Sustainable practices are at the forefront of redefining the healthcare ecosystem today and play a significant role in promoting well-being, according to various reports. The market for global green hospitals was valued at US$41.68 billion in 2022 and is expected to grow at a compound annual growth rate (CAGR) of 12.5 per cent to reach US$106.93 billion by the end of 2030, clearly indicating sustainability's impact on healthcare.
One of the most effective approaches to accelerating sustainable practices and development is adaptive reuse, as it facilitates extending a building’s life while encouraging the reuse of embodied energy. Adaptive reuse, the process of converting old or underutilised buildings for new purposes, provides a unique opportunity to improve healthcare accessibility by transforming urban structures into hospitals. This approach also allows healthcare organisations to save costs as the infrastructure and enclosure of the building are already in place. Overall, adaptive reuse also reduces environmental impact while still providing modern, functional spaces for medical care.
When applied in healthcare, it can also help in "repurposing existing structures to meet evolving requirements," explained Ravideep Singh, Associate Director, Creative Designer Architects (CDA), an interdisciplinary architectural practice that specialises in healthcare, commercial, and retail projects.
Adaptive reuse can also effectively address changing healthcare needs and optimise infrastructure when applied to healthcare facilities. In urban areas where land is scarce and expensive, repurposing existing infrastructure offers an environment-friendly solution to meet the growing demand for healthcare facilities.
Addressing gaps in healthcare infrastructure
The growing need for hospitals and care facilities has highlighted significant gaps in urban healthcare infrastructure. For instance, in India’s densely populated urban hub of the National Capital Region, which has an exorbitant population density of close to 25,000 people per square kilometres, there were reportedly no quality healthcare facilities in close vicinity, requiring people to travel to Noida or the capital New Delhi in search of quality clinical care, until last year. To combat this challenge, Sarvodaya Hospital and the Fortis Hospital in Greater Noida applied adaptive reuse to address these gaps in healthcare infrastructure by revitalising defunct spaces to create transformative facilities that positively shape the lives of individuals and communities.
Adaptive reuse cements environmental conservation in healthcare
Healthcare infrastructure globally is under immense pressure due to the growing demand for quality healthcare services. The pandemic also brought forth the functional inadequacies of healthcare infrastructure. It imposed an urgency to ramp up and build high-quality infrastructure swiftly.
Moreover, over the past few decades, the burden on healthcare systems has begun to pile up as the population continues to soar. "We have also witnessed rapid urbanisation and the emergence of new construction materials and technologies. While green buildings and energy-efficient technologies promise to reduce carbon footprints and create a healthier built environment, we are beginning to see the irony of what building so-called 'sustainable’ infrastructure entails. Building new infrastructures, although they may be a ‘sustainable project,’ requires manufacturing of new resources, taking away from it being a sustainable practice,” commented Singh.
Adaptive reuse has proven to be a game-changer here, as reusing infrastructure reduces the carbon footprint associated with manufacturing new building materials. Hence, healthcare facilities can contribute significantly to environmental conservation by adapting and enhancing existing buildings.
Challenges while embarking on adaptive reuse projects
Mechanical services and their specific height requirements are one of the many challenges in brownfield projects. But, for instance, implementing ducted cassette units can be a space-efficient alternative to optimise height and enhance the overall spatial experience within the hospital. This approach is a cost-effective and sustainable way to help cut down on construction time and build community-centric healthcare facilities that improve access to quality care and promote well-being.
However, it is important to remember that from a medical planning perspective, existing structures can present limitations in terms of connectivity and seamless planning. It can be challenging to segregate departments and optimise operational efficiency. Therefore, when an existing building is being converted into a healthcare facility, architects need to plan by considering specific healthcare services, equipment, technology, and medical workflows. Overcoming these challenges requires a collaborative approach involving architects, medical professionals, and regulatory bodies.
In the case study of Sarvodaya Hospital, the original structure was designed as a commercial mixed-use facility, with busy stores on the lower floors and unoccupied office spaces on the higher floors. One of the challenges was to construct a highly efficient hospital inside the confines of an already operational business centre. The tight and diverse blocks posed roadblocks in terms of medical department connectivity. To address this issue, these blocks were linked by eight-foot-wide corridors added at various points to allow for seamless transitions and movements for patients, doctors, and staff.
Impact on patient care
Well-designed spaces can create a sense of comfort, privacy, and familiarity for patients, positively impacting patient care and staff well-being. Repurposed healthcare facilities often feature larger windows, improved lighting, and better ventilation. For staff, functional layouts can enhance efficiency, reducing stress and fatigue. The overall result of prioritising acoustics, natural light, and green spaces builds a healing environment.
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