Sustainable Future-Proof Healthcare Facilities: Modular and Adaptable Design Approach
Publication: Journal of Management in Engineering
Volume 40, Issue 6
Abstract
The challenge of implementing industrialized construction to achieve sustainable future-proof healthcare facilities is not only about construction methods themselves but also about how to shift design methodologies. COVID-19 has raised the attention of research and practices in using modular design and construction for healthcare facilities. However, the lifespan and functional differences between general and emergency healthcare facilities mean that their sustainable design requirements are not exactly the same. Drawing from 27 interviews and design review sessions with 19 international groups of experts, this research proposes a modular adaptable hospital design (MAHD) approach based on the Open Building Concept (OBC). This includes an evaluation framework composed of five design categories and 23 subcategories complemented with a set of design guidelines and it concludes by identifying a future implementation pathway. This research extends the implementation of OBC through theoretical contributions for modular and adaptable designs and practical guidelines for future design implementation.
Get full access to this article
View all available purchase options and get full access to this article.
Data Availability Statement
Some or all data, models, or code generated or used during the study are proprietary or confidential in nature and may only be provided with restrictions.
Acknowledgments
This paper is derived from the first author’s unpublished master thesis at ETH, titled MAHD: Design and Construction Methodology for Future Innovative Adaptable Hospitals. Part of the content was published in the ASCE Construction Research Congress 2022. Many thanks to the interviewees and companies who participated in the process.
References
Aalto, L., P. Sirola, T. Kalliomäki-Levanto, M. Lahtinen, V. Ruohomäki, H. Salonen, and K. Reijula. 2019. “User-centric work environments in modular healthcare facilities.” Eng. Constr. Archit. Manage. 26 (6): 1047–1062. https://doi.org/10.1108/ECAM-04-2018-0169.
Anåker, A., A. Heylighen, S. Nordin, and M. Elf. 2017. “Design quality in the context of healthcare environments: A scoping review.” Herd: Health Environ. Res. Des. J. 10 (4): 136–150. https://doi.org/10.1177/1937586716679404.
Assaad, R. H., I. H. El-adaway, M. Hastak, and K. LaScola Needy. 2022. “The COVID-19 pandemic: A catalyst and accelerator for offsite construction technologies.” J. Manage. Eng. 38 (6): 04022062. https://doi.org/10.1061/(ASCE)ME.1943-5479.0001091.
Baldwin, C. Y., K. B. Clark, and K. B. Clark. 2000. Design rules: The power of modularity. Cambridge, MA: MIT Press.
Bao, Z., V. Laovisutthichai, T. Tan, Q. Wang, and W. Lu. 2022. “Design for manufacture and assembly (DfMA) enablers for offsite interior design and construction.” Build. Res. Inf. 50 (3): 325–338. https://doi.org/10.1080/09613218.2021.1966734.
Capolongo, S., M. Buffoli, D. Nachiero, C. Tognolo, E. Zanchi, and M. Gola. 2016. “Open building and flexibility in healthcare: Strategies for shaping spaces for social aspects.” Ann. Dell’istituto Super. Di Sanità 52 (Jun): 63–69. https://doi.org/10.4415/ANN_16_01_12.
Carthey, J., and V. Chow. 2011. “Flexible and adaptable hospitals–Australian case studies.” In Proc., Haciric Int. Conf., 160–175. Loughborough, UK: Loughborough Univ. Research Repository.
Carthey, J., V. Chow, Y.-M. Jung, and S. Mills. 2010. “Achieving flexible & adaptable healthcare facilities-findings from a systematic literature review (presentation). Health and care infrastructure research and innovation centre (Haciric).” In Proc., 3rd Annual Conf.: Better Healthcare Through Better Infrastructure. Loughborough, UK: Loughborough Univ. Research Repository.
Castleberry, A., and A. Nolen. 2018. “Thematic analysis of qualitative research data: Is it as easy as it sounds?” Curr. Pharm. Teach. Learn. 10 (6): 807–815. https://doi.org/10.1016/j.cptl.2018.03.019.
Choi, J. O., B. K. Shrestha, Y. H. Kwak, and J. S. Shane. 2020. “Innovative technologies and management approaches for facility design standardization and modularization of capital projects.” J. Manage. Eng. 36 (Feb): 04020042. https://doi.org/10.1061/(ASCE)ME.1943-5479.0000805.
Gil, N. 2009. “Evolvable or ‘future-proof’ infrastructure design: Integrating modularity and safeguards.” In Open building manufacturing: Key technologies, applications and industrial cases book, 2. Bellville, TX: ManuBuild.
Groat, L. N., and D. Wang. 2013. Architectural research methods. New York: Wiley.
Guest, G., E. Namey, and M. Chen. 2020. “A simple method to assess and report thematic saturation in qualitative research.” PLoS One 15 (5): E0232076. https://doi.org/10.1371/journal.pone.0232076.
Han, Y., Y. Li, Y. Li, B. Yang, and L. Cao. 2023. “Digital twinning for smart hospital operations: Framework and proof of concept.” Technol. Soc. 74 (Jan): 102317. https://doi.org/10.1016/j.techsoc.2023.102317.
