ARCHDESVI: LECTURE 01 HEALTH AND MEDICAL FACILITIES

HOSPITALS
 A hospital is an institution for providing health care treatment to the
patients with specialized staff and equipment.

A general hospital is divided into operational areas of administration,

examination, treatment, supply, disposal, residential areas, and support
areas for service operation.

1 CATEGORY A : (25-50 BEDS)

2 CATEGORY B : (51-100 BEDS)

Functional Planning
Norms by Medical
3 CATEGORY C : (101-300 BEDS)
Council of India

4 CATEGORY D : (301-500 BEDS)

Hospital 5 CATEGORY E : (501-700 BEDS)

 Quiet Place
Treatment rooms
Almost sq. area Aligned along North-West and
North-East direction

Location Future Expansion Nursing Wards

Aligned along South to South-
area West direction

No loss of amenity Special rooms

Aligned along North direction

No contaminated
land

Selection of Site for Hospital

Space Plan: Zoning

The different areas of a hospital are

grouped according to zones:

1 OUTER ZONE

2 SECOND ZONE

3 INNER ZONE

4 DEEP ZONE

5 SERVICE ZONE
Space Plan: Zoning

1 OUTER ZONE

SECOND ZONE

- areas immediately accessible to the public:

emergency service, outpatient service,
and administrative service

- located near the entrance of the hospital

Space Plan: Zoning

2 SECOND ZONE

- areas that receive workload from the outer

zone: laboratory, pharmacy, and radiology

- located near the outer zone

Space Plan: Zoning

3 INNER ZONE

- areas that provide nursing care and

management of patients: nursing service

- located in private areas but accessible to

guests.
Space Plan: Zoning

4 DEEP ZONE

- areas that require asepsis to perform the

prescribed services: surgical service,
delivery service, nursery, and intensive
care

- segregated from the public areas but

accessible to the outer, second and inner
zones.
Space Plan: Zoning

5 SERVICE ZONE

- areas that provide support to hospital

activities: dietary service, housekeeping
service, maintenance and motorpool service,
and mortuary

- located in areas away from normal traffic

Space Connectivity Matrix
Space Requirements
Spaces Areas
Supply/disposal 40-80 sqm. PA/planned bed-care area
Nursing area 19-25 sqm. PA/planned bed
Intensive therapy 30-40 sqm. PA/bed
Surgical area 130-160 sqm. PA/surgical unit
Rehabilitation 19-22 sqm. PA/treatment place
Physiotherapy 68-75 sqm. PA/treatment place
X-ray 60-70 sqm. PA/diagnosis room
Radiotherapy 300-350 sqm. PA/equipment
Recovery area 25-30 sqm. PA/recovery bed
NMR diagnosis 100-150 sq. PA/diagnosis room
Clinical physiology 80-100 sqm. PA/diagnosis room
Clinical neurophysiology 78-100 sqm. PA/diagnosis room
Central reception 140-160 sqm. PA/examination/treatment room
Delivery area 85-100 sqm. PA/delivery room
Dialysis 70-80 sqm. PA/dialysis bed
Specialist departments 55-75 sqm. PA/examination/treatment room
PA = Productive area
 Dimensions of Bed Lift

Corridors Doors Stairs Lifts

• Access • Normal door – • Width – 1.5-2.5m • Lift car – 0.9-1.2m

corridors – 1.5 m 2.2m
• Step height – • Shaft – 1.25-1.5m
wide
• Vehicle entrance 170mm
• Patient’s – 2.5m • Tread depth –
corridors – 2.25m • Transport 280mm
wide entrance – 2.8m

Corridors, Doors, Stairs and Lifts

Circulation
External Traffic Control
 The Examination Room should be close to the nurses
station and the consultation room.

Consultation Room is mostly used when lengthy

conversation is involved between the doctor and the patient.

The OPD has facilities Clinical Department of OPD includes clinics which can use
for screening, standard accommodation, general medicine, surgery, etc.
counseling, clinical
examination, Types of clinics: surgical, orthopedic, medical, pediatric,skin,
treatment and ophthalmic, ENT, dental, chest, psychiatric, cardiology clinic.
referral.
OPD for the surgical department should be located on the
It consists of the ground floor and near the emergency with direct access to it.
following:

Minor Surgery Room may be used as a cast room, ECG

room, minor operations. It should have a separate entrance.

Support services includes clinics which can use standard

accommodation, general medicine, surgery, etc.

Out Patient Department (OPD)

 Isolation unit- An area of 14m2 for such rooms to contain a
bed, beside locker, etc and separate toilet facilities.

Wards for the particular specialties, should be located closer

to their respective department, self contained centers.

Ward unit shall comprise total req’d beds. Isolation rooms

Inpatient- means that should be present for 15% of the patients in a hospital.
the procedure requires
the patient to be
Aim is to minimize the works of the nursing staff and provide
admitted to the
basic amenities to the patients with in the unit.
hospital so that he can
be closely monitored
during the procedure Orientation of rooms should face south-east or south for the
and afterwards for adequate day lighting in the wards
recovery.

Size- Width of the doors > 1.2 m, dado to a height of 1.2 m.

