Improving sustainability during hospital design and operation: a multidisciplinary evaluation tool
In: Green energy and technology
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In: Green energy and technology
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In: SpringerBriefs in Applied Sciences and Technology Ser
Intro -- Foreword -- Preface -- Contents -- Abbreviations -- 1 A New Challenge in Healthcare for India -- Abstract -- Rethinking the Healthcare in India -- The Indian Context -- The West Bengal Region -- References -- 2 The Current Indian Healthcare System and West Bengal's Health Status -- Abstract -- Indian National Health System -- Epidemiological Scenario and Health Criticisms -- Maternal and Child Health and Gender Issues -- Access to Improved Toilets and Wastewater -- Human Resources -- Health Status in West Bengal -- References -- 3 The Existing Indian NGOs' Scenario and the Local Actions in West Bengal -- Abstract -- The Indian NGOs' Scenario -- A Brief History Description of NGOs in India -- NGOs in West Bengal -- References -- 4 Design Approaches for a New Indian Healthcare -- Abstract -- Definition of the Factors Involved and Goals to be Achieved -- Environmental and Climatic Factors -- Social, Cultural and Typological Factors -- Construction-Technological Factors and Strategies -- Bamboo -- Mud -- Straw -- Steel -- Linoleum -- Lime -- Sum up -- References -- 5 Healthcare for All: A New Multidisciplinary Approach for Designing and Managing Hospital Layouts in India -- Abstract -- A Dimensional, Building Performance and Healthcare Services' Focus of IIMC' Healthcare Facilities for Understanding the Current Scenario -- Criteria of Settlement Development -- Identification of Main Flows and Paths -- Strategies for the Definition of the Urban Morphology -- The Module -- Functional Blocks and Aggregative Forms -- A First Level of Care: Urban/Receptive Block -- A Second Level of Care: The Outdoor Sanitary Block -- A Third Level of Care: Indoor Sanitary Block -- Energy Community Centre -- Development of a Masterplan Meta-Project for a New Healthcare Scenario -- Management Model -- Considerations and Perspectives -- References
Indoor Air Quality (IAQ) is one of the main topics in which governments are focusing. In architectures for health, several researches are reporting a growing number of data analysis and research works in order to improve users' health. Although many studies have been conducted related to the biological and physical risks, the chemical risks have been less investigated and only in some specific functional areas of the hospitals. Starting from some systematic reviews and research works, the paper aims to identify and list the best healthy practices for an adequate IAQ in inpatient wards. In particular, the handbook lists the solutions and strategies related to chemical pollution, starting from design and management, with a focus on (1) localization of hospitals and inpatient rooms, (2) hospital room, (3) microclimatic parameters, (4) ventilation systems, (5) materials and finishing, (6) furniture and equipment, (7) cleaning products and activities, (8) maintenance and (9) management activities, and (10) users and specific training of the workers. The multidisciplinary approach emphasizes the need for interdisciplinary knowledge and skills aimed to find solutions able to protect users' health status. The design and management decision-making, ranging from the adequate choices of construction site and hospital exposure, finishing materials, cleaning and maintenance activities, etc., which can affect the IAQ must be carried out based on scientific research and data analysis.
