Environment and Sustainability - Gazetted
Environment and Sustainability - Gazetted
Environment and Sustainability - Gazetted
FACILITY GUIDES
Environment and
Sustainibility
Gazetted
8 May 2015
Supported by:
Document tracking
Version Date Name Comments
Dicussion Draft 1 06 Feb 2013 J Gibbard, W Jonker-Klunne
08 March 2013 J Gibbard, W Jonker-Klunne,
Dicussion Draft 2
T v Reenen
Dicussion Draft 2.1 10 March 2014 J Gibbard
Proposal V.1 31 March 2014 J Gibbard, T v Reenen
Proposal V.2 11 June 2014 T v Reenen Language and spelling
Gazetted 8 May 2015 National Health Act,2003(Act
no.61 of 2003)
INFORMATION NOTES
Reviewed by:
CONTENTS
PART A - INTRODUCTION ............................................................................................................................... 9
PART B - INTEGRATING SUSTAINABILITY ..............................................................................................11
1. Introduction ............................................................................................................................................................................. 11
2. The environmental context ................................................................................................................................................ 11
3. The contribution of the built environment .................................................................................................................. 12
4. Carbon emission mitigation strategies .......................................................................................................................... 12
5. Defining sustainability ......................................................................................................................................................... 13
6. South Africa’s Ecological Footprint and Human Development Index performance...................................... 14
7. The legislative and policy context ................................................................................................................................... 14
7.1. The South African Constitution ................................................................................................................................................ 14
7.2. Environment ..................................................................................................................................................................................... 14
7.3. Sustainability policy and legislation ...................................................................................................................................... 15
8. Built environment sustainability objectives ............................................................................................................... 15
8.1. Environmental objectives ........................................................................................................................................................... 15
8.2. Economic objectives ...................................................................................................................................................................... 15
8.3. Social objectives .............................................................................................................................................................................. 15
8.4. Integrating sustainability objectives into health facilities ........................................................................................... 16
8.5. Sustainability integration plans ............................................................................................................................................... 17
PART C - ENERGY .............................................................................................................................................19
1. Objective.................................................................................................................................................................................... 19
2. Introduction ............................................................................................................................................................................. 19
3. Criteria ....................................................................................................................................................................................... 19
4. Design and operation ........................................................................................................................................................... 19
4.1. Orientation ......................................................................................................................................................................................... 20
4.2. Building shape .................................................................................................................................................................................. 20
4.3. Building depth .................................................................................................................................................................................. 20
4.4. Insulation ............................................................................................................................................................................................ 20
4.5. Solar shading and glazing ............................................................................................................................................................ 21
4.6. Opening areas ................................................................................................................................................................................... 21
4.7. Air tightness ...................................................................................................................................................................................... 21
4.8. Mechanical systems ....................................................................................................................................................................... 21
4.9. Equipment .......................................................................................................................................................................................... 22
4.10. Internal lighting ............................................................................................................................................................................... 22
4.11. External lighting .............................................................................................................................................................................. 22
4.12. Building Management System ................................................................................................................................................... 23
4.13. Sub-metering .................................................................................................................................................................................... 23
4.14. Renewable energy .......................................................................................................................................................................... 23
4.15. Energy targets .................................................................................................................................................................................. 24
PART D - WATER ..............................................................................................................................................25
1. Objective.................................................................................................................................................................................... 25
2. Introduction ............................................................................................................................................................................. 25
3. Criteria ....................................................................................................................................................................................... 25
3.1. Hand basin taps .............................................................................................................................................................................. 25
3.2. Toilets................................................................................................................................................................................................... 25
3.3. Showerheads ..................................................................................................................................................................................... 25
Black water: Waste water with food waste or sewage from toilets.
Construction worker: Employees of construction firms or the main contractor(s) involved in the construction of a
building.
Envelope: The external elements of the building such as the walls, windows and roofs.
Glazing: Windows, glazed doors or other transparent and translucent elements including their frames (such as glass
bricks, glazed doors, etc.) located in the building fabric.
Grey water: The relatively clean waste water from baths, sinks, washing machines, and other kitchen appliances.
Gross floor area: The total floor area of the building protected from the elements but excluding parking.
Local community: People and organisations that work and live near the building (does not include occupants). Near
the building is defined as being within 4 km of building.
