CASE STUDY AND LIBRARY STUDY ON ESCORTS,FORTIS HOSPITAL AMRITSAR_ Introduction to hos Types of hospitals a According to speciality General: (which is set up to deal with many kinds of di normally has an emergency department to deal with im ate anc threats to health) “= Specialized: (hospitals for dealing with specific medical needs such psychiatric problems, certain disease categories such or orthopaedic problems) Teaching: (combines assistance to patients with teac! | and nurses and often linked to a medical school, nursing schot According to size er Small (50 beds) ae iF Medium (50-150 beds) Large (150-600 beds) Central (©600 beds)Introduction to hos According to health care level Primary care hospitals: (health care that is provided at a baste ledaly v an initial approach to a doctor) Secondary care hospitals: (service which is provided by medical spec usually provided by cardiologists, urologists and dermatolc , usually Tertiary care hospitals: (specialized consultative health car inpatients) According to ownership ‘ Government z Private District hospitals xe A district hospital typically is the major health Aicareitachi in its regi numbers of beds for intensive care and long-term care. 'Overview we Initially, Hospitals are the most complex of building typés. Each hospital is comprised a wide range of services and functional units.These include diagnostic and treatment functions, such as clinical laboratories,imaging,emergency rooms, and surgery hospitality functions, such as food service and housekeeping, and the fundamental inpatient mareonbed related ‘ function. at Hospital design discipline is extremely important in founding and building hospitals, Hospitals must have specific attributes matching the internationaluction to hospital de Accessibil ity Interior Design Aestheti csIntroduction to hos Efficiency { » Minimizing distance of necessary travel between trequendfeme spac Allow easy visual supervision of patients by limited staff. Provide sufficient no. of elevators, staircases etc. Include all needed spaces and sharing services, but no. Provide optimal, functional adjacencies, such as locatin unit adjacent to the operating suite Flexibility > Follow modular concepts of space planning and layout >» Served by modular, easily accessed,and easily modifi systems >» Open-ended design, with well-planned directions for future expa posit ning “soft spaces” such as administrative departments, a spaces” such as clinical laboratories. VV¥VVIntroduction to hospita Interior Design Aesthetics > Every effort should be made to make the hospital stay as unthr ning; comfortable and stress-free as possible. “a i * Usage of artwork. ® Using cheerful and varied colors for interior finishes and used linens. > Provide views of the outdoors from every patient bed and elsewhere where\ Cleanliness and easy maintaining > Proper, durable finishes for each functional space. » Careful detailing of such features as doorframes, casework and transitionst dirt-catching and hard to clean crevices and joints. » Adequate and appropriately located housekeeping services. Accessibility > All areas inside and outside the hospital should be designed to be easy to u kind of patients with temporary or permanent handicaps, > Ensuring grades are flat enough to allow easy movement and sidewalks and corridors are wide enough for two wheelchairs or stretchers to pass easily.Main entrancg >» Main entrance should be clearly visible, identifiable and easily accessible, preferably with a covered setting-down point fron Receptio >» The reception area should be visible from the entrance. >» Allow 1.5m counter length for each reception and space in front of the counter for patient without encroaching on circulation routes. > Counter design should be open but providing protection for the staff. > Provision for people with disabilities should bag incorporated. Record Storage: >» Needs to be close to the reception area, but ig not part of it. ® Records