Antolin Thesis Book

Republic of the Philippines
POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

College of Architecture, Design and the Built Environment
CENTRAL LUZON TRAUMA CENTER:
CREATING AN OPTIMAL HEALING ENVIRONMENT FOR A PHYSICAL
TRAUMA TREATMENT AND REHABILITATION CENTER THROUGH
EVIDENCE-BASED DESIGN
ANTOLIN, KIM LEANNA C.
RESEARCHER
AR. MELBA A. PAUAL
RMA ADVISER
TABLE OF CONTENTS
Chapter 1 – Introduction……………….………………………………............1
Background of the Study………………………………………………………….1
Statement of the Problem…………………………………………………………3
Significance of the Study………………………………………………………….4
Goals and Objectives………………………………………………………………5
Scope and Delimitation…………………………………………………………….6
Justification of the Study……………………………………………………………8
Definition of Terms……………………………………….…………………………9
Chapter 2 – Methodology………………………………………………………..12
Research Paradigm………………………………………………………………..12
Research Design…………………………………………………………………...14
Research Methods…………………………………………………………………14
Sources of Data……………………………………………………………………..16
Tools/Materials used in Research………………………………………………..24
Chapter 3 – Review of Related Literature……...……………………………..25
Related Literature
Physical Trauma……………………………………………………………………25
Optimal Healing Environment………………………………………………..…...35
Evidence-Based Design…………………………………………………..………37
Hospital Design………………………………………………………………….…53
Theoretical Framework…………………………………………………………….55
Conceptual Framework…………………………………………………………….56
Case Studies………………………………………………………………………..58
1. East Avenue Medical Center……………………………….....58
2. Las Pinas General Hospital and Satellite Trauma Center....63
3. Landstuhl Regional Medical Center……………………….....69
4. Bristol Southmead Hospital…………………………………...71
5. Queen Elizabeth National Spinal Injuries Unit……………...74

6. Khoo Tech Puat Hospital……………………………………...76
Chapter 4 – Presentation and Analysis of Data……...………………………..25
Site Inventory…………………………………………………………………………84
Site Selection Criteria…………………………………85
Site Justification……………………………………….91
Macro Site Analysis………………………………………………………………….95
PHYSICAL PROFILE…………………………………….......96
Land Use and Zoning………………..………………..96
Circulation…………………………………………….100
Soil Geology and Topography……………………...102
Hydrology……………………………………………..103
Climate………………………………………………...104
Utilities…………………………………………………106
Risk and Hazard………………………………………108
SOCIO-ECONOMIC PROFILE……………………………...111
Age-Sex Group………………………………………..112
Education and Literacy……………………………….113
Employment……………………………………………115
Religion…………………………………………………116
Crime/Accident Rate………………………………….116
Catchment Area……………………………………………………………………..117
Micro Site Analysis………………………………………………………………….119
Site Selection…………………………………………..119
Topography and Elevation……………………………120
Surface Water Run-Off………………………………..123
Sun and Wind Path……………………………………123
Vegetation………………………………………………124
Sound and Vistas………………………………………126
Accessibility…………………………………………….126
Boundaries……………………………………………..127
Vicinity Map…………………………………………….128
SWOT Analysis………………………………………………………………………131
SWOT Matrix…………………………………………...132
Interview………………………………………………………………………………133
User Analysis………………………………………………………………………...135
Survey…………………………………………………..137
User Identification……………………………………...138
Organizational Structures…………………………………………………………..143
Behavioral Patterns…………………………………………………………………144
Chapter 5 – Architectural Programming……...………………………………..154
Spatial Identification……………………………...…………………………………154
Staffing Requirement……………………………………………………………….169
Space Programming………………………………………………………………..174
Executive Department…...........................................175
Administrative Department……………………………175
Administrative Department – HIMS………………….177
Emergency Service Facilities…………………………177
Trauma Department…………………………………...180
Outpatient Service Facilities………………………….181
Ancillary Service Facilities……………………………183
Nursing Service Facilities…………………………….186
Service Facilities……………………………………….188
Rehabilitation Service………………………………….190
Nutrition and Dietetics Service………………………..195
Outdoor Facilities……………………………………….197
Engineering and Maintenance Service Facilities……197
Support Service Facilities……………………………...199
Total Floor Area…………………………………………202

Parking Requirements……………………………………………………………….202
Graphical Spatial Translations………………………………………………………204
Matrix Diagram………………………………………….204
Bubble Diagram………………………………………...216
Chapter 6 – Environmental Systems………….………………………………..226
Structural Systems…………………………………………………………………..226
Waffle Mat Foundation…………………………………226
Steel Framing…………………………………………...227
Pre-tensioned Concrete……………………………….227
Building Vibration Insulation…………………………...228
Double-stud Wall System………………………………229
Aluminum Fins…………………………………………..230
Mechanical Systems…………………………………………………………………230
Hydraulic Elevator………………………………………230
Air handling Unit………………………………………...231
Electrical System……………………………………………………………………..232
TARELCO……………………………………………….232
Generator Set…………………………………………..232
Solar Panels…………………………………………….233
Photovoltaic Glass……………………………………..233
Water Supply………………………………………………………………………….234
Balibago Waterworks System Inc…………………....234
Stainless Steel Modular Water Tank…………………235
Pool Ozone Generator…………………………………235
Water Filters…………………………………………….236
Water Pump……………………………………………..236
Temperature and Pressure Gauges………………….237
Gray Water Recycling System…………………………237
Rainwater Harvesting System…………………………238

Fire-fighting System…………………………………………………………………238
Water Mist Sprinkler System…………………………..238
Smoke Detectors………………………………………..239
Sound and Light Fire Alarms…………………………..239
Dry Chemical Fire Extinguisher………………………..240
Security System……………………………………………………………………...240
Closed Circuit Television……………………………….240
Electronic Access Systems…………………………….240
Panic Button Emergency System……………………..241
Landscaping System…………………………………………………………………241
Carabao Grass………………………………………….241
Roof Farming……………………………………………242
Vegetable/Flower Garden……………………………..243
Permeable Paving……………………………………...243
Drip Irrigation System………………………………….244
Green Wall Systems……………………………………244
Acoustics………………………………………………………………………………245
Acoustic Ceiling Panels………………………………..245
Rubber Flooring…………………………………………246
Decorative Acoustic Wall Panels……………………...246
Accessibility…………………………………………………………………………...247
Side-walks………………………………………………..247
Elevated Walkways………………………………………247
Wayfinding……………………………………………………………………………248
Hedge Design…………………………………………….248
Landmarks………………………………………………..248
Hand Rails………………………………………………..248
Signage……………………………………………………249
Waste Management………………………………………………………………….250
Materials Recovery Facility……………………………...250
Composting……………………………………………….251
Waste Segregation………………………………………251
Hazardous Waste………………………………………...251
Chapter 7 – Design Framework…….………….………………………………..226
Design Philosophy…………………………………………………………………..253
General Design Concept…………………………………………………………...255
Sub-concepts………………………………………………………………………..258
Planning Concept…………………………………………258
Materials Concept………………………………………...266
Architectural Details………………………………………267
Time Concept……………………………………………..271
Sustainability Concept…………………………………...271
Design Considerations………………………………………………………………271
Architectural Style Guide……………………………………………………………273
Chapter 8 – Manner of Financing…….………….…………………..…………..275
Source of Funding……………………………………………………………………275
Probable Project Development Cost……………………………………………….275
Land Acquisition Cost…………………………………….275
Building Cost………………………………………………276
Ancillary Facilities Cost…………………………………..277
Medical Equipment Cost…………………………………277
Fit-Out Cost……………………………………………….278
Land Development Cost…………………………………279
Contingency……………………………………………….279
Summary of Probable Project Development Cost…….280
Professional Fees…………………………………………..280
Total Project Development Cost…………………………..282
Chapter 9 – Findings and Conclusion…….………….……………..…………..283

