Introduction to hospital design

Types of hospitals

According to speciality
General: (which is set up to deal with many kinds of disease and inj
normally has an emergency department to deal with immediate and
threats to health)
Specialized: (hospitals for dealing with specific medical needs such
psychiatric problems, certain disease categories such as cardiac, on
or orthopaedic problems)
Teaching: (combines assistance to patients with teaching to medica
and nurses and often linked to a medical school, nursing school or
According to size
Small (50 beds)
Medium (50-150 beds)
Large (150-600 beds)
Central (>600 beds)
 Introduction to hospital design
According to health care level
Primary care hospitals: (health care that is provided at a basic level w
an initial approach to a doctor)
Secondary care hospitals: (service which is provided by medical speci
usually provided by cardiologists, urologists and dermatologists)
Tertiary care hospitals: (specialized consultative health care, usually
inpatients)

According to ownership
Government
Private

District hospitals
A district hospital typically is the major health care facility in its regi
numbers of beds for intensive care and long-term care.
 Introduction to hospital design

Overview

Initially, Hospitals are the most complex of building types. Each

hospital is
comprised a wide range of services and functional units.These
include diagnostic
and treatment functions, such as clinical
laboratories,imaging,emergency rooms,
and surgery hospitality functions, such as food service and
housekeeping, and the fundamental inpatient care or bed-related
function.

Hospital design discipline is extremely important in founding and

building hospitals,
Hospitals must have specific attributes matching the international
 Introduction to hospital design

Efficienc
y

Accessibil
ity
Hospital Flexibilit
y
Basic
sections
Interior
Cleanline Design
ss Aestheti
cs
 Introduction to hospital design

Efficiency
 Minimizing distance of necessary travel between frequently used space
 Allow easy visual supervision of patients by limited staff.
 Provide sufficient no. of elevators, staircases etc.
 Include all needed spaces and sharing services, but no redundant ones
 Provide optimal, functional adjacencies, such as locating the surgical i
unit adjacent to the operating suite
Flexibility
 Follow modular concepts of space planning and layout as possible.
 Served by modular, easily accessed,and easily modified mechanical and
systems
 Open-ended design, with well-planned directions for future expansion;
positioning “soft spaces” such as administrative departments, adjacent
spaces” such as clinical laboratories.
 Introduction to hospital design
Interior Design Aesthetics
 Every effort should be made to make the hospital stay as unthreatening,
comfortable and stress-free as possible.
 Usage of artwork.
 Using cheerful and varied colors for interior finishes and used linens.
 Provide views of the outdoors from every patient bed and elsewhere wherev

Cleanliness and easy maintaining

 Proper, durable finishes for each functional space.
 Careful detailing of such features as doorframes, casework and transitions t
dirt-catching and hard to clean crevices and joints.
 Adequate and appropriately located housekeeping services.

Accessibility
 All areas inside and outside the hospital should be designed to be easy to u
kind of patients with temporary or permanent handicaps.
 Ensuring grades are flat enough to allow easy movement and sidewalks and
corridors are wide enough for two wheelchairs or stretchers to pass easily.
 Main entrance
 Main entrance should be clearly visible, identifiable and easily
accessible, preferably with a covered setting-down point from cars.

Reception:
 The reception area should be visible from the main
entrance.
 Allow 1.5m counter length for each receptionist,
and space in front of the counter for patients to stand
without encroaching on circulation routes.
 Counter design should be open but providing some
protection for the staff.
 Provision for people with disabilities should be
incorporated.

Record Storage:
 Needs to be close to the reception area, but ideally
not part of it.
 Records should be out of sight of patients and secure.
 GP records will be kept centrally near reception.
 Space required needs to be calculated for the selected storage system
(lateral shelving, filling cabinets, carousels)
 Waiting Area
 Waiting area should be visible from reception area
 6 seats should be allowed for each consulting and treatment
room (1.4 square metre for each)
 This can be reduced for large premises, particularly
when appointment systems are operated.
 Arrangements can be made to screen off part of large
area to provide space for other activities at times
when it is not all required for waiting
 Patients should not wait in corridors nor outside
consulting or treatment room doors.
 Pram storage and WCs need to be near the reception
and waiting area.
 Part of the waiting area can be designed and
furnished for children.
 Some seating suitable for the elderly should be
provided.
 Emergency Department
 The primary role of emergency department is to deal with serious
casualties and accidents so it should be located on ground floor
 Separate emergency entrance with minimum vehicle headroom 3.5m.
 Clear signposting to the drive-in entrance is important
 There should be a separate approach, other than the OPD with a spacious
parking area for cars and cycles.
 It should be located just adjacent to the OPD so the sources can be pooled
in case of major disaster.

