HOSPITAL PLANNING

AND DESIGN
GROUP 10

Plan for a new hospital

Specialisation - Neurology

ARCHANA SHARMA
PRATEEK MISHRA
SAMEER PATTNAIK
SHRUTI SINGH
TAANISH KUMAAR
VIDUSHI AGRAHARI
OUR SETUP
HPD Group 10 presents a unique combination of highly-experienced specialists and
technologically-advanced medical infrastructure and equipment that come together
seamlessly and work towards one goal — ensuring patients a better quality of life.

AAROGYAM
VISSION & MISSION

VISION

To lead in the delivery of healthcare, medical education, and neurological research,

as well as to fulfil the community's evolving expectations.

MISSION

"To be a responsible healthcare organisation & provide exceptional patient care and
clinical excellence."
 SPECIALISATION: NEUROLOGY
WHY NEUROLOGY
Neurology is the branch of medicine concerned with the study and treatment of disorders of
the nervous system
As part of the 2019 Global Burden of Diseases, Injuries, and Risk Factors Study, the
prevalence or incidence and disability-adjusted life-years (DALYs) for neurological diseases
from 1990 to 2019 for all states in India have increased significantly.

Services Provided:
Brain cancer

Tetanus
Stroke
Hospital location & other details

State - Odisha (Population of Odisha -4.37 crores )

Primary catchment area - Ganjam (Population-35,20151)
Secondary catchment area- Bhubaneshwar (Population-1,226,033)
Target population - Higher middle class and higher-class income groups.
Health needs – In Odisha a total of 260 (out of 10,000 studied) individuals
were found positive for neurological disorders yielding a crude prevalence
of 2.6%. (Raina, Gandhi, Bhardwaj and Sood, 2022)
Socio-economic class- Upper middle-class for strokes, though
neurological disorders can affect people of any segment.
Existing competition – CARE Hospital Ganjam (100 Beds), Trinity Neuro
Hospitals Ganjam, (100 Beds) Apollo Bhubneshwar (200 Beds)
Why Odisha?
Odisha has a higher prevalence of
neurological diseases when
compared to the national average.
Fifty-eight per cent of people in
Odisha never undertake health
check-ups as compared to the
national average of 47 per cent.
(Also depicts tremendous gaps in
the infrastructure)
 Brain cancer AGE DISTRIBUTION

The incidence of central nervous system (CNS) tumors in India ranges from 5 to 10 per 100,000

population
incidence - 28,000 cases reported each year

Typical characteristics of patient

1. Weakness in particular part of the body

2. Dizziness
3. Severe headaches, especially in the morning with nausea / vomiting
4. Paraesthesia (abnormal sensation)
5. Clumsiness or balance disorder
6. Single or multiple muscle jerks / seizures
7. Altered mental status
8. Difficulty with vision / Blurred vision
9. Speech difficulties
10. Hearing problems GENDER PREDISPOSITION
PROGNOSIS
ALOS for those who take hospital-based treatment - 3 to 5 days
Surgeries done for treating brain tumor
craniotomy and neuroendoscopy

Critical care stay requirement (nil, little, moderate, high, very high)
Prognosis
Cost of treatment - Rs. 83,00 to Rs. 2,80,000.

Specialists required - neurologists, oncologists, radiation oncologists

Major equipment/infrastructure required for providing treatment-

Craniotomy - equipment required

High-speed pneumatic cranial drill
Intensive care setting post-
Hudson brace handheld manual drill operatively to allow for
loupes close monitoring
microscope
high-definition cameras/an endoscope

Neuroendoscopy - equipment required

endoscope
trocar
flexible fiberscope
forceps and scissors
Stroke
Stroke is one of the leading causes of death and disability in India. The estimated adjusted prevalence rate of stroke range, 84-

262/100,000 in rural and 334-424/100,000 in urban areas. The incidence rate is 119-145/100,000 based on the recent population

based studies.
We found in a study, the incidence of stroke to be higher in men than in women (53% vs 47%).

Though the incidence of stroke in women was lower than in men in age less than 65 years, the risk of

ischemic stroke increased significantly beyond that age.

Higher incidence of stroke, stroke risk factors, and rates of stroke mortality are generally observed in

low compared with high socioeconomic groups.

