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Li
ter
atur
eSt
udy
Re
-De
vel
opme
ntofJ
NMC,
Ali
gar
h

S
ubmi
tedt
o:Ar
.NawabAhmad
Ar
.Kha
nAma durRa
hma
n

Pr
ese
nte
dby: Hare
e maSi
ddi
qui|17arb557
Mohamma dArba
zuddin|17arb564
MohdUma i
r|17arb565
Pr
iyankaJ
oshi
|17a r
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 NT
Wh atishosp i
tal •
Amb ul
atorytrea
tme ntuni
tsServi
ces
Aima ndo bject
ive •
La undry
Basicform •
Mo rtuary
ONTE
Levelsofcare •
Me dicalgase
s
Unde rst
andingh ospi
talpl
anning •
Kitchen
Clas
s iic
ation •
CS SD(CentralSt
eril
esupplydepart
me nt
)
Sit
es el
ecti
o ncri
teri
a •
P harmacy
Fact
o rsinluencingthedesi
gno fhos
pita
l •
Firei g
h t
ing
Verti
calarrangeme ntofhospi
tal •
Wa stedisposaluni
t
Bedd ist
ributi
on •
Pa r
king
Hosp i
taltypology •
T r
an s
po r
tservice
sE ngi
neeri
ngservic
es
Me di
ca ldepart
me nts •
So und
•OPD(f un c
tions,pl
anninganddesign •
Ill
umi nat
ion
parame ter
s,physical
faci
li
ti
esma i
n,subsi
dia
ry, •
Wa tersupply
additi
on al
,consult
ati
on,waiti
ngarea) •
E mergencysignage
•I
P D •
C al
lbell
s
•I
C U •
Me chanicalengg
•Diagnosti
cs •
E l
ectri
cE ngi
neeringSubStat
ionandGe ner
ati
on
•Laboratori
e s
C

•Surgicaldepart
me nt
•Eme rgencyd epar
tme nt
•Conn ect
ions
 sHOS
Whati PI
TAL?
Ah o spi
talisah ealt
h c
areinsti
tution
t
hatp r
ovidesme dica
l,sur
gicalan dn urs
ingtreat
me ntstot hesicko rinj
u r
edt hroug hspecia
l-
i
zedstaffande qu i
pme nt
. Ho spitalisnotjustacu recenter,itisap la
c efo rcurea swellas
Accor
dingtoWHO, “Hospi
tali
sanint
egralp
art pl
easan
t,cleanli
ness,heal
thya ndmi nds upport
ing.Itp rovi
d ehap pi
ness,c al
ma n dma k eto
ofsoci
alme d
icalor
gani
sati
on,thefunc
tio
nso f se
lfcontro
l. Aswek n ow“ healt
hi swe al
th”heal
thymi ndlivesinah eal
th yb odyan dh eal
thy
whic
hist oprov
idecomplet
eh e
alt
hc a
reforthe poorma nisricherandh appierthanar icherse
ekma n.Tou set heprosperityineffici
entwa y
popul
ati
onb o
th,cur
ati
veandp r
eve
nti
veandwh o wen e
edah ealt
hyb odyi nt hi
sp h ysi
calwo r
ld.Theh uma nb odyi smo stp eculi
ara nda d-
re
achouttothefami
lyandit
sh o
mee nv
ir
o n
me nt
. va
ncedma chined eve
lopedb yn at
u r
ewh os
ee f
fic
iencya nde nergylevelunkn ownt i
lln o
w, one
Thehospit
ali
salsoacent
refort
rai
nin
go fhea
lth ca
n’tmeasuretheh uma nmi nda n db odyinp er
fectwa y.Th ereareh undredo fp athtoc ure
worke
rsandforbio-
soci
alre
sear
ch.
” se
ekp e
o pl
ef ewo fthema reco mmo nl
yu se
da ndfewa r
erarelyu s
ed .I
tiss acre
dp lace,wh e
re
mostpeoplewe r
eb orna ndd i
e. Peop l
eareserv
edan dt a
k encareo fh e
re,wh enth eyareme n-
Anoth
erd ef
ini
ti
onwasg i
venb yWHO i n1963 t
all
ya ndphy si
cal
lyill
.Itsetsaf oun dat
iono fsta
bles oci
ety.He n c
e, t
hec on ce
pto fh ospit
al
byth
eexpertcommit
teest
atin
gth a
t: “
Ho s
p i
ta
lis goe
sfarb e
yo ndth econventi
on alideao fap l
aceoft reat
me nto fs i
ck.Th er api
da nda lmost
ares
ident
iales
tab
li
shme n
twh ichprovi
desshort uncont
roll
edg rowtho fpop ul
a t
ionh a
sp utth
eh ea
lthcarefacil
iti
esu nderseverepressure
, t
hat
t
erma ndlongter
mme di
calcar
eco ns
ist
ingofo ar
ea l
re
adyins ignif
icantdefi
ciency. Accor
dingtoWHOn orm, India’
sp r
o po r
ti
o no fho sp
i-
se
rva
ti
o na
l,dia
gnost
ic
,t he
rapeut
ica ndreha
bil
it t
alb e
dstop o pul
ationislessthano ne-
thi
rdo fthes etst
an dards.He nce,Ind i
anee dstoa dd
t
ivese
rvi
cesforper
sonssuff
eri
ngo rsusp
ecte
dto morebedan dh ospit
al,abouttwo -thir
do fwh i
chsh ouldco meu pi nruralareas.Arch i
tect
ure
besu
ffer
ingfr
omad is
easeorinj
urya n
dforpatu- ef
fect
sp e
op l
e .
Th earchit
ectureo fh ospi
talcont
ributestot hewe l
l-bei
nga n drecoveryofp a-
ri
ent
.Itmayo rmayno tal
soprovi
d eser
vi
cesfor t
ients
.Th i
sb oldp ro
p osi
ti
o nsd atesb a
cktot helate1 8thce nturyandh a sb e
enar ec
u r
ring
i
np a
ti
ento ra
no ut
pat
ientbasi
s.
” t
hemei nfun ct
ionaldevel
op me ntofh o
spit
a la
rchi
tectureevers i
n ce
.

Aim andObj ec ti
ve Bas i
cfor
m ofHospi
tali
s Level
sofMedi
calCar
e
i
deall
ybasedoni
tsf
unc-
1
.Topromot
eawa
rene
ssofhea
lt
hca
rea
mon
gal
l
s
ect
ion
softh
eInd
ianpeo
p l
e. t
ions
2
.Topr
omo
teawa
ren
essa
mo ngf
unc
tion
ari
esi
n-
v
olv
edi
nHea
lt
handHo s
pit
alMana
gement
. Be
d-rel
at
ed Out
pat
ie
nt- PRI
MARY SECONDARY TERTI
ARY QUATERNARY
i
npa
ti
ent rel
at
ed
3.
Top r
omot
ere
sea
rchinthef
iel
dofHe al
thand f
unc
ti
ons f
unc
ti
ons
Hospi
ta
lMana
gement
. i
norde
rtoi
mp r
ovethee
f-
f
ic
ien
cyofHeal
thCaredel
i
verySy
ste
ms. Dispe
nsar
y,pri
ma- I
nte
rmedia
tedis
-
ryhea
lt
hc e
ntreor t
ri
cthos
pit
alsor I
nst
it
u t
eo fre-
4
.Topromot
ethede
vel
opmentofhi
ghqual
i
ty Di
agn
osti
can
d
Ad
mini
st
rat
ion subc
ent
re.Gener
al e
quiv
al
entme d
ica
l Pro
vinc
ia
l orsi
mi- s
ear
cha ndh i
ghe
r
h
osp
ita
lse
rvi
ce
sandc
ommu n
ityh
eal
thc
are
. tr
eat
ment
fun
cti
ons pra
cti
ti
oner,
me d
i- f
aci
li
ty
.Mo s
tly l
arreg
ionalhos
pi- t
ra
ini
n gme di
cal
func
ti
ons
cal
assi
st
antand g
ener
alpra
ct ta
lmedic
a l
faci
li
ty
. f
aci
l
ity.Supersp
e-
5
.Top r
omot
eaf or
umfortheexc
hang
eo fid
eas mult
ipur
pose t
ion
er,pa
rtl
yspe- Spec
ia
li
stsaret
he c
ia
li
stsandr e
-
a
ndinf
ormat
ionamonghe
alt
ha n
dh o
spit
alpl
an- worke
rarethede c
ia
li
sts
,et
carethe dec
is
ionma ker
sat s
ear
chersarethe
n
ers
,aca
demic
ian
s,admi
nis
tra
tor
s,va
ri
o u
ssta
tu- Se
rvi
ce Res
ear
ch ci
si
onma ker
s. d
eci
sio
nma ker
s. th
isl
evel
. d
eci
si
o nma ker
s.
t
orybodi
esandthegen
eralpubl
icfortheim- fu
nct
ions a
ndtea
chi
ng
p
rove
mentofHo s
pit
ala
ndHe al
thCaredel
iv
ery (
foo
dsuppl
y) f
unct
ion
s
S
yst
ems.
Under
standi
ngHos
pit
alPl
anni
ng

Ho s
pit
alist
hemo s
tvisi
bl
efac
eo fheal
thc
areindus
try
.Itprovi
deap l
atf
ormwh ereth
e
pr
acti
ti
oner
so fmedici
nei
nte
gra
teth
eh e
alt
hcar
etec
hnologywit
htheli
vi
ngp r
oces
s .
Th e
ycanbeg ro
upe dbyvari
ouscla
ssi
fi
ca-
t
ionsl
ikeown e
rshi
p,t
ypeo
fsyst
emetc.
Buttheyal
lar
ep l
anne
dtop r
ovi
dealeve
lofh ea
lt
h c
are
,whichordin
ari
lycannotbepro-
vi
deathome .
Hospi
tal
sareamo n
gstt
hel
arg
esta
ndmo st
comp l
exofal
lmo de
rnins
ti
tut
ions.
Ho s
p i
tala
rchi
te
ctur
eisap ar
tofthiscomple
xit
y.
Unli
keotherorga
niza
ti
ons
,whic
hma ybebui
ltinva
rio
uswa y
shospi
ta
lbuild
inghasles
sercho
ices
.Itdiff
er
sfrootherbuil
di
ng
t
ypesi
nt h
ec omple
xit
yoffu
ncti
ona
lrel
at
ions
hipsth
atmustexi
tbet
weenthevar
iouspart
sofaho s
pit
al.Apar
tfrop r
ovi
dingth
e
r
ighten
vir
on mentfo
rthepa
ti
ent
sandthecar
ep r
ovi
der
s,ahospi
tal
buil
di
n gshou
lda l
sobesens
iti
vetothenee
d softhevis
it
or.

Thefi
rs
tins
tru
cti
onofFlo
ren
ceNight
ian
gal
e
“TheHo s
pita
lsh
o u
lddopat
ie
ntsn
oh ar
m.”
Mu
stb
eobeye
dfore
verwhi
lePla
nni
ngandDesi
gni
ngaHo
spi
ta
l

Hospi
ta
lar
eacombin
ati
onoftec
hnol
ogi
es
,proc
ess
esan
dh umanre
sources
.Astr
uct
uremayhav
efunc
ti
ons,a
ndmanyfun
cti
ons
an
danyfun
cti
onmaybeful
fi
ll
edbyal
te
rnat
iv
est
ruct
ure
sorproce
sses
.Itmustpr
ovi
deasea
mles
sint
egr
at
ionofcl
ini
ca
lre
quir
e-
ment
swit
hbuil
di
ngpla
nnin
gandd e
si
gni
ngis
sue
s.St
ra
tegi
esmustbefo
r mul
ate
dtocopewi
thvar
yi
ngheal
thnee
ds,
cul
tur
es,
cli
-
mat
esandbud
get
s.Desi
gnre
spons
esmus
tals
oembrac
eallpar
tsan
da spec
tsofth
ehospi
tal
s.

Cl
ass
ific
atonofHOS
i PI
TAL

•Gene
ral
-pu
rpose •Al
lo
pathi
c •Ca
teg
oryA-25to50bed
s
•Te
achi
nghospi
ta
ls •Una
ni •Ca
teg
oryB-51to100be
ds
•Acut
ecar
efac
il
it
ies •Ay
urve
da •Ca
teg
oryC-101to300be
ds
•Long
-te
rmh os
pit
al
s •Homeopa
thy •Ca
teg
oryD-301to500beds
•Communit
yhospi
tal
s •Ca
teg
oryE-500to750be
ds
•Res
ear
chhospi
ta
ls •Ca
teg
oryF->7 50b
eds
•Tr
aumacent
re
s
•Si
ngl
e-S
peci
al
ty •Ru
ral
•Mult
i-
Speci
al
ty •Ur
ban
•Su
per-
Spec
ial
ty

•Pr
iv
ate
•Pr
imary •Pr
opri
et
ors
hip
•Se
condar
y •Gove
rnmen
tOwne
d
•Te
rti
ar
y •Communi
ty
 Lots
iz
eex
ceeds5
0%o fth
esugg
est
-
edmin
imumlotsi
zere
qui
re
mentse
t
i
ntheNat
ion
alBui
ldi
ngCode
.
Pri
vacyandconf
i-
den
tia
lit
yatre
cep-
Acc
ess
edb
yb use
s, t
iondeskand
t
axi
sandp
riv
ateveh
icl
es
. Loca
ti
on: Zoni
ng: c
li
nic
alare
asduri
ng
s
houl
dbeconve
- p
ubl
iczone
,cl
i
ni- andafte
rthecon
-
n
ien
ttopeop
lei
t c
alz
o n
eandst
aff s
ultat
ionan
d
se
rve
s. zon
e
No exist
ingu t
il
it
iesand
s
erv
icesandhasknowndif
-
f
ic
ulti
eso facces
so nsi
te.
Theyshouldbeadj
acen
tor Circul
at
ion: Sec
uri
tyand Flex
ibi
l
ity
ne
aro rp ref
era
blywithi
n ent
ra
n c
eandcir
cu- s
upe
rvi
si
oninthe andgr
owth
t
heexi
s t
ingsi
te. l
ati
onwithi
nthe pre
mise
s. (
fut
uree
xte
nsi
on)
.
bui
ldi
ngmu s
tcon-
si
derwheel
cha
ir
use
rs,pa
rent
swit
h
S
iteshoul
dhaveeas
il
yac-
s
mallki
dsand
c
ess
ibi
li
tytomai
nroadvi
a
p
eopl
ewithdis
abi
li
-
v
ehic
ula
r t rans
port
at
ion
ti
es.
a
ndreas
onabl
ewalki
ngdi
s-
t
ance
.

Topf
loo
r:hel
i
pad,ai
r-
condi
ti
oni
ngp
lan
t
S
ites
houl
dh a
vedef
in
edpe-
ro
om,
nursi
ngs
cho
o l
,l
abor
at
ori
es.
d
estr
ian p at
hway a nd
p
roperci
rc
ula
tor
yspac
efor
t
hemo ve
me n
to fmedic
al
v
ehic
le. 2
nd/3
rdf
loo
r:wa
rds

1
stfl
oor:
sur
gic
alar
ea,
cen
tra
lst
e r
il
is
at
ion,
S
iteshou
ldhaved e
fi
ni
te i
nte
nsi
vec
are
,mate
rni
ty
,chi
ld
ren
’shosp
ita
l
d
rai
nag
es oth
atnowa t
er
c
ouldaccu
mula
teo nthe Grou
ndfloo
r:ent
ra
nce
,radi
ol
ogy,medi
cal
e
it
herpo
rti
onofsi
te
. se
rvi
ce
s,ambul
ance,pa
ti
ents
,e mer
gen
cy
war
d,i
nfo
rmati
on,a
dmini
st
rat
ion
,caf
et
eri
a
Bas
ement
:sto
res
,phys
iot
her
apy
,k i
tc
hen
,
HVACp l
antr
oom,r
adi
o-t
her
apy
,li
nea
rac
-
ce
le
rat
or
S
itesho
uldhav
e Si
tes ho
uld have
e
nough p r
ope
r go
odc li
matea n
d
o
rien
tat
ion to wea
the
rcond
iti
on. S
ub-ba
sement
:un
der
gro
undg
ara
ge,e
le
c-
s
unandwind. t
ri
ci
tysupp
ly
BedManagmentandDi
str
ibut
ion
Numberofbedsanddi
mens
ioni
ngoft
hehos
pit
al
•Therequi
redn umberofb edsdep
endsonthenumberofinha
bi-
ta
nts
.
•Numb erofpa t
ien
tsino neyea
rfor10 0
0inhab
ita
nts:
-200inallhospi
tal
s,
-174ineme r
gencyho s
pit
als,
-26inspeci
ali
zedh os
pit
als.
•Numb erofbe d
sfor10 00i nha
bit
ant
s:
-11inallhospi
tal
s,
-8ineme r
gencyhospit
al
s,
-4inspeci
ali
zedh os
pit
als.
•Avera
gedurat
iono fhospita
li
zat
ion:
-18d a
ysinallhospi
tal
s,
-14d a
ysineme r
gencyhospit
als
,
-49d a
ysinspeci
ali
zedho s
p i
tal
s.
•Requir
edarea/vol
umef oronebed(fort
hewholebui
ltar
ea/v
ol-
umeincl
udingannexes
,
te
chni
calandstor
agerooms ):
-Are
a :
from7 0m2t o1 00m2
-Vol
ume :f
rom2 00m3t o2 80m3
•Areashar
inginac ommo nh os
pit
al(
advi
sed
):Ea=effec
ti
vear
ea
Bui
ldi
ngTypol
ogy

Name Di
agr
ame Di
scr
ipt
ion Advant
age Di
sadvant
age

St
reetTy
pol
ogy Thepa
vi
li
onswo
u l
dhavec
li
ni
cals
pac
es Fl
exi
bil
i
tyan
dex
ten
d i
bi
li
tya
swel
Iasl
eg- La
rgea
rean
eed
edf
orc
ir
cul
at
ion
onl
owe
rle
vel
swi
thwar
dsab
ove
. i
bil
it
ythatt
hes
tr
eetit
se
lfof
fe
rstopa-
ti
ent
s.

I
ndiv
idua
lbui
l
ding
sdi
spos
eda
roun
dthe Fl
exi
bi
li
ty
. La
rgea
rean
eed
edf
orc
ir
cul
at
ion
CampusTy
pol
ogy
s
it
ewithorwi
tho
uten
clo
sedc
ir
cul
at
ion Se
gre
gat
iono
ftr
aff
icf
lo
w
n
etwork
.

I
tisapa
tte
rnofsegr
egat
ionoft
hedua
g-
n
osti
candthet
re
atmentonth
eonehan
d,
CampusTy
pol
ogy Ef
fi
ci
entc
ir
cul
at
ion Ar
ti
fi
ci
alv
ent
il
at
ionn
eed
ed
a
ndo nt
heothe
rthenurs
ingf
unc
tio
ns
a
longas
h a
redc
ir
cula
ti
on.
Theol
d e
stt
ypol
ogyandst
il
linc
ommon
Li
nkedpav
il
ionorfingerpl
an us
e.Thepav
il
ion
swouldof
tenha
vecl
in
i- Fl
exi
bi
li
ty La
rgea
rean
eed
edf
orc
ir
cul
at
ion
ca
lspa
cesonlo
werle
vel
swit
hwards Se
gre
gat
iono
ftr
aff
ic
ab
ove.

Thist
ypo
log
ycanoff
erahumansc
alein
co
ntra
stt
othei
nst
it
uti
ona
lcha
rac
tertht Fl
a exi
bi
li
ty I
twi
llte
ndtoapp
lyt
othel
ar
ger
,
Low-r
isemulti
-cour
tyar
d n
on-
urb
ansi
te
sors
mal
l
ers
it
es
.
orcheckboar
d t
endstoo
ver
whel
mmo sth
ospi
tal
desig
n. Se
gre
gat
iono
ftr
aff
ic

Thesmallat
ri
a/l
igh
twel
l
scanta
kemany
Eff
ic
ie
ntci
rc
ula
ti
on
f
o r
msandthel
owerfl
oor
smayha
vefe
wer
,
Monobl
ock wit
hdeeppla
nnin
gfornoon
-pa
ti
enta
rea
s
Opport
uni
tytoinc
orp
ora
teI
nte
rst
it
ia
l Ar
ti
fi
ci
alv
ent
il
at
ionn
eed
ed
se
rvi
ce
orope
rat
ingth
eat
res
.

Th
ewardsar
eto
werwi
thc
li
ni
calh
ospi
ta
l. Upperf
loo
rscanbeprob
lema
ti
cin
Podi
um andt
ower Ef
fi
ci
ento
nur
bans
it
es
Ge
ner
al
lyint
hela
bsan
dte
chni
ca
lare
as. t
ermsoftr
ave
ll
ingd
ist
anc
e.

Thepa
vil
i
onswoul
dhav
ecl
ini
ca
lsp
ace
s Ef
fi
ci
entonu
rba
nsit
es
. Req
uir
ela
rgesi
tear
eafo
rpro
per
Podi
um ormor
ewi
tht
ower
s onl
owerl
eve
lswi
thwa
rdsa
bov
e. Av
oid
ssomeofpot
ent
ia
ltr
ave
ldi
st
anc
e. di
st
anc
ebe
twee
ntwobl
ock
s.

Thecl
i
nic
alan
dt e
chn
ica
lar
easg
ener
al
ly Dayl
i
ghtca
npene
tr
at
eonwo
rki
ngf
lor Ce
o ll
ula
rcha
rac
tero
fhos
pit
alb
uil
d-
St
reetTy
pol
ogy i
nlowe
rar
easandwar
dsar
eupperl
ev
els
. i
ngmakest
hisale
sso
bvi
oussol
u-
f
rombot
hsi
des
.
t
ion
.
OPD(
OutPat
ientDepar
tment
)

AnOPDp rov
idespri
marya n
d Func t
ions
wel
lascompreh
ensi
vehea
lt
hcar
eforpat
ien
twh ocomef ord
iagno- •con
trol
d ie
sesbyear
lydia
gnosi
sandtimel
ytrea
tmen
t
si
s,t
reat
mentorfo
ll
ow-upcare
.Itist
hepoin
to ffi
rstcont
actbe- •Fac
il
it
atestr
eatmen
tandf u
rthe
rinve
st
igat
ionwit
houta
dmiss
ioni
ntot
heh
os-
t
weenah ospi
ta
landap at
ie
nt.I
mp or
tanc
eo fOPDi stha
titre- pit
al
,thusreduci
ngthein-
pati
entl
oad.
duc
esthenumb e
roftermina
ll
yillpa
ti
entst
raff
ic
, asit
shel
p si
n •Pr
ovid
esf o
ll
o wupcaretodis
char
gedpati
ents
.
ea
rl
yd et
ect
ionort
imel
yc a
reofanydis
eas
e.I
tisthefir
stpoi
n tof •Scr
een
sc as
esandinves
ti
gat
esifthehosp
ita
li
zati
oni
srequ
ir
ed.
con
tactwit
hthehospi
ta
l. •Fac
il
it
atestr
aini
ngofp a
ramedica
lst
aff
,nurse
sanddoc
tors
.

•Th efac
ili
tys hal
l beplanne dk eepi
n ginmindt hema xi
mu mpeak
hourpatie
n tloada nds hal
l havet hescopeforfutureexpans
ion.
•OPD s hal
lh avea pproachf rom ma i
nr oa
dwi ths i
gnagevis
ibl
e
fr
omad is
tanc e
.
•Re cept
iona ndEn quir
y:En qu i
ry/Ma yIHe lpd e
sks ha
llbe
av
ail
a b
lewithc omp et
entstafff l
u entinlocall
angu a
ge.
•Wa it
ingSp aces:Wa iti
nga reawi thadequateseat
ingarrang
ement
sha
llbep r
o vi
d ed.
Maine ntr
an ce,gen e
ralwa i
tin gan dsub s
idi
arywa it
ingspace
sare
re
quiredad j
acentt oe ac
hc o nsultat
iona ndtreat
me ntroomina l
l
th
ec l
ini
cs.Wa iti
nga reaatth escaleof1s qft/peravera
ged a
il
ypa-
ti
entwithmi nimu m4 00s qf tofa reaistobep r
ov i
ded.
•Layouto fOPDs hal
lfoll
o wf unctionalfl
owo ft h
ep a
tie
nts.
•Patie
nta men i
tiesthefollowi ngame niti
esshal
lb eprov
ided
-Potabl
ed rinkingwa ter.
-Fun c
tionalandc leantoile
tswi thr unningwaterandf l
ush.
-Fans/Co olers
.
-Seati
nga rra
n geme ntasp erloado fp ati
ent
•Clini
cs-thec l
inicsshouldi ncludegeneral
,me di
cal,su
rgic
al,
oph-
th
almic,ENT ,d e nt
al,ob stet
rica ndg ynae
cology,postpart
um E
nqui
ry S
ub-
wai
ti
ng Bi
l
li
ng
uni
t,paediatr
ics,derma tol
o gya nd
psy
ch i
atr
y,o r
th opaedic.
-doctorch amb ersh oul
dh a veamp l
esp ac
etos i
tf or4-5p e
ople
.
cha
mb ersizeo f1 2.0sqme tersisadequ a
te. Di
agnos
ti
cs
-theclini
csf orin f
ecti
o usa ndc ommu nic
ablediseas
esshoul
db e Regi
st
rat
ion Cl
i
nic (l
ab/
X-r
ay)
l
ocatedinisolati
o n,pref
erably,inr e
mo tecorner,
p ro
vide
dwi t
hin-
dependentaccess.immu nization
cl
ini
ch avi
n ga na r
e aof3m×4m.a l
lcli
nicssh a
llbeprovi
ded
wit
he xaminationt abl
e,x-ray-v i
ewb ox,sc
reensandh andwishi
ng Wa
iti
ng
Dr
essi
ngroom/
Pha
rma
cy E
xit
I
njec
tionr
oom
fa
ci
lity
.
-pharma c
ys hallb einclosep roximityo fOPD. ad e
q u
atenumber
ofwh eel
chairsands tret
chers hallbep rovi
ded.
 TypesofOPDSer
vic
es
OPD(
OutPat
ientDepar
tment
) 1
.Ambula
toryCareCe
ntr
e
2
.Po
lyc
lin
ic
3
.Heal
thCentre
Pl
anni
ngandDes
ignPar
amet
ers 4
.Wal
k-i
nCl i
nic
5
.DayHo s
pita
l
AnOPDs hou l
db eas e
p arat
ecomp le
xwi thi
nah ospi
talandloca
- 6
.Di
spensa
ryetc
t
io nshouldb esuchth a
ti tshar
esdiagnosti
cs,
labora
toryetc.hos
-
pitalse
rvi
ces.
•Th eTraff
ico fOPDs ho ul
db etotal
lysepara
tedfromrestofthe
hosp i
ta
l,especia
ll
yf romt heIPD a n
dAc ci
dentandEme rge
ncy TypesofOutPat
ient OPDPr
oces
s
De part
me nt
.
•Itshouldber ead
ilyaccessi
blefromma inentra
n c
e. 1
.Gene
ralo
u tpat
ient Ar
ri
va
latOPD
•OPDs houldh av
ee as
ya ccess
ibi
li
tytome d
ica
l i
maging,l
aborat
o- 2
.Emer
gencyo u
tpati
ent
ryan dPh a
rma cy. 3
.Ref
er
redou tpat
ie
nt
•Inag ener
alh osp
itali
ta l
l t
hep ol
ycli
nicsshoul
db eacc
o mmo dat
-
edinas ingl
eOPD. Ho we v
er,i
ns pec
ialt
yh os
p i
tal
s,t
herema ybe
Re
cep
tio
n
separat
eOPD' s 1.Gener
alOutpat
ient
f
o rvaryi
ngs peci
alt
ies.
•OPDs houldb elocat
eds uchthati
tc anbeshutd o
wnd uri
n geve
- Al
lth
epa
ti
ent
sot
hert
hane
mer
gen
cie
swh
ore
por
tdi
re
ctl
ytot
heOPD.
Re
gis
tr
at
ion
ningh ours
.
•OPDs houldb eo ri
enteds uchthatitisimpossi
bletolookinto 2.Emer
genc
yOutpat
ient
t
h etreat
me ntande xaminationroom. I
ss
ueo
fTo
kenNu
mbe
r
•De si
gnsho ul
dc atertof utur
ee x
pansion,incasethenumb erof Aper
song
ive
nemer
gen
cyme
dic
alc
aref
orc
ond
iti
onwh
ichi
sre
alo
rpe
r-
departmentsisincreas
ed. c
ie
vedeme
rge
ncy
. Wa
it
ingRo
om
•Wa it
ingareasshou l
db el ar
gee nought oaccommo da
tep ati
ent
s
anda cc
omp anyingfrie
nd sanda t
tendants
.Spacerec
omme nd e
dfor 3.Ref
err
edOutpat
ient
wa i
ti
n g I
nve
st
ig
ati
ons Co
nsu
lt
at
ionwi
thDo
cto
r
areasis0 .
8m2p erp ati
entsforo net hi
rdo ftheaveragedail
y Ape
rso
nrefe
rre
dtoanOPDbyhi
sat
te
ndi
ngme
dic
al
/de
nta
lpr
act
it
ion
er
numb erofp ati
entsatte
n dingOPDi no neses
sion. f
ors
peci
fi
cdia
gnos
ti
c/t
re
atme
ntp
roc
edur
e.
•Itisdesi
rabl
et oprovideag oodv i
ewo ftheo ut
side
.Wa i
ti
n gar
ea Re
fer
ral
toS
pl I
ss
uan
ceo
fMe
dic
alc
hit
mu sthaveawa rme nvironme ntwithn atur
alli
ghtin
ga ndg ood
ventil
at
ion.
Ar
ri
va
latp
har
mac
y
TypesofOutPat
ientSer
vic
e
To
kenn
umb
er
Ce
n t
ra
li
sed De-
Centr
al
is
ed
OutPat
ie
nt OutPat
ie
nt
S
e r
vi
ces Ser
vi
ces Co
ll
ec
ti
ono
fMe
d
Allse
rvi
ce
sa r
ep r
ovi
ded Se
rvi
cesar
ep r
ovi
dedi
n
i
nac ompactar
eawh i
ch t
her esp
ect
iv
ed e
par
t-
i
nclu
desa l
ld i
agn
ost
ic ment
s. De
par
tur
e
andther
aput
ic
sf a
ci
li
ti
es
bei
ngp ro
vide
di nt he
sa
mep l
ace
.
OPD(
OutPat
ientDepar
tment
)

