A Project Proposal

on
“PRIMARY HOSPITAL DESIGN”

SUBMITTED BY: SUBMITTED TO:

Rose Paneru(21041119) CIVIL DEPARTMENT
Sujan Shrestha(21041127) ……………………………..
Pawan Shrestha(21041111)
Namuna Nagarkoti(21041102)
Asha Wangchhu Lama(21041086)
Ashish Basnet(21041087)
Dipak Kumar Shah(21041096)

Date: 2024 Jan 1

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 LETTER OF APPROVAL
This project proposal is all about the research done on the topic of “PRIMARY HOSPITAL
DESIGN” of civil 5th semester students (Rose Paneru , Namuna Nagarkoti,Asha Wangchu
Lama,Ashish Basnet,Pawan Shrestha & Sujan Shrestha) is approved for the submission and have
been submitted to Engineering Department,Ritz College as partial fulfillment of Project.
…………….………………
Head of Department

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 ABSTRACT
Hospital, an institution that is built, staffed, and equipped for the diagnosis of disease; for
the treatment, both medical and surgical, of the sick and the injured; and for their housing during
this process. The modern hospital also often serves as a center for investigation and for teaching.
The design of healthcare facilities plays a crucial role in shaping the quality of healthcare
services and the overall well-being of patients, staff, and visitors. This college project explores
the multifaceted aspects of hospital design, focusing on the integration of functionality,
sustainability, and patient-centric approaches.
The project begins by examining the evolving trends in healthcare delivery and their impact on
hospital design. It delves into the importance of creating spaces that facilitate efficient
workflows, optimal communication, and seamless coordination among healthcare professionals.
The incorporation of advanced technologies to enhance diagnostics, treatment, and patient care is
also a key aspect under consideration. Sustainability is a paramount concern in contemporary
hospital design. The project investigates how environmentally friendly practices, energy-efficient
systems, and green building materials can contribute to the reduction of a hospital's ecological
footprint. Strategies for waste management, water conservation, and the implementation of
renewable energy sources are explored to create a hospital that is not only healing but also
environmentally responsible.
Furthermore, the project emphasizes the significance of patient-centric design principles. It
delves into the psychological and physiological impact of the physical environment on patients,
aiming to create spaces that promote healing and enhance the overall patient experience. Factors
such as natural light, privacy, accessibility, and the incorporation of nature into the built
environment are examined in detail.
The study employs a holistic approach, considering the perspectives of healthcare professionals,
administrators, patients, and the surrounding community. Through case studies, surveys, and
expert interviews, the project aims to identify best practices and innovative solutions that can be
applied to future hospital designs.
In conclusion, this college project aims to contribute to the ongoing dialogue on hospital design,
offering insights into creating healthcare facilities that not only meet the functional requirements
of modern medicine but also prioritize sustainability and the well-being of patients and
healthcare professionals alike.

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 ACKNOWLEDGEMENT
We would like to present our heartfelt thanks to the entire civil department to encourage and
guide us all through in depth knowledge of the project. They also help us to understand and
remember important detail sand guidelines of the project. It was very good learning experience
for us to have this project as it involved many unique practices as well as challenges.

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 Table of Contents
ABSTRACT ...................................................................................................................................................................... ii
ACKNOWLEDGEMENT .................................................................................................................................................. iii
1. INTRODUCTION .....................................................................................................................................................2
1.1 Background ..................................................................................................................................................2
1.2 Project Objectives: .......................................................................................................................................2
1.3 Site Analysis..................................................................................................................................................2
1.4 Design Principles ..........................................................................................................................................3
1.5 Facility Layout ..............................................................................................................................................3
1.6 Technology Integration ................................................................................................................................4
1.7 Safety Measures: ..........................................................................................................................................4
2. LITERATURE REVIEW ..................................................................................................................................................6
2.1 TERMINOLOGY: ....................................................................................................................................................6
2.1.1 General Terms ..............................................................................................................................................6
2.1.2 Classification of Building ...............................................................................................................................7
3.METHODOLOGY ..........................................................................................................................................................9
4. Budget and Timeline: ...............................................................................................................................................10
5.POSSIBLE OUTCOME/CONCLUSION ..........................................................................................................................11
6. REFERENCE ..............................................................................................................................................................12

