By Bhushan Avsatthi / Special to Healthcare Facilities Today

What good is a nation when all it has is advances in technology and none implemented on civilians’ health and safety, or none commercialized in healthcare sector? By healthcare, I not only mean mediclaims, insurance policies, well-qualified medical practitioners, and healthcare facilities equipped with medical devices. I extend my perspective to well-constructed healthcare facilities with technology assistance of BIM and lean construction approach. I also mean facilities that are running efficiently on the least energy when I say well-constructed healthcare facilities. What I'm asking is whether the healthcare facility construction has improved since AEC industry shifted to digital BIM workflow.

What does healthcare construction sector need from AEC professionals alongside BIM?

From construction perspective, and being an AEC industry professional for 15+ years now, I am of the strong opinion that Healthcare construction projects need a concentrated investment in coordinated MEP layout design. Designing MEP layout for healthcare construction is often daunting in terms of project tenure and budgets and also to ensure its suitability with architectural and structural designs. It is not only the right policy but also right construction technique that has a major role to play for patients’ health.

Keeping in mind health goals and also planning an efficient schedule, pre-construction clash resolutions and scheduling is paramount to general contractors. But with a proper and digitized workflow in BIM, there is an equal need of having soothing facility design and efficient MEP components arrangement across the facility.  

Doing justice to patients with right architectural designs

While technology is venturing in healthcare by the much-heralded efforts of biomedical engineers in designing medicinal devices; healthcare building construction aspects have evolved too. New age healthcare construction do not look like hospitals; they have grown to be fancier for creating spacious interior, that allows plenty of natural light inside the facility for patients’ comfort.   

Low lobbies, and stark and noisy waiting rooms have now become a historical trend in healthcare construction. 3D visualization of as-built models enabled architects to plan and visualize turning this place in to useful, better and a place to sooth patients; as a result today we address these areas where patients receive care and immediate first-aid attention by the hospital’s staff. This, however, is an instance of evolution of only a part of entire facility. Likewise, better architecture of the entire facility is not becoming only a requirement but also a means to deliver better services. Other evolved design features include claddings, light-filled interior spaces and perforated white material for soothing effect.  

Meeting the ends of design and needs of healthcare organizations construction is indeed a crucial task. However; BIM has empowered engineers and architects to come together and demolish the silos currently prevailing in collaborating designs with technology.  

MEP and HVACR are driving factors for hygiene of healthcare facility

With evolving architectural designs in healthcare construction sector, MEP requirements too have strengthened. If an MEP professional is asked to define a specific challenge he/she would answer it to be limited capital budgets for expensive MEP systems across the facility to maintain hygiene.

Hospitals, specifically, are considered to be the high-energy usage buildings because there are rigorous ventilation, filtration, humidification, and pressurization needs all round the day; and all these with appropriately controlled temperature settings throughout the year. Each individual hospital has its specific needs and requirements for design solutions.  

Moreover, hospitals are patient-centric, pointing to the fact that the building and MEP system designs are configured in a way to support healing of patients in each section of the facility. As a result, MEP and HVAC goals of healthcare are way more challenging than any other building construction.

Furthermore, in healthcare construction, specialty rooms will have their own HVACR requirements of controlled air flow, limited humidity and the hygiene of place. Medical gas piping, telemetry and emergency power distribution for critical care unit’s power station will also add to the requirements while accounting for adverse times. These HVAC engineering challenges are centered at indoor air quality (IAQ), infection risk control, contamination control, room pressurization, and noise analysis based on ASHRAE, NFPA, and local energy consumption codes authorities.

It doesn’t end yet – energy efficient buildings are becoming the trend  

On top of MEP and HVACR needs, there is a worldwide boom for developing energy efficient buildings and hospitals being high-quality energy buildings, they need it the most. Achieving efficient energy consumption needs as per Green Building Council’s guidelines, and LEED, BREAM and ESTIDAMA certification requirements, with controlled air quality and circulation is even more difficult. Energy modeling solutions of as-built structures, light analysis, shadow analysis etc. in BIM essentially will give a smooth track forward to MEP consultants.

Along with energy efficiency, healthcare construction emphasizes equally on developing buildings that are least infectious to patients for their well-being. Although today, AEC professionals are not equipped with WELL building standards, which includes a focused understanding of human health and wellness originating from light and quality of air and water; it will be playing a significant part in developing a well-constructed healthcare facility real soon. It also focuses on Hospital Acquired Infections [HAI] that contributes in increasing patients’ comforts.

Best practice: Integrate architects, MEP consultants and medical practitioners through CDE

While looking at the definite and stringent architectural and MEP requirements in healthcare construction sector, from construction as well as medicinal perspective, there arises a need of bringing architects, MEP consultants and medical practitioners on a common platform to finalize designs. Taking up a collaborative approach with data-rich BIM-ready 3D models will enhance the project outcomes. Common Data Environment (CDE) in BIM will serve as a virtual ecosystem for planning designs, developing them, scheduling an execution plan for construction, ordering right construction material, and maintaining the facility efficiently.

Today, hospitals are evolving and facing number of challenges that have changed the need and characteristics of construction. These new rising needs have posed serious challenges in delivering efficient, cost effective and yet perfect from medicinal perspective as well. BIM succors MEP engineers and architects in designing healthcare facilities that is more than a mere hospital to AEC professionals, and to medical practitioners, as well.

Bhushan Avsatthi is an Associate Director at Hi-Tech iSolutions LLP.