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PLANNING AND DESIGN

LITERATURE STUDY:

CIRCULATION
It is said that hospital planning start from circulation .In the word of Emerson Goble,“Separate all
departments, yet keep them all close together, Separate types of Traffic, yet save steps for everybody,
that’s all there is to hospital planning”. Thus the different type of traffic of traversing the buildings should
show planned so as to avoid inter-mixing of functions there by keeping them as short as possible as “time” is
an also important aspect. The main aim while caring for the sick is to prevent cross infection, maintain
asepsis of highest order and ensure ease of movement for patients and supplies. Therefore, all movements
need to be well planned in advance to facilitate ease for function and asepsis maintained.
The traffic in Hospital constitutes of five main streams:
• Out patients
• In patients

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• Visitors ub
• Staff, and
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• Supplies
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And for their functional interrelation, it is necessary to know well as to where they circulate. Throughout the
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planning, traffic requires careful thought. Besides, the various complicated lines of traffic within the hospital,
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traffic to and from the hospital must be given consideration. To be able to regulate traffic within the building,
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we should start by regulating it first on the outside of the building.

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External Traffic
• Patients – arriving or leaving by foot or by vehicle
• Visitors
• Staff members
• Delivery of incoming supply
• Removal of dead
• Delivery of removal and removal of refuse
• Out patient’s traffic.
Internal traffic
• Incoming patients – from x-ray, admission etc.
• Outgoing patients
• Inter–departmental traffic
• Deceased patients
• Visitors
• Staff members
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• Out patients – enroute to laboratory, x-ray, therapy etc.
• Non – medical employee
• Food supply and waste
All these elements, comprising the traffic in a hospital and their typical line of circulation shall be related as
such as allow free and unobstructed movement to each one of them.
In the design process, circulation being the principle subject for study, it involves the proper investigation of
the many departments so that different types of traffic through the building will be separated as much as
possible, traffic routes will be short and important functions protected against intrusion. Circulation will
Determine the efficiency of the hospital for all the years of its use.

PRIMARY PRINCIPAL OF CIRCULATION SCHEME

• Protection of the patient is the primary principle of circulation scheme. Too much traffic in the
nursing corridor will disturb the patient; will involve excessive risk of contamination, or at least of
confused and inefficient area. Any unwanted traffic in the surgical suite means dilution of the
effectiveness of aseptic technique. Assured protection against contamination is the very heart of
good patient care and the basis of hospital planning.

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• Short traffic routes, with as much separation as is feasible, assists in assurance of asepsis. Obviously

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short routes save steps for everybody concerned with hospital care. Nurses, doctors, patients, service
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and office personnel, all have a share in the patient’s welfare. All must work fast at times, and all are
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subject to fatigue.
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Separation and segregation

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It is a principal in which the separation of dissimilar activity likes clean and dirty, quite and noisy,
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different type of patients/traffic etc help in better functioning along with the prevention of infection, patient
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discomfort, Accident, this segregation should also be incorporated out-side of building. But care should be
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taken that too much of physical separation hamper proper functioning of certain related activities
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Control

Control is important general objective, in which the vast variety of traffic that is on continues to-and-fro
motion in the Hospital and its premises does require strict and disciplined control. There need to be check
over visitors Entering patient Areas, sensitive patients, safety and security of patients, Good supplies etc. All
these calls for special safety measures with limited Asses entry points under well supervision.

Separation of external traffic

It is necessary to separate the external traffic before getting into the building. Usually, there are separate
main traffic lines.
• Outpatients.
• Inpatients and visitors.
• Emergency patients (or ambulance cases).
• Supplier and fuel.