Requi
rement
sforOPD

•60%o far
eash
ouldbef
orwait
ingan
dc o
rri
dor
s.
•Se
atsf
or1/3ofd a
il
yat
tenda
nce@ 8sqft/pt
.
•Consu
lta
ti
onroom–1 5
0s qf
t
•At
tache
dexami
nati
onroo
m–8 0sqft

Pr
ojec
tionofOut
-Pat
ientLoad

•F
orev
eryho
spi
ta
lbed,
1.5to3pa
ti
ent
sat
te
ndOPD
•1
-10vi
si
tspe
rca
pit
aperye
aroft
hede
pend
entp
opu
lat
ionb
asi
s

SomeReco
mme ndat
ionsaccor
dingtoBI
S(Bu
rea
uofI
ndi
anS
tan
dar
ds)
:
•Ent
ranc
eZo ne-2s
q.me t
er/be
d .
•Ambula
toryZone-10sq.mete
r/bed.
•Diag
nost
icZone-6sq.meter
/bed.
•Tot
alhos
pita
lar
ea-60sq.
me t
er/be
d

Dai
lyOPDAt t
enda
nce:
•Usual
l
y4p e
rIn-
pati
entb
edor1
0p e
rd a
il
yadmi
ss
ion
•RuleofTh
umb :
4p a
ti
ent
sfo
reve
rybedeac
hdaya
bout4
0%n
ewa
nd6
0%
ol
d

Func
tionalRel
ati
ons
hipsMat
rix

Thefol
lowin
gd i
agr
amp r
es
entst
hepro
ximi
tyrel
at
ion
shi
psoftheva
ri
ous
f
unct
ion
al a
rea
sorsp
ace
sfoun
dinout
pat
ie
ntcl
in
icsi
namatri
xfo
rmat
.

Pr
oxi
mit
yCode
sForDi
agr
am

Thedeg
reeofpro
ximi
tythati
sdes
ira
blewit
hotherd
ep a
rtme
ntsora
rea
sthat
s
hareaf
unct
ion
alre
lat
ion
shi
pwiththeOutpat
ie
ntCli
nici
sind
icat
edbyasc
al
e
of1to4(1repr
ese
nti
ngthegre
ate
stle
velo
fadjac
enc
y).

1VeryStrong:Adj acent
2Str
ong:Cl ose,samefloor
3Moder ate:Conv enient
,di
fferentfloorac
ceptabl
e
4Weak:Maybes epar at
ed,l
imitedtr
afficorcommuni
cat
ionnec
ess
ary
XSeparationr equiredordesi
rable
OPD(
OutPat
ientDepar
tment
)

Pl
anni
ngModul
e Mul
ti
pleModul
eRel
ati
ons
hip

Typical
l
yOu tpati
entCli
nic
swill
havese
ver
alPri
maryandSpec
ial
tyCaremodul
es.Exam/trea
t-
men tmo d
ulesmayb ear
range
dwithcommo nci
rcul
at
ionasshownforMo du
les1an d2.This
Cl
ini
cs:Si
ngl
eRel
ati
ons
hipModul
e mayp rovi
dep la
nningando pe
rat
iona
leff
ici
enc
iesfr
oms ha
redspaceorequi
p ment(suc
ha s
“overf
low”intoanadjac
entmoduleonbusycl
ini
cdays)
;andcanh e
lpmaint
ai
ne ff
ic
ientst
aff
ands u
pp o
rtcirc
ula
tionse
para
tefr
omp ubl
i
croutes
.Somemo d
ules(sp
eci
al
tycl
inic
sinparti
cu-
l
ar)ma yn e
edt oli
mit“thr
oughtraf
fi
c”andshoul
db eke
ptdisti
nctf
romadjunctmo d
u l
esas
sh
o wnb ytherel
ati
onshi
pb e
twee
nMo d
ule
s2a nd3.
Typi
cal Exa m/Treat
me nt
Mo dul
eisbase
do n10t o19 Standard
exa
m r oo
ms a nd s upport Consulti
ng
spac
es.Ro oms a r
ea r
ranged Suit
e
al
ongd oubl
eloadedc or
ri
d or
s.
“Publ
ic”funct
ionsa r
elocated
atthe“fron
t”o ft hemo dul
e.
Mo s
tstaf
foffi
cesandcommo n
suppor
tfunct
ionsareloc
atedat
the“back
”o fthemo du
le.Pa-
ti
entacce
sstothee xam/trea
t-
ment a re
as i s c ontr
o l
led
thr
ought he Re cepti
ona nd
Tri
agefunc
tion
al ar
eas.
OPD(
OutPat
ientDepar
tment
)

Communi
tyBas
edOut
pat
ientCl
ini
c(CBOC) Sat
ell
it
eOut
pat
ientCl
ini
c(OPC)

Thefuncti
onala
reasin
clude
dinthespac
eprogr
amf oraCBOCwi l
lvar
y Thef unct
ionalar
easincl
udedinthespac
ep r
ogramf oraSatel
l
iteOPC
wit
ht h
eme di
calprogra
m,wo r
kloa
dp roj
ect
ion
s,st
affi
ng,andtheavai
l- wil
lv ar
ywitht heme di
calpro
gram,workl
oadp ro
ject
ions
,ands t
aff
ing
.
abi
li
tyandcapac
it
yo fexi
st
ingse
rvi
cesi
nthepare
ntMe di
calCent
er.This Thisd i
agr
ami ll
ust
rat
esgener
alconc
eptua
lre
lati
onshi
psforthefu
n c
ti
on-
Diag
rami l
lus
tra
testhere
lat
ions
hip
so fthefunc
ti
on a
larea
sinat ypi
cal alare
asinatypica
lClini
c.Sta
ffentr
yandcir
cula
tionshoul
db ese
p a
rat
ed
Cli
ni
cwh ic
hma yincl
udearea
sforRecep
tio
n,Pati
entCare,
Support,a
nd fr
omp at
ie
ntcircu
lat
ionifposs
ibl
e.Ind
ivi
dualent
ri
esma ybeappropr
ia
te
St
affa nd Administ
ra
tio
n.Wh enin c
lude
di ntheme di
calprogra
m, f
ors omespecial
tycl
inic
so rdepa
rtment
sincl
udingAmb ula
torySurge
ry
CBOCsma yb eexpande
dtoc o
ntai
nlimit
eddia
gnosti
cfunct
ion
s( Labo- andMe ntal
He alt
hCl i
nic
s.Ser
vic
eandd o
ckarea
ssh o
uldbelocat
edaway
ra
tor
ya ndRadiol
og y
)andPh a
rmacy
. fr
omp at
ie
ntan dst
affci
rcul
ati
on.Lar
gerbui
ldi
ngswillusu
all
yrequi
rean
EnergyCenter(orcentr
alpla
nt)toacc
ommo datethenece
ssar
yb ui
ldi
ng
se
rviceequi
pme nti
nclud
ingboil
er
s,chi
ll
er
s,e
lect
ric
algear
,andemerge
ncy
ge
n er
ator
s.TheEn er
g yCente
randEn gi
neer
ingspace
sshouldbelocat
ed
nearthese
rvi
cea r
eaandd ock
.
OPD(
OutPat
ientDepar
tment
)

Eas
yVi
sibi
li
ty

Toencou
rag
eit
suse,t
hefac
il
it
yshou
ldbe:
1.Eas
ytofi
nd,c
le
arl
yvisi
bl
efr
omt h
eappro
achroa
d,wit
hgooddir
ect
ion
alsi
gna
gefro
m
nea
rbymaj
orroa
ds
2.Eas
ytore
cogni
ze,
withawel
comingi
mageandcl
ear
,app
ropr
ia
tel
yloc
ate
dd i
re
cti
onal
si
gna
ge
3.Eas
ytoent
er
,wit
hv i
si
ble
,wel
l-
ide
nti
fi
edent
ran
ce,a
ndacle
arro
utefr
omp ar
kin
g

Ac
ces
sibi
li
ty

Alla
rea
s,bot
hins
ideandout
,sh
ould:
1.Complywi
ththemini
mumr e
qui
remen
tsoft
h eSt
at
eDisabi
l
iti
esAc
tand,
iff
ede
ral
l
y
fu
n d
edorowned,
withtheNat
iona
lAcce
ssi
bi
li
tySt
andar
ds
2.Beea
sytouseb
yt h
ema n
ypati
ent
swit
htempora
ryorper
manentha
ndi
ca
ps
OPD(
OutPat
ientDepar
tment
)

Door
s Ci
rcul
ati
on Ci
rcul
ati
onf
orHandi
capped

Cove
ri
ngshavetob eres
ist
anttothema i
ntenan
ceand -Acc
essp ass
ages
:1 .
5mwide, -Pas
sag
es:1.
30mwid emini
mu m,be
tte
rif2mwide,
di
si
nfe
ctan
tp r
oducts
. -Pa
ssa
ge sforlyi
ngp a
ti
ent
s’t
ran
sfer
:2.
25mwi demini
- -Doors:0.
95m wideminimum,ama gnet
icc
los
urei
s
-Thesamesoundinsul
ati
o nastheoneforwall
sisre
- mum, ad
vis
ed,
qui
re
d:alea
fwi t
htwowa ll
scanabsorbnoi
sesupto27 -Cei
li
ngsi npass
ages:
2.40mhighmini
mum, -Swi
tches
,han
d l
es
,windowscl
o s
ure
..
.ha
vetobewit
hin
dBmini
mu m. -Maxima ldist
ancebet
weentwowindowsinap a
ssa
ge ea
syre
ach:1-
1.05mhigh,
-Heig
htofd oors
:2.
1-2.2m, way
:25m, -Widepushb
utto
nsarerequi
re
d,
-Heig
htofoverdesi
gneddoorsf
orc a
rs:
2.5m,-Heigh
t -Widtho fp a
ssag
ewa y
smu st
n’tbereduc
edb yany -Acce
ssways
:1.20-
2mwi de,
ofdoor
sforthepass
ageoftrans
portvehi
cl
es:2.
7-2.
8m, obj
ec
to rp os
t, -Sl
opes
: 5
% ma x
imum, 6mlongmaximum,
-Mini
ma lhe
ightofdoorsforac
cesstoahal
l f
orly
ing -Acc
ordingt othereg
ula
ti
onsfi
redoor
sarere
quir
edin -Widt
hb et
weenhandra
il
s:1.
20m.
peo
ple
:3.5m. pa
ssa
gewa ys.
OPD(
OutPat
ientDepar
tment
)

Spec
ial
izedOPD
Cove
ri
n gshavetoberesi
st
anttothema i
nte
n a
nceand
di
si
nfect
antp r
oduct
s.
-Thesames oundins
ulat
ionasth
eo neforwall
sisr
e-
qui
re
d:al e
afwithtwowall
scanabs
o r
bn oi
se
su pto27
dBminimu m.
-Heig
h tofd oo
rs:
2 .
1-2.
2m,
-He i
ghto fo ve
rd es
igne
dd oorsforc a
rs:2.5
m,-
Heig
hto fd oor
sforthepass
ageoftran
sportveh
icl
es
:
2.
7-2.
8m,
-Minimalh e
igh
tofd oor
sforacc
esstoahallf
orlyi
ng
peo
ple:3.
5m.
i
. ENT
i
i
. Opt ha
lmolo
gy
i
i
i.Me dic
ine
i
v. Sur
ger
y
v
. De rt
matol
ogy
v
i.Or th
opaedi
c
v
ii
.Pa e
dia
tr
ics
v
ii
i.Obst
etr
ic
s&Gy n
aec
olo
gy
i
x.Ps y
chi
atr
y x
i.Ey
eCli
ni
c
x
. De nt
al x
ii
.Fa
mil
yWel
fa
reCl
i
nic
OPD(
OutPat
ientDepar
tment
)

Ot
orhi
nol
aryngol
ogy(
ENTDepar
tment
) Medi
calCl
ini
c
Otol
aryngo
logyistheoldes
tme dicalspec
ial
ty.Otolar
yn gol
ogi
stsar
e Thecli
nicsho
uldhav
eaconsu
lt
at
ion
am+xuni
nat
ionr
oomdependi
ng
ph
ysici
anstr
ai
n e
dint hemedicalands ur
gic
alma nagementandt re
at- uponthelo
ado fou
t-p
ati
ent
s.
Thecl
ini
csh
oul
dals
ohavef
aci
l
iti
esf
or
mentofp a
tie
n t
swithd i
sea
sesandd i
sor
dersofth eear,nose
,throat ca
rdio
graphi
cexami
nati
on.
(
ENT) ,andrelat
edstruc
turesoft heheada ndneck .
Th eyarecom-
monlyre
fer
redtoasENTp hysici
ans. Spat
ialRequi
rement
s:
Thei
rspeci
als
k i
ll
sinc
ludediagnos
inga ndma n
agingd i
seas
esofthesi-
nu
ses,l
arynx(voi
cebox),ora
lcavit
y, an
du pperpharynx( mouthand
t
hroat)
,aswellasst
ructu
resoft hen ec
ka ndface
.Ot olaryn
gologi
sts
di
agnose
,tr
eat
, a
ndma nagespec
ial
ty-speci
fi
cdisor
dersaswe l
lasmany
pr
imarycar
ep ro
ble
msi nb o
thch i
ldrenandadults
.
Thec l
in
icshouldhavefaci
li
tie
sfo rane xa
rninat
ion-cu m-t
reat
me nt
s
ound -
proo
fa udio
me t
ryr ooma nds peachthera
p y.Fort e
st
ingt h
e
s
tat
eo fhea
ringpowerofe a
r,rooml engt
ho f6mi sa dvis
abl
e. Sur
gic
alCl
ini
c
Thecl
in
icsh
ouldhavefa
cili
ti
esfo
rtr
eat
ment-
cumdr
es
sin
gs.
Forcon
-
ve
nie
nce
,th
issh
o u
ldb epl
acednextt
ocons
ult
at
ion
-cu
m-exa
mina
ti
on
r
oomwithade
quatewait
ingspac
e.

Spat
ialRequi
rement
s: Spat
ialRequi
rement
s:
OPD(
OutPat
ientDepar
tment
)

Der
mat
ologyandSTDCl
ini
c Or
thopaedi
cCl
ini
c Pedi
atr
icCl
ini
c

Thecl
ini
cshouldprov
idedi
agnos
ti
candcura
ti
vef
aci
li
ti
esforderma- Theclini
cshoul
di n
cludearr
angement
sforp la
st
erp r
epar
ati
on,fr
ac- Thecl
inicshou
ldprovi
deme di
ca
l
t
olo
gy,se
xual
lytra
nsmit
teddis
eas
eandle
prosy
.Thetr
eat
men tr
oo ms t
u r
etreat
ment,be
si
desconsuM.ionc
um-ex
arninat
ion.ForX-ra
yfkil
i- ca
refo
rc hil
dre
nu pt
ot heageof
f
order
ma t
olo
g yandvene
reo
logymaybecombi
ned,b
uttr
eatmentfor t
iesthecl
ini
cshoul
db eincl
oseproxi
mit
yofr adi
ologydepar
tment
, 12yea
rs.Owingtor i
skofinfec
-
l
epr
osyshou
lda l
waysbese
greg
ate
d.Thecl
i
n i
cmayal
sohavefac
il
iti
es emerg
encyandacci
dent,i
no r
dertomakethema xi
mu mu s
eofequip- t
ionitise s
sent
ia
ltoi s
ola
tethe
f
orsupe
rf
ici
alther
apyandaski
nlabor
at
ory
. mentandtor e
ducethecir
cul
ati
on.Pla
st
eran dspl
intst
orag
eroomi s cl
i
nicf
romo the
rcli
nic
s.Thecl
ini
c
nece
ssar
yforstor
ingp l
ast
erma t
eri
al
s,sp
li
n tsando t
herthe
rapeu
tic s
hallb
ep r
ovi
dedwithas ep
arat
e
ai
dsan dforpre
pari
ngp l
ast
er,banda
ges
,etc.Frac
tureandtre
atment t
rea
tmentroomforimmu n
isa
ti
on.
s
h oul
db espac
iousenoughtoa c
commo da
tead r
es
singcouchanda
mobil
eX- ra
yunit
,Ar ec
over
yr o
oma dj
ace
ntt othefr
actur
eandtre
at-
mentroomisesse
nti
al
.

Spat
ialRequi
rement
s:
Spat
ialRequi
rement
s:
OPD(
OutPat
ientDepar
tment
)

Obs
tet
ric
s&Gynaec
ology Ps
ychi
atr
y Dent
al

Thecli
nics h
ou l
dincl
udeas e
parat
erece
ptio
na ndregi
str
ati
on,con- Thef ac
il
it
ie
sr equi
redfo rtheclini
cs houl
di nc
ludec ons
uha- Thedent
alcli
ni
cma yhavefa
ci
li
-
su
lt
ing-
cum+x aminati
on,t
reat
mentandcli
nica
llabor
ator
y.Thecli
ni
c t
ion-
cum-ex
aminat
ionroom,ECTt r
eatmentro
om,re
cove
ry,
psychol
o- t
ie
sford e
ntalhyg
ien
ea ndroom
sh
ouldb ep l
annedclos
etoi n
-pat
ien
twa r
du ni
tstoe nab
lethemto gi
standaso
cia
lworkerroom.Thecl
inicshoul
dpre
fer
abl
yb eloca
ted f
orp a
tie
nt’
sr e
cove
ry.Consul
ta
-
makeuseo fthecl
ini
csatt
imesforant
eandp os
tnat
alcar
e.Thecli
ni
c ongroun
df l
oort
or e
d u
cetheri
skofsu i
ci
deandacc
ide
nt.Allrooms t
ion
-cumex
aminati
onroo
ms houl
d
sh
ouldalsobeataconveni
entdi
sta
ncefro
mo thercl
ini
csintheOPD. ofthecl
ini
cshal
lhavedadoonemetrehighandal
lel
ect
ri
calfit
ti
ngs s
erv
easc ombin
edp ur
poseroom
Ante
nat
a lpat
ient
sh a
vetounder
gocer
tai
nformal
iti
espri
ortoe
xamina- s
hallbepr
ote
cte
d.InECTr oomthepati
entiss
ubj
ect
edtoel
ectro
con- f
or c ons
ult
ati
on, examin
ati
on
t
ionbyth edoctor
s,cl
ini
call
abora
tor
yf o
rthepu r
poseises
sent
ia
l.A vul
si
veth
erap
y(shock
).Aresus
ci
tat
ion(re
cover
y)r
oomisneededcl
ose de
nta
lsur
geryandtr
eat
ment.
t
oil
et-
cum- ch
angingroo
mc los
etotre
atmentsho
u l
dals
ob eprov
ide
d. t
ot h
isro
om.

Spat
ialRequi
rement
s: Spat
ialRequi
rement
s:
OPD(
OutPat
ientDepar
tment
)

EyeCl
ini
c Fami
lyWel
far
eCl
ini
c

Thecli
ni
cs hou
ldprovi
deeduc
ative
,pre
vent
ive
,dia
gnost
icandcura
ti
ve
Thecl
ini
cshou
ldinc
ludecons
u l
ta
ti
on-c
um-ref
rac
ti
onandminorsu
r-
f
acil
it
ie
sformater
nal,c
hil
dhealt
h,scho
olheal
thandheal
theducat
ion
.
ge
ry-
cum-t
rea
tmentro
om. Fortes
ti
ngthes
tat
eofref
rac
ti
vepowerof
I
mp ort
anceofhealt
heducat
ionisbei
ngincre
asi
ngl
yrecogn
izedasan
t
heeye,
roomlengt
hn o
tlesstha
n6 mises
sen
tia
l.Howe
verbyuseof
ef
fec
ti
vetoolofp r
event
iv
etre
atment.Peop
levis
it
inghospi
talshou
ld
mir
rorl
engt
hc a
nb eredu
ced.Da r
kroomshoul
db epl
acedcl
oseto
beinf
ormedo fenvi
ronment
alh yg
iene
,cl
eanh a
bit
s,needfortaki
ng
co
nsul
ta
tio
n,pre
fer
abl
y,wit
ha nint
er
communic
ati
ngdoor
.
pr
event
iv
eme asu
resaga
ins
tepidemic
s,fa
milypla
nning
,etc
.Treat
ment
r
oo minthiscl
ini
cshoul
da c
ta soper
ati
ngroomf orI
UCDi nse
rti
on
andin
vest
igat
ion
,etc.

Spat
ialRequi
rement
s:
Spat
ialRequi
rement
s:
OPD(
OutPat
ientDepar
tment
)

Fl
exi
bil
it
yfort
hef
utur
e

Facil
ityd e
signreprese
ntsalong-ter
mi nve
stmentforh e
alt
hc ar
eo rgani
zati
ons.Toma kethemo s
t
ofth i
si nv
estme nt
,iti
sessenti
altoiden t
ifyfut
urecareprocess
esan dthenstandardiz
et hedesi
gn
asmu cha spossibl
etoenab l
ethebuil
d ingtoadapttofutureneedsthatcanbep redi
cteda n
dt ho
se
thatcan not.
Toh e
lpp r
edictfutur
en eeds,ano r
gani
z at
ionfir
stshou l
da t
temp ttor e
cog n
izeand
correc
tc urre
n tine
ffi
cie
nciestostr
eaml i
nep ro
cess
esa ndma kebett
eru s
eo fspace.Thiscanma xi
-
mizet heo rganiz
ati
o n
'simme diat
es paceu t
il
izat
iona ndreduceth eneedfo rtotalspaceinthe
future
. Studyi
n ghowo thergroupsared el
iver
ingcar
ec anp r
ovideau sef
ulou t
sidep e
rspect
iveon
thep ossi
bil
it
iesforp r
ocessandfaci
li
tyd esi
gn.Organizat
ionsshouldconside
rt hetypesofp a
tie
nt
vi
sitstheyp l
ant ooffe
ran dincl
udeap propri
ateexa
mr oomsforeach.Ifgroupo re-vi
sitsar
ep r
o-
j
ectedt ob epartoft h
emi x,thedesi
g nsho u
ldincl
ud ear
easthatme ettheneedso ftheseser
vic
es.
Benchma rksarev a
luabl
eind et
erminingc urr
entandf ut
uren e
eds.Becausesomes peci
alti
eshavea
higherp at
ientthroughputthano t
hers,thenumb e
ro fexamr oomsp erphysi
cianp erspeci
alt
yis
ap art
icularl
ywo rthwhil
eme t
ricfora mbu l
at
orycared esi
gn.Th en umbero fh al
f-daysac l
ini
c
me et
sisa l
soimp ort
a nt
.Clini
csthatme etatle
astfo
u rhal
f-daysawe ektypi
call
ya r
ep rovi
dedwith
dedicatedspace.Surgic
ala ndgeneralme dic
alsubspeci
alt
iesoft
e ncans har
es pace,forexample
,
withe achme eti
ngth r
eed ay
sawe eki nth esa
mec li
n i
c.Standar
dizedcli
n i
cmo dul
esd esi
gnedto
functi
o neffi
cientl
yforav ari
etyofp rovider
sa l
lo
wh eal
thcareorganiza
tionstoa daptifp a
tie
nt
volume sshif
tf r
omo n
esp ec
ial
tytoa notherdownth eroad.
I
n-Pat
ientDepar
tment(
IPD’
s) Typesofwar
d:
Thei
n-p
ati
ent
sward
smu s
thaveres
tr
ic
teda
cce
sst
op a
-
Ar
rangement
sofwar
ds:
t
ie
nts
,doc
tor
sandnurs
es.
Thea d
missi
onofvi
si
tor
s
s
houl
dberes
tr
ic
tedtodi
ff
ere
nttimes
. Wa
rdsma
ybee
it
hern
igh
tin
gal
eorr
ig
sty
pe.
:

War ds
(
5.5mx3 .
5me ac
h) Nighti
ngale-b
edsar
earr
ang
eda tar
ig
hta
ngl
etot
hewa
llwi
th
Thewardssho
uldbesp
aci
oustopre
ventaf
eel
i
ngo
f t
hefeetto
war
dst
hec
entr
alc
orr
ido
r.
cl
aus
trop
hobia
.
Fe
nestr
at
ions
:20%o fto
tal
flo
o ra
rea
-Otherwar ds:
-Eme rg
ency
Beds -Burnward
Dimensi
onofabed -Orthopedi
c
2.1
5x1 .
035
m -P o
stopera
ti
ve
-Eve
rybeds
hallb
ep r
ovi
dedwi
thI
Vsta
nd,
bed
-si
de -Oph t
hal
mo l
ogy
l
o c
kerandst
oolf
oratt
endant
. -Malar
ia
-Mi n
imumd i
st
ancesbet
weenbeds -Inf
ect
iousDis
ea s
e-Its
houl
db epl
ac
eda sasepar
at
ebu i
l
dingc
onnect
ing
t
h ema i
nb ui
ld
ingthr
oughacov
eredpas
sage.Th
eunitmaybepl
ac
edinthe
ma i
nwa rdbl
ockits
elfbuts
houldb
eseparat
edbyanairga
p.
Thefo
ll
owingqual
it
yp ar
ame t
erssho
u l
dbeensur
ed: Riggs-4to6bedsar
ear
ran
gedp
ara
ll
elt
oth
elo
ngi
tu
din
alwa
ll
s
-
Scr
eens ha
llbeava
il
ableforpri
vacy
. an
df a
cin
geachot
he
-
Ded i
cat
edto i
l
etswithrunningwaterfac
il
it
yand
Pri
vatewar d:
f
lus
hshal
lbep r
ovi
dedfo reachward.
Depen
dingupo
nther
equi
re
mentofthehosp
ita
landcat
chmen
tar
e
-
Dirt
yuti
li
tyroomwiths l
uici
ngfaci
l
ityandja
nit
or
a,
appro
pria
teb
edsmaybeal
lo
weedfo
rap ri
va
tefa
cil
i
ty.10
%ofth
e
r
oomss h
allbepro
vid
edwi t
hinwa r
d.
t
otal
bedstr
eng
thi
sre
commendedasp
riv
atewar
dsbeds.
-
Allwar
dsshal
lbeprov
idedwi thposi
tiv
eventi
la
ti
on
(
excepti
sol
atio
nwa r
d)a ndfans.

