INTRODUCTION

The healthcare industry is an essential sector in any community, and the availability
and accessibility of healthcare facilities are critical to ensuring the well-being of individuals
and communities.
In the Philippines, hospitals are categorized into 3 levels that are set by the
Department of Health. Level 1 which caters to patients that only need minor care and
supervision this level does not have Intensive Care Unit (ICU). While level 2 has the same
amenities as level 1 with additional facilities and services such as ICU and specialist doctors
for gynecology and pediatrics. Lastly, level 3 offers high-level specialty intervention like
physical rehabilitation or dialysis treatment.
Background of the Study
Talisay Batangas is a rapidly developing municipality located in the province of
Batangas, Philippines. The municipality is situated along the shores of Taal Lake and is
known for its scenic beauty, natural attractions, and rich cultural heritage. However, despite
the town's many attractions, the healthcare infrastructure is inadequate to cater to the growing
population's healthcare needs.
In a study conducted by Philippine Institute for Development Studies, it is said that
some hospital in the Philippines does not have basic diagnostic equipment such as X-ray,
ECG, and ultrasound equipment. 20% of hospitals do not have access to electronic medical
records. 8 % of hospitals do not meet standards for their facility level or have functional
sterilization equipment. While electricity, water, waste disposal, and ambulances continue to
be a challenge in some hospitals. Only 31 % have a reliable generator. 30 % have no access
to clean drinking water. 24 % have access to landfill, and for ambulances, 86 % have at least
1 emergency vehicle and meet DOH standards.

The existing healthcare facilities in Talisay Batangas are limited, and the few that are
available are often overcrowded and understaffed. The nearest major hospital is located in
Lipa City, which is over 20 kilometers away, making it challenging for residents to access
medical services promptly.

Moreover, Talisay Batangas is vulnerable to natural disasters such as typhoons,

earthquakes, and volcanic eruptions, which can cause significant damage to existing
healthcare facilities, leaving the community without access to medical services during these
critical times. Therefore, the need for a 25-bed hospital in Talisay Batangas is essential to
provide access to quality healthcare services to the growing population.
The proposed hospital aims to cater to the community’s healthcare needs and the
surrounding areas. It will provide essential medical services, including primary care,
emergency care, surgery, obstetrics, and gynecology. The hospital will be equipped with
state-of-the-art medical equipment and facilities to support the delivery of quality healthcare
services. The hospital will also be staffed with highly qualified and experienced healthcare
professionals, including doctors, nurses, and support staff, to ensure that patients receive the
best possible care.
In conclusion, the proposed 25-bed hospital in Talisay Batangas is a much-needed
development that will address the gaps in healthcare infrastructure in the area. The hospital
will provide access to quality healthcare services to the growing population, contributing to
the overall health and well-being of the community.
Statement of the Problem
Hospital design is a complicated process resulting from the accumulation of essential
information in conformity with the procedure and planning within the parameters of
government regulation, user requirements, and clients’ financial limitations. When architects
and medical facility planners design spaces with infection control, safety, and security
protocols in mind, they can reduce infection rates and promote patient safeguards at every
level.
Goals and Objectives
The main goal is for patients to feel completely at ease in a clean, safe, healing environment
from the moment they walk through a hospital’s door. Design the hospital in accordance with
the following main zones:
 Administrative Service Facilities
 Clinical Service Facilities
 Ancillary Service Facility
 Nursing Service Facility
 Dietary Service Facility
 Engineering Maintenance and Housekeeping Service Facility
Guidelines for Hospital Planning and Design

