Chapter 1: Introduction o 1.3.

2 Greek Hospitals:
• 1.1. Introduction:
This chapter holds five paragraphs that focus on several aspects, including project selection,
history of hospitals, theoretical study, aims and goals, study structure and conclusion.
what was known of human anatomy and physiology was more of a rational than a
superstitious or religious nature. His work enhanced the knowledge of anatomy. The
temples of Saturn, Hygeia, and Aesculapius, the Greek god of medicine, all served as both
medical schools for practitioners and resting places for patients under observation or
treatment.

• 1.2. Project selection:

• Based on development projects and the Egypt vision plan, there is a plan to set up an
integrated medical complex project in the city of Meidum .
• Developing medical complexes in Egypt, which achieves the principles of sustainability .
• Supplying the necessary medical services for the region.
• Renaissance medical tourism in Egypt.
• Take advantage of the area, which stands for a historical landmark.

• 1.3. History of medicine:

Fig.1.3.2 Painting depicting patients Fig.1.3.2 Aesculapius God of medicine,
o 1.3.1 Mesopotamia: in an Asclepios in Ancient Greece healing, rejuvenation, and physicians

ancient region of southwest Asia known as Mesopotamia. this fertile land has been
called the cradle of civilization. The first recorded doctor’s prescription came from Sumer
in ancient Babylon (1728–1686 BC).

o 1.3.3 Indian Hospitals:

Historical records show that efficient hospitals were constructed in India by 600 BC.
During (273–232 BC), Indian hospitals started to look like modern hospitals: They
followed principles of sanitation, and cesarean sections were performed with close attention
to technique to save both mother and infant.

Fig.1.3.1 Mesopotamia Overview map Fig.1.3.1 Mesopotamia temple design

 o 1.3.4 Roman Hospitals:
The Roman talent for organization did not extend as
readily to institutional care of the sick and injured.
Although infirmaries for sick slaves were established,
it was only among the military legions that a system
for hospitalization was developed. After the injured
were cared for in field tents, the soldiers were moved to valetudinaries, a form of hospital
erected in the garrisons along the frontier. Those stone and wooden structures were
carefully planned and were stocked with instruments, supplies, and medications. The
decree of Emperor Constantine in AD 335 closed the Aesculapius and stimulated the
building of Christian hospitals.

Fig.1.3.4
Roman Military
Hospital -
Valetudinarium

Fig.1.3.5 In a fashion that would still be recognizable today, the typical Islamic
hospital was subdivided into departments such as systemic diseases, surgery,
ophthalmology, orthopedics, and mental diseases.

o 1.3.5 Islamic Hospitals:

The development of efficient hospitals was an outstanding contribution of Islamic
civilization. The Arabs’ medical inspiration came from the Persian hospital in Djoundi
Sabour (sixth century, Turkey) Asylums for the insane were founded 10 centuries before
they first appeared in Europe. In addition, Islamic physicians oversaw the establishment of
pharmacy and chemistry as sciences. In the Arabic hospitals, separate wards were set aside
for different diseases, such as fever, eye conditions, diarrhea, wounds, and gynecological
disorders. Convalescing patients were separated from sicker patients, and provisions were
made for ambulatory patients.
Fig.1.3.5 Depicting a scene in the hospital at Cordoba, then in Al-Andalus (Muslim
Spain), this 1883 illustration shows the famed physician Al-Zahrawi (called
Abulcasis in the West) attending to a patient while his assistant carries a box of
medicines.

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 o Notable hospitals established between 500 and 1500 AD:
Year/AD Hospital Location
o 1.3.6 Modernisms:
529 Academy of Gondishapur Iran
Modern Medicine Modern hospitals during the 1920s combined technological fetishism
580 First Spanish xenodochium Mérida, Spain with intense social conservatism. Architects evoked historical styles and used traditional
706/707 Al-Wahid Bimarstan Syria, Damascus materials for the conservative outside of their buildings.

727 Ospedale di Santo Spirito Rome, Italy

800 or earlier Early hospital established in Sri Lanka Sri Lanka

805 Medieval Islamic Bimaristan Bagdad, Iraq

829 Hôtel-Dieu Paris, France

872 Al-Fustat Hospital Fustat, Egypt
981 Al-'Adudi Hospital Bimaristan Bagdad, Iraq

1083-1084 Hospital of St Nicholas, Nantwich Nantwich, England

1085 Hospital of St John the Baptist Winchester, England

1090 Santa Maria della Scala fig 1.3.6. Section of the Ottawa Civic Hospital showing the smooth tunnel connection of the kitchen and patient rooms.
Siena, Tuscany, Italy
1123 St. Bartholomew's Hospital London, England
1140 Old St. John's Hospital Bruges, Belgium
1197 Hôpital de La Grave France parking was an important feature of the modern hospital. For doctors and private patients,
1211–1222 Ospedale di San Paolo Florence, Tuscany, Italy
a private entrance, and an ambulance garage.

