Architecture thesis report- The SSG Hospital Rejuvenation

Sir Sayajirao General Hospital – SSG Rejuvenation Vadodara, Gujarat, India

Sunetra Viraj Gaekwad B. Arch. V – Second Semester (2021-2022)

Primary Guide:

Ar. Chetan Somani

Secondary Guide: Dr. Bhawna Vasudeva

Department of Architecture Faculty of Technology and Engineering The Maharaja Sayajirao University of Baroda D. N. Hall, Pratap Gunj Vadodara, India

MAY 2022

Certificate

Sir Sayajirao General Hospital – SSG Rejuvenation Vadodara, Gujarat, India by

Sunetra Viraj Gaekwad This Design Thesis report is submitted in partial fulfillment of the requirements for the Degree of Bachelor of Architecture at the Department of Architecture Faculty of Technology and Engineering The Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, India It is approved as creditable work on the Design Thesis subject completed in a satisfactory manner.

Primary Guide:

Ar. Chetan Somani

Secondary Guide:

Dr. Bhawna Vasudeva

Design Thesis Chair:

Dr. Bhawna Vasudeva

Head of the Department: Dr. Bhawna Vasudeva

MAY 2022

Abstract

The thesis topic SSG Hospital Rejuvenation focuses on the development of the hospital campus and also an attempt to change the perception among the people towards a government hospital.

The government hospitals are affordable by majority of the people of lower income groups. Also, because of the face of the government hospitals in terms of infrastructure, the higher income is not willing to go to the government hospitals. This project bridges the gap between the various income groups by bringing them under one roof and satisfying their expectations.

Also, various issues are prevailing in the SSG Hospital which needs to cater. Thus, the entire development plan is divided into three phases which then helps in changing the hospital campus.

Thus, the thesis topic focuses on the redevelopment of the SSG Hospital campus offering wide range of opportunities to its stakeholders and is a stepping stone towards the advancement in the Indian Healthcare System.

In my opinion, every government hospital must be studied and developed for the betterment of the citizens which reflects on the overall development of a country.

i

This thesis is dedicated to my parentsMrs. Leena Gaekwad and Mr. Viraj Gaekwad

ii

Acknowledgements

First and Foremost, I would like to thank all the professors at the Department of Architecture, Faculty of Technology and Engineering, MSU who has helped me throughout my academic endeavor.

I would like to extend my sincere gratitude to my thesis guide Ar. Chetan Somani and Dr. Bhawna Vasudeva, who has known me from the past five years. Without their assistance and dedicated involvement in ever step throughout the process, this thesis would have never been accomplished. I would like to thankyou for supporting, understanding and mentoring over my academic years.

Besides my guide, I am deeply grateful to all the jury members for their insightful comments and suggestions at every stage of the thesis.

Moreover, I would like to thank Dr. Ranjan G. Aiyer, the Medical Superintendent of the SSG Hospital for their support in my thesis research and data collection.

I also placed on record, my sense of gratitude to all the staff and medical personnel of the SSG Hospital and to one and all, who directly or indirectly, have lent their hand in this venture.

Finally, I must express my very profound gratitude to my parents for providing unfailing support and continuous encouragement throughout my years of study. This accomplishment would not have been possible without them.

