HOSPITALS AND REHABILITATION CENTERS

Part 1

Backgrounder and Terminology

Part 2

Space Requirements and Relevant laws

Part 3

Flowcharts

Part 4

Illustrations

Prepared by:
Arch. Peter A. Villanueva, uap

THE BROWN BAUHAUS REVIEW CENTER

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Arch. Peter Villanueva
 HOSPITALS AND REHABILITATION CENTERS

PART 1

BACKGROUND:

The hospital is one of societys most important civic buildings. It is most often where we
are born and where we die. In between, it is also a place of much emotional turmoil and
much joy. The architecture of the hospital must respond to both this emotional context, of
hope and tragedy, and the functional requirements of treatment and technology.

HOSPITAL CLASSIFICATION IN THE PHILIPPINES: ( from administrative order

70-a series of 2002-Revised rules and regulations governing operation of
hospitals and other health facilities)

Classification shall be as follows:

1. Government
2. Private

GOVERNMENT - OPERATED AND MAINTAINED PARTIALLY OR WHOLLY

BY THE NATIONAL, PROVINCIAL, CITY OR MUNICIPAL GOVERNMENT OR
ANY OTHER POLITICAL UNIT; OR BY ANY DEPARTMENT, DIVISION,
BOARD OR AGENCY THEREOF.

PRIVATE PRIVATELY OWNED, ESTABLISHED AND OPERATED WITH

FUNDS THROUGH DONATION, PRINCIPAL, INVESTMENT, OR OTHER
MEANS, BY ANY INDIVIDUAL, CORPORATION, ASSOCIATION, OR
ORGANIZATION.

SERVICE CAPABILITY:

a. Primary hospital up to 24 beds

b. Secondary 25-100 beds
c. Tertiary 100 bed and up

GENERAL provides services for all types of deformity, disease, illness or

injury.
SPECIAL - primarily engaged in the provision of specific clinical care and
management.

TERMINOLOGIES:
DEPARTMENTS:
1. ADMINISTRATION forms the general office spaces of a health
care facility. Typically grouped together to support operational
efficiency and cross-utilization of personnel.

2. PHARMACY provides prescription medications, intravenous

solutions, and investigational drugs for clinical research, as well as
other related products for patients.

3. OUTPATIENT DEPARTMENT provides services for consultation

and required treatment and does not necessarily to admit the patients.

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Arch. Peter Villanueva
4. CLINICAL LABORATORY are process-intensive centers. They are
responsible for collecting or receiving specimens, preparing and
logging them for tracking/reporting purposes, analyzing them through
automated or manual procedures, and reporting the results to a
physician.

5. OBSTETRICS a major component, dedicated to the care of

pregnant women prior to and through the delivery of the infants, as
well as to the care of the newborn. Such a unit generally consists of
labor, delivery, and recovery rooms, and nursery and support areas.

6. SURGICAL One of the most important areas of a hospital, wherein

surgical procedures are performed on patients for a wide variety of
reasons. Primary services includes anaesthesia, pre-operative holding,
operating rooms, recovery rooms, and supports from other
departments including pharmacy, laboratory, housekeeping,and central
sterile supply.

7. THERAPY DEPARTMENT Treatment for cancer patients, two

common forms are chemotherapy and radiation therapy.
Chemotheraphy is the intravenous admission of chemicals that attack
cancer cells. Radiation therapy is the exposure of cancer cells to
radiation either direct or by means of a beam.

8. RADIOLOGY DEPARTMENT recording of images via electronic

and/or film media. Such equipment are Computed Tomography or CT
Scan, MRI, mammography, etc.

9. NURSING UNIT the core of the hospital, its purpose has been to
house patients requiring care, often for long periods of time.

10. PHYSICAL MEDICINE AND REHABILITATION offers services to

individuals who are physically disadvantaged, with the purpose of
returning them to maximum physical capabilities. It includes Physical
therapy (emphasis on regaining movement) such as gymnasium and
hydrotherapy area, Occupational therapy (optimizes patients
independence where concentration on finer physical movements) such
as vocational training and work-hardening program, Speech pathology
and Audiology for communication disabilities, and other Specialized
programs.

