**1. Introduction**

Many essential facilities such as hospital buildings are in high seismic zones throughout the world, and some of them were designed and built at a time without sufficient earthquake knowledge nor performed and are consequently susceptible to earthquakes.

The typical building design process is not performance-based. In the typical process, design professionals select, proportion, and detail building components to satisfy prescriptive criteria contained within the building code. Many of these criteria were developed with the intent to provide some level of seismic performance. However, the intended performance is often not obvious, and the actual ability of the resulting designs to provide the intended performance is seldom evaluated or understood.

Therefore, it has been noted in this period generation procedures some limitations in the: accuracy and reliability of available analytical procedures in predicting actual building response, the level of conservatism underlying the acceptance criteria, the inability to reliably and economically apply performance-based procedures to the design of new buildings and the need for alternative ways of communicating performance to stakeholders that is more meaningful and useful for decision- making

purposes [1]. Other limitations in the performance based-design procedure were also the non-account of non-structural equipment's very important economically but also regarding their behavior during an earthquake. For example, 50% of the injuries and 3% of the deaths in the 1999 Kocaeli Mw7.4 earthquake were caused by non-structural elements and 30% of the losses were found to be furniture, white goods, electronic equipment and other valuable items [2, 3]. In addition, in the 1989 Loma Prieta and 1994 Northridge earthquakes, 10 large hospitals were evacuated or had to be closed due to damage caused by non-structural elements (plumbing) [4, 5].

So, to fulfill the promise of performance-based engineering, FEMA started the development of next-generation performance-based design procedures to address the above limitations. By result, it has been finalized the FEMAP58 [1, 6, 7] guideline to count not only the structural damage but also non-structural damage in the performance assessment. Specifically, others research also focused on the study of the non-structural seismic behavior and assessment and for hospital building [8, 9].

This paper provides practical guidance principally on implementing the seismic performance assessment methodology set forth in FEMA P-58-1 and the guidelines for Seismic performance assessment of buildings, [1, 10], to assess the seismic performance of individual buildings based on their unique site with structural, non-structural, and occupancy characteristics, expressed in terms of the probability of incurring casualties, repair and replacement costs, repair time. The FEMA-P58-2 Implementation Guide [2] contains examples illustrating the performance assessment process, including selected calculation and data generation procedures, by using the selected electronic materials provided in Volume 3 – Supporting Electronic Materials and Background Documentation [7, 11].

**Figure 1.**

**Figure 2.**

**Figure 3.**

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*Floor plan of building.*

*Architectural 2D view of the healthcare building.*

*Performance-Based Design for Healthcare Facilities DOI: http://dx.doi.org/10.5772/intechopen.95320*

*Architectural Façade view of the healthcare building.*

This study does a nonlinear static analysis for an existing typical six (6) story hospital building following the Turkish Building Earthquake Code [6] and the ASCE 41 [9] provisions as well as ACI-318 for reinforced concrete and masonry structure [7, 8], aiming to provide a more realistic estimate of the seismic demands and economic-effective assessment strategy. The PACT (Performance Assessment Calculation Tool) is used in the analysis of the sample hospital building [12–14].

Many financial institutions including lenders, investment funds, and insurers use Probable Maximum Loss (PML), Scenario Expected Loss (SEL), and Scenario Upper Loss (SUL) as preferred performance measures. These performance measures are quantitative statements of probable building repair cost, typically expressed as a percentage of building replacement value [1]. Some building owners, developers, and tenants have also relied on these performance measures to quantify seismic performance. In this regard, it is believed that this study will be a sample study for evaluation of seismic performance of a typical hospital building and its probable consequences.
