Laundry Service

Laundry service is responsible for providing an adequate, clean and constant supply of
hospital linen to all users.
The term hospital linen includes all textiles used in the hospital including mattress,
pillow covers, blankets, bed sheets, towels, screens, curtains, doctors coats, theatre
cloth and table cloths.
Linen processing may be done within the hospital facility or off-site in a commercial or
shared laundry, depending on the Operational Policy. Each facility shall have provisions
for storage and exchange of clean and soiled linen for appropriate patient care.
The basic tasks include:
Sorting
Washing
Extracting
Drying
Ironing
Folding
Mending
Delivery

Linen Quality Requirement

Quality of
fabric

Factors
Methods
of
Washing

Frequency
of change

Washing Method
Wash Through contractor

Totally dependant on contractor

Constant Supervision needed
Transportation
No maintenance required
Cost low

Centralized

Readily available clean linens

No transportation
Maintenance required
Trained staff required

Frequency of change

IPD- 2-3 kg of dry linen per bed per 2 day (if change on alternate days )

OT- no. of linens in one operation X no. of operations in one day.

Its better not to use linens immediately after wash, rather use after one
day store, this may increase linen life.

 Minimum requirements

Linen Handling and Storage Areas

A separate room for receiving and holding soiled linen until ready for pick
up or processing
A central, clean linen storage and issuing room/s that has the central
storage capacity
Trolley storage areas with separate storage of clean and soiled linen
trolleys out of traffic paths
A clean linen inspection and mending room or area
Hand-washing facilities shall be provided in each area where soiled linen is
handled

Staff Areas including:

Manager or Supervisor's Office

Access to a meeting room for Training and staff meetings
Access to Staff Room, Toilets, Shower and Lockers; these may be shared
with general hospital staff.

Trolley Washing area that may be shared with other service units.

Laundry Off-Site
If linen is processed outside the building, provisions shall be made for:
A service entrance, protected from rough weather, for loading and
unloading of linen
An area for pick-up and receiving.
Laundry On-Site
If linen is processed in a laundry facility which is part of the hospital, the
following shall be provided:
Laundry processing room with commercial type equipment.
Storage for laundry supplies

Linen Inspection and Mending

The Linen Handling Unit may include a Linen Inspection and Mending
room to examine clean linen and assess for repairs, particularly sheets,
wraps and uniforms.
Linen examination is undertaken on a large flat surface. Sewing machines
may be available for linen repair.
If an external linen service is provided, linen inspection and repair may be
undertaken off-site.
If included, the Linen Inspection and Mending will be located adjacent to
the Clean Linen Handling area.
Linen examination benches or tables may include lighting to the bench
surface and a high level of overhead lighting to aid identification of tears
and holes in linen.
Other requirements may include:
Ironing facilities
Tables for folding
Racks for hanging linen items.

Functional Relationships
The Linen Handling Unit will require ready access to:
Loading dock for deliveries
Clean Linen Holding areas
Waste Management area for dirty linen holding and collection
CSSD for sterilization process
All Hospital Units that require linen deliveries and collection services.

Functional
Relationship
Diagram

 Elaborative requirement

The laundry should be located in an area that has ample daylight and natural
ventilation. Ideally, it should be on the ground connected or adjacent to the
water and power plant.

Space for heavy equipments like washing machine, squeezer etc.

Provision for supply of water and power.
Storage place for cleaning agents.
Space is also needed for sorting the soiled linen
Facilities to manually wash some required linens
Clothes lined to dry in the sun or dryer spaces
Place for sewing, and mending area.
Place for ironing.
Desk to have registers and files.
Space in every ward for storing clean linen / linen chutes

Laundry Linen
Soiled Collection-washing-pressing-

Infected Linen
Sluicing-soaking in disinfectant-washing-conditioningpressing

Foul Linen
Collected in water proof containers
Central sluicing-normal process of washing

Radioactive Linen
Segregated by suitable detectors put in special
washer- confirm radiation free status- normal washing