Functional spaces in ER Space requirements:

Triage room
Reception area = 150-250
Examination room
SQFT
Treatment room
Resuscitation room(CPR) Examination area = 100 SQFT
Plaster room
Resuscitation room = 400
Surgical dressing room
SQFT
Observation room(short stay room)
Supporting spaces X-RAY = 80SQ FT
Laboratory = 200SQFT
Minor OT = 350SQFT
Recovery room = 70
Emergency Department
 Emergency Department
Public Sector Areas
• Entrance for patients arriving by ambulance , other modes of
transportation, or conveyances
• Entrance for walk-in patients
• Control station
• Public waiting space with appropriate public amenities

Treatment Facilities
• Patients' observation room
• Treatment cubicles
• Examination rooms
• Cast room
• Critical care rooms
 Emergency Department
 The entry to the emergency should
be shielded from the main hospital
entrance preventing general patients
from being a witness to ghastly
sights or to tattered limbs
 In planning the Emergency Activity,
particular attention must be paid to
movements of people (patients and
staff) and material (equipment and
supplies)
 Supportive services such as laboratory,
diagnostic x-ray, electrocardiographic
and pulmonary function facilities will
be
located at the boundary between the
Emergency and Outpatient Activities,
assuring easy access to both .
 The door to the room and to its
toilet must open outward to prevent
the patient from locking himself
 Emergency Department
Treatment cubicles have curtains for privacy, if necessary, and are equipped
to handle examinations and minor treatments . More severe injuries are
treated in critical care rooms which are of two sizes.
For a coronary patient, the emergency team may consist of a number of
specialists using numerous kinds of portable equipment: therefore, larger
space is required to accommodate both .
The cast room, used for closed reduction of fractures, is equipped similarly
to a treatment cubicle with the addition of a plaster sink and trap.
A blood bank should be accessible by the shortest route within the
emergency .
In particular there should be direct access – by separate entrance if
necessary – the x-ray department for speedy diagnosis. Alternatively
separate x-ray facilities can be provided.
Because of the urgent nature of high proportion of accident cases ,the
relationship with supporting department is crucial .
The door must allow passage of a patient on a stretcher who, after
treatment, may be immobilized by means of orthopedic accessories and
attachments to the stretcher . We have already mentioned that out-
patients should have access to the OPD directly through the Main
Entrance
 INTER-
DEPARTMENTAL
RELATIONSHIP
SCHEME

INTERNAL BASIC
LAYOUT
FOR EMERGENCY
PURPOSE: Patients who do not need overnight
hospitalization are admitted in the Outpatient
Department. Surgical, dental and nursing care is
provided to patients in Outpatient Department

ACCESS REQUIREMENTS: PEDESTRIAN AND

AMBULANCE ACCESS
LOCATION: MAIN RECEPTION AND WAITING
AREA USUALLY GROUND FLOOR BUT MAY BE
ON THE OTHER LEVELS.
RELATIONSHIP: FRACTURE CLINIC TO
ACCIDENT DEPARTMENT, CONVENIENT
ACCESS TO PHARMACY, GOOD ACCESS TO
MEDICAL RECORDS DEPTT. OFTEN ADJACENT.
 RELATIONSHIP
DIAGRAM
TO
I.C.U/O.T.

WALKING EMERGENC
MAIN RECEPTIO
CASUALITIES Y
ENTRANCE TO N AND
ENTRANCE
HOSPITAL WAITING
EYE TREATMENT
AREA:25M SQ
AREA REQUIREMENTS: TREATMENT
CHAIR,EXAMINATION AND DIAGNOSTIC
INSTRUMENTS, AN EXAMINATION COUCH,A WASH
BASIN AND A WRITING DESK.
DENTAL TREATMENT
PURPOSE:TEETH ,GUMS ETC. TREATMENT
AREA:25-30 M SQ
AREA REQUIREMENTS:A TREATMENT CHAIR WITH DENTAL
UNIT
A DESK, A WASH BASIN, X-RAY, ANAESTHETIC
EQUIPMENT, A SINK ACLOVE WITH STERLIZER
UROLOGICAL TREATMENT
PURPOSE: X-RAY DIAGNOSIS OF KIDNEYS AND
UTERUS
AREA: 25-30M SQ
PREFERENCE: CLOSE TO SURGICAL DEPTT.
AREA REQUIREMENTS: EXAMINATION AND
TREATMENT TABLE EQUIPPED WITH WASH
BASIN,SUSPENDED IRRIGATOR,FLOOR
DRAINAGE,TWO CHANGING CUBICLES AND
W.C.,INSTRUMENT ROOM(15 M SQ)
  SURGICAL DEPARTMENT
 FUNCTION AND LAYOUT
• SHOULD BE CLOSE TO THE INTENSIVE CARE DEPARTMENT , THE RECOVERY
ROOM AND THE CENTRAL STERILISATIONAREA
BECAUSE OF EXTENSIVE INTERACTION BETWEEN THESE DEPARTMENTS .
LOCATION
• BEST LOCATED CENTRALLY IN THE CORE AREA OF HOSPITAL WHERE THEY
ARE EASY TO REACH .
•THE RECEPTION AREA FOR EMERGENCY CASES MUST BE AS CLOSE AS
POSSIBLE TO THE SURGICAL AREA SINCE SUCH PATIENTS OFTEN NEED TO BE
MOVED INTO SURGERY IMMEDIATELY.