Typical Characteristics of patients:

Trouble speaking and understanding what others are saying.
Paralysis or numbness of the face, arm or leg.
Problems seeing in one or both eyes.
Headache.
Trouble walking.

The average length of stay was 13.7 ± 8.9 days.

Severe stroke patients frequently need ventilatory or hemodynamic support provided in an intensive

care unit (ICU) setting.

Prognosis was generally less favorable for Stroke.

Cost of treatment: Rs 5 lakhs to Rs 7 lakhs.

Specialists: Neurologist, Rehabilitation doctor (physiatrist), Rehabilitation nurse, Dietitian, Physical

therapist, Occupational therapist, Recreational therapist, Speech pathologist, Social worker or case

manager.
Major equipment/infrastructure required for providing treatment-

Coil Retrievers- equipment required

Used for correction of migrated coils & stent

Equipment's required in

misplacement.
Intensive Care Unit setting

Aspiration devices.- equipment devices

Suction thrombectomy devices employ vacuum

aspiration to remove occlusive clot in acute

ischemic stroke.

Stent Retrievers- equipment required

Tiny mesh tubes that grab and extract blood clots in

blocked arteries.
Stent retrievers are an extension of the technology

involving the use of stents for the treatment of acute

ischemic stroke.
Tetanus
Symptoms of tetanus include -
• First sign – Most commonly spasms of the muscles of the jaw, or lockjaw.
• Jaw cramping
• Sudden, involuntary muscle tightening (muscle spasms) — often in the stomach
• Painful muscle stiffness all over the body
• Trouble swallowing
• Jerking or staring (seizures)
• Headache
• Fever and sweating
• Changes in blood pressure and heart rate

The incubation period — time from exposure to illness — is usually between 3 and 21 days (average 10 days).
Most cases occur within 14 days
Shorter incubation periods is seen with:
• More heavily contaminated wounds
• More serious disease
• A worse outcome (prognosis)

Prognosis
The prognosis of severe tetanus depends on the experience of the treating centre and the availability of intensive care facilities. Mortality due to non-neonatal
tetanus in resource-limited countries ranges from 5% to 53%, and is much lower in developed countries with better intensive care facilities.
Poor prognostic features include age >60 years, period of onset <48 h, incubation period <7 days, severe tetanus requiring neuromuscular blockade and mechanical
ventilation, and severe autonomic dysfunction.
Deaths are commonly due to nosocomial infections or severe autonomic dysfunction with cardiac arrhythmias.

Cost of treatment for surgery – Rs. 16,000

 The cases of tetanus
AGE reported is
DISTRIBUTION more in males as
compared to females.

DURATION
OF STAY
 A case of atraumatic tetanus developed
initially with worsening headache
in a woman regularly cared for chronic headache
Instruments used-
Lasers, Ultrasound Monofilament pads,
Forceps, scalpels
demand supply gap

OPD required
OT required

ASSUMPTION-Hospital plans to keep Ots functional for 8 hours in

a day and closed for Sunday and about 23 holidays in a year
Limitations
The total number of OTs is approximately coming to
20, which is on the higher side.
Ganjam is distantly located from the secondary
catchment area. There is also massive competition in
Bhubneshwar.
 REFERENCES:
Singh, G., Sharma L., 2022. The burden of neurological disorders across the states of India: the Global
Burden of Disease Study 1990–2019.
https://www.researchgate.net/publication/312164772_Clinicopathological_pattern_of_brain_tumors_A_
3-year_study_in_a_tertiary_care_hospital_in_India> [Accessed 13 August 2022].

Medindia.net. 2022. Neonatal Tetanus- Prevalence & Deaths in India | Medindia. [online] Available at:
<https://www.medindia.net/health_statistics/diseases/tetanus-neonatal-india-healthstatistics.asp>
[Accessed 13 August 2022].

https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.025165#:~:text=Median%20length%20of%20
hospital%20stay,group%20(P%3C0.001).
https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.wound-debridement-
before-your-procedure.abk1504

https://www.medindia.net/health_statistics/diseases/non-neonatal-tetanus-india-healthstatistics.asp

https://www.medindia.net/health_statistics/diseases/tetanus-neonatal-india-healthstatistics.asp
THANK YOU