Hospitals are controlled yet complex ecosystems which provide a therapeutic environment that promotes healing, wellbeing and work efficiency for patients and staff. As these buildings accommodate the sick and vulnerable, occupant wellbeing and good indoor environmental quality (IEQ) that deals with indoor air quality (IAQ), thermal comfort, lighting and acoustics are important objectives. As the specialist nature of hospital function demands highly controlled indoor environments, this makes them energy intensive buildings due to the complex and varying specifications for their functions and operations. This paper reports on a holistic building performance evaluation covering aspects of indoor air quality, thermal comfort, lighting, acoustics, and energy use. It assesses the performance issues and inter-relationships between IEQ and energy in a new building on a hospital campus in the city of Bristol, United Kingdom. The empirical evidence collated from this case study and the feedback received from the hospital staff help identify the endemic issues and constraints related to hospital buildings, such as the need for robust ventilation strategies in hospitals in urban areas that mitigate the effect of indoor and outdoor air pollution and ensuring the use of planned new low-carbon technologies. Whilst the existing guidelines for building design provide useful instructions for the protection of hospital buildings against ingress of particulate matter from outdoors, more advanced filtration strategies may be required to enact chemical reactions required to control the concentration levels of pollutants such as nitrogen dioxide and benzene. Further lessons for improved performance in operation and maintenance of hospitals are highlighted. These include ensuring that the increasingly available metering and monitoring data in new buildings, through building management systems, is used for efficient and optimal building operations for better IEQ and energy management. Overall, the study highlights the need for an integrated and holistic approach to building performance to ensure that healthy environments are provided while energy efficiency targets are met.

Building performance evaluations (BPE) of five secondary schools and academies constructed under the Building Schools for the Future (BSF) programme in England found that CO₂ emissions associated with operational energy performance in all these buildings is higher than the median of the secondary schools. Whilst the new regulatory requirements for building fabric performance have led to some improvements in heating energy when compared against good practice and typical benchmarks, there is still significant discrepancy between heating energy use and the design expectations. Electricity use in these buildings is also 37–191% more than the median school and significantly worse than the design expectations. These results point to the importance of post-occupancy building fine-tuning and measurement and verification of performance in-use with respect to design projections to narrow the performance gap. It is also necessary to set out clear operational performance targets and protect energy efficiency measures from value engineering throughout building procurement and in operation to achieve good level of performance. Finally, it is suggested to adopt a holistic view of energy, environmental quality, and educational performance to have a better understanding of schools' performance and potential conflicts between energy efficiency measures and indoor environmental quality (IEQ).

This paper reports the results of an interview survey conducted among different stakeholders involved in design, installation and operation of residential ventilation in seven European countries. In total 44 interviews were performed. The results provide a valuable snapshot of current practices and insights into potential barriers and challenges regarding installation of mechanical ventilation in low-energy residences to maintain high indoor air quality (IAQ). The results show that mechanical ventilation with heat recovery is becoming a common choice in new low energy residences in Europe. However, there are countries that apply airing or other types of ventilation such as mechanical exhaust or natural ventilation due to tradition, national legislation, climatic conditions and/or cost reasons. Demand-controlled ventilation (DCV) is often allowed or even recommended in standards, but rarely implemented in practice, except for exhaust-only humidity-based DCV in France and Belgium. The main barriers against mechanical ventilation seem to be high capital cost, space requirements and duct routing. The respondents commonly reported problems resulting from poor construction, lack of commissioning and/or maintenance. The main needs to be identified in the survey were more legislative pushes including more flexibility in legislation, a coordinated approach to energy efficiency and IAQ, and control mechanisms to ensure good implementation and operation.