Chapter 10 – Recommendations…………..………….……………..…………..286
Annex………………………………………………………………………………….79
Figures…………………………………………………………………………………288
Figure 1 Trauma Statistics…………………………………288
Figure 2 Patient Flow……………………………………….288
Figure 4 Framework OHE………………………………….289
Figure 5 Mortality Rates per Region………………………289
Figure 6 Top 10 Causes of Death…………………………289
Figure 7 Top 10 Leading Causes of Death……………….290
Figure 8 Trimodal Pattern of Death Injury…………………290
Figure 44. CLLEx Phase 1………………………………….291
Figure 45 Trauma Profile Infographics…………………….292
Tables………………………………………………………………………………….293
Table 4 Spaces with Area Requirements/user……………294
Table 5 Selected Cause of Death Central Luzon………...294
Table 6 Selected Causes of Death per Region…………...295
Table 7 20 Injury deaths in rank…………………………….295
Table 8 20 Injury deaths rise in rank………………………..296
Survey Results………………………………………………...297
Interview Questions…………………………………………...304
House Bill 1960………………………………………………..306
Bibliography…………………………………………………………………………308
CHAPTER 1
INTRODUCTION
Background of the Study
Physical Trauma is a physical injury that when sustained can endanger a
patient’s life. The common causes for physical trauma include, road and traffic
accidents, falls, knife wounds, bullet wounds, burns, drowning, explosion, and
many more incidents that entail impact towards the body. Major trauma, when
experienced need immediate health attention for it has potential to cause life-long
disabilities or even death.
Physical trauma remains as one of the leading causes of premature death
not only in the Philippines, but also worldwide. According to a statistical report in
2015 (Figure 1) by the National Center for Injury Prevention and Control, an
organizational component of the Center for Disease Control, the leading cause of
death worlwide is trauma, accounting for 47% of total death for ages 1-46 years
old and 30% of all potential life lost before the age of 75. The Department of Health
of the Philippines, with the Disease Prevention and Control Bureau (DPCB), has
institutionalized a program called “Violence and Injury Prevention Program”, first
introduced in 2007 as an offshoot of Administratice Order 2007-0010 but then
further enhanced in January of 2014, now AO 2014-0020 Revised National Policy
on Violence and Injury Prevention. This program aims to lessen mortality, morbidity
and disability due to injuries from road traffic accidents, interpersonal violence,
falls, work-related accidents, drowing, and many other trauma related incidents.
With this program the Department of Health has developed the ONEISS or the
Online National Electronic Injury Surveillance System which consolidates all data
on these accidents. With data from this official system shows that from 2015 up to
2018, there has been 37.41% annual growth rate of injury-related accidents. The
2015 data totals to 62,670 reported incidents and in 2018 it reaches to a staggering
164,492. Data from the ONEISS that constitutes the whole of 2019 has recorded
181,814 cases.
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As of 2018, Trauma still remains one of the leading causes of death in the
Philippines, despite of the country’s efforts to enhance trauma care through better
equipment and increased number of ambulances available in most hospitals.
President Alejandro Dizon of the Philippine College of Surgeons once stated that
the key to better survival, prevention of death and disability is through initiation of
treatment within an hour after an out of hospital accident has occurred which is
called the “golden hour” by medical professionals. This means that in an accident
prone area, trauma care must be available as near as possible for better chances
of survival.
Former House Speaker Feliciano Belmonte and Rep. Estrellita Suansing
recognized this importance when they filed House Bill 6035, with the later signing
as co-author and the following year becoming the principal author of House Bill
1960 when it was re-filed in 2016. Both of these have the same agenda; the
construction of a premiere trauma care facility in Central Luzon, its main goal; to
provide this specialty hospital within the vicinity of the expressways located in
cental luzon. With data from Toll Regulatory Board showing that vehicular
accidents along all 8 expressways has risen 60% from 2016-2018, NLEX had the
most number of fatalities, of the 182 fatalities since 2016, 1 out of 3 was in NLEX.
17 lives were claimed in NLEX, followed by TPLEX with 11 lives, and SCTEX with
9 lives in 2018. NLEX also has the highest number of sustained injuries, from the
2,371 wounded people, 47% was from NLEX totaling to 1,016 individuals. 224
were from SCTEX and 206 were from TPLEX in the same year. This facility will
also be able to cater to other trauma-related accidents within central luzon. With
ONEISS showing that there have been 2,396 cases reported from central luzon in
2018 from the 2015 data of 909 cases, data from 2019 totaling to 3,021, and for
the first quarter of 2020 having 439 injured individuals.
The proposed site for this development is in Zaragoza, Nueva Ecija, as
stated in the house bill filed by Rep. Estrellita Suansing. This municipality is within
the vicinity of expressways NLEX, SCTEX and TPLEX, but most importantly the
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Central Luzon Link Expressway currently in construction, with phase 1 nearing its
completion transversing through the municipalities of La Paz, in Tarlac, and
Zaragoza and Aliaga in Nueva Ecija. This expressway when completed will prove
to be an important lateral link between the overall expressway network of central
luzon.
It is within the Philippine Health Facility Development Plan 2017-2022 to
improve specialty hospitals which include trauma centers, requiring a 40 Billion
peso investment. With all these in consideration the researcher has decided to
pursue this proposal. This study aims to provide a medical health care facility for
these increasing emergency situations. A trauma center that provides services
from the admittance of a patient from an out-of-hospital trauma accident to
stabilization of injury and performance of trauma surgery if required without the
need of transfering the patient to another facility so as to increase the chances of
survival. This facility will also include physical trauma rehabilitation services for
patients who may have acquired disabilities that threaten their place as properly-
functioning individuals in the society. With this higher level of trauma care all
located in one setting, the Department of Health’s vision of preventing injury and
violence related deaths and life-long disabilities will be upheld.
Statement of the Problem
Trauma is one of the leading causes of premature death among Filipino
people from all age groups, and we are facing the sad reality that most of the
hospitals where these patients go to receive treatment are not well-equipped to
provide the speciallized services for better chances of survival. The existing
healthcare facilities lack consideration on their user’s comfort and need to lessen
the burden that comes with process of healing from a physical injury. The following
are the minor problems the researcher seeks to address:
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1. The spaces in a number of healthcare facilities are poorly planned, with
these users clashing with each other, and the patients have difficulty in
navigating from one place to another.
2. Lack of basic provision of different architectural interventions that can help
in the patients inability to move around with ease, without too much
assistance from their healthcare providers, due to the physical trauma they
have experienced.
3. The ambience of hospitals does not promote hope and utilize components
from the environment that can help thoughout this process.
4. The lack of different spaces or services that can aid in the treatment and
rehabilitation of patients that has suffered from a physical trauma.
Significance of the Study
` All the findings of this study will be of great benefit towards the following
sectors:
1. Community. Through the provision of a premier healthcare facility geared
towards the treatment and rehabilitation of physical trauma, the community
as well as the users passing through central luzon that may have
experienced unforseen accidents will feel more at ease at the notion that
there is a hospital that is well-equipped and ready to attend to these
increasing emergency situations and increase their chances of survival. As
stated by the Department of Health – Central Luzon, there are no trauma-
capable government hospitals within the region, but with the provision of
this development the community will be able to see lower mortality and
morbidity rates due to accidents that can otherwise be avoided.
2. Government. The government’s priority will always be the well-being of its
people, and health is just one of these. Through this proposal the
government, specifically the Department of Health’s vision on the
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prevention and reduction of mortality rates caused by injuries and violence
will be upheld. This goal can be seen through various programs such as the
Violence and Injury Prevention Program as well as the Philippine Health
Facility Development Plan for 2017-2022. This development will just be a
product of those goals.
3. Health. This healthcare facility will become an optimal space for the healing
of patients with physical disabilities as a result of trauma accidents. The
people of central luzon will also have a place to go to receive better
treatment and rehabilitation. Along with its significance as a place to receive
treatment, programs regarding prevention of trauma accidents will also be
implemented and therefore reducing further risks of death and injuries due
to physical trauma.
4. Architecture. This structure will contribute to better design solutions for the
achievement of an optimal healing environment not just through the
guidance of standards for healthcare design but also through evidence-
based design solutions. Architecture has abundant effects on an individuals
healing process, and through this development healing will not only be
achieved through the medical programs and interventions provided to the
users but also provide positive effects on a user’s innate abilities to heal.
5. Future researchers. This study can become a basis for future
researchers who aim to propose a treatment and rehabilitation center
geared towards physical trauma. This study will offer evidence-based
solutions that when applied by future researchers shall ensure a facility that
will take the user’s comfort and experience into main account.
Goals and Objectives
The main goal of this proposal is to provide an optimum healthcare facility
through evidence-based design solutions that will be able to cater to all the needs
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of a patient that has suffered from physical trauma, from start to finish, until their
reintegration into the society.
The objectives that will aid in the achieving of the main goal is as follows:
1. To improve the layouts of spaces in a healthcare facility for physical trauma
patients where all users are able to navigate through these different areas
with ease.
2. To design a hospital that is accessible to patients who have sustained
physical inabilities as a result from their accidents and be able to move
without being too dependent on their healthcare providers.
3. To improve hospital design from merely using standards set by authorities,
as well as ensure the use of environmental components such as daylight
and vegetation for the achievement of an ideal healing space.
4. To improve space provision and ensure that all services needed for a
physical trauma treatment and rehabilitation center are present within the
development.
Scope and Delimitation
The scope of the study will focus on (1) the factors that affect the rise of
these emergency health situations as well as the issues faced by physical trauma-
related developments (2) designing a medical facility focused on the treatment of
injuries from major traumatic incidents and other injuries that require immediate
attention as well as the rehabilitation of the patients that have acquired disabilities
as a result of these accidents (3) the process of designing a medical institution that
will prove to be an optimum healing space for the treatment and rehabilitation of
physical trauma patients through the use of evidence-based design solutions (4)
the community by which the development will be made available as well as all the
target users, with all the expressways located in central Luzon accounting to 1,446
wounded individuals as of January to September of 2018 and the region of central
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Luzon reporting 2,396 cases on the same year, people that has sustained injuries
either life-threating or not and patients suffering from disabilities as a result of these
accidents, (5) the operational flow and the needed spaces of the structure such as
an emergency department equipped to provide treatment in an instant and where
both patients and healthcare providers can move with ease to reduce traffic, as
well as spaces for general surgery and specialties for instant care for patients that
has suffered physical trauma such as orthopaedic surgery, neurosurgery,
anesthesiology, radiology, plastic surgery, oral and maxillofacial, pediatric, critical
care, wards, rehabilitation rooms and open spaces where in-patients can spend
their time with minimal support from other people despite constraints in their
physical abilities.
The design of the development will only be focused on how architecture can
prove to be a means of guaranteeing better healing through the design of spaces
and the utilization of environmental factors, such as the value of daylight, the
connection with nature, and the provision of open spaces for the users in a hospital
setting. The development will only be catering to the region of Central Luzon
because of constraints in travelling; one of the characteristics of a trauma center
is that it should be as near as possible in an accident-prone areas such as the
expressways located in central Luzon namely NLEx, SCTEx, TPLEx, and CLLEx,
to ensure better chances of survival and the reduction of risks to a life-long
disability.
This study also delimits the acquired disabilities related to psychological and
mental aspects because it requires a different type of treatment that the users may
be able to access in a mental health institution, and that rehabilitation care in this
development will focus solely on the restoration of motor-skills and skills lost due
to acquired traumatic brain injuries.
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Due to an unforeseen situation in the midst of a global pandemic, this study
will only be using data gathering techniques that can be done virtually without
physical contact for safety purposes.
Justification of the Study
With living in an age of advancement, where accidents happen when we
least expect them, there must always be a place that can attend to all emergency
situations. A trauma center that is well-equipped and can provide whatever service
needed to save a life in a setting where these accidents are bound to happen is
crucial. Treatment should always go hand in hand with rehabilitation, to ensure that
these accidents will not impair the patient’s chance to go back to the life that they
had before any of the unfortunate things happened. This proposal will provide a
medical facility that will cater to the needs of a physical trauma patient; from the
time they have been taken to the establishment to their assimilation back to
society. This will promise a better chance of not just survival but the reduction of
costs in traveling to different hospitals just to receive treatment.
With the usage of evidence based design solutions, the development will
have a better chance of becoming the best possible place for healing, because
although we are guided by different standards for the design of our structures,
sometimes what is only used is the minimum standards and these decisions lead
to the sacrifice of the user’s well-being. Through the evidence based design
approach, an approach that is backed up by research, all decisions when it comes
to the designing of the development will ensure the achievement of an optimal
healing environment.
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Definition of Terms
The terms used in this study have been taken from different reliable sources
that can be found in the internet which includes medical journals, articles, as well
as dictionaries. The operational definitions are stated depending on what their
function are in the research as indicated by the researcher.
I- Glossary
Injury - is damage done to the body by an external force and is often
used interchangeably with physical trauma according to the World
Health Organization in their ‘Guidelines for Essential Trauma Care’.
Major Trauma – University Hospital Southampton, Hampshire
states that this term is used to describe multiple serious injuries that
can result to life-threatening harm and can be a result of accidents,
sports or violence.
Interpersonal Violence – According to the World Health
Organization, this term refers to violence between individuals which
can be categorized into child maltreatment, intimate partner violence,
elderly abuse and also includes youth violence, assault by strangers
and violence in workplaces or other institutions. This with the goal of
harming another individual that may lead to injury or death.
Out-of-hospital – In the world of emergency medicine, this is an
event or accident that has occurred outside the premises of a
medical facility.
Golden Hour – concept created by Dr. Adams Cowley, the “Father
of Trauma Medicine”. This states that if an individual is critically
injured they have less than 60 minutes to survive, one might day 3
days or 2 weeks later but something has already happened in the
body that will be irreplaceable.
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Rehabilitation – According to the WHO, the goal of this process is
the restoration of some or preferably all of a patient’s capabilities that
he/she has lost due to an injury.
Physical Trauma – According to the National Institute of General
Medical Sciences, this refers to injury that has potential to cause
serious damage towards the body. Can be one of two types:
(1) Blunt force trauma - when an object or force strikes the
body, often causing concussions, deep cuts, or broken
bones. The procedure of treatment for this type of surgery
needs to be non-invasive as much as possible.
(2) Penetrating trauma - when an object pierces the skin or
body, usually creating an open wound. The type of
treatment required here most of the time is through
operation and surgery.
Acquired Traumatic Brain Injury – According to the Brain Injury
Association of America, this is an injury to the brain that is not caused
by hereditary, congenital, degenerative, or induced by birth trauma.
It is essentially a brain injury that occurred after birth. It is rather an
alteration of brain function caused by an external force.
II- Abbreviations
NCIPC – National Center for Injury Prevention and Control
CDC - Center for Disease Control
DPCB - Disease Prevention and Control Bureau
DOH – Department of Health
AO – Administrative Order
ONEISS – Online National Electronic Injury Surveillance System
NLEX – North Luzon Expressway
SCTEX – Subic-Clark-Tarlac Expressway
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TPLEX – Tarlac-Pangasinan-La Union Expressway
CLLEX – Central Luzon Link Expressway
WHO – World Health Organization
III- Operational Definition
Trauma Center – This is a medical facility which focuses on
providing immediate care towards a life-threating injury. It involves
the presence of specialized services, such as trauma surgery, where
emergencies are treated as early as possible.
Optimal Healing Environment – According to the Samueli Institute,
this refers to the state of a medical facility that is the best possible
environment for the support of a patient’s inherent ability to heal as
well as their relationships and their healthcare providers.
Evidence-based Design – is the process of designing a structure or
a physical environment based on research for the achievement of
the best possible outcomes.
Environmental Factors – refers to the components of nature that
architecture can utilize and use for the improvement of a space and
user-experience.
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CHAPTER 2
METHODOLOGY
This chapter provides details on the research methodology that will guide
the proponent through the course of this study. The intention of this chapter is to
have a basis on how information and data can be logically obtained. The intention
of this chapter is to show how data will be properly handled or gathered.
2.1 Research Paradigm
For the achievement of a physical treatment and rehabilitation center that is
highly relevant and functional the researcher has followed the paradigm above.
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Where the problem, goals and objectives were identified and set during the first
stage of research which is setting up through the review of different articles and
journals relevant to the study. After these has been set up, it is then time to access
different sources relevant to the study, these data are then gathered through the
use of mixed methods mode of research. The type of MMR used in the study is
called the Sequential Transformative; this is characterized by the usage of either
qualitative or quantitative data first and the results are integrated into an
interpretation phase, highly useful in an architectural research paper where
findings are interpreted into an end product which is a structural development. The
researcher will be using this method in order to strengthen the study, by acquiring
some quantitative data such as statistics and becoming a basis of the relevance
of the study while also using the acquired quantitative data as a basis for coming
up with qualitative approaches to gain more depth and provide interpretative
possibilities.
The this study also used both the interpretive and case study approach of
qualitative research, wherein interpretive method is considered one of the most
naturalistic approach of data collection which includes interviews, surveys for
experienced users, as well as the interpretation, analysis, and understanding of
literatures. In the case study model, the researcher will be conducting studies
depending on the ones relative to the development or to the design approach. For
the quantitative approach to data collection, the researcher will mainly use
secondary statistical data from both private and government agencies.
The use of MMR is often seen in translational research where all the
research done leads to a practical setting, such is needed in a research of an
architectural focus. In studies of health, in the case of this research; healthcare
design, Tripp-Reimer and Doebbeling (2004) stated that the use of qualitative
research in a quantitative study adds ‘human dimensions’ to the care of patients,
thus the researcher has deemed it fit for MMR to be used.
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As shown in the figure above, data collected was then be processed and
used in the identification of spaces and programs needed in the development, the
concepts and approaches, as well as user analysis. These information are then
processed and architectural solutions are then formulated and evaluated to form
the translations to architectural plans.
2.2 Research Design
This research adapted the 5As of Ian Jukes, Anita Dosaj and Bruce
MacDonald (2000) which focuses on information processing. This research model
presents a manual for effectively imbedding information literacy skills across all
grade levels and subject areas. The elements of the 5As include:
● Asking- key questions to be answered
● Accessing- relevant information
● Analysing- the acquired information
● Applying- the information to a task
● Assessing- the end result and the process
Research Methods
A. Setting up for Research
This part of the research entails that all key questions that are observed by
the researcher be identified. All the issues by which the general public, a certain
locality, both the natural and built environment are very much involved. After all of
this relevant information or issues are identified by the researcher, the scope is
then determined based on the academic focus, the purpose and the objective of
the research so the proponent has a guide for the data required in order to provide
a solution.
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The main purpose of this study is to provide well-equipped and effective
healthcare facility victims that have acquired injuries sustained from both
accidental and intentional. This facility will cater to their needs from the beginning
of the emergency situation to their rehabilitation and in turn ensure their
reintegration to society as fully-functioning individuals. This development will also
uphold the Department of Health’s vision of reducing victims of injuries and
violence that lead not just to life-long disabilities but also death.
B. Accessing Sources
After all relevant issues have been identified by the researcher; the next
step is to access the needed data that will aid the study in finding for a solution to
the problem. These sources may include journals and research papers of
relevance to the topic, a collection of laws and legal basis for the proposal, case
studies of which the researcher can be provided more insight not just on similar
developments but also the research topic. The next thing is the collaboration with
different officials or agencies that could provide more insight on the development
and be able to share the ideas that have been formulated by the researcher.
To accumulate these data the researcher will need to use reliable and
verified sources not just through internet browsing but also through visits in the
library to access available information. Another way to gather information is to
collaborate with different officials such as knowledgeable officials of the topic from
the Department of Health, City Health and Planning officials from the sites,
Philippine Society on Trauma Surgery and Philippine Orthopaedic Trauma Society
for insights on trauma care in the Philippines, and the Toll Regulatory Board for
data on accident rates for the accident prone area expressways in Central Luzon.
Due to the pandemic that has resulted in the constraints to the data
gathering of the researchers, some relevant information to the study are accessed
through digital means. Interviews have been done through online meeting through
15
different video calling platforms, surveys are only distributed through social media,
coordination with relevant organizations are limited to email exchanges, and some
statistical and descriptive data are accessed only via the internet. But despite this
limitation, the researcher has collected information relevant to the pursuit of this
study.
Sources of Data
1. Primary Sources
The table below shows all the agency and officials by which the researcher
will seek to acquire the data needed as well as what information will be needed
from them and its application to the study.
APPLICATION TO
DATA PURPOSE PROCEDURE
THE STUDY
Gathering
Sources
Procedure
The researcher has

conducted a semi-
The information structured interview
that will be and provide major
gathered will questions such as the
To gain their
serve as a guide current status of AO
insights on the
for the 2014-002 and other
development as
Department of Health researcher in programs
well as further
National Focal Person / Program putting the implemented by the
Interview knowledge on AO
Manager country's best DOH to ensure that
Dr. Clarito U. Cairo, Jr. 2014-002, or the
interest in violence and injury is
Violence and Injury
achieving better prevented through
Prevention
health situations email. Other follow-
program.
through up questions that the
architectural researcher deems to
interventions. be of importance to
the study will be
asked on the spot.
16
The researcher has
To acquire
contacted Ar.
knowledge from a
The data to be Lichauco for a semi-
well-versed
collected has structured interview
architect on
been utilized in via Facebook
hospital design. To
the researcher's Messenger. They
also gain his
design have already
Ar. Dan Lichauco insights on the
considerations to conducted a voice
proposed
ensure that call where the
development and
patients are researcher has
also receive his
getting the best inquired the
advices for the
user experience. questions sent prior
improvement of the
to the scheduled
design.
date.
As the The researcher has

