Out-Patient Deparment: Hospital Design: Case Study

4 OUT-PATIENT DEPARMENT
HOSPITAL DESIGN: CASE STUDY REVATHI,PARVATHY

POOJA,SHRETIKA
ARCHITECTURAL DESIGN 7TH SEMESTER
FACULTY OF ARCHITECTURE SURBHI,ELIZABETH
MANIPAL UNIVERSITY JULY 2013 RIYA,DIPAL
INTRODUCTION COLUMBIA ASIA
Columbia Asia offers OPD services for the following
departments
ENT surgeon
General surgeon
Obstetrics and gynaecology
Ophthalmologist
Orthopaedic surgeon
Paediatrics
Physician
With working hours of 8AM to 8PM on all
Gastroenterologist
Dermatology weekdays and Saturdays there are a total of 20
Allergist and immunology consultation rooms
Neurosurgery
Plastic surgeon
Vascular surgery
OPD
Psychiatrist
Endocrinology
Cardiology
Pulmonologist OPD
Columbia Asia receives
Urology
800 patients on the weekdays
1200 patients on the weekends
4. OUT-PATIENT DEPARTMENT
2
REVATHI, PARVATHY POOJA, SHRETIKA SURBHI, ELIZABETH RIYA, DIPAL HOSPITAL DESIGN: CASE STUDY ARCHITECTURAL DESIGN 7TH SEMESTER FACULTY OF ACHITECTURE 2013
LOCATION OF COLUMBIA ASIA
DEPARTMENT
IPD
CAFÉ ADMIN EMERGENCY
OPD
Vertical arrangement seen from
Labs the entrance of the hospital
Waiting
area
Radiology
and OPD IPD
diagnostics
OPD
Pharmacy Waiting
EMERGENCY
area Vertical arrangement as seen from
the right side of the hospital
The whole OPD is spread out on the
Entry Administration Emergency ground floor
The OPD can also be accessed from
the emergency department
The patients are confined to a
Layout of OPD department particular area of the hospital and
does not interact with the IPD
3
PATIENT ACTIVITY COLUMBIA ASIA
MOVEMENT
Old users
New users
Patients who have a
appointment and
New patients are the medical records move
users coming to the directly to the waiting
hospital without a Waiting area room
appointment or a
medical record In the waiting area the
nurses station keeps the
Administration movement of patients into
the consultation rooms
under control
Taking of appointments, asking for
information and payment occurs OPD
here DIAGNOSTICS
The doctor can ask for further
investigations for which the patient
LABS goes to the lab or the diagnostic
centre
4
PATIENT MOVEMENT COLUMBIA ASIA
OPD New patients without

appointments go to the
administration department to get
an appointment
Labs Waiting area
Upon getting it they move to the
waiting area
Radiology and
diagnostics OPD From here they are called by the
nurse to the respective
Pharmacy consultation room
Waiting area
The doctor may advice them to do
further test which leads them to
the labs and diagnostic centres
Administration Emergency
Entry
5
PLACEMENT OF DEPARTMENTS COLUMBIA ASIA
Administration department
• placed on the right side to the
OPD entrance into the hospital
•Function-handles the
administration and appointment
Labs Waiting area making for the OPD
Radiology and Advantage

diagnostics •easy access for patients coming
OPD through the main entrance
•Acts as a help desk as well as a
Pharmacy security (the desk is manned at all
Waiting area hours)
Disadvantage
Administration Emergency •Creates a bottle neck situation
Entry for users going the OPD
6
ADMINISTRATION AREA COLUMBIA ASIA
Area of admin and billing-

71.065sq m Admin area
7
WAITING AREA COLUMBIA ASIA
•Common waiting area for the
consultation rooms
OPD
•Two separate waiting clusters
connected by a single corridor
Labs •Each waiting area was equipped with
Waiting area its own nurses station which helped in
managing the consultations
Radiology and
diagnostics OPD
Pharmacy Total number of seats-88 seats

Waiting area Area per seat-0.65msq
Area for the waiting area-57.2msq
Measured area-354.606
Entry Taking 800 patients
Area for seating -0.6 x 800
= 480msq
8
Advantages
•Patients consulting several doctors do not
have to travel to different waiting areas
Waiting
area
•Common waiting area helps in segregating the different
users such as the IPD visitors, emergency visitors etc
•Placement of public facilities such as toilets and
drinking water becomes combines rather than dispersed
9
PLACEMENT OF AREA- COLUMBIA ASIA
WAITING AREA
Disadvantage
•Large number of people in a single area can
cause confusion and high amounts on noise
Seat arrangements •A single nurses station

servers each of the waiting
areas
10
11
FACILITIES IN THE WAITING COLUMBIA ASIA
AREA
OPD
Labs Waiting
area
Waiting
area
Entry
-PLAY PEN
Age group- 3 to 6 years
Security – closed of on 3 sides and one side opening
directly into the main circulation passage
Designing for the children-soft flooring with different
colour patterns and also a TV displaying cartoons also
present
12
CONSULTATION ROOM COLUMBIA ASIA
Furniture and fittings present
•Doctor’s table and workstation
•Chairs for the doctor, patient and attending
•Examination bed with a step
•A sink for the doctor to wash
•X-ray viewing box
•Cabinets for storage
LAYOUT OF CONSULTATION ROOM

Advantage-circulation space for the
doctor and patient to move to and from
the examination bed
13
CONSULTATION ROOM COLUMBIA ASIA
Services required
•electrical and water supply
•data cable for computers
•smoke detectors for fire protection
•nurse call bell
1.2
1.2
1.2
Area of consultation room- 51.256463msq
14
SIGNAGES COLUMBIA ASIA
Signs with consultation room
number along with name of doctor
given
Name of doctor on a temporary
removable board thereby allowing
flexibility in the use of the
consultation room.
Signage with names of doctors and theirs
specialisation placed at the entrance of
the OPD section of the floor
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LIGHTING AND COLUMBIA ASIA
VENTILATION
Lighting in consultation room-

light directly above the
Lighting in waiting area– use of diffused lighting in the consultation table and the
seating area examination bed
Direct lighting in areas of circulation
16
MATERIALS COLUMBIA ASIA
Consultation room-
Vinyl flooring
Easier to clean in an area
where cleanliness is a must.
Waiting area-
Seats places on carpeted area while
circulation space is tiled
Carpeted area becomes difficult to
clean and the tiled areas may
become slippery.
17
FIRE EMERGENCY COLUMBIA ASIA
During an emergency the evacuation route for the OPD
users go through the emergency room. Maximum distance to be covered
The path covers the OPD, waiting area, labs and diagnostic for the emergency evacuation is
areas 70.55m
Labs
Waiting area
Radiology and
diagnostics
Pharmacy Waiting area
Entry
18
WINDOWS AND COLUMBIA ASIA
DOORS
Opaque blinds used in areas in rooms where
the light can effect the tests conducted on the Temporary blinds that can be
patient used when required
19
INTRODUCTION VIKRAM HOSPITAL
Vikram’s Hospital offers OPD services VIKRAMS HOSPITAL -200 bedded hospital.
The hospital is built across 8 floors with the first three floors comprising of
for the following department
ENT Dermatology
the Emergency, OPD and Diagnostic department. The rest of the floors
General Sciences Allergist and immunology comprise of the OT’s, ICU,IPD and the food court.
Obstetrics
gynaecology Neurosurgery Vikram’s Hospital is a multispecialty hospital which caters to various
Ophthalmology Cardiology departments
Orthopaedic Pulmonologist Cardiology, Gastroenterology, Gynecology, Nephrology etc.(about 15
Paediatrics Urology departments)
Physician
Gastroenterology Nephrology
The OPD foot fall is 230-250 patients per day
--3000 new patients per month
USERS --avg of 7000 patients per month
-Patients & their accompanying
families The hospital refers injured patients to the emergency even in the case of
-Children OPD patients.
-Adults
Older People Staff No. in OPD –(100-115 people.. Including doctors, secretaries,
Physically and Mentally Challenged nurses and other employees)
People
-Doctors & Nurses
-Administration Staff
-Cleaning Staff
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SITE PLAN AND ENTRANCE VIKRAM HOSPITAL
LAYOUT FOOD COURT
----------------
ENTRANCE
ICU AND IPD
RECEPTION II
RECEPTION
-MAIN RECEPTION ACTIVITY-
-SECONDARY RECEPTION ACTIVITY- OTS AND IPD
MAINTAINING APPOINTMENTS OF
CREATION OF APPOINTMENTS EVERY DEPT.
CARDIOLOGY OTS
APPOINTMENT OPD
TAKEN
EMERGENCY
CRITICAL CONDITION OF DIAGNOSTIC OPD
OPD PATIENT
CONSULTATION EMERGENCY OPD LABS

