| Dr Badrinath, Chairman, Sankara Nethralaya & Dr Alok Roy, Chairman and MD, Medica Group during inaugural function of Sankara Nethralaya |
According to the 2011 fact sheet of World Health Organization, 285 million of the world population is visually impaired, 39 million are blind and 246 have low vision, and about 90 per cent of these people live in developing countries. In India, it is estimated that there are between 15 – 18.6 million people with blindness, which amounts to about one fourth of the world’s blind population. The prevalence of blindness is higher among population belonging to lower socio-economic status.
Super speciality ophthalmology hospitals play a major role in the reduction of visual impairment. Stalwarts in India who contribute in eradication of visual impairment, like Aravind Eye, LV Prasad, Sankara Nethralaya, cater to people belonging to any economic strata through their cross subsidisation model of eye care delivery systems and also improve the quality of eye care through community outreach programmes, teaching, training, research and consultancy.
CEO – Projects & Consultancy Division, Medica Synergie |
Sankara Nethralaya, a unit of Medical Research Foundation, Chennai, one of the most renowned eye care delivery systems in India has been receiving patients from the eastern and north eastern region of India, seeking eye care, since its inception in 1978. To serve more people from eastern and north eastern India, Rotary Narayan Sankara Nethralaya was built in Salt Lake, Kolkata in December 2002.
As the awareness for eye care increases, so does the demand. Realising the ever increasing gap for more number of eye care hospitals in eastern India, Sankara Nethralaya envisioned building a modern state-of-the art eye hospital in Kolkata, wherein MedicaSynergie’s visionary chairman, Dr Alok Roy and his team facilitated the turnkey development of this unique hospital, thus making the dream of Dr Badrinath a reality.
Asso. Consultant – Projects & Consultancy Division, MedicaSynergie |
MedicaSynergie, as the principal project consultants with its experience of planning and designing over five million square feet of healthcare space carried out the entire spectrum of work from assessing the demand, paying capacity of the people, determining the project cost, planning, design development, construction management and commissioning assistance of Sankara Nethralaya’s flagship hospital in the east.
As the age old adage says, any healthcare business is all about creation of right service in the right place, at the right price and the right time. Market survey and feasibility study guides in spelling all these elements right, which can otherwise be disastrous. MedicaSynergie initially started with a detailed market study to assess the demand, existing disease profile, competitors’ profile, catchment area and identification of site for the proposed hospital. Since Kolkata is the gateway to east India, one fourth of the country and even patients from the neighbouring countries like Bangladesh, Nepal, Bhutan and Myanmar come down to this state for treatment. However, our survey revealed that there is less eye care delivery systems in Kolkata, which in turn caused people from the eastern part of the country to travel to South India for better treatment.
| Pond adjacent to the proposed site | During construction |
MedicaSynergie then identified site for the proposed hospital in Kolkata. It divided Kolkata into four quadrants and studied the demographics, socio-economic profile, density of eye care delivery systems, connectivity and modes of communication. Then it performed a comparative analysis to identify the best suitable locality within the city. Later, study and analysis of each site identified within the choosen locality was undertaken to understand the topography, connectivity, climatology, water body options, seismic zone considerations and statutory requirements. Following the analysis, the site was finalised at EM bypass in consensus with the Government of Bengal and Sankara Nethralaya. EM bypass, running along the eastern rim of the city, is one of the most important economic lifelines of Kolkata.
Planning and designing sustainable hospital buildings which accomodate present day requirements and cater to future needs is definitely a challenge formodern day hospital designers and planners. Continuing advances in medicine and ever changing needs of the society impose great demands on the planning team. With our enriching experience in planning and designing state-of-the-art multi-speciality hospitals across the country, our hospital planning team developed evidence-based design for the proposed hospital under the guidance of Col Raghavan of Sankara Nethralaya.