Sunetra Viraj Gaekwad

iii

Table of Contents

Abstract

i

Dedication

ii

Acknowledgments

iii

List of Figures

iv

1.1 Scope of healthcare in India

03

1.2 Government initiatives in healthcare sector

04

1.3 Government initiatives in healthcare sector

04

1.4 SSG Hospital and its context

07

1.5 SSG Hospital site

07

1.6 SSG Hospital google earth image- year 2000

08

1.7 SSG Hospital google earth image- year 2003

08

1.8 SSG Hospital google earth image- year 2005

08

1.9 SSG Hospital google earth image- year 2007

08

1.10 SSG Hospital google earth image- year 2010

08

1.11 SSG Hospital google earth image- year 2012

08

1.12 SSG Hospital google earth image- year 2014

08

1.13 SSG Hospital google earth image- year 2017

08

1.14 SSG Hospital google earth image- year 2022

08

2.0 Existing Master Plan of the SSG Hospital

10

2.1 SSG Hospital master plan analysis- void

11

2.2 SSG Hospital master plan analysis-solid

11

2.3 SSG Hospital master plan analysis- landscape

11

2.4 SSG Hospital master plan analysis- road network

11

2.5 SSG Hospital infrastructure analysis

12

2.6 Traffic plan SSG Hospital- Emergency department

13

2.7 Traffic plan SSG Hospital- OPD

13

2.8 Traffic plan SSG Hospital- Medical college

13

iv

Table of Contents

2.9 Traffic plan SSG Hospital- Admin department

13

2.10 Traffic plan SSG Hospital- Operation theatre

13

2.11 Traffic plan SSG Hospital- Surgical building

13

2.1.1

Key plan- Admin, ortho and prosthetics workshop

2.1.2

14

Admin, ortho and prosthetics workshop analysis

14

2.1(a) Photo of prosthetics workshop

15

2.1(b) Photo of ward- closed

15

2.1(c) Photo of patient’s lift

15

2.1(d) Photo of courtyard

15

2.1(e) Photo of DOTS ward

15

2.1(f) Photo of Chest ward

15

2.2.1

Key plan- Surgical building and Radiology department

2.2.2

16

Surgical building and Radiology department analysis

16

2.2(a) Photo of surgical staircase

16

2.2(b) Photo of ground floor area

17

2.2(c) Photo of lift area

17

2.2(d) Photo of first floor closed area

17

2.2(e) Photo of radiology department corridor

17

2.2(f) Photo of electrical panel

17

2.2(g) Photo of radiology entrance

17

2.2(h) Photo of radiology staircase

17

2.3.1

Key plan- OPD

18

2.3.2

OPD patient distribution chart

18

v

Table of Contents

2.3.3

Out Patient Department- OPD analysis

18

2.3(a) Photo of opd corridor area

19

2.3(b) Photo of opd exit

19

2.3(c) Photo of opd corridor area

19

2.3(d) Photo of opd pharmacy area

19

2.3(e) Photo of outside of the consultation room

19

2.3(f) Photo of opd corridor waiting area

19

2.4.1

Key plan- Kitchen, store and record room

20

2.4.2

Kitchen, store and medical record room analysis

20

2.4(a) Photo of medical record room

20

2.4(b) Photo of washroom and lobby

20

2.4(c) Photo of medical record room

20

2.4(d) Photo of medical record room

20

2.5.1

Pie chart- physical environment analysis

21

2.5.2

Pie chart- adequate facilities analysis

21

2.5.3

Pie chart- cost of treatment analysis

21

2.5.4

Pie chart- knowledge of staff analysis

21

2.5.5

Pie chart- modes of travel analysis

21

2.5.6

Pie chart- education of the patients analysis

21

3.1.1

SVP Hospital site plan

27

3.1.2

Photo of SVP Hospital

27

3.1.3

SVP Hospital- Master plan

28

3.1.4

SVP Hospital- Ground floor plan

28

3.1.5

SVP Hospital- Basement plan 1

29

3.1.6

SVP Hospital- Basement plan 2

29

3.1.7

SVP Hospital- First floor plan

30

vi

Table of Contents

3.1.8

SVP Hospital- Second floor plan

30

3.1.9

SVP Hospital- Third floor plan

31

3.1.10 SVP Hospital- Fourth floor plan

31

3.1.11 SVP Hospital- Tenth floor plan

32

3.1.12 SVP Hospital- Fifteenth floor plan

32

3.1.13 SVP Hospital- Sixteenth floor plan

33

3.1.14 SVP Hospital- Eighteenth floor plan

33

3.1.15 SVP Hospital- Water plant

34

3.1.16 SVP Hospital- Boiler room

34

3.1.17 SVP Hospital- Pump room

34

3.1.18 SVP Hospital- Pump room

34

3.1.19 SVP Hospital- PTS system room

34

3.1.20 SVP Hospital- Electrical room

34

3.1.21 SVP Hospital- General ward

34

3.1.22 SVP Hospital- Informal waiting area

34

3.2.1

Bhailal amin hospital site plan

35

3.2.2

Bhailal amin hospital- Ground floor plan

35

3.3.1

Haraldsplass hospital view

36

3.3.2

Haraldsplass hospital site plan

36

3.3.3

Haraldsplass hospital- Ground floor plan

37

3.3.4

Haraldsplass hospital- First floor plan

37

3.3.5

Haraldsplass hospital- Section

38

3.3.6

Haraldsplass hospital- Entrance view

38

3.3.7

Haraldsplass hospital- Concept section

38

4.0

