HOSPITAL

LITERATURE STUDY PRESENTATION

PRESENTED BY: PRESENTED TO:

Geetakshri. Ar. Vibha
 What is a hospital?
• An institution for the treatment, care, and cure of the sick and wounded, for the study of
disease, and for the training of physicians, nurses and allied healthcare personnel.
• A medical treatment facility capable of providing inpatient care.
• It is appropriately staffed and equipped to provide
diagnostic and therapeutic services, as well as the necessary
supporting services required to perform its assigned
mission and functions. A hospital, in addition, discharge the functions clinic.

•Multi speciality hospital:

Multi speciality Hospitals Provide services in more than two medical specialties.
• Super speciality hospital:
A super speciality hospital is defined as a hospital that is primarily and exclusively engaged in
the care and treatment of the patients suffering from a specific illness. They offer specialized
services to their patients.
 TYPES

General District Specialized Teaching Clinic

• General Hospital:
The best-known type of hospital is the general hospital, which is set up to deal with many
kinds of disease and injury. It has an emergency department to deal with immediate and urgent
threats to health.
• District Hospital:
It is the major health care facility in its region, with large numbers of beds for intensive
care and additional beds for patients who need long-term care.

• Specialised Hospitals:
It include trauma centres, rehabilitation hospitals, children's hospitals, seniors' (geriatric)
hospitals, and hospitals for dealing with specific medical needs such as psychiatric treatment
and certain disease categories such as cardiac, oncology, or orthopedic problems etc.

• A teaching hospital:
It combines assistance to people with teaching to medical students and nurses.

• Clinic:
The medical facility smaller than a hospital is generally called a clinic.
 DEPARTMENTS

Emergency Cardiology ICU Pediatric Neonatal Cardiovascular

Obstetrics and gynecology Neurology Oncology

• Common support units include a dispensary or pharmacy, pathology, and radiology.
• On the non-medical side, there are medical records departments, release of information
departments, information management clinical engineering facilities management,
maintenance , dining services, and security departments.
• Emergency department (ED):
Also known as an accident & emergency
department (A&E), emergency room (ER) or casualty department, is a
medical treatment facility specializing in emergency medicine dealing
with the acute care of patients.
• Cardiology:
 It is a branch of medicine dealing with disorders of the
heart as well as parts of the circulatory system.
 The field includes medical diagnosis and treatment of congenital
heart defects, heart failure and heart disease .
 Physicians who specialize in this field of medicine are called
cardiologists.
• ICU:
 An intensive care unit (ICU), also known as an intensive therapy
unit or intensive treatment unit (ITU) or critical care unit (CCU), is a
special department of a hospital or health care facility that
provides intensive treatment medicine.
 ICU cater to patients with severe and life-threatening illnesses and
injuries, which require constant, close monitoring from specialist
equipment and medications to ensure normal bodily functions.
• Paediatrics:
 It is the branch of medicine that deals with the medical care
of infants, children, and adolescents, and the age limit usually ranges from
birth up to 18-21 years of age.
 A medical practitioner who specializes in this area is known as
a pediatrician, or paediatrician.
• Neonatal:
A neonatal intensive care unit (NICU), also known as an intensive care
nursery (ICN), is an intensive care unit specializing in the care of ill or
premature newborn infants.
• Neurology:
It is a branch of medicine dealing with disorders of the nervous
system. Neurology deals with the diagnosis and treatment of all
categories of conditions and disease involving
the central and peripheral nervous system.
• Obstetrics and gynecology:
 Obstetrics and Gynecology is the medical specialty that deals
with obstetrics and gynecology.
 It is the branch of physiology and medicine which deals with the
functions and diseases specific to women.

• Oncology:
It is a branch of medicine that deals with the prevention, diagnosis
and treatment of cancer. A medical professional who practices
oncology is an oncologist.

OUTPATIENT
• An outpatient department is the part of a
hospital designed for the treatment of
outpatients, people with health problems
who visit the hospital for diagnosis or
treatment, but do not require to be
admitted for overnight care.
• Outpatient departments offer a wide
range of treatment services, diagnostic
tests and minor surgical procedures.
INPATIENT
The term “Inpatient” refers to patients who
stay in a hospital overnight or for a longer
amount of time as their care plans require.
• It includes ward, nursing station and all
other services necessary for patient’s care.
• Hospitalized for intermediate time.

• Hospitalized for less than 24 hours.

