H O S PITAL d e s i g n

CASE STUDY & LITE RATU R E STU DY

Submitted by: ASHISH RANA RISHI VERMA SHREY SHARMA SUNAINA NANDWANI A081009 A081026 A081032 A081036

I N T RO D U C T I O N
A hospital is a health care institution providing patient treatment by specialized staff and equipment.

Types of hospitals (as per no of beds)

Smallest acute
(upto 50 beds)

Small
(upto 150 beds)

standard
(upto 600 beds)

large
(more than 600 beds)

Types of hospitals(as per function)

General hospitals:
General hospitals diagnose and treat major all the major ailments with facility to hospitalize patients for scrutiny and care.

Specialty hospitals:
Have specialized departments as in cardiology, neurology , etc. which specialize in a particular sphere of medicine.

University hospitals:
They are the most broad hospitals as they are also a college for medicinal studies.

PLANNING CONCEPTION
Location: The site should offer sufficient space for self contained residential areas and hospital departments. It should be a quiet location with no possibility of future intrusive development not excluded by regulations on adjacent sites. Adequate open areas for later expansion must also be planned. Orientation: Treatment and operating rooms - north-west and north-east. nursing ward facades - south to south-east is favorable East and west facing rooms have comparatively deeper sun penetration, though less winter sun. The orientation of wards in hospitals with a short average stay is not so important. Some specialist disciplines might require rooms on the north side so that patients are not subjected to direct sunlight.

NURSING

NU RS ER Y

SERVICES LAUNDRY KITCHEN DINING HELPER LOCKER NURSES BLOCK STORAGE MECHANI CAL PLANT

DIAGNO STIC FAC.

SURGERY

DELIE VERY

HEALTH CENTRE

OPD

E M R

ADMINISTRA TION

A/C PLANT PARKING

AMBULENCE

OUT PATIENTS

PATIENTS

BASIC CIRCULATION FLOW CHART OF A

STAFF

HOSPITAL

SERVICE AND HELP

PATIENTS

VISITORS

STAFF

OUTDOOR PATIENT DEPARTMENT : CIRCULATION

EMERGENCY : CIRCULATION

Registration/ payment emergency Check-in surgery Doctors check up hospitalization examination Lab tests X-ray ECG Ultrasound delivery

payment

hospitalization

pharmacy

exit

 OT : 1 OT for every 50 general impatient beds and 1 OR for every 25 surgical beds ICU beds: 5-10% of total beds FLOOR SPACE FOR EACH ICU BED : 25-30 M2/BED FLOOR SPACE FOR EAH PEDRIATIC ICU BED : 20-24M2/BED

LAUNDRY: 1 - 1.5 M2/BED OPD REGISTRATION SPACE : 0.5 M2/BED DOOR OPENINGS PATIENT BEDROOMS: MINIMUM : 1500MM WIDE & 2100 MM HIGH CORRIDORS : With frequent trolley movement : 2100-2400 mm Without frequent trolley movement : 1800 mm No transportation : 1200 mm Major inter department corridors : 2100mm

FLOOR SPACE FOR HOSPITAL BED : 15-18M2/BED

BED SPACE IN WARDS: 7M2/BED C/C DISTANCE BETWEEN TWO BEDS: 2500mm CLEARANCE AT FOOTEND OF EACH BED : 1200mm WAITING AREA IN OPD : 0.5 1 M2 / PATIENT ELECTRICAL REQUIREMENT/BED/DAY: 3-5 KW WATER REQUIREMENT/BED/DAY :400-500 LITRES

Ceiling heights : Minimum ceiling heights in occupied areas . Corridors, passages and recesses : 2400mm Ceiling heights : therapy rooms, ICU and kitchen : 2700 mm X-ray rooms , OTs : 3000 mm Bed/service lifts : Clear door opening : 1200mm X 2000 mm Car dimensions : 1300mm X 2400 mm(deep) Passenger Lifts : Clear door opening : 800 mm X 2000 mm Car dimensions : 1300mm X 1100 mm

DOCTORS ROOM, TREATMENT ROOM , NURSES WORKROOM AND STATION SUPERVISION ROOM BED LIFT FOR PATIENTS

BED LIFT FOR PATIENTS

CORRIDORS Corridors must be designed for the maximum expected circulation flow. General access corridors 1.5m wide Corridors in which patients will be transported on trolleys 2.25m wide The suspended ceiling in corridors may be Installed up to 2.40 m. Windows for lighting and ventilation should not be further than 25m apart.

