ACREHEALTH 2018

OVERVIEW OF HEALTH CARE DESIGN

RAJAPPA SHOBANA ARCHITECTS

08.09.18
AGENDA
INTRODUCTION
• AN UNDERSTANDING OF HOSPITAL
DESIGN
• TYPES OF HOSPITALS

DESIGN
• DESIGN ASPECTS
• SERVICES
• MATERIALS
• HOSPITAL STANDARDS
 INTRODUCTION

AN UNDERSTANDING OF
HOSPITAL DESIGN ii.TYPES
TYPESOF
OFHOSPITALS
HOSPITALS
 UNDERSTANDING OF HOSPITAL DESIGN

1. HOSPITAL DESIGN IS COMPLEX AND

3. DELIGHT AND PLEASURE IN HEALTH
DIFFERENT FROM OTHER BUILDING
CARE SURROUNDINGS ASSIST IN THE
DESIGNS – FUNDAMENTAL FUNCTIONAL
HEALING PROCESS
REQUIREMENTS NEED TO BE MET FIRST
HOWEVER
4. THE QUANTITY OF CURING, HEALING
2. HEALTHCARE DESIGN IS AT THE
AND CARING IS ENHANCED BY THE
EXTREME PRACTICAL END OF DESIGN
QUALITY OF THE HOSPITAL SPECS, THE
SPECTRUM, WHERE ACTIVITIES AND
ROOM DESIGN, LIGHTING,SHAPE,
EFFICIENCY DESIGN THEMSELVES AND
COLOURS, AND THE CONVENIENCE OF
DESIGN OPTIONS ARE LIMITED
ACCOMMODATION
UNDERSTANDING OF HOSPITAL DESIGN
5. WHILE DESIGN MUST ADDRESS
MEDICAL ACTIVITY, ACCOMMODATION,
ADMIN, STORAGE, RESEARCH & 7. DESIGN SHOULD FACILITATE FREE
TEACHING, EVERY ASPECT OF THE FLOW OF TRAFFIC AND CLARITY IN
DESIGN SHOULD BE PATIENT FOCUSSED COMMUNICATION AND SIGNAGES
IN ORDER TO HUMANISE THE OTHERWISE
UNFAMILIAR CLINICAL SURROUNDINGS

6. DESIGN SHOULD FACILITATE SEAMLESS

8. THE HOSPITAL SHOULD BE
INTERACTION BETWEEN ALL SERVICE
PLANNED IN ORDER FOR TRAUMA
PROVIDERS WITHOUT WHICH THE
AND EMERGENCY CARE TO BE
EFFICIENCY OF HEALTHCARE IS NOT
ACCESSIBLE 24 X 7
OPTIMAL
UNDERSTANDING OF HOSPITAL DESIGN

AESTHETIC EXPECTATIONS OF DIFFERENT GROUPS -

STAFF –
PATIENTS –
HOSPITAL SHOULD BE MANAGEMENT –
HOSPITAL SHOULD BE
WELL PLANNED TO HOSPITAL DESIGN
WARM AND FRIENDLY,
REDUCE ANY MANUAL SHOULD REFLECT THEIR
REDUCING THE ANXIETY
DELAYS, WHILE BEING VISION, VALUES AND
AND GIVING POSITIVE
CHEERFUL AND PHILOSOPHY
VIBES
SUPPORTIVE
TYPES OF HOSPITALS - CRITERIA

FUNCTIONALITY SIZE OWNERSHIP

LOCATION SPECIALISATION
TYPES OF HOSPITALS

FUNCTIONALITY
•GENERAL PURPOSE

•TEACHING

•RESEARCH

•ACUTE CARE

•COMMUNITY HOSPITAL
TYPES OF HOSPITALS

SIZE

• SMALLEST (UPTO 50 BEDS)

• SMALL (UPTO 150 BEDS)

• STANDARD (UPTO 600 BEDS)

• LARGE HOSPITAL (ABOVE 600 BEDS)

TYPES OF HOSPITALS

OWNERSHIP
• GOVERNMENT HOSPITAL
• PRIVATE HOSPITAL
TYPES OF HOSPITALS

LOCATION

• RURAL HOSPITAL
• URBAN HOSPITAL

IN RURAL AREAS – THE SCOPE FOR

HORIZONTAL EXPANSION IS MORE
WHEREAS,
IN URBAN AREAS – MOSTLY VERTICAL
EXPANSION IS ONLY POSSIBLE
TYPES OF HOSPITALS

SPECIALISATION

• MULTISPECIALTY
• PEDIATRIC
• MATERNITY
• CANCER HOSPITAL
• CARDIOLOGY HOSPITAL
• OPHTHALMOLOGY HOSPITAL
• OTHER SPECIALITIES
 DESIGN

