Bartolome, Christine A.

Ar. Marcelino L. Cabacaba, uap

ARD 415- Architectural Design 7 – Community Architecture and Urban Design

Hospital

Hospital, an institution that is built, staffed, and equipped for the diagnosis of disease;

for the treatment, both medical and surgical, of the sick and the injured; and for their
housing during this process. The modern hospital also often serves as a centre for
investigation and for teaching.

To better serve the wide-ranging needs of the community, the modern hospital has
often developed outpatient facilities, as well as emergency, psychiatric, and
rehabilitation services. In addition, “bedless hospitals” provide
strictly ambulatory (outpatient) care and day surgery. Patients arrive at the facility for
short appointments. They may also stay for treatment in surgical or medical units for
part of a day or for a full day, after which they are discharged for follow-up by a primary
care health provider.

Hospitals have long existed in most countries. Developing countries, which contain a
large proportion of the world’s population, generally do not have enough hospitals,
equipment, and trained staff to handle the volume of persons who need care. Thus,
people in these countries do not always receive the benefits of modern medicine, public
health measures, or hospital care, and they generally have lower life expectancies.

In developed countries the hospital as an institution is complex, and it is made more so

as modern technology increases the range of diagnostic capabilities and expands the
possibilities for treatment. As a result of the greater range of services and the more-
involved treatments and surgeries available, a more highly trained staff is required. A
combination of medical research, engineering, and biotechnology has produced a vast
array of new treatments and instrumentation, much of which requires specialized
training and facilities for its use. Hospitals thus have become more expensive to
operate, and health service managers are increasingly concerned with questions of
quality, cost, effectiveness, and efficiency.

A hospital and other health facilities shall be planned and designed to observe
appropriate architectural practices, to meet prescribed functional programs, and to
conform to applicable codes as part of normal professional practice. References shall
be made to the following:

• P. D. 1096 – National Building Code of the Philippines and Its Implementing Rules and
Regulations

• P. D. 1185 – Fire Code of the Philippines and Its Implementing Rules and Regulations

• P. D. 856 – Code on Sanitation of the Philippines and Its Implementing Rules and
Regulations
• B. P. 344 – Accessibility Law and Its Implementing Rules and Regulations

• R. A. 1378 – National Plumbing Code of the Philippines and Its Implementing Rules
and Regulations

• R. A. 184 – Philippine Electrical Code

• Manual on Technical Guidelines for Hospitals and Health Facilities Planning and
Design. Department of Health, Manila. 1994

• Signage Systems Manual for Hospitals and Offices. Department of Health, Manila.
1994

• Health Facilities Maintenance Manual. Department of Health, Manila. 1995

• Manual on Hospital Waste Management. Department of Health, Manila. 1997

• District Hospitals: Guidelines for Development. World Health Organization Regional

Publications, Western Pacific Series. 1992

• Guidelines for Construction and Equipment of Hospital and Medical Facilities.

American Institute of Architects, Committee on Architecture for Health. 1992

• De Chiara, Joseph. Time-Saver Standards for Building Types. McGraw-Hill Book

Company. 1980

1 Environment: A hospital and other health facilities shall be so located that it is readily
accessible to the community and reasonably free from undue noise, smoke, dust, foul
odor, flood, and shall not be located adjacent to railroads, freight yards, children's
playgrounds, airports, industrial plants, disposal plants.

2 Occupancy: A building designed for other purpose shall not be converted into a
hospital. The location of a hospital shall comply with all local zoning ordinances.

3 Safety: A hospital and other health facilities shall provide and maintain a safe
environment for patients, personnel and public. The building shall be of such
construction so that no hazards to the life and safety of patients, personnel and public
exist. It shall be capable of withstanding weight and elements to which they may be
subjected.
 3.1 Exits shall be restricted to the following types: door leading directly outside the
building, interior stair, ramp, and exterior stair.

3.2 A minimum of two (2) exits, remote from each other, shall be provided for each floor
of the building.

3.3 Exits shall terminate directly at an open space to the outside of the building.

4 Security: A hospital and other health facilities shall ensure the security of person and
property within the facility.

5 Patient Movement: Spaces shall be wide enough for free movement of patients,
whether they are on beds, stretchers, or wheelchairs. Circulation routes for transferring
patients from one area to another shall be available and free at all times.

5.1 Corridors for access by patient and equipment shall have a minimum width of 2.44
meters.

5.2 Corridors in areas not commonly used for bed, stretcher and equipment transport
may be reduced in width to 1.83 meters.

5.3 A ramp or elevator shall be provided for ancillary, clinical and nursing areas located
on the upper floor. 5.4 A ramp shall be provided as access to the entrance of the
hospital not on the same level of the site.

6 Lighting: All areas in a hospital and other health facilities shall be provided with
sufficient illumination to promote comfort, healing and recovery of patients and to enable
personnel in the performance of work.