To gain proper
development will contacted the office
guidance on the
be government of DOH for an
design of hospitals
funded, it is interview regarding
from the
Department of HealthAr. important to their plans on
perspective of
Jean Paolo Policarpo gain insight on Healthcare Facilities.
professional well-
the agency that The interview has
versed on the
will be taken place in Google
standards set by
overseeing the Meet. It was a semi-
the government.
development. structured interview.
17
The office of Rep.
Suansing has replied
to all inquiries of the
researcher, although
there has not be a
The proponent face-to-face-
of the bill as well interview, the
as the researcher has
To gain recent
representative provided a semi-
developments on
by which the structured interview
House Bill 1960 as
development will questions via
filed in the 17th
be put might Facebook Messenger
Congress by Rep.
have insights on of the official of Rep.
Suansing, the bill
Office of Rep. Estrellita the possible Suansing. Her kind
that seeks for the
Suansing improvement of office has taken the
establishment of a
1st District Representative the time to reply to all
Nueva Ecija
premiere
development. All inquiries of the
healthcare facility
response from researcher and has
located in the
the person of given an update on
vicinity of the
interest will be the current status of
accident prone
taken into the bill. They have
expressways of
account and thus informed that they
Central Luzon.
be proven useful are currently
to the undergoing a
researcher. research and refiling
the bill soon and has
provided
encouragement to
the researcher's
study.
18
The researcher used
The researcher
Google Forms as a
utilized the data
The development medium of acquiring
gathered from
uses evidence- data. She will be
this survey to
based design, using a sample size of
take into
therefore it is 40 respondents as to
account the
crucial to gain get an idea of what
Survey Physical Trauma Survivors user's
insights from users physical trauma
experience, may
that has patients may have
it be good or
experienced the gone through from
bad, and use it to
traumatic accidents the time the accident
improve the
and survived them. happened to long
proposed
after the injury has
development.
healed.
Table 1. Primary Sources of Data
The data acquired from the sources above is mainly of qualitative nature.
All the knowledge gathered from different healthcare professionals, both doctors
and designers, has been used for better understanding on the care for trauma
patients.
2. Secondary Sources
The table below shows all data that have been acquired from research
papers and journals, case studies, statistical data, regional health profile from
Central Luzon, and the profile of the municipality where the site is located.
19
DATA
APPLICATION TO THE
PURPOSE
Gathering STUDY
Materials Sources
Procedure
To know the physical
properties of Zaragoza.
Data will include the
The profile of Zaragoza
following:
provided a more in
1. Hazards Maps
depth knowledge on the
2. Area maps
a fraction of the
3. Land-Use Map
Profile of Office of Planning and project's users as well
4. Location Maps
Zaragoza, Development, Zaragoza as Valenzuela's physical
5. Road Network Map
Nueva Ecija Municipal Hall profile that will be
6. Topographic/Slope
deemed as useful for
Map
the architectural
translation of the
other information needed
development
will also include:
1. Vacant Lots
2. Socio-economic Profile
Through the data

gathered, the
researcher will be able
Central Luzon To gain insight on the to get the idea on the
Regional Office of the
Center for scale of users the number of users the
Central Luzon Center for
Health development will be development will need
Health Development
Development attending to. to cater and therefore
Request for will be prepared to
Data - Virtual attend to all emergency
situations.
to know what concepts

and design strategies can
be applied to the project
of same context
to know what
The aspects taken from
architectural evidence
these existing structures
based solutions are
(both negative and
applied to each
positive) has been
development and its
assessed and the
effects on the users and
Case Studies Local positive outputs was
the natural and built
applied to the
environment of a
development while
heathcare facility
ensuring that all
negative impacts are
to know what negative
avoided.
aspects in each
development can be
avoided so as to ensure a
better environment for
the current project
proposal
East Avenue Medical to know what concepts The aspects taken from
Research Case Studies
Center and design strategies can these existing structures
20
Documents and Las Pinas General be applied to the project (both negative and
Records Hospital and Satellite of same context positive) has been
Trauma Center assessed and the
to know what positive outputs applied
Foreign architectural evidence to the development
Khoo Teck Puat Hospital based solutions are while ensuring that all
Landstuhl Regional applied to each negative impacts are
Medical Center – Level I development and its avoided.
Trauma Center effects on the users and These documents and
the natural and built records greatly provide
Bristol Southmead
environment of a assistance and serve as
Hospital – Design for
heathcare facility guide for the
Single-room wards
researchers in the doing
Queen Elizabeth to know what negative of their own projects.
National Spinal Injuries aspects in each These also provide
Unit – Horatio’s Garden development can be relevant knowledge on
avoided so as to ensure a the topic of not just
better environment for hospital design and
the current project healthcare but also in
PUP Library proposal the context of injury
(Main and CEA) to acquire intial prevention in the
knowledge from previous Philippines.
proposals of same
context as the study
These documents and
records greatly provided
To access different assistance and serve as
National Library research papers relevant guide for the
to the study researchers in the doing
of their own projects.
These also provide
relevant knowledge on
Documents and the topic of not just
Records hospital design and
Local and healthcare but also in
Foreign the context of injury
Materials prevention in the
relevant to the To gain different Philippines.
Department of Health
Study materials on the different The development is an
Staffing and Design
standards of Healthcare optimal healing
Standards
design in the Philippines environment with the
application of both
evidence based design
solutions as well as the
different standards
provided by the
government.
Local and
Foreign To gain statistical data The data served as
Materials Global Health Estimates from an international proof of the burden that
relevant to the 2016: Disease burden sources that clearly physical trauma has on
Study by Cause, Age, Sex, by shows the issue of the lives of people as
Information Country and physical injury towards a well as provide the
from by Region; WHO global, regional, and relevance of the study
Government national scale towards a grave issue
Sectors
21
Through the maps
obtained, the
researcher had a clearer
view of the site and
NAMRIA, PHIVOLCS, To obtain maps relevant therefore know what to
PAG-ASA, and NDRRMC to the study utilize and what to
improve in the
development itself to
match with the
conditions of nature.
This further enhanced

the justification of the
To obtain the Philippine study concerning the
Department of Health
Health Statistics statistics of individuals
who are victims of
Physical Trauma
Information Through the data

from gathered, the
Government researcher was able to
Sectors To gain statistical on get the idea on the
Relevant Videos Philippine Statistics death rates caused by number of users the
on Trauma Authority accidents or deliberate development will need
(Rehabilitation, cause of violence to cater and therefore
Experiences, will be prepared to
and Design) attend to all emergency
situations.
Due restrictions for safety

