Hospital Buildings Research Articles

Critical Egress Parameters Governing Assisted Evacuation in Hospital Buildings

This paper presents the critical egress parameters that influence emergency evacuation in a typical hospital building. A parametric study of a 20-story hospital building is conducted using a computer model “Pathfinder” to simulate the evacuation efficiency and assess the influencing parameters. The main egress parameters that influence the evacuation efficiency, including the location of stairways, number of stairways, location of the fire, exit width, and number of low-speed occupants are varied. Two scenarios are simulated: one being the regular (practice) evacuation drill and the other is the actual fire drill. The result shows that the location of stairways significantly affects the total evacuation time with the optimal stairway arrangement consisting of one stairway outside the core of the building. Similarly, the story level at which the fire occurs is another key parameter with fires at lower levels being critical to dictating the evacuation time in a hospital building. The total evacuation time when the fire occurs between the third and sixth floor is found to be 170 min which is 36% and 15% higher than fires at the top story levels (15–18th floor) and the intermediate story levels (9–12th floor), respectively.

APPLICATION STUDY IN CONSTITUTE THE TNTERIOR BNVIRONMENT IN LOCAL HOSPITAL

Architectural environment engineering and part of it is the interior design plays a great role in achieving trie recovery through the hospital building. The interior design in hospitals consirJered as a very specialization field .The aim of this research is to develop the interior treatment spaces in the medical buildings and make it looks more humanistic, through the deep study of the treatrnent efftcts of some interior design elements trying to appoint them in accordance to the people needs in our society in such buildings which represent the houses of mercy and recovery in their imagination which it's interior environment aims to achieving the human requirements for the users of its spaoes . The recenf research based on it's rvork the fleld study through choosing some of our local hospital also distribute the questionnaire to the users of these spaces in order to reach to the design decisions carne frorn the needs of the Iraqi people basing from our traditions which mustn't ignored when designing an interior environment in this building in order to overplus the psychological advocation of the patient and increase the performance ability of the medical staff

Performance assessment and improvement of district cooling system: A case study of enhancing energy efficiency of hospital buildings

In addressing the performance degradation issue of district cooling systems, although various evaluation methods exist, they either neglect design objectives or focus on independent equipment, overlooking the synergies between devices. Therefore, the study establishes a comprehensive performance assessment framework, encompassing efficiency, environmental impact, economic factors, and technological aspects. The Analytic Hierarchy Process (AHP) and Entropy Weight Method are employed to determine the comprehensive weights for each indicator. In a specific case study, the operational status of an existing district cooling system is assessed, considering collaborative interactions among equipment. A fault tree analysis is applied to scrutinize 13 potential events contributing to system inefficiency and their logical relationships with relevant parameter variations. Based on these findings, specific optimization measures, such as check valve replacement and adjustments to pump and fan frequencies, are recommended. The performance of the optimized system is then re-evaluated, demonstrating substantial improvements with comprehensive performance scores increasing from 18.3 to 27.8 and 29.5, respectively.

Study of Spatial Disorientation and Wayfinding Challenges in Buildings Using Axial Analysis: A Case of Hospital Buildings in Nigeria

All living creatures rely on spatial orientation to navigate through familiar environments. For humans, everyday activities depend on spatial orientation for navigating routes from outside locations to final destinations. The study suggests that the larger buildings get, the more the challenges of spatial orientation for their users. Likewise, building forms and configurations impact significantly on the course of wayfinding. In the case of hospitals, spatial configuration has been identified as significant in influencing human movements, performances of users and efficiency of services. This paper analyses the layout configurations of selected large hospital buildings in Nigeria using axial lines and relates the analysis with spatial orientation and wayfinding process. The aim of the study was to identify the extent of the impact of building layout configuration on spatial orientation and wayfinding process. The three large-sized hospitals selected for the study presented different scenarios which identified simplicities and complexities of building layout configurations as significant in the process of wayfinding. A comparative summary of the three hospitals in the study suggests that the less complex hospital layout presented the least spatial disorientation effect. This is mostly due to the linear sightlines utilized in the layout configuration design with fewer turns that enable visual connectivity to destination points thus indicating lesser challenges for wayfinding.

