01

WHAT ARE HOSPITALS? 1.Emergency: for patients in ambulances and other

vehicles for emergency department.
AN INSTITUTION PROVIDING MEDICAL AND 2.Service: for delivering supplies and collecting
waste.
SURGICAL TREATMENT AND NURSING CARE FOR 3.Service: for removal of dead.
inpatient
SICK OR INJURED PEOPLE. 4.Main: for all others. Emergency
entry

outpatient lobby Emergency

SERVICES IN dept.

A HOSPITAL • THE DIFFERENT AREAS OF

HOSPITAL SHALL BE GROUPED Main
ACCORDING TO THEIR ZONES. entry

ESSENTIAL DESIRABLE
(MINIMUM (WHICH WE
ASSURED SHOULD
SERVICES) ASPIRE TO
ACHIEVE)
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• THE SERVICES INCLUDE OPD, INDOOR,
EMERGENCY SERVICES. I
GENERAL HOSPITAL T
RELATIONSHIP E
DIFFERENT DEPARTMENTS R
ADMINIST-
OF HOSPITAL A
-RATION AS HOSPITAL IS A COMPLEX SERVICEMBUILDING
HAVING DIFFERENT BUILDING COMPONENTS WHICH
PERFORM DIFFERENT FUNCTIONS AT THEIR POINT OF
T
U
LEVEL. BASICALLY, GENERAL HOSPITALS ARE DIVIDED
INTO FOLLOWING COMPONENTS:

1.
2.
OUT PATIENT DEPARTMENT
IN PATIENT DEPARTMENT R
DIAGNOSTIC
3.
4.
ACCIDENT AND EMERGENCY DEPARTMENT
OPERATION THEATRE E
INPATIENT AND OUTPATIENT 5. CSSD
TREATMENT 6. INTENSIVE CARE UNIT
7. OPERATING UNIT
8.
9.
LABORATORY
BLOOD BANK
S
10.
11.
DIAGNOSTIC
PHARMACY T
12.
13.
ADMINISTRATION AREA
DAY CARE SERVICES U
14. CRITICAL CARE UNIT
SERVICE
RESEARCH
AND D
TEACHING MEDICAL SERVICES
Y
OT/DIAGNOSTICS
EMERGENCY INPATIENT
OUTPATIENT /CASUALTY
ENTRANCE AREA
• BARRIER FREE ACCESS ENVIRONMENT FOR EASY ACCESS TO NON-
AMBULANT (WHEEL-CHAIR, STRETCHER), SEMI-AMBULANT, VISUALLY CONSULTANT PATHLOGY/ GENERAL
DISABLED AND ELDERLY PERSONS. ROOMS RADIOLOAGY WARDS

PRIVATE
• The various types of traffic shall be grouped for entry SUPPORTING OPERATION
WARDS
FACILITIES THEATRE
into the hospital premises according to their nature.
BLOOD INTENSIVE
CARE UNIT
• An important consideration is that traffic moving at BANK
extremely different paces (e.g. a patient on foot and an
ambulance) shall be separated. There can be four access PHARMACY
points to the site, in order to segregate the traffic.

ARC 311 NOTES REMARKS MULTISPECIALITY HOSPITAL

MAJOR DESIGN
PROJECT
02 • The clinics for infectious and communicable diseases
OUTPATIENT DEPARTMENT should be located in isolation, preferably, in remote
(OPD) corner, provided with independent access.

• The facility shall be planned keeping in mind ❑NURSING SERVICES

the maximum peak hour patient load and
shall have the scope for future expansion.
• OPD shall have approach from main road
with signage visible from a distance.
DIFFERENT CLINICS
• Various clinics under Ambulatory Care Area require
nursing facilities in common which include dressing
room, side laboratory, injection room, social
service and treatment rooms etc.
• space required for Nursing Station in OPD for
dispensing nursing services. (Based on OPD load of
patient)

- MEDICAL CLINIC
- SURGICAL CLINIC
- ORTHOPAEDIC CLINIC
- EYE CLINIC
- ENT CLINIC
- DENTAL CLINIC
-
-
OBSTETRIC AND GYNAECOLOGICAL CLINIC
FAMILY PLANNING CLINIC
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-
-
PAEDIATRIC CLINIC
SUPPORTING FACILITIES I
- CENTRAL INJECTION ROOM
- SPECIMAN COLLECTION ROOM T
- CLINICAL LABORATORY
- WAITING
LAYOUT OF OPD
E
R
IT shall follow functional flow
of the patients, e.g.:

ENQUIRY

REGISTRATION
A
WAITING T
SUB- WAITING
U
CLINIC

DRESSING
R
ROOM/INJECTION
ROOM E
BILLING

S
DIAGNOSTICS
(LAB/X-RAY)

PHARMACY
T
U
EXIT

❑ RECEPTION AND ENQUIRY

Services available at the hospital displayed at the
enquiry.
D
❑WAITING SPACES
Y
. Main entrance, general waiting and subsidiary waiting
spaces are required adjacent to each consultation and
treatment room in all the clinics. Waiting area at the
scale of 0.09 sq M/per average daily patient with minimum
37 sq M. of area is to be provided. LINK BETWEEN OPD
AND THE
❑PATIENT AMEITIES LABS/Diagnosis
• Potable drinking water.
• Functional and clean toilets with running water and All the hospital’s OPDs
flush. are linked to the
• Fans/Coolers. Seating arrangement as per load of diagnostic section of the
patient. hospitals. They are of
different types –
❑CLINICS pathology, radiology,
• Doctor chamber should have ample space to sit for 4-5 blood lab.
people. Chamber size of 12.0 sq meters is adequate.

