The use of refurbishment, flexibility, standardisation and BIM to support the design of a change-ready healthcare facility

Healthcare in the UK is a very important sector; it provides state of the art accommodation that meets the need of patients, visitors, medical professionals and other staff. The UK Government is currently cutting costs within the different sectors of the economy, while there are raising figures in UK National Health Service (NHS) spending. These are due to a growing and ageing population, advancement in modern healthcare delivery and special needs for different facility users. There is a UK Government proposal set out that requires the delivery of £15-20 billion in efficiency savings over the three year period from 2011 (Department of Health, 2010-2015). This study has understood that cost savings can be achieved by adopting and implementing a framework that supports refurbishment, flexibility, standardisation and Building Information Modelling (BIM). These cost savings can be achieved through Mechanical Engineering and Plumbing (MEP) clash detections using (BIM). 65% of hospital designs are centred on MEP services (interviews). The NHS needs to save cost when responding to possible future changes without compromising the quality of standard provided to the public. A change-ready healthcare facility is proposed to address the issue of change and the design of quality spaces that can enhance effectiveness and efficiency in the delivery of health and social care. A change-ready healthcare facility can be described as a facility that accommodates known or proposed future changes creating novel pathways to increase the quality and life span of facilities. There is also a large chunk of NHS estates that is underutilised EC Harris, (2013). Therefore, healthcare facilities need to respond to future changes in order to optimise their spaces. To achieve quality and cost efficiency in healthcare buildings, key considerations are refurbishment and reconfiguration, optimisation of flexibility, maximising standardisation and implementation of BIM. This research explores opportunities to save costs, time and improve quality of healthcare facilities by making emphasis on the design delivery process. Therefore, the new RIBA Plan of Work 2013 was used as a mechanism to help translate ideas into physical form and yet has been hindered by lack of development and ability to keep up with technological development such as BIM. This is the rationale for developing a framework. The RIBA Plan of Work is accepted nationally. Due to the UK BIM mandate by 2016, this research is focused on the use of BIM to support both space standardisation and space flexibility within a refurbished or new building. Space is a vital component competent in every healthcare facility. It provides the environment for healthcare services to be performed, and links one functional space to another, it can be designed for multifunctional usage. Healthcare spaces are complex entities due to the range of services and technology they support and the number, variety and quality of requirement combined with a rapidly changing environment. Flexibility enables a facility to easily respond to changes, while the introduction of standardisation supports staff performance by reducing the reliance on memory which will reduce human error. But the main question that emerges from current literature is how healthcare designers and planners manage healthcare spaces that cannot easily be standardised due to the constraints of existing structures, diversity in patient and staff needs? With analysis of different flexibility frameworks in the Architecture, Engineering and Construction (AEC) industry, there is a need to improve the existing frameworks. Therefore, a framework for designing a change-ready healthcare facility was developed through a sequence of data analysis starting with literature, preliminary data, questionnaire survey and interviews. Three frameworks for designing a change-ready facility were revised, organised and merged to produce a state of the art framework. Three frameworks were revised as different research methods were required. The successful framework can guide the design process of embedding different flexible design options for a defined project brief to save costs and improve design efficiency. The framework was validated with some of the top 100 architectural practices in the UK, NHS Estates, facility managers and the RIBA through an interview process. Further research and development arising from this research focuses on the process of applying BIM to record or identify key decisions taken for each of the different design options generated from a single brief to inform the designers, clients or other stakeholders involved while collaborating. Findings of this research are described in five peer-reviewed papers. The only certainty in healthcare is change Gressel and Hilands, (2008)

Using Building Information Modelling (BIM) to design flexible spaces with design standards in healthcare facilities

