When the time came to transform the district headquarters hospital of Sialkot into a teaching hospital, the Infrastructure Development Authority of Punjab (IDAP) sprang into action. The authority, formed in 2016, is an autonomous body responsible for the planning, design, construction and execution of infrastructure in Punjab, and is tasked with engaging experienced consulting firms specialised in the design and construction of healthcare facilities.

An international tender was floated, which led Saudi Arabian DAR Engineering to work on the Allama Iqbal Specialised Hospital project.

“We won the contract through competitive bidding and were initially commissioned for architectural design review and modification, structural, HVAC, electricity, PHE, fire fighting and medical gases, detailed design and resident construction supervision, as the existing hospital had to be upgraded to a teaching hospital,” explains Sultan Saleh Al Sudais, GM of DAR Engineering.

The RFP called for the addition of several departments and services, which meant the hospital would need a number of new facilities including a library, private rooms, cardiology, urology and neurosurgery wards, and an auditorium. DAR’s scope of work also included exterior accessibility and landscaping, covering parking areas, decorative elements, access roads and a connection between the new hospital and the existing emergency building.

Concept Design Master Plan
The project has a plot area of 304,678sqft with a built-up area of 483,079sqft. The existing hospital is directly serviced on its west side by Commissioner Road, with a second entrance towards the south through Jinnah Islamic College Road. Khawaja Safdar Road borders the north side of the complex.

The 6.06 acres provided for the new building are mainly flat and the plot is square in shape. It is bordered on the west to Commissioner Road and to the south by the existing emergency building, which will have a dedicated link to the Imaging department and operating theatre in the hospital. On the east side, the new nursing school is currently under construction.

Site Access and Wayfinding
Hospitals are complex and demanding buildings with several entrances and circuits that demand segregation and clear guidance. People visit for different reasons and through various methods of transportation, and each one requires a different response – staff, transport vans, ambulances, public and private transport, walk-in patients, scheduled patients, visitors, families, etc.

Segregation of circuits and clear guidelines and reference points are critical to a proper flow of people and to prevent visitors and employees from getting lost or confused. In the engineering company’s proposal, the following accessibilities and circuit segregations were considered: logistics accessibility through internal complex roads in the south, teaching area accessibility through internal complex roads on the east, and cardiac and private patient entrance through the north, via Khawaja Safdar Road.

For the cardiac centre, a dedicated emergency road is clearly marked and cannot be used by any other vehicles. Staff and public patient access comes through Commissioner Road.

From landscaping to building design, by integrating a variety of cues from the local architectural culture into the way-finding components (shape, colour, textures, etc), DAR Engineering was able to create intuitive relations between people and the buildings. This led to a better understanding and experience for employees and visitors moving around inside the hospital.

Schematic Design
Since the new teaching hospital building is to be integrated into an existing site, major attention has to be paid to the existing buildings, mainly the emergency department building and the existing main hospital.

Massing design was carefully evaluated so that the new building blends harmoniously with the present facilities. To optimise the available area, reduce walking distances inside of the facility and correctly relate all the departments, an over-stacking layout solution was used. Preference was given to a solution of overlaid floors, to reduce the building footprint, maximise views and allow natural light to enter.

Two shapes are clearly identifiable in the building masses, each is related to a specific use: a podium and two towers. The podium, with four floor levels, includes all the major clinical departments as well as the entrances into the building. Its shape is articulated with the surroundings and all access points are clearly visible and identifiable.

DAR Engineering wanted the structure to inspire confidence and shelter and embrace users (patients or families) on their approach. The firm also wanted the hospital to be visible from a distance and provide visual cues that direct users to the correct entrances.

On the top of the podium, there are two towers with three floor levels which will contain the nursing wards. The stacking solution of wards is said to bring several advantages: duplicating the nursing ward floor layout brings flexibility to the occupation of each floor according to the needs of each inpatient department; it helps reduce the walking distances on each floor; it reduces ward dimensions and provides better visual and access control in each level; and shafts and ducts better align across the building, which offers better MEP integration with common vertical ducts and shorter horizontal runs.

Putting the rooms on the upper floors means the structure offers visitors better views, air flow and increased sun exposure and natural daylight. It also moves inpatients to a further location inside the building and away from the daily use of the hospital by outpatients. Patients will be accommodated in a more reserved area where they can rest and be close to their families.

Strong Symbol
Once the project is completed, DAR Engineering says the building will be a symbol of health and hope and will inspire the community. In line with this, the firm made contemporary design and a human scale approach key priorities, and notes that this approach should be pursued in every aspect of the design.

As with any project, there were a few issues. “Our biggest challenges were challenging timelines, the incorporation of progressively elaborate client expectations, lack of existing as-built data, ineffective coordination with bidders and budget constraints,” notes Al Sudais.

That said, he is confident that the hospital expansion is a signature project for his company. He concludes: “This project showcases the full architecture and design capabilities of DAR, because the work was done 100% in-house by the design team of DAR & ARC-IDC. The architecture design that we came up with introduces modern design in the healthcare sector of Pakistan, and proven engineering design best practices acquired by DAR through working on international projects have been applied in this project as much as was practical.”