Bed count

An artist's impression of the Cleveland Clinic hospital in Abu Dhabi, which is under development by Mubadala.

Linked to this issue is that of equipment installation. Since each division of the hospital is likely to require high-tech equipment, installation jobs would be extremely difficult for non-specialists.

“If you consider X-ray equipment for example,” says the Abu Dhabi designer, “it requires a specific power supply, certain wirings and cables, specific connections to the Building Management System (BMS), its own flooring requirements or platforms and room temperature control. The walls will also need to be insulated effectively to protect them from X-rays.”

And where multi-million pound machines such as MRI scanners need to be integrated, there is an added risk of serious financial outlay should the contractors take it upon themselves to install this kind of equipment and accidentally damage it.

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Even where specialists are brought in, project managers should remain aware of the risk of damage caused by leaving equipment in the heat for long periods.

Tricky finishing works
The finishing works, sometimes perceived to be ‘post-construction works’, are extremely important in hospital building. According to technical experts, the need for perfection puts a substantial amount of pressure on those not only carrying out the finishes, but on the other contractors as well.

“On completion, a hospital building has to be immaculately clean,” explains Clough. “This means that nothing other than the equipment required should be left in floor or ceiling voids, dust has to be kept to a minimum during all stages of the build and surfaces have to be sealed.”

Central to these requirements is hygiene and the ongoing use of the building after construction – it being imperative to consider the long-term operation of the facility during the design, supply and construction phases.

“The paints and all the finishes must be washable and must not allow bacterial growth,” says the Abu Dhabi designer.

“All the materials and equipment installed must be suitable for their purpose for a long time without the need for regular repair and maintenance. In a hospital, you can’t tolerate failures or shut-downs for repairs.”

He adds that the public areas where operators expect heavy pedestrian and light equipment movement, must be fitted with heavy duty flooring and paintwork to protect them from damage.

Across the board, experts agree that successful hospital building boils down to quick and early coordination. This, on top of expert knowledge of the specific requirements, and an approach to building which is advanced as the systems themselves.

Integrated architecture and engineering is therefore paramount, alongside recognition that the hospital environment is profoundly influenced by the building form and envelope.