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Introduction. Indoor air quality is one the main issues in which governments are focusing. In healing spaces, several research studies are reporting a growing number of data analysis and research works in order to guarantee and prevent health of users and workers. Currently the main investigations are about biological and physical risks; otherwise chemical ones are less investigated. Several countries are carrying out indoor air quality monitoring in those professional workplaces in which chemicals are used but also in some typically indoor (generic) spaces for the building hygiene assessment. The indoor air is affected by several factors that currently are analyzed punctually, without a whole scenario of all the variable performances. The authors have done a systematic review on the current state of the art and knowledge related to chemical pollution in healing spaces and the emerging strategies, supported by scientific literature, for healthy inpatient rooms and their indoor air. Methodology. The systematic review has been done through the analysis of papers from SCOPUS, DOAJ, and PubMed databases. The survey sample considered 483 scientific articles, between 1989 and 2017, and starting the systematic reading and analysis of the abstracts, only 187 scientific papers were selected, and only 96 were accessible. Discussion. Since scientific literature reports very different outputs and results, the resulting work from the survey is divided into specific fields of interest related to construction and finishing materials, installations, components, ventilation systems, processes, etc. Starting from the systematic reading, the paper classifies the factors of indoor air in four macroareas: outdoor air and microclimatic factors (temperature, relative humidity, air velocity, air change, etc.); management activities (management and maintenance activities, ventilation systems, HVAC, cleaning and disinfectant activities, etc.); design factors (room dimensions, furniture, finishing materials, etc.); and human presence and medical activities (users' presence, their health status, and medical activities carried out in inpatient rooms). Conclusion. The systematic review gives rise to a broad scenario on the existing knowledge regarding the indoor air pollution, design, and management strategies for healthy spaces and several emerging topics. Although the aim of the investigation is strictly related to chemical pollution, several considerations from the biological point of view have been listed. The systematic review, supported by the existing scientific literature, becomes a starting point for considering the importance of the topic and to stimulate the knowledge around this field of interest for improving studies, analysis, and simulations.
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Emergenza e infrastrutture sanitarie Sono molte le condizioni di emergenza che, nel panorama globale attuale, ci si trova ad affrontare. Da definizione, lo "stato di emergenza" è una misura adottata per affrontare casi di pericolo e/o minaccia imminente, e solitamente viene dichiarato quando si verifica un disastro naturale, oppure la presenza di disordini civili o a seguito di una dichiarazione di guerra. Caratteri differenti e molteplici distinguono l'ampia casistica delle situazioni di emergenza e altrettante criticità si presentano nel momento in cui l'uomo cerca di porvi rimedio con risposte differenti per temporaneità, efficacia ed impatto dell'intervento sul territorio. Negli ultimi anni si sono registrati numerosi eventi che hanno determinato situazioni di emergenza a livello sanitario-epidemico, ambientale e socio-politico, a scala globale o locale. Seppur dovuti da differenti cause, l'aspetto che accomuna questi diversi stati di emergenza è la necessità di garantire strutture socio sanitarie e abitative che possano supportare le operazioni di primo soccorso. In tale contesto, pertanto, è di fondamentale importanza la risposta delle strutture sanitarie esistenti e/o l'allestimento di strutture socio-sanitarie e abitative in grado di assicurare un ricovero a coloro che hanno dovuto abbandonare la propria abitazione. Tale tema risulta essere estremamente attuale e di fondamentale importanza all'interno del quadro sociale globale perché tale condizione implica necessariamente una diffusione capillare della conoscenza delle suddette tematiche, in modo tale da implementare e migliorare la risposta all'emergenza. Casi esemplificativi a scala nazionale e internazionale Attualmente, in diversi contesti sociopolitici piuttosto critici per la presenza di conflitti bellici, le architetture per la salute si sono adattate per rispondere a diverse esigenze di emergenza: per esempio nell'Assuta Hospital in Israele i piani parcheggi interrati sono stati concepiti come dei veri e propri bunker e sono stati pertanto progettati per poter trasformarsi in aree sanitarie e rispondere alla necessità emergenziale di garantire il servizio sanitario anche in caso di attacco aereo. La flessibilità degli spazi e delle organizzazioni risulta essere quindi un requisito fondamentale per far fronte a diverse situazioni emergenziali siano esse temporanee o prolungate nel tempo. Sul territorio nazionale, invece, si