AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Using approved recommendations and findings of the strategic plan, findings

of physical and functional evaluations and workload projections, the functional
planner formulates recommendations for operational concepts, the detailed
room composition of the project, required phasing, alterations, internal and
external traffic flows, interdepartmental relationships and operating systems.

5. Space programming:

Based on the functional program, as amended and approved by the hospital a

room by room listing is made of all areas in the proposed project. Net square
footage is assigned to each space, and totals accumulated for every
department or functional entity. using the net figures, appropriate calculations
are then made to set gross totals for each department or functional entity as
well as the total for the entire project.

Some pointers to successful hospital planning

Good planning is critical to the hospitals success:

If a hospital has to be successful it must be built on the bedrock of three sound
principle namely good planning, good design and construction and good
management. The absence of the first two of the equally important but closely
related triad, good planning and good design and construction means failure to
design the facilities for the optimum utilization of staff and services. This in turn
results in a mediocre hospital that fails to realize its economic goals.

Efficient, Functional and economical hospital:

The real test of any hospital is the quality of healthcare it provides. If the hospital
has to pass this test- a truly rugged test-planning and design must result in a
functional, efficient and economical hospital. It should be remembered that even
minor defects in designing could make the operation of a hospital inefficient. The
corollary of this is that an inefficient hospital costs significantly more to operate,
staff and maintain, not to mention the fact that the patients within it get less
health services for the money they pay.

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

It should be borne in mind that economy of operation and maintenance over the
life of the building as well as the quality care to patients depends in a large
measure on the proper planning and designing of the hospital and is more
important than the economy of construction. The initial cost of building a hospital
is insignificant when compared to the cost of running and maintaining it over the
years- by one reckoning eighteen to twenty times over a period of say twenty
years. Another study says that the running cost of a hospital over 4 to 5 years
from the date of completion is about the same as the capital cost. and if the
facilities are not planned and designed properly this intangible cost can be
enormous. the efficiency with which the physicians and their assistants can
function has been greatly handicapped by obsolete design. Patient comfort and
provision for expansion have often been overlooked. Growing efficiency and
innovative ideas have revolutionized hospital building construction to meet
among other things, the special needs of patients. It is believed that a pleasant
environment that makes for an enthusiastic and more productive staff also
benefits the patients albeit indirectly.

Promoters and hospital planners often overlook to include in the facilities design
what helps to preserve the patients' dignity and status as a human being or
details that would make the hospital more livable. Many patients complain that
hospitals as institutions reduce privacy, individuality and more importantly
human dignity. Many of these details and facilities can be incorporated with little
or no extra cost.
While planning and designing a hospital the patients needs and expectations
should be kept uppermost in mind and any design should aim at his satisfaction
and comfort.
Today's healthcare facility is by its very nature a complicated entity and planning
and designing such a facility to serve the increasingly complex needs of its
patients, staff and management team is difficult and complicated. The problem is
compounded by rapid changes and advances that are taking place in the fields of
technology and medicine and the constant need to modernize, renovate, replace
and expand healthcare facilities.
Process of planning:

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

A common understanding should be established between the architect and the

engineers on one hand and the promoters, doctors, administrators and planners
on the other. A wide variety of professionals need to be integrated into a
planning team that is responsible for the implementation of this complex process.
Initial planning encompasses the general physical facilities that are being
considered, the space requirements, cost constraints, time schedules, standards
that must be included.
In the next step details of the operational plan for each department should be
considered- location of each department, requirement of floor space,
intradepartmental and interdepartmental relationships, circulation, traffic flow
and requirements in relation to equipment, personnel and patients.

