Out –Patient Department
The out –patient is a very important wing of the hospital which
is visited by a large section of the community . This is the first
place where the sick and their relations come in direct contact
with the hospital and staff. The care and attention provide to
them goes a long way in building up the reputation and
confidence of the people in the hospital.
a. Ambulatory Care: Medical care provide to the non-
residential patients. The patient may walk or may be
brought-in on wheel chair /bed by the relatives.
b. Out-Patient Department (OPD): This is an establishment
which is the first point of contact and provide primary and
comprehensive health care for ambulatory patients who
come for diagnosis, treatment or follow –up care. Patient
may reach directly or be referred from dispensaries and
heath centers.
c. Curative Medicine: The process of attempting to remove
the disease from the patient.
d. Preventive Medicine: The science and art of preventing
disease, prolonging life, and promoting physical and mental
e. Promotive Medicine: The process of enabling people to increase control over
and to improve health.
f. Primary Health Care: Essential health care based on practical, scientifically
sound and socially acceptable methods and technology made university
accessible to individuals and families in the community through their full
participation and at a cost that the community and country can afford to
maintain at every stage of their development in the spirit of self-reliance and
self-determination.
g. Diagnostic Services: The procedure involving the use of technology by
medical or paramedical personnel to know the nature, extent and the cause of
disease.
h. Supportive Services: The facilities which assist in smooth functioning of
clinical and nursing care in a hospital.
i. Rehabilitation : Combined and coordinated use of medical, social educational
and vocational measures for training or retraining the individual to highest
possible level of functional ability and enabling the disabled and handicapped
to achieve social integration.
j. Medical record: A clinical, scientific, administrative and legal document
maintained in chronological order related to patient care.
k. Unit –Serial System: The technique in which patient is given a hospital
number on his first admission in out-patient department of the hospital. The
patient retains that number on all subsequent admission to any department
of the hospital. All admission records are filed together in one folder and
under one number.
Function of OPD
a. Early diagnosis, using the best possible modern techniques,
including prophylactic examinations for the detection of
undiagnosed disease.
b. The ambulatory and domiciliary treatment of all case which
can be treatment at the clinic or at home .
c. The admission or referral for admission to the hospital of
those patient who need it. About 4 to 5 of the total admission
in in-patient department are admitted through OPD.
d. After care and medical rehabilitation when necessary after
discharge from hospital.
e. The promotion of health of the individuals under their care by
means of health education .
f. The use of out-patient facilities for the training of medical and
nursing students.
g. The keeping of records and collection of data for
epidemiological and social research and for periodic
assessment of medical work.
Expected Workload
The number of patients visiting the out-patient department will depend
upon various factors:
a. Location of the hospital,
b. Availability of other health care facilities in the vicinity,
c. Policy and available resources ,
d. Population and their needs:
I. Socio-economic, cultural and educational status
II. Prevalent disease pattern
e. Transport facilities ,
f. Season of the year, and
g. Geographic and topographical factors
A commonly used rough criterion observed in this country is that every
hospital bed attracts 5 to 6 patients per day in the OPD and pout of
which 50 per cent as follow up cases. In western countries the figures
are slightly lower i.e. on an average maximum of 500 out patients for
each hospital bed during a year, and out of this about 40 per cent are
new patients and 60 per cent are old or follow-up patients.
Planning of the OPD
Principles of Planning
As it has already been motioned, the main functions of the OPD are
diagnostic , curative, preventive, educative, Promotive and rehabilitative.
Also the trends indicate that the need for and use of OPD services will
increase and will be almost double in every 7 to 10 years. Some of these
principles are:
a. Form Follows Function: The Building and its facilities must express the
function or activities to take place within it. Architectural, esthetic or
other considerations must be secondary to the primary function.
b. Maximum flexibility and expendability are paramount considerations.
c. External and internal traffic pattern must be simple, clear cut, easily
understood and as short as possible .
d. Physical and functional separation must be achieved in traffic flow of
people and things, both horizontally and vertically.
e. Labor saving devices and automations must be utilized with a
functional organization in order to reduce operational expenses and to
gain maximum utilization of professional time and skill in patient care.
f. In building any new facility, the old must adjust to the new. Functional
operation of the new facility must be not be compromised by existing
buildings.
g. Provisions to tackle with the emergencies arising. As per the Jain
Committee report that on an average 10 per cent of the total patients
Location
There should be a separate wing for OPD
attached to the main hospital complex such
that :
a. It is easily accessible from the main
entrance of the hospital with direct
approach from the main road.
b. It is segregated from the in-patient
department.
c. It is preferably in the ground floor.
d. It has easy assess to hospital diagnostic
facilities and other support services.
Size
The size of the OPD depends upon the volume
of attendance, the clinics provided, and the
extent of other facilities like laboratory, blood
bank, health education programme, operating
facilities and an emergency department. As it
is already mentioned, it should be so laid out
that is capable of expansion
Estimation of No. of Out-patients
It is observed that on an average one person
roughly visits the OPD three times in a year,
from a given community. This means that if the
area catered by an OPD is having 1,00,000
population than the number of visits in that OPD
in a year will be 3,00,00.
i.e. for 100000 population = 300000 patient
visits in a year
The space requirement, calculated by this
method will take care for the increase in
workload and expansions for next 30 years.
space Requirement
There is no universally accepted method
available, based on which the space requirement
of the OPD could be determined. But one method
which the easily be applied is an follows:
The total space required for setting up of an OPD
can be determined by the number of patients
who be visiting the OPD in one year.
In general, approximately 2/3 to 1sq. Feet overall
is required per annual out-patient visits .
Hence, if there are roughly 3,00,000 visits in a
year than the total space requirement for the
OPD will be 2,00,000 to 3,00,000 sq. feet
a. Public or entrance zone;
b. Ambulatory zone;
c. Diagnostic and supportive zone;
d. Administrative zone;
e. Staff zone.