Jang, S., and G. Lee. 2018. “Process, productivity, and economic analyses of BIM–based multi-trade prefabrication—A case study.” Autom. Constr. 89 (Jun): 86–98. https://doi.org/10.1016/j.autcon.2017.12.035.
Kamali, M., and K. Hewage. 2016. “Life cycle performance of modular buildings: A critical review.” Renewable Sustainable Energy Rev. 62 (Apr): 1171–1183. https://doi.org/10.1016/j.rser.2016.05.031.
Kamali, M., and K. Hewage. 2017. “Development of performance criteria for sustainability evaluation of modular versus conventional construction methods.” J. Cleaner Prod. 142 (Feb): 3592–3606. https://doi.org/10.1016/j.jclepro.2016.10.108.
Karlsson, S., G. Lindahl, and M. Strid. 2021. “Future-proofing in healthcare building design.” In Proc., 4th Conf. on Architecture Research Care & Health, Arch19 June 12–13, 2019. Trondheim, Norway: Sintef Academic Press.
Kendall, S. 1999. “Open building: An approach to sustainable architecture.” J. Urban Technol. 6 (3): 1–16. https://doi.org/10.1080/10630739983551.
Kendall, S. 2005. “Open building: An architectural management paradigm for hospital architecture.” In Proc., Cib W096 Architectural Management, 273–284. Stuttgart, Germany: Fraunhofer Institute for Building Physics.
Kendall, S. H. 2018. Healthcare architecture as infrastructure: Open building in practice. New York: Routledge.
Kyrö, R., A. Peltokorpi, and L. Luoma-Halkola. 2019. “Connecting adaptability strategies to building system lifecycles in hospital retrofits.” Eng. Constr. Archit. Manage. 26 (4): 633–647. https://doi.org/10.1108/ECAM-10-2017-0217.
Lawson, M., R. Ogden, and C. Goodier. 2014. Design in modular construction. Boca Raton, FL: CRC Press.
Li, Y., X. Pan, Y. Han, and J. E. Taylor. 2021. “Sustainable healthcare facilities: A scoping review.” J. Constr. Eng. Manage. 147 (12): 03121007. https://doi.org/10.1061/(ASCE)CO.1943-7862.0002170.
Lu, W., K. Chen, F. Xue, and W. Pan. 2018. “Searching for an optimal level of prefabrication in construction: An analytical framework.” J. Cleaner Prod. 201 (Jan): 236–245. https://doi.org/10.1016/j.jclepro.2018.07.319.
Macchi, G. 2018. “System separation: A strategy for preventive building design.” In Healthcare architecture as infrastructure. New York: Routledge.
Masood, T., D. Mcfarlane, A. K. Parlikad, J. Dora, A. Ellis, and J. Schooling. 2016. “Towards the future-proofing of UK infrastructure.” Infrastruct. Asset Manage. 3 (1): 28–41. https://doi.org/10.1680/jinam.15.00006.
Memari, S., T. Kocaturk, M. Lozanovska, F. Andrews, and R. Tucker. 2022. “The interdisciplinary conceptualization of future proofing in the context of hospital buildings.” Build. Res. Inf. 50 (7): 810–826. https://doi.org/10.1080/09613218.2021.2011704.
Memari, S., T. Kocaturk, M. Lozanovska, F. Andrews, and R. Tucker. 2023. “Future proofing for hospital building design: From research to practice.” Archit. Eng. Des. Manage. 19 (6): 681–700. https://doi.org/10.1080/17452007.2022.2162842.
Mills, G., C. Goodier, J. Kingston, P. Astley, A. Symons, T. Tan, and C. Sherwood. 2020. Challenging space frontiers in hospitals: Accelerating capabilities and advancing platforms for modern hospital manufacture. London: London’s Global Univ.
Mittal, Y. K., V. K. Paul, A. Rostami, M. Riley, and A. Sawhney. 2020. “Delay factors in construction of healthcare infrastructure projects: A comparison amongst developing countries.” Asian J. Civ. Eng. 21 (4): 649–661. https://doi.org/10.1007/s42107-020-00227-1.
Neufert, E. 2019. Architects’ data. New York: Wiley.
Nowell, L. S., J. M. Norris, D. E. White, and N. J. Moules. 2017. “Thematic analysis: Striving to meet the trustworthiness criteria.” Int. J. Qual. Methods 16 (Apr): 1609406917733847. https://doi.org/10.1177/1609406917733847.
Olsson, N. O., and G. K. Hansen. 2010. “Identification of critical factors affecting flexibility in hospital construction projects.” Herd: Health Environ. Res. Des. J. 3 (2): 30–47. https://doi.org/10.1177/193758671000300204.
Pan, W., and Z. Zhang. 2022. “Evaluating modular healthcare facilities for COVID-19 emergency response—A case of Hong Kong.” Buildings 12 (9): 1430. https://doi.org/10.3390/buildings12091430.
Pilosof, N. P. 2021. “Building for change: Comparative case study of hospital architecture.” Herd: Health Environ. Res. Des. J. 14 (1): 47–60. https://doi.org/10.1177/1937586720927026.
