Healthcare services are mainly delivered on site, necessitating an adequate space for practitioners. The initial cost of a new hospital is quite significant and could be reduced by reusing existing buildings (e.g., office buildings, warehouses, and multi-family residential). This article addresses the adaptive reuse of buildings for hospital use, a topic that has received very little attention in health science literature. The practice involves economically repurposing an older, depleted, or otherwise vacant building. The authors outline a framework for healthcare professionals with specific steps to select and evaluate buildings for adaptive reuse as hospitals.
The objective of this article is to promote the practice of the adaptive reuse of facilities to healthcare professionals through the discussion of several case studies to demonstrate adaptive reuse strategies implemented by a healthcare system in the Southern US to identify, acquire, and renovate abandoned existing buildings.
In the projects implemented by the authors, opportunities and obstacles are discussed and an operational framework is provided to allow healthcare professionals to evaluate and affordably acquire buildings for adaptive reuse. The authors provided the following adaptive reuse steps:
1- Market surveillance
2- Preliminary analysis
3- Feasibility study
4- Property acquisition
5- Implementation
According to the authors, the organization’s experiences in multiple adaptive reuse projects were economical and effective. The case studies presented for adaptive reuse provide options for addressing spatial requirements economically to improve the delivery of medical services. In addition, adaptive reuse provides the following opportunities:
Financial incentives – Unoccupied buildings that were on the market for a long period of time are more affordable for adaptive reuse since they are often offered at discounted prices. And in many cases the building’s infrastructure can be reused, for additional savings.
Premium location availability – Normally, premium locations in exiting communities are not available but a vacant building offers an affordable opportunity for a local hospital.
Community renewal support – Urban renewal is needed in many communities and the adaptive reuse of an abandoned building encourages local support.
Conservation of resources – Adaptively reusing a depleted building is simply recycling its spaces and infrastructure, conserving resources in demolition and new construction.
The following obstacles were noted in the applicability of the case studies:
Insufficient or nonexistent availabilities – In many incidents an appropriate building is just not available in the desired area.
Excessive renovation costs – Depending on the building condition, the renovation cost can be prohibitive if it exceeds the cost of new construction.
Disagreements with stakeholders over reuse – In some cases the local community might object to the hospital project, which makes the location not feasible.
Zoning difficulties – Zoning ordinances and building classification requirements in a certain area could prevent locating a hospital in a favorable structure.
The study focused on only one health systems approach. Though all the five examples vary in area, cost, original function, acquisition procedure, etc., some experiences encountered by other entities could have gone unaccounted for.