Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview

Adaptive Reuse of Social and Healthcare Structures: The Case Study as a Research Strategy

The regeneration and reuse of abandoned healthcare facilities represent one of the most complex issues in the broader field of disused public architectural heritage and its valorization. The leading causes of an elevated quantity of abandoned hospitals are the lack of resilience of these structures, as well as the evolution of the regulatory framework used to increase the quality standards of the National Health System and the constant changes caused by medical discoveries. In addition, the transfer to a new building typically does not involve consideration of the future of the dismissed facility with a lack of a strategic view for its regeneration, thus causing its progressive degradation. Although their large dimensions and unbuilt areas make recovery plans complex, the re-functionalization of these facilities represents an excellent opportunity for social and economic development, as several case studies demonstrate. This paper selects some useful examples of the reconversion and reuse of disused social and healthcare buildings through an accurate comparison that highlights the importance of the topic and the possible actions to be taken into consideration. Although this research focuses on a limited number of case studies, the paper gives rise to some strategies that can be applied to several current cases of disused buildings that could be used to support Decision Makers (DMs) from different countries.

Flexibility during the COVID-19 Pandemic Response: Healthcare Facility Assessment Tools for Resilient Evaluation

Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the extraordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.