This document defines "Tertiary Level III hospital" The list below are the following spaces needed

paces needed for

and discusses its significance and benefits in the a level 3 hospital according to the Department of
Philippines. It also covers the classification of Health:
hospitals and categories of general hospitals. The
paper discusses the spaces that are required in the
a. Lobby
construction as well as the factors that must be
addressed while planning and designing this kind of i. Waiting Area
hospital. This article can also serve as a guide for ii. Information and Reception
designing and constructing a level III hospital. Area
iii. Communication Booth
The planned hospital modernization plan, according iv. Public Toilet
to Senate Bill 1100, is neither grandiose nor difficult. It (Male/Female/PWD)
is a straightforward plan to supply local hospitals v. Staff Toilet (Male/Female)
with what they require, such as current technology, b. Admitting Office
facility upgrades, and an acceptable number of
physicians. c. Business Office
The bill's sole purpose is to make health-care services i. Billing
more accessible, available, affordable, and acceptable ii. Cashier
to our citizens. iii. Budget and Finance
"Tertiary Level III hospital" refers to a hospital that d. Medical Records Office
has been specifically chosen to provide tertiary
e. Prayer Area
hospital services, including teaching, training, and
research. f. Personnel Office
g. Office of the Administrative Officer
Level 3 hospital creates an efficient and effective h. Office of the Chief of Hospital
health care delivery system throughout the country. i. Office of the Chief of Clinics
upgrade the health-care delivery system to the point j. Conference and Training Room
where it can completely and effectively carry out its k. Library
constitutional mission of protecting and promoting
people's right to health. At provincial hospitals and l. Staff Toilet
medical centers, this type of institution implements a m. Laundry and Linen Office
residency training and accreditation program, as well i. Sorting and Washing Area*
as the accreditation of private specialized
ii. Pressing and Ironing Area*
practitioners.
iii. Storage Area
Level 3 hospital also:
n. Engineering Office
● provides outstanding clinical healthcare
services. i. Work Area
● provide high-level specialised interventions ii. Housekeeping Area
such as physical therapy or dialysis treatment iii. Motorpool* and
● serves as nurse and doctor training facilities Ambulance Parking Area
● provide a teaching and/or training hospital that o. Property and Supply Office
provides certified residency training program for p. Waste Holding Room
doctors q. Dietary
● A blood donation center i. Nutritionist-Dietitian Office
● A dialysis unit ii. Supply Receiving Area*
● A surgical ambulatory clinic iii. Cold and Dry Storage Area*
● A physiotherapy and rehabilitation unit iv. Food Preparation Area*
v. Cooking and Baking Area*
vi. Special Diet Preparation
 Area 4. Surgery
vii. Serving and Food 5. Anesthesia
Assembly Area
6. Emergency
viii. Dishwashing Area Medicine
ix. Garbage Disposal Area c. Dialysis Clinic
x. Dining Area i. Dialysis Station (at least 6m2
xi. Toilet per station)
r. Social Service Office ii. Nurses’ Station with Work
s. Morgue Area, Lavatory/Sink and
Storage Cabinets
i. Autopsy Area
iii. Storage Room for sterile
ii. Shower Area instruments/supplies, etc.
iii. Toilet iv. Toilet Facility with water
closet, urinal and lavatory
a. Emergency Room v. Water Treatment Room
i. Waiting Area (min. 12m2)
ii. Toilet vi. Reprocessing Room
iii. Nurses’ Station with Work (optional) for reprocessing
Area with Sink or Lavatory of dialyzer
iv. Triage Room d. Surgical Service
v. Examination and i. Major Operating Room
Treatment Area with Sink ii. Minor Operating Room
or Lavatory iii. Recovery Room with
vi. Observation Area Nurses’ Work Area
vii. Minor OR/Area iv. Sub-sterilizing
viii. Equipment and Supply
Storage Area Area/Work Area
ix. Decontamination Room v. Sterile Instrument, Supply
with Shower/Dressing Room and Storage Area
x. Isolation Room with Toilet vi. Scrub-up Area
and Ante Room with PPE vii. Clean-up Area
Rack, Sink or Lavatory viii. Male Dressing Room and
xi. Wheeled Stretcher Area Toilet
xii. Doctor-On-Duty Room ix. Female Dressing Room
and Toilet
b. Outpatient Department
i. Waiting Area x. Nurses’ Station/Work Area
ii. Toilet (Male/Female/PWD) xi. Wheeled Stretcher Area
iii. Admitting and Records xii. Janitor’s Closet with mop
Area sink
iv. Consultation Area e. Obstetrical Service
v. Respiratory Unit i. Delivery Room
vi. Examination and ii. High Risk Pregnancy Unit
Treatment Area with Sink iii. Labor Room with Toilet
or Lavatory iv. Scrub-up Area
vii. Dental Clinic v. Sub-sterilizing
viii. Office of the Department
