The Architecture of Care

A new acute services building as part of the $498m expansion and redevelopment of Flinders Medical Centre is being delivered by ARM in partnership with Studio STH for the Southern Adelaide Local Health Network, SA Health and Department for Infrastructure and Transport. This is a recap is by Philippe Naudin of a presentation by ARM’s Jesse Judd and STH’s Leah Salamon to the 2026 SA Major Projects Conference.

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Reframing Hospital Design Around Human Experience

Healthcare projects are among the most complex, scrutinised, and capital-intensive undertakings in the built environment. They are defined by program, driven by cost, and constrained by operational risk.

For all that complexity, why do we continue to frame hospitals around beds, departments, and throughput? Hospitals aren’t simply systems of care delivery; they are human experiences under pressure. And if we fail to design for that reality, we misunderstand the brief.

A Simple Truth We Overlook

On the Flinders Medical Centre Acute Services Building, we kept returning to a simple proposition: A hospital’s job is to move people from a horizontal state to a vertical state – and back out the door.

It’s a clinical truth. And also profoundly human. People arrive at hospitals at their most vulnerable. They’re disoriented, anxious, and often accompanied by family navigating the same uncertainty. Staff operate under sustained pressure, making critical decisions in compressed timeframes. So the real question is not just how efficiently we deliver care – but: How do we do it with dignity?

What’s in the Box?

At Flinders, the investment – approximately $500 million – needed to deliver immediate capacity, support existing operations, and set up the hospital for the next 25 years.

The Acute Services Building brings together:

• 64 new inpatient beds across two wards
• A new intensive care unit with an integrated CT suite
• Four operating theatres, including hybrid capability
• A day treatment unit and specialist services, including ophthalmology and podiatry
• Day of surgery admissions
• A new front-of-house entry and arrival sequence

Alongside this, a series of enabling works were critical to keeping the hospital operational:

• Expansion of imaging services
• Rapid delivery of additional beds within repurposed spaces
• Relocation of the main hospital entry
• Upgrades to essential back-of-house infrastructure – sterilisation, kitchen, mortuary

These are the components that keep the hospital functioning. Although rarely visible, they’re essential. The challenge wasn’t simply to deliver these elements – but to integrate them into a live, complex system without interrupting care.

From Infrastructure to Experience

Flinders Medical Centre is a quaternary hospital serving a vast and diverse catchment, extending well beyond metropolitan Adelaide. It is a campus that has evolved over decades, now moving toward 1,000 beds, layered with legacy infrastructure and continuous expansion.

Into this context, the Acute Services Building is not simply an addition of capacity.

It is an attempt to make a complex system legible, navigable, and humane – while being delivered within a live, operational hospital that cannot pause.

That tension – between complexity and clarity – is where the discipline of healthcare design is evolving.

The “Software” of Design

In major projects, we rigorously measure cost, program, and risk. These are essential. But they are not what determines whether a hospital actually works for people.

At Flinders, we deliberately elevated what might be described as the “software” of design – the qualitative conditions that shape human experience:

• How people orient themselves
• How they feel when they arrive
• How they connect with others
• How they find moments of relief

We structured this through a set of evaluative principles:

• Sociability
• Connection
• Sensitivity
• Positive distraction

These are operational drivers, not abstract aspirations. In healthcare environments, stress, confusion, and isolation are not incidental – they directly affect outcomes.

Why a Hospital Should Feel Like Home

One of the more provocative ideas we tested was that, in certain ways, a hospital should feel like home. Not literally, but experientially.

The most significant moments in life – birth, illness, recovery, end-of-life – are deeply personal. Yet hospitals often default to environments that are institutional, disorienting, and impersonal.

At Flinders, design responses focused on:

• Drawing natural light deep into the building
• Creating clear visual relationships between spaces
• Providing quiet areas for families and moments of retreat
• Modulating scale and volume to slow movement and reduce stress

These are fundamental moves to creating an environment where people can recover – physically and psychologically.

The Hospital as Workplace

As well as places of treatment, hospitals are places of work – and some of the most demanding workplaces in our society.

Healthcare staff operate under extraordinary pressure. Retention is increasingly difficult. Burnout is real. If we design hospitals that are efficient but exhausting, we will fail both staff and patients.

At Flinders, this translated into:

• Work environments with access to daylight and outlook
• Clear and efficient planning to reduce fatigue
• Spaces for retreat, reflection, and decompression

In this context, staff wellbeing is a core performance metric.

Building Within a Live System

One of the defining challenges of the project was not the building itself, but the conditions in which it was delivered.

The hospital needed to remain fully operational throughout construction. Critical infrastructure – entry points, imaging, sterilisation, kitchens – had to be upgraded or relocated without disrupting care.

This required:

• Careful staging across multiple live environments
• Early enabling works to create capacity quickly
• Strategic sequencing of interventions

More than simply form-making, healthcare architecture at this scale is about systems integration under pressure.

From Horizontal to Vertical Care

The Acute Services Building introduces a significant shift in how care is organised.

Traditionally, hospitals operate horizontally – distributed across large floorplates. At Flinders, care is stacked vertically:

• Surgery
• Intensive care
• Inpatient units

Connected by immediate adjacencies, patients can be moved from theatre to intensive care in seconds. Staff operate within tighter, more connected systems. It’s a reconfiguration of how care is delivered.

Wayfinding as Care

Hospitals are often disorienting places and signage alone isn’t enough.

At Flinders, wayfinding is embedded into the architecture itself through a narrative drawn from the geology and landscapes of Adelaide:

• Creek beds
• Grasslands
• Canopy
• Sky

These layers are expressed through material, colour, and integrated artwork, creating a legible sequence through the building for people to orient and develop a sense of where they are.

Designing with Kaurna Country

The project is located on Kaurna Country, which is fundamental context to how the building is conceived.

The design draws from local landscapes – creek lines at the base of the ranges, geological formations, and broader environmental systems – to create a building that is grounded in place. We see this reinforced through a curated artwork strategy, engaging First Nations artists to embed cultural narratives into the building fabric – through walls, ceilings, balustrades, and landscape. This approach moves beyond acknowledgment, and beyond the symbolic.

It’s about:

• Creating a sense of belonging
• Reflecting the community the hospital serves
• Supporting connection, particularly for Aboriginal patients and families

In a healthcare setting – where people may be far from home – this connection to Country is meaningful.

A New Definition of Success

Healthcare projects have traditionally been measured by:

• Delivery against budget
• Delivery against program
• Capacity outcomes

These metrics remain essential but aren’t sufficient on their own. The next generation of hospitals will be judged by:

• Patient experience
• Staff wellbeing
• Cultural relevance
• Long-term adaptability

In other words: Success will be measured not just by what a hospital does – but by how it makes people feel.

Designing for Dignity

The Flinders Medical Centre Acute Services Building reflects a broader shift in thinking about healthcare environments.

From:

• Infrastructure to experience
• Efficiency to dignity
• Buildings to places

The challenge for the industry is clear. We must design hospitals that recognise the full human condition, not just the clinical one.

Because ultimately, healthcare design is not about buildings.

It is about people –
at their most vulnerable,
and at their most resilient.