
Hospital Renovation & Upgradation Services in Pakistan
By Tanveer Ahmed, CEO, Ahmed Construction Company (ACCO) · Updated · Reviewed by ACCO architects and engineers
Quick Answer
Hospital renovation in Pakistan while staying open: phasing, infection-control barriers, OT/ICU upgrades, MEP retrofit, fire safety and PHC compliance. Ahmed Construction Company (ACCO), based in Gulberg-III Lahore since 1998, provides hospital design & construction services with design drawings free on award of construction.
Every operating hospital eventually needs renovation. Equipment changes, licensing standards are updated, air-conditioning and electrical systems age, and new specialties or extra beds are added. Hospital renovation in Pakistan is harder than new construction because, in most cases, the hospital must keep treating patients while work goes on around them. Dust, noise, service shutdowns and vibration all become clinical risks. This guide explains the main types of hospital renovation and upgradation, how phased work is planned to protect patients, which standards apply, and how owners can control cost and disruption.
Hospital Renovation in Pakistan at a Glance
| Common reasons | Licensing compliance, ageing MEP systems, OT and ICU upgrades, new specialties, extra beds, fire safety, energy savings, patient experience |
|---|---|
| Main scopes | Department refurbishment, MEP retrofit, structural strengthening, vertical or horizontal extension, finishes renewal |
| Key risk | Infection and disruption to live clinical areas |
| References | Punjab Healthcare Commission standards, WHO infection prevention, ASHRAE 170, NFPA life safety, Building Code of Pakistan |
| Pricing | Survey-based itemised BOQ for each phase |
Why Hospitals in Pakistan Need Renovation
Many private and public hospitals in Pakistan were built decades ago, often as converted houses or commercial buildings, and have grown in stages since. Typical triggers for renovation include:
- Licensing and inspection findings from the provincial healthcare commission
- Ageing services: HVAC, electrical panels, medical gas and plumbing reaching the end of their life
- Clinical upgrades: modernising operation theatres, ICUs, NICUs and emergency departments
- New services: adding dialysis, cardiac, IVF, oncology or imaging
- Capacity: more beds, more theatres or a larger OPD
- Infection control: replacing porous finishes and improving ventilation
- Fire and life safety: adding compartmentation, alarms and protected escape routes
- Running cost: energy-efficient chillers, lighting and solar PV
Types of Hospital Renovation
1. Department refurbishment
A single department, such as an OT complex, ICU or ward, is stripped and rebuilt while the rest of the hospital stays open. This is the most common form of hospital renovation. See ACCO’s guide to operation theatre renovation.
2. MEP retrofit
Replacing or upgrading HVAC, electrical distribution, generators, UPS, medical gas, water treatment and drainage. These works often run through ceilings and shafts across many departments, so they need careful sequencing.
3. Structural strengthening
Where floors are added or loads increase (for example, new imaging equipment), existing columns, beams and foundations may need strengthening by jacketing, steel plates or fibre-reinforced polymer wraps, based on a structural assessment.
4. Extension
Adding floors or a new wing. The connection to the existing building, the shutdown of services for tie-ins and noise from piling or concrete work all need careful planning.
5. Interior and finishes renewal
Replacing floors, wall finishes, ceilings, doors and fittings with hygienic, durable materials. ACCO’s guide to hospital finishing works covers material choices.
Keeping Patients Safe During Renovation
The biggest difference between hospital renovation and ordinary refurbishment is infection risk. Construction dust can carry fungal spores such as Aspergillus, which is dangerous for patients with weak immunity. A formal infection control risk assessment (ICRA) should be agreed with the hospital’s infection-control team before work starts.
Barriers
Sealed, floor-to-slab dust partitions with lockable doors and sticky mats at entrances.
Negative pressure
Exhaust fans with filtration keep the work zone at negative pressure so dust does not escape.
Separate routes
Dedicated access, lifts or time slots for workers and debris, away from patient routes.
Monitoring
Daily inspection, cleaning outside the barrier and coordination with the infection-control nurse.
Noise and vibration also matter, especially near theatres, ICUs and wards. Noisy work such as core drilling and demolition can be scheduled for agreed hours, and sensitive procedures can be planned around them.
Phasing: Renovating a Hospital That Stays Open
Phasing is the heart of a successful hospital renovation. The project is split into stages so each department can move to temporary space, be renovated and return, while the hospital keeps its essential services running.