Head Area/Work Area
1. Medicine vi. Sterile Instrument, Supply
and Storage Area
2. Pediatrics
3. Obstetrics and vii. Scrub-up Area
Gynecology viii. Clean-up Area
ix. Male Dressing Room and
Toilet
x. Female Dressing Room
 and Toilet
xi. Nurses’ Station/Work Area
xii. Wheeled Stretcher Area
xiii. Janitor’s Closet with mop
sink
f. Neonatal Intensive Care Unit (NICU)
i. Nurses’ Station/Work Area
with Sink
ii. Newborn Care Area
iii. Treatment Area
iv. Viewing Area
v. Breastfeeding Area with
Lavatory
g. Nursing Unit
i. Patient Room with Toilet
ii. Isolation Room with Toilet
and Ante Room with PPE
Rack and Lavatory/Sink
with hamper
iii. Nurses’ Station
1. Utility Area
2. Linen Area
3. Toilet
4. Equipment and
Supply Area
iv. Treatment and Medication
Area with Lavatory/Sink
v. Doctor-On-Duty Room
vi. Garbage Bin Room
vii. Janitor’s Closet
h. Intensive Care Unit (ICU)
i. Nurses’ Station with Work
Area with Lavatory/Sink
ii. Medication Preparation
Area
iii. Toilet
iv. Patient Area
v. Dressing Area
vi. Equipment and Supply
Storage Area
i. Rehabilitation Room
i. Toilet
ii. Treatment Area
iii. Therapy Area
j. Central Sterilizing and Supply
Room
i. Receiving and Cleaning
Area
ii. Inspection and Packing
Area
iii. Sterilizing Room
iv. Storage and Releasing Area
a. Nursing Office
b. Toilet
a. Tertiary Clinical Laboratory with
Histopathology
i. Clinical Work Area with
Lavatory/Sink (min. of
60.00 sq.m.)
ii. Pathologist’s Office
iii. Microbiology Room
iv. Histopathology Room
v. Blood Bank
vi. Bleeding Area
vii. Toilet
viii. Extraction Area separate
from the Clinical Work
Area
b. Radiology – 3rd Level
i. X-Ray Room with Control
Booth, Dressing Area, and
Toilet
ii. Dark Room
iii. Film File and Storage Area
iv. Radiologist Area
c. Pharmacy with work counter and
sink
In conformity with accepted architectural standards,
functional programs, and legal requirements,
hospitals and other healthcare facilities must be
planned and constructed as part of standard
professional practice. It should be planned and
designed according to the guidelines in the planning
and design of a hospital and other health facilities
(DOH):
 An airport, railroad, freight yard,
children's playground, industrial plant,
or disposal facility shouldn't be too close
to a hospital or other healthcare facility.
They should also be free from intrusive
noise, smoke, dust, or foul odors.
 It is prohibited to convert a structure
meant for another use into a hospital. All
local zoning laws must be followed at
hospital settings.
 Hospitals and other healthcare facilities
are required to offer and maintain a safe
environment for patients, employees,
and the general public. The building
must be built such that there are no
hazards to the personnel, patients, or
general public's health and safety. The
pressure and environmental conditions
that they could experience must be able
to withstand it.
a. Only exits with direct access to the
outdoors, inside stairs, ramps, and
outside steps are allowed.
b. A minimum of two (2) exits, remote
from each other, shall be provided
for each floor of the building.
c. Exits must end just outside the
building, in a clear space.
 A hospital and other health facilities
shall ensure the security of person and
property within the facility.
 Whether a patient is on a bed, a
wheelchair, or a stretcher, they must
have the freedom to move around.
Patients must be able to always move
freely and openly between different
areas.
a. Corridors for access by patient and
equipment shall have a minimum
width of 2.44 meters.
b. Corridors in areas not commonly
used for bed, stretcher and
equipment transport may be
reduced in width to 1.83 meters.
c. A ramp shall be provided as access
to the entrance of the hospital not on
the same level of the site.
d. A ramp or elevator shall be
provided for ancillary, clinical and
nursing areas located on the upper
floor.
 A hospital or other healthcare facility
must have enough light in every area for
patients' comfort, healing, and recovery
as well as to make it possible for staff to
do their jobs.
 To guarantee the comfort of patients,
employees, and the general public,
adequate ventilation must be supplied.
 In order to meet the acoustical and
privacy requirements in defined areas
and for the unhindered conduct of
activities, a hospital and other
healthcare facilities must maintain an
appropriate sound level and sufficient
visual seclusion.
 When accessible, a hospital and other
healthcare institutions must use an
authorized public water supply system.
The water supply must be drinkable,
sufficient, and safe for consumption. It
must also be transported into the
building without any cross connections.
 When a public sewage system is
provided, liquid waste must be
discharged into it, and solid waste must
