Application of an evaluation tool for mega-hospital site sustainability. Assessment of public private partnership large sized healthcare infrastructures in European context.

Application of an evaluation tool for mega-hospital site sustainability. Assessment of public private partnership large sized healthcare infrastructures in European context.

Authors

  • Andrea Brambilla a:1:{s:5:"en_US";s:39:"Politecnico di Milano, Dipartimento ABC";}
  • Lara Ergur School of Architecture and Urban Planning (AUIC), Politecnico di Milano, Milan, Italy
  • Stefano Capolongo Design&Health Lab. Department of Architecture, Built Environment and Construction Engineering (DABC) Politecnico di Milano, Italy

Keywords:

site sustainability, healthcare facilities, public private partnership (PPP), hospital evaluation, assessment tool, mega hospital, one health

Abstract

Background and aim: Healthcare facilities are large and complex infrastructures designed to respond to a growing need of sanitary services in specialized environments to serve an increasing population number while containing costs. New financial and design models emerged for large sized Hospital ­Facilities (Mega-hospitals) but their site sustainability is questioned. Methods: The paper focuses on a comparison ­between European region case studies of Public Private Partnership (PPP) Mega-Hospitals. A total of 21 large sized hospitals in operation after 2010 have been compared with the application of the Assessment Tool for ­Hospital Site Sustainability (ATHOSS). A specific focus on Turkish Hospitals has been also provided as the PPP model is widely adopted in this country. Results: This analysis shows that Turkish cases gets general lower scores than European ones in terms of Construction Density and Community Connectivity (28%;50%), Alternative Transportation (18%; 50%), Site Development (26%; 38%). Connection to Natural World (30%; 52%) and Heat Island Effect (33%; 43%). Only in Development Density criteria (30%; 16%) the score was higher. It also emerged that gross floor area per bed ratio is much larger for Turkish cases (334m2/bed; 198 m2/bed) which can be interpreted as one of the weaknesses related to oversizing such infrastructures. Conclusions: The tool application highlighted some point of attention to be considered when designing and planning Mega-hospital facilities and improvement strategies for site sustainability are ­suggested.

References

Cavicchi C, Oppi C, Vagnoni E. Back and Forth on Sustainable Development: A Focus on Healthcare Organisations. Sustainability. 2022;14(9): 4958. doi: 10.3390/su14094958.

McKee M, Merkur S, Edwards N, Nolte E, [eds.]. The Changing Role of the Hospital in European Health Systems.. 1st ed. Cambridge University Press; 2020. doi: 10.1017/9781108855440.

Brambilla A, Mangili S, Das M, Lal S, Capolongo S. Analysis of Functional Layout in Emergency Departments (ED). Shedding Light on the Free Standing Emergency Department (FSED) Model. Applied Sciences. 2022;12(10): 5099. doi: 10.3390/app12105099.

Marquard E, Bartke S, Gifreu i Font J, Humer A, Jonkman A, Jürgenson E, et al. Land Consumption and Land Take: Enhancing Conceptual Clarity for Evaluating Spatial Governance in the EU Context. Sustainability. 2020;12(19): 8269. doi: 10.3390/su12198269.

Sdino L, Rosasco P, Dell’Ovo M. Reclamation Cost: An Ecosystem Perspective. In: Bevilacqua C, Calabrò F, Della Spina L (eds.) New Metropolitan Perspectives. Cham: Springer International Publishing; 2021. p. 1352–1358. doi: 10.1007/978-3-030-48279-4_126.

Danish Ministry of Health. The Danish Super Hospital Programme. A transformation of the danish healthcare landscape. 2021. https://sum.dk/Media/0/2/TheDanishSuperHospitalProgramme2021.pdf. Last accessed: 10th March 2023.

Campbell D. Plans to build 40 new hospitals in England ‘moving at a glacial pace’. The Guardian. 2022; https://www.theguardian.com/society/2022/jul/08/plans-to-build-40-new-hospitals-in-england-moving-at-a-glacial-pace. Last accessed: 10th March 2023.

Dhaene G. Mega PPP hospital in Turkey: Award winning infrastructure investment. 2020. https://decidehealth.world/en/pppturkey. Last accessed: 10th March 2023.

Tuncay E, Spicer J. Turkey mega hospital builders agree 1.1 billion euro loan restructuring - sources. Reuters. 2020; https://www.reuters.com/article/turkey-economy-restructuring-int-idUSKBN26K1MT. Last accessed: 10th March 2023.

