SYNOPSIS

(MULTI-SPECIALITY
HOSPITAL)
A hospital which does not feel, look or smell like one.

Rohan Birajdar 6/2/21 5th Year 10th Semester

 SYNOPSIS (MULTI-SPECIALITY HOSPITAL)

1.1. PROJECT INTRODUCTION

 A hospital is a health care institution providing patient treatment with specialized

medical and nursing staff and medical equipment. The best-known type of hospital is the
general hospital, which typically has an emergency department to treat urgent health
problems ranging from fire and accident victims to a sudden illness. A district hospital
typically is the major health care facility in its region, with many beds for intensive care
and additional beds for patients who need long-term care. Specialized hospitals include
trauma centers, rehabilitation hospitals, children's hospitals, seniors' (geriatric)
hospitals, and hospitals for dealing with specific medical needs such as psychiatric
treatment (see psychiatric hospital) and certain disease categories. Specialized hospitals
can help reduce health care costs compared to general hospitals. Hospitals are classified
as general, specialty, or government depending on the sources of income received.

 A teaching hospital combines assistance to people with teaching to medical students

and nurses. A medical facility smaller than a hospital is generally called a clinic. Hospitals
have a range of departments (e.g., surgery and urgent care) and specialist units such as
cardiology. Some hospitals have outpatient departments and some have chronic
treatment units. Common support units include a pharmacy, pathology, and radiology.

 Hospitals are usually funded by public funding, health organizations (for profit or
nonprofit), health insurance companies, or charities, including direct charitable
donations. Historically, hospitals were often founded and funded by religious orders, or
by charitable individuals and leaders.

 Currently, hospitals are largely staffed by professional physicians, surgeons, nurses, and
allied health practitioners, whereas in the past, this work was usually performed by the
members of founding religious orders or by volunteers. However, there are various
Catholic religious orders, such as the Alexians and the Bon Secours Sisters that still focus
on hospital ministry in the late 1990s, as well as several other Christian denominations,
including the Methodists and Lutherans, which run hospitals. In accordance with the
original meaning of the word, hospitals were originally "places of hospitality", and this
meaning is still preserved in the names of some institutions such as the Royal Hospital
Chelsea, established in 1681 as a retirement and nursing home for veteran soldiers.

Topic- Multi-Specialty Hospital.

Sub topic- Multi- Specialty Hospital + Medical College + Hostel.

Funding and financing of the project-

1.2. Need of the study

 As the quality of health care has increasingly become an issue around the world,
hospitals have increasingly had to pay serious attention to this matter. Independent
external assessment of quality is one of the most powerful ways to assess this aspect of
health care, and hospital accreditation is one means by which this is achieved.

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 The World Health Organization noted in 2011 that going into hospital was far riskier
than flying. Globally the chance of a patient being subject to an error was about 10% and
the chance of death resulting from an error was about 1 in 300 according to Liam
Donaldson. 7% of hospitalized patients in developed countries, and 10% in developing
countries, acquire at least one health care-associated infection. In the USA 1.7 million
infections are acquired in hospital each year, leading to 100,000 deaths, figures much
worse than in Europe where there were 4.5 million infections and 37,000 deaths.

Problems faced by a Doctor:

 Valuable is an understatement when it comes to defining a doctor’s contribution to
society. They perform a duty which if successful can uplift them to the status of a “God,”
but if it goes the other way, they might end up in jail. There is no middle path, only two
extremities in this profession, which makes it all more priceless and precarious at the
same time.

 A doctor’s life is not an easy one. It is mired with difficult life-altering decisions, a
rigorous work schedule with no guarantee of family life. The most important aspect is
that although they are adept in their specialty practice, the expertise does not warrant a
positive outcome all the time. For doctors to perform efficiently, there are certain
external factors which play a crucial role. Unfortunately, for Indian doctors, these
external elements do not pan out positively, therefore, affecting their performance and
result in chronic stress which takes a toll on their health as well. Let us go through some
of these external factors.

 When a patient is admitted to a hospital, the doctor is not only taking the responsibility
of diagnosing the afflicted but indirectly has to take the responsibility of explaining the
process to the patients’ relatives who have pinned their hopes on the professional. From
the moment the patient enters a hospital, all eyes and ears are towards the doctors. This
is a significant pressure to work in. Additionally, in India, people visit doctors with a
thought that it is a surety that the latter will successfully cure the ailment. Not saying
that it is wrong to put faith in a doctor but this backfires with severe consequences in
the case of a negative or unexpected medical outcome.

 Doctors being physically assaulted is one common consequence. Such incidents are not
new and unanticipated in the Indian medical fraternity. In February 2018 in Kolkata,
relatives of a patient who died due to alleged medical negligence beat up the doctors
who they thought were responsible for the death. The doctors alleged that the patient
had been attended appropriately and they referred the patient to the relevant medical
department. Regardless of the fact whether there was medical negligence involved or
not, one must note that the patients did not hinder to assault the doctors rather than
file an official complaint regarding the matter.

