A Conference With Futuristic Solutions

The International Conference on Planning and Designing of Healthcare Facilities in Goa witnessed an exchange of ideas on the profound impact of health architecture

EHM News Bureau

The lighting of the lamp by Dr Anbumani Ramadoss, Union Minister of Health and Family Welfare

It was a forum for the literati and the erudite. The 'International Conference on Planning and Designing of Healthcare Facilities' saw a galaxy of delegates deliberating on the futuristic trends and requirements of healthcare facilities. Experts attending the conference included hospital promoters, healthcare policy makers, representations from financial institutions, facility managers, health and hospital administrators, hospital planners, project consultants, engineers, architects, equipment manufacturers, experts from the construction industry and faculty members from the medical colleges, both from private and public institutions. This was not all. From the international circuit, there was a congress of experts from various disciplines from countries like Singapore, the US, the UK, Sweden, South East Asian countries and Australia.

Ideally, the three primary components in any medical institution include its services, infrastructure of its buildings and the staff. Each component is interdependent on the other and if any one component is excluded out, the other two crumble down. Moreover, with corporatisation and competition entering the scenario, planning and designing of healthcare facilities have a pivotal role to play.

Realising this need and to commemorate the Golden Jubilee celebration of its institution, The All India Institute for Medical Sciences (AIIMS), New Delhi, in collaboration with the School of Planning and Architecture (SPA), New Delhi and the Indian Institute of Architecture (IIA) organised this conference from the 15-17 September, 2006, at Goa. Express Healthcare Management was the official media partner for this conference.

For three continuous days, experts deliberated meticulously on the need for planning and designing of healthcare facilities, which has a great bearing on the socio-economic trends in the country.

Day One

The first day of the conference commenced on a positive note with the Mistress of the Ceremony, Shivani Kant, referring to a famous quote by Winston Churchill, "First we shape our buildings and thereafter they shape us." This encapsulated the idea of the primary need to plan and design our hospitals. The conference was inaugurated with the lighting of the lamp by the Union Minister of Health and Family Welfare, Dr Anbumani Ramadoss and the Chief Minister of Goa, Pratapsingh Rane. The welcome address was delivered by Dr Shakti Kumar Gupta, Medical Superintendent, Dr RP Centre for Ophthalmic Sciences, AIIMS and also the chief organiser of the conference. Stressing on the need to formulate a patient-friendly healthcare system, he mentioned, "This conference will herald the emerging trends in planning and designing in healthcare like healing architecture, green hospitals and mobile hospitals."

Delivering the key note address, Dr Abdul Sattar Yoosuf, Director, Sustainable Development and Environment, WHO Regional Office for South East Asia, New Delhi, gave some shocking statistics on the appalling conditions of healthcare in developing countries. "Healthcare in India is far from satisfactory. The South East Asian countries need much more involvement in healthcare facilities with the globalisation of healthcare services," he said. He further highlighted that the problem of Hospital Acquired Infections (HAI) is 20 times more pronounced in developing countries than developed countries. Professor Vijay Shrikrishna Sohani, President, Council of Architecture, pointed out the dearth of courses in hospital designing in schools for architecture, the need for specialised courses in this field at the post graduate level and programmes to be conducted, to provide of inputs for around 40,000 existing architects in the country. This indeed was some food for thought!

Dr Justice AS Anand, Former Chief Justice of India, arrested the attention of the audience by stating, "Even after 56 years of independence, people in India are living in abject poverty and do not have access to the basic healthcare facilities, let alone affordability." Rane gave a brief picture of the healthcare scenario in Goa. He mentioned that the birth rate and the death rate in the State have plunged considerably. Moreover, the quality of life in the State had also increased. There is a 100 per cent registration in the universal immunisation programmes in the state. "Goa is the only State to provide financial help up to Rs eight lakh for the those afflicted with cancer," he stated. He merely did not portray the glossy side of the picture. Rane pointed out that the rise in tourism in the State has also led to the increase in HIV/AIDS load. Hence, plans are on the cards to make HIV testing compulsory in Goa for all couples before they get married.

