Guidelines for Optimising Hospital MEP Design

Everyone wants an early glimpse of the next big thing; a peek into the future of healthcare design. So we asked Satish Kamble, General Manager, MEP Services, Hosmac for his take on how to cut costs, customise and optimise the MEP Design.

What important idea or innovation is being overlooked today in healthcare design? We live in an era where how we live and work today can be made far more efficient and inclusive through optimization- through tools like technology.

There are three major principles of MEP design which are compact space, low capital expenditure and low operational expenditure. Every client demand for these three primary principles for every project, no matter how small the project is.

As compared to Greenfield, brownfield project is tough to maintain compact and design efficient spaces as you have hardly any choice left to designer and the designer have to adapt to the available options on areas.

Unlike greenfield project, in brownfield, most importantly you have challenges, like available space in the building structure where you will have mostly issue with slab design for heavy equipment, core cuts ( if it is Post Tensioned slab), availability of Mechanical Electrical Plumbing and Fire Fighting shafts which will face many challenges in MEP design especially space planning and higher beam depths which causes difficulty to maintain higher false ceiling height.

So, what are the crucial concepts of a lean MEP design?

Satish Kamble, General Manager, MEP Services, Hosmac India Pvt Ltd

According to Satish Kamble, General Manager, MEP Services, Hosmac, a designer, needs to think about the following crucial aspects.

• Infection control

• Maintaining air changes per hour for managing the indoor oxygen level and reduce CO Level

• Precise indoor temperature and humidity control

• Design MEP spaces so precisely to maintain medical process flow without hampering medical department space planning

• Air filtration & Dust control to maintain good indoor air quality

• Positive or negative pressure gradient to avoid cross-contamination as per the application for infection control

• Patient safety and best hygienic environment

• Uninterrupted and conditioned electrical power supply

• Potable and good quality of water with uninterrupted supply with sufficient terminal pressure

• Fire safety for prevention and after fire hazard protection

• Some of the guidelines are clear cut, but many Indian designers do seem befuddled by MEP design.

According to Kamble, some of the common errors by Indian designers are the following:

• Forgetting smoke exhaust shaft inside the building

• Lack of maintenance space for MEPF equipment

• Lack of providing equipment hatch for access for lifting and shifting of heavy medical /MEPF equipment

• No provision of server room/UPS room

• Importance of providing Fire control room on ground floor level

• Lobby pressurization provision

• Provision of cross ventilation for natural pressurization for external staircases

• Provision of fire shaft of the proper size and giving it inside the corridor instead of near to staircase door

• Not providing zone wise and department wise AHU rooms

• Lack of maximum number of plumbing shafts for the minimum slope of drainage pipes

• Not providing full height maintenance door for all inside shafts

• External shafts with no provision of a ladder to access to all floors from outside

• No space for running external MEPF services especially for stormwater down takes and disposal

But is there any cost difference by optimising?

Many clients want overnight profits, but benefits of a good MEP design can be reaped only over the years, says Satish Kamble. "The incurred cost on an excellent MEP design is slightly higher, but hospital benefits from the operation expenditure savings, because of the low maintenance of MEPF services."

What are the challenges of implementing?

Kamble believes that the significant challenges for MEP are to have compact MEPF spaces and higher false ceiling height where you have structural problems due to higher depth beam. "Low CAPEX has always been a challenge when the client expects lower OPEX of MEPF equipment without investing chunk value to procure energy-efficient machines which still have higher costing," he adds,

Rules and Regulations

It is also essential to stick to compliances, code and regulations that hospital planners, even if the design is lean.

"One needs to keep in mind for precise infection control, patient safety, patient and staff comforts, specific pressure gradient, good thermal comforts. Designers need to follow especially healthcare norms laid down by NABH, MCI, JCI, ASHRAE -170, HTM and FGI for efficient and well certified by these statutory bodies.

What are the essential pointers/guidelines/ for designers to consider when customizing MEP Design?

According to Kamble, following are the fundamental rules.

• Compact MEPF spaces ( AHU room, Shafts, Plant room etc.)

• Low-cost MEPF equipment with optimum capacity without unnecessary overdesign

• Minimum distribution path of the run of MEPF services all over the building to minimize losses and hence less operating cost, and lesser capital cost and higher false ceiling height

• Energy modelling to have proper energy analysis to determine minimum energy billing and optimizing of MEPF Equipment running cost

• Selection of energy-efficient equipment and that also with a lesser number of footprints

• Avoid too many trap doors inside false ceiling and trying to consolidate the services junctions

• Thorough Analysis of a selection of various options available in the market and selecting the best suited project-specific system to benefit the client.

Resilient Design

Being a hospital is an essential operation which required 24 x 7 operations. It is critical that 100 % power back up is maintained primarily in rural areas, whereas frequent load shedding happens. It can be done in the following general manner:

a) DG Sets are provided in multiple quantities of the demand electrical load b) UPS system is equipped to ensure power back up during the lag period of the power outage, and DG starts for crucial areas like OT, specific medical equipment and emergency lights. UPS is usually provided for 15 mins to 30 mins back up.c) Nowadays, thermal storage by running machine during night time is done to reduce power bills by taking benefits of tariff difference offered by Govt. during peak morning hours. Storing AC energy in case of power failure to cut a massive load of the chiller on Dg sets in case of emergency is another useful measure," he concludes.