Framtidssäkring i vårdbyggnadsprojekt

Licentiate thesis, 2019

Buildings are affected by physical, economical, functional, technological, social and legal drivers. These aspects also change over the life time of a building and results in new requirements. This development drive change in all building design projects and more importantly so in healthcare. This results in a need to consider future-proofing (FP) approaches to manage the continual change and requirements. Previous research on FP approaches has mostly focused on the importance of FP as such, i.e. that it is considered. There has been little attention on how the architectural practice actually worked with FP related to healthcare buildings, or their interpretations of related concepts to FP, such as flexibility.

The objective of the licentiate thesis is to explore how FP in Swedish healthcare building design is approached by architects and stakeholders in healthcare building design projects. In the licentiate thesis the following research questions are addressed: 1) Which aspects of FP was discussed when working on the strategy during the design process in Swedish healthcare buildings according to the architects in the study? 2) Which building design due to FP has been or not been implemented (but discussed) in Swedish healthcare buildings according to the architects in the study? 3) Which FP design strategies has not been discussed, in relation to a broader foreign framework, by the architects in the study? 4) In what way does stakeholders in the Swedish healthcare projects relate to the concept of FP and flexibility?

The licentiate thesis is explorative in its character and contain two studies. The first study takes its point of departure in a qualitative, multi-case study of planned and/or built Swedish healthcare buildings. Data has been collected from presentations of healthcare building design projects encompassing FP approaches and through semi-structured interviews with architects designing healthcare buildings. The interviews were transcribed and analyzed through content analysis focusing on the architects view and interpretation of FP in their projects. In the first study a qualitative synthesis has also been done concerning the third research question. The synthesis compare result from the second research question with a larger framework containing 12 design strategies and 60 building characteristics (a framework constructed by Schmidt and Austin, 2016). The second study which aims to answer the fourth research question was a survey study. Data has been collected from a survey (n=42) and has been analysed through a word analysis.

Results show that architects, healthcare staff and clients has planned and considered future changes in all the healthcare project discussed in the study according to the architects. Result also describe different changes in the design process and finds that certain building design strategies aimed to ease changes during the management stage, also eases changes during the concept- and developed design phases. Sixteen different types of building design strategies addressing future changes were identified in the projects that were studied. Results from studies related to the third research question and a part of study one indicates that architects in the study do consider all 12 design strategies from the broader framework constructed by Schmidt and Austin (2016). However, 23 of the 60 building characteristics in the framework were not discussed in relation to FP in the studied projects. In the second study respondents showed a different understanding of the relationship between flexibility and future proofing.
 
The view among the architects, that were included in the study, on FP approaches is found to be based on a narrow scope and include a vague terminology. While it is difficult, even impossible, to predict all future changes in a healthcare building design project there is a need to develop design strategies that can address FP. However, and herein lies the challenge, an FP approach needs to be broad enough to allow for variations and defined enough to be justifiable from a project cost and delivery perspective as well as enabling a design supporting the healthcare activities. This could be relevant to further research such as studying or working with a healthcare building project process in detail or developing a new tool for practitioners working with approaches for FP.

This licentiate thesis is written in Swedish.