be gathered, processed, and disposed of
in compliance with any applicable
regulations, laws, or ordinances.
 To provide a clean and healthy
environment, utilities for the upkeep of
sanitary systems, including permitted
water supply and sewerage system,
should be supplied via the buildings and
premises.
 For patients, staff, and the general
public, hospitals and other healthcare
institutions must create and maintain a
hygienic and pleasant atmosphere.
 An efficient program for building
maintenance must be in place. Buildings
and equipment must be preserved in
excellent working order. To prevent
unforeseen equipment and building
breakdowns, proper
maintenance must be given.
 The flooring, walls, and ceilings must all
be made of durable materials that are
also fire resistant, easy to clean, and
durable.
 Wards must follow the sex-based
segregation policy. One (1) toilet must be
kept for every eight (8) patients or staff
members, with separate facilities for
male and female patients and staff.
 There must be fire safety precautions in
place, such as smoke detectors in
 the ceiling, peepholes in the doors, and
fire alarms in the walls. At key locations,
there must be fire-quenching equipment
that is both visible and accessible, such
fire extinguishers or fire hoses.
 The use of an effective graphic system,
which consists of various individual
visual aids and devices organized to
provide information, orientation,
direction, identification, prohibition,
warning, and official notice, is necessary
for a hospital's and other healthcare
facility's best possible operation.
 For every twenty-five (25) beds,
hospitals and other healthcare
institutions must have at least one (1)
parking place available.
 The different areas of a hospital shall be
grouped according to zones as follows:
a. 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.
b. Second Zone – areas that receive
workload from the outer zone:
laboratory, pharmacy, and
radiology. They shall be located near
the outer zone.
c. Inner Zone – areas that provide
nursing care and management of
patients: nursing service. They shall
be in private areas but accessible to
guests.
d. 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.
e. Service Zone – areas that provide
support to hospital activities: dietary
service, housekeeping service,
maintenance and motorpool service,
and mortuary. They shall be in
areas away from normal traffic.
 The different areas of a hospital shall be
functionally related with each other.
a. The emergency service shall be
located on the ground floor to
ensure immediate access. A separate
entrance to the emergency room
shall be provided.
b. 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.
c. 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 in private areas.
d. The nursing service must be kept
out of the public. The nursing
station must be situated so that
patients may be seen easily. In all of
the hospital's inpatient units, nurse
stations must be available, with at
least one (1) station for every 35
beds. The size of the rooms and
wards must be enough to
accommodate patient
movement and workflow. The
restrooms must be easily reachable
from the rooms and wards.
e. The location and configuration of the
delivery service must stop unrelated
traffic. To ensure asepsis, the
delivery room must be as far away
from the entryway as is practical.
After changing into surgical attire,
the dressing room must be situated
to prevent exposure to soiled regions.
The nursing station must be situated
such that patients' movements may
be seen visually. The nursery must
be separate from the delivery room
yet easily accessible from there.
f. The dietary service shall be away
from morgue with at least 25-meter
distance.
 Toilet 1.67
 There needs to be enough room for Nurse Station 5.02/staff
the people, activity, furniture, Examination and
equipment, and utility. Treatment Area with 7.43/bed
Notes: Lavatory/Sink
Observation Area 7.43/bed
1. 0.65/person – Unit area per person Equipment and Supply
occupying the space at one time 4.65
Storage Area
2. 5.02/staff – Work area per staff that Wheeled Stretcher Area 1.08/stretcher
includes space for one (1) desk and one (1) Outpatient Department
chair, space for occasional visitor, and space Waiting Area 0.65/person
for aisle Toilet 1.67
3. 1.40/person – Unit area per person Admitting and Records 5.02/staff
occupying the space at one time Area
4. 7.43/bed – Clear floor area per bed that Examination and
includes space for one (1) bed, space for Treatment Area with 7.43/bed
occasional visitor, and space for passage of Lavatory/Sink
equipment Consultation Area 5.02/staff
5. 1.08/stretcher – Clear floor area per Surgical and Obstetrical Service
stretcher that includes space for one (1) Major Operating Room 33.45