ORGANISATION OF THE SURGERY DEPARTMENT

• EVERY SURGICAL DEPARTMENT REQUIRES THE FOLLOWING
ROOMS:
I. OPERATING THEATRE 40-
48MSQ
II. ENTRY ROOM 15-
20MSQ
III. EXIT ROOM 15-
20MSQ
 Diagram illustrating the relationships between an
operating theatre and other hospital services.
  MAIN SURGICAL
ROOMS
• A SUITABLE SIZE WOULD BE 6.50X6.50M,
• A CLEAR HEIGHT OF 3M AND AN EXTRA
HEIGHT ALLOWANCE OF ROUGHLY 0.70M
FOR AIR CONDITIONING AND OTHER
SERVICES .
• OPERATING THEATRE SHOULD BE DESIGNED
AS SQUARE AS POSSIBLE TO ALLOW WORKING
•OFOTWHATEVER DIRECTION
SHOULD BE THE TO
CONNECTED TABLE IS
ANESTHETIC
TURNED
ROOM IN.
,DISHARGE ROOM, A WASH ROOM, STERILE
ROOMS VIA ELECTRICAL SLIDING DOOR OPERATED
BY FOOT FOR HYGIENE PURPOSE.
ANAESTHETICS ROOM
• ROOM SHOULD BE APPROXIMATELY 3.80X3.80M IN SIZE.
•THE ROOM SHOULD BE EQUIPPED WITH A REFRIGERATOR, DRAINING SINK,
RINSING LINE,
CONNECTIONS FOR ANAESTHESIA EQUIPMENT AND EMERGENCY POWER.
WASHROOM
• MINIMUM WIDTH OF ROOM BE 1.80 M.
• FOR EACH OPERATING THEATRE THERE SHOULD BE THREE WASHBASINS
WITH FOOT CONTROL.
  STERILE GOODS ROOM
•THE SIZE OF THIS ROOM IS MORE FLEXIBLE BUT THERE MUST BE
SUFFICIENT SHELF AND CUPBOARD SPACE AND IT MUST BE ACCESSED
DIRECTLY FROM THE OPERATION THEATRE .
• ONE ROOM OF ROUGHLY 10MSQ IS REQUIRED PER OPERATION
THEATRE.
• A ROOM SIZE OF 20MSQ IS REQUIRED FOR EQIPMENT ROOM
SUBSTERILISATION ROOM
•IT CONTAINS A NON CLEAN AREA FOR NON STERILE MATERIAL AND A
CLEAN AREA FOR PREPARED STERILE ITEMS.
•IT CONTAINS A SINK, STORAGE SURFACE , WORK SURFACE AND STEAM
AUXILIARY FUNCTIONS
STERILISERS.
•THE ROOMS FOR AUXILIARY FUNCTIONS DO NOT NEED TO BE IN THE
IMMEDIATE AREA OF THE OPERATING THEATRE,NURSES LOUNGE .
•THE DIMENSION OF THIS ROOM DEPENDS ON THE SIZE OF THE
SURGICAL DEPARTMENT.
• IT SHOULD BE ASSUMED THERE ARE EIGHT MEMBERS OF STAFF PER
SURGICAL TEAM(DOCTORS,THEATRE NURSES, ANAESTHESIA NURSES)
THE LOUNGE MUST OFFER SUFFICIENT SEATING ,CUPBOARDS,AND A
SINK.
 NURSES WORKSTATIONS
• THESE SHOULD BE LOCATED CENTRALLY AND SHOULD HAVE
VISUAL CONNECTION WITH THE WORKING CORRIDOR.

PHARMACY
A 20MSQ PHARMACY CAN SUPPLY A COMBINATION OF ANAESTHETICS
AND SURGICAL MEDICATION AND OTHER MATERIALS.

CLEANING ROOM
A SIZE OF 5MSQ IS SUFFICIENT FOR CLEANING ROOMS . THEY SHOULD
BE CLOSE TO THE OPERATING THEATRE SINCE CLEANING AND
DISINFECTION ARE CARRIED OUT AFTER EACH OPERATION.

LIGHTING
•LIGHTING IN OPERATION THEATRE
SHOULD BE ADJUSTABLE TO
PROVIDE LIGHT AT DIFFERENT
ANGLES.
•MOST FREQUENT LIGHTING
SYSTEM IS MOBILE CEILING
PENDANT OPERATING LIGHTS.
•EGG SHAPED OPERATING THEATRE
TYPICAL LAYOUT OF SURGICAL DEPARTMENT
INTENSIVE CARE AREA
ARRANGEMENT
•THE INTENSIVE CARE DEPARTMENT
MUST BE A SEPARATE AREA ,AND ONLY
ACCESSIBLE THROUGH LOBBIES .
• THE CENTRAL POINT OF AN
INTENSIVE CARE UNIT MUST BE AN
OPEN NURSES WORKSTATION FROM
WHICH IT IS POSSIBLE TO OVERSEE
•EVERY
NO. OFROOM .
PATIENT S PER UNIT SHOULD BE
BETWEEN SIX TO EIGHT TO AVOID
OVERLOADING.
ARRANGEMENT OF BEDS
•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 .
•WITH A CLOSED ARRANGEMENT THE
PATIENTS ARE ACCOMMODATED IN SEPARATE
ROOM WHICH MUST BE IN SIGHT OF A
CENTRAL NURSE STATION.
AUXILIARY FUNCTIONS