The layout should allow unidirectional flow of the product with least chances of
contamination. The laundry layout is broadly divided into four basic areas:
Reception and Sorting Area

Processing Area
Clean Linen Store
Tailoring Section

Ancillary Facilities:

Chief Laundry Manager's Office

Linen Superintendent's Office

Linen Store

Detergent Store

Working Rest Room

Mending Room

Toilet
A survey conducted by the Govt. of India Ministry of Health for Delhi hospital has
recommended space of 10sq.ft( 0.9 sq.m) for every 2.5 kg of linen per day
Utilizing the norm a 500-600 bedded hospital shall require space of about 5000-6000 sq.
ft. (465 557 sq.m)
(One patient requires about 2.5 kg of linen in 24 hrs. Thus 500 bedded hospitals will
generate 1250 kg of dry linen in 24 hrs.)

Laundry Processing
Sluicing
Machine

Reception/Receiving

Sorting
Waste
disposal
Room

Washing

Hydro extractor

Trolley Wash

Central Clean
store

Distribution/Issue

Sterilization

Drying open/
Dryer

Checking and
Mending

Clean
Store

Packing

Ironing

Equipments

Catering Unit/ Dietary Services(Kitchen)

The Catering System shall provide food service for

staff,
inpatients,
outpatients, and
ambulatory patients as appropriate.
The patient food service will include catering for the special dietary needs of
patients, food service to VIP rooms and provision of nourishment and snacks
between scheduled meal services.
Provision of food services for visitors and staff may include cafeterias, kiosks,
or vending machine dispensing areas, particularly for after-hours access
The catering system needs to consider
storage,
preparation and
serving of specialized food for clinical conditions, patients with food
allergies, vegetarian diets, non-veg diets

Types of Food Preparation

The Catering Unit may be designed to accommodate a Cook-Chill or a

Cook-Serve food preparation system.

Cook-Chill refers to the process where food (fresh or frozen) is prepared,
cooked and then chilled for up to five days.
Food may be chilled in bulk or cold plated and then chilled.
Plated, chilled food may then be re-thermalised and served.
Alternatively, bulk chilled food may be reconstituted and then
plated and served.
Cook-Serve refers to the process where food, fresh or frozen is prepared,
cooked, plated and served immediately. Variations of the Cook-Serve
process include:
Hot plating, delivery and serving
Delivery of hot bulk food, then plating and serving.

Functional Areas
Food preparation systems require space and equipment for receipt, storage,
preparing, cooking and baking.
The Catering Unit may include the following Functional Areas dependent on the
planning model adopted:
Trolley return/ stripping and trolley washing area
Food preparation areas
Cooking facilities
Reheating facilities and/ or re-thermalisation facilities if cook-chill food is
processed
Refrigerator/s, cool rooms and freezers of adequate size to store perishable
foodstuffs
Storage areas for dry goods
Plating areas
Food distribution including parking and cleaning areas for food distribution trolleys
Dishwashing and pot washing areas
Staff dining room
Access to staff amenities
Supplies Receipt area
Waste disposal

Trolley Areas
Trolley Return/ Stripping
The Trolley Return area will hold used meal delivery trolleys. Trolleys will
then be taken into the Trolley Stripping area where they will be
dismantled, dishes, trays and waste removed and the trolley cleaned in
the Trolley/Cart Washing Area.
The Trolley Return/ Stripping area will be located adjacent to the
dishwashing and the Trolley/ Cart Washing area, with direct access from
the Entry Airlock.
Provide wall and corner protection for trolley impact zones. A hand
washing basin should be located in close proximity.
Trolley/ Cart Wash
An area shall be provided for washing and disinfecting of trolleys and
carts, with ready access to the trolley return and parking areas.

