Living Tree Creates a New Kind of Patient Experience at Brisbane Hospital

The new Lady Cilento Children’s Hospital in Brisbane is the largest children’s hospital in Queensland, replacing two older facilities and bringing their staffs and services to a single 115,000-sq.-meter (1.2 million sq. ft.) hub of pediatric services for the state and region. Located in a busy inner-city neighborhood close to Brisbane’s Central Business District, the 12-story building is also linked to the former Mater Children’s hospital building, external parking garages, and the adjacent Centre for Children’s Health Research building.

Dotdash (Brisbane), a design practice specializing in wayfinding and visual communications in the built environment, worked with the hospital and its architectural team for more than seven years on the project, developing a comprehensive wayfinding system to guide patients and their families, visitors, and staff through the complex external and internal spaces.  The result is a clear information system that reduces stress and environmental graphics that add a sense of joy and vibrancy to the hospital. 

Navigating the tree
The hospital’s architectural design incorporates several research-based strategies shown to directly support patient health and wellbeing, including natural light, connections to the outside, and views of nature.

Clear wayfinding was another key factor, says Stefano Scalzo, principal of architectural firm Lyons (Melbourne), which teamed with Brisbane-based Conrad Gargett on the project.  The team envisioned a “living tree,” with a network of double-height spaces (“branches”) radiating from two vertical, light-filled atria (“trunks”). The branch spaces extend to form framing portals for views of key landmarks, including nearby parks, distant mountains, and the Brisbane River. The same windows allow views into the building, helping to demystify the hospital experience, particularly for children.

“The ‘living tree’ concept is both the wayfinding and planning armature of the building,” says Scalzo. “It evolved from our desire to create an architectural environment that supported ease of wayfinding for patients, parents, and visitors.” (The living tree structure also acts as a large thermal chimney, allowing the building to breathe naturally on temperate days, he adds.)

The sheer size and complexity of the building, its location in a busy urban neighborhood, its linkages to other facilities, and its vertical orientation were key wayfinding challenges, says Despina Macris,Dotdash director. Early and ongoing collaboration with the architectural team ensured that the building itself carries some of the wayfinding functions: areas of high-contrast color on walls and floors highlight key decision points such as elevator lobbies and entrances, and levels are identified with a palette of bold colors.

Dotdash augmented the architectural cues with a system of more than 1,500 wayfinding signs, from super-scaled, 3,800mm (12-ft.-high) sculptural floor identifiers to interior and exterior directionals for the hospital, parking garages, clinical areas, in-patient and outpatient wards, and back of house areas. The scope also included 3,500 room signs.

The core of the program, and one of her team’s biggest challenges, says Macris, was to visually communicate the hospital floor plan in a simple, legible graphic map. Used on floor identifiers and simplified on elevator directories, it illustrates the stacked color system designating floors and shows the hospital’s two major public elevator cores (the “trunks”) and the levels (“branches”) they service.

Australia’s ADA
Another major challenge in the project was how to provide wayfinding assistance to vision-impaired visitors within such a complex building, says Domenic Nastasi, Dotdash senior designer.

“A simple strategy was required, rather than installing a complex system of Braille and tactile signs and tactile ground surface indicators (TGSIs), which can add to the clutter and confusion.” The solution was to install Braille and tactile signs and TGSIs at key arrival point intercoms where vision-impaired visitors can access wayfinding assistance in a dignified manner.

All signs incorporate high color contrast and are located within clear visual zones, adds Nastasi. Braille and tactile room signs incorporating grade 1 braille (uncontracted) were installed for all sanitary facilities, hearing augmentation spaces, and public accessible rooms.

Australia’s Disability Discrimination Act (DDA), much like the ADA in the United States, requires public places to be accessible to people with disabilities. DDA and building code regulatory signs were developed in collaboration with access consultant Eric Martin & Associates.

In a project that spanned more than seven years and involved numerous stakeholder groups, Macris says coordination was a major undertaking. Working with the hospital’s user groups was a particularly complex challenge—but one that Macris and her team welcomed because it directly informed the design outcomes.

Through a series of workshops, the team first identified the primary user groups: young patients, their adult parents/caregivers, and the hospital’s new staff. They then identified the key challenges facing each group and discovered that high stress levels, emotional distress, and a sense of urgency were the top concerns, along with the age of young patients and visitors.

Information, and emotion
Both the client and the architects recognized that strong wayfinding was important in creating a place where patients and their families could get the care they need with as little stress as possible. The team also agreed that graphics could go a long way toward creating a positive, joyful environment. Having the opportunity to collaborate with both parties from the outset of the project was a big factor in its success, says Macris. “We all worked closely together to develop concepts for the look and feel of the wayfinding system, and we were able to help steer their vision.”

The result, she adds, is a system of clean, crisp graphics that are highly legible to eliminate confusion and a cheerful, vibrant aesthetic that lightens the experience of the facility for its younger visitors.

“The thrust of the project rested on developing a strong wayfinding strategy for a very complex scenario. Our environmental graphics solutions were first in response to the wayfinding strategy—information plus emotion.”


Client:  Queensland Health

Location:  Brisbane

Project Area:  115,000 sqm

Open Date:  November 2014

Budget:  AUD $1.2 billion (signage fabrication, $2 million)

Design:  Dotdash

Design Team:  Despina Macris (director); Domenic Nastasi (project lead); Erin Stromgren, Juri Yamamura, Keith Sullivan (design development); Heath Pedrola, Ida Molander (graphic elements)

Consultants:  Conrad Gargett Lyons (architects), Abigroup/Lend Lease (managing contractor), Aurecon (project manager), Eric Martin & Associates (access consultant)

Fabrication:  Albert Smith Signs

Photos:  Dianna Snape, Christopher Frederick Jones

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