Challenges in a Running Hospital Brown Field Project: A Case Study

By Ar. Prasanna Wategaonkar

Brown Field Project.jpg

From phasing the project and departmental reorganisation to making best of existing struc-tural challenges, remodelling a running hospital is more than a mammoth task. Prasanna Watergaonkar shares his experience of refurbishing a 1970s hospital building to accommodate modern-day fire safety norms.

Original Building:

The building was designed as hotel with part basement, ground and 20 upper floors in South Bombay’s prime and high-income group residential area.

Form of Building: Rectangular cuboid

Size: Length 58 m & Width 16 m & Height 62 m

Total built up area: Approx. 2.50 lakhs square feet

Structural Design: The structure is designed with conventional slab, beam and columns (RCC framed structure); each floor height 2.9 m slab to slab.

Project Brief:


Revamping a running hospital is already a mammoth task. The existing internal planning and operations obviously gets disrupted. In this project, the total area carved out for internal fire access corridor i.e. 1375 sq ft. will get deducted in current habitable planned area of approximately 10000 square feet of floor plate. Thus, reducing the functioning size of the hospital and the number of available beds. (Ref. Image attached)

What made the revamping even more difficult in this particular project was the discovery that no major repairs (in terms of MEPF services and RCC-framed structure) had been carried out since the hospital’s establishment in 1973; only minor repairs and refurbishment as and when required. Just like any car, any machinery, even a building needs regular maintenance servicing.

First step was to carry out a structural audit of the building, which detected weakened RCC-framed structure; strengthening through jacketing of slab, beams & columns was advised and on immediate basis, which would result in an additional thickness of 100 mm of RCC-frames from all around. Ideally, strengthening should start from foundation to terrace-level so that the additional jacketing load gets distributed evenly. However, it’s a running hospital. Hence phasing was planned to minimise revenue loss. Reorganisation of department planning is much easier on paper than in reality. The phase-wise refurbishment planning of department was done by the hospital team, in a way to maximise operational efficiency and minimise revenue loss.

Secondly, a detailed survey of existing MEPF services revealed that it’s infrastructure, like old chilled water pipes, vertical drainage pipe lines, power cables, sprinklers etc. are beyond repair. The repairs were so urgent that it would be fair to say that the building was on ventilator and could go into coma if not treated immediately. The new or replaced MEPF services line needs to connect new vertical stack lines as principal but again cannot replace entire vertical stack in running hospital. Thus, it would be carried out phase-wise.

Next challenge was routing of HVAC ducting within 2.7 m clear slab to finished floor height, where in at some places beam depths are 700 mm max. Thus, only 2.0 m height was available below the beam to pass HVAC ducting. Modern-day design standard demands a door height of 2.1.m, but in this case the available depth was 1.9 m in many areas resulting from MEPF routing above false ceiling. Most areas had to be managed with cassette units instead of long, wide HVAC ducts which reduces false ceiling heights. Furthermore, some areas were advised core cuts in beams through chilled water and sprinkler water pipe lines to maintain desired ceiling heights. Core cuts thereafter had to be strengthen with MS plates on either side of beams. A few slab bottoms also needed cladding with MS plates for strengthening. To cool the building further, sliding windows were replaced with double glazed units openable and fixed glass windows to enhance sound and heat insulation.

Lastly, there is always the issue of delay in project completion. In a running hospital, one cannot have noisy, hammering, repair work all day long, considering the fact that patients need rest for healing. The phasing of floor refurbishment reduced working hours as anticipated. However, it can never be said it won’t diminish further. Hospital management also needs to prioritise patient needs. In this case as well, patients’ complaints about inevitable repair noise led to a massive delay.

I would like to request all hospital stakeholders, to check your hospital building life periodically by means of structural and MEPF services audits before taking any refurbishment activity.



Beyond repairs condition of MEPF services.

Beyond repairs condition of MEPF services.






Completed Pics of refurbishment Project.



Author: Ar. Prasanna Wategaonkar has over two decades of experience in architecture planning and interior design. He has extensively worked on conceiving his detailed design sketches to develop, construct and manage varied projects in multiple sectors including residential, industrial, IT malls, parks and multiplexes.