Healthcare Buildings Research Articles

Health burden and costs attributed to the carbon footprint of health systems in the European Union

Abstract Background Health systems have an environmental impact of around 4.6% of global emissions, contributing to aggravating the climate crisis. However, the health impact of the carbon emissions originated by health systems is not regularly assessed. We aim to estimate the health burden and associated costs of the carbon footprint of health systems across the European Union (EU). Methods We calculated DALYs and associated costs based on human health damage factors (DALYs/kg-CO2e) by considering four scenarios. Three scenarios for shared socioeconomic pathways (S1 - high growth, S2 - baseline, and S3 - low growth) represented variations of global society, demographics, and economics until 2100. A fourth scenario (S4) considered the current EU’s 55% reduction goal of greenhouse gas emissions. The healthcare sector’s emissions per capita (in CO2-equivalent) in 2019 were extracted from the Lancet Countdown, and population data were retrieved from Eurostat for the same year. Results In the EU, 365,047 DALYs (95%CI: 194,692-535,403) are expected to be caused by health systems’ emissions at baseline (S2). In an S1 scenario, the burden would slightly decrease to 315,374 DALYs (95%CI: 170,355-462,393), whereas a S3 scenario would increase 486,730 DALYs (95%CI: 243,365-681,422). If EU’s carbon goals are met, the burden could be substantially reduced to 164,271 DALYs (95%CI: 87,611-240,931). The monetisation of DALYs can result in costs amounting to 25.6 billion euros. Conclusions CO2 emissions from health systems are expected to significantly impact human health. It is therefore of the utmost importance to ensure that EU climate policies for healthcare buildings are in line with the Paris Agreement. This will require the implementation of climate mitigation programmes within the health sector and a review of clinical practices at the local level. Key messages • The carbon footprint of health systems is estimated to significantly impact health, with high economic burden. • EU climate policies for healthcare buildings and procurement must be aligned with the Paris Agreement.

Effect of a participatory whole-systems approach on mortality in children younger than 5 years in Jigawa state, Nigeria (INSPIRING trial): a community-based, parallel-arm, pragmatic, cluster randomised controlled trial and concurrent mixed-methods process evaluation

In 2019, Nigeria reported the highest mortality rate in children younger than 5 years globally. We aimed to assess a whole-systems approach to improving child mortality in northern Nigeria. We conducted a community-based, parallel-arm, pragmatic, cluster randomised controlled trial in Kiyawa local government area, Jigawa state, Nigeria, and a concurrent mixed-methods process evaluation using ethnography and quantitative implementation monitoring. Trial clusters were population catchment areas of 32 government primary health-care facilities. Compounds were randomly sampled, proportional to cluster size, and all women aged 16-49 years and children younger than 5 years who were permanent residents were eligible for inclusion and recruited as the evaluation population. Children younger than 7 days were recruited but excluded from analysis. Evaluation clusters were allocated to intervention or control via simple randomisation with a 1:1 ratio. Cluster names were written on paper, folded, and placed in a container by community representatives. Different community representatives took out names one by one, with the first half assigned to receive the intervention. The intervention consisted of three components: participatory learning and action (PLA) groups for men and women (including compound heads [ie, the member of the compound that residents deemed most senior]), partnership defined quality scorecard (PDQS), and health-care worker capacity building; it was delivered from March 1, 2021, to Dec 31, 2022. We could not mask participants, field staff, or intervention-delivery staff to cluster allocation but baseline, endline, and follow-up data excluded information on cluster allocation. PLA groups involved separate groups of up to 25 men or women from all villages in the intervention clusters. The primary outcome was all-cause mortality in children aged 7 days to 59 months between Oct 1, 2021, and Sept 20, 2022, referred to as the evaluation period. The trial was prospectively registered (ISRCTN 39213655) and the protocol has been published. We recruited 3800 compounds at baseline, with 12 893 children contributing to analysis of the primary outcome (7316 [56·8%] of 12 893 in the intervention group and 5577 [43·3%] in the control group). 6617 (51·3%) of 12 893 children were male, 6275 (48·7%) were female, and one (<0·1%) child had missing sex data. Sampled compounds randomly came from 388 (91·3%) of 425 villages in the 32 clusters. We conducted verbal autopsies for 1182 deaths, of which 369 (31·2%) were children aged 7 days to 59 months during the evaluation period. Of these 369, 91 (24·7%) were classified as pneumonia deaths. Children contributed a median 361 days (IQR 236-365) to the analysis, with 369 (2·9%) of 12 893 children censored on their date of death, 1545 (12·0%) on their 5th birthday, and 3392 (26·3%) on the date of the most recent follow-up in which their residence or survival status was known. We found no significant decrease in all-cause mortality (hazard ratio 0·95, 95% CI 0·68-1·33; p=0·79) or suspected pneumonia mortality (0·79, 0·43-1·46; p=0·46) in the intervention group. The process evaluation showed low coverage and issues in reach of the intervention, but qualitative data highlighted mechanisms for positive effects on health and relationships. Our intervention did not affect mortality. However, due to the high child mortality in this region, further efforts should be made to adapt our participatory whole-systems approach to use communities of action within compounds. GSK and Save the Children UK. For the Hausa translation of the abstract see Supplementary Materials section.

