#HFMC17

Prachi GarnawatPhD Candidate

School of Property, Construction and Project Management

RMIT University

Beyond compliance: meeting the indoor environmental needs of the occupants in hospital buildings

#HFMC17

• Background to the research • Objectives of the study• Initial findings from the case study• Discussion • Way forward

Outline

#HFMC17

IEQ

Air Quality

Visual Comfort

Acoustic comfort

Thermal Comfort

• There are various parameters that influence IEQ of a building

• IAQ, thermal, acoustic and visual comfort are considered as the key parameters

• The nature and impact of the IEQ parameters vary with the types of buildings

Indoor environmental quality (IEQ)

#HFMC17

Major Impacts of IEQ in Healthcare Facilities

#HFMC17

IEQ regulations and guidelines for healthcare facilities

#HFMC17 Sources: 1Building Code of Australia (ABCB, 2016); 2AS 1668.2 (Standards Australia, 2012); 3ANSI/ASHRAE Standard 62.1 (ASHRAE, 2010); 4AS 4260 (Standards Australia, 1997a); 5ASHRAEStandard 55 (ASHRAE, 2013); 6AS/NZS 1680-2.5 (Standards Australia, 1997b)

Compilation of IEQ standard limits

#HFMC17

• There is a limited information and research available on IEQ in Australian healthcare facilities

• There are no standardized IEQ assessment methods and guidelines for healthcare facilities

• The related guidelines suggest minimum requirementswhich might not meet occupant needs and occupant satisfaction

Assessment of IEQ in Healthcare Facilities

#HFMC17

• To identify the current practices in management of IEQin Australian Hospitals

• To identify the IEQ parameters considered by building occupants (such as hospital staff) to provide satisfactoryindoor environment

• To analyse and manage the gap between the occupants’ preference and the building performance in terms of IEQ

Objectives of the study

#HFMC17

Research Instrument

#HFMC17

Manager Survey Staff Survey

Survey Design

#HFMC17

• Regional public hospital in Victoria• It provides services from emergency, medical, surgical

to aged care and rehabilitation• Medium sized hospital with 65 acute and 90 high care

beds

Case Study

#HFMC17

• Total occupancy- 120

• Response rate- 28%

• Gender- Female- 80 %

• Average age- 42 years• Average Experience in HC- 15

years (1-36 years)• Average Experience in the

hospital 10 years (1-30 years)

Survey Results

9%

35%

3%

15%

29%

9%

Respondents

Medical

Officer/Practitioner

Nurse

Diagnostic

professionals

Allied health

professionals

Administrative and

clerical staff

Other

#HFMC17

Code Parameter

AQ1 Presence of operable Windows and natural

ventilation

AQ2 Air Quality (Dusty)

AQ3 Air Freshness (Stuffy)

AQ4 Olfactory (odour) Comfort (Smelly)

AQ5 Ability to control air quality

TC1 Air temperature during winters

TC2 Relative Humidity

TC3 Ability to control air temperature

TC4 Air temperature consistency in a day

TC5 Air temperature during summers

LC1 Level of light or luminance

LC2 Flickering of Light

LC3 Ability to control artificial lighting level

LC4 Availability of natural/daylight

LC5 Access to outside views

LC6 Shading devices on window to control sunlight

Code Parameter

AC1 Noise Levels

AC2 Ability to avoid disturbance due to

noise from co-workers

AC3 Ability to avoid disturbance due to

noise from equipment

SQ1 Space available for individual work

SQ2 Cleanliness

SQ3 Availability of places of Respite

SQ4 Privacy

SQ5 Availability of Prayer and quiet rooms

SQ6 Availability of Children activity room

SQ7 Way finding

F1 Availability of feedback system

F2 Regular survey for feedback

F3 Action taken on the reports

#HFMC17

Satisfaction with IEQ

62

%

45

%

79

%

69

%

59

%

35

%

92

%

95

%

96

%

96

%

91

%

81

%

IND OOR A IR QUA LITY

THERMA L COMFORT

LIGHTING A COUSTIC SPA TIA L QUA LITY

FEED BA CK

OVERALL IEQ

Satisfaction

Importance

#HFMC17

• Lighting and acoustic comfort were given the highest importance followed by thermal comfort and air quality.