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 i. The main entrance would usually serve for ambulant inpatients, or leaving after their stay. They
proceed through main lobby to admitting desk and then to his or her bed. Visitors also use the main
entrance largely for reason of control of visitor traffic by receptionist. The main entrance can also be
used by doctors, so that may be clocked in or out, or possibly so that the records clerk may catch them
for a task the doctors always seem to find overused. On the other hand, doctors frequently prefer a
separate entrance so that they will not be buttonholed by the visitors or relatives or just friends.
Another consideration is that usually the doctors have a separate parking area, and another entrance
may be much more convenient.
ii. Separate entrance is desirable for outpatients since any volume of them would soon confuse the main
entrance and the departments nearby. Moreover, there is need to control the movements of outpatients,
to keep them out of principal corridors, to confine them to certain areas.
iii. The ambulance or emergency entrance- Is presumed to be convenient for inpatients who must be
brought in by ambulance or private car. The emergency is principally intended, however, for real
emergency cases, who might Arrive in some unsightly condition and who would require instant
attention in the emergency suite. The emergency patient_ might even be drunk, or criminal arriving
with full escort. Also the emergency case might be a medically dirty patient, not to be taken any
farther than necessary until he can be given some preparation.

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iv. Parking space
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It is usually grouped roughly According to entrances. At the least, there should not be expected to
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fight a traffic jam at each visit. Perhaps, hospital workers should have a separate parking area. Clearly,
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any separation that can be arranged for parking areas will help to maintain separations of types of
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traffic both within and without the building.

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Internal traffic
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Architects have developed notable integrity in schematics designed to control traffic. The cruciform plan is
an old favorite, providing a central traffic and service core and a good number of cull de sac locations in the
wings. The T form is another favorite. Again, there is a central core, with various medical departments
isolated in bays of the T, floor by floor, and nursing units facing south in the top of the T. Variations are
found, literally by the dozen, with wings added on to isolate departments, particularly on the lower floors.
Sometimes, a wing is sent out, only to be folded back again against the building.
Always the intent is to separate departments yet keep horizontal travel to a minimum. It is worth noting, and
quite healthful, that standard schemes do not seem to do very well against the wide variety of individual
conditions and sites. And against the ever changing display of originally that architects have exhibited.

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CARE AREA
(INPATIENT NURSING UNIT)

WARD DESIGN: GENERAL

Outlooks on ward sizes subject rapid change. Main recent trend away from classical ward types (eg
Nightingale: 12-B open ward with nurses desk at 1 end; Rigs: 24-B with nursing room outside
ward, beds set in clusters); preference now for2—4 B. Despite this strong preference still
controversial: very small wards give privacy and in theory more personal attention but can also be
lonely, less often visited; le society and staff supervision possibly better in larger ward. Patients
need audio and visual privacy during med visits. Background noise and bed curtains provide some
in large ward but lights disturb at night; small wards peaceful for resting patient but do not provide
audio-privacy. Average stay in hospital for acute med or surgery has fallen, e.g.: major surgery

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10—12 days, minor 2—3 days, max 6 weeks (mainly orthopedic). Wards for these purposes
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therefore designed for max efficiency of staff working. For physically and mentally handicapped
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and elderly— long stay’ —ward design more domestic and social.
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• Walking distance: keep walking distances short as possible for nurses and ambulant
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patient. Max distance from bed to Wc 12 m and from nurse working room to furthest bed approx 20
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m.
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• Observation: continuous observation of patient by staff essential part of nursing care:

during day achieved mainly in course of walking from 1 duty to another, at night from nurses
station. Good design aim: 50%of beds to be visible from nurse’s station. Patients gain confidence
from seeing staff at work, dead-leg wards not popular for this reason. If staff have no duty perform
less likely visit ward.

• Control: patients, particularly children, adolescents and confused, need to be controlled;

dayr must not be too isolated from rest of ward. Mixed-sex wards have own control problems.
Staffs need to control visitors and check that they do not overtire patients.

• Noise: problem in large open areas; telephones and other el and mecheqp can be noisier than
acceptable. Design for 40—45 dB by day and 35—40dB at night in multi-B wards; 1-B wards
should be 35—40 dB at all times. Courtyard designs can create problems of noise from adjacent
windows to different room.

