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Winners of HHAC2017 #1

Winners of HHAC2017 #1

Details of Design

ASSISTED LIVING CENTRE

An idea whose time has arrived

SITE: Sowripalayam, Coimbatore, Tamil Nadu

SITE CONTEXT: The second largest city in Tamil Nadu, Coimbatore has emerged as one of the top retirement cities in the country due to its excellent healthcare facilities and pleasant climatic conditions, as well as the development of several retirement communities. One of the three traditional retirement towns of India.

CONCEPT:
Contemporary yet traditional setting based upon “bhartiya ghar”- Aangan (Central courtyard), surrounding bedrooms or clusters, interactive pockets and verandah. Inspired by human senses- sight, hearing, touch and smell, the design is done to incorporate these elements. A place, not just to support people of physical challenges but to provide them with a home away from home; release mental pressure by healing and establishing increased social networks through design.

RESPONSE:
Imbibing traditional ways of living in modern settings to provide peace to the heart and comfort to the frail fighters. Sight- array of trees; hearing- chirping of birds and sound of fountain; smell- flowers and scented candles; touch- groves and textures. Providing visual relief through diffused light levels, shadow and greenery. Building orientation to optimise wind flow, combat extreme conditions and minimise glare. Universal design and reduced distances to break the barriers of flow and depression.

DESIGN STRATEGY:
Reviving age old living customs and strategies to make residents feel at home. Drawing inspiration from prevailing layouts of dwellings in order to utilise the available climatic condition. Smaller spaces opening up into ever increasing areas with increasing social connectivity to never let a resident feel alone. Personal gardens and community spaces to help people socialise. Seating spaces at regular intervals for seniors to take rest whenever needed. They can choose who to socialise with. Decreasing travel distances from personal rooms to areas of congregation and interaction. Self-guiding and linear design so that residents seek minimum assistance. Segregation through blocks as per the assistance needed and yet integration through cluster formation. Alternate open and semi open spaces to drive out gloomy corners and integrate people from various walks of life together at a single place. Making occupants self-independent by creating a platform for them to exhibit their talents and knowledge- Earn while you stay. Zoning of spaces w.r.t the privacy needed. Providing earth berms to cater to safety and comfort in terms of reduced noise levels and relaxation spaces. Provision of both direct and diffused light in interior spaces as per the need of different individuals. Ergonometric of palliative zone allow them to have exterior views while lying down on bed which is achieved by lower sill level.

VERNACULAR APPROACH:
Inspired from Nalukettu- Blocks on four sides with a central courtyard, a typical design ideology of Kerela practiced in other parts of South India as well. People live under one roof and enjoy commonly owned facilities. The pitched roof elevation is a pure reminiscence of Gopurams- that mark the entrance to a holy place, here, our elders. Jali works to create impressions of Rangoli- the famous art of South.

FEATURES
Play of light, colours and shades to provide ultimate user comfort and experience. Hues of orange, yellow and reds to improve energy levels in common gathering spaces. Green colours to make residents feel at peace. Dark grey ceiling is used to minimise glare. Textured walls with grooves and undulations to help people take support of walls and identify spaces and routes through feel and touch. Pergola provides interior shading. Rooms are designed giving priority to flexible nature of inmates. Interior corridors are protected from harsh climate by use of rolling jute mats. The red colored exterior walls cladded with vettukallu induces energy and vigour in residents

SUSTAINABLE FEATURES
Satisfying the building’s energy demands with use of passive cooling and heating systems. A biogas plant to generate electricity through human wastes. Locally produced compressed earth blocks to incorporate traditional mud architecture in a better way. Boulders and stones from nearby Subarnarekha river to form plinth. Maximum natural light ingress through increased courtyards in and around the building. Photo voltaic panels in roof to generate solar power. The earth berms provided on site are created using excavated soil. “ATHANGUDI” tiles locally made using broken ceramic, glass and soil are used for external cladding of yoga and meditation canter. Use of “vettukallu” -laterite for exterior cladding as it is low cost and gains strength with increasing exposure to sun and air. PVC sheets covered pathways to allow natural light. Landscaping through herbal gardens provide natural cures. With low thermal mass due to limited use of concrete, lesser carbon footprint is generated. Provision for future expansion is provided.