Mixed-mode ventilation: A hybrid solution where natural ventilation systems are assisted by mechanical systems to
achieve improved ventilation and comfort criteria. Complementary and zone-mixed strategies are most commonly
adopted.
Natural ventilation: Ventilation provided by thermal, wind, or diffusion effects through doors windows or other
intentional openings in the building." ASHRAE Standard 62.1-2007, Section 3
R-value: Used in the construction industry to denote the measurement of the thermal resistance of a material.
The R-value can be described as the ratio between the temperature difference across an insulator and the heat flux of
that material(𝑅 = ∆𝑇⁄ ̇ ). Alternatively, it is the effectiveness of the material to resist the flow of heat, i.e. the thermal
𝑄𝐴
2
resistance of a component is calculated by dividing its thickness by its thermal conductivity(𝑅 = 𝐾. 𝑚 ⁄𝑊 ).
Shading coefficient: A measure of the solar gain performance of windows. It is the ratio of the solar energy
transmitted and convected by the window to the solar energy transmitted and convected by clear 3 mm glass.
Solar heat gain coefficient (SHGC): A measure of the amount of solar radiation (heat) passing through the entire
window, including the frame. SHGC is expressed as a number between 0 and 1.0. The lower the SHGC the better.
Thermal mass: A term to describe the ability of building materials to store heat.
Thermal resistance: The resistance to heat transfer across a material. Thermal resistance is measured as an R-value.
The higher the R-value the better the ability of the material to resist heat flow.
Useable area: The area of floor in a building capable of occupation. This excludes areas such as toilets, bathrooms,
storage, ducts and vertical circulation.
Ventilation: The process of supplying air to or removing air from a space for the purpose of controlling air
contaminant levels, humidity or temperature within the space.”. ASHRAE Standard 62.1-2007, Section 3
Watt (W): A unit for power (P) or the rate at which work is performed.
Recommended
Recommended
Recommended
Recommended
SERVICES ENVIRONMENT/ OPERATION
CROSS-CUTTING ISSUES
Essential
Essential
Essential
Essential
Adult inpatient Administration Generic Room X Integrated X
Services and Related Requirements Infrastructure
Services Planning
Clinical and General Hospital Hospital Design Principles X Briefing Manual X
Specialised Diagnostic Support Services
Laboratory Guidelines
Mental Health Catering Services Building Engineering X Space Guidelines X
for Hospitals Services
Adult Critical Care Laundry and Environment and Cost Guidelines
Linen Sustainability
Department
Emergency Centres Hospital Materials and Finishes X Procurement X
Mortuary
Services
Maternity Care Nursing Future Healthcare Commissioning X
Facilities Education Environments Health Facilities
Institutions
Adult Oncology Health Facility X Healthcare Technology Maintenance
Facilities Residential
Outpatient Facilities Central Sterile Inclusive Environments X Decommissioning X
Service
Department
Paediatrics and Training and Infection Prevention and X Capacity
Neonatal Facilities Resource Centre Control Development
Pharmacy Waste Disposal X Information Technology
and Infrastructure
Primary Healthcare Regulations
Facilities
Diagnostic Radiology
Adult Physical
Rehabilitation
Adult Post-acute
Services
Facilities for Surgical
Procedures
TB Services
Colours Legend
Consultants
Administrators
Related documents
1. Purpose
These guidelines have been developed to support the integration of sustainability into planning, design and operation
of health facilities. The document defines sustainability and outlines the implications of this for the built environment.
Sustainability objectives and criteria are defined to inform the development of health facilities in South Africa. The
document provides a framework for addressing sustainability in health facilities; greater detail on referenced aspects,
such as equipment and systems, is provided in sister IUSS guides.
2. Background
Global warming and South African legislation and policy make it imperative that built environment projects address
sustainability. However, there is still limited South African guidance on how sustainable development can be integrated
in built environment projects. There is also the perception that addressing sustainability in facilities is expensive and
complicated.
This document provides guidance that can be used to support the integration of sustainability into health facilities. It
shows that by addressing sustainability early in projects, additional costs can be minimised and innovative, high
performance solutions that benefit society, the economy and the environment can be achieved. It also shows that
achieving more sustainable facilities need not be complex, but can be based on robust, sensible and simple measures.
