Proposed Hospital Complex for Los Angeles

Medical Centre Hospital (LAMCH) at

Anagarika Dharmapala Mawatha, Dehiwala

Presented by: Supervised by:

Group 12 Prof. L.I.N. de Silva
Dr. K.H.S.M. Sampath
Content
• Background
• SWOT analysis
• Site location
• Reconnaissance survey
• Findings from literature
• Guidelines
• Alternative designs (Architectural)
• Alternative 1
• Alternative 2
• Alternative 3
• Feasibility study
• Environmental
• Social
• Financial
• Multi criteria analysis
• Environmental impact assessment
• Building services design
• Structural design
• Geotechnical design
• Sustainability design
• Special provisions for disabled people
• Acknowledgement
• References
 Background

Los Angeles Medical Center Foundation

• Los Angeles Medical Center is a general practice/OB-

GYN, pediatric clinic in the Westlake district of Los
Angeles, California, launched in 1975 by Dr. Walter
Jayasinghe — a Sri Lankan by birth and a U.S citizen by
naturalization
• Hospital network currently operating at 4 locations in US
• The client wants to built up a new branch of Los Angeles
medical center in Sri Lanka
01
 Improving the Dehiwala
municipal area's health
standards by offering an Promotion of
effective healthcare advanced medical
facility with the aid of treatment facilities.
modern technology.

Objectives
Encourage national and Earning profits
international initiatives to while being
invest in health services to competitive in the
improve the nation's local market.
overall well-being.
.
02
 Client’s Requirements

• Luxury type private hospital

• Target group : upper intermediate and high
income holders
• Bed requirement : minimum 140 Beds
• Car parking need to be provided.
• Helipad is required.
• Hospital should be LEED certified.

03
 Problems with Typical Health Infrastructure in Sri Lanka

Limited Inefficient
resources management
(human/physical)

Lack of
Overcrowding Poor
specialized
and high waiting infrastructure
services
times
.

04
 Strengths
SWOT Analysis • High-end technology and partnerships with technology
companies
• Convenient location near the Galle road and Ratmalana
THREATS airport
• Having a helipad is extremely useful in emergency cases
T • Attraction of foreign exchange through medical tourism
• Potential for high profits and increased land and property
STRENGTHS
values.
SWOT O
S OPPORTUNITIES
Weaknesses

WEAKNESS
W •
•
Facilities may not be accessible for low-income people
Limited space availability
• Potential for increased traffic and noise
• Potential disruptions to the local community during the
construction and operation

05
 Opportunities
SWOT Analysis • Enhancing public health and well-being
• Attracting people who would typically go abroad for
medical treatments
THREATS • Growth of the local economy.
• Creating new job opportunities for healthcare
T professionals Earning LEED certification by adopting
sustainable practices, which can improve the hospital's
STRENGTHS
reputation.
SWOT O
S OPPORTUNITIES
Threats
• Competition with other hospitals
WEAKNESS
W • Negative perceptions of the hospital's impact on the
surrounding community
• Legal or regulatory issues.
• The limited accessibility for low-income people can lead
to criticism

06
 Site Location

Western province- Dehiwala-Mount Lavinia Galwala GND

Colombo District Municipal Council
07
 Site Plan

North- MOH Office Dehiwala

East – Temple
South – Commercial building, channel
West – Residential buildings

Private own land in Dehiwala area (No. 32, Anagarika

Dharmapala Mw. (B011 road), Dehiwala
(6.8612, 79.8662)
08
 Land features
• Land extent: About 75 perches
• Bare ground with level terrain

Before site clearing After site clearing

09
 Site Analysis
Urban Context

• Dehiwala – Mt. Lavinia

Municipal Council Area

• Mix development zone 1

• Land use- Mostly residential

• Zoning factor – 2.75

According to the Dehiwala – Mount Lavinia development plan, 2022-2031

10
 Site Analysis
Accessibility

Front access

Anagarika Dharmapala Rd –B11

Approximately 300 m away from

Colombo – Galle road (A2 road)

Back access

Millennium Rd- Local road

Approximately 170 m away from

Colombo – Galle road (A2 road)
Traffic Condition

11
 Hospitals in 5km Range

• Colombo south teaching

hospital(Kalubowila)
• New Delmon
• Royal hospital
• Lanka Hospital
• Asiri hospital
• Ninewells hospital
• Army hospital
• Durdans hospital

12

Abandoned three storey building
Nearby five storey building
13
Reconnaissance Survey
• Reconnaissance survey was carried out on 01st
November 2022.
• Following details were collected.
• General information
• Client’s requirements
• Site specific details
▪ Historical uses of site
▪ Details of nearby buildings
▪ Land use characteristics
 Findings from Literature
Main Departments in
• Administration Department: Oversees hospital operations including
a hospital financial and human resources management.
• Outpatient Department (OPD): Provides ambulatory medical services to
patients who don't require hospitalization.
• Diagnostic & Treatment Department: Provides medical tests and
procedures to diagnose and treat various health conditions.
• Inpatient Department (IPD): Provides medical care to hospitalized
patients.
• Research & Training Department: Conducts medical research and
provides training to healthcare professionals.
• Support Services Department: Provides support services such as food,
Ref. - Understand The Design of General Hospital,
Mazen Fani laundry, and housekeeping to patients and staff.
14
 Findings from Literature
General Zoning
Arrangement in a
• Outer zone: Immediately accessible to public (eg:
Hospital emergency service, outpatient service, administrative
service)
• Second zone: Receive workload from the outer zone (eg:
laboratories, pharmacy, radiology division
• Inner zone: Private areas but accessible to guests (eg: wards,
patient rooms)
• Deep zone: Segregated from public areas (eg: surgical
service, delivery service, intensive care)
• Service zone: Provide support for hospital activities (eg:
dietary service, housekeeping service, maintenance,
Ref. - Understand The Design of General Hospital,
Mazen Fani
mortuary)
15
 Guidelines

City of Colombo Dehiwala – Mount Lavinia

Development Plan Municipal Council Area
(Compiled edition) – Urban Development Plan 2022–
Development Authority, 2031, Urban Development
Ministry of Megapolis and Authority, Ministry of Urban
Western Development, Development & Housing
2018

16
 Guidelines

Manual on management
Health Building Notes (HBN) of teaching, provincial,
- by National Health base and special hospitals
Services (NHS), UK – Ministry of health,
highways & social
services, 1995

17
 Guidelines

STEMI management Cardiovascular laboratory International health facility

guidelines by Sri Lanka Heart service design guide guidelines -part B cardiac
Association investigation unit
18
 Design Related Parameters

Zone Mixed development zone

Zoning factor 2.75
Floor Area Ratio (FAR) 8
30 m <Building Height <50 m 65%
Plot coverage
50 m <Building Height< 75 m 50%
30 m <Building Height <50 m 4m
Rear space
50 m <Building Height< 75 m 5m
30 m <Building Height <50 m 3 m both sides
Side space
50 m <Building Height< 75 m 4m both sides
Ref. - Dehiwala – Mount Lavinia Municipal Council Area Development Plan 2022–2031, Urban Development Authority, Ministry of Urban
Development & Housing

19
Three different alternatives are proposed based on three
different concepts.

Smart Hospital General Hospital Cardiology specialized

hospital
Alternative
Provide treatment Provide treatment Provide specialized Designs
facilities for multiple facilities for multiple care for patients with
diseases with the help diseases while cardiology related
of advanced maximizing the diseases
technology efficient functionality. (Tertiary Care)
(Secondary Care) (Secondary Care)
 Alternative 01 - Concept
SMART hospital is a novel
concept for Sri Lanka, where
modern technology will be highly
utilized for patient treatments.

Smart Hospital
It helps to streamline hospital
operations through Internet of
Things (IoT), big data analytics, and
artificial intelligence (AI),
eventually resulting in better
patient experience.
21
 Special Features

• Patient engagement through mobile apps.

• Entrance through QR code verification/card system
• Navigation panels
• Automated inventory management
• Telemedicine facility/ online consultations with
reputed foreign doctors
• Patient monitoring systems & record keeping/ real
time collection of patient’s bio signals/ e-bed maps
(detect patient occupancy)
• Automatic doors and automatic lighting
21
 Alternative 1
Manual sketches

23
 Alternative 1
Master plan

Main building

Parking area for

Service building ambulances

24
 Alternative 1
Vertical floor arrangement
RF Helipad
F11-F12 Theatre complex
F10 Central Stereline Service Department (CSSD) Drug store
F7-F9 Patient rooms Patient care centre
F5-F6 ICU HDU Patient care center Multi bed rooms
F4 Gynecology & obstetrics Pediatrics
F3 laboratories Radiology
F2 Consultation rooms Telemedicine rooms
F1 Consultation rooms Administration Cafeteria
Accident & emergency X-ray Mortuary
GF
unit
CT room Laboratory OPD Pharmacy
room
B2-B1 Car park

25
 Alternative 1
Floor plans

Basement car parking

Ground floor
26
 Alternative 1
3D view

27
 Alternative 2
Concept
• Provide wide range of healthcare services to
patients of all ages and with various medical
conditions
• Create a space that is functional, efficient and
comfortable for patients and staff

Special Features
• Offers a high level of comfort, convenience and a
personalized service
• Roof top gardens available at two levels
• Comfortable and stress free environment for patients
• Using high-end technologies and delivering top- quality
medical care
28 30
 Alternative 2
Manual sketches

