Hospital Project Planning with Vision 2030

Manomav is providing end to end construction solutions to its customers. Global level changes in terms of latest innovation and technology are changing Hospital Designs. Manomav representatives are sharing new ways of designing hospital considering future with Entrepreneurs of Hospital Industry.

Future Vision of Hospital in Urban Cities & Tier 2, 3 Cities

From the amount of advancements the world has observed in last decade, it is evident that year 2030 will be very different from 2019. In 2030, India will face new challenges in terms of expansion of already existing hospitals and construction of new hospitals with re-designed infrastructure and technology. Currently, the care provided at the hospitals is divided into three categories a) Primary, b) Secondary and c) Tertiary Care. Speciality Hospitals can only work when they are supported with the right Infrastructure as discussed by Dr. Gaurav J. Kumar, Facility Director, Medanta – The Medicity. The demand of Tier -2 & Tier -3 cities are focused towards introduction of new facilities since the traditional treatment already exists through family references as informed by Dr. Shuchin Bajaj, Founder Director, Cygnus Hospitals.

Designs of Hospitals

Girish Bommakanti, CEO, Gleneagles Global Hospitals had shared interesting futuristic concepts in Urban Landscape of having smooth connectivity from Smart Homes to Smart Hospitals.

He shared that hospital design should consider movement of patients right from the parking lots to discharge areas while planning to have services like MRI & Ct Scan on the same floor. Future is changing soon so the current hospitals should be designed by categring to at least 5 years of future functionality in mind. Dr. Sanjeev Bagai, Chairman – Nephron Clinics, has suggested common considerations to be made while positioning hospital components like –

  • Lift should be closer for Joint Pain or Orthopaedics
  • OPD should be in Isolation to Other building blocks
  • Psychiatrist in OPD should not be closer to Gynaecologies.
  • Ward beds should have beautiful visuals
  • Blood Banks can be closer to the laboratories
  • NICU & BICU should be separate, Rest ICUs can be combined

Army Hospital are also designed with flexibility of its locations which includes various concerns like –

  • Sizes are defined in multiple of 7 along with Toilets which serve different cadres
  • Operations Theatre are preferred on Top Floor Location
  • AHU should also be placed on Top which results in lesser heat loss
  • Orthopaedics and OPD should not be on Top Floor

Budget of Hospitals

30% of Hospital construction budget goes into Equipment Buying and if you exclude construction, it makes 60%-70% of Hospital Budget. Dr. Bharat Gadhvi, Regional Director – HCG Hospitals said that equipments have less Shelf Life and Lower Staff like Radiologies, Pathologist and Oncologist should be engaged when equipment purchase decisions are being discussed. In case owners are short of budget they should leave space for future activities, so make sure that services are available for 7-10 years. It is suggested to consider 7 year cyclic cost of equipment which includes buying cost, AMC cost and third party services. Delivery of Equipment shall be done very carefully because Half Life of Helium decreases in 68 days so PO shall be given with clear terms & conditions.

Approvals of Hospitals

One of the most critical activities in construction of hospital is dealing with approvals. NABH and JSI are two of most accreditionals standards in India. NABH has its own requirements on top of the Building Approvals. There are more than 104 Laws which govern hospital construction today. Various laws are applied  which are dependent upon the services of hospital including Building Approvals, Support Services License, Laboratory approval from NABL, Air/Water/Environment Laws with Biomedical Waste (Trace & Track it from start to end), Atomic Energy/Radiologistic from ACPVP Regulations, Shop Act, Food Facility License, Clinical Establishment Acts, GACI Standards in 14 standards which are applicable from NABH.

In case of hospital expansion and renovation generally, it does not require approval for modification. However if modification is changing usage pattern of building or floor, approval is required from competent authority.

In case of External Building Change, approval is required from competent authorities.

Safe & High Quality of Environment in Hospitals

Ministry of Environment and Forest (MoEF) is implementing BMW (Bio Medical Waste Rules in Hospitals) which are revised in 2016, 2018 and in 2019. Effluent Treatment Plants are playing vital role in hospitals due to the nature of waste. HVAC Systems are coming with Ashrae Standards. Even the standards are being revised. Recently in 2016 National Disaster Guidelines have recommended to avoid usage of Flat Slabs in Buildings. Though Guidelines are not mandatory but is required because of two reasons:

  1. Fire Rating Issue which needs extra flooring which increases its thickness and affects building usage.
  1. Earthquake can cause bigger collapse if not designed properly.