Daycareunit:
I
tisd
esi
rab
let
hatupto2
0% ofth
etota
lbed
smaybeea
rmar
kedf
or
t
heday
car
efac
il
it
ie
s,a
smanyp
roc
edur
escanb
edo
n eonda
yca
reba
si
s
TandYsha
pedwar
d i
nmo d
ernti
mes.
•L,
Ha n
dEs ha
pedwa
rd

Nursestation:
Theba
si
caiminplan
nin
gawa r
du n
itsho
uldbetomini
mizethework
oft
henurs
ingst
affa
ndprov
idebas
icameni
tie
stothepat
ie
ntswit
hin
t
heuni
t.Thed i
st
anc
estobetra
vel
ledbyan ursef
romb e
da r
easto
t
rea
tme
ntroom,pant
ryet
c.s
houldbekepttothemini
mum.
Nur
ses
tat
ion: I
n-Pat
ientDepar
tment(
IPD’
s)

Thebas
icaimi nplanni
ngawa r
du n
itshoul
db eto

d
alWar
mi
nimiz
et hewo r
ko fthenurs
ingst
affandprovi
de
ba
si
came n
iti
estothepat
ie
ntswi
thi
ntheuni
t.Thedi
s-
t
ance
stob et r
ave
ll
edb yan ur
sefr
omb e
da r
easto
t
re
atmentroom,pantr
yetc
.shou
ldbekeptt
othemin-

01Gener
i
mum.

-Ona nav
er a
geonenursi
ngst
ati
onperwar
dwi l
lbe
pro
vided.Itshou
ldbeen s
uredtha
tnur
sin
gs t
at
ion
cat
erstoaround40-4
5b eds,ou
tofwhic
hh a
lfwil
l

d
cWar
beforacu
tepati
entsandhal
fforch
ron
icpat
ients
.
-Maximu mdi s
tan
ces:
-Bedt ow/c -12m
-Nursest
at
iontofar
thestbed-20m.

at
02Pedi i
r
Ar
eaAnal
ysi
s

enat
03Ant d
alWar
I
ntens
iveCare Uni
t(ICU)AND
HighDependency Ward Envi
ronment :
Agoodna
tur
all
ig
htan
dp l
ea
san
ten
vir
onme
ntwo
ulda
ls
obeo
fgr
eath
elpt
oth
e
I
nt hi
sunit
,cri
ti
cal
l
yillpat
ie
ntsrequ
iri
nghi
ghlyski
ll
ed pa
ti
ent
sandst
af
faswel
l.
l
if
esa
vingme d
ica
lai
da ndnurs
ingcar
ea r
econc
entr
ate
d.
Thenumb erofpat
ie
ntsreq
uir
inginte
nsi
veca
rema ybe
ab
out5t o10%p er
cen
to ft
otalmedi
cala
ndsurgi
ca
l p
a-
t
ien
tsinah os
pit
al
.Outo ft
hese,t
heycanbeequa
ll
yd i
-
vi
dedamo n
gICUa ndHighDe pen
dencyWard
s Addi
ti
onalf
aci
li
ti
es-

-Chang
ingroomshoul
db eprov
ide
dforpat
ie
ntsanddoc
tors
.
-Ther
eshoul
db ecl
ear
-cu
ta d
missi
on,
dis
char
geandref
er
ralpol
i
cy.
Beds:
-Nu r
sesSt
ati
on
ICUandh i
ghdepend
encywar
dbe
ds;
-Clea
nUt i
li
tyArea
5to10% o fto
talbe
ds
-Equi
pmentRoom
Eac
hu ni
t-4-12beds
Des
ignGui
del
ines -Thi
sun i
twil
lal
sonee
da l
lthespe
ci
al
ize
dserv
ice
s,s
uchas
,apipe
dsuct
iona
nd
Ped
iat
ri
c:10-1
2s q
mp erbe
d
medic
algas
es,
unint
err
uptedel
ect
ri
csuppl
y,
heat
ing,
vent
il
at
ion,
cent
ra
lai
rcon-
Highdepen
dency
:20-24sqm •Te
mp–2 1-24°C dit
ion
ingandeff
ic
ie
ntli
feserv
ice
s.
Gener
al
:25-30sqmp e
rbed •RH–3 0%-60%
•Pr
ess
ure–P os
it
ive
•Ai
rCh an
g e
s–3f re
sh/1 5t o
tal
Li
ght
ing& Envi
ronmentCont
rol
•Ai
rFil
trat
ion–2 0µ
•Si
zeofwa r
d-De p
endingupont ypeofpati
ent
,ki
nd •Reco
mme nd
ed3 00luxlig
htill
uminat
ionforpat
ie
nt
•Ar
eaofwa rd
-8-10s q
.me t
erpe rbed ar
easwithant
i-
gl
ar
ea r
ran
gement
,1 00luxforco
rri
dor
,
•Di
sta
nceb e
tweentwobeds-1.25me ter 150luxforsta
ffar
eaandf l
oorli
ghtsformoni
tori
ng
•Door
s-No tle
ssthan1.25meterwi d
ea n
d2 .
25mete
rhe
igh
t drai
nages
eal
andsuc
ti
onequipme
n t
.
•Di
sta
nceb e
tweenbedandwa l
l-0 .
25me t
er •Ic
ushoul
dbesoun
dp r
oofandairco
ndit
ione
d.
•Cei
li
ngheight
-Atlea
st3me te
rs
•Windows-20%o ffl
oorareaf
o rsi
nglewind
ow,15%off
loora
reaf
or
mul
ti
ple
.
TypesofI
CU:

-Ps
ychi
atr
icInt
ensi
veCa r
eUn it(PICU)
-Neo n
atalI
nte
nsi
veCa reUn i
t(NI CU)
-Pe
diat
ri
cInten
siv
eCa reUn i
t(PICU)
-Car
diacCareUnit(CCU)
-Neurol
ogi
calI
ntens
iveCareUn it(Neur
oICU)
-Po
st-ana
est
heti
cCa r
eUn it(PACU)
-Su
rgic
alInte
nsi
vecareu n
it(SICU)
-Medic
alIntens
iv
ecareUn it(
MI CU)

Pr
oxi
mit
y:
Easyandconveni
entac
ces
sfr
om emer
genc
yandac
cidentdepar
tmenti
s
als
oessenti
al.
Neonat
alI
ntens
iveCar
eUni
t Car
diacCar
eUni
ts(
CCU)
ANI CUisani
nte
nsi
veca
reu
nits
pec
ia
li
zi
ngi
nth
e •s
houldbeloc
ate
dinaqu
ietl
oca
ti
on
ca
reofi
ll
o rpr
emat
uren
ewbor
ninf
ant
s •be
dn umber
smayvar
yfr
om4t o8ins
mal
lfa
ci
li
ti
est
o20o
rmo
re
Lev
el
s: i
nla
rgecent
re
s.

•Le
vel
Ic a
re(mil
d)
•Le
vel
IIcare
(moder
at
e) •Bed
sma ybeamixofsi
ngl
eand2be
drooms
•Le
vel
IIIcar
e(c
ri
ti
cal
) •Si
ngl
ePati
entBe
droomsi
ncl
udin
gIs
ola
ti
onRoo
ms,
sha
llh
avemi
ni
-
mumd i
mensi
onsof
390
0mmx3 900mm
Des
ignGui
del
ines
In
patientareas
:
•2t o3o xygeno u t
let
s.
,2c ompre s
seda i
ro utl
et
s. •ami xo fsing
lean d2b edrooms
•2t o3s u ct
iono utl
ets
. •showersa ndtoi
lets,s
taf
fstati
on
•Ea chp ati
ents tat
ionsho ul
dh ave1 2-16c ent
ral •cl
eanu til
it
yroo m, medi
cati
onr oom-as ecu
re,a
larmedroomwith
volt
ages t
a bi
li
z ede l
ectr
ico ut
let
s. vi
si
bili
tyin t
otheu nit
•gapo fabou t6f eetbetweentwoi nc u
b a
to r
sfor •equipme ntbay
, l
inentrol
leybay/s stora
ge,v
isi
torloung
eand/o r
adequa t
ec i
rculati
o nandk eepthee ssenti
al di
str
essedr e
lat
ives
l
ifes
avinge quipme nt’s
,spacen e
ed e
da bo ut120 ro
om
squarefeet. •Provi
siono findivi
d ua
lens u
itesho
we rs/toi
le
tstop a
tie
ntbed-
•F orthep at
ien tcare,100s quarefeeti
sr equi
red ro
omsAc ousti
cs,
foreachb aby •fl
oorc overi
ngsthatabsorbsound
•Ad ditionalpo werp l
ugp ointwo uldb erequi
red •Wallsan dcei
li
n gsshoul
db econstr
uctedofma t
er
ialswit
hh i
gh
forthep orta
b lex -
rayma chineclosetot he so
unda b s
o r
p t
ioncap a
bil
it
ies.
pati
en tcarearea. •Ceil
ings off
it
sa ndb af
fl
esh e
lpreduceechoe
dsoun ds
.
•Th eu nitmu sth aveanu ni
n t
erruptedc l
eanwa t
er •Do orwaysshouldb eoffs
et,r
atherthanbei
ngp l
ac
e dinsymmetr
ic
al
-
supplya ndeachp at
ientcareareamu st l
yo pposedp osi
ti
o ns,t
oreducesoundt r
ansmis
si
on.
al
soh aveawa shb asi
nwi thfooto relbowo pe
rat
- •Cou nter
s,part
iti
o ns,a
ndg l
assdoorsareal
soeff
ecti
veinred
uci
ng
edtap es. noi
selevels
Lighting:
•Th el i
ghtinga rrange
me ntshou l
d- provi
d euni- Natu
ralLi
ght
form, sha
d owi ll
u minat
iona ttheb aby'
slevel. •Natur
all
ighttoal
lbedr
oomsbyme ansofawindo
wPr i
va
cy
i
na dd it
ion,spo till
uminationsho ul
db ea vai
lab
le. •Vis
ualan
dac o
u s
ti
cpri
vac
yisre
q u
ire
db u
thighst
affvi
si
bi
li
tyi
ses-
Soun ds se
nti
al
.
•thei nte
n si
tyo fn ois
ek eptwell b
elow7 5d e
ci
- •Eac
hp at
ie
ntbeda n
dtoil
et
/showerar
eashoul
dhavepr
ovi
si
onsf
or
bels
. vi
sua
lpri
vac
yf r
omc as
ual
obser
vati
onbyotherpa
ti
entsa
ndvis
it
ors
.
Ro oms
•roo msfo risolati
ona ndp roce
d ure,keepingthe
x-
r a
ya ndu lt
ras ou ndma chines
.
Ventil
a t
ion:
•Mi nimu mo fs i
xa i
rcha nge
s,2a irchanges
shouldb eo ut
s i
d efil
ter
ingthein nerair
.
Paedi
atr
icsWar
d Equi
pment
s

P
aedi
atr
ic
sisthebra
n chofmedi
ci
nethatdea
lswi
ththe -Mini
mu me s
sent
ialmedic
al eq
u i
pme ntforpedia
tri
cinpa
ti
ent
s:
c
area
ndd ev
elo
p mentofinf
ant
sandchi
ldr
enandwith Resus
ci
tati
onc a
rtconta
ini
n greadi
lyacces
sible
,eas
il
y
t
hepre
venti
onandtreat
mentofthe
irdi
sea
ses
.AP ae
di- i
d e
nti
fi
able
,neces
sar
ywe i
gh t
-o rle
ng t
h-appropri
at
eemerge
ncydru
gs,
a
tr
icce
ntrei
sthere
foreahea
lt
h-ca
refa
ci
lit
yforch
il
- et
c.
d
ren.
BEDDI STRIBUTI ON:10-12% -Def
ibr
il
lat
ord e
sign
edf o
rp edi
a t
ri
cu s
ewi thp a
ddle
sfori
nfa
ntsan
d
chi
ldr
en
Qual
it
yofs
pac
e •Sc
•Th
al
e
e
r
sa
mo
nds
me
t
t
e
a
r
di
o
sa
me
n
t
db
erf
l
oo
ori
dp
n
r
f
a
e
s
n
s
t
u
sa
r
n
eme
do
a
s
l
d
ur
e
i
rc
n
h
gd
i
l
e
d
v
r
e
i
c
n
e
•Cardi
ores
pirat
orymo ni
tors
•Mo to
r-dri
vennebul
izer
san dele
ctri
cs u
ctionma c
hine
sifnosuc
ti
on
wal
lunit
sareavai
lab
le.
I
ndoors pace- Int
rav
enous,phl
ebot
o my,a
n dlumb arpuncturetr
ays
-
spa
cene
edstobecl
ea
n ,
ti
d y
,bri
ght
,co
lour
fula
ndspa- appr
opri
ateforchi
ldr
en.
c
iou
s. Back
boardforcar
diopul
mo naryres
u sc
ita
ti
o n
-
Maximu
md ayli
ght
ingandnotmuchar
ti
fi
cia
lli
ght
ing

Outdoorspace-
Pl
anni
ngf
orout
doors
pac
ein
clu
desthepro
vis
iono
f
pl
ayan
dwell
ela
bor
ate
dla
nds
capear
eas.

Playarea
-Pla
ygroundsareve
ryes
sent
ialc
omp o
nent
sinthehea
l-
i
n gandeducat
iona
lproc
essofchi
ldr
en
-Outdoorpla
y,the
rap
eut
icpl
a y
,dev
elop
mental
l
ya p
pro-
pri
ateac
tiv
iti
esandcr
eat
iv
eartthe
rapi
eshe
lpsth
echil
d
t
oc opewiththehea
lt
hcar
eexper
ien
ce.

I
nfluenc
ingFact
orsand
Des
ignI
mplic
ati
ons
•Pap
ooseboar
dfori
mmo bi
l
izat
ionofi
nfant
sandt
oddle
rs
Hospit
al
sh a
vees
tab
li
shedrou
tin
esandru
lestha
t
•Twent
y-f
ourhou
racce
sst
oa nel
ect
roc
ard
iogr
aphmachi
ne
maylea
dtop at
ie
nts
’hel
ple
ssn
ess
,la
ckofpriv
acy
,
•Wh e
el
chai
rs,
cru
tch
es,s
li
ngs
, a
ndspl
int
sforal
lpe
dia
tr
icag
e
po
o rwayfi
ndin
g,physi
ca
lbar
rie
rsan
dp o
orcommu -
gr
oups
ni
cati
onareamongtheas
pec
tstha
tint
ens
if
ythefee
l-
•Pul
seoxi
mete
rs
i
ngo fl
ackofcontr
ol.
Mat
erni
ty Depar
tment

Mat
ern
ityse
rvi
cei
ncl
ude
san
ten
ata
lca
re,
del
i
ver
y
a
ndpost
n a
tal
car
e.

Thei
n-p
ati
entuni
tsh
allc
ompri
se
:
(
a)de
li
ver
ysuit
euni
t
(
b)nur
si
ngunit
(
c)ne
onat
aluni
tandthe
ysho
uldbep
lac
edo
nth
esa
mef
loo
r.

NeonatalUnit
Fo
rpre
ma t
ure
,hi
gh-
ri
skb
abi
esa
nds
ic
kne
wbo
rns
:

-Premat ur
enur sery
Pre
ma t
urebab
iesar
eaccommo da
tedi
nin
div
idu
alh
eat
edb
ass
ine
tso
rin
cub
ato
rswi
tht
emp
era
tur
ean
dhu
mid
ity
contr
ola
n da
no xy
geno u
tl
etin
sta
ll
ed.
Flo
o rs
pacepe
rb a
ssi
net=3 .
5m2 .

-Septi
cNur ser
y
Babi
esknowntobeors
uspe
cte
dofbei
ngi
nfe
cte
dshal
lbeke
ptina
nisola
tedroo
mwithc
ubi
cl
es
.Th
eys
hou
ldb
e
segr
ega
tedfr
omnormala
ndp r
ema
tur
enur
ser
ie
s.Fl
oors
pac
eperba
ssi
net=3 .
5sqm.

-NormalNur s
ery
Aninde
pend
en tnur
ser
yforn
ormala
ndh
eal
th
yba
bie
sisn
otc
ons
ide
rede
sse
nti
al
.Ho
wev
er,
anu
rse
rywi
th2t
o4
bas
si
net
smayb epro
vide
d.
Flo
orspa
ceperbass
ine
t=3 .
5sqm

Deli
verySui t
eUni t Door s
Thedel
i
v e
rysui
teuni
tisl
oca
tedn
eart
oop
era
ti
ont
hea
tr
e. Doorsus
edfore
merge
ncybedtr
ansf
er
swith
intheUni
tortot
he Li
ghting
1del
i
veryroo
mp e
r12b e
ds. Bi
rthi
ngorOper
ati
ngUnit
smustbeapp
ropri
ate
lyp
osi
ti
oneda
nd Art
if
ic
ial
li
ghti
ngmus
tbec
olo
urco
rre
cte
dtoall
ows
ta
fft
oob
ser
ven
at-
si
zed
.Ami ni
mumo f140
0 mmcle
aropen
ingisr
eco
mme n
dedfor ur
als
kinton
esandd
immab
lefo
rni
ghtl
ight
ing
.
door
srequ
iri
ngbe
d/tr
oll
eyac
ces
s.
SizeOfTheUni t
Thenumberofbedswil
lbedet
ermi
nedbythef
aci
l
ity
’s
se
rvi
cepl
an.
Th epre
fer
redmax
imumnumb e
rofbedsi
n Acoustic
th
eMa t
erni
tyUniti
s20-25bed
sinorde
rtoacc
ommo - I
npati
entac
commo dat
ionsh
oul
db ede
si
gnedt
omini
mis
eth
eambi
ent
dat
eaddi
ti
onalr
oomssuchast
heGener
alCar
eNu r
ser
y, noi
sele
velwi
thintheunita
ndtra
nsmi
ss
ionofso
undbe
twe
enpa
ti
ent
ar
eas
,st
affar
easan
dp ubl
ica
rea
s
Di
agnost
ic
Dia
gnosisist
heide
ntif
ica
tionofthenat
ureandcaus
eofacer
tai
nphenomenon.Dia
gnosi
sisuse
di nmanydi
ffe
rentdi
sci
pli
neswi
thv
a r
iat
ionsint
heuseoflogi
c,a
nal
yti
cs,a
nde
xpe
rie
nce
t
ode t
ermine"ca
useandeffec
t".I
nsyst
emsengine
eri
ngandc
ompute
rscie
nce,iti
stypi
cal
lyuse
dt odet
ermi
nethecaus
esofsympt
oms,miti
gati
ons
,andsol
uti
ons

Pat
hol
ogy
Pat hol ogy ist hes tudyofdi se
a s
e.I ti sthebr idgebetwe ens c
iencea nd me dicine.It
unde rpinseveryaspectofpa t
ientca r
e,from diagnosticte
sti
nga ndt rea
tme nta dv
icetous i
ng
cutting -
edgegenetictechnol ogiesandpr e
ventingdi s
ease
.
Pa
Ge
thol
nera
ogyma
lPa t
ybedi
hology-i
vi
n
de
v
di
olve
ntos
sami
pe
x
c
t
ia
ur
l
istdi
eofa
sc
na
i
pl
t
i
omi
ne
c
si
a
nc
la
l
udi
ndcl
ng(
i
nica
butnotl
lpathol
i
mi
ogys
tedt
pec
o)
i
al
:
ti
esi nthe
Di
agnost
ic
oneUni tAna t
omi calPathol ogy–i n v
olvesthedia gnosi
sofdi s
e as
eba se
dont hemi cr
os copic,
chemi cal,immunol ogica nd mol ecularexa minati
on ofor gans,t i
ssues
,a nd whol ebodi e
s
(autops y);
1.Ana tomicalpathologyi si tsel
fdi videdi nsubs peci
alt
iesinc l
udingSur gicalPathol ogy,
Cyt opathologyandFor ensicPa thology.
2.Cl inical
/Che micalPa thologyi nvolvesdiagnosisofdiseas
et hroughthela borat
orya nalysi
s
ofbl ood and bodilyf luidsa nd/ort iss
ue susingt hetoolsofChe mist
r y,Mi cr
obiol ogy,
He ma tologyandMol ecularPa thology; Pat
hol
ogy Radi
ology

Radi
ology
Radiologyisthemedic
alspe
cia
ltythatuse
sme dica
limagi
ngtodi agnos
ea ndtrea
tdise
a s
es
withi
nthebody.A vari
etyofima g
ingt e
chniquessuchasXr ayr a
diogra
ph y
,ultra
sound,
compute
dt omogra
phy( CT),nucl
earme dici
nei ncl
udi
ng posi
tron emiss
ion tomography
Loadi
ngDock\
(PET),andmagnet
icre
sonanc
eimaging(MRI )areusedtodiag
nos eortre
atdiseas
es Centr
alSt
ores

Funct
ionalAr
eas
I
mpatientuni
ts
i
cuoperati
ng St
aff
/Speci
menent
ry Ci
rcul
ati
on Offi
ces
t
heat
res Reporti
ng

ThePa t
hologyUni twillconsistoft hefollowingFuncti
onalAre
as:
Recept
ion/
Speci
menSor
t
•Entry/Re cepti
ona r
eawi t
hpa t
ie ntwa i
ting. Admin
•Specimenc oll
ect
ionareaincludi ngpa tie
ntt oile
ts(thi
sareama ya
lsobeloc
ate
dr e
motely
in OutPat
ientEnt
ry
Ci
rcul
ati
on
Labor
ator
y St
ore
AmbulatoryCa r
ea r
eas)
;thec olle
c tiona r
eas hallhav
eaworkbench,s
pacef
orpati
entseat
ing
and
handwa s
hingf a
cil
iti
es. Wai
ting
Col
lect
ion Suppor
t
•SpecimenRe cepti
onregist
rationa ndsortinga re
a.
wc
• Laborat
ories,which ma yi nclude s peciali
stslabor
ator
ies Suppor tare
as,incl
uding
Clea
n-up,
Radi
ology
Patientwa i
tinga reass houl d bel ocated nea rthe
ma ine ntrancet ot hes erv i
c eand pr o
v i
dedi rec
t
accesst o dia gnosti
cr oomsa nd dress
ing r ooms .
Ce ntrali
zedpa tientc heck- ins houldbepr ov i
de dto
simpl if
yt hepa t
ientv isitf orpa tie
ntsa swe llas
pro v
idef ors taffe ffici
e nc y.Pa t
ientholdinga rea
s
should bel oc at
ed ne arhi ghv olumemoda lit
ies.
Ra diology Pr ocedure Rooms us ed f or qui ck
turn-a -
round,hi ghv olumee xaminati
onss ucha s
chest,a bdome n,a nde x
t remi ti
esshouldbel oca t
ed
closesttot here c
eptiona ndpa tie
ntwa it
inga reasin
ordert o de crease pa t i
e nt t ra
vel distancea nd
impr ovepa tientwa y -fi
ndi ng.Roomswi thl ong e
r
proce duretime ssucha sUl t
rasounda ndMRIma y
be s ome whatmor er emo v ed.Rooms wi thl ong
proce duretime ssucha sSpe cialProceduresma ybe
locatedf urt
he rf r
om t he ma inr eception a nd
wa it
inga reas
.

MRIScanni
ngRoom
MRIScanni
ngRoom
Heat
ing,Vent
ilat
ingAndAi
rCondi
tioni
ng Power
•Genera
l:3,200W ( Recepta
cles)
•InsideDesignCondi
ti
ons:70°
F-75° F(21°C- 24°)40% -
60% RH Coordi
natewit
hMRI
•480V,3pha se,f
lush-mountedc i
rcuitbreake
rwi ths hunttri
pf orMRIsys
tem.
Ma nufa
ctur
erMinimum Ai
rChange
spe rhour:12
Coor
dinaterat
ingwiths ys
tems upplie
r.
•SupplyAir100% Exhaus
t:No100% Out si
deair:NoRoom Ai
rBal
ance:Pos
iti
veDedic
ated
•480V,3pha se,fl
ush-mountedc i
rcuitbreak
erwi t
hs hunt-t
ripforcomput
err
oom
ExhaustSyste
m:Ye s– Note2 Occupancy:4 peopl
eAC Load-Equipment
:10,000 Btuh
A/Cunit( whenprovide
d).Coor di
na t
er a
tingwi t
hsys t
ems uppli
er.
(3,
000W)ACLoa dLighti
ng:2.
0W/SF( 21W/M2) .
•3DCpo we rsuppl
y(Re ct
if
ier)forMRISc anningRoom l ig
hting(whenpr
ovi
ded)
Li
ght
ing
Partiti
ons
•Gener
al:30fc
•The‘ par
entwall
’istypica
llyfra
me dands he
a t
hedt otheunders
ideofthede
ck
•Dualswitc
hedre
ces
sed,l
ense
dincande
sce
ntdownlightwi
th100W ,A21l
amps
.
abov
e .
•LED Do wnli
ght
ingoril
lumina
tedgra
phicdi
spl
ay.
•TheRFs hi
eldwallty
pical
lyst
andsindependentfrom t
he‘pa
rentwall
,
’oft
enwi
th
Gener al a2-inchgroundis
olati
onc a
vity
.
•Ce i
li
ng:Ac ousti
calCei
li
ngTileRFCe il
ingHe ight
:Coordi
natew/e qui
pment •Ifrequir
ed,pas
siv
ema gnet
icshiel
dingwouldbet ypi
cal
lybeinst
all
edbet
weent
he
•ma nuf
a ct
urerWa llFi
nis
h:PaintWa i
nscot
:-Base:Resi
li
entBase/Co veFloorFi
nis
h:Stat
ic par
entwa l
landthef i
nishwallal
ongwi t
htheRFs hie
ld.
Dissi
pati
ngFl ooringSlabDepress
ion:MR Ma nufa
ctur
erma yrequi
refloortr
enc
h/r a
ceway
Fl
oor
s
SoundPr ot
ection:NC40
•RFWi ndowf rom Cont
rolRoom toScanningRoom •Struct
uralsubfl
oor
,RFs hie
lding,prot
ect
ivelay
e ra
ndf i
nis
hma teri
als
.
•MRISc a
nne rRoom s
truc
turalsubfl
oorshouldtypi
call
yber e
cess
ed1t o2
Pl
umbi ngandMedi calGases i
nchestoa voi
dr a
mpedthres
holdsa tt
heMRISc annerRoom entr
y.
•Finis
hf l
ooringint
heMRISc annerRoom shoul
dbes eamle
sssheetmater
ialwi
th
•Pro
videnonf
err
ousmat
eri
alf
orpi
ping
,andha
nge
rsi
nsi
det
hes
hie
ldi
nge
ncl
osur
e
afl
ash-covebase.

Labor
ator
ies
Modernmedici
nei
sbecominginc
rea
singl
ydependentonlabor
atoryser
vicesforpr
eve
ntion,di
agnos
isa
ndc
ont
rolofdi
sea
se.
itg
ene
rat
epa
tie
ntr
ela
tedi
nfor
mat
iont
hate
nha
ncet
hede
liv
ery
ofhe
althc
are
.Thehos
pitalla
bora
toryconduc
ttest
sf ort
hediagnosi
s,progre
ssandres
ponsetother
apy
.

