Case Studies
Mar 14, 2017

Retrofitting of Healthcare Facilities: Case Study Approach

Publication: Journal of Architectural Engineering
Volume 23, Issue 3

Abstract

Healthcare facility retrofit projects are among the most challenging types of construction. Such projects are often disruptive to patients and can cause significant patient safety issues. The aim of this study was to investigate current practices of retrofitting healthcare facilities, with a particular focus on patient safety and energy efficiency. To achieve this, the study followed a systematic approach to investigating the issues involved with retrofitting healthcare facilities. Three case studies were conducted, and data were collected through interviews, shadowing, site visits, and cognitive walkthroughs. Direct observation of retrofit projects was also undertaken to acquire firsthand knowledge of the retrofit process and to explore possible solutions associated with current practices. As more facilities consider the decision to retrofit, it is essential to provide a practical rationale for pursuing retrofit projects that are energy efficient and safe for patients.

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References

AHRQ (Agency for Healthcare Research and Quality). (2015). “About AHRQ.” ⟨http://www.ahrq.gov/cpi/about/index.html⟩ (Oct. 20, 2015).
AIA (American Institute of Architects). (2006). Guidelines for design and construction of health care facilities, Washington, DC.
Aiken, M. (2011). “Retrofitting emergency departments: The KPIs, process and strategic stages.” ⟨http://www.slideshare.net/iqpcaustralia/retrofitting-emergency-departments-the-kpis-process-and-strategic-stages⟩ (Oct. 20, 2015).
ASHE (American Society for Healthcare Engineering) and IFMA (International Facility Management Association). (2015). “Operations and maintenance benchmarks for health care facilities.” ⟨http://www.ashe.org/press/2010/ifmabenchmark.html⟩ (Oct. 20, 2015).
ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers). (2004). “Energy standard for buildings except low rise residential buildings.” Standard 90.1-2004, Atlanta.
Bartley, J. M. (2007). “Hospital construction: Stirring up trouble.” Eng. Syst., 24(7), 36.
Berry, L. L., Parker, D., Coile, R. C., Hamilton, D. K., O’Neill, D. D., and Sadler, B. L. (2004). “The business case for better buildings.” Front. Health Serv. Manage., 21(1), 3–24.
Bonnema, E., Studer, D., Parker, A., Pless, S., and Torcellini, P. (2010). “Large hospital 50% energy savings: Technical support document.” National Renewable Energy Laboratory. ⟨http://www.nrel.gov/docs/fy10osti/47867.pdf⟩ (Feb. 15, 2016).
Carpenter, D., and Hoppszallern, S. (2010). “Proceed with caution. Lean year expected for hospital construction.” Health Facil. Manage., 23(2), 11–18.
Capezuti, E., Zwicker, D., Mezey, M., Fulmer, T., Gray-Miceli, D., and Kluger, M. (2007). Evidence-based geriatric nursing protocols for best practice, 3rd Ed., Springer, New York.
CDPH (California Dept. of Public Health). (2016). “Healthcare associated infections in California hospitals annual rep. for January to December 2014.” ⟨https://www.cdph.ca.gov/programs/hai/Documents/2014-HAI-in-CA-Hospitals-Annual-Rep.-2014.pdf⟩ (Feb. 15, 2016).
DOE (Dept. of Energy). (2009). “Department of Energy announces the launch of the hospital energy alliance to increase energy efficiency in the healthcare sector.” ⟨http://energy.gov/articles/department-energy-announces-launch-hospital-energy-alliance-increase-energy-efficiency⟩ (May 5, 2012).
Donaldson, M. S., and Mohr, J. J. (2001). “Exploring innovation and quality improvement in health care micro-systems: A cross-case analysis.” Technical Rep., Institute of Medicine, Washington, DC.
Geerts, C. (1973). “Thick description: Toward an interpretive theory of cultures.” The interpretation of cultures, Basic Books, New York, 3–30.
Hendron, R., Leach, M., Bonnema, E., Shekhar, D., and Pless, S. (2013). “Advanced energy retrofit guide: Practical ways to improve energy performance.” National Renewable Energy Laboratory. ⟨http://www.nrel.gov/docs/fy13osti/57864.pdf⟩ (Feb. 15, 2016).
