Chapter 10 SITE SELECTIONChapter 10 SITE SELECTION A. RATIONALE A hospital should be available 24 hours a day to ils service catchment area for the provision of the entire spectrum of health care. In times of disasters and calarnilies, a hospital must remain absolutely accessible and should be the last institulion ever to stop operations. Successful health care delivery is therefore linked to the location of sites of hospitals and health facilities, Making the correct decision on the identification of sites Is just the beginning of the problem. For the site of a hospital and health facility is finally selected based on its accessibility, physical conditions, acceptability and land development costs. FACTORS TO BE CONSIDERED IN LOCATING A HOSPITAL a. It should be within 15 - 30 minutes travelling time. In a district with good roads and adequate means of tensporl, this would mean a service zone with a radius of about 25 kilometers. b. It should be grouped with other institutional factities such as religious (church), educational (school), tribal (cultural) and commercial (market) centres. c. It should be free from dangers of flooding, it must therefore not be sited al the lowest point of the district. d. It should be in an area free of pollution of any kind, including air, water and land pollution, e. It must be serviced by public utilities; water sewage and storm-water disposal, electricity, gas and telephone. In areas where such utilities are not available, substitutes must be found, such as a deep well for water, generators for electricity and radio communication for telephone. SYSTEMS AND PROCEDURES. C.1_ Inventory and profile of alternative sites Site selection starts with an inventory of available lands. The technical details of the available sites are oblained through ocular and geodetic survey.©.2_ Evaluation of the locatio: d quality of site A number of allernative sites should be assessed based on a physical conditions, acceptability and land development cn sibility, C24 Accessibilily The nearer the site to highly populated areas, the more desirable itis. Land uses such as residential, commercial, industrial and institutional are provided with improved servicss and are therefore beller linked with the hospital . The cost of infrastructure is likely to go higher and may unlikely get political support when the sile is far from densely populated zones. c, Physical Conditions a. Size The site must be large enough to meet all the planned physical requirements including any expansion envisioned for the hospital within the next 10 years. The following standards are recommended: * 28-bed capacity hospital + 1,202.0 hectares » 400-bed capacity hospital - == 2.0 to 4.0 hectares * 200-bed capacity hospital - ~—= 4.00 7.0 hectares * 200-bed capacity hospital - ~—= 7.0 fo 10.0 hectares ». Topography A flat and gently rolling terrain are the easiest and least expensive lo bulid on. A sloping ene, though difficutt and expensive lo develop, can offer interesting site layouts ©. Soll Soil characteristics determine building foundation schemes. Ideally, the ‘subsoil should be such that conventional economical structural design and foundation plans can be used d. Available Utilities Electrical, water and Communicaticn lines should be available. If nt, generator, deep wells, water pump and radio communication lines must be provided e. Natural Features Natural lakes and ponds and tush vegetation are considered as advantage in building design, Fruit-bearing and flowering trees and century-old trees like acacia, should be retained at all costs and the site must be planned according to their location.cs €.2.3 Acceptability A hospital and health facility site should be established in the overall context of the zoning classification restrictions of the locality, in city and municipal ordinances which either refine ar elaborate existing planning and building laws, rules and regulations to realize the overall physical plan of the community. Other aspects which affect the acceptability of {he site include peace and order situation, distance to high vollage transmission lines, cemeteries, slaughterhouses end waste disposal grounds. C.2.3 Land Development Costs Site quality in terms of its development costs, has a major impact on site selection. For oxampie, land may be susceptible (0 flooding, subsidenes, land slippage or may be located in solid rock. Such land is cheap to purchase but expensive to develop, ive sites to the end users for selection Presenting altern’ The comparative analysis of the alternative sites should be offered to the end users for selection. On-site visitations should be mandatory for the end user to verify the information presented.SITES EI] -ECTION PROCESS FLOW INPUT aguurry Corer rs as a wea aes] i,ocation Plans. eee (Cand Use and Zor IMediuin Temy Physical. |_| a Plan; Ay “Tdently altervative sites Survey Design ‘Gonducl site survey Tor=or [Forogeaphies 5 \Gecdotic Surveys land ownership: Tans ‘auriuct_ Sock jal_assasament| kapid apprazal Jnforrjalion on} (Conduct “socio-economic land _parcepti argo! tchmont aroa ‘on survey ofl, investigate altematve tos] fas to I+ Accessibilty J+ Physical condition Is Acceptability Land Development cost [List oF Sxeting inrastrua. ture and social services [consultative ragetings [Sacio-esonants profie of community; ¢-Protileof lcommunity: servioas ‘aspiration and| of =the! commun tevel. of skits I& fesouroes far incomo- lueneratiig actives. Selection af sito Cee pret ‘of algwalve sites rec auth Document Non-documentChapter § PROJECT DE LOPMENTChapter 