Keeping a 2009 Design Award-Winning Intensive Care Unit Current: A 13-Year Case Study.

In a complex medical center environment, the occupants of newly built or renovated spaces expect everything to "function almost perfectly" immediately upon occupancy and for years to come. However, the reality is usually quite different. The need to remediate initial design deficiencies or problems not noted with simulated workflows may occur. In our intensive care unit (ICU), we were very committed to both short-term and long-term enhancements to improve the built and technological environments in order to correct design flaws and modernize the space to extend its operational life way beyond a decade. In this case study, we present all the improvements and their background in our 20-bed, adult medical-surgical ICU. This ICU was the recipient of the Society of Critical Care Medicine's 2009 ICU Design Award Citation. Our discussion addresses redesign and repurposing of ICU and support spaces to accommodate expanding clinical or entirely new programs, new regulations and mandates; upgrading of new technologies and informatics platforms; introducing new design initiatives; and addressing wear and tear and gaps in security and disaster management. These initiatives were all implemented while our ICU remained fully operational. Proposals that could not be implemented are also discussed. We believe this case study describing our experiences and real-life approaches to analyzing and solving challenges in a dynamic environment may offer great value to architects, designers, critical care providers, and hospital administrators whether they are involved in initial ICU design or participate in long-term ICU redesign or modernization.

Open Office Space: The Wave of the Future for Academic Health Centers?

Facing space constraints similar to those experienced by many urban campuses, the University of California, San Francisco (UCSF) looked to innovative office workplace design to curb growing facilities expenditures. Mission Hall, a new office building primarily for desktop and clinical researchers and staff, was designed as an activity-based workplace (ABW), a type of open-space design. ABW was simultaneously being proposed as the template for future UCSF desktop research workspaces. ABWs can be less costly to construct than other designs, and their mix of shared and open workspaces is intended to improve efficiency and interaction. Evaluations of ABWs in corporate settings have yielded mixed results. Examples of ABW buildings for faculty in academic health centers (AHCs) are rare.The Mission Hall experience provided a unique opportunity to understand the impact of an ABW design on faculty satisfaction, work effectiveness, well-being, and engagement. In a 2016 survey of faculty, 1 year after occupancy, respondents reported adverse changes in all 4 areas. The most common complaints involved noise exposure and lack of visual and auditory privacy. In response to these issues, faculty reported working at home or elsewhere more frequently, making collaboration more difficult. In 2018, UCSF retrofitted the building to create some private offices and adjusted its overall program to balance private office and open workspaces in future projects.Lessons drawn from this experience can inform workplace solutions at other AHCs. Most critical are the needs to assess functional requirements of work and align design, change management, and technologies to support those requirements.

Data-driven space planning: using Suma to collect data.

Library users frequently make individual requests to staff about how they would like us to improve the services and resources, but it can be difficult to prioritize such requests. To proactively understand how we can improve our library, library staff undertook a comprehensive assessment of spaces and resources using Suma.

The Ethics of Smart Stadia: A Stakeholder Analysis of the Croke Park Project.

The development of "smart stadia", i.e. the use of "smart technologies" in the way sports stadia are designed and managed, promises to enhance the experience of attending a live match through innovative and improved services for the audience, as well as for the players, vendors and other stadium stakeholders. These developments offer us a timely opportunity to reflect on the ethical implications of the use of smart technologies and the emerging Internet of Things (IoT). The IoT has the potential to radically transform society and is representative of the ways that novel technologies will alter human life. We use Dublin's Croke Park stadium smart project as a case study for examining the development of smart stadia.

Consumers fueling outpatient construction.

Construction leaders continue to see their biggest opportunities in outpatient care, but providers still face challenges delivering levels of customer service that patients have come to expect.

Low air exchange rate causes high indoor radon concentration in energy-efficient buildings.

Since 1995, requirements on energy-efficient building construction were established in Russian Building Codes. In the course of time, utilisation of such technologies became prevailing, especially in multi-storey building construction. According to the results of radon survey in buildings constructed meeting new requirements on energy efficiency, radon concentration exceeds the average level in early-constructed buildings. Preponderance of the diffusion mechanism of radon entry in modern multi-storey buildings has been experimentally established. The experimental technique of the assessment of ventilation rate in dwellings under real conditions was developed. Based on estimates of average ventilation rate, it was approved that measures to increase energy efficiency lead to reduction in ventilation rate and accumulation of higher radon concentrations indoors. Obtained ventilation rate values have to be considered as extremely low.