DESIGN CONSIDERATIONS SERVICES

MATERIALS HOSPITAL STANDARDS

 LOCATION OF THE BUILDING

FORMS OF BUILDING

CIRCULATION

EFFECTIVE ZONING

DESIGN FLEXIBILITY AND FUTURE GROWTH

CONSIDERATIONS
FACILITIES & SERVICES

COST, LOW-MAINTENANCE

NOISE CONTROL

VENTILATION

SECURITY AND SUPERVISION

LOCATION OF BUILDING

LOCATION

SITUATED IN A QUIET
ADEQUATE AREA
SHOULD BE AWAY LOCATION WITH LEAST
SHOULD BE THERE
FROM DUST, NOISE POSSIBILITY OF
FOR FUTURE
AND POLLUTION FUTURE INTRUSIVE
EXPANSION
DEVELOPMENT
FORMS OF BUILDING

SPINE FORM – WITH RADIAL FORM – FLOW ANY OTHER FORM

BRANCHING SECTIONS OF TRAFFIC WILL MOVE
OUTWARD FROM THE
CENTRE
CIRCULATION
GENERAL MAIN
ADMINISTRATION
SERVICES INTERNAL HOSPITAL ENTRY

• KITCHEN (IN PATIENT DIVISION)

• LAUNDRY
• MAINTENANCE
• MORTUARY INTERNAL MEDICINE
• STORAGE ETC.
TREATMENT DIVISION
• OPERATION THEATER
• INTENSIVE CARE
• OBSTETRICS

ADJUNCT
THERAPEUTIC ADJUNCT DIAGNOSTIC EMERGENCY
EMERGENCY ENTRY
SERVICES SERVICES

• PHYSICAL
THERAPY
• RADIOLOGY OUTPATIENT DVISION
OUTPATIENT
• O/P CLINICS ENTRY
• PHARMACY
ZONING
THE TYPICAL ARRANGEMENT OF FACILITIES IN A HORIZONTAL EXPANSION

OT COMPLEX SERVICES

OUT PATIENT DIAGNOSTICS & IN PATIENT

RADIOLOGY

EMERGENCY &
LABOUR ADMIN
ZONING
THE TYPICAL EFFECTIVE ARRANGEMENT OF FACILITIES IN A VERTICAL EXPANSION

BASEMENT : Stores, Physiotherapy, Kitchen, Heating And Ventilation Plant Room, Radio
Therapy, Linear Accelerator, Garage

GROUND FLOOR : Entrance, Radiology, Medical Services, Ambulance, Entrance For Bed-
ridden Patients, Emergency Ward, Information Centre, Administration, Cafeteria

1ST FLOOR : Central Sterilization Unit, Surgical Area, Intensive Care, Maternity, Children’s
Hospital