Computer-aided hospital layout optimization based on patient flow analysis: A case study from China

Chinese hospitals face challenges with overwhelming patient flow and efficiency. This study focuses on optimizing the outpatient building layout of a general hospital to reduce patients’ travel distances. Electronic medical records (EMRs) (N = 64,315) were analyzed using process mining and systematic layout planning to understand patient flows. Optimal path planning was then used to simulate travel routes and calculate travel distances. The existing layout was optimized using a genetic algorithm to minimize total travel distance for general patients, high-volume department patients, and those with mobility limitations. The final layout was selected manually considering relocation expense, local building codes and regulations, functional continuity, and design flexibility. The layout effectively met the optimization objectives, reducing total travel distance for general outpatients by 5.84%, high-volume department patients by 4.58%, and limited mobility patients by 1.90%. Additionally, the final layout demonstrates outstanding performance in spatial adjacency, site-building relationship, and flow disturbance reduction. This study proposes a computer-aided design framework to improve outpatient building renovations. Utilizing EMR data with a large sample size, it broadens the research scope, refines travel distance calculation methods, and includes practical architectural indicators for a comprehensive analysis. The novelty of the study lies in integrating the optimal path planning method considering travel costs of a multi-story building into the framework of Hospital Layout Problems (HLPs) based on Patient Flow Analysis (PFA), and incorporating the opinions of stakeholders at various stages of computerized design. The method offers the potential to enhance hospital building performance and efficiency with minimal adjustments to existing structures.

BENEFITS OF SADAQAH JARIYA IN A ISLAMIC RELIGION PERSPECTIVE

Sadaqah is any voluntary act of righteousness or kindness that is made with no expectation for anything in return. There is no minimum amount of Sadaqah that must be given and no requirement to give regularly. Sadaqah can be split into two further acts of kindness, Sadaqah itself, which is considered a short-term gesture and Sadaqah Jariyah, which is a gesture that gives long-term. There is no requirement to what you need to do to fulfil Sadaqah, meaning that something as simple as sharing your knowledge in Islam can be a gesture that continues to give. Sadaqah Jariyah differs slightly from Sadaqah. While Sadaqah Jariyah is still a voluntary form of charity like Sadaqah, it must have a lasting impact on the receiver. To that end, examples of Sadaqah Jariyah include planting a resourceful tree, such as fruit trees or contributing towards the building of water wells, schools, or hospitals . What's beautiful about Sadaqah Jariyah is, you can donate on behalf of someone, whether it's for someone alive or a deceased family member. For your loved ones, they will be rewarded in their graves and in the hereafter as if it was a deed they've performed when they were alive.

Multi-stage and multi-objective design optimization for improving resilience of base-isolated hospital buildings

The hospital is a critical infrastructure for treating the injured after the earthquake. The hospital is a complex system composed of structure, non-structural components, and medical equipment that are located on different floors, have different importance and seismic performance, and need different control objectives, enhancing any component could improve the hospital's functionality. It is imperative to economically and rationally choose enhancement measures to minimize initial functionality losses and improve hospital resilience. This study provides a hospital functional evaluation method that takes into account the physical dimension of the damage to the structure, non-structural components and medical equipment, as well as the organizational dimension of the treatment process of earthquake casualties. Bayesian networks and discrete event simulation methods are used to calculate the availability probability of medical rooms and the functional indicator of the number of earthquake casualties that can be treated. Then, a two-stage and multi-objective functionality improvement method was proposed to improve hospital functionality. The first stage is the design optimization of the isolation system with the objectives of minimizing the functionality loss and displacement of the isolation layer. The second stage optimizing the enhancement strategies for non-structural components and medical equipment aims at minimizing the functionality loss and enhancement budget. The proposed method uses a fast and elitist non-dominated sorting genetic algorithm (NSGA-II) approach to optimize the design of the isolation system and the enhancement of non-structural components and medical equipment. The method is applied to a hypothetical hospital to highlight the proposed method's capability of improving the hospital's functionality.

Innovative Models of Care for Hospitals of the Future.

New ways of providing acute care outside of traditional hospital building complexes, such as virtual care or hospital in the home, are becoming more common. Despite this, many hospitals are still conceived as "bricks and mortar" centralised constructions, and few health service infrastructure organisations meet intensively with consumers or clinicians prior to conceptualising hospital design. Our study sought to understand the needs and expectation of community members and healthcare providers, and co-design innovative models of acute care to inform development of a new metropolitan hospital in Australia. Our study used a three-step approach, consisting of academic and grey literature reviews; a demographic analysis of the hospital catchment population; and a series of 20 workshops and 6 supplementary interviews with community members and local healthcare providers. We found that care should be tailored to the healthcare needs and expectations of each consumer, with consumers cared for in the community where possible and safe. We propose an innovative model of care for hospitals of the future, consisting of fully integrated acute care underpinned by appropriate digital architecture to deliver care that is community focussed. It is vital that new hospitals build in sufficient adaptability to leverage future innovation and meet the needs of growing and changing communities.