1)The res hould be s cope of f utur

ee xpansi
on. Modul ar Repor
tCent
re
str
uc tur
alsysteme nsuree a
seinf utureflexibi
li
ty.
2)Spe ci
alPl umbing,e l
ectri
ca la nd ant ivibrat
ion mea s
ures Wai
tingAr
ea
shouldbei ncorporated.
3)Da yli
ghttobeut i
lize
dma ximally. Speci
men
4)Itshouldbel ocate
dc losetoa cutepa t
ientcareandambulatory
care.
Mi
crobi
ology Cyt
opat
hol
og
5)Thepr ocessingareasne ednotbea ccessi
bletothe
patients
/publ i
cbutt hec oll
ectionpoi ntshouldbe .
I
mmunol
ogy Hi
stopat
hol
ogy
6)Thema i
nde terminantsofs pa ceinal aborat
orya r
etheextent
ofa utomationa ndtypeoft echnologyus edinit.As ta
nding
Bi
ochemi
str
y Hemat
ology
huma nbodyr e
quires4s qua r
ef eetspace,whereasasitt
ing
posturesrequires6squa refeetspa ce.
Sur
gicalDepar
tment
Themai
nsurgic
a lr
ooms/Opera
tionThea
tre(
OT)a
rea
ssi
ste
dwi
th
ot
hera
cti
vit
iesroom ,v
ita
lfortheope
rat
ion.

Ac
ces
sibi
li
tya
ndl
ayout
•
Itshouldbec l
oset otheintensiv
ec a
redepar
tment,t
herec
over
y
r
oom andthecentralste
ril
iza
tiona r
ea.
•
Surgi
caldepar
tme ntsarebestlocat
edcent
ral
lyinthecor
eare
aof
t
hehospit
al
•
Ther ece
ptionareaf oremerg e
ncyc as
es(ca
sual
ti
es)mustbeas
c
los
ea sposs
ibl
et othes ur
gic
a lar
ea.

Spaces

Pr
e-OT Ana
est
het
icsRoom
Rece
ptionarea •Room s izea ppr o
x i
ma tel
y3.80x3. 80m
Thereshoul
dbeas
mal
lre
cept
iona
reac
onne
cte
dwi
tht
her
ecor
dor •Clearwi dthofe lectri
cs l
idingdoor sintot heoperat
ingt he a
treis
st
orerooms. 1.40m
EntryRooms/HoldingArea •.
Ther oom s houldbee quippedwi t
har efriger
ator
,dr ainings ink
Room size15-20 sq.mforpre-OT pr
epa
rati
onsli
kec
athe
ter/ (sl
uice )
,rinsingl ine,cupboardsf orcannul as
,connectionsf or
gas
trict
ubeins
e r
tion,c
onnec
tionofmonit
orsetc
. anaesthesi
ae qui pme ntande me r
g encypo wer.
Thea naest
he ti
cr oom wi llprovideamor et ra
nquilatmos pheretothepa ti
entthant heOT.
Changi
ng&Staffrooms Itshoul dpr ovides pacefora naestheti
ct roll
eysande qui pme ntands houldbel oca
tedwi th
Menandwomenc hang
edr e
ssfr
omst
ree
tcl
othtoOTatti
re;l
ock
ers dire
c taccesst oc irculat
ionc orridorsandr ea
dya cc
esst ot heope r
atingroom.I twi l
lalso
andla
vator
yar
ee ss
enti
al;r
estr
oomTV,et
c.ar
edes
ira
ble. all
owc leaning,t e s
ting and storing of a naest
hesi
ae qui pment.Its houldc onta
in wor k
benche s
,s i
nk( s
) .Its houldha v
es uffi
cientpo weroutletsa ndme di
calg a
spa ne
lsfort es
ting
Wa shroom ofe quipme nt.
Onewa shbasina ndonewe st
ernc l
oset(WC)s houldbepr o
vided
for8- 10pe r
sons.Sho wersandt heirnumberisama tt
erofl ocal P
.A.
C.U
decisi
on.I ncl
usion oft oi
letfacili
ti
esinc ha
ng i
ngr oomsisnot Pref
e rabl
ya dja
centtor e
coveryroom.The s
es houldcontai
name dic
ati
onstat
ion,hand
acceptable
;theys houldbelocate
di na nadj
ace
nts pa
ce. washing stati
on,nursestati
on,s t
orages pacef orstr
etc
hers,suppl
iesand monitor
s/
Mi nimum wi dth oft her oom should be1.80 m a nd f
ore a
ch equipme ntandgas,s
ucti
onoutlet
sandv e
nt i
lator
.Additi
onall
y80s qft(7.
43sqm)f oreac
h
operatingtheat
ret her
eshouldbet hre
enon-spl
ashwash-bas
inswith pati
e ntbed,clear
anceof5f t(1.
5m)be tweenbe dsand4f t(1.
22m)be t
wee
npa ti
entbed
footc ontr
ols
. si
desa nda dja
centwall
sshouldbeplanned.
 Corridorsnotl e sstha n2. 85m wi dt hf ore asymo ve
me ntofme n,s t
retcher&ma chi nes
Separatecor ridor sforus esot hert ha ng oingintoOT.
Roomsf ordif ferentpe rsonswor kingi nOT&f ordifferentpur pos e(itshouldbea spe rzone
&s i
z e)
Gas& s uc ti
on( control ,suppl y& e me rg encyst ock)fora llOTs& a r
easwhe r
epa tie
ntsa r
e
ret
ained.Ox yge n,g asa nds uctionpi pet obec onne ct
edwi t
hc ent ralfaci
lityands tandbyl ocal
faci
lit
ys houlda l
s obea vail
able .
Provisi
onf ora de quate&c ontinuouswa tersuppl y:
Besi
de snor ma ls uppl yofa vailablewa tera tther a
teof400l itre spe rbedpe rda y,as eparat
e
res
ervee me rgenc yo ve rhe adt anks houl dbepr ov i
dedf orope rationt heatre.Elbo wt apsha v
e
tobe10c m.a bo v ewa shba s
ins .
Properdr ainag es ystem.
Pre-operativea r eawi thr eceptionwi ths epara
t ede s
igna t
eda r eaf orpa ediatr
icpa ti
entsis
desi
r a
ble.
Adequa tei l
lumi nationwi t
hs ha do wl essl ampsof70, 000-120, 000Lume nsint ensit
y,for
ass
essingpa tientc oloura ndt i
s s
uev isibi l
ity(discussedunde r"Li ghti
ng ").
Oper at
ionr ooms: Thes af
e t
yi n wor kingpl acei se s se
nt ial,and f ir
ee xtinguishe rsha vet o bepl annedi n
Thenumber&s izecanbeasperther equi
rementbutre
c omme ndedsizeis6.5m x6. 5m appropriatez one .
x3.5m.Gl a
sswindowscanbeplannedonones i
deonly. Provisi
onf ore xpa nsionoft heOT c ompl e xshoul dbebor nei nmi nddur i
ngpl annings tage
s
it
self.
Doors:Ma i
ndoort otheOT compl e
xha stobeofa dequa t
ewi dt
h( 1.
2t o1.5m) .The Itisobs er
v edt ha toutofa lls urgica lbe ds,oft hehos pital,50% ofpa tientsaree xpecte
dt o
door
sofe a
chOTs houl
dbespri
ngl oadedflapty
pe,buts l
idingdoorsarepre
ferr
eda sno undergos urger y.Thusf or100be ds ,wi tha vera
g elengthofs t
a yof10da ysforeac hpa t
ient,
ai
rcurre
ntsarege
ne r
ate
d.Allf
itt
ingsinOT s houldbeflusht ypeandma deofstee
l. 10ope rationspe rda yc anbepe rfor me d.

Thesurf
ace/f l
oor
ingmustbesli
pr e
sist
ant,str
ong& i
mpe r
viouswithmi ni
mum j
oints
(e
g.mosaicwi t
hcopperplat
esf oranti
sta
t i
ce ff
ect)orj oint
les
sc onducti
vet
il
e s
/
t
erra
zzo,linol
eum et
c.,The re
comme nded minimum conducti
vit
yi s 1m ohm and
maxi
mum 10m Ohms .

Pre
sent
lyt
heneedf
ora
nti
sta
ticf
loor
ingha
sdi
mini
she
dasf
lamma
blea
nae
sthe
tica
gent
s
ar
enolongeri
nuse
.

Wa l
ls-Laminatedpolyes
terors moot
hpa i
ntprovidessea
ml e
sswa ll
;til
escanbreakand
e
po xypaintcanchipout.Collus
ioncorner
stobec over
edwi t
hs te
eloralumini
um pla
tes,
c
olourofpa intshoulda l
lowr e
fle
cti
onofl i
ghtandy etsoothingtoe yes
.Lightcol
our
(
li
g htblueorgr e
en)wa shabl
epa i
ntwillbeide
al.A semi-mattwallsurf
acere
flec
tsles
s
l
ightthanahig hl
yg l
ossfi
nishandislesst
iri
ngtot heeye
sofOT t eam.

Oper
ati
ont
abl
e:Oneoper
ati
ont
abl
eperOT

Ele
ctri
cpoi
nt:Ade
qua
tee
lec
tri
cpoi
ntsont
hewa
ll(
at< 1.
5m he
ightf
rom t
hef
loor
)
(di
scus
sedl
ate
r)

X-
Ra yi
ll
umi
nat
ors:
The
res
houl
dbeX-
rayf
il
mil
lumi
nat
orspr
efe
rabl
yre
ces
sedi
ntot
he
wa
ll.

Sc
ruba
rea:t
obepl
anne
dfora
tle
astf
or2-
3pe
rsonsi
nea
chOT. Ty
pic
alOT c
ompl
exl
ayout
Ste
ril
egoodsroom
10m²i srequi
redperoper
ati
ngthe
atr
e .
Ther
emustbesuff
ici
ents
hel
fandc
upboa
rd
spa
ceanditmus tbea
cce
sse
ddire
ctl
yfrom t
heope
rat
ingt
heatr
e.

Equi
pmentr
oom
Roomsi
zeofappr
oxi
mat
ely20m²f
orv
ari
ouse
qui
pme
ntus
edi
ntheope
rat
ivea
cti
vit
ies
.

Recor
dorSt orerooms
Theoffi
ceshoulda l
lowacce
sstobot hunr
est
ric
tedandsemi-
rest
rict
edar
easa
sfre
que
nt
communica
tionwi t
hpublicisneede
d.
Thisisdesi
g nedtos t
orelarg
ebutl essf
requent
lyusedequipmentintheOT.Ther
e
shoul
dbestor a
gespaceforspeci
alequi
pmentafte
rcle
aning
.

Scrubroom
Thisisplannedtobebuil
twi t
hintherestr
icte
da rea
.Elbowope rate
dorinfraredsensor
operat
edtaps/wa t
ersourceiside
al.I
tise ss
entia
ltoha venons l
ipper
yflooringinthis Anaest
het
icr
oom
ar
ea
Scrubroom shal
lbeapproximatel
y9.25s quareme t
ers.Faci
lit
iesmustincludeas cr
ub Post
-OT
si
nkf oratlea
st3people,withhandsfreeoperablecontr
ols.Thereshal
lbeag l
oveand Thenumbe rofbedsre
quiredi scal
culat
eda s1.5
gownbe nc
hort r
oll
eyseparat
edf r
om thesink. timest
henumberofope r
atingt he
atre
s.
•Anur se'
smonit
ori
ngpos i
tionmus tbepr ovi
dedfrom
whichallt
hebedscanbeseen.De sig
nss houldal
low
i
nda yl
ighttohel
pthepatie
nt stoorientat
e
themse
lves
.
Mai
nOT •Adjoi
ningisasmal
lslui
cer oom withdrainagesi
nks
•Theope ra
tingthea t
res houl dbede signedt obea ssquar eas
poss i
ble
Exi
tRoom
•Sui tablesizewoul dbe6. 50x6. 50m,wi thac l
earheightof3. 00
Exi
troomsofa
rea15s
q.mi
sre
qui
redpos
ttheope
rat
ion
ma nda ne xt
rahe ig
hta llowa nceofr oug hly0.70m f ora ir
condi t
ioninga ndot herse r
v ices.
•Conne ct
ionsforv acuum li nes,ni trouso x
idea nde me r
ge ncy
powe rmus tbepl aceda tl e
a st1. 20m a bo vef l
oorl ev
el. Di
sposal
The aterma ybel argerde pendi ngont her equirement;roomsf orc ardio
v a
scula
r, Disposala rea
sfr om ea c
hOR &c orr
idorlea
dt odi sposal
orthope dic,neurologicala ndot hers pe cialpr oce
durest ha
tr e
quirea dditi
onal zone.
personne l Theres hallberoom t owa s
hdo wnt r
oll
eys,containe
r sf
or
and/orl ar
gee quipme nt
,whe ni nc l
ude dt hisr oom shallha veina dditiontot he dir
tyline n,rubbis handdirty
abov ea ins
trume nt.
mini mum c leara reof56 s qua reme terswi t h ami nimum of6 me t
erc l
ear -The s oil
ed wor kr
oom s hal
lc onta
in af lushing ri
m,
dime nsion drai
ner,as lophoppe rorother
exclusi
v eoff i
xedorwa llmount edc abine tsandbui ltins helves. provi
sionsf ordis posalofli
quidwa s
te.
-Whe nope nhe artsurgeryi spe rforme da na dditi
onalroom i nt here s
tric
tedarea -The r oom s ha l
l not have dire
ctc onne c
tion with
oft hes urgic
alsuitpr ef
er ablya dj oi
ni ngt hisope rat
ingr oom s hallbede si
gnated operat
ingr oomsorot hers
ter
ile
asapumpr oom whe r
eex tracor por e
a lpumps ,suppliesanda cce ss
oriesa r
estored act
ivit
yr ooms .
Ser
vicesoft
heOT
Vent il
at ion
Ve ntil
ations houl dbeont hepr inciplethatthedi rec
tionofa irfl
owi sfrom
the ope ra t
ion t heatr
et owa rdst he ma ine ntrance.
The res houl
d be no
interchang ea i
r mo vement be tween one OT a nd a nother. Effi
cient
vent i
lat
ion wi l
lc ontrolt e
mpe raturea nd humi dit
yi n OT,di lutet he
cont amina ti
onbymi c
ro-organismsa nda naest
he ti
ca gents
.
20- 30a ire x
cha nges/hourf orr e
-circula
teda ir
Onl yupt o80% r eci
rcula
tionofa irtopr ev
entbui ldupofa naest
he t
icand
othe rgase s
Ul tracl
eanl amina rairflow-t hef i
lteredairde l
iverymus tbe90% e ffi
cient
inr emo vingpa rticl
esmor etha n0.5m m.
Pos it
ivea irpressuresystemi nOT:I tshoulde nsureapos it
ivepres
sureof5
cm H 2O f rom c ei
li
ngofOT do wnwa rdsandout wards,topushouta i
r
from OT. Fact
orsaf
fect
ingt
heno.ofOTs
Elect r
icalsuppl y
Us eofc ircuitbreak e
rs/i nterrupte
rsisdesir
ableifthe r
eisano ver
loadorgr oundf ault
.
Powe rlineof220Vol ts
Suspende dc e
ili
ngout letsshouldhavelockingplugstoa voi
da cc
identaldis
conne ct
ion.
Insulat
iona roundc eil
inge lectr
ica
lpo wersourcesshouldwi t
hstandfrequentbe ndingsandfle
xings
.The y
shouldnotde vel
opc r
acksa nds houldnotda ma gewires.Wiresinsi
der ig
idorr etra
ctabl
ecei
lingservi
ce
columnc anhe lptos omee xt
ent
Wa llout l
e t
st obei nsta
lled1. 5m aboveground( asalr
e a
dyme nti
oned).
Us eofe x plosi
onpr oofpl ugs.
Mul ti
pleout le
tsfrom di ff
erentele
ctri
calli
nes ource
ss houl
dbea vail
able.
Electri
ca lloadc a
lculati
ons houldbeba se
don,e quipmentsli
kelytobeus edanda ppropria
tecur
rentcarr
ying
capacit
yc ordstobeus ed.
Eme rgenc ypo wer:OTe lect
ricalnet
worksne e
dt obec onnect
edtot heeme r
gencyg enerat
orswi
tha ut
oma ti
c
Lighting
Ge ne
rallighti
ng:Col ourcorre
ctedfl
uoresce
ntlamps(r e
ces
sedorsurf
acece i
li
ngmount ed)topr
oduceeven
il
luminationofa tl
ea st500Luxa tworkingheig
ht,withminimalg
lar
ea r
epr efe
rre
d.
About2000Luxl ightisneededtoassesthepati
entscol
our.
Ov er
headl ig
hts houldbes hadowles
sa ndgive25000-125000Luxofl ight(50000t o100000Luxa tthe
centr
ea nda t
least15000Luxa ttheperiphe
ry).
Lightsshouldbef reelymo v
ablebothinhor i
zontalandver
tica
lra
nges.Pendantsyst
emsa repre
fer
red.OT
li
ghts houldpr oducebl uewhitecolourofda yl
ightatspectr
alene
rgyra ngeof50000K ( 35000-67000
kelvi
na ccepta
ble)
FireSaf ety
Fir
eSa fet
y
Bothi oniz
ation and optic
alf ir
ede te
ctorsshould beprov
idedintheoper
ati
on the
ate
rsinst
ead he
at
det
ectors,sinceequipmentorientedoperat
ionthe a
tersar
clike
lytocrea
temoresmokethanheatinthe
eve
ntua l
it
yoff ir
e.Hy drant
sa ndf i
reext
ingui
shersshoul
dbeprovi
ded.
Thefi
reexi
trout
eshoul
dbec l
ear
ly
ide
ntif
i e
d,earmarkeda ndwe l
l-il
lumina
ted.
Ot
herr
elat
edspacesandser
viceswi
thOT
Pip[e
dg as
esinOT.
Automati
c/s e
mi -
automat
icfai
lsaf
ema nifoldr
oom t
obede s
igne
d.
Cle anroom t e
chnologya ndAircondi
ti
oning
Twoout l
etsforO 2a ndsuct
ionandonef orN 2O areaminimum i
nea
chOT.
•Toma int
a intheh ygi
e neoftheoper
ati
nge quipmenta nareaofa pprox
imate
ly3.00x
Pipel
inesupplysyste
ms houl
dbea blet
oc utofff
rom mai
nlinei
ftheprobl
em oc
cur
s
3.00
anywher
ea l
ongt hedeli
ver
yhosing/tubing .
ms houldbea ll
o wed.
•Thea irc onditi
onings ys
tema l
soreducest helev
e lofa i
rborneg e
rmsbyf il
teri
ng,
dilutingandc ompr ess
ingtheair
•15- 20a irchang e
spe rhourarere
qui
redtoe nsur
ea dequa
tedecontaminat
ionoftheair
betwe enope ra
tions

Nurses'lounge
•Thedi mensionsofthi
sroom dependonthesi
zeoft
hesurg
icalde
partme
nt.
•Itshouldbea s
sumedthatt
hereareei
ghtmember
sofst
affpersur
gic
alte
am( doc
tor
s,
t
heatrenur s
es,anes
thes
ianur
ses).

Nurses'works
tat
ions
•The s
es houl
dbel oca
tedc
ent
ral
lya
ndha
vel
arg
egl
asss
cre
enst
oal
lowt
hewor
king
cor
ridortobev i
ewed.
Dic
tat
ionroom
•Nolarg
ertha
n5m²i
nsi
ze,s
uchr
oomsa
rewhe
ret
hedoc
tor
spr
epa
rer
epor
tsf
oll
owi
ng
anope
rati
on.
Zone
sofa
nOT
Pharma
cy (1)Protecti
vezone:Itincl
udes
•A20m²pharmacyc
ans
uppl
yac
ombi
nat
ionofa
nes
the
tic
sands
urg
ica
lme
dic
ati
ona
nd Changer oomsfora l
lme di
calandpa
ramedi
cals
taf
fwi
thc
onv
eni
enc
es
othe
rmate
ria
ls. Transfe
rba yforpatie
nt,mater
ial&equi
pments
Roomsf ora dminis
tra
tives
taff
Store
s&r ec
ords
Ba
sict
hre
ety
pesofOT uni
ts: Pre&pos t
-operat
iverooms
Thes ing
let heatres uit
ewi t
h OT,s crub-up and gowning,a
naesthesiaroom,troll
ey I.
C.U.a ndP.A.C.U.
prepar
ati
on,ut i
lit
ya nde x i
tbayplusstaffchangeandl i
mi t
edanci
ll
a ryaccommodati
on. Ster
ilestore
s
The twint he a
tres uite withf ac
ili
tiessimil
art o 1,butwi th duplicate
da nci
ll
ary
accommodation imme diatetoe ach OT,s ometimessharingas mallpos tana
e s
thes
ia (2)Cl eanzone:Conne ctsprot
ect
ivez
onet
oas
ept
icz
onea
ndha
sot
hera
rea
sal
sol
ike
rec
o v
eryarea
. Stores&c l
eanerroom
OT c omplexesoft hr eeormor eOTswi thancil
lar
ya ccommodation incl
udi
ngpos t Equipme nts t
oreroom
anaest
hes
iarec ove
ry,r ec
e pt
ion,porte
r’sdesk,st
eril
estoreandsta
ffc hange Ma i
nt enanceworks hop
tme mbersofs taf
fpe rsurgi
calteam(doc t
ors, Kitchenette(pantry)
theat
renurses,anest
he si
anur ses
). Fire
fightingdevicer oom
Eme rgencyexits
Serviceroom forst aff
Pendantse
rvi
ces.
Closec ir
cuitTV c ontrolare
a
Twoc ei
li
ngpendantsforpipe l
ineser
vicesshouldbedesigned;oneforsurgica
lteama nd
oneforanaes
thet
ist.Ana e
s theti
cpendants houldberet
ractableandha
v elimit
edlatera
l
(
3)As
ept
icz
one-I
ncl
ude
sope
rat
ionr
ooms(
ste
ril
e)
mo ve
mentandprovideashelff ormonitori
nge quipment.Itshouldhav
eo x
ygen,nit
rous
oxide,f
ourbarpressureme dicalcompress
e da i
r,medic
a lvacuum,sca
ve ngi
ngt e
rminal
(
4)Di
spos
alz
one-Di
spos
ala
rea
sfr
om e
achOR &c
orr
idorl
eadt
odi
spos
alz
one
.
outle
tsandatl
eas
tfoure l
ectricsocket
s.
Emer
gencyAct
ivi
ty Toi
scr
e
l
e
et
sf
ne
orbot
df r
hs
om t
exesa
hepubl i
de
cv
qua
ie
t
e
w,
ly
Inpl anni ngt heEme rgencyAc tivi
t y
,pa rticulara ttentionmus tbepa idto tel
ephone sensuringpr ivacy,vendi ng
mo v eme nt sofpe opl e( patient sands taff
)a ndma teri
a l(equipme nta nd machineswi thbev erage sors nacks ,
suppl ies). Thef ir stpr i
ori ty,ofc ourse,mus tbet hemo veme ntoft hos e comfortableseati
nga rr angeme nts( not
pa t
ie ntswhor equi rei mme diateorur g
entme dic alattentiona ndt he benches)a l
lcontribut et ophy s i
cal
respondi ngme mbe rsoft heme dicals t
aff. Thet i
mef actorint ermsof comfort. Theg ener alde signoft he
mi nut esc anma ket hedi fferenc ebe twe e
nl ifea ndde ath.Al lne cessary waiti
ngs pace(includi ngc olor
,t exture,
equi pme nta ndl ifes a
vinga ppa ratusmus tbel oc atedi nde s
igna teds pac e
s decor,acoustic
alc ont rol)a llcontribute
soa snott oi mpe det hemo v eme ntofs taffy etber eadilya ccessiblewhe n tothewe lfareofwa iti
ngpa tients.The
nee de d. publicwa it
ingareas houl dbes cree ned
TheEme rgencyAc ti
vitys houl dbel ocatedont hegr oundf loort oe nsure vis
uallyfrom incomi nga mbul ance s
easya cces sforpa tientsar rivingbya mbulanc eora uto.As epa ratee ntry disc
ha r
gingpa ti
ent s.Ada y
light
forwa lk- inpa tient sisr e
qui re d. The see ntrance s,whi cha res eparate windowt ot heout sidei sof tende sirabl
e
from t heOut pa t
ie ntAc t
ivity,mus tbee asi
lyi de ntifi
able,pr ot ec
tedf r
om butc ar
es houldbet ake nt oa v
oid
incleme ntwe ather,a nda cc essiblet oha ndic a
ppe dpa tients.The locat
iont hatwillfoc usa t
t e
ntionoft he
eme rg enc yf aci
litya l
somus tbee asilyaccessiblef rom t hehos pitalto pati
entsona mbula ncea rr
ivals
pa t
ie ntsa ndt ot hehous es taffpe rformingt he irr outinedut ie sorbe i
ng
summone df orc ons ultati
onore me rgencya ction. Tre atme ntFac i
litie
sPa t
ientsa retre
ated
ins pa c
e ssurroundi ngt henur sing
station,t hehubofa l
lactivit
ies.This
stationi sba c
ke dupbyt heme dical
PublicSect orAr eas prepa rationroom a ndt heof f
iceoft he
.Entra
nc eforpa tientsar
rivi
ngbyambulanc
e, chiefnur sewhos upe rvi
sesa l
l
othe
rmode soft ransport
ation,orc
onvey
ances ope rations. The ref
or e,ag laz
ed
.Entra
nc eforwa lk-inpatie
nt s par t
itioni spr ovidedwhi c hens ur
es
.Controlstation acous ti
c alprivacya nda ffordsv is
ual
.Publi
cwa i
ti
ngs pacewitha ppr
opr
iat
epubli
c cont rol.St affa meni ti
esinc l
udet oil
ets
,
amenit
ies loung e,a ndloc kerr oom forf emalestaf
f
TreatmentFaci l
ities .Loung ea nds leepinga ccommoda ti
ons
.Pati
ents'obse rv
a t
ionroom arepr ov idedfort hre efull-t
ime
.Tre
atme ntcubi cle
s phy sici
a nsandr esi
de ntme dicalstaff
.Examina t
ionr ooms whoof t enwor kl onghour sand,
.Castroom althoug hnotc ont i
nuous l
y ,areonc all.
.Crit
icalcarer ooms
Thec astroom,us edforc l
osedreducti
onoff ract
ures,isequippeds i
milarl
ytoat reatmentcubicl
ewi t
hthe
additi
onofapl a
s t
ers i
nka ndtrap.Allsuppli
es,spli
nts,andf r
actureframesarekepti ntheroom .The
AnEme r
g encyAc ti
vit
yma yals
oincludeapa t
ient'ssecur
ityroom and doormus tallowpa ss
ageofapa ti
entonas tre
tcherwho,a ft
ertreatment,maybei mmobi li
zedbyme a
nsof
areaspro
v idingsupporti
veser
vice
sa nds taf
fa cc
ommoda tions.pol
ice orthopedicacce
ssoriesanda t
tachmentstothes t
retc
her. Thepa ti
ent'sobserv
ati
onr oom mus tbeinfull
room maya l
sobeus edbyreporte
rsa nda tt
orneys.I mme diat
eme mbers vie
woft henursingstation.Privac
ybe twee
npa ti
entsma ybea chi
e ve
dbyac ubic
lec urt
ain.Toilet
sfor
oft hefa
mi l
yma yreti
retothefamilyr oom pendingtheout comeof boths e
xesarepro v
ided.Nur ses
'wor kcounter
sa r
ea teachendoft heroom .Thee ntir
eEme rgency
me dic
alinterventi
oninvolv
ingalife
- threa
teni
ngs ituat
ionofapa t
ient; Activi
tyise a
sil
ya cces
siblefr
om thehos pi
talandthex -rayandlaboratoryfaci
lit
ieswhi c
h,locate
dbe t
ween
here,doctors. thetwoa cti
vit
ies
,a resharedwiththeOut pati
entAc ti
vity
Emer
gencyDepar
tmentSt
andar
ds
Recept
ion/
Wai
tingAr
ea
Consi
der
ati
onsf
orDesi
gni
ng
•Mi nimum fl
oora r
ea:4.4m2/1000att
endancespe
r
annum I
nter
nalFunct
ionalRel
ati
onshi
ps
•Chi l
dren
’swait
inga r
ea:6m2/1000pa e
diat
ric •Ent rance/wa i
tingroom/r ecepti
onar e
a
att
endancesperannum •Triagea rea
•Mi nimum ofthreeseat
sperpat
ientt
reat
ment •Re suscita
t iona rea
cubic
le. •Me nta lhe altha s
sessmentar e
a
•Ac utet re
a tme ntarea
Cor
ridors,Entr
ancesandExi t
s •Cons ul t
ationa re
a
•Al
lcorr
idor
sandent
ranc
esore
xitss
houl
dal
lowt
wot
rol
ley
stopa
ssunhi
nde
red •Adj unc t
ivea r
eas(x-ray,ShortStayUni t(
SSU),
al
lie
dhe alth,i nvest
igati
onsr oom)
Pat
ientTr
eat
mentSpaces •Staff/a me nitiesarea
s
•Admi nist
r ativeareas
•Ope npl ande s
ign
•Stor a
g eare as
•Mo veablecubiclediv i
ders
•Cle anpr epa rati
ona nddr ugpr e
para
t i
onroom(s
•Re s
uscitati
onc ubiclesrequir
ea dditi
onalspac
ebecaus
eofthenumbe r
sof
•Dir tyut i
litya nddi sposalareas
pers
onne lworkings imultaneousl
yi nthesespac
esandthespa
cetakenupwith
•Patienta me ni
tiesareas
res
uscit
atione quipme nt
•Toilet( st
a ffa ndpa ti
entinc l
udingfordis
abl
ed
•Chi l
dren’streat
me nta r
easrequirespaceformedi
calequi
pment
,f l
oorspa
cefor
pat
ients )andba throom/s hower
thechil
d,t oysands pa c
ef orfamilyme mbers
fa
cil
i t
ies
•Mi nimum f l
oora reape rpati
entc ubicl
e:16m2
Ext
ernalFunct
ionalRel
ati
onshi
ps
Resusci
tat
ionAr
ea
•Hospitala ccess/egr es
s
•Suf ficients pacet oe nsure360de gre ea cce s
st ot hepa tie
nt
•Ac l
oser elati
ons hipt ot hema i
ne nt
ranceoft hehospi t
al,forwayf
indi
ng
•Por ta blex -ra ya c
qui si
tion
•After-
hour sac cessa nde gress,andpa rking/publictransport
•Vi sua la nda uditorypr ivacyf orpa tient s,relativesands taff
.
•Accesstoi nvestigativemoda l
ities
•Ful li ndi vi
dua lphy si
olog i
ca lmoni tor ingi nc ludingECG,NI BP,Ox y
ge n
•Radiologya ndot hers pecialinvestiga
tiveunits
sat
ur ation,c oret empe rature,in v
asivemoni toring,e nd-tidalCO2moni tori
ng,et
c.
•Ultras
ounda ndCTs canning
•Ve nt i
lator s:The r
es houl dbeonev ent i
l atorf ore achresuscit
ati
onba y.
•Closepr oximityt oot hera cutes ervi
ces
•Thr eeo x ygenout l
ets,wa llmount eds uc tion
•Reservedc arpa rkingf oron- calla na
estheti
sts,obste
tricia
ns,sur
geons
•Re sus citatione quipme nti ne achs pac ef ori ntuba t
ion,de f
ibri
llat
ion
•Angiographys ui te
•wi the xterna lpa ci
ngc apa biliti
es,c annul ation,e tc.
•Highde pe ndenc yuni t
•Se rvic epa ne lwi thami nimum oft we l
v ee lectricalsocketsandfourCa tegory5
•Corona r
yc are
socket s
•Inte
nsivec are
•Equi pme ntoro verhe a
dr ailt oha ngI Vf luids
•Ope r
atingt heatre
•Ha nd- wa shingf a
ciliti
es
•Clearune ncumbe redr out etowa rds.
•Ti mi ngf aciliti
es
•Functionalr e
lations hi
pswi thot heraspectsoft hehospitalimport
antint
hee
vent
•Ope ra ti
ngt he atr
equa litylight
ofmassc asualtyinc i
de nts:
•Wa llmount edopht halmos cope/ot osc ope
•Communi cati
ons /c omma nd/me di acentr
e
•Ov erhe adX- r
ayg antryora lternativei mme di ate
lya cc
e ss
ibleimagingsystem
•Outpat i
ents( f
ora mbul atorypa tient
s)
•Cl inic alwa st efacil
ities:shar psandc linic alwa ste
•Ope na r
ease .
g .carpa rksf orma s sdecontaminationrequiri
ng
•Mi nimum f loora rea:25m2pe rresus citat i
onba yexcludingstoragespace
st
ate
/reg i
ona leme rgenc yse r
vices
Emer
gencyDepar
tmentSt
andar
ds
Speci
alFunct
ionTr
eat
mentRooms
•De si
gna t
edr oom forENTe xaminat
ion
•Qui e
tr ooms
•Opht halmologya s
s ess
me ntroom
•Intervie
wr oom fors ocialcar
e
•Privat
er oom forgy naecology/i nt
imateexami
nat
ion
•Plast
e rapplicat
ionr oom,wi thappropri
atewas
tedis
posal
•Procedureroom wi thope rati
ngtheatrest
andar
dli
ghtingfors
uturi
ng
andwoundc are
•Mi ni
mum f loora r
e a:16m2
•Addi t
ionalspa c
ema yne edtobea ll
ocat
edtotheENTa nd
Ophthalmica sses
sme ntroomsduet otheextr
aequi
pmentr e
qui
red