ARC 311 NOTES REMARKS MULTISPECIALITY HOSPITAL

MAJOR DESIGN
PROJECT
03
ACCIDENT AND OPERATION DEPARTMENT
EMERGENCY • The location of the operating department in
• The accident and emergency unit must be the overall organization of the hospital is
quickly reached by accident patients (on of great significance. The design should
stretchers) via the ambulance hall (clear include a short distance to the intensive
access road height= min. 3.50 m) and by care unit, recovery room and central
ambulant patients from the main entrance. sterile store, because rapid access
• 24 x 7 operational emergency with dedicated between these departments must always be
emergency room shall be available with ensured.
adequate man power. • The following rooms or room zones belong
• It should preferably have a distinct entry in every operating department: -operating
independent of OPD main entry so that a theatre, preparation, transfer, scrub room,
very minimum time is lost in giving immediate sterile goods store, with a total area of
treatment to causalities arriving in the approx. 80m2.
hospital. • THE OPERATING THEATRE should be as
• There should be an easy ambulance square as possible to enable proper
approach with adequate space for free
passage of vehicles and covered area for
working with the operating table (size
approx. 6.50 x 6.50 m) turned in any
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alighting patients. direction.
I
T
E
R
A
T
U
R
E
❑ TRIAGE AREA
AN IDENTIFICATION AREA IN EMERGENCY IN WHICH A NURSE WILL IDENTIFY
STATE OF PATIENT AND WILL DECIDE WHERE THE PATIENT TO GO ON BASIS
OF TREATMENT REQUIREMENTS BY PLACING A TAG LIKE. S
-
-
-
IMMEDIATE
URGENT
NON-URGENT
T
- DEAD

❑ RESUSCINATION
OPERATION THEATRE
PREPARATION ROOM
U
AN AREA COMMONLY REFERRED TO AS “TRAUMA.” THE MOST SERIOUS ILL
OR INJURED PATIENTS WILL BE DEALT WITH IN THIS AREA. AS IT CONTAINS
THE EQUIPMENTS AND STAFF REQUIRED FOR DEALING WITH IMMEDIATELY
EQUIPMENT CENTRE
D
LIFE THREATING ILLNESS AND INJURIES.

• PLASTER ROOM
Y
AN AREA DEALING WITH FRACTURE TREATMENT.
• CONTROL ROOM
PHARMACY DEPARTMENT
A ROOM WHICH DEALS WITH AMBULANCE COMMUNICATION SYSTEM • The pharmacy should be located in an area conveniently
• POLICE ROOM accessible from all clinics.
AN AREA WHERE POLICE WILL MAKE ENQUIRY FOR ANY ACCIDENT CASES • The size should be adequate to contain 5 percent of the total
OR OTHER CRUCIAL CASES. clinical visits to the OPD in one session.
• For every 200 OPD patients daily there should be one dispensing
counter. Pharmacy should have component of medical store
facility for indoor patients and separate pharmacy with
accessibility for OPD patients.

ARC 311 NOTES REMARKS MULTISPECIALITY HOSPITAL

MAJOR DESIGN
PROJECT
04
IN PATIENT DEPARTMENT NURSING STATION

THE PATIENT ADMIT ZONE IN THE HOSPPITAL

WHERE PATIENTS ARE REQUIRED TO ADMIT IN
CASE OF THEIR TREATMENT REQUIRED
OBSERVATION UNDER THE DOCTORS.

General IPD beds As per need and infrastructure

shall be categorized
as following
1. Male Medical ward
2.Male surgical ward
3. Female Medical
ward
4. Female surgical
ward
5. Maternity ward
6. Pediatric ward
7. Nursery Isolation
ward
hospital have following wards
1. Emergency ward/trauma ward
2. Burn Ward Orthopedic ward
3. Post operative ward
4. Ophthalmology Ward
5. Malaria Ward
6. Infectious Disease Ward
7. Private ward: Depending upon
the requirement of the hospital
and catchment area, appropriate
beds may be allowed for private
facility. 10% of the total bed
strength is recommended as
private wards beds.

• Location of the ward should be such to ensure

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quietness and to control number of visitors. I
T
E
R
A
T
U
R
ROOM TYPES
E

circulation S
• Corridors shall be at least 3 m Wide to T
accommodate the daily traffic.
• Corridors shall be wide enough to
accommodate two passing trolley, one of
U
which may have a drip attached to it.
D
• It is desirable that up to 20 % of the total
Y
beds may be earmarked for the day care
facilities, as many procedures can be done
on day care basis in modern times
• The distances to be traveled by a nurse
from bed areas to treatment room, pantry
etc. should be kept to the minimum. Ward
unit will include nursing station, doctors’
duty room, pantry, isolation room,
treatment room, nursing store along with
wards and toilets as per the norms.
• There shall be at least 2.5 meter between
centers of two beds to prevent cross infection
and allow bedside nursing care.
• Every bed shall be provided with IV stand, bed
side locker and stool for attendant.
• Screen shall be available for privacy.
• Dedicated toilets with running water facility and
flush shall be provide for each ward.
• Dirty utility room with sluicing facility and
janitors rooms shall be provided with in ward.
• All wards shall be provided with positive
ventilation (except isolation ward) and fans.

ARC 311 NOTES REMARKS MULTISPECIALITY HOSPITAL

MAJOR DESIGN
PROJECT