Evaluating Initial Building Designs Considering Possible Future Changes and Decision Flexibility: The Example of The New PET Centre of the University Hospital of Zurich

Location of building E1 within the hospital (left), and location of the PET centre in the ground floor plan of the building E1 (right). The blue box around the PET centre, labelled with the letter «A», marks the area of interest for the analysis. Left image courtesy of the University Hospital of Zurich.

The uncertainty on the future treatments demand, recently evidenced by the COVID-19 pandemic, makes it challenging for hospitals managers to determine the optimal design of new clinics. Flexibility can help in optimally minimizing the service risks when the benefits of the investments justify the costs, considering the dynamism of treatment demand.

In this work the real options process is used to rigorously determine the best design for the new clinic of nuclear medicine of the university hospital of Zurich. The results suggest that when some flexibility is embedded in the initial design, the estimated net benefit over the clinic’s lifetime is 167.18 million CHF, which is 2.2% and 20% higher than the other two fix designs considered. Conclusions are then drawn on the advantages and limitations in using the real option process to optimize the design of a new hospital clinic, and suggestions are outlined for the further development of its use in practice.

Article published in: International Journal of Architecture, Engineering and Construction, Vol 9, No 4, December 2020, 12020021, 1-21

Flexible floor layout © Chair of Infrastructure Management, ETH Zurich.
Flexible floor layout © Chair of Infrastructure Management, ETH Zurich.
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