Increasing importance of energy and technology

Evolution in Flemish healthcare construction

Over the past 25 years, the healthcare landscape in Flanders has undergone major changes. These changes affected architecture and techniques as well as policy and funding. They were characterized by a shift in focus toward sustainability, technology, inclusiveness and the well-being of patients and caregivers.

A major trigger was the demographic evolution. The increasing aging population and decreasing family size made and continues to make it necessary to think further about alternatives to traditional elder care. Some alternatives, such as kangaroo living, remain marginal. Others, such as the combination of home living or assisted living with some services in a service center, housed in a nearby assisted living facility, seem to be catching on more readily. A more recent development is that of the integrated social care campus. Centrally located, spacious sites, such as those of defunct monasteries, are particularly well suited for this.

For now, the Covid 19 pandemic mainly set minds in motion. Earlier, it was already clear that the existing Belgian situation, where the federal level (Belgium) is responsible for "public health" and the regional level (Flanders) for "welfare," residential and home care is anything but ideal. Hospitals have to turn to Belgium for their operating costs and to Flanders, Wallonia or Brussels for their infrastructure needs. During the pandemic, it appeared that no fewer than nine federal and regional ministers (public health, care, welfare, prevention) were responsible for aspects of it. This was not very conducive to a practical approach. A reshuffle seems a logical future step.

From pioneer to standard technology

At the end of the 20th century, solar and green roofs and deep geothermal drilling were still very exceptional in Flanders. Today, they are part of the standard, in some places even compulsory measures in new buildings. Although the care sector was quick to follow the trend toward green and solar roofs, it was not a pioneer. The first realizations were rather small-scale in solar energy and extensive in green roofs. In deep geothermal energy (BEO), things were different. Here, the care building sector showed itself to be a real pioneer. Among the first Belgian BEO projects were the Sint-Rembertziekenhuis in Torhout, AZ Damiaan in Ostend, AZ Sint-Vincentius (now merged into ZAS) in Antwerp and residential care center De Nieuwe Notelaar in Beveren-Waas. Today, all participants in major construction projects are familiar with Building Information Modeling (BIM), but when AZ Sint-Maarten (Mechelen) drew up its first new construction plans in 2007, it was an "early believer.

New buildings of residential care centers and hospital buildings strive for the most energy-neutral profile possible. Renovations of older buildings also strive to reduce energy consumption through better insulation, LED lighting with motion detectors and smart HVAC installations. When it comes to the use of biodynamic lighting, Flanders lags behind the Netherlands for now. Here, schools took the lead.

Growing participation

Technical managements, staff members at various levels and patient organizations were initially cautious and took the opportunity to get actively involved in construction and renovation issues with little notice. And that's a shame, because there are significant long-term benefits, especially for the organization of internal circulation, working comfort and the efficiency of maintenance and cleaning. One evolution more visible to the outside world was the tendency toward consolidation. More and more residential care centers merged into large groups and hospitals merged into extensive hospital networks. Today, Flanders has care strategy plans for the further development of the hospital infrastructure. These plans describe the role of hospitals and hospital networks in the care offer of their catchment area. To apply for Flemish government subsidies for new building projects, they must have an approved care strategy plan. This must lead to a broad basic offer and a concentration of expertise and high-tech care.

Further evolution

In the future, a hospital is likely to have a much broader anchoring in society. This means that practices already taken for granted in other sectors will become so here. Like a check in service like in hotels, with personalized messages about surgery and treatment and a real-time appointment flow on the room TV. Or a digital connection to the patient's home environment and other healthcare facilities. This implies a smooth and secure exchange of data from different systems and the provision, in addition to curative, of preventive care.