29
 Alternative 2
Master plan
N

2
1. Proposed hospital building
6

2. MOH-Dehiwela
3

3. Residential building

5
4. Commercial building
1 5. Temple
3

6. Generator, transformer
7. Water pretreatment-unit
8. Channel
4

7
8

30
 Alternative 2
Vertical floor arrangement
RF Helipad
F8-F15 IPD wards and suits Nurse station
F7 ward Suits Nurses station Rooftop garden

F6 Labor room Post natal rooms NICU Kids play Family area
area
F5 Physical therapy Medical longue Cafeteria Rooftop garden

F4 Operational room Diagnostic Nursury ICU

F3 Hemodialysis Blood Laboratory Eye clinic Dental Cardiovascular
bank clinic
F2 ENT Consultant rooms Obstetric & gynecology Surgery
F1 OPD Waiting area Laboratory Administration
GF Emergency unit Main lobby OPD Pharmacy Kitchen Cohort Radiology Mortuary
ward
B1 Car park Storage Laundry
B2 Car park Tank and pump room

31
 Alternative 2
Plan views

32
 Alternative 2
3D and Section view

33
 Alternative 2
Information on buildings

• Vehicle movement has been done between the Basement and the ground using rampers.
• Staff parks and emergency parking vehicles situate near the vertical circulation point and
entrance.
• Separate parking slots allocated for 2-wheel vehicles.
• Emergency unit placed near the 2nd front entrance.
• Cohort ward situated isolated with separate entrance at ground floor.
• On the 1st floor have a lobby area with a balcony.
• 2 Bed lifts, 2 normal lifts, service lift, fireman lift and 3 staircases with fire staircase use for
vertical circulation.
• There are 7 suites with V.I.P, standard and normal condition per floor inpatient zone.
• Rooftop gardens with footpaths are used to facilitate physical therapy treatments and as a
sustainable solution.

34
 Alternative 3
Concept

• According to the Sri lanka Heart

Association, mortality from CVD
(Cardiovascular Diseases) is 524 deaths
per 100,000
• The waiting time for a cardiothoracic
operation is increase day by day and
with the devastating economic situation
this may become even higher
• Eventhough the cost of a heart surgery
in a private hospital varies from Rs.
800,000 to Rs. 1,000,000 it is worth to Harischandra, T. et al. (2020) The workload, outcome and waiting
time of cardiothoracic operations: A single unit study in Sri Lanka,
reduce waiting time and saving lives. Sri Lanka Journal of Surgery. Available at:
https://sljs.sljol.info/articles/abstract/10.4038/sljs.v38i2.8678/
(Accessed: 31 May 2023).

35
 Alternative 3
Special Features

• Beds for cardiac patients (Normal) – 85

• Cardiac catheterization laboratory
• Echocardiography laboratory
• Cardiac stress testing laboratory
• Cardiac biomarker laboratory
• Beds for non cardiac patients – 34
• Beds for VIPs – 16
• Beds for visitors for Yoga & meditation – 5
• Total No. of beds – 140
• Plot area = 49 %

• Pulmonary function laboratory

• Yoga and meditation room
• Music therapy room
• Exercise room
• Luxury visitor type rooms

36
 Alternative 3
Master plan

• Main building
• No. of stories – 13 (including 2 basements)
• Height of the building – 49.600 m (FFL)

• Building 2
• No. of stories – 6 (including 2 basement)
• Height of the building – 17.600 m (FFL)

• Service building
• No. of stories – 3
• Height of the building – 13.600 m (FFL)

• Plot area = 49%

• FAR = 3.99
• Rear space = 5 m

• Side space = 7m
37
 Alternative 3
Vertical floor arrangement
H Helipad 49.600 m FFL

R Roof Rainwater harvesting 45.600 m FFL

tank
10 Meditation & Yoga Music therapy Exercise room (7 beds) 41.600 m FFL
9 Patient rooms (for non cardiac patients) (20 beds) 37.600 m FFL
8 Patient rooms Cardiac patients (20 beds) 33.600 m FFL
7 Patient rooms Cardiac patients (20 beds) 29.600 m FFL
6 Maternity room Children care unit Infant feeding room (12 beds) 25.600 m FFL
5 CCU (19 beds) 21.600 m FFL
4 CCU 17.600 m FFL
3 OPD 13.600 m FFL
2 OPD Admission Consultation and treatment rooms (4 beds) 9.600 m FFL

1 Labs X-ray, MRI Cardiac theatre (2 beds) 5.500 m FFL

G ETU Catheter lab (6 beds) 0.900 m FFL
B1 Car park 50 slots -3.500 m FFL
B2 Car park 50 slots -7.200 m FFL
38
 Design of service building
Conceptual design

Separate service building design ensures that maintenance or repair activities

in the service building have minimal impact on patient care.

Generator room, Transformer room, Switch room,

First floor Waste storage room, gas storage, pump room, small
office room
Second floor Sterilization room, Laundry room, Mechanical room,
Fire protection Control room
Third floor Kitchen, Central Supply room, Telecommunication
control room, Store

39
 Alternative 3
Floor plans

Building2 – first floor

Service building – first floor

Building 1- Building 1-
First floor Eighth floor

40
 Alternative 3
Section views

Transverse section
Main building-Longitudinal view

41
 Alternative 3
3D view

42
 Alternative 3
Rendered view

43
 Feasibility Study
An assessment conducted to determine the
viability and potential success of various
alternatives, aiding in the selection of the
most optimal option for a project or decision-
making process.
Environmental Feasibility

Social Feasibility

Financial Feasibility

44
 Feasibility Study cont.
Methodology

Positive and negative attributes which were relevant to the project were selected

Assign weightages for the attributes using Analytic hierarchy Process (AHP)

AHP method is a decision making method that can be used in feasibility studies to symmetrically evaluate and
prioritize alternatives based on multiple criteria. It involves breaking down the decision making process into a
hierarchy, comparing the relative importance of criteria and alternatives, and deriving overall priority scores to
rank and compare the alternatives.

45
 Feasibility Study cont.
Methodology

Relevance scores will be assigned to each attribute separately for positive and negative impacts

Score Value Significance or Severity

+3 or -3 High
+2 or -2 Moderate
+1 or -1 Low

Impact = 𝛴 ( Score value x Weightage)

➢ Derive Weightages for Positive Impacts Using AHP Method

Net Impact = Sum of Negative Impact – Sum of Positive Impact

46
 Feasibility Study cont.
Environmental Feasibility – Positive Impact
No Attributes
1 Uses energy efficient building materials
2 Storm water management & rainwater harvesting
3 Demotivates paper work
4 Use renewable energy
5 Wastewater treatment

Step 1 :- Pair-wise comparison matrix (A0) was developed

Attributes 1 2 3 4 5 Scale Definition Explanation

1 1 1 3 1 2 Two activities contribute
1 Equal importance
equally
2 1 1 3 1 2
3 0.33 0.33 1 0.33 0.5 3
Moderate importance Judgement slightly favour one
of one over another activity over another
4 1 1 3 1 2
5 0.5 0.5 2 0.5 1 Essential or Judgement strongly favour
5
strong importance one activity over another

47 2,4 Intremediate values

 Feasibility Study cont.
Environmental Feasibility – Positive Impact
Step 2 :- Multiply each value of the raw and take the power into 1 / (no. of attributes)
A1
1.4310
1.4310
0.4503
1.4310
0.7578
Sum 5.5011

Step 3 :- Divide each element of A1 matrix by sum of A1 elements and formulate A2 matrix
A2
0.2601
0.2601 ❑ A2 matrix gives the weightage for attributes
0.0819
0.2601
0.1378
Sum 1.0000
48
 Feasibility Study cont.
Environmental Feasibility – Positive Impact
Step 4 :- Consistency check
➢ Multiply the A0 matrix and A2 (result is A3)
➢ Divide each element in A3 matrix by corresponding element of A2 matrix and formulate A4
(𝑎𝑖,𝑗)3
A3 = A 0 x A2 A4 = Consistency Index =
𝜆𝑚𝑎𝑥 − 𝑛
(𝑎𝑖,𝑗)2 𝑛 −1

𝜆𝑚𝑎𝑥 = average of A4 matrix elements

n = number of attributes
A3 A4
1.3015 5.0033 Consistency ratio = consistency index/random index
5.0033
1.3015
5.0191 Consistency ratio should be less than 0.1
0.4109 5.0033
1.3015 5.0207
0.6917 𝜆 max 5.0099

49
 Feasibility Study cont.
Environmental Feasibility – Positive Impact
Step 5 :- If consistency ratio less than 0.1, weightages can be taken as per A2 matrix

Score Score x Normalized Weightage

Attributes Alternative Alternative Alternative weightage Alternative Alternative Alternative
1 2 3 1 2 3
Uses energy efficient building
2 2 2 0.2601 0.5203 0.5203 0.5203
materials
Storm water management &
2 1 3 0.2601 0.52023 0.2601 0.7804
rainwater harvesting
Demotivates paper work 3 1 1 0.0819 0.2456 0.0819 0.0819
Use renewable energy 2 2 2 0.2601 0.5203 0.5203 0.5203
wastewater treatment 1 2 2 0.1378 0.1378 0.2755 0.2755
1.0000 1.9441 1.6580 2.1783