World Economic Forum. City Hospital Projects, Turkey. 2020. https://www.weforum.org/reports/six-qualities-of

-sustainable-infrastructure-in-action/meridiam-city/. Last accessed: 10th March 2023.

Clark RM, Hakim S, [eds.]. Public Private Partnerships: Construction, Protection, and Rehabilitation of Critical Infrastructure. Cham: Springer International Publishing; 2019. doi: 10.1007/978-3-030-24600-6.

European Commission, Directorate-General for Health and Consumers. Health and economic analysis for an evaluation of the public-private partnerships in health care delivery across Europe. 2014. https://data.europa.eu/doi/10.2772/13906.

Dalton KR, Rock C, Carroll KC, Davis MF. One Health in hospitals: how understanding the dynamics of people, animals, and the hospital built-environment can be used to better inform interventions for antimicrobial-resistant -gram-positive infections. Antimicrobial Resistance & Infection Control. 2020;9(1): 78. doi: 10.1186/s13756-020-00737-2.

Health Care Without Harm, ARUP. Health Care’s Climate Footprint. How the health sector contributes to the global climate crisis and opportunities for action. 2019. https://noharm-global.org/sites/default/files/documents-files/5961/HealthCaresClimateFootprint_092319.pdf. Last accessed: 10th March 2023.

Brambilla A, Buffoli M, Capolongo S. Measuring hospital qualities. A preliminary investigation on Health Impact Assessment possibilities for evaluating complex buildings. Acta Bio Medica Atenei Parmensis. 2019;90(9-S): 54–63. doi: 10.23750/abm.v90i9-S.8713.

Dell’Ovo M, Oppio A, Capolongo S. The Location Problem. Addressing Decisions About Healthcare Facilities. In: Decision Support System for the Location of Healthcare Facilities. Cham: Springer International Publishing; 2020. p. 1–28. doi: 10.1007/978-3-030-50173-0_1.

Buffoli M, Capolongo S, Bottero M. Sustainable Healthcare: how to assess and improve healthcare structures’ sustainability. Annali di Igiene: Medicina Preventiva e di Comunità. 2013;(5): 411–418. doi: 10.7416

/AI.2013.1942.

Bottero MC, Buffoli M, Capolongo S, Cavagliato E, di Noia M, Gola M, et al. A Multidisciplinary Sustainability Evaluation System for Operative and In-Design Hospitals. In: Capolongo S, Bottero MC, Buffoli M, Lettieri E (eds.) Improving Sustainability During Hospital Design and Operation. Cham: Springer International Publishing; 2015. p. 31–114. doi: 10.1007/978-3-319-14036-0_4. [Accessed 15th February 2023].

Brambilla A, Apel JM, Schmidt-Ross I, Buffoli M, Capolongo S. Testing of a Multiple Criteria Assessment Tool for Healthcare Facilities Quality and Sustainability: The Case of German Hospitals. Sustainability. 2022;14(24): 16742. doi: 10.3390/su142416742.

Kavas M. Healthy and sustainable healthcare facilities. Development of an assessment tool for hospital site sustainability (ATHOSS).[Master Thesis]. Milano, Italy: Politecnico di Milano, School of Architecture Urban Planning Construction Engineering | AUIC ; 2020.

Ergur L. SUSTAINABLE HEALTHCARE SOLUTIONS Site Sustainability Meta Design Strategies for Public Private Partnership Model Mega-Healthcare Structures. [Master Thesis] . Milano, Italy: Politecnico di Milano, School of Architecture Urban Planning Construction Engineering | AUIC; 2021.

Sadler BL, Berry LL, Guenther R, Hamilton DK, Hessler FA, Merritt C, et al. Fable Hospital 2.0: The Business Case for Building Better Health Care Facilities. Hastings Center Report. 2011;41(1): 13–23. doi: 10.1002/j.1552

-146X.2011.tb00093.x.

Sdino L, Brambilla A, Dell’Ovo M, Sdino B, Capolongo S. Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview. Healthcare. 2021;9(7): 888. https://doi.org/10.3390/healthcare9070888.

Castro M de F, Mateus R, Bragança L. Healthcare Building Sustainability Assessment tool - Sustainable Effective Design criteria in the Portuguese context. Environmental Impact Assessment Review. 2017;67: 49–60. https://doi.org/10.1016/j.eiar.2017.08.005.

