Standardization of Solutions in Hospitals: a Path to Efficiency

CUF - Hospitals and Clinics is the leader in providing quality healthcare in Portugal, recognized for its distinctive quality. Its activities are carried out in an integrated and comprehensive manner through an extensive network of hospitals and clinics, digital channels, and proximity care.

With over 80 years of history, CUF has experienced accelerated development in the last two decades, particularly in the last ten years. Currently, it operates 24 hospitals and clinics. The collection of buildings where CUF conducts its activities results from its own project development at different times ("greenfield") and the acquisition of health groups and/or their buildings ("brownfield"), generating a diverse and naturally uneven portfolio.

CUF has been on a path of systematization and standardization solutions with the aim of achieving efficiency throughout the construction, maintenance, and life cycle management of its hospitals and clinics.

Given the rapid growth of the CUF network and the development of projects with different teams, it became imperative to accelerate the process of standardizing project solutions, focusing on three fundamental aspects:

• Standardization of architectural materials: defining materials with recognized and tested quality and durability throughout the building's life cycle; examples of this choice include the selection of vinyl flooring or wall covering (use of HPL and vinyl materials).

• Standardization of CUF's image: establishing a consistent visual identity for CUF buildings, functioning as a layer of standardization over previously selected materials.

• Standardization of Technical Solutions: defining technical solutions based on the life cycle cost (acquisition, maintenance, and energy costs) and not just the acquisition cost; commitment to the highest standards of air quality and comfort conditions in hospital environments to prevent cross-contamination and reduce nosocomial infections.

CUF Tejo Hospital, opened in 2020, stands out as the most prominent result of this process, serving as a standard for future projects. 

Standardization of solutions has brought enormous efficiency gains in all phases of the process of constructing new buildings, allowing critical reduction in the overall project development timeline.

However, the standardization of solutions is not and can never be a static process. The evolution in various fields of knowledge, as well as CUF's goals regarding sustainability and energy efficiency, needs an ongoing process towards improving technical solutions.

Sustainability is a priority for CUF and is increasingly incorporated into projects. Regarding water usage, the focus has been on the reuse of rainwater for irrigation and the use of gray water in various applications, such as garage cleaning waters or toilet seats..

In energy management, the principle of energy conservation is followed, ensuring high levels of thermal isolation, shading, and the use of natural light to reduce lighting needs. Most needs are met by renewable sources, such as the  energy recovered from chiller condensation gases or photovoltaic panels. HVAC equipment selection is based on its energy efficiency, and the Building Management System (BMS) plays an essential role in adapting building operating conditions to its real needs, avoiding energy waste.

Sustainability and circularity objectives are increasingly incorporated into new buildings. In the case of the CUF Leiria Clinic, a temporary clinic built to operate until the completion of the new hospital, the application of prefabricated modular solutions allows for disassembly and reassembly in a new location, with a 50% overall reuse of the current building.