50
 Feasibility Study cont.
Environmental Feasibility – Negative Impact

Score Score* Normalized Weightage

Attributes
Weightage Alternative Alternative Alternative
Alt. 1 Alt. 2 Alt. 3 1 2 3
1 Waste generation (clinical+other) -2 -3 -3 0.2021 -0.4042 -0.6063 -0.6063
2 Excavated soil/ spoil material -3 -2 -2 0.1324 -0.3972 -0.2648 -0.2648
3 Construction induced vibrations -3 -2 -2 0.1324 -0.3972 -0.2648 -0.2648
4 Noise pollution -3 -2 -2 0.0875 -0.2625 -0.1750 -0.1750
5 Air pollution -2 -2 -2 0.0875 -0.1750 -0.1750 -0.1750
6 Water pollution -1 -1 -1 0.0875 -0.0875 -0.0875 -0.0875
7 Possibility of ground water contamination -1 -1 -1 0.0388 -0.0388 -0.0388 -0.0388
8 Incineration related environmental impacts -1 -1 -1 0.0429 -0.0429 -0.0429 -0.0429
9 Heat island effect -1 -1 -2 0.0905 -0.0905 -0.0905 -0.1810
10 Soil erosion -1 -1 -1 0.0388 -0.0388 -0.0388 -0.0388
11 Accidental leakage of explosive gases -1 -1 -1 0.0388 -0.0388 -0.0388 -0.0388
12 Effect on biodiversity (fauna & flora) -1 -1 -1 0.0209 -0.0209 -0.0209 -0.0209
1.0000 -1.9942 -1.8440 -1.9345

51
 Feasibility Study cont.
Social Feasibility – Positive Impact

Score Score* Normalized Weightage

Attributes Alter. Alter. Alter. Alternative Alternative Alternative
Weightage
1 2 3 1 2 3

1 Enhance public health & well being 3 3 3 0.2011 0.6032 0.6032 0.6032
2 Uses high-end technology for patient care 3 1 2 0.0880 0.2640 0.0880 0.1760
3 Accessible for emergency treatments (ETU & helipad) 3 3 3 0.1676 0.5028 0.5028 0.5028
4 Attract people who seek to travel abroad for medical treatments 3 2 3 0.0859 0.2577 0.1718 0.2577
5 New employment opportunities within hospital premises 1 3 2 0.0248 0.0248 0.0745 0.0497
6 Property and land value increase 3 3 3 0.0248 0.0745 0.0745 0.0745
7 Design is oriented to reduce waste (eg: waiting times, movement) 3 2 3 0.0765 0.2296 0.1531 0.2296
8 Floor plans are well designed to ensure patient safety 3 3 3 0.0792 0.2375 0.2375 0.2375
9 Enhance patient experience and mentality 2 3 3 0.1361 0.2722 0.4083 0.4083
10 Provides a friendly environment for hospital staff 2 2 2 0.0466 0.0932 0.0932 0.0932
11 New employment opportunities outside the hospital premises 2 2 2 0.0253 0.0506 0.0506 0.0506
12 Treatment for multiple diseases 2 3 1 0.0440 0.0880 0.1320 0.0440
1.0000 2.6983 2.5896 2.7272

52
 Feasibility Study cont.
Social Feasibility – Negative Impact
Score Score x Normalized Weightage
Attributes
Alt.1 Alt. 2 Alt. 3 weightage Alt.1 Alt. 2 Alt. 3
Disturbances to nearby people during
-2 -2 -2 0.1795 -0.3590 -0.3590 -0.3590
construction stage
Social discrimination -2 -2 -2 0.3422 -0.6844 -0.6844 -0.6844
Health issues arising from hazardous chemicals
-1 -1 -1 0.2538 -0.2538 -0.2538 -0.2538
& radiation
Trigger the traffic congestion in area -1 -1 -1 0.0554 -0.0554 -0.0554 -0.0554

Risks to community health and safety due to

the transport, storage, and use and/or disposal -1 -1 -1 0.1109 -0.1109 -0.1109 -0.1109
of materials such as explosives, fuel, and other
chemicals during construction
Impacts from Construction Workers on the
-1 -1 -1 0.0582 -0.0582 -0.0582 -0.0582
existing community
-1.5217 -1.5217 -1.5217

53
 Feasibility Study cont.
Environmental & Social Feasibility - Summary

Alternative 1 Alternative 2 Alternative 3

Positive environmental
1.9441 1.6580 2.1783
impacts
Negative environmental
-1.9942 -1.8440 -1.9345
impacts
Net environmental
-0.0501 -0.1860 0.2437
impact
Alternative 3 is environmentally
& socially more feasible than
Alternative 1 Alternative 2 Alternative 3
other alternatives.
Positive social impacts 2.6983 2.5896 2.7272

Negative social impacts -1.5217 -1.5217 -1.5217

Net social impact 1.1766 1.0680 1.2056

54
 Financial Feasibility
Step 1
The calculation of capital
cost involved assessing the
various expenses involved
in the project's
development, such as
construction materials,
labor, and equipment.
.
55
Step 4
A cash flow diagram was
Step 3 plotted. Net present value
(NPV) calculation was used
The revenue generated by to evaluate the financial
Step2 each facility within the performance of the project
Operational and project was analyzed to by discounting the cash
maintenance cost determine its financial flows to their present
calculations were contribution and potential value and assessing the
performed to estimate the profitability. profitability of the
recurring expenses needed investment
for the continuous
operation and upkeep of
the facilities.
Estimation of O & M cost for the hospital building Project for improvement of
Anuradhapura Teaching Hospital
(2010) was taken as base project to
calculate the cost by using cost per
square meter method

Category Area (m2) Item Cost Rs. Cost $ (1$=115rs)

Clinical - surgery, ENT, dental OB&GYN 1044.85 Electricity without smart 6832320 59411.48

Operation department - Doctors' room 441.23 Telephone 164250 1428.26

pantry etc. City water 1762950 15330
Sterilization unit - washing, cleaning 93.37
administration Fuel for generator 861120 7488
ICU - pediatric& premature 486.61 Facility maintenance 3500000 30434.78
Labs - hematology, pathology, 253.04 Equipment maintenance 2300600 20005.22
biochemistry
Endoscopy, physiological 110.88 Wastewater 1166000 10139.13
Additional areas 400
Medical equipment maintenance 7991457 69490.93
Total 2829.98
Electricity smart 6457.77

56
 Calculation Assumed that the average exchange
rate between the US dollar (USD) and

Results the Sri Lankan rupee (SLR) at that

specific time was 1 USD = 350 LKR
Estimation of O&M cost for all 3 projects
Category Unit cost Alternative1 Alternative 2 Alternative 3 Estimation of Capital cost & Revenue
$ (Smart) (General) (Cardiology)
Area Cost/yr $ Area Cost/yr $ Area Cost/yr $ Capital Cost (million Rs.)
(m2) (m2) (m2) Alternative 1 6199.3
Electricity 20.9936036 19305 405281.52 26769 561977.7742 15597 327437.235
without smart Alternative 2 7332.34
Electricity 2.65754013 19305 51303.81 0 0 0 0 Alternative 3 4884.7
smart
Telephone 0.50468939 19305 9743.03 26769 13510.03018 15597 7871.640359
City water 5.41699941 19305 104575.17 26769 145007.6573 15597 84488.93985
Fuel for 2.6459551 19305 51080.16 26769 70829.57194 15597 41268.96162
generator Revenue income (million Rs.)
Facility 10.7544161 19305 207614.00 26769 287884.9658 15597 167736.6287
maintenance
Equipment 7.06903137 19305 136467.65 26769 189230.9007 15597 110255.6822 Alternative 1 7601.25
maintenance Alternative 2 8430.77
Wastewater 3.58275692 19305 69165.12 26769 95906.82005 15597 55880.25972
Medical 28.5973261 19305 552071.38 26769 765521.8219 15597 446032.4949 Alternative 3 7539.3
equipment
maintenance

Total $ 1587301.85 2129869.542 1240971.842

Total (LKR) 555555648. 745454339.8 434340144.8

1USD = 350SLR
57
03
 Calculation
Results
Estimation of NPV, IRR & Benefit/ Cost ratio
ADMINISTRATION EXPENSES (promotion & marketing, accreditation, salaries etc.)
Invester will invest 22 MN USD = 7700Mn LKR
Assume 1$ = 350 LKR
4,212,239,944 LKR
Asiri hospital group- admin. Expenses (for 800 beds) • The investor will invest at two stages (now & end of
first year) - risk mitigation
789794989.5 LKR • Average inflation rate as 10% for next 50 years
Estimated admin expenses (for 150 beds) • Design life of hospital as 50 years
• Hospital charges are adjusted 8% per every two
Assume 100 MN LKR used for promotion and marketing before the commencement of hospital years for first 30 years
operations • Then hospital charges are adjusted 10% per every
Salvage value for building 53548167.38 year
Salvage value for medical equipment 36.12212426 • Medical equipment value at 30% depreciation rate
• 10% depreciation rate for non residential
Salvage value of medical equipment is negligible. developments
Present land value 408.5

Future land value 47954.1634

Hence, final salvage value

48007.7114
58
 Calculation F=P 1+𝑖 𝑁

Results
Estimation of NPV, IRR & Benefit/ Cost ratio
𝑃=
𝐹
1+𝑖 𝑁

Internal Rate of Return (IRR) and Benefit/Cost Ratio (BCR) using the available data on capital
cost, operational and maintenance cost, administrative cost, and revenue
• Cash flows: Calculate the net cash flows for each year by subtracting the total expenses (including capital cost,
operational and maintenance cost, and administrative cost) from the total revenue generated.

• Cumulative cash flows: Sum up the net cash flows for each year to calculate the cumulative cash flows.