1249 Great Hospital Norwich, England

1277 Ospedale del Ceppo Tuscany, Italy
1288 Hospital of Santa Maria Nuova
Florence, Italy
13th Century Maristan of Sidi Frej
Fez, Morocco
(late)
fig 1.3.7. Ottawa Civic
1339 San Giacomo degli Incurabili Hospital with cars, 1925.
Lazio, Italy
1388 University Hospital Heidelberg Heidelberg, Germany

1454 Hôtel-Dieu de Lyon

Lyon, France
1456 Ospedale Maggiore di Milano Milan, Italy

1491 Dar-ul-Shifa India

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 o 1.3.7 New ways to work:

The hospital restructured its working methods. Facilitate the working methods of doctors,
nurses, demand teams, other assistants, administrators, and cleaning and laundry staff, all of whom
are trained to work as efficiently and productively as possible. In addition to the general
arrangement of the building that grouped patients according to the general treatment they needed,
the inclusion of non-medical technology such as time clocks, communication systems and the
addition of machines. The pursuit of efficiency, not driven by medical science but by social
change, has also created the need to improve the performance of existing non-medical
technologies such as elevators.

Fig 1.3.8. Elevator advertisement featuring the Royal Victoria Hospital.

Fig 1.3.9. Wall section showing soundproofing system, 1925.

Fig 1.3.10 Interior view, Royal Victoria Hospital laundry, 1931.

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• 1.4. Theoretical study: o 1.4.1.2 Basing on objective:

Most hospitals are classified according to their size, with large hospitals offering more services
and amenities than small hospitals. Hospitals may also be classified according to their specialties
or type of care provided. For example, some hospitals are designed solely for adult patients while
others provide care for both adults and children. There are other types of specialized hospitals that
are designed to treat specific medical conditions or provide services for patient populations. Each
classification of hospital has distinctive characteristics and criteria for
inclusion. some of methods to classification hospitals are given below:
General hospitals
• General Hospitals are meant to provide wide-range of various types of
healthcare, but with limited capacity. They care for patients with various-
disease conditions for both sexes to all ages, medical, surgical, paediatrics,
obstetrics, eye and ear etc. Usually, General hospitals are devoid of super-
specialist medical care.
special hospital

• They limit their service to a particular condition, maternity, paediatrics,

geriatrics, oncology etc. orthopedics.

Teaching cum Research Hospitals

o 1.4.1 Classified into:
• College is attached for medical/ nursing/ dental/ pharmacy education.
hospitals are classified according to: Main objective is to provide medical care, teaching and
research is secondary.
1. Basing on objective.
2. Basing on length of stay.
o 1.4.1.3 Basing on length of stay:
3. Basing on administration, ownership, control or financial income.
4. Depending on type of medical staff.
Short-term or short-stay hospitals
5. As per WHO classification.
6. Basing on bed capacity (size). • These are hospitals where over 90% of all patients admitted stay less than 30
7. Basing on type of care. days.

Long-term or long-stay hospitals

• These are hospitals where over 90% of all patients admitted stay 30 days or
more, i.e. mental hospital.

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 o 1.4.1.5 Depending on type of medical staff:

o 1.4.1.4 Basing on administration, ownership, control, or financial income:

Open Staff Hospital
Governmental or public hospital
• Open medical staff, which means any physician can request to practice at the
• They are owned, administered and controlled by the government. They facility, regardless of their hospital affiliation.
provide free care for patients. The hospitals are owned by: governmental
• The Ministry of Health. Close Staff Hospital
• The University
• Others. • A closed hospital system is one in which all doctors are on staff, and also
doctors that aren't on staff may not have access or privileges at said hospital.
public hospital or government hospital