purposes, the researcher
cannot observe in a
hospital seting, these
These educational
videos in turn will provide
videos filled the
information to the
researcher with the
researcher about the
Youtube knowledge on how to
experiences of real-life
design for the people
patients that have
that will use the
undergone theraphy. As
development.
well provide insight on
what really is the
situation inside a trauma
care facility.
Table 2. Secondary Sources of Data
22
C. Processing Information
In this part of the research, all data that has been gathered will be carefully
analysed by the proponent. All consolidated data will be looked at in the context of
architecture and how it will affect the issue and provide solutions to it in an
architectural perspective.
The researcher shall then provide a user analysis from the statistical data
acquired as well as the staffing requirements as provided by both standards and
the data from research. The user analysis will be crucial in the architectural
programming of spaces that will also be acquired through the information provided
by the professionals interviewed and the research materials the researcher has
been given access to such as the documents and records and the local and foreign
materials relevant to the study.
D. Transferring all Data to Learning
This part of research translates all acquired data and information and
formulates conclusions and recommendations from these. It is also where final
details of the design of the development are conjured.
E. Evaluation
This is the final part of the research where all architectural solutions
provided are assessed and translated into architectural drawings and design
frameworks. In short, this is the part where the architectural solutions and
strategies derived by the researcher from the data acquired are tested.
23
2.3 Tools/Materials Used in Research
TOOLS PURPOSE
The cellphone can both serve as a camera to capture important
CELLPHONE moments as well as a recording device for video and during
interview so that all important information is captured
The laptop is used in doing the write-up related to the research
papers, it is also a useful tools during the research process and
LAPTOP
when sending emails to officials who are possible primary sources of
data
In order to record information during interviews or even in mere
NOTEBOOK AND PENS
observations, the researcher will use a notebook and some pens
To store important information such as statistical data that may be
FLASHDRIVE
provided only in soft copy form from other agencies
This is useful in research to access readily made information as well
INTERNET
as a means of communication
BOOKS/JOURNALS/RESEARCH These verified data sources from libraries are crucial to the study
PAPERS specially in acquiring initial solutions to the architectural problem.
This will be used during interviews set by the researcher with the
ONLINE VIDEO
professionals whose knowledge is needed for ensuring a
CONFERENCING PLATFORMS development that is optimal for its users.
This will be used for better used understanding because it will be
SURVEY FORMS
answered by a population of physical trauma victims/survivors.
Letters are used as a means of verification when acquiring data that
LETTERS is not easily accessible to the public. Shows that the researcher has
authorization to conduct the study and acquire the data they need
Table 3. Tools/Materials used in Research
24
CHAPTER 3
REVIEW OF RELATED LITERATURE
3.1 RELATED LITERATURE
I – Physical Trauma
Physical Trauma is defined by the National Institute of General Sciences of
the United States Department of Health as serious injury to the body and according
to the WHO, injury and trauma is used interchangeably. The Philippine College of
Surgeons, Committee on Trauma then defines injury as a bodily lesion resulting
from exposure to energy interacting with the body in the amounts that exceed the
limits of physiologic tolerance.
A. Types of Physical Trauma
According to the World Health Organization, physical trauma or injuries are
sustained through road traffic collisions, drowning, poisoning, burns, falls,
occupational injuries and violence.
1. Road Traffic Injuries – As of February 7, 2020, the WHO states that
approximately 1.35 million people die each year from these accidents. These
accidents are commonly because of human error such as speeding, driving under
the influence, non-use of helmets and seatbelts, distracted driving, unsafe road
infrastructure, and unsafe vehicles which makes it highly preventable. The World
Health Organization also states that because of inadequate post-crash care
increase the severity of these injuries are increased.
2. Drowning – According to the World Health Organization, this is the
process of experiencing respiratory impairment due to submersion to liquid which
then results in injuries or death. As of February 3, 2020, it has been classified by
the WHO as the 3rd leading cause of unintentional injury deaths worldwide which
25
then accounts for 7% of all injury-related deaths. Drowning has an estimated
320,000 deaths each year internationally.
3. Poisoning – injury occurs when individuals ingest or touch enough of a
hazardous substance/poison. This can cause injuries and illnesses in small
amounts but can cause deaths in large doses or through long-term exposure. The
World Health Organization states that natural and technological disasters can lead
to release of toxic chemical which in turn harm human beings.
4. Burns – The World Health Organization states that burns are injury that
are acquired because of heat, radiation, radioactivity, electricity, friction, or contact
with chemicals which damage the skin or other organic tissue of the body. As of
March 6, 2018, there is an estimated 180,000 deaths per year due to burns and
the majority of these cases occur in low- to middle-income countries and non-fatal
burns are the leading cause of morbidity worldwide despite being highly
preventable.
5. Falls – this is defined by the WHO as when an individual has
unintentionally come to rest on the ground or floor or other lower level. The
organization has stated that as of the 16th of January, 2020, falls are the second
leading cause of accidental injury deaths worldwide and has an estimated 646,000
individuals die each year and 80% of those are from low- to middle-income
countries. Adults older than 65 years are the most susceptible to falls and about
37.3 million falls are severe enough to require medical attention annually.
6. Occupational Injuries – these injuries are ones contracted primarily
because of exposure to risk factors in a work environment according to the WHO.
As of November 30, 2017, the World Health Organization Reports that
occupational risks such as injuries which accounts for 37% of all cases of backpain
and also accounts for 8% of injuries.
26
7. Violence – the Violence Prevention Alliance which is part of the Global
Campaign for Violence Prevention of the WHO defines violence as “the intentional
use of physical force or power, threatened or actual, against oneself, another
person, or against a group or community, that either results in or has a high
likelihood of resulting in injury, death, psychological harm, maldevelopment, or
deprivation." It is categorized into three which includes self-directed violence
(where the perpetrator and the victim are the same person), interpersonal violence
(refers to violence between individuals), and collective violence (refers to violence
commited by larger groups of people).
B. Trauma Profile
The 2016 Philippine Health Statistics from the DOH Epidemiology Bureau has
shown that the top 3 regions of the country having the most deaths are
CALABARZON with 82,764 deaths, followed by NCR with 76,839 deaths and
Central Luzon with 68,757 deaths (Figure 5), but among these three regions only
Central Luzon had the highest percentage of deaths that was not attended by a
medical professional with attended cases accounting to 37.5% and not attended
cases with 62.3% (Figure 7).
The graph in Figure 6 shows the top 10 leading causes of death in the
Philippines as per 2016 published by the Department of Health. Accidents are in
the top 5 of the list with a total 44,426 deaths. It also shows that 15,666 are
attended by medical professionals while the number of cases not attended are
higher with 28,507 and 253 are not stated.
Accidents are third on list of causes of mortality that was not attended by a
medical professional (Figure 7). The same publication has stated that for every 5
deaths caused by an accident, 3 were not attended medically.
The consolidated health statistics also showed that in selected causes of death
per region, Central Luzon had the highest number of deaths caused by transport
vehicles with 1,356 deaths in 2016 and 241 cases of death due to falls (Table 5).
27
It also had the highest number of deaths due to accidental drowning with 368 and
third on the list for deaths due to assault at 4,982 with NCR coming in first with
2,796 cases and CALABARZON at 2,074 in second (Table 6).
According to the Global Health Estimates 2016, a study conducted by the
World Health Organization, road injury and interpersonal violence, both
classifications of physical trauma, as shown in Table 7 ranks 6th and 19th in years
of life lost in the 20 leading causes of death globally.
Another study by the WHO, entitled “Injury and Violence: The Facts” show
that with the how mortality from injuries have been rising for the past years, Table
8 shows where it will be in the year 2030. It shows that road traffic injuries will jump
two spots and will become 7th in ranking for causes of death worldwide and Falls
which is previously not included in the top 20 ranking will ensure a spot.
Situation of Trauma Care in the Philippines
a. Overview of Healthcare in the Philippines
According to an article entitled “10 Shocking Facts about Healthcare in the
Philippines” published on June 16, 2017 by Katelynn Kenworthy, the WHO refers
to the Philippines’ healthcare system as “fragmented” which means that there is a
history of unequal access to healthcare between the rich and the poor that causes
high out-of-pocket expenses. An article published by Hans Jesper del Mundo also
posts about the shortage of hospitals and healthcare workers in the Philippines.
He states that the healthcare in the Philippines creates an illusion that our country
does not produce an adequate amount of healthcare workers when this is in fact
not the truth. With the annual production of 38,000 nurses and 4,500 physicians,
but even with these numbers being sufficient the ideal number of healthcare to
patient ratio is still far from ideal because there are just not enough job
opportunities especially in government hospitals leading for some to either go
abroad or change career paths. There is especially a shortage for hospitals in rural
28
areas despite incentives given by the Department of Health due to lack of
equipment and improvement of hospitals there, being the budget of our country
only allots 4.2% for healthcare. Among the 18 regions present in the Philippines,
only four has the sufficient number of beds per 1000 population. In fact, according
to a study made by the Philippine Center for Investigative Journalism, as of 2018,
the ratio of government hospital beds to patient ratio is 1:2,320 which is far for the
Department of Health’s goal of 1:800 beds to population ratio. The article also
posts that the ratio of government hospitals to population in Central Luzon is
1:200,908. Although Central Luzon is among the regions with the highest number
of mortality it only accounts to 52 government hospitals, the same number as NCR,
while CALABARZON has 72 government hospitals.
According to an article published in the Philippine News Agency in 2018
(Montemayor, Teresa), Trauma remains one of the leading causes of death in the
Philippines and that trauma care, according to President Alejadro Dizon of the
Philippine College of Surgeons, is different from basic life-support training. He
stated "CPR (cardiopulmonary resuscitation), basic resuscitation techniques
address patients who are unconscious or in cardiac arrest. The other is for
immediate treatment and resuscitation of trauma patients. There are specific things
you need to do to a trauma patient. The biggest problem of injury and death, among
them, is loss of blood and organ damage due to the trauma."
An article entitled “At a glance: The Philippine Healthcare System”
published by The Manila Times on April 26, 2018 poses facts on the country’s
stand on Emergency Services, with only a few institutions actually have the
capacity to measure up to international standards. With the few being only private
hospitals or tertiary care facilities. Some facilities actually cannot handle cases of
complex trauma and major emergency situations.
To this day, the Philippine College of Surgeons (PCS) in agreement with
the American College of Surgeons has launched a course called the Advanced
29
Trauma Life Support or the ATLS. ATLS is an educational initiative of the American
College of Surgeons (ACS) aimed at reducing death or disability following
traumatic injuries. It is a standardized program taught in 60 countries with over a
million doctors (surgeons and non-surgeons) already trained worldwide. It targets
the initial “golden hour” when a trauma patient is first seen by a doctor in a medical
facility and which may spell life or death for the patient.
C. Rehabilitation after Major Trauma
The World Health Organization defines Rehabilitation as a set of
interventions designed to optimize functioning and reduce disability in individuals
with health conditions in interaction with their environment. This organization states
rehabilitation is needed in an individual’s life when they arrive at a point in their
lives after they have experienced injury, surgery, disease or illness, or due to the
decline in age. This highlights that rehabilitation can help to reduce, manage or
prevent complications because of certain injuries such as spinal cord injuries or
fractures. The World Health Organization addresses that rehabilitation should not
be a luxury health service only available to the people that can afford it and should
be started following the notion of a health condition alongside other medical
interventions. As of October 26, 2020, there is an estimated 2.4 billion people living
with health conditions that benefit from rehabilitation programs. Rehabilitation
programs continue to be unmet specially in low- and middle-income countries
where 50% of patients do not receive the rehabilitation they require to fully recover.
According to the Better Health Channel, depending on injuries, rehabilitation
services may include orthopedic rehabilitation, post-amputation rehabilitation,
neurological rehabilitation, hand therapy, pediatric rehabilitation, and burns
rehabilitation. The Philippine Academy for Rehabilitation Medicine also includes
rehabilitation programs for hip injuries, lower back, shoulder, neck, etc. which
includes aquatic therapy, balneotherapy, Electrical Muscle Stimulation (EMS),
multi-modal therapy, tai chi, Transcutaneous Electrical Nerve Stimulation (TENS),
30
and cold therapy. The Space Planning Criteria for Physical Medicine and
Rehabilitation Service of Veterans Health Administration of Washington, D.C.
which was last revised on October 3, 2016 also provides programs which includes
kinesiotherapy, occupational therapy, physical therapy, and vocational
rehabilitation therapy. The New Jersey Department of Health in their “Licensing
Standards for Rehabilitation Hospitals” also provides insight on services such as
speech-language pathology and orthotics and prosthetics.
Categorization of Major Trauma Centers
The Committee on Trauma of the Philippine College of Surgeons has
provided a pattern for Trauma Accidents (Figure 8) wherein it shows that the first
phase should always be prevention, because although these types of incidents are
unpredictable, they are also preventable. The second phase is through the Trauma
System and lastly Critical Care and Rehabilitation with notes from their
recommendations their hope for the standardization of Trauma Care through the
ATLS and Disaster Preparedness.
The American Trauma Society has provided three categorizations of major
trauma centers according to the specializations and scope of the services they
offer on trauma patients. The different categories are as follows:
Level I
Level I Trauma Center is a comprehensive regional resource that is a
tertiary care facility central to the trauma system. A Level I Trauma Center is
capable of providing total care for every aspect of injury – from prevention through
rehabilitation. A Level I Trauma Center may also be able to admit 1,200 patients
yearly.
Elements of Level I Trauma Centers Include:
31
 24-hour in-house coverage by general surgeons, and prompt availability of
care in specialties such as orthopedic surgery, neurosurgery,
anesthesiology, emergency medicine, radiology, internal medicine, plastic
surgery, oral and maxillofacial, pediatric and critical care.
 The operation room must be available within 15 minutes, a 24 hour
laboratory service as well as an adequate supply of blood.
 Referral resource for communities in nearby regions. Helipads are usually
incorporated for receiving patients that need to be airlifted so they can
receive faster and better medical care.
 Provides leadership in prevention, public education to surrounding
communities.
 Provides continuing education of the trauma team members.
 Incorporates a comprehensive quality assessment program.
 Operates an organized teaching and research effort to help direct new
innovations in trauma care.
 Program for substance abuse screening and patient intervention.
Level II
A Level II Trauma Center is able to initiate definitive care for all injured patients.
Elements of Level II Trauma Centers Include:
 24-hour immediate coverage by general surgeons, as well as coverage by
the specialties of orthopedic surgery, neurosurgery, anesthesiology,
emergency medicine, radiology and critical care.
 Tertiary care needs such as cardiac surgery, hemodialysis and
microvascular surgery may be referred to a Level I Trauma Center.
32
 Provides trauma prevention and continuing education programs for staff.
 Incorporates a comprehensive quality assessment program.
 Meets minimum requirement for annual volume of severely injured patients.
Level III
A Level III Trauma Center has demonstrated an ability to provide prompt
assessment, resuscitation, surgery, intensive care and stabilization of injured
patients and emergency operatio
Elements of Level III Trauma Centers Include:
 24-hour immediate coverage by emergency medicine physicians and the
prompt availability of general surgeons and anesthesiologists.
 Incorporates a comprehensive quality assessment program
 Has developed transfer agreements for patients requiring more
comprehensive care at a Level I or Level II Trauma Center.
 Provides back-up care for rural and community hospitals.
 Offers continued education of the nursing and allied health personnel or the
trauma team.
 Involved with prevention efforts and must have an active outreach program
for its referring communities.
Level IV
A Level IV Trauma Center has demonstrated an ability to provide advanced trauma
life support (ATLS) prior to transfer of patients to a higher level trauma center. It
provides evaluation, stabilization, and diagnostic capabilities for injured patients.
Elements of Level IV Trauma Centers Include:
33
 Basic emergency department facilities to implement ATLS protocols and 24-
hour laboratory coverage. Available trauma nurse(s) and physicians
available upon patient arrival.
 May provide surgery and critical-care services if available.
comprehensive care at a Level I or Level II Trauma Center.
 Incorporates a comprehensive quality assessment program
 Involved with prevention efforts and must have an active outreach program
for its referring communities.
Level V
A Level V Trauma Center provides initial evaluation, stabilization and diagnostic
capabilities and prepares patients for transfer to higher levels of care.
Elements of Level V Trauma Centers Include:
 Basic emergency department facilities to implement ATLS protocols
 Available trauma nurse(s) and physicians available upon patient arrival.
 After-hours activation protocols if facility is not open 24-hours a day.
 May provide surgery and critical-care services if available.
comprehensive care at a Level I though III Trauma Centers.
These trauma centers are awarded these levels through a process of
designation or verification. The different levels refer to the kinds of resources
available in a trauma center and the number of patients admitted yearly.
ANALYSIS AND APPLICATION TO THE STUDY
With all the increasing numbers of physical trauma cases and a healthcare
system that is far from being ideal, the Philippines is stall lagging behind on the
provision of a premier trauma care center which can provide most if not all all the
34
services needed for the treatment and rehabilitation of said cases. All the issues
posed about the situation of healthcare in the Philippines has played a vital part on
what problems the researcher seeks to address. Other countries have provided
categorizations of trauma care facilities, and with trauma still being one of the
leading causes of not just death but also disability, we must be able to provide the
same type of developments. This proposal can be patterned to what the American
Trauma Society categorizes as a Level I Trauma Center that provides care from
treatment to rehabilitation.
II – Optimal Healing Environment
The World Health Organization (WHO) defines “healing” is not merely the
absence of disease and infirmity but the state of complete physical, mental & social
well-being. With this the researcher has deemed it fit to aim for the achievement
of an optimal healing environment for a healthcare facility.
A study entitled “Optimal Healing Environments” published in May 2015
provides a framework on OHE which includes 4 different environments namely
internal, interpersonal, behavioural, and external (Figure 4). These environments
provide direction to patients, families, care providers, and organizations to optimize
the potential for healing. Each of the environments and constructs of the OHE
framework work synergistically to support and stimulate health creation and
healing (a concept known as salutogenesis). (Sakallaris, Bonnie et.al.)
The term Optimal Healing Environment was first coined by the Samueli
Institute (2004) which describes a healthcare system that helps the patient’s
inherent ability to heal, their families, and care providers.
A. Internal Environment
The concept of OHE begins with the individual themselves, thus the
integration of his and her internal environment. Internal environment includes the
individual’s thoughts, hopes, our expectations, emotions, intentions and beliefs
35
which have a direct impact on our bodies, choices, and our relationships. It starts
in the person’s individual internal environment because this dictates our bodies’
readiness to receive healing and be healed. In OHE, the usage of internal
environment is focused on engaging a healing that is mind-body-spirit. Imbalance
in one aspect can cause negativity in other, sever emotional stress can cause our
physical bodies illnesses and likewise a physical body that has attained illness or
injury can negatively affect the mind through depression and the like (Jonas Wayne
2019).
B. Interpersonal Environment
The interpersonal environment stated in OHE deals with a patient’s
relationship on a personal, professional, and organizational level. It can be noted
in the study on Optimal Healing Environments stated earlier, that one type of
interpersonal environment that can help with healing is through social structure,
with data showing that patients that receive social support from their healthcare
providers and family members have an impact on their behavior change, mortality
and morbidity. Research published by Carnegie Mellon University in the past
decade showed that social support and belonging can reduce stress, heart disease
and improve quality of life.
C. Behavioral Environment
The concept of an optimal behavioral environment is the patient’s ability to
promulgate healthy lifestyles which in turn will help in enhancing their innate
abilities to heal. What you eat, how much you move, and your ability to manage
stress has profound effects on your health and ability to heal. A healthy lifestyle is
one that incorporates adequate amounts and types of exercise, a nutritious and
balanced diet, relaxation and stress management, a balance of work and leisure,
sufficient sleep, and creative outlets. An OHE provides education, training, and
support for healthy lifestyles, attending to the needs of patients, family members,
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and staff. The behavioral aspect of an OHE is made up of those actions we take
to prevent illness, improve health and engage in self-care in a way that allows your
natural healing processes to emerge.
D. External Environment
The external environment in an OHE is the place where people work, live
and play. The intent behind the work of external environment is to create a positive
physical environment that cohesively supports the mind, body, and spirit to find
peace, rest, and vitality. Healing spaces evoke a sense of cohesion of mind, body,
and spirit, support healing intention, and foster healing relationships. Physical
space is one area of life over which most of us have some degree of control.
External environments support your healing and shows what can be done to
improve the things that you have the ability to change.
A patient’s healing is influenced by many factors, be it themselves or the
people around them, or the space by which they receive the treatments. Providing
an Optimal Healing Environment goes beyond making sure they are
psychologically prepared and mentally healthy, they must also be staying in a
space that is conducive for healing just as much as it is a place where curing is
possible. Although psychological factors have a huge impact on ones healing, how
we design those spaces in a physical setting is truly what optimal healing is about
in the context of architecture.
III – Evidence-Based Design
The concept of evidence-based design started in 1984, when Dr. Roger
Ulrich, professor of Architecture at Chalmers University in Gothenburg, Sweden
published a research paper that focused on patients and how they reacted to
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different room environments. Where in this study, he made half of the patients in a
room whose windows were faced to views of the nature, and half stayed in rooms
of brick walls. He found out that the patients that that stayed in the room with the
view of nature recovered quicker and need fewer painkillers. It was in 2003 when
the term “evidence-based design” was coined and defined by Ar. Kirk Hamilton, an
advocate for the usage of evidence-informed healthcare design.
Evidence-Base Design mostly shows the importance of improving
outcomes for a range of design characteristics or interventions which includes:
1. The Value of Daylight
2. Views of Nature
3. Good Acoustic Environment
4. Appropriate Lighting
5. Ergonomics
6. Acuity-Adaptable Rooms
7. Floor Layouts
According to the Center for Health Design, one of the agencies that are
prompting the use of EBD in hospital design, Evidence-Based Design is the
process of basing decisions about the built environment on credible research to
achieve the best possible outcomes. Included in this process are the following
eight steps:
 Define evidence-based goals and objectives.
 Find sources for relevant evidence.
 Critically interpret relevant evidence.
 Create and innovate evidence-based design concepts.
 Develop a hypothesis.
 Collect baseline performance measures.
 Monitor implementation of design and construction.
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 Measure post-occupancy performance results
Through evidence-based design, the environment can have a maximum
positive impact, and although architecture cannot provide a care, it can prove to
be a tool for the enhancement of the quality of care from these healthcare facilities.
A. The Value of Daylight
A paper entitled “Daylight Benefits in Healthcare Buildings” (Strong, DTG,
et.al.), reviews all research undertaken worldwide about the impact of daylight in
the design of healthcare buildings. The benefit daylight provides in factors such as
their length of stay, pain relief, and disinfection, reduction of stress and treatment
of depression. When it comes to the sunlight being one of nature’s most effective
disinfectants, this has been applied even in earlier times of architecture. When
After the First World War, a new form of modern architecture appeared, modelled
after the new tuberculosis sanitariums where they fought disease with design.
They didn't have antibiotics, but they had light, fresh air and openness.
Neutra, Le Corbusier and Chareau all designed iconic houses for doctor
clients around these principles (Alter, Lloyd 2018). Now in 2018, a study conducted
by Noel Kirkpatrick and Kevin Van Den confirms this popular notion, Kirkpatrick
therefore states in this study that in the dark rooms, they found that 12 percent of
the bacteria was still alive and able to reproduce, while the rooms exposed to
daylight only had 6.8 percent viable dust bacteria. Rooms that received only UV
light had 6.1 percent of viable bacteria. This study also shows that sunlight has