• IRR: Use a financial calculator or software to find the discount rate that makes the net present value (NPV) of
the cumulative cash flows equal to zero. This discount rate is the Internal Rate of Return (IRR).

• BCR: Divide the total discounted cash inflows by the total discounted cash outflows. The resulting ratio is the
Benefit/Cost Ratio (BCR).

59
Estimation of NPV, IRR & Benefit/ Cost ratio
Expenses/yr 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25

Initial investment 5000 2700

Capital cost 6199.3 6199.3
O&M 555.556 611.1116 672.2228 739.445 813.3895 894.7285 984.2013 1082.621 1190.884 1309.972 1440.969 1585.066 1743.573 1917.93 2109.723 2320.6953 2552.765 2808.041 3088.845 3397.73 3737.503 4111.253 4522.379
Administration
expenses 100 789.8 868.78 955.658 1051.224 1156.346 1271.981 1399.179 1539.097 1693.006 1862.307 2048.538 2253.392 2478.731 2726.604 2999.264 3299.1906 3629.11 3992.021 4391.223 4830.345 5313.379 5844.717 6429.189
Net expenses 5000 8899.3 6299.3 1345.356 1479.892 1627.881 1790.669 1969.736 2166.709 2383.38 2621.718 2883.89 3172.279 3489.507 3838.458 4222.303 4644.534 5108.987 5619.8859 6181.874 6800.062 7480.068 8228.075 9050.882 9955.971 10951.57
-5000 -8899.3 -6299.3 -1345.36 -1479.89 -1627.88 -1790.67 -1969.74 -2166.71 -2383.38 -2621.72 -2883.89 -3172.28 -3489.51 -3838.46 -4222.3 -4644.53 -5108.99 -5619.886 -6181.87 -6800.06 -7480.07 -8228.07 -9050.88 -9955.97 -10951.6

Income/yr
Income 0 0 0 7601.25 7601.25 8209.35 8209.35 8866.098 8866.098 9575.386 9575.386 10341.42 10341.42 11168.73 11168.73 12062.23 12062.23 13027.21 13027.207 14069.38 14069.38 15194.93 15194.93 16410.53 16410.53 17723.37
Salvage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Net income 0 0 0 7601.25 7601.25 8209.35 8209.35 8866.098 8866.098 9575.386 9575.386 10341.42 10341.42 11168.73 11168.73 12062.23 12062.23 13027.21 13027.207 14069.38 14069.38 15194.93 15194.93 16410.53 16410.53 17723.37

Net amount -5000 -8899.3 -6299.3 6255.894 6121.358 6581.469 6418.681 6896.362 6699.389 7192.006 6953.668 7457.527 7169.138 7679.223 7330.272 7839.925 7417.695 7918.22 7407.3208 7887.509 7269.321 7714.866 6966.859 7359.646 6454.558 6771.803

MARR 0.22
present value -5000 -7294.51 -4232.262833 3445.164 2763.176 2435.139 1946.645 1714.357 1365.075 1201.19 951.9532 836.8289 659.4 578.9479 452.9836 397.1133 307.9723 269.47 206.62564 180.3446 136.2377 118.5146 87.72447 75.95928 54.60477 46.95789

NPV 3869.742

26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

4974.616 5472.078 6019.286 6621.214 7283.336 8011.67 8812.836 9694.12 10663.53 11729.89 12902.87 14193.16 15612.48 17173.73 18891.1 20780.21 22858.23 25144.05 27658.46 30424.3 33466.73 36813.41 40494.75 44544.22 48998.64

7072.108 7779.319 8557.251 9412.976 10354.27 11389.7 12528.67 13781.54 15159.69 16675.66 18343.23 20177.55 22195.3 24414.84 26856.32 29541.95 32496.15 35745.76 39320.34 43252.37 47577.61 52335.37 57568.9 63325.79 69658.37
12046.72 13251.4 14576.54 16034.19 17637.61 19401.37 21341.51 23475.66 25823.22 28405.55 31246.1 34370.71 37807.78 41588.56 45747.42 50322.16 55354.37 60889.81 66978.79 73676.67 81044.34 89148.77 98063.65 107870 118657
-12046.7 -13251.4 -14576.5 -16034.2 -17637.6 -19401.4 -21341.5 -23475.7 -25823.2 -28405.5 -31246.1 -34370.7 -37807.8 -41588.6 -45747.4 -50322.2 -55354.4 -60889.8 -66978.8 -73676.7 -81044.3 -89148.8 -98063.6 -107870 -118657

17723.37 19141.24 19141.24 20672.54 20672.54 22739.79 25013.77 27515.15 30266.67 33293.33 36622.67 40284.93 44313.43 48744.77 53619.24 58981.17 64879.29 71367.21 78503.94 86354.33 94989.76 104488.7 114937.6 126431.4 139074.5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48007.71
17723.37 19141.24 19141.24 20672.54 20672.54 22739.79 25013.77 27515.15 30266.67 33293.33 36622.67 40284.93 44313.43 48744.77 53619.24 58981.17 64879.29 71367.21 78503.94 86354.33 94989.76 104488.7 114937.6 126431.4 187082.2

5676.646 5889.844 4564.704 4638.35 3034.931 3338.424 3672.266 4039.492 4443.442 4887.786 5376.565 5914.221 6505.643 7156.207 7871.828 8659.011 9524.912 10477.4 11525.14 12677.66 13945.42 15339.97 16873.96 18561.36 68425.21

32.26534 27.44027 17.4316 14.51872 7.786707 7.020801 6.330231 5.707585 5.146183 4.640001 4.183608 3.772105 3.401079 3.066546 2.764919 2.49296 2.24775 2.02666 1.827317 1.647581 1.485523 1.339406 1.207661 1.088875 3.290217

60
 Calculation
Results
Estimation of NPV, IRR & Benefit/ Cost ratio
Cash Flow Diagram - Alternative 01
250000

200000

150000

100000
LKR MN

50000

0
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
-50000

-100000

-150000
Years

Cash outflow Cash Inflow

61
 Calculation
Results
Estimation of NPV, IRR & Benefit/ Cost ratio

NPV (million Rs.) IRR Benefit/ Cost

Alternative 1 3869.74 26% 1.577

Alternative 2 4165.85 26% 1.494
Alternative 3 6279.6 29% 1.722

Alternative 3 has been identified as the optimal choice, meeting all client requirements and feasibility
parameters. Extensive evaluations confirm its financial viability and functionality.

62
 Multi-Criteria Analysis (MCA)
What is MCA?

• MCA helps make decisions by considering multiple factors at once.

• Useful when there are many choices and different factors to consider.

• Provides a systematic and organized approach to decision-making.

• Considers various criteria simultaneously for a comprehensive evaluation.

• Aids in selecting the best option based on the identified criteria.

63
 Multi-Criteria Analysis (MCA)
Methodology

• Selection of attributes – Financial, Social, and Environmental.

• Suggest weightages of each attribute based on their significance to the project.

• Normalize each attribute weightages.

• Assign score to attributes based on the severity level of occurrence.

• Calculate net score by summing up the positive and negative impacts.

• Assign weightages to each impact type based on their feasibility significance.

64
 Multi-Criteria Analysis (MCA)
Methodology
• Financial aspect
▪ Given the highest weightage (0.45) due to private ownership and investment in the
project.
▪ Need to ensure the financial feasibility, profit return, and capital allocation.

• Environmental aspect
▪ Given the second largest attribute (0.35) due to the location (municipal zone)
requires adherence to development guideline and limits.
▪ Need to ensure the environmental sustainability and need of LEED Certification.

• Social aspect
▪ Assigned a comparative weightage (0.20).
▪ Project aims to serve diverse social groups with different needs.

65
 Multi-Criteria Analysis (MCA)
Methodology
• Calculate the net score by multiplying the previous summations with the weightages and
its summation which is the net impact.

• Selected the best alternative which is having the highest net positive impact.

• Based on the net impact, Alternative 3

was selected as the best
model.(Cardiology Specialized
Hospital)

66
Environmental
Imapct
Assessment
 Environmental Impact Assessment (EIA)
What is EIA?
✓ Environmental Impact Assessment (EIA) is a systematic process used to evaluate the
potential impact of a proposed development project on the environment.
✓ It helps decision-makers understand the likely consequences on the environment and
consider them alongside social, economic, and other factors before commencing and
implementing the proposed project.

Objective of Environmental Impact Assessment

➢ Identify and evaluate the potential environmental effects of a proposed
development project on the surrounding environment.
➢ Propose suitable mitigation methods to reduce pollution, environmental
disturbance, and nuisance during construction and operation.
➢ Adhere to socio-environmental legal procedures during the project's
development and operating phases.
➢ Develop a systematic approach to monitor and audit management practices
throughout construction and operation.
67
 Environmental Impact Assessment (EIA)
Assessment of the legal framework and acts used

• National Environmental Protection Act No. 47 of 1980

• National Environmental (Protection and Quality) Regulations No. 1 of
1993
• The Urban Development Authority Act No. 41 of 1978 and the Sri
Lanka Land Reclamation & Development Corporation Act No. 15 of
1968
• National policy on health care waste management

68
 Baseline information of the study area
Topography

1. Topography
➢The proposed project site is located
on mostly flat and level terrain

➢Mostly bare land with a small one-

story building to be demolished
Demolished buildings
before construction

➢Five-story building preserved and

integrated with new construction.

