APPRAISAL ASSIGNMENT

The building's typology selected is a hospital, and it is located in the palayamkottai ward
of tirunelveli, Tamil Nadu. The Hospital is a Neurology Clinic in Samadanapuram,
Tirunelveli. Mangala Hospital's hours are as follows: Mon-Fri: 15:15-19:30, Sat: 15:00-
19:30, and Sun: 14:00-15:00. The hospital offers services such as neurology, neuro
ophthalmology, and neuro surgery.It is at Tirunelvel, near St Anthony's Church
Samadanapuram. The hospital was built by a construction company called Swathi
Constructions, with Mr. Muralitharan as the primary structural engineer. Swathi
Constructions was founded in 1995 as one of the top interdisciplinary appraisal
organisations, including real estate valuers, structural stability certificates, construction
and major valuation services. The facility covers an area of 2009 square metres. It's a g+2
arrangement.
Does the hospital provides Accesibility and facilities that leaves the user with an
experience of joy , happiness , satisfaction or difficulty , stress , uncomfortable ?
The study is done to verify/check if the building has sufficient accessibility for users
and if the building meets the demands of users while also being safe. Health care is an
industry in which the patient’s user experience is crucial; patients need to be happy with
their physicians and hospitals as a whole. Improving the patient’s user experience
should be the main goal when we think about improving health-care systems and
organizational strategy. Therefore, while designing a health care, we should keep three
priorities in mind for the system: functionality, safety, and usability.
This study is to understand the circulation pattern of a hospital , the safety
measures required in a hospital , accessibility and comfort that needs to be provided for
the users . Internally, traffic routes are required for linking major clinical departments for
use by patients and staff, and for delivery of supplies to these departments. The
circulation space involves corridors, stairways and lifts. And also to verify and compare
with norms if the hospital chosen has the above mentioned facilities.

The aim of the study is to find out if the building has proper accessibility, basic
facilities and proper ventilation by comparing with the norms of the state.

The significance of the study is to find if the hospital has proper accessibility for the
users and they are provided with proper basic facilities and ventilation. All areas, both
inside and out, should comply with all standards, and ensure grades are flat enough to
allow easy movement and sidewalks and corridors are wide enough for two wheelchairs
to pass easily. The study is done verify if the hospital has been buil according to norms in
providing facity for the users.
The study is limited to understand and verify if the users have proper accessibility and are
satisfied with the facilities by comparing with the norms of the state.
ACCESSIBILITY - To have easy and safe access within a building, allowing users to travel
easily from one location to another. It involves horizontal and vertical circulation within a
building, as well as corridor width to provide people simple and pleasant access.

SAFETY - It contains all of the precautions that need be taken within the building to
ensure the wellfare of the users. This includes providing safeguards such as security, fire
safety, and so on.