BY DOCTOR
EXAMINATION CASH
ROOM COUNTER -Pathology lab on first floor a later
DOCTOR PERFORMS PAYMENT OF BILL ICU
PHYSICAL EXAMINATION TREATMENT development
PROCEDURE ADMITTED TO IPD OPD with diagnostic dept.-easy
DIAGNOSIS
ROOM TESTS TAKEN BY access for patients
MINOR ACTIVITY PATIENTS/RESULTS SENT
PERFORMED BY
DOCTOR & NURSES
TO DOCTORS No OPD on ground floor. Only lift
and stair case access.
Emergency and Day Care
connected to OPD with IPD lifts for
treatment of patients in
pain/trauma
21
SITE PLAN AND ENTRANCE VIKRAM HOSPITAL
LAYOUT
ROUTE FOR EXTERNAL ACCESS-EXIT FOR
VEHICLES
SERVICE
ENTRY
SERVICES ENTRANCE
TO OPD
IPD
LIFTS
EMERGENCY
ENTRANCE
VISITORS
ENTRANCE
PARKING FOR
No entrance from
AMBULANCES front provided. A side
FOR EASY AID access provided for
OPD patients
22
SITE AND ENTRANCE LAYOUT VIKRAM HOSPITAL
Hospital
Building
Very less frontage space led to a side entry.
The valet parking people help with parking
services at the entrance.
Cars park their vehicles at the side or at
5m
some other place by hospital authorities
The side entry was narrow, a walkway with
illustration describing the various departments
were put up leading the visitors to the entrance.
Other than that no Feature marks the entry to the
hospital The frontal part of the site is given away for two
The side entry is not pedestrian friendly. Patients wheeler parking for staff and a few visitors.
tend to move to the sides giving their way to the The front entry is sealed off as it is used by the
vehicles. pathology department which was a later
development
23
VERTICAL ZONING VIKRAM HOSPITAL
OTHER OPD’S &

CONSULTATION
ROOMS
OTHER OPD’S &

WAITING AREA LOCATED CONSULTATION
IN THE CENTER sketch SECOND FLOOR ROOMS PLACED ON
DIAGNOSIS
FACILITATING ALL OPD’S- THIS FLOOR
EASIER ACCESS
CONSULTANCY FIRST FLOOR RADIOLOGY LOCATED
TESTING
SAMPLE
ROOM AROUND IN THE END WHICH

THE WAITING AREA FACILITATES ALL OPD’S
SPECIALISING IN
CARDIO. LOBBY
GROUND FLOOR
GENERAL WAITING VERTICAL
AREA FACING MAIN TRANSPORTATION AT
ROAD WITH CENTER FOR ACCESS
CURTAIN WALL FOR TO EACH DEPT.
MAX. NATURAL
LIGHTING
RESEARCH LABS MORGUE LOCATED
LOCATED ON ON GROUND
GROUND FLOOR FLOORWITH AN
OUTDOOR ACCESS
24
ADMINISTRATION VIKRAM HOSPITAL
Signage's guiding patients to respective
The entrance lobby departments- sign ages important near
contains the security main transportation since all people
desk and the help desk. enter from this point
The side wall bears the
directory board which
guides the patients to
the other departments
ENTRANCE LOBBY
Help Desk SECURITY DESK
Master health
The lobby check up counter
leads the which further
leads you to the
patient/visit opd
or to the
WAITING AREA lifts and
staircase. Security desk placed near the entrance
WAITING AREA, Individual receptions works-No token System
to guard & record staff entry
RECEPTION & ACCESS TO
OPD
Each department with one reception desk
reduces work load on main reception desk and
conveys instructions to patients faster
Main reception -Main reception need not have been so huge-
Individual
counter for OPD wastage of space-The executive lounge and a
reception desks
part of waiting space could have been used to
for each
make common waiting space or minor
department for
consultation rooms
appointments,
system records
25
WAITING AREA Executive waiting area
VIKRAM HOSPITAL
WAITING AREAS –FIRST The executive area is for
FLOOR privileged people, VIPs as per
The ambience in the decided by hospital authorities. It
waiting area is
appears first before the main The executive waiting area
Executive unlike other
is about 28-30m2
hospitals. It is OPD waiting area.
lounge area designed like a The No. of patients for the
lounge to give a executive lounge are very less on
sense of comfort to
the visitors and a day to day basis-about 5-8
patients people. Wastage of place
Glass panels
m2
7.7
around the
lounge for
visual
7.2m According to connectivity
standard the waiting
area is 0.65 m 2 per The lighting is recessed and the
person with 15% waiting area is provided with a
speaker for light music to keep the
The main waiting area has a seating circulation.
ambience pleasant
capacity of about 35-40 seats. (0.65*40=26m2)
The waiting and processing time for each +(0.15*26=3m2 )
patient is about 1-1 1/2 hours. Therefore the waiting
The first floor receives about 10-12 area is more than
patients per hour. enough provided for
Area of the waiting area is about 50 m2 the first floor.
which is sufficient enough to The waiting area is carpeted which is a lot of
accommodate the people. maintenance. It could have been separated with
another type of flooring
26
CLUSTER CONCEPT VIKRAM HOSPITAL
CONSULTATION
The hospital adopted a cluster concept where there would be ROOMS
clusters for each department and each cluster had 2-3 consultation
rooms with one staff toilet. They also had one room in the cluster (if
required by that department) for any tests or laser surgeries to be
done. WAITING
AREA
No vision barrier created
between the OPD patients and
DIABETOLOGY the doctors working at the
/INTERNAL consultation rooms.
MEDICINE Doctor’s movement is through
CARDIOLOGY the normal visitors' passage-no
Doctor’s movement across the floor
OPD privacy for the doctor. Situations
of visitors interrupting the
OPD doctor’s activity may occur.
WAITING CARDI The door opens to the view
AREA OLOGY A TYPICAL CONSULTATION ROOM of the round table which
CARDIOLOGY OPD addresses the doctor giving a
OPD sense of belonging.
-Each cluster has its own reception

