EDESIGN Hospital PDF

H +
H
UNIVERSAL SYMBOL
FOR HOSPITALS DURING
TIMES OF PEACE
+ UNIVERSAL SYMBOL
TIMES OF CONFLICT
H
UNIVERSAL SYMBOL
TIMES OF PEACE
+ UNIVERSAL SYMBOL
TIMES OF CONFLICT
HOSPITAL
• A place where sick or injured
people are given care or
treatment and where children
are often born
HOSPITAL • A charitable institution for the
needy, aged, infirm or young
• An institution where the sick
or injured are given medical
or surgical care
Merriam-Webster DIctionary
Etymology :
Middle English, from Anglo-
French from Medieval Latin
HOSPITAL “hospitale”(hospice), guest
house from neuter of Latin
“hospitalis” of a guest, from
hospit-, hospes (14th Century)
Merriam-Webster DIctionary
San Lazaro Hospital
- Oldest Hospital
Oldest Hospital in the country, established as a dispensary clinic in

Intramuros in 1557 by Spanish Frey Juan Clemente
• Classified under
Group D Institutional
HOSPITAL – Government &
Health Services
Based on Rule VII.1 of the NBC, Schedule of Principal, Accessory &

Conditional Use / Occupancy of Building / Structure
• A community to national
level of institutional use, or
occupancy, characterized
mainly as a low – rise,
medium – rise or high – rise
HOSPITAL building / structure for
medical, government
service administrative and
related services.
Based on Rule VII.1 of the NBC, Schedule of Principal, Accessory &

Conditional Use / Occupancy of Building / Structure
• ACCORDING TO OWNERSHIP
• ACCORDING TO SCOPE OF
SERVICES
• ACCORDING TO FUNCTIONAL
TYPES OF HOSPITALS CAPACITY
• BY SERVICE CAPABILITY
• BY OPERATION
• BY BED STRENGTH
Based on DOH (2015) Administrative Order 2012-0012. Rules and
Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
• ACCORDING TO OWNERSHIP
• ACCORDING TO SCOPE OF
SERVICES
• ACCORDING TO FUNCTIONAL
TYPES OF HOSPITALS CAPACITY
• BY SERVICE CAPABILITY
• BY OPERATION
• BY BED STRENGTH
ACCORDING TO OWNERSHIP
• GOVERNMENT
TYPES OF HOSPITALS
• PRIVATE

GOVERNMENT
• The hospital is created by law.
• A government health facility
may be under the National
TYPES OF HOSPITALS Government, DOH, Local
Government Unit (LGU),
(by Ownership) Department of Justice (DOJ),
State Universities and Colleges
(SUCs), Government-owned
and controlled corporations
(GOCC) and others
Philippine General
Hospital
-Government
Founded 1907, designed by Arch.William E. Parsons based on the plans

by Daniel Burnham
PRIVATE
• Owned, established, and
TYPES OF HOSPITALS operated with funds from
donation, principal,
(by Ownership) investment, or other means by
any individual, corporation,
association, or organization

Asian Hospital and
Medical Center
- Private
Founded in 2002, designed by Luis and Associates

ACCORDING TO SCOPE OF SERVICES
• GENERAL
TYPES OF HOSPITALS
• SPECIALTY

GENERAL
TYPES OF HOSPITALS • A hospital that provides
services for all kinds of
(by Scope of Services) illnesses, diseases, injuries
or deformities

GENERAL
• It provides medical
TYPES OF HOSPITALS and surgical care to
(by Scope of Services) the sick and injured,
maternity, newborn
and child care
GENERAL
• It shall be equipped with
the service capabilities
TYPES OF HOSPITALS needed to support board
(by Scope of Services) certified/ eligible medical
specialists and other
licensed physicians
rendering various services.
GENERAL
• Clinical Services (Family
Medicine, Pediatrics, Internal
Medicine, Obstetrics and
Gynecology, Surgery)
TYPES OF HOSPITALS • Emergency Services
(by Scope of Services) • Outpatient Services
• Ancillary and Support Services
(Clinical Laboratory, Imaging
Facility, Pharmacy)
Chinese General
Hospital and Medical
Center
- General
Founded in 1891 by Cralos Palanca Tanchueco and with businessmen

Chan Guan and Mariano Velasco
SPECIALTY
TYPES OF HOSPITALS • Specializes in a particular
(by Scope of Services) disease or condition or in
one type of patient

SPECIALTY
A specialized hospital may be devoted to
the treatment of the following:
• Treatment of a particular type of
illness or for a particular condition
requiring a range of treatment
TYPES OF HOSPITALS • Treatment of patients suffering
(by Scope of Services) from a particular diseases of a
particular organ or group of
organs
• Treatment of patients belonging to
a group such as children, women,
elderly or others
SPECIALTY
A specialized hospital may be devoted to
the treatment of the following:
• Treatment of a particular type of
illness or for a particular condition
requiring a range of treatment
TYPES OF HOSPITALS • Treatment of patients suffering
(by Scope of Services) from a particular diseases of a
particular organ or group of
organs
• Treatment of patients belonging
to a group such as children,
women, elderly or others
Philippine Heart
Center of Asia
-Specialty
Designed by Arch. Jorge Ramos, inaugurated 1975

ACCORDING TO FUNCTIONAL CAPACITY
• GENERAL HOSPITAL (LEVELS 1 to 3)

TYPES OF HOSPITALS • SPECIALTY HOSPITALS
• TRAUMA HOSPITALS

LEVEL 1 GENERAL HOSPITAL
• A staff of qualified, medical, allied
medical and administrative
personnel headed by a physician
duly licensed by the PRC
TYPES OF HOSPITALS • Bed space for its authorized bed
(by Functional capacity, in accordance with DOH
Guidelines in the Planning and
Capacity) Design of Hospitals
• An operating room with standard
equipment and provisions for
sterilization of equipment and
Based on DOH (2015) Administrative Order 2012-0012. Rules and supplies in accordance with:
• DOH Reference Plan in the
Planning and Design of an
Operating Room or Theater
• DOH Guidelines on Cleaning,
TYPES OF HOSPITALS Disinfection, and Sterilization of
Reusable Medical Devices in
(by Functional Hospital Facilities in the
Philippines
Capacity) • A post-operative Recovery Room
• Maternity Facilities consisting of
Ward(s), Room(s), a Delivery
Room, exclusively for maternity
patients and newborns
• Isolation facilities with proper
procedures for the care and control of
infection and communicable diseases
as well as for the prevention of cross
infection
TYPES OF HOSPITALS • A separate dental section/ clinic
• Provision for blood donation
(by Functional • A DOH-licensed secondary clinical
Capacity) laboratory with the services of a
consulting pathologist
• A DOH licensed Level 1 imaging facility
with the services of a consulting
radiologist
Based on DOH (2015) Administrative Order 2012-0012. Rules and • A DOH licensed pharmacy
• As minimum, all of Level 1
capacity, including but not limited
to:
TYPES OF HOSPITALS An organized staff of qualified and
competent personnel with Chief
(by Functional of Hospital/Medical Director and
appropriate board certified
Capacity) Clinical Department Heads

• Departmentalized and equipped
with the service capabilities
needed to support board
certified/ eligible medical
TYPES OF HOSPITALS specialties and other licensed
(by Functional physicians rendering services in
the specialties of Medicine,
Capacity) Pediatrics, Obstetrics and
Gynecology, Surgery, their
subspecialties, and other ancillary
services
• Provision for general ICU for
critically ill patients
• Provision for NICU
• Provision for HRPU
TYPES OF HOSPITALS • Provision for Respiratory Therapy
(by Functional Services
• A DOH licensed tertiary clinical
Capacity) laboratory
• A DOH licensed level 2 imaging
facility with mobile X-ray inside
the institution and with capability
Based on DOH (2015) Administrative Order 2012-0012. Rules and for contrast examinations
• As minimum, all of Level 2, including
but not limited to:
Teaching and/or Training Hospital with
accredited residency training program
TYPES OF HOSPITALS for physicians in the four major
specialties namely: Medicine,
(by Functional Pediatrics, Obstetrics and Gynecology,
Capacity) and Surgery

• Provision for physical medicine and
rehabilitation unit
• Provision for ambulatory surgical clinic
TYPES OF HOSPITALS • Provision for dialysis facility
(by Functional • Provision for blood bank
• A DOH licensed level 3 imaging facility
Capacity) with interventional radiology

TYPES OF HOSPITALS SPECIALTY HOSPITAL
(by Functional
Capacity)

Philippine Orthopedic
Center
-Trauma
Designed by Francisco Manosa and Partners, inaugurated 2004

TRAUMA HOSPITAL
• The trauma capability of hospitals
shall be assessed in accordance with
the guidelines formulated by the
Philippine College of Surgeons
• Trauma Capable Facility is a DOH
TYPES OF HOSPITALS licensed hospital designated as a
Trauma Center
(by Functional • Trauma Receiving Facility is a DOH
licensed hospital within the trauma
Capacity) service area which receives trauma
patients for transport to the point of
care or a trauma center

