What Should Healthcare Providers Consider Before Refurbishment?
By HATZ Health Team | Latest update October 2026
Refurbishing an existing healthcare facility can improve patient experience, support contemporary models of care and extend the useful life of a valuable asset.
However, healthcare refurbishment is rarely straightforward.
Clinical services may need to continue throughout the project. Existing infrastructure may have limited capacity. Infection prevention, accessibility, patient privacy and staff workflows must all be protected, while undocumented building conditions can introduce further uncertainty.
The strongest projects therefore begin well before design solutions are selected. They begin by understanding the facility, its users, its operational constraints and the outcomes the organisation needs to achieve.
Begin With the Purpose of the Project
A refurbishment project should start with a clear understanding of why change is required.
The underlying driver may be:
- Changing models of care
- Increased service demand
- Outdated clinical environments
- Accessibility barriers
- Ageing infrastructure
- Patient experience concerns
- Inefficient staff workflows
- New equipment or technology
- Compliance obligations
These drivers should be clearly distinguished from the proposed solution.
For example, the problem may be inadequate privacy rather than insufficient floor area. The answer may involve reconfiguring existing rooms rather than extending the building.
Defining the problem before committing to a design response helps ensure the investment addresses the organisation’s actual priorities.
Understand How the Facility Operates
Healthcare facilities are complex operational environments.
The way a building appears on a plan may not reflect how clinicians, staff, patients and visitors use it in practice. Informal workarounds, temporary storage, changing service patterns and operational dependencies may have developed over many years.
Before refurbishment planning progresses, the project team should understand:
- Patient journeys
- Staff workflows
- Clinical adjacencies
- Equipment movement
- Public and service circulation
- Privacy requirements
- Storage needs
- Peak periods
- After-hours operations
- Critical services that cannot be interrupted
This operational understanding helps distinguish between isolated inconveniences and more fundamental planning problems.
It also allows the project team to protect activities that must continue throughout delivery.
Engage Clinical Staff, Patients and Facility Teams Early
The people who use and operate a healthcare facility often understand its limitations better than anyone else.
Clinical staff can identify workflow conflicts, unsuitable adjacencies and recurring operational problems. Facility managers can explain building-service limitations and maintenance concerns. Patients and carers can highlight barriers affecting accessibility, privacy, confidence and ease of navigation.
Early engagement may include:
- Staff interviews
- User workshops
- Patient journey mapping
- Operational observations
- Consumer consultation
- Facilities and maintenance reviews
- Briefing sessions with specialist advisers
Meaningful engagement helps ensure the brief reflects lived experience rather than assumptions.
The Australian Commission on Safety and Quality in Health Care describes co-design as bringing consumers and health professionals together to create solutions informed by real experience. Its principles include equal partnership, respect, transparency, representation, accessibility and inclusion. [safetyandq...ity.gov.au]
Investigate the Existing Building
Existing clinical facilities often contain conditions that are not fully documented.
Original drawings may be incomplete. Services may have been altered over time. Structural elements, hazardous materials or concealed infrastructure may only become apparent once investigation begins.
Early investigations may need to consider:
- Structural capacity
- Mechanical systems
- Electrical infrastructure
- Hydraulic services
- Fire protection
- Communications and security
- Hazardous materials
- Acoustic performance
- Building-envelope condition
- Accessibility
- Existing equipment
- Current compliance requirements
The purpose is not to eliminate every uncertainty. It is to identify significant constraints early enough for the project team to develop practical responses.
Investment in early investigation can reduce the likelihood of disruptive discoveries during construction.
Assess Infrastructure Capacity
Healthcare environments rely heavily on building services.
Clinical functions may require specialised ventilation, electrical capacity, essential power, data infrastructure, security, water, drainage and equipment connections. Older buildings may not have been designed for current clinical technology or future service demands.
Before determining what a refurbished facility can accommodate, providers should understand:
- Existing service capacity
- Remaining infrastructure life
- Required upgrades
- Redundancy arrangements
- Maintenance access
- Potential service interruptions
- Future expansion requirements
The Victorian Health Building Authority engineering guidelines state that engineering services are fundamental to achieving the health and wellbeing objectives of healthcare facilities. The guidelines apply to healthcare building and refurbishment projects delivered by the authority and are intended to be read alongside the Australasian Health Facility Guidelines. [vhba.vic.gov.au]
Services should therefore be considered as a core planning input, not something added after room layouts are developed.
Consider Infection Prevention From the Beginning
Construction and renovation can introduce risks through dust, disturbed materials, changes to airflow, water-system interruptions and movement between construction and clinical areas.
Infection prevention should consequently influence briefing, design, staging and construction planning.
Considerations may include:
- Separation of construction and clinical zones
- Dust and air-quality control
- Temporary ventilation arrangements
- Water-system protection
- Clean access routes
- Waste removal
- Patient and staff movement
- Commissioning and verification
- Handover procedures
The Australasian Health Facility Guidelines identify risk management as an important part of healthcare construction and renovation, particularly within occupied facilities. [healthfaci...nes.com.au]
The Australasian College for Infection Prevention and Control also recommends involving infection prevention professionals from the outset of healthcare planning, co-design and construction activities. [acipc.org.au]
These requirements should shape the project strategy before construction begins.
Determine What Must Remain Operational
Many healthcare organisations cannot close an entire facility for refurbishment.
Services may need to continue in adjacent areas or move temporarily while works occur. Access, essential infrastructure and emergency arrangements must remain safe and reliable.