significance in improving air quality.
This literature included in this topic has provided the researcher with an
insight how important daylight really is in our designs; daylight going beyond as a
means of energy conservation but also its use as an effective tool in the medical
field through its antibacterial properties.
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B. Views of Nature
“Healing Architecture in Hospital Design” by Dinesh Anand (2016), lists the
examples of design interventions to healthcare buildings which includes
connection to nature through:
 Nature window views
 Garden accessible to patients
 Nature art : no abstract art
 Daylight factor
 Internal courtyard connected to ward, patient room
 Quiet coronary care unit
 Air quality
 Landscaped courtyard
 Floor to ceiling windows
 Setback landscaping
 Front porch
 Entry garden
 Plazas
 Roof terraces
 View/walk in garden
 Sound of water
 Roof Garden
 Wide walkways outside patient rooms
It was found that that humans have a deep need to connect to nature and
that even a brief view of a garden or interaction with a water element, for example,
can have immediate physiological benefits in terms of reducing stress and anxiety
(Ulrich 1984; Ulrich 1999; Parsons and Hartig 2000). Presence of nature elements
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like greenery and waterfall help in reducing environment stressors, providing
positive distraction, faster healing and thus reducing patient stay.
The literature above has provided a guide as to how to utilize nature in its
natural setting as a means of healing for the patients. Through the incorporation of
views to nature, the effects is beneficial to the reduction of stress caused by a
disease or an illness and in turn when applies to the development will ensure that
healing takes place and that patients have lesser amount of in-patient stay.
C. Good Acoustic Environment
A quiet hospital proves to be a challenging issue, and while the WHO
recommends that noise do not exceed 35dB, many studies conducted in hospitals
have found average background noise ranges between 45 dB and 68 dB, peaking
at more than 90 dB.
An article entitled “A Sound Plan: How to Achieve Optimal Healthcare
Acoustics” (Horwitz, Bennet, 08 Dec 2016), lists different solutions to acoustic
design of hospitals from different professionals.
The solution first presented is targeted design. Tina Larsen, principal at
Corgan (global architecture firm specializing in healthcare planning and design),
states that even in the design phase of architecture, there are many interventions
that can be done such as the usage of same-handed rooms (room layouts that are
the same for all) where the patient doors are further away which helps in reduction
of sound transmission, even when doors are left often.
According to Benjamin Davenny, senior consultant for acoustics in
Acentech, same-handed rooms have the benefit of cancelling high-frequency
sounds transmitted by the patient’s oxygen pipes. One problem though is that in
same handed-rooms a toilet wall of another room is attached to another patient’s
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non-toilet wall resulting in plumbing noise transfer, but Davenny also provides a
possible solution for this problem through the utilization of double-stud construction
can be used to prevent pipes from coming into rigid contact with the wall framing
supporting the gypsum wall board on the adjacent patient room. Alternatively,
Davenny recommends resilient pipe clamps to attach the plumbing pipes to the
stud framing and prevent the pipes from touching the wall.
Larsen notes that mirrored rooms’ back-to-back headwalls are also
vulnerable to sound transmission caused by electrical and medical gas
penetrations in outlets along the shared wall and outside of headwall units.
To better control noise entering patient rooms, Davenny says an inboard
configuration with toilet rooms placed adjacent to the corridor creates a nice barrier
between the patient bed and door. However, another consideration is that inboard
toilets may obstruct staff’s ability to observe patients from outside. Consequently,
this isn’t an ideal layout for higher acuity rooms such as cardiac care or for patients
with fall risks. However, in spaces like postpartum units, the inboard configuration
would be an effective choice.
Nurses’ stations are also often sources of noise. Rich Dallam, partner at
NBBJ (Seattle), states that it is important that nurse’s stations are dispersed so as
to avoid employees from congregating in a single place. This approach will only
limit hallway conversations and will still provide the staff with spaces where they
can collaborate, these spaces should be acoustically separated from the patient
rooms along with staff lounges.
The selection of fabric, flooring, and ceiling materials can also have a
significant effect on sound reduction in healthcare facilities. For example, Anna
Mancini, an interior designer at Shepley Bulfinch (Boston), recommends acoustic
ceiling tiles with a high noise reduction coefficient (NRC), rubber flooring, sound-
absorbing flooring backing, and sound-absorbing wall panels to limit noise
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transmission levels. Tom Simbari, senior project manager at Bergmann Associates
(Rochester, N.Y.), adds acoustical lay-in ceiling tiles and perforated specialty tiles
with acoustical baffles to the list. While carpeting is a good noise-softening option,
it’s not appropriate for patient care areas, so architects instead suggest using sheet
vinyl or sheet linoleum flooring products, which offer decent acoustics.
On a smaller scale, products such as hospital-grade fabrics for privacy
curtains can be useful in minimizing noise transmission. However, in higher profile
public areas, or patient areas where a greater level of finish is preferred, designers
may need to splurge on more expensive acoustically rated products, such as a
wood-look ceiling system with an acoustical liner.
When selecting products, Larsen says designers should consider the NRC
value that measures sound absorption properties. Low is considered below 0.60,
and 0.65 to 0.85 falls in the medium range. Additionally, ceiling attenuation class
(CAC) values below 25 will block mechanical system noise emanating from the
plenum space and noise traveling across a partition to an adjacent space.
In addition to materials solutions, mechanical noise can be addressed by
first referencing mechanical equipment manufacturers’ sound values. Simbari
states that with the collaboration with mechanical manufacturers, we as designers
can have an idea of which of these equipment are considered acceptable with
regards to patient’s perception of noise.
Manufacturers are continuing to develop products that further address
sound masking in healthcare settings. For example, an antimicrobial, acoustically
rated wall and a HIPAA-approved voice privacy masking system are both in the
works. Meanwhile, Davenny anticipates that improvements in medical device and
alarm interoperability/communication will produce fewer nuisance alarms, too.
Simbari also states that the goal of acoustical design in hospitals is the
comfort of the patients because patients don’t want to hear what’s going on in the
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room next to them. The expectation is that the design will help provide a patient
experience that encourages healing and creates a positive environment and
experience.
There are many ways to design a space, especially in a healthcare setting,
for the reduction of noise for optimal healing of patients. They vary from proper
placing of spaces to the usage of appropriate acoustical materials, to construction
methods that will improve noise mitigation. This is crucial in this development, as
it is also a hospital that aims to provide the best possible environment conducive
for healing, these design interventions will prove to be useful.
D. Appropriate Lighting
For appropriate lighting in healthcare design, Barbara Horwitz-Bennett
(2016, May 31) published an article that talks about the strategies in lighting design
catered towards the comfort of the users. These strategies coming from well-
versed professionals one of which is Jennifer Kenson, the principal of healthcare
interiors at Francis Cauffman (Philadephia), when she suggested an approach that
integrates the use of indirect or integrated architectural lighting that reduces the
harsh effects of direct downlighting. The usage of dimmable switches for patients
in their private rooms has increased demand in the past years.
LED lighting fixtures have also seen increased demand in the healthcare
facility scene because of their cost-effectiveness. AIA Guidelines for the Design
and Construction of Hospital and Health Care Facilities recommend the elimination
of mercury from light fixtures. LED technology is a viable and socially-responsible
alternate to incandescent bulbs, HIDs and fluorescents for healthcare facilities.
Replacing mercury with better and safer materials is a must. Such as mercury
containing sphygmomanometers replaced by aneroid devices. There is little
wisdom in risking patient exposure to mercury by using fluorescent lights. These
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lights are on 24/7 and deliver the best returns on investment. The payback period
for these lights can be less than a year. Fluorescent troffers can be upgraded or
replaced with LED. Fluorescent lights flicker, causing eyes strain and headaches.
Replacing them with LED creates a better work and patient environment. Toning
down the color temperature and dimming the lights provides an inviting
environment. It makes your indoor areas more appealing.
Another strategy is to create comfortable spaces where the lighting isn’t
perceivable by the user, which is achieved by hiding the light sources in
architectural details—such as using linear recessed fixtures and other LED
products that blend into the clean lines of a building without making the ceiling look
busy. The result is soft, ambient lighting that accentuates the architecture rather
than competes with it.
Studies over the past two decades have found abundant evidence of the
connection between good lighting and patient healing. Other patient benefits may
be less obvious. When McLaren Health Care System in Michigan upgraded 11 of
its primary hospitals with smart LED lighting systems, they found they could reduce
noise levels through control of the lighting. By dimming the lights in patient and
visitor areas at certain times in the evening, they signalled that it was time to quiet
down and allow patients to rest.
Doctors and nurses may also perform better under better lighting. Studies
have shown that dim night-shift conditions make caregiving and medical decision-
making more difficult. Since more than half of registered nurses are over the age
of 50, when the human eye requires three times as much light as a person aged
25, adequate light is vital for their job performance. Lighting can also affect
performance and stress levels in the operating room, and error rates in dispensing
medication. At McLaren Port Huron, the hospital’s housekeeping staff reported that
with the improved lighting, they could “see what they’re cleaning,” a vital aspect of
the fight against in-hospital infections.
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To assist in this process, references such as the Illuminating Engineering
Society’s handbook offer well-researched light levels for specific tasks a 2nd
spaces within healthcare facilities, and building codes often dictate wattage
requirements.
The literatures presented in this topic will prove to be useful when designing
lighting in the proposal. A hospital should be functional not just in the morning when
there is abundant daylight but also during the night. This literature has also
provided insight on how lighting has affected patient care through its placing and
design. This proposal will be using the LED fixtures as recommended by the
research papers analysed in this topic for energy-conservation and better patient
health.
E. Ergonomics
A paper entitled “Ergonomics in Healthcare” provides different guidelines to
prevent ergonomic risk in the operating room for:
In this paper it is stated that rest break should be incorporated frequently during
days of work. Surgeons must also be able to vary their postures while operating if
possible especially because certain surgeries take a certain amount of time and
can lead for hours on end. They should also be provided with anti-fatigue mats to
reduce discomfort from having to stand through long periods of time.
The handles of the instruments that surgeons use must be positioned at elbow
height. The instruments, devices, and equipment to be used must be selected with
ergonomic guidelines in mind, such as an instrument should permit one-handed
use, interchangeable shafts, buttons should be easily accessible, allows both force
and precision grip, can be used comfortably throughout various rotations, and
requires low amounts of force to operate.
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Healthcare providers should be able to stretch frequently and be allowed to
take rest breaks. Forward tilting sitting stools can be used, although it may depend
on the user because these type of sitting stools may cause compression to the
chest and/or abdomen which may they result in further discomfort.
Monitors used in minimally invasive surgeries should be set at a visible distance
so that healthcare workers do not need to lean forward or squint. The height of the
monitor should be set in a way that the top of the screen is at eye level, and that
they should be situated on a flexible arm.
The Operating Room Bed should be situated in a way that it is positioned at
elbow height of the surgeon. These beds should have height adjustability but this
type of setting may not fit the comfort of the entire surgical team. With this, the
surgeon could stand on height adjustable platforms.
In order to minimize twisting of the body and/or leg, the foot pedal must be
placed in alignment with the same direction as the surgeon is facing. Foot pedals
with a built-in footrest that alleviates the need to repetitively lift and lower the foot
from the floor can be considered for use.
Other Ergonomic Evidence-Based Techniques
Additional proven effective techniques to reduce ergonomic related injuries include
the following:
“Ergonomics for Healthcare Environments” by Tim Springer, lists down ergonomic
strategies such as:
• Trip management system. This system consists of a cord cover designed to
reduce trips and falls caused by cords and tubings on the OR floor. Many of these
covers are available in a bright color, so that they are easily seen; they also serve
as a signal so that healthcare personnel know where cords and tubings are located
on the floor. They also typically have adhesive strips to keep it in place during use.
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• Fluid management systems and absorbent floor pads. To prevent slips and falls
in the OR, one of the best measures is to control fluids at their source, ie, so that
they never reach the floor. Proactive measures that can be taken to prevent OR
floors from becoming wet include the use of:
- Absorbent pads placed on the floor around the OR table. These
pads are used for absorbing fluids to keep the floor dry, thereby reducing
the risk of slips and falls; the absorbent materials in these pads generally
absorbs fluid without expanding, similar to a diaper, so it maintains a low
profile and does not become a tripping hazard.
• Adapt the workplace to the worker - not vice versa. People are very
adaptive. They can accommodate poor design and hostile environments. But
adaptation takes its toll on users, requiring energy to adapt. Adapting to poor
design or environmental elements leads to de-creased performance and fatigue.
Fatigue leads to errors, accidents and injury. Appropriately adaptive equipment
and environments relieve strain on the worker to adapt to short-comings in the
workspace. Provide adjustable furniture and equipment to support the wide range
of sizes and shapes of people in the workforce.
• Support work in the way it is done. Appropriate support of work styles and
practices should be provided. For example, if people prefer storing paper
information in “piles”, expecting information to be stored in drawers or bins works
against the way work is done. Providing of horizontal surfaces and shelves for
storage supports the inherent work behaviors. Similarly, multiple users assuming
multiple positions and postures require easily moveable and adjustable support
surfaces.
• Optimize support for the primary task. Work surfaces that are solid and
large enough to support the primary task are required.
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• Provide appropriate user control. Control over their workplace is important
to workers’ sense of satisfaction and performance. Adjustments must be simple
and easy to perform. Some workplace adjustments may be made at the time of
setup; however important adjustments like seat position should be user controlled.
• Emphasize ease of use. Adjustments, control motions, connects and
disconnects should be easy to use. For example, controls (e.g., seat adjustments)
should be easy to reach, easy to operate and should be either clearly labeled or
communicate function by shape or motion. Access to power, net-work, and
telecommunication ports should be at desk height or belt-line level, not where
access re-quires stooping, bending or crawling under work surfaces.
• Provide for Personalization of Space. Accessories that complement, as
opposed to supplant, the function of the workplace allow the user to “fine tune”
their workspace to meet their individual preferences.
• Train people in the proper use of equipment. Good design is not enough.
Ergonomics may seem intuitive - but people still need to be shown how to use
features and understand how some behaviors increases risk of injury. Training that
demonstrates the technique and benefits of appropriate adjustments are required.
The best workplace is only effective if people know how and why to use it.
The literatures consolidated above show how designers can provide a
better workspace for healthcare providers, because the comfort of these
employees is just as important as the patients they are taking care of. They should
be provided with adequate number of spaces where they can rest in between
breaks and at the same time spaces that alleviate some of the hard work they
provide. Through this knowledge the researcher will be able to apply an optimal
space not just for healing but also for the provision of healthcare procedures done
by medical professionals.
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F. Acuity-Adaptable Rooms
Acuity-Adaptable Patient Room is a single room concept where a patient is
cared for in the same room during the entire hospital stay at any level of acuity.
This room concept has demonstrated benefits with regards to patient safety,
patient experience, and decrease length of stay. (Bonuel, Nena, 2017 Dec 19).
Evidence indicates that patients cared for in this room have positive clinical
consequences with regard to infection prevention, client preference as well as
satisfaction, nurse and physician satisfaction, patient safety, and reduced length
of stay compared to care delivered in the standard patient room. The evidence also
suggests that acuity-adaptable rooms contribute to a decrease in noise levels.
Because all acuity-adaptable patient rooms are single-bed rooms, Ulrich points out
the benefits of this model in reducing infection and cross-contamination of patients
and their belongings that may occur in multi-bed rooms. Patient and family
satisfaction has been noted to increase when care is provided in an acuity-
adaptable room and provides the opportunity for confidential discussions between
the caregiver, the patient, and the family or other visitors.
In an acuity adaptable room, different levels of care are given in a single
room so as to minimize the need to transfer patients as their acuity level changed
(Hendrich, Fay, and Sorrells 2004). Patients fall when they get out of bed
unassisted. Decentralized nurse stations, single-bed rooms designed to support
family presence, providing grab bars to assist patients in reaching toilets; using
design features such as night light features were found to decrease the number of
patient falls.
Acuity-adaptable rooms could reduce patient transfer times, decrease
costs, and increase patient quality of care and satisfaction.
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In as healthcare facility specializing in critical care, the usage of acuity
adaptable rooms will ensure a better chance of patient survival because of the
reduction of in-hospital accidents such as falls and infections. Through this design
intervention, all services needed by a patient, such as someone who has
experience major traumatic injuries can be performed without the need of
transferring the patient to different areas just so they could receive treatment.
G. Floor Layouts
The patient flow of the Cheyenne Regional Medical Center Emergency
Department (Figure 3) has been awarded the Evidence-based Design
Accreditation and Certification by the Center for Health Design.
Hospital design has begun to mimic healthcare in its adoption of an
evidence-based approach. Just as doctors and nurses adjust treatments based on
the latest medical studies, hospital leaders and their construction partners
understand that better-designed hospitals can improve patient outcomes, enhance
site security, boost staff satisfaction, increase operational efficiency and reduce
adverse environmental impacts.
And, as the Association of American Medical Colleges discusses in an
article, good things happen when design elements maximizing patient and family
experiences are combined with floor plans that:
 Let medical teams centralize their work to deliver care more
efficiently.
 Keep separate teams (like medical staff and custodial personnel)
from getting in each other’s way.
 Allow security teams and local law enforcement to more easily unify
their response to emergencies.
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The design principles discussed above are passive measures proven to
improve health outcomes. Opportunities to implement active measures exist, too.
By that, it means making design decisions that directly affect the way hospital or
healthcare facility staff deliver care. The key to developing improved floor plans is
collaboration. It means conducting extensive interviews with the doctors, nurses
and other support staff who will use the facility daily.
The literature discussed above shows the proper layout of spaces of basic
emergency care as well as the circulation of healthcare providers, from medical
teams to custodial staff. To incorporate an efficient service, proper lay outing of
spaces should be done in this proposal not just for the patients but also for the
staff.
H. Single-Ward vs. Multiple-Ward
Private Rooms in hospitals is being pushed to become the norm. Single
rooms reduce the risk of hospital-acquired infections, although some argue that
multiple bed wards stimulate social interactions and make the patient not feel like
they’re alone. Roger Ulrich, professor of architecture at Chalmers University of
Technology in Gothenburg, Sweden, and a worldwide expert in health care design,
says that “it’s hard to cite any evidence anywhere that patients do better when
they’re with other patients.” He also states “Social support comes from being with
people who matter to you, not strangers,” says Ulrich. According to Ulrich’s study
on the effects of single vs. multi-bed rooms on outcomes, single-bed rooms help
to reduce infection rates because it enables proactive isolation of patients at
admission, far easier to decontaminate after the patient has been discharged, and
are vastly more superior to multi-bed rooms in terms of managing air changes,
pressure and maintaining clean air.
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Although this proposal will not make use of single bedrooms for all its
patients, the literature above has provided the researcher with the idea of providing
more single rooms because of their benefits not just on the patients but also to the
staff of the hospital because it makes maintenance easier for them.
ANALYSIS OF EVIDENCE-BASED DESIGN APPROACH
The related literature consolidated above has been analyzed and it has
come to the researcher’s conclusion that most of the evidence-based design
solutions are geared towards how the external environment such as daylight and
only the views of nature affect the healing process of the patients as well provisions
on internal spaces. Although all these solutions will be undertaken, the researcher
also hopes to better integrate the outside environment such as open spaces,
hallways, and communal areas as places where patients can receive optimal
healing and to also provide a healthcare facility where way finding would not be an
issue.
III – Hospital Design
A. Department of Health
The DOH provides technical basis on the design of healthcare facilities,
these are provided in their guidelines for the planning and design of a hospital and
other health facilities (DOH 2004 Nov). Some of which include guidelines for the
safety of both patients and personnel through providing minimum numbers of exits.
It also provides minimum dimensions for the ease of patient movement and
advices on circulation for the users. As a development that accepts a wide range
of users daily, it is also important to properly segregate individuals. Minimum
numbers of parking spaces are also stated in these guidelines as well as a proper
zoning techniques which include an outer zone, second zone, inner zone, deep
zone, and a service zone. The different areas of a hospital should also be
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functionally related with each other and techniques to ensure this are also
presented in the manual. Adequate area shall be provided for the people, activity,
furniture, equipment and utility. Table 4 shows the space the corresponding
minimum requirement of their area in square meters. It also notes space provisions
per user in area at any given time.
There are different categories of hospitals, depending on ownership or
offered services. This study deals with a government owned project.
A Government owned hospital is defined in the “Revised Organizational
Structure and Staffing Standards for Government Hospitals”, a manual by DOH,
as a hospital owned, established, established and created by law; facility may be
under the national government like the, the Department of Health (DOH),
Department of National Defense (DND), Philippine National Police (PNP),
Department of Justice (DOJ), State Universities and Colleges (SUCs),
Government Owned or Controlled Corporations (GOCC) or Local Government
Units (LGUs). This project is also classified as a specialty hospital because it
specializes in a particular disease or condition or in one type of patient, in the case
of this study patients suffering from physical trauma.
B. World Health Organization
The WHO with their Violence and Injury Prevention Program has provided
standards for that can be made available to every injured person in the world
through a manual entitled “Guidelines for Essential Trauma Care”. They then seek
to define the resources that would be necessary to assure such care. These
include human resources (staffing and training) and physical resources
(infrastructure, equipment and supplies).
The authors of these guidelines has provided resource tables from human
to physical resources that a trauma patient from rural health posts, to small
hospitals with general practitioners, to specialty hospitals and tertiary care centers.
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The Guidelines for essential trauma care specifically focus on care delivered at
fixed facilities (e.g. clinics and hospitals)
3.2 Theoretical Framework
Figure 9. Theoretical Framework for a Physical Trauma Treatment and Rehabilitation Center Integrating the Active Use of
External Components for a Patient’s Optimal Healing
The Framework above shows the consolidated knowledge gathered from
established research and sources. Through the analysis of the gathered related
literature, the existing design approach such as the utilization of evidence-based
design and the standards of hospital design that will be integral to the completion
of the project; the researcher has also come up with an innovative approach for
the design of the development. The researcher has deemed it fit to integrate the
active usage of the external environment beyond the superficial use of nature
through daylight and only views of nature, by integrating architectural interventions
that use nature to its full potential without harming it. There have been numerous
studies that have showed results of nature’s role for optimal patient healing and
through this proposal will showcase it. The use of external environment will go
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beyond the utilization of nature; it will also integrate the design of spaces that are
integral to patient’s healing beyond where they receive initial care like operating
rooms and wards. These spaces will include communal spaces and way-finding
through different areas of the development.
3.3 Conceptual Framework
OPTIMAL HEALING ENVIRONMENT

