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The need for 24/7 operation, and the increasing requests of high-quality healthcare services contribute to framing healthcare facilities as a complex topic, also due to the changing and challenging environment and huge impact on the community. Due to its complexity, it is difficult to properly estimate the construction cost in a preliminary phase where easy-to-use parameters are often necessary. Therefore, this paper aims to provide an overview of the issue with reference to the Italian context and proposes an estimation framework for analyzing hospital facilities’ construction cost. First, contributions from literature reviews and 14 case studies were analyzed to identify specific cost components. Then, a questionnaire was administered to construction companies and experts in the field to obtain data coming from practical and real cases. The results obtained from all of the contributions are an overview of the construction cost components. Starting from the data collected and analyzed, a preliminary estimation tool is proposed to identify the minimum and maximum variation in the cost when programming the construction of a hospital, starting from the feasibility phase or the early design stage. The framework involves different factors, such as the number of beds, complexity, typology, localization, technology degree and the type of maintenance and management techniques. This study explores the several elements that compose the cost of a hospital facility and highlights future developments including maintenance and management costs during hospital facilities’ lifecycle.
Leopoldo Sdino; Andrea Brambilla; Marta Dell’Ovo; Benedetta Sdino; Stefano Capolongo. Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview. Healthcare 2021, 9, 888 .
AMA StyleLeopoldo Sdino, Andrea Brambilla, Marta Dell’Ovo, Benedetta Sdino, Stefano Capolongo. Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview. Healthcare. 2021; 9 (7):888.
Chicago/Turabian StyleLeopoldo Sdino; Andrea Brambilla; Marta Dell’Ovo; Benedetta Sdino; Stefano Capolongo. 2021. "Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview." Healthcare 9, no. 7: 888.
Aim: The research sheds light on the challenges and limitations of Spanish and Italian hospital design by looking at the gaps between education and practice. Background: Hospital design plays an important role in providing high-quality and cost-effective facilities for any healthcare system. Spain and Italy face contemporary challenges (i.e., elderly population, staff retention, and obsolete healthcare facilities) and have similar issues of life expectancy, health expenditure, hospital beds provision, and decentralized tax-financed healthcare systems. Method: A cross-sectional, mixed-method study was used. This involved two different data collection strategies and analysis for each area of investigation: (i) education and (ii) practice. For the former, educational programs were reviewed via a web search; for the latter, an online survey of 53 architectural/engineering offices involved in hospital design was conducted. Results: Hospital design education is limited to 0/58 in Spanish and 2/60 courses in Italian universities, although each country offers three postgraduate courses. The practitioners’ survey shows that even though their offices have a long history of healthcare design, only 48% in Spain and 60% in Italy have received specific university training. Office staff lack employees with medical backgrounds, which hinders any partnership between health and design fields either for design practice or the education fields. Laws, national regulations, technical guidelines, and previous experience are the most useful information sources, while international scientific publications appear underused by practitioners. Conclusions: Italian and Spanish healthcare architecture could be improved by promoting multidisciplinary teams (in practice and education) and improving the education offer by tailoring it to national needs.
Laura Cambra-Rufino; Andrea Brambilla; José León Paniagua-Caparrós; Stefano Capolongo. Hospital Architecture in Spain and Italy: Gaps Between Education and Practice. HERD: Health Environments Research & Design Journal 2021, 14, 169 -181.
AMA StyleLaura Cambra-Rufino, Andrea Brambilla, José León Paniagua-Caparrós, Stefano Capolongo. Hospital Architecture in Spain and Italy: Gaps Between Education and Practice. HERD: Health Environments Research & Design Journal. 2021; 14 (3):169-181.
Chicago/Turabian StyleLaura Cambra-Rufino; Andrea Brambilla; José León Paniagua-Caparrós; Stefano Capolongo. 2021. "Hospital Architecture in Spain and Italy: Gaps Between Education and Practice." HERD: Health Environments Research & Design Journal 14, no. 3: 169-181.
