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Transcript of Hospital Case Plus
8/2/2019 Hospital Case Plus
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C A S E S T U D Y
&
L I T E R A T U R E S T U D Y
H O S P I T A L d e s i g n
Submitted by:
ASHISH RANA - A081009
RISHI VERMA - A081026
SHREY SHARMA - A081032
SUNAINA NANDWANI - A081036
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I N T RO D U C T I O N
A hospital is a health care institution providing patient treatment by specialized staff and equipment.
Types of hospitals(as per function)
University hospitals:They are the most broad
hospitals as they are alsoa college for medicinal
studies.
Specialty hospitals:Have specialized departments
as in cardiology, neurology ,
etc. which specialize in a
particular sphere of medicine.
General hospitals:General hospitals diagnose and
treat major all the major ailments
with facility to hospitalize patients
for scrutiny and care.
Types of hospitals (as per no of beds)
Smallest acute(upto 50 beds)
Small(upto 150 beds)
standard(upto 600 beds)
large(more than 600 beds)
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PLANNING CONCEPTION
Location:
• The site should offer sufficient space for self contained residential areas and hospital departments.
• It should be a quiet location with no possibility of future intrusive development not excluded by
regulations on adjacent sites.• Adequate open areas for later expansion must also be planned.
Orientation:
• Treatment and operating rooms - north-west and north-east.
• nursing ward facades - south to south-east is favorable
• East and west facing rooms have comparatively deeper sun penetration, though less winter sun.
• The orientation of wards in hospitals with a short average stay is not so important.
• Some specialist disciplines might require rooms on the north side so that patients are not subjectedto direct sunlight.
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HEALTH
CENTRE OPD
EM
RADMINISTRA
TION
SURGERY
DIAGNO
STIC
FAC.
DELIE
VERY
NURSING
SERVICES
LAUNDRY
KITCHEN
DINING
HELPERLOCKER
NURSESBLOCK
STORAGE
MECHANICALPLANT
A/CPLANT
PARKING
NU
RSER
Y
P A T I
E N T S
P A T I E N T S
S T A F
F
O
U T
P A T
I E N T S
A M B U L E N C E
S T A F
F
V I S I T
O R S
S E R V
I C E
A N D
H E L P
BASIC CIRCULATION FLOW CHART OF A HOSPITAL
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Registration/
payment
Check-in
examination
Doctor’scheck up
payment
Lab tests
X-rayECG
Ultrasound
hospitalization
pharmacy
exit
OUTDOOR PATIENT DEPARTMENT : CIRCULATION
surgery
emergency
delivery
hospitalization
EMERGENCY : CIRCULATION
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OT :
1 OT for every 50 general impatient beds and 1 OR for every
25 surgical beds
ICU beds:
5-10% of total beds
FLOOR SPACE FOR EACH ICU BED :
25-30 M2/BED
FLOOR SPACE FOR EAH PEDRIATIC ICU BED :
20-24M2/BED
FLOOR SPACE FOR HOSPITAL BED :
15-18M2/BED
BED SPACE IN WARDS:
7M2/BED
C/C DISTANCE BETWEEN TWO BEDS:
2500mm
CLEARANCE AT FOOTEND OF EACH BED :
1200mm
WAITING AREA IN OPD :0.5 – 1 M2 / PATIENT
ELECTRICAL REQUIREMENT/BED/DAY:
3-5 KW
WATER REQUIREMENT/BED/DAY :-
400-500 LITRES
LAUNDRY:
1 - 1.5 M2/BED
OPD REGISTRATION SPACE :
0.5 M2/BED
DOOR OPENINGS PATIENT BEDROOMS:MINIMUM : 1500MM WIDE & 2100 MM HIGH
CORRIDORS :
• With frequent trolley movement : 2100-2400 mm
• Without frequent trolley movement : 1800 mm
• No transportation : 1200 mm
• Major inter department corridors : 2100mm
Ceiling heights :
• Minimum ceiling heights in occupied areas . Corridors,
passages and recesses : 2400mm
• Ceiling heights : therapy rooms, ICU and kitchen : 2700
mm
• X-ray rooms , OT’s : 3000 mm
Bed/service lifts :
• Clear door opening : 1200mm X 2000 mm
• Car dimensions : 1300mm X 2400 mm(deep)
Passenger Lifts :
• Clear door opening : 800 mm X 2000 mm
• Car dimensions : 1300mm X 1100 mm
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DOCTOR’S ROOM, TREATMENT ROOM , NURSE’S
WORKROOM AND STATION SUPERVISION ROOM
BED LIFT FOR PATIENTS
BED LIFT FOR PATIENTS
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CORRIDORS
• Corridors must be designed for the maximum expected
circulation flow.