11. CENTRAL STERILE a service whereby medical/surgical supplies

and equipment-both sterile and non-sterile- are cleaned, prepared,
processed, stored, and issued for patient care. Its primary function is
the sterilization of instruments for surgery, labor, and delivery.
Commonly divided in 3 zones- Decontamination zone,
Assembly/sterilization zone, Storage and distribution.

12. FOOD SERVICE responsible for all activities involving food,

nutrition, and beverages in the health care facility. Primary function is
to provide nutrition and dietetic care patients.

13. ENVIRONMENTAL AND LINEN SERVICES responsible for

maintaining a clean and sanitary environment in the hospitals.
Environmental services are housekeeping closets, housekeeping
storage and supplies, bed and equipment storage. Linen services are
linen storage, receiving and sorting and holding area for soiled linen,
centralized clean linen storage, soiled and clean linen cart storage,
handwashing in soiled linen, laundry, and general storage for laundry
supplies.

14. ENGINEERING AND MAINTENANCE responsible for the

maintenance of the entire physical plant and grounds of the hospital.
Services includes preventive maintenance, corrective maintenance, and
minor construction.

15. MATERIALS MANAGEMENT responsible for the acquisition,

general storage, daily inventory, and restocking of consumable
materials used within in a facility.

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Arch. Peter Villanueva
INFIRMARY A health facility that provides emergency treatment and care to the sick
and injured, as well as clinical care and management to mothers and newborn babies.

BIRTHING HOME A health facility that provides maternity service on pre-natal and
post-natal care, normal spontaneous delivery, and care of newborn babies.

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The Brown Bauhaus Review Center

ACUTE-CHRONIC PSYCHIATRIC CARE FACILITY A health facility that provides

medical service, nursing care, pharmacological treatment and psychological intervention for
mentally ill patients.

CUSTODIAL PSYCHIATRIC CARE FACILITY a health facility that provides long-term

care, including basic human services such as food and shelter, to chronic mentally ill
patients.

SPECIALIZED INPATIENT NURSING UNITS

INTENSIVE AND CORONARY CARE UNITS

Resembled the post-anaesthesia recovery areas from which they evolved

MATERNITY AND WOMENS HEALTH

Large single patient rooms utilized for labor, delivery, and recovery.

PEDIATRIC PATIENTS UNITS

AIDS/HIV/CANCER/AND INFECTIOUS DISEASES

To contain the spread of infectious disease, patients units should contain rooms with
negative airflow as well as with anterooms for visitors/staff to change clothing.

AMBULATORY CARE FACILITIES

A. AMBULATORY SURGERY CENTERS

B. OPTHALMOLOGY CENTERS examination, diagnosis, and treatment of various
eye diseases
C. PROTON THERAPY CENTERS cyclotron proton therapy is an innovative
treatment that uses a highly concentration proton beam to irradiate certain
cancerous tumors without damaging surrounding tissues.
D. AMBULATORY PSYCHIATRIC FACILITIES patients with behavioral diagnoses
E. EMERGENCY DEPARTMENTS diagnostic and treatment areas intended for those
patients urgently requiring medical treatment for injury or illness.
F. WOMENS HEALTH CARE CENTER patients coming to a facility for gynecological
examinations. Offers mammography or x-ray for breast.
G. HEART CENTERS offers comprehensive diagnostic treatment and rehabilitative
program for patients with disorders of the heart and vascular system.
H. CANCER CENTERS offers computer tomography (CT), radiology, radiation
oncology, and magnetic resonance imaging services to aid in the diagnosis and
treatment of cancer.
I. DIALYSIS CENTERS patients with kidney diseases.

ANCILLARY DEPARTMENTS

The ancillary departments of a health facility serves as the backbone for delivery of
inpatient and ambulatory care. These departments offer a variety of support functions
ranging from treatment to information distribution.
Ancillary departments include three major categories:
b. Public and Administrative departments
c. Diagnostic, interventional, and therapy departments clinical laboratory,
diagnostic imaging; ambulatory procedure unit such as blood transfusion,
cosmetic and plastic surgery, cystoscopy, endoscopy, general surgery,
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Arch. Peter Villanueva
 gynecology, orthopedics, neurosurgery, gastroenterology; oncology therapy or
treatment for cancer patients-chemotherapy and radiotheraphy.
d. Logistical support departments central sterile processing, food services, linen,
engineering,pharmacy.