With these key considerations Manomav shall be able to provide you a futuristic solution for hospital designing which aligns with your vision while considering Budget, Best Interiors, Approvals and Smooth Management of Hospital Buildings Execution.

Leadership: Taking Onwership by Mr. Mudit Vijayvergiya

October 23rd, 2018 Monday, Manomav Engineers conducted their 8th Pratham Meet with Mr. Mudit Vijayvergiya, the co-founder and director of Curofy, the premium networking app for the doctors. He is a graduated from IITD in 2013. Winner of IIT Delhi alumni award, 2014, Mudit has been a passionate speaker at various leading summits on topics related to Entrepreneurship, Leadership. He is also recently selected in Forbes India 30 under 30 list of 2018. His presence at the Pratham Meet made a great impact as he shared his thoughts on leadership development through real-life examples. He started off with a small interaction with all the guests present in the room, asking them a few simple questions like, where do they see themselves after a few years? And how do they define success? We got a variety of answers from everyone like from opening a food joint to owning businesses into different fields.  Followed by a little team building group activity. Wherein, one member was to share his glitches, he is experiencing in achieving his goals, while the others would engage in analyzing the problem statements and come up with possible solutions. Through this exercise, Mr. Vijayvergia concluded the session by telling that how can one work towards his or her goals to achieve something in life by actively fixing the problems in the way.

Project Cost Of Management by Raj Vikash Singh As the meeting continued, now it was time for the second speaker of the day, Mr. Raj Vikas Singh, project manager at Manomav Engineers to come up with his second presentation on this platform. He is an ace master in the scope and cost management for different kinds of projects and is one of the oldest members of the Manomav Engineers. He started off with a brief description of ‘Cost Management and its importance and principles of direct and indirect cost involved in a particular project. He also explained that how can a cost management plan be implemented in the construction project to get a cost budget and controlled cost factor at site. Then he took everyone through a sample cost budgeting sheet and S curve prepared for a particular project. The session concluded with lots of discussion and Q&A.

 

Management Process & Report By Vanshaj Raj Behel Vanshaj Raj Bahal, the third Speaker for the day in his presentation, shared his personal career experience with Manomav Engineers. He opened his speech with “we can lead a horse to pond but we cannot make him drink water and same goes with humans, we can show them the path but it’s in their hands how to reach success”. He took his real life example of how he joined Manomav and how was he constantly supported by the three A’s of Manomav.

Importance of Earthing And Grounding by Harish Sharma

Manomav Engineers Conducted there 7th Meet for Pratham where Construction Professionals and Manomav Engineers talk about Construction Monitoring and Technology with a very Pleasant Morning of 25th September, 2018 at The Entrepreneurship School Phase-1 Gurugram in continuation of energy from last meeting. In this Meeting our Guest of Honour was Mr. Harish Sharma from BDS Consultant an electrical engineer and he shared his thoughts on Importance of Grounding and Earthing in Life cycle of Building.

 

Importance OF Earthing And Grounding BY Harish Sharma

Mr. Harish Sharma is a young & 1st Generation of entrepreneur in his family and providing Electrical Consultancy Services since 2015 with highly qualified & experienced team to the various reputed Architects & Interior Designers. He has more than 9 years of practicing experience in planning & designing across the globe of all kinds of Prestigious projects like Residential, Commercial as well as Industrial Projects. He briefly Shared the concept of Different types of Grounding with the help of Circuit Diagrams and Importance of grounding.

 

It was the time to welcome our first Speaker Mr. Hari Om Kumar Singh. He Prepared a presentation on his Favourite role in the company i.e. Procurement Management he briefly explained the Basics of process of Procurement and also Explained the Framework prepared by Manomav for Best Procurement Management.

 

Then it was the time for our Second Speaker of the day Mr. Antriksh Tawar he presented on the latest Technologies and future of construction with Manomav Engineers.  Vamsi from NICMAR helped Manomav working on few of this point and prepared a report during his internship. Being a Director in Manomav Engineers, he promised the following technologies out of which some are already implement and checked or others are in the research period and to be Implemented soon.