Dr Ramadoss in his inaugural address enumerated on the myriad ambitious programmes to be undertaken, viz the establishment of the Clinical Establishment Act and the ASHA project for rural areas. He, however, informed that in the next 40 years, the biggest challenge to be faced by India would be the 'Big three', namely tuberculosis, HIV and malaria.

Day one ended with a presentaion by K Smith, Chairman, MGI-SI, India on 'Modern Methods of Construction-A Healthcare Infrastructure Solution for the Future'. "In modernising any healthcare system, there is a substantive capital investment requirement to ensure effective delivery of services through an appropiate and responsive fit-for-purpose infrastructure. There is a dire need of faster, more efficient forms of construction to keep pace with the healthcare modernisation process. One way to keep pace is to utilise modern methods of construction otherwise known as MMC," added Smith.

Also, Dr Gupta's fourth book, 'Modern Trends In Planning and Designing of Hospitals Principles and Practice' was released. The book, co-authored by Dr Sunil Kant, Joint Medical Director (Personnel), Office of DG AFMS, New Delhi and Dr R Chandrashekhar, Senior Architect, DGHS, New Delhi provides a comprehensive and holistic view of exixting and futuristic concepts in planning and designing of hospitals.

Day Two

The technical and scientific session of the conference started from the second day. The day commenced with Surg Vice Admiral V K Singh's keynote address, who gave a bird's eye view on the history of the healthcare system in the country and rounded off his speech by giving an overview of India's stand which includes lack of co-ordination between different sectors and the importance of a proper disaster management programme to be initiated.

Martin Fiset, Healthcare Facilities Planning and Design Consultant and a member of the Royal Architectural Institute of Canada, focused on the contemporary trends in medical architecture like healing architecture, patient care areas, environment-friendly hospitals, morphology, urban integration and medical equipment and IT in healthcare. While speaking on the importance of IT in healthcare, he stated, "It is not possible to have a paperless hospital, but we have surely can have less paper hospitals in the future."

Kurt Hornstein, Managing Director, Moser Architekten International Ziviltechniker GMBH, Handelskai and Henning Lench, CEO, Dandca, Germany presented case studies in medical architecture in their respective countries. Peter Thomas, Managing Director, Silver Thomas Hanley, Australia gave an interesting perspective on the 21st Century hospitals, which he termed as "smart hospitals" for the future.

The next set of speakers deliberated on the guidelines and trends in healthcare facilities. Joseph G Sprague, Principal Director of Healthcare Facilities, HKS Architect, US, gave an elaborate presentation on the Facilities Guidelines Institute (FGI) used by 42 states out of 50 states in the US, "which makes the process of accreditation easier." Sprague also stressed that the main objective of the FGI was to see to it that the guidelines should be revised and reviewed periodically.

Gaurav Chopra, who handles strategic planning and design, NBBJ, Seattle, USA gave an enlightening overview on evidence-based design tools being used in medical architecture. He focused on two projects, one in Arizona and the other in Alaska, where the same principles of health architecture were used, but yielded different outcomes due to difference in climate in the two zones. He mentioned, "Evidence-based design tools are not just about creating pretty hospitals, but about creating performance-based hospitals." Wing Commander (Dr) Rajiv Pathni, Resident Administrator, AIIMS, New Delhi spoke on value-added services in hospitals. Value-added services, Pathni higlighted are those which add value to the existing core services and distinguishes a premium hospital from an ordinary one.

Dr R Chandrashekhar, Senior Architect, Directorate General of Health Services, Ministry of Health and Family Welfare gave an infrastructural overview of the facilities of the six AIIMS like institutes. "There is a need in the country to improve on the infrastructure, equipment, human resources and bulk services," he added.