A set of 2- 4 doctors work in the cluster at Doctor’s
a time Round
Workstation(space Examination
If the required dept needs a surgery or consultation room-
for storage, Bed
treatment room it is included inside the removes the
computer
cluster itself psychological
,stethoscope and
barrier between the
other requirements Doctor and Patient.
Each consultation room has one fire alarm The layout also
and sprinkler. Room height 2.75 m gives provision for
Sprinkler diameter-5m the patients' family
(sufficient for one consultation room) to be a part of the
discussion.
27
1ST FLOOR PLAN VIKRAM HOSPITAL
The consultation rooms are
arranged around the waiting
area with separate reception Fire Escape route
for each cluster.
-Easy approach to the
patient and doctor
DIAGNOSTIC
DEPARTMENT
CARDIO DIAGNOSTIC
TEST DEPARTMENT
CENTER
FIRE ESCAPE
LIFTS CORRIDOR
EXECUTIVE
WAITING AREA
OPD WAITING
AREA
OPD
CONSULATION
CLUSTERS Max run from the farthest point to fire
v
exit is 24 meters
28
TOILETS One set of toilet
VIKRAM HOSPITAL
facilities provided
near the diagnostic
centre.
Toilet services
provided near
The toilet facility at the diagnostic
the entrance
department suffices the requirement.
of the
But as it is placed away from the main
diagnostic
waiting area. It is not known to a lot of
department.
people unless the visitors pass through
the connecting passage.
The door almost opens on
to the WC which is not
ethical for the physically
challenged .
Only one toilet A screen

provided near the OPD is
department. Common provided
for all. Toilet at the
It doesn’t prove All toilets
base of
comfortable for Indian dimensions – are
the door
public and insufficient (1.5*2)m2 provided
to help
according to with a
any
handle but
standards patient in
not
case of a
completely
situation
barrier free.
29
MATERIAL AND FINISHES VIKRAM HOSPITAL
A carpet flooring
separates the waiting
areas and corridors.
Too much maintenance
Granite also used to suit the

color and theme of the hospital
interiors
Matt finish walls-cream color walls Granite flooring used in corridors and other
used which gives a calm serene places except waiting areas.
effect to the patients. Polished granite would not be safe for
Mono color laminates used patients with physical ailments
Vinyl flooring used on the sides and throughout the hospital gives an Grey color granite stone does not show up
used for skirting as well. identity to the ambience dirty spots well.
The central part of the corridor was
marked of by a running stretch of Crash guard used all along the
unpolished granite which would be corridor as a handle and to
patient friendly and easy for the prevent the stretcher from
movement of stretchers and barging into the wall.
wheelchair holding the patient
30
OPD DEPARTMENTS VIKRAM HOSPITAL
CARDIOLOGY AND DIABETOLOGY and Diabetology
GYNAECOLOGY The dialectology cluster is same as the cardiology.
-No examination bed provided though given in the drawings.
Cardiology The department receives about 10 patients per day.
The cardiology had altogether three clusters with a total of
12 consultation rooms and three reception desks.
The cardiology consultation room exactly look like the

typical consultation room of the hospital
The doctors have been provided with a blood pressure
equipment to check the health of the patient. Total area of the diabetology cluster
The test rooms for cardiology are located on the same -45m2
floor as the clusters are located. No wash basin provided.
No provision for curtain-also because the
consultation room doesn’t open out to the
waiting area.
Gynecology
24m
distance
from the
staircase One consultation
room
-No of patients per
day-10 on avg.
Total area of one cardiology -consulation room same

cluster is –45.5m2 size as typical room
Rooms-(4*9)=36
Curtain provided as the
Lobby and reception-7.2m2
Toilet-2.5m2 rooms opens out to the
corridor
31
2ND FLOOR VIKRAM HOSPITAL
The second floor of the hospital contains the opd and renal dialysis department.
The opd departments consist of the –urology-nephrology- neurology- orthopedic- ENT-
UROLOGY OTHOPEADIC &

OPD PHYSIOTHERAPY
DIALYSIS
WAITING ENT/PULMONOLGY/AU WAITING

AREA DIOMETRY WAITING AREA AREA
NEURO FIRE ESCAPE

OPD ROUTE
ONCOLOGY
&BARIATRIC DERMATOLOGY
OPD
The max. run to the nearest

fire staircase is 24 metres on
the 2nd floor
32
WAITING AREA VIKRAM HOSPITAL
The waiting area comprises of 70-80 waiting capacity.
The 2nd floor has a footfall of about 180 patients per
day.
The average waiting time for the opd patients varies a
lot in each department.
-The seating capacity although suffices the requirement
and is sufficient enough even for peak hours.
The average waiting space is 0.65m2

The first waiting area is 49m2. The waiting floor above also has no partition
The other waiting area is about 35m2. The Doctors move through the normal patient/visitor
Therefore corridor.
(0.65*90=58.5m2)+(0.15*58.5+ 0.15*35) =72m2.
(49+35=84m2)-suffices.
The ambience is set as per the other floors. The
The ambience is same as the waiting area below space gives a psychological comfort to patients
Carpeted floor for waiting area-high maintenance. and improves their mood
Waiting areas.
33
UROLOGY DEPARTMENT VIKRAM HOSPITAL
The no. Of consultation rooms
are two UROFLOWMETRY
DYNAMICS
The no. Of patients the ROOM
department receives are 15-20
per day UROLOGY OPD
URO
Age group visiting
20 to 50 years -65% LITHOTRIPS
Above 60 years -35% Y ROOM
WAITING CONSULTATIO
AREA N ROOM
Advantage of layout
•Combining of similar departments allows
easier management
•Uro dynamics and uroflowmetry place in
same cluster for easier access for patient
Advantage of location and doctor
-The lithotripsy room is located in the Furniture in the consultation room-
urology cluster thereby allowing easy •Informal seating
access for the patients and doctors •Doctors work space
-The patient is made to lie on a bed where •Xray viewing box
an over head emitter emits radiation to •Hand washing sink
break kidney stones
The lithotripter machine is adjusted in a room which is just little more

than the size of the consultation room. There is hardly any space for the
doctor to move around the lithotripter machine bed.
34
NEURO SCIENCES VIKRAM HOSPITAL
The Neuro sciences department receives about 10-12
patients per day. The Nerve Conduction and
Special treatment for certain patients was done in the EEG machine
day care.
The age group comprised more of children Most of the patients are
People suffering from Epilepsy and Fits are treated here. children but no provision
2- consulation rooms for their comfort has been
2-treatment rooms done
CON SULTATION All the reports are studies

ROOMS through computer devices
TREATMENT LAB-EEG
AND NERVE
and treatment inferences are
CONDUCTION prepared in the Treatment
lab itself
TREATMENT The dark room for other

type of EEG readings
LAB
35
ENT & AUDIOMETRY ROOM VIKRAM HOSPITAL
No examination bed has been
The ENT dept receives about 30 patients per day. The dept receives all provided.
age groups ,but specifically infants and babies which comprise 20 A patient seat and a ENT workstation
patients of the total occupies the space.
The Nephrology room receives about 15patient per day. Instead of the round table a seats for
It has a typical layout with an addition of a wash basin. the patients' family has been
This department is located right in front of the reception desk. provided
ENT Nephrology
room room
ENT
Audiometry work
room station
Surgical
chair
The Nephrology room and Audiometry room

