Projects | Monash Medical Centre Emergency Department Expansion, Melbourne, Australia

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More people in Melbourne, Australia, now have access to the hospital care they need with the completion of the Monash Medical Centre emergency department (ED) expansion and refurbishment project.

The Monash Medical Centre emergency department is one of the busiest in the city and Victorian state government forecasts indicate it will experience a significant increase in presentations over the next decade due to population growth in the region. Before the project began, the hospital was recording more than 93,000 emergency department presentations each year. It is now estimated to be able to support 46,000 extra presentations annually.

Aurecon was appointed by the Victorian Health Building Authority (VHBA) as the project manager to help deliver this significantly larger and more contemporary emergency department, with dedicated triage areas for children, and a separate crisis hub for vulnerable patients.

The project has provided an additional 28 emergency department beds and a further 6 short-stay beds for patients who need extended observation. The redevelopment also improves access for ambulances arriving at the emergency department so that patients can be seen more effectively.

Delivering pandemic relief ahead of schedule

One of the most significant challenges encountered was overseeing the project through the COVID-19 pandemic. To ensure the hospital was able to treat and isolate patients presenting with symptoms, Aurecon designed and managed a temporary resuscitation unit for Monash Health.

The emergency department expansion project had to continue to ensure vital hospital resources were coming online for the future. Clear communication and robust protocols were paramount to ensuring the safety of workers to progress the site’s development. The project was accelerated to be delivered ahead of schedule in order to open and provide health facility relief for the pandemic response.

Staged construction

The project site was immediately adjacent to the existing main entrance, intensive care unit, operating theatres, ambulance access area, and Monash Children’s Hospital.

Therefore, designs were focused on ensuring the hospital and its emergency department could remain live and operational throughout the construction period. This included planning for disruptive works to be completed after-hours or around critical hospital activities.

Building new facilities within the footprint of existing buildings, while maintaining operations, considerably increased the project’s complexity and risk. To respond accordingly, the project was delivered in five separate portions and progressively handed over throughout the construction phase. Each portion was reliant on the timing and delivery of the previous, and the next, to proceed and maintain emergency access for patients, and uninterrupted medical services and care.

External works	Build temporary ambulance bays and entry to existing emergency department, condense existing emergency department, prepare fire separation between new build and existing facilities, identify and isolate services
Stage 1	Divert all emergency department traffic to one half of the site’s footprint (named ED South), build ED North
Stage 2	Reroute ambulances to new permanent drop-off bays, handover ED North to Monash Health for relocation and operation
Stage 3	Relocate all emergency department operations from ED South to ED North, build ED South including new main entrance for patient drop off
Infrastructure works	Associated infrastructure works completed such as road widening to include footpaths, new traffic light intersections, and back-of-house vehicle access including significant works to external main roads

Table 1. The Monash Medical Centre expansion projects was delivered in five stages to ensure minimal disruption to hospital operations.

Location

Woiworung Country
Melbourne, Victoria

Client

Monash Health

Partners

Victorian Health Building Authority (VHBA), Kane Construction

Aurecon's Role

Project management

Expertise

Program Advisory

Complete

2022

Improving patient and staff experience

Improving patient experience and quality of care was a key aim and outcome of the project.

To ensure this, the project team engaged with stakeholders and staff early who were connected to the project. Prioritising clear and open communication facilitated by regular reporting addressed concerns early and enabled efficient on-site decision-making. As stakeholders had visibility of construction works, this meant their feedback could be incorporated into the process.

The project team also engaged with the Australian Medical Association and the Australian Nursing and Midwifery Federation to maintain acceptable working conditions for doctors, nurses and other staff throughout the decanting, construction, and handover phases.

The Monash Medical Centre emergency department is one of the busiest in the city.

Taking new from old

One of the challenges of working with older buildings is the potential for discovering latent conditions that are unexpected. It was discovered that the routing of services was different to the as-built drawings the team had of the original building once the existing emergency department was divided into two parts with fire separation.

Strategies developed between Aurecon and the contractor immediately reduced the impact with a robust plan identified to reroute and relocate critical services for hospital operations to continue.

Benefits for patients

The expansion has improved facilities, introduced new state-of-the-art technology and equipment, and enhanced Victoria’s healthcare service delivery to meet the needs of growing local communities.

Healthcare professionals can better segregate adult and children’s care, provide dedicated treatment, and seamlessly transfer patients within the emergency department and to other areas of the hospital.

The project was a success due to the drive and ambition of each contributing organisation, to think innovatively during the challenging time of the pandemic, and remain focused on outcomes for local communities.