Admi
nist
rat
ionandSt
affAr
eas
•StaffDut yBas
e:10m2or1m2f ore a
ch1000pa t
ienta
ttenda
ncesper
year
,whicheveri
sthelarge
r
•Mi ni
mum f l
oora r
eaforstor
age
:2.2m2/1000pa t
ientat
tendanc
espe r
annum
•Mi ni
mum f l
oora r
eaforstaf
fref
reshmentroom:0.8m2/1000pa t
ient
att
endanc
e sperannum
•Mi ni
mum f l
oora r
eaforadmini
str
ativefunc
tion:4m2/1000pa tie
nt
att
endanc
e sperannum

Consul
tat
ionRooms
•Eachc ons ultationr oom s houldha ve
:
•2o xygenout lets
•Wallmount e ds uction
•As ervi
c epa ne lwi tht ene l
ectri
calsocketsandf ourCategor
y5s
ocke
ts
•Apa tientt rolley
•Patie
ntc hai
r
•Swivelc hair/s t
ool
•Hand- wa shingf a c
ilitie
s
•Patie
ntdoc ume ntatione quipme nt(writ
ingboa rds/des
k)
•Comput erte rmi nala nddi agnosti
cima gevi
e wingf a
cil
it
ies
•As urgicallig ht
•Awa ll-mount edopht halmos copeandot osc
ope .
•Apa nicbut ton
•Accesst odr e ss
ing sa ndwoundc a
reequipme nt
•Sharpsbi n
•Clinic
a lWa st edi s
pos albi n
•Alltreatme ntc ubi clesshouldha v
ea nident
ic a
ll a
yout
Physi
other
apy
•Phy
siot
hera
pyisthetr
eatme
ntofdi se
ase,i
njur
y,ordef
ormi tybyphys
ica
lmethodssuchasmassa
ge,hea
ttr
eat
ment,a
ndex
erc
isera
thert
hanbydrugsorsur
ger
y.
•Aphysi
other
apyser
vic
easse
s s
es,de
alswithandprev
entsproblemsofmobil
it
ya ndfunct
ionusi
ngnatur
ala
pproa
ches
.The
searebas
edess
ent
ial
lyonmo v
ement
,manua
l
t
her
apyandothermodal
iti
essuchasvari
ousformsofele
c t
rothera
py,c
ryot
her
apya ndhydr
othe
rapy.

Funct ionalAr eas Physi

calTher
apyExer
ciseAr
eaCal
cul
ati
on(
inNetSq.Feet
Thef unda mentalre
quir
eme
ntforany
physi
ot herapydepart
menti
ncl
udesthe
fol
lowinga r
eas:
•Rece pt i
ona r
ea
•Staffs pa c
e
•Exami ningroom
•Treatme nta r
ea
•Toiletf aci
lit
ies
•Storag e

Desi
gnGui
del
ines
Location
•Theareasel
ect
edforphys
ica
ltherapyshouldbecent
ral
lyl
ocate
dtomi ni
misepr
obl
emsoftrans
port
ingpati
entsandtofa
cil
it
ategi
vingbeds
idet
rea
tme
ntwhe
nne
ces
sar
y.
•Spec
ialat
tent
ionshoul
dbegiventoa c
cessi
bil
it
y,andtoha
vingasfe
ws te
psasposs
ibl
e,asf
ewlongcorr
idor
sa ndheav
ydoorstonegot
iat
e.
•Agroundfloorloc
ati
on,c
onvenie
ntforbothina ndout
-pa
tient
sandforacc
esst
oa nout
doorar
eaisre
comme nded.
InteriorFinish
•Thea cti
vit
yofpa tie
ntsinwhe e
lchai
rs,onst
retchersandc r
utchessubj
ect
sfloorsandwa ll
stoheavywear.Mater
ial
swhichwil
lsta
ndupundersuc hroughusa
ge,r
ema
in
att
rac
tiveandr e
quireami nimum ofma i
nte
nances houl
dbes pecifi
ed.
•Allinter
iorwallsurf
acesoft hede par
tmentshouldha veadurableandatt
racti
vewainscottoprot
ectthe
ma gai
nstdama
g ebywhee
lcha
irs
,st
ret
chersandcarts.
•Theus eofde cor
ativ
ecol orsforinte
riorf
ini
shesa ndequipmentis,ofcours
e,highlydesi
rabl
einthisdepar
tment.
•Hospi t
alshandwa s
hingla v
atori
eswi t
hhotandc ol dwate
rmi xingoutl
ets
,prefe
rabl
yf ootoper
ate
d,shouldbeloca
tedatthepr
operhei
ghti
nc on
venientpla
ces.

Vent il
at ion
Adequa te,contr
olle
dv e
ntil
ati
onisofext
r e
mei mportanceinaph ys
icalt
hera
pyde partment.Manyoft hetreat
mentprocedur
esrequir
etheuseofdryormoi s
the a
t,oracti
ve
exer
c i
se,whi chrai
sebodytemper
ature
s.Ac onti
nuous,re
lia
bleflowoffres
ha i
rise ss
entia
ltothec omfortofpati
ent
sa ndstaf
f.
CeilingMoor ing
Thes emoor ings
,stra
tegi
cal
lyloc
atedinthec ei
li
ngint r
eat
me ntare
as,ha
vebeenf oundusefulf
ora t
tachingover
hea
de quipmentsuchashoi
sts,pul
ley
s,ba
rs,counterba
lanci
ng
equipme nt,etc.Theyshouldbeconst
ruc
t e
da nda t
tac
hedt ojois
tsinsuchama nnerthateachsupportsatlea
st500pounds .
Doors
Fora
ccommoda
tionofs
tre
tche
randwhe
elc
hai
rtr
aff
ic,door
swi
thi
nthede
par
tme
nts
houl
dbea
tle
ast40i
nche
swi
de.Ra
ise
dthr
eshol
dss
houl
dbee
limi
nat
ed.
Hydr
other
apy Radi
other
apy Li
ght
ing
Radi
at
ionth
erapy(a
lsocal
le
dradi
othe
rap
y)isac
anc
ertre
atme
nttha
t Radi
at
ionbunker
sands
imul
ator
swill
requ
ir
edimmabl
eli
ght
ingwit
hadj
ust
-
Hydrot
her
apyisapartofp
hysi
oth
erap
ythati
nvo
lve
sth
e
us
eshi
ghdosesofra
diat
iontoki
llc
ance
rcel
l
sandsh
rin
ktumours
. ab
lel
ight
ingle
vel
sfo
rpat
ie
ntcomfort
.
us
eo fwat
erf
orsoot
hing
•Radi
at
ionther
apycanbedel
iv
ere
dtwoways: •Gener
alli
ght
ingi
nsta
ffworkar
eassho
uldbeev
en,
suff
ic
ie
ntfori
ll
umi
na-
pa
insandtr
eat
ingc
ert
ainme
dic
alcon
dit
ion
s.
t
ionoftheworkar
eaan
dn o
nref
le
cti
ve.
1.
Exter
nal
ly2 .
Int
ern
all
y

Func
tionalAr
eas Func
tionalAr
eas Ac
ous
tic
s

•ENTRANCE: Theentr
ancecons
is
tsofast
af
fb as
eab ay Rece
pti
on ,
Wa i
ti
ng,admini
st
ra
ti
veand Acou
sti
ctre
atmentwil
lb erequ
ir
edtoa l
le x
amina
ti
on,cons
ult
at
ion
fo
rparki
ngwh e
elch
air
s, re
cord
sareas r
oomsandoff
ice
stoens
urepri
vac
yfordi
sc
u s
si
onswit
hpati
ent
s,f
ami
li
es
st
re
tche
rs,t
rol
ley
s,etc
;asub-wai
ti
ngare
aandspaceforpa- •Cli
nica
l c
onsul
tare
a an
dstaf
f.
ti
ent
stotra
nsf
erfrom •Pati
enttrea
tmentarea
sincl
udi
ngRa di
oth
era
pyBu
nke
rs,
Tre
atme
nt •Pro
vid
isi
onforthec
ontrolofnoi
seas
soci
at
edwithmachi
ner
yinthe
war
dstre
tche
rstopooltr
oll
eys. Pl
anning
,Si
mu l
ati
on,Holdi
ngare
a,
Pati
ent
Toil
et ap
pli
anc
efabr
ica
ti
onworkshopare
assh
ouldbetak
enint
oconsi
der
at
ion
.
•THEPOOL: Hydrot
her
apyp o
olsar
ewarmwaterpool
s(- •Fil
mp roce
ssi
ngandstor
agear
eas
te
mperat
urebet
ween3 4
-40 •Supportar
easi
ncl
uding,Uti
li
ti
es,
Clea
ner'
s Radi
ati
onPr
otec
tion
C)usual
lyusedbyp hys
iot
hera
pis
tswhil
etr
eat
ingpatie
nts Room,Store
,Dispos
alrooms
Coba
ltan
dlin
earac
cel
er
at
o rr
oomsreq
uir
eradi
at
ion
whomayh av
ep h
ysi
cal •Sta
ffarea
sincl
udi
ngS t
affSt
ati
on,Off
ic
es,
pr
ote
cti
ontha
tmayinc
ludeco
ncre
tewal
ls
,fl
oor
sandce
il
in
g
pr
oble
mso rspec
ialne
eds. St
affChangeandToil
ets
.
t
oaspeci
fi
edthi
ckn
ess
.

Des
ignGui
del
ines
Spac
eCal
cul
ati
on
Door
s
Thesi
zeofthepoo
lsca
nv a
ryfr
om asma
llhy
drot
her
apy Cons
truc
tionCons
ider
ati
ons
po
olof6 m x4muptomu chla
rge
rones
,ge
nera
ll
ywith Al
l e
ntr
yp o
ints
,doorsorope
ning
srequi
ri
ngb e
d/tro
lle
y
de
pthbet
ween1.
0mand1.2
m; t
hemini
mumsp
acere
qui
red ac
ces
sincl
udi
ngRa dia
ti
onThera
pyandPr o
cedure
Thefloori
ngforaRa di
at
ionOncol
ogyUnitsha
llbe
f
oreac
hpati
enti
s2.
5mx2.25m. Roomsarer
ecomme nde
dtobeami n
imu mof1 400mm
adeq
uatetome etthelo
adrequi
re
mentsfo
re q
uipment
,pa
ti
ent,a
ndpe-
wi
de,unobs
truc
ted.
sonne
l.Floo
rsurfa
cess
houldbei
mp e
rvi
ous
,eas
yt oc
lea
n,se
ale
dandco
v-
•Int
eri
ordoor
ss ho
uldbe1¾i nc
hthicksol
idcor
eflus
h
edattheedges
.
PoolSer
vic
es pa
nelwoodd o
orsorh o
ll
owme t
aldoor
sinho l
l
owme ta
l
•Provi
sionforcab
leduct
sorcondu
it
sshoul
db emadeinthef
loor
sand
f
rames.
Conti
nuousfi
l
tra
ti
onanddis
inf
ect
iono
ft heh
ydr
oth
era
py cei
li
ngsasrequi
red
.
poolwat
erise
sse
nti
alt
oco
ntr
olwate
rqua
li
tywi
thi
nacc
ept
- •Al a
y-inty
peo fcei
li
ngshou
ldbecons
ide
redforea
seof Medi calGas es
ab
leli
mits
. i
n s
ta
ll
ationandserv
ice
.
Theunitwi
llr
eq u
ir
e:
•Oxygenandsuct
ioninal
lpat
ie
ntbaysandproce
dureroo
ms
Fl
oor Location •Prov
is
ionofme di
calai
rtopat
ie
ntre
cover
yb ay
sisopti
onal

Thepoolhal
lfloorandalls
urr
oun
din
ga re
asinc
lud
ing Emer gencyCall
ch
ang
ingf
aci
l
iti
esandtoi
l
ets
,sh
oul
dbecove
redinn
on-s
li
p, Gener
all
y,t
heRadiati
onOn colo
g yUnitsho
uldbeloc
ate
d
ea
syt
ocle
anmater
ia
ls. ongroundle
veld
uet otheweightoftheequi
pmentand Pa
ti
entandEmerg
encyCa
llf
aci
l
iti
ess
hal
lbep
rov
ide
dinal
l
shi
el
ding
, f
orea
seofinstal
l
a t
ion
/r epl
acemen
tofspeci
al
is
edequi
pment. pa
ti
entare
asi
norderf
orp
ati
ent
sandst
af
ftore
ques
tfo
r
Emer
genc
yCal
l •TheUn i
tshoul
db elo
catedwithre
adyacce
ssfo
ro u
tpat
ie
nts
,i
nclud
ing u r
gen
ta s
si
st
anc
e.
peopl
ewithdis
abi
lit
ies
,peoplearri
vi
ngb ypat
ie
nttra
nsf
erse
rvi
cesand
Anemer
gen
cyala
rmc a
llsy
ste
mshoul
dbep r
ovi
deda
nd ambul
ances
,andforinpa
tie
n t
sinwh e
el
c h
air
sandonb e
dsortr
oll
eys
.
pu
llc
ord
stoac
ti
vat
eitne
edtobes
it
edwit
hinr
eac
hoft
he
t
her
api
st
.
Di
alysi
s
•Dialys
isisaprocessofr emovingwast
eore xces
swate
rfrom thebody,andisuse
dpr ima
ril
ytoprovi
dean
ar
tif
icialr
epla
c e
mentforl ostkidne
yfunctioninpeopl
ewit hkidneyfai
lur
e.
•Ani n-hospi
taldial
ysisunitisaspeci
fie
duni tofali
censedhos pi
tal
,desi
gne
d,equippe
da ndst
aff
edto
off
erdialy
sisther
apyona nout -pati
entbasis
,andtoprovidetrai
ningforhomedial
ysisa
ndr e
nal
tr
ansplant
ati
ona sappropriat
e.

Desi
gnGui
del
inesLocat
ion

•Ha emodial
ysi
sfaci
litie
ss houldideal
lybelocat
edont hegroundflooronthefring
eofthema inr
enal
unitanda dj
ace
nttot heot herarea
swi t
hintha
tuni t
,incl
udingperi
tonealdi
aly
sisandre
na lout
pat
ient
s,
adminis
trati
on,tr
ansplant,technic
alserv
ice
sandt herenali
npati
entward.
•Itshouldhavecove
re dacc e
sstoot he
rhospit
aldepartment
s,part
icula
rlyra
diology
,ca
rdiology
,ur
ology,
dia
betologyandtheg eneralwa r
ds.

SpaceConsi derati
ons
Theareashal
lnotbel
esst
han6squa
reme
ter
stoa
ccommoda
teabe
dorc
hai
r,t
hedi
aly
sise
qui
pme
nta
nd
emer
gencyequipme
nti
fneede
d.

FunctionalAr eas
•Ma i
nEnt r
y/Re ce
pti
onAr
ea
•Wa i
ti
ng
•Treat
mentAreas
•Staf
fAr e
as
•SupportArea
s
•Stor
ageAreas:
 Connect
ionsandSer
vices
Cor
ridor
s

•Ma inc orridors houlda llowforpa ss

ag eoftwobe dswi thpe rsonsons ides.
•I trequire s~2. 5me terwi dth Le sst han100be ddedhos pi t
alsc anhaveonebe dpassa
ge.
•I trequire s~2. 0me terwi dth.
•Se greg a
tionofc l
eana nddi rt
ycor r
idor s
•Hos pitalsma ybepla nnedwi thclear
lyde si
gna te
ds taff-
onl yandpa t
ientcorridors;t
he
requireme ntsf orpa t
ientc orri
dorswi l
lnota pplyt os t
a f
fonl ya ccesse
dc orri
dor s.
•Al lc orridorwi dthsi dentif
iedareclearofha ndr ailsand/orc ra
shr ai
lsorot herite
mss uc
has
drinkingf ount ains,handba sins,t
e l
ephoneboot hs,c olumns ,vendingma c hi
nesa nd
por t
abl e/mobi leequipme nt.Equipme ntba y
sa ndobs tructionsl ocate
di ncorridorsmustnot
impe det het raffi
cf l
ow.Ana llowanceof100mm i srecomme ndedf orhandrails
.
•Cons iderations houldbeg i
ventot hee li
minationofpot ential
lyda ngerous'bli
nds pots
’
Pa
tie
ntCor
ridor
s
I
npa t
ientar
eassuchasI
npat
ientUni
ts,Operat
ingUni
tsandInt
ensi
veCar
eUnits
,wherebe
ds,
t
roll
eysandstr
etche
rswi
llbemo v
edr
eg ul
arl
y,mini
mum c
lea
rcorr
idorwi
dthsof2450mm a
re
r
ecomme nde
d.

St
affOnl
yCor
ridor
s
Sta
ffonlycor
ridor
swi thnopa t
ienttra
ffi
ca ndwherethec or
ridorle
ng t
hisnotgrea
tertha
n12me t
ers,s
uc ha
sac or
ridortoagroupofst
affoff
ice
s,mayhaveacle
arwidthof
1200mm.Considera
tionmus tal
sobeg ive
nt oacce
ssibi
li
tyr e
quirementswhi
chma yinc
ludeloc
ali
zedcorri
dorwideni
ngorpr ovi
si
onofdoubledoor
stoall
owdisabl
edstaf
ftopass
ortoacc
essdoors.
Thec orri
dorha sbeenmodifi
edt oenableape r
soninawhe e
lchai
rtherequi
redci
rcula
tionspa
cetoa cc
essandopera
tet
hedoor.There
quir
ementsofwidth-la
tch
si
de,wi
dth-hingeside,cle
aropeningofadoor way,thelengt
h,thedi r
ect
ionofdoorswingandthedirec
tionofwhichape r
sonapproa
che
sthedoorwayar
einte
r-r
ela
tedandvar
y
acc
ordi
ngtolocalacces
sibi
lit
ycodea ndstandar
ds.
Tr
ave
l&Publ
icCor
ridor
s
Tra
velcorr
idor
sareint
er-c
onnec
tingdepa
rtment
alc
orr
idorst
hatmaybeuse
dbystaf
f,pa
tie
ntsandvis
itor
s.Thewidthofmaj
orint
er-
depa
rtmentart
eri
alcor
ridor
sandpubl
ic
cor
ridor
sgener
all
yshouldbeaswideasisdee
mednece
ssar
yforthepr
opos
edtr
aff
icfl
ow,butshoul
dnotbel es
sthan2450mm.Publi
ccor
ridor
sshouldnotbeles
stha
n1600mm.
Ce
ili
ngHe
ight
s
Ac e
ili
ngheightof2700mm i srec
omme ndedinworkareassuchasPat
ientt
reatmentar
eas
,Of
fic
es,Confe r
enc eRooms
,Adminis
tra
tiveare
a sandKitchens.
Themi ni
mum a c
cept
ableceil
ingheightinoc c
upiedare
asisrecommendedtobe2400mm,butconsidera
tions houl
dbegiv
entothesize(sensoryconsi
derat
ion)anduseoftheroom.
Ceil
ingsinpati
entbedare
asi nc
ludingBe dRooms ,Be
dBa ysandRecoverya
reasshoul
dbeaminimum of2700mm.Be dRoomsforba ri
atr
icc ar
ema yrequi
reani nc
rea
sei
nc e
ili
ng
hei
ghttoa c
commodatelif
tingequipme nt.I
nc r
iti
calc
arebeda re
assuc
ha sICU,CCU,HDU andRe s
uscita
tionRoomsac ei
li
ngheightof3000mm i srecomme ndedtopr
ovi
de
suf
fici
enthei
ghtforcei
li
ngmount ede quipmentandservi
cependant
s.
St
air
casesandRamps
Ex
ter
nalSt
air
cas
e
Thee xternals taircasesa r
et hestairc asespr ovidedont hee xt
ernalwa l
l/f acade,andshallcomplywi t
ht he
foll
owing :
a)Ex te
rna ls t
a i
rss ha l
la l
wa ysbek e pti ns ounda ndus ableconditi
on.
b)Al lexterna lstairss hal
lbedi rec tlyc onne ctedt ot hegr ound.
c)Ent r
a ncet ot hee xternals t
airssha llbes eparatea ndr e
mot efrom theinter
na ls
tair
case.
d)Whe rea ne xterna lstai
rc a
seispr ovide d,itsha llbee nsuredt hattheuseofi tatthet i
meoff ir
ei snot
prej
udice dbys mok eandf lamef rom ope nings(fore x ampl e
,windo ws,doors)inthee x
t er
nalfa
ceoft he
buil
ding .Ca resha llbet ak entoe nsur et hatnoe xterna lwa l
lorwi ndow
openingope nsont oorc losetoa ne xterna lstai
r.I fs uchope ningsexist
swi t
hin3m f rom anexternal
stai
rcase,the ysha llbepr ot ec
tedwi thf irer a
teddoor s/wi ndowa ssembli
e swithrati
ng
ofa tleast60mi n.
e)Thee x t
e rnals tairsshallbec ons tructe dofnon-c ombus ti
blema ter
ial
s,anda nydoor wayle
adingt oitshal
l
havemi nimum 120mi nf ireresi
s t
a nce.
f)Noe xternals taircasesha l
lbei nc li
ne da ta na ng l
egr eaterthan45°f r
om thehor i
zontal.
g)Ex te
r nals t
a i
rss ha l
lha vestraightf lightnotl esstha n1500mm wi de.h)Ha ndrai
ls,tobeprovidedonbot h
side
s,sha llbeofahe ightnotl esst han1000mm a ndnote xceeding1200
mm. The res hallbepr ovisionsofba luste rswithma ximum g apof150mm.

