Circularity is increasingly important in the built environment, as reducing operational energy use alone is insufficient to address the environmental impact of buildings. Building services are especially relevant in this transition, because they contain large amounts of materials and are replaced more frequently than structural building elements. In hospitals, this challenge is even more complex. Heating, Ventilation and Air Conditioning (HVAC) systems are essential for safety, technical performance and continuity of care, which means that circularity cannot be assessed from a material perspective alone.
Although circularity in HVAC systems is becoming more relevant, it remains unclear how it can be systematically integrated into projects and especially in hospital renovation projects. The existing literature identifies circular principles and general barriers, but provides limited insight into how these interact with the specific conditions of hospital HVAC systems and the dependencies across the supply chain. This thesis therefore investigates how circularity can be systematically integrated into HVAC systems in Dutch hospital renovation projects to contribute to reducing material-related environmental impact.
The research uses a qualitative exploratory research design. A literature analysis was conducted to identify circular strategies, assessment criteria and hospital-specific conditions. This was followed by a stakeholder overview and 14 semi-structured interviews with clients, advisors, producers, a governmental actor, an end-of-life actor and researchers. The interview data were analysed using the Gioia method and synthesised with the literature findings. Based on this synthesis, six stakeholder action perspectives were developed and evaluated during an expert validation session.
The findings show that circularity in hospital HVAC systems is not mainly limited by technical impossibility, but by the interaction between technical, economic, legal, organisational and hospital-related conditions. Circular opportunities are often lost early in the project process when they are not included in design requirements, procurement criteria or investment decisions. Later in the lifecycle, implementation is further constrained by limited product and maintenance information, unclear warranty and liability conditions, fragmented responsibilities and undeveloped return logistics. In hospitals, these barriers are reinforced by strict requirements for safety, reliability, infection prevention and continuity of care.
The thesis translates these findings into six action perspectives focused on early design choices, procurement and investment decisions, legal uncertainty, product and maintenance information, return logistics, and operation and maintenance planning. The research concludes that circularity in hospital HVAC systems should be understood as a lifecycle and supply chain challenge. Moving from circular ambition to implementation requires not only practical actions, but also motivation, knowledge, coordination and enabling conditions across the supply chain.
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