ENERGY CONSERVATION
Energy controlled design with use of vernacular elements, vettukallu (laterite), diffused lighting, courtyards, solar panels and jali works. Small turbines in basins to produce hydro-power. Photo-voltaic panels in roof at alternate bands with wooden pergola .Reduced dependency on mechanical devices by lowering interior temperatures through materials used.

ADDITIONAL PROGRAMMES
Provision of YOGA AND MEDITATION CENTER in north-east suffice physical and mental cure to residents. The surrounding open spaces and deck can be used to perform yoga amidst nature and sun. Helps to reduce depression levels and combat vitamin D deficiency. AYURVEDIC TREATEMENT block is provided with cures for constipation performed via wet therapy. Space for aroma therapy is given to battle stress. Open area in front of Ayurveda zone caters sun therapy. These open spaces can be used by residents to carry out their personal hobbies like teaching, weaving, singing etc. AMPHITHEATRE in NW to provide entertainment to seniors. A platform for them to exhibit their talents. Students from near- by institutions can perform for them. Herbal plants like kuthiraikulambu-reduce body heat; rail pachilai- treat headache; mulvelikizhangu- increase immunity are provided in gardens. ACCU- PRESSURE to treat health issues and CYCLE TRACK is provided for leisure.

 

How Indian Healthcare can set the Right Conditions for Research

How Indian Healthcare can set the Right Conditions for Research

Futurism, once considered a forte of science fiction writers, has become mainstream today. Universities offer advanced courses and a growing number of companies are building teams for the future. But what about the healthcare sector? Don’t we need more researchers to prepare us for the future? An HE report.

India has an advanced technological base. In 2014, Indian space scientists successfully placed a satellite in orbit on Mars. The budget for this extra-ordinary feat was just $72mn, less than the budget of the Hollywood movie Gravity. Even the image of women scientists celebrating the success in the Bangalore mission control room went viral. In fact, a Canadian scientist Catherine Mavriplis tweeted, “When was the last time you saw women scientists celebrate a space mission?”

While there is a lot of emphasis on R&D in space and technology, equal commitment to invest in critical sectors such as healthcare seems lacking. At 0.83% of gross domestic product (GDP), India is among the countries with the lowest investment in scientific research. Despite economic growth, Indian researchers face a lot of problems, including poor infrastructure, red tape, and disconnectedness from global trends.

A large proportion of medical device requirement in the country is met by imported products, with the US being the lead supplier. Twenty-three of the world’s largest medical technology firms have established sales and marketing offices in India. The domestic medical equipment sector is small and fragmented. With an estimated 700 manufacturers, most domestic players are focused on consumables. The higher end market remains to be dominated by global companies.

Financing of Research

In fact, a parliamentary panel has asked the Centre to increase budgetary allocation for critical healthcare research after it found “huge” mismatch between demand and allocation of funds for Department of Health Research (DHR) policies.

The panel recommended increased investments in health research to provide affordable and quality healthcare. They noted that in the USA, the budget of National Institute of Health, which functions like that of Indian Council of Medical Research (ICMR) under DHR, is 32 billion dollars per year.

Changing the Culture

Dr.CliveDr Clive Fernandes, Group Clinical Director of Wockhardt Hospital, points out, “There is a huge cost involved with no guarantee of ROI for healthcare research. Literally put, for research you require deep pockets. More money has to be poured as research is like aiming in the dark. There is no guarantee of success and, more often than not, the desired outcomes are never attained. This leads to a lack of interest in the funding of such projects.

“It is difficult to have start-ups in this field due to the same reason. No one would want to put their money where the chances of failure are greater than that of success. Research normally takes time and by time, I mean a long time. In this age of quick returns, there are very few entrepreneurs and companies who are willing to wait endlessly for the desired results.”