SSG Hospital- Demolition Master plan

40

4.1

SSG Hospital master plan- Phase I

41

4.2

SSG Hospital master plan- Phase II

41

vii

Table of Contents

4.3

SSG Hospital master plan- Phase III

41

4.4

SSG Hospital master plan- SSG Proposal

41

4.2

SSG Hospital master plan- Phase I

43

5.1.1

SSG Hospital site selection

43

5.1.2

SSG Hospital- Proposed site

44

5.3.1

Concept sketches

48

5.3.2

Process sketches

48

6.1

Ground floor plan

50

6.2

First floor plan

51

6.3

Second floor plan

52

6.4

Typical floor plan-3,4,5 floor

53

6.5

Basement plan zoning

54

6.6

Ground floor plan zoning

55

6.7

First floor plan zoning

56

6.8

Second floor plan zoning

57

6.9

Typical floor plan- 3,4,5 floor zoning

58

6.10

Section AA and Section BB

59

6.11

Section CC and Section DD

60

6.12

North and East elevation

61

6.13

South and West elevation

62

6.14 3D view of Existing SSG Hospital

63

6.15 3D view of the Proposal Master Plan- Phase I

63

6.16 3D view

64

6.17 3D view

64

6.18 3D view

64

6.19 3D view

65

6.20 3D view

65 viii

Table of Contents

6.21 3D view

65

6.22 Photo of model- Existing site plan SSG

66

6.23 Photo of model- Existing site plan SSG

66

6.24 Photo of model- Existing site plan SSG

66

6.25 Photo of model- Proposal Phase I master plan

67

6.26 Photo of model- Proposed Phase I master plan

67

6.27 Photo of model- Proposed Phase I master plan

67

6.28 Photo of model- Proposed design for SSG

68

6.29 Photo of model- Proposed design for SSG

68

6.30 Photo of model- Proposed design for SSG

68

7.1

Comparison of the Existing Master Plan and the Proposed Master Plan of the SSG Hospital

70

7.2

Existing OPD plan

71

7.3

Proposed OPD plan

71

7.4

Existing CSSD plan

72

7.5

Proposed CSSD plan

72

7.6

Existing Radiology department plan

72

7.7

Proposed Radiology department plan

72

7.8

Existing Surgical ward plan

73

7.9

Proposed Surgical ward plan

73

List of Tables

ix

Table 1.1

DOTS and Chest ward distribution

14

Table 2.1

Surgical ward patient distribution

16

Table 3.1

OPD patient distribution

18

Table 4.1

Program

45

Table 4.2

Program

46

Table 4.3

Program

47 ix

Table of Contents 1:

2:

INTRODUCTION

01

-About Indian Healthcare system

02

-Scope in Indian Healthcare system

03

-Challenges in Indian Healthcare system

04

-Background study- the SSG Hospital

06

-Scope of development in the SSG Hospital

08

SITE ANALYSIS

09

-Existing site plan of SSG Hospital

10

-Analysis mapping of SSG Hospital

11

-Analysis of Infrastructure

12

1. Admin, Ortho and Prosthetics workshop

14

2. Surgical block and Radiology department

16

3. Out Patient Department OPD

18

4. Kitchen, store and Medical record room

20

-Analysis of people’s perception

21

-Changing the perspective

22

-Issues prevailing in the SSG Hospital-overview

22

-SWOT Analysis

23

-PESTEL Analysis

24

x

Table of Contents 3:

4:

5:

CASE STUDIES

26

-SVP Hospital, Ahmedabad

27

-Bhailal Amin General Hospital, Vadodara

35

-Haraldspass General Hospital, Norway

36

DESIGN PROPOSAL

39

-Demolition Master Plan SSG Hospital

40

-Proposal Master Plan SSG Hospital

41

DESIGN PROCESS

42

5.1 Site selection

43

-Final site plan

6:

44

5.2 Program

45

5.3 Concept

48

5.4 Process sketches

48

FINAL DESIGN

49

-Ground floor plan

50

-First floor plan

51

-Second floor plan

52

-Typical floor plan-3,4,5

53

-Basement plan zoning

54

-Ground floor plan zoning

55

-First floor plan zoning

56

-Second floor plan zoning

57

-Typical floor plan zoning

58

xi

Table of Contents

7:

-Sections

59

-Elevations

61

-3D views

63

-Site model photos

66

-Proposed master plan model photos

67

-Design model photos

68

CONCLUSIONS

69

-Comparison of Master Plan

70

-Comparison of existing and proposed OPD

71

-Comparison of existing and proposed CSSD

72

-Comparison of existing and proposed Radiology Department

72

-Comparison of existing and proposed Surgical ward

73

LIST OF REFERENCES

74

xii

1:

INTRODUCTION

01

The healthcare sector is one of the most important domains that impacts the entire global population and is closely linked to the development of any country. It also plays a crucial role in how a country is perceived in maintaining economic stability. The golden triangle of ideal healthcare consists of accessibility, affordability and quality. The sustainability of healthcare depends on the latter two, hence, it is important that we look at the ways in which it can be made accessible for the communities we serve.

