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Presented byPresented byAssoc. Prof. Datin Ar. Norwina Mohd NawawiAssoc. Prof. Datin Ar. Norwina Mohd Nawawi
International Islamic University MalaysiaInternational Islamic University Malaysia
Hospital Design – a brief Hospital Design – a brief insight on the development insight on the development of hospitals in Malaysia in of hospitals in Malaysia in
comparison to projects comparison to projects overseasoverseas
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OutlineOutline
IntroductionIntroduction• HealthcareHealthcare• Hospital ArchitectureHospital Architecture
Development of Hospital AbroadDevelopment of Hospital Abroad Malaysian Healthcare ServicesMalaysian Healthcare Services Development of Malaysian Hospitals pre Development of Malaysian Hospitals pre
and post independenceand post independence Current issues in hospital developmentCurrent issues in hospital development Summary Summary
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IntroductionIntroduction
Healthcare and Hospital Healthcare and Hospital ArchitectureArchitecture
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IntroductionIntroduction ““Health care presents a different problem in Health care presents a different problem in
every country for the way it is organised is a every country for the way it is organised is a response to response to geography, climategeography, climate, historical , historical development, economic situation and social, development, economic situation and social, cultural and political conditions…cultural and political conditions…
Appreciation of these differences is Appreciation of these differences is fundamental to understanding of the fundamental to understanding of the situation which prevails in a country.”situation which prevails in a country.”
Anthony Cox, Philip Groves.1990. Hospitals and Healthcare Facilities. Gt.Britain.Butterworth & Co.
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Definition on HealthDefinition on Health
““Health is a state of complete physical, mental, Health is a state of complete physical, mental, and social well-being and not merely the absence and social well-being and not merely the absence of disease or infirmity”of disease or infirmity”
W.H.O.W.H.O.
““Health, as we define it today, is a state of Health, as we define it today, is a state of
complete physical, psychological, social and complete physical, psychological, social and spiritual well being.”spiritual well being.”
Islamic worldviewIslamic worldview
…………………………………………Thus, Thus, provides the overview that health isprovides the overview that health is not just the not just the absence of disease in physical sense but encompass the whole well-absence of disease in physical sense but encompass the whole well-being of the person.being of the person.
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What is healthcare?What is healthcare? ““Essential health care based on practical, Essential health care based on practical,
scientifically sound and socially scientifically sound and socially acceptable methods and technologies acceptable methods and technologies made universally accessible to individuals made universally accessible to individuals and families in the community through and families in the community through their full participation and at a cost that their full participation and at a cost that the community and country can afford to the community and country can afford to maintain at every stage of their maintain at every stage of their development in the spirit of self-reliance development in the spirit of self-reliance and self determination”and self determination”
The Declaration of Alma Ata in 1978The Declaration of Alma Ata in 1978
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Health PyramidHealth Pyramid Healthcare buildings encompass the Healthcare buildings encompass the
predefined healthcare strata of PRIMARY, predefined healthcare strata of PRIMARY, SECONDARY and TERTIARY level of care. SECONDARY and TERTIARY level of care.
Tertiary
Secondary
Primary
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The Level of CareThe Level of Care Primary carePrimary care embraces all the general health embraces all the general health
practices, educational, preventive and curative, practices, educational, preventive and curative, that are offered to the population at the point of that are offered to the population at the point of entry into the System.entry into the System.
Secondary CareSecondary Care comprises the care provided by comprises the care provided by more specialised services to which people are more specialised services to which people are rendered by the primary care services.rendered by the primary care services.
Tertiary CareTertiary Care includes highly specialised includes highly specialised services not normally found at secondary level, services not normally found at secondary level, including super-specialities such plastic surgery, including super-specialities such plastic surgery, neurosurgery and heart surgery. neurosurgery and heart surgery.
Anthony Cox, Philip Groves.1990. Hospitals and Healthcare Facilities. Gt.Britain.Butterworth & Co.
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Principle of Referral of PatientsPrinciple of Referral of Patients
The principle of The principle of referral of patientsreferral of patients from from a lower level of care to a higher level as a a lower level of care to a higher level as a method of method of sortingsorting them according to their them according to their need for specialist diagnosis or the need for specialist diagnosis or the nature or the degree or their disabilities is nature or the degree or their disabilities is also universally recognised.also universally recognised.
Another is aim to work in both direction Another is aim to work in both direction for which the reverse is meant for for which the reverse is meant for convalescence.convalescence.