Projects, plans and programmes for complex environments such as healthcare facilities need to be designed with specific consideration of the multitude of users, technologies and policies in order to address a sustainable and resilient development. Several Evidence Based Design (EBD) studies highlight the deep interrelation between built and natural systems with human or organizations-related outcomes, but the effect on healthcare staff such as Medical Doctors (MD) is still underexplored. The paper investigates the assessment of self-reported satisfaction and wellbeing of MDs in healthcare facilities. A multidimensional assessment model composed of 53 Likert scale questions has been developed from literature review and existing tools, and submitted to a statistically significant sample of workers in 2 different office settings of an Italian hospital. Since MDs spend a considerable amount of their working time in offices, the qualities of such space are very important. The study highlights and confirms that localization, indoor environment, natural and artificial light are relevant drivers for staff satisfaction and wellbeing. Further investigations on a wider and diverse sample are encouraged.
Andrea Brambilla; Alessandro Morganti; Göran Lindahl; Andrea Riva; Stefano Capolongo. Complex Projects Assessment. The Impact of Built Environment on Healthcare Staff Wellbeing. Transactions on Petri Nets and Other Models of Concurrency XV 2020, 12253, 345 -354.
AMA StyleAndrea Brambilla, Alessandro Morganti, Göran Lindahl, Andrea Riva, Stefano Capolongo. Complex Projects Assessment. The Impact of Built Environment on Healthcare Staff Wellbeing. Transactions on Petri Nets and Other Models of Concurrency XV. 2020; 12253 ():345-354.
Chicago/Turabian StyleAndrea Brambilla; Alessandro Morganti; Göran Lindahl; Andrea Riva; Stefano Capolongo. 2020. "Complex Projects Assessment. The Impact of Built Environment on Healthcare Staff Wellbeing." Transactions on Petri Nets and Other Models of Concurrency XV 12253, no. : 345-354.
Purpose Several healthcare quality assessment tools measure the processes and outcomes of the care system. The actual physical infrastructure (buildings and organizational) aspects are, however, rarely considered. The purpose of this paper is to describe the process of validation and weighting of an evidence-informed framework for the quality assessment of hospital facilities from social, environmental and organizational perspectives to complement other assessments. Design/methodology/approach Sustainable High-quality Healthcare version 2 (SustHealth v2) is the updated version of an existing framework composed of three domains (social, environmental and organizational quality). To validate and establish a relevant weighting, interviews were conducted with 15 professionals within the field of healthcare planning, design, research and management. The study has been conducted through semi-structured interviews and the application of the Simon Roy Figueras (SRF) procedure for the elicitation of weights criteria. The data collected have been processed through the DecSpace web platform. Findings Among the three domains, the organizational qualities appear to be the most important (W = 49%), followed by the environmental (W = 29%) and social aspects (W = 22%). Relevant indicators such as future-proofing, wayfinding and users’ space control emerged as the most important within each macro-area. Those results are confirmed by the outcome of the interviews that highlight user/patient-centeredness, wayfinding strategies and space functionality as the most important concepts to foster in existing healthcare facilities improvement. Practical implications The study highlights important structural and organizational aspects that hospital managers and planners can consider when dealing with healthcare facilities’ quality improvement. Originality/value The use of the SRF multicriteria method is novel in this context when used to weight an assessment tool with a focus on hospital built environment.
Andrea Brambilla; Göran Lindahl; Marta Dell'Ovo; Stefano Capolongo. Validation of a multiple criteria tool for healthcare facilities quality evaluation. Facilities 2020, 39, 434 -447.
AMA StyleAndrea Brambilla, Göran Lindahl, Marta Dell'Ovo, Stefano Capolongo. Validation of a multiple criteria tool for healthcare facilities quality evaluation. Facilities. 2020; 39 (5/6):434-447.