 VARIOUS DEPARTMENTS OF A MEDICAL
SERVICE BUILDING
1.Out-patient departments
5.Administration division.
a) General facilities
6. Inpatient division includes
b) Clinics for various medical disciplines
a) Patient wards.
c) Supporting facilities like laboratory, injection b) Nurses wards.
room, etc.
c) Inpatient services
d) Pharmacy 6. General service division includes;
e) Blood blank a) Laundry.
2.Emergency and casualty department b) Kitchen.
3.Diagnostics and treatment department c) Storages.
a) Pathology d) Mechanical services.
b) Radiology e) Security.
f) Parking.
c) Physiotherapy
g) Landscaping.
d) Operation theatre
4.In-patient & nursing unit
a) General ward
b) Ward for particular facilities
c) Intensive care unit
d) Operation theatres
OPD (out patient department)
WHAT IS THE FUNCTION?
The out-patient department ( OPD ) is needed to perform
Following chief functions, namely:
• to diagnose and treat patients at an early stage,
• follow up treatment after discharge from the hospital, and
• to institute health education programme to educate the public in environmental
hygiene.
WHERE IT SHOULD BE LOCATED?
• The department should be located close to the main entrance with independent
approach.
• It should be segregated from the in-patient department ( IPD ) so that patients visiting
the out-patient department need not pass through the in-patient areas.
• Some of the treatment facilities like radiology, pathology, physiotherapy and blood
bank should be interposed between OPD and IPD so as to be equally accessible to
both.
• It is recommended to site surgical, orthopaedic, antenatal and paediatric clinics on the
ground floor. Rest of the clinics may be placed on upper floors, if necessary.
Physical facilities and space requirements of
OPD
• General facilities:
a) Entrance hall: It serves as waiting area for the patients before getting
registered and for the followers who wait for the return of the patients.
b) Waiting areas: Apart from the entrance hall, general waiting per clinic and
subsidiary waiting spaces are required adjacent to each consultation and
treatment room in all the clinics.
c) Medical record room: It is desirable to maintain the medical records of the
out-patients in continuation of registration area.
• Clinics for different medical discipline: These clinics include medical, surgical,
orthopaedic, eye, ENT, dental, obstetric and gynaecological, family planning,
paediatric, skin and psychiatric, etc.
• Supporting facilities like laboratory and injection,
• Pharmacy,
• Blood bank
 IN-PATIENT DEPARTMENTS (IPD)
IPD units require nursing care and nursing care fall under following
categories:
• General Wards- ward for patients who are not critically ill, but need
continuous care or observation and have to be in bed.
• Ward for Specialities - Wards for patients who are suffering and
needs hospitalization in particular specialities like post operatron,
orthopaedic, paediatric, psychiatry, infection, skin, obstetric and
gynaecology, etc.
• Intensive Care Unit - Wards for acute coronary, post operative and
critically ill patients.
WHERE IT SHOULD BE LOCATED?
• Wards should be relegated at the back to ensure quietness and
freedom from unwanted visitors.
• An area of 7 m per bed is recommended, and should be arranged
with a minimum distance of 2.25 m between centres of two beds and
a clearance of minimum 200 mm between the bed and wall.
 Requirements of a clinic
WHAT IS THE FUNCTION?
• The clinic should have a number of consultation-cum-examination room depending
upon the load of out-patients. The clinic should also have facilities for cardiographic
examination.
• The treatment and dressing room should he spacious enough to accommodate a
medicine chest, a work counter for preparing dressings, medicines, sinks, dressing
tables with screen in between and a pedal operated bins to hold soiled material.

WHERE IT SHOULD BE LOCATED?

