One of the most present debates in the current architecture is the degree of intervention to be carried out in the existing urban areas and plots, that is to say, the necessity or not of build new constructions, when we have a large number of buildings with the possibility of being renovated.
However, in order to make the right decision, it is necessary to take into account all the parameters involved in each type of action. This time we will focus on health centres, specifically on the suitability to remodel or build a new construction hospital.
Criteria for designing a hospital
To contextualize the possibilities of remodelling or building a new construction hospital it is essential to have very clear the main aspects in the design and construction of a health centre, in order to be able to decide how it will be more appropriate to implement these criteria.
On the one hand, it is essential to take into account the provision of spaces for future hospital extensions, as well as the possibility of expanding hospital services within the existing space, through the creation of multi-functional zones that allow the adaptation of hospital services to the needs of each moment.
On the other hand, among the constructive elements of a hospital, those that have the greatest impact on the design of the building are the facilities, the interior distribution elements, the equipment and, finally, the building box, that is, the structure and the enclosures.
In this sense, a good planning of the interior distribution is important, proposing a flexible plant that allows to accommodate the new uses and requirements without the necessity of making major constructive interventions in the future, allowing the variability and the adaptability of different systems.
Together with these constructive criteria, it is important to take into account the safety in the hospital design, since we are talking about a very complex public building typology, which is open to the public 24 hours a day and which houses a sector of the fragile population that requires a safe and quiet space to recover.
Other parameters to evaluate are acoustics, energy efficiency or the design of healthy environments in health centres. The quality of the indoor environment in buildings is becoming more important, together with the incorporation of nature and the appropriate treatment of their environment.
There are many aspects that influence the moment of making the decision to remodel or build a new construction hospital.
Let’s see the advantages and disadvantages of each of the alternatives.
Advantages and disadvantages to remodel or build a new construction hospital
Remodelling a hospital
The main advantage of the renovation or extension of a sanitary building is the energy savings involved in the construction of new structures.
Today the building sector consumes 40% of the total energy in the European Union and it is estimated to continue to grow. For this reason, the remodel or expansion of hospitals is an alternative that takes increasing importance, since it minimizes the energy expenditure of the execution of the work.
In addition, by opting for the use of an existing building, the square meters of soil necessary for the intervention are greatly reduced. This factor is becoming increasingly important in urban areas where building densification is very high and it is difficult to find large extensions to build.
However, it is not always easy to decide whether it is more appropriate to remodel or build a new construction hospital.
In some cases, it is very difficult to intervene in certain architectural models, such as those that have shaped hospitals in the past decades, based on a fully functional, completely closed model, with no possibility of successive modification.
In these cases it is more advisable to create new building health centres that allow to implement an appropriate design from the beginning, including criteria to minimize energy demand and enhance the use of energy sources in the building.
Another complication that arises at the time of remodelling an existing hospital is the need for a very strict planning and management of the work, which allow the daily activity of the hospital to be reconciled with the remodelling of the building.
In this sense, dust and debris from materials generated in the building carry fungi and bacteria that may be responsible for infections associated with healthcare, also called nosocomial infections. The planning of biosecurity measures to control and prevent them should be part of our works projects.
In addition, strict control over the production of noise and vibration is required, as well as constant coordination with the infrastructure and prevention services.
For all these reasons, the projection of a project in phases is essential to carry out the remodel or expansion of a hospital successfully, optimize available resources and minimize the impact of the work on the most immediate medical services.
New construction hospital
Just as a hospital remodelling reduces the environmental impact, the construction of a new hospital usually generates more energy expenditure and environmental impact due to its great magnitude.
However, the construction of a new hospital also has some advantages. The main one is to be able to realize a design without initial conditions, that allows the projection of a space that is better adapted to the current needs of the population.
Increasingly, there is a need for multipurpose and flexible spaces, along with the introduction of nature and vegetation in hospitals. When we leave an existing building we do not always have enough space to create these oases within the health centre.
In these cases, the construction of a new building allows the different spaces of a hospital to be conceived from the outset taking into account all the factors that will influence the daily activity of the hospital and also considering the creation of pleasant spaces for patients, a parameter that is difficult to find in existing centres.
In addition, when building new construction it is possible to choose the most suitable location for the hospital, as well as orientation, volume and enclosures to maximize the use of natural resources for energy generation.
As we see the alternatives to remodel or build a new construction hospital are very varied, presenting both options advantages and disadvantages. Therefore, it is important to have all the variables present so that we can make the most appropriate decision on each occasion.
In this sense, at CASA Solo we value in each project what is the optimal option to design efficient sanitary spaces and respectful with the environment.
As architects, our work can contribute to improve the quality of life of patients, families and professionals, as well as to save energy and preserve the natural resources of our planet.