Operational and Functional planning first:

Before any plans can be drawn by the architect an understanding of the

requirements of the hospital in terms of services it is going to provide, number of
beds, departmental functions, departmental needs, major equipment, space
requirements, required personnel, relationships and adjacencies must be agreed
upon. All this must form a written document. This is called operational planning-
a written programme needed for any architectural project.
Operational planning establishes a dept-by dept description of needed space by
outlining for example, the no. and type of surgeries, X ray rooms, outpatient
services, laboratory services etc. the exercise thus determines current and
projected needs within the facility. A consultant or an administrator who is
knowledgeable and has experience in the operation of the hospital is by far the
best person to develop this document. Normally there is either no briefing of the
architect or the brief given to him is inadequate. The promoters must clearly tell
the architect the requirements of the hospital and not the other way round. The
architect should not dictate to them nor should he conjecture what the
requirements are or what he should design. More often than not there is no
written brief or operational program and to know what is needed the architect
has to fend for himself. Sometimes he is asked to prepare his building schedules
with the help of doctors, at other times he is asked to observe other hospitals
and take guidelines from them. Both these are unsatisfactory methods.

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Key to Functional planning:

The proper sequence is the development of operational planning that defines

the major requirements and needs first. The operational plan is then developed
into a functional plan. Planning of the hospital on a functional basis-that lists
every room and suggests net sizes for major functional rooms and the total size
of the department. The key to functional planning is not just a room list but
understanding that travel and adjacencies will affect operational cost for the life
of the facility says David R. Porter the renowned hospital architect.

Mistakes in planning may prove costly:

Instances are aplenty of hospitals that were not planned with these critical
factors in mind-within five to ten years they found that the cost of construction
had been equalled or surpassed by operating expenses.
Functional grouping of high traffic areas such as X-ray, laboratories, surgical and
delivery suites, physical therapy and clinics on two floors is desirable. It permits
concentration of hospital activities in a manageable unit. When future expansion
or changes becomes necessary, they can be accomplished without disturbing the
nursing areas.

Operational Plan and Functional Plan must precede Architectural Plans:

Planning and Building a hospital to serve the increasingly complex needs of

modern healthcare is an intricate job. The architect though competent in his
profession may not be competent in the technical aspects of hospital architecture
and may lack knowledge of some of the specialized clinical and administrative
areas and matters. This document called the operational plan and functional plan
developed from it form the basis and are necessary prerequisites for the architect
to prepare the architectural plans.

Hospitals must be planned for the future:

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

A fundamental rule that promoters should remember is that the hospital should
be planned for at least 10 to 15 years ahead or else experts say plans will be
obsolete when they come to the drawing board. With the rapid development and
advances in technological, medical and administrative sciences and innovative
techniques and therapies, space requirements of every department has increased
markedly. New departments come to be needed, and more space is required to
some specialties. In addition to space needs, technology is imposing a host of
physical demands on our hospitals. Well planned systems must be built into them
to keep pace with the changes. Said one design expert ' We have got to design
`Smart` hospitals that respond to present needs while anticipating future
change.
Within the building all departments must be planned in such a way that they can
stand individually. This can be done by freely locating each department with
space around for expansion. Further care should be taken that expensive
permanent fixtures and fixed equipment such as plants and elevators are not
located at the free ends of the departments as they would permanently block
expansion plans. Future expansion is rendered easy with free ended buildings
with extendable corridors.

Space Program:

