Adaptive Reuse In Healthcare Infrastructure

In the past few decades, we have witnessed the emergence of new buildings and technology that has accelerated urbanisation. As a result, 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. 

Furthermore, in a pandemic-ridden world, healthcare systems are grappling with decreasing reimbursements and increasing costs. The first two waves of the viral outbreak added enormous pressure on India’s already insufficient healthcare infrastructure. With the impending third wave, 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 viral mutations, 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 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 to tackle the much-dreaded third wave of 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. 

Ravideep Singh

Guest Author The author is Associate Director, Creative Designer Architects He is an alumnus of the University of Illinois UC, School of Architecture and has earned a specialization in ‘Healthcare Planning’ from Cornell University, NY