Healthcare MEP needs better design and coordination

The design and coordination of healthcare buildings is by its very nature challenging, JPW's managing director, Gary Walton, says

Gary Walton, managing director, JPW Consulting Group.
Gary Walton, managing director, JPW Consulting Group.

The design and coordination of healthcare buildings is by its very nature challenging. Many factors require careful consideration and coordination: the nature of the facility, the extent, standard and type of MEP services, and the specialist systems to be accommodated within the development.

More than just being high volume high traffic edifices, hospital buildings represent lives. These facilities incur high operational and maintenance costs. It is therefore of paramount importance that scrupulous attention be given to the planning and integration of services within the overall building.

In this regard, MEP services and special systems are critical to ensure facilities function as intended over the life cycle of the development.

Key issues in the design and coordination process for healthcare facilities are as follows. 

Client brief

At the very beginning, the client and the developer must establish a realistic budget for the planned healthcare facility. 

MEP services and specialist systems are a fundamental component for any facility and typically amount to more than 40% of the project construction costs. In this equation, the importance of a solid brief cannot be stressed enough. For example, whether staff accommodation forms part of the design brief. 

The facility life cycle must be considered in the overall budget. Undertaking a value assessment at the design stage will avoid “value engineering” during contract stage which often leads to disruption and reduced engineering and life cycle standards. Early design team involvement is always advised with client and stakeholders.  

Design standards and codes

An MEP engineering consultant’s duty is to backbrief the client on standards and procedures. 

The recognised design codes are from North America, Australia, the UK and the UAE. To ensure both consistency and accountability it is recommended that the selected standards and codes are not mixed and a common international standard is used for the overall project design.

Design team coordination 

Early team coordination ensures that the building, architecture, structural, MEP services and medical equipment facilities are in harmony. 

The importance of an MEP engineer’s hospital experience

Technical knowledge of hospital design is an important consideration for clients in selecting their MEP engineering consultant partner. 

Completeness of the design

Designs that are complete and coordinated prior to tender and construction stages will mitigate risk to the project budget and construction period.

Quality specifications

Compromise is never a good idea, especially on project specifications and design drawings that are detailed, clear, and specific to the project. A robust, coordinated design will go a long way to assuage disputes during the contract stage of the project.

Retaining the design team through the construction process

It is advantageous to retain a design team as Engineer of Record to ensure project specifications and client requirements are achieved.

MEP space requirements/planning

The building designer and architect must work closely with the MEP consultant engineer to establish the principles of MEP plant space and distribution. For example, the extent of horizontal ceiling mounted equipment will determine the depth of ceiling voids which will directly impact  the slab-to-slab floor heights and consequently the overall height of the building.

MEP and specialist systems must be integrated in a manner that they can be maintained with minimum disruption to normal activities or to patients. Design stage thinking and deliberations such as the optimum sizing and location of plant rooms and services zones can pay real dividends. Not only will this kind of diligence reduce construction costs, but will also result in a beneficial financial gain. 

Patient safety

The safety of staff and patients is beyond compromise in a healthcare facility. MEP services play a critical role in the following: (1) providing positive, negative and neutral air pressure regimes associated with operating theatres, isolation rooms and the hospital in general; (2) design of water systems to avoid legionella and poor water quality; (3) electrical power quality including measures against harmonics; (4) selection of integrated bedhead trunking systems combining power, data, medical gases and lighting that are readily available and provide a concealed solution for dealing with multiple services; (5) ease of cleaning to reduce the risk of infection.

Medical equipment/systems interface

Service types and connections required for medical equipment require coordination to ensure the correct level of service is provided at the point of connection.


The UAE promotes sustainable and building efficiency designs. ESTIDAMA and LEED targets should be established at the outset of the project. 

Testing commissioning periods

All commissioning should include the critical cause and effect of systems by undertaking black out tests. This is a complex issue and the time required to undertake these critical tests should not be underestimated. All record documents and maintenance manuals should be complete, recorded and approved before the facility officially opens for business. 

Technological advancements

Designing for adaptability at the outset does not need to cost a great deal. Ensuring that plant areas are accessible, service routes are safeguarded and risers can be modified or expanded easily will go a long way to make future modifications straightforward.

With years of healthcare experience, JPW Consulting Group guides clients and project teams to make cost effective engineering solutions that are practical for the overall building functionality.  

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