CDA taps huge potential of healthcare architecture

Ravideep Singh, Associate Director at Creative Designer Architects (CDA) dwells on what it takes to build medical facilities in an exclusive interview with Bizz Buzz, "Particularly, in healthcare, design struggled to move beyond old layouts that are mandatory for hospitals to follow and remain uninspired. As designers, we understood the impact architecture has on its inhabitants, and especially on the most vulnerable end-users - patients. This persuaded us to create meaningful spaces and make a positive difference in the lives of all stakeholders," he says.

How did Creative Designer Architects begin its journey, and how has it evolved?

CDA began its journey as a small architectural studio led by Maninder Kaur and Mohanbir Singh. Since then, CDA has always believed in delivering projects that integrate innovation, adaptability and sustainability. With a paramount goal to create spaces that utilise natural light and focus on experience, efficiency and functionality, we slowly and steadily built an influential clientele across the country. It has been a learning experience that continues even today, which has enabled us to expand our reach and capacity to deliver innovative architecture. Today, CDA has over sixty ongoing projects pan India, out of which around forty-five are healthcare projects of various scales and specialties.

What led you to focus on healthcare projects?

Initially, when we began, focus on healthcare projects was not a conscious strategy. However, we realised that there was massive potential in healthcare architecture in terms of design, experience and operations, which wasn't being tapped into by architects back in the day. Particularly, in healthcare, design struggled to move beyond old layouts that are mandatory for hospitals to follow and remain uninspired. As designers, we understood the impact architecture has on its inhabitants, and especially on the most vulnerable end-users - patients. This persuaded us to create meaningful spaces and make a positive difference in the lives of all stakeholders.

How many projects were you able to complete during the pandemic?

During the pandemic, we, at CDA, were extremely fortunate to have the opportunity to do our bit as extended members of the healthcare community. We worked with several of our existing and new clients to enable them to adapt their existing facilities. We ensured that the healthcare facilities could increase their efficiency and surge bed capacities with the high influx of infectious patients. We are more than happy to have delivered services to over ten healthcare facilities during the pandemic, including hospitals at Max Healthcare.

What are some of your objectives while creating a project for Covid patients?

The Covid-19 pandemic has compelled architects and designers to re-look at the way healthcare facilities are designed. At CDA, we have made some fundamental changes in the way we approach healthcare architecture. We now aim to create a forward triage to segregate infectious and non-infectious patients right at the hospital entrance. We have planned for clearly segregated functional zones for the Covid-19 infected and other patients within the hospital. While designing new facilities, it has become necessary to factor for the surge in bed capacities, adaptive beds and MEP arrangements in as many areas as possible. It is also crucial to utilise mechanical systems that are strategically zoned and have alternating air exchange capacities for creating air-borne infection isolation whenever required.

What are the challenges you face while reconfiguring hospitals for use during the pandemic and how flexible can hospitals be when they require to be ready for a second wave?

Reconfiguration of existing hospitals is possible, but with caveats. The extent to which an existing hospital can be seamlessly transitioned into a Covid-19 responsive facility depends on several factors like availability of space to add or segregate entrances for infected patients and availability of space to add additional beds. It also depends on the provision the existing facilities have for medical gases, capacity and flexibility of existing mechanical systems to rezone to avoid air exchange between infectious and non-infectious zones. Hence, it has become imperative for architects to change how they approach healthcare design to enable hospitals to be better prepared for future outbreaks and epidemics.

How important is segregation in times of a pandemic, and how do you plan for creating facilities for these patients?

During times of an infectious outbreak like Covid-19, segregation of areas becomes highly critical, not only for the patients but also for caregivers and healthcare staff. Today, we hardly have any healthcare facility in India that is planned ideally for infectious diseases, and the extent to which this can be achieved is highly inconclusive. Principally, the goal should be to create a common functional zone for the staff and the caregivers with seamless access to an infectious zone along one end and non-infectious zone on the other, with each zone having its discrete access from outside.

How accessible are the hospitals you created available to patients in the quickest possible times and round the clock?

Accessibility for a hospital is fundamental, and we take utmost care to ensure that our hospitals are designed to reflect that. We always aim for high street visibility to casualty and other entrances. Although from a logistics aspect, we as architects extend our support to operational strategies by providing platforms for health technology like remote booking of consultations, casualty access and tele-health facilities. These were highly relevant during the first wave of the pandemic and continue to be so as we struggle to sustain the second wave.

Which are your ongoing projects, and how important are they to your portfolio?

Of the several projects that CDA has undertaken during these unprecedented times, the most crucial ones are the healthcare facilities. AIIMS Guwahati is one of the largest and most comprehensive health campuses in India. It lays heavy emphasis on patient experience, health and wellness and sustainability. The Hoshiarpur and Kapurthala Integrated Medical Campuses were recognised during the pandemic for their responsiveness to Covid-19 along with CDA's underlying strategies for sustainability and wellness. Another important project in CDA's pipeline is the expansion of Nanavati Hospital in Mumbai. Set to be one of the largest private hospitals in the city, it attempts to blur boundaries between healthcare and hospitality and be a beacon of international health tourism in India.

Do you see a change in India's healthcare facilities, and what more can be done to improve the situation?

Although we have come a long way from where our healthcare facilities were during the early 2000s, there is still a lot of work to do. More emphasis needs to be laid on the life cycle assessment of hospitals during the strategy, budgeting and concept design phases. With minor additional investments upfront, hospitals can yield meaningful returns in the longer run.

To reinforce the Indian healthcare system, we also need to look into public-private partnerships, where we can benefit from the best of location, infrastructure, and cutting-edge technology and operations. Evidence has shown more significant medical and financial outcomes where the design of facilities focus on doctors and the caregivers' comfort and well-being as much as the patients.

What are your future plans?

At CDA, we are looking forward to continuing to do our part as architects, in terms of helping healthcare systems in whichever way possible. Moving forward, we are gradually expanding our capacities into a broader spectrum of healthcare design, factoring for better healthcare technology and the incoming paradigm shifts in healthcare delivery.