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• Daylight & glare: windows should not cause glare in bedfast patients’ eyes; beds should be
parallel to windows unless brise-soleil, external or between-glass blinds or similar devices fitted.
Windows design important: confused patients may try get out; all opening lights should have device
restricting accessible opening to 100.

• Ventilation: mechanical ventilation often noisy and unsatisfactory, full air-conditioning

expensive install and run. Normal sites away from air or traffic noise should rely on natural
ventilation; 3 beds deep from window max before mechanical ventilation required. Central work
rooms require mechanical ventilation and suffer from heat build-up in summer.

• Nurse call systems, closed circuit television (CCTV): Devices ofvarious grades of
sophistication; all liable to abuse or failure. Seriously ill patients cannot operate call systems
therefore unwise rely on these rather than personal observation; acceptable as auxiliary system.

Inpatient nursing units, that is, ward concept is fast changing due to policy of early ambulation and
in fact only a few patients really need to be in the bed. The basic considerations in placement wards

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is to ensure
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sufficient nursing care, locating them according to the needs of treatment, in respective medical
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discipline and checking cross infection

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Nursing care should fall under the following categories:

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General Wards- Wards of traditional type for patients who are not critically ill but need
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continuous care or observation and have to be in bed. These include wards for medical, surgical,
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ENT and eye disciplines, etc.

• Private Wards (Optional)- Wards for patients who are in a position to pay high towards
Medicare. These may be air conditioned or non-air conditioned.

• Wards for Specialities- Wards for patients who are suffering and need hospitalization in
particular specialties, like, pediatric, obstetrics, gynaecology, neurology, nephrology etc.

• Location
Wards should be relegated at the back to ensure quietness and freedom from unwanted visitors.
General ward units are of repetitive nature and hence they may be conveniently piled up vertically
one above the other which will result in efficiency, easy circulation and service economy. Wards for
particular specialties, however, should be located closer to their respective department to act as self-
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contained centers. In such case, post-operative ward may be placed horizontal to operation theatre
and maternity ward to the delivery rooms.

• Planning ward unit

In planning a ward, the aim should be to minimize the work of the nursing staff and provide basic
amenities to the patients within the unit.
The distances to be travelled by a nurse from bed areas to treatment room, pantry, etc, should be
kept to the minimum for the ward unit may be made of desired number of beds at the rate of 7
Sqmt. per bed and should bearranged with a minimum distance of 2.25 mt between centre of two
beds and a clearance of 200 mm between the bed and wall.
In wards, the width of doors shall not be less than 1.2 mt and all wards should have dado to a height
of 1.2 mt. Isolation unit in the form of one single bedded room per ward unit should be provided to
cater for certain cases requiring isolation from other patients.
An area of 14 Sqmt. for such rooms to contain a bed, bedside locker and easy chair for patient, a
chair for the visitor and a built in cupboard for storing clothes is recommended. This isolation unit

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should have separate toilet facilities.
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• Size of the Patient Rooms
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The patients’ beds must be accessible from three sides and this sets the limits for the overall room
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sizes. The smallest size for a one bed room is 10m2; for a two and three-bed room, a minimum of
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8m2 per bed should be allowed (in accordance with hospital building regulations). The room must
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be wide enough for a second bed to be wheeled out of the room without disturbing the first bed
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(minimum width 3.20 m). Next to each bed must be a night table and, where appropriate, towards
the window there should be a table (900 x 900 mm) with chairs (one chair per patient) The fitted
cupboards (usually against the corridor wall) must be capable of being opened without moving the
beds or night tables. In new buildings, the wet cells should be located towards the inside, off the
station corridor, because future renovations will most likely make use of the external walls as the
means of extending the existing areas.