Perspectives of Families and Healthcare Staff on the Design of Inpatient Hospital Rooms in Saudi Arabia.

Aim: This study aims to explore the relationship between the perspectives of both family members and healthcare staff regarding the design of hospital inpatient rooms. It investigates the impact of family presence on the healing environment and examines the influence of specific design elements within inpatient rooms on the extent of family presence. Background: The positive impact of family presence in healthcare settings is rooted in the notion that patients and their families are significant stakeholders in the care process. However, little is known about the influence of inpatient room design elements on family presence in healthcare settings in the Middle East. Methods: A questionnaire survey was conducted among 359 participants, encompassing patients, family visitors, and healthcare professionals from three hospitals in Saudi Arabia. The questionnaire items sought insights into the influence of design elements within inpatient rooms on family presence and the overall healing environment. Results: The results indicate a strong preference for single-patient rooms (74.5%), natural light (77.6%), comfortable seating (85.8%), and a family zone positioned by the window for unobstructed views of nature (50.5%). Furthermore, the study reveals that family presence is perceived to have positive effects on the healing environment (84.0%), patient safety (81.3%), and satisfaction with the care process (88.0%). Conclusion: This study proposes a design model for inpatient rooms that can effectively cater to the needs of patients and their families, thereby contributing to the overall improvement of healthcare building design.

The role of passive, active, and operational parameters in the relationship between urban heat island effect (UHI) and building energy consumption

The energy performance of buildings located in urban areas is strongly influenced by the UHI phenomenon, which usually leads to higher cooling energy consumption and lower heating energy consumption. Despite the known effects of UHI on building energy consumption, there is a lack of detailed knowledge on the role of building design and operational parameters in determining the effects of UHI on building energy use. To address this knowledge gap, this study analyzes the impacts of UHI on annual, heating, and cooling energy consumption of 16 prototype buildings located in 16 climate zones in the United States. The objective is to determine the relative relevance of building types (e.g., residential, commercial, healthcare facilities etc.), occupancy parameters (e.g., occupancy schedule) and the Heating, Ventilation and Air Conditioning (HVAC) systems in governing the impact of UHI on the building energy use matrices. Additionally, the thermal properties of the building envelope were evaluated to determine their relative importance in mitigating the effects of UHI on building energy performance. We found that, among the studies building types, while the cooling energy use of restaurant and outpatient healthcare buildings was most affected by UHI (higher cooling energy demands), the outpatient healthcare buildings were most impacted by UHI in terms of their heating energy use (lower heating energy use). The selection of HVAC systems type was found to have negligible influence on the energy impacts of UHI. Lastly, with regard to the thermal properties of the building envelope, window insulation was noted to be the most influential thermal property, followed by roof and wall insulation. Also, the role of insulation as well as other thermal properties was higher in the context of UHI’s impact on heating energy consumption as compared to cooling energy consumption. Not only are the results of this study useful for urban planning purposes to determine the vulnerability of different buildings to UHI, but they also are beneficial to UHI-resilient building designs.

