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Why using BIM in hospital projects?

We invite BIM actors to share their daily challenges and their working methods with us. There is a lot of talks about BIM, but how does it work in practice? What are the challenges for BIM teams? How mature is BIM in France, particularly in the hospital sector?

We had a chat with Mr. Stéphane Limoge, BIM Manager at the Dijon Burgundy University Hospital Center (CHU). Mr. Limoge explains the interest of working in BIM for a CHU, how this new working method was implemented in terms of tools, collaboration, training and describes a concrete example of BIM implementation ...

Can you describe the Dijon Burgundy University Hospital Center (CHU)?

The Dijon Bourgogne University Hospital Centre employs more than 8,040 staff, making it the leading company in the Côte d'Or (France) (2018 figures). The CHU represents 250,000 m2 of floor space and more than 35 million € of work per year in new or refurbishment.

Equipped with modern infrastructures and cutting-edge equipment, the Dijon Burgundy University Hospital offers its patients comfort, safety and access to the most innovative treatments. The CHU is the regional health centre of reference and invests to improve the buildings from both a technical and architectural point of view (thermal improvement, security of medical fluids and electrical installations, video surveillance, site security, asbestos removal). The Dijon Burgundy CHU is committed to a policy of sustainable development and using eco-materials.

Stéphane, what is your background in a few words and your current mission as BIM Manager?

I've been a DPLG architect for 20 years. I have worked as an architect in various agencies (Cabinet Magnin and Atelier Regnault, AA Group Dijon). I have always been very interested in 3D and I converted to BIM 5 years ago. I was able to train in BIM at the same time as my professional activity, when I obtained the University diploma with honours "Digital modelling of building: BIM". I was thus able to apply my knowledge and set up new processes and working methods.

In March 2019, I joined the Dijon Burgundy CHU as an architect and BIM Manager, with the main task of continuing the work carried out on the models internally and externally, optimising the management of the hospital's assets and management and maintenance.

As BIM Manager, I have a cross-functional mission within the Hospital and externally. I have to take up several challenges on a daily basis:

  • Training internal teams in digital BIM and digital BIM tools.
  • Developing teams and players’ skills (architects, companies, engineers) to encourage the adoption of BIM by the greatest number of people. 
  • Optimising the transfer of models between project stakeholders
  • Downloading objects from a plate-form and/or modelling objects in the mock-ups
  • Facilitating connections between technical and IT services
  • Improving collaboration with project stakeholders internally and externally
  • Facilitating communication with non-technical staff

Why and how did the CHU decide to switch to BIM?

The Hospital has been using BIM for several years. Patrice MUREAU, Director of Technical Services and Sustainable Development, was able to see the advantages of BIM. He was following the digital developments in the sector and the public authorities' desire to introduce a digital transition plan in France.

I’ve noticed that in France, large cities are one step ahead of medium-sized cities about BIM.

It is therefore important for us to train and educate the players towards this digital transformation. This is why I am participating in a BIM commission in our sector. We are trying to understand together the interests of BIM and how to optimise its implementation. A fundamental shift is taking place within the CHU with the "creation of a BIM commission".

I work in a working group that brings together engineers and architects from the hospital world, several commissions have been created: thermal, sustainable development, BIM... Our commission, after having met and discussed with various BIM actors (design office, architects...), has just written a first guide for the general managers of France's CHU: "BIM in hospitals", Engineering and Architecture Commission, May 2020.

Indeed, currently, many CHU are questioning about BIM, the stages of implementation, its assets and its constraints:

  • which software should be chosen to facilitate exchanges with all the players (interoperability problem)?
  • should we work with an AMOA?
  • which LOD or LOI should be used in the mock-ups, at what stage of the project?
  • which operating and maintenance system?...  

The aim of this guide is to provide information on BIM and facilitate decision-making. Work will continue on the definition of nomenclatures in the broadest sense (objects, families, views, sheets, etc.).

What are the main challenges of BIM, its constraints and advantages?  

The technical department at the CHU employs 150 people and there are about ten of us in the BIM department: architects, HVAC and electrical engineers.

We face many challenges to make the most of BIM in all its dimensions.

  • Internally, our challenge is to increase the skills of our team so that everyone can model in 3D. We have set up a training plan.
  • Externally, the interoperability’s challenge: The CHU has chosen to work on Revit, we try as much as possible to choose partners who work on the same software, to facilitate work and collaboration, so that we don't lose any data and don't have to re-enter it. Data exchanges can also be a sensitive point between the project management and the design offices.

Digital transformation is one of the CHU's areas of development. Our objective is to work in 100% BIM to optimise the management and maintenance part. 100% digital project management (BIM level 2) is desired in the medium term (2 years) (training courses in progress, and IT deployment).

With BIM model, you can see all part of the building

Every year, the CHU invests in works to renew, extend and rehabilitate its facilities. Digital technology is used to improve the conditions in which patients are received and cared for. Level 3 of the BIM is not excluded but will take a few more years.

The contribution of BIM to hospital projects is important because of the multitude of possible uses of an efficient database and the modeling/visualisation tools that currently exist.

