Mobile Drive-Through Health Service

As a nation, we pride ourselves on a great healthcare system, with readily available support for in-need communities and efficient processes that deliver first-class patient care, but is that really the case? Dr Lance O’Sullivan thinks we do better.

Dr O’Sullivan had a vision; to create and construct one of the first real-world mobile drive-through medical clinics, creating a more efficient way to deliver healthcare to more people.

With the goal of increasing access to quality healthcare for all New Zealanders, Dr O’Sullivan sought help from Chow:Hill Architects to design a transportable clinic that can be retrofitted inside a 40-foot shipping container.

For Chow:Hill Architects’ director Stuart Mackie, this was a passion project.

“In parts of New Zealand, there is currently a real disconnect between the community and access to immediate healthcare, and Dr O’Sullivan is aiming to change that,” Stuart explains. “Chow:Hill jumped at the opportunity to help this cause, designing the mobile clinics that would facilitate quicker, more readily-available healthcare services in the more rural communities.”

Small Clinic, Large Challenges

Designing a clinic which moves easily around the country gave Chow:Hill the opportunity to put their experience with healthcare planning to good use. The brief was simple: fit two triage areas, a consultation room, waiting area, break-out area, and accessible toilet within a 40-foot shipping container. But there was a catch. The container must also be able to operate in locations with no electricity, water, and wastewater services.

“The challenge for any project with limited space available is agreeing with stakeholders what is a must-have and what is a nice-to-have,” Stuart explains. “The need for off-grid capability meant this had to be considered early in the design. We integrated the system into a dedicated services room at the far end of the container and included a generator, gas bottles, battery packs, solar system, air conditioning, and distribution board.”

Another aspect to consider was the waiting area. “We designed it using an inside-outside approach where patients have an area inside to wait, with the option to utilise a shaded deck outside. The deck, accompanying ramp, and solar panels are modular to allow for easy folding and packing inside the container during transport. A freshwater tank and wastewater system are also available allowing the container to be used almost anywhere in the country.”

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"As a design practice, we are well-known for large-scale healthcare projects and this offered a great opportunity to contribute at the tiny end of the range and at the grassroots community level."

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The Clinic in Practice

The container clinic works by having an off-site doctor overseeing multiple clinics, with nurses attending to patients on-site, either in triage or via drive-through window. Straight-forward cases are diagnosed by the nurse, and information for more serious cases is sent to the off-site doctor. A prescription is then issued if required and the patient collects this from the nearest pharmacy.

A unique operation, the mobile clinics have the capability to be both walk-in and drive-through centres. Nurse practitioners can conduct initial checks on patients and then, with the use of technology, including digital photographs, send their reports on to a doctor located anywhere in the country. While a doctor may get through around 15 patients a day in a typical surgery, this approach could allow for up to 100 reports being reviewed, with diagnoses sent back very quickly.

The Lending of Expertise

Following initial discussions with Dr O’Sullivan, it was decided the team at Chow:Hill would donate design resource, providing architectural support to the project. In January 2020, Stuart and Friedrich Strey from Chow:Hill’s Auckland studio began design discussion with the wider project team, working up a brief and the design for the mobile clinic.

“As a design practice well-known for its large-scale health care projects, this offered a great opportunity to contribute at the tiny end of the range, and at the grassroots community level,” Stuart explains. “In fact, Friedrich was in a unique position as his experience working on HIV container clinics in South Africa made him the ideal team member for this project.”

All parties involved in the creation of the mobile clinic, from Chow:Hill in its design, through to flooring suppliers, Jacobsens, donated either their time or resource to the project.