New Royal Adelaide Hospital is open for business
UPDATE: The $2.3bn new RAH is officially open for business after a smooth start that saw no patients waiting at the emergency department doors — while down the road tears were shed as the old hospital shut for good.
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THE $2.3 billion Royal Adelaide Hospital has opened for business after a smooth start that saw no emergency patients waiting at the door when the emergency department opened to the public at precisely 7am.
The first “walk-in” arrived at 7.02am, a man dropped off in a car who was put into a wheelchair and taken inside, followed by three ambulance arrivals in the next ten minutes, which included a car rollover victim taken into a resuscitation unit and was in a stable condition.
Director of RAH emergency medicine Dr Tom Soulsby described it as a “gentle start” to the gleaming new facility.
However, at the old RAH there were tears of nostalgia, as well as smiles — even a game of indoor cricket — from long-serving staff. And there were plenty of ambulances right up until its ED closed at 7am, as the state’s former flagship hospital continued its tradition of service right up until closing time.
Heavy demand putting EDs into overcapacity “code white” status saw the Lyell McEwin Hospital, Flinders Medical Centre and The Queen Elizabeth Hospital all diverting ambulances to the old RAH overnight even as it prepared to close its doors.
At mid-morning there were 30 patients in its ED, who were expected to be transferred to the new facility by the end of the day, plus patients expected to be discharged today.
The transition phase saw full medical teams in the EDs of both facilities to ensure patient safety.
An uneventful day yesterday saw 131 patients moved to the new RAH — one more than anticipated.
About 102 patients are expected to be moved today and the final group tomorrow, in a rotation of 16 ambulances and the ambulance bus along North Terrace.
Staff are also moving as the huge new facility becomes fully operational.
The new hospital’s Mental Health Unit opened today, with one patient being transferred from the old facility.
Premier Jay Weatherill and Health Minister Jack Snelling joined medical staff and administrators at the ED to mark the opening.
Mr Weatherill said the transfer of patients was the largest seen in the state but was proceeding smoothly.
“A new era of health care in South Australia has opened with the opening of the new Royal Adelaide Hospital,” Mr Weatherill said.
Mr Snelling noted the hospital was the most advanced in the nation and a crucial part of the new Health and Biomedical Precinct, which could not have been achieved by upgrading the old site.
He said the opening was a “one-in-200-year event” and was cautiously optimistic with the progress of the move.
“I’m very very happy with where we are at — we expect to have all patients moved by tomorrow,” he said.
He also thanked staff at other hospitals who have helped shoulder the load while the old RAH emptied of patients in preparation for the move.
After a decade of controversy including a name change, cost blowouts and a 17-month delay in opening, inpatients can now enjoy modern facilities including single-patient rooms with ensuites, opening windows for fresh air and plenty of natural light through the building.
The fencing is down, staff are ready but officials are also asking people not needing emergency care to avoid the new ED, following interstate experience showing a “honey pot effect” attracting people with minor ailments curious about new facilities.
The ED will have 65 cubicles ready to treat patients from Tuesday with the ability to open up to 70 depending on demand, compared with 59 at the old RAH.
Staff are excited about the new hospital, including ED clerk Jason Spicer who starts his first day on the job on Tuesday following training, after switching from the oil and gas industry.
“It is a brilliant hospital and I am thrilled to be starting my first proper day on the actual day it opens,” he said.
Nurse educator Jessica Gannon spent 11 years at the old RAH and said staff were “incredibly excited” to be providing care in a cutting-edge facility. “This is leaps and bounds ahead of what we have been working in,” she said.
“Nursing staff have worked hard preparing for this and are excited to be able to put it into practice.”
ED site director Dr Megan Brooks said staff were fully prepared. “As emergency physicians, we expect the unexpected — we are fully prepared for any contingency,” she said.
“We are privileged to be working in this facility and want to thank the public for providing it so we can care for patients — we are ready to go.”
Dr Brooks praised staff at other metropolitan and nearby country hospitals who have helped shoulder the load while the RAH ramped down prior to the move.
The old hospital had been emptied to less than half its usual capacity, with 383 patients left on Monday morning prior to starting the three-day the move, including those due to be discharged rather than transferred.
The challenging task of shifting patients continues Tuesday and Wednesday after 131 — one more than the official target — were moved Monday in a fleet of 16 ambulances and the ambulance bus.
The first patient moved, Roselyn Katsikas, 56, who is being treated for Crohn’s disease, said the old hospital was “functional but tired” and she was looking forward to the new: “It sounds like a holiday resort,” she said.
People who arrive at the old ED prior to Tuesday’s 7am cut-off will be treated at the site and the ED is expected to be emptied by late afternoon. People arriving after 7am will find fencing, signs and staff directing them to the new site.