69
73
Baseline information of the study area
Climatic & Meteorological Conditions

• Precipitation

• Temperature

• Average humidity

70
74
Environmental Monitoring Plan
Cost
Impact Mitigation measure Frequency Responsibility
implementation
Pre construction stage

Cost for Contractor,

removing of vegetation and
Structures for soil retention and machinery & Project
preparation of the ground
conservation should be incorporated into designs. first 2 weeks equipment Implementation
causing minor landslides and
Limited vegetation removal should be done (Included in civil Unit
the collapse of soil banks
works) (PIU)

When tree removal is unavoidable, new

trees should be planted within the hospital
Contractor
compound at a ratio of 1:2 (2 new trees for one
Cost for tree (PMU &
Removal of large trees removed tree). The species chosen for replanting
first 3 weeks removal & PIU should
(if any) should be native varieties, and should be at least 2
replantation monitor the
m tall saplings and maintained until grown well.
process)
Permission for the removal of trees that exceed 30
cm DBH should be sought by the engineer.

Construction stage

Regular watering (at least twice a day) should be

done in the construction site for dust suppression.
The site should be cleaned every day, especially Contractor
Cost for dust
Transportation & stockpiling surfaces that are affected by soil and dust. (PMU &
level testing, cost
of To prevent dust from entering the air, excavated regularly PIU should
for hiring water
materials soil that is temporarily stored on site should be monitor the
bowsers
covered with tarpaulin or another suitable local process)
material. Speed limits must be imposed on
construction vehicles
71
Building Services
Design
 01) Estimate the population in each floor
Population of lobby area

Total area 135 m2 Sanitary Appliances

Assume half of this area is reserved for waiting.
Waiting area 67.5 m2

Assume 2.5 m2/person in waiting areas 02) Estimate the number Water Wash
Urinal
of appliances required. Closet Basin
No.of persons in waiting areas 27
Male 3 3 2
Female 5 5 _
Assume rest of 67.5 m2 is for lobby & circulation
Assume 10 m2/person Ref: BS6465-1 : 2006
No. of persons in circulation area 7

Total population for lobby area 34

Area Population
Emergency unit 32
Lobby area 34
Catheter lab 15
Anesthesic room 4
Reception area 12
Preparation & ECG room 4
101

72
 Design of Water supply scheme
Assumptions

73 IS – 1172:1993 Standards
 Design of Water supply scheme
Detailed breakdown calculation of needed water for 1st floor
MRI Unit – 2 staffs + 1 technician
X-ray Unit – 2 staffs + 1 technician
Haematology lab – 2 lab technicians + 2 supporting staffs
Clinic chemistry lab – 2 lab technicians + 2 staffs
Cardiac operation theatre – 1 cardiac surgeon + 1 Anaesthesiologist + 1 perfusionist + 2 Nurses + 2 technicians
Pulmonary function lab – 1 physician + 1 therapist + 1 technician + 1 supporting staff
Anaesthetic room – 1 anaesthesiologist +1 nurse
Cardio bio maker lab – 1 lab scientist + 1 lab supervisor + 1 supporting staff
MLT room – 1 technician + 2 nurses
Receptionists – 2
8 beds + 1 nurse per bed
Consulting room – 2 consultants + 10 visitors per day

Needed water calculation (1st floor)

Staffs = 45x40 = 1800 litres
Bed patients = 8x450 = 3600 litres
Visitors = 10x8 = 80 litres
Total = 5480 litres
74
 Design of Water supply scheme
Total water consumption of the building
Floors Needed water (liters per day)
Ground floor 8362
1st floor 5480
2nd floor 9820
3rd floor 7860
4th floor 10150
5th floor 10150
6th floor 6178
7th floor 8400
8th floor 8400
9th floor 8400
10th floor 2990
Total 86,190

75
 Design of Water supply scheme
Design of break-pressure tanks and water sump

Tank 1 : Covers GF + 1st + 2nd + 3rd + 4th + 5th floors

Total water demand for tank 1 = 51,822 liters per day
Total water demand with fire safety allocation = 1.3 x 51,822
= 67.37 m3/day

Dimension for tank 1 = 6m x 4m x 3m

Likewise, Dimensions for tank 2 = 6m x 4m x 2m

Water sump

Assume 50 persons wash their clothes in laundry.

Water needed for laundry = 50 x 25 = 1250 liters per day

Total water demand for sump with fire allocations = 113.18 m3/day

Dimension for water sump = 8m x 8m x 2m = 128m3

76
 Horizontal Circulation
Health Building Note 00-04 was used as the reference for horizontal circulation
design. For the movements of wheelchairs and persons with crutches, a width of
2100 mm is required. A minimum width of 2150 mm is allowed for passages by
considering the straight bed movements.

77
 Horizontal Circulation

By considering the turning facility of beds at edges, the following

spaces are allowed.

78
 Vertical Circulation
T + 2 R = 630 mm
The clear width of a stair = 1400 mm
Take T = 330 mm,
Handrails are provided on both sides
top handrail → 1000 mm from surface
330 mm + 2 R = 630 mm
second handrail → 600 mm from surface
2 R = 300 mm
R = 150 mm

Floor-to-floor height = 3600 mm

3600 𝑚𝑚
no. of steps = 150 𝑚𝑚 = 24

Length of staircase = 330 mm x 24 = 7920 mm

provide a U-shaped staircase with a length of 3960 mm

1800 𝑚𝑚
Angle of staircase = tan-1 = 24.40
3960 𝑚𝑚

79
 Vertical Circulation
Lifts for Bed movements

For the vertical circulation of patient beds, two separate lift cars will be
provided for the bed movement. Since they are not used frequently, they can
be used for normal passengers' movements also. According to the Health
Building Note 00-04, the dimensions of lifts for bed movements are as follows.

Inside (car size) → 1800 mm x 2700 mm

Shaft size → 2500 mm x 3200 mm

80
 Vertical Circulation
Lifts for Bed movements

For the turning of beds, more space in the lobby

area should be provided. Therefore, a width of
3400 mm is allowed for the lobby area.

81
 Vertical Circulation
Lifts for passenger movements
The project is located in the Dehiwala area which is a suburban area. Therefore, the building type is investment-
suburban
The area allocated for a person  8 - 9 m2/person (take 9 m2 / person)
Population handled in 5 minutes  12 % - 14 % (take 14 %)
Average interval  30 s - 45 s (take 40 s)

Rentable floor area (taken from Revit model) = 1284 m2 per floor
1284
Population per floor = = 142.67 persons
9

Total population = 142.67 * 10 = 1426.7 persons

Population handled in 5 minutes = 1426.7 * 0.12 = 171.2 persons
From the graph, the car size is 28 passengers.

82
 Vertical Circulation
Lifts for passenger movements
Assume the lift car speed is 4 m/s. From the graph,
round trip time = 120 s
120 𝑠
no. of cars = 40 𝑠
=3

Based on the calculation above, three cars that can carry 28

passengers are required for regular passenger movements. One lift
car with a car size of 28 people is accessible since the lifts served for
bed movements also serve the purpose of regular passenger
movements when they are not required for bed movements. The
lift lobby and shaft have the following dimensions.
Inside = 2300 * 1650 mm
Shaft = 2650 * 2400 mm

83
 Electricity Supply System
01) Determine required illumination 02) Obtain efficacy & luminous flux
levels for each areas values of proposed fixtures
Recommended Efficacy Luminous
Area Area
Illuminance (lm/W) flux (lm)
(Lux)
Reception 110 1150
Consulting areas, general 300
Corridors 126 4300
Consulting areas, examination 500 Waiting rooms 120 2025
Corridors, general 150
Examination rooms 88 3500
Ward corridors, day 200
Ward corridors, night _ Imaging rooms 149 2200
Laboratories, general 300 Patient rooms 139 3400
Laboratories, examination 500 Office area 139 3400
Nurses station 300
Nurses station 110 1150
Ward bed head _
Ward bed head, reading 150 Parking area 144 2700
Surgeries, general 300 Ref: "Designing people-centric hospitals using Philips lighting
solutions“
Surgeries, waiting rooms 150
https://www.lighting.philips.co.uk/prof
Ref: Energy Efficiency Building code for Commercial Buildings in SL

84
 Electricity Supply System

03) Determine the number of luminaires required by the Lumen method, and the power consumption by lights
Area Power No. of
Usage E (lux) F (lm) N Amphere
(m2) (Watts) sockets
Emergency unit 165 300 3500 21 39.77 3.63 16
ECG room 37 500 2200 13 14.77 0.83 4
Store 21 100 1300 2 13 0.11 2
Mortuary 64 300 3500 8 39.77 1.38 10
Catheter lab 64 500 3500 14 39.77 2.42 8
Anesthesia room 29 200 3400 3 24.46 0.32 4
Washroom 49 150 1300 9 13 0.51 2
Corridor 95.82 150 4300 5 34.13 0.74 4
Waiting area 73 150 2025 8 16.88 0.59 8
Reception 73 150 1150 14 10.45 0.64 6
Lobby 206 150 1150 40 10.45 1.82 2
12.99 66

85
 Electricity Supply System

03) Determine the total power

consumption (by lights, sockets, AC
machines, elevators)

Amphere usage from sockets 85.8 A

Amphere usage from lights 12.99 A
Amphere usage from air conditioners 229.504 A
328.294 A

Power consumption 60.5 kW

Power consumption by elevators 48 kW
Total power consumption for GF 108.5 kW

Electricity supply system for a hospital – Schematic diagram

86
 Building Services Design
Thermal Comfort

The mean annual temperature of in this area is 26.5 °C.