• The least satisfactory parameter to the staff was regular survey of IEQ followed by their ability to controltemperature and ventilation settings.

• There seems to be a need to move beyond compliance to include occupants’ need in hospital IEQ provision

Discussion

#HFMC17

• Provide research for evidence based designing of hospital buildings that reflects the needs of all the occupants

• Include the experience of IEQ and facilities managers in the hospital research and development

• Investigate and develop integrated IEQ assessment and management framework which involves all the stakeholders

Way Forward

#HFMC17

Thank You.

Prachi Garnawatemail: prachi.garnawat@rmit.edu.au

School of Property, Construction and Project ManagementRMIT UniversityMelbourne, Australia

#HFMC17

• 1ABCB. 2016. National Construction Code, Building Code of Australia Volume 1 - Class 2 to 9 Buildings, Canberra: Australian Building Codes Board (ABCB)

• 2Standards Australia. 1997b. AS/NZS 1680-2.5: Interior lighting Part 2.5: Hospital and medical tasks, Sydney: Standards Australia and Standards New Zealand

• 3ASHRAE. 2010. ANSI/ASHRAE Standard 62.1-2010: Ventilation for Acceptable Indoor Air Quality. Atlanta, GA: ANSI/ASHRAE Standard 62.1-2010: Ventilation for Acceptable Indoor Air Quality

• 4Standards Australia. 1997a. AS 4260: High efficiency particulate air (HEPA) filters— Classification, construction and performance. Homebush, NSW: Standards Australia

• 5ASHRAE. 2013. ANSI/ASHRAE Standard 55-2013: Thermal Environmental Conditions for Human Occupancy (pp. 58). Atlanta, GA: American Society of Heating Refrigerating and Air-conditioning Engineers (ASHRAE)

• 6Standards Australia. 1997b. AS/NZS 1680-2.5: Interior lighting Part 2.5: Hospital and medical tasks, Sydney: Standards Australia and Standards New Zealand

Sources

#HFMC17

• ABS 2012, Industry Structure and Performance Australian Bureau of Statistics, viewed 25/04• ACSQHC 2012, Review of Patient Experience and Satisfaction Surveys Conducted Within Public and

Private Hospitals in Australia, ACSQHC, Australia.• AIHW 2016, Australia's Health, AIHW, Canberra.• Armstrong, BK, Gillespie, JA, Leeder, SR, Rubin, GL & Russell, LM 2007, 'Challenges in health and

health care for Australia', Medical Journal of Australia, vol. 187, no. 9, pp. 485-489, • Australian Government 2016, Industry Employment Projections, Canberra• Garnawat, P, Andamon, MM, Wong, JP & Woo, J 2017, 'Assessment of indoor environmental

quality in Australian healthcare facilities: a review of standards and guidelines', Healthy Buildings 2017 Europe, Lublin, Poland

• Health Workforce 2014, Australia’s Future Health Workforce – Nurses Overview Report, Canberra.• NHMRC 2010, Australian Guidelines for the Prevention and Control of Infection in Healthcare

NHMRC, Canberra, Australia• Naccarella, L, Buchan, J, Sheahan, M, Reading, M, Chevez, A & Pollard, B 2016, Design Matters For

Nurses: Hospital design for nurse attraction and retention, HASSELL, Melbourne, Australia.• Ulrich, R, Quan, X, Zimring, C, Joseph, A & Choudhary, R 2004, The Role of the Physical Environment

in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity.• U.S. Department of Health and Human Services 2012, The Physical Environment: An Often

Unconsidered Patient Safety Tool, viewed 19/06

References