There’s a well-understood correlation that as the economy of a country improves, so the health of its citizens improves. What may be less obvious is that the opposite is also true – improving the health of a nation’s citizens can directly result in economic growth, because there will be more people able to conduct effective activities in the work force.

INDIAN HEALTH CARE SYSTEM: Healthcare has become one of India’s largest sectors, both in terms of revenue and employment. Healthcare comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment. The Indian healthcare sector is growing at a brisk pace due to its strengthening coverage, services and increasing expenditure by public as well private players.

Scope in the Indian Health care system: The healthcare market can increase three-fold to Rs. 8.6 trillion (US$ 133.44 billion) by 2022. A growing middle-class, coupled with rising burden of new diseases, are boosting the demand for health insurance coverage. With increasing demand for affordable and quality healthcare, penetration of health insurance is poised to expand in the coming years.

02

Strong demand

Attractive opportunities

Rising manpower

Policy and government support

Some of the recent initiatives in the Indian healthcare industry are as follows: 1.

November 18, 2021, 80,136 Ayushman Bharat-Health and Wellness Centres (AB-HWCs) are operational in India.

2.

As of November 18, 2021, 638 e-Hospitals were established across India as part of the central government's ‘Digital India’ initiative.

3.

In July 2021, the Union Cabinet approved continuation of the National Ayush Mission, responsible for the development of traditional medicines in India, as a centrally sponsored scheme until 2026.

4.

In March 2021, Union Health Minister Harsh Vardhan informed the Rajya Sabha that 157 medical colleges are under various stages of implementation across India. Of this, 58 colleges are in the first phase of implementation, 24 in the second phase and 75 are in the third phase.

Fig 1.1 03

Fig 1.2

Fig 1.3

Challenges in the Indian Health care system: The Indian healthcare scenario presents a spectrum of contrasting landscapes. At one end of the spectrum are the glitzy steel and glass structures delivering high tech medi-care to the well-heeled, mostly urban Indian. At the other end are the ramshackle outposts in the remote reaches of the “other India” trying desperately to live up to their identity as health subcenters, waiting to be transformed to shrines of health and wellness, a story which we will wait to see unfold. With the rapid pace of change currently being witnessed, this spectrum is likely to widen further, presenting even more complexity in the future.

Today, we are a country of people who present an enormous diversity, and therefore, an enormous challenge to the healthcare delivery system. According to the Indian Journal of Community Medicine, these challenges can be presented by five A’s:

04

AWARNESS: In terms of prevailing health issues, public health care as well as their own. Only 11.3% adolescent girls know about reproductive health issues.

Thus, low education results in poor literacy rate which results in low priority and awareness for health.

ACCESSIBILITY: ‘The right or opportunity to use of benefit from’. There is lack of connection between the urban areas and the rural areas. Thus, people are not able to reach to better health care and also health care services are not fully available in the remote areas.

ABSENCE: Lack of trained personnel, health workers, proper fundings, etc also affects the entire health system. The current ratio in India is 20 health workers per 10,000 population. The reason being the role of education and lack of facilities for the workers.

AFFORDABILITY: The economic gap is created in terms of providing services to the people. The private sector provides all the facilities but only fewer population can afford. While the government sector is very affordable but it is not reliable and generally is not the first choice because of negligence.

ACCOUNTABILITY: Procedures and processes by which one justifies and takes responsibilities for its activities. The hospital responsibility is categorized as1.

Worker, staff: expect to have a proper code of conduct

2.

Clients, family: expectations of better treatment and facilities

3.

Government, state: expects from the hospital for its contribution in the overall develop.

05

BACKGROUND STUDY - THE SSG HOSPITAL, VADODARA Sir Sayajirao General Hospital was started in 1865 as the 56 bedded Countess of Dufferin Hospital. It was opened to commemorate the visit of the Viceroy, the Earl of Dufferin to Baroda, and was named after his wife. It was designed by Major Charles Mant (1840-81) in an Indo-Saracenic style.

The hospital along with the Baroda Medical college is located in a 36acre campus located in Central Baroda, 1km from the Vadodara Railway and Bus Station and 3km from the Vadodara Airport. The hospital also caters to the primary health care needs of the people of Gujarat, Madhya Pradesh and Rajasthan.

