Building to care: meeting the demanding standards of hospital buildings

An architecture of welcome, care and protection

Accessibles spaces and their specific features

Unlike other types of public building, hospitals are not strictly speaking public access premises. These buildings are designed primarily to welcome and care for vulnerable or sick patients whose conditions may be infectious; sometimes for long periods. Their design demands careful consideration of the specific needs of each space¹, and the flows of each type of user as they pass through and use it.

So welcome facilities for patients and those accompanying them (waiting rooms, reception desks, cafeterias, etc.) will be designed differently from those used exclusively by healthcare staff (offices, staff rooms, rest areas, logistics spaces used for medical equipment storage, etc.). The same applies to care delivery spaces (consulting rooms, imaging and diagnostic spaces and surgical units) and post-operative spaces, such as recovery rooms and patient rooms, which are often separated according to the type of illness being treated.

Emergency departments are often treated as a separate category for both logistical and health security reasons.

From car parks to treatment rooms, all access routes, signage and emergency exits must be useable by people with disabilities. This demands the use of wheelchair-accessible entry systems, appropriate emergency exits, etc. Similarly, spaces must arranged in such a way as to enable patients arriving by emergency ambulance to reach treatment rooms as quickly as possible. 

Building and network security 

Security can never be taken for granted in an environment as sensitive as a hospital. Some regulations, including those relating to fire and human-induced and natural hazards, apply to all public buildings. However, the regulations specific to healthcare facilities of a certain size are often much more strict. French legislation², for example, requires surgical units to be separated by fire-resistant walls and floors offering at least two hours of protection, and airlocks with door closers or automatic closures. Specific rules also apply to high-risk areas, such as the storage facilities used for medical gases and flammable liquids. Floors with patient rooms must also have fire refuge areas where patients unable to move unaided can be kept safe.

Hospitals are classified as sensitive infrastructures, and therefore subject to the requirements set out in the Vigipirate³ plan. In addition to recognising the importance of raising staff awareness of the need for vigilance to prevent potential acts of violence, malicious behaviour or attacks, many hospitals are installing access control, CCTV and alarm systems in key areas⁴.

Equally important is the risk of cyberattacks⁵, which has been rising steadily in recent years. The French Cybersecurity Agency (ANSSI)⁶ goes so far as to regard the healthcare sector as ‘a prime target for a diverse range of actors’. Securing hospital information systems (HIS) is therefore essential to prevent the theft of confidential data or the entire IS being taken down, forcing staff to revert to paper-based procedures.

Electricity, air treatment, fluid management… a diverse range of services to be maintained

Electricity: ensuring a continuous, uninterrupted supply

As well as meeting their significant demand for electricity, hospitals must at all costs avoid power cuts that could potentially endanger both patients and staff. In many countries, it is even a mandatory requirement to have a backup power system, such as high-power generators⁹ (as is the case at Timone University Hospital in Marseille, which has nine 2,000 kW diesel generators with a total generating capacity of 16 MW). The lives of some patients may depend on an uninterrupted power supply. And surgeons can hardly afford to experience a power cut in the middle of a surgical procedure.

So building emergency power units is a specific requirement. In May 2026, VINCI Energies subsidiary Omexom was appointed by the regional authority for Västra Götaland County in Sweden to supply four emergency power units and associated systems for Nerra Älvsborg Hospital¹⁰. The contract includes ongoing maintenance of these systems for three years.

But it is important to remember that many hospitals around the world have no reliable source of electricity. As highlighted by the World Health Organization (WHO)¹¹, between 12% and 15% of healthcare facilities in South Asia and sub-Saharan Africa reportedly have no access whatsoever to the electricity vital for sustaining the lives of many patients. Upgrading power supply grids and developing local solar power generating plants in such locations would help improve the health of thousands of people, as would the construction of health centres.

Air treatment: demanding standards 

Air quality in healthcare facilities must meet a series of standards, where the main focus is on preventing airborne healthcare-associated infections. Internationally, the ASHRAE 170 standard set by the American Society of Heating, Refrigerating and Air-Conditioning Engineers sets out a series of regulations to be met by ventilation, air flow and filtration systems¹². More specifically, it sets standards for air changes per hour, positive pressure and a minimum filtration level.

In France, the NF S 90-351 standard regulates air treatment requirements based on different levels of risk. In Zone 1 areas, such as standard treatment rooms, the risk of infection is considered to be zero. Conversely, a Zone 4 rating indicates a very high risk of infection in areas such as orthopaedic operating rooms, organ transplant operating rooms and severe burns units¹³. Zones at higher risk of infection must meet stricter air quality criteria, particularly in terms of the number of airborne particles per cubic metre. Specifying unidirectional ventilation delivers better outcomes, since particles are propelled externally by the continuous flow of air.

Hospital clean rooms are designed, built and operated to provide control over the concentration of airborne particles, and minimise the introduction, generation and retention of particles within the room in accordance with standard NF EN ISO 14644-14. Clean room temperature, humidity and pressure are also monitored.

Management of medical fluids

Building a hospital also involves installing systems to supply the various care and treatment rooms with all the medical gases required for their operation: air, oxygen, nitrous oxide, carbon dioxide, medical-grade nitrogen, etc. Hospitals often have their own oxygen plant¹⁵ to ensure on-site production and availability of this gas.

Healthcare buildings and environmental performance?  

Facilities such as backup power supplies and compliance with stricter standards for impeccable air quality mean that hospitals inevitably face higher than normal energy costs. At the same time, building environmental standards (such as the RE2020 regulation in France) also apply to hospitals. So how can operational obligations of hospitals be balanced with the need for greater energy efficiency?

