Hospital buildings need to be facilities that
help medical staff in the efficient 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 mean for
the project team to accomplish these requirements by helping
improve the function, value and whole life performance of the
As well as providing the structural frame
concrete can be used to improve the overall performance of the
Concrete is inert with no harmful off-gassing,
and its structural form is commonly associated with enhanced
natural ventilation and daylighting. It provides robust,
damage-resistant surfaces for walls, partitions, columns, soffits
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.
Concrete is inherently fire resistant and, unlike some materials,
normally requires no added fire protection. This avoids the
delays and disruptions of following trades caused by site applied
protection or repair on site of damaged off-site applied
protection. Concrete’s fire protection is provided at no extra
cost and does not need continuing maintenance or reapplication
after refurbishment or retrofit.
In addition, the inherent fire resistance
results in concrete often performing in excess of design
requirements for occupant safety. This benefits the building
owner/user as repairs and the period before re-use following a fire
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 control is
crucial particularly in areas such as operating theatres and night
wards and is an important factor in the design specification of
building frames. Concrete can easily be designed for the most
complete control of vibration over whole areas.
Healthcare methods, provision of IT, patient
expectations and standards of environment and equipment are all
changing rapidly, so flexibility 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
Concrete is a robust material that is capable
of withstanding severe treatment 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.
The choice and design of a building’s frame
and cladding can have a surprisingly large influence on the
performance of the final 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, flat 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 flat slabs are post-tensioned to reduce slab thickness and
provide potential for longer spans of up to 12 metres if
Ribbed in-situ slabs on wide shallow beams
Ribbed in-situ slabs
on wide shallow beams are lighter than flat slabs and even better
for vibration. However, this has to be offset against being less
versatile and taking longer to construct.
Hybrid concrete construction
construction combines the best qualities of precast concrete
(high-quality finishes, off-site manufacture) with those of in-situ
construction (flexibility for late changes, mouldability,
robustness, two-way spanning, local manufacture). For more
information refer to The Concrete Centre publication
Hybrid Concrete Construction.
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 benefits 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.