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

The space plan is made on the basis of personal interviews with hospital
administrators experienced in building hospitals and also with the help of
literature review and would help the architect in finalizing his plans. Hospitals are
a difficult planning subject as explained earlier. The maxim ‘Design follows
function’ must be kept in mind while allocating space details. The area
specifications may be taken as indicative as suitable alterations would have to be
made by the architect to conform to the grid matrix.
The total space area including the parking space, HVAC and water is 1,05,319 sq
ft which works out to be 1053.19 sq ft. This is in concurrence with modern
standards of constructing hospitals which provide for an area of 800-1200 sq ft
per bed.
Ground Floor:
Key Departments like OPD, Emergency, Radiology, Laboratory would be situated
on the ground floor. The Radiology dept. would be situated near the Emergency
dept.(According to a study nearly 40% of cases coming to Emergency require X
rays)
The administration department would be located on the 1st floor along with the
Blood bank and General and Paediatric wards.
The Labour room, Obstetric ward and NICU would be located on the 2 nd floor
along with the semi-private ward.
The CSSD would also be located on the 2nd floor just below the operation theatre
with provision for dumb waiters between the CSSD and the OT.
The OT’s will not be located on the top floor to avoid the excess heating nor will
they be located near the major traffic areas.
The ICU’s and private wards will also be located on the 3rd floor.
The residential area will be located on the 4 th floor just above the ICU’s and the
OT’s. So a doctor can easily attend to the patient when called.
30% of the area is kept for circulation.

Department wise area allocation

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Department Area sq.ft

General ward 3978

Semiprivate + deluxe 8437
Private+deluxe 8437
Obstetric Ward 3679
Paediatric Ward 2847
NICU 4921
ICU 7235
OT 5844
OPD 4940
Physiotherapy dept 975
Radiology 5005
Other diagnostic Facilities (ECG, 3380
EEG, Stress test, Endoscopy)
Laboratory 2425
Blood Bank 1840
Pharmacy Outlet 260
Pharmacy Store 520
MRD 1430
CSSD 1957
Laundry 1918
Kitchen 2300
Restaurant 2860
Housekeeping 325
Telecommunication 390
PR Department 260
Security 195
Auditorium 1950
Prayer Room 260
Mortuary 975
Library 390
Manifold Room 390
Administration 2314
A/c Department 780
Stores 2405
EDP 780
Emergency Room 1937
Ambulance 325
Telephone Booth 260
Shoppe 130
Executive health checkup 1300
Residents 15000
Total Space for 100 beds 105319

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Area per bed 1053.19

(Current standards 800-1200 sq ft)

Parking Space 46875

Electrical+HVAC+Water 4550

Distribution of floor space by wards and departments

Wards 45378 43%

Diagnostic Facilities 12650 12.01%
OPD+ Emergency+ Related Areas 10117 9.60%
Administrative Area 11349 10.78%
Service departments 10790 10.25%
Residential Areas 15000 14.25%
100%

Breakdown of Space Requirements of key departments

Area Sq ft per bed
Nursing Units 273.78
ICUs 121.56
Operation Theatres 58.44
Radiology 50.05
Laboratory 24.25
Pharmacy 7.8
CSSD 19.57
Dietary 23
MRD 14.3
Housekeeping Dept 3.25
Laundry 19.18
Mechanical Installations 49.4
Stores 24.05
Administration 30.94

Distribution of Beds
General 16
Semi- Private (two in one) 26
Private 13
Deluxe 6
ICU 10
NICU 9
Obstetric Ward 10
Paediatric 10
Total 100
Other Beds
Pre -op 4
Post op 6
Emergency 4

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Allocation of Departments floor wise

G+0
OPD 4940
Emergency 1937
Radiology 5005
Laundry 1918
Kitchen 2300
Physiotherapy 975
Pharmacy outlet 260
PR Dept 260
Manifold room 390
Shoppe 130
Telecommunications 390
Prayer Hall 260
Ambulance 325
Telephone booth 260
Mortuary 975
Laboratory 2425

Total space 22750

G+1
Restaurant 2860
Housekeeping 250
Administration 2314
Security 195
Accounts Department 780
Executive Health Check Up 1300
Blood Bank 1840
MRD 1430
General Ward 3978
Paediatric 2847
Other Diagnostic Facilities 3380
Pharmacy Stores 520
EDP Dept 780

Total space 22474

G+2
CSSD 1957
Semiprivate ward + Deluxe beds 8437
Stores 2405
Obstetric ward 3679
NICU 4921

