Future proofing for hospital building design: From research to practice

The rapid increase of rates of change, disruptive events, risk and uncertainty increasingly threaten the long-term utilisation of hospital buildings. This challenge calls for an evolution in the lifecycle thinking that has always been integral to the hospital building design processes; or an approach that is termed 'future proofing'. Yet the implementation of future proofing as an emerging design requirement is impeded by lack of holistic understanding of the concept, and clarity about its objectives. As such, this research aims to provide a conceptualisation of future proofing via a taxonomic hierarchy. We interviewed sixteen experienced hospital architects from leading consultant firms across Australia to explore their general perceptions, and implementation in practice, of future proofing. The semi-structured interviews were informed by and indeed tested a theoretical model of future proofing previously constructed via literature review and were analysed and validated via thematic analysis and member checking. Our findings align theoretical understanding with hospital architects' practice-based perceptions and experiences of future proofing; elucidating future proofing as a dynamic meta-capability involving a multi-purpose hierarchy. Accordingly, a hierarchical integrated model of future proofing in practice was developed based on three axes (Survive, Evolve and Thrive), respectively defining three sets of spectrums with two extremes ranging from passivity to activity (Resilience-Mitigation, Maintainability-Improvement, and Changeability-Transition). While in previous research future proofing has been oversimplified and perceived largely in terms of adaptability, our findings support a more expansive definition of future proofing that includes various lifecycle design considerations.