For people in unconditioned (free-running) buildings, the centre point is given by a simple linear function:
Tn = 17.6 + 0.31 T0 ; Where T0 is the mean annual temperature
neutrality temperature = 17.6 + 0.31 × 26.5 = 25.815 (Let the neutrality temperature as 26 0C)

Data: 1991 - 2021 Min. Temperature °C (°F), Max. Temperature °C (°F), Precipitation / Rainfall mm (in), Humidity, Rainy days.
Data: 1999 - 2019: avg. Sun hours

87
 Building Services Design
Thermal Comfort

Basic Comfort Zone

The comfort zone represents using a Psychrometric chart

Assuming a bandwidth of 2°C either on either side, the side boundaries of

the comfort zone were drawn through as.

Extended Comfort Zone

Air movement produces a physiological cooling effect. The physiological
cooling effect produced by the air movement can be approximated as a
function of the air velocity. This is given by the relationship dT = 6 x υ - υ 2.
Consider 0.6 m/s, 0.4m/s and 0.25 m/s air velocities which can be obtained
by natural ventilation.

The cooling system at the hospital building is designed to make use of these
zones.
88
 Ground floor
Description Condition Units Amoun 90F Cooling (SI)
t (factor) load

Windows exposed to sun N& E sq.ft. 1896.113 42

(BTU)
79636.7632 176.1547 Building Services Design
NW
NE or SW
W
sq.ft.
sq.ft.
sq.ft.
0
0
385.9508
77
57
85
0
0
32805.8156
0
0
35.856
(Design of AC systems
All windows not included in Item 1 sq.ft. 1174.773 20 23495.4637 109.14
Steps
Wall exposed to sun (Use Light lin. Ft 590.5512 60 35433.0709 180
only the wall with the construction
- The cooling load of the entire building was calculated using standard charts and dimensions
exposure used in Item 1) Heavy lin. Ft 0 40 0 0 from architectural models.
Construction - Microsoft Excel was used to convert the calculations into the required unit system.
All exterior walls not included in Item 3 lin. Ft 225.0656 22 4951.44357 68.6
- The total cooling load was determined by applying the appropriate factor for a temperature
Partitions all interior lin. Ft 972.769 20 19455.3806 296.5
walls adjacent
of 90 degrees Fahrenheit.
to an - Each floor was assumed to accommodate a maximum of 120 people, with an allocation of 12
unconditioned square meters per person.
space
Ceiling or Roof (use only Ceiling with sq.ft. 0 1 0 0
- Lighting was estimated to consume 5 watts per square meter, while other electrical
one) unconditioned equipment was assumed to consume 15 watts per square meter.
space Floor Cooling load (BTU)
Ceiling with no sq.ft. 0 8 0 0
Ground floor 627022.9642
insulation
sq.ft. 0 2 0 0
1st floor 639229.2386
Attic space
with insulation 2nd floor 639229.2386
Flat roof with sq.ft. 0 7 0 0 3rd floor 616851.0689
no insulation 4th floor 603355.7086
Ceiling with sq.ft. 19259.86 3 57779.5947 1789.3
5th floor 603355.7086
insulation
sq.ft. 0 16 0 0
6th floor 611493.2248
Roof with no
insulation 7th floor 617951.5711
Floor over unconditioned space sq.ft. 19259.86 3 57779.5947 1789.3 8th floor 617951.5711
People (Includes allowance for ventilation No. 120 800 96000 120 9th floor 617951.5711
of people through unit) 10th floor 621180.7442
Light & Electrical equipment in use W 35786 3.41 122030.26 35786
Total cooling load 6815572.61
Doors or arches continuously open to sq.ft. 390.6223 250 97655.5773 36.29
unconditioned space 89
Total cooling load 627023
 Fire Safety Design

Construction Industry Development Colombo Municipal Council Fire Service

Authority Fire Regulations Department Requirements
90
 Fire Safety Design
Fire safety requirements
According to the guidelines considering purpose group, Height, and size of the buildings.

• Main Building • Building 2 • Service Building

• Basic Systems to be provided • Basic Systems to be • Basic Systems to be
• Portable fire Extinguishers provided provided
• Hose reel and Landing valve • Portable fire • Portable fire
Extinguishers Extinguishers
• Sprinkler
• Hose reel
• Mandatory Structural fire protection
and Access requirements • Mandatory Structural fire • Mandatory Structural fire
• Protected stairway (120 min. fire protection and Access protection and Access
rated) requirements requirements
• Alternative means of escape • Protected stairway (60 • Protected stairway (60
• Compartmentation min. fire rated) min. fire rated)
• Firefighting shaft • Alternative means of
escape (Spiral
• Fire Command Centre
stairway accepted up
• Provision for external access 10 m.)
91
 Fire Safety Design
Fire protection system

Main Building – Schematic Diagram Building 2 – Schematic Diagram

92
 Fire Safety Design
Fire Sprinkler system – Upper floors (G.L – R.L)

Schematic Diagram Fire Sprinkler System level 7 ( 29600mm)

93
 Fire Safety Design
Fire sprinklers system - Basements

Schematic Diagram Fire Sprinkler System Basement 2 ( -

94 7200mm)
Structural Design
 Structural Design
Methodology

• Identification of structural members and locations from

Architectural drawing
• Preparation of General Arrangement (GA) drawing
• Identification and calculation of different loads types
• Preliminary member sizing of structural members
• Selection of required materials and properties
• Construction of the FEM
• Design of structural elements
• Preparation of detailed structural drawing

95
 Preliminary Structural Layout

Structural Skeleton Structural floor plan

96
 Initial Member Sizing
150 mm slab
thickness

beam size: 600 mm × 300 mm

250 mm slab Span/ depth ratio was considered

thickness Column sizes
when determining beam depths &
slab thicknesses.
600 mm × 600 mm (Ref: IstructE manual)
600 mm × 800 mm

97
 Structural Design
Load Calculation
❑ Calculated loads for beam along grid line 19

Span ULS (kN/m) SLS (kN/m)

4-27 80.89 57.36
27-26 37.46 26.45
Grid line 19
27-1 64.46 45.75

❑ Calculated loads for beam along grid line 26

Span ULS (kN/m) SLS (kN/m)

33-20 62.06 43.94
20-19/ 19-18/ 18-17 64.89 45.89
17-31 76.35 50.82
31-35 / 35-3 29.19 20.63 Grid line 26

98
 Structural Design
Moment Distribution Method
Joint A Joint B Joint C Joint D
A0 A2 AB BA B0 B2 BC CB C0 C2 CD DC D0 D2
Length 3.6 3.6 7.689 7.689 3.6 3.6 3.902 3.902 3.6 3.6 6 6 3.6 3.6
UDL 80.9 80.9 37.46 37.46 64.46 64.46
DF 0.4475 0.4475 0.105 0.044 0.435 0.435 0.086 0.085 0.43 0.43 0.055 0.13 0.435 0.435
FEM 0 0 -398.572 398.572 0 0 -47.529 47.529 0 0 -193.388 193.388 0 0

Balance Moment 398.572 -351.043 145.859 -193.388

Balancing Moment 178.361 178.361 41.85 -15.446 -152.704 -152.704 -30.19 12.398 62.719 62.719 8.022 -25.14 -84.124 -84.124
COM -7.723 20.925 6.199 -15.095 -12.57 4.011
Balance Moment 7.723 -27.12402812 27.66505314 -4.011109837
Balancing Moment 3.456 3.456 0.811 -1.193 -11.799 -11.799 -2.333 2.352 11.896 11.896 1.522 -0.521 -1.745 -1.745
COM -0.597 0.405 1.176 -1.166 -0.261 0.761
Balance Moment 0.597 -1.581 1.427 -0.761
Balancing Moment 0.267 0.267 0.063 -0.07 -0.688 -0.688 -0.136 0.121 0.614 0.614 0.078 -0.099 -0.331 -0.331
COM -0.035 0.031 0.061 -0.068 -0.049 0.039
❑ Calculated
Balance Moment 0.035 -0.092 0.117 -0.039
Balancing Moment 0.016 0.016 0.004 -0.004 -0.04 -0.04 -0.008 0.01 0.051 0.051 0.006 -0.005 -0.017 -0.017
moments will be
COM -0.002 0.002 0.005 -0.004 -0.003 0.003 used to verification
Balance Moment 0.002 -0.007 0.007 -0.003 of the 3D model
Balancing Moment 0.001 0.001 0 0 -0.003 -0.003 -0.001 0.001 0.003 0.003 0 0 -0.001 -0.001
COM 0 0 0 0 0 0
0 0 0.001 0

Moment (kNm) 182.101 182.101 -364.201 403.223 -165.234 -165.234 -72.755 46.077 75.282 75.282 -196.642 172.436 -86.218 -86.218
99
 Structural Design
Wind load calculation for the main building

Wind load calculation for the main building which is

49.6 m high was carried out and important step are
given below

Reference: EN 1991-1-4:2005, SLS EN 4.2

100
 Structural Design
Wind load calculation for the main building

Wind load calculation for the main building which is

49.6 m high was carried out and important step are
given below

Reference: EN 1991-1-4:2005, SLS EN 4.2

101
 Design of service building
Structural design
• Columns are located such a way that minimize the number of
columns, optimizing space and enhance aesthetics appearance
• initial member sizes of structural members
• Column – 300mm x 450mm
• Beam – 300mm x 450mm
• Slab thickness – 200mm
• Loads acting on the structure
▪ Dead load
Self weight = 25 kN/m3 (Concrete density)
Floor finishes= 1 kN/m2
Partition wall= 0.5 kN/m2
▪ Imposed load = 7 kN/m2
▪ Roof load
Roof dead load = 1kN/m2
Imposed load = 0.4 kN/m2
• Develop a finite element model for the service building using
SAP2000