Evaluation of Energy Renovation Measures for Hospital Buildings using the PSI Method

This study investigated the potential for energy savings and reduction in CO2 emissions in hospital buildings in Bosnia and Herzegovina (B&H), through the implementation of energy renovation measures. The building sector in B&H is characterized by significant energy consumption, and hospitals account for a substantial portion of the total energy consumption in public buildings. This study analyzes certain energy renovation measures for selected hospital buildings, including the installation of thermal insulation on exterior walls and flat roofs, and the installation of a photovoltaic plant on the flat roof. The Preference Selection Index (PSI) multicriteria decision-making method was employed to evaluate and rank renovation scenarios based on energy, environmental, and financial criteria. The results indicate that the most preferred measure is the installation of a photovoltaic plant on a flat roof, resulting in significant primary energy and CO2 savings, with an acceptable discounted payback period. The findings emphasize the effectiveness of energy renovation measures in enhancing energy efficiency and reducing the environmental impact of hospital buildings in B&H.

Nurse Scheduling Problem in Pandemic Situation: An Application in Ankara City Hospital

With the Covid-19 epidemic, which first appeared in China in December 2019 and affected the world in a short time, the importance of health is increasing day by day. The increasing importance of health in combating the epidemic causes an increase in the need for hospitals and health personnels. The health personnels that have the most role in this struggle are nurses. As nurses are mentally and physically healthy, it is possible to provide better service to patients. In this study, a goal programming model has been developed in order to make November 2020 shift schedule of 50 nurses working in 4 clinics in Ankara City Hospital's General Hospital building. While developing the model; hospital rules, laws, Covid-19 measures were taken into consideration. In addition, extra precautions have been taken for the special conditions of nurses and for nurses who are in the high risk group for the trans-mission of the virus. The optimal result has been achieved by writing the developed model into the ILOG CPLEX Studio IDE program.

‘Sick Hands, Thin and White, Were Always Slipping Offerings across My Windowsill, Offerings for the Little Birdlings’: Multispecies Encounters within and around Modern Rural British Sanatoria

The use of ‘open-air’ as a therapeutic agent in sanatoria, hospitals, and schools in the late nineteenth and early twentieth centuries led to the development of specific material features associated with modern design. By taking a sensory history approach which intersects with architectural and medical history methodologies, this article will use patient memoirs and oral histories of British experiences to explore multispecies encounters, particularly with birds, both within and around these clinical institutions. Medical concepts which prioritised the importance of fresh air and sunshine for prevention as well as therapeutic purposes led to architectural and design interventions for rural hospital buildings that encouraged windows and doors to be kept open at all times, as well as the construction of balconies and terraces onto which patients could be wheeled. This lack of firm architectural boundaries caused tensions for medical staff as it led to potentially unwanted ‘germ-laden’ species, such as birds and mice, to cross the institutional threshold into the clinical ‘germ-free’ interior. In turn, and often in contradiction to the concerns of medical staff, these multispecies interactions were sometimes able to co-produce a valuable sensory experience for patients, perhaps occasionally mitigating the difficulties and challenges of the modern, clinical setting.

Assessment of mould remediation in a healthcare setting following extensive flooding

A new hospital building was close to completion when a large pipe carrying clean water broke, causing extensive flooding. To determine the flood-associated fungal risk to susceptible patients who would use that building. Though standard flood remediation by the builders was relatively straightforward, there was no model for specialist assessment of patient risk due to the flood-associated mould growth. As levels of background airborne fungal spores can be expected to vary significantly over time, we could not use absolute levels to indicate either an excess of airborne fungal spores or successful remediation. Therefore it was decided to use weekly settle plates, exposed at the same time in flooded (test) and equivalent non-flooded (control) areas to compensate for variations in background levels. Flood-related risk was estimated by the ratio between fungal colonies on the test and control sets of settle plates, rather than absolute number. Whereas the physical flood remediation, including the use of 'anti-fungal' treatments, was completed in three weeks post flooding, fungal contamination in flooded areas took 38 weeks to return to control levels and remained so for a further six weeks of observation. By the use of this method, we were able to assure the absence of flood-associated fungal risk to susceptible patients who would use that building. We recommend that infection prevention and control teams consider using this approach should they be faced with similar situations.