had a similar layout as of a typical room layout.
No labs concerning these departments were
attached to the respective departments above.
The surgical chair, ent
workstation, working cabinet
The hospital only gives minor services in the and the doctors' chair was
above departments. concentrated on one side
crowding up the area
36
VERTICAL ZONING
INTRODUCTION FORTIS
CARDIOLOGY OPD LEVEL 3
PEDIATRIC – DENTAL -
LEVEL 2
GYNACOLOGY
ORTHOPEDIC-NEUROLOGY – LEVEL 1
OPD PHARMACY
UROLOGY-NEPHROLOGY LEVEL -1
Fortis Healthcare Limited is an established chain of super speciality
hospitals .
GENERAL OBSERVED FEATURES
They include multi-specialty hospitals and super-specialty centers
• Fortis planners have grouped OPDs considering the
Provide tertiary and quaternary healthcare to patients in areas like : physical condition of patients in mind.
• cardiac care, • Every doctor has a room to himself.
• orthopedics • Doctors take shifts on a daily basis.
• neurosciences & oncology Fortis has arranged • 2-3 departments are clubbed on a level
• renal care, gastroenterology their OPDs as a • Every OPD has a common lobby and reception.
• mother and child care. vertical complex • Most consultation rooms are centrally air conditioned.
considering ease of • OPD’s have their own diagnostic services.
It is a 250 bed hospital. patient access in • Examination space is combined with the consultation
Commenced in 1999 mind. rooms.
Lack of natural ventilation is observed
37
USERS • Other major activities are : FORTIS
Patients - (childern /adults/senior citizens)
• Vertical circulation
 300/day
• Lab test procedures
Patient escort - mother/friends ..etc
• Physical health checks
Visitors - (children/students/adults)
• Dietary activities
The OPD location starts • Patient care – stretchers, wheelchairs
Staff : 1. Medical at ground floor and can • Waiting areas
2.Admin be easily located and • Visual surveillance
3.Service accessed. • Food and dining  cafeteria
• Examination and Recovery spaces
Other services :
laundry LOCATION OF THE OPD COMPLEX
raw food materials - loading unloading
OPD
ACTIVITIES OPD
ENTRANC
ENTRANCE LOBBY E FOYER
• To the left is the reception & billing section.

• On the right side wall is an information board
with the names of all the departments and their
concerned specialists. LEVEL 1 LEVEL 2 LEVEL 3
• The lobby provides no seating spaces for the
users, which was seen as a necessity. (CON) Access to OPD can be from main entrance or through
• An OPD pharmacy is present in the same space. the 2 fire exits, one to the left and other far in-front
• The lobby then directs patients towards the health of the OPD.
check and Out Patient Department.
38
CONNECTIVITY FORTIS
The hospital has no provision of ramps. (CON)
The OPD complex is located next to the elevators and one of
- They substitute ramps with more number of
the 3 fire exit stairs.
One can get direct access to the BONE & JOINT – BRAIN & elevators.
SPINE department through the entrance lobby – in less than
2 MINS - Can cause difficulty during emergency / fire
Spaces are vast and grouped commonly for

departments.
Many restricted areas à staff/patient only
39
ORTHOPEDIC-NEUROLOGY OBSERVATIONS FORTIS
DEPARTMENT • Combined waiting lobby with reception.
• 35 – 40 waiting seats
LOCATION : Ground floor. • Isolated consultation chambers doubly loaded on a 1.5m
USER : patients with joint/bone pain or spine/nerve corridor .
condition. • EEG room & ECG room  3 x 2.5 sq.m.
 patient has difficulty in moving from place to • 9 orthopedic and 5 neurology consultation rooms
place. observed.
ACTIVITY : Registering Narrow corridors • According to the staff these rooms may be temporarily
waiting leading to used by doctors on daily shifts.  nameplate outside also
consulting/examination consultation changeable.
rooms. No visual • Restrooms : 1 Male & 1 Female
connectivity for Consultation rooms are
patients designed flexibly and
not department specific
except dental
40
COMPONENTS OF A ROOM DOORS AND WINDOWS FORTIS
Main door is double opening type.
 for stretchers need be
The consultation room doors are:

80cm wide
• DOCTORS DESK + CHAIR 2.1m in height.
• PATIENTS CHAIRS Off white in color  to compliment the soothing peach walls
• EXAMINATION BED + STEPS Doors open into the room.
• SIDE SHELF
• X RAY VIEWER Windows are rarely seen in the rooms  lack of peripheral spaces
• TABLE LAMP or inner courtyards (open to sky)
• COMPUTER SYSTEM 2-3 rooms have natural ventilation.
• CABINET
• BOOK SHELF
CPWD
PROPORTION OF SPACES
• No ramps present in the hospital.
• Consultation room = 3.5 x 2.5 = 8.75  A  eats up space
• Waiting + reception + circulation = 41.5 sq. m. • OPD has level surface.
 4.5A
• Corridors not ideally designed for
• ECG/EEG = 5.2 sq. m.  0.6A wheelchairs
( required 1.5m  present 1.2 m)
• Entire department = 206.91 sq. m.  24A
5 x 14 = 70  required waiting area in sq m • No special railings seen.
41
MATERIAL & FINISHES SERVICES FORTIS
• Flooring : Vinyl sheets  Anti Static & Anti Bacterial Lighting : due to lack of natural light
for hospital
• Walls : peach color, smooth finish A/C : Lack of natural ventilation
• Skirting is COVED with the floor.  ease of cleaning corners Plumbing : For wash basins
• Paintings hung on the walls in intervals.

LIGHT & VENTILLATION
• Thick glass name plates used for doctors chambers.
• Recessed lighting used .
• Natural ventilation & light hardly seen.
• Centrally Air conditioned throughout.
STRUCTURAL GRID
Columns are 6 m apart
Waiting area seating
42
PEDIATRIC- DENTAL - GYNACOLOGY DEPARTMENT FORTIS
LOCATION : Level 2
This department leads
USERS : children & parents, women, dental patients
ACTIVITIES : patients first into the
waiting pediatric & gynecology
taking care of babies spaces and then moves
consulting with the doctors onto dental at the back.
Creates chaos as all 3

departments share same
common waiting space
PEDIATRIC DEPARTMENT
• 5 Pediatric rooms
• Glass for doors and walls used No play area  disadvantage.
(waiting area  consult. Room)
Feeding
5 x 5 = 25  pediatrics room –
translucent
3 x 7= 21  dental
glass
6 x 7 = 42  gynecology
Total waiting area reqd = 88 sq m
43
GYNACOLOGY DEPARTMENT DENTAL DEPARTMENT FORTIS
Gynecology 3 consultation rooms + examination rooms
department to the
left. Equipment : Ped-Gyno-Dental
dental chair grouping with no
Combined x-ray viewer separate waiting
consultation – doctors desk or recovery for
examination rooms. patients waiting chairs dental patients
wash space
storage units
44
CARDIOLOGY DEPARTMENT FORTIS
LOCATION : 3rd level Other Features
USER : heart patients, cardiac staff, visitors
ACTIVITIES: Rooms arranged in a peripheral layout
waiting
consulting Corridors are not more than 1.8m
watching tv
This department has its own spaces for: Provision of minor test services (x-ray)
ECG LOCATION
TMT (tread mill test) PLAN
PFT (pulmonary function test) Lighting & Ventilation
ECHO tests Department has its
60 waiting spaces observed. own diagnostic spaces, No windows  Centralised A/C
sample rooms Artificial lighting  recessed
treatment rooms
Proportion of spaces
• Consultation room = 6.5 sq. m.

A
A • Waiting Area = 78.3 sq. m.