Phasing principles
- Create “decant” space first, so a department has somewhere to move
- Never shut down essential services such as oxygen or power without a tested temporary supply
- Plan service shutdowns and tie-ins at night or at weekends, with clinical approval
- Commission and clean each completed area before patients return
- Keep fire escape routes open and signed at all times
Renovation vs New Build: Which Makes Sense?
| Factor | Renovate and upgrade | New building |
|---|---|---|
| Disruption | Must be managed around live operations | Little impact on existing services until move-in |
| Cost | Usually lower if the structure is sound | Higher, includes land or demolition and full construction |
| Speed | Department by department, faster for small scopes | Longer overall but a clean programme |
| Design freedom | Limited by existing columns, floor heights and shafts | Full freedom to meet modern standards |
| Best when | Structure is sound and the layout can be adapted | Structure is weak or the site is far too small |
A condition survey and structural assessment are the starting point for this decision.
Upgrading Critical Departments
Operation theatres
Modern OT upgrades typically include dedicated air handling with HEPA filtration and positive pressure, modular wall and ceiling panels, seamless flooring, pendants, medical gas outlets and isolated power. ACCO’s guide to operation theatre upgrades in Lahore explains the options.
ICU and emergency
More bed spacing, better visibility from the nurse station, isolation rooms, additional power and gas outlets per bed, and improved ventilation. See ACCO’s guide to ICU and emergency department design.
Wards
Fewer beds per bay, attached bathrooms, hand-wash basins near beds, nurse call systems and better daylight improve both safety and patient experience.
Energy and Running-Cost Upgrades
Electricity is one of the largest operating costs for any hospital in Pakistan, and renovation is the ideal time to reduce it. Useful measures include:
- Replacing old chillers and split units with efficient chillers or VRF systems sized to actual loads
- Variable-speed drives on pumps and fans
- LED lighting with occupancy sensors in stores, toilets and corridors
- Roof insulation and shading for top-floor wards and west-facing rooms
- Rooftop or car-park solar PV to offset daytime loads
- A building management system to monitor and schedule plant
These upgrades can often be phased alongside clinical renovation, so ceilings are opened only once. Savings depend on the existing systems and usage, so ACCO assesses them during the survey stage.
Compliance and Licensing
Renovations are often driven by inspection findings from the Punjab Healthcare Commission or the healthcare commission in Sindh, Khyber Pakhtunkhwa or Islamabad. The renovation design should address each finding directly, and the completed works should be documented so the hospital can show compliance at re-inspection. Structural changes, additional floors or changes of use also require building approval from the local authority. ACCO’s guide to PHC requirements explains common licensing standards.
How a Hospital Renovation Project Runs
Survey
Condition, structural and MEP surveys, plus clinical and licensing needs.
Design & phasing
Renovation design, infection control risk assessment and a phasing plan agreed with management.
BOQ & approvals
Itemised BOQ for each phase and any required building approvals.
Execute & hand back
Phased works, testing, cleaning and handover of each area.
Common Mistakes to Avoid
- Starting work without an infection control risk assessment
- Renovating finishes while ignoring ageing electrical and HVAC systems
- Unplanned shutdowns of oxygen, power or water
- Adding floors without a structural assessment
- Blocking fire escape routes during construction
- Handing back areas before full cleaning and system testing
Frequently Asked Questions
Can a hospital stay open during renovation?
Yes, in most cases. Work is phased department by department, with dust barriers, negative pressure, separate routes and planned service shutdowns to protect patients.
How is the cost of hospital renovation estimated?
ACCO surveys the existing building and services, agrees the scope with the hospital, and prepares an itemised BOQ for each phase. Costs depend heavily on the condition of existing systems.
Do we need approval for hospital renovation?
Internal refurbishment may not need a new building approval, but structural changes, extra floors or change of use do. Clinical changes should also be checked against provincial healthcare commission standards.
How long does an OT or ICU upgrade take?
It depends on scope, equipment lead times and phasing. A single OT is much quicker than a full theatre complex. ACCO provides a programme after the survey and design.
Is it better to renovate or build new?
If the structure is sound and the layout can be adapted, renovation is usually more economical. If the structure is weak or the site cannot meet modern needs, a new building may be better.
What should a hospital renovation survey include?
A good survey covers the structure, HVAC, electrical, medical gas, plumbing, fire safety and finishes, together with clinical workflows and any licensing findings. It gives a clear picture of what must be replaced, what can be reused and how the work should be phased.
Does ACCO handle both design and renovation works?
Yes. ACCO provides survey, design, BOQ and phased execution as part of its hospital design and construction services.
Conclusion
Hospital renovation in Pakistan is a specialist task that combines construction skill with clinical awareness. With a proper survey, an infection control plan, careful phasing and an itemised BOQ, hospitals can modernise theatres, ICUs, wards and engineering systems without putting patients at risk. ACCO, based in Gulberg-III Lahore since 1998, plans and delivers hospital renovation and upgradation projects across Pakistan.
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