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This paper aims to evaluate the level of compliance of fire safety with the legal requirements in Malaysia government hospital buildings by evaluating via fire risk management.

Five government hospitals were selected. These five hospitals were selected due to the location of Penang, which is one of the fast-growing states in Malaysia (Salleh, 2019; Ebekozien, 2019). This state is the second most densely populated state after Wilayah Persekutuan Kuala Lumpur, with an average distribution of 1,490 persons per square km. This higher population caused the higher demand on the health-care services by the public (DOSM, 2016). The observation and building audit processes are as described. Hundreds of photos were taken for qualitative analysis, and all fire safety elements were measured for the descriptive analysis for each hospital. The framework of audit elements is created based on the Life Safety Code: NFPA 101 (2018), UBBL 1984: Part VII (Fire Requirements) and Part VIIII (Fire Alarms, Fire Detection, Fire Extinguishment and Fire Fighting Access). The cross-sectional descriptive evaluation is conducted in the case studies building in accordance with Life Safety Code of NFPA, also known as NFPA 101. To conduct the study, the information needed to assess the fire safety status was extracted from the CFSES software based on the NFPA 101 standard and prepared and compiled by the researcher as a checklist. In the next stage, gathered information was analysed using Computerised Fire Safety Evaluation System (CFSES) software. This method was developed based on the NFPA 101 standard and evaluated the fire risk from four dimensions of containment, extinguishment, people movement and general safety. This software gives the risk assessment results in three areas of fire control, exits and general safety. To assess the fire risk of the commercial buildings after entering the background information (height, age, number of stories, etc.) in the software, the software first calculates the score that the building should obtain in the three aspects of fire control, exit routes and general safety (minimum score required).

The utmost zones in the case studies (44.3%) occupied by limited mobility are located at low-rise buildings or at the first floor to third floor of the hospital buildings. Hospitals managements lacked in creating the maximum exit route and egress the occupants to disclosed the building during evacuation, it correlates to the patients' mobility positions strategy to assign their categories that fell on effortless mobilisation. Surveyed hospitals were built with the non-combustible materials, even though four of the case studies were built before 1984. Hospitals were equipped with hazard separations and vertical smoke pores, and in most of the zones, sprinkler system is installed only in the corridors, equipped with communication system and system of communication with fire and relief organisations and has a fire detection and alarm system throughout the building. Results of fire risk assessment on four groups of elements were tested via CFSES revealed from 122 zones of surveyed hospitals; 102 or 84% of zones give the highest failed rate to comply the NFPA 101 requirements in terms of people movement in the building. The high-occupied Penang General Hospital contributed as the highest case study for not complying with the minimum requirements in all dimensions: people movement elements (41 zones), fire containment (31 zones), fire extinguisher (31 zones) and general safety (20). Fire extinguishment (62 zones) recorded the highest numbers of zones that complied with NFPA 101 (2013). The overall results of the fire risk assessment suggested that in terms of the fire control, egress and general safety aspects, the fire risk assessment score was unacceptable (failed) in all hospital buildings studied, and in the three areas mentioned, the general safety, egress/exit routes and fire control were in a worse status in terms of the score obtained in the software. None of the surveyed hospital received the minimum safety score in the three areas mentioned. The involvement of Emergency Response Team is crucial to overcome this egress or fire exit requirement and parameters.

Several limitations exist in this research that cannot be controlled. Firstly, the occupancy rates only determined during peak hour. Accessibility into hospital compound permitted only during daytime. Secondly, the fire safety audits and fire safety risk management in this research are not being conducted by a professional architect or engineer and as a result must be relied on the direct inspection checklist to create valid results. Thirdly, this research has some limitations which need to be noted but does not affect the robustness of the study’s findings. This study focuses only on five selected public hospitals in one state of the northern region of Malaysia and excluded data gathering from all other parts of Malaysia. The perception of hospital operators regarding fire safety issues from different state hospitals may allow comparisons.

The findings of this paper should make a key practical contribution to the body of knowledge. In practice, the proposed framework should expand the knowledge of public hospital fire safety management plan concerning the level of fire safety compliance with the requirements in government hospital buildings and develop a fire safety management plan framework for government hospital buildings.

