HOSPITAL FLOOR FINISHES OVERVIEW

There are a variety of different use areas within a hospital and no ones floor finish is perfect for every environment. Flooring options have changed over the past 50 years and new technology is available that addresses some of the deficiencies of commercial flooring when used in hospitals. 

In most hospitals, the maintenance costs for all flooring finishes will be higher than those experienced in other commercial markets. It is also likely that the life of any flooring surface will be on the low end of the range simply due to the fact that the facility is in constant use and the cleaning regiment is frequent and aggressive. 

A quick analysis of this data clearly shows that initial costs are not the best indicator of economy. These numbers vary from one study to the next and actual costs and life will depend upon the usage conditions and area of the country. 

TYPES OF FLOORING SYSTEMS
  1. Vinyl Composition Tile
  2. Luxury Vinyl Tile & Polyolefin Tile
  3. Linoleum and other Resilient Sheet Goods
  4. Rubber Floors
  5. Ceramic or Porcelain Tile
  6. Carpet or Carpet Tile
  7. Terrazzo
  8. Polished and Stained Concrete
  9. Seamless Resinous Floors
TYPICAL HOSPITAL FUNCTIONAL PROPERTIES
  • Smooth surface to accept wheeled traffic
  • Slip resistance
  • Minimum sound transmission
  • Low porosity for ease of cleaning and disinfection
  • Ease of maintenance and disinfection, including transitions
  • Chemical resistance to anticipated conditions such as cleaning chemicals, foods, body fluids or trafficked soil
Vinyl Composition Floor
VINYL COMPOSITION TILE

VCT was one of the most commonly used hard surface floor finishes in the past due to the low initial cost. In hospitals where cleanliness is a requirement, this product requires the most maintenance with mopping, waxing, buffing, and stripping. In addition, replacement can be expensive and disruptive. 

Vinyl Tile Floor
LUXURY VINYL TILE & POLYOLEFIN TILE

The tile manufacturers addressed the high maintenance costs of VCT by developing Luxury Vinyl Tile and Polyolefin Tile, which are produced with a protective coating to minimize the maintenance process and costs. The LVT tile design does not extend throughout the tile as with VCT. Therefore, the life of the tile is dependent upon the rate of wear through of the protective coating. Although the product ranks well with respect to life cycle costs, seams may present a problem for hospitals, especially in wet areas or areas requiring a high degree of disinfection. 

Lineoleum Floors
LINOLEUM AND OTHER RESILIENT SHEET GOODS

Resilient sheet goods minimize the seams as compared with tiles and are manufactured with a protective coating to minimize maintenance costs. Welded seams are potential areas for system failure, especially in wet areas. Expected life will be limited in the area receiving the most aggressive wear pattern. Replacement may be more expensive than initial installation due to removal and surface preparation requirements. 

Rubber Floors
RUBBER FLOORS

Rubber sheet goods have been used in hospitals because they minimize seams and provide a resilient smooth surface that is comfortable, sound damping and good for wheeled traffic mobility. This finish has good chemical resistance and is relatively easy to maintain. Initial cost of this product is higher than tile or other sheet goods with comparable expected life. 

Ceramic Floors
CERAMIC OR PORCELAIN TILE

The weak link with ceramic and porcelain tile for hospital applications is the grout tile for hospital applications is the grout joints. Uneven surfaces in hospitals become problematic for wheeled traffic. Grout joints are also much more difficult to maintain, may harbor dirt and microbes, and frequently need repair or replacement. 

Carpet Tile Floors
CARPET OR CARPET TILES

Although studies have shown that the patient recovery is positively affected by a "homey" environment, carpet acts as a reservoir for fungi and bacteria. It should not be used in areas at risk of spills or wet conditions. Cleaning and sanitizing carpet is more difficult than hard floor finishes. Hospitals should limit carpet selection to non-patient treatment areas such as waiting rooms and offices. 

Terrazzo
TERRAZZO

Terrazzo, especially resinous terrazzo, has proven to be a highly decorative, long lasting finish. Terrazzo is ground to a smooth, honed and polished finish. Caution must be taken when using this finish in any area expected to be wet due to potential slipperiness. Hospitals will frequently select this finish for lobbies to enhance first impressions. The initial cost of terrazzo is high relative to the other options but it is common to expect a useful life of three to five decades. 

Polished Concrete
POLISHED AND STAINED CONCRETE

Stained and polished concrete have become popular over the course of the last 10 to 20 years. Using grinding and densifying techniques the concrete itself is finished as a decorative wear surface. As with terrazzo, the smooth polished surface requires care to prevent slip and fall accidents in wet conditions. The surface also requires frequent period protective coating to prevent wear through to the concrete itself. It is important to prevent long-term exposure of chemicals or spilled foods as they may adversely affect the sealant and stain. Hospitals may choose to utilize this finish in exterior patios, covered walkways, or lower traffic decorative areas. 

Resinous Flooring
SEAMLESS RESINOUS FLOOR

Seamless resinous flooring systems are fluid applied and cured in place. The product functionality and aesthetics are driven by the resin chemistry, the aggregates and the application techniques. The system designs provide a great deal of flexibility to this category. Some systems utilize resins with extremely fast cure cycles expediting renovation applications. Other systems are designed specifically for hospital environments using flexible resins to provide a sound damping and resilient finish similar to rubber. All resinous flooring systems intended for hospital applications have excellent chemical and stain resistance to harsh cleaning chemicals, body fluids and foods. Most manufacturers of resinous floor systems utilize environmentally friendly, low VOC chemistry, qualifying for LEED® and Green Globes® material and air quality credits. 

By definition, resinous floors and wall coatings are ideal for maintaining a clean disinfected area. The resins utilized typically have high crosslink densities providing excellent chemical and stain resistance plus cure to a smooth surface minimizing microbial growth areas. Depending upon the system design, resinous flooring can utilize color for aesthetics or wayfinding and include surface texture to improve safety. Unlike many of the other options, resinous flooring is unique in that with the appropriate cove detail, the wall to floor transition provides a completely seamless interface with a "negative" edge that will not collect dust. 

ABOUT THE AUTHOR

Tom Murphy is an independent consultant having been associated with the construction industry for more than 20 years. In addition to participating on several committees developing guides and standards for concrete coating industry. Tom assists material manufacturers, specifiers, owners and contractors to design, select and install the best product for the application.