• The clinics for infections and communicable diseases shouId be located in isolation
preferably in remote corner, provided with independent access and completely cut off
from the rest of the hospital.
• The cubicles for consultation and examination in all types of clinics should provide for a
doctor’s chair and table, patient’s stool, follower’s seat, wash basin, examination couch
and equipment for examination.
Different types of clinics and their allied rooms
• Medical clinic - The clinic should have a number of consultation-cum-examination
room depending upon the load of out-patients. The clinic should also have facilities for
cardio graphic examination.
• Surgical clinic - The clinic should have facilities for treatment-cum-dressings. For
convenience, this should be placed next to consultation-cum-examination room with
adequate waiting space.
• Orthopaedic clinic - The clinic should include arrangements for plaster preparation,
fracture treatment besides consultation-cum-examination. Fracture and treatment
should be spacious enough to accommodate a dressing couch and a mobile X-ray unit.
A recovery room adjacent to the fracture and treatment room is essential.
• Eye clinic - The clinic should include consultation-cum-refraction, minor surgery,
treatment and a dark room. For testing the state of refractive power of the eye, room
length not less than 6 m is essential. However by use of mirror length of room can be
reduced. Dark room should be placed close to consultation preferably with a
intercommunicating door.
• ENT clinic - The clinic should have facilities for treatment and a sound-proof
audiometry room.
• Dental clinic - The clinic should have facilities for dental hygienist, dental workshop
and room for patients recovery. Consultation-cum-examination room should serve as
combined purpose room for consultation, examination, dental surgery, treatment and
X-ray facilities.
• Obstetric and gynaecological clinic - The clinic should include a separate
reception and registration, consulting-cum-examination, treatment and clinical
laboratory. The clinic should be planned close to in-patient ward units to enable them
to make use of the clinics at times for ante and postnatal care. The clinic should also be
at a convenient distance from other clinics in the OPD. Antenatal patients have to
undergo certain formalities prior to examination by the doctors, clinical laboratory for
the purpose is essential. A toilet-cum-changing close to treatment should also be
provided.
• Family planning clinic - The clinic should provide educative, preventive, diagnostic
and curative facilities for obstetric and gynaecological treatment, paediatric and health
education. Importance of health education is being increasingly recognised as an
effective tool of preventive treatment. People visiting hospital should be informed of
environmental hygiene, clean habits, need for taking preventive measures against
epidemics, family planning, etc. Treatment room in this clinic should act as operating
room for IUCD insertion and investigation, etc.
• Paediatric clinic - The clinic should provide medical care for infants (including new
born ) and children up to the age of 12 years. Owing to risk of infection it is essential to
isolate the clinic from other clinics. The clinic shall be provided with a separate
dressing, treatment and immunisation room.
• Skin and STD clinic - The clinic should provide diagnostic and curative facilities for
dermatology, STD ( sexually transmitted disease ) and leprosy. The treatment rooms for
dermatology and STD may be combined, but treatment for leprosy should always be
segregated. The clinic should also have facilities for superficial therapy and a skin
laboratory.
• Psychiatric clinic - The facilities required for the clinic should include consultation-
cum-examination room, ECT treatment room, recovery, psychologists and a social
worker room. The clinic should preferably be located on ground floor to reduce the risk
of suicide and accident. All rooms of the clinic shall have dado one metre high and all
electrical fittings shall be protected. In ECT room the patient is subjected to
electroconvulsivetherapy ( shock ). A resuscitation (recovery room ) is needed close to
this room.
Various clinics under OPD requires supporting facilities in common which include clinical
laboratory, injection room, social service department, etc.
• Injection room - For administering injection to patients a central injection room
should be provided in conjunction with the dispensary.
• Clinical laboratory - For quick diagnosis of blood, urine, etc, a small work room
facilities should be provided close to injection room with all essential require
• Social service - A social worker room to render service to the patients should also be
provided.
PHARMACY
• The dispensary should be
located in an area
conveniently accessible
from several clinics.
• The dispensing and
compounding room shall
have multiple dispensing
windows, compounding
counters, drug storage
cabinets and shelves. The
pattern of arranging the
counters and shelves shall
depend on the size of the
room.
• Medicines which require
cold storage may be kept in
refrigerators.
 • The function of blood bank is
BLOOD BANK to maintain current blood
groupings, to collect, store and
issue blood and also to supply
the blood for transfusion to
the patients.
• The blood bank shall be in close
proximity to pathology
department and at an accessible
distance to operation-theatre
department, intensive care units
and emergency and accident
department.
• The units shall include a
reception-cum-waiting room,
bleeding room, laboratory for
groupings, recovery room and a
room for storage of blood.
• Blood taking also requires a
comfortable reception with
toilets. Bleeding room should be
quiet and not a thoroughfare and
should be divided into cubicles
for privacy.
• A rest room should also be
provided for donors to rest and
take light refreshment before
returning home.
 ACCIDENT & EMERGENCY DEPARTMENT
• It should have a distinct entry independent of OPD main entry so that a very minimum time is
lost in giving immediate treatment to casualties arriving in the hospital.
• It should be located in the complex of the OPD for reasons of easy accessibility and sharing
medical facilities with the OPD.
• It shall be placed on the ground floor of the hospital.
• Guidance to the route from main gate to the doorways of reception hall shall be ensured.
• It should include accommodation for out-patients and in-patients in one block with a separate
entrance for ambulance, all facilities for reception and immediate treatment including X-ray unit,
operation theatres, clinical laboratory, the necessary supporting services and resuscitation
services.
• There should be an easy ambulance approach with adequate space for free passage of vehicles
and covered area for alighting patients.
• The arrangements for reception of trollies and walking patients should be close by but
independent.
• It should serve as waiting space also for persons accompanying the patients. As the accident
cases are closely associated with police department, a separate room for their use shall be
provided in this area.
• Separate toilet facility for men and women should be provided nearby.
PATHOLOGY DEPARTMENT
• Pathology is concerned with the analysis of diseased tissue or fluids and other
elements in the body. The pathology department in a hospital is mainly diagnostic in
function.
• Other activities connected with the department is mortuary and autopsy.

