Case Study

Rising numbers in coronavirus infection placed immense pressure on India’s healthcare system, especially in urban centers such as Maharashtra. There was a serious need to increase the capacity of the public health care system. Wipro volunteered its existing 25-acre IT campus in Pune, Maharashtra and converted it into a 450-bed intermediary care COVID-19 hospital. Wipro’s re-purposed IT campus is India’s first public-private partnership hospital for COVID-19, where the physical infrastructure is from Wipro while the medical staff is provided by the government. It was opened in June of 2020 and will be operational for the duration of the pandemic. Thereafter it will be converted back to an office facility.

There were challenges to convert an IT facility into a hospital that met specifications and standards. The project was delivered in 30 days during a complete lockdown in the country.

The hospital is a fully equipped COVID-19 intermediary hospital with 450 isolation beds, an ICU area, reception areas, a testing lab, room accommodation for doctors and medical staff, and a kitchen and restaurant for patient and staff dining. The government's public health care system operates the facility, with a skeletal staff provided by Wipro.

The hospital provides medical care for the economically disadvantaged from neighboring villages and suburbs. Patients are not charged for their treatment, stay, medicine, tests, food or transportation.

Some insights from the project:

Integrated design process

The client was the orchestrator and set goals, quality, budget and timeline. The team of architects, designers, mechanical, engineering and plumbing consultants and on-site team collaborated closely to evaluate possibilities and study feasibility of design proposals. This made it possible to retain parts of the existing fit-out and building systems to re-purposing the workspace into a COVID-19 hospital. It was an integrated process from the start resulting in a holistic design, where more was achieved with less.

Subject expert advisory

Team of doctors and medical experts advised and guided the design from the functional programming, equipment, spatial layouts, user movements, air conditioning, materials and specifications to ensure it met the best practices prescribed by India’s government and the World Health Organization for COVID-19 care. The subject experts ensured design was up to date with constantly changing protocols, especially during the early days of pandemic.

Remote collaboration

Before the pandemic it was unthinkable to design without visits to the site. Online collaboration tools allowed designers and the site team to work seamlessly in tandem. Within no time, the team adjusted to the video-call site visits to using quick sketch and mark-up on instant messaging groups to accelerate decision making.

The project required agility to pivot and reimagine solutions while facing challenges from lockdown restrictions and the availability of materials and workers. Regular project review with architects, services and site teams, ensured all design decisions were checked for execution feasibility.

Hospital planning

The planning focused on ensuring segregated movements for patients and healthcare staff. Pressure differentials were checked between the ward and medical staff areas to avoid cross contamination.

Patients enter a designated reception lobby on the lower ground floor and then take elevators designated for patients to reach their respective ward floor. The entire ground floor was planned for a medical staff lounge, locker areas, a nap room, shower and changing rooms, all with no patient access. From the staff area, two elevators were dedicated to medical staff movement. On each floor, the doctors’ elevator opened into an air lock where there was a PPE changing area with separate passages to avoid contamination. Each ward consisted of 30 beds with a patient lounge and there was an airlock at the ward entrance to maintain differential pressure between ward and the outside corridors.

The hospital was self-sustaining with all ancillaries including kitchen for patient food, restaurant for medical staff dining, a mortuary, bio medical waste disposal, laundry and storage for medicines and medical equipment and two ambulances.

Focus on user experience

The journey of medical staff and patients through the hospital was interspersed with graphics and content to help elevate the mood and user experience. Use of both local (Marathi) and a common language (English) to curate content united and informed patients from different backgrounds. Inside the hospital, designers focused on creating a touchless journey where possible using motion sensor lights and sink taps. To enhance patient comfort, curated music is played in the wards to keep the patients motivated and create a sense of change through the day.

Retrofit process

The retrofit design focused on retaining elements of the existing fit-out to reduce execution time and ensure funds were used for better care equipment. Previously this building had offices. A thorough study of the existing building and fi tout maximized reuse. The false ceiling, walls, meeting room partitions, and certain flooring areas were retained as-is. Existing elevators were checked against hospital standards and it was decided to order stretchers which would fit through elevator doors. Evaluation of existing services by experts helped design a clear strategy to upgrade systems to meet best practices.

The air conditioning system was modified for COVID-19 wards. All the fresh air intake was treated with UV radiation and pressure differentials were ensured between the ward and medical staff areas to avoid cross contamination. Air changes were ensured in-line with global standards to maintain health and hygiene requirements. Natural and forced exhaust was provided to create a decentralized system.

Ensuring construction site safety

Execution planning was critical because of the limited availability of workers and material, and restrictions on movement. Accommodation for more than 250 workers was created within the campus with all food arrangements while adhering to strict social distancing measures. Construction activities were sequenced and planned to ensure social distancing between workers on-site. All workers and vendors entering the site went through a thermal screening at the security gate and were given masks and gloves to be worn at all times. Contactless hand sanitizers were available at entry and exit points on each floor. No COVID-19 infections were recorded until the project’s completion and handed over.

Technology & training as a preventive measure

Frequent contact between the healthcare worker and the patient increases the probability of passing on the infection. Patients wear a small device that transmits vital data to a central location where multiple patients can be simultaneously monitored from afar.

Because this virus is new there is more emphasis on staff training on cleanliness, disinfection protocols and on waste segregation. There is also mandatory training for all staff regarding donning and doffing of PPE without contaminating any surface.

The hospital treats patients with mild to severe symptoms. Critical cases are stabilized in the ICU and then transferred to a tertiary care hospital in the vicinity. The mortality rate in the hospital has been 0.1 percent, meaning it has a recovery rate of 99.9 percent.

Most patients are from economically disadvantaged areas in neighboring villages and suburbs. Apart from medical treatment, all tests, medication and meals are served at no charge to the patient. The hospital infrastructure supports the safety of the healthcare workers who risk their lives to do their duty with empathy, hospitality and utmost professionalism. The project’s success are the stories of patient recovery. This is the vision of this project.