PRINCIPLES OF HOSPITAL DESIGN - IRTPMS · PDF filePRINCIPLES OF HOSPITAL DESIGN Dr A PRAKASH...
Transcript of PRINCIPLES OF HOSPITAL DESIGN - IRTPMS · PDF filePRINCIPLES OF HOSPITAL DESIGN Dr A PRAKASH...
PRINCIPLES OF HOSPITAL DESIGN
Dr A PRAKASHSr. Professor, Health Management
National Academy of Indian Railways(Formerly Railway Staff College)
VADODARA – 390 004
Dutch architectural historian Cor Wagenaar has called many hospitals:
"... built catastrophes, anonymous institutional complexes run by vast bureaucracies, and totally
unfit for the purpose they have been designed for ... They are hardly ever functional, and instead
of making patients feel at home, they produce stress and anxiety."
The research of British Medical Association shows that good hospital design can reduce patient's recovery time. Exposure to daylight is effective in reducing depression. Exposure to nature and hospital gardens is also important - looking out windows improves patients' moods and reduces blood pressure and stress level. Eliminating long corridors can reduce nurses' fatigue and stress.
THE PLOT
Where the clients want it Easy reach of captive population Free access Area not less than double the floor area IS 10905 Pt I – one hectare per 25 beds Gates – Main / Emergency / Service
BUILDING
Maintenance free Environment friendly Minimum energy expenditure for ambient light &
climate control Functional segregation Emergency exits, ramps, fire alarms Disabled friendly
FLOOR AREA OF HOSPITAL
700 – 900 sq ft per bed
One bed requires 75-100 sq ft Total floor area required is 10 times this
FLOOR AREA ALLOCATION
OPD – 12%-18% Wards – 37%-45% Diagnostic & Therapeutic – 18%-22% Administration – 8%-12% Service Departments – 15%-20%
FLOOR AREA DETAILED BREAKUP
Nursing – 250-280 Nursery – 12-18 Labour Room – 15-20 OT – 30-50 Physical Medicine – 12-18 Radiology – 25-35 Laboratory – 25-35 Pharmacy - 4-6
FLOOR AREA DETAILED BREAKUP
CSSD – 8-25 Dietary – 25-35 Medical Record – 8-15 House Keeping – 4-5 Laundary – 12-18 Mechanical Installations – 50-75 Maintanence Workshop – 4-6 Stores - 25-35
FLOOR AREA DETAILED BREAKUP
Public Areas – 8-10 Staff Facilities – 10-15 Administration – 40-50 Circulation – 115-140 TOTAL – 681-991 Add Partitions, Walls etc – 95-125 GROSS TOTAL - 780-1005
CORRIDORS
Main corridor should allow for passage of two beds with persons on sides
It requires ~2.5 metre width Less than 100 beded hospitals can have one
bed passage It requires ~2.0 metre width Segregation of clean and dirty corridors
LIFTS
Depends upon number of beds above ground floor
Up to 60 – one Up to 200 – two Up to 350 – three
Size – >2280X1600X2300 mm
with door size >1300X2100 mm
OPD
For every bed three patients are seen in OPD 60% of area should be for waiting & corridors Seats for 1/3 of daily attendance @ 8 sq ft/pt. Consultation room – 150 sq ft Attached examination room – 80 sq ft
CASUALTY
Easy access Consultation room 150 sq ft Resuscitation room 175 sq ft Waiting area
WARDS
24 to 32 beded 75 sq ft area for each bed Center to center distance between beds 8 ft Edge to edge distance between beds 4 ft Service corridor between bed rows 8 ft Wash basin one between 10 beds Sluice room 120 sq ft Broom closet 40 sq ft MGPS
WINDOWS IN WARDS
Window area 20% of floor area if only on one wall
Window area 15% of floor area if on opposite walls at same sill level
CABINS
At least 6 cabins per 100 beds
Australian standard is 25% of beds in single, double & quadruple units
BED DISTRIBUTION
Medical 30%-40% Surgical 25%-30% (includes Orthopedics – 5%) Obs & Gynae 15%-18% Peadiatrics 10%-12% ENT & Eye etc 10%-15%
ICU
Bed strength – 2% to 5% of total beds Not less than 5 or more than 15 in a unit Each bed 150 – 200 sq ft Not more than 40%-50% floor area for beds Hence ICU size 500 sq ft per bed Power – 2X15 amp & 3X5 amp at least MGPS Monitor cabling
OT – THE NUMBER
One OR per 50 beds
No. of Operations = Surgical BedsXBORX365 ALSX100XWorking Days
No. of OT = No. of Operations per day Expected Output per OT