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 A 2017 news report by The Hindu quoted a survey by the Indian Medical Association
(IMA) which revealed that a massive 82.7% of Indian doctors are “stressed out” in their
jobs. The survey results further said that that “the fear of violence” was the central
cause of the stress with 46.3% of the surveyed doctors claiming the same. 24.2% of the
doctors were scared of being prosecuted while 13.7% of them worried about criminal
prosecution.

Problems faced by staff and patients in hospital:

 Majority of hospital staff work overtime and are rewarded for the extra efforts that they
put in. The overtime per week is more than 5-man hours and the main reason for such
overtime is to help the organization and superior order.
 During the study it was found that the staff problems included problem of dissatisfaction
with their pay scale.
 Majority of staff did not have problems relating to motivational programs provided in
the organization.
 It was found that, patient face long waiting hours, uncomfortable night stay provision,
rough behavior of security and business-like attitude if staff. According to the patients
and their relatives’ provision for night stay was a major problem faced by patients.
 The study showed that majority of respondents can afford their and their family’s
medical expenses.
 It was found that ideal hospital should have qualities such as patient centric culture,
quality consciousness, staff development and motivation, improved hospitality and
trustworthiness of hospital regarding cost diagnosis and treatment.
 Satisfaction level of the patient was found to be average. But still it can be said that the
patients were not totally satisfied.
 It was found that actual medical expenses of patients were more than the estimated
figures.
 During the study it was observed that a patient is attracted towards a hospital mainly
because of the medical facilities. Friendly behavior of staff, advance technology and
reference from acquaintances also play an important role in selecting a hospital.

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 The study concluded that the professionalism in hospitals is not appropriate and as
expected by patients.
 It was found that a patient seeks an ideal hospital that has patient centric culture,
quality consciousness, staff development and motivation, improved hospitality and
trustworthiness with respect to cost, diagnosis and treatment. Hospitality and
trustworthiness are two main qualities that a patient seeks in an ideal hospital.

A good designed hospital building approaches the problems faced by the doctors, staff
and patients and it also includes the following:

1. Good Campus Planning

Good campus planning and architecture allows the layout of streets, building
approach and building entries to serve as wayfinding devices. Trying to read
signs while driving is nerve-wracking. Vehicular access and approach roads
should be designed to be intuitive and clear to alleviate stress on the commute.
In addition, choices in scale, lighting and materiality for the main entry to the
hospital, parking structures, and medical office buildings put patients and their
families on the quickest path to the front door. Locating vertical circulation
towers and major public spaces near main entries serves as a beacon for those
arriving at night, signaling to patients and families where to go with clearly
illuminated entrances.

Randall Children’s Hospital at Legacy Emanuel by ZGF Architects, Portland, OR

2. Welcoming Design Aesthetic

Good hospital design should reflect both the region and the visual and cultural
ethos of the institution. Today, many institutions reference elements of
hospitality design when discussing their vision for new buildings. This includes
covered drop-offs with valet parking, open and transparent lobbies and public
spaces, and warm, natural materials that evoke a sense of comfort. Concierge
and check-in services are becoming more common. Art and sound play a key
role in creating a calming and welcoming aesthetic and providing positive
distractions upon arrival.
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3. Drop-Off and Parking

There is no better way to feel that you are being taken care of – pampered even
– than by eliminating all worry of arrival, drop-off and parking. Free valet
services reduce stress of finding a space, paying and returning to your car. An
expanded vehicular drop-off and pick-up area accommodates these services. It is
also adaptable for ride-share and a potential autonomous car revolution. With
more patients and visitors utilizing alternative arrival methods, this drop-off
sequence will become more important than ever before as parking garages
shrink or are converted to other hospital functions.

4. Internal Wayfinding

When architecture, medical planning, interior design and environmental

graphics harmoniously blend, a first-time visitor can walk through a space
without the aid or “you are here” maps. Aligning the patient journey with key
architecture and interior elements alleviates the need for excessive signage,
which can become distracting. Less signage also means more room for design
that creates joy and delight. For example, bold colors or visually distinct changes
at elevator banks pull people toward them. Using the concourse concept or
promenade to connect departments together is a way to intuitively organize
wayfinding.
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5. A Better Waiting Area

The same holds true for check in desks and waiting areas – use the spaces and
their visual identities to intuitively help patients navigate. The waiting room is
one of the most stressful parts of a visit so make it an amazing place to be:
provide expansive views, windows for daylight, art and beautiful, comfortable
furniture. Locating waiting areas along the perimeter is an effective way to
promote wayfinding and mitigate patient and family stress.