“One of the things that are easier said than done is accepting that, during the journey, there will be many more failures than success. Are we willing to accept failure? We have very few individuals and companies who have the mindset required for research and it shows, as the question itself reveals a lack of research culture,” he adds.

To put this in perspective, the world’s 12 biggest drug companies are making a return of just 3.2 percent on their research and development spending this year— down from 10.1 percent in 2010, according to Deloitte’s annual survey of pharma R&D investment.  At the same time, the average cost of launching a drug has soared to a record $2bn from $1.5bn in 2016 and $1.2bn in 2010, when the professional services firm launched its pharma survey.

More to be done to put Ideas into Practice

sujataInterestingly, K Sujatha Rao, former Secretary of health and family welfare, points out in her book, Do We Care? India’s Health System, that “In systems of good governance, policy making is participatory and inclusive. Research institutions are fostered to produce the required evidence and key stakeholders taken into confidence. This was seen when crafting HIV/ AIDs policies, were key population groups most vulnerable were considered during policy making.  But this was a rare example.

“By and large, policy makers have displayed a lack of conviction for such inclusion of target groups and have neglected to foster and nurture research institutions. Costly mistakes have been made such as disbanding malaria workers with multipurpose workers, reducing vigil and community-monitoring, neglecting primary care, opening up health markets without putting in place appropriate regulations, prioritizing immunization over comprehensive child health, or tackling the causal determinants of infectious diseases and so on.”

“We don’t have enough evidence to frame a policy on. Further, there is no money in research. A clinician earns ten times more than a researcher and our system of education is also for passing exams and cramming,” Rao told HE.

Shared Vision is key to Changing System

AbhijitAbhijit Nadkarni, Co-director of Addictions Research Group of Sangath, seconds her views. He notes that the major challenges for mental health research in India are the shortage of funding, the focus of research in clinical settings (as against public health perspective), almost non-existent training programmes in graduate and undergraduate courses, shortage of leaders who can advocate for sustained and strategic investment in mental health research.

Nadkarni stresses that government invests in control and management of communicable diseases, maternal and child health, control of nutritional disorders and some major non-communicable diseases like cancer, cardiovascular diseases, and diabetes.

According to a  2016 study about correlation between public investment, intellectual property rights, drug pricing policies and innovation in global life-sciences, India ranked among the lowest (in the bottom five). This is due to weak intellectual property protection, lack of data protection for biologics, low investment in R&D and price regulations.

So, in order to have a world-class research ecosystem, what should the government do? “We should strengthen research training, invest in public health research and increase research funding,” he explains. “Further, we must give universities autonomy to raise research funding through other sources. Promotions of academics should be based on research outputs and not the duration of tenure. We must promote links with universities abroad and groom research leaders who have a larger vision and not just their personal research outputs.  Lastly, India must also develop a national research agenda with clear time-bound milestones linked to national health priorities, funding, and outputs,” he concludes.

Is Evidence Based Diagnosis Cost Effective?

Is Evidence Based Diagnosis Cost Effective?

Evidence based medicine is a concept of medical healthcare where evidence in the form of tests and diagnosis is used to make a factual conclusion. Cost for healthcare in India is done on the basis of an individual service/test/diagnosis manner as opposed to a package manner. The recent case pertaining to MAX Hospital charging 13 lakhs for treatment of dengue is an example of individual costing gone wrong.

So with this in mind, we decided to ask the industry experts for their views on whether “evidence based medicine is cost effective?

Dr. Rajendra Patankar, Chief Operating Officer, Nanavati Super Speciality Hospital

Dr. RajendraThese days all standard healthcare practices are evidence-based. It’s an over generalized misconception that doctors or hospitals like to prescribe extra investigations for financial benefits. I believe that with ethical and patient centric health care practice guided by evidence-based medicine, we always ask for what is appropriate and required. The patient is always made aware of the tests and investigations are done only with their consents.

