Integrated Design of Hospital Wards for a Safe and Sustainable Patient Environment

Lead Research Organisation: University of Leeds
Department Name: Civil Engineering


Redesigning healthcare building infrastructure to minimise infection risk, meet demanding government carbon reduction targets and create a safe and comfortable environment for patients and staff is one of the biggest challenges currently facing the NHS. Hospital acquired infection remains at the forefront of the Department of Health agenda. Targets to halve MRSA by 2008 and cut C Difficile infections by 30% by 2011, together with increasing awareness that the environment influences the risk of transmission, have put infection control at the heart of hospital building and refurbishment programs. Building related energy use is also an increasing concern for the NHS, with the national carbon reduction targets of 20% by 2010 and 60% by 2050 are almost certain to be demanded of hospitals. These two issues present a major design conflict. Improving ventilation to increase patient comfort and reduce infection while at the same time reducing the need for mechanical building services to cut energy use is a huge undertaking. The research outlined in this proposal will tackle these design challenges from an integrated building services and infection control perspective. The aim of the proposal is to develop robust design tools and an interactive computational based modelling environment that can used to evaluate and optimise hospital building design strategies in terms of several different aspects; energy use, infection risk and thermal comfort as well as patient safety and cost implications. A series of targeted projects, initially focusing on the design and ventilation of ward accommodation, will be used to develop these design tools and at the same time establish specific evidence-based solutions that address critical issues in existing outdated hospital wards. The proposal will establish a cross-disciplinary research team drawing on expertise from academia, industry and healthcare providers to identify, develop and exploit the latest scientific advances and create the knowledge base necessary to establish the best designs for both refurbished and new build accommodation. By the end of the five year funding term the research will have significantly advanced strategies for redesigning hospital accommodation. It will have created usable design tools that for the first time formally integrate multiple issues, including the risk of infection, as well as facilitating real, on the ground, changes in UK hospitals. The future research strategy will incorporate aspects beyond the physical built environment including human behaviour and microbial dynamics, to be able to evaluate the management and operation of a facility alongside the core infrastructure. By 2020 this will enable ward environments to meet both the immediate and long-term energy and infection targets, and will have also cascaded the modelling techniques and design methodologies across other areas of hospitals to yield real benefits across whole hospital estates.


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Description This was a wide ranging project exploring a range of aspects relating to ventilation of hospitals, with a particular focus on airborne infection. Key outcomes include:
- validation of CFD model for bioaerosol transport and deposition
- development of stochastic model linking hospital design, human behaviour, environmental contamination and risk of HCW hand contamination (and hence infection risk)
- data to quantify surfaces touched by healthcare workers during different care types
- methodology for linking building thermal simulation with numerical optimisation methods to evaluate local comfort and energy in hospital rooms
- methodology to link CFD modelling with numerical optimisation approaches to simulate infection risk and comfort
- scale model approach to simulating contaminant movement in hospital corridors and theoretical model to translate to full scale
- CFD simulation of airborne contaminant movement due to human activity
- Methodology for quantifying ventilation rates and pathogen transport risk in naturally ventilated spaces using tracer gas and inert particles
- In depth study to characterise ventilation and infection risks in naturally ventilated hospital wards at full scale
- Analysis of redesign options for large naturally ventilated hospital wards using experimental and CFD approaches
- Methodologies for CFD simulation of airflow in large naturally ventilated wards
- Comparison of bioaerosols and particles in air and on surfaces under different ventilation regimes
- Development of novel real-time CFD models to simulate airflows and pathogen transport in hospital environments
Exploitation Route Findings give insight into:
- methodologies for assessing airflows and infection risks in the built environment, which may be applied by other researchers or industry.
- influence of the design of the hospital environment on the risk of infection, which may be applied in research, design of facilities or by infection control and estates teams in hospitals
- novel real-time CFD methods which have substantial potential for further development in research and ultimately application in industry
- understanding of the influence of human behaviour on infection risk which may have application with the operation of hospital environments
Findings led to an EPSRC Healthcare Impact Partnership award to develop the infection risk models and real-time flow models into tools to evaluate hospital ward environments. This is in partnership with two NHS Trusts and two industry partners.
Sectors Construction,Energy,Environment,Healthcare

Description Work on CFD modelling of indoor airflows and particle deposition methods is included in two recent guidance national documents on ventilation, CIBSE AM11 (2015) and ESDU TM180 (2015). Work on natural ventilation of hospital wards and modelling dispersion of pathogens in hospital wards has featured in three press releases which have resulted in national and international media attention. This includes a video piece for the BBC website, radio interview for an Australian station and articles in several newspapers including Daily Mail and Irish Times. Work on natural ventilation is cited in Department of Health guidance on windows for hospitals.
First Year Of Impact 2015
Sector Energy,Environment,Healthcare
Impact Types Societal,Policy & public services

Description CIBSE AM11
Geographic Reach National 
Policy Influence Type Citation in other policy documents
Description IHS ESDU TM 180: committee and co-author
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Description Arup, studentship support
Amount £14,000 (GBP)
Organisation Arup Group 
Sector Private
Country United Kingdom
Start 10/2009 
End 03/2013
Description Healthcare Impact Partnership
Amount £1,000,000 (GBP)
Funding ID EP/P023312/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 09/2017 
End 08/2021
Description White Rose funding
Amount £6,780 (GBP)
Organisation White Rose University Consortium 
Sector Academic/University
Country United Kingdom
Start 09/2012 
End 09/2013
Description British Science Festival 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact Press release in May 2015 relating to paper King MF, Noakes CJ, Sleigh PA (2015) Modelling environmental contamination in hospital single and four-bed rooms, Indoor Air: international journal of indoor air quality and climate 25(6): 694-707. Picked up by international media including video piece on Brazilian TV.
Press briefing at British Science Festival in Bradford on 8th Sept 2015 relating to work on modelling particle deposition and hand contamination risk in hospital wards. Work picked up and reported well by several media outlets including BBC, Irish Times, Daily Mail as well as international media in USA and Australia.
Year(s) Of Engagement Activity 2015
Description Cardiff infection control lectures 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact ?
Year(s) Of Engagement Activity
Description UKIEG conference 2014 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Discussion with other researchers

Year(s) Of Engagement Activity