• General access corridors
1.5m wide
• Corridors in which patients will be transported on trolleys2.25m wide
• The suspended ceiling in corridors may be Installed up to
2.40 m.• Windows for lighting and ventilation should not be further than
25m apart.
BED REQUIREMENTS In the planning of new buildings, about 70-100 m2 must be
allowed per sick bed, and roughly 200-280 m3 per bed mustbe allowed for alterations (which includes all ancillary spacessuch as environmental controls and storage)
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AN EFFECTIVE ARRANGEMENT FOR A HOSPITALWOULD BE AS FOLLOWS:
top floor: helipad, air-conditioning plant room,nursing school, laboratories
2nd&3rd floor: wards 1st floor: surgical area, central sterilization,
intensive care, maternity, children'shospital
ground floor: entrance, radiology, medical services,ambulance, entrance for bedridden patients, emergency
ward, information, administration, cafeteria basement: stores, physiotherapy, kitchen, heating
and ventilation plant room, radio-therapy,linear accelerator
sub-basement: underground garage, electricity supply
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FUNCTIONAL AREAS OF A HOSPITAL :
Supply/disposal 6 - 14m2 PA/planned bed care area
nursing area 4 - 5m2 PA/planned bed care area
Intensive therapy 5 – 8m2 PA/bed
Surgical area 21 - 28m2 PA/surgical unit
Rehabilitation 4 – 5 m2 PA/treatment unit
Physiotherapy 11 – 12.5m2 PA/treatment place
X-ray 10 – 12m2 PA/diagnosis room
Radiotherapy 50 – 60m2 PA/equipment
Recovery area 4 – 6m2 PA/recovery bed
NMR diagnosis 16 – 25m2 PA/diagnosis room
Clinical physiology 13 – 16m2PA/diagnosis room
Clinical neurophysiology 13 – 16m2 PA/diagnosis room
Central reception 23 – 27m2 PA/examination/treatment room
Delivery area 14 – 16m2 PA/delivery room
Dialysis 12 – 13m2 PA/dialysis bedSpecialist departments 9 – 13m2 PA/examination/treatment room
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SURGICAL DEPARTMENT
operating theatre 40-48 m2entry room 15-20 m2exit room 15-20 m2washroom 12-15 m2
equipment room 10-15 m2
The image displays an Ideal floor plan of an externalsurgical area with a direct link to the main building. The
corridor system IS separated into staff corridors with links tothe functionalrooms and pre-operative and post-operative patientcorridors. A requirement when planning a new building IS
that it must be expandable on at least one side.
MAIN SURGICAL ROOMS 6.50 x 6.50mwith a clear height of 3.00m and an extra heightallowance of roughly 0.70m for air conditioning andother services.
ANAESTHETICS ROOM The anaesthetics room should be approximately3.80 x 3.80m
WASHROOM The minimum width of the room should be 1.80m.For each operating theatre there should be threenon-splash wash-basins with foot controls.
STERILE GOODS ROOM 10m2 is required per operating theatre.
EQUIPMENT ROOM A room size of approximately 20m2 should beallowed.
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POST OPERATIVE FACILITY
• Beds must not be too close together in the recovery room and allowenough space for the anaesthetist and his equipment to reachat least three sides.
• The route between the recovery room, the operating theatre and theward should contain several doors and be as short as possible so the
anesthetist can get to the patients quickly in case of emergency.
Recovery room requirements The number of beds required is calculated as1.5 times the number of operating theatres.