Chicago/Turabian StyleAndrea Brambilla; Göran Lindahl; Marta Dell'Ovo; Stefano Capolongo. 2020. "Validation of a multiple criteria tool for healthcare facilities quality evaluation." Facilities 39, no. 5/6: 434-447.
Since the World Health Organization (WHO) declared the coronavirus infectious disease 2019 (COVID-19) outbreak a pandemic on 11 March, severe lockdown measures have been adopted by the Italian Government. For over two months of stay-at-home orders, houses became the only place where people slept, ate, worked, practiced sports, and socialized. As consolidated evidence exists on housing as a determinant of health, it is of great interest to explore the impact that COVID-19 response-related lockdown measures have had on mental health and well-being. We conducted a large web-based survey on 8177 students from a university institute in Milan, Northern Italy, one of the regions most heavily hit by the pandemic in Europe. As emerged from our analysis, poor housing is associated with increased risk of depressive symptoms during lockdown. In particular, living in apartments 2 with poor views and scarce indoor quality is associated with, respectively, 1.31 (95% CI: 1046–1637), 1.368 (95% CI: 1166–1605), and 2.253 (95% CI: 1918–2647) times the risk of moderate–severe and severe depressive symptoms. Subjects reporting worsened working performance from home were over four times more likely to also report depression (OR = 4.28, 95% CI: 3713–4924). Housing design strategies should focus on larger and more livable living spaces facing green areas. We argue that a strengthened multi-interdisciplinary approach, involving urban planning, public mental health, environmental health, epidemiology, and sociology, is needed to investigate the effects of the built environment on mental health, so as to inform welfare and housing policies centered on population well-being.
Andrea Amerio; Andrea Brambilla; Alessandro Morganti; Andrea Aguglia; Davide Bianchi; Francesca Santi; Luigi Costantini; Anna Odone; Alessandra Costanza; Carlo Signorelli; Gianluca Serafini; Mario Amore; Stefano Capolongo. COVID-19 Lockdown: Housing Built Environment’s Effects on Mental Health. International Journal of Environmental Research and Public Health 2020, 17, 5973 .
AMA StyleAndrea Amerio, Andrea Brambilla, Alessandro Morganti, Andrea Aguglia, Davide Bianchi, Francesca Santi, Luigi Costantini, Anna Odone, Alessandra Costanza, Carlo Signorelli, Gianluca Serafini, Mario Amore, Stefano Capolongo. COVID-19 Lockdown: Housing Built Environment’s Effects on Mental Health. International Journal of Environmental Research and Public Health. 2020; 17 (16):5973.
Chicago/Turabian StyleAndrea Amerio; Andrea Brambilla; Alessandro Morganti; Andrea Aguglia; Davide Bianchi; Francesca Santi; Luigi Costantini; Anna Odone; Alessandra Costanza; Carlo Signorelli; Gianluca Serafini; Mario Amore; Stefano Capolongo. 2020. "COVID-19 Lockdown: Housing Built Environment’s Effects on Mental Health." International Journal of Environmental Research and Public Health 17, no. 16: 5973.
Sustainable, inclusive and resilient cities and urban settlements are fundamental in enabling people to live long and healthy lives. Elderly population is growing all over the world and in Italy is among the largest. Within this scenario, epidemiological data show that Alzheimer disease, a dementia which manifest with ageing, is also forecast to rapidly increase, up to 150 million cases in 2050. Within urban settlements, the health and socio-sanitary structures for elderly patients represent a fundamental social infrastructure that collects important investments but must be suitable to host people with dementia. The paper describes the methodology adopted for the definition of an assessment tool able to evaluate the indoor and outdoor qualities and characteristics of socio-sanitary facilities for Alzheimer and elderly people. In the first phase the analysis of scientific literature, international case studies and sustainability assessment framework led to identification of 4 criteria, 19 indicators and 71 variables validated by experts in geriatry, psychiatry and architecture. In the second phase the tool has been operationalized and tested on a sample of three territorial structures in Lombardy Region, Italy. The outcomes of the evaluation can lead to the definition of sustainable project strategies.
