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Sustainability in Healthcare Facilities
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Sustainability in Healthcare Facilities

A special issue of Sustainability (ISSN 2071-1050). This special issue belongs to the section "Health, Well-Being and Sustainability".

Deadline for manuscript submissions: closed (31 March 2019) | Viewed by 33573

Special Issue Editors

Prof. Dr. Justo García Sanz-Calcedo

E-Mail Website
Guest Editor
Department of Engineering Projects, University of Extremadura, 06006 Badajoz, Spain
Interests: innovations in the research of healthcare buildings; healthcare engineering; buildings; project engineering
Special Issues, Collections and Topics in MDPI journals
Prof. Carlos Alberto Herrera Cáceres

E-Mail Website
Guest Editor
Universidad del Valle, Colombia
Interests: healthcare engineering; hospital facilities; energy efficiency; passive building acclimatization

Special Issue Information

Dear Colleagues,

Healthcare buildings are equipped with extensive and complex facilities. Certain characteristics are required in order to guarantee their sustainability: Adequate design, high quality equipment, energy saving installations, and maintenance efficiency, among others.

This type of infrastructure generates a great impact on the environment due to its intensive use and high energy consumption. The influence of the facilities on the overall sustainability of the buildings is substantial, becoming a challenge to healthcare engineering, since no action to improve sustainability should compromise the health and safety of hospital users.

This Special Issue includes new research and the latest technologies related to design and sustainable management of hospitals and healthcare centers. In particular, it includes a series of documents focused on:

  • New technologies for sustainable healthcare facilities: medical gases, HVAC, lighting, electricity, CWHC, DHW, compressed air, telecommunications, among others.
  • Studies related to consumption indicators of energy, water, medicinal gases, and fuels.
  • Resilient hospital facilities.
  • Production and treatment of hazardous clinical waste.
  • Air quality improvement.
  • Advanced reliability-based maintenance: Maintenance 4.0
  • Design of integrated operating theatres.
  • Strategies to improve energy efficiency in healthcare facilities.
  • Integration of renewable energies.
  • Eco-efficient and evidence-based design criteria for healthcare facilities.
  • Benchmarking, cost/benefit ratios, and KPIs proposed for hospital technical management.

We hope this Special Issue will improve the overall sustainability of hospital facilities, help to minimize their carbon footprint, and improve the safety and health of their patients and staff.

This Special Issue focuses on new research and the latest technologies related to design and sustainable management of hospitals and healthcare centers.

This Special Issue aims to improve the overall sustainability of hospital facilities, help to minimize their carbon footprint, and improve the safety and health of their patients and staff.

Within the field of healthcare building sustainability, this Special Issue contributes to a better understanding of and development of new technologies and their implementation in order to improve management efficiency in healthcare facilities, more in accordance with current demands.

Prof. Justo Garcia Sanz-Calcedo
Prof. Carlos Alberto Herrera Cáceres
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Sustainability is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Healthcare facilities
  • healthcare engineering
  • resilient installation
  • sustainable hospital management

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (5 papers)