It’s an obvious fact that correct treatment is based on correct diagnosis. The second part of the story is the essentiality of documentation in every clinical practice. Not only the diagnosis but also the follow up (both in case of recovery or deterioration) needs to be scaled and documented both for clinical and medico-legal purposes. Now, let us assume the patient is willing to undergo non-evidence based medical treatment. In this situation, are doctors not indemnified, if the patient worsens.

Technology has given us an extra edge and we should build our skills to utilize the same. Also I would urge the society to restore their faith in the healthcare system and avoid generalization.

Narendra Karkera, Director, HOSMAC

KarkeraThis issue needs to be addressed from 2 points, consumer and availability. There is a shortage in purchasing power of the consumer i.e many patients are unable to keep up with the gradual rising cost of healthcare yet there is no shortage in terms of availability of such services, particularly in urban areas.

The concept of ‘general practitioners’ is virtually non-existent in the modern time. This inflates the cost of healthcare for the patient. GPs and super specialities have very different roles; GPs perform small checkups and prescribe medication whereas super-speciality doctors are highly evidence-based due to company policy, red tape and legislation. The highest individual cost here comes from the investigative side i.e the tests, scans and diagnosis.

Healthcare does not mean medical care. For instance, consuming clean water plays a key role in healthcare. If there is a water-based infection in an area, then no number of hospitals will solve the problem at the source. Similar nuances exist in other of these interconnected disciplines including food consumption, education and academic fees, societal/cultural practices etc. which inflate the cost. In such a system, evidence-based diagnosis further adds to the tremendous fees of medical care.

Arjun Arkal Rao, PhD candidate in computational biology, UC Santa Cruz

ArjunThe Indian system is a little flawed but has potential to be way better than the USA. A lot of the extra tests and choices of extra tests in the USA are guided by the insurance plan held by the patient as well. Insurance is an integral part of healthcare affordability. If you don’t have insurance and have a serious medical problem,you’re going to get bankrupt. If you have insurance and you’re on the network you pay a nominal amount. Out of network, you’re going to have a hard time. When my fiance had an allergic reaction to shrimp, she spent 4 hours in an ER where a nurse gave her 1 bottle of saline, 1 shot of antihistamines, and the bill after insurance was almost $1.3k. This is after paying almost $360/month as an insurance premium. After being here 5 years, I think the Indian way isn’t ideal and can be fixed, yet it is definitely better than here.

Ravindra Karanjekar, CEO and Executive Medical Services and Quality, Jupiter Hospital

RavindraGood clinical examination and seeing what is not obvious was certainly the hallmark of Indian allopathic and other ancient medicine. However in recent years the medico-legal cases have increased and the judiciary is asking for evidence on the procedures and tests. This evidence is given to support your diagnosis in a provable manner in a court of law.

Clinical acumen comes only with experience. However, the cost of this evidence is much higher and to be borne by the patient. And doctors are getting into habit of creating proof for their diagnosis

This is leading to increase health care costs. We need to balance these cost some wherever.

Dr. Joy Chakraborty, Chief Operating Officer, Hinduja Hospital

Dr. JoyWith the advent of consumerism and increasing level of patient expectations, healthcare providers and physicians are questioned regarding treatment protocols, adequacy of treatment coverage and justification for treatment. This is a relatively new phenomenon and indicative of a trust deficit which severely deteriorates the doctor-patient relationship. As a result doctors employ defensive strategies which leads to a further rise in evidence based medicine.

It is needless to say that evidence based medicine, if properly practiced, can bring about an authentic treatment flow for the patient. When the patient has to pay for several investigative procedures out of his/her pocket it leads to unaffordable healthcare. This leads to an ineffective scenario in healthcare delivery.

It is not that evidence based medicine is ineffective, but if it is not backed by suitable affordability then it becomes ineffective for the patient.

How to Create Hassle-free Parking at your Hospital?

