Healthcare

Hospital buildings need to be facilities that help medical sta in the e cient 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.

Concrete bene ts

As well as providing the structural frame, concrete can be used to improve the overall
performance of the building, including:

Work environment

Concrete is inert with no harmful o -gassing, and its structural form is commonly associated
with enhanced natural ventilation and daylighting. It provides robust, damage-resistant surfaces
for walls, partitions, columns, so ts 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.

Fire resistance

Concrete is inherently re resistant and, unlike some materials, normally requires no added re
protection. This avoids the delays and disruptions of following trades caused by site applied
protection or repair on site of damaged o -site applied protection. Concrete’s re protection is
provided at no extra cost and does not need continuing maintenance or reapplication after
refurbishment or retro t.

In addition, the inherent re resistance results in concrete often performing in excess of design
requirements for occupant safety. This bene ts the building owner/user as repairs and the
period before re-use following a re are minimised.

Acoustics
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

Vibration control is crucial particularly in areas such as operating theatres and night wards and
is an important factor in the design speci cation 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.

Flexibility

Healthcare methods, provision of IT, patient expectations and standards of environment and
equipment are all changing rapidly, so exibility 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 exibility.  

Toughness

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.

Concrete solutions

The choice and design of a building’s frame and cladding can have a surprisingly large in uence
on the performance of the nal 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.

Flat slab construction

Currently,  at 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 at 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 

Ribbed in-situ slabs on wide shallow beams are lighter than at slabs and even better for
vibration. However, this has to be o set against being less versatile and taking longer to
construct.

Hybrid concrete construction 

Hybrid concrete construction combines the best qualities of precast concrete (high-quality
nishes, o -site manufacture) with those of in-situ construction ( exibility for late changes,
mouldability, robustness, two-way spanning, local manufacture).  For more information refer to
The Concrete Centre publication Hybrid Concrete Construction.

Concrete proof 

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 bene ts discussed above should be included in
the cost comparison because they can reduce costs for other elements of the building.

To see results of the study, download Hospital Construction, published by The Concrete Centre.
For the full results, purchase the full technical report.