PART 2

SPACE REQUIREMENTS
based on Department of Health Manual on Technical guidelines for hospitals and health
facilities Planning and Design. 100 bed tertiary hospital.

A. ADMINISTRATION Clean-up room 15.00

Lobby 42.00 sq.m.
Admitting office 12.00
Affiliates room and library 48.00
Office of the Chief hospital 36.00
Accounting room 24.00
Office of the Chief nurse 24.00
Office of the Administrative officer
24.00
Business and Finance office 105.00
Commission on Audit office 21.00
Office of the Department head 10.50
Conference room 37.00
Printing and storage room 15.00
Toilet facilities 36.00
Radio room 6.00
Sub-sterilizing room 6.25
Surgical supervisors office 8.75
Anesthesiologists area 8.75
Anesthesia storage 12.25
Sterile instrument and supply storage
12.25
Staff locker room and toilet 27.00
Staff lounge 18.00
Nurses locker room 18.00
Central sterilizing and supply room
60.00
Recovery room 72.00
Intensive care unit 108.00
Visitors waiting area 18.00
D. OB-GYNE

CLINICALSERVICE FACILITY: Delivery room 36.00

Labor room 54.00
B. EMERGENCY Recovery room

Nurse station 16.00

Minor operating room 18.00 E. NURSERY
Treatment cubicles 23.00
Observation room 42.00 Nurse station 15.00
Waiting area 15.00 Septic nursery and work room 15.00
Doctors on duty room 27.00 Suspect/Pathologic Nursery and work
Nurses locker room 6.75 room 24.00
Breastfeeding room 10.00
C. SURGICAL
STRETCHER NOOK AND TRANSFER
Operating room 36.00 12.00
Scrub-up 8.75 STORAGE ROOM 6.00

ANCILLARY SERVICES:
F. RADIOLOGY DEPARTMENT G. LABORATORY
Bacteriology and Serology Section
Radio-flouroscopy x-ray room 29.84 18.00
Radiographic x-ray room 20.64 Histopathology Section 18.00
Control booth 3.36 Urinalysis and Biochemistry section
Dark room 14.00 18.00
Ultrasound room 14.64 Hematology section 18.00
Waiting area 25.36 Blood doning 10.50
Radiologists office 19.95
Staff room 15.05
Clerical room 12.25
Film file storage 8.75
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Arch. Peter Villanueva
 Waiting area 30.50 J. MEDICAL SOCIAL SERVICE
Pathologists office - 16.00 OFFICE 30.00
Staff area - 28.00 K. MEDICAL RECORDS ROOM
Glass Washing and Sterilizing 21.00 68.00
Storage room 7.00
Locker room and toilet 13.50 L. MORTUARY 54.00 sq.m.

H. PHARMACY Lobby/waiting area 16.50

Autopsy room 24.00
Chief Pharmacists office 12.75 Morgue 7.50
Staff work area 13.50 Locker room and toilet 6.00
Patient dispensing Area and drug
information 13.50 M. NURSING SERVICE FACILITY
Receiving/breakout/inspection area
12.00 Ward nurse station and service group
Flammable storage 5.25 45.00
Bulk storage 12.75 Nurse station
Distribution area 18.00 Utility area 6.30
Linen rooms 6.30
I. OUTPATIENT Treatment room 15.96
Equipment storage 3.84
OPD Waiting area 54.00 Bed ward

O. DIETARY
Prepared by: Arch. Peter A. Villanueva ,uap
The Brown Bauhaus Review Center Dieticians office 22.00
Receiving area 16.00
Dry storage 12.00
Cold storage 12.00
Equipment storage 15.00
OPD admitting/information counter Food preparation area 197.00
18.00 Special diet room 8.00
Office of the OPD chief 21.00 Staff dining room 87.00
Consultation room (pedia/under 6/ Dishwashing area 18.00
medical/surgical/OB-Gyne/Family Tray truck park, wash area 16.00
planning/ENT/eye/ - 18.00 each Locker room and toilet 24.00
Dental consultation room 36.00 Garbage disposal cubicle 8.00
Minor operating room 28.00
Utility room -8.00
Toilet facilities 36.00

ENGINEERING MAINTENANCE AND

HOUSEKEEPING SERVICE FACILITY

P. LINEN AND LAUNDRY

Linen office and work room 36.00

Central linen storage-25.50
Receiving and sorting area 57.00
Washing area 62.00
Pressing and ironing area 59.50
Toilet 6.00

Q. ELECTRICAL ROOM 18.00 sq.m. Carpentry workshop

48.00
R. MAINTENANCE AND MOTORPOOL 336.00 sq.m.

Office 36.00 sq.m.

