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Hospital planning and designing

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Some of the basic fundamentals which are to be kept in mind hile planning for a hospital. – PowerPoint PPT presentation

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Title: Hospital planning and designing


1
Planning and Designing a Hospital
  • Parnab Roy
  • MHM(1st year)
  • SMU

2
Hospital must meet two basic fundamental needs-
  • Must meet the needs of the patient it is going to
    serve adequately.
  • It must be in a size and proportions which the
    owners or promoters will be able to build and
    operate.

3
Basic objectives which are to be met by the
hospital-
  • Sound architectural plan
  • Economic viability
  • Effective community orientation
  • Quality patient care

4
Principles of hospital planning-
  • Protection from unwanted and unnecessary
    disturbances in order to help speedy recovery
  • Separation of dissimilar activities
  • Control the nurses station should be positioned
    strategically to enable proper monitoring of
    visitors entering and leaving the ward, infants
    and children should be protected from theft and
    infection etc.
  • Circulation- all the departments of a hospital
    must be properly integrated.
  • (separate all departments, yet keep them all
    together separate types of traffic, yet save
    steps for everybody that is all there is to
    hospital planning Emerson Goble)

5
Selection of site-
  • Needs of the community
  • Ease of accessibility
  • Range of services offered
  • Availability of specialists
  • Availability of technology
  • Study of existing hospital(if any)
  • Requirements of staff and services

6
Type of hospital-
  • Primary
  • Secondary
  • Tertiary
  • Private
  • Partnership
  • Public charitable trust
  • Cooperative society

7
Bed planning-
  • Bed PopulationA S 100
  • 365 PO
  • A number of inpatient admissions/1000
    population/year
  • S average length of stay
  • PO percentage occupancy

8
Planning of finances-
  • Funds required for constructing, furnishing and
    equipping the hospital.
  • Operating funds- salaries, loans and interest,
    other maintenance expenses.
  • Arranging financial assistance-patient fees, bed
    charges, and other modes of revenue generation
    process.

9
Equipment planning-
Built in equipment These include counters and cabinets in laboratory, Pharmacy and other parts of the hospital,elevators,incinerators,coolers,fixed sterilizing equipment etc.These are usually included in the construction contract and the planning of these equipments is the architect's responsibility.
Depreciable equipment This includes equipment that has a life of five years or more and is not purchased through construction contracts. These are large pieces of furniture which have a relatively fixed location and are capable of being moved e.g., diagnostic and therapeutic equipment, laboratory instruments, office furniture etc.
10
Non depreciable equipment These are small items with a low unit cost and life span of less than five years. These are generally under the control of the store room and are bought through other than construction contracts. They include kitchen utencils,surgical instruments,linen,waste baskets etc.
11
Operation programme-
Admission Human resource
Administration Stores
General engineering Purchasing
Laundry Maintenance
Clinical services Waste disposal plant
Pharmacy Fire and safety
Nursing services Disaster plan
House keeping information
Records Dietary services
Public relations Clinical engineering
Employee facilities Sanitation
12
Planning of departments-
  • In patient department-
  • Patient room- These may be private/semi private
    rooms or multibed general wards. They should be
    designed to be safe and aesthetically pleasing so
    as to assist in quick recovery of patient. They
    must contain space for equipments, staffs and
    various need of the patient.
  • Nurses control station- should be located and
    designed in such a way that the nurses can
    observe the patient room.
  • The work area- related to handling materials
    necessary for patient care, maintaining
    communication and records etc.