1. Introduction
South Africa faces a range of social, economic and environmental challenges. HIV/Aids has resulted in significant
reductions in life expectancy since 1998. Unemployment is estimated to be between 20 and 30% and climate change is
leading to increasing water stress, reduced food security and loss of species and ecosystems (Department of
Environmental Affairs and Tourism, 2009a).
Sustainable development, which aims to achieve social and economic improvements while reducing negative
environmental impacts, can be used to address these challenges. Sustainable development however can be difficult to
achieve. This is because a holistic and integrated approach is required and the development sector and the construction
industry, in particular, operate in a highly fragmented way. In addition, the concept of sustainable development is still
not understood and has not been adequately translated into practical steps that can be implemented.
This section defines sustainability and translates this into built environment objectives. It also describes the role of the
built environment in creating environmental and other problems and shows how integrating sustainability
considerations into construction and the built environment can make a substantial contribution to improving the social,
economic and environmental performance of the built environment.
5. Defining sustainability
The World Wildlife Fund’s definition of sustainability is useful for the built environment as it is quantified and
geographically-based. This defines sustainability as the achievement of an Ecological Footprint (EF) of less than 1.8
global hectares per person and a Human Development Index (HDI) value of above 0.8 (World Wildlife Fund, 2006).
An Ecological Footprint is an estimate of the amount of biologically-productive land and sea required to provide the
resources a human population consumes and absorbs the corresponding waste. These estimates are based on
consumption of resources and production of waste and emissions in the following areas:
• Food, measured in type and amount of food consumed
• Shelter, measured in size, utilisation and energy consumption
• Mobility, measured in type of transport used and distances travelled
• Goods, measured in type and quantity consumed
• Services, measured in type and quantity consumed
The area of biologically productive land and sea for each of these areas is calculated in global hectares (gha) and then
added together to provide an overall ecological footprint. This measure enables the impact of infrastructure and
lifestyles to be measured in relation to the earth’s carrying capacity of 1.8 global hectares (gha) per person.
The Human Development Index was developed as an alternative to economic progress indicators and aimed to provide
a broader measure that defined human development as a process of enlarging people’s choices and enhancing human
capabilities (United Nations Development Programme, 2007).
The measure is based on:
1. A long healthy life, measured by life expectancy at birth
2. Knowledge, measured by the adult literacy rate and combined primary, secondary, and tertiary gross
enrolment ratio
3. A decent standard of living, as measure by the GDP per capital in purchasing power parity (PPP) in terms
of US dollars
Progress towards sustainability at a national level can be understood by ascertaining performance in these two areas in
relation to sustainability targets.
For South Africa to move towards sustainability, there must therefore be an improvement in both the Ecological
Footprint and Human Development Index performance. Support for this improvement is provided in South African
legislation and policy.
7.2. Environment
Everyone has the right :
• to an environment that is not harmful to their health or wellbeing; and
• to have the environment protected, for the benefit of present and future generations, through reasonable
legislative and other measures that
• prevent pollution and ecological degradation;
• promote conservation; and
1 http://www.footprintnetwork.org/en/index.php/GFN/page/world_footprint/
2 Human Development Report 2006, United Nations Development Programme
4
Section 24 of the South African Constitution
1. Objective
The building is energy efficient and uses renewable energy.
2. Introduction
Energy is used in health facilities to operate equipment, heat water, and to ensure that required lighting, ventilation and
thermal comfort standards are met. In most existing South African buildings, it is estimated that savings of up to 30% of
energy consumption can be achieved at little, or no, cost. In new facilities, where passive strategies, energy-efficient
equipment and renewable energy systems have been used, energy consumption can be 50% lower than in existing
older facilities.
Ensuring that health facilities are more energy efficient and use renewable energy has a wide range of benefits,
including:
1. Reduced carbon emissions and therefore global warming impacts
2. Reduced impact of mains power outages
3. Reduced negative health impacts associated with pollution from coal-fired power stations
4. Reduced operational costs
5. Improved internal environments as a result of better day lighting and natural ventilation
3. Criteria
Highly energy efficient facilities are developed by optimising and integrating solutions that respond closely to the local
site, the local climate and required internal functions. It is therefore difficult to prescribe a set of criteria for all
situations. However the following measures can be used to ensure energy considerations have been addressed.