BIM and virtual reality for pre-design evaluation of building performance

ABSTRACT This study aimed to assess the extent to which design errors that cause construction performance failures in healthcare facilities, typically identified in a Post-Occupancy Evaluation (POE), can be anticipated through Pre-Design Evaluation (PDE). The methodological approach involved comparing two case studies crossing results of a POE with walkthrough, questionnaires, interview, and checklist, and a proposed PDE using a checklist and simulation with an immersive virtual reality device. An exploratory study of POE and PDE, involving user participation in two healthcare facilities in Brazil, was conducted to validate the data. Diagnostic maps were created to assess the relationship between design issues identified in both POE and PDE. The findings indicated that many problems detected in the POE could have been foreseen through the proposed PDE model, with input from a limited number of expert users. Immersive virtual reality integrated with BIM workflows facilitates communication between designer and users, guiding the development of appropriate design solutions related to sizing, space functionality, and furniture and equipment requirements. The practical implications suggest that implementing the proposed PDE in future studies can help anticipate potential performance issues in healthcare buildings, leading to resource optimization and enhanced performance in the built environment. This study demonstrates the implementation of a PDE approach based on the principles of POE, integrating both technical expertise and user perspectives. It confirms that this type of evaluation can significantly contribute to the early stages of the design process.

A Multi-Stage Method for Spatial Demands Prediction in Healthcare Buildings

A Multi-Stage Method for Spatial Demands Prediction in Healthcare Buildings

A Comparative Study driven by Spatial Performance and VR toward Wayfinding in Architectural Space: Healthcare Buildings as a Case Study

Healthcare buildings can be complicated to navigate, causing patients to experience stress and lose time if not adequately planned. This study aims to identify the relationship between the spatial layout in healthcare buildings and wayfinding for users, by utilizing Behavioral Sequence Analysis (BSA) and Space Syntax through Immersive Virtual Reality (iVR). The methodology is based on behavioral and spatial data and was tested by using the experimental setups in VR environments. Space syntax analysis is applied to collect spatial data. Experiments were conducted by assigning wayfinding tasks in virtual hospitals with various plan configurations. Behavioral data obtained from BSA was associated with the spatial data driven by the space syntax analysis to gain a comprehensive understanding of the participants’ wayfinding behavior. The results indicate that the semi-centralized floor plan layout with high visibility levels performs better in wayfinding while the decentralized layout with low visibility values performs worse.

Thermal comfort in healthcare waste management buildings: insights from Seti Hospital, Dhangadhi, Nepal

Thermal comfort in healthcare waste management buildings: insights from Seti Hospital, Dhangadhi, Nepal

A Track Study of Sustainability Focus in East Timor

This paper discusses the role of international cooperation and aid in supporting sustainable development initiatives in Timor-Leste, focusing on the involvement of non-governmental organizations and governmental organizations. It explores the impact of international support in addressing challenges related to environmental conservation, healthcare, education, poverty alleviation, and capacity building. The limitations of external aid and future recommendations for promoting self-sufficiency and local capacity building are also highlighted.

260 Barriers to the Delivery of Obstetric Care Within Primary Health Centres (PHC) in India- a Scoping Review

Abstract Aim This scoping review aimed aims to identify challenges in delivering obstetrics care within PHCs in India, using the 6 WHO healthcare building blocks. Method A literature search covered PubMed, MEDLINE databases, and Google Scholar. Studies published from 2012 to 2022, discussing PHC-based obstetrics care in India, were included based on predefined criteria. Title, , and full-text screenings were conducted using Covidence, involving 2 reviewers for screening and 1-2 reviewers for conflict resolution. Data extraction on the 6 WHO building blocks was performed by 4 reviewers. Results Twenty-two studies were included for final review, mostly cross-sectional (59%), mainly from the state of Bihar (23%). Service delivery (77%) and health workforce (73%) were the most extensively discussed building blocks. Leadership and governance were the least discussed (14%). Challenges in service delivery encompassed limited antenatal care uptake, inadequate emergency obstetrics care and adjunct services, inadequate infrastructure, equipment and space and poor transport, and onward referral services. Health workforce issues included staffing levels and competency and training deficiencies in existing staff. Conclusions This review highlights significant challenges in obstetrics care delivery within Indian PHCs in India, primarily related to service delivery and health workforce. Our scoping review identified literature gaps within the four building blocks outside service delivery and health workforce, and geographical literature gaps from the Northeast of India. PHCs play a crucial role in the equitable delivery of obstetrics services that can reach the most underserved population across India. It is imperative that surgical and obstetrics plan strategies include primary care within them.