The last session of the day focused on the importance of creating the right hospital environment. Peter Laser, Executive Director, Business Development, Karl Storz Gmbh and Co, Germany, spoke about 'Infection Control Issues In Endoscopy' where he mentioned, "Healthcare has no barriers and so is the case with infections." He gave alarming figure that in the US, where every year, around two million people are afflicted with HAI. He suggested a step-by-step integrated technology for operation theatres like device integration, data management and telemedicine. The day rounded off with Prof V P Choudhry, Head of Department of Hematology, AIIMS, New Delhi, speaking on 'National haematology facilities.'

Day Three

The last day of the conference focused on aspects like healthcare financing, planning and designing of operating rooms and planning and designing of healthcare facilities and trends. Prof Ashok Hemal, Department of Urology, AIIMS spoke on 'Robotic Assisted Urolgy Planning And Designing Criteria', in which he highlighted the issues faced by a planner, limiting factors for a laparoscopic surgery, robots used in urology, types of procedures followed like the Computer-Assisted Robotic Surgery (CARS) and the overall revenue. Dr Aarti Vij, Assistant Professor in Hospital Administration at AIIMS and Chief of ORBO gave an interesting overview on 'Stem Cell Facility-Planning and Designing Criteria'. She also spoke on factors determining planning and design, the potential as far as stem cell facility is concerned, and interesting aspects of the umbilical cord banking. Parvez Dewan, Chairman and Managing Director, India Tourism Development Corporation Ltd spoke on medical tourism in India and the initiatives that the Government will be taking to give it a boost.

Planning and designing of an operating room was another important aspect which was taken up at the conference. Naresh S Mathur, Vice President, HKS, US, spoke on the 'Next Generation Ors'. Mathur pointed out, "In view of the advancements in communication and information technology, surgical rooms have become the most complex and expensive." The last phase of the technical session focused on healthcare financing. There was a three-dimensional deliberation on façade engineering, project financing, financing healthcare institutions in India, integration of capital and operational consideration influencing design of hospital facilities. While speaking on 'Integration Of Capital And Operational Consideration Influencing Design Of Hospital Facilities', Peter Cox, CEO and Principal, Padghams, pointed out, "As far as health financing goes, the key cost drivers include complexity, type of patients, models of care and patient management."

Dr Shakti Kumar Gupta, Medical Superintendent, Dr RP Centre for Ophthalmic Sciences, AIIMS, New Delhi	Pratapsingh Rane, Chief Minister of Goa
Dr R Chandrashekhar, Senior Architect, DGHS, New Delhi	Ajay Maken, MOS for Urban Development
Dr Abdul Sattar Yoosuf, Director, Sustainable Development & Environment, WHO Regional Office, SE Asia, New Delhi	K Smith, Chairman, MGI-SI, India
Peter Thomas, Managing Director, S Silver Thomas Hanley, Australia	Launch of  Dr Shakti Gupta’s fourth book
Gaurav Chopra, Strategic Planning and Design, NBBJ, Seattle, USA

Epilogue

The three-day conference ended with the valedictory session. Professor PC Chaubey, Head of Department, Hospital Administration, AIIMS, New Delhi delivered the chairman's address. He was followed by Lt Col (Dr) Kant, who gave a brief on the conference proceedings. Finally, the valedictory address was given by Ajay Maken, MOS for Urban Development. Maken mentioned, "The conference was in tune with the times with the emergence of India as a technically-advanced nation. Discussions on modern infrastructure was of great significance."

In a nutshell, the conference opened new vistas for deliberation and implementation as far as planning and designing of healthcare facilities is concerned. A common forum to deliberate on designing hospital infrastructure and with delegates from all across the globe was never held before. Towards the end of the conference, Chopra mentioned, "The conference was very fruitful and informative. I am happy that AIIMS took the initiative to organise such a conference on such a large scale."

ehm@expresshealthcaremgmt.com