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Basic Hospital Forms and ConfigurationsBasic Hospital Forms and Configurations
Diagnostic & Treatment zones
Diagnostic & Treatment zones
The Outpatient ZoneThe Outpatient Zone
Medical and Non Medical Support Zones
Medical and Non Medical Support Zones
Supplies and Disposal
Visitors
Em
erg
enc
y E
ntry
Visitors Control
Visitors Control
Inpatient zonesInpatient zones
Naturally ventilated areas are normally long and thin while fully air conditioned areas are thick and wide
Outpatient entry
visitors
In the tropics
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Ward LayoutWard Layout
Clinic LayoutPatient Waiting Area
C/E rooms
C/E rooms
Dirty Utility
Treatment RoomStores
C/E rooms
C/E rooms
Procedure Room
C/E rooms
Clean Utility
Staff corridor Linking to staff areas
Linking to Main Entrance or Hospital Street
Natural Day light
reception
natural ventilation and natural lighting.
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Development of Hospital Development of Hospital Architecture AbroadArchitecture Abroad
UK, USA, EUROPE,JAPAN, UK, USA, EUROPE,JAPAN, SOUTH AFRICA, BRAZIL…SOUTH AFRICA, BRAZIL…
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British ExperienceBritish Experience In the early 50s-60s during the In the early 50s-60s during the energy crises,energy crises,
the British the British embarked on several hospital embarked on several hospital development program starting from development program starting from • the Greenwich experience, the Greenwich experience, • through the Harness system, through the Harness system, • the Best Buy Mark I, then Best Buy Mark II,the Best Buy Mark I, then Best Buy Mark II,• through the varied Nucleus Hospital program through the varied Nucleus Hospital program
including the energy efficient Nucleus Hospital of St. including the energy efficient Nucleus Hospital of St. Mary on the Isle of Wright.Mary on the Isle of Wright.
• Now ..one off designs through……Private Now ..one off designs through……Private Finance Initiative (PFI)Finance Initiative (PFI)
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Greenwich hospitalGreenwich hospital
The construction methods would be revolutionary - all lateral engineering services were to be contained in a 6-
foot gap between floor and ceiling of each pair of floors so that repairs and maintenance works could be carried out without disturbing ward or department routine. All wards would have natural light but the service departments e.g. x-ray, pathology and operating theatres would be in the
centre and artificially lit.The whole hospital was to be ventilated mechanically and
none of the windows would open so that the air in the wards would be as ‘pure’ as possible.
PLANPLAN
floor
InterstitialService floor
http://mysite.wanadoo-members.co.uk/offkilter/page6.html retrieved 070808
closed on 31st March 2001.
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USA ExperienceUSA Experience
Being on private insurance based healthcare Being on private insurance based healthcare system, asystem, architects in the United States had to rchitects in the United States had to convince the convince the facility facility management that management that good good healing design healing design is profitable.is profitable.
Extensive Extensive campaign campaign or or crusades on both sides of crusades on both sides of the Atlantic to market the will of the Atlantic to market the will of healing healing environment through provision of good view, environment through provision of good view, music therapy, good interior design, lots of music therapy, good interior design, lots of sunlight, fresh air and energysunlight, fresh air and energy efficiency through efficiency through passive design strategiespassive design strategies are done with m are done with many any researches being conducted to provide evidence researches being conducted to provide evidence that environment do indeed improves the person that environment do indeed improves the person health outcomes.health outcomes.
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European ExperienceEuropean Experience In Europe, In Europe, apart from access to daylight and fresh apart from access to daylight and fresh
air, strategies for passive designair, strategies for passive design include the choice include the choice of building materials for healthcare buildings that of building materials for healthcare buildings that has rigorous requirements. has rigorous requirements. • The material is specifically specified to be environment The material is specifically specified to be environment
friendlyfriendly e.g. e.g.the choice of wall and floor finishes the choice of wall and floor finishes shouldshould not not be from material that canbe from material that can burn nor emit toxic fumes. burn nor emit toxic fumes.
BBuilding services system uilding services system should should promote the recycle promote the recycle of waste water; retention of natural water before of waste water; retention of natural water before gradual discharge; recycle heat energy of air gradual discharge; recycle heat energy of air condition to radiators; use of solar power with photo condition to radiators; use of solar power with photo voltaic, wind energy and others. voltaic, wind energy and others.
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The Asian ExperienceThe Asian Experience There have been movement in the Asian scene There have been movement in the Asian scene
about going back to tradition and local Asian about going back to tradition and local Asian values when designing hospitals. values when designing hospitals.
