‘Hospital expansion in India has become imminent as the norms and needs are changing’

Renovating an existing hospital structure while it is functioning is difficult and requires joint effort of construction and hospital operation. Ajay Gupta (AIA), Executive Director, Kgd-architecture explains to M Neelam Kachhap several aspects of construction process and potential problems for hospital operations during renovations

What is the biggest challenge for an architect while working on a hospital project?

A hospital is a unique building and probably the only one which requires more than 20 specialised consultations to be integrated into efficient design. For example; each hospital room is not only designed for efficient space but also factors like power, water, hygiene and sanitation, medical gases, acoustics etc need to be considered.

Flow of operation is the priority and the hospital is designed with this in mind. With each project the approach has to be different. Besides, a hospital is a service oriented building with constant human interaction. This makes proper space allocation for all needs very crucial. These make a hospital project very challenging for architects but at the same time very exciting. A well executed hospital project is a matter of pride.

How are hospital projects different from other commercial projects?

The basic difference between a hospital and a commercial project is the fact that the owner and operator is the same entity in the former. As compared to commercial or residential projects where the owner usually sells it of or rents the building.

A hospital project is therefore a better project to execute as the owner is more sensitive to the design aspects and is in sync with the architect. However, a hospital project has a more aggressive schedule and a tight time frame. In addition, the project is not only CAP-ex sensitive but also OP-ex sensitive.

How has your experience been working with the hospital sector?

It has certainly been a good experience working in this sector. Kgd-architecture has been in this segment for the past seven years and we have traversed our learning curve. For an architect, a hospital is the most organised sector to work on a building project. The mandate of a hospital is very clear and this helps in design and execution.

We have till date worked on 20 hospitals across India and neighbouring countries, besides working on projects in GCC area and North Africa.

Tell us about any memorable project you have worked on?

Columbia Asia East (Whitefield) has been one of the most exciting projects we have worked on till date. It’s a brownfield project but the building acquired by the hospital had only the skeleton structure in place as it was made keeping retail in mind. So, converting this retail building to suit the standards required for a multispeciality hospital was quite exciting.

With a total area of 200000 sq ft, this hospital was completed in a record time of 16 months at total project cost of about Rs150 crores. We have tried to give the hospital a very non-clinical feel, for example ; concealed the medical stuff behind beautiful paintings. The use of natural light, art work, appropriate colours and right material was done to reduce the stress level of the attendee, patients, staff and doctors, as well as to enhance the hospitality services offered.

While considering hospital expansion what factors should be kept in mind?

Hospital expansion in India has become imminent as the norms and needs are changing. Working on a running hospital is very tough as several factors have to be controlled, primarily infection. The hospital can opt for modular construction which is done off-site and later assembled into place. Construction techniques like pre-cast modular construction, steel fabrication etc can be adopted for the hospital. This has many advantages like speed of construction, flexibility and minimum disruption of existing operations.

What are the options for small hospitals if they are 20 years old and the area around the hospital has developed with no room for expansion? How can they expand and increase their FSI?

In India, the practice of demolishing and reconstructing a building after it has run the course of life is alien. Elsewhere in the world, every building is constructed with a lifespan in mind. In India, people believe that once a building is constructed it should last multiple lifetimes.

For expansion in an existing building, it should be structurally sound. Once that is determined the architect can work around horizontal expansion designs with less weight bearing material. The philosophy of life safety should not be compromised.

What is your advice for hospitals looking at remodelling or renovating the present structure?

The hospitals around the world are facing the challenge of designing a flexible hospital to suit unpredictable future needs. Change is a constant feature in architecture, yet the pace at which our healthcare is changing is greater than any other field and thus the demand for evolving hospitals is also mind boggling. The hospitals should have provisions for change and adaptability.

Hospitals, thus, should opt for a flexible design keeping in mind the future requirements. A variety of construction tools and new technology that not only provides space but also pleasant and non-stressed healing environment is ideal for utilisation.

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