Central sterilization - 40-120 m2. Approx.Dictation room - 5m2 approx.Patients' room
1 bedded room - 10m22 and 3 bedded room -8m2 (per bed)
Non clean work room 10m2Nurse’s work area 25-30m2Rest room/kitchenette 15m2Station doctor 16-20m2Clean workroom 10m2
Plant room 8m2
Patients lounge 20-25m2
Internal medicine treatment area Examination room 25m2Physician’s room 25m2
Radiology 18-30m2
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INTENSIVE CARE UNIT
Arrangement:• The intensive care department must be a separate area, and only accessible through lobbies (for hygiene
reasons).•
The central point of an intensive care unit must be an open nurses' workstation from which it is possible tooversee every room.• The number of patients per unit should not be more than 6-10.• Following should be included in the plan :1. One nurse's duty station,2. a sterile workstation(medication and infusion preparation),3. one materials room and4. one equipment room per unit (six to ten beds)
Arrangement of the bed spaces:• The beds may be placed in an open, closed or combined arrangement.• All the beds must be in clear view of a central nurses' duty station.• The patients are separated by moveable half-height partitions which
should be lightweight and easy to move.• The ideal plan is star shaped, with rooms radiating out from the
nurses' workstation, but this is often not feasible because of space
restrictions so more traditional arrangements are used.
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ENTRANCE
RECEPTION
C-T SCAN
CHEMIST
DOCTOR
CHAMBERS
RETIRING
ROOM
DOCTOR’S
CHAMBER WAITING HALL
CASUALTYRAMP
TOILETSULTRA
SOUND
DOCTOR’S
CHAMBER
WAITING HALL
SAMPLE
ROOM
X-RAY
ADMINISTRATION
ICU
LIFT &
STAIRS
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PRIVATE
WARD
GENERAL
WARD
WAITING HALL
PRIVATE
WARD
AUTOCLAVEPRIVATE WARD
PRIVATE WARD
GENERAL
WARD
PRIVATE WARD
LIFT &
STAIRS
KITCHEN
PRIVATE
WARD
COMMON
ROOMO.T
O.T
FOYER
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RAMP
LAB
CONFERENCE
MANAGER
PHYSIOTHERAPY
FOYER
Sarvodaya Hospital , Hisar
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y p ,
Physiotherapy 40 ‘ x 16 ‘
Conference room 25 ‘ x 16 ‘
Manager room 10 ‘ x 10 ‘
Laboratory 12 ‘ x 15 ‘
Patient ward 9 ‘ x 16 ‘ , 9 x 12 ‘
Common room 11 ‘ x 16 ‘
O.T 14 ‘ x 13 ‘
Autoclave 11 ‘ x 13 ‘
General ward 17 ‘ x 12 ‘ , 17 ‘ x 15 ‘
Corridor 7 ‘ wide
Lift 6 ‘ x 8 ‘
I.C.U 40 ‘ x 30 ‘
Ultrasound 10 ‘ x 6 ‘
X – Ray 11 ‘ x 14 ‘ , dark room – 7 ‘ x 3 ‘
Waiting 12 ‘ x 12 ‘
C. T.scan 11 ‘ x 16 ‘+ console= 8 ‘ x 12 ‘
D. chamber 9 ‘ x 12 ‘ , 16 ‘ x 10 ‘
Chemist 9 ‘ x 13 ‘
Ramp 5 ‘ wide
Standards
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Corridors 1.5 m least
2.25 m for trolleys
3.00 m main corridors
Doors 2.1 – 2.2 m normal doors
2.5 m vehicle entrance
2.7 – 2.8 m transport entrance
Stairs effective width of stairs and landing in essential stairscase
Must be a minimum of 1.5 m and should not exceed 2.5 m.
Step height of 170 mm permissible and minimum required
Tread is 280 mm.
Rise : tread = 150 : 300 mm
room size 117 – 172 sq.ft single bedroom
157 – 210 sq.ft double bedroom
308 – 401 sq.ft four bed room
Major difference is found in room depths.
Depth 14 ‘ 6 “ for single
15 ‘ for double
21 ‘ 8 “ for four
Typical bed side table = 16 “ x 20 “
Surgical department
Ot 40 48 sqm
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Ot 40 – 48 sqm
Entry room 15 – 20 sqm
Exit room 15 – 20 sqm
Wash room 12 – 15 sqm
Equipment room 10 – 15 sqm
Ot should be designed as square as possible to allow working whatever direction the
operation table is turned in.
Suitable size of ot is 6.5 x 6.5 m with height of 3 m.
Extra height allowance is 0.7 m for air conditioning.
Anaesthetic room
Approx. size 3.8 x 3.8 m
Electric sliding door 1.4 m clear width Washroom
1.8 m min. width
For each ot there should be 3 non splash wash basin with foot control.
Sterile room
Approx. size 10sqm required for ot and should be accessible directly
from ot.
Equipment room
Approx. area 20sqm.
Directly access from ot.