FOR A PHYSICAL TRAUMA
TRETATMENT AND REHABILITATION
CENTER
EVIDENCE-BASED DESIGN
Issues of EBD
INTERNAL
 Superficial use of Nature
 Difficulty in Wayfinding
“ACTIVE”
 Outdoor spaces for
BEHAVIORAL treatment INTEGRATION OF
 Social support from loved THE EXTERNAL
ones, not strangers ENVIRONMENT
INTERPERSONAL  Daylight and natural

ventilation
 Inclusive design for less-
abled and abled
EXTERNAL individuals
 Efficiency of staff
BIOPHILIC DESIGN
- Direct and indirect relationship with the
natural environment
Figure 10. Conceptual Framework for an Optimal Healing Environment for a Physical Trauma Treatment and Rehabilitation
Center Integrating the Active Use of External Components for a Patient’s Optimal Healing through the use of Biophilic Design
In order to design a structure that is truly optimal, we employ Evidence-
based Design strategies, but EBD has issues that need to be addressed. Optimal
Healing Environments are based on 4 frameworks namely internal, behavioral,
interpersonal and external. As researchers in the field of architecture, our control
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lies mostly on how we design the physical environment hence the focus on the
external environment. The active integration of the external environment has been
recognized as the missing piece of design optimal spaces through EBD and we
achieve this through the employment of the concept of Biophilic Design.
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3.4 CASE STUDIES
I – Local Case Studies
A. East Avenue Medical Center – Trauma Center
Location: East Avenue, Diliman, Quezon City, Philippines
Figure 10. East Avenue Medical Center as viewed from East Avenue
Source: https://www.phildoc.com/
Figure 11. East Avenue Medical Center

Source: https://www.google.com/maps
Summary
The EAST AVENUE MEDICAL CENTER is a 600-bed, tertiary, general
hospital under the Department of Health. It has the primary goal of providing quality
medical care and treatment to patients irrespective of sex, socio-economic status
and religious creed.
Designated by the DOH as a training and teaching center, the hospital
provides appropriate training programs, materials and facilities that aim at
providing its medical and non-medical staff with opportunities for professional
development and competency-building. Thus, with its well-trained and competent
professionals, the hospital has continued to achieve its primary goal- the delivery
of quality health care services to its patients.
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Architectural Analysis
 Spaces
The EAMC offers different services that aim to cater to different emergency
situations; such services reflect the different spaces that are available in this
hospital.
Emergency Cases
 Medical
 Surgical
 Obstetrics and Gynecology
 Pediatrics
 ENT
Medico-Legal Cases
 Vehicular Accidents
 Gunshot wounds
 Stab/hack wounds
Burn Cases
This medical center has different capabilities, some of which include the
provision of immediate care to these emergency situations, ambulances for when
patients from EAMC are in need of transfer to hospitals that are provide special
trauma services as well as therapeutic procedures.
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Accessibility
Figure 12. Vicinity Map showing road connectivity from EAMC

EAMC EAST AVENUE BIR ROAD EDSA ELLIPTICAL
ROAD
The image above shows what major pathways can be used to access the
East Avenue Medical Center. EAMC is accessible via a major road called the East
Avenue which is directly connected to the elliptical road and connected to Epifanio
de los Santos Avenue (EDSA) via the BIR road. It is surrounded by medical and
government buildings such as the
Lung Center of the Philippines,
Philippine Children’s Medical
Center, Urology Center of the
Philippines, Philippine Heart Center,
Bureau of Internal Revenue National
Office, PAGASA, Central Bank of
the Philippines, Philippine Statistics
Authority, National Irrigation
Figure 13. Site Map of EAMC

60
Administration, Social Security System, and the Quezon City Hall.
 Site and the Building
The development is located in a 4.128 Hectare parcel of land and is located in
an area with an abundance of medical and government institutions in Quezon City,
Philippines. The structure has a 6-storey building that houses 600 beds and
different offices for medical and administrative services.
The development also houses the DOH Eye Center, and the Dermatology
Department. Other buildings present inside the site are the Philippine Foundation
for Breast Care, Women Crisis Center, National Reference Laboratory (NRL), and
the Philippine Institute of Traditional and Alternative Health Care (PITAHC).
 Circulation and Interior Spaces
The East Avenue Medical Center’s goal has always to provide comfort to
its users and they achieve through providing spaces that a hotel-like ambience.
The main for example has granite flooring and walls that reflect the light from the
outside that makes the lobby appear brighter and maaliwalas. The lobby flows
easily into the main elevator bank that has six large-capacity carriages.
 Patient Rooms
Figure 14. Hallway leading to patient rooms Figure 15. Private Room
Source: https://tetaron412.blogspot.com/ Source: https://tetaron412.blogspot.com/
61
Figure 16. Semi-private room Figure 17. Semi-suite
Figure 18. Dining Area Figure 19. Toilet and Bath

