What was the challenge?
Stage 3A was the biggest expansion in Latrobe Regional Health's history: 44 new inpatient beds, three new operating theatres, a new sterilising department, a resuscitation bay, more intensive care, maternity and special care nursery capacity, a 49.8% increase in the hospital's capacity. The build was funded and scheduled. The workforce to run it was not.
Recruiting in Gippsland is hard. Supplementary staff already made up 17% of the hospital's workforce, and the gap between the roster and permanent staff was running at more than 200 EFT. The executive needed to know, department by department and role by role, how many more people the expanded hospital would need, so recruitment could start years before the doors opened.
What did Health-e do?
Health-e profiled the hospital from July 2022, loading three years of payroll and rostering data and validating every department's profile with its manager. That gave a current-practice baseline, built with strict adherence to the Safe Patient Care Act ratios and the enterprise agreements, which became the comparison point for everything that followed.
For Stage 3A, Health-e worked from the functional brief and interviews with general and department managers on cost centre structures, skill mix, roster practice, activity drivers and future workflows, then modelled every affected department at full occupancy: the emergency department with its new resuscitation bay, the critical care unit at 16 beds, seven operating theatres, the new 32-bed orthopaedic ward, and the restructured maternity, paediatric and special care nursery services. Medical, allied health and support uplifts were modelled on activity.
The model also reshaped the organisation. Managers couldn't see service demand inside the single large cost centres for theatre and maternity, so Health-e proposed five new cost centres, separating the day procedure unit, recovery, sterilising, the orthopaedic ward, and paediatrics with special care nursery, so each could be recruited to and managed on its own.
Since then Health-e has built the hospital's budget every year from 2024, added shortfall reporting against budget in 2025, profiled every cost centre for the 2027 FY in April 2026, and in September 2026 briefed ward and unit managers on activating their budgets. Managers receive budget reporting every fortnight.
What were the results?
At full occupancy the Stage 3A model set the workforce for the departments in scope at 913 EFT, an increase of 248 EFT on current practice. Nursing carried most of it, with the critical care unit alone needing 32 more EFT and perioperative services 59. Junior medical staff rose by 27 EFT and senior medical by 13, allied health by 9.
Set against permanent staff, the model gave the hospital a recruitment target of 344 EFT, broken down by skill type: 229 nursing, including 112 registered nurses, 26 clinical nurses and 21 graduates; 74 medical; 17 allied health; and 24 support, including 13 instrument technicians for the new sterilising department. Each number came with the roster it was built from, so recruitment, training plans and the transition to the new building could be planned role by role.
Stage 3A was completed in December 2023 and declared complete by the Victorian Health Building Authority in March 2024.
What does this make possible?
An expansion can be staffed from a model built to the ratios and the agreement before a single position is advertised, with a recruitment target for every role and a cost centre structure that matches how the new building will actually run.
And because the same profiles carry on after opening, the hospital now builds its budget on them every year, reports shortfall against them every fortnight, and briefs its ward managers on them, so the expansion model became the operating model.