Pilosof, P., and Y. E. Kalay. 2017. “Open architecture for healthcare: Case study of hospital change in practice.” In Proc., Seoul World Architects Congress, 1–10. Seoul: Federation of Institutes of Korean Architects.
Rivas, R., and L. Vilcahuamán. 2017. Healthcare technology management systems: Towards A new organizational model for health services. Cambridge, MA: Academic Press.
Salama, T., A. Salah, O. Moselhi, and M. Al-Hussein. 2017. “Near optimum selection of module configuration for efficient modular construction.” Autom. Constr. 83 (Jun): 316–329. https://doi.org/10.1016/j.autcon.2017.03.008.
Schmidt Iii, R., and S. Austin. 2016. Adaptable architecture: Theory and practice. New York: Routledge.
Stefano, C., T. A. Afifi, K. Al Khuwaitem, A. Mirco, B. Andrea, F. C. E. Costa, M. R. Fossati, F. Alice, M. Palumbo, and G. Peretti. 2017. “Open rooms for future health care environments.” Acad. J. 19 (Jan): 62–70.
Taherdoost, H. 2016. “Sampling methods in research methodology; How to choose a sampling technique for research.” In How to choose a sampling technique for research. Mezzovico-Vira, Switzerland: Helvetic Editions Ltd.
Tan, T., W. Lu, G. Tan, F. Xue, K. Chen, J. Xu, J. Wang, and S. Gao. 2020. “Construction-oriented design for manufacture and assembly guidelines.” J. Constr. Eng. Manage. 146 (8): 04020085. https://doi.org/10.1061/(ASCE)CO.1943-7862.0001877.
Tan, T., G. Mills, J. Hu, and E. Papadonikolaki. 2021. “Integrated approaches to design for manufacture and assembly: A case study of Huoshenshan Hospital to combat COVID-19 in Wuhan, China.” J. Manage. Eng. 37 (6): 05021007. https://doi.org/10.1061/(ASCE)ME.1943-5479.0000972.
Tan, T., G. Mills, and E. Papadonikolaki. 2024. “Exploring multidimensional modularity: Strategies to reduce complexity in design activities.” J. Manage. Eng. 40 (3): 05024002. https://doi.org/10.1061/JMENEA.MEENG-5596.
Tan, T., G. Mills, E. Papadonikolaki, B. Li, and J. Huang. 2022. “Digital-enabled design for manufacture and assembly (DfMA) in offsite construction: A modularity perspective for the product and process integration.” Archit. Eng. Des. Manage. 19 (3): 267–282. https://doi.org/10.1080/17452007.2022.2104208.
Tatum, C. B. 1989. “Management challenges of integrating construction methods and design approaches.” J. Manage. Eng. 5 (2): 139–154. https://doi.org/10.1061/(ASCE)9742-597X(1989)5:2(139).
Tillmann, P. A., P. Tzortzopoulos, and C. T. Formoso. 2010. “Redefining healthcare infrastructure: Moving toward integrated solutions.” Herd: Health Environ. Res. Des. J. 3 (2): 84–96. https://doi.org/10.1177/193758671000300208.
Verderber, S. 2010. Innovations in hospital architecture. New York: Routledge.
Wagenaar, C., N. Mens, G. Manja, C. Niemeijer, and T. Guthknecht. 2018. Hospitals: A design manual. Basel, Switzerland: Birkhäuser.
WHO (World Health Organization) and World Bank. 2021. Tracking universal health coverage: 2021 global monitoring report. Washington, DC: World Bank.
Xin, Y., Y. Zhou, L. Yang, Y. Liu, and T. Tan. 2024. “Enhancing healthcare environment design evaluations through an interactive virtual reality-based approach: A design science research.” Dev. Built Environ. 18 (Apr): 100440. https://doi.org/10.1016/j.dibe.2024.100440.
Yin, R. K. 2017. Case study research and applications: Design and methods. Thousand Oaks, CA: SAGE.
Zhan, W., W. Pan, W. Law, and H. Shen. 2024. “Stakeholders’ knowledge, attitudes, and intentions of adopting modular integrated construction for sustainable development in Hong Kong.” J. Manage. Eng. 40 (2): 04023070. https://doi.org/10.1061/JMENEA.MEENG-5642.
Information & Authors
Information
Published In
Journal of Management in Engineering
Volume 40 • Issue 6 • November 2024
Copyright
© 2024 American Society of Civil Engineers.
History
Received: Sep 26, 2023
Accepted: May 15, 2024
Published online: Aug 7, 2024
Published in print: Nov 1, 2024
Discussion open until: Jan 7, 2025
ASCE Technical Topics:
- Architectural engineering
- Architecture
- Building design
- Buildings
- Business management
- Construction engineering
- Construction industry
- Construction management
- Construction methods
- Design (by type)
- Engineering fundamentals
- Facilities (by type)
- Health care facilities
- Industrial facilities
- Modular structures
- Practice and Profession
- Structural engineering
- Structures (by type)
- Sustainable development
Authors
Metrics & Citations
Metrics
Citations
Download citation
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.