Andrea Brambilla; Roberto Maino; Silvia Mangili; Stefano Capolongo. Built Environment and Alzheimer. Quality Evaluation of Territorial Structures for Patients with Dementia. Blockchain Technology and Innovations in Business Processes 2020, 178 -186.
AMA StyleAndrea Brambilla, Roberto Maino, Silvia Mangili, Stefano Capolongo. Built Environment and Alzheimer. Quality Evaluation of Territorial Structures for Patients with Dementia. Blockchain Technology and Innovations in Business Processes. 2020; ():178-186.
Chicago/Turabian StyleAndrea Brambilla; Roberto Maino; Silvia Mangili; Stefano Capolongo. 2020. "Built Environment and Alzheimer. Quality Evaluation of Territorial Structures for Patients with Dementia." Blockchain Technology and Innovations in Business Processes , no. : 178-186.
The COVID-19 pandemic has upended the global healthcare systems. The surge in infections and sick critically ill patients has tested the resilience of healthcare infrastructures and facilities forcing organizations to quickly adapt and embrace emergency solutions. The paper proposes a decalogue of design strategies applicable both to new hospitals and to the refurbishment of existing hospitals. The authors conducted observations at hospitals, during public health webinars and through experts working groups from March to May 2020. In this commentary, the authors present a list of strategies for creating critical care surge capacity and exploring design strategies for healthcare design for resilient hospital facilities. The strategies are organized into two tiers: I) design and II) operations. The (I) Design phase strategies are: 1) Strategic Site Location; 2) Typology Configuration; 3) Flexibility; 4) Functional program; 5) User-centerdness. The (II) Operation phase strategies are: 6) Healthcare network on the territory; 7) Patient safety; 8) HVAC and indoor air quality; 9) Innovative finishing materials and furniture; 10) Healthcare digital innovation. Hospitals, health care systems, and institutions urgently need to assess their resources, identify potential bottlenecks, and create strategies for increasing critical care surge capacity. The COVID-19 pandemic disrupted healthcare operations and accelerated the processes of innovation and transformation. The design and operational strategies can enable the achievement of resilient hospital facilities. Further multidisciplinary researches is needed to validate the strategies empirically. (www.actabiomedica.it)
Stefano Capolongo; Marco Gola; Andrea Brambilla; Alessandro Morganti; Erica Isa Mosca; Paul Barach. COVID-19 and Healthcare Facilities: a Decalogue of Design Strategies for Resilient Hospitals. 2020, 91, 50 -60.
AMA StyleStefano Capolongo, Marco Gola, Andrea Brambilla, Alessandro Morganti, Erica Isa Mosca, Paul Barach. COVID-19 and Healthcare Facilities: a Decalogue of Design Strategies for Resilient Hospitals. . 2020; 91 (9-S):50-60.
Chicago/Turabian StyleStefano Capolongo; Marco Gola; Andrea Brambilla; Alessandro Morganti; Erica Isa Mosca; Paul Barach. 2020. "COVID-19 and Healthcare Facilities: a Decalogue of Design Strategies for Resilient Hospitals." 91, no. 9-S: 50-60.
Important public health improvements have been achieved over the past decades, but new challenges are emerging and progress cannot be taken for granted. Urban settlements host most of the global population, but they are also sources of several threats. The aim of the paper is to investigate the role of architects and planners in contributing to overcome these critical health challenges and propose strategic actions for collaboration with the public health workforce. Taking global trends and public health challenges as starting point, a scoping literature review has been conducted to illustrate the possible synergies that architecture and public health workforce should exploit to support population health improvement and tackle key public health challenges. The built environment affects climate change and public health through the use of resources, site location, and green spaces. In architecture curricula, limited space is devoted to health and vice versa. There is an urgent need for recognition of the benefits of collaboration and cross-fertilisation between public health and planning workforce from local to global levels. Public health is evolving from a bio-medical to a socio-anthropological approach and architects/planners have fundamental roles; further collaboration, research and training are needed.
