribution and packaging robots. Hopefully this will cut down on the lengthy wait times for faxed medication requests from wards.

2 chopper pads reduces the chance of staff having to do the more dangerous 'hot unloads.'

Anyways, these are the departments that I mostly specialise in so so far the plans earn a from me.

*edited for spelling*

[AtD]

^^ Thanks for that Amused, interesting read.

[Wayno]

Not sure of expected traffic volumes, but I hope the 2 entry points (eastern entrance on North Tce, western entrance on Port Rd) don't cause traffic congestion.

Traffic coming from West Tce and entering the hospital at Port Rd must traverse the tramline & oncoming traffic. Many cars destined for the hospital (again coming from West Tce) may find themselves in the wrong lane upon entering Port Rd and needing to slow down and quickly navigate across to the centre lane. Also, is the turning lane already in place? and isn't the tram line elevated? hard to picture how it will all work effectively.

[AtD]

Wayno: I'm not sure if I follow. The access from West Tce is directly though the Port Road / North Terrace intersection. All three entrances in the plan were built when the tram line was extended.

http://www.nearmap.com/?ll=-34.922145,1 ... d=20101213

[Wayno]

Wayno: I'm not sure if I follow. The access from West Tce is directly though the Port Road / North Terrace intersection. All three entrances in the plan were built when the tram line was extended.

http://www.nearmap.com/?ll=-34.922145,1 ... d=20101213

ah, i see that now. I was analysing page 18 of the traffic management plan (link below). It's a bit fragmented and i did not clearly comprehend the direct access via the North/West Tce intersection. I should have looked at nearmap

What still gets me is the 'right hand turn' lane into the western entrance from Port Rd. I thought the tramline was elevated at that point? Is there already a set of traffic lights in place at that junction? I suppose all traffic lights in immediate vicinity will be synchronised to limit the impact.

http://www.adelaidecitycouncil.com/adcc ... ssment.pdf

[Will]

I was having a read of the documents available for public consultation, and I was surprised to read that the new hospital will be 11 levels and 41m at its highest point, which is its northern facade.

I was quite surprised by this. Likewise, the new medical research building, will be 9 levels in height at its northern facade, which means that it could be 35m at its highest point.

As such, these buildings will make a significant impact to the Adelaide skyline, particualrly when one considers their low-rise surroundings.

[AtD]

Yeah, the lights and turning lane already exist (see Nearmap).

Although I do agree with your earlier point that the approach from the south (West Tce) is a bit confusing for those unfamiliar. It could do with better lane markings.

[skyliner]

I was having a read of the documents available for public consultation, and I was surprised to read that the new hospital will be 11 levels and 41m at its highest point, which is its northern facade.

I was quite surprised by this. Likewise, the new medical research building, will be 9 levels in height at its northern facade, which means that it could be 35m at its highest point.

As such, these buildings will make a significant impact to the Adelaide skyline, particualrly when one considers their low-rise surroundings.

Agreed. On closer inspection I noticed this too - I thought it would originally be 3 stories - could not figure out how they would fit everything in with a floor area like that. Good result. Impressive from the north.

ADELAIDE - TOWARDS A GREATER CITY SKYLINE

[rhino]

Yeah, the lights and turning lane already exist (see Nearmap).

Although I do agree with your earlier point that the approach from the south (West Tce) is a bit confusing for those unfamiliar. It could do with better lane markings.

I would suggest we are putting the cart before the horse here? Better lane markings will not be required until the hospital is built, surely?

[AtD]

Of course.

[Pikey]

I have changed this to SWP, as the railyards have started to be removed and preliminary surveying is taking place.

I also have been told that the rail yards will be completely empty and relocated by the end of Feb, how accurate that is, I can't guarantee.

[Professor]

Driving back from the Sting concert last Wednesday night (Ok - I could not resist it) there is a large lit-up railyard on the RHS of Port Wakefield road when driving into the city, when approaching Gepps Cross. It looks new and I think that's where the railcars etc will be "parked" from the time that they move away from the north tce RAH site.

PS the northern expressway is great. 1 hour from the carpark at the Tanunda venue down to the GPO!

[AG]

Driving back from the Sting concert last Wednesday night (Ok - I could not resist it) there is a large lit-up railyard on the RHS of Port Wakefield road when driving into the city, when approaching Gepps Cross. It looks new and I think that's where the railcars etc will be "parked" from the time that they move away from the north tce RAH site.

PS the northern expressway is great. 1 hour from the carpark at the Tanunda venue down to the GPO!

Yep, that site that you refer to is the new depot at Dry Creek that is waiting to be commissioned and replacing the current one.

[stumpjumper]

Today, the government announced that the new RAH project would not be subject to scrutiny by Parliament's Public Works Committee. In fact, as a PPP, all but the most basic details of the arrangements will be hidden for over 35 years by 'commercial in confidence' considerations.

PPPs have come under sustained attack from many quarters in recent years. Henry Ergas of Deloittes is a harsh local critic.

Note that I am not discussing the design or the need for the new hospital, but relaying expert comment on the method chosen to procure it.

Here are some of Ergas's views on PPPs:

"[PPPs] involve one group of people spending other people's money. When poor quality projects are selected, the community loses twice: scarce capital is wasted and taxes are required to fund these projects, imposing welfare loss.

''Even when a project is privately funded, as in public private partnerships, this does not reduce the social cost of bad projects . The result can be to create incentives for governments and infrastructure builders to collude in promoting projects that are privately profitable but socially wasteful, undermining the efficiency with which capital is used in the economy as a whole.

"The risks of poor quality assessments in general are compounded by the fact that there is little transparency in project appraisal - no jurisdiction systematically publishes cost benefit analyses and even when published, it is impossible to gain access to the underlying data. The situation is worse for PPPs, for which commercial confidentiality is used to limit disclosure.

"The whole exercise is built around the "public sector comparator" which purports to show the ''net present cost'' of the project if it were financed by the government so that if the PPP ''net present cost'' comes in below the public comparator, the difference is the saving that accrues to the taxpayer.

"Despite the high cost of capital inherent in the PPP model, the comparator always manages to show government financed infrastructure is more expensive over the life of the project because under the PPP model the ''risk'' burden is transferred to the private operators. The comparator exercise generates voluminous documentation, which is then presented to the relevant minister and cabinet's expenditure review committee, who would not have a clue what the information means unless they have a higher degree in mathematics.

"The process is described as being comprehensive and rigorous. It is neither, being best described as selective and self-serving to certain public/private interests.

The methodology and valuations developed in preparation of the public sector comparator would bear little resemblance to those used by the bidders in order to frame their responses to the project brief. Both the government and the market know the nature of the game and can depend on a ''friendly'' comparator that always establishes that the private sector alternative provides ''value for money''.

This hospital will cost far, far more than $1.7 billion.