Hospitals have been changing in shape, size and functions to adopt themselves to the advancements in the medical field and socio-economic changes around them. |[pic] |
|Col AK Dutta |
Hospitals are dynamic organisations. They have been changing in shape, size and functions to adopt themselves to the advancements in the medical field and socio economic changes around them. Advances in medical fields like discovery of ether in 1846, Lister's use of carbolic spray for antiseptic surgery, Roentengen's discovery of X-ray in 1895, introduction of CT scanners, ultrasound and MRI and socio-economic changes like Public Health Act, national health programmes, and healthcare financing all had profound impact on the structure and functions of hospitals. Hospitals originated as a result of sympathy for the sick and suffering and were initially a part of religious institutions. Two ancient civilisations, Indian and Egyptian, had well-developed hospitals in early Greek and roman civilisations. Hospitals were not separate entities but formed part of big temples where more of soul healing then physical healing was done. An efficient hospital requires a well-balanced organisation for compassionate care within an adequate technical and environmental framework. This basis has remained vital throughout the centuries, although patterns of diagnostics, therapeutics and care have changed. Healthcare 50 years hence cannot be visualised clearly but it is certainly delivered also in facilities planned now. 'Tomorrow is born out of today'. Planning a Hospital
More often than not, the hospital planning process concentrate more on the designing of buildings and their architectural appearance, and devotes inadequate attention to the planning of organisation and equipment as well as accommodating them and generating spaces to meet policies. The concern of hospital planning is the quality of medical care and the improvement of its standards. There is no place for perpetuation of the status quo as well as for astounding innovations. Continuing advances in medicine and society impose great demands on the planning team. A sound general design can always be modified in detail: a perfect detail does not guarantee a perfect whole. Innovate or Die
Innovation is not incremental, but it is radical. Innovation is disruptive to the establishment, core competition and industry but not to its customers. There are some principles for change that can be followed to bring in innovations. Modular construction: There is a dire need for faster, more efficient forms of construction to keep pace with the healthcare modernisation process and for better quality outcomes in lesser time. The use of modular construction is directly influenced by the client's requirements for speed of construction, addition of new departments, least disturbance to existing facilities, quality, and added benefits of economy of scale as well as single point procurement. Flexibility in Design: Flexibility has always been a source of aggravation in hospital design. Hospitals are facilities that are heavily serviced and are built to last, and yet they have to constantly adapt to changing needs coming mainly from technological development and new medical practices. In regard to morphology and spatial organisation, over the last decade, some major factors have been shaping the contemporary hospital; like the introduction of public spaces within the hospital, and the importance accorded to natural light and new medical practices. The introduction of interior streets and atria has led to horizontal organisations. Services are distributed along a major spine that brings in daylight and diversions are created for patients and staff. These new horizontal hospitals create better functional relationships between departments and allows contiguity between services which otherwise would have been on different floors. New diseases profile: The...