Food Preparation Areas

Food preparation areas will be located with ready access to storage areas,
refrigeration for food supplies, cooking areas, boiling water units and ice
dispensing machines.
Food Wash Area should be provided (separate areas for veg and non-veg
wash)
Equipment required for food preparation may include food processors,
slicers, mixers, cutters etc
Baking area
Dietitian Room

Cooking, Reheating/ Re-thermalising

areas
Cooking areas must be properly ventilated
with an exhaust hood covering the entire area.
Separate areas for veg and nonveg

Plating area
Cooked food may be plated:
Cold (as in cook-chill food service) and then chilled for future
reconstitution and delivery
hot (as in cook-serve food service) followed by hot transport
and immediate delivery.
The process of plating includes tray setting and plating of food
using a multiple station process line for efficiency, each
station adding an item to the food tray to end with a
completed meal.
The Plating area will be located with ready access to the food
delivery trolleys for efficient distribution.

Refrigeration, Freezers and Blast

Chillers

Cool rooms may be installed/ walk-in

refrigerators may be installed
Locate with ready access to food
preparation,
cooking
and
rethermalisation areas.
Refrigeration units should generally not
be located directly adjacent to cooking
equipment or other high heat producing
equipment which may interfere with the
temperature
control
within
the
refrigerator or freezer
Blast Chillers are required for the CookChill process and are used for rapid
chilling of cooked food in order to store
food until ready for plating.
In Cook / Chill food production, the Blast
Chillers will be located with ready access
to the cooking and food preparation
areas.

Dish washing
The Catering Unit will require separate stainless
steel sinks and drainers or equipment for washing
of dishes, utensils and cutlery. The area shall also
provide space for receiving, scraping, rinsing,
sorting and stacking of soiled tableware.
Dedicated crockery, utensil and cutlery washing
(ware washing) facilities shall be located as far as
practical from the food preparation and serving
area.

Pot washing
The Catering Unit shall provide separate stainless steel sinks
and drainers or automated equipment for washing of pots.
If automated Pot scrubbing facilities are installed then sinks
shall also be provided for emergency manual pot washing in
the event of equipment failure
Pot washing sinks or equipment shall be located with ready
access to preparation and cooking areas and may be colocated with dishwashing areas.

Food Distribution
A cart distribution system shall be provided with spaces for storage,
loading, distribution, receiving, and sanitizing of the food service
carts.
The cart traffic and the cleaning and sanitising process shall be
designed to eliminate any danger of cross-circulation between
outgoing food carts and incoming, soiled carts. Cart traffic shall not
be through food processing areas.
Patient meals may be re-thermalised in the Catering unit or in the
Inpatient Unit Pantries, depending on operational policy.
Cook-Serve meals will require an enclosed tray trolley delivery
system with insulated plate covers to keep hot food hot during
delivery. Consideration should be given to parking of trolleys in
Inpatient Units when not in use, awaiting collection of used meal
trays.

Staff Dining Room

The Room shall provide space for all staff potentially
requiring sit down dining space during any single
shift
The minimum area for a Staff Dining Room shall be
1.25 m2 per person dining at any one time

Unloading Area
Storage:
Storage space for at least a four day supply of food shall be
provided. Separate space will be required for dry foods storage and
crockery, utensils and cutlery storage.
Supplies Receipt
An area shall be provided for the receiving and control of incoming
food supplies such as a loading dock.
The receiving area shall contain the following:
A control station
A breakout for loading, un-crating, and weighing supplies.
These areas may be shared with clean dock areas.
Supervisor room

Waste Disposal
Provision shall be made for regular wet and
dry waste storage, removal and disposal

Functional Relationship Diagram

Spaces

Loading Unloading dock

Storage
Dry
Refrigerated
Bulk

Washing area
Preparation/production
Cooking
Veg
Non-veg

Dietician room
Manager
Quality check
Dish wash area
Distribution area

Mortuary

Mortuary complex:
Morgue is the place where dead bodies are kept before burial/cremation, whereas
Mortuary is a place where dead bodies are kept in the refrigerated body store and
examined in the post mortem room.
Morgue: The Hospital Morgue is a facility for the viewing and/or identification of a
body and the temporary holding / storage of bodies prior to transfer to a
Mortuary.
The design must address the following:
Number of bodies to be stored;
Method of storage i.e. refrigerated cabinets, cool room, freezing capacity;
Separation of entries for families to view/identify bodies, and
Delivery of bodies from inside the hospital and external delivery.
It should be noted that the standard hospital Morgue facility should not be used
for storage of a body associated with a criminal investigation. In this case the body
is evidence and enhanced security should be provided.