13
  • Economical
  • High quality patient care
  • Comfort to the patient
  • Efficient operation of the unit
  • Meeting the needs of the visitors

14
Facilities and space required-
  • Examination and treatment room with wash basin
    etc.
  • Cupboard for clean linen.
  • Basket for soiled linen with sink, waste
    receptacles.
  • Equipment storage room for walkers,IV stands etc
  • Space for storing stretchers and wheel chairs
  • Lockers for staff personal belongings
  • Staff toilet
  • Small laboratory

15
Out patient department-
  • Preferably on the ground level with a separate
    entrance and adequate parking facilities.
  • It should be close to admitting area ,
    MRD,emergency,radioogy /,lab services and
    pharmacy.
  • Attention should be paid to circulation, which
    results in the smooth flow of various traffic
    lines Traversing the department.
  • Properly signed

16
Emergency department-
  • Should be located on the ground floor with easy
    access for patients and ambulances
  • Separate entrance for the department
  • Well marked with proper lighting and signs.shoud
    be easily visible and accessible from the street.
  • Should be close to the admitting department,
    medical records and cashiers booth, radiology
    department, lab services, blood bank,elivators
    and wards

17
Intensive care unit-
  • Should preferably be located on the ground floor
    with convenient access from the operation theatre
    suit and emergency department and easy
    accessibility for wards.
  • It consists patient area, staff area, support
    area.
  • Four basic requirements-
  • Direct observation of the patient by nursing and
    medical staff
  • Surveillance of physiological monitoring
  • Provision and efficient use of routine and
    emergency diagnostic procedures and
    interventions.
  • Recording and maintenance of patient information.

18
  • Monitoring equipment
  • Cardiovascular therapy
  • Respiratory therapy
  • Dialysis equipment
  • Radiological equipment
  • Laboratory equipment
  • others

19
Obstetrical unit-
  • The obstetrical unit should ideally be located
    close to the labour and delivery room as also to
    the nursery to avoid the exposing the bodies to
    infection.
  • A room for patient education and group
    discussions is essential with cheerful decoration
    is desirable

20
Newborn unit-
  • An area of 30sq.ft/ infant with a space of at
    least three feet around is recommended
  • All partition should be made of clear glass to
    permit observation.
  • Furnishing in the full term nursery include a bed
    side cabinet,incubator,utility table, wash basin,
    waste receptacles, outlets for oxygen and
    suction, facilities for examination etc.

21
Pediatric unit-
  • Equal space should be provided for beds.
  • If patients are allowed to stay with the parents,
    provision must be made for toilets, sleeping and
    storage of personal belongings
  • Separate provision for examination and treatment
    of infants.
  • Each pediatric unit have isolation room with
    other necessities like washing facilities and
    sterile gowns and masks.
  • Single room for critically ill and uncontrollable
    patients
  • Recreation or play room
  • Storage space for toys,linen,recreational
    materials
  • Walls between patient room and the corridor
    should have glass panels for viewing
  • Lighting decoration and equipment must create a
    cheerful atmosphere.

22
Psychiatric unit-
  • Consultation area containing staff offices for
    individual and family care sessions.
  • Conference therapy area for group therapy
    session.
  • Inpatient area for hospitalizing patients
  • Activities area for occupational recreational
    therapy.
  • The number of beds should be between 20-24 I
    order to permit proper observation and treatment
    and private rooms are preferred.
  • One room for the management of violent patients
    are desirable.
  • There should be no object which can be used to
    hurt one self.

23
Radiology and laboratory services-
  • Should be easily accessible to the OPD, casualty
    and the inpatient wards.
  • Preferably be sited on the ground floor.
  • Adequate reception and registration area
  • Convenient patient flow with minimization of
    criss cross traffic.
  • Adequate waiting area
  • Separate entrance for accident and emergency
    cases in busy hospital
  • Provision of room for technical functioning
  • Flexibility, expandability and upgradability need
    to be kept in mind while siting the department.

24
Pharmacy-
  • Out patient should have ready access to the
    hospital pharmacy to collect prescription.
  • Staff of wards and department can access it
    without having to travel a long distance thorough
    other crowded areas.
  • Collection of indents and dispensing of
    prescription for inpatients can be carried out in
    a central dispensing area which is accessible to
    hospital staff when they come to consult the
    pharmacist or to obtain stocks for ward use.
  • Suppliers have an access to it from out side
  • Space required for-
  • Dispensing counter
  • Cash counter
  • Drugs storage including dressings
  • Cool and cold storage
  • Administrative office
  • Circulation space
  • Space for compounding and bulk preparation