The deep rooted wisdoms on the use of The deep rooted wisdoms on the use of Feng Feng ShuiShui (literally means (literally means wind, waterwind, water) by the Chinese ) by the Chinese and and Vaastu ShastraVaastu Shastra by the Indians had made by the Indians had made significance come back in this millennium. significance come back in this millennium.
Both values, are basically Both values, are basically based on the planning based on the planning of the environment that deals with orientation of the environment that deals with orientation and provision of good healthy living. and provision of good healthy living.
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Worldwide experience summaryWorldwide experience summaryMore hospital planning layouts are going away from deep planning and More hospital planning layouts are going away from deep planning and
massive concept to thinner blocks with courtyardsmassive concept to thinner blocks with courtyards to provideto provide
opportunity for all habitable rooms or spaces to have a natural daylight and view to the outside;
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• More patients’ spaces are accessible to the More patients’ spaces are accessible to the gardens or sizeable courtyards whether it is on gardens or sizeable courtyards whether it is on the roof-tops or on the ground floorsthe roof-tops or on the ground floors;;
Nortalie Hospital, Sweden
Albert Einstein Hospital, Sao Paolo
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• More external cladding, although of high tech More external cladding, although of high tech material, provides the shades and light at material, provides the shades and light at their openings through provision of retractable their openings through provision of retractable blinds or hoods as and when necessary.blinds or hoods as and when necessary.
Sunderby Hospital, Sweden
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Atriums with gardens and natural daylighting are Atriums with gardens and natural daylighting are a common feature. Due to their four seasons and a common feature. Due to their four seasons and differential natural day-lighting intensity differential natural day-lighting intensity throughout the year, ventilation systems need to throughout the year, ventilation systems need to be boosted with mechanical means to provide the be boosted with mechanical means to provide the space with the required thermal comfort level.space with the required thermal comfort level.
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Malaysian Healthcare Malaysian Healthcare Services SystemServices System
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Malaysia – Vital StatisticsMalaysia – Vital Statistics
Other Vital StatisticsLand Area: 330,252 sq kmPopulation ( 2006): 26,640,200 Population Density: 81 / sq. kmPopulation Growth: 1.5%14 States
Source: Health Facts 2006, Ministry of Health Malaysia
Bel
ow
15
year
s –
33%
15-6
4 ye
ars
–63%
65 y
ears
& a
bo
ve-4
%
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Malaysian Health VisionMalaysian Health Vision
“ “ Malaysia is to be a nation of healthy Malaysia is to be a nation of healthy individual, families, and communities, through individual, families, and communities, through a health system that is equitable, affordable, a health system that is equitable, affordable, efficient, technological appropriate, efficient, technological appropriate, environmentally adaptable and consumer environmentally adaptable and consumer friendly, with emphasis on quality, innovation, friendly, with emphasis on quality, innovation, health promotion and respect for human health promotion and respect for human dignity, and which promotes individual dignity, and which promotes individual responsibility and community participation responsibility and community participation towards an enhanced quality of life”towards an enhanced quality of life”
Ministry of Health Malaysia
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The health vision is not static but The health vision is not static but dynamic that sets in place framework dynamic that sets in place framework to ensure that the health system could to ensure that the health system could develop and adapt to the changing develop and adapt to the changing environmentenvironment
Health care facilities were Health care facilities were pragmatically plan and developed to pragmatically plan and developed to provide the support towards that visionprovide the support towards that vision
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Spectrum of Healthcare FacilitiesSpectrum of Healthcare FacilitiesLevelLevel Primary CarePrimary Care Secondary CareSecondary Care Tertiary CareTertiary Care Long Term CareLong Term Care
TypeType
Promotive . Promotive . Preventive, Preventive, CurativeCurative
CurativeCurative Curative, Curative, RehabilitativeRehabilitative
Home/Palliative/Home/Palliative/Terminal CareTerminal Care
Built Built facilitiesfacilities
Midwife/Rural Midwife/Rural Health ClinicHealth Clinic
Cottage Hospital 20-Cottage Hospital 20-70 beds70 beds
National Referral Centre National Referral Centre of Excellenceof Excellence
hospiceshospices
Dispensary / Dispensary / mobile mobile DispensaryDispensary
