Consider all the intricacies of planning, commissioning and building a new home, or renovating an existing one. Then imagine how much more devilish is the detail when applied to a hospital, one of the most complex public buildings, where mistakes have the potential to cost lives.

Health Projects International (HPI) is an Australian company that has applied its expertise in the planning, design and equipping of hospitals, medical centres, day procedure centres and other healthcare projects, not just at home but around the world. In the past year the company has opened branches in India, Hong Kong and Malaysia and recently walked away with a State Export Award in recognition of the demand for its services overseas, that now accounts for 50 per cent of its income.

For a relatively small company (there are 53 professionals working out of its Sydney-based headquarters), women make up a significant proportion of staff, particularly at a senior level, within HPI.

DIANNE BARTON is senior associate, health planner/nurse planner at HPI. Barton is a qualified nurse and midwife, originally from Yackandandah in Victoria, and, as the most senior healthcare professional, has a pivotal role in the organisation.

“I’m the interpreter,” she says.
“I transmit the hospital’s views to the architects and the architects views to the medical people – and you need to keep the language of both groups in your head. One group will call a basin a sink and the other will question why they want sinks everywhere!”

It’s one of Barton’s jobs to keep up with the latest developments in technology and trends in nursing care. “Nursing needs are very similar everywhere and surgery and medicine are driven by technology. So I read a lot of magazines and attend seminars on health planning. All the company reps are good at keeping us up to date with new technology as well.”

Barton’s senior nursing career segued into planning when she was taken on at the Royal Perth hospital, working on the development of the hospital’s new north block. After moving to Sydney to work on the commission for the St George Private Hospital at Kogarah, she left to join HPI in 1996.

The company’s move into the international arena in recent years has meant Barton and her colleagues have had to adapt rapidly to the way clients work overseas. “We learn on the job, talking to the hospital nurses, doctors and other staff. In the Middle East, for example, things that are appropriate to us are not appropriate to them. One of the significant differences that is culturally essential for them is the separation of the male and female areas. We have to duplicate a lot of service areas, which just means some of the departments are a lot bigger over there.”

Medical treatment is more family-centric in Asia and the Arab world, comments Barton. “When someone is sick they bring the whole family in to look after them, sit with them, just be there. So again, we need to provide enough facilities not just for the patient but also for the extended family, and that’s reflected in waiting areas, car parking and restaurants.

Barton says she has found clients in the Middle East to be very open-minded and receptive to the ideas and expertise of HPI. “The medical staff have generally been internationally trained in Europe and the UK and they are all very respectful and very appreciative of the input that presents them with alternatives to what they’re doing.”

A growing trend worldwide, says Barton, is the rise of “mediresorts”, providing services that blur the distinction between hotel and hospital. “It’s happening in the Middle East and Asia where international patients come for fly-in surgery. A patient who comes for a procedure may not be quite ready to go home, so they can move to the mediresort. It’s a hotel that has access to hospital facilities. They cater not just for cosmetic surgery but other medical procedures, too.” Currently HPI is working on plans to extend the Al Wasl Women and Children’s Hospital in Dubai that include a mediresort with 250 rooms, staff accommodation and royal quarters. While in Oman, the first medical tourism centre is underway, with a private hospital and specialist medical suite to stand alongside extensive leisure, shopping and entertainment facilities, set amid lush gardens.

 HAI SUN TAN is senior healthcare architect at HPI, and joined the company in 2001, straight from university in NSW. Hailing from Kuala Lumpur, she looks after the company’s projects in Malaysia and has worked on the Sunway Medical Centre and, most recently, the University of Malaya Health Metropolis.

Tan says designing a hospital is very different from the residential and commercial projects she worked on before joining HPI: “It’s almost like designing a small city, every corridor is like a street in a town.” Tan says HPI gets involved at a project’s inception, even before a site has been chosen in some cases, right through to the operational running of the hospital. “As consultant health planners we have specialists who can help a client assess whether the population in an area can support a private hospital, for example. We can help attract financial support, create a design and find builders as well as operational assistance.”

