Ar. Ravideep Singh, CDA, lists the de­sign bench­marks for a pa­tient-friendly heal­ing en­vi­ron­ment

There is a long se­quence of de­sign bench­marks that ought to be ad­hered to in or­der to achieve a pa­tient-friendly heal­ing en­vi­ron­ment, writes Ar. Ravideep Singh, Cre­ative De­signer Ar­chi­tects (CDA)

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The ul­ti­mate goal in the de­sign of any health­care fa­cil­ity is, with­out doubt, ‘Pa­tient com­fort and care’. De­sign­ing for the very in­stance that a pa­tient en­ters into a fa­cil­ity and his/her im­me­di­ate re­sponse to the sur­round­ings, is the first im­per­cep­ti­ble par­a­digm that is ex­tremely cru­cial to health­care de­sign. This is fol­lowed by de­sign­ing a clear and a straight-for­ward move­ment for var­i­ous end-users such as vis­i­tors, doc­tors, ser­vice staff, etc., through all the re­quired de­part­ments in or­der to re­spond ef­fec­tively to a set­ting where each sec­ond could be crit­i­cal for a pa­tient’s life.

Ut­most em­pha­sis is laid on pa­ram­e­ters that af­fect the com­fort and well-be­ing of the pa­tients. Apart from a fault­less de­part­men­tal zon­ing and cir­cu­la­tion, it is the aura of the in­te­rior, through warm heal­ing colours and plenty of nat­u­ral light, that co­a­lesces with the psy­chol­ogy of the pa­tients and at­tempts to el­e­vate their minds. An­other area of im­por­tance is the se­lec­tion of fin­ishes that are non­porous, have low VOC con­tent and are easy to main­tain, so as to cre­ate and main­tain a highly pro­tected and ster­ile heal­ing en­vi­ron­ment. Be­sides, state of the art equip­ment that aug­ment ef­fi­cient func­tion­ing of hos­pi­tals to­day, we give to­tal re­gard to the em­i­nence of med­i­cal staff and their well-be­ing. They in­deed stand at the ul­ti­mate level in the health­care de­liv­ery chain and would per­form even ef­fec­tively if they have sub­stan­tial in­fra­struc­ture such as welle­quipped rest rooms, kitchens and other recre­ational fa­cil­i­ties that prompt job sat­is­fac­tion, ul­ti­mately en­abling them to per­form bet­ter. We be­stow im­mense sig­nif­i­cance to land­scape de­sign through ‘Ther­a­peu­tic Heal­ing gar­dens’ and green­ery in the in­te­rior. These are a part of EBD [Ev­i­dence Based De­sign], that a de­signed ex­po­sure to na­ture can boost heal­ing sig­nif­i­cantly. Fi­nally, in the rapidly ad­vanc­ing tech­nol­ogy, it is of ut­most im­por­tance to re­alise that the hos­pi­tals we cre­ate are to made flex­i­ble to adapt with newer equip­ment and plan­ning realms by virtue of mod­u­lar­ity in construction and flex­i­ble MEP de­sign.

Aakash Su­per-spe­cialty Hos­pi­tal: A Bea­con of Con­tem­po­rary Health­care

For the de­sign of Aakash Health­care, a green­field construction on 4 acres of land in Dwarka, New Delhi, we en­vi­sioned it as a bea­con of high­est qual­ity con­tem­po­rary health­care. The project was con­cep­tu­alised as a con­cise block with care­fully worked out in­ter-de­part­men­tal re­la­tion­ships around an open cen­tral court­yard. Cu­rated around the prin­ci­ples of so­lar pas­sive de­sign, the longer side of the build­ing aligns per­fectly along the N-S ori­en­ta­tion, en­sur­ing am­ple amount of nat­u­ral light dur­ing most times of the day. Saint Gobain’s highly ef­fi­cient DGU’S (Planitherm) al­lowed ex­pan­sive spans of the skin to be glazed, per­mit­ting sub­stan­tial amount of nat­u­ral light to pen­e­trate in the in­te­rior and thereby con­sid­er­ably, sav­ing on the elec­tri­cal en­ergy use.