A hospital and other health facilities shall be planned and designed to observe
appropriate architectural practices, to meet prescribed functional programs, and to conform
to applicable codes as part of normal professional practice. References shall be made to the
following:
 P. D. 1096 – National Building Code of the Philippines and Its Implementing
Rules and Regulations
 P. D. 1185 – Fire Code of the Philippines and Its Implementing Rules and
Regulations
 P. D. 856 – Code on Sanitation of the Philippines and Its Implementing Rules and
Regulations
 B. P. 344 – Accessibility Law and Its Implementing Rules and Regulations
 R. A. 1378 – National Plumbing Code of the Philippines and Its Implementing
Rules and Regulations
 R. A. 184 – Philippine Electrical Code
 Manual on Technical Guidelines for Hospitals and Health Facilities Planning
and Design. Department of Health, Manila. 1994
 Signage Systems Manual for Hospitals and Offices. Department of Health,
Manila. 1994
 Health Facilities Maintenance Manual. Department of Health, Manila. 1995
 Manual on Hospital Waste Management. Department of Health, Manila. 1997
 District Hospitals: Guidelines for Development. World Health Organization
Regional Publications, Western Pacific Series. 1992
 Guidelines for Construction and Equipment of Hospital and Medical Facilities.
American Institute of Architects, Committee on Architecture for Health. 1992
 De Chiara, Joseph. Time-Saver Standards for Building Types. McGraw-Hill Book
Company. 1980
1 Environment: A hospital and other health facilities shall be so located that it
is readily accessible to the community and reasonably free from undue
noise, smoke, dust, foul odor, flood, and shall not be located adjacent to
railroads, freight yards, children's playgrounds, airports, industrial plants,
disposal plants.

2 Occupancy: A building designed for other purpose shall not be converted

into a hospital. The location of a hospital shall comply with all local zoning
ordinances.

3 Safety: A hospital and other health facilities shall provide and maintain a
safe environment for patients, personnel and public. The building shall be
of such construction so that no hazards to the life and safety of patients,
personnel and public exist. It shall be capable of withstanding weight and
elements to which they may be subjected.

3.1 Exits shall be restricted to the following types: door leading directly
outside the building, interior stair, ramp, and exterior stair.

3.2 A minimum of two (2) exits, remote from each other, shall be
provided for each floor of the building.

3.3 Exits shall terminate directly at an open space to the outside of the
building.

4 Security: A hospital and other health facilities shall ensure the security of
person and property within the facility.

5 Patient Movement: Spaces shall be wide enough for free movement of

patients, whether they are on beds, stretchers, or wheelchairs. Circulation
routes for transferring patients from one area to another shall be available
and free at all times.

5.1 Corridors for access by patient and equipment shall have a minimum
width of
2.44 meters.

5.2 Corridors in areas not commonly used for bed, stretcher and
equipment transport may be reduced in width to 1.83 meters.

5.3 A ramp or elevator shall be provided for ancillary, clinical and

nursing areas located on the upper floor.

5.4 A ramp shall be provided as access to the entrance of the hospital

not on the same level of the site.

6 Lighting: All areas in a hospital and other health facilities shall be provided
with sufficient illumination to promote comfort, healing and recovery of
 patients and to enable personnel in the performance of work.

7 Ventilation: Adequate ventilation shall be provided to ensure comfort of

patients, personnel and public.

8 Auditory and Visual Privacy: A hospital and other health facilities shall
observe acceptable sound level and adequate visual seclusion to achieve the
acoustical and privacy requirements in designated areas allowing the
unhampered conduct of activities.

9 Water Supply: A hospital and other health facilities shall use an approved
public water supply system whenever available. The water supply shall be
potable, safe for drinking and adequate, and shall be brought into the
building free of cross connections.

10 Waste Disposal: Liquid waste shall be discharged into an approved public

sewerage system whenever available, and solid waste shall be collected,
treated and disposed of in accordance with applicable codes, laws or
ordinances.

11 Sanitation: Utilities for the maintenance of sanitary system, including

approved water supply and sewerage system, shall be provided through the
buildings and premises to ensure a clean and healthy environment.
12 Housekeeping: A hospital and other health facilities shall provide and
maintain a healthy and aesthetic environment for patients, personnel and
public.

13 Maintenance: There shall be an effective building maintenance program in

place. The buildings and equipment shall be kept in a state of good repair.
Proper maintenance shall be provided to prevent untimely breakdown of
buildings and equipment.

14 Material Specification: Floors, walls and ceilings shall be of sturdy

materials that shall allow durability, ease of cleaning and fire resistance.

15 Segregation: Wards shall observe segregation of sexes. Separate toilet shall

be maintained for patients and personnel, male and female, with a ratio of
one (1) toilet for every eight (8) patients or personnel.

