Towards Passive-First Healthcare Buildings
Occupant-centred evaluation of passive and hybrid cooling performance in Dutch hospital patient rooms under projected 2050 climate conditions
L.G.A. Buijssen (TU Delft - Architecture and the Built Environment)
A.C. Boerstra – Mentor (TU Delft - Architecture and the Built Environment)
A. Luna Navarro – Mentor (TU Delft - Architecture and the Built Environment)
T. Wang – Graduation committee member (TU Delft - Design & Construction Management)
Peter Buurman – Graduation committee member (Deerns Nederland B.V.)
Jeffrey van der Laag – Graduation committee member (Deerns Nederland B.V.)
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Abstract
Dutch hospital buildings face increasing cooling demand under projected 2050 climate conditions, while patient rooms must provide stable thermal comfort for users with different levels of vulnerability, activity, and adaptive capacity. This thesis investigates how passive and hybrid cooling strategies at the patient-room scale can support occupant-centred thermal comfort, reduce cooling demand, and contribute to climate-resilient healthcare design.
The research combines a literature review, EnergyPlus-based simulations, and stakeholder interviews. The literature review establishes the building-physics and thermal-comfort basis for passive and hybrid cooling. Subsequently, a representative Dutch hospital patient room is simulated under morphed 2050 climate conditions, using operative temperature, SET, PMV/PPD, cooling load, and active cooling hours for staff, mobile patients, and bedridden patients. Finally, stakeholder interviews examine how passive and hybrid cooling strategies are currently understood, constrained, and implemented in healthcare design practice.
The results show that passive envelope measures reduce transmitted solar radiation by up to 80%, but remain insufficient when internal heat gains, continuous occupancy, and thermal storage dominate the room heat balance. Natural ventilation provides intermittent comfort benefits, whereas hybrid cooling with local air movement enables a higher mechanical cooling setpoint and reduces the ideal cooling load under the tested assumptions.
The interviews show that implementation is constrained by fragmented requirements, risk-averse decision-making, infection-prevention concerns, cost allocation, and an installation-led design culture. This thesis therefore concludes that passive cooling should not replace mechanical cooling in hospitals, but should form part of a passive-first hybrid design philosophy: reducing heat gains, managing internal loads, supporting heat dissipation, and using active systems as a controlled fallback rather than the default starting point.