BY SERVICE CAPABILITY
• PRIMARY
TYPES OF HOSPITALS • SECONDARY
• TERTIARY
Based on DOH Manual on the Technical Guidelines for Hospitals and

Health Facilities Planning and Design (DOH, 2001)
• PRIMARY – equipped with the service
capabilities needed to support licensed
physician rendering service in:
TYPES OF HOSPITALS • Medicine
(by Service Capability) • Pediatrics
• Obstetrics, and
• Minor Surgery

• SECONDARY – equipped with the service
capabilities needed to support licensed
physician rendering services in the field of:
TYPES OF HOSPITALS • Medicine
• Pediatrics
(by Service Capability) • Obstetrics, and Gynecology
• General Surgery and
• Ancillary S

• TERTIARY – Fully departmentalized and
equipped with service capabilities needed
to support certified Medical Specialists and
other licensed physicians rendering
TYPES OF HOSPITALS services in the field of:
• Medicine
(by Service Capability) • Pediatrics
• Obstetrics and Gynecology
• Surgery and their
• Subspecialties and Ancillary Services

BY OPERATION
• TEACHING OR TRAINING
• FRONTLINE HOSPITAL
TYPES OF HOSPITALS • OUTPATIENT HOSPITAL

Health Facilities Planning and Design (DOH, 2001), the Whole Building
Design Guide (WBDG, 2011), and The Frontline Hospital by Philip Mein
(World Health Organization)
The Medical City
-Teaching
Designed by Francisco Manosa and Partners, inaugurated 2004

UST Hospital
-Teaching
Inaugurated 1945 in Espana, Manila, 2011 expnasion by Arch. John

Joseph Fernandez
• TEACHING OR TRAINING
TYPES OF HOSPITALS • Departmentalized hospital with accredited
Residency Training Program in a specified
(by Operation) specialty or discipline

• FRONTLINE HOSPITAL
• The farthest outpost for organized
healthcare to which the sick were
TYPES OF HOSPITALS expected to come
• The forefront of health care delivery
(by Operation) • Typically rural hospitals
• Centre for outreach and primary
health care serving community health
needs within its catchment area
Based on The Frontline Hospital by Philip Mein (World Health

Organization)
American Outpatient
Clinic
-Outpatient
Americzan Hospital, Intramuros, Manila

• OUTPATIENT HOSPITAL
• A type of hospital without overnight
patients, loosely called clinics
• Generally less expensive to build and
operate compared to a bedded
TYPES OF HOSPITALS hospital
• Can range from simply Physicians’
(by Operation) Offices providing primary health care
to large, independent “hospitals
without beds” to community-level
outpatient clinics that are satellites of
larger medical centers or systems
Based on the Whole Building Design Guide (WBDG, 2011)

BY BED STRENGTH
• SMALL : less than 100 beds

TYPES OF HOSPITALS •
•
MEDIUM: 100 to 300(up to 500) beds
LARGE: more than 500 beds

Health Facilities Planning and Design (DOH, 2001), the Whole Building
Design Guide (WBDG, 2011), and The Frontline Hospital by Philip Mein
(World Health Organization)
Primary Health Care
Programme
From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
Definition of a
District Hospital

1998)
• The term "district hospital" is
used here to mean a hospital
at the first referral level that
is responsible for a district of
a defined geographical area
Definition of a containing a defined
District Hospital population and governed by a
politico-administrative
organization such as a district
health management team
1998)
• Such hospitals can provide
wide-ranging support for
patient referral as well as
Role of a support for various
District Hospital technical, administrative
and educational/training
activities in the district.

1998)
Services of a
District Hospital

1998)
Services of a
District Hospital

1998)
(1) Total number of admissions
per year
(2) Bed-days per year
Size of the Hospital (3) Total number of beds
required when based on
occupancy

1998)
(1) Total number of admissions per
year = district population x rate of
admission per year
Size of the Hospital

1998)
(1) Total number of admissions per
year = district population x rate of
admission per year

= 150,000 x 1/20
= 7,500

1998)
(2) Bed-days per year =
total number of admissions per
year x average length of stay in
hospital

1998)
(2) Bed-days per year =
total number of admissions per
year x average length of stay in
hospital

= 7,500 x 5
= 37,500

1998)
(3) Total number of beds required
when occupancy is 100% =
Bed days per year / 365 days

1998)
(3) Total number of beds required
when occupancy is 100% =
Bed days per year / 365 days
Size of the Hospital = 37, 500 / 365

= 102.74
say 105 beds.

1998)
(4) Total area of hospital =
total number of beds x 40 square
meters per bed
Size of Hospital

1998)
(4) Total area of hospital =
total number of beds x 40 square
meters per bed
Size of Hospital
= 105 beds x 40
= 4,200 square meters

1998)
Location of the
Hospital

1998)
INVENTORY& DISTRIBUTION OF HEALTH
FACILITIES
Location of the
Hospital
One of the most effective ways of determining
the location of a new facility is to use a base
map of the district and vicinity, on which one
can enter, translate and compare data, facts
and information
1998)
INVENTORY& DISTRIBUTION OF HEALTH
FACILITIES
Location of the
Hospital
One of the most effective ways of determining
the location of a new facility is to use a base
map of the district and vicinity, on which one
can enter, translate and compare data, facts
and information
1998)
SERVICE CATCHMENT AREA:
POLITICO-ADMINISTRATIVE BOUNDARIES
Politico-administrative boundaries
are usually the strongest
determinant, as they set a defined
Location of the area and imply an established
organization which directs,
Hospital manages and operates the affairs
of the population within its
jurisdiction

1998)
GEOGRAPHICAL BOUNDARIES
Location of the
Hospital

1998)
TIME BOUNDARIES
Location of the
Hospital

1998)
(1) It should be within 15-30 min
Factors to consider in travelling time. In a district with good
roads and adequate means of
locating a District transport, this would mean a service
zone with a radius of about 25 km.
Hospital

1998)
(1) It should be within 15-30 min
Factors to consider in travelling time. In a district with good
roads and adequate means of
locating a District transport, this would mean a service
zone with a radius of about 25 km.
Hospital

1998)
(2) It should be grouped with
Factors to consider in other institutional facilities, such as
locating a District religious (church), educational
(school), tribal (cultural) and
Hospital commercial (market) centres.

1998)
(2) It should be grouped with
Factors to consider in other institutional facilities, such as
locating a District religious (church), educational
(school), tribal (cultural) and
Hospital commercial (market) centres.

1998)
(3) It should be free from dangers of
flooding; it must not, therefore, be
Factors to consider in sited at the lowest point of the
locating a District district.
Hospital

1998)
(3) It should be free from dangers of
flooding; it must not, therefore, be
Factors to consider in sited at the lowest point of the
locating a District district.
Hospital

1998)
(4) It should be in an area free of
pollution of any kind, including air,
Factors to consider in noise, water and land pollution.
locating a District
Hospital

1998)
(4) It should be in an area free of
pollution of any kind, including air,
Factors to consider in noise, water and land pollution.
locating a District
Hospital

1998)
(5) It must be serviced by public
utilities: water, sewage and storm-
water disposal, electricity, gas and
Factors to consider in telephone.
locating a District
Hospital

1998)
locating a District
Hospital

1998)
locating a District In areas where such utilities are not
available, substitutes must be found, such as
Hospital a deep well for water, generators for
electricity and radio communication for
telephone.

1998)
Site Selection
CRITERIA

1998)
Site Selection
CRITERIA
SIZE OF THE SITE
The site must be large enough for all the
planned functional requirements to be met
and for any expansion envisioned within the
coming ten years (Fig. 5).
1998)
Site Selection
CRITERIA
SIZE OF THE SITE
The site must be large enough for all the
planned functional requirements to be met
and for any expansion envisioned within the
coming ten years (Fig. 5).
1998)
TOPOGRAPHY
• A flat terrain is the easiest and least
expensive to build on.
Site Selection
CRITERIA

1998)
TOPOGRAPHY
• A rolling or sloping terrain is more
difficult and more expensive to build on,
but the solutions can be interesting and
innovative; by using the natural slope of
the ground, the drainage and sewage
disposal systems can be designed so as to
Site Selection result in lower construction and
maintenance costs
CRITERIA

1998)
DRAINAGE
Site Selection The terrain must allow for easy
movement of water away from the
CRITERIA site. A high point in the community is
ideal.