2ND/3RD FLOOR : Wards Can Be Provided

TOP FLOOR : Nursing Quarters, Laboratories

VENTILATION
DUST FREE ENVIRONMENT

MECHANICAL
VENTILATION
AMBIENT TEMPERATURE
MAINTAINED AT ALL TIMES

HIGH COST &

LOW COST &
MAINTENANCE
MAINTENANCE
VENTILATION
NATURAL
VENTILATION CLIMATE DEPENDENT

OPEN TO INFECTIONS

NATURAL CAN BE USED FOR

COMBINATION
LOW RISK & MECHANICAL
VENTILATION
FOR HIGH RISK AREAS
NOISE
TRAFFIC

OUTDOOR NOISE

INDUSTRIAL

NOISE MECHANICAL
SOURCES EQUIPMENT

IMPACT NOISE
SERVICES

INDOOR NOISE
LOUDSPEAKERS,
RADIO, PHONES
AIR BORNE NOISE

PEOPLE
NOISE CONTROL
OUTDOOR NOISE SOURCE
• INTRODUCING MORE GREENERY AND
LANDSCAPE IN THE BUFFER SPACE
BETWEEN THE BUILDING AND ROAD
• ZONING THE CRITICAL AREAS TO THE
REAR PART OF THE HOSPITAL AWAY
FROM THE ROAD
• DOUBLE GLAZED WINDOWS
• DOORS AND CAN BE FITTED WITH
SILENT CLOSERS
INDOOR NOISE SOURCE
• PROPER MAINTENANCE OF AHU AND
OTHER MEDICAL EQUIP
• NOISE FREE VENTILATION SYSTEM
• DRAINING BOARDS AND RUBBER-SHOD
EQUIPMENTS, PLASTIC UTENSILS ETC.
• DOUBLE GLAZED WINDOWS
• DOORS AND CAN BE FITTED WITH
SILENT CLOSERS
• IN THE CORRIDORS & WARDS,
ABSORPTION IS PROVIDED BY SOFT
FURNISHINGS
FACILITIES AND SERVICES
FACILITIES
WHEELCHAIR &STRETCHER REGISTRATION COUNTER
RECEPTION &
STORAGE ALCOVE & CUBICLE FOR STAFF
INFORMATION DESK

LOBBY & WAITING WATER COOLERS OR

LOUNGE DRINKING FOUNTAINS

MULTIPURPOSE
PUBLIC TELEPHONES
ROOM(S)
FACILITIES
SPACE/OFFICE(S) FOR
SUPPLIES, EQUIPMENT PUBLIC TOILET

CLINICAL FACILITIES EMPLOYEES’ FACILITIES

COFFEE SHOP/ GENERAL STORAGE

MEDITATION ROOM
SNACK BAR FOR SUPPLIES
SERVICES
HOSPITAL SERVICES

SUPPORTIVE AUXILIARY
MAIN SERVICES
SERVICES SERVICES

-- EMERGENCY -- CSSD
SERVICES -- ENGNEERING AND
-- PHARMACY MAINTENANCE SERVICES
-- OUT-PATIENT SERVICES
SERVICES -- REGISTRATION AND
-- DIET KITCHEN INDOOR CASE RECORDS
-- IN-PATIENT -- LAUNDRY
SERVICES -- STORES
-- LABORATORY -- TRANSPORT
-- INTENSIVE CARE
UNIT -- DIAGNOSTICS & -- MORTUARY
RADIOLOGY
-- OPERATION -- HOSPITAL SERCURITY
THEATRE -- NURSING SERVICES
MAIN SERVICES
EMERGENCY DEPARTMENT
• Should be located on the ground floor with separate entrance, close to diagnostics.
• Ramps to be provided for wheel chair
OUTPATIENT DEPARTMENT
• Should be located on ground level, preferably with separate entrance and adequate
parking facilities.
• Easy access to labs, radiology & pharmacy
INPATIENT DEPARTMENT
• Should be easily accessible to admin, diagnostics, nursing services
• Preferable in the upper levels

INTENSIVE CARE UNIT

• Closer to the recovery room in the operation theatre complex
• Should be easily accessed from emergency department

OPERATION THEATER
• Very close to the ICU and CSSD
• Should be easily accessible from Inpatient department
SUPPORTIVE SERVICES
CSSD
• CSSD adjacent to the surgical department, either on the same floor or directly above/below
is recommended

HOSPITAL PHARMACY
• Locating it in the ground floor with storage in the basement.
• Readily accessible to elevator for the IPD & OPD patients.

LABORATORY
• To be conveniently located in ground floor for the OPD, IPD & emergency department.
• Also easily accessible to surgery, ICU, radiology & obstetrics

DIAGNOSTICS & RADIOLOGY

• Very close to emergency department and external clinics
• Easily accessible from internal division
AUXILLIARY SERVICES
CIVIL

ELECTRICAL

MECHANICAL
MAINTENANCE

& ENGINEERING COMPUTER

SERVICES
COMMUNICATION

FIRE

BIO MEDICAL
Reference - Swastik
Reference - Swastik
Reference - Swastik
Reference - Swastik
Reference - Swastik
Reference - Swastik
Reference - Swastik
HVAC REQUIREMENTS
CRITICAL NORMAL NON CRITICAL

PHARMACY & DRUG

OT/ICU/ CCU WARDS LAB
STORAGE

LABOUR AND PHYSIOTHERAPY

MRI & CT SCAN KITCHEN
DELIVERY ROOM

CSSD STERILE
AUTOPSY ROOM CSSD LAUNDRY
STORE
MATERIALS
MATERIALS USED IN INTERIORS FINISHES

FLOORS
CRITICAL AREA

WALLS

NON CRITICAL
AREA
CEILING

SOFT
FURNISHING
MATERIALS - FLOORING
HAVE PLEASING VISUAL IMPACT

BE DURABLE

THE PREFERRED
BE EASILY CLEANED
FLOORING

BE RESILIENT

BE SLIP-RESISTANT

BE NON ABSORBENT TO LIQUIDS AND

ODOURS

BE RESISTANT TO MICROBIAL GROWTH

CRITICAL AREA FINISHES
FLOORING

• EPOXY
• VINYL
• TERRAZO

WALL
CEILING
• PU PAINT
• ANTI-BACTERIAL AND • SANDWICH PANEL
ANTI-FUNGAL PAINTS WITH COVING
• SS PANELLING • STAINLESS STEEL
• VINYL/ CORIAN PANEL WITH COVING
NON CRITICAL AREA FINISHES
FLOORING

