PROPOSAL:

Asian Heart Institute & Research Center (AHIRC): Post Occupation Evaluation Study
Architectural Design, Facilities Operations & User Satisfaction

EXECUTIVE  SUMMARY

The intention of this Post Occupation Evaluation (POE) Study is threefold, as follows:

• To determine the ‘fit’ between architectural design intention and the resultant patterns of human activity as influenced by the physical elements of the space provided.
• To determine to what extent the physical facility (as built) facilitates (or hinders) the operations of the hospital.
• To determine user (patient, staff and visitor) satisfaction with the physical elements of the space.

The study has four major goals, as follow:

• To enable HOSMAC India to acquire the skills, methodology and information required to design, conduct and analyze the post occupation evaluation of healthcare facilities.
• To determine the functional success of AHIRC so that the owners and management might note those architectural elements that worked well or those that may need modification or change.
• To enable the lead architects for the project, HOSMAC India, to determine how closely the built facility functions in reality with respect to the assumptions that were made during architectural and interior design as to how it was intended to function. This would provide inputs towards improving the design of future healthcare facilities by the firm.
• To be the first among a series of such POE studies to be carried out on other healthcare facilities designed by HOSMAC India, eventually resulting in a document which would be published. This would provide healthcare facility designers (and healthcare providers) in the developing world with valuable insights into the operational and social functioning of such facilities, as well as a qualitative and quantitative design tool to conceptualize, design and evaluate such facilities.

AHIRC – Proposed Post Occupancy Evaluation: The Status Quo

The Problem and It’s Setting

Post Occupancy Evaluations (POE’s) are assessments made of a building after the building has been occupied for a sufficient length of time to allow people to adapt to their new surroundings, usually at least several months to a couple of years. These studies assess the degree of success of planning and design decisions in terms of satisfying the variety of user needs. It can provide insights into how the physical realities of design concepts affect human satisfaction; it can be used as a resource for programming new buildings of a similar type or function; and the information can point out problems needing renovations in the evaluated building.
Post Occupancy evaluations have been conducted on buildings since 1960 and have been published regularly in the major scientific and professional architectural journals. In the developed West a number of architectural firms are now engaged in this POE activity for their clients, while other clients retain design research consultants to document evaluation studies for them.

Asian Heart Institute & Research Center (AHIRC)

AHIRC is the latest major dedicated cardiac care hospital to be commissioned in Bandra-Kurla Complex, a rapidly growing commercial hub in the city of Mumbai, the commercial capital of India. It is the brainchild of the visionary cardiac surgeon, Dr. Ramakanta Panda. It was designed by HOSMAC India Private Limited, in collaboration with the Cleveland Clinic, Cleveland, Ohio, USA.

The first phase is now complete, 400,000 square feet of hospital building, inaugurated by Dr. Floyd D. Loop, Chairman of the Board of Governors, the Cleveland Clinic Foundation, on the 1^st of November 2002.

PROJECT DATA:                                                                                                                                                                                        

Client                                                     =          Contemporary Healthcare Private Limited

Project Location                                    =          Bandra-Kurla Complex, Mumbai, India

Total Built-Up Area (Phase 1)                =          400,000 square feet

Project Cost (INR)                                 =          One Billion

Project Duration                                    =          20 months

Architects                                              =          HOSMAC (India) Private Limited

Project Managers                                  =          HOSMAC (India) / Bovis Lend Lease

Structural Consultants                          =          MESACON Consulting Engineers Private Ltd.

Interior Designers                                 =          Prakash Mankar & Associates

HVAC & Plumbing Consultants             =          Spectral Services Consultants

Electrical Consultants                          =          Vikas Joshi & Associates

Landscape Architects                          =          Mini-gardens

Liaison Architects                                 =          Anil Patil Consultants Private Limited

Kitchen / Laundry Consultants             =          PHG Associates

MAJOR FACILITIES DATA: Phase – 2                                                                                                                                                       

Operation Theaters (Cardiac)                   =          6 Theaters
625 square feet / theater

Cardiac Catheterization Laboratories     =          3 Cath. Labs. With 3 Control Rooms
+ Control & Computer Rooms                                  700 square feet / Cath Lab + Control Room

68 Intensive Care Beds                            =          Individual Cubicles with Hand wash / 2 Cubicles
(Medical + Surgical)                                                165 square feet / Cubicle
4 Isolation Rooms (2 Infectious +2 Immuno-suppressed)

