In this case it is remodeling a hospital or a hospital complex. The procedure requires a master plan setting functional and economical priorities and being flexible in relation to that master plan. For that, a series of deadlines, budgets and priorities of actions are set up and, obviously, a number of areas are selected as a flexible element that allows the removal of each of the functional activities so that the work never paralyses the hospital activity.

A number of areas for action are established by parts of the directive area both of general services and doctors, from which the duration of the works, its phases as well as its full costs are programmed. This action implies a great coordination between the consulting business and the hospital management, especially due to dividing works in phases, preventing that way the subsequent closure of the service.

The hospital has a program with needs and a maximum budget of execution; thus, the consultant is responsible for organizing hierarchically which actions have the highest priority so as to avoid budget deviations and also to meet a minimum set of requirements.

Here there are two types of intervention. One is given by the structural pathologies derived from the age of the building, which consists of a study of the intervention by phases without interrupting, if possible, the normal activity of the centre. The second type originates in the implementation of heavyweight equipment, such as radiology or laboratory for instance, which means a structural reinforcement, being the least aggressive with the existing structure.

Currently, there are quite a large number of hospitals that have been going for over 20 years, which constitutes the great majority of healthcare buildings. The trend seen in recent years is that the administration and private companies prefer to invest in remodeling, restoration and expansion of existing hospitals (given the increasing shortage of resources). This is more profitable from the economic point of view (the ratio of cost per m2 is significantly reduced) and from the perspective of the citizen assistance. Also, these interventions are cost-effective and efficient for several reasons:

  • It implies the use of the existing general facilities within the hospital.
  • These architectural interventions bring the projected medical service closer to other complementary services in the same building.
  • The interventions in existing building allow the work without paralyzing the services since these actions are normally executed in phases.
  • Within the hospital operation and management, corporations or multinational companies assuming the provision of services, equipment, consumables, medicines, etc. usually offer improvements in their service contracts with the hospital or the counseling, which entails funding certain renovations.
  •  Performing the work within the hospital provides greater interaction with healthcare professionals, who will be the medical staff using these facilities later.
  • The constant advances in medicine must be also taken into account, making it necessary for the medical equipment to be regularly renewed. Thus, in many cases the hospital direction prefers not to own such appliances.
  • Deadlines are another advantage of remodeling existing hospitals compared to the new developments.
  •  On the contrary, in cases of new hospital construction, everything is considerably slowed down by the administrative process, the program of requirements, the project award, the writing and supervision of the constructions with the subsequent work in addition to the later equipment and human resources management.
  •  All the arguments above are not only applicable to remodeling, renovation or adaptation of hospitals, but could also refer to the work of enlargement of such enclosures in a larger or smaller scale.
  •  This alternative, which is quite central, has many advantages over new hospitals.