This paper explored key factors that can enhance the designer's role when designing space for flexibility with the focal use of building information modelling (BIM) and design standardisation. An exploratory study was conducted using a questionnaire survey. The questionnaire was piloted to a Web-based Group (48 responses) and then it was distributed to the top 100 UK architectural firms (10 responses) based on the Building Magazine, (2010). Both descriptive and inferential statistics were used. The questionnaire survey included both open ended and close ended questions. The paper provides empirical insights about how design standardisation and flexibility can be applied with BIM. It suggests that embedding flexibility can be enhanced with BIM by supporting the generation of different design options and scheduling design tasks with different information attached. The results also showed that strategies such as “adapting,” “contracting” and “expanding” are more beneficial than other flexible strategies. Regarding standardisation and flexibility, the results showed that although standardisation is not the panacea of providing flexible solutions, it is indeed applied and applicable in construction projects that require flexibility. The chosen research approach measures, records and reports the perceptions and worldviews of the respondents. Therefore, the research findings are based on how reality is formed by the participants and their experiences. With that in mind, the information identified was used to draw some noteworthy findings that provide detailed information on embedding flexibility in healthcare buildings

Space standardisation and flexibility on healthcare refurbishment

One of the most common features and aims of a flexible solution is to help all stakeholders throughout the lifecycle of a healthcare facility, own or take (full or part) responsibility of reducing, mitigating or abating the redundancy impacts throughout a building’s lifecycle with the integration of flexibility and standardisation into healthcare refurbishment, this can be achieved effectively with task partitioning. This paper has acknowledged that there are barriers to task partitioning. Flexibility and standardisation strategies have been implemented globally across different sectors and industries. Refurbishment is usually undertaken to improve the current state or functionality of a building in order to extend its valuable life span. Flexible designs are intended to provide future proof solutions. This requires providing the ability to adapt to unforeseen future changes at a specific place and time. Standardisation can and should be used to improve efficiency and reduce errors, it has been implemented in many manufacturing processes such as the automobile industry, but the question is how will it impact buildings especially existing healthcare spaces? This paper is aimed at identifying the impact of space standardisation and flexibility on healthcare refurbishment, with the view to identifying best practice and prescribing possible processes for integrating and optimising space standardisation and flexibility during the refurbishment of healthcare facilities

Creativity with Building Information Modelling tools

Whilst the application of BIM continues to be acknowledged and prevailing, design practitioners and academics find themselves in a paradox with an on-going discussion on the impact of BIM tools on design creativity and innovation. Literature suggests that BIM tools can hinder design creativity due to: parametric limitations; interoperability; and the demand for detailed information at preliminary design stages. However, other literature shows that BIM tools increase design creativity, and at some point provide limitless opportunities to be creative. The aim of this paper is to identify and verify the impact of BIM tools on design creativity. It is important for architectural students and practioners to be aware of the impact of BIM tools on the design. A literature review was used to identify the benefits and constraints of BIM tools on design creativity; a questionnaire survey was used to verify its impact. The questionnaire survey was conducted with the top 100 UK architectural firms (group one) and CNBR Yahoo Group (group two). It was found that BIM tools do not affect design creativity and innovation in the opinion of the respondents. This paper enlightens the status-quo of BIM tools on creativity and innovation, but will focus on the impact of BIM tools on architectural design creativity in the early design phase more closely. This research would be important to both academics and architectural designers using BIM in their various applications

Building information modelling implementation plans a comparative analysis

To realize the benefits of BIM in construction management using (4D and 5D applications), it has to be implemented first. There are various BIM implementation plans to select from; with BIM features and guides, companies better understand BIM concepts and can easily choose a plan to apply in their operations. A literature review was conducted and 15 different definitions of BIM were encountered. Twelve different BIM implementation plans were found in publications by academics, software vendors and Architecture/Engineering/Construction (AEC) industry professionals. Those implementation plans were compared using a matrix which covers the complete building lifecycle. This research concludes that out of the 12 implementations plans, three were equipped with additional guides attached to their plans, simplifying project data collection; namely those by Autodesk, Penn State University and Indiana University. One implementation plan that scored very highly (based on 16 key issues identified from the three categories of stakeholders specified in this project) was the implementation plan proposed by a major software vendor. BIM is poised to solve many of the shortcomings reported in the construction industry. However, before realizing the full potential of BIM in construction management, it needs to be systematically implemented