Prevention of legionella infections from toilet flushing cisterns

INTRODUCTIONImmunocompromised patients are at an increased risk of severe Legionella infections. We present the results of an outbreak investigation initiated following a fatal case of hospital-acquired legionellosis linked to contaminated water from a toilet-flushing cistern. Additionally, we provide experimental data on the growth of Legionella spp. in flushing cisterns and propose a straightforward protocol for prevention. METHODSWe monitored the growth of Legionella spp. in the building's hot and cold-water systems using quantitative bacterial culture on selective agar. Molecular typing of L. pneumophila isolates from the infected patient and the water system was conducted through core-genome multilocus sequence typing (cgMLST). RESULTSLegionella contamination in the hospital building’s cold-water system was significantly higher than in the hot water system and significantly higher in toilet flushing cistern’s water compared to cold water from bathroom sinks and showers. Isolates from the patient and from the flushing cistern of the patient’s bathroom were identical by cgMLST. In an experimental setting, daily toilet flushing for a period of 21 days resulted in a 67 percent reduction in the growth of Legionella spp. in the water of toilet flushing cisterns. Moreover, a one-time disinfection of cisterns with peracetic acid, followed by daily flushing, decreased Legionella growth to less than 1% over a period of at least 7 weeks in these setting. CONCLUSIONSOne-time disinfection of highly contaminated cisterns with peracetic acid and daily toilet flushing as short-term measure can significantly reduce Legionella contamination in flushing cisterns. These measures may aid in preventing Legionella infection among immunocompromised patients.

Preferred Seismic Performance Attainment in Important Buildings

In the aftermath of earthquakes, hospital buildings are expected to remain occupiable to treat the injured. For the purpose, firstly, an appropriate structural system that ensures no or limited structural damage should be provided in such buildings; wall-frames are the recommended structural systems in hospital buildings. Secondly, it is also essential to adequately design wall-frames to help meet the preferred Occupiability seismic performance. The work presented in this paper examines the contributing factors for failure of structural elements in hospital buildings and explores structural configuration and design strategies for mitigating these failures. Nonlinear analyses studies of a typical hospital building in high seismic region in India are carried out to help provide quantitative guidelines for: (a) Structural Plan Density (SPD) of structural walls, and (b) design parameters, for achieving the preferred performance. Displacement-based limit state of structural damage adopted from traditional displacement demand estimation rules is proposed. Lateral stiffness, strength, and ductility are evaluated of study buildings, and efficacy of results obtained from nonlinear static analyses confirmed by performing nonlinear time history analyses in commercial software PERFORM 3D. Results demonstrate inadequacy of moment frame structural system in hospital buildings under strong earthquake shaking, identifies optimum overall SPD of structural walls and relative column-to-beam strength ratio of frame members, required to achieve Occupiability. A minimum 3% SPD of structural walls in Wall – Special Moment Resisting Frame (WSMRF), 4% SPD in Wall – Ordinary moment resisting frame (WOMRF) hospital buildings, and a minimum column-to-beam strength ratio (CBSR) of 2 is required in hospital buildings to attain Occupiability performance.

Analyses of the energy efficiency enhancement in Bulgarian health care premises

The presented study examines how hospital buildings in Bulgaria consume energy, reduce emissions, and save energy. The study uses data from energy efficiency surveys of 38 hospital buildings, where 137 energy-saving measures were implemented between 2015 and 2021. These hospital buildings range in size from 465 m2 to 19,026 m2, with a total studied area of 151,306 m2, divided into three groups for analytical convenience. The study presents detailed findings on annual energy savings, with the highest savings achieved in Group 2 (G2), reaching an impressive 51.1% in 2021. Furthermore, the study analyzes the reduction in carbon emissions, with Group 2 again showing the largest decrease, reducing emissions by 2,097 tCO2 in 2019. These results underscore the significant positive impact of the implemented energy-saving measures, demonstrating substantial improvements in the energy efficiency of the studied hospital buildings. In addition, to highlight the financial and environmental benefits of the reduced energy consumption and lower carbon emissions, the study also offers a valuable model for similar initiatives in other regions. It emphasizes the critical importance of energy efficiency and how targeted measures can effectively contribute to sustainable development in the healthcare sector. This comprehensive analysis provides policymakers, healthcare administrators, and energy efficiency advocates with valuable insights and effective strategies for reducing energy use and emissions in hospital buildings. By showcasing the success of these measures, the study aims to inspire broader adoption of energy efficiency practices, ultimately contributing to global sustainability efforts.