• is a hospital which is owned by a government and receives government
funding. In some countries, this type of hospital provides medical care free
of charge, the cost of which is covered by government reimbursement.
Private Hospital
• Privately owned or controlled by an individual or group of physicians or
citizens or by private organization. eg, Square Hospital. Purpose is to
provide services for profit making.
Semi Govt Hospital
• Hospitals run both by the govt and private entity.
Corporate Hospital
• Hospitals which are public limited companies formed under the companies
act.
Voluntary Agency Hospital
• Not for profit hospitals by the Voluntary Organizations.
o 1.4.1.6 According to level of care:
Primary Care Hospital
• Primary care is the day-to-day healthcare given by a health care provider,
Typically this provider acts as the first contact and principal point of
continuing care for patients within a healthcare system, and coordinates other
specialist care that the patient may need. Provides mostly basic health care. It
is generally regarded as the 'gateway' to receiving more specialist care.
Secondary health care:
• his level of services are provided in District hospitals. This is the first level
of referral services, and more complicated services are dealt with which is
beyond the scope and capacity of the primary level. This level is assigned to
provide some specialist services particularly in Internal Medicine, General
Surgery, Obstetrics and Gynaecology, and Paediatrics. These are usually 50-
200 bedded hospitals.
Tertiary level
• This level deals with highly specialized services provided at regional or
central level hospitals, Such as teaching hospitals. Super specialized
hospitals, Cancer Hospital, Chest Hospital, Infectious Disease Hospital,
Mental Disease Hospital are also included in this level. These institutions
provide referral support to primary and secondary level health This also
includes Divisional and National Level Hospitals

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 o 1.4.1.7 WHO Classification (Expert Committee 1957):

o 1.4.2. Organization structure:

Regional Hospital

• Provides complex range of treatment and highly specialized services. Serves Board
a larger area than a local hospital.

Intermediate/ District Hospital Administration

• A district hospital typically is the major health care facility in its locality .
Specialty services in major disciplines (eg, Medicne, Surgery, Gynae etc). Primary services Secondary services Supportive services

Rural Hospital
-Central sterile supply -Laundry
• Remote hospitals with small number of beds and limited service capacity. It -Emergency care department -Transport
should have 20-100 beds. -Inpatient -Dietary -Maintenance
-Outpatient (OPD) -Pharmacy -Record
-Operation theatre -Therapy -Education
-Intensive care unit (ICU) -Diagonostic -Accounting
o 1.4.1.8 Basing on bed capacity (size):
-Radiology -Mortuary
-Nursing
Small hospitals -Social

• less than 100 beds.

Medium hospitals o 1.4.2.1 Staff involved in the hospital:

Medical: Others:
• 100 to 499 beds. • Doctors • Dietician
• Nurses • Nonmedical
Large hospitals
• Pharmacist paramedical staff. • Administrative assistants
• 500 or more beds • X-ray technician. • Clerk
• Physiotherapist. • Attendant
• Peon
Typically, these sizes are classified by the number of beds they have — although there can be
some variation within these groups of hospitals and medical centers. • Sweeper
• Cleaner

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 o 1.4.2.2 Functions of a hospital: • 1.5. Aims, goals, objective:
Hospitals aim to provide patients with the best possible care. To do this, hospitals have set
specific objectives for themselves. These objectives help hospitals to achieve their overall goals.

o 1.5.1 Aims:

Health • Design a healthy building for patient care.

supervision and
prevention of • Optimization of spaces of utilities.
disease • The hospital should be a safe and free form infection area.

o 1.5.2 Goals:

• Understanding the main sections of a hospital.

Investigation, • differentiate details in the hospital departments.
diagnosis and • design hospital that meets the needs of patients and gives them the
Education health
Medical research care of the care providers
sick and best care Possible.
injured
o 1.5.3 Objective:

• obtaining a function program appropriate to project needs.

• Analyze similar cases.

Rehabilitation o Understanding circulation.

o Understand the functional program.
o Understanding the relationships between the different sections.

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• 1.6. Study structure:
This diagram contains five chapters discuss Introduction, Planning principle &
• 1.7. conclusion:
Desigen principle, Case studies & Function program, Structure style &
This chapter contains five paragraphs that begin with the introduction which paves the way for the
Environmental studies, Site analysis and conclusion.
topics raised in the chapter , then continues to the selection of the project which in turn identifies the
most important reasons for choosing the project , then presents the ancient history and includes the most
important eras and stages in which hospitals were built , then to the theoretical study and clarifies the
classification of hospitals , The objectives that must be achieved from this study , and the structure of
the study for this research.
Introduction, project selection, history,
Chapter 1 Introduction theoritical study, aims & goals, study structure, .
conclusion

Planning principle Introduction, Planning principle, Design

Chapter 2 principle, conclusion
& Design principle

Case studies & Introduction, Case studies, comparative

Chapter 3 function program analysis, function program, conclusion

Structure, style Introduction, , style , structure, system,

Chapter 4 enviroment enviroment studies, conclusion

Introduction, location & historical overview,

Chapter 5 Site analysis accessing project site natural & physical
features, conclusion