7 Ventilation: Adequate ventilation shall be provided to ensure comfort of patients,

personnel and public. 8 Auditory and Visual Privacy: A hospital and other health
facilities shall observe acceptable sound level and adequate visual seclusion to achieve
the acoustical and privacy requirements in designated areas allowing the unhampered
conduct of activities.
9 Water Supply: A hospital and other health facilities shall use an approved public water
supply system whenever available. The water supply shall be potable, safe for drinking
and adequate, and shall be brought into the building free of cross connections.

10 Waste Disposal: Liquid waste shall be discharged into an approved public sewerage
system whenever available, and solid waste shall be collected, treated and disposed of
in accordance with applicable codes, laws or ordinances.

11 Sanitation: Utilities for the maintenance of sanitary system, including approved water
supply and sewerage system, shall be provided through the buildings and premises to
ensure a clean and healthy environment.

12 Housekeeping: A hospital and other health facilities shall provide and maintain a
healthy and aesthetic environment for patients, personnel and public.

13 Maintenance: There shall be an effective building maintenance program in place.

The buildings and equipment shall be kept in a state of good repair. Proper
maintenance shall be provided to prevent untimely breakdown of buildings and
equipment.

14 Material Specification: Floors, walls and ceilings shall be of sturdy materials that
shall allow durability, ease of cleaning and fire resistance.

15 Segregation: Wards shall observe segregation of sexes. Separate toilet shall be

maintained for patients and personnel, male and female, with a ratio of one (1) toilet for
every eight (8) patients or personnel.

16 Fire Protection: There shall be measures for detecting fire such as fire alarms in
walls, peepholes in doors or smoke detectors in ceilings. There shall be devices for
quenching fire such as fire extinguishers or fire hoses that are easily visible and
accessible in strategic areas. 17 Signage. There shall be an effective graphic system
composed of a number of individual visual aids and devices arranged to provide
information, orientation, direction, identification, prohibition, warning and official notice
considered essential to the optimum operation of a hospital and other health facilities.
18 Parking. A hospital and other health facilities shall provide a minimum of one (1)
parking space for every twenty-five (25) beds.

19 Zoning: The different areas of a hospital shall be grouped according to zones as

follows:

19.1 Outer Zone – areas that are immediately accessible to the public: emergency
service, outpatient service, and administrative service. They shall be located near the
entrance of the hospital.

19.2 Second Zone – areas that receive workload from the outer zone: laboratory,
pharmacy, and radiology. They shall be located near the outer zone.

19.3 Inner Zone – areas that provide nursing care and management of patients: nursing
service. They shall be located in private areas but accessible to guests.

19.4 Deep Zone – areas that require asepsis to perform the prescribed services:
surgical service, delivery service, nursery, and intensive care. They shall be segregated
from the public areas but accessible to the outer, second and inner zones.

19.5 Service Zone – areas that provide support to hospital activities: dietary service,
housekeeping service, maintenance and motor pool service, and mortuary. They shall
be in areas away from normal traffic.

20 Function: The different areas of a hospital shall be functionally related with each
other.

20.1 The emergency service shall be located in the ground floor to ensure immediate
access. A separate entrance to the emergency room shall be provided.

20.2 The administrative service, particularly admitting office and business office, shall
be located near the main entrance of the hospital. Offices for hospital management can
be located in private areas.

20.3 The surgical service shall be located and arranged to prevent non-related traffic.
The operating room shall be as remote as practicable from the entrance to provide
asepsis. The dressing room shall be located to avoid exposure to dirty areas after
changing to surgical garments. The nurse station shall be located to permit visual
observation of patient movement.

20.4 The delivery service shall be located and arranged to prevent non-related traffic.
The delivery room shall be as remote as practicable from the entrance to provide
asepsis. The dressing room shall be located to avoid exposure to dirty areas after
changing to surgical garments. The nurse station shall be located to permit visual
observation of patient movement. The nursery shall be separate but immediately
accessible from the delivery room.

20.5 The nursing service shall be segregated from public areas. The nurse station shall
be located to permit visual observation of patients. Nurse stations shall be provided in
all inpatient units of the hospital with a ratio of at least one (1) nurse station for every
thirty-five (35) beds. Rooms and wards shall be of sufficient size to allow for work flow
and patient movement. Toilets shall be immediately accessible from rooms and wards.

20.6 The dietary service shall be away from morgue with at least 25-meter distance.
21 Space: Adequate area shall be provided for the people, activity, furniture, equipment
and utility.
Notes:

1. 0.65/person – Unit area per person occupying the space at one time

2. 5.02/staff – Work area per staff that includes space for one (1) desk and one (1) chair, space for
occasional visitor, and space for aisle

3. 1.40/person – Unit area per person occupying the space at one time

4. 7.43/bed – Clear floor area per bed that includes space for one (1) bed, space for occasional visitor,
and space for passage of equipment

5. 1.08/stretcher – Clear floor area per stretcher that includes space for one (1) stretcher

Driveway is a piece of hard ground

that leads from the road to the front of

a house or other building.

 Commonly used as paths to

private garages, carports, or

houses.

Minimum width of a driveway is 3 meters

Main entrance/exit means the

entrance to a building located on a
public right-of-way.
Emergency entrance means an access to subdivision development for emergency

vehicles only, in the event that the main access to the development is not accessible.