Ra
mps
Ma ximum s lopef orha nd-prope ll
edwhe elchairra
mpss houl dbe1"ofr i
setoevery12"ofl ength
(4.
8de greea ngle;8.3% gr ade).
Ma ximum s lopef orpo werc hairsshouldbe1. 5"ris
et o12"l ength(7.1degreeangle;12.5%
grade).
Mi nimum wi dths houldbe36"( i
ns i
der ai
ls)-(48"i sideal).
Rampsc anha v
eama xi
mum g oingof10m ( 32ft.10i n),beyondwhi c
htherehast obeal anding
beforec onti
nui nga sar amp. Thema ximum pe rmiss
iblegradientfornondome st
icdwe ll
ings,1:12,
appliest orampswi t
hag oingnogr eaterthan2m ( 6ft.7i n).Thisequat
estoama ximum Ri s
e
of133mm ( 5in) .Thegr adientoft hel ongestpermissibl
er a
mpg oi
ngof10m ( 32f t
.10i n)
mus tnotbes teepe rthan1:20. Thi sequa t
est oama xi
mum Ri seof500mm ( 20i n).Inbe t
we e
n
thesetwol i
mi t
sofr ampg oi ngsthea l
lowa bl
es t
eepestgr a
dientvarie
sinagradua te
dwa y.(1)TO
CALCULATETHEGOI NG FOR AKNOWN RI SE( all
dime nsi
onsi nmm. )Going= ( RiseX 10000)/( 1000-Ri s
e)Not e.

St
air
casesandRamps
Hospi
talEl
evat
ors
Funct
ions
•Tr ans fersma dewi ththepa tientsha vetobef asta nd,a tthes amet i
me,s afea ndg entle
.They
arenott he reforea dmi ssible,s udde nmo veme nts.Es pe c
iallywhe nstoppinga nds tartingoccurs
.
•Thee qui pme ntmus tbepr e pa re
dt ofunctionpr ope rl
yi nthee ventofhi ghi nt e
ns itypeaks,
whi choc curr oug hlya tme al
t i
me sorv i
sits
.Al so,t hisc apabili
tyoft hea pparatus ,sot hatit
s
ope r
at i
oni snota f f
ectedi no verloadingcasesus ei sv ita
l,fore xampleinj oints
ma rkedbyt hec oi ncidenc eofs e r
iousorur gente vent s(forex ample,ama s
sivei nfluxof
patients ,dueme dicalint ervent iona f
teradi saster).
•Wemus ttak eint oa c
countt hee xis
tenceofpr eferentialtraff
icinhos pital
sr elatedt othe
mo veme ntoft rucksoff ood( inv er
yc oncretea nds pe ci
fictime t
ables)andg urneyt obe
re
a chingt heope ratingr ooms( withSwi s
spunc tuality).
•Thet i
me outofhe alt
hwor k ersmus tbemi nimi zed. Thi srequire
me ntisa s
s ociatedbr oadly
,
botht hes pe edofdi spla ceme nta ndt heope ningoft hedoor s.
•Ont heot herha nd,pl a cingt heba nksa nds epa r
a tionofs t
a f
fwhoi svisit
inga r
e
re
c omme nde d.Ina dditi
on,t hema neuversmus tbec arri
edoutwi thoutinterme dia tes t
opsand
el
ev atorsa retobeope rat e
doutofmul tipleba nk,i fne cessa
r y
.

Speci
ficFeat
ures
•Tra
nsferofpeople:doctors,nurses,pati
entsandv i
sitorsout pat
ient
.
•Pas
sengertra
nsport:pati
e ntsinwhe el
chair
sors t
retchers,food,clot
hing,toolscarts
,etc.
•Ingenera
l,hospi
talele
vator scanreachendureal oadofbe tween600a nd2, 500kilos.
•Theusualcapaci
tyoft hes eli
ftsisbetween8a nd13pe ople( wit
hlimitedki l
os,onthe
ot
herhand).
•Thema xi
mum pa t
ht hatc anma kethesedevic
esis16f loors.
•Thema xi
mum he i
ghttha tc a
nr is
ee l
evat
orshospitalreaches45me t
ers.
•Thespeedlimitatwhicht heyc ang e
ttheseelev
atorsi ssetat1.6me ter
spe rsecond.

El
evat
orSi
teRequi
rement
s
•Thet emperatureoft hema chi
ner oom andeleva
torhoi stwa yshallbebelow40°C.
•Thef oll
owingc onditionsa rere
qui r
edforma int
aininge l
e vatorperformance
•Ther el
ati
vehumi dityshallbebe l
o w90% onamont hlya verageandbe l
ow95% onadaily
aver
age
•Preventi
ons hallbepr ovidedagainstic
inga ndconde nsationoc curri
ngduet oarapi
ddr
opi n
thetemperat
ur eint hema chineroom ande le
vatorhoistway
•Thema c
hiner oom andt hee le
vatorhoistwayshallbefinis hedwi t
hmor tarorot
hermat
eri
als
soastopr ev
entc onc r
etedus t
•Voltagefl
uctua t
ions hallbewi t
hinar angeof+5% t o- 10%.
Ser
vic
es

La
und
ry Ph
arma
cy

Mo
rtu
ary CS
SD

Medi
cal Fi
reFi
ght
ing
Ga
ses

Ki
tc
hen P
ark
ing

Wast
e Tr
ans
port
Di
spo
sal
Uni
t S
erv
ice
s
Laundr
y Mor
tuar
y

Themai
nobj
ec
ti
veo
fthisf
aci
l
ityi
stop
rov
idef
oras
uit
abl
epl
ac
efo
rte
mpo
rar
y
Themainfunct
ionsofthela
undryser
vi
cearea
sfol
lo
ws: ho
ldi
ngofade
adbody
.
•Col
lec
tionandrece
iptofsoi
le
da ndinf
ect
edl
ine
n.
•Sor
ti
ng ,
slui
ci
ng,dis
infe
cti
ng,was
hingandir
oni
ngof Rec
eiptands
ort
ing Loc
ati
on
t
heli
nen.
•Repa
irofd a
ma g
edlinen •thenee
df oradeq
u a
tevehi
cul
arac
ces
sfromthes e
rvi
ceroad;
•Ass
emb l
ingandp ac
k a
gin
gs p
e c
ia
ltyit
emsandlin
en •wh e
rethefac
il
it
yislocat
edonahospit
alsi
te
,thefun
ctiona
lla
youtoftheho
s-
pa
cksf
o rst
eri
l
izat
ion. Central pi
talandthen ee
df orthemo r
tua
rytob edis
cree
tl
ys i
tedawayfro
mc li
ni
cal
,
•Dis
tr
ibuti
ono fl
inentotheus
erdepart
ments
. St
orage
di
sinfec
tionarea ki
tchenandd i
ni
nga r
eas,
withnodir
ectent
rytop u
bli
candstaf
fthorou
ghfa
res
;
•thedes
irab
ili
tyfort
h emortu
aryt
ob el
ocate
da tgr
oundleve
l;
Location St
orage •theneedforconv
enienc
eofa c
ces
sbythevar
ioususe
rs
Thelocat
ionofthel
aundrysho
u l
db econ
veni
enttothe (s
taf
f,vi
sit
orsandundert
aker
s);
us
erunit
sandclos
etotheser
vi
ceelev
ator
.Dependin
gon •thenee
df ort
hemo rt
u a
rytobeas
soc
iat
edwith/ornearahi
stopa
thol
ogyla
bo-
Sl
uic
ing
th
etypeofh ea
thcar
eb ui
l
d i
ng,i
tma ybeloc
atedinthe Cl
ass
ific
ati
on andWas hi
ng ra
tory;
bas
ementwithprope
rdrai
nage.
Ifp oss
ibl
e,i
tshoul
db e
cl
oseproxi
mitytoCS SDa ndd i
etaryse
rvi
cesd u
eto
commonr e
q u
ir
ementofsteamfromb oil
erpl
ant.Als
o,
mate
ria
lfromlaun
d r
yisal
sosenttoCS S
Df or
st
eri
l
izat
ion. Washingand Ext
rac
tion
Ext
r act
ions
Requirement s
INPATIENT
•2-3kgofli
nenperbe
dp erday
.
•Minimum6s e
tsofli
nenperbed
Fix
edArea Condi
ti
oni
ng Condi
ti
oni
ng
•OPD, obse
rva
ti
onroom, re
stroo
m.
•chan
gedatl
eas
ttwic
eawe ek
OT,ICU,Emerg
ency
•Line
nrequi
re
dp e
ropera
ti
o n
*n o
.ofo
per
at
ion
perda
y*365.
Dr
ying,I
roni
ngandCal
ender
ing
Acti
vities
•Coll
ecti
ngandrecei
vi
ngdir
ty
l
ine
nfromwa rdsandothe
r
de
partment
•Sor
tingofline
n As
sembl
ingandPac
king
•Remo v
ingofb l
oodsta
in
•Dis
infect
ion
•Washinganddryi
ng
•Repair
ing\sewing Di
spat
ch/
Iss
ue
•Pre
ssi
nga ndfol
ding
•St
orage
•Is
sueofma te
ri
al L
aundar
yFl
owDi
agr
am Ty
pic
alMor
tuar
yLay
out
CSSD(
Cent
ralSt
eri
leSuppl
yDepar
tment
) Fi
refight
ing
ACent
ra
lS t
er
ileSu
pplyDepa
rtment(
CSSD)isahos
pi- LayoutPl anni ng
t
als
upportse
rvic
e,whic
hisentr
ust
edwithproc
ess
ing •Su f
fic
ientopenspacearoundthebuildi
ng.
a
ndis
sueo fsuppl
ie
sincl
udi
ngste
ri
lein
str
umentsand •Lo bbi
es,st
air
case(
wid t
h2 m)ramp s
,shoul
dbe
e
qui
pmentusedinvar
iou
sdepa
rtment
sofahospi
tal
. suf
fici
entl
ywi detoensureeas
ymo vementoftr
affi
cand
quickeva
cu a
ti
ond uri
n gemergen
cies
.
Pl
anni
nganddes
ignpar
amet
ers •He avydutyelev
atorespeci
al
lyforuseoffi
refi
ghti
ng
•Ea chbui
ldingshouldhavesepar
atefi
reexi
t,s
tai
rca
se
•Ther
eshouldbenoBacktra
cki
n gofst
er
il
egoods withp r
opersig
n a
ge.
•Thecle
an,st
eri
l
ea n
dd i
rt
ya r
eassh
o u
ldbese
par
ate
d •Cr i
tic
alare
aslik
elabs,x-rays
,OT, ICU,wherehea
vy
byphy
sic
albarr
ie
rs. equipmentareins
tal
ledsh o
uldbewe l
l p
rote
cte
d .
•Spac
erequi
rementde
pendsonthetot
alnumbe
rof •Fireproofd oor
s,windows,wall
sandr oo
fcovere
dwith
bed
s.I
tvari
esfr
om0 .
7to1s quar
eme t
erpe
rbed fi
rep r
oofma te
ria
l.

Fi
rePr otecti
ngSys tem
SpaceRequi rement s:
Rec
eivi
ngandcleanuparea
=1 0% Phar
mac
y •Fi
r
•Fi
r
ewa
epr
o
te
rh
t
ec
y
t
i
d
o
ra
n
ns
ts
ys
t
y
e
st
e
m.
m.
Cle
anwo r
ka r
eaincl
udi
ngareaf
orst
eri
li
zat
ion
=30% A20ms q
uaremete
rar
eacans
uppl
yacomb
ina
ti
ona
nae
st
het
ic
san
d
•Fi
rede
tecti
onsys
tem.
Unste
ril
est
orageare
a=15% s
urg
ica
lmedi
cat
iona
ndoth
ermat
er
ial
s.
•Fi
reex
tingu
ishe
rs.
St
eri
lest
orag
earea=16% •Fi
ref
ight
ingequi
pme n
t.
Syr
ingenee
dleandinst
rumentp
roce
ssi
ngandst
er
il
e
ar
ea=12% Was
tedi
spos
aluni
t Fir
eFig
hti
ngin
sta
lat
ionaredonebyfir
espr
ink
ler
,st
andp
ipesp
ump
s
Glo
vep r
oces
sin
ga re
a=5%
andst
ora
gepr
ess
uretank
s.
Off
iceroom\r estr
oom\d r
ess
inga
sse
mb l
y=1 4%
SPRINKLERS:Usedinb as
ement,an
yroomexce
edi
ng500m2
CO2 :
Usedinele
ctr
icfi
recann
o tb
eu s
ed.
Be
dsSpa
ce Re
qui
re
mentI
nSq
uar
eMe
tr
e
75
-99 0.
9
10
0-149 0.
8 f
orFi
reEs
capes
tai
rcas
e
15
0-200 0.
78 Mi
nimumWidt
h -1 500mm
20
0-249 0.
74 Mi
nimumTr
ead -3 0
0mm
25
0-299 0.
69 He
ighto
fha
ndrai
l -1
000mm
Moret
han3
00 0 .
65 Mi
nimumwi
dthofex
itdo
or-1 500mm
Mi
nimumhe
igh
tofexi
tdoor-2000mm
Mi
nimumwi
dthofcor
ri
dor-2 400

Di
spos
alSys
tem
Handl
ingwas
teatth
epointofprod
uct
ion
Tra
nspor
tat
ionwit
hint
hefac
ili
ti
es
.
In
ter
nalst
ora
ge
i
nter
nalProc
ess
ing/tre
atme
n t
Tra
nspor
tat
iont
op oi
ntoffi
naldi
spos
al
Par
king Was
teDi
spos
al
•Wastesh
ouldnotbest
ore
dintheg
ener
at
ionar
eaformoreth
ana
per
iodof4-6hour
s.
•Theresho
u l
dbesepa
rat
ecor
ri
dorandli
ftt
ocarr
ya ndtr
ans
por
t
was
te.
•Segre
gat
ionshou
ldbedonea
tthepoi
ntofgen
era
ti
o nan
dp uti
n
se
parat
ecol
oure
dbags
.
Ambul
anc
eBay
Connec
tse mer
genc
yme di
calser
vi
ces(
EMS )p e
rso
nne
lan
dth
eir Medic
alge
ner
alwas
te62%
pat
ie
ntst
oc ar
est
affand In
fec
ti
oushaz
ard
ouswast
e23%
equ
ipmentofaloca
l h
ospi
tal
. Nond e
gra
dabl
emedic
alwas
te1
2%
•Timel
ytra
n s
por
to fpat
ie
ntsfr
omt h
eamb u
lan
ceto Bi
ome di
ca
lsha
rp3%
emer
genc
ywa r
d.
•Saf
etre
atmentofpati
ent
s. Ge
ner
alWas
te(Bl
ac
kBin)
•Inf
ect
ionpre
vent
ionandcontr
olf
romc o
ntami
nate
d •P
ape
r,ki
tc
henwas
te,
wrap
per
s.
Fi
res
afet
y equ
ipment.
In
fec
tio
usWast
e(Yel
lo
wBin)
Op
enS
pac
es Gener
ator •soi
le
dlin
en,
conta
minat
edg
own
s,d
res
si
ng,
5KVAwit
hPOLf
orI
mmu
niz
ati
onCo
ldCh
ainma
int
ena
nce
. band
ages
.
-
F r
eesp ac
eo uts
idetheh ospi
tal
,tofacili
tat
ethefree Tel
ephone
mo ve
me ntofp ati
entsande mergency/fir
evehicl
es. Sh
arpAndDispo
sab
leWast
es
Min
imumtwod
ire
ctl
i
neswi
thi
nte
rco
mfa
ci
li
tys
hou
ldb
eav
ai
la
ble
.
-
F r
eefromo bst
ructi
on. •i
nfe
cti
ousandn
onshar
pplas
ti
cwa
st
e,I
\Vs
et
s,
-
Ad
ve
h
e
i
c
q
l
u
e
a
st
tep
oe
as
n
sa
t
e
ge
rt
wa
h
y&c
eh o
l
e
s
p
a
i
r
t
a
a
n
lp
cef
re
orf
mise
i
ref
ss
i
h
g
h
a
l
t
i
lb
ng
e
Bas
ement dr
ai
ns,p
ipes
.

Bas
ementssh
allb
euse
do n
lyforpar
kin
gvehi
cle
san
dsh
all
be
p
-
r
o
Th
vi
de
ewi
d.
dtho fs uc
he ntrance
ss hal
lb en otbeless pro
tec
tedwithaut
omat
icsp
rin
k l
ersy
ste
ms. Wat
erSuppl
yUni
t
t
ha n4.5mt rswithclearh e
adro omn o tl
essthan5 -Ea
chbasements
hal
lbese
para
tel
yventi
la
ted
. -Suppl
yof10,
000li
tr
esofpot
abl
ewate
rperdayt
omee
tal
lth
erequ
ir
ement
s
mtrs. (i
ncl
udi
ngla
undry
)ex
ceptf
ir
ef
igh
ting
.
-
Th ewi dtho ftheaccessroads h
a l
lb eami ni
mu m -Cl
ea
rhe
adr
oomo
fmi
ni
mum2
.4m -S
tora
geca
paci
tyf
or2d a
ysr
equi
rement
ssh
o u
ldbeont
heba
siso
ftheab
ove
of6mt r
s. cons
umpti
on.
-
At ur
n i
ngr adi
u sof9mt rsshallbep r
ovide
df or -
Amini
mumce
il
in
ghe
igh
tofan
yb a
seme
ntsha
llb
e0.9m
f
iretendermo vement. a
ndmax
imu
m1 .
2mab
oveth
eav
era
gesur
rou
ndi
nggro
und -Roundthecl
ockwat
ers
uppl
y.
-
Th ec overi
ngs l
abo fs torag
e/s t
at
icwa t
ert an
k l
ev
el
. -Emer
gencyover
hea
dtanksh
allb
epr
ovi
dedfo
ro p
era
ti
onthe
atr
e.Ne
ces
sar
y
s
ha l
lbea bl
etowi ths
tandt hetota
l v
ehicula
rloado f wate
rs t
orag
eoverh
eadta
nkswit
hpumpi
ng/boo
sti
ngarr
ang
ements
hal
lbe
45t oneequall
yd ivi
deda safourp oi
n tload(ifthe -
Thea c
ces
stot hebasementsh
allb
esepar
atef
romthemai
n made.
s
labf o
rmsap artofp a
th/d ri
veway). a
nda l
te
rna
ti
v est
air
caseprov
idi
ngacc
essan
de x
itf
romhi
gher
-
Sh al
ln otb eu sedforp arki
nga nd/o ra nyo t
her f
loo
rs.Wherethest
a i
rcas
econt
inue
s,i
nthecas
eofbui
ldi
ngs -
Thela
yin
ganddi
st
ri
but
ionoft
hewate
rsupp
lysy
ste
msh
allb
eac
cor
din
gto
purpose. s
erv
edb ymo r
et h
a no nest
air
cas
e,thesameshal
lbeo f t
hepr
ovi
si
onso
fIS:
2065-
1 9
83(aBI
Sstan
dar
d).
-
Th eS etbackareashallbeami nimum4 .5m. e
ncl
o s
edtypes erv
inga saFi reSepar
ati
onb et
wee
nt he
-
Th ewi dt
ho fth emainstreetonwh i
cht hehospit
al b
asementa
ndh igherfl
oors. -
Co l
dandh
otwat
ers
uppl
ypip
ingshou
ldberu
ninco
nce
al
edf
orme
mbe
dde
d
buil
dingabutsshallnotbelesstha
n1 2mt r
s&wh e
n i
ntowal
lwi
thf
ull
pre
cau
ti
onstoav
oidanys
eep
age
.
onee ndo fthatstre
etsha l
ljoi
na notherstree
t,the
s
treetshal
l n
o tbelessthan1 2mt rwide . -
Openrampssha
llbepe
rmi
tt
edifthe
ya r
econs
tru
cte
d -
Gey
seri
nO.
T./L.
R.a
ndo
nei
nwa
rda
ls
osh
oul
dbep
rov
ide
d.
wi
thi
nthebu
il
di
ngli
nea
ndsu
rfa
cedr
ai
nagedoe
snoten
ter
t
hebas
emen
t. -
Whe
rev
erf
eas
ibl
eso
lari
nst
al
la
ti
onss
hou
ldb
epr
omo
ted
.
 Bl
oodst
orage
Bloodandbl oodproduc
tsarenormal
lyst
oredi
noneoft wowa ys
:inrefr
iger
atorand
free
zercabinet
sori nwal
k-inc
oolroomsandfree
zerooms.Choosi
ngoneoft hese
twome thodsforthepri
ma r
ystor
ageofbloodandbl
oodpr oduc
tsiscent
raltothe
operat
ionoft hebloodcent
reandshoul
donlybemadeafteradeta
ile
dr e
viewoflocal
Bl
oodBank cir
cumstances.

Refr
iger
atora ndf r
eezercabinet
Thebloodcentreist heloc
ationforthecoll
ect
ion,re
ceipt,process
ing,t
esti
ng ,s
tori
ngand
•Fail
ureorbr eakdownofonec abinetonlya f
fectsthecont
entsoft hatparti
cularcabinet
.
dis
tri
buti
onofbl ood.I tal
sousuall
yhous estheadministr
ationoft heBTSori scl
osel
y
•Ifabiome dicalengineerisnota vail
abl
et oma intai
ndefe
cti
veca binet
s,brokenca binet
s
ass
ocia
tedwi t
hi t.Thebl oodc e
ntrema yaccommoda t
eas tati
cbloodc ol
lecti
onfacil
it
y
maynotber epa i
redando v e
rt i
me ,tota
lstoragec a
pacit
yatthebloodc entrewillde cl
ine
.
whil
ea l
socoordinatingmobi lea
ndde mountablecol
lecti
onf aci
lit
ies
.Additionalnat
ional
•Partsrequi
r edinc a
bi netrepairandma intenancema ynotbere adil
ya va
ila
blea sma ny
orregi
onalspeci
alistlabor
atoryserv
icesandresea
rchactivi
tiesmaya l
sobepr ovi
dedfrom
manufact
urersus ethe
iro wnuni quec omponents.
thefa
cil
ity
.
•Cabinetsrequiremor espacetos toreagivena mountofbloodt ha nwalk-i
nc oolr ooms
andfree
zerrooms .

Pl
anni
ngi
ssues Coolr
•Coolr
oomsa
oomsa
ndfr
ndf
e
r
e
e
z
e
ez
rr
e
ooms
rr
:
oomsa resimilartot hoseusedi nt hefooda ndhotelindustr
ies
.
Gr
owt
handchange The refore,skil
ledma intenances t
affa ndc ompone nte quipme ntareus uall
ya vaila
blein
mos tto wnsa ndcit
ies
.
Bloodc entr
esa r
enots tati
co vertime .The yc hang ea ndgrow.Cha ng ei sdrivenbya •Coolr oomsa ndf r
eez e
rr oomsr equirelesss pacetos toreag ivenv olumeofbl oodthan
numbe rof f a
ctorsinc l
uding thei ntroduc t
ion of ne wt e
chnologie
s,e quipmenta nd refr
igera t
ora ndfre
ezerc abinets.
process
es,newc li
nicalpr act
ice
si nt heus eofbl ooda ndthei mprovede ducati
ona nd •Tot alfa i
lur
eofac oolr oom orf reezerroom t hatcannotber epair
edqui cklyma yleadto
trai
ningofs ta
ff.Bloodc entr
esgr owt oa bsorbc hangea ndtopr ovi
dei ncreasedcapacit
y thet otallossofa l
lc ontent s
.Thi scouldr e s
ultisac ritic
a ldisruptiontot hes upplyof
requir
edt oservi
cepopul ati
oninc re
as e
s.Whe nt hec entrei
slocatedonal ar
gepa rc
elof bloodi nt hehealt
hs y s
tem.Aspa rtoft hec entr
e sriskma nageme nt,coolr oomsa nd
land,growthma yoc cursimplybye xpandingt hec entre.Whe nthesitei ss mallandthe free
z err oomsi nbotht hepr oces
singa ndi n
ventorya nddi s t
ributi
ona r
eass houldhave
centr
ei smul t
i-s
toreyed,growthi smor edi f
ficult
.Somef lexi
bil
ityca nbea chieve
dby excessc apaci
tytoallow
locat
ingoffic
es( s
oftore asil
yre-locatabl
ea ccommoda t
ion)adja
centtoa re assuchasthe
laborat
orie
sthatarelikel
yt ogrow.I nex t
remec ases,someoft heof f
icesma yber e
locat
ed
off-s
ite. Bloodf l
ow
Thepl anni
ngofabloodc entr
eshoul
dpe r
mitthemo ve
mentofbloodinone
dire
cti
ont hroug
hthecentr
e .
Theproces
sflowforbloodshoul
dbeplanneds
othat
ther
eismi ni
mum re-
tra
cingorc r
ossi
ngofpathsatdiff
ere
ntpoint
sintheha
ndl
ing
Ri
skManagement
proces
s.
Thebl oodc entr
ei sre s
pons i
blefort heprocess
ing,testi
nga nds tor
ageofbl oodi nthe
nationa lorprovincialBTS.I fthefac i
li
tyiscentr
alized,a nyf ai
lureinthepr ocess
ing , AccessandLocat i
on
tes
tinga ndstorageofbl ood,oroft hebui l
dingtha thous ethe s
ea ct
ivi
ties,mayha vea Thebl oodc entreisthehubf orthecoll
ecti
on,s t
orageanddi s
tri
but i
onofbl oodand
highlya dver
sei mpa cton t heBTS.Thebl ood c entrebui lding,and pa rt
icular
lyi ts bloodpr oducts.Itmus tbeacces
sibl
etot hestaff
,donors,thedeli
ve r
yofs uppli
es
engine eri
ngs er
vices,shoul dbedesignedwi t
hc l
osec onsi
de rat
i onofl i
kelyris
ksa ndho w and
bestt hesec a
nbema nage d.Thiswillofte
nr e
sultinade greeofdupl ic
ationins omeof equipme ntandt hedispatc
hofbl ood.Toc arr
youtt heserole
se f
fecti
vel
y,thefacil
it
y
thee ngineer
ing equi pme nt.Aspa r tof theor ganization’
so veral
lr i
sk ma nageme nt mus tbel ocat
edc l
oset omajorpublictr
ansportroutesandpopul at
ioncentres.
str
at egy,a na ct
ion pl ans hould bef ormulateda nd impl eme ntedint hee ventofa Althoughr oada cce
ssisofpr imaryimportance,goodroada c
cessfrom t
hef aci
li
tyto
proce ss
ing ,t
esti
ng,bui ldingors er
vic e
sfail
uretoe nsuret hatv er
ifi
edbloodi sav a
ilable ma j
orr a
i lnodesand/ora i
rportswillal
sobei mpor t
antforfaci
lit
iescover
ingl a
rge
asre quired. geographica r
eas.
Hour sofoper ati
on
TheI n v
entor
ya ndDi stri
butiona re
asofabl oodc entr
eg e
ne r
all
yope rate24hour s
, Coll
ecti
on
se
ve n daysawe ekt oe nsuretha tblood i
sa vai
lableto hospit
alsa tallt i
mes,and AtBloodCent r
eor
partic
ularl
yint hec as
eofe mergenci
es.Otherareasofthebloodc entreusuall
yoperate atcoll
ecti
oncentr
e
duringnor malbus i
nesshour s
,althoughcolle
ctioncentresmayope ra
teoutofbus i
ness
hourst oma x
imi zedonora cces
s.Thede sig
noft hec e
ntreshoulda ll
owf or“ l
ocking
down”a reast
ha ta r
ec l
osed,whi l
ema inta
ini
nga ccesstothosearea
st hatareoperati
ng.
Securit
ya ndstafff a
cili
tie
ss houldbede si
gnedt osuitthehoursofope r
ationofe ach
departmentwi t
hi nthebloodc entre.

Regi
str
ati
on Test
ing
Disabledaccess
Thebloodc e
ntreshouldbeacc
ess
ibl
etos ta
ffa nddonorswithdisa
bil
iti
es.Theheal
th
sec
torshoul
dl e
adthewa yinpr
ovi
dingwhe e
lchaira
cces
sinbuildi
ngswhe r
ediff
ere
nces
inleve
lsoffloori
ngoc cur
.Doors,cor
ridorsandtoil
etc ompart
me nt
sshouldals
obe
buil
ttoaccommoda tepers
onsi
nwhe el
chair
s.