102
 Substructure Design
Determination of Shear Strength Parameters of Soil Layers

N’70 =CN x η1 x η2 x η3 x η4 x N
CN → Adjustment of effective stress
η1 → Average energy ratio GWL = 2.0 m
η2 → Rod length correction
Weak alluvial deposits = 2.5 m
η3 → Sampler correction
Highest Basement rock level = 12.3 m
η4 → Borehole diameter
Assumed Er of 50%
Bore hole of diameter 75 mm without liner.
Soil strength parameters were calculated for the soils and the values are as bellows

103
 Substructure Design
Determination of Shear Strength Parameters of Soil Layers

N
Depth Overburde Eff. 𝜼𝟐 Round
Soil type N PWP CN correct c' 𝝓' c_u 𝝓_u
(m) n Stress N
ed
0.5 Clayey 5 8 0 8 3.460 0.75 9.267 9 50 0
1.5 sand 6 24 0 24 1.997 0.75 6.421 6 25 0
2.5 (fine) 11 40.6 5.886 34.714 1.661 0.85 11.093 11 58 0
3.5 20 60.6 15.696 44.904 1.460 0.85 17.733 18 0 33
4.5 23 80.6 25.506 55.094 1.318 0.95 20.577 21 0 34
Fine sand
6 29 110.6 40.221 70.379 1.166 0.95 22.955 23 0 35
7.5 39 140.6 54.936 85.664 1.057 0.95 27.981 28 0 37
Clayey 102.44
9 >50 172.1 69.651 0.967 1 50.000 50 0 50
sand 9
with 119.23
10.5 42 203.6 84.366 0.896 1 26.886 27 0 40
gravel 4
102.02 141.17
12.3 HWR >50 243.2 0.824 1 50.000 50 0 50
4 6

104
 Geotechnical Design
Modeling the excavation

Idealization of the model

A

Geotechnical investigations consist of four

boreholes at the site. The locations of the
boreholes are shown in the following figure. Since,
A
there is a five storey building located near to
retaining wall, Section A–A is identified as the
critical-case.

105
 Geotechnical Design
Modeling the excavation
BH-01 and BH-03 are located near to the Section A-A. From
them, BH-01 seems to be the worst case. Therefore, subsurface
profile obtained through sections A–A based on BH-01 is as
follows

106
 Geotechnical Design
Modeling the excavation

Idealized model of the excavation and retaining wall

107
 Geotechnical Design
Modeling the excavation

Mesh Details

Deformed Mesh

108
 Geotechnical Design
Modeling the excavation
Results obtained through the FEM analysis,

Parameter Result
Maximum horizontal movement of retaining wall 44.52 mm
Maximum bending moment acting on retaining wall 152.61 kN m / m
Maximum shear force acting on retaining wall 246.17 kN / m
Maximum axial force acting on retaining wall - 165.11 kN / m
Maximum vertical settlement at ground level of the retained side - 67.42 mm
Maximum axial force of Lateral support at - 0.8 m - 126.60 kN / m
Maximum axial force of Lateral support at - 4.0 m - 443.70 kN / m

109
 Sustainable Design
WATER EFFICIENCY
Location and Transportation 9 Materials and Resources 19
Credit LEED for Neighborhood Development Location 9 Prereq Storage and Collection of Recyclables Required
Credit Sensitive Land Protection 1 Prereq PBT Source Reduction- Mercury Required
Credit High Priority Site and Equitable Development 2 Credit Building Life-Cycle Impact Reduction 5
Credit Surrounding Density and Diverse Uses 1 Credit Environmental Product Declarations 2
Credit Access to Quality Transit 2 Credit Sourcing of Raw Materials 2
Credit Bicycle Facilities 1
Credit Material Ingredients 2
Credit Reduced Parking Footprint 1
Credit PBT Source Reduction- Mercury 1
Credit Electric Vehicles 1
Credit PBT Source Reduction- Lead, Cadmium, and Copper 2
Credit Furniture and Medical Furnishings 2
Sustainable Sites 9
Credit Design for Flexibility 1
Prereq Construction Activity Pollution Prevention Required
Credit Construction and Demolition Waste Management 2
Prereq Environmental Site Assessment Required
Credit Site Assessment 1
Credit Protect or Restore Habitat 1 Indoor Environmental Quality 16
Credit Open Space 1 Prereq Minimum Indoor Air Quality Performance Required
Credit Rainwater Management 2 Prereq Environmental Tobacco Smoke Control Required
Credit Heat Island Reduction 1 Credit Enhanced Indoor Air Quality Strategies 2
Credit Light Pollution Reduction 1 Credit Low-Emitting Materials 3
Credit Places of Respite 1 Credit Construction Indoor Air Quality Management Plan 1
Credit Direct Exterior Access 1
Credit Indoor Air Quality Assessment 2
Credit Thermal Comfort 1
Water Efficiency 11
Credit Interior Lighting 1
Prereq Outdoor Water Use Reduction Required Credit Daylight 2
Prereq Indoor Water Use Reduction Required
Credit Quality Views 2
Prereq Building-Level Water Metering Required
Credit Acoustic Performance 2
Credit Outdoor Water Use Reduction 1
Credit Indoor Water Use Reduction 7
Credit Optimize Process Water Use 2 Innovation 6
Credit Water Metering 1 Credit Innovation 5
Credit LEED Accredited Professional 1
Energy and Atmosphere 35
Prereq Fundamental Commissioning and Verification Required Regional Priority 4
Prereq Minimum Energy Performance Required Credit Regional Priority: Specific Credit 1
Prereq Building-Level Energy Metering Required Credit Regional Priority: Specific Credit 1
Prereq Fundamental Refrigerant Management Required
Credit Regional Priority: Specific Credit 1
Credit Enhanced Commissioning 6
Credit Regional Priority: Specific Credit 1
Credit Optimize Energy Performance 20
Credit Advanced Energy Metering 1
Credit Grid Harmonization 2 TOTALS Possible Points: 110
Credit Renewable Energy 5
Credit Enhanced Refrigerant Management 1

110
 Sustainable Design
WATER EFFICIENCY

Water Efficiency 11
P1 Prereq Outdoor Water Use Reduction Required
P2 Prereq Indoor Water Use Reduction Required
P3 Prereq Building-Level Water Metering Required
C1 Credit Outdoor Water Use Reduction 2
C2 Credit Indoor Water Use Reduction 6
C3 Credit Cooling Tower Water Use 2
C4 Credit Water Metering 1

111
 Sustainable Design
WATER EFFICIENCY Points – 11/11
Outdoor water use reduction- P1 & C1 Point - 01

R To reduce the outdoor water use

To show that landscape does not require permanent
O1
PR1 Outdoor Water use reduction irrigation system
To reduce irrigation by atleast 30% from baseline
O2
standard
R To reduce the outdoor water use
To show that landscape does not require permanent
O1
irrigation system
C1 1-2 Reduce outdoor water use
To reduce irrigation by atleast 50% from baseline
O2 standard by plant selection and irrigation system
efficiency

• Landscape design with no requirement of an irrigation system.

• Natural rainfall and manual watering methods use
• Includes plants well-suited to the local climate and require minimal watering.
• No vegetated surfaces, such as permeable or impermeable pavement used for landscaping.
• Implement water-conserving practices like mulching, proper soil preparation, and grouping
plants with similar water needs

112
 Sustainable Design
WATER EFFICIENCY
Indoor Water Use Reduction – P2 & C2 Point - 07

To reduce indoor water use by reducing 20% of water

PR2 Indoor water use reduction R
usage
To reduce indoor water use by further reducing usage
C2 1-6 Reduce Indoor water use R
from 25% to 50%

Percentage reduction Points (BD&C) Points (Healthcare)

25% 1 1
30% 2 2
35% 3 3
40% 4 4
45% 5 5
50% 6 -

Water use reduction strategies:

• Install water-efficient plumbing fixtures such as:

- Efficient flow fixtures: lavatories, sinks, and showerheads with lower gpm rates
- Efficient flush type fixtures: dual flush toilets, waterless toilets/urinals, composting toilets, highly efficient toilets HET
• Use nonportable water such as captured rainwater, grey water or municipally claimed wastewater for toilets and urinals.
• Use water-efficient fixtures, non-potable water, or municipally treated wastewater.

