Hospital · Ventilation
Ventilation in hospital: what the SRI measures
Ventilation is about demand-controlled ventilation: more air when more people are present or CO2 rises, less when a room is empty. Heat recovery, free cooling with outdoor air and air-quality reporting count as well.
In short
- 1Hospitals always have HVAC capacity above 290 kilowatts, which means the Smart Readiness Indicator is expected to become mandatory here.
- 2The Ventilation domain carries maximum weight for this building type, with a weighting factor of 3 out of 3.
- 3This page shows which smart-ready services within ventilation determine a hospital's SRI score.
Weight of this domain for this building type
Which services count
| Service | Lowest level | Highest level | Advice |
|---|---|---|---|
| Supply air flow control at the room level V-1a · A · 5 levels | No ventilation system or manual control | Local Demand Control based on air quality sensors (CO2, VOC, ...) with local flow from/to the zone regulated by dampers | highest level |
| Air flow or pressure control at the air handler level V-1c · 5 levels | No automatic control: Continuously supplies of air flow for a maximum load of all rooms | Automatic flow or pressure control with pressure reset: Load dependent supplies of air flow for the demand of all connected rooms (for variable air volume systems with VFD) | – |
| Heat recovery control: prevention of overheating V-2c · 3 levels | Without overheating control | Modulate or bypass heat recovery based on multiple room temperature sensors or predictive control | – |
| Supply air temperature control at the air handling unit level V-2d · 4 levels | No automatic control | Variable set point with load dependant compensation. A control loop enables to control the supply air temperature. The setpoint is defined as a function of the loads in the room | – |
| Free cooling with mechanical ventilation system V-3 · 4 levels | No automatic control | H,x-directed control: The amount of outside air and recirculation air are modulated during all periods of time to minimize the amount of mechanical cooling. Calculation is performed on the basis of temperatures and humidity (enthalpy) | – |
| Reporting information regarding IAQ V-6 · A · 4 levels | None | Real time monitoring & historical information of IAQ available to occupants + warning on maintenance needs or occupant actions (e.g. window opening) | highest level |
Worked example
If everything in this domain is at level 0, the domain contributes nothing. At the highest level for all services, the indicative total score for this building type rises by about 10 percentage points (from 31 to 41 percent, with all other domains at level 1).
Why does ventilation carry such heavy weight in hospitals?
Hospitals are among the most installation-intensive buildings that exist. Strict requirements for air handling create high energy consumption and complex technical systems.
Within the Smart Readiness Indicator (SRI), a European methodology that measures how well a building manages smart technology, the Ventilation domain receives the highest weighting factor for hospitals: 3 out of 3. This means that performance in this domain has greater impact on the final score than in many other building types.
Which smart-ready services play a role?
The Ventilation domain consists of six services that together determine how intelligently a hospital manages air handling. Each service has functionality levels from 0 to 4, where a higher level means greater automation and control.
- V-1a: control of supply air flow per room, from manual adjustment to local demand-driven control based on air quality.
- V-1c: control of air flow or pressure at the air handling unit level, up to automatic pressure reset in variable-volume systems.
- V-2c: control of heat recovery to prevent overheating.
- V-2d: control of supply air temperature, from a constant setpoint to load-dependent compensation.
- V-3: free cooling with a mechanical ventilation system, up to control based on temperature and humidity combined.
- V-6: reporting of air quality, up to real-time monitoring with alerts for maintenance or user action.
For hospitals, emphasis often lies on demand-driven control and reliable reporting, because air quality is directly linked to patient safety.
What does this mean for the obligation above 290 kilowatts?
Hospitals almost always fall into the category above 290 kilowatts HVAC capacity. For this category, a building automation and control system (BACS) has been required since the end of 2024.
The Smart Readiness Indicator itself remains voluntary for now. The European Commission must adopt a delegated act by 30 June 2027 at the latest that will make the SRI mandatory for non-residential buildings above this threshold.
What this means for you
- Owner
- Have the building management system (BMS) reviewed across the six ventilation services, with particular attention to demand-driven control and air quality reporting, as these carry the most weight. A higher score on these services not only reduces energy consumption but also supports the upcoming obligation above 290 kilowatts.
- Tenant
- As a user of a hospital building, you will primarily notice the difference in air quality and comfort, for example through less draught or more stable temperatures in patient rooms. Smart ventilation also enables faster intervention when problems occur, as deviations are automatically reported.
- Advisor
- When assessing hospitals, evaluate not just the presence of systems but also the actual functionality level for each service, as the difference between level 2 and level 4 can significantly affect the score. Account for the weighting factor of 3 out of 3 for Ventilation, which means shortcomings in this domain have greater impact than elsewhere.
Next step
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