• FOLLOWING AREAS SHOULD ALSO BE PLANNED

IN
1. MINOR OPERATING THEATRE(25-30m SQ)
2. LAB SPACES
3. KITCHENETTE
4. STERILISATION(20 Msq)
5. DUTY DOCTOR’S ROOM
6. SANITARY FACILITIES
  CARE AREAS
 FUNCTION AND
STURUCTURE
•THE INDIVIDUAL CARE AREAS IN A HOSPITAL ARE ATTACHED TO THE
SPECIFIC MEDICAL FACULTIES(SURGERY, MEDICAL, ACCIDENT, AND
EMERGENCY ETC)AND THEREFORE NEED TO BE PLANNED AS SEPARATE
UNITS .
• THEY CATER THE PATIENTS WHO STAY IN HOSPITAL FOR OBSERVATION
AND RECOVERY.
• MEDICAL ROOMS AND WASHROOMS SHOULD BE ACCESSED FORM THE
 LAYOUT
MAIN STATION OF ROOM
CORRIDOR WHICH IS EASILY SUPERVISED FROM NURSE
WORKSTATION TO PREVENT UNAUTHORISED ENTRY.
 SIZE OF THE PATIENT ROOMS
•PATIENT’S BED MUST BE
ACCESSIBLE FROOM
THREE SIDES.
•SIZE OF SINGLE BED-
ROOM =10M SQ

•FOR TWO OR THREE BED ROOMS MIN

OF 8M SQ AREA PER BED SHOULD BE
ALLOWED.

3910

Double room ,must be wider to allow

beds to pass.
SIX BED ROOM
PATIENT
BATHROOM
• AREA OF ABOUT 5.5 M SQ
SHOULD BE ALLOCATED TO
BATHROOMS.
WET CELLS
• NO. OF SHOWERS OR
BATHS AND WCS ARE KEPT
TOGETHER KNOWN AS WET LAYOUT PLAN AND
CELLS. ELEVATION OF BATHROOM
CLEAN WORKROOM
•AREA APPROX. 10 M SQ.
•EQUIPPED WITH FIXED SHELVES 600
MM DEEP.
•USED FOR STORAGE.

NON-CLEAN WORKROOM
•AREA APPROX. 10 M SQ
•FOR HANDELLING SOILED
MATERIALS
•CONTAINS SINK AND SLUICE,MADE
OF STAINLESS STEEL.
 NURSING TEAM

• EACH STATION IS SERVED BY

INDEPENDENT NURSING TEAM . AS THE
NURSES WORKSTATION HAS TO BE
CONSTANTLY OCCUPIED ,IT IS TO BE
LINKED TO NURSES KITCHENETTE AND
REST ROOM.
• SHOULD BE SITUATED IN A CENTRAL
POSITION.
• REQUIRES AREA OF 25-30M SQ.

STAFF REST ROOM

/KITCHENETTE
ROUGHLY 15M SQ AREA SHOULD BE
ALLOCAED FOR STAAFF BREAKTIME.
STATION DOCTOR

•PROVIDED WITH A 16-20 M SQ

ROOM
•INCLUDES DESK,SHELVES,AN
EXAMINATION COUCH.
 CENTRAL NURSE
SINGLE STATION
ROOM
BATHROOMS

SIX BEDROOM

SIX BEDROOM
SINGLE BEDROOM

LAYOUT PLAN OF WARDS

  TREATMENT AREAS
TREATMENT AREAS INCLUDE :
•RADIOLOGY
•RADIOTHEARPY
•INTERNAL MEDICINE TREATMENT AREA

•RADIOLOGY
INCLUDES :
I. XRAY ROOM +ADMISSION ROOM(25-30 MSQ
AREA)
II. SONOGRAPHY (12-18 M SQ)
III. MAMMOGRAPHY (12-18 M SQ)
IV. CT SCAN ROOM VC (35 M SQ)
V. ANGIOGRAPHY ROOM
VI. CHANGING ROOM
VII. WCs (FOR STOMACH INSPECTION)
VIII.ULTRA SOUND ROOM
RADIOLO
GY
•RADIOTHERAPY

FUNCTION:
CONDITIONS DIGNOSED IN RADIO THERAPY DPT. ARE TREATED HERE
INCLUDES:
1. RECEPTION +WAITING AREA
2. DOCTORS ROOM (18 SQ M )
3. LOCALISATION ROOM (25 SQ M )
4. SERVICE ROOM
5. FILM DEVELOPING ROOM (10 SQ M)
6. STORE
7. TREATMENT ROOM(CHANGING ROOM) (15 SQ M)
8. LAB (15-18 SQ M )