WHERE IT SHOULD BE LOCATED?

• The department should be located at a place which may be easily accessible to both
indoor and outdoor patients. In hospitals of category B it may form a part of OPD.
SPACE REQUIREMENTS
• Laboratory - Separate laboratories should be provided for biochemistry,
microbiology, clinical pathology and hematology, histology and cytology, and serology.
Each laboratory should be provided with 600 mm wide and 800 mm high bench of
length about 2 m per technician and to full width of room for pathologist incharge of
the laboratory.
• Each laboratory bench shall have laboratory sink with swan neck fittings, reagent
shelving, gas and power point and under counter cabinet. bench shall be of acid and
alkali-proof material.
Land Area Requirement
Movement in Passages and Waiting
 STANDARDS FROM MODERN HOSPITAL
ARCHITECTURE – KANT GUPTA
Walls and Ceilings
• Wall materials in areas such as operating units should be impervious, joint less, non-
absorbent and easily cleaned.
• X-ray view box, electrical plugs/switches should be flush with the wall surface to facilitate
cleaning.
• Walls and floors, if situated above ground floor level of imaging department, must be
provisioned with shielding material such as lead, to prevent radiation exposure.
• Corner of walls should be protected against physical impact by stretches/trolleys.

Doors and Windows

• Doorways should have minimum 90 cm clear opening width to allow easy passage
including those on wheel chairs.
• A level surface of at least 152 cm wide should extend about 45 cm on either side of the
doorway for facilitating opening/ closing by a wheel chaired person.

Water
• Water conservation and re- utilisation by rain water harvesting should be ensured.
• Landscape which require minimum irrigation should be designed.
• Approximately 500 litres of water per bed day are required.
Surface Materials
• Fixtures and fittings should be designed to facilitate easy cleaning and discourage
accumulation of dust.
• Horizontal, textured or moisture retaining surfaces should be avoided.
• Inaccessible areas where dust and moisture would accumulate should be avoided.
• Surfaces should be smooth, impervious and easily cleaned. There should be of seamless materials in high
risk clinical areas such as operating units, ICU’s and obstetric units.

Ramps, Stairs and Lifts

Ramps:
• The gradient of the ramp should be between 1:12 and 1:20.
• Pedestrian ramps must of handrails (one at height of 0.9m and the other at 0.5m for ease of people in
wheel chairs.)
• The minimum width of ramps should be 1:6m to allow easy passage of patients including those on
wheel chairs.

Stairs:
• Recommended height of risers is 0.15m having 0.30m treads.
• It should have level and non-skid surfaces.
• Handrail should be positioned on both sides of stairs beyond first and
• Last step to facilitate people with leg braces to pull themselves beyond those points.

Lifts:
• Passenger lifts are ideally recommended for all healthcare facilities
having patient services located on a level other than ground floor.
• Lifts required for transporting patients on beds and emergency lifts should be capable of accepting
hospital beds with emergency equipment.
A General ward is a type of hospital ward, which contains one large room without
subdivisions for patient occupancy.
These wards contain about 24 to 34 beds usually arranged along the sides of the ward.
Area/ Bed Space
• The actual area required by a hospital bed
is 2 sqm.

• Space must be allowed for nursing and

general circulation is 6 sqm.

• For each nursing unit of 20-30 beds, other

facilities such as toilets, shower, pantry,
duty room, examination room, storage and
utilities must be included.

• The total floor area per bed required in the

inpatient department is 8 sqm.

• The total floor area per bed required in the

outpatient department is 70 sqm. which
includes labs, imaging services: kitchen ,
laundry stores etc.
 TIME SAVERS STANDARDS
Bedrooms
• The number of beds per nursing unit,
or the proportions of single, double and
four-bed rooms within given units .
Size
Ranges of net clear floor area from corridor
door
to window stool, not including built-in
wardrobes, are :
• Single rooms : 117 to 172 sq ft (deluxe are
larger)
• Double rooms : 157 to 210 sq ft
• Four-bed rooms: 306 to 401 sq ft
• Depth: of rooms from inside of exterior well
to room side of corridor partition, all the way
from 14 ft-6 in .
• For single rooms or 15 ft-0 in . for double
and four-bed rooms to 21 ft-6 in . for all types .
• In the two and four-bed rooms a clear
distance of 14 ft-0 in . for two beds and two
bedside tables is "snug," but it should be noted
that the majority of rooms studied measure
nearer to 15 ft-0 in .