Providers should identify:
- Services that cannot be interrupted
- Spaces that must remain accessible
- Acceptable shutdown periods
- Temporary accommodation requirements
- Patient transfer arrangements
- Staff access routes
- Emergency egress
- Construction access
- Noisy or disruptive works
- Suitable out-of-hours work periods
This information provides the foundation for a staged delivery strategy.
The staging plan should be developed alongside the design, not after the layout has been finalised.
Establish a Realistic Staging Strategy
Staging may allow clinical services to continue while parts of a facility are progressively upgraded.
Depending on the project, the strategy may involve:
- Temporary relocation of selected services
- Construction within controlled zones
- Progressive occupation of completed areas
- Decanting staff and services into renewed spaces
- Refurbishment of the vacated area
- Testing, commissioning and final handover
Each stage should consider how patients, staff, equipment, materials and contractors move through the facility.
The plan should also address:
- Infection prevention
- Access and security
- Noise and vibration
- Temporary services
- Wayfinding changes
- Communication responsibilities
- Contingency arrangements
The objective is not simply to keep the building open. It is to protect care, safety and staff effectiveness throughout the works.
Review Accessibility and Inclusive Design
Refurbishment provides an important opportunity to improve how people access and experience a healthcare environment.
This may involve more than satisfying minimum compliance requirements.
Providers should review:
- Arrival and drop-off
- Step-free entry
- Accessible parking
- Reception counters
- Door widths
- Internal circulation
- Waiting areas
- Amenities
- Signs and wayfinding
- Lighting and contrast
- Places to pause and rest
Accessibility should be considered across the entire patient journey.
A compliant treatment room does not create an inclusive facility if the route to it remains difficult, confusing or undignified.
Balance Immediate Needs With Future Change
A refurbishment project should resolve current problems without making future adaptation unnecessarily difficult.
Healthcare services, technologies and models of care will continue to evolve. Spaces designed too narrowly around present requirements may become restrictive.
Future adaptability may be supported through:
- Flexible room planning
- Standardised room types where appropriate
- Adaptable services
- Accessible ceiling and service zones
- Multi-purpose spaces
- Capacity for technology upgrades
- Opportunities for staged expansion
The Australasian Health Facility Guidelines provide resources informed by clinical, consumer and research input and are designed to accommodate a range of models of care. [healthfaci...nes.com.au]
Future flexibility does not mean every room must accommodate every possible activity. It means avoiding unnecessary constraints and understanding where change is most likely.
Compare Refurbishment With Other Options
Refurbishment should not be assumed to be the correct response before alternatives are tested.
A feasibility process may compare:
- Targeted upgrades
- Partial refurbishment
- Comprehensive renewal
- Adaptive reuse
- Extension
- Staged redevelopment
- New construction
Each pathway may be assessed against:
- Clinical outcomes
- Patient experience
- Operational disruption
- Capital cost
- Programme
- Infrastructure capacity
- Sustainability
- Future adaptability
- Long-term value
The comparison should identify not only what can be delivered, but which option best supports the organisation’s objectives.
HATZ’s internal strategy positions feasibility, adaptive reuse and staged refurbishment as important services both before and after major health infrastructure investment. [Business C...h Strategy | Word]
Establish Clear Decision Points
Healthcare refurbishment projects often involve uncertainty.
Rather than committing the full capital budget before that uncertainty is understood, providers can establish decision points throughout the planning process.
These may occur after:
- Existing-condition investigations
- Confirmation of the operational brief
- Feasibility and options testing
- Cost planning
- Staging analysis
- Design development
- Risk review
At each point, the organisation can confirm whether the project remains aligned with its objectives, budget and operational requirements.
Clear decision points give providers greater control over investment and allow emerging risks to be addressed before they become difficult to manage.
Conclusion
Healthcare refurbishment is most successful when it begins with investigation rather than assumption.
Providers need to understand the facility, the services it supports, the people who use it and the infrastructure on which it depends.
Clinical workflows, patient experience, accessibility, infection prevention, staging and future adaptability should then be considered together.
The strongest refurbishment projects do more than update finishes or replace ageing components. They improve how care is accessed, delivered and experienced, while extending the useful life of an important healthcare asset.
Frequently Asked Questions
When should refurbishment planning begin?
Planning should begin before a preferred design solution is selected. Early investigation and stakeholder engagement help clarify needs, constraints and feasible options.
Can healthcare services continue during refurbishment?
Often, yes. Continued operation generally requires careful staging, separation of work areas, protected access, services planning and clear communication.
Why are existing-condition investigations important?
Existing buildings may contain undocumented services, structural limitations or hazardous materials. Early investigation helps identify these constraints before construction.
Who should be involved in planning a healthcare refurbishment?
The process may involve clinical staff, patients or consumer representatives, facility managers, infection prevention advisers, accessibility specialists, engineers and the project delivery team.
Should providers refurbish or build new?
The appropriate response depends on building condition, clinical suitability, infrastructure capacity, operational disruption, cost, sustainability and long-term objectives. A feasibility study can compare the available pathways.
Related Reading
- What Makes an Effective Clinical Environment?
- How Does Design Influence Patient Experience?
- How Can Existing Clinical Spaces Be Improved?
- How Do Healthcare Facilities Support Future Models of Care?
- When Is Adaptive Reuse Better Than New Construction?
Planning a Healthcare Refurbishment?
Whether you are responding to ageing infrastructure, changing clinical requirements or patient experience concerns, HATZ can help investigate existing conditions, evaluate options and develop a practical refurbishment strategy that protects care delivery and long-term value.