Too much ado about data: continuous remote monitoring of water temperatures, circulation and throughput can assist in the reduction of hospital-associated waterborne infections

National and international guidance provides advice on maintenance and management of water systems in healthcare buildings; however, healthcare-associated waterborne infections (HAWIs) are increasing. To identify parameters critical to water quality in healthcare buildings and to assess whether remote sensor monitoring can deliver safe water systems, thus reducing HAWIs. A narrative review was performed using the following search terms: (1) consistent water temperature AND waterborne pathogen control OR nosocomial infection; (2) water throughput AND waterborne pathogen control OR nosocomial infection; (3) remote monitoring of in-premises water systems AND continuous surveillance for temperature OR throughput OR flow OR use. Databases employed were PubMed, CDSR (Clinical Study Data Request) and DARE (Database of Abstracts of Reviews of Effects) from January 2013 to March 2024. Single ensuite-patient rooms, expansion of handwash basins, widespread glove use, alcohol gel and wipes have increased water system stagnancy resulting in amplification of waterborne pathogens and transmission risk of legionella, pseudomonas, and non-tuberculous mycobacteria. Manual monitoring does not represent temperatures across large complex water systems. This review deems that multiple-point continuous remote sensor monitoring is effective at identifying redundant and low use outlets, hydraulic imbalance and inconsistent temperature delivery across in-premises water systems. As remote monitoring becomes more common there will be greater recognition of failures in temperature control, hydraulics, and balancing in water systems, and there remains much to learn as we adopt this developing technology within our hospitals.

The Impact of Color and Texture on Wayfinding in Healthcare Building Circulation Areas

People's ability to perceive space is a consequence of their perception bonding with their surroundings, which allows them to communicate with space. Individuals see the physical components of the environment first, and then their behavior is shaped by their perceptions. People use the physical components of spaces as a point of reference when they are wayfinding in the circulation areas that link the spaces. In this context, users become stressed and lose time when navigating the circulation areas of large, complex buildings, which discourages them from using the space. The purpose of this study is to identify the colors and textures that influence how well people navigate around the circulation areas of healthcare facilities. The digital environment was used to model the Konya City Hospital's circulation area, which was identified as the sample area. A route was made, and the animation and three-dimensional visuals were produced based on the variables. Memorability and orientation decision levels were assessed in the context of wayfinding using the survey technique. As a result of the survey conducted on a total of 399 people, it was analyzed that people remembered the orange color and wood-textured surface coverings and requested orientation.

Assessment of healthcare buildings in terms of spatial requirements in disaster cases together with healthcare professionals: Adana city hospital emergency department during the Covid-19 pandemic

From the past to the present, various pandemics have affected societies to varying degrees, leading to changes in various fields such as social, cultural, and architectural aspects. In this context, the study examines the specific arrangements for the COVID-19 pandemic in the emergency department of a city hospital, conducted in January 2022. The aim is to develop a methodology for questioning the emergency department based on evidence and experience regarding flexibility, spatial adequacy, space organization, and isolation in extraordinary situations such as pandemics and to provide design input for the future. For this purpose, a questionnaire form and a space evaluation form were created. In order to benefit from field experiences, a survey form was administered to 137 healthcare professionals working in the emergency department who are directly affected by spatial design. The authors, who are architects, evaluated the space of the emergency department by filling out the “space evaluation form.” The findings were evaluated comparatively.The study found that the emergency department's spatial performance was adequate in terms of evaluations related to flexibility, spatial adequacy, and spatial organization but inadequate in terms of evaluations related to isolation. The design elements causing this situation were discussed. The aim is that the findings obtained will be data for hospital managers and designers in the design of future emergency services and the organization of existing emergency services.

Nanotechnology applications in interior design of hospitals to enhance thermal comfort and decrease the infection spread for the occupants

Background In healthcare facilities, the significance of sensitive architecture cannot be overstated. In regions facing challenges such as Egypt, the healthcare sector is grappling with deteriorating conditions. The design of hospitals is crucial for addressing the needs of patients with varying illnesses and for creating an environment that fosters psychological well-being. The interior design process, especially the selection of materials, plays a pivotal role in ensuring a hygienic and safe environment within healthcare facilities. Walls, floors, ceilings, and furniture materials are key elements that contribute to the overall design. A study was conducted to investigate the application of nano materials in healthcare facility interior design in Egypt. Methods The study involved first a literature review on nano technology and its application in healthcare interior spaces. It culminated in a framework and guidelines for nano materials in different hospital zones. The analytical part of the study analysed successful international examples, leading to a checklist of nanomaterials categorized by hospital zones. The third part involved a base case study in Alexandria, Egypt, simulating the impact of nano coatings on air temperature, radiant temperature, and relative humidity using the DesignBuilder software. Results The results demonstrated a positive impact on patient health and thermal comfort with nano materials. The use of nano coatings in interior design finishes resulted in decreases in air temperature, radiant temperature, and relative humidity. There was an average decrease of 12.3%-16.7% in air temperature, 3%-4.2% in radiant temperature, and 7%-12% in relative humidity throughout the year. Conclusions The study highlighted the effectiveness of nano technology in enhancing the interior finishes of healthcare buildings, leading to improved patient health, thermal comfort, and decreased infection spread rate. We provide valuable recommendations for optimizing material selection in existing hospital buildings in emphasizing potential benefits of nano materials in healthcare facility design.