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Patient Conveniences (Sanitary requirements)
Toilet for an individual room (single or twobedded) in a ward unit shall be 3.5 Sq.mt.comprising a
bath, a wash basin and WC. Toiletcommon to serve two such rooms shall be 5.25Sq.mt. to comprise
a bath, a WC in separatecubical and a wash basin.For multiple beds of a ward unit, requirement
offitments is given below:
ITEM NUMBERS REQUIRED
1 For Every 8 Beds Or Part Thereof (Male)

WATER CLOSETS
1 For Every 6 Beds Or Part Thereof(Female)

1 In Each Water Closet Plus 1 Water Tap With Draining Arrangement In The
ABULATION TAB
Vicinity Of Water Closets
URINAL 1 For Every 12 Beds Or Part Thereof (For Male Only)

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WASH BASIN 1 For Every 12 Beds Part Thereof
BATH .o
1bath With Shower For Every 12 Beds Part Thereof
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BED PAN WASHING SINK 1 For Each Ward Dirty Utility Sluice Room
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CLEANER’S SINK AND

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SINKS/
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SLAB FOR CLEANING 1 For Each Ward Dirty Slab Cleaning Utility And Sluice Room
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MACKINTOS
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KITCHEN SINK 1 For Each Ward In Wards Dishwasher Pantry

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STANDARDS FOR HOSPITAL:

Guideline areas for a standard hospital

Areas for the overall hospital including functional area for:

Supply/disposal 40-80 m2 PA/planned bed care area
Nursing area 19-25 m2 PA/planned bed
Intensive therapy 30-40 m2 PA/bed
Surgical area 130-150m2 PA/surgical unit
rehabilitation 19-22m2 PA/treatment place
physiotherapy 68-75m2 PA/treatment place
X-ray 60-70 m2 PA/diagnosis room
radiotherapy 300-350 m2 PA/equipment
Recovery area 25-30 m2 PA/recovery bed
NMR diagnosis 100-150 m2 PA/ diagnosis room

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Clinical physiology 80-100 m2 PA/diagnosis room
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Clinical neurophysiology 78-100 m2 PA/diagnosis room
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Central reception 140-160 m2 PA/examination/treatment room

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Delivery area 85-100 m2 PA/delivery room

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dialysis 70-80 m2 PA/dialysis room

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Specialist department 80-100 m2 PA/examination/treatment room

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(PA= productive area)

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CORRIDOR DOOR STAIR, LIFT AND RAMP

Corridor
Corridors must be designed for the maximum expected circulation flow. Generally, access corridors must be
at least 1.50m wide. Corridors in which patients will be transported on trolleys should have a minimum
effective width of 2.25m. The suspended ceiling in corridors may be installed up to 2.40m. Windows for
lighting and ventilation should not be further than 25m apart. The effective width of the corridors must not
be constricted by projections, columns or other building elements. Smoke doors must be installed in ward
corridors in accordance with local regulations.

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 Ward corridor/nursing area

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DOOR
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• When designing doors the hygiene requirements should be considered. The surface coating
must withstand the long- term action of cleaning agents and disinfectants, and they must be
designed to prevent the transmission of sound, odours and draughts. Doors must meet the same
standard of noise insulation as the walls surrounding them. A double-skinned door leaf construction
must meet a recommended minimum sound reduction requirement of 25dB. The clear height of
doors depends on their type and function:

• normal doors 2.1O—2.20m

• vehicle entrances, oversized doors 2.50m

• transport entrances 2.70—2.80m minimum height on approach roads 3.50m

STAIR AND RAMP

Stairs should not have any abrupt nosing ensure adequate lighting without confusing shadow minimum
width 1.2 W. Maximum of 13 risers to a run. 17 cm tread and 25 cm tread Ramps should have a gradient
1:20 or less.
Stairs
• Railing height = 900 mm
• Minimum width = 1500 mm
• Maximum riser = 150 mm
• Minimum tread = 300 mm
• There should be not more than 12 steps in a single flight.

Ramps
• Maximum slope = 1:10 to 1:12
• Minimum width = 2500 mm

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• Turning radius = 3000 mm
• Landing space = 3000 mm (for turning of stretchers)
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• Railing height = 900 mm
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• The floor should be non slippery.

