Over the past few decades, we have witnessed rapid urbanisation and emergence of new construction technologies. While green buildings and energy-efficient technologies promise to reduce carbon footprint and create a healthier built environment, we are beginning to see the irony of what building so called “sustainable” infrastructure entails, practically. On the other side of the spectrum, the pandemic brought forth the functional inadequacies of healthcare infrastructure across the globe and imposed an urgency to ramp up and build high-quality infrastructure swiftly. The demand for efficient, resilient and sustainable healthcare systems has been on the rise.
Today, as we find ourselves amidst a health and climate crisis, the question arises–to build or not to build? Recognising the interconnectedness between the planet and our health, it has become critical for us to explore long-term, sustainable building solutions. As a result, architects are now focused on designing medical facilities that are not only sustainable, but also pandemic and future-proof.
Sustainability
and healthcare
Lately, adaptively repurposing and reusing existing built structures has been a successful endeavour for several industrial and commercial projects, significantly cutting down construction costs and time. Making its way into the healthcare industry, “adaptive reuse”, though was deemed a sceptical concept initially, is gradually gaining meaningful acceptance. A hospital’s design specificities often pose a challenge. However, with careful consideration and meticulous planning, this approach offers financial, environmental and communal benefits. While an adaptive repurposed hospital can undoubtedly provide high operational efficiency, a few fundamental design decisions can offer adequate resilience and flexibility during times like the Covid-19 pandemic.
Pandemic-proof design
Principally, for a hospital to be resilient against any unprecedented adversity, it must focus on three crucial aspects of healthcare planning–triaging, segregating and surging capacity. Triaging and segregation essentially require a carefully planned Emergency Department which immediately screens and secludes infectious patients within the facility, thus minimising the risk for caregivers and uninfected patients. Segregation refers to the physical separation of spaces and the mechanical isolation of the air conditioning systems. This could be slightly challenging in areas where the segregated zones do not have separate air handlers—causing return air from the infected zones to recirculate into other hospital areas.
Surging capacity requires additional beds and carefully factoring for the 4S’s—staff, stuff, structure, and systems. Therefore, resilient healthcare design constitutes facilities equipped with the requisite infrastructure and planning flexibility to escalate their bed numbers while ensuring optimal areas for additional staff and medical paraphernalia.
Preparing for
the future
Hospitals should broaden the healthcare horizon beyond buildings to institute a healthier and more resilient population with better endurance against infections, ailments, or future pandemics. Achieving this will involve the re-orientation of the system in two stages. The first stage will enable hospitals to penetrate and educate communities. During the design and planning phase of a healthcare ecosystem, designers, developers, policymakers and other stakeholders must consider two fundamental principles—preventive health and wellness and equity in care delivery. To effectuate communal health and wellness, hospitals must focus on community integration and cultural penetration. Healthcare providers, policy-makers and designers should come together to design collaborative spaces and programs that will encourage interaction and educate the community about health and wellness, such as maintaining healthy diets, self-monitoring etc.
The second stage includes advances in technology, IoHT etc., inciting healthcare to move out of the physical seams of the hospital buildings and step into homes through smart technology. The future of healthcare, like most other industries, is digital. Healthcare futurists and researchers are now focused on orienting the healthcare system towards a physically disintegrated and digitally seamless care delivery model. The future of healthcare will collaborate with IoT, make the best use of rapidly changing technology, and manifest into an efficient model that is less susceptible to untimely collapse, claim researchers. Employing tools such as Big Data and Artificial Intelligence will allow healthcare professionals and designers to comprehend patterns out of the existing profiles of patients and put them to use for creating dynamic, iterative design layouts for hospitals that are reconfigurable. With the help of technology and the growing acceptance of digital interactions, patients’ health will soon be monitored by smart infrastructure remotely by doctors and nurses.
Significant strides in research and development of these schemes are underway, and the future looks promising. The involvement of tech giants is already underway, paving way for gigantic investments for research and development in this space. With a commitment to improving the healthcare scenario in India, I am optimistic that with architects working in partnership with doctors, researchers and tech giants, an evolved healthcare ecosystem awaits us all.
Ravideep Singh is Associate Director at Creative Designer Architects (CDA), an interdisciplinary architectural practice that is an established design leader in healthcare, institutional and commercial projects.