Effective corridor width of 2.40 m up to 3.10 m.

Size- Area of 7 m2 per bed is recommended, arranged with a

minimum distance of 2.25 m between centers of two beds.

In Patient Department (IPD)

 Renders services right from the elementary first aid to
sophisticated management of surgical and medical emergencies
and full scale trauma care.

1
Should be located on the ground floor with separate access for
the patients and ambulances, away from the outpatient entrance
2
Should be well marked with proper lighting and signs and should
be easily visible and accessible from the street
3
Raised platform for ambulance discharge, ramps provided for
wheelchair and pedestrian access
4
Close to admission, medical records, cashier’s booth, laboratory
services, and the blood bank
5
Proximity to elevators is also important in order to proceed to
surgery without loss of time.

Emergency
 Radiology includes the specialist areas which use ionizing
radiation for diagnostic and therapeutic purposes. This includes
X-Ray diagnosis, radiotherapy and nuclear medicine.

1
Should always be close to the ambulance entrance and because of
the great weight of the equipment should be on ground floor.
2
A connecting corridor which can be used simultaneously as a
store, dictating room and switch room for staff is desirable.
3
Sonography, mammography and jaw X-ray require about 12-18 sqm.
Whereas standard X-ray and admission rooms need to be 20-30 sqm.
4
The access route for the patients should be through 2 changing
cubical.
5
WC’s should be installed in the X-ray room used for
stomach/intestinal inspection.

Radiology
Flow Chart of X-Ray Department
X-Ray Room Dark Room

Toile Reading &

t Interpretation
ICU OT
(Radiologist)
Changing
Room
Doctor’s
Viewing
Waiting

File Collection&
Reception Storage
Control
 In radiotherapy, conditions diagnosed in the radiography
department (e.g. tumors) are treated.

1 It comprises of reception, waiting area, doctor’s room (18 sqm.), switch

room (15 sqm.), localization room (20-25 sqm.), service room (20 sqm.),
film developing room (10 sqm.), stores and cleaner’s room.
2
Each treatment room requires a changing cubicle for patients.

3
If the department includes a linear accelerator, a workshop (15 sqm.)
and at least one physics laboratory (15-18 sqm.)
4
The clear height of the radiation rooms must be 4.3m.

5
For hygiene reasons the patient waiting area , examination,
localization, preparation and radiation rooms must be well ventilated.

Radiotherapy
 This department contains a wet area consisting of an exercise
pool (4X6m), a four cell bath, a butterfly bath, inhalation rooms, a
massage bath, hand and foot baths as well as necessary
subsidiary rooms. Slip resistant tiles to be used.
1
Should be accessed through the main reception area.

2
Additional rooms – changing rooms, WCs, rest rooms, linen
stores, waiting areas, cleaner’s room and service room.
3
A gymnasium to be included in it.

4
Because of the high internal temperatures (28-30 degree) construction
physics problems should be anticipated.
5
Should be arranged on basement floor where natural lighting can
be admitted through roof lights and light shafts.

Physiotherapy
Flow Chart of Surgical Unit
Wards

Post-operative
ICU
Recovery
Theatre Sterile
Frozen Section Supply Unit
Laboratory OT
Clean-up
Scrub-up
Anesthesia
room Central
Doctor’s Nurse’s Sterilization &
Changing Changing Supply Unit
room room

Other Hospital
Patients Nurses
Areas
Doctors
Operation Theater (Operating Room)
Freedom from noise and Freedom from contamination
disturbances. and possible cross infection.

Independent of general Correct & convenient

traffic movement from relationship with ICU, CSSD,
rest of the hospital. Radiology & Pathology Lab.

Adequate glare free natural OR Most present day operations

light is required which has use artificial light, but good
psychological impact. Hence light and ventilation are of
north light is desirable. added advantage.

Freedom from noise and Temperature range should be

disturbances. between 23 to 24 deg C.
Operation Theater (Operating Room)
Min. width – 1.8m. For each OT
there should be 3 non-splash
Size of room – 3.8x3.8m. Electric wash basins with foot controls.
sliding door of clear width 1.4m.
Room should be equipped with a
refrigerator, draining sink, rinsing
line, cupboards, connections for Washroom Size of roughly 10
anesthesia equipments and
emergency power. Sterile sqm. Must be directly
accessed by the OT.
Anesthetics goods
room Attach- room
ments
Plaster Equipment
For hygiene reasons this is not room room Size of approximately
located in the surgical zone but Sub- 20 sqm. Should be as
in the outpatient area. In sterilisation close as possible to
emergencies the patient must the OT.
be channeled through lobbies room
in order to get to the OT.
It contains a non-clean area for non-
sterile material and a clean area for
prepared sterile items. Should be
equipped with a sink, storage surface,
work surface and steam sterilizer.
 Nursing
station

Workroom
Room for for nursing Cloakroom Sanitary
the staff staff
nurse

Room for Sluice room

the Head
nurse

Storage for
the stretcher
Examination
& Treatment
room Laboratory
Ward store

Linen room

Pantry

Ward Facilities
Intensive Care Unit (ICU)
Description of ICU

The task of intensive care is to prevent life-threatning disruption of the

vital bodily functions. The services of ICU include monitoring and
treatment as well as care of the patient.