The use of solutions such as renewable energy generation in combination with heat pumps, district heating networks and systems utilising heat/cooling recovery is essential if hospitals are to meet environmental and health standards simultaneously¹⁶.

At the construction stage, the use of low-carbon concrete (90% of all concrete used for the VINCI Construction Nantes University Hospital project is low carbon¹⁷), bioclimatic architecture and the use of green roofs can all help to reduce the carbon footprint of buildings¹⁸. For example, the Women and Children's Building at the Countess of Chester Hospital in England, designed by VINCI Construction, is the country’s first net-zero NHS building. This building is all-electric, uses no gas, and is designed to maximise the amount of natural light internally as part of promoting patient recovery and reducing stress¹⁹.

The many challenges involved in building and maintaining a hospital must not distract from its primary mission of helping patients back to health and supporting them through what can often be challenging periods in their lives. Whether at the design stage or during a conversion or renovation project, the opportunity always exists to consider how hospitals could be improved with the aim of leaving them free to focus on people and their wellbeing. Natural light, colour and children’s play areas not only improve the appearance of hospitals, but can also be comforting in ways that help reduce the stress associated with a hospital inpatient stay. Reflecting on the essential structure of the hospital and its green spaces can help not only to increase its focus on patients, but also to make it more environmentally friendly and sustainable.

Sources :

¹ Yann Bubien, Groupe Moniteur: ‘Hospital design and construction. Hospitals, clinics and outpatient centres’  – https://www.kheox.fr/kheox_mediatheque/1/7/8/000001871.pdf  

² Legifrance: ‘Decree of 25 June 1980 approving the fire and panic safety regulations for public buildings (ERPs)’ – https://www.legifrance.gouv.fr/codes/section_lc/JORFTEXT000000290033/LEGISCTA000020336385/  

³ General Secretariat for Defence and National Security: ‘Vigipirate – Guide to best practice for security in public spaces’ – https://www.sgdsn.gouv.fr/files/files/Publications/guide-unique-de-sensibilation-vigipirate-pact-num-v7.pdf  

⁴ ANFH : ‘Principles and measures for hospital security’ – https://www.anfh.fr/sites/default/files/fichiers/8._belazreuk_-_s_curit__0.pdf  

⁵ French Ministry of Health: ‘Cybersecurity: a major challenge for healthcare facilities’ – https://sante.gouv.fr/systeme-de-sante/numerique-en-sante/sih/dossier-cybersecurite/article/la-cybersecurite-un-enjeu-majeur-pour-les-etablissements-de-sante  

⁶ L’Usine Digitale: ‘Cyberattack paralyses the Pontarlier HospitalIT system’ – https://www.usine-digitale.fr/article/une-cyberattaque-touche-l-hopital-de-pontarlier-son-systeme-informatique-a-l-arret.N2239874 

⁷ VINCI Energies: ‘Expertise and innovation for health and safety’ – https://www.vinci-energies.com/projet/expertise-et-innovation-au-service-de-la-sante-et-de-la-securite/  

⁸ VINCI: ‘Construction of temporary hospitals in the United Kingdom’ – https://www.vinci.com/newsroom/actualites/construction-dhopitaux-provisoires-au-royaume-uni  

⁹ Révolution énergétique : ‘Hospitals’ secret weapon against power cuts’  – https://www.revolution-energetique.com/actus/la-botte-secrete-des-hopitaux-contre-les-coupures-delectricite/  

¹⁰ VINCI: Installation of an emergency backup power supply for Norra Älvsborg Hospital. 

¹¹ World Health Organization (WHO): ‘Electricity in health-care facilities’ – https://www.who.int/fr/news-room/fact-sheets/detail/electricity-in-health-care-facilities  

¹² HVAC – HVAC Systems Encyclopedia: HVAC – HVAC Systems Encyclopedia – https://ingener.by/codes-standards-regulations-safety/codes-standards-regulations/ashrae-standards-detailed/ashrae-170-healthcare/ 

¹³ France Air: white paper ‘Understanding the NF S 90-351 standard for hospital hygiene’ – https://www.france-air.com/wp-content/uploads/2022/10/Livre-blanc-hygiene-hospitaliere-norme-NFS-90-351.pdf

¹⁴ Xpair: ‘Frequently asked questions: clean room, white room and hygiene’. – https://conseils.xpair.com/consulter_savoir_faire/hygiene_climatisation_hospitalier/faq_salle_propre_hygiene.htm#part-1297  

¹⁵ Oxygon: ‘Oxygen systems in hospitals: a cornerstone of medical care’ –https://oxygon.ma/centrale-doxygene-dans-les-hopitaux-un-pilier-essentiel-des-soins-medicaux/  

¹⁶ Xpair: ‘Energy efficiency and air quality. ‘What’s the paradox?’ – https://conseils.xpair.com/consulter_savoir_faire/hygiene_climatisation_hospitalier/performance_energ%C3%A9tique_qualit%C3%A9_air_paradoxe.htm#part-1553  

¹⁷ Esprit VINCI 97: Nantes University Hospital: one of the largest hospital construction projects in Europe. 

¹⁸ VINCI Construction: ‘Expertise in hospital projects’ – https://france.vinci-construction.com/fr/projets-hospitaliers/  

¹⁹ VINCI Building: “Countess of Chester Hospital” – https://www.vinci-building.co.uk/sectors-and-projects/health/#lightbox1-1  

²⁰VINCI Facilities: ‘Responsive healthcare services’ – https://www.vinci-facilities.com/app/uploads/sites/6/2021/02/Etablissements-de-sante.pdf