•INTERNAL MEDICINE TREATMENT

AREA
COMPRISES OF:
1. EXAMINATION ROOM(25M.SQ)
2. SECRETARIAL/ADMN OFFICE 20 M SQ
3. SENIOR PHYSICIAN ROOM (15 M SQ)
4. CHEIF PHYSICIAN ROOM (20 M SQ)
5. STAFF STAND BYROOM
LABORATORY DEPTT.
PURPOSE : The lab deptt. is concerned mostly with the
preparation and processing of blood urine and faecal
samples.

LOCATION: Often separated from treatment and nursing

areas.
AREA REQUIREMENTS :Lab itself is a Large room with
built-in work places to offer a high level of flexibility.
PURPOSE: X-RAY OF THE
PATIENTS
LOCATION:USUALLY
GROUND FLOOR
AREA REQUIREMENTS:
WAITING AREA,
EXAMINATION
ROOM,DARK ROOM
RELATIONSHIP: ACCIDENT
DEPARTMENT ,
FRACTURE CLINIC
DESIGN REQUIREMENT :Flexibility in the design essential to
accommodate wide range of techniques and equipments.
RELATIONSHIP:A direct connection with the laboratory department is
beneficial.
A data link to the radiology , radiotherapy and surgical departments
is necessary to allow combined monitoring.
SERVICES
SUPPLY
AND
DISPOSA
L ROUTE
 SERVICE YARD
PURPOSE: SUPPLY AND
DISPOSAL OF HOSPITAL
GOODS,EMERGENCY
ELECTRICAL GENERATORS,
SPRINKLER CONTROL
ROOM, OXYGEN
DISTRIBUTION SYSTEM.
LOCATION: BASEMENT
ACCESS:ACCESSIBLE VIA
RAMP WITH A SLOPE OF 15
DEGREE.
 BIO MEDICAL WASTE
DISPOSAL
Chutes should be provided in every department
for the disposal. Incinerators should also be
provided for the burning up of the waste.
STERLIZATION
•Surgical deptt and sterlisation unit should be
situated close together.
• the central store for drugs and instruments must
be closely linked to the central sterlisation unit.

DISPENSARY
•Consists of a work and dispensing room(25 m
sq) which is directly accessed from the main
circulation corridor.
• fitted out with the desk , washing facility,
sink , weighing station and lockable
cupboards.
•Adjoining are a dry store and medicine store
(15 m sq) , a cold store (10m sq) for
hazardous substances and a dressing
 Parking

Parking can be provided in 3 ways

 Short term parking: should be such placed that they
can be used by visitors. Can be provided on the ground
floor.

 Long term parking: provided for people working in

offices and , can be provided in the basement or on the
roof top.

 Service core parking: provided for service traffic.

Should be provided on the backside of the building for
easy loading & unloading of goods.
 Parking

FIG.17: PARKING ARRANGEMENT AND THE SPACES REQUIRED

(SOURCE: TIME SAVERS STANDARD)
 Parking

Turning radius - Dimension of vehicle

Inner radius Car 5.0m x 2.5m
3.5m Two wheeler 2.5m x
Outer radius 0.5m
5.0m
 Parking
Width of aisle –24‟ for 90˚parking
13‟ for 45˚ parking

FIG.21: POSSIBLE CAR PARKING ARRANGEMENTS

(SOURCE : NEUFERT)
 Parking

FIG.22: PARKING PARALLEL TO THE FIG.23: 30° OBLIQUE SPACES

ROAD (SOURCE : NEUFERT)
(SOURCE : NEUFERT)
 Parking
•Ramp Slopes
The maximum ramp slope should be
20 percent.
For slopes over 10 percent , a
transition at least 8 ft long should be
provided at each end of the ramp at
one half the slope of the ramp itself .

Radii for one-way straight ramps,

minimum width is 12 ft(3 .66m);
for
two-way straight ramps, where
opposing traffic flows are not
separated, 22 ft (6 .71 m) is the
recommended minimum width.
Where a barrier is used between lanes
to separate traffic flows, each lane
should be at least 12 ft (3 .66 m) wide
for tangent lengths.
 Circulation area
Pedestrian areas :
•Pedestrian space serves two functions :
1. Movement & circulation
2. Relaxation areas.
•They must be busy & colorful, exciting & stimulating, must make
walking enjoyable.
•Trees, fountains, sculptures, murals, as well as architecture of
free standing structures are a vital part of the overall scheme

Ramps :
•A ramp when provided shall not have a slope greater than
1 : 12. Larger slopes shall be provided for special uses but
in no case greater than 1 : 8.
•Minimum clear width shall be 36” (3 feet). in the basement
using car parking shall be 6.0 mt.
• Handrails shall be provided on both sides of the ramp.
Ramps shall have level landings at bottom and top of each
ramp and each ramp run.
 Circulation area
Corridors:
 Must be designed for the maximum expected circulation flow.
 Generally, access corridors must be at least 1.50m wide.
 Corridors in which patients will be transported on trolleys should have a
minimum effective width of 2.25m.
 Suspended ceiling in corridors may be installed up to 2.40m.
 The effective width of the corridors must not be constricted by
projections, columns or other building elements.
 Circulation area
 If ramps change direction at landings, the mini-mum landing
size shall be60 inches by 60 inches . A ramp shall have a non-
slip surface.