1998)
DRAINAGE
If a “high point” is not available and the
site is at a low point or in a depression,
the following must be checked:
• how the surrounding natural terrain and
Site Selection waterways can be used to move water
away from the site;
CRITERIA • whether the type of soil allows rapid
absorption and disposal of water;
• the use of other technical means of
ensuring drainage such as the building
on a podium or on stilts, or digging
temporary reservoirs
1998)
DRAINAGE
If a “high point” is not available and the
site is at a low point or in a depression,
the following must be checked:
• how the surrounding natural terrain and
Site Selection waterways can be used to move water
away from the site;
CRITERIA • whether the type of soil allows rapid
absorption and disposal of water;
• the use of other technical means of
ensuring drainage such as the building
on a podium or on stilts, or digging
temporary reservoirs
1998)
Site Selection
CRITERIA

1998)
Site Selection
CRITERIA

1998)
Site Selection
CRITERIA

1998)
SOIL CONDITIONS
• Waterlogged areas, swamps and former
ricefields should be avoided
• Check the bearing capacity of the soil.
As foundation requirements vary greatly
with the form of construction and the
building materials used, the subsurface
Site Selection soil and water conditions must be
determined
CRITERIA • Scrap unstable top layers, if necessary,
and fill with well compacted, suitable
materials, like clean coarse sand
• Seek engineering advice before finalizing
the depth and size of the foundations,
From the World Health Organization Western Pacific Series District which should be designed to suit the site
1998)
conditions
SOIL CONDITIONS
determined
1998)
conditions
SOIL CONDITIONS
determined
1998)
conditions
SOIL CONDITIONS
determined
1998)
conditions
UTILITIES
• Electrical, water and communication
lines should be available. If not,
generators, deep wells and water pumps
Site Selection must be provided and radio
communication lines established
CRITERIA • Health care facilities are quite ineffective
if all-weather roads, water supplies and
a reliable electrical supply are not
available at the site.

1998)
NATURAL FEATURES
• Building design should respond as much as
possible to the site, so that the structure is in
context with the environment.
Site Selection
CRITERIA

1998)
NATURAL FEATURES
Site Selection
CRITERIA

1998)
NATURAL FEATURES
Site Selection
CRITERIA
• A waterway that bisects a site also generally

bisects the building form; this might call for
From the World Health Organization Western Pacific Series District an innovative design solution.
1998)
NATURAL FEATURES
Site Selection
CRITERIA

1998)
NATURAL FEATURES
Site Selection
CRITERIA
• The presence of a large pond on a site

diminishes its area and coverage and might
From the World Health Organization Western Pacific Series District call for a multi-storey solution on a site
1998)
NATURAL FEATURES
Site Selection
CRITERIA

1998)
NATURAL FEATURES
• Solutions can be numerous, involving
creativity and innovation, but they should be
based on two overriding considerations:
(i) that the design respects and follows the
laws of nature; and
Site Selection (ii) (ii) that the limitations imposed by the
natural features do not detract from the
CRITERIA functional performance or cost-
effectiveness of the facility.

1998)
NATURAL FEATURES
• Solutions can be numerous, involving
creativity and innovation, but they should be
based on two overriding considerations:
(i) that the design respects and follows the
laws of nature; and
Site Selection (ii) (ii) that the limitations imposed by the
natural features do not detract from the
CRITERIA functional performance or cost-
effectiveness of the facility.

1998)
Site Selection
CRITERIA
LIMITATIONS
• Direct access from the road?
• Is it a contiguous piece with proper
ownership title?
1998)
Site Selection
CRITERIA LIMITATIONS
• Does the site have existing structures?
• Can they be incorporated into the
design of the new structure and the
existing parts converted into
From the World Health Organization Western Pacific Series District functional spaces in the new
1998)
hospital?
Site Selection LIMITATIONS
CRITERIA • If the existing structures are too old to
become part of the new hospital, could
they be converted to a motor pool,
laundry, store or workshop? Are these
buildings suitably located on the site?
• Are they so old and dilapidated that
From the World Health Organization Western Pacific Series District they must be demolished? If so, are any
Health Facilities Guidelines for Development & Operations (WHO< of the parts, members or elements
1998)
retrievable for possible re-use?
DOCUMENTS
Master Physical • The Title
Development • The Survey Plan
• The Topographic Survey
BASIC DOCS & INFO • The Slope Map

1998)
THE SITE SURVEY
• Definitions of property line
• Dimensions and locations of any buildings,
structures, easements, rights-of-way or
encroachments on the site;
• All existing utility services, including their size
and characteristics;
Master Physical • Official data on which elevations are based

and permanent values established on or
adjacent to the site;
Development • Information regarding the disposal of
sanitary wastes and storm-water and
BASIC DOCS & INFO suitability of subsoil for disposal of rainwater
arid sewage;
• All trees and types of vegetation within the
plot; and
• Elevations on a horizontal grid system of not
more than 6-m interval, indicating changes of
slope, to form a basis for a contour map of
1998) 50-cm intervals.
LEGAL DOCUMENTS
Master Physical • Zoning Restrictions
Development • BuIlding Code
• Fire Code
BASIC DOCS & INFO • Other Codes

1998)
OPERATIONAL FUNCTIONS
• Aims and objectives of the services to be
provided
• Patients and types
Master Physical • Types of illnesses to be treated
• (Activities involved
Development • Minor operational functions
• (Other functions contemplated (e.g.,
OPERATIONAL POLICY teaching, research)
• People involved (e.g., patients, staff,
researchers, students, outside faculty
members)

1998)
SCALE
Master Physical • Workload (e.g., daily number of in-
patients treated, of in-patient meals
Development served, of X-rays taken)
• Manpower and staffing needed to meet
OPERATIONAL POLICY the workload

1998)
• ORGANIZATIONAL POLICY
• Patient Movement
• Staff and Staffing Movement
• Supply Delivery
Master Physical • Disposal of Used Goods
• Laundry Services
Development • Food Services
• Domestic Services
OPERATIONAL POLICY • Engineering
• Fire Safety
• Communications and Call Systems
• ADMINISTRATION
1998)
DESIGN CONTROL PARAMETERS (DCP):
• Occupancy:
Group D Institutional Division 2
• Allowable Building Height Limit (BHL)

Master Physical = 15 meters (or 5 floors, at 3.0
Development meters F2F)
SITE UTILIZATION • Maximum Alllowable Building

Footprint (AMBF) for a regular lot
• W/ Sprinklers: 60% of TLA
• W/O Sprinklers: 50% of TLA
Based on Rule VII and VIII of the IRR of the National Building Code
• Occupancy:


• Occupancy:


• Parking Requirements:
• Public: 1 for every 25 beds
• Private: 1 for every 12 beds
• 1 Truck Loading Dock for every
Master Physical 5,000 SQM of GFA
Development • Maximum Allowable Floor-Area-Ratio:

2.50
SITE UTILIZATION
• Maximum Allowable PSO:
• W/O Firewalls: 50% of TLA
• W/ Firewalls: 60% of TLA

2.50
SITE UTILIZATION

2.50
SITE UTILIZATION

2.50
SITE UTILIZATION
ORIENTATION
Master Physical
Development
SITE UTILIZATION

1998)
ORIENTATION
Master Physical
Development
SITE UTILIZATION
• It has been found that orienting buildings

along an east-west axis, giving the longer
From the World Health Organization Western Pacific Series District sides of the building northern and southern
1998) exposures, is the most desirable.
ORIENTATION
Master Physical
Development
SITE UTILIZATION

1998)
ORIENTATION
• In areas where the major climatic

Master Physical problem is humidity rather than
Development heat, buildings should be sited at a
slight angle, either towards the east
SITE UTILIZATION or the west, depending on the
direction of the prevailing wind.

1998)
ORIENTATION
• Illumination and ventilation are

Master Physical major problems in hospitals, and
these are further aggravated by
Development modern trends to construct "deep"
SITE UTILIZATION buildings using steel and reinforced
concrete.

1998)
ORIENTATION
• Illumination and ventilation are

Master Physical major problems in hospitals, and
these are further aggravated by
Development modern trends to construct "deep"
SITE UTILIZATION buildings using steel and reinforced
concrete.

1998)
ORIENTATION
• Good ventilation in tropical climates

ideally requires long, narrow
Master Physical buildings; but this is not always
Development feasible, and a compromise must be
found by separating activities and
SITE UTILIZATION orientating buildings or wings of
buildings.

1998)
ORIENTATION
Master Physical • Incorrect orientation of buildings

Development strongly affects the consumption of
energy in the finished hospital.
SITE UTILIZATION

1998)
ORIENTATION
Master Physical • In areas where there are heavy rains

accompanied by wind, all openings
Development should be protected against wind-
SITE UTILIZATION driven rain.

1998)
ORIENTATION
• In hot, humid areas, the external

Master Physical surface should reflect as much solar
radiation as possible, and the walls
Development and roof should, as far as possible,
SITE UTILIZATION be made of lightweight material with
low thermal capacity.