The role of technology in shaping the coexistence of local hospital buildings

Architecture is one of the reflections of the development of societies and an indication of the extent of their development from the technological aspect, as this results in products characterized by uniqueness and positivity, as the role of technology is highlighted in the occurrence of symbiotic interference on existing buildings, especially hospital buildings, because this type of building has a constant need for expansion, so the relationship between the origin and the symbiont differs. Depending on the time of addition and the subsequent technological developments that give possibilities and possibilities for coexistence, in addition to the factor of the surrounding environment, the general fabric, and the original building, the important role in determining patterns for reconfiguration of coexistence. However, the concept of technology has the fundamental role in determining the type of relationship and connection and its degree between two cities, as the research aims to clarify the perception. Knowledge about the impact of technology on existing local hospital buildings in terms of materials, structures and mechanisms used when merging old and new, and applying the theoretical framework that has been reached on two samples of existing local hospitals and showing how to achieve the coexistence formation of this type of building to arrive at the most important conclusions (developments affect Technology on hospital configurations when adding and expanding, especially at the levels (structures - materials - facades - basic composition)).

The influence of miasmatic theory on the construction of the Hospital Geral de Santo António in Porto in the nineteenth century.

The aim of this work is to ascertain the relevance of the miasmatic theory for the construction and spatial organization of the Hospital Geral de Santo António in Porto, Portugal, in the 19th century, from then recent graduate physicians' viewpoint. The methodology consists of analyzing the inaugural dissertations presented to the Escola Médico-Cirúrgica do Porto in order to assess the physicians' perceptions of the Santo António Hospital building, with emphasis on the relationship between health, medicine and environment. This work intends to contribute to better understand the relationship between the theoretical referential approach to disease and medical practice, at the interface of health, medicine, and environment by analyzing interspecies encounters.

Identification of Natural and Forcing Frequencies through Noisy Measurements Acquired in Operational Conditions on a Hospital Building

Identification of Natural and Forcing Frequencies through Noisy Measurements Acquired in Operational Conditions on a Hospital Building

Room Air Quality at Husada Prima Hospital, East Java Province

The microbiological quality of the air in the NICU and surgical rooms exceeds standards. The physical quality of the NICU and operating room exceeds the standard. This study aimed to determine the microbiological and physical quality of hospital room air (NICU room and surgical rooms) at Husada Prima Hospital, East Java Province. This research design was descriptive. Observation, field measurements, and laboratory tests collected data. The measurement results will be compared with RI Minister of Health Regulation No. 2 for 2023. The results of air microbiology sampling in the NICU, surgical room 1, and surgical room 2 still need to meet the requirements. The results of physical air quality measurements, namely temperature in the three rooms, humidity in the NICU room, lighting, and ventilation rate in the three rooms, must meet the requirements. The variables that meet the requirements are humidity in both operating rooms and lighting in the surgical room (Table 2). The condition of hospital facilities and buildings in the three rooms has met the requirements. The conclusion is that the room's air quality at Husada Prima Hospital, East Java Province, did not meet the criteria. The condition of the facilities and buildings was good. The hospital is advised to clean and repair air conditioners regularly, use humidifiers to maintain humidity in the room and increase or decrease lighting according to each room's needs.

CO2 emission reduction, loads analysis, and strategies for new healthcare facilities design – Application on a case study

To understand the “Zero Emission Building” goal introduced by the Energy Performance of Buildings Directive (EPBD) revision, it is certainly important to define its scope, since different considerations must be made for buildings with different uses, characteristics and locations. In this paper, the case study of a new construction hospital building is analysed, bringing attention to two main aspects: the correct identification of energy needs of the Heating, Ventilation and Air Conditioning (HVAC) systems; Mechanical, Electrical and Plumbing (MEP) design strategies aimed at minimizing CO2 emissions. To pursue these objectives, the hourly trends of energy consumption are examined, focusing on the interpretation of their distribution, the main influencing variables and on the distribution of such energy consumption among the different utilities of the analysed system. It is opinion of the authors that this in-depth study is preparatory to the proper MEP design of the systems: in fact, by knowing the most energyconsuming users and the distribution of heating and cooling loads during the year, it is possible to identify the optimal design strategies and generation technologies to reduce the consumption of Primary Non-Renewable Energy. In this regard, the choice of an ap-propriate calculation model is highlighted as crucial. Possible design strategies related to the case study under consideration are analysed in this paper, ultimately exposing the general considerations regarding the ZEB issue in the hospital setting.