può osservare come nell'area del Pronto Soccorso (Dipartimento Emergenza e Accettazione) degli ospedali italiani è possibile trovare aree dedicate ad affrontare similari situazioni, anche se meno consuete. È il caso dell'area "Bioterrorismo – decontaminazione" e l'area polifunzionale "Catastrofi – Emergenze", composta da spazi "polmone" adatti ad ospitare un numero elevato di utenti al sopraggiungere di specifiche situazioni di emergenza. Tali locali non afferiscono a quegli spazi obbligatori che la normativa nazionale prescrive sotto forma di requisiti strutturali, tecnologici ed organizzativi minimi per l'esercizio delle attività sanitarie da parte delle strutture pubbliche e private per Decreto del Presidente della Repubblica del 14/01/1997. L'analisi approfondita di alcune aree di Pronto Soccorso di recente realizzazione in Italia, ha evidenziato che in 4 casi su 16 (25%) è possibile riscontrare la presenza di aree "Bioterrorismo – decontaminazione", mentre in un solo caso (6%) si è rilevata la presenza dell'area polifunzionale "Catastrofi – Emergenze". Questi dati evidenziano una grande criticità e carenza di spazi per la gestione straordinaria delle emergenze attraverso le strutture ospedaliere italiane, anche alla luce di recenti stime che propendono per una crescita sempre maggiore di emergenze per cause naturali e non, già in continuo aumento. Criticità delle strutture sanitarie italiane La carenza di spazi dedicati all'interno delle aree di Pronto Soccorso per rispondere alle grandi emergenze, la mancanza di una cultura diffusa sul tema e l'obsolescenza della maggior parte delle strutture sanitarie italiane (oltre il 70% è stato realizzato prima del 1970), porta ad individuare nell'allestimento di campi di emergenza temporanei la soluzione più ottimale e strategica. Attraverso la raccolta di informazioni riguardo la tematica delle strutture socio-sanitarie e abitative per l'emergenza, però emerge una mancanza di competenze adeguate da parte di volontari e operatori che per le prime volte si sono trovati a lavorare nell'ambito della realizzazione di tali allestimenti. Obiettivo della ricerca Pertanto, emerge la necessità di proporre strategie organizzative e indicazioni progettuali sulla realizzazione e sul funzionamento dei campi di primo soccorso e di tutte le strutture adibite alla cura in situazioni di emergenza che possono anche configurarsi come tendopoli. L'obiettivo è quello di rispondere alle necessità di diffondere e rendere facilmente accessibili la conoscenza delle principali procedure attuabili in condizioni di emergenza di vario genere. Metodologia Supportati da un ampio campione di casi studio, si sono distinti gli stessi in tre grandi macro-gruppi, caratterizzanti le tre principali tipologie di emergenze, ovvero: • legate ad una componente epidemica; • generate da un evento naturale o climatico disastroso; • dovute a problematiche sociali e politiche, quali le guerre e migrazioni. Per la raccolta dei materiali utili, è seguita una prima fase di analisi di casi studio, basata sulla tipologia di struttura relazionata alle dimensioni, il numero di pazienti ospitabili e il numero di operatori necessari per gestirla; il tutto è quindi stato posto in relazione alla tipologia di emergenza che la tendopoli o la struttura sanitaria si trovavano a dover affrontare. Una matrice di analisi basata su dati quantitativi (quali l'estensione, la capacità ricettiva e la permanenza) e qualitativi (come l'organizzazione logistica delle funzioni interne) ha permesso di confrontare diversi casi studio internazionali. L'obiettivo di tale analisi è la comprensione delle modalità di pianificazione e allestimento delle diverse tipologie di strutture per l'urgenza. A partire dalla matrice di confronto, i casi studio sono stati sottoposti ad un'analisi critica che ha permesso di analizzare le differenti funzioni al loro interno, la loro organizzazione e le relazioni spaziali e funzionali in essere tra le diverse aree. Questa analisi ha permesso così di sviluppare una coscienza critica riguardo alle corrette modalità di realizzazione delle strutture in questione e una maggior consapevolezza riguardo gli accorgimenti da mettere in atto nelle fasi di progettazione e allestimento delle stesse. Risultati e sviluppi della ricerca Il risultato finale si traduce in una proposta meta-progettuale di layout funzionali, rispettivamente per ogni macro-area, e la definizione delle principali raccomandazioni che costituiscono un supporto alla realizzazione e all'allestimento del soccorso sanitario per le vittime colpite da calamità naturali, problematiche socio-politiche o emergenza di carattere epidemico. Tali considerazioni, suddivise in base alle diverse tipologiche di evento catastrofico, possono supportare i decisori nella scelta delle strategie ottimali da attuare quali l'individuazione dell'area, la programmazione delle fasi di soccorso e di insediamento, e l'applicazione delle relazioni funzionali e spaziali più adeguate ed efficaci. Il lavoro di ricerca si pone dunque come punto di partenza per un più approfondito studio riguardante le modalità che meglio si adattano ad ogni contesto di rischio, per effettuare scelte consapevoli, efficaci e coerenti rispetto alla tipologia di emergenza che ci si trova ad affrontare.
