Sustainable building practices are a response to environmental issues. Businesses and industries are assessing how their activities affect the environment. The architecture, engineering and construction (AEC) industries have significant impacts on the environment and economy, while the industry is considered one of the largest contributors to greenhouse gas (GHG) emissions and has, therefore, been highlighted by researchers as a key area of intervention with a great potential to reduce environmental impacts. This paper critically reviews and evaluates the current state of sustainable building certification systems with the purpose of having a good understanding of the status quo and possibilities for future directions in Saudi Arabia. It reviews the academic literature on Saudi Arabia’s green/sustainable building codes, standards, certification systems, methods and tools. It starts by addressing sustainability in the broadest sense. Then, it investigates sustainability strategies and evaluates the building certification systems in Saudi Arabia, followed by an introduction to the new practice of sustainable healthcare building assessment. Life cycle assessment (LCA) and building information modelling (BIM) techniques have also been investigated. The paper introduces the updated Saudi Building Code (SBC) with further evaluation of the Saudi Green Building Code (SBC 1001-CR). Finally, the paper clearly highlights the key role of sustainable building practices and the need to develop a certification system that considers the new trends and the local context.

This study aims to develop and test a life-cycle-based sustainability index that incorporates patient-centredness for assessing and reporting the sustainability of healthcare buildings in Saudi Arabia. The research strategy follows a triangulation method approach to meet the objective of this research. Semi-structured interviews were initially employed in developing sustainable healthcare building indicators based on a previously conducted literature review that explored sustainable building in Saudi Arabia. Then, a scoping review protocol including the Delphi technique was used to develop patient-centredness care, PCC, indicators. Questionnaire surveys were also employed in data collection for industry investigation and patient involvement. Lastly, case study practice tests were conducted involving a specialised hospital and a pre-occupant hospital for indicator verification. A set of sustainability indicators were developed to assess and report the sustainability performance of healthcare buildings. Patient-centredness indicators were also developed and incorporated into the resulting index. A case study practice test was conducted to confirm the feasibility of all final resulting indicators. The research study contributes towards a holistic approach to assess and report sustainability in healthcare buildings incorporating patient-centredness. The objectives of the research include (1) the development of sustainable healthcare indicators (primary indicators); (2) the development of patient-centredness indicators (secondary indicators); and (3) indicator practice tests for validation. The resulting index could be implemented to assess and report sustainability in healthcare buildings, and it could be a pivotal step to shift to sustainable patient-centred healthcare buildings in Saudi Arabia.