4.1. Orientation
Orienting facilities so that the long facades face north – south helps to reduce unwanted heat gains from low angle
sunlight in the early to mid-morning and mid- to late in the afternoon. Where there is no alternative but to have facades
face east and west, appropriate solar shading should be provided to avoid glare and control solar heat gain. Minimising
energy consumption through orientation can be achieved through the following steps:
1. Long facades of facilities should be orientated to face within 15 degrees of a north – south orientation.
2. Glazing on west and east facades should be minimised. Where this exists this should be appropriately
shaded. Using trees or planting to create this shading is a low cost, easy option in many situations.
4.4. Insulation
Insulation, especially when combined with thermal mass, can be used to maintain comfortable indoor conditions
without significant use of mechanical equipment. Insulation ensures that valuable heat gains from people, equipment
and the sun can be retained in the building to support comfort during winter. It can also reduce unwanted heat gains
from ambient conditions in summer. Minimising energy consumption through insulation can be achieved through these
steps:
1. The building envelope U-values should achieve or surpass minimum values outlined in SANS 204 (South
African Bureau of Standards, 2007).
2. Analysis of the building envelope should be undertaken to identify areas with particularly high heat flows.
For instance, this may occur on an exposed west façade. Where this occurs, additional insulation and/or
shading measures may be appropriate to reduce flows in these areas.
4.9. Equipment
As equipment used in buildings can consume large amounts of energy, the energy efficiency of equipment and energy
ratings should be a key consideration. In addition, controls that ensure equipment is switched off when not in use
should be specified. Minimising energy consumption by equipment can be achieved through these steps:
1. Selecting energy-efficient equipment. Power requirements, smart controls and equipment energy
efficiency ratings, such as Energystar, should be key considerations in the selection of equipment.
2. Ensuring that the equipment, or the local electrical circuits, have controls which ensure that equipment is
off when not required.
4.13. Sub-metering
An appropriate sub-metering system enables effective energy management. A facilities manager can see how much
energy is used in different areas or for different uses in the facility. Sub-meters also show when and how energy is used
through profiles which show consumption and demand over time. Minimising energy consumption through sub-
metering can be achieved through these steps:
1. Designing an energy sub-metering system that will monitor all of the main energy uses in the facility. In
particular, the design of this system should be based on who can influence and control energy consumption
in a particular area. Thus, instead of all the lighting of an entire site being on a meter, it may be more
appropriate to sub-meter lighting for a specific building, where nominated personnel can be responsible
for ensuring that lighting is off, when not required.
2. Providing energy management data in formats and reports that can be easily understood and analysed to
support improved energy management.
3. Ensuring that energy management reports are issued to all key role players including facilities managers
and senior managers. Linking reporting to quarterly reviews which aim to improve energy efficiency over
time.
4. Any outsourced function, such as a restaurant or sports facility, should be sub-metered and invoiced for
consumption.
1. Objective
The building minimises the consumption of mains potable water.
2. Introduction
Water is used in health facilities for cleaning equipment, utensils and facilities as well as for laundry, irrigation, food
preparation, cooling and drinking. In most existing South African health facilities it is possible to reduce mains potable
water consumption at little, or no, cost. In new facilities, where water-efficient technologies, grey water and rainwater
systems have been used, water consumption can be over 50% lower than in older, less efficient facilities.
1. Ensuring that health facilities are more water efficient has a wide range of benefits including:
2. Reduced water consumption and associated negative environmental impacts
3. Reduced impact of water shortages or outages
4. Reduced operational costs
3. Criteria
The consumption of potable water in health facilities can be addressed in a range of ways, with the applicability of each
measure dependent on local circumstances and the functional requirements of the health facility. However, the
followings standard criteria can be used to ensure water efficiency is addressed.
3.2. Toilets
Reducing WC flush rates in waterborne sanitation can be used to reduce water consumption. This can be supported by
the following measures:
1. Specifying WCs with flush rates that do not exceed 6 ℓ / flush.
2. Requiring all WCs to have dual flush controls which enable reduced flush rates when full flushes are not
required.