Hospital lobby is where people check in for appointments, wait to receive care, or pass

through on their love one. Traditionally,

hospital lobbies have included a front desk,

ample seating, and perhaps an adjoining

space to grab a coffee or tea.

 Hospital front desk. Serves patients
by greeting and helping them,
scheduling appointments, and
maintaining records and accounts.
Welcomes patients and visitor or on the
telephone, and answering or referring
inquires.

Hospital cashier. The cashier will make

use of technical and financial skills to track

and manage patient cash flows, credit, and

insurance payment. Apart from handling

the usual duties of a cashier, they also

provide support to the hospital front desk

by helping patients fill out admission forms and providing visitors and families with

information regarding the facility’s services.

Main stair

Type of Building Minimum Width

Residential 1.00 - 1.25 m

 Residential hotel 1.5 m

Assembly 2.00m

Educational 1.50 m

Institutional 2.00 m

Emergency exits (at least 2 units).

An exit that is used to provide a safe means of escape from a structure or area in the
event of an emergency, such as a fire. The exit must be in an easily accessible,
unobstructed and permanent location

Hospital hallway. Corridors for access of patient and equipment shall have a minimum

width of 2.44 meters. Corridors in areas not commonly used for bed, stretcher and

equipment transport may be reduced in width to 1.83 meters.

Hospital outpatient department (OPD) is

defined as a part of the hospital with allotted

physical facilities and medical and other

staffs, with regularly scheduled hours,

provide care for patients who are not

registered as inpatients. A hospital department where patients receive diagnosis and/or

treatment but do not stay overnight.

Single bed rooms with toilet (minimum 20 units)

Two bed rooms with toilet (minimum 10 units)

Disabled person’s rooms with toilet (male and female)

 Hospital kitchen area.

Hospital kitchen design

facilitate the bulk

production and services of food within specific windows of time. From the delivery of

goods, all the way through to the patients dining table, HACCP is critical. Given the

high-risk nature of serving food to patients with a wide variety of needs, maintaining and

monitoring temperatures is absolutely essential for food safety.

Hospital ICU. Intensive care unit are areas of the

hospital where seriously ill patients receive specialized

care such as intensive monitoring and advanced life

support. These units are also called critical care unit,

intensive therapy units, or intensive treatment units.

Hospital emergency room is a medical treatment

facility specializing in emergency medicine, the acute

care of patients who present without prior appointment;

either by their own means or by.

 Hospital consultation room.

A room where a doctor

examines a patient and

discusses their medical

problems with them.

X-ray room.

The general x-

ray room is

used for taking

standard x-ray

such as back, neck, chest, limb, hand or foot. The patient may be lying or standing

during the procedure. Shielding x-ray room is typically 2mm lead. Rooms are typically

smaller in size from 10’0” x 12’0” up to 16’0” x 20’0” and require shielded walls, x-ray

glass control window minimum 18” x 18” or larger for a clear view of patient and

procedure, and shielded door.

Hospital Covid wards with toilets (minimum 10 units)

Hospital Covid Isolation ward with toilets (minimum 10 units)
Doctor’s lounge. The doctor’s lounge used to be a great

meeting place for doctors. A place where only doctors could go

to discuss medical cases and share the stresses of everyday

practice.

Doctor’s conference room.

Medical conferences were

created to help physicians

stay up to date with the ever-evolving field of medicine. They are typically run by experts

in the field and offer many different lectures that you can choose from to attend.

Hospital laundry chute. A laundry chute is a tube or duct that

runs from one part of a home or building to another. The

purpose of the laundry chute is to allow a person to drop laundry

from higher level to the home or building down into a lower level

or basement where the washing machine and dryer located.

Standard linen chute is available in neither 600 mm or 800 mm diameters.

Hospital laundry area. It should be located away from the main service area of the

hospital. Close to boiler and heating system. The laundry should be located in an area

that has ample daylight and ventilation.

Hospital public toilets (male/female)

Hospital cyberspace

Hospital co-working space

Linen room is responsible

for the preparation,

maintenance and monitoring

of all linen and related items

used in the hospital as well as the laundry services for these linen items for the whole

hospital.

Utility storage area

Waste disposal area

 Security guard area. Secures the premises and

personnel by patrolling property; monitoring

surveillance equipment; inspecting buildings,

equipment, and access points; permitting entry. Prevents losses and damage by

reporting irregularities; informing violators of policy and procedures; restraining

trespassers.

Security fence. The role of safety fencing is to

protect the safety of the people who work, visit or

live in a building. But designing safety fencing for

a vital institution such as hospital poses a special

set of challenges including the need to; prevent

unauthorized entry and at the same time prevent

others from leaving or harming themselves, and keep staff and visitors safe without

creating a hash institutional appearance.

Schematic Diagram
r
Site Analysis

Bagacay, Calbayog City, Samar

12°03'36.0"N 124°36'58.7"E

Noise Source
Northeast monsoon

Noise Source
Design Inspirations