stretcher Delivery Room 33.45
Sub-sterilizing Area 4.65
Sterile Instrument, Supply
4.65
and Storage Area
Scrub-up Area 4.65
Clean-up Area 4.65
Lobby Dressing Room 2.32
Waiting Area 0.65/person Toilet 1.67
Nurse Station 5.02/staff
Information and
5.02/staff Wheeled Stretcher Area 1.08/stretcher
Reception Area
Toilet 1.67 Janitor’s Closet 3.90
Business Office 5.02/staff Nursing Unit
Medical Records 5.02/staff Semi-Private Room with
7.43/bed
Office of the Chief of Hospital 5.02/staff Toilet
Laundry and Linen Area 5.02/staff Patient Room 7.43/bed
Toilet 1.67
Maintenance and
5.02/staff Isolation Room with Toilet 9.29
Housekeeping Area
Nurse Station 5.02/staff
Parking Area for Transport 9.29
Treatment and
Vehicle
Medication Area with 7.43/bed
Supply Room 5.02/staff
Waste Holding Room 4.65 Lavatory/Sink
Dietary Central Sterilizing and Supply
Dietitian Area 5.02/staff Room
Supply Receiving Area 4.65 Receiving and Releasing
5.02/staff
Cold and Dry Storage 4.65 Area
Area Work Area 5.02/staff
Food Preparation Area 4.65 Sterilizing Room 4.65
Cooking and Baking Area 4.65 Sterile Supply Storage 4.65
Serving and Food Area
4.65
Assembly Area
Washing Area 4.65 Office of the Chief Nurse 5.02/staff
Garbage Disposal Area 1.67
Dining Area 1.40/person Primary Clinical Laboratory
Toilet 1.67 Clinical Work Area with
10.00
Cadaver Holding Room 7.43/bed Lavatory/Sink
Pathologist Area 5.02/staff
Emergency Room Toilet 1.67
Waiting Area 0.65/person Radiology
 X-Ray Room with Control
Booth, Dressing Area, and 14.00
Toilet
Dark Room 4.65
Film File and Storage 4.65
Area
Radiologist Area 5.02/staff
Pharmacy 15.00
● Government
- a hospital that is owned, established,
established, and constructed by law; the
facility may be under the control of the
national government.
● Private
- a hospital owned, developed, and run using
cash provided by any individual, non-
governmental corporation, association, or
organization through donation, main
investment, or other methods.
● General
- a hospital that provides services for all kinds
of illnesses, ailments, traumas or deformities.
A general hospital must provide sick and
injured people with medical and surgical
care, as well as maternity, infant, and child
care.
● Specialty
- a hospital that specializes in a certain disease
or condition or in one sort of patient.
A Level 1 hospital must provide at least the following
services and facilities capacity:
● A team of skilled medical, allied medical, and
administrative personnel led by a physician with
a Professional Regulation Commission (PRC)
license;
● Bed space for its approved bed capacity, in
conformity with DOH Guidelines for Hospital
Planning and Design.
● An operating room outfitted with conventional
equipment and space for equipment and supplies
sterilization.
Table 1: The services and amenities supplied
by eachlevel.
● A recuperation room following surgery;
● Maternity services
● Facilities for isolation with suitable procedures
for the care and control of infectious and
communicable diseases, as well as to prevent
infection transmission
● A DOH-approved pharmacy
● A Level 1 imaging facility licensed by the DOH
and staffed by a consulting radiologist
● A DOH-licensed secondary clinical laboratory
with consulting pathologist services.
● A blood donation center
● A distinct dental portion
A Level 2 hospital must have all of the capabilities of
a Level 1 hospital, including, but not limited to, the
following:
● A well-organized team of trained and capable
individuals led by the Chief of Hospital/Medical
Director and Clinical Department Heads.
● Departmentalized and outfitted with the
necessary service capabilities to assist board-
certified/eligible medical specialists and other
licensed physicians.
● An Intensive Care Unit (ICU) for critically ill
patients in general.
● A Neonatal Intensive Care Unit (NICU).
● A Unit for High-Risk Pregnancy (HRPU)
● Offering respiratory therapy services;
● A tertiary clinical laboratory licensed by the
DOH inside the institution is a DOH-licensed
Level 2 imaging facility with mobile x-ray.
A Level 3 hospital must have all of the capabilities of
a Level 2 hospital, including, but not limited to, the
following:
● Teaching and/or training hospital has a medical
residency training program that is accredited.
● Departmentalized and outfitted with the
necessary service capabilities to assist board-
certified/eligible medical specialists and other
licensed physicians.
● An Intensive Care Unit (ICU) for critically ill
patients in general.
● A Neonatal Intensive Care Unit (NICU).
● A Unit for High-Risk Pregnancy (HRPU)
● Offering respiratory therapy services;
● A tertiary clinical laboratory licensed by the
DOH inside the institution is a DOH-licensed
Level 2 imaging facility with mobile x-ray.
 Services Level 1 Level 2 Level 3