OT – THE NUMBER
BEDS MINOR MAJOR EM MINOR EM MAJOR
50 0 1 0 1
100 1 1 0 1
300 2 3 0 1
500 2 5 1 1
750 2 8 1 1
1000 2 10 1 1
ZONING IN OT
Protective Zone Clean Zone Sterile Zone Disposal or Sluice Zone
ENVIRONMENTAL CONTROL
Temperature – 20+2 Relative Humidity – 40%-60% Air Changes 25/hr (at least 10 of fresh air) Clean air thru HEPA filter (0.3μ & 99.7%
efficiency) Clean area – 12 or more air changes, same
temperature & RH
OT FLOOR AREA DISTRIBUTION
Special OR (25'X25') – 625 sq ft Major OR (20'X20') – 400 sq ft Minor OR (18'X18') – 324 sq ft Scrub Room – 80 sq ft Fracture Room – 249 sq ft Plaster Room – 80 sq ft Sterile Storage – 160 sq ft Equipment Storage – 240 sq ft
OT FLOOR AREA DISTRIBUTION
Instrument Storage – 160 sq ft Anaesthetist's Room – 160 sq ft Anaesthesia Store – 80 sq ft Anaesthesia Room* – 160 sq ft Doctor's Change Room – 120 sq ft Nurses' Change Room – 120 sq ft Staff Change Room – 120 sq ft OT Office – 120 sq ft
OT FLOOR AREA DISTRIBUTION
General & Linen Store – 120 sq ft 2 bed recovery – 160 sq ft Mobile X ray & Dark Room – 120 sq ft Trolley Bay – 80 sq ft Safaiwala Alcove – 80 sq ft
OT FLOOR AREA DISTRIBUTION
ADD IN CASE OF DAY CARE SURGERY Reception – 100 sqft Men's Change Room – 120 sqft Ladies' Change Room – 120 sqft Patient's Preparation – 120 sqft Gowned Waiting Area – 80 sqft
PLUS Circulation Area
SERVICES FOR OT
Electricity – Clean Water Supply – Clean Lighting – General Background /
Operation /Special MGPS
? SEAMLESS / MODULAR OT
LABOUR ROOMS
Septic & Aseptic Segregation Lighting MGPS Neonatal Resuscitation Area Vicinity of Nursery & OT
NURSERY
Vicinity of Labour Room Natural Light
MORTUARY
Connected to Service Gate Cold Room Side Room with Plumbing Waiting Area
PROVISION FOR GROWTH
Area Growth Acceleration Indoor 8.7% 1.0% Outdoor 10.8% 4.1% Medical Services 28.4% 15.3% Teaching & Research 45.9% 31.1% Staff 18.5% 4.9% Services 9.5% 1.8% Administration 23.3% 6.5%
AIRCONDITIONING
Dilution CO2 / Heat Load / Microbial Load
Control of Microbial Spread Room to Room Pressure Difference Flow Control within Room
Humidity Control Air Purification
Filters / UV / Ozone
AIRCONDITIONING
Integration of – Ventilation Lighting Fire fighting MGPS Cabling for computers & monitors etc
AC – OT
Temp – 20-23 RH – 50%- 60% Pressure – Positive, Negative in Sluice Room Air changes – 10 fresh / 25 total Air Filtration – HEPA (0.3 μ) in OR 20μ else Pressure maintained in OR 24X7
AC – ENDOSCOPY ROOM
Temp – 20-23 RH – 30%-60% Pressure – Negative Air Changes – 2 fresh / 12 total Air filtration – 20 μ All air vented out
AC – POSTOPERATIVE
Temp – 21-24 RH – 30%-60% Pressure – Positive Air change – 2 fresh / 6 total Air Filtration – 5 μ
AC – MICU/SICU
Temp – 21-24 RH – 30%-60% Pressure – Positive Air change – 5 fresh / 15 total Air Filtration – 5 μ
LABOUR ROOM
Temp – 20-23 RH – 30%-60% Pressure – Positive Air Changes – 3 fresh / 15 total Air Filtration – 5 μ
NURSERY
Temp – 22-26 RH – 30%-60% Pressure – Positive Air Changes – 3 fresh / 15 total Air Filtration – 5 μ
WARDS
Temp – 21-24 RH – 30%-60% Pressure – Positive Air Changes – 3 fresh / 15 total Air Filtration – 20 μ
Over crowding in visiting hours
PATHOLOGY
Temp – 24 RH – 30%-60% Pressure – Negative Air Changes – 6 total All air exhausted outside
RADIOLOGY
Temp – 24 RH – 30%-60% Pressure – Positive, Negative in Dark Room Air Changes – 6 total, 10 total in Dark Room Heat Load Calculation is important
REFERENCES
Private Hospital Guidelines Australia IIIed
Private Health Care Facilities Lisencing Procedures & Specifications UAE
Hospital Planning and Administration, R Llewellyn-Davies & HMC Macaulay
Principles of Hospital Administration and Planning, BM Sakharkar
Hospital Administration, CM Francis & Mario C de Souza
REFERENCES
IS 10905 (Indian Hospital Standards)
HTM 2025 (Ventilation in Health Care Facility)
HTM 05 (Fire Safety) & HTM 06 (Electrical Services)
HTM 2014 Electromagnetic Interference to Medical Equipment
EN 12464 for lighting
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