Saint Gobain’s highly ef­fi­cient DGU’S [Planitherm] al­lowed ex­pan­sive spans of the skin to be glazed, per­mit­ting sub­stan­tial amount of nat­u­ral light to pen­e­trate in the in­te­rior and thereby con­sid­er­ably, sav­ing on the elec­tri­cal en­ergy use. Si­mul­ta­ne­ously, the glass’s low e-value al­most ceases the heat gain, re­sult­ing in a sub­stan­tial slash in the heat load and hence adding to the over­all en­ergy sav­ings

Fact File

Project name: Aakash Health­care Su­per Spe­cialty Hos­pi­tal Ar­chi­tect Firm: Cre­ative De­signer Ar­chi­tects (CDA) Lead Ar­chi­tects: Manin­der Kaur, Mo­han­bir Singh, Ravideep Singh Lo­ca­tion: Dwarka, New Delhi Com­ple­tion Year: 2017 Gross Built Area: 3,50,200 sqft Photo cred­its: Suryan, Dang, Aakash Health­care

Key Con­sul­tants

Me­chan­i­cal & HVAC En­gi­neers: New Growth As­so­ci­ates Elec­tri­cal & Plumbing En­gi­neers: Acro­bat En­gi­neers Struc­tural Con­sul­tants: NNC De­sign In­ter­na­tional Land­scape Con­sul­tants: DIA Land­scape Con­trac­tors: NS Con­struc­tions, Dhruv In­te­ri­ors

Ma­te­rial Pal­ette

Glaz­ing: Saint Gobain’s Planitherm Floor­ing: Tar­ket low-voc Vinyl Floor­ing/ Ho­mo­ge­neous Vinyl floor­ing/ Static con­trol floor­ing ‘li­noleum con­duc­tive’ Lam­i­nates: Green­lam anti-bac­te­rial lam­i­nate fin­ishes Elec­tri­cal switches: Le­grand’s anti-mi­cro­bial coated Pneu­matic Chute Sys­tems: SNG Health­care au­toma­tion and Anti-mi­cro­bial treat­ment: Le­grand Health­care LED lights: Philips Anti- Bac­te­rial Min­eral com­pos­ite ‘Co­rian Fin­ishes’: Dupont Air han­dling Units: Daikan Films and Wall Graph­ics: 3M Acous­tic Grid Ceil­ings: Arm­strong Si­mul­ta­ne­ously, the glass’s low e-value al­most ceases the heat gain, re­sult­ing in a sub­stan­tial slash in the heat load and hence adding to the over­all en­ergy sav­ings. Founder J.C Chaudhry (also founder of ed­u­ca­tional group Aakash In­sti­tute) along with Dr. Ashish Chaudhry, en­vi­sioned this hos­pi­tal as an ex­ten­sion of their phi­lan­thropist vi­sion to pro­vide high­est level of ter­tiary health­care at af­ford­able prices. The de­sign aimed at cre­at­ing a pleas­ing multi-height en­trance foyer, em­bel­lished in warm heal­ing colours. An open ‘cen­tral court­yard’ acts as a green refuge for the pa­tient and the rel­a­tives. The ground floor houses the en­tire out-pa­tient, emer­gency and the cafe­te­ria, fol­lowed by the Dial­y­sis, Spe­cialised day-care and VIP ad­min­is­tra­tion on the first floor. The crit­i­cal­ity of the func­tions rises as we tran­scend higher in the ver­ti­cal stack, with ICU’S on the sec­ond and The­atre depart­ment on the third floor. This is then sand­wiched by a ser­vice floor for the aug­men­ta­tion of the AHU’S and other ser­vices of in­ten­sive care fa­cil­i­ties, and the dis­per­sion of plumbing and med­i­cal stacks of the IPD floors above. The en­tire ver­ti­cal cir­cu­la­tion is aug­ment by two lift cores, dis­crete for the vis­i­tors and the doc­tors, and an ef­fort­less hor­i­zon­tal cir­cu­la­tion through the var­i­ous de­part­ments that en­able smoother func­tion­ing of the hos­pi­tal. An­other crit­i­cal as­pect of health­care de­sign is the ex­treme pre­cau­tion laid for the se­lec­tion of fin­ishes such low VOC Vinyl floor­ings and anti-bac­te­rial lam­i­nate fin­ishes. We sin­cerely be­lieve that prod­ucts that have a higher level of ex­po­sure are the most im­por­tant in terms of their se­lec­tion. Prod­ucts such