25
Hospital store It should be located centrally to the hospital Approachable by supply vehicles and should have separate service entrance Risk of fire and explosion in a medical supplies storehouse, storage of acids, inflammable materials and oxygen and other gas cylinders will require special attention
CSSD CSSD mostly serves the operation theatre, emergency, casualty department, wards, maternity suit and should be so cited as to be central to all this
Hospital dietary service Should be located taking into consideration the prevailing wind direction so that smoke and kitchen odours are not constantly wafted to patient care area Should be sited at ground level and connected to store with lift
26
Hospital work shop/BME department A large quantum of various types of mechanical and electrical equipment is installed in a hospital and requires repair and preventive maintenance.
Laundry Used linen from wards, operation theatres and delivery suites maybe infected, and therefore needs careful handling at an area remote from all other clinical and supportive services areas Space for washing, storing, drying shades and ironing rooms have to be catered for at an appropriate area with plentiful supply of water
MRD Should be located immediate to the admission and registration area. Enough space for keeping/storing of patient files Adequate safety .
27
Space requirements of some basic departments-
Area Sq .ft / bed
Nursing unit 250-280
Nursery 12-18
Delivery suite 15-20
Operation theatre 30-50
Physical medicine 12-18
Radiology 25-35
Laboratory 25-35
Pharmacy 4-6
CSSD 8-25
Dietary 25-35
Medical record 8-15
28
Area Sq .ft / bed
House keeping 4-5
Laundry 12-18
Mechanical installation 50-75
Maintenance work shop 4-6
Stores 25-35
Public areas 8-10
Staff facilities 10-15
Administration 40-50
Total 567-751
Circulation 115-751
Total net area 682-891
29
Project costing-
  • The most common method of estimating hospital
    construction costs has been the per bed
    method,i.e.,if the total cost of a 100 beded
    hospital has been Rs.400 lakhs,the cost/ bed is
    Rs.4,oo,ooo.
  • Break up of project cost-
  • Acquisition of site
  • Site survey, investigation
  • Landscaping
  • Construction contact-building with fixed
    equipment
  • Supervision and inspection
  • Equipping the hospital-diagnostic and therapeutic
    equipment
  • Movable equipment, furniture etc.
  • Architect's fee
  • Consultants fee
  • Site engineers fee

30
Phasing -
  • The necessity to bring facilities into use as
    quickly as possible for operational reasons.
  • The necessity to split a major project into a
    smaller units as a contractual consideration
  • The necessity of having certain departments ready
    before others
  • Limitation on availability of capital funds

31
Commissioning-
  • Formation of commissioning team
  • Hospital consultant
  • Hospital administrator
  • Chief of clinical services
  • Senior nurses
  • Supplies officer
  • Others
  • Activities-
  • Bring the hospital building, plant and equipment
    to a state of the operational readiness
  • Development operational system
  • Testing of equipments
  • Coordinate training of staff
  • Ensure good communication

32
Hospital project staging-
Stage A Functional content Outline brief Project team Assessment of functional content Submission of owners( Govt,private organization etc.)for approval Site appraisal, gross floor areas Building space. Draft master plan Estimation of cost and phasing Appraisal of work by owners
Stage B Operational policies Developmental plan Operational policies Departmental and inter related activities Departmental and hospital policies Development control plan Budget cost Continuous informal discussion with owners
33
Stage C Schedules of accommodation, sketches, Final cost estimate Schedules of accommodation Sketch drawing Equipment schedules component estimates Cost revenue and staffing estimates Final cost approval
Stage D Detail design working drawings, tender action Working drawings Engineering details Bills of quantities Calling tenders
Stage E Contract and construction Assessments of tenders Award of contract Construction Engineering commissioning
Stage F Commissioning Staff assembly and training Equipment and supplies assembly Testing of installation
34
Conclusion-
  • Technology requirement must be met
  • Clinical needs must be considered
  • Safety is a major factor
  • Standards and Guidelines are essential
  • Importance of the role of Hospital Staff in
    construction and design.

35
THANK YOU
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