6. Pleasant Clinical Environment

Patients and staff benefit from a well-designed space. While it is tempting to
focus only on lobbies and waiting areas, clinical areas need just as much
attention. Imaging suites, procedure rooms where patients are conscious, and
blood-draw stations benefit from natural daylight and positive distractions in
art, material palette and views. These areas are critical in creating a calming and
healing environment.

7. Onstage/Offstage Environments
Today, many healthcare institutions take cues from Disney’s onstage/offstage
concept, where impeccable service appears to happen seamlessly. When
designing a new hospital, it isn’t just about separating experience areas from
service areas but designing a circulation and planning diagram that allows the
separation of goods and services from patients and their families, both vertically
and horizontally. There are varying degrees to this separation and many
influential criteria. For example, adding service and patient transport elevators
centered in the patient wing instead of at the end of the units decreases the
amount of crossover between patients and services.

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The University of Arizona, The University of Arizona Cancer Center by ZGF Architects, Phoenix, AZ

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8. Healthy Building = Healthy Occupants

Healing happens inside hospitals and the building itself should participate in that
healing process. Designing with Red List-free materials, providing clean and
filtered air, and offering access to outside experiences with operable windows or
terraces in places where immune systems are not compromised are all
strategies for healthier buildings. Looking beyond patients to a healthier planet,
excess heat, rain and wind should be captured and stored for use. Since
hospitals are mission critical facilities and need to remain open and accessible
after events like wildfires, tornados and earthquakes the perfect hospital is a
standalone, net zero, resilient structure.

9. Personalization and choice

Personalization goes a long way in creating a comforting experience. It also
helps patients and their families have a better visit – potentially leading to
better outcomes. Just think of all the different ways for patients to customize
their experience: change room color or lighting; pick from a group, semi-private
or private room for infusion or dialysis treatment; customize overhead music or
artwork; select from city or river views. When patients are offered choice, it
provides a feeling of control over their visit and their care.

10. Dignified Discharge

Finally, consider how to give a dignified exit for patients who are leaving the
hospital, but still require assistance. Provide a comfortable and private discharge
route that does not go through the main hospital doors for those using crutches
or a wheelchair for the first time or recovering from a day procedure. This not
only provides the departing patient a more dignified departure but can calm
nerves for new patients entering the hospital.

As designers, we must pay attention to these 10 patient-centered elements to

create positive reactions for all populations within a hospital. For healthcare
institutions, this list can be used to start asking the right questions about your
own healthcare project and how design decisions will affect your hospital. For
patients, these 10 elements have the power to ensure a comfortable visit for
patients and their families, faster healing and improved outcomes.

1.3. Aim of the study

This study aims at designing and integrating Multi Specialty Hospital, Medical College, Hostel,
and a wellness center together, creating a society friendly place where not only patients visit but
people here come for educating themselves about their health, learn how to be healthy, what to
eat and how to live a healthy lifestyle i.e. A Hospital which promotes health but do not feel, look,
smell like one. Also designing a hospital that could help in the healing process of patients. One
such example for this type of hospital is Khoo Teck Puat Hospital in Singapore.

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1.4. Objective of the Study

 To reduce the stress level of doctors, nursing and other staffs working in the hospital.
 To design a hospital that can help in the healing process of patients.
 To improve the hospitality and trustworthiness for the patients and their relatives.
 To create a hospital that has patient centric culture, quality consciousness, staff
development and motivation, improved hospitality and trustworthiness with respect to
cost, diagnosis and treatment.
 To educate people in society to take of their own health, their diet habits with healthy
eating and encouraging them for the mental and physical exercises.
 To design a society friendly space where people can enjoy nature with silence.
 To design a hospital which does not feel, look, smell like hospitals.
 To improve the overall energy efficiency of the hospital building.
 To introduce the light, nature and natural ventilation right into the basements so that
the basement doesn’t feel like basement anymore.
 To design a hospital without any fences so that anybody can walk in.
 To design the hospital with various gardens, viewing towers, jogging tracks etc.
 To also introduce an urban farm in the hospital to educate people and children learn
about farming and how their foods are grown.
 To design a stress-free environment for the medical college and hostel. Taking care of
their convinces.
 To design a cycle lane and providing cycles for the people to encourage cycling to the
work or hospital instead of using transport.
 To also include stay facilities for the hospital staff and patients’ relatives.
 To design a praying space/structure for every religious person.

1.5. Scope

This study covers designing a multi-specialty hospital while trying to solve the most common
problems observed in hospitals. It also covers designing of spaces which will not only educate
people about being healthy but also connect people to each other by means of workshops and
other social activities.

1.6. Limitation

This study only covers designing a multi-specialty hospital, medical college, hostels for students,
library, canteen, auditorium, food court, campus, stay facilities for medical staff and patients’
relatives, urban farm, gardens, viewing tower, jogging track, cycling lane, praying
space/structure.

1.7. Site

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