Importance of Mortuary Services

The concept of health of the population from "womb to tomb" in
the community health care clearly indicates that in a health care set
up, a doctor's duty is not only caring for the living but also in
helping to arrange for the disposal of those patients who die.
The subject of disposal off the dead is hedged around by religious,
social and cultural beliefs and practices.
It is necessary to provide within the hospital or its precinct, a place
to which a dead body can be moved quietly and discretely, so that
other patients are not upset.
It is also necessary to see that the body can later be removed from
the hospital for burial or cremation by an exit away from the
common view of patients and others in the hospital.

The mortuary broadly serves the following purposes:

To keep the dead till the relatives claim and take over the body for
disposal.
To keep unclaimed bodies until disposal (burial or cremation) is arranged
by the hospital authorities.
To allow viewing and identification by relatives, police and other people.
To receive dead bodies requiring pathological post-mortems pending final
disposal.
For teaching the undergraduates as well as post -graduates.

Ideally as per the sub-committee report (Bureau of Police Research and

Development) of 1975, which has been accepted in principle by the government, no
teaching hospital should have more than 500 autopsies in a year otherwise teaching
activities suffer. It may be mentioned that at MLN Medical College, Allahabad, a total
of 2436 autopsies were performed during the year 2005 far more than accepted
norm

Planning Consideration:

The location of the mortuary and autopsy room for obvious reason is always a
problem and preferred to be in an obscure place.
This is normally because both hospitals authorities and physicians by and large
prefer to project their successes rather than exhibit the dead body, which
apparently indicate their failure
This mind set requires to be changed and mortuary complex must be situated at a
reasonable vicinity to the main hospital complex so that it is not only convenient
to the hospital staff but also to relatives, police and other officials who are
required to visit mortuary very frequently
Location:
The mortuary should be located in a separate building near the pathology
laboratory on the ground floor
Easily accessible from the wards, accident and emergency departments and
operation theatres
In an area with ample natural light through windows; the widows of the principal
rooms should preferably be on the northern side.
It should be located preferably away from the general traffic routes used by the
public.
It must have a separate entrance and exist for relatives.

Physical Facilities Area & Space

Requirement:

The access to the unit should have a covered area along with parking
space for vehicles leading to the mortuary complex
It is also desirable to have an exit to a subsidiary road and nearby car park.
The mortuary and post mortem unit should consist of:
A. Reception and Waiting area
B. Cold room for body preservation
C. Post mortem room
D. Ancillary areas: Like consultant's room, conference room, prayer room,
toilet and other facilities for the staff and the visitors, trolley bay comp,
stores, etc.

Reception and Waiting Area: (Size 240 sq. ft. /22.3 sq.m)
It is the place where the body is received and documents are verified and
checked.
It is essential that this particular area be at a prominent place for easy
accessibility.
This area can also be used as prayer area where relatives and friends of all
religion may like to offer prayer
A lavatory also must be provided with and kept thoroughly clean.
Cold Room for Body Preservation:(Size sufficient to accommodate 50 bodies).
It is the place where all the bodies including hospital dead will be
transferred and kept prior to post mortem/autopsy or cremation.
The number of bodies to be accommodated will depend upon the size and
type of hospital, but for preliminary planning purposes an estimate of three
percent of the hospital bed holding may be taken.
It is desirable, rather it is essential, that the body racks should be
refrigerated, as it is not always possible to know how long a body will have
to remain here.