16 Fire Protection: There shall be measures for detecting fire such as fire
alarms in walls, peepholes in doors or smoke detectors in ceilings. There shall
be devices for quenching fire such as fire extinguishers or fire hoses that are
easily visible and accessible in strategic areas.

17 Signage. There shall be an effective graphic system composed of a number

of individual visual aids and devices arranged to provide information,
orientation, direction, identification, prohibition, warning and official notice
considered essential to the optimum operation of a hospital and other health
 facilities.

18 Parking. A hospital and other health facilities shall provide a minimum of

one (1) parking space for every twenty-five (25) beds.

19 Zoning: The different areas of a hospital shall be grouped according to

zones as follows:

19.1 Outer Zone – areas that are immediately accessible to the public:
emergency service, outpatient service, and administrative service.
They shall be located near the entrance of the hospital.

19.2 Second Zone – areas that receive workload from the outer zone:
laboratory, pharmacy, and radiology. They shall be located near the
outer zone.

19.3 Inner Zone – areas that provide nursing care and management of
patients: nursing service. They shall be located in private areas but
accessible to guests.

19.4 Deep Zone – areas that require asepsis to perform the prescribed
services: surgical service, delivery service, nursery, and intensive
care. They shall be segregated from the public areas but accessible to
the outer, second and inner zones. Service Zone – areas that provide
support to hospital activities: dietary service, housekeeping service,
maintenance and motorpool service, and mortuary. They shall be
located in areas away from normal traffic.

20 Function: The different areas of a hospital shall be functionally related with

each other.

20.1 The emergency service shall be located in the ground floor to ensure
immediate access. A separate entrance to the emergency room shall
be provided.

20.2 The administrative service, particularly admitting office and business

office, shall be located near the main entrance of the hospital.
Offices for hospital management can be located in private areas.

20.3 The surgical service shall be located and arranged to prevent non-
related traffic. The operating room shall be as remote as practicable
from the entrance to provide asepsis. The dressing room shall be
located to avoid exposure to dirty areas after changing to surgical
garments. The nurse station shall be located to permit visual
observation of patient movement.

20.4 The delivery service shall be located and arranged to prevent non-
related traffic. The delivery room shall be as remote as practicable
from the entrance to provide asepsis. The dressing room shall be
 located to avoid exposure to dirty areas after changing to surgical
garments. The nurse station shall be located to permit visual
observation of patient movement. The nursery shall be separate but
immediately accessible from the delivery room.

20.5 The nursing service shall be segregated from public areas. The nurse
station shall be located to permit visual observation of patients.
Nurse stations shall be provided in all inpatient units of the hospital
with a ratio of at least one (1) nurse station for every thirty-five (35)
beds. Rooms and wards shall be of sufficient size to allow for work
flow and patient movement. Toilets shall be immediately accessible
from rooms and wards.