 12A
45
OPTHALMOLOGY DEPARTMENT FORTIS
LOCATION : Ground floor, in the Health
Check Division
USERS : Eye Patients, doctors,

receptionist, accompanying persons
ACTIVITIES:
Waiting in lobby
KEY PLAN – LEVEL 1 consulting with doctor
undergoing visual tests
waiting after medication
OPD PHARMACY
LOCATION : Ground floor, entrance
lobby
USERS : OPD patients, pharmaceutical

staff
ACTIVITIES :
storage of medicines
attending to patient
2.5 x 6 sq. m. Minimum 2.5m
prescriptions
between patient and reader
payment & bill
board
20 waiting spaces
Approximate dimension : 4.5 m x 5m
1 Sonography room
46
SIGNAGES FORTIS
ROOM INFORMATION
LEVEL/ FLOOR DIRECTORY BUILDING DIRECTORY
Signages are informative

but may not be legible to
the less literate.
Less number of pictoral

signages.
OVERALL DIRECTORY - LEVELS DOOR DETAILS
47
INTRODUCTION MANIPAL HOSPITAL
MANIPAL Hospital is an established chain of super speciality hospitals .
They include multi-specialty hospitals and super-specialty centres

GENERAL OBSERVED FEATURES
Provide tertiary and quaternary healthcare to patients in areas like :
dentistry, • Manipal planners have spread out the OPDs in 4 floors 2
neurology basements and 1st floor and ground floor considering the
dermatology physical condition of patients in mind.
diabetes and endocrinology • Every doctor has a room to himself.
paediatrics • Doctors take shifts on a daily basis.
• No departments are clubbed on a level
. • Every OPD has a common lobby and reception.
• Most consultation rooms are centrally air conditioned.
• OPD’s have their own diagnostic services.
It is a 800 bed hospital. • Examination space is combined with the consultation rooms.
USERS
Patients - (children /adults/senior citizens)  300/day

Patient escort - mother/friends ..etc
Visitors - (children/students/adults)
Staff : 1. Medical 2.Admin 3.Service
Other services :
laundry
raw food materials - loading unloading
the floor beneath the wards is for services alone
social work centre
Xerox centre
health check up centre
48
Location : MANIPAL HOSPITAL
Drop off area
Main road
parking
Secondary road
The hospital is
connected directly
to the main road.
Drop off area
49
ZONING – GROUND FLOOR •
MANIPAL HOSPITAL
Patients and staff members
enter from the main lobby after
they are dropped at the drop off
lane.
• Patients enter into the main
lobby and are directed to the
reception.
• Main lobby has directive and
textual signages that aid people
to identify the location of
different departments.
TOILETS DENTISTRY 10th floor

9th floor
8th floor
LIFTS 7th floor
6th floor
&S 5th floor
4th floor
PHAR 3rd floor
2nd floor
T T MACY
1st floor
Ground floor
Ground floor
Basement -1
s L Basement -2
MAIN D&E
LOBBY R
R Drop off area
Public spaces (Toilets, Lobby, Lifts and Staircases)
Administration/ Reception(R)
Fire escape staircases
Pharmacy
DROP OFF LANE Diabetes and Endocrinology OPD
50
FIRST FLOOR LAYOUT MANIPAL HOSPITAL
• The users from the entrance lobby
TOILETS use lifts or staircase to reach the
first floor.
• The departments in the first floor
LIFTS are accessed through a common
corridor.
&S
PHAR
MACY
T T
s L
First floor
Ground floor
MAIN
R
s R LOBBY s LIFTS
&S
Entrance
Drop off lane
Ground floor to first T T
Ophthalmology OPD
floor circulation layout Neurology and Neuro sciences OPD
General medicine OPD s L
Circulation
Drop off area
Public spaces (Toilets, Lobby, Lifts and Staircases)
Administration/ Reception(R)
Fire escape staircases
Pharmacy
Diabetes and Endocrinology OPD
Dermatology OPD
51
DENTAL MANIPAL HOSPITAL
dentistry
DENTAL PHARMACY
MACHINE
PHARMACY
DENTAL CHAIR MAIN
ENTRY
SPACE FOR WHEEL
CHAIR
RAMP
LEADING
LOCATION _GROUND FLOOR WAITING INTO THE
AREA,18
SEATS
DEPT
ROOM AREA 2.5
STAFF ROOM 4SQM M
EMERGENCY 5SQM MANA
2M 1.5m GERS
ROOM ROOM
CLEANSING+XRA 10.5+5SQM
EMERG
Y ROOM ENCY
ROOM
CONSULTATION 8SQM Consultation
SPACE space X RAY
CONSULTATION 6.25SQM VIEWE
ROOM R
E RAY VIEWERS 3SQM

ROOM LIGHT AND VENTILATION
Total 120sqm GLASS WINDOW FOR MORE
LIGHT INTO THE ROOM
52
SPECIAL FEATURES MANIPAL HOSPITAL
SPECIAL
ROOM
WHEEL CHAIRS
FOR THE OLDERLY
STORAGE SPACES
53
EQUIPMENTS MANIPAL HOSPITAL
CONSULTATION X ray and
AREA cleansing
EQUIPMENTS room
equipments
Dental machine of
size 1.5m *1m
SUCTION X RAY CONE
TUBES in the Kept in the x-ray room
CLEANERS
ROOM
ULTRASONIC
CLEANER MACHINE
Suction machine Spit on MAIN ENTRY IN CLEANING AND
X RAY ROOM
A SMALL FRIDGE
INSTALLED NEXT TO
THE CONSULTATION
Waste
AREA
bins
54
DIABETES AND ENDOCRINOLOGY MANIPAL HOSPITAL
PLAN OF THE
DEPARTMENT
PHARMACY MAIN ENTRY

RECEPTION
WAITING
MAIN LOBBY D AND AREAS
E RECEPTION
UTILITY EXAMINA
ROOM TION CR
1. LOCATION : Ground floor ROOM
2. PHARMACY : Common pharmacy
located at the ground floor.
3. TOILETS : Common toilets outside the
OPD for both doctors and patients
CONSULTATION ROOM
NO. OF CONSULTATION ROOMS = 4
•No of doctors = 4 consultants and 3
juniors WAITING CONSULTATION ROOM
CONSULTATION
•AREA = 4.5x5sq.m CHECK UP ROOM AREA
AREA
•SHARING/SINGLE = single
8. NO OF PATIENTS / DAY= 70-100 MAX
TV
55
ENTERTAINMENT MANIPAL HOSPITAL
PRACTICES EQUIPMENTS
USED IN CHECK
UP AREA WAITING
AREAS_2
SEPERATE
GLUCOMETER
AMBIENCE CEILING
CEC
TREATEMENT
56
DERMATOLOGY MANIPAL HOSPITAL
TV
CONSULTANT CONSULTANT Dermatology is the branch

DUTY
ROOM ROOM
DOCTORS PROCED of medicine dealing with
URE
ROOM
ROOM
the skin and its diseases, a
unique specialty with both
medical and surgical aspects'
STORE
LIBRARY STORE
ROOM
GENERAL ROOM
MEDICINE , LOCATION_FIRST
MICROSC FLOOR
OPE
MICROSCOPE USERS =100 PER DAY
CONSULTANT ROOM
dermatology ROOMROOM ACTIVITIES
1.CONSULTATION
2.waiting in the
FIRST FLOOR NEOROLOGY waiting area which is
PROCEDURE next to the reception
ROOM 2 SETS OF 3.PATIENTS COMING
WAITING IN FOR HAIR REMOVAL
DERMATOLOGY AREAS
GENERAL MEDICINE
NEOROLOGY RECEPTION AESTH