should be out of sight of patients and secure. » GP records will be kept centrally near reception. >» Space required needs to be calculated for the selected storage system (lateral shelving, filling cabinets, carousels)» Waiting area should be visible from reception area >» 6 seats should be allowed for each consulting and treatment | room (1.4 square metre for each) Vv This can be reduced for large premises, partig when appointment systems are operated. Arrangements can be made to screen off par area to provide space for other activities at when it is not all required for waiting Vv v B Patients should not wait in corridors nor outs in| a consulting or treatment room doors. | v Pram storage and WCs need to be near the re and waiting area. ¥ Part of the waiting area can be designed and furnished for children. » Some seating suitable for the elderly should 4 provided.Emergency De > The primary role of emergency department is to deal with serious casualties and accidents so it should be located on ground floor Separate emergency entrance with minimum vehicle headroom 3.5 Clear Sepsis to the drive-in entrance is important vv v There s' feed area for cars and cycles. It shoul in case of major disaster, Functional spaces in ER Triage room Examination room Treatment room Resuscitation room(CPR) Plaster room Surgical dressing room Observation room(short stay room) Supporting spaces ould be a separate approach, other than the OPD with a spacious Id be lacated just adjacent to the OPD so the sources can be pooled Space requirements: Reception area = 150-250 SQFT Examination area = 100 SQFT Resuscitation room = 400 SQFT X-RAY = 80SQ FT Laboratory = 200SQFT Minor OT = 350SQFT Recovery room = 70Emergency DepartmeEntrance for patients arriving by ambulance , other modes of transportation, or conveyances Entrance for walk-in patients Control station Public waiting space with appropriate public amenities Patients’ observation room Treatment cubicles Examination rooms Cast room Critical care rooms =f> Emergency Department The entry to the emergency should be shielded from the main hospital entrance preventing general patients from being a witness to ghastly sights or to tattered limbs In planning the Emergency Activity, particular attention must be paid to movements of people (patients and staff) and material (equipment and supplies) Supportive services such as laboratory, diagnostic x-ray, electracardiographic and pulmonary function facilities will be located at the boundary between the Emergency and Outpatient Activities, assuring easy access to both. The door to the room and to its. toilet must open outward to prevent the patient from locking himself eed TENT Thercelfl in.Emergency De Treatment cubicles have curtains for privacy, if necessary, and are equipped to handle examinations and minor treatments . More severe injuri 2 ° treated in critical care rooms which are of two sizes. For a coronary patient, the emergency team may consist of a number of specialists using numerous kinds of portable equipment: therefore, larger space is required to accommodate both . The cast room, used for closed reduction of fractures, is equipped similarly to a treatment cubicle with the addition of a plaster sink and trap. A blood bank should be accessible by the shortest route within the IA BSFBEOA there should be direct access - by separate entrance if necessary - the x-ray department for speedy diagnosis. Alternatively eparate x-ray facilities can be provided. deause of the urgent nature of high proportion of accident cases ,the relationship with supporting department is crucial . The door must allow passage of a patient on a stretcher who, after treatment, may be immobilized by means of orthopedic accessories and attachments to the stretcher . We have already mentioned that out- patierits should have access to the OPD directly through the Main EntranceOUT PATIENT DEPARTMENTPURPOSE: Patients who do not need overnight « hospitalization are admitted in the Outpatient Department. Surgical, dental and nursing care is provided to patients in Outpatient Department ACCESS REQUIREMENTS: PEDESTRIAN AND AMBULANCE ACCESS LOCATION: MAIN RECEPTION AND WAITING AREA USUALLY GROUND FLOOR BUT MAY BE ON THE OTHER LEVELS. RELATIONSHIP: FRACTURE CLINIC TO ACCIDENT DEPARTMENT, CONVENIENT ACCESS TO PHARMACY, GOOD ACCESS TO MEDICAL RECORDS DEPTT. OFTEN ADJACENT. <=RELATIONSHIP DIAGRAM pharmacy dispensary area accident « || emergency dept medical out=potients’ records department ‘ 7 | pO ENTRANCE TO—— N AND ENTRANCE HOSPITAL WAITINGEYE TREATMENT AREA:25M SQ AREA REQUIREMENTS: TREATMENT CHAIR,EXAMINATION AND DIAGNOSTIC INSTRUMENTS, AN EXAMINATION COUCH,A WASH BASIN ANGENT TREATMENT PURPOSE: EAR,NOSE AND THROAT TREATMENT AREA:25-30 M SQ AREA REQUIREMENTS: TREATMENT TABLE FOR EXAMINATIONS,A TREATMENT CHAIR, STERLIZER , A SINK AND A WASH BASIN, STORAGE SPACES FOR PORTABLE EQUIPMENTS. S‘TEETH ,GUMS ETC. TREATMENT :25-30MSQ A TREATMENT CHAIR WITH DENTAL UNIT A DESK, A WASH BASIN, X-RAY, ANAESTHETIC EQUIPMENT, A JUROLOGICAL TREATMENT : X-RAY DIAGNOSIS OF KIDNEYS AND UTERUS : 25-30M SQ : CLOSE TO SURGICAL DEPTT. : EXAMINATION AND TREATMENT TABLE EQUIPPED WITH WASH BASIN,SUSPENDED IRRIGATOR, FLOOR DRAINAGE, TV W.C.,INSTRUIQO) SURGICAL DEPARTMENT “FUNCTION AND LAYOUT * SHOULD BE CLOSE TO THE INTENSIVE CARE DEPARTMENT , THE RECOVERY ROOM AND THE CENTRAL STERILISATIONAREA BECAUSE OF EXTENSIVE INTERACTION BETWEEN THESE DEPARTMENTS . “LOCATION + BEST LOCATED CENTRALLY IN THE CORE AREA OF HOSPITAL WHERE THEY ARE EASY TO REACH . -THE RECEPTION AREA FOR EMERGENCY CASES MUST BE AS CLOSE AS POSSIBLE TO THE SURGICAL AREA SINCE SUCH PATIENTS OFTEN NEED TO BE MOVED INTO SURGERY IMMEDIATELY. “ORGANISATION OF THE SURGERY DEPARTMENT + EVERY SURGICAL DEPARTMENT REQUIRES THE FOLLOWING ROOMS: . OPERATING THEATRE 40- 48MSQ ENTRY ROOM 15- 15-id other Seta services.% MAIN SURGICAL “A RAQMS ze WOULD BE 6.50X6.50M + A CLEAR HEIGHT OF 3M AND AN EXTRA HEIGHT ALLOWANCE OF ROUGHLY 0.70M FOR AIR CONDITIONING AND OTHER SERVICES . + OPERATING THEATRE SHOULD BE DESIGNED AS SQUARE AS POSSIBLE TO ALLOW WORKING OFS WA BOER GH REG TEE 714 SGT HETIC EBRHARGE ROOM, A WASH ROOM, STERILE ROOMS VIA ELECTRICAL SLIDING DOOR OPERATEI BY FOOT FOR HYGIENE PURPOSE. >ANAESTHETICS ROOM amrior * ROOM SHOULD BE APPROXIMATELY 3.80X3.80M_IN SIZE. *THE ROOM SHOULD BE EQUIPPED WITH A REFRIGERATOR, DRAINING SINK, RINSING LINE, CONNEG II RSBNINAESTHESIA. EQUIPMENT AND EMERGENCY POWER. - MINIMUM WIDTH OF ROOM BE 1.80 M. OPERATING THEATRE THERE SHOULD BE THREE WASHBASINS>» STERILE GOODS ROOM «THE SIZE OF THIS ROOM IS MORE FLEXIBLE BUT THERE MUST BE SUFFICIENT SHELF AND CUPBOARD SPACE AND IT MUST BE ACCESSED DIRECTLY FROM THE OPERATION THEATRE . » ONE ROOM OF ROUGHLY 10MSQ IS REQUIRED PER OPERATION THEATRE. + AROOM SIZE OF 20MSQ IS REQUIRED FOR EQIPMENT ROOM *SUBSTERILISATION ROOM +IT CONTAINS A NGN CLEAN AREA FOR NON STERILE MATERIAL AND A CLEAN AREA FOR PREPARED STERILE ITEMS, «IT CONTAINS A SINK, STORAGE SURFACE , WORK SURFACE AND STEAM STERMASHRELIARY FUNCTIONS *THE ROOMS FOR AUXILIARY FUNCTIONS DO NOT NEED TO BE IN THE IMMEDIATE AREA OF THE OPERATING THEATRE,NURSES LOUNGE . *THE DIMENSION OF THIS ROOM DEPENDS ON THE SIZE OF THE SURGICAL DEPARTMENT. + IT SHOULD BE ASSUMED THERE ARE EIGHT MEMBERS OF STAFF PER SURGICAL TEAM(DOCTORS, THEATRE NURSES, ANAESTHESIA NURSES) THE LOUNGE MUST OFFER SUFFICIENT SEATING ,CUPBOARDS,AND A SINK.