Central Sterile Supply Department         =          2 Double Door Sterilizers (Gettinge)
( 3 – Zone: Decontamination,                                 Ethylene Oxide Sterilizer
Wrap & Pack & Sterile Store)                                 Sterile Dumbwaiter to OT Suite

Radiology & Imaging Sciences                =          Magnetic Resonance Imaging (MRI)
Computed Tomography (CT Scan)
Gamma Camera
Ultrasound
X-Ray with Fluoroscopy

Cardiac Diagnostics                                 =          Stress Test
& Cardiac Rehabilitation                                      Echo with Holter
Pulmonary Function Test
Bronchoscopy
Physiotherapy

DESIGN INTENTIONS: A Brief Overview

The air-conditioning system runs mainly on natural gas, an eco-friendly energy source. The basement contains parking spaces for 150 cars, making the hospital a friendly neighbor in what is fast becoming the commercial center of Mumbai.
The Operation Theater Suite, consisting of 6 theaters, is housed on the third floor, which also contains related facilities like space for 3 cardiac catheterization laboratories and an 18 bed surgical intensive care unit. The theaters have been provided with HEPA filters and dedicated air-conditioning conforming to the best international standards of sterility. The ICU’s are individual airtight cubicles of 165 square feet, matching the best international standards. Each pair of cubicles has an observation station with a sink, to enable continuous, comfortable attention to each patient by nursing staff, and also be conducive to preventing cross-infection by enabling nursing staff to wash after each patient interaction.
The podium floor, which contain the facilities that are most complex in terms of their layouts and demands on building services, are sandwiched between the service areas in the basement and an interstitial (service) floor 2.4 M in height, enabling medical facilities planning and building services flexibility.

Structural design for the building are done to facilitate future changes in layout and to provide for new demands that these changes may make on building services like electricity, air-conditioning or plumbing. The podium slabs are designed to support new walls at any point. The grid slab allows for punctures anywhere. Service shafts, column design, elevator provisions and water supply and sewage pipe sizing allow for substantial, planned vertical expansion.
The interior design of the hospital has been done with the intention of reducing stress by creating a more relaxed environment and supporting people’s dignity and identity. It is a patient-focused, collaborative design effort between the architects and the interior designers, to create an environment conducive to healing. This approach to holistic design makes good sense in terms of patient, staff and visitor satisfaction and it’s effect on patient recovery, which is of considerable interest to health care providers.
Dr. Ramakanta Panda, who is the visionary cardiac surgeon behind this hospital, was a client who demanded quality. In HOSMAC we believe that quality is a state of mind, not an optional extra. It cannot be bolted on. The lead must come from a strong and committed client, and the pursuit of quality then forms every strand of the process.

AHIRC – Proposed Post Occupancy Evaluation: The Methodology Proposed

At the onset of the proposed evaluation a list of architectural / social / psychological concerns will be identified to determine the issues with which the proposed evaluation will concern itself. These are enumerated below:

• Architectural Concerns: How close is the ‘fit’ between design intention and reality?

• Social Concerns: Does/has the institution set an example for social responsibility through its design, construction and operational processes?

• Psychological Concerns: To what extent does the environment the building creates address the emotional needs of patients, staff and visitors?

Following this the evaluation process will be conducted in three stages, as follows:

Stage 1

Develop focal evaluation research questions.  These will be developed by:

1. Searching existing literature on cardiac care facilities.
2. Interviews with patients, staff and visitors.
3. Documenting of design intentions by the architects (HOSMAC India).
4. Talks with Dr. Ramakanta Panda and the management of the facility.

Stage 2

This will consist of designing and conducting the study. This will be done by:
The variables will be selected and given operational definitions.

1. The information gathering and measurement instruments are to be constructed, pre-tested and revised.
2. The data analysis methods to be used are to be anticipated.
3. Procedures are to be developed.
4. The sample is to be drawn.
5. The data is to be collected.

Stage 3

This will consist of developing major findings and recommendations. This will be done by:

1. The data is to be subjected to descriptive and inferential statistical analyses.
2. Major findings and recommendations are to be uncovered.
3. The final report is to be prepared.

Please click on the link below for examples of Healthcare Facility Case Studies:

Academy of Architecture for Health: Case Study Library

The Project Afterwards: Using Post-Occupancy Evaluations to Improve Healthcare Environments

Re-Assessing Green Building Performance: A Post Occupancy Evaluation of 22 GSA Buildings

Post Occupancy Evaluations

UK College of Design Emergency Department Post
Occupancy Evaluation