Research needs for enhancing pre-occupancy evaluation of buildings

PurposeMany buildings fail to meet user expectations, causing a performance gap. Pre-occupancy evaluation (PrOE) is believed to have the potential to close the gap. It enables designers to obtain end-user feedback in the design phase and improve the design for better performance. However, PrOE implementation faces challenges due to still maturing knowledgebase. This study aims to understand the state-of-the-art knowledge of PrOE, thereby identifying future research needs to advance the domain.Design/methodology/approachA systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework was conducted. A thorough search in five databases and Google Scholar retrieved 90 articles, with 30 selected for systematic review after eliminating duplicates and irrelevant articles. Bibliometric analyses were performed using VOSviewer and Biblioshiny on the article metadata, and thematic analyses were conducted on their contents.FindingsPrOE is a vehicle for engaging building end-users in the design phase to address the credibility gap caused by the discrepancies between the expected and actual performance of buildings. PrOE has gained limited applications in healthcare, residential, office and educational building design for two broad purposes: design management and marketing. Using virtual reality technologies for PrOE has demonstrated significant benefits. Yet, the PrOE domain needs to mature in multiple perspectives to serve its intended purpose effectively.Originality/valueThis study identifies four knowledge gaps for future research to advance the PrOE domain: (1) developing a holistic PrOE framework, integrating comprehensive performance evaluation criteria, useable at different stages of the design phase and multi-criteria decision algorithms, (2) developing a mixed reality tool, embodying the holistic PrOE framework, (3) formulating a PrOE framework for adaptive reuse of buildings and (4) managing uncertainties in user requirements during the lifecycle in PrOE decisions.

Creation of a System of Cost Management Indicators for the Construction Investment Projects of the Green Healthcare Buildings

Introduction. Construction of the green healthcare buildings is a rather new and priority direction of construction in China. One of the key components of efficient implementation of the projects of green healthcare buildings is the cost management of a construction investment project. The projects of green buildings envisage the advanced technical content of a facility, a wide project scope and large number of participants. Therefore, the cost management requirements have to be more demanding, however, the traditional fragmented management fails to meet the requirements fostering the development of the green healthcare buildings. The present research investigates the issues of cost management of the green healthcare construction projects, analyses the necessity, feasibility, development trends and practical cost management problems thereof. The research strives to develop the cost management assessment indicators for all life cycle stages of the projects of green healthcare buildings.Materials and Methods. The research was conducted using such methods as the literature review and the expert interview methods. The expert interview method allows using the experience of experts from the related fields to assist in decisionmaking. Therefore, a questionnaire was developed as a part of the research.Results. Upon in-depth study of the various factors affecting the cost management of the green healthcare construction projects, the strategies and response measures have been developed based on the advantages and cost management features. By summarizing the cost management assessment indicators referring to implementation of the green healthcare construction projects and by combining the opinions of the experts and scientists from the related fields, the cost management assessment system for a project of green healthcare building has been created. The created assessment indicators make it possible to implement better control over the costs assigned to the green healthcare construction projects, elevate the level of project cost management, enhance the integrated benefits of the project and ensure the cost management and cost control for the similar projects.Discussion and Conclusion. The results of the research provide a theoretical basis for creating a cost management assessment system for the green healthcare construction projects aimed to solve the problems of cost management of the green healthcare buildings. The practical significance consists in providing a real practical approach to improving the cost management of the projects of green healthcare buildings.

