The Queen Elizabeth Hospital transformed its ageing block with a modern five-storey facility designed for efficiency, infection control and integration with South Australia’s green grid.
The Queen Elizabeth Hospital (TQEH), in Adelaide’s western suburbs, has long been a vital community health hub. But its mid-20th-century tower no longer met the needs of a rapidly growing and ageing population.
Built in the 1950s, with major expansions in the 1970s, it was beyond end of life. Faced with rising admissions and an expectation for modern models of care, SA Health saw an urgent need to replace the old structure with a purpose-built facility – committing $314 million to Stage 3 of the TQEH redevelopment, led by Built Environs.
The five-level Kangkanthi clinical services building, which opened on 3 July 2024, features a 46-bay emergency department, 12 operating theatres, a 14-bed intensive care unit, a 52-bed rehabilitation ward and four procedure rooms. The building also incorporates recovery areas, a central sterile supply department, a medical imaging suite, a cardiac catheterisation laboratory, a pathology laboratory and dedicated staff support spaces.
And it’s Australia’s first major all-electric hospital building.
Tony Jachmann, General Manager South Australia at Built Environs, explained the intricacies of the project, which has been nominated for the Australian Construction Achievement Award.
The decision to adopt an all-electric model for Kangkanthi was driven by rigorous life-cycle and carbon-footprint analyses, Jachmann said.
“Traditionally, on face value, the cheapest capital way is to have gas boilers and gas hot-water systems,” he said.
However, with abundant renewables such as wind and solar now feeding South Australia’s grid, there’s been a great push to make use of that electricity – reducing both operating costs and embodied emissions.
By shifting government assets away from gas and onto clean electricity, the project aligns with the state’s broader green-energy targets.
“Particularly hospitals, because they have simultaneous heating and cooling demands all year round to achieve tight temperature and humidity control of clinical spaces,” Jachmann said. “That is the biggest user of power.”
Designing for energy efficiency and infection control
Beyond its carbon benefits, the Kangkanthi building incorporates innovative destination- and tenancy-controlled lifts – another first for an Australian public hospital.
“Tenancy control provides separation for the staff and public movements within the shared bank of lifts, optimising the vertical movement of people through the building while maintaining the secure boundary between public and clinical spaces and preventing the mixing of staff and the public, and unauthorised access to clinical areas,” Jachmann said.
For improved infection control, the lifts are also single touch. And more efficient routing also means staff don’t stop on every floor. “For example, if you need to go to level three, it makes sure that the lift goes straight there.”
The same applies to bed movements, allowing clinicians and patient movements to be conducted in the privacy of their own space without having a dedicated lift.
“Traditionally, you’d have two more lifts in the building, which would be a huge capital cost,” Jachmann said. “Destination control and tenancy control allows a smaller number of lifts to be used far more efficiently.”
Meanwhile, to address airborne infection risks and stringent thermal comfort targets without relying on any on-site fossil-fuel systems, the hospital’s heating ventilation and air conditioning system was equipped with several cutting-edge features.
“Drawing on lessons from the COVID pandemic, key areas of the hospital have been programmed with a pandemic mode which can be activated at the press of a button,” he said. “So if you have someone come into a space with a highly transmissible disease, they’re able to push a button that purges the area – which is part of the longer-term thinking and lessons learned out of COVID.”
The facility also uses an all-electric thermal plant, selected for ultra-high efficiency. “We changed the low load chiller to a six-pipe unit, which provides simultaneous heating and cooling – improving the overall efficiency and redundancy of the system.”
By optimising chiller staging and leveraging the grid’s contracted renewable power, the design achieves tight temperature and humidity control while minimising carbon emissions.
Navigating green infrastructure upgrades
A significant upgrade to high-voltage infrastructure was critical for the all-electric design. The 1970s paper insulated cable was proactively replaced to prevent future failures and ensure uninterrupted power to life-safety systems.
“We have increased clinical capacity and bed numbers at the QEH so we need more power to support it. This growth to the site’s capacity necessitated HV upgrades, which make use of South Australia’s largely renewable grid,” Jachmann said.
For resilience, biofuel-enabled emergency generators were combined with centralised battery backup for critical clinical functions. The batteries sustain the building’s critical clinical functions while the generators are firing up to restore full supply.
“The generators [provide] a seamless transfer from emergency power back mains for the entire facility. The clinical teams don’t even know the change back has occurred as there is no interruption,” Jachmann said.
In an environment such as Adelaide’s, which has experienced blackouts in the past, this dual-layer approach guarantees uninterrupted power for critical clinical services.
The all-electric model also comes with significant economic benefits for the hospital, with cost savings in the order of $100,000 annually.
“The less money they’re wasting on energy bills, the more they can spend on doctors, nurses and other programs.”
Tackling brownfield complexities
Constructing a new building on an occupied hospital campus posed logistical hurdles for the team, with the site – formerly home to nurses’ quarters and a car park – undergoing staged demolition and remediation to maintain continuous hospital operations.
“We tie into the existing hospital on multiple levels, so we had the existing drop off that needed to be maintained at all times and we were also bordering a busy road,” Jachmann said. “So maintaining really strong communication with the hospital and keeping them informed of construction activities, and them keeping us informed of hospital activities, was a real strength of the project.”
Identifying and mitigating hidden site risks before construction began was also essential, given the potential for immovable elements on the brownfield site to derail the project timeline.
“There were some existing footings that couldn’t be removed from the old development,” he said. “But we were able to coordinate the new piles to suit the existing layout, which meant that we didn’t encounter any of the old piles.”
Then there was the task of tying the new structure into dozens of live services – from pneumatic tube systems to high-voltage cabling fire and security systems – requiring comprehensive, critical-work plans for every cut-and-tie-in.
On opening day, the emergency department was ready on schedule and reached capacity in just two hours.
Ultimately, the redevelopment increased annual emergency department admissions by 50,000 – nearly 1000 extra patients per month –while navigating COVID delays, global supply shortages and geopolitical pressures.
“I’m really proud of being able to deliver a job as complex as this on time under budget,” Jachmann said.
Registrations to attend the Australian Construction Achievement Awards 2025 are open until 31 July.
“Traditionally, you’d have two more lifts in the building, which would be a huge capital cost. Destination control and tenancy control allows a smaller number of lifts to be used far more efficiently.”
Sounds mighty fine…I am just wondering how the evacuation of patients is going to proceed in case of an emergency – like some fire in the building?