20.6 The dietary service shall be away from the morgue with at least a 25-
meter distance.

21 Space: Adequate area shall be provided for the people, activity, furniture,
equipment and utility.

Space Area in Square Meters

Administrative Service
Lobby
Waiting Area 0.65/person
Information and Reception Area 5.02/staff
Toilet 1.67
Business Office 5.02/staff
Medical Records 5.02/staff
Space Area in Square Meters
Office of the Chief of Hospital 5.02/staff
Laundry and Linen Area 5.02/staff
Maintenance and Housekeeping Area 5.02/staff
Parking Area for Transport Vehicle 9.29
Supply Room 5.02/staff
Waste Holding Room 4.65
Dietary
Dietitian Area 5.02/staff
Supply Receiving Area 4.65
Cold and Dry Storage Area 4.65
Food Preparation Area 4.65
Cooking and Baking Area 4.65
Serving and Food Assembly Area 4.65
Washing Area 4.65
Garbage Disposal Area 1.67
Dining Area 1.40/person
Toilet 1.67
Cadaver Holding Room 7.43/bed
Clinical Service
Emergency Room
Waiting Area 0.65/person
Toilet 1.67
Nurse Station 5.02/staff
Examination and Treatment Area with Lavatory/Sink 7.43/bed
Observation Area 7.43/bed
Equipment and Supply Storage Area 4.65
Wheeled Stretcher Area 1.08/stretcher
Outpatient Department
Waiting Area 0.65/person
Toilet 1.67
Admitting and Records Area 5.02/staff
Examination and Treatment Area with Lavatory/Sink 7.43/bed
Consultation Area 5.02/staff
Surgical and Obstetrical Service
Major Operating Room 33.45
Delivery Room 33.45
Sub-sterilizing Area 4.65
Sterile Instrument, Supply and Storage Area 4.65
Scrub-up Area 4.65
Clean-up Area 4.65
Dressing Room 2.32
Toilet 1.67
Nurse Station 5.02/staff
Wheeled Stretcher Area 1.08/stretcher
Janitor’s Closet 3.90
Space Area in Square Meters
Nursing Unit
Semi-Private Room with Toilet 7.43/bed
Patient Room 7.43/bed
Toilet 1.67
Isolation Room with Toilet 9.29
Nurse Station 5.02/staff
Treatment and Medication Area with Lavatory/Sink 7.43/bed
Central Sterilizing and Supply Room
Receiving and Releasing Area 5.02/staff
Work Area 5.02/staff
Sterilizing Room 4.65
Sterile Supply Storage Area 4.65
Nursing Service
Office of the Chief Nurse 5.02/staff
Ancillary Service
Primary Clinical Laboratory
Clinical Work Area with Lavatory/Sink 10.00
Pathologist Area 5.02/staff
Toilet 1.67
Radiology
X – Ray Room with Control Booth, Dressing Area and Toilet 14.00
Dark Room 4.65
Film File and Storage Area 4.65
Radiologist Area 5.02/staff
Pharmacy 15.00
Table 1. Adequate ratio of rooms in a hospital.
Notes:
1. 0.65/person – Unit area per person occupying the space at one time
2. 5.02/staff – Work area per staff that includes space for one (1) desk and one (1) chair,
space for occasional visitor, and space for aisle
3. 1.40/person – Unit area per person occupying the space at one time
 4. 7.43/bed – Clear floor area per bed that includes space for one (1) bed, space for
occasional visitor, and space for passage of equipment
5. 1.08/stretcher – Clear floor area per stretcher that includes space for one (1) stretcher

Parking Requirements of a Level 1 Hospital

Parking requirements and loading requirements in the Philippines may vary
depending on the type of occupancy.
TYPE OF OCCUPANCY PARKING REQUIREMENTS
HOSPITALS 1 SLOT/25 BEDS
OFFICE BUILDINGS 1 SLOT/ 125m²
Table 2. Parking Requirements of a Level 1 Hospital.
TYPE OF OCCUPANCY LOADING REQUIREMENTS
HOSPITALS 1 TRUCK LOADING SLOT
Table 3. Loading Requirements of a Level 1 Hospital.
Plumbing and Sanitary Guidelines in Building a Hospital
Building a hospital requires careful planning and consideration of plumbing and
sanitary guidelines to ensure the health and safety of patients, staff, and visitors. The
following guidelines are the minimum plumbing facilities for a hospital.

TYPE OF WATER URINALS LAVATORIES DRINKING OTHER

OCCUPANCY CLOSETS (FIXTURES (FIXTURES PER FOUNTAINS/
PER PERSON) FACILITIES
(FIXTURES PER PERSON) (FIXTURES
PERSON) PER PERSON)
Business occupancy 1 per 150 1 service
(office, professional Male Female Male Male Female sink or
or service type 1: 1-50 1: 1-15 1: 1-100 1: 1-75 1: 1-50 laundry
transactions) – tray
banks, vet clinics, 2: 51- 2: 16-30 2: 101-200 2: 76-150 2: 51-100
hospitals, car wash,
banks, beauty 100 3: 31-50 3: 201-400 3: 151- 3: 101-150
salons, ambulatory 3: 101- 4: 51-100 4: 401-600 200 4: 151-200
health care
facilities, laundries 200 8: 101- 4: 201- 5: 201-300
and dry cleaning,
4: 201- 200 300 6: 301-400
educational
institutions (above 400 11: 201- 5: 301-
high school), or
training facilities 400 400
not located within
school, post offices
and printing shops