Total Space 21399

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

G+3
OT 5844
ICU 7235
Private + Deluxe 8437

Total space 21516

G+4
Residential Area 15000
Library 390
Auditorium 1950

Total space 17180

Department Wise Space Plan

General Ward

Beds 16 120 1920

Nursing Station 1 200 200
Doctors room 1 100 100
Nurses room 1 100 100
Treatment room 1 100 100
Staff toilet 1 50 50
Store 1 60 60
Pantry 1 60 60
Clean utility room 1 60 60
Dirty utility room 1 60 60
Toilets General 3 50 150
Waiting Area 1 200 200
3060
Add 30% circulation space 918
Total space 3978

Semi private (2 in 1)

Beds 26 175 4550

Beds deluxe 3 350 1050
Nursing station 1 200 200
Dr's room 1 100 100

Nurses rest room 1 100 100

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Store 1 60 60
Pantry 1 60 60
Clean utility room 1 60 60
Dirty utility room 1 60 60
Toilet 1 50 50
Waiting area 1 200 200
6490
Add 30% circulation space 1947
Total Space 8437

Single Room\ Private

Beds 13 350 4550

Beds deluxe 3 350 1050
Nursing station 1 200 200
Dr's room 1 100 100
Nurses rest room 1 100 100
Store 1 60 60
Pantry 1 60 60
Clean utility room 1 60 60
Dirty utility room 1 60 60
Toilet 1 50 50
Waiting area 1 200 200
6490
add 30% circulation space 1947
Total Space 8437

ICU
Beds 8 225 1800
Beds - Isolation room 2 250 500
Nursing Station 1 350 350
Equipment Room 1 250 250
Stat Lab 1 50 50
Doctors Room 1 100 100
Nurses Rest room 1 100 100
Toilet (staff) 1 50 50
Toilets -General 2 50 100
Store 1 60 60
Pantry 1 60 60
Clean Utility Room 1 60 60
Dirty utility Room 1 60 60
Waiting Area 1 300 300
Beds For Relatives 10 150 1500
Toilets cum Bath 3 75 225

5565

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Add 30% circulation space 1670

Total space 7235

NICU

Open Care units 9 125 1125

Nursing Station 1 200 200
Equipment store room 1 200 200
Doctors room 1 100 100
Nurses rest room 1 100 100
Toilets staff 2 50 100
Component milk formula room 1 50 50
Feeding room 1 60 60
Nursing room 1 100 100
Toilets - General 3 50 150
Waiting Room 1 250 250
Beds for relatives 9 150 1350
3785
Add 30% circulation space 1136
Total space 4921

Obstetric Ward
Beds 10 120 1200
Nursing Station 1 200 200
Doctors room 1 100 100
Nurses room 1 100 100
Clean utility 1 60 60
Dirty utility 1 60 60
Pantry 1 60 60
Staff toilet 1 50 50
General toilets 2 50 100
Store 1 100 100
Labour rooms 2 300 600
Waiting Area 1 200 200
2830
Add 30% circulation space 849
Total space 3679

Paediatric Ward
Beds 10 120 1200
Nursing Station 1 200 200
Doctors room 1 200 200

Nurses room 1 100 100

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Clean utility 1 60 60
Dirty utility 1 60 60
Pantry 1 60 60
Store 1 60 60
Toilet- Staff 1 50 50
Toilet- General 2 50 100
Waiting Area 1 200 200
2190
Add 30% circulation Space 657
Total space 2847

Operation Theatre
OT rooms
General OT Room 2 450 900
Specialty OT Room 1 625 625
Scrub room 2 100 200
Instrument room 2 100 200
Wash room/ Dirty utility 2 60 120
Store room 1 200 200
Chief anaesthetist room 1 100 100
Dr's room 1 150 150
OT incharge room 1 60 60
Nurse room 1 60 60
Dumbwaiters 2 20 40
Pantry 1 40 40
Equipment room 1 200 200
Trolley bay 1 150 150
Toilet 2 40 80
Change rooms 3 50 150
Reception 1 60 60
Waiting room 1 100 100
Pre operation room 4 beds 350
Post operation room 6 beds 600
4495
Add 30% circulation space 1349
Total 5844

