Design and Delivery of Robust Hospital Environments in a Changing Climate (DeDeRHECC)

英国卫生部和英国国民健康保险制度尤其受到气候变化的影响。尽管其他建筑类型的居住者可能会考虑在夏季略微提高他们的舒适温度门槛，并暂停使用机械冷却，但较高的夏季气温很可能会损害NHS患者的福祉和安全。事实上，卫生署和国民健康保险制度受到双重打击，一方面是减少能源消耗的压力，另一方面是保护病人和员工免受过热的压力，而这种压力的危险在近年的夏季热浪中可见一斑。新建筑需要创新的低能耗设计战略和技术，最重要的是，对于现有的建筑存量，NHS保留地产的27,701,676平方米。然而，在NHS大楼中实施这种创新干预措施存在许多障碍，患者安全至上。令人担忧的问题包括无法实现稳定的温度控制和安全的通风(正如我们的同事凯斯·诺克斯博士自由承认的那样，病原体的空气传播是一门新兴科学)，医疗设备的使用激增，为医院内部增加热量，以及现代合同安排的机制，这些合同安排让私人公司负责健康建筑的设施管理，考虑到它们面临的处罚，这些公司在采用变化时极其谨慎。这个名为《气候变化中稳健医院环境的设计和交付》(DeRHECC)的项目将调查这些谜团，为现有医院提出经济实用的低能源整修策略。它将对急性医院的复原力作出更严格的定义，尤其是为医院内各种类型的空间--非临床、病房、诊断和治疗，甚至手术室--为医院环境设定的标准。该团队对所有这些都符合一项宝贵的要求表示怀疑，并将审查英国和美国的标准。使用从该项目的四个参与的主要NHS信托基金中提取的四组医院场地，它将从NHS存量的大量样本中对基本医院建筑类型进行“编目”，确定最常见的类型，评估它们当前对气候变化的适应能力，并为每种“类型”提出适当的解决方案或干预措施群。它将对这些想法进行建模，以便能够量化相对的能源节约，并确定它们对外部温度变暖的适应能力。这会让他们付出代价的。它将计算终身运行成本和能源节约，并评估物有所值。它还将审查需要交付这些创新解决方案的采购环境，以及设计、核准和实施翻新项目所依据的协议。他们的交付将会招致风险。该项目将采用创新的风险评估工具进行变更，为工程设计开发，并将其应用于这些未来的大中型建设项目。它将制定程序，使这些创新的、低能耗的干预措施与医院整修项目的整合更加顺利，对那些将提供这些干预措施的人来说更加熟悉。它将以文本和网络形式制作指导和实例，最重要的是，作为参与者讨论挑战、焦虑、想法和如何实现这些挑战的DVD电影。伴随的动画将生动而快速地将战略和沟通传达给非常忙碌的人。

The Department of Health (DH) and the NHS are particularly exercised by climate change. Whereas the occupants of other building types might consider raising their comfort temperature thresholds a little in summer and suspend the use of mechanical cooling, NHS patients' well being and safety may well be compromised by higher summer temperatures. In fact the DH and the NHS are hit by a double whammy, the pressure to reduce energy consumption, colliding with the pressure to protect their patients and staff from overheating, the dangers of which were manifest in recent years' summer heatwaves. Innovative low energy design strategies and techniques will be required both for new buildings and, most importantly, for the existing building stock, the 27,701,676 square metres of the NHS Retained Estate. However there are many barriers to the implementation of such innovative interventions in NHS buildings, patient safety being paramount. Worries include the inability to achieve stable temperature control and safe ventilation (the airborne transmission of pathogens is an emerging science as our colleague Dr.Cath Noakes freely admits), the proliferation in the use of medical equipment adding heat to hospital interiors and the mechanics of modern contractual arrangements which place private companies in charge of the Facilities Management of health buildings, which, unsurprisingly, given the penalties they face, are ultra-cautious about adopting change.This project, 'Design and delivery of Robust Hospital Environments in a Changing Climate' (DeDeRHECC), will investigate these conundra to come up with economical and practical low energy refurbishment strategies for existing hospitals. It will derive a closer definition of resilience in the context of an acute hospital and, most particularly, the criteria set for hospital environments for the various categories of space found in hospitals; non-clinical, patient rooms, diagnostic and treatment, even operating theatres. The team is sceptical that these all align into a cherent requirement and will review UK and US criteria. Using four sets of hospital sites drawn from the project's four participating major NHS Trusts, it will 'catalogue' basic hospital building types from this sizeable sample of NHS stock, identify those most frequently occurring, assess their current resilience to climate change and propose appropriate solutions or clusters of interventions for each 'type'. It will model these ideas so that relative energy savings can be quantified and their resilience to warming external temperatures determined. It will cost them. It will calculate the lifetime running costs and energy savings and assess Value for Money. It will also examine the procurement environment in which these innovative solutions need to be delivered, the protocols by which refurbishment projects are designed, approved and implemented. Their delivery will incur risks. The project will take innovative risk assessment tools for change, developed for engineering design, and apply them to these future large and medium scale construction projects. It will develop processes to make the integration of these innovative, low energy interventions into hospital refurbishment projects smoother and more familiar to those who will be delivering them. It will produce guidance and worked examples in text and web form and, most significantly, as a DVD film of participants discussing the challenges, their anxieties, the ideas and how to deliver them. Accompanying animations will communicate the strategies and communications vividly and quickly to very busy people.