Clinical Services for Medicine, Pediatrics,
in-patients Obstetrics & Gynecology
, and Surgical
Consultants
Emergency and
Outpatient Services
All of Level 1 plus: All of Level 2 plus:
Departmentalized Teaching/training services in
Clinical Services the four primary clinical
services with authorized
residency training programs.
Respiratory Unit Physical Medicine and
Rehabilitation Unit
General ICU

Isolation Facilities
Surgical/ High Risk Pregnancy Ambulatory Surgical Clinic
Maternity Facilities Unit

Dental Clinic NICU Dialysis Clinic

Ancilliary Services Secondary Clinical Tertiary Clinical Tertiary laboratory with

Laboratory Laboratory histopathology

Blood Station Blood Station Blood Bank

1st Level X- ray 2nd Level X- ray with 3rd Level X- ray
mobile unit

Pharmacy Pharmacy Pharmacy

The impact of a level 3 hospital in implementing a program of extending technological, financial, and
administrative help to LGUs to support and improve the provision, operation, and maintenance of health facilities
and equipment has been demonstrated in this study. Also, in order to improve hospital capacity, the DOH must
provide qualified physicians to each LGU to help the local chief executive as needed.

(2004) Planninganddesignhospitalsother facilities-doh.gov.ph, . Retrieved from:

https://doh.gov.ph/sites/default/files/public ations/planning_and_design_hospitals_other
_facilities.pdf

FifteenthCongressoftheRepublicofthe PhilippinesSenate1100(no date). Retrieved from:

https://legacy.senate.gov.ph/lisdata/858071 34!.pdf.
PTCAO2016-
0042CHECKLISTFLOORPLANHOSL3PGES95-
100(2016). Retrieved from: https://hfsrb.doh.gov.ph/wp- content/uploads/2021/05/Hospital-Level- 3.pdf.

WelcometoDepartmentofHealthwebsite| DepartmentofHealthWebsite(2020). Retrieved from:

https://doh.gov.ph/sites/default/files/public ations/DOH-Hospitals-Profile_0.pdf.

NewDohHospitalclassifications(2015) NewDOH HospitalClassifications2015. Retrieved from:

https://publichealthresources.blogspot.com/ 2015/04/new-doh-hospital-classifications- 2015.html.

HEALTHsystemsintraNSITIon09/2 013...(2013). Retrieved from: https://apo.who.int/docs/librariesprovider15

/publications/hits/philippines_living_hits_2_5
_2_health_facility_planning.pdf?sfvrsn=9d61 bc9a_5.