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Indoor air quality (IAQ) is one of the main topics in which governments are focusing. In healthcare facilities, several studies have reported data analysis and case studies to improve users' health. Nowadays, although many studies have been conducted related to the biological and physical risks, the chemical risks have been less investigated and only in some specific functional areas of the hospitals. Starting from some systematic reviews and research works, this paper aims to list the best healthy practices for an adequate IAQ in inpatient wards. In particular, the decalogue lists the strategies related to chemical pollution, starting from design and management, with a focus on (a) localization of hospitals and inpatient rooms, (b) hospital room, (c) microclimatic parameters, (d) ventilation systems, (e) materials and finishing, (f) furniture and equipment, (g) cleaning products and activities, (h) maintenance and (i) management activities, and (l) users and workers. The multidisciplinary approach emphasizes the need for interdisciplinary knowledge and skills aimed to find solutions able to protect users' health status. The design and management decision-making, ranging from the adequate choices of construction site and hospital exposure, finishing materials, cleaning and maintenance activities, etc., which can affect the IAQ must be carried out based on scientific research and data analysis.
BASE
Indoor air quality (IAQ) is one of the main topics in which governments are focusing. In healthcare facilities, several studies have reported data analysis and case studies to improve users' health. Nowadays, although many studies have been conducted related to the biological and physical risks, the chemical risks have been less investigated and only in some specific functional areas of the hospitals. Starting from some systematic reviews and research works, this paper aims to list the best healthy practices for an adequate IAQ in inpatient wards. In particular, the decalogue lists the strategies related to chemical pollution, starting from design and management, with a focus on (a) localization of hospitals and inpatient rooms, (b) hospital room, (c) microclimatic parameters, (d) ventilation systems, (e) materials and finishing, (f) furniture and equipment, (g) cleaning products and activities, (h) maintenance and (i) management activities, and (l) users and workers. The multidisciplinary approach emphasizes the need for interdisciplinary knowledge and skills aimed to find solutions able to protect users' health status. The design and management decision-making, ranging from the adequate choices of construction site and hospital exposure, finishing materials, cleaning and maintenance activities, etc., which can affect the IAQ must be carried out based on scientific research and data analysis.
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In: Land use policy: the international journal covering all aspects of land use, Band 76, S. 634-644
ISSN: 0264-8377
Accessibility is often translated in design practice by means of a prescriptive approach, focusing on legislation's application, instead of understanding the real needs and wishes of users. On the contrary, the descriptive and performance-based approach of Design for All can help architects in designing inclusive environments. Therefore, it is fundamental to translate the existing theory into information that meets the architects' needs to link knowledge and practice. This study focuses on methods to inspire and support architects applying a Design for All strategy by gathering information and advice. In particular, the paper demonstrates a literature review to identify how to transfer design guidelines to architects. Based on the analysis of the included papers, four criteria were defined to translate Design for All information from users' needs into design indications for architects in a descriptive way. The current results will provide the basis for developing a tool to inspire and create awareness for architects on Design for All in architectural practice.