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 1. INTRODUCTION
1.1 Background
As early as 4000 BCE, religions identified certain of their deities with healing. The temples
of Saturn, and later of Asclepius in Asia Minor, were recognized as healing centres. Brahmanic
hospitals were established in Sri Lanka as early as 431 BCE, and King Ashoka established a
chain of hospitals in Hindustan about 230 BCE. Around 100 BCE the Romans established
hospitals (valetudinaria) for the treatment of their sick and injured soldiers; their care was
important because it was upon the integrity of the legions that the power of ancient Rome was
based.
Bir Hospital is the oldest hospital of Nepal. This hospital was established in 1947 BS, under the
name of contemporary Prime Minister Bir Shamsher Jung Bahadur Rana.
1.2 Project Objectives:
a)Increase healthcare accessibility in rural as well as urban areas.
b)Enhance the hospital’s capacity to serve the community.
c)Ensure the design with local cultural and environmental factors.
d) Prioritize the creation of patient-centric spaces by considering the psychological and
emotional well being of patients.
e) Assess the broader impact of hospital design on the surrounding community.
f) Evaluate and redefine the layout and spatial organization of hospital facilities to optimize
workflow, minimize bottlenecks, and enhance the overall functional efficiency of healthcare
delivery.
1.3 Site Analysis
A) Site Information:
• Location: Clearly identify the site's address, coordinates, and accessibility.
• Topography: Understand the land's natural features, such as slopes, elevation changes,
and drainage patterns.
• Area: Determine the total area available for construction and any constraints or
limitations.
B) Climatic Condition:
Analyze the local climate, including temperature ranges, precipitation, and seasonal variations.
C) Water Content:
Water Content in the subsurface level should be examined.

D) Site History:
• Previous Land Use:

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Investigate the site's historical use and any potential environmental issues associated with
previous activities.
• Land Ownership:
Confirm land ownership and potential legal considerations.
1.4 Design Principles
A) Patient-Centered Design:
• Healing Environment: Create a welcoming and calming atmosphere that promotes
healing. Use natural light, soothing colors, and artwork to reduce stress and anxiety.
• Privacy and Dignity: Ensure private spaces for patient consultations, examinations,and
discussions. Respect patient confidentiality and dignity.
B) Infection Control:
• Isolation Units: Design isolation rooms to prevent the spread of infectious
diseases.Ensure proper ventilation and access to handwashing facilities.
• Easy-to-Clean Surfaces: Choose materials that are easy to clean and maintain to reduce
the risk of infection.
C)Sustainability:
Incorporate eco-friendly practices and materials.
D) Flexibility and Adaptability:
• Modular Design: Plan for flexibility in spaces to accommodate changes in technology,
equipment, and healthcare practices.
• Future Expansion: Anticipate future growth and design the hospital to allow for
expansion without major disruptions to existing operations.

1.5 Facility Layout

A) Reception and Waiting Area:
• Place the reception desk near the entrance for easy access.
• Design a comfortable waiting area with sufficient seating and natural light.
• Include a separate area for patient check-ins and information.

B) Outpatient Department (OPD):

• Create specialized zones for different medical departments (e.g., cardiology, orthopedics,
pediatrics).
C) Diagnostic Services:

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 • Plan for a centralized diagnostic area for tests and imaging (X-ray, MRI, CT scan).
• Allocate space for laboratories and blood testing.
D) Emergency Department:
• Design a dedicated emergency entrance for quick access.
• Include separate areas for triage, treatment rooms, and observation units.
E) Pharmacy:
• Place the pharmacy near the outpatient department for easy prescription fulfillment.
• Design a layout that facilitates efficient dispensing of medications.
F) Landscape and Green Spaces:
• Integrate outdoor areas and green spaces for patient recovery and relaxation.
• Design accessible pathways for patients and visitors.
1.6 Technology Integration
A) Electronic Health Records(EHR):
Streamline patient information management.
B) Telemedicine Infrastructure:
Enhance remote healthcare services.
C) Advancing Imaging:
Provide comprehensive diagnostic capabilities.
1.7 Safety Measures:
A) Fire Safety:
• Implement state-of-the-art fire detection and suppression systems.
• Design fire exits with clear signage and ensure they are easily accessible.
• Conduct regular fire drills and train staff on emergency procedures.

B) Infection Control:
• Design spaces with infection prevention in mind, including proper ventilation
systems, isolation rooms, and hand hygiene stations.
• Use materials and surfaces that are easy to clean and disinfect.
• Implement strict protocols for waste management to prevent the spread of
infections.

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C) Chemical Safety:
• Store and handle chemicals and hazardous materials in accordance with safety
regulations.
• Provide appropriate ventilation and storage facilities for chemicals.
D) Emergency Exits:
Clearly marked and excessible routes.