Bio-medical equipment room 28.00
Mechanical and electrical room 32.00
Garage and work are- 164.00
Locker room and toilet 28.00

S. WATCHERS AREA

Multi-purpose area with balcony 94.80 sq.m.

Kitchen 7.20
Toilets 7.20
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Arch. Peter Villanueva
Laundry area 14.80 sq.m

GUIDELINES IN THE PLANNING AND DESIGN OF A HOSPITAL

AND OTHER HEALTH FACILITIES
(from annex 2 of Revised rules and regulations, series of 2002)
A hospital and other health facilities shall be planned and designed to observe appropriate
architectural practices, to meet prescribed functional programs, and to conform to
applicable codes as part of normal professional practice. References shall be made to the
following:
1. P.D. 1096 National Building Code
2. P.D. 1185 Fire Code of the Philippines
3. P.D. 856 Code on Sanitation of the Philippines
4. B.P. 344 Accessibility Law
5. R.A. 1378 National Plumbing Code of the Philippines
6. R.A. 184 Philippine Electrical Code
7. Manual on Technical Guidelines for Hospitals and Health Facilities Planning and
Design, Department of Health, Manila, 1994
8. Health Facilities Maintenance Manual. Department of Health
9. Manual on Hospital Waste Management. Department of Health, Manila, 1997.
10. District Hospitals: Guidelines for Development. World Health Organization,1992
11. Guidelines for Construction and Equipment of Hospital and Medical Facilities.
American Institute of Architects, Committee on Architecture for Health, 1992
12. Time-Saver Standards for Building types. De Chiara, Joseph.

PATIENT MOVEMENT

Corridors for access by patient and equipment shall have a minimum width of 2.44 meters.
Corridors in areas not commonly used for bed, stretcher, and equipment transport may be
reduced in width to 1.83 meters.
A ramp or elevator shall be provided for ancillary, clinical and nursing areas located on the
upper floor.

SEGREGATION
Wards shall observe segregation of sexes. Separate toilet shall be maintained for patients
and personnel, male and female, with a ratio of one toilet for every 8 patients or personnel.

PARKING
A hospital and other health facilities shall provide a minimum of 1 parking space for every
25 beds.

ZONING
Outer zone areas that are immediately accessible to the public: emergency service,
outpatient service, and administrative service. They shall be located near the entrance of
the hospital.

Second zone areas that receive workload from the outer zone: laboratory, pharmacy, and
radiology. They shall be located near the outer zone.

Inner zone areas that provide nursing care and management of patients: nursing service.
They shall be located in private areas but accessible to guests.

Deep zone areas that require asepsis to perform the prescribe services: surgical service,
delivery service, nursery, and intensive care. They shall be segregated from the public
areas but accessible to the outer, second and inner zones.

Service zone areas that provide support to hospital activities: dietary service,
housekeeping service, maintenance, and motor pool service, and mortuary. They shall be
located in areas away from normal traffic.

NURSE STATION RATIO

1 nurse station for every 35 beds.

REFERENCES ;

BUILDING TYPES BASICS FOR HEALTH CARE FACILITIES

BY MICHAEL BOBROW; JOHN WILEY AND SONS INC., 2000

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Arch. Peter Villanueva
MANUAL ON TECHNICAL GUIDELINES FOR HOSPITALS AND HEALTH FACILITIES
PLANNING AND DESIGN, Department of Health, Manila, 2001

ADMINISTRATIVE ORDER NO. 70-A, SERIES OF 2002 REVISED RULES AND

REGULATIONS GOVERNING THE REGISTRATION, LICENSURE AND OPERATION OF
HOSPITALS AND OTHER HEALTH FACILITIES IN THE PHILIPPINES. Department of Health,
2002

TIMESAVERS STANDARDS FOR BUILDING TYPES. DE CHIARRA, JOSEPH; INTERNATIONAL

EDITION 2001.

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Arch. Peter Villanueva