Non Specialist Non Specialist Hospital 70-150 bedsHospital 70-150 beds
Teaching hospitals –Teaching hospitals –public and privatepublic and private
elderly/retirement homeselderly/retirement homes
Health post Health post Specialist Hospital Specialist Hospital 150-350 beds 150-350 beds
Research institutionsResearch institutions- Institution of Medical - Institution of Medical Research (IMR)Research (IMR)
Special Institutions – Special Institutions – RehabilitationRehabilitation
Flying DoctorsFlying Doctors Private HospitalsPrivate Hospitals Organ based hospitalsOrgan based hospitals
Cardio ThoracicCardio Thoracic
Eye Hospital (Private)Eye Hospital (Private)
cancer, leprosarium, cancer, leprosarium, psychiatrypsychiatry
Health Clinic Health Clinic /Community /Community ClinicClinic
Specialist Hospital Specialist Hospital 350-550 beds 350-550 beds
- Specialist Hospital - Specialist Hospital 550-750 beds (State 550-750 beds (State /Regional)/Regional)
nursing homesnursing homes
Private GPsPrivate GPs
Infectious Infectious DiseaseDisease
Infectious Disease Infectious Disease (CID)(CID)
Support FacilitiesSupport Facilities
cerebral palsy centrescerebral palsy centres
public health/ public health/ school /dentalschool /dental
Private Maternity Private Maternity HomesHomes
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Government / Public Sector 75-80%Private Sector
20-25 %
Min. of EducationMin. of Education
Min. of Home Affairs
Min. of Home Affairs
Dept. of AboriginesDept. of Aborigines
Armed ForcesArmed Forces
Min. of HealthMin. of Health
FEDERAL GOVERNMENT
Public health/medicineDisease ControlLaw Enforcement
FEDERAL GOVERNMENT
Public health/medicineDisease ControlLaw Enforcement
STATE/ LOCAL GOVERNMENTEnvironmental Sanitation,Housing Standards,Implementation,Law enforcement
STATE/ LOCAL GOVERNMENTEnvironmental Sanitation,Housing Standards,Implementation,Law enforcement
PRIVATE HEALTH CARE FACILITIES
PRIVATE HEALTH CARE FACILITIES
Source: Ministry of Health Malaysia
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IntroductionIntroduction
On the On the macro levelmacro level, the paper relate on , the paper relate on the the national referral systemnational referral system then, in place then, in place and in the process of planning; and in the process of planning;
On On micro aspectmicro aspect, the design development , the design development of these hospitals were discussed on the of these hospitals were discussed on the rationale of its development as outcome of rationale of its development as outcome of the country’s health trend.the country’s health trend.
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Malaysian Healthcare Referral SystemMalaysian Healthcare Referral System
State/General Hospital
State/General Hospital
National Referral Hospital
National Referral Hospital
Large District Hospital
Large District Hospital
Medium District Hospital
Medium District Hospital
Small District Hospital
Small District Hospital
Health ClinicHealth Clinic
Community Health Clinic/ Rural Health Clinic
Community Health Clinic/ Rural Health Clinic
Just over 1000 beds
Not more than 1000 beds
500-750 beds
300-500 beds
150-300 beds26-150 beds
With and withoutAlternative Birthing Centre
SE
CO
ND
AR
Y
CA
RE
TE
RT
IAR
Y
CA
RE
PR
IMA
RY
CA
RE
No
rmal
re
ferr
al
Em
erg
en
cy r
efe
rra
l
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Bed NumbersBed Numbers
0
10000
20000
30000
40000
50000
60000
1995 1997 2006
Total beds
Private
PublicAcutePublicSpecialNon MoHgovt
1995 1990 1995 2006
Acute Bed: 1000 population
1.37 1.30 1.18 1.16
Bed to Pop ratio 1:482 1:531 1:477 1.887
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post independent period1957-1970sColonial
Period 1700-1957
Pre Colonial Period
Mid 1970s-1990s
Simple structuresTropicalArchitecture
Non StandardSingle, low rise sprawling structures in Estates/ Plantations
medium rise donation based hospitals in capital cities for the poor
Simple structuresTropicalArchitecture
Non StandardSingle, low rise sprawling structures in Estates/ Plantations
medium rise donation based hospitals in capital cities for the poor
• New Hospitals (Maternity/ Chinese)• GPs (Clinics)• Support Services• Nursing Homes
Integrated within commercialCentres for GPs,Nursing homes with the suburbs
• New Hospitals (Maternity/ Chinese)• GPs (Clinics)• Support Services• Nursing Homes
Integrated within commercialCentres for GPs,Nursing homes with the suburbs
Architecture
Customised design forhospitals
• More GPs Clinics•Pharmacies•Laboratory Services•X ray services•Teaching (Medical/Nursing schools)
Customised design forhospitals
• More GPs Clinics•Pharmacies•Laboratory Services•X ray services•Teaching (Medical/Nursing schools)
Homebased
PRIVATE HEALTHCARE ( URBAN BASED)
1957
Medical TourismAfter careHospices
Private Healthcare Facilities and Services Act 1998
Shops change to hospital
Purpose built hospitalShop lots to clinic and maternity homes
5yrs x 1,2,3,4,5,6,7,8,9.. Malaysia Plans 50yrs5yrs x 1,2,3,4,5,6,7,8,9.. Malaysia Plans 50yrs
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Healthcare Facility Healthcare Facility “…“….means any premises in which one .means any premises in which one
or more members of the public or more members of the public receive healthcare services..”receive healthcare services..”