> NURSES WORKSTATIONS + THESE SHOULD BE LOCATED CENTRALLY AND SHOULD HAVE VISUAL CONNECTION WITH THE WORKING CORRIDOR. > PHARMACY A 20MSQ PHARMACY CAN SUPPLY A COMBINATION OF ANAESTHETICS AND SURGICAL MEDICATION AND OTHER MATERIALS, CLEANING ROOM A SIZE OF SMSQ IS SUFFICIENT FOR CLEANING ROOMS . THEY SHOULD BE CLOSE TO THE OPERATING THEATRE SINCE CLEANING AND DISINFECTION ARE CARRIED OUT AFTER >LIGHTING -LIGHTING IN OPERATION THEATRE SHOULD BE ADJUSTABLE TO PROVIDE LIGHT AT DIFFERENT ANGLES. *MOST FREQUENT LIGHTING M IS MOBILE CEILING 4) Sarpicat pendant inyp with aataite THEATRETYPICAL LAYOUT OF SURGICAL DEPARTMENTOINTENSIVE CARE AREA | > ARRANGEMENT “THE INTENSIVE CARE DEPARTMENT MUST BE A SEPARATE AREA ,AND ONLY ACC! IBLE THR H LOBBIES . + THE CENTRAL POINT OF AN INTENSIVE CARE UNIT MUST BE AN OPEN NURSES WORKSTATION FROM WHICH IT IS POSSIBLE TO OVERSEE “NER ORORMENT S PER UNIT SHOULD BE BETWEEN SIX TO EIGHT TO AVOID QYARRANSEMENT OF BEDS *THE BEDS MAY BE PLACED IN AN OPEN,CLOSED OR COMBINED ARRANGEMENT . *ALL THE BEDS MUST BE IN CLEAR VIEW OF A CENTRAL NURSES DUTY STATION . «WITH A CLOSED ARRANGEMENT THE PATIENTS ARE ACCOMMODATED IN SEPARATE ICH MUST BE IN SIGHT OF A> AUXILIARY FUNCTIONS + FOLLOWING AREAS SHOULD ALSO BE | IN OQupwn= . MINOR OPERATING THEATRE(25-30) . LAB SPACES KITCHENETTE . STERILISATION(20 Msq) . DUTY DOCTOR'S ROOM . SANITARY FACILITIES visitors’ balcony 10 ——30— @ Eiohebed i care subgroup; glazed individual rooms ¢Q) CARE AREAS >» FUNCTION AND “GHEUMRUAGSUAR EARE AREAS IN A HOSPITAL ARE ATTACHED TO THE SPECIFIC MEDICAL FACULTIES(SURGERY, MEDICAL, ACCIDENT, AND EMERGENCY ETC)AND THEREFORE NEED TO BE PLANNED AS SEPARATE UNITS . + THEY CATER THE PATIENTS WHO STAY IN HOSPITAL FOR OBSERVATION HDT BERRA HROOMS SHOULD BE ACCESSED FORM THE MA HICH IS EASILY SUPERVISED FROM NURSE WORKSTATION TO PREVENT UNAUTHORISED ENTRY. fi 330 —— © Sinsle-bed room. ne tobbys observation possible from corridor — 330 4 1) sincte-ned room with tebby»SIZE OF THE PATIENT ROC *PATIENT'S BED MUST BE ACCESSIBLE FROOM THREE SIDES. SIZE OF SINGLE BED- ROOM =10M SQ i : O seers, @ ewe D «FOR TWO OR THREE BED ROOMS MIN OF 8M SQ AREA PER BED SHOULD BE ALLO\ pass door ta re ee 5 L| 1 3 o Double room ,must be wider to allow beds to pass.¥ PATIENT FEREARS Mout 5.5 M so SHOULD BE ALLOCATED TO BATHROOMS. YWET CELLS + NO. OF SHOWERS OR BATHS AND WCS ARE KEPT. TOGETHER KNOWN AS WET (©) Patisnn mathicam (© etovation + @ LAYOUT PLAN AND TEEN WORKROOM ELEVATION OF BATHROOM *AREA APPROX. 10 M SQ. -EQUIPPED WITH FIXED SHELVES 600 MM DEEP. *USED FOR STORAGE. v¥NON-CLEAN WORKROOM *AREA APPROX. 10 MSQ “FOR HANDELLING SOILED SLUICE,MADE»NURSING TEA * EACH STATION IS SERVED BY INDEPENDENT NURSING TEAM . AS TH NURSES WORKSTATION HAS TO BE CONSTANTLY OCCUPIED ,ITISTOBE LINKED TO NURSES KITCHENETTE AND REST ROOM. S * SHOULD BE SITUATED IN A CENTRAL ™ POSITION. + REQUIRES AREA OF 25-30M SQ. >STAFF REST ROOM /KITCHENETTE ROUGHLY 15M SQ AREA SHOULD BE ALLOCAED FOR STAAFF BREAKTIME.»STATION DOCTOR *PROVIDED WITH A 16-20 M SQ. ROOM *INCLUDES DESK,SHELVES,AN EXAMINATION COUCH. Xray instrument workroom viewer table dish cleaning cleaning refuse room @) Veetor’s room, treatment room, nurses’ workroom and station supervision room combined in one unit Architect: ResentieldSINGLE ROOM BATHROOMS SIX BEDROOM SINGLE BEDRO\QO) TREATMENT AREAS >TREATMENT AREAS INCLUDE : *RADIOLOGY *RADIOTHEARPY -INTERNAL MEDICINE TREATMENT AREA *RADIOLOGY INCLUDES : |. XRAY ROOM +ADMISSION ROOM(25-30 MSQ AREA) Il. SONOGRAPHY (12-18 M SQ) Il. MAMMOGRAPHY (12-18 M SQ) IV. CT SCAN ROOM VC (35 M SQ) V. ANGIOGRAPHY ROOM VI. CHANGING ROOM Vil. WCs (FOR STOMACH INSPECTION) VIIILULTRA SOUND ROOMMeV Sate CT Sule*RADIOTHERAPY FUNCTION: CONDITIONS DIGNOSED IN RADIO THERAPY DPT. ARE TREATED HERE INCLUDES: . RECEPTION +WAITING AREA . DOCTORS ROOM (18 SQM) . LOCALISATION ROOM (25 SQM) » SERVICE ROOM . FILM DEVELOPING ROOM (10 SQ M) STORE - TREATMENT ROOM(CHANGING ROOM) (15 SQ M) . LAB(IS-18 SQM) PNDuswns *INTERNAL MEDICINE TREATMENT AREA COMPRISES OF: 1. EXAMINATION ROOM(25M.SQ) 2. SECRETARIAL/ADMN OFFICE 20 M SQ 3. SENIOR PHYSICIAN ROOM (15 M SQ) PHYSICIAN ROOM (20 M SQ)LABORATORY DEPTT.PURPOSE : The lab deptt. is concerned mostly with the preparation and processing of blood urine and faecal samples. LOCATION: Often separated from treatment and nursing areas. AREA REQUIREMENTS :Lab itself is a Large room with built-in work places to offer a high level of flexibility. separation of rooms can andl without patient trai; routine laboratory segregated from clinacal chemistryX-RAY DEPARTMENT PURPOSE: X-RAY OF THE PATIENTS LOCATION: USUALLY GROUND FLOOR AREA REQUIREMENTS: WAITING AREA, EXAMINATION ROOM,DARK ROOM RELATIONSHIP: ACCIDENT DEPARTMENT , FRACTURE CLINIC aoso UNCTIQNAL DIAGNOSIS accommodate wide range of techniques and equipments. RELATIONSHIP:A direct connection with the laboratory department is beneficial. A data link to the radiology , radiotherapy and surgical departments is necessary to allow combined monitoring. 