BED REQUIREMENTS In the planning of new buildings, about 70-100 m2 must be allowed per sick bed, and roughly 200-280 m3 per bed must be allowed for alterations (which includes all ancillary spaces such as environmental controls and storage)

AN EFFECTIVE ARRANGEMENT FOR A HOSPITAL WOULD BE AS FOLLOWS: top floor: helipad, air-conditioning plant room, nursing school, laboratories 2nd&3rd floor: wards 1st floor: surgical area, central sterilization, intensive care, maternity, children's hospital ground floor: entrance, radiology, medical services, ambulance, entrance for bedridden patients, emergency ward, information, administration, cafeteria basement: stores, physiotherapy, kitchen, heating and ventilation plant room, radio-therapy, linear accelerator sub-basement: underground garage, electricity supply

FUNCTIONAL AREAS OF A HOSPITAL :

Supply/disposal nursing area Intensive therapy Surgical area Rehabilitation Physiotherapy X-ray Radiotherapy Recovery area NMR diagnosis Clinical physiology Clinical neurophysiology Central reception Delivery area Dialysis Specialist departments 6 - 14m2 PA/planned bed care area 4 - 5m2 PA/planned bed care area 5 8m2 PA/bed 21 - 28m2 PA/surgical unit 4 5 m2 PA/treatment unit 11 12.5m2 PA/treatment place 10 12m2 PA/diagnosis room 50 60m2 PA/equipment 4 6m2 PA/recovery bed 16 25m2 PA/diagnosis room 13 16m2PA/diagnosis room 13 16m2 PA/diagnosis room 23 27m2 PA/examination/treatment room 14 16m2 PA/delivery room 12 13m2 PA/dialysis bed 9 13m2 PA/examination/treatment room

SURGICAL DEPARTMENT
operating theatre 40-48 m2 entry room 15-20 m2 exit room 15-20 m2 washroom 12-15 m2 equipment room 10-15 m2
MAIN SURGICAL ROOMS 6.50 x 6.50m with a clear height of 3.00m and an extra height allowance of roughly 0.70m for air conditioning and other services. ANAESTHETICS ROOM The anaesthetics room should be approximately 3.80 x 3.80m WASHROOM The minimum width of the room should be 1.80m. For each operating theatre there should be three non-splash wash-basins with foot controls. STERILE GOODS ROOM 10m2 is required per operating theatre. EQUIPMENT ROOM A room size of approximately 20m2 should be allowed.

The image displays an Ideal floor plan of an external surgical area with a direct link to the main building. The corridor system IS separated into staff corridors with links to the functional rooms and pre-operative and post-operative patient corridors. A requirement when planning a new building IS that it must be expandable on at least one side.

POST OPERATIVE FACILITY

Beds must not be too close together in the recovery room and allow enough space for the anaesthetist and his equipment to reach at least three sides. The route between the recovery room, the operating theatre and the ward should contain several doors and be as short as possible so the anesthetist can get to the patients quickly in case of emergency.
Recovery room requirements The number of beds required is calculated as 1.5 times the number of operating theatres. Central sterilization - 40-120 m2. Approx. Dictation room - 5m2 approx. Patients' room 1 bedded room - 10m2 2 and 3 bedded room -8m2 (per bed) Non clean work room 10m2 Nurses work area 25-30m2 Rest room/kitchenette 15m2 Station doctor 16-20m2 Clean workroom 10m2 Plant room 8m2 Patients lounge 20-25m2 Internal medicine treatment area Examination room 25m2 Physicians room 25m2 Radiology 18-30m2