OPD
May I help you desk 1 50 50
Registration/billing 1 200 200
Waiting area-- Reception 1 500 500
Toilets (M&F) 8 25 200
Reception and Records room 1 250 250
OPD waiting area 1 400 400
Consultants rooms (Medicine, 5 150 750

Surgery, Gyn obs, Paed & Ortho)

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Sub Waiting Areas 5 50 250

Staff toilets 2 50 100
Doctors toilets 1 75 75
Trolley/ Wheelchair bay 1 200 200
Collection room 1 50 50
Minor OT 1 300 300
OPD Store 1 75 75
Staff room 1 250 250
Administrators office 1 150 150
3800
Add 30% circulation space 1140
Total 4940

Other Diagnostic Facilities

ECG Room 1 300 300
EEG Room 1 350 350
2 D echo room 1 500 500
Stress Test Room 1 750 750
Endoscopy Dept
Reception 1 50 50
Waiting 1 200 200
Consultation 1 100 100
Endoscopy room 1 350 350
2600
Add 30% circulation Space 780
Total 3380

Physiotherapy Department 1 750 750

add 30% circulation space 225
total 975

Radiology
MRI 1 750 750
Ultrasound 1 350 350
Ultrasound Room
Change room
Sub Waiting
X ray- General 1 650 650
Radiography room
Control room
Change room
Sub waiting
Special X ray 1 900 900
Radiography room

Control room

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Change room
Toilet
Barium Preparation
Sub- Waiting

Staff room 1 100 100

Radiologist room 1 100 100
Waiting room 1 300 300
Reception 1 100 100
Technicians room 1 100 100
Staff toilets 2 50 100
Records room 1 150 150
Film Store 1 150 150
Reporting room 1 100 100
3850
Add 30% circulation space 1155
5005

Laboratory
Reception 1 75 75
Biochemistry 1 300 300
Haematology & clinical pathology 1 200 200
Histopathology 1 200 200
Microbiology 1 200 200
Serology 1 200 200
Sample collection 1 150 150
Toilet 1 40 40
Toilets (staff) 2 50 100
Waiting 1 100 100
Report dispatch area 1 100 100
Staff room 1 100 100
Technicians 1 100 100
1865
Add 30% circulation space 560
Total 2425

Blood Bank
Waiting area 1 200 200
Examination room 1 75 75
Recovery& refreshment room 1 150 150
Bleeding room 1 150 150
Staff room 1 60 60
Blood bank in charge room 1 100 100
Component separation room 1 400 400
Toilet (staff/visitors) 2 40 80

Issue counter 1 50 50

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 AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL

Store room 1 150 150

1415
Add 30% circulation space 425
Total 1840

Pharmacy
Store area 1 400 400
Retail area 1 200 200
600
Add 30% circulation space 180
Total 780

MRD
Process room 1 500 500
Office room 1 100 100
Record cum store room 1 500 500
1100
Add 30% circulation space 330
Total 1430

CSSD
Receipt area 1 100 100
Wash room 1 200 200
Gloves sterilizing room 1 75 75
Change room 1 50 50
CSSD Supervisor room 1 100 100
Clean area for packing 1 100 100
Actual sterilizing room 1 450 450
Sterile store room 1 200 200
Staff toilets 2 40 80
Trolley Park 1 150 150
Dumb Waiters 2 20 40
1505
Add 30% circulation space 452
Total 1957

Laundry
Receipt area 1 100 100
Dirty area 1 150 150
Ironing/ wash area 1 400 400
Laundry incharge room 1 150 150
Toilet 1 50 50
Store room 1 200 200
Mending room 1 100 100

Delivery/ Distribution 1 100 100

33