1 functional diagnosis 2 heart moniionng 8 echocardiography 9 clean workroom 10 jung function testing 11. general examination room 12 Sanior doctor 15 long-duration £CG 16 ECG 17 statt 18 senior doctor 18 secretary (©) Bet ct liaSERVICESSUPPLY AND DISPOSA L ROUTESERVICE YARD PURPOSE: SUPPLY AND DISPOSAL OF HOSPITAL GOODS,EMERGENCY ELECTRICAL GENERATORS, SPRINKLER CONTROL ROOM, OXYGEN DISTRIBUTION SYSTEM. LOCATION: BASEMENT ACCESS:ACCESSIBLE VIA RAMP WITH A SLOPE OF 15 DEGREE. aBIO MEDICAL WASTE chidoRORAL provided in every department for the disposal. Incinerators should also be provided for the burning up of the waste. Segregation of Vvaste in color coded Bags BLACK ort leng Delos pee Pe blades.sharp s eae rerVentilation and gases: The ventilation equipment is best situated near to the open air. During planning, the horizontal and vertical ventilation ducts should be tested against technical fire protection criteria. It is necessary to provide medical gases for the surgical, intensive care and radiology departments, and special supply rooms are required. The pumps for oxygen, carbon dioxide, vacuum and compressed air should be duplicated so as to provide a backup in case of failure. An additional technical requirement is an emergency electrical supply system Electrical systems The power supply is taken from the national grid: 220-240V standard voltage and 380V high voltage. The low voltage system is cantrolled from the distributor room which requires at least two free-standing transformer cell units. Sufficiently wide doors (at least 1.30m clear width) and good ventilation must be provided and all relevant VDE and professional association regulations must be complied with. The size and number of emergency power units depends on the size of the hospital and local plants for individual functional units (surgical/outpatients department, care areas, radiology) are preferable to a central emergency power system. Anti-vibration foundations should be used underneath these units to reduce noise. Additional batteries must be provided for lighting and emergency power in the surgical department.Laundry provision Figures for the amount of dirty dry washing generated per bed per day vary between 0.8 and 3.0kg. The following sequence of work is preferred in the laundry: receipt, sorting, weighing, washing, spinning, beating out, mangling or drying (tumble dryer), pressing (if possible high pressure steam connection), ironing, sewing, storage issue. The laundry hall consists of a sorting and weighing area (15m2), laundry collection room under laundry chutes from the wards, wet working area (50m2), dry working area (60m2), detergent store (10m2), sewing room (10m2) and laundry store (15m),STERLIZATION *Surgical deptt and sterlisation unit should be situated close together. * the central store for drugs and instruments must be closely linked to the central sterlisation unit. DISPENSARY *Consists of a work and dispensing room(25 m sq) which is directly accessed from the main circulation corridor. * fitted out with the desk , washing facility, sink , weighing station and lockable cupboards. *Adjoining are a dry store and medicine store 1) , a cold store (10m sq) for nces and a dressingParking can be provided in 3 ways > Short term parking: should be such placed that they, © | can be used by visitors. Can be provided on the ground floor. > Long term parking: provided for people working in offices and , can be provided in the basement or on the roof top. | ; m4} | > Service core parking: provided for service traffic. THR Fi é Should be provided on the backside of the building for easy loading & unloading of goods.parking space arrangement Vspace | poxsibie no. of | possible no. of King apen | spaces/100m? | spaces/100m of doors) orca road (one side anty) + @ 0” - parallel to road. Eniy: 2 aa 7 and exit (0 parking bay diffic Suitable for narrow roads 2) 30° -angle to access road 26.3 a8 21 Easy entry to parking bay and exit Uses a large ares + @ 45° angle to access oud 20.3 49 at Good entry to parking bay and t. Flat a/parking Space. Non your * @) 60° -angle to access road 19.2 82 37 Relatively good entry and oxit 0, parking Bay: small area/parking Space. Arrangement often used + @ Right-angies to road (parking 1984 50 40 spaces 2.501 wide). Sharp turn eeded for entry and exit - @) Rightangies to road (parking 192 oz 37 spaces 230m wide. Small area needed/parking space. Ideal for compact parking layouts, used frequently FIG.17; PARKING ARRANGEMENT AND THE SPACES REQUIRED. (SOURCE: TIME SAVERS STANDARD)Turning radius - c _Dinerion Inner radius Car 5 Om x2. 3.5m Outer radius 5.0mWidth of aisle -24" for 90° parking 13" for 45° parking {I mai) uaa WH ; U l FIG.21: POSSIBLE CAR PARKING ARRANGEMENTS (SOURCE = NEUFERT)satoty strips —- o — 7 oft of 208 FIG.22: PARKING PARALLEL TO THE ROAD (SOURCE : NEUFERT) beet ed FIG.23: 30° OBLIQUE SPACES (SQURCE : NEUFERT) 4 ffor one-way straight ramps, minimum width is 12 ft(3 .66m); for two-way straight ramps, where opposing traffic flows are not separated, 22 ft (6.71 m) is the recommended minimum width. Where a barrier is used between lanes. to separate traffic flows, each lane should be at least 12 ft (3 .66 m) wide for tangent lengths. Civeutar camn lanesc menharailu chaula +Ramp Slopes The maximum ramp slope s 20 percent. For slopes over 10 percent , transition at least 8 ft longs be. provided at each end of the rar it ‘one half the slope of the ramp itself. id b 8Pedestrian areas : *Pedestrian space serves two functions : 1. Movement & circulation 2. Relaxation areas. - They must be busy & colorful, exciting & stimulating, must make walking enjoyable. + Trees, fountains, sculptures, murals, as well as architecture of free standing structures are a vital part of the overall scheme Ramps : +A ramp when provided shall not have a slope greater than # : 12. Larger slopes shall be provided for special uses but in no case greater than 1 : +Minimum clear width shall be 36” (3 feet). in the | phen : wn WF i using car parking shall be 6.0 mt. + Handrails shall be provided on both sides of the ramp. Ramps shall have level landings at bottom and top of each ramp and each ramp run.Circulation a Corridors: Must be designed for the maximum expected circulation flow, ‘ » Generally, access corridors must be at least 1.50m wide, > Corridors in which patients will be transported on trolleys should have a minimum effective width of 2.25m, » Suspended ceiling in corridors may be installed up to 2.40m, > The effective width of the corridors must not be constricted by projections, columns or other building elements.Circulation a > If ramps change direction at landings, the mini-mum landing size shall be60 inches by 60 inches . A ramp shall have a non- slip surface. a) > Each ramp shall have at least 180 cm of straiaht clearance FIG.26, RAMP (SOURCE . NEUFERT)Circulation a Stairs: The minimum width of a staircase other tha: a fire escape shall be as follow: > Business, industrial storage, hazardous buildings (a) Low Rise -1.5 (b) High Rise -2.0 APRRTAANGRM BIN Ringstele. hospital) (a) Upto 10 beds -1.5 (b) Over 10 beds -2.0 » Educational building (a) Upto 24m. high -1.5 (b) Over 24 m. high - 2.0 » Residential building (a) Lowrise -1.2 (SOURCE ; NEUFERT) (b) Hotels and High rise -1.5Circulation a » Step heights of 170mm are permissible ff f inimum