This paper develops an early framework component related to the occupants’ safety which gives the basis for future research in hospital fire safety settings as it imparts early investigation into the consequence of investigating the phenomenon from the operators’ perspective as an attempt to improve public health-care fire safety performance in hospitals.

This paper has created a few measurement tools that can be applied among public hospital buildings stakeholders to perform the fire safety audit and risk management and rate the performance of Fire Safety Management in public hospitals.

The maintenance of hospital buildings is often acknowledged as challenging tasks yet inevitable to ensure effective delivery of health-care functions. This study aims to investigate the rationale behind the execution of maintenance which provides essential input for better prioritization of maintenance tasks.

This study evaluated the determinants of building maintenance of public hospitals in Malaysia from the perspectives of key personnel appointed to monitor, supervise and inspect the activities of the privatised support services in public hospitals. A total of 66 questionnaire survey responses were analysed.

Findings revealed that the maintenance practices in public hospitals are user-centric with high emphasis on user’s expectations and complaints. Comparatively, vandalism and improper use of facilities were less of concerns.

This paper reveals the key determinants that influence decision-making in building maintenance of the Malaysian public hospitals from the perspective of maintenance personnel. It adds value to the under-researched topic of privatised hospital support services, which is currently outsourced to five concession companies nationwide.

This study aimed to propose a performance-oriented approach of automatically generative design and optimization of hospital building layouts in consideration of public health emergency, which intended to conduct reasonable layout design of hospital building to meet different performance requirements for both high efficiency during normal periods and low risk in the pandemic.

The research design follows a sequential mixed methodology. First, key points and parameters of hospital building layout design (HBLD) are analyzed. Then, to meet the requirements of high efficiency and low risk, adjacent preference score and infection risk coefficient are constructed as constraints. On this basis, automatic generative design is conducted to generate building layout schemes. Finally, multi-objective deviation analysis is carried out to obtain the optimal scheme of hospital building layouts.

Automatic generative design of building layouts that integrates adjacent preferences and infection risks enables hospitals to achieve rapid transitions between normal (high efficiency) and pandemic (low risk) periods, which can effectively respond to public health emergencies. The proposed approach has been verified in an actual project, which can help systematically explore the solution for better decision-making.

The form of building layouts is limited to rectangles, and future work can explore conducting irregular layouts into optimization for the framework of generative design.

The contribution of this paper is the developed approach that can quickly and effectively generate more hospital layout alternatives satisfying high operational efficiency and low infection risk by formulating space design rules, which is of great significance in response to public health emergency.

Hospital building maintenance management constitutes a pertinent issue of global concern for all healthcare stakeholders. In Malaysia, the maintenance management of hospital buildings is instrumental to the Government’s goal of providing efficient healthcare services to the Government's citizenry. However, there is a paucity of studies that have comprehensively explored all dimensions of hospital building defects in relation to maintenance management. Consequently, this study seeks to evaluate the defects of hospital buildings in Malaysia with the aim of proffering viable solutions for the rectification and prevention of the issue.

The study utilised a quantitative approach for data collection.

The findings indicated that cracked floors, floor tile failures, wall tiles failure, blocked water closets, and damaged windows were some of the flaws that degrade hospital buildings. The study’s outcomes reveal that defects not only deface the aesthetic appearance of hospital buildings but also inhibit the functionality of the buildings and depreciate the overall satisfaction.

Considering the indispensable role of hospital buildings in the grand scheme of healthcare service provision and ensuring the well-being of people, the issue of defects necessitates an urgent re-evaluation of the maintenance management practices of hospital buildings in Malaysia. Previous studies on the maintenance management of hospital buildings in Malaysia have focused primarily on design, safety, and construction.

This is particularly important because defects in hospital buildings across the country have recently led to incessant ceiling collapses, fire outbreaks, ceiling, roof collapses, and other structural failures. These problems are typically the result of poor maintenance management, exacerbated by poor design and construction. These disasters pose significant risks to the lives of hospital building users.

This study offers invaluable insights for maintenance organisations and maintenance department staff who are genuinely interested in improving hospital buildings’ maintenance management to optimise staff's performance and enhance the user satisfaction of hospital buildings in Malaysia and globally.