1855 • Countess of Dufferin hospital established in the reign of Maharaja Ganpatrao Gaekwad.

• Later on the building became inadequate with the rising needs of the city.

1870s • Work started to meet the rising demands during the reign of Maharaja Sayajirao Gaekwad III. 1876 • A full-fledged medical department started by the State administration under the • guidance of Sir T. Madhavrao.

1886 • The hospital was built, replacing the old State Hospital from Lady Dufferin Fund.

• It was designed by Major Mant in Indo-Saracenic style.

1896 • Nursing college was established in the campus.

1917 • The new State Hospital was established.

06

Fig 1.4

Fig 1.5 07

Scope of development over the years: Constant growth in terms of infrastructure in the form of addition and demolishing the buildings can be seen over the span of 20 yrs.

Demolishing old structures due lack of visionary approaches and construction techniques can be seen. Addition of different buildings for various departments is seen due to increasing demand for healthcare facilities in society.

Fig 1.6

2000

Fig 1.7

2003

Fig 1.8

2005

Fig 1.9

2007

Fig 1.10

2010

Fig 1.11

2012

Fig 1.14

2022

Fig 1.12

2014

Fig 1.13

2017 08

2:

SITE ANALYSIS

09

Fig 2.0

10

Fig 2.1

Fig 2.2

Fig 15

Fig 2.3

Fig 2.4 11

Analysis of Infrastructure: Physical Infrastructure (Buildings, fixtures and utilities) 1

Location of the infrastructure and access by the poor and vulnerable:

• Lack of understanding of the importance of health facility among the health managers and officials.

• Unplanned and rapid expansion of infrastructure, without thinking of access and utility to the public.

• No knowledge and understanding of the techniques available to arrive at optimal location.

• No integration among the health facilities • No systematic study of the factors before implementation of future plans

Fig 2.5

Radiology department, Labs Admin, offices Record room, store, workshops Educational areas Operation theatre Chest, flu department Emergency department Lecture halls, auditorium 12

TRAFFIC ANALYSIS

The location of the emergency department needs to be change and to locate near the main entry/exit.

Fig 2.6

The opd block must be placed on the outside area of the entire hospital campus to control the traffic movement within the campus.

Fig 2.7

The educational area is having its separate entry but it is not much in use by the students. They prefer the main entry from the jail road side.

Fig 2.8

The admin areas needs to be integrated and A separate land is to be dedicated to the entire admin area.

Fig 2.9

The operation theatre is placed near the entry serves right for the people and the medical personnels.

Fig 2.10.

The radiology and labs needs to be integrated.

Fig 2.11 13

2

Design of Infrastructure and quality of construction: • Lack of proper patient and material flow • Lack of privacy in • Lack of proper and adequate working spaces in various rooms • Lack of comfortable and waiting areas for patients and relatives • Lack of utilities and public conveniences such as drinking water, electricity, toilets, etc • Lack of waste disposal management

1.

Admin, Ortho and Prosthetics workshopArea: 1392 sq mts Built: almost 20 yrs ago Maximum life left: 10 yrs Ground floor: Prosthetics workshop.

Fig 2.1.1

The other half is closed because of dilapidated condition.

First floor: Administration department.

The other half is closed because of dilapidated condition.

No. of staff working: 70 Second floor: Chest and DOTS ward Fig 2.1.2

Chest ward

DOTS ward

General beds:

21

General beds:

21

ICU beds:

05

ICU beds:

05

Avg patient/day

07

Avg patient/day

03

Table 1.1

Dead spaces

Closed areas

14

Used spaces

Fig 2.1 (b)

Fig 2.1 (a)

Fig 2.1 (d) Fig 2.1 (c)

Fig 2.1 (e)

Fig 2.1 (f)

15

2.

Surgical ward block and Radiology departmentArea: 4380 sq mts Built: almost 20 yrs ago Maximum life left: 25 yrs 1. Surgical ICU Ground floor: No. of ICU beds: 05 The other half is in dilapidated condition.

Fig 2.2.1

2.Radiology department First floor: Orthopedic surgery wards.

The other half is in dilapidated condition.

Second floor: ENT surgery wards Third floor: Eye OT and wards Fourth floor: Burns and plastic surgery wards.

Total teaching beds: 240 Service beds: 90 1 five bedded ICU No. of emergencies/day: 290 No. of surgeries in a day: No. of tests/day: 2000 No. of radiological tests: 600 Annual avg opd: 9 lakhs patients Annual avg ipd: 67,000 patients

Fig 2.2.2.