LITERATURE REVIEW
The journal talks about the types of accessibilities and the need for it in a hospital.
• Sensory accessibility
• Outdoor environment
• Horizontal accessibility
• Vertical accessibility
Sensory Accessibility
Everyone, including persons with limited vision and blindness, needs easy access to
information and communication in order to traverse physical spaces. A consistent and
continuous guiding system incorporates tactile cautions, guide ways, and braille
information. Signs can be read with enough lighting. It is also vital to allow those who
communicate using sign language or visual clues to see their communication partners.
Vertical accessibility
Vertical accessibility refers to building components that allow people to navigate level
transitions and reach upper floors in the built environment. Avoiding needless level
changes, providing ramps, installing lifts, and installing emergency stairs are all vertical
accessibility components that contribute to an accessible environment and adhere to
universal design principles.
Outdoor Environments
Obstacles, signage, street furniture, paths, kerb ramps, pedestrian crossings, parking, and
children's playgrounds are all covered. Obstacles, projecting features, and anything else
that obstructs the travel path should be eliminated or relocated. Directional signs,
emergency and hazard alerts, information notice boards, and location signs are all
examples of signage. It should be clear, easy to read and understand, well-lit at night,
noticeable, and well-placed. Kerb ramps may comprise a tiny ramp placed into the
footpath to facilitate access to the roadway. These are notably beneficial to those with
disabilities, but they are also beneficial to bikers, pedestrians with baby carriages, and
other groups. Kerb ramps that are well-designed allow users to deal with the level
differences between walkways and street or building entrances with minimal
inconvenience.
Horizontal Accessibility
It comprises horizontally accessible building features such as doors, entrance areas and
lobbies, corridors, handrails and railings, as well as bathrooms and toilets. Entrance
spaces and lobbies should be easily accessible, well-lit, and well-supported by clear and
consistent signage. Handrails and railings must be appropriately configured and installed
between 800 mm and 1 m in height. Handrails should be installed around all accessible
balconies, galleries, dangerous locations, platforms, ramps, roofs, and stairs for safety,
help, and rest.
The journal states that , Architecture is about creating environment for user; for them to
experience it. Well-designed places and objects can improve healing, while poor design
can inhibit it.
It also states that , the case of patients who irrespective of their health problems,
also have physical, mental, sensory or psychological impairments.
The process of adapting the hospital setting to the needs of all users must, of course, cater
for those cases where there is a difficulty in moving around, but it must also cater for
those who have difficulties communicating, hearing, seeing, finding their bearings or
knowing where they are heading within the hospital space.
It also talks about the need of providing proper accessibilities for the users.
FACTORS REQUIRED TO BE CONSIDERED FOR A HOSPITAL
Circulation
Accessibility
Safety
Providing comfort
CIRCULATION
Hospitals are the type of structures where a large number of people need to be served. The
movement is carried out by all users. In order to perform this action, the elements of
circulation must be used, and the more users there are, the more complex the circulation
becomes.
A hospital is a complex system of interconnected functions that necessitates the
continuous movement of people and materials. Much of this movement should be
regulated.Outpatients who are visiting diagnostic and treatment areas should avoid visiting
inpatient functional areas or coming into contact with severely ill inpatients.Outpatient
routes should be straightforward and well-defined.Visitors should be able to walk directly
to each patient's nursing unit without having to pass through other areas of the
facility.Patients and visitors should be kept separate from industrial/logistical areas or
floors.Trash, recyclables, and filthy materials should be kept apart from meals and clean
supplies, and both should be kept away from patient and visitor pathways.Patients and
visitors should not be able to see cadavers being transported to and from the morgue.
Dedicated service elevators for deliveries, food and building maintenance services
Hospitals, like small cities, have main circulation corridors that are commonly referred to
as hospital streets. The manner in which the various components of the hospital are put
together to form a cohesive whole with distinct elements. In hospital architecture and
planning, the following circulations are generally considered:Patient circulation, medical
staff circulation, material circulation, visitor circulation, waste circulation, and support
staff circulation are all examples of circulation. For some circulation, certain places will
be prohibited. For instance, no visitor traffic is permitted in the Operating Theater,
isolation chambers, or laboratory workshop.In CSSD, the circulation of sterilised / clean
and unclean materials must not follow the same path.In the operating room, staff and
patient circulation should be separated.
ACCESSIBILITY
All areas, both inside and out, should:
Ensuring grades are flat enough to allow easy movement and sidewalks and corridors are
wide enough for two wheelchairs to pass easily.
Ensuring entrance areas are designed to accommodate patients with slower adaptation
rates to dark and light; marking glass walls and doors to make their presence obvious.
SAFETY
Patient safety is the most important aspect in a hospital design, and with good cause.
Every year, between 700,000 and 1,000,000 people are admitted to hospitals in the
United States, according to the Agency for Healthcare Research and Quality. Patients
are more prone to slip and fall if the room is badly built, according to the FDA. This
accidents can be reduced by applying the following parameters :-
Handrails, smooth flooring treatments, and supportive furniture should all be included in
the design: Although railings are necessary in hospital wards, copper-coated handrails
added along hallways can assist patients transit a space safely and minimise the spread
of disease. Falls can be prevented with seamless vinyl flooring, which is smoother, more
resilient, and easier to sanitise than rubber flooring. Patients can stand or walk around
the room without the use of a wheelchair with the help of sturdy chairs with lockable
wheels.
Trips and falls: According to the Joint Commission, hundreds of thousands of patients
fall in hospitals each year, with 30-50 percent of those falling injuring themselves and
lengthening their hospital stays. The patient bathroom is a dangerous place to be.
Curbless showers, smart water management, and continuous rails can all contribute to
a safer environment for patients.
Creating pathways and areas in patient rooms for mobile workstations on wheels
(WOWs) can make it easier for the team to treat patients with everything they need in
their hands. WOWs allow personnel to view every patient's medical record while on the
fly. By incorporating them into the room design, risks in hallways are eliminated.
Efficiency and Visibility: Nurse units are frequently designed as a racetrack, with patient
rooms surrounding a nursing station that serves as a support core. This design places
support and observation functions away from the patients. Consider using a more patient-
centered floor layout, like the one we designed for Temecula Valley Hospital in California.
Multiple support hubs were constructed along a major hallway, with modest nursing
stations and patient rooms within 60 feet of them. This allows workers to more easily
watch and attend to patients, as well as have easier access to the materials needed to
treat them.
Track patients using technology and security checkpoints: In order to improve patient
safety, technology plays an important role. Electronic bracelet security devices, for
example, are increasingly being required in obstetric delivery units, neonatal critical care
units, and hospital nurseries to warn staff when an infant is transported from the unit.
These systems additionally provide security checkpoints at the entrances to these baby-
sensitive facilities to ensure that non-permitted employees and guests do not obtain
entry, and that no newborn leaves the facility without medical professionals' knowledge
and approval.
Patient lifts: Investing in overhead lifts and hiring a specialised "lift team" at the hospital
may pay off sooner than we anticipate. Musculoskeletal diseases accounted for over half
of all nurse and nurse support staff accidents and illnesses, according to the Occupational
Safety and Health Administration (OSHA). Many hospitals that have installed them in
patient rooms have seen a quick return on their investment, increased staff retention, and
provided a safer workplace for both staff and patients by reducing lift injuries.
COMFORT
Fear and confusion are common sentiments among hospital patients, and these emotions
can obstruct healing. Every effort should be taken to make the hospital stay as
comfortable, stress-free, and unthreatening as possible. In the effort to create a healing
environment, the interior designer plays a critical role. The interior design of a hospital
should be based on a thorough understanding of the facility's mission and patient profile.
The degree to which the interior design should handle age, loss of visual acuity, other
physical and mental problems, and abuse will be determined by the patient profile's
characteristics. The following are some key elements to consider while designing a
therapeutic environment:Whenever possible, use known and culturally relevant materials
that are compatible with sanitation and other functional requirements.
Using a variety of bright and varied colours and textures, while keeping in mind that some
colours are inappropriate and can interfere with provider assessments of patients' pallor
and skin tones, disorient older or impaired patients, or agitate patients and staff,
especially some psychiatric patients.Allowing as much natural light as possible and
employing color-corrected lighting that closely resembles natural daylight in indoor
spacesProviding views of the outdoors from every patient bed, and wherever else
possible; picture murals of nature settings are useful when outside views aren't available.
Every project should have a "way-finding" procedure. Patients, visitors, and staff must all
know where they are, what they are going, and how to get there and back. Making areas
easy to find, identify, and utilise without asking for aid increases a patient's perception of
competence. Building components, colour, texture, and pattern, as well as artwork and
signs, should all provide cues.