How to Create Hassle-free Parking at your Hospital?

Metro cities worldwide are famous for the population density. With a higher population comes an exponential increase in automobile traffic, greater probability of accidental and regular patients, and the ever-growing problem of parking. Hospitals, as a structure, are one among the many that fall at the intersection of all these problems of urbanisation.

However, a hospital is more accountable for immediate social good and immediate mass welfare than a mall, a school or any other business entity. In fact, healthcare along with education are the only single-industries which directly influence a country’s growth factor. Schools however are rarely frequented by unexpected individuals and overall schools have the ability to group up several students and staff members in the convenience of automobiles. Hospitals don’t have this luxury. Being five minutes late to class is a better alternative than being five minutes late to the hospital. After all, board exams are not as much of a matter of life and death as, literally, life and death. But what happens if the parking and traffic flow isn’t mapped? The hospital would be in a state of utter chaos.

So we decided to take a closer look at the traffic flow and parking in hospitals.

“Firstly, there are two kinds of parking planning projects, namely, greenfield and brownfield. So to provide adequate parking space, even the future is taken into consideration. In a city like Mumbai, where each square-foot is valuable, parking is a challenge. There are restrictions on basement parkings too, so you have to go with a multi-level car park.” says Prassanna Wategoankar , Senior Manager Architectural Services, Hosmac India.

“There are a few parameters to consider before the planning actually starts. Hospital bed size and speciality, site location and size, expected number of staff and patients are the key factors. Once these parameters are fixed, the next step is the planning of the space around these parameters. The government has basic guidelines and requirements for this. In case a hospital has an Accident and Emergency department, the plan not only accommodates more ambulances despite bed size, but it also provides more parking spaces for visitors.

Additionally, higher priority is given to emergency cases and disabled individuals.” says Yunus Basheer, Traffic Engineer, MinConsult. “When it comes to drawing out an effective plan, there are some logistical concerns. Having a single traffic flow system is ideal as it ensures swift and neat movement within the parking spaces. Slope gradient is another key factor that comes to play in hospital parking. Slopes in a hospital slightly increase the time taken to cover distance and when it comes to every second making a difference, it cannot be taken lightly.” Yunus adds.

How much scrutiny goes into the parking lot of a hospital? After all it’s just a waiting room for your transport isn’t it? Well a lot, as explained by Dr. M.D Marker, Medical Director, BMJH, Vasanthnagar and Girinagar, Bangalore. “During a conference with the traffic police of Bangalore and other BBMP members, I was once asked – “The main road is only 30 meters wide and you have 500 parking spaces. What if all 500 people decide to leave the hospital together?” As baffled as I was, I tried my best to give a satisfactory answer to the committee. There’s a tough round of prodding by the local officials and police forces once the plan has been proposed and the parking area plan is thoroughly scrutinized.”

Dr. Marker adds “Planning the parking flow is essential for any hospital as it gauges the traffic flow within and from outside to inside in a facility. The government parameters are already in place and we follow the same guidelines when it comes to planning our facilities. Traffic flow must be unhindered especially to the emergency care centres and this is absolutely crucial. This process can be aided by using signage, pointer arrows and other navigational tools. “

But what about old hospitals trying to grow? According to Prassanna “The biggest challenges are always faced while planning the parking of the brownfield. Due to permanent structure which have a maximum height and other immovable physical factors, multi-level parking and latest trends are harder to accommodate. The existing parking conditions must be altered in such a way that it makes the most of the available resources. In this case, numbers are often sacrificed due to a lack of space.”

Apart from all the guidelines and physical limitations, there’s also a lot of added though that goes into it. As Yunus says, “A key factor for nailing down parking in hospitals is creating a stopping area for ambulances where paramedics can quickly gain access to the patient. This stopping area cannot affect the flow of traffic and must be at a closer location as opposed to the other departments in the traffic flow because of the time factor. Along with all these measures, certain other nuances must be considered. These include walking time to-and-from buildings to parking for both patients and their aides, ease of access of the vehicle within the parking lot area alignment and keeping the parking area as secure as possible from a design perspective.”