Over 400, add 1 Over 600, add Over 400, add 1 fixture
fixture for each 1 fixture for for each additional 250
additional 500 males each males and 1 fixture for
and 1 fixture for each additional 300 each additional 200
additional 150 males females
females.
 Table 4. Minimum Plumbing Facilities of Business Occupancy.
REVIEW OF RELATED LITERATURE
Green Space as a Tool for Healing and Productivity
In architecture, a green space refers to an area within a built environment that is
designed to incorporate vegetation and other natural elements. Green spaces can take many
forms, including parks, gardens, and green roofs. These spaces are important for a number of
reasons, including providing visual and physical relief from the built environment, reducing
the heat island effect, improving air quality, and supporting biodiversity. Green spaces can
also serve as gathering places for communities and can contribute to a sense of well-being
and connection with nature. As such, they are increasingly recognized as an essential element
of sustainable design and urban planning.
Green space is a vital aspect of every community. It offers a location where people
can unwind, take in the scenery, and breathe fresh air. However, there are numerous
advantages to green space that might not be as obvious. According to studies, green spaces
have significant advantages for people. They can boost mental clarity, lessen aggression,
lessen stress, and improve physical health.
In Chicago, a comparison of apartment buildings with and without vegetation
revealed that vegetation cuts crime in half. According to other studies, workplace greening
increased productivity (Biasotti, n.d.).
In addition to that by allowing people with busy schedules to escape from the
difficulties of their urban environments and actively participate in nature, green spaces help
people feel better about themselves. They also help people escape the daily fatigue and city
noise. to feel, see, hear, and smell the components that makeup.
The natural world can help people clear their minds, recharge, and give them a sense
of peace and tranquility (Kaplan, 1983, as cited by Yılmaz & Mumcu, 2016).
Green Space Design Principles
CASE STUDY
Local
 Baler
Hospital,
Baler
Philippines
by Carlos
Arnaiz
Architects:
CAZA

Architectural Analysis:

Baler Hospital—located in a rural area of the

Philippines with poor access to comprehensive health
services—combines a general hospital and a trauma center
into a single facility that serves regional needs and fortifies
emergency response capabilities. The hospital’s perimeter
portico acts as an iconic edge that allows the different interior functions to be legible from the
exterior. It features stone cladding, verdant courtyards, and light-filled interior spaces.

For the project, CAZA developed a specialized 9-meter by a 9-meter structural grid that
supports a range of programs and specialized room layouts, enabling the hospital to adapt as new
needs emerge. The structural grid efficiently accommodates the exacting spatial requirements of
both the hospital and trauma center programs. The grid is interspersed with garden courtyards that
anchor the hospital’s various departments, maximizing natural lighting and connecting staff and
patients with the landscape. A central spine provides efficient circulation between each of the
departments.
 Baler Hospital Floor Plan

Summary:
The architecture, space, and program are planned around a nine-by-nine-meter grid
that accommodates a three-by-three-meter room module, providing the flexibility to form a
variety of different arrangements for patient and examination rooms. Central spine will also
help efficiently circulate staff and medical supplies from the trauma centre to the general
hospital.

Memphis Mission Hospital, Victoria City by by Carlos Arnaiz Architects: CAZA

Architectural Analysis:
The Memphis Mission Hospital is the first ground-up charity mission hospital in the
Philippines. With a project of this scale and importance, CAZA saw an opportunity to both
improve access to health services in the region and introduce public programs that strengthen
the community as a whole. Designed for Memphis Mission of Mercy, a charity focused on
serving impoverished communities with little or no access to healthcare, the hospital will be a
regional hub for humanitarian efforts and emergency medical response. To maximize impact,
CAZA based the design on analyses of the challenges facing healthcare delivery in the
Philippines, the types of treatments in most dire need, and the logistical hurdles of providing
emergency services in a poorly connected region of more than 2.5 million people.
The hospital includes state-of-the-art facilities for treatment, staff residences, and
community spaces like a library, artist studio, and chapel. These programs are arrayed across
four interconnected volumes in a distinct semi-open arrangement. This breaks down the
hospital—often an imposing and monolithic building type—into a welcoming collection of
smaller structures that feel like a neighborhood. Each of the buildings offers sweeping vistas
over gardens from every window, making for an inviting and comfortable interior experience.
Monumental steps lead to the operating rooms contained in a simple single-pitch structure
clad in natural stone and bounded by a vegetable garden to the north.
 After identifying the demand for healthcare services in the region, CAZA developed a
comprehensive program that responds directly to local needs. The hospital’s functions are
split across four zones. Routine care and staff housing are arrayed near the main entrance,
while surgical and inpatient services occupy two volumes further back from the public access
road.
The design also includes community facilities that establish the hospital as a regional
hub, enhancing public visibility and access to the healthcare and emergency services it
provides. Upon arrival at the hospital, a large curved roof welcomes visitors to an open-air
plaza. Entering, visitors find a library, a health-focused restaurant, consultation rooms, and a
registration area—positioning the hospital as a resource for both patients and community
members. Two public spaces at the eastern edge further integrate the building into
community life: the chapel and artist studio.