1.8 m

The chambers should be about 6 ft.(1.8m)

wide, 8 ft. 9 inches (2.7 m) deep and 6
feet(1.8 m) high in which six bodies may be
stored in two sets of three tiers. Depending
on the layout, a depth of 18ft (5.5 m). for
the body store is usually satisfactory. Space
is needed in front of the cold chambers for
the withdrawal of trays and for working
space for the morgue attendants.
A/C Plant Room:
Where more then twelve bodies are to be
stored, a separate plant room 25-30 sq. ft.
may be required, immediately adjacent to
the body storeroom.
Access for
maintenance should be arranged externally
so that it is unnecessary to enter the
building.

Post Mortem Room: size 30(9m) 20(6m)

This is a room where the body is investigated and dissected, so the room,
like an operation theatre must be kept clean to protect the doctors and
staff from bacterial contamination.
Two tables or 400 sq. ft. (37 sq.m) are required for every 450 hospital
deaths (probably one third of the total hospital death only will be
examined).
Autopsy complex should have a room with washing and drainage facilities
mortuary tables should be (preferably of stainless steel with arrangements
for allowing free drainage of a constant flow of water).
Ancillary areas:
Consultant Room: Size 100 sq. ft. (9.2 sq.m)
This is the place where the doctor and police fulfill legal formalities and
where the post-mortem/death reports are generally written or dictate on
telephone or recorded on tape during the course of an autopsy. It may
also be used for discussion with members of the clinical staff.
Changing Room:
Two separate male and female changing rooms are required for the
doctors and other clinical staff to change before entering the post-mortem
room

Ante Room:
A small lobby is needed for discarding soiled garments and boots before
the doctors and clinical staff returns to the changing room.
Consultant lavatory: Size 160sq.ft.(15 sq.m)
One separate male and female W.C. lavatory, basin and a shower cubicle
are needed.
Room for the mortuary supervisor.
Mortuary attendant's and cleaner's room: Size 100-150sq.ft.( 9 -14 sq.m)
This is the place required for the attendants assisting the doctors in postmortem to change before entering the post-mortem gowns aprons and
boots
Attendant lavatory: Size 80 sq. ft (7.5 sq.m)

A W.C. and washbasin will be necessary together with a

shower cubicle

Stores :

Three small stores may be required (size 30-40sq.ft./2.7-3.7 sq.m

each).
Clean Store: For clean gowns, aprons, rubber gloves, gumboots,
towels etc. It should be adjacent to consultant room and outside
post-mortem room.
Instruments and Equipment Stores: Required to hold the reserve
stock instruments, unused specimen jars, chemical solutions, the
electric resecting saw, the portable trolley, mounted spot light, etc.
this should open directly in the post-mortem room.
Chemical Store: Where chemical solutions for preserving the
internal organs and specimen jars and packing material are kept.
Sluice room

Specimen Room: (Size 120 Sq. ft./11 sq.m)

This should be provided in which body tissues may be stored
(in jars tanks of formal in) prior to their removal to the
department of histology for microscopic pathological
examination or permanent preservation.
Viewing Room:(120 - 180 sq.ft/11-17 sq.m)
This should be designed as a small chapel, which will be used
by relatives of the deceased. This chapel must not be
cramped, as space is necessary for turning body trolleys,
coffins, etc. Requirement for specific religious denominations
must be ascertained at the outset as the requirements and
accommodation will vary.
Undertakers vestibule: (Size 150sq.ft./14 sq.m)
This lobby might conveniently provide working space for the
undertakers assistance and could contain writing top and
table.

Foresaid Radiology Section:

Arrangements may be made for conduction of X-ray though
portable machines and facilities of view box for viewing X-ray
films.
Forensic Photography Section
Medical Observation Room: (Size 70-150 sq.ft./6.5-14 sq.m)

It is a room that allows clinical staff to attend autopsy without changing. It

may be in form of gallery or room, separated from the post-mortem room
by a full-length glass-viewing panel above worktop height, would allow
adequate observation and discussion.

Doctors Room:

This room is required for writing of reports. It may be used for discussion
with members of the clinical staff, so the size and dimension of the room
should be adequately planned.