Key criteria of sustainable hospital refurbishment: A stakeholder review

Hospital refurbishment has taken a secondary role in the last decade, in favour of new build facilities. This has allowed the Client and the Design Team to build and specify with greater flexibility and from essentially a 'blank canvas'. Correspondingly, sustainability as an issue has been easier to plan and implement from the earliest briefing and design stage. The changing economic landscape has necessitated that the focus has now shifted to the refurbishment of the existing healthcare estate. Refurbishment is widely recognized as presenting unique challenges in its own right. Add to this the institutional and statutory requirements in the arena of sustainability and the unique functional characteristics of an operational hospital and these challenges are increased. Given the practical and economic challenges of refurbishment as an activity, weighed against a facility as multi-faceted and complicated as a hospital, a structured and prioritized process of decision making is required. A multi-criteria decision making (MCDM) approach is discussed as being most suitable for this process. A pilot study of a non-random sample of industry experts is analysed to establish a baseline knowledge platform of the key research variables and subsequent method of selecting criteria. The overall findings establish a good awareness of sustainable development and familiarity with key documentation and guidance, however knowledge of the capital investment appraisal process and the use of MCDM tools is shown to be very limited.