IOM (Institute of Medicine). (1999). “To err is human: Building a safer health system.” ⟨http://www.pharmacyerrorinjurylawyer.com/reportbrief.pdf⟩ (Feb. 15, 2016).
Joint Commission. (2015). “About the Joint Commission.” ⟨http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx⟩ (Feb. 15, 2016).
Joseph, A., Keller, A., Quan, X., Quist, C., and Hua, Y. (2010). “An open-source searchable database to assess the impact of environmental strategies on outcomes in healthcare facilities.” Technical Rep. for U.S. Green Building Council, Center for Health Design, Concord, CA.
Kahn, N. (2009). “National healthcare capital project benchmarking—An owner’s perspective.” HERD: Health Environ. Res. Des. J., 3(1), 5–14.
Kohn, L. T., Corrigan, J. M., and Donaldson, M. S., eds. (2000). To err is human: Building a safer health system, National Academies Press, Washington, DC.
Mauldin, P. D., Salgado, C. D., Hansen, I. S., Durup, D. T., and Bosso, J. A. (2010). “Attributable hospital cost and length of stay associated with health care-associated infections caused by antibiotic-resistant gram-negative bacteria.” Antimicrob. Agents Chemother., 54(1), 109–115.
Mohammadpour, A. (2014). “Retrofitting healthcare facilities to enhance patient safety and energy efficiency.” Ph.D. thesis, Dept. of Architectural Engineering, Pennsylvania State Univ., State College, PA.
Mohammadpour, A., Anumba, C. J., and Messner, J. I. (2016). “Integrated framework for patient safety and energy efficiency in healthcare facilities retrofit projects.” HERD: Health Environ. Res. Des. J., 9(4), 68–85.
Sadler, B. L., et al. (2011). “Fable Hospital 2.0: The business case for building better health care facilities.” Hastings Cent. Rep., 41(1), 13–23.
Sehulster, L., et al. (2003). “Guidelines for environmental infection control in health-care facilities.” MMWR 52(10), Centers for Disease Control and Prevention, Atlanta.
Studer, D., Parker, A., Pless, S., and Torcellini, P. (2010). “Large hospital 50% energy savings.” Technical Support Document IS-2010-157, National Renewable Energy Laboratory, Golden, CO.
Tobias, L., and Vavaroutsos, G. (2009). Retrofitting office buildings to be green and energy-efficient: Optimizing building performance, tenant satisfaction, and financial return, Urban Land Institute, Washington, DC.
Ulrich, R. S., et al. (2008). “A review of the research literature on evidence-based healthcare design.” HERD: Health Environ. Res. Des., 1(3), 61–125.
Vesely, R., and Hoppszallern, S. (2014). “Moving ahead. Executives assess facilities in light of Obamacare.” Health Facil. Manage., 27(2), 19–24.
Whitson, A., and Fischer, G. (2012). “Economics, efficiency, energy and environment: Making the 4Es work together in healthcare.” 2010–2011 North America Survey Results, Corporate Realty, Design and Management Institute, Portland, OR.
Yin, R. K. (2014). Case study research: Design and methods, 5th Ed., Sage, Thousand Oaks, CA.
Zimlichman, E., et al. (2013). “Health care-associated infections: A meta-analysis of costs and financial impact on the US health care system.” JAMA Internal Med., 173(22), 2039–2046.

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Published In

Go to Journal of Architectural Engineering
Journal of Architectural Engineering
Volume 23Issue 3September 2017

History

Received: Apr 14, 2015
Accepted: Jan 3, 2017
Published online: Mar 14, 2017
Discussion open until: Aug 14, 2017
Published in print: Sep 1, 2017

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Authors

Affiliations

Atefeh Mohammadpour, M.ASCE [email protected]
Assistant Professor, Dept. of Manufacturing and Construction Engineering Technology, Indiana Univ.–Purdue Univ. Fort Wayne, 221K ET, 2101 East Coliseum Blvd., Fort Wayne, IN 46805 (corresponding author). E-mail: [email protected]
Chimay J. Anumba, F.ASCE
Dean and Professor, College of Design, Construction and Planning, Univ. of Florida, P.O. Box 32611-5701, Gainesville, FL 32611.
John I. Messner, M.ASCE
Professor, Dept. of Architectural Engineering, Pennsylvania State Univ., 104 Engineering Unit A, University Park, PA 16802.

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