 Each ramp shall have at least 180 cm of straight clearance at

the bottom

FIG.26: RAMP FIG.27: STEPPED RAMP

(SOURCE : NEUFERT) (SOURCE : NEUFERT)
 Circulation area
Stairs:
The minimum width of a staircase other than
a fire escape shall be as follow:

 Business, industrial storage, hazardous

buildings
(a) Low Rise -1.5
(b) High Rise -2.0

 Assembly buildings
Institutional - 2.0
buildings (i.e. hospital)
(a) Upto 10 beds -1.5
(b) Over 10 beds -2.0

 Educational building
(a) Upto 24 m. high -1.5
(b) Over 24 m. high - 2.0
FIG.28: SUPERIMPOSED STAIR
SAVE SPACE
 Residential building
(a) Low rise -1.2 (SOURCE : NEUFERT)
(b) Hotels and High rise -1.5
 Circulation area

 Step heights of 170mm are permissible

 Minimum required tread depth is 280mm.
 It is better to have a rise/tread depth ratio of 150:300mm
 Doors must not constrict the useful width of the landings and in
accordance with hospital regulations, doors to the staircases must open
in the direction of escape.
 Circulation area
Lifts:
•The user entering or exiting the lifts, even those carrying hand baggage
do not get in each other’s way

•Largest loads to be carried by the lift in question for eg: prams, wheel
chairs,etc can be maneuvered in and out without risk of injuring people or
damaging the building and the lift itself

FIG.29:
SHAFT AND
LIFT MOTOR
ROOM
(SOURCE :
NEUFERT)
FIG. 31 : DOORS
(SOURCE : NEUFERT)
 Circulation area
Escalators:
 Installed at an angle of 30 degrees
 Installations are generally 2 speed-with the higher speed
(120 fpm) utilized during rush hours and the lower (90 fpm) at off hours.
 Moving stairways are generally available in widths of 32” and 48”,
measured at hip level between the balustrades.40” can carry 2
persons/tread
 32” has a tread width of 24” and 48” width has 40” tread.
 All treads have a rise of 8” and 16” depth.
32” wide step-5, 000 passengers/hour, with a speed of 90 fpm, and 6,666
passengers/hour with a speed of 120 fpm.
 48” wide step-8, 000 passengers/hr with 90 fpm speed and
10,665 passengers/hr at a speed of 120 fpm.
 Cafeteria
 The first aspect that hospital cafeterias must
address is design.
 Cafeteria should include high windows that
look out upon sunset and other natural scenes.
 Paint in bright, warm colours and avoid using
fluorescent light and install bright but warmly
toned lights.
 Vary the light fixtures, rather than relying on
 standard overheads.

Seating:
 Seats should be arranged to foster intimacy and
to create comfortable, lounge-like feel.
 Place plants or dividing walls between seating areas.
 Design separate sections for hospital employees.
 Prevent crowds from hovering over tables by
placing ordering areas separate from seating sections.
 CASE
STUDY

ESCORTS, FORTIS
AMRITSAR
 ESCORTS FORTIS

 CLIENT: FORTIS HOSPITALS

 ARCHITECT: ARVID GUPTA AND

ASSOCIATES,NEW DELHI

 LOCATION: AT BYPASS ROAD, 1KM

 FROM VERKA CHOWK, AMRITSAR

 COMPLETED: 2003

•SITE IS 135X120M IS AT SET

BACK FROM MAIN ROAD.

•THE BUILDING FACES NORTH The 152 bedded, multispecialty

EAST. hospital has been designed to
house the most advanced medical
technology and equipment.
ATTARI ROAD
1 KM

VERKA
AMRITSAR
BYPASS
CHOWK
N
 OXYGEN
N GAS PLAN

STP

ENTRY

MAIN
PARKING HOSPITALSERVICE
BLOCK BLOCK
 EMERGENCY
PUBLIC
STAFF
N AND
DOCTORS
SERVICES

MATERIAL GATE
ENTRY
• THERE IS COMMON ENTRY TO CASUAL AND EMERGENCY

• SEGRREGATED ENTRY FOR SEVICES AND DOCTORS;STAFF

 THREE MAIN ENTRANCE IN FRONT FOR
EMERGENCY , IPD , OPD.
 REAR ENTRY FOR
 STAFF,KITCHEN SERVICES, TWO FIRE
EXITS.
 AT MACRO LEVEL SITE IS DIVIDED INTO THREE
ZONES:

 1.PARKING
 2.LANDSCAPING
 3.BUILDING BLOCK

 AT MICRO LEVEL:
 MAIN BUILDING BLOCK IS FURTHER ZONED IN:

 EMERGENCY ,IPD, OPD, SERVICE BLOCK.

