posted on 2011-11-11, 14:20authored byAmey Z. Sheth
The healthcare sector is mainly characterised by changing technologies, increasing market demands, social pressures, and political pressures. A significant amount of money has been invested by the Department of Health through the National Health Services (NHS), Private Finance Initiative (PFI), and Local Improvement Finance Trust (LIFT) to provide healthcare services. This has resulted in development of several new healthcare facilities. Since formation of the NHS in the mid 19th century, significant developments in medical technologies, and increasing health and safety and privacy related concerns almost every decade new approaches towards designing were observed. Thus, modern technologies (interoperable tools) and concepts such as Building Information Modelling (BIM), building simulation, healthy/sustainable facilities, healing environments and so forth have been incorporated and proved to be major catalysts for a change in overall design practices for healthcare. Despite significant investment and advancement in technologies, many existing healthcare facilities, even today remain significantly unimproved or inadequate when energy and overall performance is considered. It is, therefore, important to evaluate existing facilities and, consequently, refurbishment processes and tools for the same. This was the focus of this research.
Recently, energy efficiency and carbon emissions are considered major issues by industry and government because of increasing importance of environment and issues related to global warming, climate change. In 2008, existing healthcare facilities were responsible for over £410 million worth of energy consumption and 3.7 million tonnes of CO2 emissions. Considering the above mentioned issues, the government has imposed following two key targets especially for existing healthcare facilities; to achieve 55-65 GJ/100m3 energy consumption and to reduce the level of primary energy consumption by 15 per cent (0.15 million tonnes carbon from 2000 level) by 2015. Also, the literatures suggest these facilities are energy inefficient because their performance is unsatisfactory and they fail to provide comfortable environment for patients despite significant energy consumption. Thus, these facilities should be considered for refurbishment. Recent developments in the construction sector such as BIM based tools or tools that are interoperable can help the project team involved during a refurbishment of a healthcare facility to take decisions and maintain acceptable environmental quality during and post refurbishment. However, there are many ideas and methodologies proposed for development of new healthcare facilities, but the challenges in using these methodologies, such as BIM, energy simulation for refurbishment of existing healthcare facilities and above mentioned targets provided a base and context for this research.
The research used both primary and secondary data collection techniques, such as literature review, case studies and a questionnaire survey. The later phases of the research highlighted a clear need for immediate actions on existing healthcare facilities, if government targets related to energy consumption and overall performance are to be achieved. Thus, redevelopment of existing healthcare facilities to support the 21st century (modern) technologies to reduce environmental impacts and improved users' satisfaction was considered as priority areas. One of the key challenges for existing healthcare facilities is the presence of occupants during refurbishment in adjacent spaces, which may not be a problem for other types of existing buildings; there is also a lack of information on existing healthcare buildings.
The research findings revealed that refurbishment lacks broad perspective, for example, issues related to mechanical systems, aesthetic considerations and redesigning facilities have never been given a sufficient importance. A Healthcare Energy and Refurbishment (HEaR) framework and decision making process was developed as part of this research to enable healthcare organisations to adopt modern methods for re-designing of existing facilities, and to exploit refurbishment practices with consideration to energy consumption. The framework was validated by demonstrating it to professionals; experts from the industry.
Keywords: Building Information Modelling, energy, existing healthcare facility, framework, refurbishment.