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Research

31 pages, 4158 KiB  
Article
Optimization of Decision Making in the Supply of Medicinal Gases Used in Health Care
by María Carmen Carnero and Andrés Gómez
Sustainability 2019, 11(10), 2952; https://doi.org/10.3390/su11102952 - 24 May 2019
Cited by 9 | Viewed by 4257
Abstract
Systems that supply medicinal gases—oxygen, nitrous oxide and medical air—serve all care units of a hospital; for example, they feed distribution systems for operating theatres, neonatal and pediatric units, dialysis, X-ray, casualty, special tests, outpatients, etc. Systems for the provision of medicinal gases [...] Read more.
Systems that supply medicinal gases—oxygen, nitrous oxide and medical air—serve all care units of a hospital; for example, they feed distribution systems for operating theatres, neonatal and pediatric units, dialysis, X-ray, casualty, special tests, outpatients, etc. Systems for the provision of medicinal gases are therefore critical in guaranteeing hospital sustainability, since the functionality or availability of other hospital systems depends on them. Availability of 100% in these systems would avoid the need to reschedule patient appointments. It would also eliminate repeat testing, which poses risk to staff and patients, and could avoid affecting people’s lives through unavailability of, for example, operating theatres or intensive care units. All this contributes to a more rational resource consumption and an increase in quality of care both for the hospital itself and for patients and visitors. Although these systems are of vital importance to health care organizations, no previous work has been found in the literature that optimizes the technical decisions on supply in these systems. This research describes a model for these systems via continuous-time Markov chains. The results obtained are used in a multicriteria model constructed with the measuring attractiveness by a categorical-based evaluation technique (MACBETH) approach. In order to assess reliability when incorporating doubt or uncertainty via the MACBETH approach, the model has been validated by means of the fuzzy analytic hierarchy process. The aim is to obtain the best objective decision, with respect to the design of these systems, by analyzing the use of economic resources, the risks, and the impact on hospital activity, all with the aim of guaranteeing the best quality of care. The models constructed by means of MACBETH and the fuzzy analytic hierarchy process give, as the most suitable alternatives, duplicate the external supply in medical oxygen systems and maintain the original design conditions for supply systems of nitrous oxide and medicinal air. Full article
(This article belongs to the Special Issue Sustainability in Healthcare Facilities)
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11 pages, 1865 KiB  
Article
Adsorption of Paracetamol in Hospital Wastewater Through Activated Carbon Filters
by Antonio Macías-García, Justo García-Sanz-Calcedo, Juan Pablo Carrasco-Amador and Raúl Segura-Cruz
Sustainability 2019, 11(9), 2672; https://doi.org/10.3390/su11092672 - 10 May 2019
Cited by 57 | Viewed by 6631
Abstract
In recent years, pharmaceutical products have been causing a serious environmental problem in hospital wastewater and water purification plants. The elimination of these pollutants is difficult due to their resistance to biological degradation. Paracetamol has been detected in higher concentrations in hospital wastewater [...] Read more.
In recent years, pharmaceutical products have been causing a serious environmental problem in hospital wastewater and water purification plants. The elimination of these pollutants is difficult due to their resistance to biological degradation. Paracetamol has been detected in higher concentrations in hospital wastewater than in other buildings. Activated carbons are a good material for removing paracetamol from hospital wastewater. One of the starting materials to obtain activated carbons is kenaf, which is an easy plant to cultivate. To study the elimination of paracetamol from hospital wastewater by activated carbon, the textural and chemical characterization of activated carbon, as well as the kinetic study and the analysis of the paracetamol adsorption mechanism by the adsorbent, have been carried out. The activated carbon samples studied are micro-mesoporous, with high specific surface values. The chemical composition with presence of oxygen groups favours the adsorption process. The adsorption kinetics were adjusted to a pseudo-second order model. The adsorption mechanism followed the intraparticular diffusion model, carried out in two stages: a fast first stage on the surface of the adsorbent and a slow one inside the pore. Based on the kinetic study, the use of this type of carbon is a good application for the removal of paracetamol from hospital wastewater. Full article
(This article belongs to the Special Issue Sustainability in Healthcare Facilities)
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16 pages, 4894 KiB  
Article
Evaluation of HVAC Design Parameters in High-Performance Hospital Operating Theatres
by Gonzalo Sánchez-Barroso and Justo García Sanz-Calcedo
Sustainability 2019, 11(5), 1493; https://doi.org/10.3390/su11051493 - 12 Mar 2019
Cited by 31 | Viewed by 7992
Abstract
Unidirectional flow air-conditioning systems are suitable for achieving indoor air quality required in high-performance operating rooms (organ transplants, cardiac surgery, aorta, orthopedic, burns, etc.). This paper analyzes indoor environmental conditions and technical and hygienic requirements for the design of heating, ventilation, and air-Conditioning [...] Read more.