Meanwhile, Dr. Marker expresses parking-related concerns of a different kind. “Some hospitals are in the business of using hospital parking as an income booster by charging patients and their attendants for each vehicle parked. This is wrong on so many levels: economic, social and human. At BMJH we never charge for parking as we consider this to be fundamentally wrong and don’t see any growth opportunity by adding unnecessary costs to the patient.” Another unforeseen aspect is that of staff behavior and trends he highlights. “In our hospital, doctors and staff members often opt to cycle to work. In this case safety of the vehicle becomes very important. Vehicles such as a hearse van and the ambulances also have to be kept away from the visitor’s or patient’s parking area for a more effective utilisation of these resources.” says Dr. Marker

Planning the parking space is a much bigger feat than what it sounds like, especially in the case of a hospital. It’s vital to ensure a smooth flow of traffic and give ambulances plenty of area to operate. Even slope gradients and walking time are considered along with meeting staff requirements and government laws. It’s not easy to plan the parking area of a hospital and only the ones who work within the established procedural framework know how important and essential it is to the delivery of healthcare services.

What makes Hospitals more Efficient: Patient-Centric or Patient-Centric Design?

What makes Hospitals more Efficient: Patient-Centric or Patient-Centric Design?

When a hospital is designed, who are the first people kept in mind by the architects? Who benefits the most from planning the design and physical space? Here’s what leading industry experts have to say.

Many researches have already established a direct relationship between physical environment and human development;  after all the average human being spends around 80% of their time indoors. Doctors, nurses hospital staff and patients are no exception to this. In fact the staff is the only link which bridges the gap between the customer satisfaction, employee satisfaction and profitability. Additionally, everyone wants to operate in an environment which is friendlier and smarter.

Having said that, the most important question is – “Who is a hospital built for?” Is it built for the doctors, the nurses, and the large number of staff or is it built for the patients who visit the hospital?  Is it built as a second-home for doctors or as a live-saving hotel for patients?

Here’s what leading hospital design experts from the industry have to say:

Bhumika Jeswani – Lead Architect with Apollo Hospitals

Bhumika“Design does not have a bias towards employees or patients. The ultimate aim is to provide an optimal healing environment which is enabling staff to care for patients effectively and achieve improved healthcare outcomes for patients. Employees, unlike patients, get acquainted with the facility hence do learn to manoeuvre with ease. Patients and visitors prefer corridors which are more accessible from a greater number of spaces and have minimum turns.

Better physical environment will result in patients being stress free and comfortable. This will also positively impact the rating of care provided by staff. Better work environment for staff means reduced errors and better outcomes for patients. Thus, physical environment works as a link which develops a symbiotic relationship between patient and employees which benefits both.”

Swati Rane – Founder and Medical Planning Expert at Healthcare Synergy Consulting and PhD Scholar from Tata Institute of Social Sciences

“The prime aspect of hospitals is that they are only concerned with the beds.  How many beds can be installed and what are the profit margins; are the two most important factors for private hospitals. Hospital structures are more profit-centric as opposed to patient/employee centric.

swati raneThe hospital is designed according to the ‘form follows function’ principle. But, what is of utmost importance, is this question – ‘Who is going to be at the hospital?  So I believe, the design should be employee-centric.

An employee-centric design is necessary to ensure the output of work is patient-centric. If a hospital is designed keeping in mind the patient’s requirement, the room size etc, and doesn’t consider the requirements of the caregivers, taking away any rest and recuperation area; then the work output is affected. If the design is patient-centric and the employee’s responsible for providing care are tired and exhausted, then the patient-care itself is affected. Doctors and nurses are currently frustrated by their jobs as it is and the workspace design doesn’t help.

The most important thing is to ensure during planning and designing the hospital has a team of users, composed of doctors and nurses. Planning a hospital without taking inputs from doctors and nurses is like planning a house without taking inputs from the residents and it’s near impossible to follow the ‘form follows function approach.”

