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Think long-term for lifetime achievement

Theme: building for health and disability -Issues ranging from the role of art in hospitals to the effectiveness of 'no-touch' taps in controlling hospital acquired infections are addressed in this feature, compiled by Martin Sutcliffe, director of health

If we want our buildings to serve their users as well as possible, we need to employ a whole-life approach to their design. This has particular implications for healthcare buildings, argues Chris Bicknell.

Designers of buildings and their associated systems rely on the briefing process to develop solutions to meet the anticipated needs of the occupants and users. Focused traditionally on the physical delivery of buildings, often these briefs have not addressed adequately the delivery of a lifetime process.

The potentially greater lifetime risks tend not to be addressed unless the design is driven from the long-term viewpoint Any building is a blend of often contradictory and complex systems and functions, and all decisions taken early on in the design process can have a profound impact on the future operational success of the project.

Designing for life is a process of understanding how developments will perform over time and catering for these needs from the start. Before the traditional design brief can be developed, a brief must be in place to inform design decisions from the whole-life needs of the complex. If you do not consider the operational issues until later in the process, you will miss the point that all design needs to be driven by these issues if a longterm solution is to be offered.

Remember that 80 per cent or more of the operational performance (and costs) are fixed in the first 20 per cent of the design process.

In any development there will be a myriad of components with intermediate lives and operational needs. All need 'designing in' from the earliest possible moment. The key to a successful and holistic solution is for the whole development team to understand these time-dependent needs.

It will rely on an integrated team really understanding from inception what drives the success of a project and where the future operational risks lie.

Buildings exist not only in space but also in time. Various elements of a building have entirely separate life profiles and must be designed with differing replacement periods in mind from inception.

Each member of the design team has a particular interest and responsibility for differing components and systems within the building. These will range from the dayto-day need of the facilities-management department to consider movement of 'stuff' such as desks within churn management, to the longer-term considerations of the architectural and engineering components in the fabric envelope.

In hospitals, patient recovery rates may be improved by creating a more relaxed environment, one that is less institutional or less 'like a hospital'. This could be achieved by specifying finishes that satisfy the same functions as 'standard healthcare' solutions but are more welcoming in style (carpets v vinyl). Which needs have priority? (Patient environment v maintenance efficiency? ) And how best should you spend a limited budget?

Alternatively, in environments where misuse is a problem, installation of more robust materials can be a realistic option to improve lifetime performance. Understanding the whole-life nature of the solution is vital to avoid ongoing failures and problems.

Each scheme may have a similar but unique set of drivers for a successful solution.

An understanding by everyone involved in the delivery of a project of how these interact can ensure a risk-managed, predictable and successful solution.

Good buildings support the processes they house and enable resources to be expended on healthcare, not on increased facilities maintenance.

Chris Bicknell is associate director of Building Performance Group

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