Proposal of a Framework to Evaluate the Building Performance of Local Healthcare Facilities

In healthcare design, building performance evaluation (BPE) is a critical aspect of the construction and operation of buildings. This type of evaluation focuses on the functional, technical and environmental aspects of the building performance (e.g. site location, accessibility, energy consumption, indoor environmental quality, etc.) but also on the social performance (e.g. effects of the design on occupants’ comfort and well-being, etc.). This is particularly relevant in the current development of local healthcare facilities (e.g. primary care centres, community hospitals, etc.) – occurring in several European countries, including Italy – where design features should be evaluated not only for their direct impact on individual health outcomes, but also on local communities and their environment. By combining a literature review and comparative analysis of 9 existing Post-Occupancy Evaluation (POE) and Building Performance Evaluation (BPE) tools for evidence-based design of healthcare environments, this paper proposes a conceptual framework, comprising building performance criteria and items across 5 different domains, aimed at streamlining the development of evaluation tools that are well-suited to assess local healthcare facilities.

Introduction—In healthcare design, building performance evaluation is a critical aspect of the construction and operation of buildings. This is particularly relevant in the current development of local healthcare facilities (e.g. primary care centres, community hospitals, etc.)—occurring in several European countries, including Italy—where design features should be evaluated not only for their direct impact on individual health outcomes, but also on families, local communities, and the environment. However, in Mediterranean countries, the recognition of building performance evaluation in healthcare design remains limited due to the lack of studies and tools in this field. For this reason, this paper aims to establish a conceptual framework to streamline the development of integrated evaluation tools that comprehensively addresses the broader impact of local healthcare facilities.Methodology—The methodology comprises: (i) a literature review to collect existing Building Performance Evaluation (BPE) and Post-Occupancy Evaluation (POE) tools for healthcare facilities; (ii) the analysis of a selection of 9 tools and their respective assessment items that were extracted and listed separately; (iii) the development of the framework through categorisation of similar evaluation items under new assessment criteria and new aggregated evaluation domains.Results—The result is the definition of a hierarchy-based evaluation framework to systematise frequently addressed healthcare building evaluation criteria and items, according to new six performance domains. This framework could support the development of building performance evaluation tools that are targeted to assess local care facilities’ design against specific objectives related to the most critical performance areas and to the stages at which they are adopted. These tools would be valuable not only to informed decision-making and to design quality achievements, but also to the meaningful engagement of different categories of end-users (e.g. healthcare organisations, healthcare staff, patients, the community, etc.) for informed prioritisation of design objectives throughout the design process. Alternatively, when implemented in post-occupancy phases, they could inform healthcare design generating a feedback loop to enhance future projects. Introduction—In healthcare design, building performance evaluation is a critical aspect of the construction and operation of buildings. This is particularly relevant in the current development of local healthcare facilities (e.g. primary care centres, community hospitals, etc.)—occurring in several European countries, including Italy—where design features should be evaluated not only for their direct impact on individual health outcomes, but also on families, local communities, and the environment. However, in Mediterranean countries, the recognition of building performance evaluation in healthcare design remains limited due to the lack of studies and tools in this field. For this reason, this paper aims to establish a conceptual framework to streamline the development of integrated evaluation tools that comprehensively addresses the broader impact of local healthcare facilities. Methodology—The methodology comprises: (i) a literature review to collect existing Building Performance Evaluation (BPE) and Post-Occupancy Evaluation (POE) tools for healthcare facilities; (ii) the analysis of a selection of 9 tools and their respective assessment items that were extracted and listed separately; (iii) the development of the framework through categorisation of similar evaluation items under new assessment criteria and new aggregated evaluation domains. Results—The result is the definition of a hierarchy-based evaluation framework to systematise frequently addressed healthcare building evaluation criteria and items, according to new six performance domains. This framework could support the development of building performance evaluation tools that are targeted to assess local care facilities’ design against specific objectives related to the most critical performance areas and to the stages at which they are adopted. These tools would be valuable not only to informed decision-making and to design quality achievements, but also to the meaningful engagement of different categories of end-users (e.g. healthcare organisations, healthcare staff, patients, the community, etc.) for informed prioritisation of design objectives throughout the design process. Alternatively, when implemented in post-occupancy phases, they could inform healthcare design generating a feedback loop to enhance future projects.