required tread depth is 280mm. 1 » It is better to have a rise/tread depth ratio of 150:300mm > N » Doors must not constrict the useful width of the landings and f accordance with hospital regulations, doors to the staircases must “open - in the direction of escape.FIG.29: SHAFT AND LIFT MOTOR ROOM (SOURCE ; NEUFERT) Circulation a ITts: +The user entering or exiting the lifts, even those carrying hand bpB9poe! do not get in each other's way ; -Largest loads to be carried by the lift in question for eg: prams, wheal chairs,ete can be maneuvered i in and out without risk of injuring people or damaging “poe 0 ae eat He FIG. 31 : DOORS (SOURCE : NEUFERT)Escalators: > Installed at an angle of 30 degrees i ‘ > Installations are generally 2 speed-with the higher speed (120 fpm) utilized during rush hours and the lower (90 fpm) at hy Urs. NR » Moving stairways are agree available in widths of 32” measured at hip level between the balustrades.40” can car! persons /tread > 32” has a tread width of 24" and 48" width has 40” tread. 2 > All treads have arise of 8” and 16” depth. 4 32” wide siepe, 000 passengers/hour, with a speed of 90 fj passengers/hour with a speed of 120 fpm. » 48" wide step-8, 000 passengers/hr with 90 fpm speed and 10,665 passengers/hr at a speed of 120 fpm. me once> The first aspect that hospital cafeterias musf address is design. > Cafeteria should include high windows that & look out upon sunset and other natural scq > Paint in bright, warm colours and avoid usi fluorescent light and install bright but war toned lights. > Nary the light fixtures, rather than relying 0} ® standard overheads. Seating: . > Seats should be arranged to foster intimacy} to create comfortable, lounge-like feel. > Place plants or dividing walls between seatir > Design separate sections for hospital emplo}, > Prevent crowds from hovering over tables by placing ordering areas separate from seating sections.SITE ANALYSIS « ESCORTS FORTIS. » CLIENT: FORTIS HOSPITALS + ARCHITECT: ARVID GUPTAAND ASSOCIATES,NEW DELHI + LOCATION: AT BYPASS ROAD, 1KM +» FROM VERKA CHOWK, AMRITSAE = COMPLETED: 2003 *SITE IS 135X120M IS AT SET BACK FROM MAIN ROAD. “THE BUILDING FACES NORTH =The 152 bedded, multispecialty EAST. hospital has been designed to house the most advanced medical technology and equipment.PARKING HOSPITALSERVICE BLOCK BLOCKCY PUBLIC STAFF AND DOCTORS SITE CIRCULATIONBUILDING LEVEL: THREE MAIN ENTRANCE IN FRONT FOR EMERGENCY , IPD , OPD. REAR ENTRY FOR > STAFF, KITCHEN SERVICES, TWO FIRE EXITS.ZONING : » AT MACRO LEVEL SITE IS DIVIDED INTO THREE ZONES: » 1.PARKING » 2.LANDSCAPING » 3.BUILDING BLOCK » AT MICRO LEVEL: » MAIN BUILDING BLOCK IS FURTHER ZONED IN: » EMERGENCY ,IPD, OPD, SERVICE BLOCK. aHORIZONTAL CIRCULATION: » THE MAIN SPINAL CHORD OF HOSPITAL CIRCULATION IS 2.1MTS WIDE CORRIDOR. VERTICAL CIRCULATION: “TWO STAIR CASE LOBBIES. *ONE LIFE FOT IPD VISITORS. “TWO BED LIFTS “ONE STAFF LIFTS “ALL STAIRCASES1.8 MTS WIDE,ENCLOSED IN WALL PROVIDED WITH FIRE RESISTANT DOORS. *NO RAMPS “ONE DUMB WAITER FOR LINEN MOVEMENT B/W CSSD AND LAUNDRY.AREA STATEMENT AREA STATEMENT GROUND FLOOR CIRCULATION= 933.47 sqm DIAGNOSTICS, SERVICES= 716.99 sqm a EMERGENCY= 411.12 sqm merce’ OPDS= 164.5 sqm TOILETS= 82.65 sqm DIAGNOSTICS= 333 sqm OTHER= 26% (ABOUT 930 sqm) (ADMIN, KITCHEN, DINNING, PANTRY, ETC)CONCEPTUAL SECTION: IPO CIRCULATION CORE OPD CIRCULATION CORE WITH STAFF TILL SECOND FLOOR, (CIRCULATION AT BACKGROUND FLOOR PLAN , J RECEPNBN 2. ICU 3.CT SCAN 8. HEART STATION 4. O0PD 9.DINNING 5.LAUNDARY 10.STAFF DINNING EMERGENCY | 1-UTILITIES LOBBY 12.SECURITY OFFICE 13.LT ROOM 14. X-RAY 15.RENAL DIAGNOSTICCIRCULATION STAFF ENTRY Average Width of Corridor SERVICE ENTRY vom DOCTOR'S ENTRY am N OPD ENTRY Ne Ground Floor PlanQhoorons ENTRAN PATIENT ENTRANCE EMERGENCY AREA a PATIENT ENTRANCE OPDLET BLOOD BANK - DIALYSIS UNIT D100 08 ay Icu HEART CARE UNIT FIRST HOS PLAN as NCOMPONENTS OF FIRST FLOOR ———* BLOOD BANK STAFF AREA }\—— cu