Natasha Azzopardi-Muscat; Andrea Brambilla; Francesca Caracci; Stefano Capolongo. Synergies in Design and Health. The role of architects and urban health planners in tackling key contemporary public health challenges. 2020, 91, 9 -20.
AMA StyleNatasha Azzopardi-Muscat, Andrea Brambilla, Francesca Caracci, Stefano Capolongo. Synergies in Design and Health. The role of architects and urban health planners in tackling key contemporary public health challenges. . 2020; 91 (3-S):9-20.
Chicago/Turabian StyleNatasha Azzopardi-Muscat; Andrea Brambilla; Francesca Caracci; Stefano Capolongo. 2020. "Synergies in Design and Health. The role of architects and urban health planners in tackling key contemporary public health challenges." 91, no. 3-S: 9-20.
World Health Organization states that is possible evaluating projects' qualities via Health Impact Assessment (HIA) but there are not specific HIA tools on hospital buildings assessment. Researchers show significant relationships between built environment and health. The research purpose is investigating how existing tools for healthcare building assessment are encouraging the development of possible hospital HIA evaluation. Based on previous works, 13 assessment tools have been included and a comparison of the criteria has been conducted to understand which the most prevalent topics are. The tools have been analyzed through literature, technical manuals and official websites. The authors identified 12 thematic categories where criteria from different tools have been clustered and discussed. The most prevalent criteria are related to Indoor Environmental Quality (IEQ) (20%). In the oldest tools the evaluation was mainly on technical features while in recent instruments several indicators are related to Architectural features and innovation (48%), Education (23%) and Food (11%). There is growing interest in tools capable of addressing healthy hospitals encouraging IEQ, physical activity and healthy food provision related to occupants' health outcomes. This preliminary study set the basis for further development on hospital facility HIA tools.
Brambilla Andrea; Buffoli Maddalena; Capolongo Stefano; Andrea Brambilla; Maddalena Buffoli; Stefano Capolongo. Measuring hospital qualities. A preliminary investigation on Health Impact Assessment possibilities for evaluating complex buildings. 2019, 90, 54 -63.
AMA StyleBrambilla Andrea, Buffoli Maddalena, Capolongo Stefano, Andrea Brambilla, Maddalena Buffoli, Stefano Capolongo. Measuring hospital qualities. A preliminary investigation on Health Impact Assessment possibilities for evaluating complex buildings. . 2019; 90 ():54-63.
Chicago/Turabian StyleBrambilla Andrea; Buffoli Maddalena; Capolongo Stefano; Andrea Brambilla; Maddalena Buffoli; Stefano Capolongo. 2019. "Measuring hospital qualities. A preliminary investigation on Health Impact Assessment possibilities for evaluating complex buildings." 90, no. : 54-63.
The recent evolution of European health policies and tourism market trends highlights the increasing attention to health promotion strategies along with healthcare tourism innovation. Thermal industry, considered as a set of places of care, represents a possible field for the integration of territorial health tourism services, thanks to its border-crossing connotation and its recognition by the European Commission as main subsector of health tourism. Although Italy represents one of the most attractive European health tourism destination, the thermal sector is still underdeveloped, in extremely heterogeneous and fragmented conditions, unable to catalyze socioeconomic potentialities as well as optimize the use of relevant built heritage. Therefore, it is necessary to develop reliable tools and decision-making models for improving the sector in terms of health, tourism and territorial qualities. Starting from previous studies, the aim of the article is to present the development of archiTHERMability tool and discuss the results of the application on different typologies of thermal facilities. The methodological path followed three steps: (a) a review was conducted among different assessment tools to understand the state of the art; (b) the existing Italian thermal heritage was mapped, and appropriate criteria and macroareas were selected and weighted based on interviews structured with multidisciplinary experts in architecture/territory/management areas; (c) the tool was tested on two different categories of thermal facilities. The tool application on four different thermal facilities highlighted, as expected, the relevance of the managerial field. Nevertheless, the importance of the territorial context and its levels of accessibility plays a fundamental role in the structure's characterization. ArchiTHERMability hence represents an innovative tool for analyzing and understanding the Italian thermal heritage potentialities. Further investigation is necessary to test the tool on a wider sample and with different weights of criteria.