INTENSIVE CARE UNIT

Arrangement: The intensive care department must be a separate area, and only accessible through lobbies (for hygiene reasons). The central point of an intensive care unit must be an open nurses' workstation from which it is possible to oversee every room. The number of patients per unit should not be more than 6-10. Following should be included in the plan : 1. One nurse's duty station, 2. a sterile workstation(medication and infusion preparation), 3. one materials room and 4. one equipment room per unit (six to ten beds) Arrangement of the bed spaces: The beds may be placed in an open, closed or combined arrangement. All the beds must be in clear view of a central nurses' duty station. The patients are separated by moveable half-height partitions which should be lightweight and easy to move. The ideal plan is star shaped, with rooms radiating out from the nurses' workstation, but this is often not feasible because of space restrictions so more traditional arrangements are used.

DOCTOR CHAMBERS
ULTRA SOUND SAMPLE ROOM TOILETS RETIRING ROOM DOCTORS CHAMBER WAITING HALL
RAMP

C-T SCAN

RECEPTION

X-RAY

WAITING HALL CHEMIST CASUALTY

ENTRANCE

ICU

ADMINISTRATION

DOCTORS CHAMBER

LIFT & STAIRS

GENERAL WARD KITCHEN COMMON ROOM PRIVATE WARD GENERAL WARD WAITING HALL

PRIVATE WARD

O.T

PRIVATE WARD

FOYER

O.T

AUTOCLAVE

PRIVATE WARD

PRIVATE WARD LIFT & STAIRS

PRIVATE WARD

LAB

MANAGER
FOYER

RAMP

PHYSIOTHERAPY CONFERENCE

Sarvodaya Hospital , Hisar

Physiotherapy Conference room Manager room Laboratory Patient ward Common room O.T Autoclave General ward Corridor Lift I.C.U Ultrasound X Ray Waiting C. T.scan D. chamber Chemist Ramp 40 x 16 25 x 16 10 x 10 12 x 15 9 x 16 , 9 x 12 11 x 16 14 x 13 11 x 13 17 x 12 , 17 x 15 7 wide 6x8 40 x 30 10 x 6 11 x 14 , dark room 7 x 3 12 x 12 11 x 16 + console= 8 x 12 9 x 12 , 16 x 10 9 x 13 5 wide

Standards
Corridors 1.5 m least 2.25 m for trolleys 3.00 m main corridors 2.1 2.2 m 2.5 m 2.7 2.8 m normal doors vehicle entrance transport entrance

Doors

Stairs

effective width of stairs and landing in essential stairscase Must be a minimum of 1.5 m and should not exceed 2.5 m. Step height of 170 mm permissible and minimum required Tread is 280 mm. Rise : tread = 150 : 300 mm

room size

117 172 sq.ft 157 210 sq.ft 308 401 sq.ft

single bedroom double bedroom four bed room

Major difference is found in room depths. Depth 14 6 15 21 8 for single for double for four

Typical bed side table = 16 x 20

Surgical department Ot Entry room Exit room Wash room Equipment room

40 15 15 12 10

48 20 20 15 15

sqm sqm sqm sqm sqm

Ot should be designed as square as possible to allow working whatever direction the operation table is turned in. Suitable size of ot is 6.5 x 6.5 m with height of 3 m. Extra height allowance is 0.7 m for air conditioning.

Anaesthetic room Approx. size 3.8 x 3.8 m Electric sliding door 1.4 m clear width Washroom 1.8 m min. width For each ot there should be 3 non splash wash basin with foot control. Sterile room Approx. size 10sqm required for ot and should be accessible directly from ot.

