Retrofitting Healthcare Facilities to Enhance Patient Safety and Energy Efficiency

Open Access
Mohammadpour, Atefeh
Graduate Program:
Architectural Engineering
Doctor of Philosophy
Document Type:
Date of Defense:
June 30, 2014
Committee Members:
  • Chinemelu Jidenka Anumba, Dissertation Advisor
  • John Messner, Committee Chair
  • James Freihaut, Committee Member
  • Dennis G Shea, Special Member
  • Healthcare Facilities Retrofit
  • Patient Safety
  • Energy Efficiency
  • PATSiE Framework
There is an increasing focus on measures to enhance patient safety within the environment of care. Unfortunately, many existing facilities are unable to address this and often struggle to cope with increasingly stringent standards for patient safety due to the fact that they are aging buildings. Under the current economic conditions, it is not feasible to contemplate the replacement of the large number of aging healthcare facilities across the country. A more realistic option is to retrofit these facilities in such a way that they meet both current requirements and foreseeable future needs. In doing this, it would be prudent to integrate into the retrofit project measures to improve the energy efficiency of the facility, as this could result in considerable savings. Retrofitting a healthcare facility poses considerable challenges, particularly with regard to maintaining healthcare delivery operations and keeping patients safe. The aim of this study is to investigate mechanisms for retrofitting healthcare facilities such that patient safety and energy efficiency are simultaneously enhanced. In order to achieve this aim and the associated objectives, this research followed a systematic approach to investigate the issues involved in retrofitting healthcare facilities. An extensive literature review was conducted to identify the current state of the related research and the knowledge gaps in achieving the dual objectives of patient safety and energy efficiency in healthcare facilities retrofit projects. Three case studies were conducted and data collected via interviews, shadowing, site visits, and cognitive walk throughs. Direct observation and experience of retrofit projects was also undertaken to acquire first-hand knowledge of the retrofit process, analyze data, and to explore possible solutions to the problems associated with current practices. Subsequently, an innovative integrated framework, the Patient Saftey and Energie Efficiency (PATSiE) Framework, was developed to simultaneously enhance patient safety and energy efficiency. The key features of the PATSiE include a step by step procedure for enhancing patient safety and energy efficiency, and the elimination of rework with a better understanding of patient safety and energy efficiency integration. A process model that guides retrofit project teams in adequately considering the critical issues in healthcare facilities retrofit has also been developed using the IDEF 0 modeling method. This provides a structured overview of the different stages involved in retrofitting healthcare facilities and improves understanding of the intricacies associated with integrating patient safety improvements with energy efficiency enhancements. Evaluation of the PATSiE was conducted through focus groups with the key stakeholders in the case study healthcare facilities. The feedback from these stakeholders was generally positive as they considered the PATSiE useful and applicable to retrofit projects in the healthcare industry.