Unidirectional flow air-conditioning systems are suitable for achieving indoor air quality required in high-performance operating rooms (organ transplants, cardiac surgery, aorta, orthopedic, burns, etc.). This paper analyzes indoor environmental conditions and technical and hygienic requirements for the design of heating, ventilation, and air-Conditioning (HVAC) systems for high-performance operating theatres. The main standards applicable to this type of operating rooms were compiled. Standard UNE 100713:2015, ASHRAE Standard 170-2017, and the European pre-norm EN 16244 were analyzed. A case study shows the lack of uniformity in design criteria and their ranges of values, which generates different design approaches. It was concluded that using these standards applicable to high-performance operating rooms leads to very different indoor environmental conditions for patients and medical personnel—air velocity profiles, air movement pattern, temperature, relative humidity gradients, and pressure stratification. Computational fluid dynamics (CFD) studies have been shown to detect areas of haven that favor microbiological load accumulation. In this way, it is possible to define cleaning protocols to attend these anomalies in a preventive way. Full article
(This article belongs to the Special Issue Sustainability in Healthcare Facilities)
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14 pages, 1886 KiB  
Article
Indoor Air Quality and Sustainability Management—Case Study in Three Portuguese Healthcare Units
by Ana Fonseca, Isabel Abreu, Maria João Guerreiro, Cristina Abreu, Ricardo Silva and Nelson Barros
Sustainability 2019, 11(1), 101; https://doi.org/10.3390/su11010101 - 25 Dec 2018
Cited by 28 | Viewed by 4931
Abstract
Adequate management of indoor air quality (IAQ) in healthcare units has relevant impacts on sustainability performance due to its effects on patient safety, occupational health and safety, and energy consumptions. This study sought to identify improvement opportunities on IAQ management by collecting and [...] Read more.
Adequate management of indoor air quality (IAQ) in healthcare units has relevant impacts on sustainability performance due to its effects on patient safety, occupational health and safety, and energy consumptions. This study sought to identify improvement opportunities on IAQ management by collecting and analyzing experimental data of selected parameters in three healthcare units in Portugal: Two general hospitals and one primary healthcare center. Indoor air temperature, relative humidity, CO2, bacteria, and fungi concentrations were measured in summer and winter campaigns in June/July 2017 and in January/March 2018. Results show that the exclusive use of natural ventilation is not adequate when the affluence of users is high, but the analyzed parameters revealed acceptable results under low occupation intensity conditions. Results also show that keeping low indoor air relative humidity has a significant impact in reducing fungi concentration and that there is a significant correlation at the 0.05 level between indoor air CO2 concentration and bacterial loads. Therefore, as opportunities to improve sustainability, IAQ management in healthcare facilities should consider natural ventilation as a complement to mechanical ventilation systems and should focus on adequate control of indoor air relative humidity and CO2 concentration to reduce the risk of airborne infections. Full article
(This article belongs to the Special Issue Sustainability in Healthcare Facilities)
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17 pages, 2245 KiB  
Article
Analytical Determination of Medical Gases Consumption and Their Impact on Hospital Sustainability
by Miguel Gómez-Chaparro, Justo García-Sanz-Calcedo and Luis Armenta Márquez
Sustainability 2018, 10(8), 2948; https://doi.org/10.3390/su10082948 - 20 Aug 2018
Cited by 19 | Viewed by 8678
Abstract
Medical gases are known to show a great environmental impact and also to consume relevant resources in terms of hospital management. The present work reports on a study performed between 2008 and 2016 in a target set of 12 Spanish hospitals with floor [...] Read more.
Medical gases are known to show a great environmental impact and also to consume relevant resources in terms of hospital management. The present work reports on a study performed between 2008 and 2016 in a target set of 12 Spanish hospitals with floor area and number of beds ranging 2314–23,300 m2 and 20–194, respectively, for which the average annual consumption rates of oxygen, nitrogen, medicinal air, carbon dioxide and nitrogen protoxide were analysed. The annual consumption of medical gases in a hospital was proved to be correlated with the number of hospital discharges, the number of surgeries, the number of emergency interventions, the number of hospitalisations, the number of hospital beds, the useful floor area of the building and the number of workers. In particular, the annual consumption per hospital bed was computed as 350 m3 for oxygen, 325 m3 for medicinal air, 9 m3 for nitrogen protoxide and 3 m3 for carbon dioxide. It is shown that healthcare activity appears as an adequate variable to quantify and to monitor medical gases consumption in hospitals, to assess the size of their facilities as well as to optimise maintenance management. Full article
(This article belongs to the Special Issue Sustainability in Healthcare Facilities)
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