as elec­tri­cal switches were used with an anti-mi­cro­bial coat­ing that could fur­ther add to the pro­tected en­vi­ron­ment we aimed to cre­ate.

Cre­at­ing a ‘green hos­pi­tal’

Hos­pi­tals un­doubt­edly fall un­der one of the most en­ergy in­ten­sive build­ing types and there­fore ne­ces­si­tates to be en­ergy-en­gi­neered. Even though, the build­ing qual­i­fies as LEED Gold to­day, the term sus­tain­abil­ity to us means much more than a LEED or a GRIHA cer­ti­fi­ca­tion. Aakash Health­care has a bio-stp in­stalled within the site with an ETP that has a zero dis­charge. Al­most 75% of its roof area has mi­cro-crys­talline so­lar pan­els that are con­nected di­rectly to the grid and con­trib­ute sig­nif­i­cantly to the en­ergy sav­ings. The hos­pi­tal also utilises a geother­mal wa­ter heater that sub­stan­ti­ates the hot wa­ter re­quire­ment in the win­ters.

Art of heal­ing

Aakash health­care’s in­te­rior are a holis­tic con­se­quence of the prin­ci­ple of heal­ing ar­chi­tec­ture. The airy cen­tral court­yard has been de­signed as a ‘Ja­panese Zen gar­den’ with a play of lev­els, green­ery and a small wa­ter body. Sim­i­larly, the refuge area at the fifth floor level has been land­scaped into a heal­ing gar­den which fos­ters well-be­ing amongst the in­pa­tients. Fur­ther­more, a large green patch ad­ja­cent to the emer­gency and the out-pa­tient de­part­ments, is de­signed as a ther­a­peu­tic heal­ing gar­den for the pa­tients. The large win­dows en­sure op­ti­mum day­light and reg­u­lated in­door air qual­ity. Func­tion­ally, the hos­pi­tal has state-of-the-art equip­ment such as Pneu­matic chutes, a fully in­te­grated BMS, and high in­fec­tion con­trol fin­ishes.

Plan­ning for the fu­ture

With the rapid ad­vance­ment of tech­nol­ogy, the equip­ment and their space re­quire­ments are bound to change. Keep­ing this in mind, most of the ser­vices in var­i­ous de­part­ments of the hos­pi­tal are de­signed hor­i­zon­tally, drop­ping from the ceil­ings rather than ver­ti­cally within walls so that the lay­out can be mod­i­fied in fu­ture with­out sig­nif­i­cant changes in the MEP de­sign. An­other im­por­tant as­pect for the fu­ture of a hos­pi­tal is the ex­pan­sion of cer­tain de­part­ments such as Ra­di­ol­ogy, Dial­y­sis etc, which has been mit­i­gated by de­sign­ing the min­i­mum size of the re­quired depart­ment ini­tially and plac­ing cer­tain an­cil­lary ar­eas such as of­fices etc. around them, which can later be re­lo­cated eas­ily, al­low­ing the de­part­ments to ex­pand ef­fort­lessly.

About CDA

CDA, a New Delhi-based multi-dis­ci­plinary prac­tice, spe­cial­izes in con­tem­po­rary Health­care Ar­chi­tec­ture and de­sign of highly sus­tain­able and ef­fi­cient en­vi­ron­ments. CDA’S highly ver­sa­tile port­fo­lio of over 120 projects in­clude res­i­den­tial, com­mer­cial and in­te­rior works, and an elab­o­rate line up of 65+ health­care fa­cil­i­ties.

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