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Reusing the unused-Transforming healthcare infrastructure

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Ravideep Singh, Associate Director, Creative Designer Architects shares his views on sustainable hospital infrastructure

In the past few decades, we have witnessed the emergence of new buildings and technology that has accelerated urbanisation. Disused buildings and abandoned construction sites are becoming increasingly common. With green building codes and energy-efficient guidelines making their way into building designs, we are beginning to see the dis-composing irony of building sustainable infrastructure. While architects and city planners are pursuing new ways to build ‘green buildings’ and battle climate change, adaptive reuse of older, depleted, or otherwise vacant buildings is gaining momentum. Lately, the phenomenon of adaptively repurposing and reusing existing built structures has been a successful endeavour for several industrial and commercial projects.

In a pandemic-ridden world, healthcare systems across the globe are grappling with decreasing reimbursements and increasing costs. Healthcare planners are exploring various strategies that can enable setting up and expanding healthcare facilities rapidly and economically. The efficacy of ‘adaptive reuse’ especially in healthcare, even though sceptic initially, is gradually gaining meaningful acceptance. Thanks to the pandemic-imposed urgency to swiftly ramp up, expand and set up new health infrastructure in the race to outrun the pandemic, healthcare professionals, architects and planners are investigating adaptive reuse as an alternative approach to rampantly building more infrastructure. The notion of adaptive reuse strategy’s sizable reduction in cost and time observed in the other building types might not transpire as such in healthcare facilities by certain peculiarities that healthcare environments necessitate. However, with careful consideration and meticulous planning, this approach offers financial, environmental and communal benefits.

One of the principal factors of a healthcare building’s feasibility is its location, visibility, and accessibility. Service areas on-site, medical zoning and functional efficiency prospects are also essential factors in determining the adaptability of a building. Hospital buildings often require loftier floor-to-floor heights than other building typologies to accommodate the complex mechanical and service systems. Low structural floor heights in older buildings can pose a challenge to its repurposing and lead to increased costs. Accounting for the constantly evolving technology and medical equipment, architects must also consider the potential of MEP induction in the existing structure. These factors require meticulous attention and planning.

While the pandemic has undoubtedly altered the future course of hospital design and planning, healthcare professionals are relooking at the efficiency of existing medical facilities during an outbreak like the Covid-19. Furthermore, it is crucial to examine the prospects of growth, flexibility and reconfiguration in a repurposed building to allow for a surge in bed counts and accommodate additional care units to serve a larger population. Along with a detailed analysis of the site conditions, structural integrity and other operational viability considerations, architects must ensure that the project complies with regional and national building codes. By investigating the various prospects of adapting an existing building to a hospital, generating a point-based decision matrix can help establish the project’s overall feasibility. In addition to the pragmatic factors, healthcare planners must re-design the building to ensure a safe and healing environment for patients, caregivers and healthcare workers. Architects must also factor in the prospects of improving community health and well-being and revitalising the structure for a holistic and sustainable approach towards the built environment.

At CDA, having undertaken several such brownfield healthcare projects, we consider each of these factors at various stages of the design process, carefully evaluating and speculating on the outcomes of each project. With meaningful interventions and a thoughtful design, adaptive reuse in the healthcare design realm is an opportunity to breathe new life into buildings, their inhabitants and the community.

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