• Must be a separate area • The beds may be placed • It should have an OR for
and only accessed in an open, closed or minor interventions (25-30
through lobbies. combined arrangement. sqm.), Laboratory spaces,
• For economical care of • Beds in clear view of Kitchenette,
OT patients, recovery central nurses’ station. Substerilisation (20 sqm.),
room is located in ICU. clean material room, non-
• Number of patients/unit clean workroom, cleaning
should be 6 to 10 room, lounge for relatives,
Duty doctor’s room,
Documentation room,
Consulting room and
Sanitary facilities.

Arrangement Auxiliary
Arrangement
of Bed Spaces Functions
ICU and CCU (Recovery Room)
Patient’s Room

One-bed room with

Section of the room
service panel

Section of 3-bed Patient’s Side view

room set cupboard
 Nursing station is given in a ward in such a way that nurse keeps
an eye on all patients. Nurse work room is used to sterilise the
instruments along with storage of necessary instruments and
machinery.
1
Double corridor nursing floor provides closer relationship between
beds, nursing stations and other service areas.
2
Clean utility is designed to accommodate carts for storing linens,
utensils and other supplies .
3
Elevators are located outside the nursing unit to cut down noise.

4
Nursing services can be integrated into the same module which
includes the typical patient room.
5
Greater flexibility in segregation of patients for various medical
reasons.

Nursing Services
 Nursing Services

Flow chart

∙ ward type ∙ depth ∙ width

∙ 1 bedroom ∙ 3.4m ∙ 3.15m
∙ 2 bedroom ∙ 3.3m ∙ 3.5m
∙ 3 bedroom ∙ 7m ∙ 3.5m
∙ 4 bedroom ∙ 5.3m ∙ 6.4m
∙ 6 bedroom ∙ 7m ∙ 6.4m
∙ 8 bedroom ∙ 5.55m ∙ 2x6.4m  detail of nursing
Sizes of Nursing rooms station and utility
 Functions of the admitting department revolve around admitting,
transfer and discharge of patients. This department coordinates
patient’s arrival, registration, medical records and initial tests.

1
Maintain bed index showing current occupancy status. Prepare
admission and discharge lists and midnight census.
2
It should be situated on the same level as hospital’s main entrance,
be readily identifiable, and provided with a sign(easily seen).
3
Admitting patients’ waiting area, large enough to accommodate
patients and relatives accompanying.

4
Clerical work area for maintaining hospital occupancy directories,
records, forms,, notices, etc.
5
Wheelchair and stretcher alcove. Space for computers and office
equipment.

Admitting Department
Admitting Dept.
Flowchart
 The medical records department maintains records and
documents relating to patient care.
1
Maintaining proper facilities and services for accurate and timely
production, processing,checking,filing and retrieval of medical records.
2
It should be close to or on the corridor leading to doctors’ lounge so
that they can stop by and complete their records and study.
3
It should be so designed with the best possible means of
transportation of medical records thorough all stages of their use.

4
Reception-cum-registration area, space for copier. Work area for
record processing, assembling, numbering, indexing, etc.
5
Storage area for medical carts. Staff facilities.

Medical Department
 Flowchart of medical records on
discharge of patient

Flowchart of medical records on

admission of patient

Medical Flowchart
 Despite of the advancement, hospital acquired infection remains
the hospital’s single most serious concern that negated some of
its otherwise good work.

1 This method basically involves cleaning, disinfecting and sterilizing

before use all instruments, materials and equipment utilized in patient
care.
2 .
Is performed by heating them with pressurized steam of by gas
sterilization.
3
Carrying out the process of decontamination or disinfection prior to
sterilizing

4
Packing all materials for sterilizing,Sterilizing,Labelling and dating
materials,Storing and controlling inventory,Issuing and distributing
5
.Accessiblity to elevators, dumbwaiters and stairs is of utmost
importance.
.

Central Sterilisation and Supply

Department (CSSD)
 Good food is important in the treatment of the patient and is a
part of his total care. The food service department in today’s
modern hospitals ranks one of the major departments.

1
Provide best possible food at a cost consistent with the policy of the
hospital..
2
The department should be close to the materials management
department.
3
In general the important factor to be borne in mind is the logical
workflow.

4
Plan and implement patient therapy, education and counselling.
.
5
A ground floor location is preferable, and is also convenient to
deliver supplies.
.

Food Service Department

Food Service Flowchart
The Medical Facilities In the Philippines are provided by
various agencies operating at various hospitals, dispensaries,
clinics and nursing homes. These agencies include the
National Government, Local Government Units,
Department of Health, Department of Public Works and
Highways, Office of Building Official, statuary bodies,
volunteer organizations and the private sectors.

Governing Agencies
 The Philippines’ DEPARTMENT OF
HEALTH issued a document named
GUIDELINES IN THE PLANNING AND
DESIGN OF A HOSPITAL AND
OTHER HEALTH FACILITIES
for the purpose of regulating and
assisting the public in general and the
health professionals as well as
Architects and other design consultants.

DOH Guidelines
END