BLOW UP OF DIALYSIS AREA___> cssp OPERATION THEATER BED LIFTS CRITICAL AREA aTHIRD AND FOURTH FLOOR PLAN "STAFF AREA TERRACECOLOR CODING: GREEN: DOMESTIC WATER RED: FIRE FIGHTING BLACK: SOIL PIPE BLUE: AIR CONDITIONINGBIO MEDICAL ROOM: "ALL THE BIO MEDICAL WASTE IS COLLECTED MANUALLY FROM THE HOSPITAL IN THIS ROOM. *THE LABORATORIES OF BIO MEDICAL WASTE HENCE COLLECT IT FROM HERE. MANIFOLD ROOM: =10 CYLINDERS PER BANK i.e. LEFT AND RIGHT BANK. #2 CYLINDERS OF NO2 AIR CONDITIONING: "EACH FLOOR HAVE DIFFERENT AHU’S, *SEPARATE AHU’'S FOR DIFFERENT STERILIZED ZONES RESTRICTING (CHANCES OF FLOW OF INFECTION. *2 CHILLERS *2 COOLING TOWERSWATER STORAGE. *WATER STORAGE TANKS ARE PLACED ON THE TERRACE. EACH TANK HAS A CAPACITY OF 10000 LT aie COMPRESSED LIQUID TREATMENT: ORVGEN: DOMESTIC =CENTRAL SUPPLY WATER IS THROUGHOUT THE TREATED HOSPITAL. *CHLORINATION =CAPACITY 2000 LTS "REVERSE 7 OSMOSIS PLANT STEAM BOILERS: =CENTRAL SUPPLY THROUGHOUT THEFIRE FIGHTING: =*MAIN HYDRANT AND SPRINKLER PUMP. = TERRACE FIRE PUMP. =AUTOMATIC SPRINKLER SYSTEM. =MANUAL FIRE ENTINGUISHERS. *FIRE HYDRANTS AROUND BUILDING PERIPHERY. POWER GENERATORS: =2 DIESEL GENSETS "2 TRANSFORMERS =ONE ATTENDANT STANDS 24 HRS FOR ANY PROBLEM.VACUUM SYSTEM 2 NO OF VACUUM PUMP WITH 2000 LT. CAPACITY VACUUM TANK, COMPRESSION AIR SYSTEM: 2 NO. 100 CFM TAILOR: "TAILOR ROOM PLACED BELOW THE STAIRCASE. MORTUARY: | 4 BEDDED WITH PROPERLAUNDRY: =STRATEGICALLY PLACED BELOW IPD. =FLOW OF LINEN : RECEIVING AREA - WASHING AND DRYING - IRONING - CLEAN AREA - DISPATCH AREA =TROLLEY IS USED FOR TRANSFER OF LINEN THROUGH BED LIFT 1 *OT's BLUE LINEN IS RECEIVED THROUGH DUMBWAITER VIA CSSD, AND AFTER WASHING IT IS RESENT TO CSSD FOR STERILIZATION. =SEPARATE WASHING MACHINE IS USED FOR NORMAL LINEN AND OT's LINEN. KITCHEN: TROLLEY IS USED FOR SUPPLYING FOOD THROUGH BED LIFT 1 VIA DUMBWAITER. RAW MATERIALS ARE BROUGHT INTO THE HOSPITAL THROUGH THE MATERIAL GATE OF AND THEN THROUGH THE SERVICE ENTRY.STRUCTURE SYSTEM AND MATERIAL USED IN THE HOSPITAL » IT HAS A COLUMN BEAM STRUCTURE. » MATERIAL USED : » CORRIDORS : MARBLE UDAIPUR GREEN , JAISLMER YELLOW » STAIRS : KOTA STONE, GROUND TO SECOND FLOOR - UDAIPUR GREEN » MAIN LOBBY ; UDAIPUR GREEN , OMANI MALWA » LIFT FASCIA : MAKRANA WHITE » O.T: UDAIPUR GREEN , MARBLE WALLS UPTO 4’0” HEIGHT aLIGHTENING AND FLOW OF MOVEMENT FAST AND EASY MOVEMENT OF PATIENT IS ACHIEVED THROUGH PROPER CORRIDOR WIDTHS AND PROPER MEANS OF VERTICAL CIRCULATION. DIFFERENT VISITOR'S AND PATIENT LIFT LOBBY IS APPRECIABLE. SERIES OF DOORS USED TO FILTER THE FLOW OF MOVEMENT BETWEEN VARIOUS DEPARTMENTS. LACK OF NATURAL LIGHTENING IN CORRIDORS INCREASES ENERGY DEMANDS OF THE BUILDING.+ SEPARATE CIRCULATION PATTERN ACHIEVED BY DOUBLE LEAF DOORS AT THE REQUIRED PLACES. * SEPARATE CIRCULATION CORES FOR IPD AND OPD STAFF. + INSUFFICIENT SPACE AND CENTRALIZED SUB WAITING AREA IN OPD CREATING MORE CHAOS AND NUISANCE. ADEQUATE AND SPACIOUS WAITING SPACE IN IPD SECTION IS WELCOMING. * PASS SYSTEM TO CONTROL TRAFFIC OF VISITORS. * EMERGENCY LACKS MINOR OT.ARCHITECTURAL EXPRESSION: » SIMPLE FACADE WITH CUBICAL FORM OF OUTLOOK. » PLASTERED FINISH WITH 2 PROJECTING OUT YELLOW SANDSTONE MASSING. » HOIZONTAL AND VERTICAL BANDS OF SAME ARE USED AS HIGHLIGHTERS IN ALL THREE MAIN ENTRANCE. aidINFERENCES FOOD SERVICE FROM THE BED ELEVATOR. IN THE LOBBY AREA THERE IS NO NATURAL LIGHT, OVERALL CHAOS IS CREATED NEAR TH! AREA OF THE OPD. SEGREGATION OF VEHICULAR AND PEDESTRIAN MOVEMENT AS PARKING FURTHER INTERVENTION OF VEHICLES INTO THE SITE. EMERGENCY, VISITORS AND STAFF CIRCULATION THROUGH DIFFERENT ENTRANCES.» NO PLINTH PROVIDED IN THE BUILDING. » PROPER DISPOSAL OF BIO- -MEDICAL WASTE. » WASTE COLLECTION DONE MANUALLY MAY CAUSE HARM. » SECURITY OF THE BUILDING IS PROPER FIRE ALARMS, SPRINKLERS , CAMERAS = ARE COVERING EVERY SINGLE AREA OF THE BUILDING. » SEPARATE AHU'S ARE PROVIDED FOR DIFFERENT OT’S RESTRICTING THE INFECTION TO THE PRONE AREAS ONLY. aTHANK YOU :D