3. Ensuring that users, through instructions, are aware of the purpose of dual flush controls.
3.3. Showerheads
Showers should be specified in preference to baths as they are more water efficient. Controlling and reducing water
flows in showers can be used to reduce water consumption. The following measures can be considered in shower
design to increase water efficiency:
1. Shower head flow rates should be specified not to exceed 10 ℓ / minute.
3.4. Irrigation
Minimising irrigation water requirements can be used to reduce water consumption. The following measures can be
drawn on to increase water efficiency:
1. Planting locally indigenous species (species found in the local area) to avoid, or minimise, irrigation
requirements.
2. Where irrigation is required, specifying highly-efficient water delivery systems, such as a drip irrigation,
linked to soil moisture probes.
3. Using grey water and/or rain water to avoid use of mains potable water for irrigation.
1. Objective
The building minimises waste directed to landfill.
2. Introduction
Waste in South African health facilities is largely directed to landfill sites. Not only does this use up valuable land, but
this can also lead to air, soil and water pollution if waste is not disposed of correctly. In addition, this waste also
consists of valuable resources that could be easily reused and recycled. Recycling and reusing materials reduce energy
and resource consumption and creates jobs and income.
1. Ensuring that health facilities minimise waste and reuse and recycle waste products have the following
benefits:
2. Reduced loss of land to landfill
3. Reduced energy and resource consumption
4. Job and small enterprise creation
3. Criteria
Waste in health facilities can be addressed in a variety of ways. The applicability of each measure will depend on local
circumstances and the respective requirements of the health facility. However, there are a range of considerations
which can be used to address waste in facilities. These are outlined below.
1. Objective
The negative impacts of construction materials are minimised.
2. Introduction
Materials used in new facilities and the refurbishment of facilities can have significant impacts. Materials may be mined,
processed, manufactured and transported before being incorporated in facilities. The extent and nature of the impacts
of these stages vary widely depending on the material. The selection of materials and products to be used in facilities is
therefore important in reducing negative environmental impacts.
• Careful selection of construction materials used in health facilities can lead to the following benefits:
• Reduced land and mining impacts
• Reduced environmental and health impacts from manufacturing processes
• Reduced transportation impacts
• Reduced material use
• Increased use of local sustainable materials
4. Criteria
Material and component selection in health facilities can be informed by developing material and product selection
criteria and using this as a basis for specification and design. It can also be shared with suppliers in order to elicit
confirmation of impacts for different types of product. The nature of these criteria will depend on local circumstances
and the respective requirements of the health facility. However, a series of steps can be used to check that key material
and component considerations have been addressed. These are outlined below.
1. Objective
The building supports biodiversity.
2. Introduction
Biodiversity plays a very important role for man through provision of ecosystem services. Ecosystem services include
the production of food and water, the control of climate and disease, supporting nutrient cycles and crop pollination
and spiritual and recreational benefits.
• Ensuring that health facilities take into account biodiversity has a wide range of benefits including:
• Maintaining local ecosystem services
• Providing natural amenities such as gardens which support recuperation
• Providing a source of fresh healthy fruit and vegetables
3. Criteria
Biodiversity in health facilities can be addressed in a variety of ways. The applicability of each measure will depend on
local circumstances and the respective requirements of the health building. However, a number of criteria can be used
to check that key biodiversity considerations have been addressed. These are outlined below.
1. Objective
The building supports energy efficient transportation.
2. Introduction
Ensuring that health facilities support energy efficient transportation has a wide range of benefits including:
• Reduced air pollution and noise from vehicles
• Health benefits from increased opportunities for exercise
• More affordable transport for health facility users
• Reduced space requirements as a result of reduced parking and road requirements
3. Criteria
Transportation impacts related to health facilities can be addressed in a variety of ways. The applicability of each
measure will depend on local circumstances and the respective requirements of the health facility. However a series of
steps can be used to ensure that transportation considerations in relation to sustainability have been addressed. These
are outlined below.
1. Objective
The building makes efficient use of resources.
2. Introduction
There are limited resources in the form of land, finance and raw materials to construct and maintain building. It is
therefore important to use resources carefully. Benefits associated with careful resource use include:
• Avoiding waste
• Ensuring effective and efficient use of resources
• Ensuring that resources are available for other uses where these are not required
3. Criteria
Resources in health facilities can be addressed in a variety of ways. The applicability of each measure will depend on
local circumstances and the respective requirements of the health facility; however, a series of steps can be used to
check that key resource considerations have been addressed. These are outlined below.