Equipment room Approx. area 20sqm. Directly access from ot. Central sterilization Usage by surgical dept. Surgical intensive and i.c.u Approx. area

40 % 15 % each 40 120 sqm

Nurse area Area 25 30 sqm Rest room 15 sqm Station doctor 16 20 sqm Clean workroom 10 sqm Patients lounge 22 25 sqm Toilet size for rooms Single toilet 2 10 3 2 , 3 10 4 10 Door size Std. bedroom door width 3 10 - 4 Lifts One multipurpose lift should be provided per 100 beds. Min. of 2 smaller lifts for portable equipment , staff and visitors. Lift car0.90 m x 1.20 m Shaft1.25 m x 1.5 m

GENERAL HOSPITAL SECTOR 6, PANCHKULA

AREAS ON DIFFERENT FLOORS

GROUND FLOOR
OPD REGISTRATION GENERAL OPD IPD REGIDTRATION EMERGENCY PHYSIOTHERAPY SURGERY ORTHO PEDICS MEDICINE PAEDIATRICS GENERAL OPD SURGERY EYE EMERGENCY LITHOTRIPSY ULTRASOUND & CT SCAN X-RAYS PHARMACY ECG SAMPLE COLLECTION PATHOLOGY/EMG LAB CASH COUNTER INJECTION ROOM VCTC

FIRST FLOOR
GYNAECOLOGY EYE ANTENATAL REGISTRATION BIRTH & DEATH REG. PP CENTRE DOT CENTRE IPD REGISTRATION EMERGENCY MEDICINE SURGERY LABOUR ROOM GYNAE/OBS. PAEDIATRICS INJECTION ROOM MAJOR O.T.

SECOND FLOOR
DENTAL CHEST & TB ENT TMT SKIN/LASER PSYCHIATRY EEG BIRTH &DEATH REG. PP CENTER PHOTOTHERAPY

CSO BUILDING
Blood BANK MORTUARY ( BEHIND) INCINEARTOR ( BEHIND )

SERVICE STANDARDS
DOCTORS 47 NURSING SISTERS 11 STAFF NURSES 69 PHARMACISTS 15 TECHNICIANS 14 O.T. ASSISTANTS 04 DRIVERS 07 CLASS 4 20 SWEEPERS 10 CONTRACT WORKERS 50

THIRD FLOOR
ADMIN. OFC. CCU PRIVATE

GROUND FLOOR PLAN

FIRST FLOOR PLAN

ENTRY AND ADMINISTRATION

IN PATIENT DEPARTMENT
WHITE PAINTED WALLS ADDED LIGHT TO THE SPACE MANY WINDOWS WERE PROVIDED FOR LIGHT & VENTILATION

As emergency entry is not provided , stretchers are kept at the entrance itself.

MOSAIC TILED FLOORING

DISPOSAL OF DIFF. TYPES OF WASTES

ADMINISTRATION B LOCK AT A DISTANCE FROM THE MAIN BLDG.

NURSE STATION ( 45 SQ. FT. approx. )

PHARMACY
X RAY ROOM ( 23 X 20 approx. ) Anti-skit Tilled Flooring

RADIOLOGY AND IMAGING

12
RECORD ROOM ( 22 X 18 approx. )

ICU
WELL FURNISHED ROOM, 5 BEDS.

CLADDED WALLS
MOSAIC TILED FLOORING

DARK ROOM ( 12 X 18 )

ECG ROOM ( 10 X 10 )

OPD ORTHOPAEDIC

MINOR OT

CHECK UP AREA

CONSULTATION AREA

PARKING AREA

23 10

10

SERVICES

PLUMBING SHAFTS Service pipes running along the ceiling.

INFERENCES:
The hospital is being re-constructed, therefore, there are some problems being faced. The fire fighting system is not adequate. But provisions are being made for the same in the new construction. The arrangement of the spaces is not proper. E.g.. Emergency ward has got no direct entrance. The blood bank was quite far from the main hospital building. The area provided for each space was ample but not planned. No lack in services was seen. Proper vacuum, oxygen, and other requirements were fulfilled. The radiology room space was well planned. I.C.U. was a single unit. No separate cabins for the patients were provided. Proper facilities for handicaps were provided.