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Lifts transport people, medicines, laundry, meals and hospital beds between floors, and for hygiene and
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aesthetic reasons separate lifts must be provided for some of these. In buildings in which care, examination
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or treatment areas are accommodated on upper floors, at least two lifts suitable for transporting beds must be
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provided. The elevator cars of these lifts must be of a size that allows adequate room for a bed and two
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accompanying people; the internal surfaces must be smooth, washable and easy to disinfect; the floor must
be non-slip. Lift shafts must be fire-resistant.

one multipurpose lift should be provided per 100 beds, with a minimum of two for smaller hospitals. In
addition there should be a minimum of two smaller lifts for portable equipment, staff and visitors:

• clear dimensions of lift car: 0.90 x 1.20m

• clear dimensions of shaft: 1.25 x 1.SOm

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FOUR TYPES OF LIFT USE IN HOSPITAL
· Freight
· Dumb waiter
· Passenger-
· Hospital services-1 for upto50,2 for60-200

TYPE OF LIFT CAR CLEAR DOOR SPEED DOOR

ELEVATOR DIMENSION DIMENSION OPENING OPENING
CLOSING
TIME
Hospital 2400 mm × 1600mm × 1200 mm (w) × 0.375m to 1 0 to 16 seconds.
Elevator 3000 mm 2400mm (deep) 2100mm (ht) meter/
seconds.
Dumb waiter 1200x900mm 700x700x800mm 700x2100mm 0.5 mt / sec.

Passenger 1900x1900mm 1300x1100mm 800x2100mm 0.75 to 1.5

meter/
second
Freight 1900x2000mm 2500x4100mm

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elevator
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A suitable size 2 ton, with inside dimensions 1.6 M x 2.6 M x 2.1 M.

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• Lifts are provided with facilities for either manual or automatic operation.
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• Service lifts are the most flexible device for moving wheeled carriers.
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• Bed lifts are essential for the_movement of beds.

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• Door should close with maximum speed = 0.5 m/s.

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• Lobby area = 5 – 6 m² per elevator on upper floors and 15 – 20 m² per elevator at ground
floor.

Structural Grid
The constructional grid must provide a precise guide as well as allowing for differentiation of areas
for the main functions, support functions and vehicular traffic.
A comparison of the individual operational areas and the rooms they require should result in a
structural grid which is suitable for all functions.
The various operations centres can be planned most appropriately with a column grid spacing of
7.20m or 7.80m. Smaller construction grids are problematic because large rooms (e.g. operating
theatres) which must be free from internal columns are more difficult to accommodate.

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FIRE FIGHTING

Fire fighting installations are done as recommended sprinkler protection, stand pipes, pumps and
storage pressure tanks.
Sprinklers:
Used in basements, any room exceeding 500 m².
CO2:
Used in electric fire, where water cannot be used, foam is formed with soda ash.
Smoke detectors:
Used where temperature rises between 0 - 38°c. (O.T, I.C.U, lobbies, diagnostic deptt. etc). Air
conditioning and ventilation systems circulating air to more than one floor or fire area shall be
provided with dampers designed to close automatically in case of fire.
For fire escape staircase:
Minimum width = 1500 mm
Minimum tread = 300 mm

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Height of hand rail = 1000 mm
Minimum width of exit door = 1500 mm .o
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Minimum height of exit door = 2000 mm

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Minimum width of corridor = 2400 mm

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FIRE FIGHTING INSTALATION REQUIRMENT IN HOSPITAL

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HEIGHT U.GRO TERRACE NEAR AT THE TYPE OF

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STATIC TANK UNDERGROUND TERRACE INSTALATION

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STATIC TANK LVL.

TANK
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0-15M 50000ltr. nil nil nil nil

15-24M nil 20,000litr. nil 500 litr/min
giving a
pressure not
less than 0.3
n/mmsq.

24- 100,000 20,000litr. 2400litr/min giving a One wet riser cum

37.5M litr. pressure not less than down
0.3N/mm sq.the pump comer/1000m sq
provided shall be of floor area.
multistage type with
suction and delivery sizes
not less than 15cm
dia.with low riser up to
storey and high level
riser delivery for upper
floors.