Sampl
eAr
chi
ve
Bl oodandsampl er egist ration Pr
ocess
Re al-ti
mec ontrolofa llblooda ndbl oods a mplemo veme ntintoa ndoutoft hec entre
isre quire
dt oe nsurea ccuratedoc ume nt ati
onofa l
ls amplesa ndpr oductst hrough
proc ess
ing,testingands tora
g eandt oe nsureoperat
iona leffic
iencyAl lblooda ndblood
produc tse nte
ringt hebl oodc ent
r es houldpa s
st hroughac e
nt r
alr ec
e pt i
ona nd/or
registrati
on poi nt.Some bl ood c entresha v
ea s eparater egi
strati
on poi ntint he
labor at
oriesfors ampl esr eferredf rom e lsewherefort e
stinga tthec entr e.Ifthi sis
propos ed,ar iska ssessme nts houldbec a
rriedoutt ode terminei fma intaini
ngt wo
registrati
onpoi ntsint hec entre( c
e ntralregist
rati
onus ual
lyinPr ocessi
nga ndas ampl e Quar
ant
ineSt
orage
registrati
oni ntheTe s
tingLa bor atories)pos esanyt hreattoa ccurateandt otal
doc ume ntati
onofa llblooduni tsands ampl es
.Similarl
y,allblooddi stri
but edf r
om t he
centr eshouldbedoc ume nteda tac entra l
dispatchregistra
tionpoi nt.Allblooddi s
pos ed
on s iteors entof fs i
tef ordi sposa ls
houl d bedoc ume nt
e da tac ent raldisposal
registrati
onpoi nt.

Rel
easeI
nvent
ory Di
sposal
Irradiat i
onf aciliti
es
Somebl oodc ent r
esma yr equi
reirradiat
ionofbl ooda ndbloodpr oducts
.I nsuc h
centre
si rradiationfa c
ili
ti
esmus tbede s
igne da c
cordingtolocalbuildinga ndr adi
ation
standards a nd r egulat
ions.Spe c
iala t
tent i
on mus tbe pa i
dt oe nclosur
e of t he
irr
a di
atione quipme ntandt hema nagementofa nywa s
tema teri
alsg ene r
ated.Whe r
e
localstandardsa ndregulat
ionsdonote xis
t ,faci
liti
esshouldbede si
g nedi naccordance
withi nterna ti
ona ls t
andards(referto Appe ndixA:Re fer
enceDoc ume nt
s).Blood
irr
a di
atione quipme ntisv er
yhe avy
.Thes t
ructuralenginee
rs houldc heckt oensure Di
str
ibut
ion
thatthes truc t
ur eisadequatetosupportt hei rr
adiator
.
ENGI
NEERI
NG SERVI
CES
El
ect
ricEng
ine
eri
ngSubSt
ati
ona
ndGe
ner
ati
on
El
ect
rica
lloa
dr e
qui
reme
ntperbe
d= 3KW to5KW.
El
ect
ricsubst
ati
onandst
andbyg
ene
rat
orr
oom s
houl
dbepr
ovi
ded.

I
ll
umi
nat
ion
Theil
lumina
tiona
ndl
ight
ningi
nthehos
pit
als
houl
dbedonea
spe
rthepr
esc
ribe
d
st
anda
rds.

Eme
rge
ncyLi
ght
ing
Sha
dowlessl
ighti
nopera
tiontheatr
eandde
liv
eryr
oomsshouldbepr
ovi
ded.
Emerg
enc
yportabl
eli
ghtunit
ss houl
dbepro
videdi
nthewardsandde
part
ments
.
Ca
llBe
lls
Cal
lbell
swithswitc
hesforal
lbe
dsshoul
dbepro
vide
dinallt
ypesofwa rdswi
th
i
ndic
atorli
ghtsandloc
ationi
ndi
cat
orsit
uat
edi
nthenur
sesdutyroom ofthewar
ds.
Ve
nti
lat
ion
Thevent
il
ati
oninthehospi
talma
ybea
chi
eve
dbye
ithe
rna
tur
als
uppl
yorby
mec
hanic
alexha
ustofair
.
Me
cha
nic
alEng
ine
eri
ng
Air-
conditioni
ngandRoom He at
inginopera
tionthea
treandneo-nat
aluni
tsshoul
d
beprovided.Aircoole
rsorhotai
rconvect
orsmaybepr ov
idedforthecomfor
tof
pati
entsands t
affdependi
ngonthelocalnee
ds.Hospi
talshoul
dbepr ov
ide
dwi t
h
watercoolersa
ndr ef
rig
era
torinwar
dsandde part
mentsdependi
ngupon
theloc
a lneeds
.
Dr
aina
gea
ndSa
nit
ati
on
Thec ons
truc
tionandma i
nte
nanceofdrai
nageandsani
tat
ionsyste
mf orwa
stewat
er,
surf
acewater
,subsoi
lwatera
ndsewera
geshallbeinacc
ordancewit
hthepres
cri
bed
sta
ndards
.Prescr
ibedst
andar
dsandlocalgui
deli
ness
hallbefoll
owed.

SOUND LEVELSAND LI
GHTI
NG
•TheWor ldHe al
thOr ganiza
tionrecomme ndst hatavera
gepa t
ientr
oom noi
sel e
vel
s
remai
na round30de ci
bels.
•Ther ec
omme ndedma ximum noi s
eleveli
s40de cibel
s.
•Av e
ragesoundl eve
la thospital
s:48de ci
bels.
•Peaknoi seleve
lreachesmor ethan80de cibel
s .
•Noi s
ele vel
sreache
d67de cibelsintheICU a nd42de ci
belsinsur
gic
alwards.
•Themos tcommons ource
sofnoi sereportedbypa t
ient
sa r
estaffcon
vers
ation,
roommates,alarms,inter
coms,a ndpagers.
Admi
nist
rat
ivedepar
tment
MEDI
CALRECORDS FI
NANCE
Thisde partmentdea
lswit
hrec
ordi
ng,andma i
ntai
ningal
ltherec
ords
/fi
lesof Thisdepart
mentlooksaft
erthefinanc ialaspectsofthehospit
al.
i
npa t
ientsas Theyma kebudget
s,fi
nanci
alplansf ort hefutureandall
ocatefi
nancial
wellasoutpatie
nts. r
esourc
estothevari
ousdepart
me ntsoft hehos pi
talfort
heirupgradat
ion.
Itiswi ththesere
cor
dsthatme
dica
lsta
tis
tic
sc a
nbef or
mulate
da ndi
tserve
sasa Theya l
soprovi
dewagestat
ementsf ort hes t
affa ndove
rse
epur chas
esof
re
ferenceforfutur
epurpos
es. medic
alsuppl
iesandpharmaceut
icalsf ort hehospita
l.

MEDI
CALMAI
NTENANCE& ENGI
NEERI
NG
MEDI
CALMAI
NTENANCE& ENGI
NEERI
NG Thisdepart
me ntmakessuret
hatthehospi
talisinope r
ablecondit
ion.
Thi sdepart
me ntmakessur
ethatthehospit
alisinoperabl
ec ondi
tion. Itma k
esplansandcarri
esoutvari
ousproj
ectsforthehos pi
tal
.
Itma k
esplansandcarri
esoutvar
iousprojec
tsforthehospital
. Thisdepart
me ntmakessuret
hatallel
ect
ric
alfacil
it
iesa r
einperfectc
onditi
on,
Thi sdepart
me ntmakessur
ethatallel
ectr
icalf
acil
it
iesareinperfe
c tc
ondit
ion,car
rie
s c
arrie
soutrepairandrepl
acementworkforai
r-condit
ioningunits
,plumbing,
outrepairandrepla
cementworkfora i
r-c
ondit
ioningunit
s,plumbing,st
eelworks,a
nd s
teelworks
,andg ene
ralta
k e
scareoftheover
allmaintenanceofthehospita
l.
gener
a lta
kescareoftheover
allmai
nt e
nanceofthehospital
.

HUMAN RESOURCES
I
NFORMATION TECHNOLOGY& Thisdepartmenti
sg i
ventheobjecti
veofr e
cruit
ingeffi
cie
nthuma nr e
sourc
es
forthehospital
.
COMMUNICATI
ON Ital
soha sthedutyofc r
eati
ngpolici
esandpr ocedur
esthatthestaffhavet
o
Allhospit
alstodayusecomputerstok eeptrackofpatie
ntrecordsandothe
rmedica
lly foll
owi nthe
r
ela
tedaffai
rs. hospita
l.
There
forethisdepart
mentisinc har
geofpr ovi
dingte
chnica
lsupportaswhenneede
d Itai
msa tensuri
ngempl oy
eesatis
fact
ion,goodwor ki
ngconditi
onsa nd
a
ndk ee
pt hesystemsupdate
da ndprovides upportwhensyst
emsc ras
h. provi
sionofmone tar
ya ndnonmone tarybenefi
tsfortheemployees
.
Theyalsoaimt oprovi
deeffe
c t
iveonlineservi
cesforpati
entsandhelptokeept
he Iti
sa l
sor e
sponsi
bleforprovi
dingcompe nsa
tionfortheserv
icesrender
edby
e
ntir
ehospitalinf
ormedofc er
taineventsthattakeplac
ewi t
hinthehospit
al. theemployees.
AHU
•From fires afe
typoi ntofv iew,s eparatea irhandli
nguni ts
(AHU) foreach
floorshallbepr ovide dsoa st oa voidt heha zardsari
singfrom spre
adoff ir
e
ands mok ethroug ht heairc onditioningduc ts.
•Thea irduc t
ss hallbes epar at
ef rom e achAHU t oits
floorandinnowa yshal
l
interconnectwi tht heduc tofa nyot he rfloor.
•Theduc ta nde quipme ntma ybei nstalledinroomha vingwa l
ls,
doorsa ndfir
e
da mperinduc texit
ing /enteringt her oom of120mi nfireres
ist
ancerating
.
•Suchsha ft
sa ndduc tsshallha vea l
lpa ssivefir
ec ont
rolme et
ing120mi nfir
e
resis
tancera
t i
ngr equi re
me ntt ome ett heobj ect
iveofi sol
ati
onoft hef l
oor
from spreadoff i
ret ouppe ra ndl owe rf l
oorsthroughs haf
t/ductwork.

Foll
owi ngaret
heparameterswhi
chshal
lbetakeni
nto
considerati
onwhi
ledesi
gningHVACsyst
em f
orheal
thcar
e
faci
li
ties:

•Temperatur
ea ndhumidi t
yr equi
rementsofv ariousspace
s;
•Venti
lati
ona ndfil
tra
tionr e
qui r
ementsforc ontaminat
ioncont
rol
;
•Restr
icti
onona irmo v
e mentbe t
we e
na djoini
ngs paces
;
•Permit
tedtolera
nceone nvi
ronme nt
alcondi t
ions;
•Syst
emr eli
abil
it
ya ndma intaina
bili
ty;and
•Adaptabil
it
yoft hesystemf orfireemergencyandf orsmokemanage
ment
. AI
RFLOW AND FI
LTRATI
ON

•Out sideairi
ntakesshal
lbelocate
da tleas
t8ma wayfromexha
ustst
acks,
AI
RDI
STRI
BUTI
ON SYSTEM cooli
ngt owerand/ora nyotherpol
lutingsource.
•Bot t
om ofa noutsideairint
a k
eshallnotbel ocat
edl e
sst
han2m abo v
e
•De s
ignoft hea i
rdi str
ibut i
ons y stems ha l
lbes uchthatairmo vementis groundl e
veland1m a boveanyroofterracele
vel.
from cleant ol esscleana reas. •Ex haustoutle
tsshallbelocate
da tami nimum heightof3m awayfrom
•Re c
irculationofa irshoul dbea voidedi nc ri
tic
a lca
reareas. groundl e
vel
.
•Forc rit
ica lcareareas,cons tantvol umes y s
temss hal
lbeusedt oma inta
in
properpr essur erel
a t
ionsa ndv entil
a ti
on.
NEGATI
VEAND POSI
TIVEI
SOLATI
ON ROOM
•Cr iti
c alar easing enera lareope rati
ngt heat
res,ICUs,isolati
onr ooms ,
ster
ilea r
eas ,pos t
ope rat
ivepa tientc are; •Ai rs houl df lowf rom cor ri
dor sintot hei s
ol at
ionr oom topr eve
ntt he
•Forpa tientr oomsa ndnon- criti
cala reas,vari
ableairvol
umes y
s t
ems hal
l spreadofa irbor nec ontami nantsf r
om thei solati
onr oom toot herareas
.
bec onsideredf ore nergyc ons ervat
ion •Thepur pos eoft hisdes ig
ni stoe l
imina tethes pre
ad ofi nfe
ctious
•Ac t
ives mok econtrols y st
emss ha l
lbeus eda l
ongwi thfirea nds moke contami nant sa nd pa t
hogensi ntot hes urroundinge nvi
ronme ntviat he
partit
ions airborner oute .
•Pr ope risol a
tionda mpe rsma ybepr ov i
de dint heaircir
culati
ons ystem •Cl assN i sapplic
a bletoa llinfectionisolationr oomswhe rethepa ti
ents
forremo valofa nestheticg asesorf umi gatione f
fect kno wnt oors uspectedt oha veinfectionsarepl aced.
•Ai rha ndl ingde vicess ha l
lbede signedt opreventwa t
eri ntr
us i
ona nd •Ai rf low mus tbef r
om t he“ c
leaner”a re
at owardst headjoini
ngs pace
permita cces sforinspe ct
iona ndma intenanc e
. (throughdoor sorothe rope nings)
•Forc riti
ca lareas,boths upplya ira ndr eturnairshallbeduc ted.Duc t
s •Cl assP i sa ppli
c abletoa llpr otect
ivee nv i
ronme ntshous i
ngs ever
ely
shal
lbes izedf orme dium v e
locitya ndme dium press
uredrop( 12m/sa nd neutrope nica ndimmuno- suppr essedpa t
ients.
4mm f or10m Ma x).
H V A C
Re
lia
blepo
wers
uppl
yshoul
dbee
nsur
edt
ocr
iti
cala
rea
s.Re
gul
ator
y Br
onchoscopyandsput
um i
nduct
ionuni
ts.
me t
hodsshouldbeadopte
dtocont
rolthefluc
tua
tionofpower
.Lo w
volt
agec a
n notope ra
tetheequi
pmell.
t,hencet oens
ureproper Thes upplya irtot heseshouldbede li
vereda thighl evelinawa ythatmi nimize
s
supply
,vol
tagecorr
ecti
ondev
ice
smaybeus e
d.Generat
ors
"shouldbe reci
rcula
tion ofpot ent
ial
lyc ont
aminatedr oom a ir
.Tot alcirc
ulateda i
rqua nti
ty
util
is
edaspo werbac
kupdevi
cespa
rti
cular
lyincri
tic
alca
reare
as. shouldnotbel e
sst han12ACHR whe nthes upplya i
rf i
lter
sa r
ea tthei
rma xi
mum
press
uredr op.Oft hisami ni
mum of25% mus tbeout doora ir
.Procedureroomsa nd
Minimum r ecomme ndeda reaswhi chshouldbeair
-condi
ti
onedare
: reco
veryr oomss houldbema inta
inedatane gati
vepr e
s s
ureinr ela
tiontoa djace
nt
•Ope rati
ont heatersandpr oc e
dur ea
reas. area
s.Roomsorboot hsusedforbronchoscopy,sputum inducti
ona ndotherhi g
hr i
sk
•Re cov
e ryarea. coughinducingproceduresshouldbepr o
videdwi thlocalexhaustventi
lat
ion.
•ICU,CCU,NI CU.
•Labora tor
ies.
•Ima gi
nga reas. •Car
diaccat
het
eri
zat
ionuni
t.Thei
mpor
tantconsi
der
ati
onsar
e:
•Hi ghde pendencyuni tsina nyde pa
rtment.
•Da yca r
ef aci
lit
ies. -Di rectionofa i
rf lowswi thinthepr ocedurer oom mus tal
wa ysbef rom cleantol es
s
•Di al
ysisrooms /facil
it
y . c
l ea
na re a
s.
•De li
verysuites/labourrooms . -Suppl ya irt othe s
et mi tss houldbede l
iver
eda thi ghl evelinawa yt hatminimi ze
s
•The rapeuti
cf aci
liti
es,endos copysuite
,r a
diot
herapyf
aci
li
ty,pat
h cir
culationofpot ent i
allyc ontaminatedr oom a ira ndpr o vi
dest hec l
eanestairsupply
l
abs,tre
a tmentroom. overthepr oc edurear e
a .
•Bloodt ransfusi
ons ervic
e( BTS) . -Tot alc ir
c ulateda irqua ntityshouldnotbel esst han15ACHR.
•Stores-wa l
ki nc ooler
s,coldr oom. *Endos copyuni ts.Ve ntilationinwor kroomswhe ree ndoscope sarec le
aneds hould
Mortuarys ervi
ces. achieveami ni mum of15ACHR.Ot herc onsidera ti
onsa r
e:
•Ge ner
a lwardsi s
olati
onr ooms( opt
ional
). -Whe rema nuale ndosc opesdi si
nfectionwi thg lut a
ralde h
ydeoc curs
,thee ndoscopes
•Privat
ewa r
ds . anddi sinfectiont rayss houldbec ontainedbyas ystem ofl oc alexhaustventil
ation.
-Whe rea ut omaticors e1ni -a
utoma ticdisinfect orsa reus ed,al ocali
zede xha us
t
Thes
emus tcomplywi t
hthefoll
owingrequi
re ments
- s
y st
e m s houl d be pr ovide dt oa chievea ppr opriatec apturea nd r e
mo val of
Humidif
ica
tion should be ac
hiev
ed by t he directinj
ect
ion of contami nateda i
r.
l
ow-pre
ssur
es tea
m. intothesupplyairs t
ream.Whe r
ereti
cul
ated -Fume smus tbedr awna wa yfrom theope r
ator'swor kpos iti
on.
st
eamisnota v
ail
able,a
ne l
ect
rodetypehumi dif
iermaybeused. -Fi breoptice ndos cope ss toragecupboa rdsmus tbeme c
ha nicall
yv ented witha n
e
x hausts ystemt or e
mo v eglut ar
aldehyder es
idua l
s .
Duc twor k with duc tmount e
d humi di
fiers hould ha
vea de
qua t
e
rneansofwa terremoval.Theot heress
enti
a lconditi
onsrecomme nded
f
orduc tworkmodul eareasf oll
ows:
-Noi nternalli
ning.
-Re asonableaccessforcleaningwithoutne edforma j
orwor ks. CONCLUSI
ON
-At tenuators must havei mpe rvi
ous lining betweenf acing and HV AC i sav i
talfuncti
onofhos pi
talde
signandcont
rol
st emper
ature,humidit
y,
acousticli
ning. cl
eanli
nessandmo v
eme ntofai
rsoastobeconduci
vet
otherequir
ementsofpa t
ient
s,
-At tenuatorsmus tber ea
di l
yr emoveda nd loca
ted withi
n plant s
taff,vi
si
torsande quipmentinthehuspi
tal
.Itmustbeplannedandi mplemente
d
r
oomsa ndot heraccess
ibleareasthatfaci
litat
ese a
syremov al
. s
cienti
fi
call
yandhol i
stic
all
y.
Fac
ili
ti
yforDi
sabl
ed
Ah o s
pitali
stradit
ionall
yd esignedfortheaverageadu ltand /o rchil
do fn or
ma l
Wheel
chai
rs
physic
al andme ntalcapabi
liti
es.Ho wever
,personswi thlo como t
ion,ma nipu
lat
o-
ryo rsensorydisa
b i
lit
iesalsov i
sittheh o
spit
alan diti sclesi
rabletoh av
ea ppr
o- Th es pacereq ui
re
me ntsformo veme nto fwh e
el
cha
ir
s
priat
efa c
il
iti
esd e
signedf orthem. isa su nder:
•Mi n i
mu mc le
arwidthf orsing
lewh eelc
h a
ir900mm
•Mi n i
mu md earwidthfortwowh e
elcha
irs1800mm
KeyPl anni ngandDes ignPar amet res •Tu rningf or\-Vhe e
lchai
r1 800mm
Cl earfloo rspaceforawh eelcha
irl 220x9 15mm
Th eaims houldb etop rovi
d eab arr
ierfre
een v
ironme n ttot h
ed isable
dp er
sons. •Cl eardo or-waywidth9 15mm
Th erecomme nd e
dd es
ignp arame t
ersforpeoplewithd is
ab i
li
tiesareasfoll
ows: Cl earsp a
c erequir
edfo rkneesan dfoo t
re
stsforwhe
el
-
•Ac cessi
bleparkings pace
sc losetoe ntr
ancesshouldb eavail
ab l
efo rthehand- c
i h ai
r
capped. ac c
e s
st oawo rkbe nc
h /washbasin/tabl
ei s800mm
•Th eresho ul
db ea c
cessibl
er outefortheh a
n di
capp edt hrougou tthehealt
hcae (
r wi dth),
faci
lit
yc onnecti
nga llserviceareas/facil
it
ies.
Th eres h oul
db ea c
cessi
blefrot 4
n 0 0 mm( d e
p t
h)and7 5 0mm( height). Clearfloors pac ef orawheel c hai r
entrancewithrampf ac
ili
ti
e s
.
•Th ereshou l
db en op r
otrusionsando bstac
lesinth ep assage
wa ysthatareli
kel
y
tob eusedb ythev i
suall
yh an di
capped, e
lder
lyandt h en on-amb ula
to r
y. Ramp Lif ts/El evat or
•As i
ng l
ev vhe
clchairrequiresac l
earfloorspaceo f1 220x9 1 5mm. Fortwo
i
.e,vhee
lchair
sc r
o s
singe acho therami n
imumc l
ear· wi dtho f1 800mm i sr- P
e a t
ien tsinwh e
el
ch a
irsrequ i
rer amp swi h Ho
t sp
ita
l e
lev
atordoorsshou
ldb ewid etof acil
i-
quired. do ub l
eh a ndrai
ls.
Th eresh o
u l
db eal an
d i
ng t at
ethemo vementofb e
ds,an dmu ltiplewh e
el-
Wh ee
lchair
ssh ouldb ereadilyavai
lableattheen t
ranc elob by
o ft h
ea mb ul
atoy p
r lan neda fterever
y9m. Lon guninterru
p t
ed c hai
rs.Aseto fdoub
leh a
ndra i
lsisreco mme nd-
carefacil
it
y.On ewh eelc
h ai
rr eq
u i
resas pa
ceo f1.0m' . ramp sa ndg r
eate
rs l
op esares af
e t
yh azar
d s e d.Thed i
mension
sforll
fts
/e levat
orc arsforu se
•Co ntrolpanelsforthel i
ftsshou l
db eatheightrangeo f8 90-13 7
0mm. an ds h ouldb eavoided.Th eg radie
n tofa b yp e
opleon·wh e
el
chair
sarea sfoll
ovv s:
•Wi nd ows i
ll
smu stb elowe n o
u ghtoe nabl
eseated( wh eel
chair)andb edri
dden r amps hou l
dn otb esteepert han1 :
1 2.The •Le ngth203 0mm( pref
err
ed2 400mm) .
patient
stoh aveano u t
sideview. mi nimu mc learwidtho far amps houl
db e •Br ea
d t
h1 370n u
n(p re
fer
red1 8 50)
.
Th ema ximu msillheightinp at
ientb e
dr oomi srecon unend e
dt ob e6 00mm. 1 2 0 0mm. •Do oropeni
n g915mm( pr
eferred1 20 0).
•A1 15 0m. md oort op a
tientro o
msi sprefer
redb eca useb e
dswi tha c
cess
o r
ie
s
arefrequentl
ymo vedf romo neroomt oa not
h e
r.
•F orpeo pl
ewithi mp ai
redv i
sioncon t
rast
ingcoloursa ndwa r
n i
n gblocksshoul
d
beu s
edt oa i
dt h eiden t
ifi
cati
o no fd oors
,s ta
irs,r amp s,passageways.Bli
nd
peop l
eb ei
ng
rest
ric
tedt otacti
lereadingin cl
ud i
ngBr a
il
le,appropriates i
gnagessh oul
db euti
-
l
isedfo rthei
rb enef
it.
Minimum dimensi
ons
•Th ereshou l
db eaud i
blean dvisualal
a r
ms yst
ema v ai
lablefora ler
tingtheaudi
- (
in mm)f orel evat
or
toryandv isua
ll
yh an di
capp ed. Sideelevat
ionoframp(al
lmeasurementsar
einmm) cars
Fac
ili
ti
yforDi
sabl
ed
Si
gnage
Apersonona· wheel
cha
irisl
essth
an1200mmh i
gh.
Thesignagesexcl
usi
ve
lyforwh e
elc
hai
ruser
sshoul
d
bebetwee
n7 50n unand1 200mm. Thesi
gna
gesfor
peo
plewithv i
sualdi
sa
bil
iti
esandpeopl
ewit
hamb u-
l
ator
yd is
abili
ti
esshoul
db ebetween1200mm will
ena
bleboththewh e
elc
hai
ru s
er/dis
abl
edambul
ator
y
Ur i
nal s
per
sontob eseenfr
omt heopposi
tesi
de. Uri
nalf
ort
hea
mbu
lat
oryd
isa
ble
dsh
oul
dbep
rov
ide
dha
vi
ngf
ol
lo
win
g
f
eat
ure
s:

Handr
ail
s •Shoul
dh a
veaminimumc lea
rspaceof7 50mmb y120
0mm.
•Ther
eshouldbenos t
epsinfr
o n
to ftheuri
nal
.
Han
drai
l
sshoul
dbein
sta
ll
edatahei
ghtof8
0 0mm •Th er
eshouldbegrabbars
.
t
o900mmo nbot
hsi
desofsta
ir
sandramps
.They •Thepri
vacyshi
el
dsshouldall
owad e
ar1-vi
dthof7
50mmo rs
houl
d
s
houl
dhaveamini
mumc l
ea
rspaceo
f4 0mmf r
om n ote
xte
ndb eyo
ndthefrontedgeoftheu r
ina
l. Conc
lus
ion
t
hewal
lande
xte
ndatl
eas
t300mmb eyon
dthest
ai
rs •Its
houldpref
era
blybeofwa l
l-hungtypewit
hther
imn o
tmor
eth
an
a
ndramps
. 430mmf romthefl
o or
. Heal
thc
arefa
ci
li
ti
esshouldcatertotheneedsof
t
hedis
able
d,bot
ha mbula
toryaswe l
lasadmitt
ed
pa
ti
ents
.Th einte
rnati
onals y
mb olo fa cces
s
s
houl
db edi
spl
ayedoutsi
debu i
l
d i
ngswithacces
-
Was
hbas
in s
ibl
efaci
li
ti
esanda ta r
easwh erefaci
l
iti
esa r
e
pr
ovi
dedforpeopl
ewithdisa
b i
lit
ie
s.Acces
sibi
li
-
Thesesh
ouldhav
ethefoll
owi
ngcha r
act
eri
st
ic
s: t
yforthevari
ousfaci
li
ti
es/s e
rvice
so f
fer
edb y
•Dimensi
onsofapprox
imat
el
y5 20mmx4 10mm. t
hehospi
tal
stothed i
sa
bledma kesnurs
ingsim-
•Minimumd i
sta
nceb et
weenthec e
n t
er
li
peoft h
e pl
er
,isl
essst
renuoustosta
ff,pati
ent
sind e
p e
n-
fi
xt
ureandthesi
dewa l
lisre
comme ndedlobe460 de
nceanddigni
t
mm.
•Topedgesho
uldbeb e
twee
n80 0-
8 40mmf r
omt h
e
fl
oor
.
•Kneespa
ceofatle
ast750widex2 0
0mmd ee
pand
680mmh i
ghwit
ha naddi
ti
onaltoespac
eofatle
ast
750mmwi de,250mmd e
epand2 30mmh i
gh.
•Cle
arfl
oorspa
ceof7 50mmwi dex1 200mmd ee
p Washbas i
nfor
thedisabl
ed
ofwh i
chama xi
mumo f480mm d epthshoul
dbe (measurement
s
unde
rthewashba
si
n. areinmm)
THEHEALI
NG ENVI
RONMENT
Thewor dhe al
ingcome sfrom Angl
o-saxonwor dha e
len,whi chme anst oharmonyofmi nd,bodya nds pri
t.He al
ingisnotthesamea scuring,whichisa boutf ixi
ngpr oblemse r
adicat
ing
diese
sa ndde c
reasi
ngs ympt oms.Peopleca nbehe aledev eniftheya renotc ur
ed.Suche nvironme ntcanr e
duc estr
essandanxiet
y,whichpos i
ti
velya f
fectsourhe al
thinanumbe rofwa y
s.
Ne ur
osc i
e nceisshowingt hatourbr a
ina ndne rvous,endoc r
inea ndimmunes yst
ema r
ec onstantlyinterac
ting.Asneurosci
enti
stsaidthat"whatyoua r
et hinkinga tanymome ntischanging
yourbioc hemistr
yofbody ".Thusanoi sy,confusinghos pit
alroom mi ghtleaveapati
entnotonl yf e
eli
ngwor rie
d,sadorhe l
plessbutalsorais
ehi s
/he rbloodpr es
sure,hear trat
ea ndmus cl
e
tensi
on. Thes amueliins t
itute
,hasdevelopedamode lthatsuggesttha theal
ingistheres
ul tofi ntensi
on,pe r
sonalwholenes
s,rel
ati
onships,heal
thyl i
festyl
e,c oll
aborati
veme dicalcar
ea nd
heali
ngs pa c
es.Thousa ndsofy earago,theGr eeksde si
g nedtempl ethatsurroundedpati
entwi t
hna ture,music,andarttorest
oreharmonya ndpr omotehe a l
ing.In19t hc entury,Florence
nighti
nga lespokeoft hei mportanc
eofna turallight
,fre s
ha i
ra ndqui etforheali
ng,sayingt hathe a
lthcareprovider
sshouldputpa t
ientinthebe stpossiblec ondit
ions ot hatna t
urec a
na c
t
andhe ali
ngc a
noc cur
.

