Published On: Fri, Mar 22nd, 2024

Fenestration considerations for healthcare

The key consideration for any hospital or healthcare facility is the well-being of patients, this can be evaluated as offering patient safety and providing a healthy environment to aid recovery. Whilst building fabric plays its part, fenestration, in the form of windows doors and curtain walls, offer an immediate link to the outside which can provide both a patient benefit and carry associated risks. The correct choice of modern fenestration systems and associated hardware is crucial to wellbeing and patient care.

Murat Uyanmis, who served as Project Director at TP Bennet for over eight years and was involved in retrofitting the NHS Trust’s building at 18 Mole Park in Surrey which features Aluprof system comments: “This short editorial covers the majority of the design intent when considering the development of healthcare projects. The review is especially important when specifying the performances of various suppliers and manufacturers when clients offer alternatives to original specifications.”

The Department for Health has produced ‘Health Building Note 00-10, Part D: Windows and associated hardware give best practice’ offers guidance on the design and planning of new healthcare buildings and the refurbishment or extension of existing facilities. The main safety risk associated with opening windows is potential falls.

The recommendation for preventing falls from windows in healthcare premises is to assess the risks of patients falling from windows and implement control measures. This includes conducting a risk assessment that takes into account the patient category and physical capability, not only for new builds and refurbishments, but also for all existing stock.If risks from falling are identified, control measures should be put in place, which usually involves the use of windows with restrictors and where necessary, safety glazing. It is also important to specify the correct type of restrictor at the procurement stage and ensure that the restrictors and their fittings are robust enough to prevent vulnerable and determined adults from forcing them open beyond the 100 mm restriction. Additionally, window restrictors should be included in planned preventative maintenance and monitoring schedules with any damaged or defective restrictors being repaired or replaced. Murat Uyanmis also adds, “In certain occasions, doors that have access to the terraces may require restrictors in healthcare projects. The risk assessment should also be reviewed in light of any findings related to the restrictor failure.

Whilst newly built healthcare facilities offer a ‘clean sheet’ for design, there is much that can be done to refurbish existing healthcare facilities. The first step is to engage with manufacturers of fenestration systems to discuss the possibilities of retrofitting modern fenestration into existing buildings. This early engagement allows for a better understanding of the options available and the feasibility of the retrofit.

Many older healthcare buildings do not comply with current regulations regarding thermal efficiency. By replacing and upgrading windows to thermally-efficient systems, existing buildings can reduce heat loss and lower energy costs. Aluminium window systems with high-performance thermal breaks are a wise investment as they are easy to maintain, have exceptionally low U-values and require minimum maintenance throughout their extensive lifespan. The lower the U value the higher the thermal efficiency of the system.

Natural daylight has a positive impact on wellbeing, so it is important to provide uninterrupted views of the outside for healthcare patients. ​Aluminium windows allow for larger expanses of glazing in slimmer frames, maximising daylighting. ​Additionally, the use of aluminium curtain walling and fixed light windows can create more welcoming entrance areas and reduce reliance on artificial light.

Not withstanding Health Building Note 00-10, replacement windows should feature easy-to-use opening mechanisms or trickle vents to ensure well-ventilated spaces. ​Substantial window restrictors are a given standard, but more recent innovations, such as parallel push style windows, can provide controlled ventilation and airflow while negating the risk of falls.

Murat Uyanmis adds, “Whilst high thermal efficiency windows come in a range of options, heat can also escape through doors, so it is important to choose door systems that achieve low U-values to minimise energy loss. Automatic opening doors, such as sliding doors, are ideal for hospital environments as they save space, can be made to larger sizes than standard doors and reduce touch points. Swing doors are also popular for quick access, but they should be robustly constructed to withstand the demands of a busy hospital environment and where necessary be fitted with 90º hold open devices where required. Certainly, all entrances are required to be DDA compliant for ease of access.”

Glazed doors can also aid navigation and boost daylighting in main entrances and communal public areas.​ While they may not be suitable for areas requiring privacy, they can make a significant difference in enhancing the overall environment. Aluminium framed commercial doors are suitable for interior spaces as they are non-corrosive and can withstand rigorous cleaning procedures without compromising their finish. ​Aluminium screens and doors can offer high levels of fire resistance and are a perfect option to compartmentalise and offer safe escape routes in case of fire.

In summary, the benefits of modern fenestration can be retrofitted into existing healthcare buildings through early engagement with manufacturers, upgrading windows to low U-value systems, maximising natural daylight, ensuring well-ventilated spaces, choosing doors with low U-values, and using glazed doors for navigation and daylighting. Situations in the UK where facades face south can be fitted with fixed or adjustable shading systems which can help control solar gain. Aluprof offers a variety of solutions for sun control in such scenarios.

There are proven benefits of naturally ventilated wards in hospitals, these include reduced cross-contamination. Opening windows inwards allows for the circulation of fresh air, which helps to dilute and remove airborne pathogens. ​This can significantly reduce the risk of cross-contamination between patients.

Research has also shown that naturally ventilated wards have lower cross-infection rates for airborne respiratory diseases, such as tuberculosis and COVID-19.  This is because the fresh air helps to disperse and remove infectious particles, reducing the chances of transmission. Natural ventilation is a low-tech solution that does not require expensive high-energy systems. It can be a cost-effective way to improve air quality and reduce the spread of infectious diseases in all healthcare settings.

Pressurised ventilation systems, if not properly maintained or designed, can contribute to the spread of infectious diseases. ​By relying on natural ventilation through openable windows, healthcare facilities can avoid potential issues associated with faulty mechanical systems, inaccessible ducts, and poor maintenance. ​Natural ventilation can also have positive effects on the overall health and well-being of patients and healthcare workers. Fresh air and natural light from open windows can create a more pleasant and comfortable environment, which may aid in the healing process and improve the overall experience of being in a healthcare facility.

Aluprof offer one of the widest range of aluminium fenestration systems which include high-performance fire-rated doors and screens. All systems are offered with technical support to ensure the right system, options and hardware meet expectations. As important, Aluprof can also offer reveal design support to minimise thermal bridging.

Wojciech BrożynaMD Aluprof UK