Below are the Technologies on which Manomav is Working on and make construction Practice more easier and time saving:

  • Pre-Fabrication & Modular Construction
  • Advanced Building Material
  • 3D printing & Additive Manufacturing
  • Autonomous Construction
  • Augmented Reality & Virtual Reality
  • Big Data & Predictive Analysis
  • Wireless Monitoring & Connected Equipment
  • Cloud Real time Collaboration
  • 3D Scanning & Photogrammetry
  • Building Information Modeling

This one of the most interesting and informative session of Pratham Meet#7 ended with a felicitation of our guest of Honour Mr. Harish Sharma and as per Pratham Meeting this time the Best Presenter was Mr. Antriksh Tawar and Best Evaluator was Mr. Abhinav Bhardwaj.

Benefits of Using Building Information Modelling (BIM)

“A foundational, intelligent model-based process for business and industry transformation”

The move from 2D drawings to 3D models is well underway and gaining steam in the architectural, engineering, and construction industry. It uses 3D models to capture, explore, and maintain consistent and coordinated planning, design, construction, and operational data. Provides greater project insight for cost, schedule, and constructability. Uses and shares the same consistent data whether you’re at your desk or in the field. Enables prompt response to change with processes that are smarter and faster.

The move from 2D drawings to 3D models is well underway and gaining steam in the architectural, engineering, and construction industry.

The model-based approach increases efficiency within individual organizations and truly shines during coordinated project delivery, below are the benefits of using BIM:

  • Capture Reality
  • Waste Not, Want Not.
  • Improve Collaboration.
  • Resolve Conflict.
  • Sequence Your Steps
  • Dive into Detail.
  • Present Perfectly.

 Capture Reality

The use of BIM creates a perfect vision for the project manager of his project sites with better mapping tools and with BIM designer can collect all the detailed information of the project and then all of that information is compiled and shared in a model—in a way that paper isn’t able to capture.

Waste Not, Want Not

With a model prepared, the chances of rework and duplication of drawing during the construction process minimize at a good level this leads to move one step forward to the on-time completion of Projects. The model contains more information than a drawing set, allowing each discipline to annotate and connect their intelligence to the project. BIM drawing tools have the advantage of being faster than 2D drawing tools, and each object is connected to a database.

 Improve Collaboration

Sharing and collaborating with models is easier than with drawing sets, as there are a lot of functions that are possible only through a digital workflow. Much of this added project-management functionality is now being delivered in the cloud, such as Auto-desk’s BIM 360 solutions. Here, there are tools for different disciplines to share their complex project models and to coordinate integration with their peers. Review and mark-up steps ensure that everyone has had input on the evolution of the design, and that they are all ready to execute when the concept is finalized and moves forward in construction.

Simulate and Visualize

There are an increasing number of simulation tools that allow designers to visualize such things as the sunlight during different seasons or to quantify or the calculation of building energy performance. The intelligence of the software to apply rules that are based on physics and best practices provides a complement for engineers and other project team members. The software can do much more of the analysis and modelling to achieve peak performance, condensing knowledge and rules into a service that can run with the click of a button.

Resolve Conflict.

 By modelling of a project in BIM before the commencement of work clashes of elements such as electrical conduit or duct work that run into a beam are discovered earlier and with these costly on-site clashes can be reduced as well the work at site is also not hampered. The model also ensures a perfect fit of elements that are manufactured off-site, allowing these components to be easily bolted into place rather than created on-site.

Sequence Your Steps.

With a model and an accurate set of sub-models for each phase during construction, the next step is a coordinated sequencing of steps, materials, and crews for a more efficient construction process. Complete with animations, the model facilitates coordination of steps and processes, delivering a predictable path to the expected outcome.

Dive into Detail. 

The model is a great end point for a lot of knowledge transfer, but there’s also a need to share a traditional plan, section, and elevation, as well as other reports with your project team. Using automation and customization features, these added sheets can save valuable drafting time.

 Present Perfectly. 