THERAPEUTI CENVI RONMENT

Itistheenvironmentwhicha i
dshe a
ling
,thusbe
comespartofthether
apyproces
s.Char
acter
ist
icsofTher
apeut
icEnvi
ronmentar
e-
1)Itissaf
e.(NoHos pit
alinfec
tions)
2)Itisappropriat
eforHe al
ing,infactita
idshe
ali
ng.(En
v i
ronment
alfac
torsdonotcre
atetoohotortoocoldtemper
atur
es;t
oohottempera
tur
eslea
dtosweat
ing,mak
esape
r s
on
susce
ptibl
et os e
condaryinfe
cti
on,tooc ol
dtemper
atur
esleadtovas
oconst
rict
ionofsur
facevasc
ulat
ure
,agai
nma ki
ngthepers
onsus
cepti
bletosec
ondar
yinf
ect
ion)Itmea
nscontr
oll
inga
ll
3)Envir
onme ntalparamete
rs.
Itissecur
e.(NoSt r
ess)

Everye ffortshouldbema detoma k

etheHos pita
ls t
aya sunthreat
ening,comfortable,ands tr
ess-
freeaspossi
ble.Hos pi
talpati
entsareveryanxious,conf use
da ndappre
hensiv
e.Thei
r
atte
nda ntsa r
ee venmoreanxious.Thesefee
lingsi mpeder e
c ov
erytog oodhe al
tha ndma yprolongpa t
ient
'sst
ayint hehospit
al.AHos pi
tal
'sinteri
orde signshouldbebasedona
compr e
he nsiveunderst
andingoft hefac
ili
ty'
smi s
sionandi t
spatie
ntpr ofil
e.Thec haracte
rist
icsoft hepati
entprofil
ewi l
ldeterminethedegreet owhic htheinter
iordes
ignshoul
da ddr
ess
specif
icpr oblemsr e
lat
edtoa gi
ng ,l
ossofv i
sua lacuit
Y,ot herphysi
cala ndme nt
aldi sabil
it
ies.Apr operdesi
gnpr o
v i
desphysica
l,me nta
landps ychologicalcomfort
swhenus i
ngthe
Hos pit
a lfaci
lit
yt her
ebyreducingconfl
ictbetwe enHos pit
a lst
affandpa t
ient
s(includingtheiratte
nda nt
s)ands peci
fic
all
yaddr es
sestheabusiv
e nesstendencie
s.Itmustme e
tthe
expectationsoft hemajori
tyofHos pi
talUser s
.Donotpr o vi
deair-
condi t
ionedinteriorstotribal
,vill
ager
sorGuz z a
rs;
justasyouwoul dnotpr ovidetheSout hIndianmeal
sinaHos pit
al
l
oc ate
di nNor thIndia.

Someimportanta spectsofc r
e a
tinggoodt he r
apeuti
ci nte
riorare:
1.Usefamiliarandc ultura
llyreleva
ntma t
erial
swhe reve
rc ons
istentwiths
ani
tat
ionandot
herfunc
tionalnee
ds
2.Usecheerfulandv ar
iedcoloursandt extures
3.Usena t
urallighta ndventil
ationwhe rev
e rfea
sible
4.Whe r
everpos s
ibl e
,providetheout doorv ie
wf rom everypatie
ntbe d
5.Usephotomur alsofna turescenes
6.Repeatsimila
robj ectsandpa tter
nst oestabli
shc onti
nuity
7.Desi
gna"wa y-finding"processbyus ings i
gnage,graphicsanda rt
worktof
acil
it
atemov
ementofPa t
ient
s,vi
si
tor
s,a
nds
taf
f
FACTORSAFFECTI
NG HEALI
NG ENVI
RONMENT

DAYLI GHT
"Lightissof undament
althati
thascometos ymboliz
elifeit
sel
fjus
tasitsopposi
te,dar
kness,s
ymbolizesdeat
h".li
ghtisknowntoaffec
thormonalandme ta
boli
cbalanceand
ente
rtainmentofbodyr hy
t hms
.Infact
,neuros
cienti
sts
,beli
eves
:"Li
ghtisthemostimportantenvi
ronmentinput,a
fterf
ood,incontr
oll
ingthebodyfunct
ion".Dayl
ightreduce
spai
n
andde pres
siona swe
llasi
mpr o
vespati
entandstaffsati
sfa
cti
on.Res
ear
chi ndi
cat
esthatexposur
etolight-dayli
ghtorbrig
ht,ful
lspect
rum ar
tif
ici
all
ight-iseff
ect
iveinreduci
ng
depres
s i
one venfort
hosehospi
tal
ize
dwi t
hs ev
eredepress
ion.

COLOUR
Colourhasthequali
tytoc ontrolt heheal
ingenvir
onme nt -
byma ki
ngpa t
ents/vi
sitorsrel
ax,andtheyimprovet
hepa ramedicalsta
ffperforma
ncebyreduci
ngf a
tig
uea ndenha nci
ng
concent
rat
ion.Thepr e
domi nantc olourusedinheal
t hcarebuil
dingsisei
thercream oroff-whit
e,duetothei
rneutralambi e
nce.Ho weve
r,nowwiththegrea
terunder
standingofhuma n
psycheandtheheali
ngqualityofv ari
ouscolours
,the yarebeingusedinhealthc
arebui l
dingsforbet
tervi
sualexpre
ssions.Colourscanbeusedtocrea
tevari
etyandcontinuity,y
et
ma i
ntai
naba l
ance.Itcanalsobee xploi
tedtoassi
sti nwa yfi
nding.Unpleas
ants mellareknownt oi
ncreas
eheartrateandr es
pirati
onandhaveopposi
teeffe
ct.Rese
archershaveshown
thatolf
act
oryme s
sagesrea
c ht hebr ai
nfastert
hana uralsigns
.Re s
earchatYaleandDuk eha sdemonstr
atedtha
ts ni
ffi
ngs pecif
icflor
alandfrui
tfra
grance
sslowedrespi
ration,lo
wered
bloodpres
sureandhe ar
trate,a ndr el
axe
dmus cle
s.Re centres
e a
rchconducte
da tMi lanUni v
ersi
tyhasshownthatessenti
aloilsareeff
ecti
vei
nt r
eat
inganxie
tyandde pre
ssion.

NOI SE
noiseisoneoft hemos tnoxiousofenvi
ronments t
ress
ors:I
tproducesagene
rali
zedstr
essreacti
ont hatcanincre
asebloodchol
est
eroll
eve
ls,i
ncr
eas
etheneedforpai
nmedi
cat
ionsby
loweri
nga li
ndividual
'spainindivi
dua
lst hr
eshold,andkeepbrai
ns t
imula
tedsothatthepa t
ientcannotrestorslee
p,whichimpedeshe
ali
ng.Inwor
dsofFlorenc
e
Ni g
htingal
e-"unnece
ssarynoise...
ist
hemos tcri
ticalabs
enceofcarewhic
hc anbeinfl
icte
dont hesic
korwe l
l'
.Hos pi
tal
sareat
tempti
ngtobothre
ducethesour
cesofa
ndimprove
soundproofi
ngwi thsound-absorbi
ngcei
ling
sa ndcarpeti
nginordertore
ducestre
ss.Carpetalonecanr e
ducea mbie
ntnoisebyupto70%.

ARTAND MUSI C
Thea rtisanexpressionbyhuma nitythatc arr
iesthelegacyofthecultur
ea ndtouchesthehe ar
t.Arthasthet e
nde nc
ytos t
iremoti
onsinpe opl
ea ndhe l
po v
ercomestr
essinthe
deepe
stne ed.I
nt hehos pita
lsett
ing,mus icanda rtther
apycanhelpt odist
ractpeoplef
r om thei
rpain,enabl
et hemtofeeltha
tlif
eiswor t
hf i
ghti
ngf or.Thi
sstateofmindpositi
vel
y
Inf
luencesheali
nga nde nhance
simmunol ogiccompe te
ncy."Musiccana l
sohaveana nal
g esi
corpa i
nkill
ingeffe
c twhenplea
surece
ntre
soft hebrainstimulat
ethepitui
tarygl
andto
rel
eas
ee ndorphins.Soothingmus i
cha sbe e
nkno wnt olowertheleve
lsofc ate
cholamine
,s uchasadrenal
ine,andt olowe
rbloodpress
ure,heartra
te,andt heamountoffreefa
ttyaci
ds
intheblood,pot e
ntiall
yreducingther i
sksofh y
pe r
tensi
on,st
roke,andcoronaryheartdisease.
Thisisther e
asonwh ymusichasbeenusedtohe l
pt r
ea tdepr
ess
ion,torea
chautis
tic
chi
ldren,andtor ela
xa git
atedpsychia
tricpa t
ients
.

NATURE/ LANDSCAPE
Anumbe rofs t
udiesha vepr e
sente
ds tr
ongevidencethate
ven3t o5mi nute sofc onta
ctwi t
hna tureca nsi
gnifi
cant l
yde cre
ases tr
ess,reduceangerandf e
ar,andi ncreasepleas
ant
feel
ings.Indoorgardens,aqua r
iums,andlandscapestobri
ngna turei
ntot hee nv ir
onme nt.Currentdesignstandardse ncouragetheus eofl a
rgewindo wsi npatienta reasthatall
ow
patientsandthei
rv is
itorstos eeoutsi
deandr ecei
vethebenefi
tsofnatura llight.Pa t
ientsinroomst ha tr
eceiv
emor esunlightma ybel essdepres
seda ndha ves horterstays
.Fort hose
reasons,windowsareno wc onsidere
dat her
apeuticcomponentofpa ti
entr ooms .Severalre
searc
he shaveshownt ha tjus
tt heviewoft heparkorna turale l
ement scanber estor
ati
v eeve
n
inthea cutel
ystr
essedpa ti
e nts
.Viewoft hevegetat
ionorthegre e
nery
,r e
duc e
st heh yperte
nsiona ndt hebl
oodpr ess
urele v
els,inducingpositi
veemot ionslike,ha ppiness
,joyetc.and
reducingpa i
n,fe
ar,angera ndt ens
ion.Greenoutdoorspacesnotonlypr o
v idef orabe autif
ulsettingforahos pit
a lbuta l
soa l
lowpa tientstoengageinmor eph ysicalacti
vit
Y,result
ing
inahe althi
erphysi
c a
lhe al
tht oo.Whe napa t
ientisequal
lyexposedtoahe avyv eget
atedareaandac oncre
tewa l
l,hef eelsmor erela
x edandc al
me ratt hevie
woft hegr e
ens.
DEVELOPI
NG AHEALI
NG ENVI
RONMENT:
Lights
• Nog l
arelight
ingi npatientRoom.
• Abi l
it
yt ocontrolintensit
yofLi ght
• Goodr eadinglight
•Wi ndows houldbel owe noughforpati
enttose
eout
door
swhi
lel
yingi
nbe
d
•Patie
ntroom l i
ghtingshouldbef ul
lspect
rum

Colour
• Care
fulus
eofc olortocre
atemood,li
ftspi
ri
t,and-makeroomscheer
ful
• Useinbedli
nens,bedspr
eads,g
owns,per
sonalh
y g
ienekit
s,acc
essor
ies
,foodt
ray
s

Viewsofnature
•Viewsofnaturef
rom pa
tie
nt'
sroom
•IndoorLa
nds c
api
ng.

Text
ure
Int
roduc
ete
xtur
alv
ari
etyi
nwa
lls
urf
ace
s,f
loor
s,c
eil
ing
s,f
urni
tur
e,f
abr
ics
,anda
rtwor
k

Noisecontrol
• Soundoff oots
tepsinc orr
idor
•Sl
ammi ngdoors,cl
ankingl a
tche
s
• Loudspeakerpagi
ngsy ste
m
• Otherpa ti
ent
s'tel
evi
sionsandradi
os
• Clankingofdishesonf oodcart
s

Ai
rqua l
it
y
Needforfr
eshai
r,s
olar
ium,orroofgar
den
• Avoi
danceofodi
fer
ousclea
ningage
nts
• Adequat
enumberofairchang
es.

Thermalcomfort
Abil
itytocontr
olroom
te
mpe ra
tur
e,humidit
y,anda
irc
irc
ula
tiont
osui
tpe
rsona
lne
eds
.

Acc
ommoda t
ionforfamili
es
Pr
ovidepl
aceforfamil
yme mberst
omakethe
mfeelwe
lcome,ra
thertha
nintrusi
ve
Pr
ovidevi
si
torlounge
sa ndacc
esstov
endi
ngmac
hines
,tel
ephonesandcaf
ete
r i
a
 FUTUREOFOT DES0I GN
1.Hy bri
dOT
Ah ybridOT i ncorporatesimaging,li
keCT a ndMR,orot hertypesofimag i
ng ,li
keC- a
rm,
int
os urger
y.Br i
ng ingima g
ingi ntoora djac
enttothes urg
icalspa
ceme anstha tthepatient
doesn’
thavet obemo ve
ddur ingsurge
ry,reduci
ngri
ska ndinconve
nie
nce.
Thebi gg es
tadvantage
ofah ybri
dOTi st hatactualscansofthea f
fect
edpartofthebodya r
eforwardeda ndavai
lable
forrevi
ewa ndus ei mmediatel
yi ntheope rat
ingroom.Thi sall
owsthes ur
g e
ont oconti
nue
operat
ing,forexampl e,inahi ghris
ka re
al i
kethebrai
nwi ththemostup-to-datedata.

2.DigitalOT
AdigitalOTi sas et
upi nwhi chimag es
,videoandot he rITa ndsof t
wares ourcesareconnected
toanddi splay
e donas ingledevice
.Thi sg oesbeyonds implec ontrolofde vicesands oft
war e
,
al
lowinga l
sof orthee nric
hme ntofme dicaldatawithint heope r
a t
ingroom.
A digit
alOT s et
upt he refor
ef unctionsa sac entralhubf orclinica
li mageda tains i
det he
opera
tingr oom andf orr ecordi
ng,c olle
ctingandf orwa rdi
ngda tat otheHos pit
alITs ystem,
whereisi tcentra
llys tored.Thes urg e
onc a
nc ontrolt heda t
ai nsi
det heOT f rom speci
fied
dis
playsaccordingtot heirdesire
ds etupa ndals
oha st heposs i
bil
itytodi s
pl a
yt heimag e
sfrom
manydi ff
erentdevice
s .

3.IntegratedOT
Inte
grationi nplanninga nddesi
gnofOT c anbes e e
nf r
om per s
pectiv
eofs erviceinte
gr ati
on
ands ystemsi nt
egration.I nservi
cei ntegr
ation,singlea ut
hori z
e dvendorisr e
sponsiblef or
gett
inga llki
ndsoft hewor kdonea l
ongwi thcoordinationwi t
ha llot
he rse
rviceprovide
r s.But,
conventional
lyintegrationi nOT isr ef
erre
dt os ys
temsi ntegrati
on,whi c
hme ansfunctionally
connectingtheOT e nvironment.Itincl
udesint e
grati
onofpa t
ientinformati
ons y
stem,a udio,
vide
o,s urgic
allightsa ndr oom li
ghts,buil
dinga utoma ti
on( HVAC) ,medicalequipment ,etc.
He a
lthcarepe rs
onne lc ane as
il
yr outea udiov i
suals ource
sa nd effe
cti
velyc ontr
ols ur g
ical
equipme nt.

4.OR21
Designoft hisfutur i
sti
cs urgic a
ls uitef e a
turingr obot
ict echnologyi swe llunderway,and
pate
ntsa r
epe ndingont hisuni quet echnol ogiesandpr oces
se s
.
OR21s uit
esc anbede si
gnedt oa ccommoda t
emul t
iplespecial
tie
sori ndi vi
duali
zedtot r
eata
speci
aldiseasecate
g ory.Specialtiesthatc anbe ne f
itfrom OR21a recardiology,car
dia
csurgery
,
neuros
ur g
ery,ne urology,v asculars urge ry,stroket hera
py ,spines urgery,or t
hopaedi
csa nd
int
erventi
ona lra
diol ogy.
Thes uiteswi l
linc ludethel a tes
ti nope r a
tingr oom de s
ign,ima gingc apabil
ity
,equipment
int
egrati
ona ndpa tientmoni tor i
ng ,includingt echnologi
ess uchas:
Inte
lli
gentlighti
ngs yst
em ope ratedt hroug hthes urgeon’
swa nd
Diagnosti
cima ginge quipme ntt hatpr ovidesr eal
-timeinforma t
iondur ings ur
gery
Comput er-
controll
e d,mot oriz
e dc ombi na ti
onope rat
ingroom t a
bleandI CU bed
Roboticcross-cl
eanings yste
mswi thbioc idalmi st
ing
.
Schedul
eofaccomodat
ion
Hospi
tal
sforTomor
row
Hos pital
swe refir
stcons t
ructeda tthecomme nce mentoftheChr i
sti
a n
eratos helte
rs i
ck/wea r
yt r
avelersandpe rsonswhowe repoor/il lt
obe
tre
a t
eda thome .Thet ransf
or mationoft her olea ndfuncti
onoft he
hospitklthrought hea g
esha sbe enme ta
mor phic.Ithastobea c ce
pte d
thatbricksa ndmor ta
ra l
onedonotma kemit standinghospi
tals
,Ma jor
tra
ns f
or mati
onsa reoc curri
ngi n del
ive
ryofhe al
thca
re.Adv a
nc esi n
basics cie
nce sincl
udingmol ecul
arbi ol
ogy ,e vi
de ncebased medicine,
demogr aphica nd epidemiologicalchangesha vea nd a
ret r
ansforming
me dic
a lcare
.Thi shasdi r
ectlyimpa ct
eda ndc ont i
nuestoinfluencethe
archit
ec t
urede s
ignandpl anningoff uturehos pital
s

NEED TO PLAN FORTHEFUTURE

Ithasbe enr ightlys a
idt ha the alt
hcarefa ci
lit
iesaget mpredictablywi th
changingme dicalt echnology ,and evolvinghe alt
hca r
ede liv
e r
ys ystem
rendering s ome obs olete wr tl
ler eprieving other s
.I t ha st o be
acknmv ledg edt ha tl
'vhati sbui ltfort uda y• Nillnotbepe r mane nt.
Predictioni sv er
ydi fficult,pa rti
cular
lywhe nl tconcernsthef uture.Itis
ahe r
cul eant askt o\'isualiz ehospital
sfort omor rows i
ncet heimpa c t
ing
dimensi onst hata reandwi lle v
olvethefuturehos pit
alsa r
emul tiL,ctoria
l
<1ndnuta hv 1y spr edicta ble
.Itha sbe encomme nt edthatifhos pita
l
archi
tec turei sr e s
tri
c t
e dt oa ntiquate
ds pecif
icati
onsa nd cookbook
approac hes,a rt
isticf reedom wi llbe c onvert
edi nto a bme aucrati
c
ri
g i
dity.I tishi ghlyde sir
abl et oma keana t
temptt opr e
viewt he we llas
tot he e mot iona l
, ph ysic ala nd ps ychological needs of pa tients.
Adopt i
on,a da ptiona ndi mpl ementat
ionoft echnologieswoul da l
sobe
patie
ntf ocus e
d.
Hospi
tal
sforTomor
row Boundar
ylessI
nst
itut
ions
Hos pitalsint hefuturewillbeut i
lizedma i
nlyf orintensiveandc ri
tical Inthef uture,t
hemor ecommonhos pit
alf uncti
onswi llmovecloserto
care
.The me dicalca re of ot hera ilments woul d be pr ovi
ded by pati
ent sa nd onlyaf ew speci
fic
,s pe ci
alize
df unct
ions will be
ambul atoryc arefacil
itie
s,da yc arec ente
rs,he al
thcarea ndhomec ar
e concentrat
e datotherplac
es.Tele
medicinec apabil
it
ieswouldbef ull
y
li
otels.Tr ans
mur alcare,)patientta i
loredca r
epr ovide
dont heba sisof uti
liz
e d.Thehos pi
tal
swouldbeahubi nane tworks e
rvi
ngpa t
ientsin
clos
ec ollaborati
on a nd jointr lsponsibi
liti
esbe tween hos pit
alsa nd hospitalsandhome s
.Advancementsi
ni nforma t
iona ndcommuni ca
tion
healthcarehomec entetswi l
lbea dopte dforc onvenie
nc e,comforta nd tec
hnol ogywi l
lenablehea
lthca
retobepr ovi
de dindependentoft ime
cost-effect
iveness
.The a ssi
s te
dl iv
ing r e
sidences wi l
la ccommoda t
e andpl ace.
resi
de ntswi th ar angeof c ognit
ivea nd physic
ala bili
tiesand of fe
r
faci
litieswhichwi llma xi
mi z
et hequa lityoflife,de pedence;autonomy , I
npat
ientandDi
agonost
icf
aci
li
ties
safe
ty ,dignit
y,choicea ndpriv a
cy.
I
nthefutur
ehospfralcha
ng esarevi
sual
ize
dinthefol
lowi
ng:
-
Shi
ftfrom i
npati
enttoda ycar
e .
-
Shi
fttohigh-t
echmology,shortsta
y,hi
ghdepende
ncycar
e.
-
Chang
ei ninpat
ientanddiagnosti
cunits
.Someofthemeare
:
Change-Anessent
ialf
eat
ureoft
he
fut
ure Exi
sti
ngandFut
urenor
ms
Hos pi talsoft hefuturewoul dre quir
etoc hangethei
rfuncti
onsa ndr oles Inf uture,thee xi
sti
ngnor msofhos pi t
alc onst
r uctionwi llbec ha nged.
freque ntly.Thi s will be ne c ess
itat
ed due t o pa ti
ent needs a nd Patientfocusedope ra
tionalr est
r uchtringwi llbet heg uidi ngpr inciple.It
expe ctations,technolog i
calandme dicaladvancementsaswella schang e has be enr ightl
yc omme nted upon t hatbui lding c ode sr eflecta nd
healthc arenor ms . perpetuatet het ecl
mol ogyofs omee arl
ierpe r i
od.The yr estrictt he
Thehos pitaloft hef utureshoul dt l
rnsbede signedforfle
xibili
tya nd potentialuseofne wide asandma ter
ia l
s.Int hehos pit
a lsoft hef utur e
,
expa nda bil
ity.Uni versal
/mul t
ipur pose/ modularde si
gn woulde na ble hospitalnor ms,gri
ds,sche duleofa cc
ommoda ti
onwi llcha ngek eepingi n
theg oldena rchitect
ur a
lpr i
ncipleofi nde t
erminacytobef oll
o wed,i .
e. ti
mewi tht hene ed,e xpe c
tationsa nd func ti
ona lity,e .g .theus eof
enabl ingbui ldingstogr ow withor derandc hangewi t
hc a
lm.Hos pital la
pa roscopicsurgery
,robot icsur gerywi llma kethepr es
e ntnor msofOT
buildi ngswi l
lbea daptabletoc hangingrequire
me ntsanddesignedsoa s re
dunda nt .Public-pr ivatepa r tners
hi psa ndout sourci ngoff acili
ties
toi nhi bitchang eoff uncti
onle ast. woul da l
sobeanor mr athert ha na ne xceptiona ndwi lli mpac tont he
pla
nni nga ndde si
gningofhos pi tal
s.

Bar
rierf
reeenvi
ronment I
mpactofemer
gingt
echnol
ogi
es
Abarr
ierfr
eeenv
ironmenttofaci
li
tatethedi
sable
dinfac
ili
tyutil
is
ation I
tisenvis
agedthatte
chnol
ogi
essuchasna
note
clr
nologywil
limpacton
wil
lbeanesse
nti
alc omponentofallthehospit
als
.Thefaci
li
tie
sint he t
hehospital
soft omorr
owinare
a ssuc
hasinf
ras
truct
ure
,sta
ffi
ng,and
hos
pit
alswoul
dbea cces
sibl
eandusablebype r
sonwit
hdisabil
it
ies. s
paceprogramming.
Concl
usi
on
Hos pitalsa rema tri
xor ganisati
ons ,ana ma lgam ofc ultur a
l,social,
architechtral,te chnologya nd e conomi c alf actors .Toe nablethe m
fulfi
lt heirr olepe rtinentt ot het ime s,i ti sess entia lt ha thospital
s
should be e n vi
s i
one df ort he pr es
e nta nd t he f ut ure.Hos pita
l
buildingsha vet obede signe dtaki ngi nt oc ons idera tiont hepr e
sent
andf utur is
ticre quireme nts.Pa t
ientf oc useda rchitec tur e,technology
integration wi the nvironme nt,s ha pe opt imi zation, c ar
eg iver
s
requireme nts,s tructurali ntegrity,ha rmoni ousc on ver genceoft he
dinical, di agnos ti
c,t herapeutic,a dmi nistrativea nd hos pi
tali
ty
dime nsionsa ree ssentialst hatwoul dbei ncor por ate di nbuilding
hospitalsoft hef uture.Someofe xisti
nghe a lt
hc arehos pital
sa l
ready
have a numbe rof f acili
tiesi nc orpor atedt ha ta re pe rc
e i
veda s
essentialsfort omor row. Thehos pi t
alsoft omor r owwi llbea blelo
balancet he' needl ist'oft hepr ofessiona ls,the' wa ntl i
st'oft he
patientsa nd t he c ommuni tya nd pr ovide a ne ffec tive,hol i
stic,
ethical,s tandardi zed,a c c
essible,a f
for dable ,a cce pta ble,s afea nd
securehe a l
thc a
rei nstit
l .
1te.
Conc
ludedPar
amet
ers
Conc
ludedAr
eaSt
andar
ds