With people living longer in the developed world, the demand for more and bigger hospitals is growing, says Tan. “Hospitals, like schools, are something we cannot live without and capacity is getting bigger.” Developments in technology, too, are driving design, she explains. “There is always a need to constantly upgrade the facility, so one of the key design considerations is to allow for future expansion with flexibility built into the design.” She gives an example of a radiology department where equipment currently requires quite a large space. “That may not be suitable in 10 years’ time as the equipment may get smaller and smaller.”

People no longer look at hospitals solely in terms of a sickness says Tan. “Expectations are higher because people have more exposure to media, so they demand more from the service and the facilities. If you are going to a private hospital, you need your room to be top notch, very comfortable – a healing space.”

Outside spaces are an important part of the design, too, says Tan, particularly in Australia. “There’s demand for a lot of greenery and an outdoor garden: somewhere that patients and visitors can go to and walk around.”

Tan travels to Malaysia, where her parents still live, on average every two months for work. Speaking the same language is an obvious asset. “A lot of the time it’s about sharing useful information; there are things that they are doing better than us and vice versa,” she says. “Most of the time in Australia the clients know exactly what they want and the brief is very clear and makes the project happen. In Malaysia, because we are international consultants, they like us to improve their system more. It’s really the knowledge that they need from us.”

Tan says nothing is more satisfying in her job than seeing something that started life on a blank piece of paper, built and completed. “You always feel proud when you walk into a building and see the clients happy. That’s the most exciting part.”

RACHEL MARSHALL is HPI’s senior interior designer, who came to the company after a career working on residential and leisure projects. Moving into healthcare, she says, “was a huge leap”. One of her first assignments, when she joined in January 2006, was for Norwest Hospital and Marshall learnt quickly that the client isn’t one person, but many. “There are the people who run health departments and the people who work in those departments. A lot of opinions are involved.” In private healthcare there is usually a project management to bring together ideas, but in the public sector, says Marshall, it’s a lot more democratic and, consequently it takes longer to reach decisions.

To aid that process, Marshall and colleagues will create photo-realistic 3D renders of interiors for the client. “An operating theatre has to look just like the real thing from a doctor’s point of view, so equipment has to be spot on. It’s not an artist’s impression,” explains Marshall.

Interior design was all Marshall ever wanted to do when she started thinking about careers. Growing up in Scotland, her father was an architect and, after studying at Glasgow’s College of Building and Printing, she moved to London and worked for eight years before hitting the backpacker trail to Australia. Like many before her, she fell in love with the country and found a job in interior design working for Mirvac before joining HPI.

The company has tripled in size since she joined in 2006, a testament, she says, to the vision of the boss, Aladin Niazmand, whose passion for excellence in healthcare and dedication to their work has inspired a loyal following among his staff.

“If you want to work in healthcare, then this is the company to be in. Some of our jobs are amazing but also very challenging, throwing up things that you haven’t encountered previously.”

For the past 18 months, Marshall has been working on phase one of a public hospital in North Lantau, Hong Kong. “It’s a challenging project because they work really differently to Australia. For a start, they have more money to spend. So initially we spent a year working on a mock-up suites of 12 rooms including an operating suite that were exact right down to the ironmongery and paint colours.”

The advances in new technology in healthcare have a knock-on effect in interior design, she says. “We obviously pay a lot of attention to infection control so have to be very aware of any materials that are even slightly porous. We’re always trying to find new products that haven’t necessarily been used before. The materials that we use a lot of, floor vinyl for example, can be boring, so we push our suppliers to come up with new colours and styles.”

Marshall says that more hospitals, particularly in the private sector, are moving away from an institutional look. “You often hear the buzz word ‘hotels’. Practicality is first and foremost but there are spaces within hospitals that can be very patient friendly. Aladin is always urging us to research specifications of luxury international resorts, to look at the finishing and detailing. It’s about the journey through the hospital, not just for the patient but for visitors and staff.”

HPI won the Emerging Exporter Award at the 49^th Australian Export Awards in December 2011.