With all of the design completed on a capture and alteration of existing reality, the model is the ultimate communication tool to convey the project scope, steps, and outcome. The fact that the design is fully 3D also means that there are fewer steps to render impressive views and fly-throughs that can be used to sell commercial space or to gain necessary regulatory approvals.

 

Project Management Triangle (Iron Triangle)

 

One of the first project management concepts that I learned was the Time, Cost, Scope, also known as the Iron Triangle. The triangle demonstrates that quality cost and time are interrelated. Any project is expected to finish at time cost and scope. We manage it in a way that we get maximum quality for same. If we change any side of this triangle, other side will also get impacted. If we fasten the progress (time) we may have to spend more (cost) or achieve lesser work completion (scope). In this way rather, something is fixed and we change it.
For example, a project can be completed faster by increasing cost or reducing scope. Similarly, increasing scope may require equivalent increases in cost and time. Cutting cost without adjusting time or scope will lead to lower quality.

The time constraint refers to the amount of time available to complete a project. The cost constraint refers to the budgeted amount available for the project. The scope constraint refers to what must be done to produce the project’s end result. These three constraints are often competing constraints: increased scope typically means increased time and increased cost, a tight time constraint could mean increased costs and reduced scope, and a tight budget could mean increased time and reduced scope. The discipline of project management is about providing the tools and techniques that enable the project team to organize their work to meet these constraints. Another approach to project management is to consider the three constraints as finance, time and human resources. If you need to finish a job in a shorter time, you can throw more people at the problem, which in turn will raise the cost of the project, unless by doing this task quicker we will reduce costs elsewhere in the project by an equal amount. The real value of the project triangle is to show the complexity that is present in any project. The plane area of the triangle represents the near infinite variations of priorities that could exist between the three competing values. By acknowledging the limitless variety, possible within the triangle, using this graphic aid can facilitate better project decisions and planning and ensure alignment among team members and the project owners.

 

Time

For analytical purposes, the time required to produce a deliverable is estimated using several techniques. One method is to identify tasks needed to produce the deliverables documented in a work breakdown structure or WBS. The work effort for each task is estimated and those estimates are rolled up into the final deliverable estimate. The tasks are also prioritized, dependencies between tasks are identified, and this information is documented in a project schedule. Time is different from all other resources and cost categories. Using actual cost of previous, similar projects as the basis for estimating the cost of current project.

According to the Project Management Body of Knowledge (PMBOK) the Project Time Management processes include:

  1. Plan Schedule Management
  2. Define Activities
  3. Sequence Activities
  4. Estimate Activity Resources
  5. Estimate Activity Durations
  6. Develop Schedule
  7. Control Schedule

 

Cost

To develop an approximation of a project cost depends on several variables including: resources, work packages such as labour rates and mitigating or controlling influencing factors that create cost variances. Tools used in cost are, risk managementcost contingencycost escalation, and indirect costs . But beyond this basic accounting approach to fixed and variable costs, the economic cost that must be considered includes worker skill and productivity which is calculated using various project cost estimate tools. This is important when companies hire temporary or contract employees or outsource work.

  • Cost Estimating is an approximation of the cost of all resources needed to complete activities.
  • Cost budgeting aggregating the estimated costs of resources, work packages and activities to establish a cost baseline.
  • Cost Control – factors that create cost fluctuation and variance can be influenced and controlled using various cost management tools.

 

Scope

Requirements specified to achieve the end result. The overall definition of what the project is supposed to accomplish, and a specific description of what the end result should be or accomplish. A major component of scope is the quality of the final product. The amount of time put into individual tasks determines the overall quality of the project. Some tasks may require a given amount of time to complete adequately, but given more time could be completed exceptionally. Over the course of a large project, quality can have a significant impact on time and cost (or vice versa).

 

Together, these three constraints have given rise to the phrase “On Time, On Spec, On Cost.”

 

 

How to use the triangle?

Decide at the start of a project which version of the triangle you will use and agree with the project stakeholders which of the three or four objectives are most important. Assess all changes, risks and issues against the triangle and weigh up your course of action against the impact on your critical objective.

For example, if the key project constraint is cost, only the most business critical change requests are likely to be approved. However, if quality is the biggest goal time and cost might move to accommodate enhancement requests.