Nandini Bazaz, HOSMAC, Health News, ET HealthWorld

Shahid Akhter, Editor-in-Chief, ETHealthworld spoke with Nandini Bazaz, Director – Architectural Services, HOSMAC, to learn more about the role and need for a flexible design strategy in hospital construction.

How important is flexible hospital design and infrastructure?
Hospital buildings are dynamic in nature and tend to change their functions over a period of time, and therefore need a flexible design strategy to ensure that the floors of the building change with minimum disruption. MEP service journeys are also becoming important as they will have to adapt to the change requested, whether it is HVAC or plumbing. Therefore, the structural grid of a hospital becomes the singularly most important decision an architect makes and in our practice we have found that 8-9 mt grids allow the greatest flexibility of change as they adapt to almost all possible configurations of hospital rooms, clinical spaces, operating room complex, diagnostics, etc. When designing new buildings and hospital complexes, subsequent development scenarios (extension of all or part of the constituent elements, modification of the functional function of certain elements); for levels of medical care, as well as to integrate related components of multifunctional medical structures that allow you to combine different processes of training, research and experimentation; the relationships between the different components of the hospital structure.

New health infrastructures must include rounded spaces, in the event of an explosion in the patient population or a pandemic. Such shelled spaces tend to serve as immediate relief and accommodation spaces or for project expansion. In such cases, the building material used to construct the spaces also plays an important role in terms of reuse and renovation.

How do hospital typologies differ in India on the basis of social strata?
India’s healthcare system is split as public and private sector and in terms of infrastructure both have very different typologies. Public hospitals are inexpensive and designed with general wards where patient privacy is compromised but volumes are better managed. Engineering services are also not advanced, and most public hospitals do not have central air conditioning. These hospitals tend to serve the lower socio-economic strata of society. In contrast, private sector hospitals are modern with central air conditioning with an emphasis on single and double rooms to be shared to protect patient privacy. Other key factors that affect the design of a healthcare project are the size, approach, combination of facilities as well as the size and finishes of a hospital.

The key factors in developing a typology are the floor plate of the hospital which determines horizontality and verticality, which also helps to separate certain services intended for a specific layer of society. The horizontal floor plate is a more spread out floor design and lower building height. This design consists of several lifting cores distributed over the entire floor plate, this could also include separate halls for doctors and wards. While a vertical typology consists of a compact floor plate and a greater building height. This would consist of a centralized lift hall and the rest of the hospital functions on the outskirts. This could then have a common hall for doctors and departments, due to the compactness of the slab.

Now in India, where there is not only a clear distinction between two distinct social strata but several. Therefore, catering for all groups is a challenge. However, since there are subsidized programs for the economically weaker part of society, we planners might consider segregating some part of hospital spaces to facilitate administration and user experience. Therefore, having different planning typologies allows efficient design.

What’s the value of having an experienced healthcare architect to design a hospital?
The most important sign of an architect’s competence in healthcare planning is their know-how and experience which translates directly to homeowners costs and efficient turnaround times. As the design must absolutely be planned for the here and now, it must also take into account future advances in medical technology and respond to different user groups to meet their increasing demands.

Both the design and its construction must use the principles of ecology. It can be good to analyze, to see in detail their sense of work and environmentally friendly deliveries of built forms. In this way, a trained health care planner knows / understands the impact that effective planning could have on the overall infrastructure and the life of the building, taking into account the increasing demands of the population to which he is addressing.

Today we see urban architecture brought to hospitals. Your views.
The efficient functioning of hospitals is influenced by many factors, including changes in the number and composition of the population, the dominant picture of morbidity, the emergence of new possibilities for medical intervention (diagnosis, treatment and rehabilitation) associated to the development of scientific knowledge and technological progress. When considering the global experience in the design, construction and operation of hospitals, it is certainly necessary to take into account the sub-regional differences of countries – each country’s health system captures its culture, its traditions, its history, its political and economic orientation. The hospital is made up of many functional groups, each characterized by its own needs, limitations and conditions.

As a rule, new architectural and urban transformations of the health system develop under the influence of economic and political imperatives, but their impact on patients and medical personnel seldom becomes the focus of research attention. Meanwhile, it can be assumed that there is a correlation between the level of treatment effectiveness, morbidity and mortality with the architectural and urban environment of the medical building, in which medical services are produced and provided.

The culture, or rather the ethics, of hospital services must also adapt to changing socio-economic circumstances and the expectations of the population. There is no ideal model, the same way of organizing a hospital system cannot be used in its “pure form” – adaptation to regional characteristics, social, economic and political capacities of each particular state is necessary. necessary, as well as taking demographics into account. indicators and dynamics of progressive diseases. Thus, the question of the influence of the architectural environment of hospitals on the state of health, the healing properties of the internal and external space of a medical building, its surrounding territory is not sufficiently studied. It should be recognized that this task is really a complex multifaceted and multifunctional interactive system. This also applies to healthcare buildings, which must be agile, adaptable and inclusive in their public and urban setting in order to remain relevant and useful to the community for years to come.

HHow can hospitals go green and cut costs?
Let’s understand the concept of going green. It starts at the design stage of any project / building, from orientation to the design of the building envelope and planning of the internal schematics of the service spaces. This helps to understand the application of passive and active design strategies in the building. Climatic considerations are necessary to ensure natural ventilation for an optimal percentage of time in buildings and this can be achieved by the design team taking advantage of the prevailing terrain breezes through different seasons. For example, clinical areas can be passively cooled and naturally ventilated with a small percentage of ceiling mounted mechanical fan assisted ventilation and exhaust fans to achieve necessary air change rates.

In addition, planning around existing vegetation to allow natural habitat to be part of the hospital design would also allow the use of natural microclimatic conditions in some of the building spaces. Shading and optimizing the envelope is another passive strategy for balancing the desire for exterior views and natural light (which can increase productivity and well-being) while avoiding excessive heat from the sun.

These are some of the first steps designers can take to cut costs, save energy, and alleviate environmental issues. Sustainability must be a way of life, it is the moral responsibility of architects as well as owners to the planet. The natural ecology of the planet should be the macro model that architects can use as a model for a green building.

Does digitization play a role in health infrastructure?
Digital healthcare is indefinitely the future of medicine in the world for improving access, reducing delivery costs, as well as for storing and retrieving information. This should ensure effective and cost-effective health solutions that can be reached for the rural population of the Indian hinterland. This allows real-time data tracking and standardization of medical procedures. Classic examples of how digitalization can make things easier for clients are Arogya Setu, COWIN, and telemedicine. PACS (Picture Archival & Communication Systems) are now commonly used in hospitals to transfer digital images to OPD clinics, operating theaters, cath labs, intensive care units, etc. rather than going through a tedious process of printing films in radiology applications.

About Octavia A. Dorr

Check Also

“Footwear Design Institute Open Office in the Footwear Cluster”

Indore (Madhya Pradesh): Footwear manufacturers have requested the opening of an office of the National …