5 PROJECT DEVELOPMENT RATIONALE The development of health infrastructure projects involves three (3) major slages of work namely Project Preliminaries, Schematic Planning and Design Development, and Project Documentation, Each major stage Is conducted through a sequential flow of activities. The completion of each stage shail be considered a milestone in project development, A hospital infrastructure project that has Gone through the project preliminaries for example, has been checked for financial requirements in the context of the hospital ten year development pian ahd indicative site development plan and in the DOH medium term development pian for heatth infrastructure A hospital infrastructure project that has hurdied the schematic planning and design stage means that the plans and designs have mot at feast licensure and qualily standards for spatial requirements and complied with the technical guidelines for planning and design of hospitals, and have been evaluated in a participatory manner by the project end userls. Laslly, @ project, with its schemalic plans and designs translated into delalled archileclure and engineering plans and other documents for contracting purposes, is considered ready to hegin the process of implementation DEFINITION OF TERMS: B1_ Project end user pertains lo any hospital or office of the DOH which intends fo develop and implement an infrastructure project, B.2 Infrastructure project or project pertains to a new construction, repair, novation works of buildings, building parts and building ulilly systems, and jarovernent of building site or premises. B.3. Project architect pertains to the architect in charge of the project and/or the office he represents which may come from the Central Office (Heallh Infrastructure Sérvice), from the Regional HeOlth office, or from the hospital ‘The project architect may also pertain to the DPWH which has been requestedBA BS C4 to assist the Project end user through a memorandum of agreement, or, if the OPWH has declined to offer technical assistance, may also pertain ta a privale architect consultant who has been hired by the project end user following the NEDA Cuicelines on Hiting of Consultants for government infrastructure projects. Project engineor pertains to the engineer in charge of the project and the office he represents which may come from the Central Office (Health Infractructure Service), from the Regional Health Office, or from the hospital, The project engineer may also pertain to the DPWH which has been requested to assist the Project end user through a memorandum of agreement, or, if the DPWH has dectined to offer technical assistance, may also pertain (o a private engineer consultant who has been hired by the project end user following the NEDA Guidelines on Hiring of Consultants for government infrasiructure project. Project tearn pertains to the technical group led by the project architect or project engineer composed of a civil enginser, electrical engineer, sanitary engineer, mechanical engineer and craftsmen, C. SYSTEMS AND PROCEDURES: Projest Preliminarias C4 Project kdentification and Approval a. The Central Office (Finance Service) identifies the specific budlyet for infrastructure of hospitals and offices which are categorized into land improvement and buildings and structures based on the approved budget for the fiscal year (General Appropriations Act). b. The project end user prepares a final list of projects corresponding to their specified budget supported by a description of projects and cost estimates. For hospitais, the final project list is prepared by the hospital Infrastructure Committee (INFRACOM). It derives the final project list based on the hospital tan year development plan, hospital indicative site plan, and on the continuing physical plant maintenance needs of the hospital c. For regional hospitals and medical centers, the hospital submits the final project list to the Regional Health Office for validation and clearance, The RHO indorses the final project list to the Central Office for ‘inal approval by the Undersecretary concerned ark for preparation of Project Program of Work by Health Infrastructure Service,d. For special/specially hospitals, the hospital submits the final project {ist to the Central for final approval by the Undersecretary concerned and for proparation of Project Program of Work by Health Infrastwucture Service, 6.1.2 Proparation of Project Program of Work a, The Central Office (Health Infrastructure Service) prepares the Project Program of Work and Budgetary Estimates, This document * summarizes the project construction activities and their comesporiding costs. b, The Central Office (Health infrastructure Service) indorses the Project Program of Work lo the Undersecretary cancemed for final approval and submitting the same to project end usar who uses it lo support the request for release of project fund allotment G1.3° Preparation of Project Narrative Report a. The project end user prepares a project narrative report whieh tisiudes a brief background cn the proposed infrastructure project, its objectives, the function of the resulting structures, the list of activities to be performed in it, the number and description of users, equipment neads, utility requirements and the allowable environmental conditions of the building, b. The project end user submits the project narrative report to the project architect for space programming C.l.4 Space Programming a. The project architect analyzes the space requirements of the’ project based on the organizational structure and functional setup as derived from the project narrative report, One method of analysis is the use of human behavior and transactions to establish linkage of spaces. 