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 2. LITERATURE REVIEW
2.1 TERMINOLOGY:
2.1.1 General Terms
2.1.1.1 Building:
Any Structure constructed of whatever material, whether used as human habitation or not and
which includes foundation, plinth, walls, floors, roofs & building services.
2.1.1.2 Public Buildings:
Public Buildings refer to all the government, non-government or private buildings which are
used for providing services, facilities, products and opportunities to the general public
2.1.1.3 Building Height:
The Height of the building shall mean the vertical distance from the average level of the ground
around to the terrace of the upper most floor to the roof..
2.1.1.4 Plinth:
Plinth means part of the building above the normal ground level and below the ground floor
level.
2.1.1.5 Plinth Area:
Plinth Area refers to area occupied by the ground floor of the building.
2.1.1.6 Built-Up area
Built-up area shall be the sum of all the floor areas in the building used for one or more
occupancy type.
2.1.1.7Habitable Rooms
A room occupied or designed for occupancy by one or more people for the purpose of study,
living, sleeping, eating, and cooking.
2.1.1.8Floor
Floor height refers to height of the room measured from the surface of the floor to the lowest
point of the ceiling.
2.1.1.9 Basement
The lower story or story of a building that are either completely below the average ground level
or extending up to 1.2m above the ground level.
2.1.1.10 Refuge Area
An area of refuge is a particular designated location in a building designed to hold occupants
during a fire or other emergency, when evacuation may not be safe or possible. Occupants can
wait there until the arrival of the rescue team. They are necessary in high rise buildings with
building height greater than 25m which is beyond the reach of normal fire brigade.

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 2.1.2 Classification of Building
1.2.1 Based on Occupancy
All buildings shall be classified according to the use or the character of occupancy into one of
the following groups. This classification may be used by other codes as required
Group A: Residential
Group B: Assembly
Group C: Educational
Group D: Hospitals & Clinic
Group E: Commercial
Group F: Office
Group G: Industries
Group H: Storage
Group D: Hospitals and Clinics
Group D shall include all medical and health institutions which are intended to house persons
suffering from physical or mental illness disease or infirmity, or to provide care for infants or
aged persons. Smaller clinics with area less than 100sq.m where the patients are not expected to
stay may be excluded from this. However all public health post should fulfill the Category 2 of
disabled accessibility requirements as specified in Part 5
Hospitals and Clinics shall be divided into two categories
Sub Group D1: Medical Institutions with less than 25 beds
Sub Group D2: Medical Institutions with more than 25 beds

Various Sections of Building Codes

101 Specification of Construction Materials

102 Dead Load of Construction Materials
103 Live load on Structures
104 Dead load on Structures
105 Seismic load on Structures
106 Snow load on Structures
107 Provision of Fire Resistant Construction
108 Site Selection
109 Load Bearing Structure
110 Construction work with Concrete
111 Street Selection
112 Timber Selection
113 Aluminium Structure
114 Safety Measures in Concrete Work

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 SUMMARY OF REQUIREMENTS BASED ON OCCUPANCY

S.No Elements of Particularly dimensional Less than 25 Beds More than 25 Beds
Buildings aspects
1 Occupancy Load Maximum area per sq m 14 14
2 Egress Maximum distance to exits 30m
or stairways within single 40m for external corridor
floor

Doorway Doors of Operation suite and Delivery

suite shall be two leaf type with min.
width of 1.5 and shall have self-closing
devices

Width of the Corridors 1.8/25/75

Staircase width 10”/11”

3 Components of Plinth Min. 450mm from existing road level

Building
Minimum height of room 3.2m for Hills & mountains
3.6m for Terai
Light and Ventelations Min area of opening for natural
ventilation shall be1/6th of the room
area

Lifts Min size of patient lift car: 1.2m X 2.4m

4 Acessibility for Shall fulfill the requirement of category

Disabled 2 to 3

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 3.METHODOLOGY

Proposal(Title Selection , Consultation with

proposal preparation and supervisor
submission)

Literature
Data Analysis and Review(Desk Study,
report writing Data Collection)

Report Submission

Fig: Methodology of Primary Hospital Design

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4. Budget and Timeline:
The project has been allocated to the completed in the time being of 5th semester of Civil
Engineering. The first phase of the project which includes the theoretical study of Hospital
Designs,document related to hospital and codes, architectural correction needed in the drawing
and preliminary design of hospital has been completed.
Presently, following tasks has been completed;
Task Time Duration(Days)
Group Formation 3
Project Selection 2
Interaction with supervisor 2
Project Briefing 3
Project Title and Objective Confirmation 2
Completion of proposal 5
Design Work 8
Total 25

The project is estimated to complete in minimum cost as possible and estimated to completed in
following ways;
Task Time Duration (Days)

Analysis of Design 5

Research on the topic 8

Site Analysis 2

Design work 14

Interaction with supervisor 8

Final Report Writing 6

Total 43

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 5.POSSIBLE OUTCOME/CONCLUSION
The project is expected to provide following outcomes:

• The plan as well as longitudinal profile of existing site.

• The detail requirements for proper structure.

• The detail design of cross section elements of hospital.

• The detail estimation for the completion of project.

• The impact of establishing such designs in community in rural and urban areas.

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 6. REFERENCE
• Encyclopedia Britannia,Pamela C. Fralick,President and CEO, Canadian Healthcare
Association.
• "Bir Hospital". kathmandupost.ekantipur.com. Retrieved 30 March 2019.
• healthdesign.org
• Nepal Medical Association, https://www.nma.org.np/
• NBC_206_2015_ARCHITECTURAL_DESIGN_REQUIREMENTS.

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