The feedback on the use of BIM in the CHU is positive. The main advantages would be:

  • Facilitate coordination and communication between all stackeholders: project owners, architects, design office, general contractors and heritage management,
  • Avoid mistakes: duplications, anticipating clashes, avoiding coring during the construction phase, and thus reducing expenses.
  • Facilitate project documentation (easier drawing and updating of plans), studies and faster response to requests for modifications issued by the MOA.
  • Facilitate decision making through a better understanding of the project and potential constraints.
  • Communicate more easily with non-technical departments. BIM offers possibilities to visualise the future realisation. The other departments can project themselves and understand the project more easily (visualise resuscitation trolleys, cupboards, washbasins and other furniture) and adopt it. Everyone, even non-BIM staff, has an overall view of the project.
  • Adopt better management of assets and maintenance over time. The technicians have a better knowledge of the buildings. They must be able to walk around the building with a tablet that projects the model and be able to spot problems and act quickly.

How do you work concretely on BIM projects?

We have established a general “BIM charter” and drawn up a more precise “set of specifications” that we use on all our projects. It's the project management team (MOE) that writes the BIM agreement and we agree with them at the outset.

Working in BIM means "positioning the project centrally by redefining the exchanges between those involved in the operation without touching on their role. Through its integrated approach, BIM makes it possible to "build digitally before building" and to take more information into account in the design, particularly elements from the operation (Building Smart France). »

How is the management of the model carried out?

We are used to talking about a single model for all phases of a project. However, on a daily basis, we still work on several models depending on the phase of the project:

  • Competition / sketch phase: first model
  • Up to the PRO phase: second model with adjustments
  • Right up to the DOE: companies optimise the model
  • Maintenance management: adjustment and revision of the model

What objects, what type of information do you need and how do you manage this information?

For the projects we carry out, we integrate objects into our model. I discovered the BIMobject platform when I was an architect in agency. This platform simplifies my work by offering a wide of products that have already been modelled because I can select and download the products I need (doors, windows, desks, tables, partitions...) and integrate them directly into the project model. The specific objects are very useful to go from the model to the reality.

We are always looking for objects for our mock-ups, we encourage manufacturers to model their products in BIM formats and publish them on a platform like BIMobject, otherwise we model the objects we can't find ourselves.

One recommendation I would like to make to manufacturers is not to detail their objects too much because it makes the models too heavy. 3D details should be limited. Indeed, in the context of maintenance management, it is important to have a model that is as light as possible.

The information that the model contains is the real added value. Being able to "query" the model to find out, for example, in just a few clicks, the nature, consumption, volume and warranty characteristics of an item.

What current projects are you conducting in BIM?

Several projects are being carried out in parallel:

  • A project for the interior design of hospital rooms to improve the well-being of patients. We work internally with architects and HVAC and electrical engineers.
  • 3D modelling of buildings: today, 70% of the buildings at Dijon University Hospital are modelled in 3D (architectural part).
  • 3D scan project: we have carried out a 3D point cloud survey of the existing underground parts with a surveyor in order to update the existing plans and above all to avoid any errors in the placement of foundations for future projects.
  • Project to extend the maternity ward to create a Fertility Institute.

Could you give us a more detailed description of this latest 100% BIM project?

A project management team is currently working on an extension to the maternity building to turn it into a Fertility Institute. 

Dates, milestones and project progress

  • October 2019: start of the project
  • Project surface area: 1,069 sq.m
  • Cost: 3.3 million euros
  • Calls for tender:
    • MOE: our choice was the Dijon architecture agency ART & FAC
    • Design office: ARCHIMEN ingénierie
    • BIM process requested by the CHU
Volume validation

  • Stakes of the project:

The main "Philosophy" of the conception of this Institute dedicated to fertility is the comprehensive care of men and women with the aim of preserving their fertility or helping them to conceive, in the best possible conditions. Indeed, in a harmonious, designed and connected space, we wish to favour individualised and global pre-conception care in a totally controlled environment at the cutting edge of technology in order to improve the quality of the gametes/embryos and the chances of success, which will eventually increase the reputation of our institute among the general public.

This extension should be the object of a strong architectural gesture, reflecting the ambition of the project, innovative and humane, resolutely turned towards the 21st century. The environmental aim of the project is to reduce its carbon footprint as much as possible in line with the economic and technical constraints of the project. This is why the materials used will be: concrete structure with high insulation properties, metal mesh cladding.

Taking into account the programm and technical constraints for this type of building, the thermal objective is a RT 2012, but we are pushing the project management to achieve a RT 2012 -20%.

  • Compliance with the BIM charter and the BIM specifications drawn up by the CHU DIJON.
  • BIM agreement with ARCHIMEN.
  • January 2021: Start of works 
  • First quarter 2022: Delivery
  • Stakes of a 100% BIM project

      They are many and varied:

      • Limiting errors by using a digital twin and avoiding extra costs during the work phase (detection of clashes, 3D synthesis, 4D planning, etc.).
      • Centralising information, making it easily accessible to all and thus avoiding communication errors (use of a collaborative platform such as KROQI). This also allows for better design and implementation control, by facilitating collaboration between all the project's stakeholders.
      • Conducting a 100% BIM project for the Dijon CHU also means being a driving force in the digital transition of the building industry for the Burgundy Franche Comté region.

      In conclusion,

      BIM optimises work and enables the management of the CHU buildings from design to maintenance. It is necessary to take time to implement BIM within a team, to train teams, to optimise workflows, however the benefits of BIM are clear. The use of BIM is part of the overall logic of the social responsibility committed by the University Hospital (economic, social and environmental responsibility).

      Ana Patricia Martínez Menéndez • Dec 3, 2020

      Ana Patricia Martínez Menéndez • Dec 1, 2020

      Ana Patricia Martínez Menéndez • Nov 30, 2020


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