Aditya Kashikar – Senior Project Manager at Imperial College Healthcare NHS Trust

“In the UK, we focus on hospitals being more patient-centric. However, it is a combination of both, say 60% patient-centric and 40% employee-centric. If a hospital is patient-centric the time taken to recover by a patient is far lesser. At the same time, the operating staff must be able to manage the services. So it’s a marriage between both these aspects.

AdityaIf employees are not considered right from the pre-planning stage then the day-to-day processes and space management techniques completely miss the point. We follow basic guidelines and international stipulations which constantly change and are upgraded, so the space is flexible.

In the UK, we have different stakeholders involved from the first stages of planning a hospital. These include doctors, nursing staff, GMs, CEOs, patient representatives and operational estates and facilities colleagues. There is an amalgamation of basic requirements and business needs which leads to a lot of coordination between different elements of the hospital. When a single stakeholder is left out, the effect it has on the business and its functioning is huge.”

Nandini Bazaz – General Manager – Architecture at HOSMAC Pvt Ltd.

“If there was a hierarchy of importance given to design, it will generally follow a client first, patient second and employee third structure. In India, planning is done according to features which economically feed the clients.

Nandini BThat being said,hospital design always weighs more on the patient side as opposed to the employee side. There’s a lot of neglect in India with regards to staff facilities and utilities. Clients usually don’t want to spend money on that and this occurs in both public and private hospitals. In some cases, staff members literally beg the architects for more consideration to their needs and requirements. We, at HOSMAC, push ourselves to accommodate all the employees and give them facilities for rest and recreational purposes. From an architect’s perspective, we design spaces from the people in the building and staff comfort is essential to us. My experience abroad in healthcare and that India has a stark difference. Internationally, doctors, nurses and staff members enjoy certain spaces and recreation as opposed to here, where break rooms and doctor’s lounges are almost unheard of.”

What Actually Works Best

These problems have given rise to an ever-increasing number of health care activists, trade union formation and joint strikes against individual or multiple institutions such as the recent events in Kerala.

Simple proven solutions to a widespread problem have been proven by research and application. Adopting a similar structure, international health care stakeholders have accelerated growth by cutting costs and ensuring higher job satisfaction and retention. A couple of examples include :

– In 2016, Royal Australasian College of Physicians conducted a study to improve non-clinical workplace solutions using a Human-Centred Design process, involving ‘Hear, Create and Deliver’ stages. Using extensive employee engagement and design experts, innovative solutions were created that focussed on creating the optimized functional workspace which helped hospitals save money on resources and resource management.

– Institute of Patient-Centred Design Inc, is a non-profit healthcare organization that advocates a patient-centric design approach. IPCD conclaves are attended by major stakeholders in the healthcare industry to ensure maximum client satisfaction and profitability which in-turn fosters a healthy workplace environment for the employees.

Clearly, Indian healthcare has a long way to go in terms of catering to the needs of the employee or the customer. Neither is the hospital staff on the winning side, nor are the sickly patients who come to be treated. There are several factors – including higher demand than supply, income disparities and accessibility – in the mix, but the same mix also features extremely rich business owners. No one doubts their hard work in bringing in health care, or them championing a noble cause or even the fact that it is a money sucking industry. The only issue is quality, particular in terms of employee standards and patient standards, which seems to be lacking. Furthermore, designing a hospital with inputs from board members who have a working experience in a hospital along with an active participation of both patients and employees during its working, can go a long way towards ensuring a constant quality and functionality check.

While working on this piece, I asked the experts a simple question – “Is the design language of a hospital built around an employee or a patient?” What I heard was quite shocking, but really not unbelievable. Without a stronger healthcare network which brings in qualitative infrastructural and aesthetic development, the Indian healthcare design model is bound to be stuck in an infinite abyss of unmotivated staff and forever growing number of patients.

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