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 A stand by pump of equal The riser shall be
capacity shall be provide fully charged with
on alternation source of adequate pressure
supply. at all time and shal
be automatic in
operation

PLUMBING AND WATER SUPPLY

1-Plumbing
The plumbing should be capable of providing the water at the required temperature at various
points i.e. 110 F or 43° C for washing and 180° F or 83° C for sterilizing. The system should be
capable of delivering 300 lt./bed/day.
Fixture
1. Lavatories - Goose neck faucets for all hand washing lavatories. The valves should be
controlled by foot, knee or wrist to prevent contamination.
2. Toilet fixtures - bed pan washer and a WC

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3. Bathing facilities - elevated bath tub or shower fitted with spray head.
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2-Water supply
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Cold:
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For domestic and drinking, for flushing W.C. and fire fighting.
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Soft:
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Air conditioning, laundry (in some cases, deminearlised water is used).

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Demineralised water:For boilers, dialysis.

Raw water:For gardening.
Hot water:
For bathing, labs, kitchen, laundry, CSSD. Hot water is supplied through the boiler (oil fired hot
water generator).
Steam:
For CSSD, laundry and kitchen. Steam is generated in boiler and supplied through the horizontal
and vertical distribution network. Pipe lines are made of G.I., mild steel, copper and P.V.C.
valves are provided to clear off the gap or air from the pipes.

Hospitals including laundry liters/head/day

• No. of beds not exceeding 100- 240 (per bed)

• No. of beds exceeding 100- 450 (per bed)

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REQUIREMENTS FOR SANITARY FITMENTS IN HOSPITALS

Sl. Fitments RequirementsIn patient wards or nursing units

No.
1 Water- closets 1 for every 8 beds or part thereof (male)
1 for every 6 beds or part thereof (female)
2 Ablution taps 1 for each water-closet plus 1 water tap with draining
arrangements in the vicinity of water –closet
3 Urinals 1 for every 12 beds or part thereof (male only)

4 Wash Basins 1 for every 12 beds or part thereof

5 Baths
6 Bed pan washing sinks
7 Cleaner’s sinks and sink/slab for
cleaning mackintosh
8 Kitchen sinks
1 bath with shower for every 12 beds or part thereof
1 for each ward
1 for each ward
1 for each ward in ward pantry

Outdoor Patient and Other Departments (Lavatory Block)

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9 Water closets 1 for every 40 persons or part thereof (male) 2 for every 50

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persons or part thereof (females)
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10 Ablution taps 1 for each water-closet plus I water tap with draining
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11 Urinals Arrangements in the vicinity of water-closet and urinals

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12 Wash basins Lavatory block

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REQUIREMENTS FOR SANITARY FITMENTS IN HOSPITALS

Requirement of water Category of Hospitals

350 liters A arid B

400 liters C D and F

Note: 1. Storage capacity for 2 days

450 liters Separate reserve emergency overhead tanks shall be

provided for operation theatre.

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 DISPOSAL SYSTEMS
Five basic components:
• Handling waste at the point of production.
• Transportation within the facilities.
• Internal storage.
• Internal processing/ treatment.

• Transportation to point of final disposal. Solid waste should be sterilized at for near the point
of production source, preferably in disposable plastic bags in containers. Pathologic waste
should be sterilized at or near the point of production, prior to removal from the place.

Two systems of incinerations are:

i). Oil/ gas fuel incinerator
ii). Electric incinerator
Oil/ gas fuel incinerator

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Advantages
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1. Reduces the volume of solid waste by 85– 90%
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2. Pathological and infectious waste can be conveniently disposed off within the premises
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without much preparation and effort.

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3. Heat recovery – can be used as stand by boilers that generate sufficient steam to operate
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laundry and kitchen.

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Disadvantages
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Maintenance cost is high

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• Fuel consumption is high

Electrical incinerator
Advantages:
1. Low operating cost, 1/3 of those of oil/gas ones
2. No oil or gas pollution
Disadvantages:
1. Need standby power in event of a commercial power failure
2. Minimum area required for incinerator =60 sq. m.

