Conclusion

For some health and care settings, the requirement for wireless telecommunication network coverage may be simply to allow external network coverage (such as outdoor commercial 4G and 5G networks provided by MNOs) to penetrate the building. For example, when medical equipment or clinical and administrative devices need a commercial 4G signal to send and receive data, or when patients need to use their personal smart phone to contact relatives or for entertainment.

For other health and care settings, the requirement for wireless telecommunication network coverage may be more complex. Today’s hospitals require almost total wireless telecommunication network coverage. Medical equipment, patient monitors, physicians, clinicians, nurses and patients must be within range of wireless networks throughout the hospital building. The most common wireless communication technology requirements are Wi-Fi, 4G, 5G, IoT, RFID and Bluetooth.

Addressing wireless communication requirements at the earliest possible stage will help avoid additional construction costs, additional effort from technicians and installers, lengthier and more complex implementations, delays in service provision, delays to the overall construction project, and potentially reduced performance. This principle applies equally to GP surgeries, care homes, community health centres and major hospitals.

Factors that impact coverage and should be considered in any new build or refurbishment include:

Clutter profile effect

The materials used to construct hospitals and other health and care settings generally hinder or block the propagation of radio frequencies. The extent to which construction materials affect propagation and cause signal loss is known as the clutter profile effect and is caused by transmission, diffraction, reflection and refraction. This factor impacts projects that require only ‘outside-in’ commercial coverage and projects that require indoor Wi-Fi and mobile networks.

Structural isolation

Aluminium facades and treated glass windows typical of many modern buildings can provide 40–70 dB of isolation and are efficiently shielded even when situated close to a commercial macro site. This is desirable when seeking structural isolation e.g. for a private network, but undesirable when seeking commercial coverage e.g. in a care home or waiting room. This factor therefore impacts projects that require only ‘outside-in’ commercial coverage and projects that require indoor Wi-Fi and mobile networks.

The corridor effect

Corridors should have cable trays and conduits to provide easy access to cables. Interior walls and doors should be constructed from light materials to enable signals to penetrate rooms. Corridors should be free from obstacles that prevent line of sight between antennas, access points and rooms. False ceilings should be constructed from light materials to minimise signal loss.

Fire zones

Fire zones cause major signal degradation. The pattern, number, and location of fire zones should be considered from a wireless coverage perspective as well as a health and safety perspective.
Emergency Departments, Operating Theatres and Intensive Care Units: Consultation with the hospital’s key stakeholders will help identify health and safety requirements and medical regulations that affect the wireless network design and distribution plans.

Emergency departments, operating theatres and intensive care units

Consultation with the hospital’s key stakeholders will help identify health and safety requirements and medical regulations that affect the wireless network design and distribution plans.

Internal interference for example radiology

Antennas should be installed at least 2m away from sources of radiation. A greater number of antennas will be required as the spacing between them will be relatively short to counter the effects of interference.

Not-spots

Hospitals and other larger health and care settings must eliminate coverage ‘not-spots’. Wireless networks must provide an adequate service throughout the building including lifts, stairwells, basements, bathrooms and toilets.

These factors should be considered at the earliest possible stage and then throughout the RIBA Plan of Work. An RF expert should be utilised to implement a Radio Frequency Engineering Methodology (RFEM) such as the model summarised below.

Applying this methodology from the outset will ensure an efficient and cost-effective build process, mitigating the need for costly and timely re-work at a later stage.