Technology, budgets, healthcare costs, patient demographics, and industry-specific challenges are unlike their predecessors ten years ago, and in another ten years, healthcare facilities are on track to be even more sophisticated than the most advanced centers today. Staying ahead of the curve to accommodate future trends is important for any healthcare facility to stay successful.
One of the strongest sectors for AEC firms in the current market, teams designing and constructing healthcare facilities should consider several trends influencing activities in this sector.
INFORMATION TECHNOLOGY INFRASTRUCTURE
To make more diagnostic and treatment procedures available, healthcare facilities often require rapid technological advances involving sophisticated techniques and equipment. As management of patient records and imaging becomes more reliant upon electronic storage and transmission, hospital networks have become pipelines for massive data transmission, and storage needs have increased the necessity for on-site data storage and connectivity. Continuing operations require full network capabilities, and increases in data center and network sizes have taxed the capacity of emergency generation and power distribution systems. Additionally, network complexity has been complicated by the demand from patients and visitors to access wireless networks for personal devices. Privacy and regulatory requirements often require numerous independent systems for both wireless and wired networks to support patient personal needs, hospital computing needs, PACS, telemetry, locator systems, and patient information systems.
As data needs increase, cabling has increasingly taken a larger portion of the ceiling space throughout patient care areas, which introduces challenges for access to mechanical and electrical equipment above the ceiling. Support spaces for data distribution and medical systems are also requiring more space. Design teams need to account for these significant data needs. BVH utilizes Revit modeling software to arrange systems above ceilings and coordinate with available space and service needs, and to help minimize patient and staff disruption, as well as maintenance time required to access equipment.
In the face of constantly changing needs and technologies, flexibility must be a basic design feature of any healthcare facility to keep it from rapid obsolescence.Although future healthcare needs are difficult to forecast with any certainty, new equipment technologies, new treatment methodologies, and changes in the patient population will all impact the facilities that house them. As a result, designers need to engineer systems that can be easily expanded or modified without affecting continuing patient care. This may be as simple as providing additional valved taps in a piped system for future use, or require more complicated design approaches. Hospital data centers, for example, have rapid projected growth rates for cooling and emergency power, and while capacity is needed in the future, overcapacity today can actually be detrimental. Designers, therefore, need to make decisions at the system level with a master plan in mind. Without proper planning, future projects that would otherwise be small and inexpensive could be strapped with the costs of a major infrastructure upgrade.
Because much of healthcare renovation work takes place in occupied spaces, design and building teams must take great care in ensuring the safe, ongoing operations of day-to-day activities. Protecting staff, patients and visitors from construction noise and disruption is paramount. Therefore, designing building systems with realistic construction phasing goals is the most important step in reducing disruption. This involves a discussion between the Owner and Design Team about what can be shut down and for how long. In projects without a Construction Manager on board, the Owner relies heavily on the Design Team’s past experience to estimate the amount of time needed and the constructability of the design solution. Complicating matters are increasing restrictions on noise and airborne pollutants in patient care areas, which require the careful planning of construction activities that may affect the patient environment, such as demolition, welding, soldering and brazing.
MEP engineers are expected to choose systems and equipment that improve the quality of the indoor environment and reduce energy usage and energy costs – for both renovations and new construction projects. Many sustainable design features can be incorporated into healthcare facility design, including daylighting, energy and water conservation, and sustainable operations and maintenance.
While healthcare facilities’ strict code requirements often create challenges for end-use energy improvements, Design Teams can help healthcare facilities achieve energy savings. Ventilation costs can be reduced with heat recovery systems that capture energy through exhaust streams. Costs savings can be achieved by reducing airflow rates in unoccupied spaces. Airflow reduction and space temperature reset in unoccupied operating rooms can also provide significant savings. Capturing waste heat from hot drains and boiler stacks can also be beneficial for pre-heating domestic hot water and boiler feed water. Reducing lighting levels in patient corridors saves energy costs and has the added benefit of reducing light pollution in patient rooms, an increasingly important need. Water use reduction can be achieved through careful selection of plumbing fixtures, faucets and flush valves, as well as medical equipment which can reduce water usage and costs. Metering of water uses not wasted to the sanitary sewer system, such as irrigation and HVAC makeup systems, can also reduce utility costs. Cogeneration systems that produce power and heat also can provide energy savings in hospitals.
Project budgets cannot always support every available energy-saving measure, so designers need to help the Owner make an informed decision. An investment should be rewarded with lower operating costs without strapping the hospital with a complicated and maintenance-intensive system.
The regulatory process for healthcare construction projects has become more intensive, and applications are reviewed with increasing scrutiny. The success of the approvals process relies heavily on a realistic design concept and budget. Strong collaborative planning early in the design process helps reduce the risk of a significant change that could set back the schedule with a costly re-submission. It is important to understand the impact of the programmatic changes on MEP systems and the building structure so that project budgets are established on realistic needs.
Whether building or renovating a healthcare facility, experienced design firms can help healthcare facilities fully maximize their potential as a place that improves patient satisfaction, facilitates healing, enhances visitor comfort and achieves greater energy efficiency. As market conditions change, patient preferences switch, and new amenities are in high demand, design and building teams can support healthcare facilities’ integral goal of improving wellbeing and finding innovative ways to efficiently meet the needs of patients.