Part 1, Preliminary, Section 2. Interpretation,Private Healthcare Facilities and Services Act 1998
Proposed HUKM teaching blockDamansara Arkitek
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What is Government What is Government Healthcare FacilityHealthcare Facility
…” …” GHF Means any facility used or GHF Means any facility used or intended to be used for the provision intended to be used for the provision of healthcare services established, of healthcare services established, maintained, operated or provide by maintained, operated or provide by the Government but excludes the Government but excludes privatised or corporatised privatised or corporatised Government healthcare facilities;” Government healthcare facilities;”
Part 1, Preliminary, Section 2. InterpretationPrivate Healthcare Facilities and Services Act 1998
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Private Sectors in the IndustryPrivate Sectors in the Industry
Island Hospital, Penang
Miriam Hospital,Penang
Upgrading and expansion
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Private Sectors in the IndustryPrivate Sectors in the Industry
Mahkota Medical Centre, Melaka
Damansara Specialist Centre
Tower and podium, atrium/lobby, cafeteria, shops,Services Outpatient (general and Ssecialist) and Inpatient
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Early post independent period1957-1970s
Colonial Period 1700-1957
Pre Colonial Period
Upgrading works1970s-1990s
Paperless HospitalsMasterplansTelemedicine late 90s-early 2000s
Simple structuresTropicalArchitecture
Non StandardSingle, low rise sprawling structures in small towns and
medium rise in capital cities
Simple structuresTropicalArchitecture
Non StandardSingle, low rise sprawling structures in small towns and
medium rise in capital cities
Standard Architecture Design for Nation Building
•Hospitals•Clinics•Support Services•Staff residence•Medical & Nurisng schools
Single, low rise sprawling structures in small towns
Standard Architecture Design for Nation Building
•Hospitals•Clinics•Support Services•Staff residence•Medical & Nurisng schools
Single, low rise sprawling structures in small towns
Greening Healing environmentup-grading, customised design building2007-to date
Architecture
New Standard Architecture Design for Nation Building
•District Hospitals•Clinics•Support Services•Staff residence•Teaching facilities
New Standard Architecture Design for Nation Building
•District Hospitals•Clinics•Support Services•Staff residence•Teaching facilities
Customised Architecture Design for Nation Building
Customised Architecture Design for Nation Building
High-rise, High-tech, art décor, post modern, retro, urban based, smaller land lots for Bigger Hospitals
homebased
PUBLIC HEALTHCARE NATION WIDE
1957 5yrs x 1,2,3,4,5,6,7,8,9.. Malaysia Plans 50yrs5yrs x 1,2,3,4,5,6,7,8,9.. Malaysia Plans 50yrs
Conventional Procurement
Package Deal Procurement
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Facility Planning NormsFacility Planning Norms
State Hospital at every StateState Hospital at every State Regional HospitalRegional Hospital Hospital for every districtHospital for every district Network of facilities for sub-specialtiesNetwork of facilities for sub-specialties
Community ClinicFor 2,000 to 4,000 population.
Rural Health Clinic
For 15-20,000 population
Health Centre
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General GuideGeneral Guide Base on the principles of total planning Base on the principles of total planning
& development, the general guide to & development, the general guide to planning healthcare facilities are as planning healthcare facilities are as follows:follows:
Site planningSite planning Minimum area or acreage Minimum area or acreage Component of healthcare Component of healthcare
facilitiesfacilities Support facilities Support facilities
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Site PlanningSite Planningi)i) Healthcare facilities should be provided Healthcare facilities should be provided
complete according to its hierarchycomplete according to its hierarchy:: a) a) HospitalHospital-includes general -includes general
hospital, district hospital, with hospital, district hospital, with oror without specialists. without specialists.