Crafting Sustainable Healthcare Environments Using Green Building Ratings for Aging Societies

As global demographics shift towards an aging population, the need for sustainable healthcare environments becomes increasingly critical. This study addresses this imperative by examining the application of Green Building Rating Systems (GBRSs) in healthcare facilities, such as hospitals and nursing homes. It emphasizes the urgency of developing environmental assessment criteria specifically tailored for healthcare buildings to meet the challenges posed by an aging society. The research involved an extensive examination of a wide array of sustainability indicators from the literature, coupled with a Delphi survey involving a panel of 15 experts to guide the rigorous selection and validation process. The Analytic Hierarchy Process (AHP) was then applied to assign relative weights to each indicator, culminating in a specialized evaluative framework that includes 54 sustainability indicators across various dimensions. This framework is designed to support decision-making in the design process of new or retrofitted healthcare buildings, offering a comprehensive tool for creating sustainable healthcare settings. The findings and proposed framework aim to act as a reference for future development, supporting the creation of sustainable healthcare settings in Hong Kong and potentially informing similar efforts in other urban areas with similar challenges.

Building Information Modeling and Geographic Information System: Integrated Framework in Support of Facility Management (FM)

Currently, the management of public real estate stocks is one of the most challenging activities. In this case, facility management emerges as a strategic but complex discipline that requires a great amount of integrated and structured data and information of heterogeneous origin and nature. Starting from this premise, this paper focuses on how FM discipline can be supported by Building Information Modeling (BIM) and Geographic Information System (GIS) integrated methodologies and tools achieving high levels of effectiveness and efficiency in public building stock management. This led to the definition and development of a framework that mainly takes advantage of open-source tools (e.g., Quantum Geographic Information System—QGIS, and Dynamo) and non-proprietary data exchange formats like the COBie (Construction Operations Building Information Exchange) international standard. This methodological framework is capable of integrating different but strongly complementary tools, data, information, and expert knowledge for a multiscale approach. The methodology presented in this paper does not provide for an integral transfer of BIM data to the GIS platform but leads instead to an effective bidirectional integration between the two informative systems, by properly relating them and allowing for an easy switch from one system database to the other. The findings of experimental applications of the methodological approach to the former Macciotta pediatric hospital, a healthcare building owned by the University of Cagliari, are presented and discussed. Finally, the analysis about potentials and criticalities of the developed methodological framework aims to trigger the widest future development and dissemination of this research.

Fundamentals of cancer treatment service design: a guideline considering the healing environment concept

PurposeCancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem. Additionally, a considerable number of studies have introduced the ‘healing environment concept’ as a substantial input for healthcare buildings. The purpose of this paper is to present a design guide for cancer treatment services that is compatible with the healing environment concept.Design/methodology/approachIn this context, studies on the healing environment have been analyzed, and the legislation of some selected countries has been assessed. Then, all the filtered data are used to form the design guideline for chemotherapy department, radiation oncology department and inpatient care services under a new series of analysis criteria.FindingsThe resulting principles are revealed according to the criteria of general settlement principles, internal function relations, medical necessities, user experience, interior design, social interaction/privacy, safety, landscape design and outdoor relations by the help of proposed plans, diagrams and schematic drawings.Originality/valueThis research constitutes the first and yet only study in its field that aims to increase efficiency and user satisfaction and provide better patient-centered care while providing a design guide on health-care architecture.

Energy Measurement and Potential Energy Conservation Measures in Five Healthcare Buildings in Malaysia

Concern is growing around the world as a result of the global economy's overall rise in carbon emissions and energy consumption. The healthcare facility is among the buildings in the world with the highest energy use. Thus, it is necessary to create energy-saving plans that evaluate the energy performance of buildings and put energy-saving measures into practice. Enhancing building energy efficiency is most commonly achieved through a comprehensive energy audit. The Building Energy Index is the current method used to analyses all forms of building energy performance. The operating hours of a healthcare facility are longer than those of a commercial building. The issue emerges when there is no clear criterion for establishing whether or not a healthcare facility is energy efficient, and the present norm may misread healthcare energy consumption. To determine the actual onsite energy use at the healthcare building, a full energy audit is performed. Five places are selected based on the sort of healthcare services offered. According to the on-site complete energy audit, cooling equipment consumes the most energy. The study's findings may be divided into two categories: Healthcare Building Energy Index from detailed energy audit results and derived directly from power bills for the years 2018 and 2019. In terms of Healthcare Building Energy Index, there is a contrast between utilizing detailed energy audit data and using utility bills directly. Nonetheless, a comparison of Healthcare Building Energy Index with existing Malaysian requirements reveals a significant discrepancy. Based on the audit and analysis results, several savings opportunities may be presented.