113
 Sustainable Design
WATER EFFICIENCY
Indoor Water Use Reduction – P2 & C2
Gross area of the hospital building = 14214 m2. Baseline case - Female
No of usage Water per usage Total per person(gal)
Gross Square feet per Occupant for Medical Office;
Water Closet 3 1.6 4.8
Employee = 20.9032 m2/occupant Lavatory faucet -15 3 (15/60) x 0.5 0.375
seconds and 0.5 gpm
Transient = 30.6580 m2/occupant Kitchen- Sink 15 1 (15/60) x 2.2 0.55
seconds
Employee =680 shower - 300 0.1 (300/60) x 2.5 1.25
Transients =464 seconds and 2.5 gpm
Total per person (FTE- female) 6.975
Part-time(5h) = 100
No of usage Water per usage Total per person(gal)
Let female: male = 3:2 for employee, 1:1 for transients Water Closet 0.5 1.6 0.8
Lavatory faucet – 0.5 (15/60) x 0.5 0.0625
total occupancy male female
FTE 303 439 15 seconds and
Visitors 182 182
0.5 gpm
Total per person (Visitors- female) 0.8625

114
 Sustainable Design
WATER EFFICIENCY
Indoor Water Use Reduction – P2 & C2
Baseline case - Male Design Case – Female

No of usage Water per usage Total per person(gal) No of usage Water per usage Total per person(gal)
Water Closet 1 1.6 1.6 HET Dual flush Water 1 1.6 1.6
Urinals 2 1.0 2.0 Closet – full flush
Lavatory faucet -15 3 (15/60) x 0.5 0.375 HET - Low flush 2 1.1 2.2
seconds and 0.5 gpm Lavatory faucet -12 seconds 3 (12/60) x 0.5 0.3
Kitchen- Sink 15 1 (15/60) x 2.2 0.55 and 0.5 gpm
Low flow kitchen- Sink 15 1 (15/60) x 1.8 0.45
seconds
shower - 300 0.1 (300/60) x 2.5 1.25 seconds
seconds and 2.5 gpm shower - 300 seconds and 0.1 (300/60) x 1.8 0.9
Total per person(FTE- male) 5.775 1.8 gpm
Total per person (FTE- Female) 5.45
No of usage Water per usage Total per person(gal)
Water Closet 0.1 1.6 0.16 No of usage Water per usage Total per person(gal)
Urinals 0.4 1.0 0.4 HET - Low flush 0.5 1.1 0.55
Lavatory faucet –15 0.5 (15/60) x 0.5 0.0625 Lavatory faucet -12 seconds 0.5 (12/60) x 0.5 0.05
seconds and 0.5 gpm and 0.5 gpm
Total per person (Visitors- male) 0.6225 Total per person (Visitors – Female) 0.6

115
 Sustainable Design
WATER EFFICIENCY
Indoor Water Use Reduction – P2 & C2
Design case - Male

No of usage Water per usage Total per person(gal)

HET – Single flush 1 1.28 1.28 Water requirement for baseline per day = (6.975 x439 + 0.8625
gravity
HET - urinals 2 0.5 1 x 182 +5.775 x 303 + 0.6225 x182) = 5082.12 gal/day
Lavatory faucet -12 3 (12/60) x 0.5 0.3
seconds and 0.5 gpm = 19.05795 m3/day
Low flow kitchen- 1 (15/60) x 1.8 0.45
Sink 15 seconds Water requirement for design case per day = (5.45 x439 + 3.93
shower - 300 0.1 (300/60) x 1.8 0.9
x 303 + 0.6x 182 +0.378 x182) = 3761.336 gal/day
seconds and 1.8 gpm
Total per person (FTE- Male) 3.93 = 14.10501 m3/day
No of usage Water per usage Total per person(gal)
HET – Single flush 0.1 1.28 0.128
Water saved = ((5082.12-3761.336)/5082.12) x 100 = 25.98 %;
Urinals 0.4 0.5 0.2 WE: P2 ok.
Lavatory faucet -12 0.5 (12/60) x 0.5 0.05
seconds and 0.5 gpm
Total per person (Visitors – Male) 0.378

116
 Sustainable Design
WATER EFFICIENCY
Indoor Water Use Reduction – P2 & C2
Rainwater harvesting
The water-saving potential is improved by up to 45%, it is possible to gain five points. This means a further 13.5% water
saving must be achieved (45% - 25.98% = 19.02%). The quantity is 5082.12 x 0.192 x 3.75 x 10-3 = 3.659 m3/day
It is necessary to capture sufficient water so that it is possible to assure at least 3.7 m3 of captured water is available per
day. Since it is not possible to have 100% efficiency in harvesting rainwater, it is advisable to have a target of 60-80%.
Hence, it is necessary to set the demand as about (3.7/0.7) = 5.285 (say, 5.3 m3 per day)
Determination of rainwater harvesting potential.
The quantity of rainwater that can be harvested depends on the rainfall intensity (R), the roof area (A), the capacity of the
storage tank (S) and the demand (D)
R =rainfall intensity - m/year
A = roof area – 1284 m2
S = capacity of storage tank - 90 m3
D = water demand – 1934.5 m3 /year (for 365 days)
117
 Sustainable Design
WATER EFFICIENCY
Indoor Water Use Reduction – P2 & C2
Average water-saving efficiency in Dehiwela = 77.5%
At 5.3 m3 per day, the total demand is 5.3 x 365 = 1934.5 m3
With 77.5 % water-saving efficiency, the total quantity of water saved = 1499.24 m3
Water requirement of baseline = 5082.12 gal/day or (5082.12 x 3.75/1000) x 365 = 6956.15 m3 /year
Water saving with better fixtures = (5082.12-3761.34) x (3.75/1000) x 365 = 1807.82 m3 /year
Water saved due to rainwater harvesting = 1499.24 m3
Total water saving = 1807.82 +1499.24 = 3307.06 m3
Percentage water saving with respect to baseline case = (3307.06/6956.15) x 100 = 47.54 %

Hence, it is possible to claim 5 points under WE when rainwater harvesting is used for flushing W/C and urinals.

118
 Sustainable Design
WATER EFFICIENCY
Indoor Water Use Reduction – P2 & C2
The healthcare building must meet the percentage reduction requirements above and appliance and process water
install equipment that meets the minimum requirements in Tables 2, 3, 4, or 5.

Our project meets the requirements in Table 2 and Table 4.

So, it can earn 2 points under indoor water efficiency.

119
 Sustainable Design
WATER EFFICIENCY
Cooling Tower Water Use - C3 Point - 02

To conduct one time potable water analysis used in

C3 1-2 Cooling tower water use R cooling tower makeup measuring atleast five control
parameters

This credit requires a one-time potable water analysis to

determine the concentration of at least five dissolved solids and
ensure maximums are not surpassed.

Achieve a minimum 10 cycles by increasing the level of

treatment in condenser or make-up water

120
 Sustainable Design
WATER EFFICIENCY
Water metering- Building Level (P3) & Submetering (C4) Point - 01

Install water meters in the building that measures the

PR3 Building Level water metering R
potablepermanent
Install water use water meters for two or more of
the systems (meter about 80% of usage) including
*irrigation *indoor plumbing fixtures *domestic hot
C4 1 Water metering R
water *boiler water *reclaimed water *other process
water

• Indoor plumbing fixtures and fittings.

- Meter water systems serving at least 80% of the indoor fixtures and fitting described in WE Prerequisite
Indoor Water Use Reduction, either directly or by deducting all other measured water use from the measured
total water consumption of the building and grounds
• Other process water.
-Meter at least 80% of expected daily water consumption for process end uses, such as humidification
systems, dishwashers, clothes washers, and other subsystems using process water.

In addition to the requirements above; install water meters: purified water systems (reverse-osmosis, de-ionized), water use in
the dietary department; water use in laundry; water use in the laboratory; water use in the surgical suite.

121
 Special Provisions for
Disabled People
Grab bars/safety bars in washroom areas

Tactile pavements for visually

impaired persons and braille
inscription on handrails.

Wheelchair accessible bathrooms with clear

turning space.

122
 Special Provisions for Disabled People

braille inscription on handrails.

Space requirements to access bathroom: independent wheelchair

Tactile pavements Grab bars/safety bars in washroom areas

123
 Acknowledgement
We would like to express our sincere gratitude toward,
• Prof. Chintha Jayasinghe, Head of the Department
• Prof. Nalin de silva, Coordinator & supervisor of CDP project
• Dr. Sampath Hewage, Supervisor of CDP project
• All staff members of civil engineering department
• Eng. Madusanka Jayasinghe (Project Manager, LAMCH site)
• Eng. Jude Gayan (Planning Manager, LAMCH site)
• Architect Mr. Nishantha (CECB, hospital design section)
• All others who helped us during the project
124
 References
• City of Colombo Development Plan (Compiled edition) – Urban Development
Authority, Ministry of Megapolis and Western Development, 2018
• Dehiwala – Mount Lavinia Municipal Council Area Development Plan 2022–2031,
Urban Development Authority, Ministry of Urban Development & Housing
• Health Building Notes (HBN) - by National Health Services (NHS), UK
• Manual on management of teaching, provincial, base and special hospitals –
Ministry of health, highways & social services, 1995
• Challenges for health care in Sri Lanka, Dr. Ranga Sabhapathige
• Sustainable Healthcare Architecture, Robin Guenther and Gail Vittori
• Understand The Design of General Hospital, Mazen Fani
• Building type basics for healthcare facilities, R.L. Kobus, R.L. Skaggs, M.Bobrow, J.
Thomas, T.M. Payette

125
 References

126
 References

https://jccp.sljol.info/articles/abst https://www.wbdg.org/FFC/ https://www.healthfacilityguidelines.c

ract/10.4038/jccp.v45i1-2.7734/ VA/VASTDALERT/salert011.p om/ViewPDF/ViewIndexPDF/iHFG_part
df _b_cardiac_investigation_unit

127 132
 Our Team

• Sachinika W.M.T. - 180549N

• Sajana H.M.T. - 180550J
• Sanjeevaraj E.S. - 180566M
• Sarathkumar B. - 180569B
• Sembanayake S.M.D.T. - 180576T
• Senevirathna D.M.R.L. - 180585U
• Shakir B.M. - 180593R
• Shamiranga K.L.L. - 180595B
• Shiraz M.K.M. - 180600N

118
Thank You!