The calculation of buildings’ carbon footprint (CFP) is an important basis for formulating energy-saving and emission-reduction plans for building. As an important building type, there is currently no model that considers the time factor to accurately calculate the CFP of hospital building throughout their life cycle. This paper aims to establish a CFP calculation model that covers the life cycle of hospital building and considers time factor.

On the basis of field and literature research, the basic framework is built using dynamic life cycle assessment (DLCA), and the gray prediction model is used to predict the future value. Finally, a CFP model covering the whole life cycle has been constructed and applied to a hospital building in China.

The results applied to the case show that the CO₂ emission in the operation stage of the hospital building is much higher than that in other stages, and the total CO₂ emission in the dynamic and static analysis operation stage accounts for 83.66% and 79.03%, respectively; the difference of annual average emission of CO₂ reached 28.33%. The research results show that DLCA is more accurate than traditional static life cycle assessment (LCA) when measuring long-term objects such as carbon emissions in the whole life cycle of hospital building.

This research established a carbon emission calculation model that covers the life cycle of hospital building and considered time factor, which enriches the research on carbon emission of hospital building, a special and extensive public building, and dynamically quantifies the resource consumption of hospital building in the life cycle. This paper provided a certain reference for the green design, energy saving, emission reduction and efficient use of hospital building, obviously, the limitation is that this model is only applicable to hospital building.

There is increasing recognition amongst healthcare providers on the necessity to improve fire safety management in healthcare facilities. This is possibly not yet satisfactory because of recent fire incidents in Asia. This paper set out to analyse the literature because of the paucity of systematic reviews on fire safety management of public healthcare facilities and proffer preventive measures.

Thirty related studies were identified with the support of the Preferred Reporting Items for Systematic reviews and Meta-Analyses via Scopus and Web of Science databases.

Influencing factors, hindrances to fire safety management and preventive measures for fire-related occurrence in Asian hospital buildings were the three themes that emerged from the reviewed. The factors that influence fire in Asian hospital buildings were categorised into technical, management and legislation factors.

The recommendations of this paper were based on literature that was systematically reviewed but does not compromise the robustness concerning fire safety management in hospital buildings across Asian countries. Much is needed to be known regarding fire safety in healthcare buildings across Asian countries. This paper recommended exploratory sequential mixed-methods approach as part of the implications for further studies. This will allow in-depth face-to-face interviews and increase the generalisability of future findings concerning fire safety management in hospital buildings across Asian countries to a larger population.

As part of the practical implications, this paper recommends fire safety management plan as one of the practical possible measures for addressing technical, management and legislation factors. Also recommended is training and fire safety education of healthcare staff in collaboration with safety firefighters to address major issues that may arise from management factors. The government should upgrade the safety technology equipment in healthcare facilities as part of measures to mitigate issues concerning technical and legislation factors. Also, the identified factors are part of the theoretical contributions to the advancement of knowledge and this brings to the front burners new opening.

This is probably the first systematic review paper on fire safety hospital buildings in Asia.

The occurrence of fire accidents in hospital buildings has become a serious challenge and more serious in developing nations. The purpose of this paper intends to assess fire safety measures in Nigerian hospital facilities. The significance of this study is to ensure that the design and construction of hospital facilities enhance the safety of users and properties.

The data were collected via a case study and questionnaire survey and administered to the facility users. The study survey is to assess the respondents' perception of fire safety measures in hospital facilities and suggest possible policy measures that will be employed to enhance safety.

This paper found that 91% of the respondents have awareness of fire safety measures in hospital facilities. Electrical faults and combustible materials were identified as the frequent causes of fire occurrences in hospital facilities. This can be averted where flammable materials and electrical appliances are correctly installed, and safety rules enforced. Findings show that safety rules are lax in public than standard private hospitals.

This paper is limited to fire safety measures in Nigerian healthcare facilities. Future research is needed to evaluate the level of compliance from design, construction and post-construction of precautionary fire safety measures in hospital facilities in Nigeria.