Dead spaces

Closed areas

Radiology

OPD patients

IPD patients

X-ray

470

230

CT scan

30

40

Sonography

200

95

ICU

Table 2.1

Fig 2.2 (a) 16

Radiology

Fig 2.2 (b).

Fig 2.2 (c)

Fig 2.2 (d)

Fig 2.2 (e)

Fig 2.2 (f)

Fig 2.2 (h) Fig 2.2 (g) 17

3.

Out Patient Department (OPD)Area: 3500 sq mts Built: almost 20 yrs ago Max life left: 10 yrs Fig 2.3.1

No. of patients/day: 1200-1300 Max. daily avg/day: 1700 OPD

Rest 6%

No. of patients avg/day

Skin

370

General medicine

310

Orthopaedic

280

Gynaecology

240

General surgery

190

Skin 25%

Surgica l 13% Ortho 19%

Genera l medicin e 21%

Gynaec 16% Fig 2.3.2

Table 3.1

Fig 2.3.3

Dead spaces

Closed areas 18

Waiting areas

• The length of the time from when the patient entered the outpatient clinic to the time the patient actually leaves • There is no separate diagnosis bloc • No availability of advance equippments • Which patient is likely to be in for consultation is not known • Long process for billing • Slow process at receiving medication from the pharmacy • Overall circulation is not well defined • No queue management when crowded • Dead spaces • No proper seating arrangement • Long queues in entire corridors • Lack of ancillary departments and its placement • No outdoor public spaces

Fig 2.3 (a)

Fig 2.3 (c)

Fig 2.3 (d)

Fig 2.3 (b)

Fig 2.3 (e)

19

Fig 2.3 (f)

4.

Kitchen, store and medical record room-

Area: 1380 sq mts Built: almost 20 yrs ago Max life left: 5 yrs Ground floor: Kitchen and medical store

Fig 2.4.1

First floor: Medical record room and medical store

Fig 2.4.2

Fig 2.4 (a)

Fig 2.4 (b).

Fig 2.4 (c)

Fig 2.4 (d) 20

3

Analysis of people’s perception:

Satisfied 25%

Satisfied 30% Not satisfied 70%

Not satisfied 75%

Fig 2.5.1

Fig 2.5.2

2. Adequate facilities lie drinking water, toilets, etc

1. Physical environment satisfaction

Excellent 13%

Not satisfied 20%

Good 29%

Poor 58% Satisfied 80%

Fig 2.5.4

Fig 2.5.3

3. Cost of treatment

4. Knowledge of staff

Foot 5%

Two wheeler 5%

Postgraduate 5%

Graduate 15% Bus 40%

Illiterate 60% Auto-rickshaw 27% Fig 2.5.5

Primary 20%

Cycle 8%

Fig 2.5.6

5. Mode of travel taken by the people

6. Education level of the people

21

Changing the perspective: • The hospital must be design as patient-centric.

• Punctuality about the management system.

• Casual behaviour of the staff must be addressed and needs to be changed.

• Quality of treatment.

• The hospitals must have top medical infrastructure.

• The service standards must meet with that of the private hospitals.

• Improve the hospital campus. Majority of the qualified personnel are not willing to come due to inadequate maintenance of the campus.

• Honesty and commitment of the doctors and other medical personnels.

Overview- Issues prevailing in the SSG Hospital: • Highly criticized due to inadequate facilities, crumbling infrastructure and multiple challenges.

• The mindset of the people towards the hospital is not positive.

• The buildings are in dilapidated conditions, plaster have come off the walls and ceiling chunks of concrete fell of the ceiling.

• Deficiency of urban health infrastructure • Overcrowding in hospitals • Lack of outreach • Negligence of standards and norms for urban health care delivery system • Social exclusion • Unavailability or ignorance of information for accessing modern health care facilities • Lack of purchasing power • No proper integration of the departments and lack of service connections

22

SWOT Analysis: STRENGTH • Good medical facilities at comparatively lower cost.

• Continuous increase in number of diagnostic centres, doctors and other medical professionals • Less cost of surgeries and cost of admission • Good reputation and high success rate in surgery • The availability of health personnel at comparably lesser cost WEAKNESS • The growing demand for quality healthcare and the absence of matching delivery mechanism, and outdated technology • Number of people possessing adequate knowledge to handle sophisticated medical equipment is also less • Lack of administrative policies and poor management • Lack of infrastructure • Technological backwardness, lack of availability of quality inputs, problem of supporting infrastructure like road, transport, power, water etc., and the socio‐political environment • Problem of ownership OPPORTUNITIES • The current demand and supply provide a significant opportunity • Factors such as changing demographics, rising life expectancy and growing public awareness can contribute to higher demand • There is a wide gap between availability and requirement of health services which has created a need for better infrastructure • Growth is accompanied by strong demand for medical equipments • Because of lower cost, people are coming from various regions.