1. Objective
The building is managed to support sustainability.
2. Introduction
Facilities can be designed to support effective management. Systems can also be developed to ensure that facilities are
effectively and efficiently used and maintained. In health facilities this is particularly important because of the stringent
environmental requirements for healthcare and the high operating costs of the facility.
• Ensuring that health facilities are effectively managed has a wide range of benefits including:
• Ensuring that operating costs are controlled and reduced
• Minimising disruption to healthcare as result of maintenance and repairs
• Ensuring that maintenance is planned for, and effectively carried out
3. Criteria
Building management in health facilities can be addressed in a variety of ways. The applicability of each measure will
depend on local circumstances and the respective requirements of the health building. However, a number of measures
can be used to ensure that building management supports sustainability. These are described below.
1. Objective
The building supports the local economy.
2. Introduction
The construction and maintenance of health facilities are a significant investment by government. This investment, if
considered carefully, can be used to support the local economy and employment. This is done by specifying products
and services from the local area.
Ensuring that health facilities support the local economy has a wide range of benefits, including:
• Increased local employment
• A diversified local economic base
• Increased local capacity for new construction and maintenance of facilities
3. Criteria
Supporting the local economy in health facilities can be addressed in a variety of ways. The applicability of each
measure will depend on local circumstances and the respective requirements of the health building. Measures that can
be used to support the local economy are outlined below.
1. Objective
The building supports use of more sustainable products and services.
2. Introduction
Products and services used in health facilities have a range of impacts and planning can be used to maximise beneficial
impacts and avoid negative impacts. The construction and maintenance health facilities are a significant investment by
government. This investment, if considered carefully, can be used to support the local economy and employment. This
is done by specifying local products and services from the local area.
Ensuring that health facilities support the more sustainable products and services has a wide range of benefits
including:
• Reduced waste
• Increased support for sustainable choices and options for health facility users
3. Criteria
Supporting the more sustainable products and services in health facilities can be addressed in a variety of ways. The
applicability of each measure will depend on local circumstances and the respective requirements of the health
building. The measures outlined below provide a number of steps that can be taken to support more sustainable
services and products in health facilities.
1. Objective
The building supports access to facilities.
2. Introduction
Current work patterns and lifestyles mean that many people have to access facilities such as banking, retail, childcare
and communications on regularly or daily. Ensuring that these facilities are within the health facility or within easy
walking distance helps to avoid or reduce associated time and transport impacts.
Ensuring that health facilities support access to facilities has a wide range of benefits, including:
• Reduced transport impacts
• Reduced time spent travelling to and from facilities
3. Criteria
Supporting access to facilities in health facilities can be addressed in a variety of ways. The applicability of each
measure will depend on local circumstances and the respective requirements of the health building. A range of
measures that can be used to support access to facilities are indicated below.
3.1. Banking
Access to banking can be provided through formal banking facilities, internet banking or through bank ATMs. Access
can be supported in the following way: Banking facilities should be readily accessible to users and occupants of health
facilities through local provision. Where facilities are not locally available, access to banking facilities should be
investigated and established in discussion with relevant role-players.
3.3. Communication
Access to telephone and internet can be provided through personal devices, internet cafes or at stand-alone kiosks and
booths. This can be provided within the health facility or within easy walking distance of this. Access to communication
can be supported through the following measures.
3.5. Childcare
Childcare and afterschool school care for children can be provided on site or within the local area. This supports
sustainability by reducing time and travel impacts of travel related to childcare. Childcare and/or afterschool care
should be provided within the health facility or in the local area. Where facilities are not available, access should be
investigated and established in discussion with relevant role-players.
1. Objective
The building supports a healthy and productive environment.
2. Introduction
Health facilities, by their definition, aim to support health and wellbeing in their users. In addition to medical care,
health can be promoted through beneficial environmental conditions including a plentiful supply of fresh air, views and
optimum thermal conditions. In health facilities, it is particularly important to avoid conditions and situations that may
be harmful to human health.