Sagip-Kanlungan of Binmaley, Pangasinan by

John Ryan Santos+Partners
Architectural Analysis:
 Compact and Simple
Sagip-Kanlungan has been designed to be a hospital that is compact yet has the service
capability of a tertiary hospital. The compact concept was derived from the idea of the Bento
Box which provides a complete set of courses for a meal in just the right serving quantities.
The design does the same in providing the complete but essential components of a full
hospital in a compact package of 2-storeys and a GFA of less than 4,000 sqm.
 Disaster Resilient
Sagip-Kanlungan is designed as a 2-storey building — earthquake-resistant structure. It is
also equipped with a SHELTER MODE which covers windows and other vulnerable
openings with metal shutters to serve as shield from extreme winds and debris during
typhoon landfall. The hospital is also equipped with redundant backup generators placed on
top of the reinforced ramp structure which provides it with maximum protection against
damage during disasters.
 Decentralized Hospital Network
Sagip-Kanlungan is intended to be the model component of what will eventually be a
network of compact hospitals distributed throughout different rural municipalities that will be
able to deliver healthcare services even if some of them are damaged during disaster
situations. This decentralized hospital network is based on the resilience concept of the World
Wide Web.
 Economical to Build
Because of its small size and scale with lean design features, the Sagip-Kanlungan
hospital building will be constructed at a cost of less than USD 3 million only. This makes it
affordable for even small local government units in the Philippines.
 Option for Community Investment
Using the private cooperative scheme, local residents of a community will have the option
to invest in even small amounts in their local Sagip-Kanlungan. This will create a greater
sense of participation in the local community by allowing residents to actually become
invested in their local hospital.
 Shelter Mode
Typhoons are a yearly occurrence in the Philippines. During typhoons, Sagip-Kanlungan
can go into Shelter Mode wherein the building is able to shield windows and other vulnerable
openings with metal shutters protecting them from high winds and flying debris. The ramp
structure has been designed with as an independent bunker-like structure. Support building
systems are placed at the top of the ramp structure to protect them from flood damage. The
support systems housed by the ramp structure are (1) Backup Generators (2) Water Filtration
Plant (3) Battery Farm for the solar panels (4) Satellite-based communications transmitter.
Foreign

Taverny Medical Centre by MAAJ Architects

Architectural Analysis:

MAAJ Architects placed a cross-shaped courtyard for growing medicinal plants at the
heart of a timber-framed health center in the French town of Taverne. Because of the busy
road next door MAAJ Architects, decided to turn the building inwards. The plan of the
Taverny Medical Centre draws on the ancient cloister typology common in monasteries.
The cross-shaped central courtyard is wrapped by the center’s main circulation area.
The central patio offers several advantages such as natural lighting for the whole building. It
also serves as an open extension of the waiting rooms and acts as an intimate and sensory
place where medicinal plants are grown, a reminder of the health and curative purpose of the
center. Waiting areas are nestled into each corner protruding into the courtyard, and staircases
positioned along its north and south edges. Treatment rooms are placed around the perimeter.
Its exterior walls are infilled with wooden sheets, with only small windows to shut out noise
and views from the road. A glazed section of the exterior envelope marks the center’s
entrance, which is approached via a small landscaped garden that helps to create a buffer
between it and the road. Interiors are pale and calm, with exposed timber between the
glazing, white ceilings and white balustrades of thin steel.