1998)
SLOPE STUDY
Master Physical
Development • On sites with steep slopes, the best areas
SITE UTILIZATION for building must be found.
• As a rule, slopes of 0-10% are desirable and
easy to build on ;
• Slopes greater than these require either
massive cuts or massive fill or a
combination of the two.
1998)
LANDSCAPING & HORTICULTURE
Master Physical
Development
SITE UTILIZATION

1998)
Master Physical
Development
SITE UTILIZATION

1998)
Master Physical
Development
SITE UTILIZATION

1998)
Master Physical
Development
SITE UTILIZATION

1998)
Master Physical
Development • The physical features of the land surrounding a
SITE UTILIZATION building -shape, contours, whether open or dotted
with large trees, location of other buildings-affect
the prevailing wind. Wind lanes are thus formed,
or useful breezes might be blocked.
• Favorable microclimate by landscaping, grassing,
paving, planting trees and shrubs, constructing
ornamental bodies of water and creating many
Health Facilities Guidelines for Development & Operations (WHO< sunny and shady areas.
1998)
Master Physical • Dense vegetation in arid areas

controls hot, dusty winds, while
Development transpiration from leaves increases
SITE UTILIZATION humidity and lowers the
temperature.

1998)
• In humid areas, bushes and trees can be

Master Physical planted to deflect or divert winds into
the building.
Development • Similarly, waterways and water channels
SITE UTILIZATION help to reduce temperatures, and the
grassing over of large areas of ground
reduces glare.

1998)
EXTERNAL ROUTES
Master Physical
Development
CIRCULATION

1998)
EXTERNAL ROUTES
Master Physical
Development
CIRCULATION

1998)
EXTERNAL ROUTES
Master Physical
Development
CIRCULATION

1998)
EXTERNAL ROUTES
Master Physical
Development
CIRCULATION
• These various types of traffic should be grouped
for entry into the hospital premises according to
their nature. An important consideration is that
traffic moving at extremely different paces
From the World Health Organization Western Pacific Series District (e.g., a patient on foot and an ambulance) should
1998)
be separated.
EXTERNAL ROUTES
Some hospital guidelines recommend four

access points to the site, in order to
segregate traffic:
Master Physical • emergency: for patients in ambulances and
other vehicles for the emergency
Development department;
• service: for delivering supplies and collecting
CIRCULATION rubbish;
• service: for removal of dead; and
• main: for all others.

1998)
EXTERNAL ROUTES
Some hospital guidelines recommend four

access points to the site, in order to
segregate traffic:
Master Physical • emergency: for patients in ambulances and
other vehicles for the emergency
Development department;
• service: for delivering supplies and collecting
CIRCULATION rubbish;
• service: for removal of dead; and
• main: for all others.

1998)
EXTERNAL ROUTES
Master Physical
Development This kind of decentralized distribution of
CIRCULATION access, however, poses security and control
problems, and hospital administrators prefer
fewer points of entry and exit. A design
solution that takes this into consideration is
to have one or a maximum of two entrances
and to break the main access road into
Health Facilities Guidelines for Development & Operations (WHO< several branches in a hierarchy of roads
1998) within the site.
INTERNAL ROUTES
CORRIDOR SIZE IN RELATION TO TRAFFIC INTENSITY:

Studies have shown that traffic problems are caused
by:
• Inadequate pace of circulation, e.g., when there
Master Physical are more users than were provided for;
• different paces of circulation, e.g., when a slow-
Development moving trolley bed with a sedated
• patient and equipment obstructs the normal flow
CIRCULATION of traffic in a busy corridor; and
• two-way traffic, e.g., when a food trolley and a
bed trolley cross at a corridor intersection.

1998)
INTERNAL ROUTES
CORRIDOR SIZE IN RELATION TO TRAFFIC INTENSITY:

Studies have shown that traffic problems are caused
by:
• Inadequate pace of circulation, e.g., when there
Master Physical are more users than were provided for;
• different paces of circulation, e.g., when a slow-
Development moving trolley bed with a sedated
• patient and equipment obstructs the normal flow
CIRCULATION of traffic in a busy corridor; and
• two-way traffic, e.g., when a food trolley and a
bed trolley cross at a corridor intersection.

1998)
INTERNAL ROUTES
• A study of traffic in hospital corridors showed

however, that a corridor 2- 3 m wide can
Master Physical accommodate daily traffic. A corridor 3 m wide in

a major hospital can accommodate a walking
traffic load of 4000 people per direction per hour,
Development or 8000 people in both directions per hour,
assuming a free-flowing walking speed in hospitals
CIRCULATION of 4 km/h. The same corridor can accommodate
20-60 journeys per hour of wheeled traffic,
including supplies, bed and food trolleys.

1998)
INTERNAL ROUTES
Master Physical
Development
CIRCULATION

1998)
VERTICAL CIRCULATION
Master Physical
Development
CIRCULATION
If site limitations and functional
interrelationships lead to a multi-
storey design, the following guidelines
should be considered:
1998)
Master Physical
Development
CIRCULATION
• Stairs, as the only means of
vertical circulation is limited to
four storeys for walking public
Health Facilities Guidelines for Development & Operations (WHO< and staff.
1998)
Master Physical
Development
CIRCULATION
• Beyond four storeys, it must be
supplemented by mechanical
equipment.
1998)
Master Physical
Development
CIRCULATION

1998)
Master Physical
Development
CIRCULATION • The ramp is very convenient for
wheeled traffic, especially when
there is no electrical supply.
• Slope must be 1:15 to 1:18
Health Facilities Guidelines for Development & Operations (WHO< • Note BP 334 – 1:12
1998)
Master Physical
Development
CIRCULATION

1998)
Master Physical
Development
• The lift is versatile for
CIRCULATION transporting all kinds of traffic
vertically.
• It is however, costly – thus,
should be designed with a clear
1998)
picture of departmental
distribution.
Master Physical
Development
CIRCULATION • Key points where the lifts will be
grouped and from which traffic will
circulate on each floor should be
mapped and studied.
• It is recommended that the distance of a
lift from the farthest point on a floor
1998) should be no more than 30 m.
Master Physical
Development
GROWTH & CHANGE

1998)
GENERAL CAUSES OF GROWTH
Master Physical
Development
GROWTH & CHANGE

1998)
Master Physical
Development
GROWTH & CHANGE • Growth of the community.
A community may urbanized or may
change drastically as the result of an
event or a catalyzing situation that
requires the equivalent growth of health
From the World Health Organization Western Pacific Series District care services.
1998)
• Accumulated needs and

Master Physical requirements.
Necessary expansion may not be
Development undertaken immediately because of lack
GROWTH & CHANGE of resources; needs are deferred and
accumulate to the bursting point.

1998)
Master Physical
Development
GROWTH & CHANGE
• Physical effects on the building
with time.
Buildings deteriorate and become obsolete
From the World Health Organization Western Pacific Series District and even irrelevant over the years.
1998)
• Changing standards and codes.

Master Physical Regulations for health and safety change
Development to meet advances in construction
techniques and materials. A building
GROWTH & CHANGE may be declared unsafe and unfit for
human use if it is not updated, upgraded
and properly maintained.

1998)
• Changing methods in medicine.

Development of new equipment,
miniaturization, computerization and
other new technologies in the medical
field translate into new requirements for
Master Physical architectural design to provide better
and more modern clinical services.
Development
GROWTH & CHANGE

1998)
TYPES OF EXPANSION
• OUTWARD GROWTH.
Among the most usual form in expansion.
Master Physical
Development
GROWTH & CHANGE

1998)
TYPES OF EXPANSION
• OUTWARD GROWTH.
Master Physical
Development
GROWTH & CHANGE
• Consider areas that are non – or slow –
growing as the central part of the complex.
• Department that are projected to grow
should be placed where that can expand
into open space without disturbing the
Health Facilities Guidelines for Development & Operations (WHO< operation of other parts of the hospital.
1998)
TYPES OF EXPANSION
• OUTWARD GROWTH.
Master Physical
Development
GROWTH & CHANGE

1998)
TYPES OF EXPANSION
• UPWARD GROWTH.
Master Physical
Development
GROWTH & CHANGE

1998)
TYPES OF EXPANSION
• UPWARD GROWTH.
Master Physical
Development
GROWTH & CHANGE
• Disrupts operations.
• Note that construction materials are
difficult to transport and may require an
From the World Health Organization Western Pacific Series District elaborate system of scaffoldings and
1998)
hoists.
TYPES OF EXPANSION
• UPWARD GROWTH.
Foundations that will accommodate

the future load of additional floors
Master Physical and all the other utility provisions
should already be considered
Development ahead of time.
GROWTH & CHANGE

1998)
TYPES OF EXPANSION
• DOWNWARD GROWTH.
Master Physical
Development
GROWTH & CHANGE