Ensuring that facilities support the health in users and construction workers has a wide range of benefits, including:
• Improved recovery rates for patients
• Reduced absenteeism associated with environmental conditions by health facility staff
• Reduce injury and absenteeism rates associated with dangerous or harmful working construction
environments
3. Criteria
Ensuring construction and health facilities promote health can be addressed in a variety of ways. The applicability of
each measure will depend on local circumstances and the respective functional requirements of the health facility.
However, outlined below are a series of criteria that can be used to check that health promotion has been addressed in
facilities.
3.2. Daylight
Day lighting can help reduce energy consumption associated with artificial lighting. It also improves internal
environmental conditions for patients and health facility employees. Health through improved daylighting can be
supported through the following provision.
1. Health facility staff working areas should be well day lit.
2. Patient areas should be well day lit.
3. Daylighting can be measured within buildings using a lux meter. Lux level requirements are determined by
the activities taking place within the space and should follow best practice standards for daylighting.
Lighting requirements are also listed in the IUSS Building Engineering Services guide.
3.3. Ventilation
High levels of fresh air are important for human health and productivity. This can be provided through natural or
mechanical ventilation. Where mechanical ventilation is used sufficiently high levels of external, fresh air should be
provided and recirculated air should be avoided or minimised. Health can be promoted through the following
measures.
1. Health facility staff working areas should be well supplied with adequate supplies of fresh air. Volumes of
fresh, non-recirculated air should be in line with good practice standards for the type of activities and
population densities accommodated and airborne infection control.
2. Patient areas should be well supplied with adequate supplies of fresh air. Volumes of fresh, non-
recirculated air should be in line with good practice standards for the type of activities and population
densities accommodated and airborne infection control.
3. Ventilation guidance is also provided in the IUSS Building Engineering Services guide.
1. Objective
The building supports education.
2. Introduction
Education and ongoing learning is increasingly been seen as an essential component of sustainable development and a
competitive economy. healthcarehealthcareEstimates indicate that a 1% increase in training days leads to a 3%
increase in productivity (International Labour Office, 2010). The importance of education is recognised in healthcare
through the requirement for healthcare professionals to undertake continuous professional development (CPD).
Education and ongoing learning can be supported through technology and spaces in facilities. Examples of this include
training rooms and access to ICT and reading material.
Ensuring that health facilities support the education has a wide range of benefits, including:
• Improve ability by health facilities staff to keep up-to-date with new developments in healthcare
• Ability to attract and retain staff
• Increasing awareness and knowledge of health issues in the local community and therefore improving disease
prevention
3. Criteria
Ensuring construction and health facilities promote education and ongoing learning can be addressed in a variety of
ways. The applicability of each measure will depend on local circumstances and the respective requirements of the
health building; however a series of steps can be used to check that education and ongoing learning considerations
have been addressed. These are outlined below.
1. Objective
The building is inclusive of diversity in population.
2. Introduction
Design for inclusion helps to ensure that facilities can be used by all users including older people, sick people, people
with children and people with disabilities. Inclusive design also often means that facilities are safer and easier to use. In
health facilities both of these aspects are particularly important.
• Ensuring that health facilities are inclusive has a wide range of benefits including:
• Less requirement to replicate facilities
• Facilities that are easier and safer to use
3. Criteria
Ensuring health facilities are inclusive can be addressed in a variety of ways. The applicability of each measure will
depend on local circumstances and the respective requirements of the health building. However a series of steps can be
used to check that key inclusion considerations have been addressed. These are outlined below.
1. Objective
The building supports social cohesion.
2. Introduction
Social cohesion refers to the extent to which individuals within a community understand, collaborate, trust and work
together. It is valuable because it enables collective knowledge and resources to be used more effectively and efficiently
to support common goals. Within a health facility improving social cohesion can support improved healthcare with
fewer resources by sharing and using these more effectively. It can also support improved communication and
cooperation within health teams and therefore better levels of service and fewer mistakes and less wastage.
Ensuring that health facilities support social cohesion has a range of benefits, including:
• More efficient and effective use of resources
• Improved communication and coordination
• Reduced wastage
3. Criteria
Ensuring health facilities support social cohesion can be addressed in a variety of ways. The applicability of each
measure will depend on local circumstances and the respective requirements of the health building. However, a series
of steps can be used to check that key social cohesion considerations have been addressed. These are outlined below.
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