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Accessibility is often translated in design practice by means of aprescriptive approach, focusing on legislation's application, instead of understanding the real needs and wishes of users. On the contrary, the descriptive and performance-based approach of Design for All can help architects in designing inclusive environments. Therefore, it is fundamental to translate the existing knowledge into information that meets the architects' needs to link knowledge and practice. This study focuses on methods to inspire and support architects applying a Design for All strategy by gathering information and advice. In particular, the paper demonstrates a literature review to identify how to transfer design information to architects. Based on the analysis of the included papers, four criteria were defined to translate Design for All information from users' needs into design strategies for architects in a descriptive way. The current results will provide the basis for developing a tool to inspire and create awareness for architects on Design for All in architectural practice. ; Peer Reviewed
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Accessibility is often translated in design practice by means of a prescriptive approach, focusing on legislation's application, instead of understanding the real needs and wishes of users. On the contrary, the descriptive and performance-based approach of Design for All can help architects in designing inclusive environments. Therefore, it is fundamental to translate the existing theory into information that meets the architects' needs to link knowledge and practice. This study focuses on methods to inspire and support architects applying a Design for All strategy by gathering information and advice. In particular, the paper demonstrates a literature review to identify how to transfer design guidelines to architects. Based on the analysis of the included papers, four criteria were defined to translate Design for All information from users' needs into design indications for architects in a descriptive way. The current results will provide the basis for developing a tool to inspire and create awareness for architects on Design for All in architectural practice.
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Accessibility is often translated in design practice by means of aprescriptive approach, focusing on legislation's application, instead of understanding the real needs and wishes of users. On the contrary, the descriptive and performance-based approach of Design for All can help architects in designing inclusive environments. Therefore, it is fundamental to translate the existing knowledge into information that meets the architects' needs to link knowledge and practice. This study focuses on methods to inspire and support architects applying a Design for All strategy by gathering information and advice. In particular, the paper demonstrates a literature review to identify how to transfer design information to architects. Based on the analysis of the included papers, four criteria were defined to translate Design for All information from users' needs into design strategies for architects in a descriptive way. The current results will provide the basis for developing a tool to inspire and create awareness for architects on Design for All in architectural practice. ; Peer Reviewed
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AbstractIntroduction: WHO highlighted the need to strengthen the relationship between health and built environment; in particular, environmental factors and inadequate housing conditions are the most harmful risk factors for NCDs. Local Health Rules (LHRs) and Building Codes (BCs) are useful tools to provide safety and hygiene in building construction. The paper presents a survey on the adoption and updating of LHRs and BCs in Italian municipalities. Methodology: The survey analyses the state-of-the-art of LHRs, BCs and Municipal Development Plans (MDPs) on a sample of 553 cities, with different demographic and geographic characteristics from each other. Results: the survey highlights the serious shortage of updated LHRs, especially in small and medium municipalities. Instead, BCs and MDPs are much more current and updated, but only 30% of them are previously validated by Local Health Authorities. Conclusion: According to the analysis, it is necessary to introduce ever more performance guidelines, instead of prescriptive rules. The Government is taking steps to give rise to a National Building Code guidelines and this initiative could also be expanded to invest LHRs' issues.
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Introduction. WHO has highlighted the need to strengthen the relationship between health and built environment factors, such as inappropriate housing conditions. Local Health Rules (LHRs) and Building Regulations (BRs) are tools which provide safety and building hygiene in construction practices. Currently the Italian Government is considering to establish a National Building Regulation and, related to the following purpose, this paper presents a survey on the status of adoption and updating of LHRs and BRs in Italian municipalities. Methodology. The current Italian state of LHRs, BRs and Municipal Development Plans (MDPs) have been examined by a survey considering a sample of about 550 cities, with different demographic and geographic features, starting from the previous research work by Signorelli et al. (1999). Results. The analysis underlines a serious shortage of updated LHRs, especially in small and medium-sized municipalities whereas BRs and MDPs are widespread. Only 30% of them are previously approved and validated by Local Health Authorities. Conclusion. Starting from a survey, the present scenario of Building Regulations requires the introduction of further performance guidelines instead of normative ones and, therefore, the current actions to give rise to a National Building Regulation could be integrated by building hygiene contents of LHRs.
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