Emilio Faroldi; Viola Fabi; Maria Pilar Vettori; Marco Gola; Andrea Brambilla; Stefano Capolongo. Health Tourism and Thermal Heritage: Assessing Italian Spas with Innovative Multidisciplinary Tools. Tourism Analysis 2019, 24, 405 -419.
AMA StyleEmilio Faroldi, Viola Fabi, Maria Pilar Vettori, Marco Gola, Andrea Brambilla, Stefano Capolongo. Health Tourism and Thermal Heritage: Assessing Italian Spas with Innovative Multidisciplinary Tools. Tourism Analysis. 2019; 24 (3):405-419.
Chicago/Turabian StyleEmilio Faroldi; Viola Fabi; Maria Pilar Vettori; Marco Gola; Andrea Brambilla; Stefano Capolongo. 2019. "Health Tourism and Thermal Heritage: Assessing Italian Spas with Innovative Multidisciplinary Tools." Tourism Analysis 24, no. 3: 405-419.
Hospitals are complex, high-performance systems that demand continuous quality improvement. Several instruments evaluate the organizational or clinical qualities but very few focus on the built environment. The purpose of this paper is to compare and review the recent tools able to assess the hospital built environment and test how they measure health, sustainability, or both through Post Occupancy Evaluation (POE). A literature review has been conducted in the field of hospital quality assessment and 13 POE instruments have been included and analyzed through Ulrich’s Evidence-Based Design (EBD) framework. The percentage and the content of health or sustainability-related criteria have been compared and further discussed. Health related criteria the most recent tools are used three times more than in the tools developed in the nineties. The most used EBD criteria are safety enhancement (n = 131; 14%) and visual environment (n = 119; 13%). Although sustainability remains a relevant issue, today, growing attention is dedicated to the impact of built environment on occupant’s health. Further investigation is needed to understand the effectiveness of those instruments in practice.
Andrea Brambilla; Stefano Capolongo. Healthy and Sustainable Hospital Evaluation—A Review of POE Tools for Hospital Assessment in an Evidence-Based Design Framework. Buildings 2019, 9, 76 .
AMA StyleAndrea Brambilla, Stefano Capolongo. Healthy and Sustainable Hospital Evaluation—A Review of POE Tools for Hospital Assessment in an Evidence-Based Design Framework. Buildings. 2019; 9 (4):76.
Chicago/Turabian StyleAndrea Brambilla; Stefano Capolongo. 2019. "Healthy and Sustainable Hospital Evaluation—A Review of POE Tools for Hospital Assessment in an Evidence-Based Design Framework." Buildings 9, no. 4: 76.
Andrea Brambilla; A Rebecchi; S Capolongo. Evidence Based Hospital Design. A literature review of the recent publications about the EBD impact of built environment on hospital occupants' and organizational outcomes. Annali di igiene : medicina preventiva e di comunita 2019, 31, 165 -180.
AMA StyleAndrea Brambilla, A Rebecchi, S Capolongo. Evidence Based Hospital Design. A literature review of the recent publications about the EBD impact of built environment on hospital occupants' and organizational outcomes. Annali di igiene : medicina preventiva e di comunita. 2019; 31 (2):165-180.
Chicago/Turabian StyleAndrea Brambilla; A Rebecchi; S Capolongo. 2019. "Evidence Based Hospital Design. A literature review of the recent publications about the EBD impact of built environment on hospital occupants' and organizational outcomes." Annali di igiene : medicina preventiva e di comunita 31, no. 2: 165-180.