23

THREATS • If proper measures are not take then the gap between various income groups will rise continuously.

• Lack of negligence will result in inadequate health care facilities • Lack of visionary decision making have resulted in such issues.

PESTEL Analysis: Political Factors • The government has initiated to provide adequate fund for its future development.

• Many initiatives have started to promote its development • Initiatives in creating awarness among people have also been introduced • The government is also promoting private-public partnership • Affordable medical treatment to all the income groups Economic Factors • Less income generation from the upper middle class and high class people • Current spend by the government till now has been less in meeting the high demand • Also, there is no other source of income except the government funding in maintaining the hospital campus Social Factors • Increasing lifestyle and life expectancy can act as an opportunity in its future development • People who cannot afford have no choice left in getting adequate health care facilities •

People are now more informed and now have become more demanding

• With rising people’s expectations the healthcare professionals are able to benefit from these • Rise in population will open up various opportunities

24

Technological Factors • There is shortage of modern technology, equipments and medical professionals • People from various regions are coming for affordable treatment • Lack of digitalization hindering the entire management flow Environmental Factors • People are becoming more prone to diseases due to adequate and healthy environment • No newer concepts of integrating nature with the built environment has been introduced • Pollution control is one of the main issue affecting the lives of the patients • Other factors such as road network, electricity and drinking water are not meeting the expectations Legal Factors • Lack of stricter guidelines and policies which results in casual behaviour of the staffs • Lack of efficient treatment due to improper managment • Improper record system without new methods

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3:

CASE STUDIES

26

1. Sardar Vallabhbhai Patel Hospital, Ahmedabad, Gujarat, India (Live case study) SVP Hospital or Sardar Vallabhbhai Patel Institute of Medical Sciences and Research is a public hospital and medical college in Ahmedabad, India.

The building, consisting of 17 floors, a ground floor, and two basements.

The hospital features 1,500 beds, 32 operation theatres, 139 ICU beds, 90 consultation rooms, and a helipad for the air ambulance.[5] The hospital utilizes a pneumatic tube system to send samples to laboratories in seconds. It has colleges of physiotherapy, medicine, and nursing

Fig 3.1.1

Fig 3.1.2 27

Fig 3.1.3

Master plan

Fig 3.1.4

Ground floor plan 28

Fig 3.1.5

Basement plan - 1

Fig 3.1.6

Basement plan - 2 29

Fig 3.1.7

Fig 3.1.8

First floor plan

Second floor plan 30

Fig 3.1.9

Fig 3.1.10

Third floor plan

Fourth floor plan 31

Fig 3.1.11

Fig 3.1.12

Tenth floor plan

Fifteenth floor plan

32

Fig 3.1.13

Sixteenth floor plan

Fig 3.1.14

Eighteenth floor plan

33

Fig 3.1.15

Fig 3.1.16

Fig 3.1.17

Fig 3.1.18

Fig 3.1.19

Fig 3.1.21

Fig 3.1.20

Fig 3.1.22 34

2.

Bhailal Amin General Hospital, Vadodara, Gujarat, India

(Live case study) In 1964, a small hospital was set up by the Alembic group to primarily cater to the health care needs of the Alembic family, and it's employees. In just over five decades, Bhailal Amin General Hospital has shaped into a 200+ beded multispecialty tertiary care hospital that offers highest medical care services to the patients in and around Vadodara.

Fig 3.2.1

Fig 3.2.2

Ground floor plan 35

3.

Haraldsplass Hospital, Bergen, Norway

(Online case study) Haraldsplass Hospital was built in 1986 and has approximately 184 beds.

The new building will cover 10,000 sq mts and give the hospital a further 108 beds on three storeys. There will also be new underground parking facilities for approximately 400 cars.

Fig 3.3.1

Fig 3.3.2

Site plan 36

Fig 3.3.3

Ground floor plan

Fig 3.3.4

First floor plan 37

Fig 3.3.5

Section

Fig 3.3.6

Fig 3.3.7

38

4:

DESIGN PROPOSAL

39

Fig 4.0

40

Development Master Plan PHASE I

Development Master Plan PHASE II

Fig 4.1

Fig 4.2

Development Master Plan PHASE III

Development Master Plan SSG Proposal

Fig 4.3

Fig 4.4 41

5:

DESIGN PROCESS

42

5.1: SITE SELECTION The entire area acts as the heart of the campus The traffic flow is not controlled within

the

campus

due

to

placement of the opd block.