ETIC
LASER
OPTHAMOLOGY ROOM CIRCULATION
LIFTS WAITING AREA
3.5 M MAIN ENTRY

57
PROPORTION EQUIPMENTS MANIPAL HOSPITAL
KEPT IN STORE
ROOM S AREAS ROOM EQUIPMENTS USED IN THE STORE
ROOM
1. PHOTOTHERA _6SQM(6%) 1.CO2 LASER
2.ALMA LASER
PY ,AESTHETIC 3.ENDIAC
2. STORE ROOM 16SQM(14%) 3.DPN
4.SUCTION MACHINE
3. CONSULTANT 9SQM(24%) 5.SHR_SUPERFICIAL HAIR
ROOM ,3 REMOVAL
6.MICRO DURBO OPERATOR
4. DUTY DOCTOR
9SQM(8.27%)
ROOM
5. PROCEDURE 6.25SQM(11.46
%) ALMA LASER USED
ROOM ,2
FOR HAIR
6. MICROSCOPE
REMOVAL
ROOM 9SQM(8.27%)
7. LAB 5SQM(5%)
8. CIRCULATION 30SQM(22.9%)
AND WAITING
SPACE,REC
ENDIAC USED FOR
109SQM TATTOO REMOVAL
1. TOTAL
CO2 LASER
58
OPHTHALMOLOGY MANIPAL HOSPITAL
Reception
First floor
Entry
Lifts
ophthalmology
1. LOCATION : 1st floor Optic shop
s L 2. NO. OF ENTRANCES : One
3. PHARMACY : Common OPD Lifts and staircase
pharmacy located at the ground floor Common corridor
and a has an eye care shop at the
Consultation and examination room
entrance.
4. TOILETS : Common toilets outside Fire escape staircase
the OPD for both doctors and Waiting area and circulation zone
5. RECEPTION :- Equipments
patients
• COMMON/SEPARATE = separate used
• NO. OF COUNTERS = one counter and one nurse station
• TOKEN SYSTEM (YES/NO)= No
6. WAITING SPACES = capacity of 33 seats Dr’s desk Desk
7. NO. OF CONSULTATION ROOMS = 6
• No of doctors = 9 Chair 3*2.5 sq.m
• AREA = 3x3 sq.m
• SHARING/SINGLE = single
• The consultants worked in shifts and the rooms were Examination 2.25s
occupied by the doctor according to the shift timings. q.m Entry
8. NO OF PATIENTS/DAY = 90-100max chair
9. WAITING HOURS = 15-30 mins
Dr’s circulation
• PATIENTS WITH APPOINTMENT = No waiting time Examination chair Patients’
• WALKING PATIENTS = 15-20 mins maximum circulation
59
Ophthalmology
Consultation room= MANIPAL HOSPITAL
Corridor space=
Examination rooms=
• LIGHTING
MOSTLY ARTIFICIAL LIGHTING
Diagnostic APPROX. 1 LIGHT FIXTURE ABOVE EACH
room BED/CHAIR (1.5M- 2M APART)
WINDOWS PROVIDED IN ROOMS HAVING AN
Field room EXTERIOR FACE – SLIDING/FIXED
cr cr
• VENTILATION
sr CENTRAL A/C SYSTEM
FEW ROOMS HAVE BEEN PROVIDED
Cr- Consultation room WITH AN ADDITIONAL SPLIT A/C
cr R L cr Sr- staff room
Cea- collie eye anomaly Lifts and staircase
R- refraction room Common corridor
cr cr cea cr L- Laser room Consultation & staff room
3.0m • Main entrance double door 1.5m Fire escape staircase
wide
• Consultation room door- 1.0-1.2m Waiting area and
wide circulation zone
• Rooms were lit by artificial lights
3.0m
and had AC outlets.

• The floors were covered with vinyl
sheets that are easy to maintain.
• Walls were painted with calm
peach or white colours to avoid 33 seats
any kind of anxiety.
Consultation room 1. Dr’s desk
layout 2. Chairs
3. Computer
4. X ray machine
5. Storage desks
60
Pros and cons MANIPAL HOSPITAL
PROS
 THE OPD DEPARTMENTS WERE IN THE GROUNDFLOOR ,FIRST FLOOR AND THE 2 BASEMENTS WHICH WAS
HIGHLY CONVENIENT FOR THE PATIENTS.
 THE OPD PHARMACY WAS PLACED IN THE GROUND FLOOR WHICH WAS EASILY ACCESSIBLE TO THE PATIENTS
USING THE OPD DEPARTMENTS.
 THERE WERE CANTEENS AND BOOKSTORES INSIDE THE HOSPITAL PREMISES FOR ALL KIND OF USERS.
 PROPER USAGE OF DIRECTIONAL SIGNAGES MADE THE USER FLOW CONVENIENT AND NON CONJUSTED.
 EVERY DEPARMENT HAD ITS OWN SPACE AND PRIVACY ,NONE OF THE 2 OPD DEPARTMENTS WERE TOGETHER.
 THERE WERE SEPARATE WAITING AREAS FOR EACH DEPARTMENT AND HENCE REDUCED ANY KIND OF
CONFUSION OR CONGESTION.
 THEY EMPLOYED THE USE OF TOKEN SYSTEM TO AVOID CONFUSION DURING HEAVY CROWDING.G
61
Pros and cons MANIPAL HOSPITAL
CONS
 THE TOILETS PROVIDED WERE USED COMMONLY BY STAFF AS WELL AS THE PATIENTS .
 THERE IS NO IMMEDIATE CONNECTION BETWEEN THE INPATIENT DEPARTMENT AND THE
OUTPATIENT DEPARTMENT.
 THE OPD DEPARTMENTS WERE ARRANGED NOT IN A ORDERLY MANNER .IT WAS SPREAD OUT
THROUGHOUT THE BASEMENT ,GROUND FLOOR AND FIRST FLOOR .THE PAEDIATRIC
DEPARTMENT WAS MIXED UP WITH A ADMINISTRATIVE SECTION.
 THE ROOMS WERE GETTING CLUSTERED AS A RESULT OF EXPANSION OF SERVICES PROVIDED BY
THE HOSPITAL .
62
INTRODUCTION NARAYANA
The main block of narayana hospital is specialized in cardiology
opd’s.
HRUDAYALAYA
The multispecialty hospital of narayana has other opd’s like
dermatology,opthamology,orthopaedic etc.
Narayana hrudayalaya initially started as a multispecialty clinic.
Later ,as the number o cardio patients started increasing they

decided to expand the department and make it the foundation .
The main wing of the hospital contains only out-patient departments

related to cardiology.
USERS ACTIVITY
PHARMACY
PATIENT VISITORS STAFF WAITING

CHECK OUT
CHILD CONSULTATION
ADULT ADMIN DOCTORS

MAINTENANCE
ELDERLY
63
LOCATION
The cardiology opd is accessed from the
main drop off area . Way to multi
specialty
Doctors enter from the main hospital
Entry.
They have been allotted specific
parking space—this will include
parking
at the side and at the rear.
ENTRY
DROP OFF
MAIN
ENTRY
64
LOCATION
The cardiology OPD department is in two floors.
the general opd is accessed from the main entry ie at the
drop off point.
There are 3 double door entry’s.
The executive cardiology OPD is accessed from the waiting OPD
area of the general opd.
The executive opd is accessible from 2 lifts and a staircase
around it
Ground floor- First floor-
GENERAL EXCECUTIVE
65
ENTRANCE
RAMP-2 Pharmacy-
RAMPS OF -General
-Opd patients
1m WIDTH
KEY PLAN -A part of future
development
The pharmacy being
outside is difficult as
DROP OFF
visitors and patient have to
comeback to the doctor
sometimes
SECURITY
KIOSK
MAIN
ENTRY
6m
66
GROUND FLOOR
The ground floor contains opd for OPD
cradiology,pediatric and dental.
It is approached by 3 double door entries
CARDIOLOGY DENTAL
PEDIATRIC
MAIN RECEPTION
AND WAITING
Verandah seating IDOL IN THE