Trowbridge MJ, Huang TTK, Botchwey ND, Fisher TR, Pyke C, Rodgers AB, et al. Public Health and the Green Building Industry. American Journal of Preventive Medicine. 2013;44(5): 489–495. doi: 10.1016/j.amepre.2013.01.010.

Dell’Ovo M, Capolongo S, Oppio A. Combining spatial analysis with MCDA for the siting of healthcare facilities. Land Use Policy. 2018;76: 634–644. https://doi.org/10.1016/j.landusepol.2018.02.044.

Dell’Ovo M, Frej EA, Oppio A, Capolongo S, Morais DC, de Almeida AT. Multicriteria Decision Making for Healthcare Facilities Location with Visualization Based on FITradeoff Method. In: Linden I, Liu S, Colot C (eds.) Decision Support Systems VII. Data, Information and Knowledge Visualization in Decision Support Systems. Cham: Springer International Publishing; 2017. p. 32–44. https://doi.org/10.1007/978-3-319-57487-5_3.

Brambilla A, Sun Tianzhi, Elshazly W, Ghazy A, Barach P, Lindahl G. Flexibility during the COVID-19 Pandemic Response: Healthcare Facility Assessment Tools for Resilient Evaluation. Int. J. Environ. Res. Public Health. 2021;18(11478). doi: 10.3390/ijerph182111478.

Carthey J, Chow V, Jung YM, Mills S. Flexibility: Beyond the Buzzword—Practical Findings from a Systematic Literature Beview. HERD: Health Environments Research & Design Journal. 2011;4(4): 89–108. https://doi.org/10.1177/193758671100400407.

Goldman DP, Vaiana M, Romley JA. The emerging importance of patient amenities in hospital care. The New England Journal of Medicine. 2010;363(23): 2185–2187. doi: 10.1056/NEJMp1009501.

Zhang Y, Li W, Deng H, Li Y. Evaluation of Public Transport-Based Accessibility to Health Facilities considering Spatial Heterogeneity. Journal of Advanced Transportation. 2020;2020: 1–10. doi: 10.1155/2020/7645153.

Health Research & Educational Trust. Social determinants of health series: Transportation and the role of hospitals. 2017. www.aha.org/transportation Last accessed: 10th March 2023.

da Silva LSPM, Costa ADL. Look with the Eyes of Others: Accessibility in Hospital Environments. In: Bagnara S, Tartaglia R, Albolino S, Alexander T, Fujita Y (eds.) Proceedings of the 20th Congress of the International Ergonomics Association (IEA 2018). Cham: Springer International Publishing; 2019. p. 1705–1711. https://doi.org/10.1007/978-3-319-96071-5_175.

O’Hara AC, Miller AC, Spinks H, Seifert A, Mills T, Tuininga AR. The Sustainable Prescription: Benefits of Green Roof Implementation for Urban Hospitals. Frontiers in Sustainable Cities. 2022;4: 798012. doi: 10.3389

/frsc.2022.798012.

Ulrich RS, Berry LL, Quan X, Parish JT. A Conceptual Framework for the Domain of Evidence-Based Design. HERD: Health Environments Research & Design Journal. 2010;4(1): 95–114. doi: 10.1177/193758671000400107.

Salonen H, Lahtinen M, Lappalainen S, Nevala N, Knibbs LD, Morawska L, et al. Physical characteristics of the indoor environment that affect health and wellbeing in healthcare facilities: a review. Intelligent Buildings International. 2013;5(1): 3–25. doi: 10.1080/17508975.2013.764838.

Allahyar M, Kazemi F. Landscape preferences of a children’s hospital by children and therapists. Urban Forestry & Urban Greening. 2021;58: 126984. doi: 10.1016/j.ufug.2021.126984.

Bulakh I, Merylova I. Sustainable Hospital Architecture - Potential of Underground Spaces. Civil Engineering and Architecture. 2020;8(5): 1127–1135. doi: 10.13189/cea.2020.080539.

Downloads

Published

30-08-2023

How to Cite

1.
Application of an evaluation tool for mega-hospital site sustainability. Assessment of public private partnership large sized healthcare infrastructures in European context. Acta Biomed [Internet]. 2023 Aug. 30 [cited 2024 Jun. 17];94(S3):e2023156. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/14281

Most read articles by the same author(s)

1 2 > >>