5 Site and Facilities Investigation a. For construction of new buildinys, the project architect andior project engincer inspects the location of the proposed infrastructure project in order to have a critical overview of the site's actual dimension, the soil conditions, topography, natural features, and available uililies, their tines and sources. bb. For repair and renovation of buildings, the project architect andor project engineer inspects the existing structures to determine thelr structural integrity, the stato of usefulness of utllty systenis and the prevailing concilion of the building elements.Architecture and Enginesring Plans including architectural, structural, electrical, plumbing/sanitary, and mechanical work plans. The project architect andlor project engineer initiates reguiar proyrass meelings of the project end user and the pyoject f2am to coordinate the preparation of the Detailed A and & Plans with the project end-user's requirements, The project team prepares the technical specifications of the project describing type and quality of materials, finish, manner of construction and the general conditions under which the project is to be executed. The project team prepares from the Detailed A and & Plans the detailed cost estimates of the materials and the labor of each item of work of the project. The project architect and/or project engineer, with the information on the cost estimates of the project and the probable project construction cost, discusses the project cost with the project end user to compare It with the fund available and agrees on the changes in vork items anc! project phasing in case the available funds could nol accommodate the cost requirements of the project, In the case of regional hospitals and medical centers, the project architect and/or engineer submits the complete set of project documents (Detailed A and E Pians, Technical Specifications, Goneral Conditions, Detailed Estimates, Scope of Works) to the Regional Mealth Office for review anc final approval. In the case of spectc¥specialty hospitals, the project architect and/or project engineer subrfis the complete set of project documents (Delailed A and E Plans, Technical Specifications, General Conditions, Detailed Estimates, Scope of Works) to the Central Office (Health Infrastructure Service) for review and recammendation for final approval by the Undersecretary concerned. The project architect and/or project engineer turns over the approved and complete sel cf project documents (Detailed A and E Plans, Technical Specifications, General Conditions, Detailed Estimates, Scope of Works) to the project end user for project implementation activities including the procurement of contractor following the provisions set forth in PD 1694 (Guidelines for the implementation of government infrastructure projects),PROCESS FLOW INPUT ACTNTY Gaur) Sa spina | SCHEMATIC PLANNING AND DESIGN DEVELOPMENT | | [ideveur Hospital \Dovelopment Plan: \Projact Narrative R.pont (Sle Profil Report [Seace Prowfamming Re (Conduct of Coorcination] rot; Ste ia. Factivas| _{seotngs wy — End-Users Investigation Report, Repragentation [Concent | 3 eras “of Project [Arctitegtire “Floor: Ping] nie : Raquiremonts into Protimi- |_| Ja: ‘Sito Flan" Budgatey Hospliay Planning = 2} nary Schematic Plans. 7|Cost Estinalgs |= IDesiiast S508 os Licensing Standards [Presentation and Evaluation of Preliminary Schematic Pians| by End-Users Rapresentatives yo Revsion of Schemalie Plans ly [Presentation of Revised Schematic Plans fo OOH infrastructure standard-satting| loftices alization an Schematic Pans fApafavad schamatic] Lb [Arctiltéctural Floor Plane] plans; Technicel Guides sits Plan, Elevations: loos on ttosptat Planning] | [Preparavon of Dasign” and]_| |Seciions, Perenectiy l& *Daign'< National’ —PDevelopment Plan Ailing Materials Speciica- Bulking Code, Engliiues Winns, s-Reysed.. Goal ing: Codd, ire_.Code,| Estittates!”.- Enoineering| lAccessieiiy Law Design. Concent, i er) Document Non-documentPy Od ECT DOCUME =H FATION PROCESS FLOW pe Specific [Aretoved asharate pia an’ desion dovelaoinent Outing: Maloray siailed Nichia | Floor Py [Sectuns, Root Pian Detaiade Aran SF igoy aur [Conduct of Coordination IMeeting belweon projact team| land end users to discuss| Ischematic. plans and dasigns| [development plans ou (Schadule of Work Aalwites| and Manpower Minaies of Moting; Ouline Materials Specifications Preparation of Wrehltectwal Plays Detailed} (Camnpials iPlang [Conduct of Coordination] IMecting botwson project tear fend users to discuss arch is, Evovations lard eng’g. details and Jroquroinents including tsnecolly.cauipeating __] fans, Elavaon, Sex ion, mame a = f36t Plans, *= ‘Steiig | yor Bor” OF Going Plane: {Easinecring ‘Archilectural [Mines of Mecting Revised | [Outing Materiats Specifications [Comotete siniclurat, electrical sanitary and mecliaiical plans [Preparation of Deteied Eat Imates & Technical Spactications| Hechiical Spectieatons [Conduct of Coordination Mocting| Ioetween project team and endl lusers to discuss prabable cost Jestimalos Inclucing indirect costs| aN [Preparation of Scope of Works) jandd Summary of Materials andl Finishes, Construction Schedulof (PERTICPM) and Finalization off Reviead Beteiea Cast Estimates : [Complete Approved [Detailed Cost Estimates Coed Estimates: | Docurmern! 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