60 Natalia Przesmycka, Rafał Strojny, Anna Życzyńska
Former hospitals are sometimes abandoned due to the
diculty of adapting them to modern requirements. This
applies both to individual buildings in the current inner
city zones and to entire urban complexes. The suitability
of such buildings for further adaptation should be preced-
ed by a thorough analysis and represent a compromise
between the desire to preserve architectural values and lo-
cal heritage with the possibility of adaptation to new pur-
poses [4]. The problem of reclaiming abandoned hospital
buildings in Naples was taken up by Claudia Sicignano
et al. who pointed out new possibilities for developing the
buildings, not excluding also the introduction of medical
functions [5]. In the Lubelskie Voivodeship, such exam-
ples of “recovered” facilities built before World War II in-
clude former hospitals in Jaszczów, Bełżyce, Hrubieszów,
Chełm (at a military unit).
In Poland, the subject of hospital modernisation was
addressed by Jarosław Bąkowski and Jacek Poplatek,
among others [6], while Piotr Gerber dealt with the mod-
ernisation and protection of historic hospitals [7]–[10]. In
her doctoral thesis, Marta Łukasik analysed functional and
spatial layouts as an element of the development strategy
of Polish teaching hospitals [11]. In our country, several
research centres can be distinguished with teams dealing
with the topic of hospitals: Gdańsk University of Tech-
nology and Silesian University of Technology. The result
of many years of research on the subject of hospitals is,
among others, a publication related to the role of research
in improving the quality of hospital operations [12].
Material and methods
The rst stage of the research involved a complete
identication of the stock of existing hospital buildings in
the Lubelskie Voivodeship. At the time of conducting the
research (June 2022), the number of facilities was 110.
The time scope of the research covered the years 2004–
2022. Based on the analysis of all projects implemented in
recent years under the Regional Operational Programme,
25 facilities were selected for further research (Table 1).
The following selection criteria were applied:
1. Function – hospitals were selected for the study (oth-
er facilities classied as health care such as sanitary and
epidemiological stations were not included).
2. Reference level of the hospital – facilities represent-
ing rst-, second- and third-level hospitals and nationwide
hospitals were selected (hospitals with one prole of ser-
vices provided – oncology and paediatric hospitals – the
subject of separate studies – were not taken into account).
3. Location – facilities representing each of the districts
of the Lubelskie Voivodeship. In the case of the city of
Lublin, four hospitals were qualied for the study.
4. Time of establishment – the 20
th
century.
Among the identied facilities, a distinction was made
between facilities located in a single building or occupying
building complexes. As part of the study, information was
reviewed on industry portals [13], websites of all hospi-
tals from the Lubelskie Voivodeship and interviews were
conducted with selected facility managers. The surveyed
facilities were analysed in terms of the structural systems
used in them, functionality, exploitation problems directly
related to the architectural form of the building (original
and resulting from modernisation), as well as heat transfer
parameters of the building envelope. The types of mod-
ernisation works and the resulting architectural, function-
al and operational problems were thus identied.
For the purposes of the study, the denition of a hos-
pital ward was adopted as a part of a hospital building
intended for a longer patient stay, while a pavilion was
adopted as a building containing one or more wards.
Results
Modernisation work carried out
The possibilities of adapting, modernising or adapting
hospital buildings to modern needs depend on a number
of factors. Just as important as the technical condition of
the building are usually the possibilities of adapting it to
modern hygienic, sanitary and technical requirements as-
sociated with advances in medicine. Changing methods of
treatment, a philosophy of ever–shorter hospitalisation pe-
riods, and increasing demands on energy eciency have
left many hospital managers with the dilemma of whether
it is worth adapting an existing pavilion to modern needs
or whether it is more benecial to build a new one. Of
great importance in the renovation process are local envi-
ronmental factors that directly inuence the architectural
solutions applied to the building [14].
From the point of view of the development of medical
technology, the modernisation of historic healthcare facil-
ities (not only hospitals) makes little sense [15]. One of
the most important problems concerning the operation of
existing healthcare facilities is their sterility and hygiene.
This is a very broad issue involving the architectural and
technological solutions adopted. It is currently considered
that a hospital building can serve its function for a maxi-
mum of 50 years. After this time, the hospital should be
demolished and a new one built in its place. This is an ap-
proach that is linked to the belief that a facility after such
a period is exposed to a health-threatening proliferation of
mutating microorganisms and viruses [16]. There is also
a clear link between sterile conditions and the quality of
the building architecture. Today, in new hospitals, an in-
terdisciplinary approach to building planning and design
includes the inclusion of microbiologists in the work [17].
In the 25 hospitals selected for the study, various types
of modernisation works were carried out between 2004
and 2022. Based on the analysis of these hospitals, seven
main types of modernisation work were identied (Fig. 1).
Thermomodernisation was carried out in most of the sur-
veyed facilities. Most often, this concerned only the insu-
lation of the external envelope and the replacement of win-
dow and door joinery. In more than half of the surveyed
facilities, bed wards were also modernised (usually to the
extent of one storey). The scope of work included, among
other things, replacing oor surfaces, replacing or install-
ing suspended ceilings, securing walls, replacing joinery,
improving functionality, renovating existing bathrooms,
introducing new bathrooms and adapting to the needs of