At this healthcare facility, patient’s rooms match hotels in comfort through the
provision of wall-to-wall carpeting, a kitchen equipped with a refrigerator, Television,
telephone, and is air-conditioned. The interior of the patient’s room provide a more
dramatic take on architecture and amenities and services that ensure a hotel like
stay in a hospital. This development has surely done its part in achieving a healing
environment that makes the patient feel like they’re at home.
Findings and Analysis
The EAMC has truly deserved its name of a tertiary general hospital and
fitting to be known as one of the country’s best in providing healthcare services.
The interior of the building is true to their goal of becoming a hospital that helps
patients feel like they are at home receiving treatment with its contemporary styles
and welcoming ambience. The rooms offer the same context of being hotel-like but
62
it would be better to provide green spaces within the development and not just
views of buildings.
Recommendations and Application to the Study
The developments are of similar context and the researcher can use the
services provided by this medical facility as a guide the different facilities the
development will provide. What the researcher aims to improve is the need for
more specialized services of trauma care, so that the innovation of the current
project is the provision of all services need for chances of survival as well as
different rehabilitative procedures, in order for the proposed trauma center to
become a one-stop shop. The researcher would also incorporate the use
contemporary designs for interior spaces while ensuring that there is abundant
source of natural light, ventilation and views to nature. As the development does
not specify where parking spaces are, the researcher will be providing more
parking spaces for this research to avoid traffic inside the site.
B. Las Piñas General Hospital and Satellite Trauma Center
Location: P. Diego Cera St., Bernabe Compound, Barangay Pulang
Lupa I, Las Piñas City
Year of Operation: 1977
Summary
The Las Pinas General Hospital and Satellite Trauma Center was first
established in 1977, when it was first called the Las Pinas Emergency Hospital,
then an out-patient clinic. Ever since its transfer to a new location in 1997, now the
Las Pinas District Hospital, it has been serving cities of Muntinlupa, Paranaque,
Pasay, and Las Pinas. It also serves the nearby cities of Bacoor and Imus in
Cavite. It was converted to its now name Las Pinas General Hospital and Satellite
63
Trauma Center by virtue of Republic Act 9240 on the 10th of February 2004, which
increased its bed capacity from 50 to 200.It has four major departments; Internal
Medicine, General Surgery, Obstetrics and Gynecology, and Pediatrics.
 Services
Las Pinas General Hospital and Satellite Trauma Center has been
rendering many years to the achievement of better health of the Filipinos that it
caters. The services this healthcare facility offers are the following:
Internal Medicine
- Acute Psychiatric Unit
- Asthma
- Cardiology
- Dermatology
- Diabetic Clinic
- Dialysis
- DOTS
- Family Medicine
- Medical Intensive Care Unit
- Nephrology
- Neurology
- Smoking Ceassation Clinic
 Obstetrics & Gynecology
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- General Obstetrics
- Gynecology
- Reproductive Health Service
 Pediatrics
- Adolescent Clinic
- General Pediatric
- Neonatal Intensive Care Unit
 Surgery
- Colorectal Surgery
- ENT
- General Surgery
- Laparoscopic Surgery
- Minor Surgery
- Ophthamology
- Urology
 Anesthesia
 Emergency Room Service
 Dental Clinic
 Out-patient Service
The placing of the hospital offers little space for parking of both the private
vehicles of the patients and doctors, spaces for emergency parking for trauma
centers are crucial specially during times when a major tragedy or accident has
occurred and patients are being delivered left and right.
65
 Accessibility
Figure 20. Vicinity Map showing road access to Las Piñas General Hospital
Las Piñas General Hospital and Satellite Trauma Center
CAVITEX Daang Radyal 2 C-5 Alabang-Zapote Road
The development is accessible by a major road called the Daang Radyal 2
with directly connects to the C-5 as well as the Alabang-Zapote Road which then
ends to the Manila-Cavite Expressway or the CAVITEX making the development
easily accessible by its users. The site is mostly surrounded by residential
communities such as the Casmiro Townhomes, Santos Homes and Bernabe
Compound and approximately 800 meters away before it reaches the
CALABARZON area, specifically Bacoor, Cavite.
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 Site
the Las Piñas General
Hospital and Satellite
Trauma Center is a general
hospital that has a 200-bed
capacity and not only that, it
is also a trauma center
which means it needs to

Figure 21. Satellite Image showing Site
Source: https://www.google.com/maps house an adequate
amount of ambulances to
cater to all major traumatic
accidents. This hospital
has four buildings in total,
but it can be seen in these

Figure 22. Streetview of Las Piñas General Hospital
Source: https://www.google.com/maps pictures that the parking
spaces for this
development have been
sacrificed resulting to
vehicle parking being spilt
onto the road which may

Figure 23. Streetview of Las Piñas General Hospital showing vehicular parking
then cause traffic or
vehicular accidents as result of the roads narrowing and areas that should be a
means of passage inside the lot has become an area for parking vehicles.
67
 Exterior
Figure 24. Image showing exterior of Las Piñas General Hospital Figure 25. Image showing exterior of Las Piñas General Hospital
5-storey building 3-storey building with old capiz windows
Source: https://www.google.com/maps Source: https://www.google.com/maps
The design of the buildings exterior is somewhat unique where there is an
application of the bahay-na-bato aesthetic with capiz windows, although some
have been replaced with awning windows perhaps due to deterioration, it can also
be seen that the remaining capiz windows is also subjected to this deterioration.
The 3-5 storey building also put into account tropical architecture through the
provision of long overhang roofs that can give way to natural ventilation without
resulting in harmful daylight entering the facility and therefore bring about lesser
energy consumption.
Hospitals should not only be functional on the inside, it must also be able to
provide basic services, such as parking, in its exterior spaces. Although the
Department of Health has guidelines that state that parking provisions are 1:25
bed capacity, with being a 200-bed hospital 8 parking slots should be enough but
through this case study it can be seen that this standard is not adequate for the
hospital. The exterior design is beautiful and has given identify to the building but
the old materials used have been subjected to deterioration.
Recommendation and Application to the Study
The researcher would apply the elements of tropical architecture from this
development as it incorporates long overhang roofs that are essential for building
68
a development that one seeks to have connection to nature but at the same
minimize its harmful effects such as harmful daylight and maximizing beneficial
elements such as natural ventilation that can result to lesser energy consumption.
II – Foreign Case Studies
A. Landstuhl Regional Medical Center – Level I Trauma Center
Location: Landstuhl, Germany
Figure 26. Landstuhl Regional Medical Center

Source: https://www.army.mil/
Summary
Landstuhl Regional Medical Center (LRMC), Germany, is the only forward-
stationed medical center for U.S. & Coalition forces, Department of State
personnel, and repatriated U.S. citizens. LRMC is the largest U.S. hospital outside
the United States where it serves as the sole military medical center for more than
205,000 beneficiaries throughout Europe, the Middle East and Africa.
LRMC is a jointly staffed, Army commanded 100-bed Medical Center that is
strategically located near Ramstein Air Base, providing 52 medical specialties and
69
over 46,000 outpatient visits per month. LRMC is the only American College of
Surgeons verified Level I Trauma Center outside the United States.
LRMC is also the evacuation and treatment center for all injured U.S.
Service members and civilians, as well as members of 56 Coalition Forces serving
in Afghanistan, Iraq, as well as Africa Command, Central Command and European
Command. More than 95,000 Wounded Warriors from Afghanistan and Iraq have
been treated at LRMC since 2001 as they make their way through the medical
evacuation system back home.
 Accessibility
Figure 27. Map showing the proximity between LRMC and Ramstein Airbase
Landstuhl Regional Medical Center
Ramstein Air Base
With the strategic location of the Landstuhl Regional Medical Center, only
11 minutes away from the Ramstein Air Base it is able to cater to the individuals
who need immediate attention and in turn prove to be an effective treatment and
center for injured soldiers and civilians from Afghanistan, Iraq, Africa Command,
70
Central Command and European Command, and give them a better chance of
going back to their homes. It’s strategic location has proven to be beneficial
because since 2001, it has been credited to have treated 95,000 wounded soldiers
from Afghanistan and Iraq. Because of the abundance of traumatic injuries they
are subjected to they have published a lot of medical journals that help in some of
the injuries that can be avoided, such as the ones not caused by modern warfare
but the situation inside the military camps they are subjected to.
Landstuhl Regional Medical Center proves that a premier trauma care
facility’s location is just as crucial as the services by which they offer. Providing a
healthcare facility with such advancement as this one surely makes a difference
because of its strategic location.
The proposed physical trauma treatment and rehabilitation center in this
study should be located in areas where these types of situations are abundant in
order to increase patient survival and ensure that the facility will be able to function
for a long time.
B. Bristol Southmead Hospital – Design for Single-room wards
Location: Bristol, UK
Architect: BDP Architects
Figure 28. Bristol Southmead Hospital

Source: http://www.defactodentists.com
71
Summary
Southmead Hospital is a large public National Health Service hospital,
situated in the Southmead ward in the northern suburbs of Bristol, England. It is
part of the North Bristol NHS Trust. The 800-bed Brunel Building opened in May
2014, to provide services (including Accident and Emergency), which transferred
from Frenchay Hospital in advance of its closure.[1] The hospital now covers 60
acres (24 ha)
The Southmead Hospital offers much ground-breaking innovation in
hospital design. Some of the specialist services this hospital offers are urology,
renal medicine and transplantation, infectious diseases, neonatal medicine,
maternity, orthopaedic services and pathology.
 Patient Rooms
Figure 29. Single-patient rooms design by Carillion for Bristol Southmead Hospital
Source: researchgate.net
This hospital shows how evidences make their way into the process of
design. This hospital was developed by Carillion and the design is quite
revolutionary for the UK National Health Service and will be very largely built using
single rooms rather than multiple shared wards. In arriving at the design for these
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rooms, every millimetre was accounted for and the location and design of all the
items simultaneously addresses the clinical agenda along with issues of privacy
and dignity, as well as views outside, minimizing the risk of falls and cross infection,
allowing for easy maintenance, and so on; all part of the components found in
evidence-based design solutions.
 Critical Care Units
Figure 30. Clear partitions with blinds for critical care Figure 31. Clear partitions with blinds for critical care
units units
Source: https://optimasystems.com/ Source: https://optimasystems.com/
For the critical care units, the designers of Bristol Southmead Hospital opted
for the usage of transparent glass partitions so that they are able to observe the
patients without disturbing them by going in and out of the rooms multiple times.
This development has shown how evidence can become a crucial part of
providing a design that takes into account comfort and safety of the patients,
especially in the design of major hospitals.
Innovations in the design of this structure such as the usage of clear
partitions for patients under observation as well as the incorporation of single
73
rooms that are designed for the benefit of the patients will be taken into
consideration of the researcher.
C. Queen Elizabeth National Spinal Injuries Unit – Horatio’s Garden
Location: Glasglow, Scotland
Garden Designer: James Alexander-Sinclair
Figure 32. Horatio's Garden in Queen Elizabeth National Spinal Injuries Unit
Source: https://www.telegraph.co.uk/
Summary
The Queen Elizabeth National Spinal Injuries Unit is responsible for the
acute and lifelong care of all adult patients in Scotland with traumatic and non-
progressive spinal cord injury. The Unit has forty-eight beds in three areas:
Edenhall Ward (twelve beds) provides high dependency facilities, Philipshill Ward
(thirty beds) provides progressive care and the Respiratory Care Unit (six beds)
for patients with ventilatory problems. The Unit offers the following services:
o The admission of adults with spinal lesions causing paraplegia or
tetraplegia whether caused by trauma or non-progressive spinal
disease.
o Intensive inter-disciplinary comprehensive care and rehabilitation
programmes to facilitate the patients’ return to their own
community.
74
o Lifetime care for out-patients
o Out-patient clinics including general review, urology, fertility,
orthopaedics, neurosurgery, skin, spasms and implantable
antispasm pumps.
o An open door policy to allow patients with specific problems to
seek advice or treatment.
 Services
To achieve these aims the Unit encourages the earliest appropriate
admission of patients following a spinal injury. The patients will normally be
referred from their local hospital and may be transferred by road or air. A helicopter
landing pad is on the hospital, which is also close to Glasgow Airport allowing
transfer of patients by fixed wing aircraft. Facilities include:
o Out-patient department
o Therapy area for occupational therapy and physiotherapy treatments
o ADL (Activities of Daily Living) kitchen
o Gymnasium/sports hall
o Therapy pool
o Step-down unit for re-integration and family visits
o Integrated research office accomodation of the Scottish Centre for
Innovation in Spinal Cord Injury
 Open Spaces
The Queen Elizabeth National Spinal
Injuries Unit not only offers treatment
to trauma caused or non-progressive
spinal injuries, it also offers
rehabilitation centers for all illnesses Figure 33. Image showing the lush garden in Queen Elizabeth
National Spinal Injuries Unit
Source: https://www.telegraph.co.uk/
75
and injuries on the spinal chord. It also houses a garden, called Horatio’s Garden,
this has transformed the view for patients from the wards and communal rooms to
something which is life-affirming to look out onto. The planting encourages birds,
butterflies and bees, adding a dimension of interest for patients who can be on bed
rest for weeks.
There has been much evidence that gardens and gardening have a positive
effect on a person’s physical, mental and emotional well-being. Having an inspiring
outdoor haven is particularly crucial for people impacted by spinal injuries and also
traumatic injuries. The integration of the evidence that nature provides healing to
patients is one that is positive to the development.
The researcher aims to provide an open space in this proposal that can
improve user experience of the patients. The provision of a helipad for the
transportation of patients beyond land is also a good intervention and would cause
a wider range of traumatic cases that can be addressed.
D. Khoo Teck Puat Hospital
Location: Singapore
Architect: CPG Consultants
Figure 34. Khoo Teck Puat Hospital

Source: https://living-future.org/
76
Bed Capacity: 591
Total Gross Floor Area: 110,000 m2/11 Ha
 Design Preferences
The design preferences the architects aimed to achieve includes
ensuring a welcoming ambience for its users; this includes making the
hospital so that it has a seamless transition to the neighbourhood. They also
prefer to ensure that architectural solutions are first addressed before the
engineering solutions. Modernization of traditional designs should be
functional and greenery would always be preferred over the hard surfaces
while also ensuring that there is lower cost not just initially but throughout
its operation through lower maintenance costs.
 Accessibility
Figure 35. Map showing the access to KTPH

Source: https://www.ktph.com.sg/
The image above shows the main roads that access the KTPH from
Yishun. The different developments present within the vicinity of the hospital
are mostly medical in context such as the Yishun community hospital and
the Yishun Polyclinic. The access to this site is made easier because of its
77
proximity to the Yishun MRT and the Yishun Integrated Terminal Hub which
serves as a bus interchange and seamlessly connect the Yishun MRT via a
basement underpass.
The table below shows the different buses available to the hospital’s
users that stop near the KTPH.
Table 9. Bus Routes for travel to KTPH

 Site and Buildings
Figure 36. Image showing the different buildings and their orientation
Source: https://www.scribd.com/
The V-shaped configuration of the buildings, with the V opening to
the North lets in the air that skims from the existing storm-water pond into
the development. To tap into this natural airflow, the envelope of the
buildings had to calibrate permeability and shade. The subsidized ward
tower is oriented with the goal of capturing the prevailing winds from the
North and South, this helps achieve optimal cooling for the wards.
78
Figure 37. Tower directory of KTPH
The development is divided into three towers namely tower A, B, and
C. Tower A includes the following spaces:
Figure 38. Directory of Tower A

79
Tower B and C includes the following spaces:
Figure 39. Directory of Tower B Figure 40. Directory of Tower C

Source: https://www.ktph.com.sg/ Source: https://www.ktph.com.sg/
 Tower A houses different wards as well as the acute and emergency
department because of its proximity to the road. Tower B also include
wards, learning centers, a number of dental services, as well as processing
areas for patients and their visitors. Tower C houses different clinics and
advance surgical services.
 Nature
The heart of the development, which makes
these principles work, is the green court.
Designed to be ‘forest-like’, it includes water
features with aquatic species and plants that
attract birds and butterflies. The greenery
cascades to upper levels of the buildings and
down into an open-to-sky basement, creating
the impression of architecture that is deeply
enmeshed in a garden. At the upper levels,
balconies with scented plants bring the
experience to the patient’s bedside, literally.

