Hospital buildings need to be facilities that help medical staff in the efficient delivery of quality healthcare and provide a positive environment for speedy patient recovery. For these reasons it is vital that a good building design is adopted. Concrete construction is a great way for the project team to accomplish these requirements by helping improve the function, value and whole life performance of the facility.
As well as providing the structural frame, concrete can be used to improve the overall performance of the building, including:
Concrete is inert with no harmful off-gassing, and its structural form is commonly associated with enhanced natural ventilation and daylighting. It provides robust, damage-resistant surfaces for walls, partitions, columns, soffits and cladding that are easily sealed for cleaning where required. Aesthetics, ease of cleaning and a healthy atmosphere all lead to enhanced user satisfaction of concrete hospitals.
Concrete is inherently fire resistant and, unlike some materials, normally requires no added fire protection. This avoids the delays and disruptions of following trades caused by site applied protection or repair on site of damaged off-site applied protection. Concrete’s fire protection is provided at no extra cost and does not need continuing maintenance or reapplication after refurbishment or retrofit.
In addition, the inherent fire resistance results in concrete often performing in excess of design requirements for occupant safety. This benefits the building owner/user as repairs and the period before re-use following a fire are minimised.
It has been shown that comfort is an important factor in recovery. Concrete’s mass and damping qualities are able to be used to achieve the required acoustic performance, which provides a restful and productive environment that is isolated from the noise and vibrations resulting from normal hospital routines.
Vibration control is crucial particularly in areas such as operating theatres and night wards and is an important factor in the design specification of building frames for hospitals. Concrete can easily be designed for the most complete control of vibration over whole areas without excessively increasing the structure. Advice on the design of concrete structures for vibration can be found in The Concrete Centre publication A Design Guide for Footfall Induced Vibration of Structures.
Healthcare methods, provision of IT, patient expectations and standards of environment and equipment are all changing rapidly, so flexibility of use of new buildings is a major design requirement. For instance, less invasive surgery is likely to continue to change required proportions of theatre, recovery and ward space. The use of concrete construction automatically ensures many of the qualities that aid flexibility.
Concrete is a robust material that is capable of withstanding the knocks and bangs likely to occur in a hospital with minimal or no damage. Reducing maintenance not only reduces costs and disruption, but prevents the building from looking neglected which can lead to lack of respect for the facilities.
The choice and design of a building’s frame and cladding can have a surprisingly large influence on the performance of the final building. Today’s concrete frames are ideally suited to support the requirements of modern hospital buildings. Concrete frames are available in a wide range of structural types to suit all needs and can be constructed in precast or in-situ concrete, or a combination of the two, known as hybrid concrete construction.
Currently, flat slab construction, typically on grids of 7.2m to 8.4m on a 1.2m module is the preferred choice for many hospitals because of its speed, vibration performance and ability to best facilitate the installation of services and partition walls.
Increasingly, the flat slabs are post-tensioned to reduce slab thickness and provide potential for longer spans of up to 12 metres if necessary.
Ribbed in-situ slabs on wide shallow beams are lighter than flat slabs and even better for vibration. However, this has to be offset against being less versatile and taking longer to construct.
Hybrid concrete construction combines the best qualities of precast concrete (high-quality finishes, off-site manufacture) with those of in-situ construction (flexibility for late changes, mouldability, robustness, two-way spanning, local manufacture). For more information refer to The Concrete Centre publication Hybrid Concrete Construction.
An independent cost study for hospitals was carried out by a team compromising Nightingale Associates, Arup, Davis Langdon and Costain. Six structural options in concrete and steel were fully priced, with the costings based on detailed plans and structural solutions both for a typical local general hospital and a district general hospital.
The study found that a post-tensioned slab was the most economic solution and that as well as comparing the cost of the structural frame, the benefits discussed above should be included in the cost comparison because they can reduce costs for other elements of the building.