Reception Reception FRONT
-AESTHETICALLY
Travel desk provided for
cash cash PLEASING
patient convenience
• Toilets –at 1 level Key plan

down
• 5 w/c Pre-operative cell
• 3 wash
basin Column size-300x600mm
• 1 storage Common waiting – 21x3(2 ENTRY Grid-8.5x4.6
LEGEND
sets)- 126 seats PATIENT
PLAN
AREA=0.5X0.8X126=50.4sqm CIRCULATION
67
CONNECTIVITY
68
GROUND FLOOR
• THE OPD ACTIVITY IS RESTRICTED TO THE • OPEN PLAN AND GOOD

FRONT CONNECTION TO OUTSIDE
• THE IPD AND OTHER DPARTMENTS START
AFTER THE BRIDGE
• EACH
• PROPER BUFFER CONSULTATION
SPACES ROOM HAS A
BETWEEN MAIN WINDOW-NATURAL
ENTRY WAITING LIGHT
AND • USE OF
SUBWAITING COURTYARDS
• BARRIER FREE
69
CARDIOLOGY OPD
CARDIOLOGY DEPARTMENT(HOSPITAL)--11 cardiologists
7 critical care
10 anesthesiologists
ONLY THE CARDIOLOGISTS AND CARDIAC SURGEONS
HAVE CONSULTATION ROOMS IN THE OPD DEPARTMENT
Working hours –9am-5pm

Each doctor has a private secretary 9 : 18 =CONSULTATION ROOM :SEATING
seated outside
NO OF PATIENTS PER DAY=50-60
Consultation
rooms-
3mx3.9m
Key plan
Waiting
2 sets of 9 chairs each on
both sides
Total-162seats
ARA=0.5X0.8X162=64.8sqm
PLAN Grid -4.4X4.5
approx.
70
CARDIOLOGY OPD
Number of consultation room=18
OPEN PLAN
USE OF COURTYARD—
NATURAL LIGHT AND
VENTILATION
main
entry
EACH CONSULTATION Key plan

ROOM HAS A
WINDOW
PROPER BUFFER SPACES
BETWEEN MAIN ENTRY
WAITING AND SUBWAITING
CONCEPTUAL PLAN
71
CARDIOLOGY Typical consultation room consists of
TYPICAL CONSULTATION ROOM Consultation desk
Consultation bed
3 chairs
1 sofa
X-ray viewer
Computer
Each doctor had a private secretary seated outside that
controls the flow of patients
Window dimensions-2x1.5m
Venetion blinds
sink
Windows facing outside with

Services-sink-plumbing, A/C , switches. venetian curtains for controlled
lighting in consultation rooms. X ray viewer
Luminaire over consultation bed and
doctors desk
Centralized
A/C for the
entire OPD
through
ventilation
ducts
through false Curtain rails
ceiling.
72
PEDIATRIC OPD
Total of 7 doctors
The pediatric department has a small play area for the
children
RECEPTION
The pediatric department is specialized in cardiology
It has a total of 25 seats-0.8x0.5x25=10sqm
Rooms-
consultation rooms-7
Feeding room
Number of patients per day– 50-70
Key plan
Play area
Aesthetically pleasing
Consultation rooms Consultation room
73
PEDIATRIC OPD
WAITING-XRAY
Duct—for the
toilets in the Key plan
wards above
TYPICAL
CONSULTATI
ON ROOM-
PEDIATRIC
74
SIGNAGES
GROUND FLOOR
FIRST FLOOR
Fire exit
Info desk at the entry
Directional signage Consultation

room(cardiology)-
Doctors name Consultation
Room no room(cardiology)-
Doctors name
Room no
List of departments and labs in Registration and

the main entry waiting cash
75
FIRST FLOOR
The first floor consists of executive opd’s
It is accessed by 2 lifts and a stair around them
The executive opd is for the private patients
It is approached by a glass partition.
Lift lobby-coffee kiosk
Chairs-12
Round tables of 1.5m diameter
RESTROOMS
2 w/c,1 handicapped toilet,3 wash basin,1 dustbin
EXCECUTIVE
OPD
(CARDIOLOGY)
Key plan
•TMT ROOM •REGISTERATION AND CASH •STAFF TOILETS

•12 DOCTORS •ECG ROOM FOR GENERAL AND
•10 CONSULTATION •SPECIMEN COLLECTION CORPORATE
ROOMS •XRAY ROOM,ELECTRO ROOM •INTERNATION DIVISION
76
FIRST FLOOR
The executive opd is visited by
scheme patients .
It is for fast consultation 13 seats
each consultation
TO IPD
room has a window
-ACCESIBLE TO SPECIMEN
18:10=GENERAL OPD :EXECUTIVE OPD
DOCTORS AND COLLECTION
NO OF PATIENTS=60-70
STAFF
TOTAL NO OF
7
SEATS=79+35+4+13=131
35 GENERAL WAITING
Area =35X0.5X0.8=14sqm
Coffee kiosk
• THE CHAIRS FOR COFFEEE

KIOSK OUTSIDE IS LESS
COMPARED TO THE NO OF
WAITING SPACES INSIDE
• LIFT LOBBY IS SMALL
COMPARE TO THE DENSITY
OF PEOPLE 12x3 seats +9x3 +9+7=79 seats
PLAN Area =0.8X0.5X79=31.6
77
• ENTRY TO IPD FOR DOCTORS AND STAFF
• RAMPED APPROACH
• DOUBLE DOORS
• ALSO FIRE EXIT. • GRANITE FLOORING
• WOODEN
PANELLEND CEILING
SIGNANGES
AHU
GROUND FLOOR-2
FIRST FLOOR -1
COVE LIGHTING
78
BASEMENT
• The restrooms for the main entrance and
for opd patients is 1 level down
• This is accessed by stairs near the lift for
the executive opd
• The stairs are almost 0.9m which is narrow
for the amount of people.
• Converted to
• The basement also has a store room and a
office
cloakroom converted office which also use
the same stairs for access.
• The buffer space at the end of the stairs is
really crowded
• Medical
records
• Women toilet
room • 5 w/c,3washbasin,1 storage
• Gents toilet
• 6 toilets
• the restroom area is crowded as it is near the office and medical

records of ipd and the stairs are very narrow due to the addition of
the stairs leading to the executive opd Key plan
• not sufficient restroom compared to waiting ratio

• Stair width-0.9 m
79
FIRE ESCAPE PLAN
RAMP
21.2 m approx
STAIR
23 m approx
45 m approx
STAIR
51 m approx
80
INTRODUCTION NARAYANA
Narayana Hrudayalaya, headquartered in the city of
HRUDAYALAYA-MULTI
Bengaluru, India, is one of India's largest multi-specialty
hospital chains. The Bangalore cardiac unit of Narayana
SPECIALITY
Hrudayalaya is one of the world's largest pediatric heart
hospitals. Narayana Hrudayalaya also receives patients
from outside India, and it has created a record of
performing nearly 15,000 surgeries on patients from 25
foreign countries. It has 5,000 beds (as of 2012) and it is
building large hospitals across India totaling 30,000 beds,
to enable it to gain large economies of scale and bargain Emergency Entry
down the cost of supplies to the hospitals.
Apart from cardiology, the hospital also offers treatments
in the area of Neurosurgery, Pediatrics, Neurology, Patient’s Entry
Gastroenterology, General Surgery, Dental, Nephrology,
Urology, Transplants, Nuclear Medicine, Medical Imaging
and Radiology. It also houses a Blood bank and
Service Entry
Laboratory. With the help of ISRO, Narayana Hrudayalaya Hospital Entry
has pioneered some of the aspects of Telemedicine. from Main Road
Hospital Entry from Main Road
Front elevation of the Multi- The Main Lobby of the Hospital with
Speciality hospital the Main Reception and the seating
areas.
81
USERS/ACTIVITIES NARAYANA HRUDAYALAYA
Activity Movement for Doctors
Activity Movement for Nurses
• Number of doctors – 130