1998)
TYPES OF EXPANSION
Master Physical
Development
GROWTH & CHANGE
• Utilizes that basement volumes
which were not part of the
original design.
1998)
TYPES OF EXPANSION
Master Physical
Development
GROWTH & CHANGE
• It is advisable to avoid this type of
growth owing to technical and
cost consideration.
1998)
TYPES OF EXPANSION
Master Physical
Development
GROWTH & CHANGE
• This can cause problems of
adequate headroom and in
clearing the existing system of
From the World Health Organization Western Pacific Series District foundation and columns.
1998)
TYPES OF EXPANSION
Master Physical
Development
GROWTH & CHANGE
• There can also be problems in
waterproofing and damp –
proofing the new retaining walls.
1998)
TYPES OF EXPANSION
Master Physical
Development
GROWTH & CHANGE
• Windows will be limited and
there will be problems in
providing natural ventilation and
From the World Health Organization Western Pacific Series District light.
1998)
TYPES OF EXPANSION
• INWARD GROWTH.
Master Physical
Development
GROWTH & CHANGE

1998)
TYPES OF EXPANSION
• INWARD GROWTH.
Master Physical
Development
GROWTH & CHANGE • Type of growth that pushes
adjoining departments out of
their location to make way for a
growing department.
1998)
TYPES OF EXPANSION
• INWARD GROWTH.
Master Physical
Development
GROWTH & CHANGE
• Usually occurs in concentrated
types of development
1998)
TYPES OF EXPANSION
• INWARD GROWTH.
Master Physical
Development
GROWTH & CHANGE
• Disadvantage:
It disrupts the operations of
growing for other departments.
1998)
TYPES OF EXPANSION
• GROWTH BY FRAGMENTATION.
Master Physical
Development
GROWTH & CHANGE

1998)
TYPES OF EXPANSION
Master Physical
Development
GROWTH & CHANGE
• Division of a single department into
several sub-units in different locations.
• Usual fragmented: administration,
dining, laboratories, storage, lockers and
Health Facilities Guidelines for Development & Operations (WHO< records.
1998)
TYPES OF EXPANSION
Master Physical
Development
GROWTH & CHANGE • Should be avoided.
• They pose problems of management
and control.
• Hospital becomes less efficient and
From the World Health Organization Western Pacific Series District productive owing to duplication of
1998) necessary support services.
Master Physical
Development

1998)
ENERGY CONSERVATION
Master Physical
Development

1998)
ENERGY CONSERVATION
PRACTICAL LOW-KEY TECHNOLOGY

• APPLICATION OF SUSTAINABLE
BUILDING DESIGN APPROACHES THAT
RELY ON THE VERNACULAR LANGUAGE
Master Physical PREVALENT IN THE LOCALE
• THE USE OF THE NATURAL FETAURES OF
Development THE SITE TO MINIMIZE ENERGY
CONSUMPTION AND OPERATIONAL
CARBON FOOTPRINT OF THE FACILITY
• USE OF LOCALLY-AVAILABLE MATERIALS
FOR CONSTRUCTION

1998)
ENERGY CONSERVATION
SOPHISTICATED HIGH-LEVEL
TECHNOLOGY
Master Physical RELIANCE ON HIGH-TECH SOLUTIONS TO
Development MINIMIZE ENERGY CONSUMPTION AND
TO AUTOMIZ E CERTAIN ASPECTS OF
OPERATION

1998)
ENERGY CONSERVATION
Master Physical UTILIZING SOLAR ENERGY

• USE OF SOLAR-HEATING DEVICES TO PROVIDE FOR
Development THE HOT WATER REQUIREMENTS OF CERTAIN
DEPARTMENTS SUCH AS LAUNDRY, KITHCEN AND
THE NURSING WARDS
• MAXIMIZING SOLAR ENERGY FOR LIGHTING
• PROVISION OF SPECIAL INLETS WITH
TRANSLUCENT COVERS AT VARIOUS PLACES IN
THE ROOF TO PROVIDE GLARE-FREE LIGHT
From the World Health Organization Western Pacific Series District DURING THE DAY FOR AREAS SUCH AS
1998) CORRIDORS, WAITING HALLS AND ATRIA
ENERGY CONSERVATION
BUILDING DESIGN
• MAXIMIZE USE OF OPEN, OPERABLE
WINDOWS BOTH FOR LIGHTING AND
VENTILATION
Master Physical • AIRCONDITIIONING IS ONLY NECESSARY
Development IN CERTAIN AREAS SUCH AS THE
OPERATING THEATRES, ICU’S AND X-RAY
FACILITIES

1998)
ENERGY CONSERVATION
BUILDING DESIGN
• HIGH-ENERGY BUILDINGS REQUIRE
MORE SOPHISTICATED EQUIPMENT AND
MAINTENANCE
• MECHANICAL AND ELECTRICAL
BUILDING SERVICE EQUIPMENT
Master Physical REQUIRE MORE REGULAR AND
PREVENTIVE MAINTENANCE
Development • RELIANCE ON HIGH-ENERGY
MECHNANICAL SERVICES NECESSITATE
THE DUPLICATION OF SOME ITEMS OF
EQUIPMENT AND THE PROVISION OF
EMERGENCY (STAND-BY) POWER
1998)
GENERAL CONSIDERATIONS
The master plan consists of two elements:

• determination of circulation routes and
MASTERPLANNING corridor systems; and
• location of elements on the site in
relation to one another

1998)
The master plan consists of two elements:

• determination of circulation routes and
MASTERPLANNING corridor systems; and
• location of elements on the site in
relation to one another

1998)
• grouping main functions, like wards, medical

services, admissions and central supplies;
• ·establishing appropriate access routes for
easy orientation of patients and visitors, with
special emphasis on disabled people; and
MASTERPLANNING • providing scope for future expansion, to cope
with an increased number of beds,
supplementary functions and medical
specialization, by ensuring maximum
interaction between hospital units and
support services

1998)
• grouping main functions, like wards, medical

services, admissions and central supplies;
• ·establishing appropriate access routes for
easy orientation of patients and visitors, with
special emphasis on disabled people; and
MASTERPLANNING • providing scope for future expansion, to
cope with an increased number of beds,
supplementary functions and medical
specialization, by ensuring maximum
interaction between hospital units and
support services

1998)
PRINCIPLES & GUIDELINES
MASTERPLANNING
• (

1998)
(1) Departments that are most closely

linked to the community should be
closest to the main entrance: out-
MASTERPLANNING patient department, emergency,
administration (especially business
sections), family planning clinic and
other primary health care support.

1998)
2. Departments that receive their

workload from (1) should be next
MASTERPLANNING closest to the entrance: X-ray,
laboratories, dispensary.

1998)
3. In-patient departments should be in the

interior zones, or wards.
4. Operating theatres, the delivery
department and the nursery should
MASTERPLANNING have easy access from the emergency
and accident departments to X-ray and
operating theatres. The delivery
department and nursery must be
separated from the operating theatre.

1998)
OTHER NOTES:
• Housekeeping and domestic service
areas should be grouped around a
MASTERPLANNING service yard: laundry, kitchen,
housekeeping, maintenance, storage
and motor pool.

1998)
OTHER NOTES:
• Staff facilities should be located on the
MASTERPLANNING periphery near roads and public
transport: staff dormitories, quarters or
housing.

1998)
OTHER NOTES:
• Teaching facilities, if any, should be close
to both staff facilities and teaching areas
MASTERPLANNING and to roads and public transport:
student areas, educational and training
components of primary health care.

1998)
OTHER NOTES:
• The mortuary should be in a special
MASTERPLANNING service yard, with a discreet entrance; it
should be away from the out-patient
department, ward block and nursery.

1998)
BUILDING SHAPE

1998)
• A district hospital should reflect the

local architecture
• The hospital should not be alien to
BUILDING SHAPE its surroundings or stand out as an
exception but should fit in with local
life, expressing its spirit and
character.