 THE MAIN SPINAL CHORD OF HOSPITAL
CIRCULATION IS 2.1MTS WIDE CORRIDOR.

VERTICAL CIRCULATION:
•TWO STAIR CASE LOBBIES.
•ONE LIFE FOT IPD VISITORS.
•TWO BED LIFTS
•ONE STAFF LIFTS
•ALL STAIRCASES1.8 MTS WIDE,ENCLOSED IN WALL
PROVIDED WITH FIRE RESISTANT DOORS.
•NO RAMPS
•ONE DUMB WAITER FOR LINEN MOVEMENT B/W CSSD
AND LAUNDRY.
AREA STATEMENT GROUND FLOOR CIRCULATION= 933.47 sqm
DIAGNOSTICS SERVICES= 716.99 sqm
9%
EMERGENCY= 411.12 sqm
CIRCULATION
EMERGENCY
12%
OPDS= 164.5 sqm
26% TOILETS= 82.65 sqm
DIAGNOSTICS= 333 sqm
SERVICES
OTHERS
26%
OTHER= 26% (ABOUT 930 sqm)
20% (ADMIN, KITCHEN,
DINNING, PANTRY, ETC)

TOILETS OPD
2% 5%
 1. WAITING 7. ICU
2.RECEPTION
GROUND 3.CT SCAN
4. OPD
8. HEART STATION
9.DINNING
5.LAUNDARY 10.STAFF DINNING
FLOOR PLAN 6. EMERGENCY 11.UTILITIES
LOBBY 12.SECURITY OFFICE
13.LT ROOM
14. X-RAY
15.RENAL DIAGNOSTIC
13

10 9 8

4
5 7
2 3 14

1 15 1
1 6

N
CIRCULATION
STAFF ENTRY Average Width of Corridor
10m
SERVICE ENTRY

DOCTOR’S ENTRY

OPD ENTRY
EMERGENCY
ENTRY MAIN ENTRY N
Ground Floor Plan
 DOTOR’S ENTRANCE

PATIENT ENTRANCE
PATIENT ENTRANCE
EMERGENCY AREA
OPD
 `
LIFT BLOOD BANK
OTS
DIALYSIS UNIT
CSSD

ICU HEART CARE UNIT

FIRST FLOOR PLAN

N
 COMPONENTS OF FIRST FLOOR

BLOOD BANK

ENTRY STAFF AREA

ICU

NURSING STATION
BEDS

BLOW UP OF DIALYSIS
AREA
RECOVERY CSSD
AREA

OPERATION THEATER

BED LIFTS

CRITICAL AREA
THIRD AND FOURTH FLOOR PLAN
STAFF AREA

WARDS
CORIDORS

TERRACE
LIFT
SERVICES

COLOR CODING:
GREEN: DOMESTIC WATER
RED: FIRE FIGHTING
BLACK: SOIL PIPE
BLUE: AIR CONDITIONING
BIO MEDICAL ROOM:
ALL THE BIO MEDICAL WASTE IS
COLLECTED MANUALLY FROM THE
HOSPITAL IN THIS ROOM.
THE LABORATORIES OF BIO
MEDICAL WASTE HENCE COLLECT
IT FROM HERE.

MANIFOLD ROOM:
10 CYLINDERS PER BANK i.e. LEFT
AND RIGHT BANK.
2 CYLINDERS OF NO2

AIR CONDITIONING:
EACH FLOOR HAVE DIFFERENT
AHU’S.
SEPARATE AHU’S FOR DIFFERENT
STERILIZED ZONES RESTRICTING
CHANCES OF FLOW OF INFECTION.
2 CHILLERS
2 COOLING TOWERS
 WATER STORAGE:
WATER STORAGE
TANKS ARE
PLACED ON THE
TERRACE.
EACH TANK HAS
A CAPACITY OF
10000 LT

COMPRESSED LIQUID
WATER
TREATMENT: OXYGEN:
DOMESTIC CENTRAL SUPPLY
WATER IS THROUGHOUT THE
TREATED HOSPITAL.
CHLORINATION CAPACITY 2000 LTS
REVERSE
OSMOSIS PLANT

STEAM BOILERS:
CENTRAL SUPPLY THROUGHOUT THE
HOSPITAL.
2 STEAM BOILERS
2 HOT WATER GENERATORS
FIRE FIGHTING:
MAIN HYDRANT AND SPRINKLER
PUMP.
TERRACE FIRE PUMP.
AUTOMATIC SPRINKLER SYSTEM.
MANUAL FIRE ENTINGUISHERS.
FIRE HYDRANTS AROUND
BUILDING PERIPHERY.

