Advancing Children's Healthcare in India
with a mission and mandate to provide quality healthcare, education, and research to the people of India, the new Tata Medical Centre in Kolkata (Calcutta) will serve the northeastern regions of India, as well as the neighboring countries of Nepal, Bhutan, and Bangladesh. Occupying a 13-acre site at Rajarhat, the 300,000-square-foot facility will be one of India's first world-class comprehensive cancer hospitals and research centers.
The new facility is designed to reflect the dignity, security, care, and stability of the Tata Trust and of Tata Memorial Centre in Mumbai, an institution that for decades has been a leader in providing quality healthcare, education, and research. With gracious, inviting grounds and entrances, the Tata Medical Centre will project a civic presence while housing the most advanced technologies in cancer care today.
An exceptional level of care has been devoted to the project's siting and organization. Rather than simply housing all programmatic components in one large boxlike building, a campus setting was created to accommodate care delivery, research, academic, and support functions in separate yet linked structures. These buildings surround a central courtyard that forms the heart of the campus, with gathering spaces and gardens that foster communication and interaction among patients, family, clinicians, researchers, faculty, and students.
Outpatient and therapeutic programs are conveniently located on levels 1, 2, and 3 of the clinical building, with patient beds integrated yet grouped separately on levels 2 through 5. Adjacent structures accommodate administrative, academic, and research programs.
An “arrival gate” bridging the academic and clinical buildings is intended to engender a powerful sense of inception and hope in all who pass through. A serene, garden-setting glass arrival hall, featuring an information center and access to counseling areas and outpatient clinics, should provide further inspiration and reassurance for all as they embark upon their journeys to wellness.
The new campus includes a low-dependency unit—essentially a freestanding, adjacent hospice environment—and a residential structure for physicians and nurses. Future phases of development envisioned in the master plan total over 800,000 square feet and dovetail with other new construction, such as a new school, residential development, and high-tech facilities planned for neighboring parcels. All future development is planned in a way that will preserve the original phase-one hospital and central courtyard, which will endure as a symbol of the Tata Trust's benevolent legacy.
Sustainable building in India
With summer temperatures commonly exceeding 40°C, more than 1.5 meters of monsoon rains falling between June and September of each year, and seasonal dust storms, the Indian climate demands durable, authentic materials, as well as traditional Indian architectural solutions. A natural stone and concrete exterior was chosen not only to withstand the extremes of wetness, dryness, and heat, but also to weather beautifully over time—and to look as if it has proudly stood there for centuries.
A double-walled system called a jali screen protects the building from the elements on the south and west. Windows of clear glass appear primarily on the complex's north face and are deeply recessed and shielded by broad overhangs to minimize solar gain and potential water penetration.
The building is carefully oriented to capture the prevailing winds, which change direction in summer and winter. Openings are strategically placed in the building's mass to allow continual movement of air through the structure. Although the complex is fully air-conditioned, mechanical provisions have been made for the use of operable windows in certain waiting areas to enhance the comfort of patients and visitors who prefer natural ventilation. (Sterile areas are, of course, designed in accordance with state-of-the-art medical air-quality standards.)
Rain is harvested and stored in underground tanks for year-round irrigation of the gardens, which are integral to the patient experience and to the creation of the Tata Medical Centre's healing environment.
As one of India's first comprehensive cancer centers, the Tata Medical Centre fully utilizes some of the world's most advanced cancer-care technologies and communications systems. Architecturally, however, high-tech materials make low-key appearances. The clear glass that provides exceptionally beautiful views and daylighting to interior spaces draws upon the latest glass technologies, and the arrival gate—a concrete plane that seems to float atop slender columns—could not exist without state-of-the-art engineering and construction methods.
Improving the Patient Experience
It is estimated that approximately 2.5 million to 3 million people have cancer in India at any given time. Each year, more than one million cases are diagnosed, and more than 650,000 Indians die of the disease. The Tata Medical Centre offers all patients, from all economic strata, the best in cancer diagnostic and therapeutic services, basic and clinical research, prevention, cure, rehabilitation, and palliative care. Above all, the design effort has focused upon the goal of creating a physical environment that will nourish and uplift the spirits of both children and adults as they endure the physiological and psychological stresses of cancer treatment.
Treatment processes and patient encounter points were re-envisioned during the planning process by the design team in concert with the client to improve both the patient experience in receiving care and the efficiency of staff in delivering care. Because a patient's entire family may travel with them when they seek cancer treatment, waiting areas and corridors are larger than typically found in the United States to accommodate the increased volume, and the low-dependency unit on-site provides a hospice environment to house patients and families who have traveled long distances.
A particular focus was ensuring the quality of the patient experience for children, helping them to cope physically and psychologically with the implications of a changing self-image and weakened immune system. To this end, the Tata Centre incorporates child-friendly spaces for play, learning, and interaction. The question of how to improve children's treatment experiences also inspired the design team's leadership to launch an internal “ideas competition” to explore design concepts that could enrich pediatric patients' lives, experiences, and treatment. Among the entries were solutions such as furnishing all children and their families with laptop computers and Internet connectivity; constructing modular on-site housing to provide children's families with a temporary, easily adaptable home close to their children receiving care; establishing a network of easily accessible, highly efficient clinics to provide outpatient care, thus reducing the need for travel; and numerous “placemaking” strategies to create distinctive spaces that nurture human health, happiness and well-being.
Slated for completion in 2008, the Tata Centre is truly a milestone in Indian healthcare delivery. It will offer an unprecedented level of world-class cancer care, house groundbreaking cancer research, train the next generation of India's physicians and clinicians, and transform the lives of many, many people. A healing environment can scarcely aim higher. HD