This paper recommended that designers and hospital administrators should improve on fire safety measures via the development of fire safety management plan and education. Thus, enforcement of fire safety measures in hospital facilities as specified in building codes should be implemented and monitored during and after the design of the hospital buildings. Findings provide valuable lessons on how to improve the fire safety measures in healthcare facilities across the states and other developing countries with similar healthcare situations.

This paper demonstrates that the stakeholders, especially government agencies concern with approval and enforcement of fire safety measures in healthcare facilities need to reawaken to her responsibility because of the lax implementation across the states.

Digital practices of facility management (FM) are undergoing transformation. Several Nordic countries have ambitious hospital-building projects, driven by large public clients with long-term experience of operating complex building campuses. There is thus an opportunity for creating state-of-the-art digital FM. This paper aims to investigate the role of digital FM in new hospital projects in Scandinavia.

Based on a literature review, a framework of understanding of digital FM in hospital operation is established. Two longitudinal cases are presented and analysed, one for a greenfield hospital and the other for an extension of an existing hospital.

The literature highlights the importance of integration between technical digitalization, competences, organization and management of digital FM. The projects are in different phases and represent quite advanced preparations for digital FM. State-of-the-art computer-aided FM systems are prepared before operation. External consultants are involved, posing a dilemma of in-house/outsourced human resources in the future digital FM operation.

Two case studies provide insights, but they have limited generalizability.

The study underscores the importance of preparation of management, organization and competences for digitalization.

Documented research on building information modelling (BIM) integrations in FM is still scarce. This article adds to the few empirical studies in the area. The findings illustrate that real estate administrators investing in FM software for new hospital buildings face challenges of aligning BIM models from design and construction to the FM system.

Globally, several studies have shown that hospital building is charged with multiple inherent risks because a large number of users are vulnerable in tragic events. Thus, the need for the fire safety management plan (FSMP) has been proved as an instrument to mitigate fire and related risks in healthcare facilities. In Malaysia, FSMP regarding public healthcare building is yet to be explored in-depth. Therefore, this paper explores the information necessary to develop the FSMP framework for public hospital buildings.

The paper’s objectives were accomplished via a combination of five face-to-face interviews and observations of five selected public hospitals in Pulau Pinang, Malaysia. The five key participants were across the five public hospitals and collated data analysed through thematic analysis with the assistance of MAXQDA 2018.

Findings show that fire safety stakeholders practice system, fire safety action plan and fire risk management were the three main variables that promote fire safety programme and will improve FSMP for Malaysia’s public hospital buildings.

This paper’s data collection is limited to Penang, Malaysia, and a qualitative research approach was used, but this does not deteriorate the strength of the findings. Future studies are needed to consider validating findings from this paper via a quantitative approach.

The suggested framework can be employed by Malaysia’s public hospital authorities as a guideline to mitigate fire hazards in the country’s healthcare facilities.

This paper is encouraging hospital operators and other key stakeholders to improve on their FSMP for healthcare buildings across Malaysia as part of the study implications.

Health-care building maintenance has been receiving concern because of the recent global pandemic. However, there are inadequate broad studies affecting health-care facilities maintenance and feasible solutions in Nigeria. This study aims to conduct an all-inclusive review of public hospital building maintenance issues and proffer possible solutions to improve maintenance practices in health-care buildings via a framework that will support studies in the future.

A review of published papers from 2006 to 2020 was conducted. Based on the keywords, 3 pertinent databases were searched and descriptions of the findings from 40 studies were recognised and used in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Two main themes (issues and feasible solutions to improve practices) emerged from public health-care building maintenance practices. The study developed a framework that describes the relationship between issues and possible solutions with an emphasis on how to improve human development, management efficiency, technical competence and professional skills, cost-minimisation and others.

As part of the paper implications, emerged issues were group into five categories (human development, management, technical, limited financial resources and others). The proposed framework for future studies will attempt to mitigate issues and proffer feasible solutions to improve hospital building maintenance practices in Nigeria and other developing countries that are facing similar challenges.

To the best of the author’s knowledge, this paper is possibly the first comprehensive review of public health-care building maintenance practices in Nigeria. Moreover, this review demonstrates how the proposed feasible solutions can mitigate problems.