POWER
GENERATORS:
2 DIESEL
GENSETS
2
TRANSFORMERS
ONE
ATTENDANT
STANDS 24 HRS
FOR ANY
PROBLEM.
VACUUM SYSTEM:
2 NO OF VACUUM PUMP WITH 2000
LT. CAPACITY VACUUM TANK.

COMPRESSION AIR
SYSTEM:
2 NO. 100 CFM

TAILOR: FROM AFTER

AIR RECEIVER
TAILOR ROOM PLACED COMPRESSOR COOLING

BELOW THE STAIRCASE.

WARDS ULTRA
MORTUARY: OTs FILTERS
DRIER UNIT

4 BEDDED WITH PROPER

REFERIGATION
FACILITIES.
LAUNDRY:
STRATEGICALLY PLACED BELOW IPD.
FLOW OF LINEN :
RECEIVING AREA - WASHING AND DRYING – IRONING – CLEAN AREA
– DISPATCH AREA
TROLLEY IS USED FOR TRANSFER OF LINEN THROUGH BED LIFT 1
OT’s BLUE LINEN IS RECEIVED THROUGH DUMBWAITER VIA CSSD,
AND AFTER WASHING IT IS RESENT TO CSSD FOR STERILIZATION.
SEPARATE WASHING MACHINE IS USED FOR NORMAL LINEN AND
OT’s LINEN.

KITCHEN:
TROLLEY IS USED FOR SUPPLYING FOOD
THROUGH BED LIFT 1 VIA DUMBWAITER.

RAW MATERIALS ARE BROUGHT INTO THE

HOSPITAL THROUGH THE MATERIAL GATE
OF AND THEN THROUGH THE SERVICE
ENTRY.
 IT HAS A COLUMN BEAM STRUCTURE.

 MATERIAL USED :
 CORRIDORS : MARBLE UDAIPUR GREEN , JAISLMER YELLOW

 STAIRS : KOTA STONE, GROUND TO SECOND FLOOR –

UDAIPUR GREEN

 MAIN LOBBY : UDAIPUR GREEN , OMANI MALWA

 LIFT FASCIA : MAKRANA WHITE

 O.T : UDAIPUR GREEN , MARBLE WALLS UPTO 4’0” HEIGHT

 FAST AND EASY MOVEMENT OF PATIENT IS ACHIEVED
THROUGH PROPER CORRIDOR WIDTHS AND PROPER
MEANS OF VERTICAL CIRCULATION.

 DIFFERENT VISITOR’S AND PATIENT

 LIFT LOBBY IS APPRECIABLE.

 SERIES OF DOORS USED TO FILTER

 THE FLOW OF MOVEMENT BETWEEN VARIOUS
DEPARTMENTS.

 LACK OF NATURAL LIGHTENING IN CORRIDORS

INCREASES ENERGY DEMANDS OF THE BUILDING.
• SEPARATE CIRCULATION PATTERN ACHIEVED BY DOUBLE LEAF DOORS AT
THE REQUIRED PLACES.

• SEPARATE CIRCULATION CORES FOR IPD AND OPD STAFF.

• INSUFFICIENT SPACE AND CENTRALIZED

SUB WAITING AREA IN OPD CREATING
MORE CHAOS AND NUISANCE.

• ADEQUATE AND SPACIOUS WAITING

SPACE IN IPD SECTION IS WELCOMING.

• PASS SYSTEM TO CONTROL TRAFFIC OF VISITORS.

• EMERGENCY LACKS MINOR OT.

 SIMPLE FACADE WITH CUBICAL FORM OF
OUTLOOK.
 PLASTERED FINISH WITH 2 PROJECTING OUT
YELLOW SANDSTONE MASSING.
 HOIZONTAL AND VERTICAL BANDS OF SAME
ARE USED AS HIGHLIGHTERS IN ALL THREE
MAIN ENTRANCE.
1. FOOD SERVICE FROM THE BED ELEVATOR.
2. IN THE LOBBY AREA THERE IS NO NATURAL LIGHT.
3. OVERALL CHAOS IS CREATED NEAR THE LOBBY
AREA OF THE OPD.
4. SEGREGATION OF VEHICULAR AND
PEDESTRIAN MOVEMENT AS PARKING
FURTHER INTERVENTION OF VEHICLES
INTO THE SITE.
5. EMERGENCY, VISITORS AND STAFF
CIRCULATION THROUGH DIFFERENT
ENTRANCES.
 NO PLINTH PROVIDED IN THE
BUILDING.

 PROPER DISPOSAL OF BIO-

-MEDICAL WASTE.

 WASTE COLLECTION DONE

MANUALLY MAY CAUSE HARM.

 SECURITY OF THE BUILDING IS

PROPER FIRE ALARMS, SPRINKLERS , CAMERAS ARE
COVERING EVERY SINGLE AREA OF THE BUILDING.

 SEPARATE AHU’S ARE PROVIDED FOR DIFFERENT OT’S

RESTRICTING THE INFECTION TO THE PRONE AREAS
ONLY.
THANK YOU :D