1998)
• The hospital building should not be a

huge, unfriendly, structure but
should be a human, welcoming part
of the community.
• Layouts suitable for tropical climatic
BUILDING SHAPE conditions include: an open-plan
layout for "hot-humid" areas; a
compact layout for "hot-dry" areas;
and a compact layout for "upland"
regions

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
BASIC SHAPES
BUILDING SHAPE

1998)
THE HOSPITAL NUCLEUS
DEPARTMENTAL THE NUCLEUS

PLANNING & DESIGN • THE OUTPATIENT/ MATERNAL &
CHILDHEALTH DEPARTMENT
• MEDICAL SERVICE (DIAGNOSTICS) – X-
RAY, LABORATORY, PHARMACY
• INPATIENT DEPARTMENT
• SURGICAL DEPARTMENT (A MAJOR
From the World Health Organization Western Pacific Series District THEATRE, A MINOR THEATHRE, AND A
Health Facilities Guidelines for Development & Operations (WHO< DELIVERY SUITE)
1998)
• ADMINISTRATIV OFFICES
THE HOSPITAL EXPANDED NUCLEUS
DEPARTMENTAL
PLANNING & DESIGN

1998)
PERIPHERAL FACILITIES
DEPARTMENTAL • PERIPHERAL FACILITIES

PLANNING & DESIGN • KITCHEN & LAUNDRY SERVING THE
INPATIENT DEPARTMENT
• CENTRAL STORE FOR SUPPLIES WITH
POSSIBLY A GARAGE FOR A SERVICE
MOBILE UNIT
• STAFF HOUSING FOR SENIOR & JUNIOR
STAFF
Health Facilities Guidelines for Development & Operations (WHO< • SHELTERS FOR RELATIVES, CAN BE
1998)
ALLOCATED FOR A SELF-CARE FACILITY
PERIPHERAL FACILITIES
• FACTORS TO CONSIDER WHEN PLACING
PERIPHERAL FACILITIES AROUND THE
NUCLEUS:
• Building must have an obvious
connection at least some part of the
nucleus
• A function likely to cause air pollution
DEPARTMENTAL (smoke, smell) must be placed at the
leeward side of the nucleus
PLANNING & DESIGN • Most buildings particularly the garage
and store will require vehicular access
• Staff housing should be placed at the
most attractive part of the side to for
peace and quiet and away from the
wards
• All peripheral facilities shall never be
From the World Health Organization Western Pacific Series District placed in such a way that will restrict
1998) the future expansion of the nucleus
THE PAVILLION –TYPE (DISPERSED)
DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Typically found in rural hospitals where there

is no shortage of land space
Health Facilities Guidelines for Development & Operations (WHO< • Facilities are scattered and buildings have
1998)
been added gradually over the years
THE PAVILLION –TYPE (DISPERSED)
DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Most flexible in terms of construction and
planning
From the World Health Organization Western Pacific Series District • Most exposed to the elements in terms of
1998)
circulation
THE BLOCK-TYPE (LINEAR)
DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Usually taking the form of a number of
block each housing a specific function,
oriented along a circulation spine
• Combines many of the advantages of the
Health Facilities Guidelines for Development & Operations (WHO< pavilllion-type with a more efficient
1998) circulation system
THE BLOCK-TYPE (LINEAR)
DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Inhibits opportunity for cross-ventilation
• May lead to wind-tunelling and dust
• Not suitable for sloping sites
• Most econonomical because of modularity,
Health Facilities Guidelines for Development & Operations (WHO< with expansion easier to execute
1998)
THE GRIDIRON-TYPE (RECTILINEAR)
DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Consists of separate rectangular blocks
positioned in a such a way to a
chequerboard of block and open spaces
with circulation along the lines of the grid
Health Facilities Guidelines for Development & Operations (WHO< • Most attractive of the types suitable to a
1998) large range of climate types
DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Main disadvantage is it is an inflexible
growth and change only by the addition of
more blocks/ grids
• The circulation routes tend to be extensive,
From the World Health Organization Western Pacific Series District circling upon itself in most cases
1998)
• Present construction difficulties with blocks
requiring single-spans acrosss buildings
DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Main disadvantage is it is an inflexible
growth and change only by the addition of
more blocks/ grids
• The circulation routes tend to be extensive,
From the World Health Organization Western Pacific Series District circling upon itself in most cases
1998)
• Present construction difficulties with blocks
requiring single-spans acrosss buildings
ZONES
Outermost zone, which is the most community oriented
• primary health care support areas
• out-patient department
• emergency department
• Administration
• admitting office, reception
Second zone, which receives workload from (1)
• diagnostic X-ray
• laboratories
• Pharmacy
DEPARTMENTAL Middle zone between outer and inner zones

• operating department
• intensive care unit
PLANNING & DESIGN • Delivery
• nursery
Inner zone, in the interior but with direct access for the public
• wards and nursing units
Service zone, disposed around a service yard ~
• dietary services
• laundry and housekeeping
• Storage
From the World Health Organization Western Pacific Series District • maintenance and engineering
Health Facilities Guidelines for Development & Operations (WHO< • Mortuary
1998) • motor pool
PRIMARY HEALTHCARE SUPPORT AREAS:
EDUCATION & TRAINING SUPPORT AREAS
DEPARTMENTAL
PLANNING & DESIGN

1998)
PRIMARY HEALTHCARE SUPPORT AREAS:
TECHNICAL SUPPORT AREAS
DEPARTMENTAL
PLANNING & DESIGN

1998)
OUTPATIENT DEPARTMENT
DEPARTMENTAL
PLANNING & DESIGN

1998)
EMERGENCY DEPARTMENT
DEPARTMENTAL
PLANNING & DESIGN

1998)
ADMINISTRATIVE BLOCK
• The administrative department is

orientated to the public but is at the same
time private.
• Areas for business, accounting, auditing,
DEPARTMENTAL cashiers and records, which have a
functional relationship with the public,
PLANNING & DESIGN must be located near the entrance of the
hospital.
• Offices for hospital management, however,
can be located in more private areas.

1998)
MEDICAL RECORDS ROOM
• If possible a full-scale computerized data
bank should be created, including a
standardization of a database
• This should be in an area that ensures the
records remain confidential
• Should be immediately adjacent to the
Admitting Section for ease od filing of new
DEPARTMENTAL patients, and retrieval of records of
returning patients
PLANNING & DESIGN • To balance the proportion of the space, the
patients records are usually fragmented –
active records are kept at the Medical
Records Room in the Public Zone, while
inactive and dead records are kept in
Medical Record Storage somewhere in the
inner areas of the hospital accessible to the
Health Facilities Guidelines for Development & Operations (WHO< central MIS
1998)
RADIOLOGY AND IMAGING DEPARTMENT
• Diagnostic imaging (or diagnostic radiology) is provided by

• X-ray units,
• ultrasound and
• radionuclide (radioisotope) scanners.
• (1) Diagnostic imaging, both X-rays and ultrasound, should be
available to both in-patients and out-patients. The equipment
needs electrical power. There are many advantages to locating X-
DEPARTMENTAL ray and ultrasound equipment in the same department. In small
hospitals with a daily workload of 5-10 patients, the two can be in
the same room. As the workload increases, separate rooms
PLANNING & DESIGN •
should be made available.
(2) Ultrasound does not require any special building construction.
The room should contain a patient couch, firm but comfortable, a
chair and at least 1m2 for the equipment. The lighting must be
dim-bright light makes it difficult to examine a patient properly-
but the room must not be very dark. Handwashing facilities
should be located either in the room or close by. There must be a
toilet close to the ultrasound room.

1998)
DEPARTMENTAL
PLANNING & DESIGN

1998)
CONSIDERATIONS:
• The diagnostic imaging area should be on the Ground
Floor of the hospital, with easy covered access to
wheelchairs, patient trolleys and beds
• Location should be close to the emergency section of the
outpatient if possible, but easy access to ALL patient
should be the first consideration
DEPARTMENTAL • One x-ray room and one dark room can handle 40-50
patients per day; because of equipment costs it is better
PLANNING & DESIGN to increase staff and lengthen working days than adding
additional rooms and equipment
• A 150-bed hospital usually can manage with one x-ray
room
• One dark room is sufficient for two x-ray rooms
• If the hospital increases in size, it is preferred to x-ray
rooms in the same area

1998)
From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)

LABORATORY SERVICES
DEPARTMENTAL A comprehensive laboratory should have the following

sections:
• morbid anatomy
PLANNING & DESIGN • Haematology
• Clinical pathology
• Microbiology
• Laboratory services come under great pressure to
• expand, as the workload tends to double every 5-8
years. Their growth will be even faster as the out-patient
department is strengthened to integrate provisions for
From the World Health Organization Western Pacific Series District primary health care. The plan for laboratory work
Health Facilities Guidelines for Development & Operations (WHO< benches must therefore be flexible, perhaps comprising
1998) modules Fig. 53. Plan for laboratory (Fig. 53).
LABORATORY SERVICES
RULES OF THUMB
• Allocate 6 SQM of floor area for
each laboratory staff, administrative
DEPARTMENTAL or technical
• This does not include corridors,
PLANNING & DESIGN stairs, toilets, stores or wall space,
for which an additional 30-50% of
space should be provided,
depending on the size and type of
equipment.
1998)
LABORATORY SERVICES
RULES OF THUMB
• Must be planned on a modular
system that allows for flexible use,
and ease of expansion
DEPARTMENTAL • External walls of the laboratory
should be of permanent, durable
PLANNING & DESIGN construction, but the partition walls
should be considered to be
temporary so that they can be
taken out or replaced easily as the
activities expand.
1998)
LABORATORY SERVICES
RULES OF THUMB
• The ceilings should be made of
materials that are easily cleaned
and disinfected so as to reduce
airborne contamination.
DEPARTMENTAL • They should be 2.55-2.80 m in
height to allow for wall-mounted
PLANNING & DESIGN distillation racks and other
equipment.
• The floors should be made of
materials that are resistant to acids,
alkali and salts and can be easily
From the World Health Organization Western Pacific Series District cleaned and disinfected.
1998)
LABORATORY SERVICES
DEPARTMENTAL
PLANNING & DESIGN
COLOR-CODING OF UTILITIES
1998)
LABORATORY SERVICES
• Doors should be located in places