The entire open land acts as paring area for the surgical block,

ot,

emergency

department.

Majority of the opd traffic is seen in front of the opd entrance which

obstructs

the

medical

college Fig 5.1.1

There is no traffic management between the hospital and institutional zones.

All the vehicles are parked alongside the road passing through the opd and college.

Site selection on the basis of1. Availability of land 2. Separate entrance 3. Easily accessible 4. Approach from the main road 5. Adjacent to supportive facilities

43

Fig 5.1

Fig 5.2

Fig 5.1.2

Fig 5.6

Fig 5.5

44

Fig 5.4

5.2: PROGRAM

Table 4.1

45

Table 4.2

46

Table 4.3

47

5.3: CONCEPT

Division od spaces and view Massing on the basis of division of view Fig 5.3.1

5.4: PROCESS SKETCHES

Fig 5.3.2 48

6:

FINAL DESIGN

49

Fig 6.1

50

Fig 6.2

51

Fig 6.3

52

Fig 6.4

53

Fig 6.5

54

Fig 6.6

55

Fig 6.7

56

Fig 6.8

57

Fig 6.9

58

Fig 6.10

59

Section BB

Section AA

Fig 6.11

60

Section DD

Section CC

Fig 6.12

61

East Elevation

North Elevation

Fig 6.13

62

West Elevation

South Elevation

3D VIEWS

Fig 6.14

Fig 6.15

63

Fig 6.16

Fig 6.17

Fig 6.18 64

Fig 6.19

Fig 6.20

Fig 6.21 65

Fig 6.22

Fig 6.23

Fig 6.24

66

Fig 6.25

Fig 6.26

Fig 6.27 67

Fig 6.28

Fig 6.29

Fig 6.30 68

7:

CONCLUSION

69

Fig 7.1

70

Proposed Master Plan of SSG Hospital after Phase 1

Existing Master Plan of SSG Hospital

Comparing the Existing and the Proposal for the SSG Hospital • The existing structures are not having enough spaces for accommodation of the people. There is an attempt to create open spaces.

• An attempt to bring in the natural light and reduction in the use of artificial energy.

• The existing structures are not having enough spaces for the staff.

• Informal areas for both staffs and patients can be seen in the proposal.

• Introduction of the basement parking to accommodate vehicles and to control the traffic movement in the campus.

• Cluster formation and courtyard planning in the new opd.

1.

Comparison of Existing OPD and the Proposed OPD

Fig 7.2

Fig 7.3 71

2.

CSSD

Fig 7.4

3.

Fig 7.5

Radiology department

Fig 7.6

Fig 7.7

72

4.

Surgical wards

Fig 7.8

Fig 7.9 73

LIST OF REFERENCES https://www.medikabazaar.com/blog/medical-equipment/operation-theatre/acomplete-guide-to-operation-theatre-essential-equipment/ https://www.archdaily.com/795981/pars-hospital-new-wavearchitecture/57e7401fe58ece205300012a-pars-hospital-new-wave-architecturephoto?next_project=no https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114612/ https://www.hindawi.com/journals/aph/2014/898502/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367007/ https://www.archdaily.com/240478/haraldsplass-hospital-c-f-moller-architects https://www.researchgate.net/publication/335273056_Healthcare_in_In dia-_A_SWOT_analyses https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117898/ https://www.nabh.co/images/Standards/NABH%205%20STD%20April%202020.pdf https://cpwd.gov.in/Publication/Compendium_of_Norms_for_Designing_of_Hospital s_and_Medical_Institutions.pdf https://www.nabh.co/Images/PDF/Fire_Safety_NABH.pdf https://www.bis.gov.in/index.php/standards/technical-department/national-buildingcode/ https://nhm.gov.in/images/pdf/guidelines/iphs/iphs-revised-guidlines-2012/districthospital.pdf https://www.researchgate.net/figure/Typical-floor-plan-of-a-CSSD-Image-courtesyof-Tuttnauer-29_fig4_281458285 https://www.slideshare.net/subh111/handbook-to-buildanhospitalcrf https://healthcarearchitecture.in/wp-content/uploads/2013/12/Hospital-DesignGuide.pdf https://www.ibef.org/industry/healthcare-india https://www.apolloclinic.com/for-franchisee/potential-in-health-care

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