Alhough the site had its own competitive advantages, there were two major constraints which posed a challenge to the planning team. The site area was small to accommodate all the requirements of a state-of-the-art ophthalmology hospital and there was ingress of water into the site since there was a pond adjacent to the site. Consolidation with fly-ash and piling (deep foundation) was accomplished to overcome ingress of water and concerns because of damp soil and high water table of the site. Also, Medica Synergie did not plan for a basement in the proposed hospital considering the high water table.
| The reality – Sankara Nethralaya, Kolkata | The concept design for Sankara Nethralaya |
Apart from designing the buildings and their architectural appearance, the architects experienced in healthcare, provided adequate attention to the internal planning including accommodation of medical and non-medical equipment, creating support spaces, etc. The hospital planners of MedicaSynergie coordinated with the architects right from master planning stage till interior designing and signage development (complete architectural design development), resulting in aesthetically appealing hospitals in sync with functional efficiency. At the outset, the hospital planners created architect’s brief, reflecting the requirements of Sankara Nethralaya, medical programme and facility mix, space functionality addressing flexibility and future growth, functional adolescences and flow patterns of stakeholders.
Based on the architect’s brief, the architectural team initiated their ideation processes to incorporate hospital planning concepts in their zoning and stacking plans before developing detailed architectural plans. Zoning plan portrayed blocks representing various hospital departments along with departmental gross square feet (DGSF) and the stacking plan defined the stacking of various departments of the different levels within the facility. On completion of this assignment, the clinical and hospital planning teams reviewed the hospital from the perspective of clinical and operational excellence. After receiving feedback from the clients on the conceptual plans and incorporating their suggestions, our architects went ahead with detailed drawings, municipal submission drawings, service drawings and construction drawings.
| Entrance lobby, Sankara Nethralaya, Kolkata | Consultation room, Sankara Nethralaya, Kolkata |
The core principles which MedicaSynergie adhered to while designing Sankara Nethralaya, a G+5 structure are as follows:
Evolution of form and design optimisation – In connection to the vision of Sankara Nethralaya and continuation of its standing as a world class eye care hospital, the elevation and the form was designed to look like a grand institutional delivery system. The elevation has been designed to attract people belonging to all socio-economic strata. It was created keeping in mind the site profile and topography and simple geometrical form to make the design user-friendly.
Community service – To make the free patients comfortable, separate floors and entrance were planned in the proposed hospital (30 per cent of free patients are treated by every unit of Sankara Nethralaya)
Ensuring functional efficiency – Space requirement for every department has been decided keeping in mind the functionality, comfortable functioning of the staff and provision for accommodating all the medical as well as non-medical equipment ideally required for efficient operations.
Maximising operational efficiency – Separate movement patterns for patients, staff, patient relatives and materials to avoid confusion and improve efficiency.
Zoning – The hospital was divided into three major zones namely patient, staff and research area to ensure comfort to stakeholders. Smooth flow has been ensured through adjacency and minimisation of traffic congestion, even during the peak hours.
Minimisation of hospital infections – Proper zoning of seven OTs and CSSD, restricted access to critical areas. The Septic OT is segregated from other OTs to prevent infections.
Low cost and vernacular architecture model – Optimisation of space to ensure judicious and minimal use of built up area to reduce the cost of construction, use of local materials for construction, etc
Green approach – The design has been planned to ensure adequate ventilation and day lighting to most of the functional areas of the hospital.
MedicaSynergie |
In sequel to completion of construction within the planned period, Medica Synergie also assisted the commissioning of the hospital. A team headed by Komal Dashora of Medica Synergie commissioned and effectively managed this ‘centre of excellence’ while implementing various systems and processes for standardisation and efficient delivery of world class eye care at Sankara Nethralaya, Kolkata.
MedicaSynergie is an integrated healthcare organisation offering turnkey healthcare consultancy services, and is presently working across six countries other than India. Medica Synergie effectively fills in the huge gap by being a one-stop shop for all healthcare entrepreneurs/ doctors/ promoters by providing end-to-end solutions across the healthcare facility—from planning and design, finance syndication, to commissioning assistance and operational management—taking away all woes of prospective hospital owners.
The author can be contacted at ayanabh.debgupta@medicasynergie.in