Shahid Akhter, editor, ETHealthworld, spoke to Architect Ravideep Singh, Associate Director, Creative Designer Architects, Delhi, to get his insight on the effect of the pandemic on global healthcare facilities and how the emerging trend addresses the architectural element in healthcare.
Impact of Covid-19 on Healthcare Design
COVID-19 brought forth a paradigm shift in how hospitals were perceived and planned. Earlier, whenever someone had to design a hospital, they would look only at the economic viability of the real estate available, the catchment area, and accommodating a maximum number of beds.
However, after the pandemic, healthcare design has become more holistic in its approach to context, functionality, and user experience. The pandemic demanded the need for alternate-care hospital facilities. During the pandemic, we had to swiftly ramp up bed capacities by two to three thousand additional beds in 10 days. These facilities make sense in an isolated location. However, the only drawback is that they are distant from critical healthcare modalities like operation theatres, MRIs, and advanced radiology equipment, which unfortunately cannot be replicated at alternate sites.
One good idea, which most providers are considering, is to select the location strategically so that there are open spaces around the site, which could double up as alternate care facilities or offshoots of the primary healthcare centres in case of pandemics or emergencies.
Impact of Technology on Healthcare
Healthcare and technology are both very rapidly evolving fields. Technology has made healthcare very volatile and susceptible to change. Initially, ten years ago, we used to design hospitals that could cater to a large influx of people. In the Indian context, one patient was accompanied by three or four visitors, and you would require waiting areas in the range of 100–200 for, say, 10–15 OPDs. This scenario is slowly changing with the advent of technology.We have online check-ins and pre-booked appointments, so we are slowly moving away from large waiting areas. This has allowed more hospital real estate to be used for clinical areas than only waiting areas where people would just sit and look at people who are under stress or ailing—a positive change technology has brought about in the healthcare landscape.
Hospital Architecture: Challenges
After the pandemic, hospitals in India have been rapidly enhancing their infrastructure. Most clients now expect their hospitals to be operational within 12 to 16 months, a significant reduction from the previous timeline of over two years. As a result, we are facing a major challenge in compressing the construction timelines.
One of the ways to address this is by changing the primary construction material from reinforced concrete to steel, so everything is fabricated off-site. The second approach is to take an existing building and make it operational as a hospital, which we call a brownfield project.
Hospital Architecture and Sustainability
Talking about hospital architecture and sustainability is like fighting against competing odds. On one end of the spectrum, when we look at the numbers, the hospital infrastructure is seemingly deficient in India, and we need to ramp up and create more infrastructure swiftly. On the other end of the spectrum, we see hospitals with effective energy channels, and building more infrastructure means we are adding a lot more carbon footprint to the environment. The answer lies somewhere in the middle, where we could pick existing buildings and turn them into hospitals.
CDA’s Journey in Healthcare Design
CDA has been associated with designing hospitals for the past two decades. It started with Max Hospital in Saket in 2003, and then the fleet of 13 hospitals from Max Healthcare followed. We have also been associated with various public and private sector clients, like the All India Institute of Medical Sciences (AIIMS) and state and regional government hospitals.
Designing and building hospitals in different states and delving into different territories and geographies has given us a fair socio-economic understanding of how the demographics are different in each state and how healthcare needs to respond appropriately to design more conducive, flexible, and receptive to their needs.
Our partnerships with the top healthcare providers in the country reflect their vision to establish high-quality healthcare and become a beacon for others. These partnerships have allowed us to comply with global standards and follow principles of research that have been happening overseas in the West, such as evidence-based design. We strive to bring more value to healthcare systems through our facilities and contribute to the evolution of healthcare in our country.
Behavioural health is slowly becoming a more relevant part of overall health and well-being, despite being predominantly stigmatised. It’s gaining acceptance in terms of how we should respond to behavioural health, even from a facility design standpoint. After all, anyone entering a healthcare facility undergoes some stress—from the invasion of privacy, medical bills, insurance, etc. As healthcare designers, our most significant value is mitigating that stress to some extent for the patient.
Currently, we’re working with most of the top private and public healthcare providers in the country, including Max Healthcare, Fortis Healthcare, Paras Healthcare, and Apollo, to name a few. In the public sector, we’ve partnered with the All India Institute of Medical Sciences and several state government institutions to set up hospitals and medical colleges. For instance, AIIMS Guwahati, which was recently inaugurated, is one of the first AIIMS campuses in the Northeast and is set to bridge the gap between the region and the rest of the country.
About CDA Architects
Creative Designer Architects (CDA) is an interdisciplinary architectural practise that is an established design leader in healthcare, institutional, and commercial projects. With an international team led by three principals—Mohanbir Singh, Maninder Kaur, and Ravideep Singh—CDA is one of the largest healthcare-focused practises in India, with more than 150 completed projects across Asia over the last two decades.
Across projects, the firm’s process integrates innovation, adaptability, and sustainability to revolutionise healthcare infrastructure in India. CDA’s approach is centred on patient experience and evidence-based design to create flexible, resilient, and empathetic environments.
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