These are provided at state These are provided at state and district level.and district level.
b) b) Health CHealth Clinicslinics are provided are provided at at local level, andlocal level, and c) c) Rural Health ClinicRural Health Clinic is provided is provided at the rural areas. at the rural areas.
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Site PlanningSite Planningii) The planning on the type of healthcare ii) The planning on the type of healthcare
facilities must be according to the region and facilities must be according to the region and the catchment area as shown in the the catchment area as shown in the Table ATable A;;
iii) The location of healthcare facilities should be iii) The location of healthcare facilities should be suitable and appropriate in terms of its suitable and appropriate in terms of its accessibility, quality of the environment, and accessibility, quality of the environment, and safe for the community; safe for the community;
iv) The healthcare site should be access by the iv) The healthcare site should be access by the network of roads and near to the public network of roads and near to the public transportation system;transportation system;
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Site PlanningSite Planning
NoNo TypeType PopPop AreaArea
Hectare/acresHectare/acres
11 Rural Health ClinicRural Health Clinic 4000-50004000-5000 0.2/0.5 0.2/0.5
22 Health Centres Type I,II Health Centres Type I,II and IIIand III
15,000-20,00015,000-20,000 2.0/5.02.0/5.0
33 HospitalHospital 2 bed/10002 bed/1000
750 beds750 beds 375,000375,000 30.0/75.030.0/75.0
250 beds250 beds 375,000375,000 18.0/45.018.0/45.0
100 beds100 beds 50,00050,000 12.0/30.012.0/30.0
76 beds76 beds 38,00038,000 12.0/30.012.0/30.0
44 Dental ClinicDental Clinic At all Health CentresAt all Health Centres --
55 With TelemedicineWith Telemedicine According to According to requirementsrequirements
--
66 Referral HospitalReferral Hospital According to According to requirementsrequirements
--
TABLE A
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Site planningSite planning
v) v) The location of a hospital need The location of a hospital need not not necessarily be in the town centrenecessarily be in the town centre to to avoid traffic congestion; but accessibleavoid traffic congestion; but accessible
vi) The location of hospital is not suitable vi) The location of hospital is not suitable at noisy and polluted areas; at noisy and polluted areas;
vii) The site planning of healthcare vii) The site planning of healthcare facilities must be in accordance to the facilities must be in accordance to the proposed and development strategy in proposed and development strategy in the local plan as well as approved by the local plan as well as approved by the state authority.the state authority.
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Site Sizing and AcreageSite Sizing and Acreagei)i) The minimum size varies according to the The minimum size varies according to the
hierarchy of the facilities as shown in the hierarchy of the facilities as shown in the Table A;Table A;
ii)ii) The lot size should be able to The lot size should be able to accommodate the main building, the car accommodate the main building, the car park, the landscape, the support facilities park, the landscape, the support facilities as well as the probable expansion;as well as the probable expansion;
iii)iii) The acreage for healthcare facilities should The acreage for healthcare facilities should be adequate as to include planned activities be adequate as to include planned activities and the required components as per and the required components as per prescribed in accordance to its hierarchy. prescribed in accordance to its hierarchy.
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Layout Plan and DesignLayout Plan and Design
i)i) The design of healthcare facilities The design of healthcare facilities should be a functional design to serve should be a functional design to serve as the health centres for all as the health centres for all communities; the building should communities; the building should reflect friendliness;reflect friendliness;
ii)ii) The design should take note the The design should take note the function and adjacency of the various function and adjacency of the various work area or departments base on work area or departments base on the workflow of patients and medical the workflow of patients and medical procedures so as not to obstruct; procedures so as not to obstruct;
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Layout Plan and DesignLayout Plan and Designiii) iii) The The designdesign should consider the requirements should consider the requirements
of emergency treatment by providing of emergency treatment by providing emergency access for vehicles in cases of emergency access for vehicles in cases of emergencies; emergencies;
iv) Healthcare facilities design should consider iv) Healthcare facilities design should consider the local culture that is clean, organised and the local culture that is clean, organised and beautiful whilst establishing a community park;beautiful whilst establishing a community park;
v) The circulation for the facilities should be v) The circulation for the facilities should be clearly organised and without obstruction with clearly organised and without obstruction with provision for safe pedestrian crossing, the provision for safe pedestrian crossing, the disable, the elderly and children;disable, the elderly and children;
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