Central sterilization
Usage by surgical dept. 40 %
Surgical intensive and i.c.u 15 % each
Approx. area 40 – 120 sqm
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Nurse area
Area 25 – 30 sqm
Rest room 15 sqm
Station doctor 16 – 20 sqm
Clean workroom 10 sqm
Patient’s lounge 22 – 25 sqm
Toilet size for rooms
Single toilet 2 ‘ 10 “ – 3 ‘ 2 “ , 3 ‘ 10 “ – 4 ‘ 10 “
Door size
Std. bedroom door width 3 ‘ 10 “ - 4 ‘
Lifts
One multipurpose lift should be provided per 100 beds.
Min. of 2 smaller lifts for portable equipment , staff and visitors.
Lift car- 0.90 m x 1.20 m
Shaft- 1.25 m x 1.5 m
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GENERAL HOSPITALSECTOR – 6, PANCHKULA
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SERVICESTANDARDS
DOCTORS 47NURSING SISTERS 11STAFF NURSES 69PHARMACISTS 15TECHNICIANS 14
O.T. ASSISTANTS 04DRIVERS 07CLASS 4 20SWEEPERS 10CONTRACT WORKERS 50
FIRST FLOOR
GYNAECOLOGY
EYEANTENATALREGISTRATIONBIRTH & DEATH REG.PP CENTREDOT CENTREIPD REGISTRATIONEMERGENCY
MEDICINESURGERYLABOUR ROOMGYNAE/OBS.PAEDIATRICSINJECTION ROOMMAJOR O.T.
GROUND FLOOR
OPD REGISTRATION
GENERAL OPDIPD REGIDTRATIONEMERGENCYPHYSIOTHERAPYSURGERYORTHO PEDICSMEDICINEPAEDIATRICS
GENERAL OPDSURGERYEYEEMERGENCYLITHOTRIPSYULTRASOUND & CT SCANX-RAYSPHARMACY
ECGSAMPLE COLLECTIONPATHOLOGY/EMG LABCASH COUNTERINJECTION ROOMVCTC
SECONDFLOOR
DENTALCHEST & TBENTTMTSKIN/LASERPSYCHIATRYEEGBIRTH &DEATH REG.PP CENTERPHOTOTHERAPY
CSO BUILDING
Blood BANKMORTUARY ( BEHIND)INCINEARTOR ( BEHIND )
THIRD
FLOOR
ADMIN. OFC.CCUPRIVATE
AREAS ON DIFFERENT FLOORS
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GROUND FLOOR PLAN
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FIRST FLOOR PLAN
ENTRY AND ADMINISTRATION IN PATIENT DEPARTMENT
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As emergency entry is not provided ,stretchers are kept at the entrance itself.
NURSE STATION
( 45 SQ. FT. approx. )
DISPOSAL OF DIFF.
TYPES OF WASTES
WHITE PAINTED
WALLS ADDED
LIGHT TO THE
SPACE
MANY WINDOWS
WERE PROVIDED
FOR LIGHT &
VENTILATION
MOSAIC
TILED
FLOORING
ADMINISTRATION B LOCK AT A DISTANCE
FROM THE MAIN BLDG.
PHARMACY RADIOLOGY AND IMAGING
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7’
12’
RECORD ROOM( 22’ X 18’ approx. )
CLADDED WALLS
X RAY ROOM( 23’ X 20’ approx. )
Anti-skit TilledFlooring3’
MOSAIC TILEDFLOORING
ECG ROOM( 10’ X 10’ )
DARK ROOM( 12’ X 18’ )
ICU
WELL FURNISHED
ROOM, 5 BEDS.
OPD ORTHOPAEDIC MINOR OT
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CHECK UPAREA
CONSULTATIONAREA
PARKING AREA
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10’ 10’
23’
SERVICES
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Service pipes running along
the ceiling.
PLUMBINGSHAFTS
INFERENCES
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INFERENCES:
• The hospital is being re-constructed, therefore, there are someproblems being faced.
• The fire fighting system is not adequate. But provisions are beingmade for the same in the new construction.
• The arrangement of the spaces is not proper. E.g.. Emergency wardhas got no direct entrance.
• The blood bank was quite far from the main hospital building.
• The area provided for each space was ample but not planned.
• No lack in services was seen. Proper vacuum, oxygen, and otherrequirements were fulfilled.
• The radiology room space was well planned.
• I.C.U. was a single unit. No separate cabins for the patients wereprovided.
• Proper facilities for handicaps were provided.