• Number of nurse – 1,200
• Number of patients each day –
1500+
Activity Movement for Patients
Activity Movement for Admin.
82
LOCATION NARAYANA HRUDAYALAYA-
MULTI SPECIALITY
LEGEND
WAITING LOBBY
VERTICAL TRANSPORT
1. OPD for General Medicine,
etc.
2. OPD for dental, urology,
prosthetics, etc.
3. OPD for Neurology,
Gastrology.
4. OPD for Oncology,
Pediatrics, Chemotherapy.
I.C.U.
EMERGENCY
A.H.U. Room
ADMINISTRATION
CASH COUNTER
PHARMACY
TOILET
CHEMOTHERAPY
83
NARAYANA
LAYOUT OF DEPT. Connectivity with other HRUDAYALAYA-
• Every department has 3-4 consultation rooms Dept. MULTI SPECIALITY
depending on the number of doctors and patients. • 4 main hospital buildings
• Some departments have a Minor OT attached to it. connected to 1 lab
• A number of 6-7 nurses are appointed for each building.
department. • Each floor of the OPD is
• Oncology – 3consultation rooms connected through a
1 minor OT series of Ramps and
staircases.
Endoscopy room
• Pediatric – 4 consultation rooms Central Registration
1 triage (emergency)
Out-Patient Registration
Consultation
Investigation • Flow of patients from

within an OPD – from
central registration to
Laboratory Radiology
consultation.
Consultation
84
CIRCULATION NARAYANA
HRUDAYALAYA-MULTI
SPECIALITY
85
COMPONENT OF A ROOM NARAYANA HRUDAYALAYA
Doors And Windows
Each Room Contains :
• Most of the consultation rooms
contain 1 main door for both
doctor and patients entry.
• Some consultation rooms have
two separate entry doors.
• Most consultation rooms contain
one large window with either
venetian curtain with transparent
glass or normal curtains with
trasclucent glass.
A diagram of a general consultation room • Distance between to
with dimensions. columns =
1. 10m
2. 8m
Each Room Contains : Desk&Chair 3. 5m
• A desk with computers, doctor’s 19.0%
41.22% Bed
accessories, etc. 15.11% • Various Sizes of columns
Store
• One chair for doctors, 2 more for =
patients and associates. Equipments 1. 1.2mX1.2m
• A bed with curtains hanging from 12.67% Open Space 2. 0.8mX0.3m
ceiling. 12%
3. 0.6mX0.3m
• A washbasin.
• Cupboards on wall for storage.
86
MATERIAL AND FINISH NARAYANA HRUDAYALAYA
• Corridor – BARRIER FREE ARCHITECTURE
• Ramps going through the vertical height
1. Walls – White washed, Dadoeing, Crash of the entire building.
Guard with hand rails.
• Separate Toilets for physically disabled.
2. Ceiling – White washed with false ceiling, • Handrails on the walls along corridors
lighting and ventilation ducts.
and ramps.
3. Floor – White Marble.
• Consultation Rooms –
1. Doors & Window – Wooden doors and
aluminum cased windows with translucent glass Provision of
panels, for viewing. hand rails in
corridor
2. Walls – Painted with light colours.
Provision of
3. Desks and chairs – wooden. wheel chairs
Dado work on
walls
Aluminum cased
Windows
White Marble Provision of

Floor hand rails
along ramp
Provision of
ramps
87
LIGHT/VENTILATION NARAYANA HRUDAYALAYA-MULTI
SPECIALITY
• Glass curtain wall through the entire height of
the building in the lobby. Centralized A/C for
the entire OPD
• Lobby lighting through artificial ceiling lighting. through ventilation
ducts through false
• Natural lighting some waiting spaces and ceiling.
consultation rooms. 1 AHU room in
each floor.
• Consultation rooms – ceiling lights, translucent
panels on doors and walls in some.
Ceiling Lights Along
• Central A/C for all consultation rooms,
corridors and in
examination rooms, waiting spaces, etc. Consultation Rooms
Windows facing outside

with venetian curtains
Glass curtain
for controlled lighting in
wall for
consultation rooms.
natural
lighting in
waiting spaces
with a
dynamic view
of the outside Large windows for
maximum lighting
Seating Area
in staircases.
88
NARAYANA HRUDAYALAYA-
FIRE ESCAPE ROUTES MULTI SPECIALITY
89
COMPARATIVE
ANALYSIS
10. OPD.xlsx
90

Out-Patient Deparment: Hospital Design: Case Study

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4 OUT-PATIENT DEPARMENT

HOSPITAL DESIGN: CASE STUDY REVATHI,PARVATHY

OPD New patients without

Radiology and Advantage

Area of admin and billing-

Pharmacy Total number of seats-88 seats

Seat arrangements •A single nurses station

LAYOUT OF CONSULTATION ROOM

Lighting in consultation room-

Pharmacy Waiting area

-Doctors & Nurses

CONSULTATION EMERGENCY OPD LABS

OTHER OPD’S &

OTHER OPD’S &

ROOM AROUND IN THE END WHICH

-Each cluster has its own reception

Only one toilet A screen

Granite also used to suit the

The cardiology consultation room exactly look like the

Total area of one cardiology -consulation room same

UROLOGY OTHOPEADIC &

WAITING ENT/PULMONOLGY/AU WAITING

NEURO FIRE ESCAPE

The max. run to the nearest

The average waiting space is 0.65m2

The lithotripter machine is adjusted in a room which is just little more

CON SULTATION All the reports are studies

TREATMENT The dark room for other

The Nephrology room and Audiometry room

• To the left is the reception & billing section.

Spaces are vast and grouped commonly for

Many restricted areas à staff/patient only

The consultation room doors are:

• Paintings hung on the walls in intervals.

Waiting area seating

Creates chaos as all 3

Total waiting area reqd = 88 sq m

• Consultation room = 6.5 sq. m.

A • Waiting Area = 78.3 sq. m.

USERS : Eye Patients, doctors,

USERS : OPD patients, pharmaceutical

LEVEL/ FLOOR DIRECTORY BUILDING DIRECTORY

Signages are informative

Less number of pictoral

OVERALL DIRECTORY - LEVELS DOOR DETAILS

They include multi-specialty hospitals and super-specialty centres

Patients - (children /adults/senior citizens)  300/day

Staff : 1. Medical 2.Admin 3.Service

Drop off area

Drop off area

TOILETS DENTISTRY 10th floor

E RAY VIEWERS 3SQM

PHARMACY MAIN ENTRY

CONSULTANT CONSULTANT Dermatology is the branch

NEOROLOGY RECEPTION AESTH

LIFTS WAITING AREA

3.5 M MAIN ENTRY

and had AC outlets.

Later ,as the number o cardio patients started increasing they

The main wing of the hospital contains only out-patient departments

PATIENT VISITORS STAFF WAITING

ADULT ADMIN DOCTORS