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HOSPITAL WASTE DISPOSAL
• Segregation of hospital waste from non-infectious(domestic type) waste,
• Packing of waste to isolate from the people and the environment ans to prevent accidental spillage,
• Labeling of waste to avoid accidental tampering or contact with waste materials, through ignorance
of its presence and/or health hazards,
• Controlled management within hospitals and during transit to disposal, such that collection, storage
and transport is secure, well supervised and maintained effectively at all times,
• Controlled disposal in a manner which minimizes access to unauthorized people as well as animals
(insects, birds, cats, etc.)
• Hospital wastes needs to be collected and treated within a maximum period of 48 hours from
the time of generation.

HOSPITAL WASTE SEGREGATION: ILLUSTRATION

Colour Waste Example of waste Category Placing

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Kitchen waste, paper, office
Non-
waste, waste from transportation
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Green yards, construction and Domestic the locations of red bins in
infectious
demolition waste, scrap metal and hospital.
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the like.
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Tissues, organs, body parts

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Within ward/examination
Yellow Infectious biopsy, animal carcasses, blood Waste Category1
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or operating rooms.
and body fluids and the like.
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Tubings, catheters, IV sets,

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isolation waste from infectious Waste Category 3, Within ward/examination

Red Infectious
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diseases such as cultures and the 6&7 or operating rooms.

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like.
Blue/White/ Within ward/examination
Needles, infusion set, scalpels,
Infectious Waste category 4 or operating rooms, to be
inclucent blades, broken glass and like
placed on work I surfaces
Within ward/examination
Discarded medicines and Waste category 5 &
Black Infectious or operating rooms,
cytoloxic drugs, chemical waste 10
pathological labs.

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 A.C. PLANT
Complete air conditioning provides following conditions for both summer and winter:
1. Air movement and circulation
2. Air filtration, cleaning and purification
3. Temperature control
Design considerations:
· Restricted movement of air in between various departments to avoid cross contamination.
· Ramps and stairs are not considered for air conditioning.
· Soft water plant shall be provided for supplying soft and filtered water.
· Ducts are made up of G.I., Aluminum. And concealed to avoid noise.

RECOMMENDED VALUES OF AIR-CONDITIONING IN

Areas Temperature Relative humidity Pressure Min. Total Air change

W.R.T.
7 17-27 45-55 + 15-20

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Recovery 24 45-55 + 6-8
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Nursing 24 50 +/- 2-6
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I.C.U. 24 30-60 + 2-6

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General 24-27 30-60 +/- 8-10

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Radiology 24-27 40-45 M- 12-15

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Diagnosis 24-27 40-45 +/- 8-12

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RECOMMENDED VALUES OF ILLUMINATION IN HOSPITALS

S.No. AREAS
ILLUMINATION(lux)
1 Reception & waiting 150
area.
2 Wards

General 100

Beds 150
3 Operating theaters

General 300

Tables 50,000 – 1,25,000
4 Laboratories 300
5 Radiology department 100
6 Stairs and corridors 100
7 Dispensaries 300

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HOSPITAL BY-LAWS:-HOSPITAL CATEGORY
• Category A- 501 beds and above;
• Category B- 201 beds to 500 beds;
• Category C- 101beds to 200 beds;
• Category D- Upto 100 beds
• Other health facilities, which include maternity home, nursing home, family welfare centre,
polyclinic, pediatrics centre, geriatric center, diagnostic center, etc.
DEVELOPMENT OF HEALTH FACILITY
Sl Maximum
.n Category Other Controls
o. ground coverage f.a.r Ht.
1.Upto 15% of max. FAR van be
30%+ utilized for residential use of
essential staff.
Additional 5% for
Hospital A(501- & multi level parking 2.Upto 10% of max FAR to be for
1 200 37M
above) (not to kept be dormitory/hostel for the patients,

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included in crèche etc.
attendants FAR)
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3. Parking standard @ 2.0
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ECS/100 sq m of floor area.