where entry and exit is easy and does
not interfere with the laboratory
benches or equipment.
• Laboratory doors should be no less
DEPARTMENTAL than 1 m wide to allow easy access of
equipment. In some areas, double
PLANNING & DESIGN doors, 1.2 m wide, should be provided
for passage of large equipment, such as
deep-freezes.
• All doors should open towards the
corridor.
1998)
LABORATORY SERVICES
• The basic utilities that are to be

provided in the laboratory are
water supply, sanitary drains and
drain vents, electricity, compressed
DEPARTMENTAL air, distilled water, carbon dioxide,
steam and gas. Others may be
PLANNING & DESIGN necessary depending on the types
of tests to be performed.
• Should have external access to a
small, remotely located store for
dangerous goods.
1998)
PHARMACY
• The pharmacist is responsible for the purchase, storage
and dispensing of all drugs and of bulk pharmaceutical
preparations, disinfectants and sterile solutions.
(1) The pharmacy must be located so that it is:
• accessible to the out-patient department,
• convenient for dispensing, and
• accessible to the central delivery yard.
(2) Traffic within the department must be economical and
flexible.
DEPARTMENTAL (3) Its size is determined by its organization and operational
policies.
PLANNING & DESIGN (4) Provision for security of dangerous drugs must be
ensured.
(5) Provision for control of fire must be ensured, as many
inflammable substances are stored there. Bulk quantities
should not be held in the pharmacy but should be drawn
from a remotely located store for dangerous goods.
(6) Finishes must be impervious to acid and alkali and easy
to clean.
From the World Health Organization Western Pacific Series District (7) The corridors must allow easy turning of wheeled
Health Facilities Guidelines for Development & Operations (WHO< vehicles.
1998)
BLOOD BANK
• Blood should be supplied from a blood transfusion
centre (national or regional) after appropriate testing.
• If this is not possible, the blood-bank system may be
based on blood obtained from previously screened local
donors.
• A third approach in which donors are recruited locally
when the need arises ("the working blood bank") is the
least desirable alternative.
• The promotion of donor recruitment is a community
task to be organized through the district health council.
DEPARTMENTAL
STERILIZATION
PLANNING & DESIGN • While major hospitals regard a central sterile -supply
department as essential, it may be easy to organize a
separate sterilization unit in a small hospital.
• However, it is essential to ensure that all instruments,
dressings, and equipment that come into contact with
patients' tissues are sterile.
• It is also necessary to ensure that, after use,
From the World Health Organization Western Pacific Series District contaminated utensils are rendered safe for handling.
1998)
OPERATING THEATRE
DEPARTMENTAL
PLANNING & DESIGN • The essential physical requirements for meeting these
conditions are:
• a place in which to work that is comfortable and
unobstructed by the movement of other staff,
• with a table is strong enough to hold the patient
and easy to clean;
• basic services of water, light and medical gases;
and
From the World Health Organization Western Pacific Series District • two sets of basic instruments, comprising about
Health Facilities Guidelines for Development & Operations (WHO< 50 pieces each.
1998)
OPERATING THEATRE
• As a general rule, one operating theatre is required for

every 50 general inpatient beds and for every 25
DEPARTMENTAL surgical beds.
• The preferred location is on the same floor as the
PLANNING & DESIGN surgical wards, which may be the ground floor. It should
be connected to the surgical ward by the simplest
possible route, It should also:
• adjoin the central sterile supply department;
• be easily accessible from the accident and
emergency department;
• be easily accessible for the delivery suite;
• adjoin the intensive care unit;
From the World Health Organization Western Pacific Series District • be located in a cul-de-sac, so that entry and exit
1998)
can be controlled; there should be no through-
traffic
OPERATING THEATRE
DEPARTMENTAL
PLANNING & DESIGN

1998)
OPERATING THEATRE
ROOM PLANNING REQUIREMENTS
(a) Reception and office - In a two- or three-theatre suite,
the reception and the theatre sister's office can be
merged.
(b) Transfer area- This area should be large enough to allow
for the transfer of a patient from a bed to a trolley. A line
should be clearly marked in red on the floor, beyond which
no person from outside the operating department should be
permitted to set foot without obtaining authority and
putting on protective clothing.
DEPARTMENTAL (c) Holding bay - This space is required when the corridor
system is used and should be located to allow supervision of
PLANNING & DESIGN patients waiting to go into the theatre. One bed per two
theatres should be foreseen.
(d) Staff changing rooms - Access to staff changing rooms
should be made from the entry side of the transfer area. At
both the transfer area and the theatre side of the changing
rooms, space must be provided for the storage, putting on
and removal of theatre shoes.
(e) Operating theatres - Each theatre should be no less than
6 x 6 m (36 m2) in area and should have access from the 1
anaesthetic room, scrub-up room and supply room.
1998) Separate exit doors should be provided.
ROOM PLANNING REQUIREMENTS cont’d
OPERATING THEATRE
(f) Scrub-up room - Scrub-up facilities may be shared by two
theatres. A minimum of three scrub-up places is required for
one theatre, but five places are adequate for two theatres. A
clear area within the scrub-up room, at least 2.1 x 2.1 m,
must be provided for gowning and for trolley or shelf space
for gowns and masks.
(g) Sub-clean-up - In suites of four or more operating
theatres, a small utility area is required for each pair of
operating theatres, for the disposal of liquid wastes, for
DEPARTMENTAL rinsing dropped instruments and to hold rubbish, linen &

tissue temporarily until they are removed to the main clean-
up room.
PLANNING & DESIGN (h) Sub-sterilizing - An area for sterilizing dropped
instruments should be provided to serve two theatres.
(i) Trolley parking - Parking space outside the theatre and
clear of all doorways is required for patient trolleys & beds.
(j) Recovery room - The recovery room should be located on
the hospital corridor near the entrance to the operating
department. The number of patients to be held, until they
come out of anaesthesia, depends on the theatre
From the World Health Organization Western Pacific Series District throughput; two beds per theatre is usually satisfactory. In
Health Facilities Guidelines for Development & Operations (WHO< hospitals where there is an intensive care unit, additional
1998) room and facilities will be needed.
INTENSIVE CARE UNIT
DEPARTMENTAL
PLANNING & DESIGN
• The number of beds in this unit should correspond to
approximately 1-2% of the total beds in the hospital. In
the Western Pacific Region, where district hospitals
provide on average 50-100 beds, this would mean only
one or two beds.
• This number would not warrant the provision of an
intensive care unit. Such a unit should contain no fewer
From the World Health Organization Western Pacific Series District than six beds in order to justify the highly sophisticated
Health Facilities Guidelines for Development & Operations (WHO< equipment and highly specialized manpower involved.
1998)
OBSTETRICS & GYNECOLOGY UNIT
• Delivery department is very similar to the operating

department in its functional requirements and layout.
• In many hospitals, the two departments are fused into
one, with shared staff and support areas, due to a
dearth of doctors, especially in rural areas, where the
chief of the hospital is also the public health officer, the
DEPARTMENTAL •
surgeon and the obstetrician-gynaecologist.
The integration of these two departments, however,
PLANNING & DESIGN violates the basic requirements for aseptic conditions in
the operating department, as these are not always
required in the delivery department.
• The two departments should thus at least be
segregated. Proximity to the operating department is
desirable, however, as transfer of delivery patients may
be necessary.

1998)
PEDIATRICS
DEPARTMENTAL • The nursery should be located adjacent to the delivery

department to ensure protected transport of newborns.
PLANNING & DESIGN • Areas must be provided for cribs for both well and ill
babies and for support services that include formula and
preparation rooms.
• The number of cribs varies depending on the maternal
and child health trends in the country.
• "Rooming-in" (Fig.62) is virtually replacing the well-baby
area in space requirements for the nursery; instead, the
dimensions of maternity wards are changing to
accommodate babies' cribs and other materials.
Health Facilities Guidelines for Development & Operations (WHO< • A small night nursery for well babies may still be
1998) required.
GERIATRIC SERVICES
• The older population of any community is usually best
cared for in community-based facilities where their
special needs and requirements are provided for in
sensitive and Fig. 62. Rooming-in caring designs that
allow them to lead independent and dignified lives for
as long as possible. However, because older persons are
also prone to conditions that cannot be attended to
except in the environment of a hospital, a geriatrics
ward may be provided within a general hospital if
economics would so warrant. If this is not possible, older
DEPARTMENTAL people may also be nursed in the regular medical or
surgical wards, depending on their illness.
PLANNING & DESIGN • As such, a geriatric ward, if provided in a hospital,

should be designed for longer than usual confinement.
Therefore, spaces should be home-like, cheerful, and
non-institutional. Apart from the regular institutional
spaces, social spaces such as day rooms must be
provided so that the older person can be encouraged to
walk about in the process of recovery from the illness.
Family spaces must be provided so that the older person
may be aided in regaining both his physiological and
From the World Health Organization Western Pacific Series District psychological well-being leading to return to the
Health Facilities Guidelines for Development & Operations (WHO< community.
1998)
INPATIENT NURSING WARDS
• These wards provide accommodation for patients who

are dependent on others because of their illness. They
have the following functions:
• to substitute for the home for regular eating,
bathing, sleeping, etc;
• to allow examination, treatment and cure of
DEPARTMENTAL patients; and
• to prepare patients to return to domestic life.
PLANNING & DESIGN • The wards in a hospital are usually classified according
to specialties: medicine, paediatrics, obstetrics-
gynaecology and surgery, which are the basic services
offered by a district hospital. There are no radical
differences between the requirements of medical and
surgical wards and only minor differences between
those of the other specialties.

