Hospital planning and designing

Emergency services
 Overview

• A hospital’s emergency department is the first point of entry into a

healthcare system for many people.
• Usually used for acute cases.
• May be used for non- acute illness too.
• Multi-disciplinary team, working on a 24/7 basis.

2
Features

• The department design should promote a sense of caring, efficiency, safety and
well being.
• A patient’s rights to confidentiality and privacy must be protected.
• The needs of the patient’s relatives, friends and visitors must also be considered.
• Patients and visitors with special needs must be accommodated.
• The process of patient care, should be facilitated by good design and the
availability of appropriate equipment and services.

3
• Functionality- an Emergency Department’s design needs to be
practical and reflect how health professionals manage and treat their
patients who have different clinical conditions

• Form– spatial considerations and relationships that promote effective

interaction between staff and patients, relatives, carers, and the flow
of clinical care.

• Patient and staff needs

4
who needs ER service ?

5
Who needs ER service ?

• Major trauma patients;

• Elderly patients;
• Children/ pediatric
• Patients with physical and mental disabilities;
• Victims of child abuse, domestic violence and sexual assault
• Patients with mental health issues;
• Patients with infectious diseases or who are immunocompromised;
• Custodial patients; and
• Patients affected by chemical, biological or radiological contaminants
6
Location

• Ground floor
• Separate entrance, assessable from street
• Should be well marked with clear visibility
• At all entrances to the hospital campus there needs to be clear signposting of the route to the ED

Temperature and lightening

• natural (ambient) light
• Since, emergency department works mostly in night, proper lighting system is
required

7
Multi-disciplinary team

consist of ?

8
Staffing

Health Professionals and other Professionals

Professionals who may be stationed primarily in the Emergency Department providing care and support
services
These people include:
• On site clinical staff e.g. doctors, nurses, allied health professionals, social workers, psychiatric services;
• Visiting clinical staff e.g. doctors from inpatient units, specialist Nurse Educators, forensic medical officers
• Ambulance, transport and retrieval services;
• Police, fire brigade, State Emergency Service personnel ( In cases of disaster)
• Administration staff
• Security personnel;
• Cleaning and maintenance staff;
• Volunteers/interns
• Funeral services personnel

9
Functional workflow

10
Design of entrance

• Sheltered entrance
• Paved and large entrance
• Ramps
• Adequate parking
• Traffic control

11
In bold “ red”

Large entrance for

easy passage of
ambulance

12
Should have its own / or should be near by

• Radio- diagnosis department

• Laboratory and blood bank
• MRD Should be close by
• ECG
• Drug dispensary
• OT (minor )
• Admission and cashier booth Should have its own

13
Components

• Triage area
• Waiting area
• Resuscitation area
• Observation wards / Consultation wards
• Operating room/area
• Scrub stations
• Administration office
• Staff / amenities rooms
• Storage room
• Soiled and cleaned utility rooms
• Police and press waiting area
• MSW
• Toilets

14
Layouts

15
16
Should have

Policies regarding
1. medico- legal cases
2. Police procedures and reporting
3. Patient brought dead
4. Disposal of bodies/ autopsy/ morgue procedures
5. Accidents and emergency room registrations
6. Medical record and release forms

17
Disaster preparedness

• 20-25% of emergency department should be expandable

18
Hospital planning and designing
Outpatient services
Introduction

• Outpatient Department (OPD) is the ‘shop-window’/ the face of the

healthcare facility
• Reduces length for hospitalization
• Recues expenses
• Community services
• Education to medical professionals

20
Types

• Centralized OPD
• Decentralized OPD

Other types of outpatient facilities include:

1. Polyclinic and Referral Clinic
2. Outpatient clinics at hospitals or other medical facilities
3. Surgery centers
4. Imaging centers
5. Cardiac catheterization centers
6. Mental or behavioral health centers, which may provide substance abuse
treatment services and mental health services for adults or children.
7. Medical group practices.

21
 Compre Diagnosis
Primary
hensive Treatment
care
care Follow up care

22
Benefits of OPD

• Cost effective
• Convenient
• Specialized treatment

23
Location

• Separate entrance
• Easily accessible
• Should have approach from main road
• Adjacent to supportive facilities, x-ray and laboratory
• Amenable for Expansion

24
Objective of designing OPD

Why OPD need to be designed carefully ?

25
Objectives of OPD planning and designing

• The design should be such that the patient in his or her first visit must
be able to understand the complete building setup with locations for
reception, admission, enquiry, and other front office units easily in
sight.
• Circulation within the building must be open with lifts and stairs
• Adequate natural light - Light plays an important role to guiding the
patients through the initial spaces of the building. This also helps the
patient not to get disoriented and leads the patient through.

26
Entrance design

• Easy access with minimum steps or best no steps to climb

• Dedicated vehicular parking
• Include buffer zone

27
Outpatient flow chart

28
Functional Layout : single

29
Functional Layout : multiple

30
New trends

31
Thank you

32