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2 Hospital B(201 to 500)

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3 Hospital C(101 to 200)

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4 Hospital D (upto 100)

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Other facilities
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a) i)Maternity home/
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Polyclinic/Dispensary
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b) i)family welfare center Parking Standard @ 2.0 ECS/100

5 30% 150 26m
sqm of floor area
ii)Pediatric center
iii)geriatric center
iv)diagonostic center

a) veterinary hospital for Parking standard @ 1.33 ECS/100

pet animals and birds
b) dispensary for pet
6 animals and birds
a)medical college
b) nursing and paramedic
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c)veterinary institute
30% 150 26%
sq m of floor area
Parking standard @ 1.33 ECS/100
sq m of floor area
35% 100 26%
As per norms of
veterinary council of
india/ministry norms
area of plot sq m

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Other controls:
a) In case of super specialty medical facilities/ hospital duly certified as such by the
competent authority, the gross area shall be worked out @ upto 125 sqm per bed.
b) In case of existing premises/ sites, the enhanced FAR shall be permitted, subject to
payment of charges as may be prescribed by the authority/ land owning agency and
other clearences.
c) In case of hospitals, service floor is exempted from FAR calculation. Basement if
utilized for hospital purpose shall be counted in FAR.

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INFERENCES:

• Adequate waiting areas in all departments.

• Atrium houses a large number of visitors and has different accesses to different departments thereby
restricted the flow ofvisitors to this areas only.
• The Service Block forms the major hub for hospital functions, without the interference of the main
stream of the hospital.
• Segregation of visitor, staff and service entry.
• Separate emergency entry, which has a direct and unhindered access.
• Separate service lift for food, linen, staff,visitors and patient help to avoid congestion.
• Flexibility for the future so that any floor could be converted from wards to rooms and vise-versa.
• Toilets are designed according to the needs of patient.
• Emergency evacuation is not catered for since there is no provision of a ramp.
• Lack of separate fire escapes in fire blocks.
• Lack of natural light and ventilation in lower floors.
• No dirt disposal corridor in the O.T. complex.

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• Increase in the cost because of introduction of service floors in the building.
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• Service floors create better floors usability as area in services is segregated on floors.
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• Service floors gives design flexibility as services considerations in design arereduced.

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OUT PATIENT DEPARTMENT:

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1. Adequate waiting spaces in o.p.d.

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2. Central waiting space betweeno.p.d. & diagnostic deptt..

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EMERGENCY:
1. Peak activity can done at any time .
2. Entrance should be unobstructed for min. time consumption .
3. Emergency should be linked with diagnostic facility and o.p.d.
4. Minor o.t. in emergency.

IN PATIENT DEPARTMENT:
1. Ventilation &veiw from every ward .
2. Piped oxygen and suction should be provide in each ward .
3. Distance of nurse stn.from the should be min. for max. efficiency .
4. Separate isolation units should be provided for patients carrying
infection or liAble to get infected .
5. High dependency ward direct related to nursesstation .
6. Toilet should be designed according to the needs of patient .

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OPERATION THEATRE & I.C.U. :
1. Placement should be in a noise free hygienic environment.
2. Blood bank, cvt ,Icu , radiology and pathology should be close
to OPERATION THEATRES.
3. O.T. in between diagnosis & ward.
4. Separate entry for doctor ,nurses& patient .
5. Access to the i.c.u. & o.t. must be strictly controlled .

DIAGNOSIS:
1. Diagnosis should be accessible to both o.p.d. and i.p.d.
2. Diagnosis should be near to emergency.
3. Adequate waiting space .

SERVICES:
1. C.S.S.D. is generally placed blow the o.t. complex connected
through dumb waiter.
2. Care should be taken to see that there is no conflict in the

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circulation of soiled material and the sterilized material.
3. Staff dining rooms are generally sited near the kitchen. .o
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4. Incinerator creates a lot of heat , sound and fumes , it will
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be economical to keep it separate from other areas or else

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a high chimney should be provided.

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