Question: We are planning for a 40-bed orthopaedic set up. We have purchased a 20-year old building and are trying to modify it for our hospital. Kindly let us know what are the things to look into in terms of architecture as we are finding it really hard to accommodate all our services.
– Dr Abhishek, Lucknow
| Tarun Katiyar |
Answer: There are two kinds of projects: greenfield and brownfield projects. In your case, since it’s a brownfield project, there are certain limitations that we have in terms of architecture. The location of columns and beams, if moved, might pose a threat to the structure since it’s a very old building. However, treatment of beams can be done in order to increase the strength of the structure, after consultation with the structural engineer.
Hence, identification of best possible space for clinical and non-clinical services seems to be a bigger challenge.
Kindly make sure that only the most important daycare services are provided in the most important parts of the building i.e., ground floor. The critical care and OT units can be moved to first floor and so on.
Question: We are a group of doctors planning to start a hospital of 200 beds in Delhi. We would like to know what are the various options we have in terms of financing the project?
– Dr Ajay Kumar, Delhi
Answer: The most important part of a greenfield hospital project is its feasibility study. This will give the detailed information about the two most important things – market research and financials involved in the project.
Unless a thorough market and financial feasibility study is done, it is very difficult to identify the sources of funds and approach the potential investors, as they look forward for a detailed report on the project.
Once a feasibility is done, the various funding options such as term loans, PE, joint venture etc can be identified depending on the feasibility of the project.
Question: We have had a small polyclinic in Mangalore for the last 20 years and intend to expand our set up. But, due to the lack of space in the existing location, we are forced to move out to a different place. Is this going to affect our patient base and what kind of area is ideal for a hospital set up?
– Dr Prashanthi, Mangalore
Answer: Since it’s a very old set up that you have, people identify your set up due to your presence there and also since it has created some sort of a brand value. Hence, moving out of this location is not a good idea as your major patient base is over there.
An ideal solution would be to retain the existing set up thereby ensuring the continuation of revenue generation. Meanwhile, identify a building on lease/ purchase and slowly move to a different location in a phase-wise manner. You may also retain the existing polyclinic as a daycare set up at a later stage.
Question: We are looking for an ideal place in the city for our hospital set up. Tell us what are the various ways to identify the potential of a particular location for a hospital project?
– Dr Vishal, Ahmedabad
Answer: The location of the hospital plays a vital role in the success of the project. We have seen a number of cases wherein despite huge investments, the project fails due to the lack of carrying out a detailed feasibility study in terms of identifying the right location.
Some of the points to be considered before finalising a hospital project location are: the location should have a good history and make sure that it’s not an abandoned land, easy accessibility should be of prime importance, soil of the land should be strong enough to hold the foundation of the building. It is good to avoid plot with too much wet soil etc.
Question: We have a 40-bed nursing home from 25 years. We are looking to improve the look of the building. Kindly suggest us ways to renovate.
– Dr Suhana, Hyderabad
Answer: After a certain period of time, hospitals do feel the need for addition of various services for which they require space. One should be careful in identifying a new service and it should also take into account the requirement and availability of space.
Depending on the strength of the structure/ building, one can divide the renovation into two parts – interior/internal and exterior/ external
Ideally, the interior designing should be more focused on improving the lobby space and the corridors. the right kind of interior designing material plays a vital role in this aspect. the external/exterior designing can be done either with glass/ACP/stone cladding depending on the requirement.
However, when a new service has to be added in to the building, care should be taken to identify the space for it first followed by interior designing.
Question: We want to build a hospital of 50 beds. We have more than an acre of land. However, we are a bit apprehensive about such a big project from the financial point of view. Hence, we are looking to begin a polyclinic and then may be expand by increasing number of beds. Please suggest.
– Dr Ahmed, Ernakulam
Answer: A 50-bed hospital would need somewhere close to 15,000 -20,000 sq ft area and the cost of the project would be around Rs five-eight crore depending on the type of facilities you want to provide. However, this cost does not include diagnostics like CT, MRI etc. This cost can be recovered by outsourcing certain departments of the hospital like Opthalmology, Laboratory, Pharmacy, Diagnostics in a tough financial situation. Though ideally, outsourcing of Lab and Pharmacy is not recommended from the revenue point of view.
You may as well go ahead with the commencement of the OPD, pharmacy and diagnostics to begin with followed by day care facility. This will give you enough time to finance the expansion project. Once the hospital is stabilised, you may add on other services.
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