1998)
INPATIENT NURSING WARD FORMS
DEPARTMENTAL
PLANNING & DESIGN

1998)
DEPARTMENTAL
PLANNING & DESIGN

1998)
DEPARTMENTAL
PLANNING & DESIGN

1998)
GENERAL SERVICES DEPARTMENT
DEPARTMENTAL
PLANNING & DESIGN

1998)
DIETARY SERVICES
• Located near the kitchen or anywhere on the
Ground Floor
• Directly accessible from the service court
• Direct delivery to refrigerated section
• Locate the dietitian in the kitchen or next to it
• Kitchen must be located such that heat and odors
are directed away areas of high population
• FOOD DISTRIBUTION
DEPARTMENTAL • Centralized Tray Service - food is prepared
in a main kitchen , loaded into conveyor
PLANNING & DESIGN carts and transported to the wards

• Bulk Service- food brought to wards in
heated carts, trays are prepared in sub-
kitchens in each ward
• MAIN COMPONENTS
• Food refrigeration and storage
• Cooking
• Serving
From the World Health Organization Western Pacific Series District • Special diets
1998)
• Dishwashing, and
• Dining (1.5 SQM per seated person)
HOUSEKEEEPING
• Housekeeepers’ Office should be located on the lowest
floor, adjacent to the linen room
• Central Linen Room supplies the whole hospital, must
have shelves and spaces for sewing, mending, and
DEPARTMENTAL marking new linen, locate at the “clean end” of the
laundry room
PLANNING & DESIGN • Soiled linen area for sorting and checking all soiled
laundry, must be located at the “dirty end” of the
laundry area with sorting bins
• Laundry can be in-house or contracted to an outside
service, if in-house proper washing and drying
equipment must be installed, if contracted-out provide
area for receiving clean and dispatching dirty linen for
sorting
1998)
STORAGE, STOCK-KEEPING & DISTRIBUTION

• As hospitals are regular consumers of a large variety of
goods, adequate space must be provided for their
storage, inventory and distribution. Many different types
of storage facilities will be required, e.g., for some live
virus vaccines at -20 °C, for large equipment and
furniture, for crude disinfectants, for medical gases, for
dangerous drugs, for radioactive agents, which need
DEPARTMENTAL different space provisions. Designers must obtain all the

relevant information to meet the requirements.
• A standard for central storage space is 2 SQM per bed, in
PLANNING & DESIGN smaller hospitals this value is usually increased
• COMPONENTS
• Pharmacy Storeroom
• Furniture Room
• Anaesthesia Storeroom
• Records Room, and
• Central Storeroom
From the World Health Organization Western Pacific Series District For smooth, rapid flow of materials both to and from the
Health Facilities Guidelines for Development & Operations (WHO< central store, sufficient space and ramps should be provided
1998) for handling, unpacking, loading, unloading and inspection.
MAINTENANCE & ENGINEERING AREA

(a) Boiler room - This must be located in accordance with
local fire ordinances. The boiler plant must be " designed by
a qualified engineer to ensure the safety of patients and
staff.
DEPARTMENTAL (b) Fuel storage - The space will vary according to the fuel
used. The designer must know for how many days stock
must be kept.
PLANNING & DESIGN (c) Groundkeeper's toolroom - Space must be provided for
working and for the storage of equipment and tools for the
staff in charge of landscaping and general upkeep of the
garden and grounds.
(d) Garage - The garage is best located in a shed or building
separated from the hospital itself. If the hospital is to
maintain 24-hour ambulance service, additional facilities
must be provided for drivers' sleeping quarters.
1998)
MAINTENANCE & ENGINEERING AREA cont’d

(e) Maintenance workshop - A carefully planned and
organized maintenance programmfor general repair of
medical and nonmedical equipment is necessary for
ensuring reliable hospital service. A mechanical workshop
with an electric shop, well equipped with tools, equipment
DEPARTMENTAL and supplies, is conducive to preventive maintenance and is
most important in emergencies. Failure of lights or essential
PLANNING & DESIGN equipment in an operating theatre, such as respirators, can
have serious consequences. Adequate space for equipment
like lathes, welding materials and wood- and metal-working
machines should be provided, and there should be storage
space for damaged material, such as stretchers, beds,
wheelchairs, portable machines and food trolleys As most
repair work is done outside of normal working hours, space
should be provided for workers, maintenance staff,
supervisory personnel and biomedical engineers..
1998)
MORTUARY
The mortuary has the following functions:
• to hold dead bodies until burial can be arranged;
• to provide a place where a pathologist can
investigate causes of death and make scientific
DEPARTMENTAL investigations
• to allow viewing and identification of bodies by
PLANNING & DESIGN relatives and other people

• Should be located near the pathology department or
laboratory
• Easily accessible from wards and the emergency and
operating departments
• Separate access available for staff, relatives and
undertakers

1998)
MORTUARY
• The following areas are needed:
• covered access
• body store
DEPARTMENTAL • staff changing room with lockers and toilets

• soiled garments holding area
PLANNING & DESIGN • ost-mortem facilities

• viewing room
• visitors' waiting room
• cleaning materials storage room
• cleaner's room
• prayer and religious rites room

1998)
SITE SELECTION
RECOMMENDED
PLANNING & DESIGN
CONSIDERATIONS

1998)
BUILDING FOEM
RECOMMENDED
PLANNING & DESIGN
CONSIDERATIONS

1998)
BUILDING FORM
RECOMMENDED
PLANNING & DESIGN
CONSIDERATIONS

1998)
ADAPTABILITY & CONVERTABILITY
RECOMMENDED
PLANNING & DESIGN
CONSIDERATIONS

1998)
INCREMENTS OF GROWTH

1998)
INCREMENTS OF GROWTH

1998)
NOTES FROM DOH
GUIDELINES
NOTES FROM THE DOH GUIDELINES


















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H +

Oldest Hospital in the country, established as a dispensary clinic in

Based on Rule VII.1 of the NBC, Schedule of Principal, Accessory &

Based on Rule VII.1 of the NBC, Schedule of Principal, Accessory &

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Founded 1907, designed by Arch.William E. Parsons based on the plans

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Founded in 2002, designed by Luis and Associates

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Founded in 1891 by Cralos Palanca Tanchueco and with businessmen

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Designed by Arch. Jorge Ramos, inaugurated 1975

• GENERAL HOSPITAL (LEVELS 1 to 3)

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Designed by Francisco Manosa and Partners, inaugurated 2004

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Based on DOH Manual on the Technical Guidelines for Hospitals and

Based on DOH Manual on the Technical Guidelines for Hospitals and

Based on DOH Manual on the Technical Guidelines for Hospitals and

Based on DOH Manual on the Technical Guidelines for Hospitals and

Based on DOH Manual on the Technical Guidelines for Hospitals and

Designed by Francisco Manosa and Partners, inaugurated 2004

Inaugurated 1945 in Espana, Manila, 2011 expnasion by Arch. John

Based on DOH Manual on the Technical Guidelines for Hospitals and

Based on The Frontline Hospital by Philip Mein (World Health

Americzan Hospital, Intramuros, Manila

Based on the Whole Building Design Guide (WBDG, 2011)

• SMALL : less than 100 beds

Based on DOH Manual on the Technical Guidelines for Hospitals and

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

Size of the Hospital

From the World Health Organization Western Pacific Series District

Size of the Hospital

From the World Health Organization Western Pacific Series District

Size of the Hospital

From the World Health Organization Western Pacific Series District

Size of the Hospital

From the World Health Organization Western Pacific Series District

Size of the Hospital

From the World Health Organization Western Pacific Series District

Size of the Hospital = 37, 500 / 365

say 105 beds.

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District

From the World Health Organization Western Pacific Series District