Furniture
• Motor operated high-low beds are
also uniformly popular-it should be
noted that they may be full 7 ft-3 in . i n
overall length.
• The typical bedside table measures
about 16 in . x 20 in .
• Hospitals purposely set lavatories at 3
ft-
above floor
Doors and Windows
• Standard bedroom door width is 3 ft-10 in
. or
4 ft-0 in . This can be reduced by 2 in . with
offset hinges .
• Toilet room door widths are 2 ft-0 in .
t o 2 ft-4 in . swinging out into bedroom
• Preferences are expressed for marble
and laminated plastic stools .
Room Finishes
• Plaster walls are most common.
• In multi-bed rooms-use of suspended
acoustical system is more valuable for
access to mechanical work then for its
acoustical properties
Built in Equipment
• 9 in . Wide flower shelves bracketed on
wall beside or opposite bed, about 4 ft-6 in .
above floor .
Lighting
• In almost all rooms there is a wall fixture ove
head of bed, mounted from 5 ft-2 in . t o 6 ft-
6 in . above floor .
Oxygen and Suction
• Outlets are 4 ft-0 in . To 5 ft-6 in . above
floors-5 ft-0 in . Minimum
Suction is provided in all rooms in
approximately one-third of the hospitals.
 SURGICAL SUITE
• Free floor space should be 18 ft by 20 ft, or approximately 350 sq ft . Many
surgeons and surgical supervisors recommend 20 ft by 20 ft free floor space .

• The planning and equipping of each operating room are based on a series such as :
(a) size,
(b) usage,
(c) environmental control,
(d) lighting-surgical and general illumination`,
(e) intercommunications and signal systems-,
(f) electronic equipment and
monitoring system',
(g) service lines, such as suction, oxygen, nitrous oxide, compressed air,
(h) provision for x-ray, not only x-ray tube stand but control, transformer, and
necessary lead protection,
(i) provision for TV camera, movie cameras, other recording equipment,
(j) safety precaution in hazardous areas, (k)
cabinet work, supply cabinets and storage for
operating table appliances, (I) need for clocks,
film illuminators .
 NURSERY
• NURSERY FOR 440 LIVE BIRTHS PER YEAR
IN HOSPITAL OF APPROXIMATELY 50 BEDS.
The number of bassinets and maternity beds required is based on number of live births
expected in hospital per year.

An area of 30 feet per infant is recommended, exclusive of the nurses' station .

The optimum number of full-term infants that can be cared for by a member of the nursing
staff is in the range of 8 to 10 .

• Bassinels should be at least 2 feet apart and, if partitions are used, cubicles should be
large enough to permit bedside care .

• Partitions should be glazed or transparent so that the infants can be easily observed by
the nurse .

• To facilitate cleaning, partitions should not extend to the floor .

• Cubicle partitions might extend only from the bottom of the bassinet to 24 inches above
.
• The supporting frames of the partitions may be attached to the ceiling and wall .
 Labor-Delivery Suite
• Labor Rooms • Delivery Room
• Basic considerations include the
• These rooms should have minimum
immediate availability of equipment and
floor area of 100 sq ft . Multiple
supplies, built-in protection against
occupancy rooms should have not
anesthetic explosion, auxiliary electrical
less then 80 sq ft per bad .
systems in case of power failure, an
adequate air-conditioning System and
• If only one delivery room is required,
finishes that promote aseptic conditions
one labor room should be arranged as
.
an emergency delivery room and
should have a minimum floor area of
• A clear floor area approximately 17 ft 6
180 sq ft .
in. square is generally large enough .
• The minimum width for labor room
• A minimum ceiling height of 9 ft is
doors is 3 ft 8 in . However, to provide
required for an obstetrical light .
for the passage of beds or stretchers,
4 ft is recommended .
• The minimum width for the delivery
room
door in 3 ft 8 in . ; however, 4 ft is
recommended since patients will often
be moved to the delivery room on a
labor bed.
LABOUR ROOM
ENT

AUDIOMETRY ROOM
MINOR OT
NURSING STATION
LABOUR ROOM
NICU
O.P.D. WAITING
EXAMINATION WAITING AREA