• MARBLE, GRANITE OR KOTA

• VITRIFIED, CERAMIC TILE,
ENGINEERED MARBLE
• VINYL – SHEET OR TILES
NON CRITICAL AREA FINISHES

CEILING

• PAINTED TRUE CEILING

• GRID CEILING WITH MINERAL
FIBER TILES OR GYPSUM
LAMINATED TILES
• CALCIUM SILICATE BOARDS OR
GYPSUM BOARDS
NON CRITICAL AREA FINISHES
WALL

• PAINT
• TILES
• LAMINATES
• CORIAN
• VINYL
• GLASS PANELS
HOSPITAL STANDARDS

GREEN HOSPITALS

NBC

STANDARDS
NABH

INTERNATIONAL
STANDARDS
GREEN HOSPITAL
LIGHTING

INDOOR AIR QUALITY - PASSIVE

AND ACTIVE MEASURES
FOCUS AREAS FOR GREEN
HOSPITAL DESIGN
CLEAN AND GREEN INTERIOR
BUILDING MATERIALS

GARDENS AND LANDSCAPE

GREEN HOSPITAL - BENEFITS

BETTER INDOOR AIR 20% - 40% ENERGY 35%-40% WATER

QUALITY SAVINGS SAVINGS

NO SICK BUILDING FASTER PATIENT

GOOD DAY LIGHTING
SYNDROME RECOVERY

REDUCTION OF ENERGY REDUCTION OF CO2

REDUCTION OF COST
CONSUMPTION EMMISION
GREEN HOSPITAL - IMPLEMENTATION

GLAZING FACADES

SKYLIGHTS

LIGHTING USE LED LIGHTING

OCCUPANCY SENSORS

TASK LIGHTING
GREEN HOSPITAL - IMPLEMENTATION

INDOOR PLANTS WHICH ABSORB POLLUTANTS

AIR QUALITY OPEN COURTYARDS TO REGULATE FRESH AIR

ZERO-VOC INDOOR MATERIALS

GREEN HOSPITAL - IMPLEMENTATION

PATHOGEN RESISTING INTERIOR TOUCH

SURFACES
GREEN BUILDING
MATERIALS
FLOORING AND WALL MATERIALS THAT DO NOT
EMIT/ ABSORB VOC AND DUST

AESTHETIC DELIGHT TO PROMOTE WELLNESS

GARDEN &
LANDSCAPES
INTRODUCE INDOOR PLANTS & VERTICAL
GARDENS
 FUNCTIONAL PROGRAM

FUNCTIONAL AND SPACE

REQUIREMENTS SECTION

MANPOWER
REQUIREMENTS

DESCRIBES FIVE
FUNDAMENTAL ASPECTS INSTRUMENTS AND
OF HOSPITAL PLANNING
EQUIPMENT

BUILDING REQUIREMENTS
 NATIONAL ACCREDITATION BOARD
FOR HOSPITALS & HEALTHCARE
PROVIDERS (NABH) STANDARDS IS
TODAY THE HIGHEST BENCHMARK
STANDARD FOR HOSPITAL QUALITY
IN INDIA

DEVELOPED BY QCI ON THE LINES

OF INTERNATIONAL
ACCREDITATION STANDARDS

RESULTS IN A HIGH QUALITY OF

CARE AND PATIENT SAFETY

STIMULATES CONTINUOUS
IMPROVEMENT

RAISES THE COMMUNITY CONFIDENCE IN THE SERVICES PROVIDED BY

THE HOSPITAL
THERE ARE ABOUT 18 INTERNATIONAL
HOSPITAL STANDARDS. TO NAME A FEW –

JCI - AMERICAN

INTERNATIONAL
ACHS - AUSTRALIAN
STANDARDS

CANADIAN HOSPITAL
ACCREDITATION
STANDARDS
 THANK YOU!

RAJAPPA SHOBANA ARCHITECTS

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