Extra staff have been rostered on to ensure full medical coverage at both EDs during this morning’s transition.
SA Ambulance Service chief executive Jason Killens said the first day of the move went smoothly despite some initial “lumps and bumps” with equipment which were swiftly resolved.
“We’ve gone pretty much to plan,” he said. “We are planning to move all patients by the end of the day on Wednesday,” he said.
This will include four patients flown to the RAH with burns after a car sprayed hot fuel over crowds at a burnout competition in Alice Springs.
The RAH, then and now
Dating back 176 years, the Royal Adelaide Hospital had modest beginnings befitting the colonial days. In 1856, major work began on the North Tce-Frome Rd site.
Tuesday’s historic opening of the $2.3 billion hospital demonstrates the stark contrast with those fledgling years.
BUILDINGS/KEY FACILITIES
THEN: The first Adelaide hospital in 1841 had accommodation for 30 patients in three wards, with no trained nurses. In the 1890s, a new operating block opened and work started on a new wing.
NOW: The $2.3 billion hospital will provide care to about 85,000 inpatients and 400,000 outpatients a year.
PATIENT ROOMS
THEN: Ward-based care. The six-bed Mercy Ward (pictured in 1895) had six post-operative beds and was part of an 1891 theatre block.
NOW: 700 overnight beds, each in single rooms with ensuites and a lounge that can be used as a bed for a carer to stay overnight. Plus 100 same-day beds.
OPERATING THEATRES
THEN: The 1891 operating block’s surgical table was described at the time as “the best of its kind” and the building was hailed as “one of the most complete ... in the world”.
NOW: 40 “technical suites”, all of them 65sq m. These suites include operating theatres, interventional cardiology and radiology rooms, along with diagnostic and interventional gastrointestinal and respiratory procedural rooms.
PATIENT CARE/TECHNOLOGY
THEN: Back in the 1890s, as in this photo, patients at the RAH would go out for an airing in beds, wheelchairs and on crutches in the hospital’s grounds.
NOW: Latest technology includes three new targeted radiation machines, valued at $3 million each, which provide high-dose cancer therapy to the millimetre. Advances also include robots transporting items such as linen and meals.
LANDSCAPE
THEN: In the hospital’s very early days, the nearby Botanic Gardens were suggested as a source of revenue — breeding leeches for sale. In 1841, the governor ordered about two acres of hospital gardens in which convalescent patients could work.
NOW: Landscaped gardens and courtyards are within two minutes of every room. The site has more than 100,000 trees and plants, along with than 70 themed courtyards and sky gardens across nine levels.
The proud history of the Royal Adelaide Hospital
1841 — The Adelaide Hospital opens near the corner of North Tce and Hackney Rd, housing 30 patients with room for an additional 10 beds.
1856 — The second purpose-built Adelaide Hospital opens on the now-old RAH’s site on North Tce.
1884 — Outpatient Block opens.
1889 — Nurse training begins.
1899 — SA’s first X-ray machine installed.
1901 — Telephones installed.
1904 — The original hospital building becomes the Consumptive and Cancer Home.
1922 — Electricity replaces gas lighting.
1925 — First direct blood transfusion given.
1938 — Institute of Medical and Veterinarian Science established. Original 1840 hospital demolished.
1939 — Granted “Royal” prefix.
1960 — First heart lung bypass operation performed.
1963 — Mass demolition of 47 1800s buildings starts to herald a new RAH. Male nurses employed.
1973 — Emergency Retrieval Service established, the first in Australia.
1980 — Radiology Unit established, requirement that nurses “live in” lifted.
1989 — Australia’s first Acute Pain Centre opens, Hyperbaric Unit established, a national record of 1052 open heart surgeries are completed.
1995 — Helipad opens
2002 — RAH is a designated centre to look after Bali bombs burns victims in Australia’s best burns unit.
2003 — New ED opens, the largest and most advanced in Australia, new critical care unit opens with 33-bed Intensive Care Unit.
2007 — Labor Government announces it will close the Royal Adelaide Hospital, replacing it with the Marjorie Jackson-Nelson Hospital on the North Tce railyards site.
2009 — Ms Jackson-Nelson has her name removed from the hospital because she did not want to be dragged into political brawling over the project, which will instead retain its RAH name.
2011 — Financial closure for Public Private Partnership to design and build hospital for $1.85 billion and annual service payments of $397 million annually over 30 years. First sod turned.
2016 — Original opening delayed and, eventually, pushed out to 2017.
2017 — Technical completion announced in March. Subsequent 90 days of testing confirm hospital ready for September opening.