Figure 41. Image showing the Central Garden
Source: https://blog.interface.com/
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The green plot ratio of KTPH – an indicator of how much greenery there is in
a development – is 3.92; in other words, the total surface area of horizontal and
vertical greenery combined is almost four times the size of the land that the hospital
sits on. This is remarkable for a development in a dense urban setting. As a
proportion of total floor area, blue-green spaces account for 18%. Forty percent of
all such spaces are publicly accessible. In post-occupancy measurements, the
microclimate of this court was some 2oC cooler than spaces just outside the
hospital.
In 2005, mid-way through design, the KTPH team expanded the hospital’s
blue-green footprint by ‘adopting’ the adjacent storm water pond. Collaborating
with other government agencies, the hospital team worked out a cost-sharing
arrangement whereby the pond – turned into a park – would serve multiple groups
from the hospital and neighbourhood. The concrete edges of the pond were
hacked away, and new aquatic plants were introduced to clean the water and
create habitats. A walking trail was added, linking the park to the hospital and a
nearby residential estate. The pond, following the revamp, increased blue-green
space available to KTPH patients and visitors by 400%.
The hospital also adopted
what is called “Wing Walls” or
Aluminum Fins which is
attached to the building’s walls
as a means channeling
prevailing winds by increasing
the wind pressure build up in the

Figure 42. Image showing the facade of KTPH with Wing Walls
façade. These fins were verified Source: https://www.scribd.com/
by a test conducted by the National University of Singapore as an effective
enhancer of the airflow by 20-30%.
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The hospital also adapted
rooftop farming as a means of
engaging the community
because along with the KTPH
staff, volunteers also give a hand
in tending to these gardens. The
produce goes to the hospital
Figure 43. Rooftop Farm at KTPH kitchen and sold as a means of

Source: https://blog.interface.com/
covering costs.
 Patient Satisfaction
According to a study conducted by the National University of Singapore,
wherein 200 users have taken part in, the results showed that On most counts –
perceived beauty, self-reported well-being, awareness of nature – KTPH did better
than the reference case which included 75 respondents from an older hospital in
Singapore. User well-being (sense of calm, levels of stress) was found to be
significantly better in KTPH. Awareness of and perceived closeness to nature was
higher in the KTPH group.
KTPH is overwhelmingly liked by staff and visitors. It consistently out-
performs all other hospitals in Singapore in the annual Ministry of Health public
satisfaction survey. Results of the 2016 study suggest that this preference, at least
in part, is linked to the quality of its space and attributes.
The Khoo Teck Puat Hospital proves how nature can greatly affect patient
satisfaction and their healing processes. As proved to be the best hospital in
Singapore to date because of the different qualities it possess such as connection
with nature and utilization of natural elements in the development where not only
man benefits but also the environment. This development has showed the
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importance of integration nature effectively in design not just merely through
daylight and views but also through farming and better landscaping.
Recommendation and Application to Study
The researcher shall incorporate the different techniques used in the
utilization of natural elements such as wind harvesting and farming spaces where
both patients and staff can have a distraction as well make the development have
some kind of sustenance. The design of the structures will be mindful of the proper
methods of preserving nature and not merely using it for the benefit of man. The
zoning of the different spaces and services present in the site will also be used by
the researcher.
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CHAPTER 4
PRESENTATION AND ANALYSIS OF DATA
This chapter presents all the data gathered by the researcher that will be crucial
to the development of a premier trauma-care facility within the region of Central Luzon.
The proponent will be discussing the site provided by the local government of
Zaragoza, Nueva Ecija on a macro and micro scale for it is where the development will
be located. It will also be presenting data that will be of great help to the proper
programming of spaces through the analysis of behavior of users.
4.1 Site Inventory
Site selection is crucial to ensure that the development will be placed in an area
that will be functional and its designated use will be utilized. Since the development
already has a municipality as proposed by authorities, this section will focus on the
selection of a specific site that the development will be situated. It will also provide the
criteria the researcher will be using to ensure the best possible outcome and finally a
justification of not only the specific site but also the region and municipality by which
the development will be made available to.
As proposed by HB 1960, the development will rise in the municipality of
Zaragoza, Nueva Ecija and will cater to immediate cases of physical trauma in Central
Luzon. Central Luzon is a suitable location for the project because of the scale of
physical trauma cases within the region, being among the top of the list along with NCR
and CALABARZON. The only difference with Central Luzon is that as per the Center
for Health Development – DOH Region, among the list of Level 1 government hospitals
none are labeled as Trauma-capable. Central Luzon also as per the 2016 Philippine
Health Statistics of DOH, the highest rate of mortality caused by physical trauma such
84
as transport vehicle accidents and being among the highest of numbers of deaths
caused by falls, drowning and interpersonal violence.
Figure 44. CLLEX Phase 1 (Source:

DPWH)
Zaragoza is a suitable place for the development because of its proximity to the
three main expressways located in Central Luzon, the NLEx, SCTEx, and TPLEx and
the current project CLLEx or the Central Luzon Link Expressway with Zaragoza being
the one of the first municipalities that will be trans versed by an expressway that will
become the most important lateral link in Central Luzon. Locating among these paths
is crucial not just for accessibility but also because of its history of unfortunate
accidents which will then prove the relevance of this study to the health issues
regarding the prevention of death and disability due to physical trauma.
4.1.1 Site Selection Criteria
The following are the sites that the researcher will be analyzing in terms of their
adequacy as a location for a premier medical institution.
85
SITE A. Sto. Rosario (Y), Zaragoza, Nueva Ecija
Figure 45. Site A (Source: Google

Earth)
Site A is one of the sites provided by the local government of Zaragoza as a
possible location for a medical institution. It is a 3.5 Hectare plot of land that can be
immediately seen upon entering the municipality therefore making it accessible by the
La Paz and Zaragoza exit of the CLLEX and is not surrounded by any major
development and mostly of agricultural land or a scarce amount of houses. It is
relatively flat, as most of the municipality and is littered with trees and overgrown reeds.
The site is also part of the zone that the municipality is proposing to expand their
institutional developments. The road that passes the site is called Sta. Rosa-Tarlac
road which is the municipality’s national road and it located within a 3 km vicinity from
the center of the municipality.
EXISTING SITE CONDITION
Figure 46. Site A Existing Condition (Source: Google Maps)
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SITE B. Carmen, Zaragoza, Nueva Ecija
Figure 47. Site B (Source: Google

Earth)
Site B is only a 5,000 sqm plot of land but the municipality has provided it as a
possible area for a hospital. The site is transversed by the provincial road of Carmen-
Cabanatuan Road that can be accessed via the Sta. Rosa-Tarlac Road and is atleast
5km from the municipal center. It is bounded at the Northeast by a number of
commercial establishments and is currently being used as a parking area for the trucks
used to transfer palay to the rice mill across the road from the site. It is currently
flattened by sand for the ease of the trucks that use it with no vegetation within.
Figure 48. Site B Existing Condition (Source: Google Maps)
87
SITE C. H.Romero, Zaragoza, Nueva Ecija
Figure 49. Site C (Source: Google

Earth)
Site C is a 7.5 Hectare plot of land located at the last barangay that is passed
by the national road before reaching the municipality of Sta. Rosa. It is relatively flat
with a few trees littering the front of the lot facing the road and is relatively flat. It is
atleast 6 km from the municipal center.
Figure 50. Site C Existing Condition (Source: Google Maps)
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The following criteria will be able to aid the researcher in choosing the most suitable
place for the development and has been formulated through the aid of related literature
reviewed by the researcher.
 Proximity to Accident Prone Areas – The project being a healthcare facility
geared towards saving the lives of critically injured patients should be located
in an area where it can provide such optimal services in a place truly in need of
them.
 Location and Accessibility – The site should be located in place trans versed
by a major road or otherwise a place in close proximity to a way of passage that
will prove to be able to provide an ease of access and easy visibility for its
possible users. This accessibility is also crucial for the emergency vehicles. The
surrounding areas or developments of the site will be of consideration because
it will provide influences, whether positive or negative, to the project and its
users. These areas will serve as a guide to the researcher in providing for
architectural solutions for the negative impacts such as areas prone to noise
and pollution like railroads, children’s playgrounds, airports, industrial plants,
and disposal plants, and figure out ways to utilize the positive and make it truly
advantageous to the development.
 Size and Potential for Expansion – The lot must have adequate space for all
facilities and the structures to be developed as well proper space provision for
parking of vehicles. The site must also be spacious enough in order to provide
abundant outdoor space crucial to healing and rehabilitation of patients. As
development calls for a 50-100 bed capacity hospital and the researcher aims
to provide adequate space for open areas, the lot size should be at least 3
hectares. And according to the Site Planning for New Hospitals (DOH) must be
large enough to accommodate functional requirements to any planned
expansion within 10 years.
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 Geographical Conditions – Geographical conditions such as climatological
data, soil type, and topography will be of major consideration and will prove to
of great impact to the development, the site must be relatively flat in nature with
a slope that may range from 4-10% in order for it to become truly accessible to
patients that have acquired physical inabilities. It must also allow for water to
easily drain away from site in order to avoid water build-up in certain areas that
may also cause accidents. These considerations are crucial to integrating the
active use of nature into the project.
 Natural Environment – As it is established that nature has an impact on a
patient’s healing, the site should be located in an area where vegetation are
abundant and natural elements can be found. This balance of a built
environment and nature will be beneficial to the users.
SITE A SITE B SITE C

SITE CRITERIA Description RATING (Sto. Rosatio (Carmen, (H. Romero,
(Y), Zaragoza) Zaragoza) Zaragoza)
Must be in close
Proximity to
proximity to areas in
Accident Prone 30%
need of a critical
Areas
care facility 28 25 26
Must be located
near a major road or
Location and passage for ease of
25%
Accessibility access. Located in
an area not prone to
noise and pollution
24 23 23
Must be atleast 3
Size 20%
hectares 20 15 20
Soil must not be too
soft and can be used
for planting and
Geographical weather conducive
15%
Conditions for healing.
Relatively flat with
water draining away
from site.
14 12 14
Must include
Natural abundant natural
10%
Environment elements such as
vegetation 10 9 9
TOTAL 100% 96 84 92
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Table 10. Site Selection
Criteria
The site selection criteria above has allowed the researcher to make a
comprehensive analysis on which site is the most adequate for the development.
4.1.2 Site Justification
Figure 51. Site A (Source: Google

Earth)
From the site selection performed above, Site A was chosen to be the most
suitable. Among all the lots provided by the local government of Zaragoza, Site A was
the one that stood out the most based on factors set by the researcher that has been
deemed as crucial for the insurance of a functional project. Site A is 3.5 hectares which
make it the perfect size for the proposed development. Site A was also the closest to
the municipal center among the three but not so much that it may cause disturbance
to the users during their times of healing. It is also not only accessible by the national
road but also by the CLLEX exits of both La Paz and Zaragoza because of its location.
There is also an abundant number of trees present in the site as well as other
vegetation which ensures that it has soil that has the capacity to grow abundant plant
life.
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4.2 Macro Site Analysis
PHYSICAL PROFILE
Figure 52. Map of Central Luzon (Source: https://3ccentralluzon.wordpress.com/2014/10/17/central-luzon-map/)
Region III, or Central Luzon, is comprised of 7 provinces namely Aurora,
Bataan, Bulacan, Nueva Ecija, Pampanga, Tarlac, and Zambales. It is the third largest
region in the Philippines, and has the largest plain that supplies most of the country’s
rice which appropriately dubs it as the “Rice Granary of the Philippines.” Central Luzon
is bounded by the Cordillera Administrative Region and Ilocos Region on the north, the
National Capital Region and CALABARZON on the South, West Philippine Sea on the
west and the Philippine Sea on the east.
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Figure 53. Luzon Spine Expressway Network (Source: https://www.autoindustriya.com/auto-industry-news/php-
8-4-trillion-in-infrastructure-projects-planned-until-2022.html)
As part of the current administration’s Build! Build! Build program certain
infrastructure projects are being proposed such includes the Luzon Spine Expressway
Network which includes seven (7) major road networks to pass through Central Luzon.
These include the North Luzon Expressway (NLEX), Subic-Clark-Tarlac Expressway
(SCTEX), Tarlac-Pangasinan-La Union-Expressway (TPLEX), the under construction
Central Luzon Link Expressway (CLLEX), and Plaridel by-pass, and the proposed
North Luzon East Expressway (NLEE) which is a 92.1 km 4-lane expressway that will
connect Commonwealth Avenue to Nueva Ecija. These road networks are a crucial
consideration to the provision of a premier medical facility within the area.
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Figure 54. Map of Nueva Ecija (Source: https://www.researchgate.net/figure/Map-of-Luzon-Philippines-with-
enlarged-province-of-Nueva-Ecija-in-Region-IV-Red-x-marks_fig2_294259366)
Nueva Ecija is the largest province in Central Luzon. It is a landlocked province
borded by Pangasinan and Nueva Vizcaya in the North, Aurora in the East, Bulacan
and Pampanga in the South and Tarlac in the West and has a land area of 5,751.33
square kilometers. It is basically in the middle of almost all the provinces located in
Central Luzon. Its capital city is Palayan. Nueva Ecija consists of 5 cities, 27
municipalities, and 849 barangays. As of latest population data of 2015 from the
Philippine Statistics Authority, Nueva Ecija had a population of 2,151,461 people.
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Figure 55. Location Map of Zaragoza, Nueva Ecija (Source: CLUP Zaragoza 2016-2026)
Zaragoza is one of the gateway municipalities of Nueva Ecija when entering
from Tarlac. It is adjacent to the municipality of La Paz, Tarlac.
Figure 56. Administrative Boundary Map of Zaragoza, Nueva Ecija (Source: CLUP
Zaragoza 2016-2026)
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Zaragoza is a 3rd class municipality and was founded in 1870. Originally
named San Vicente, it was previously part of Aliaga, Nueva Ecija. It has a land area
of 11,760 and is comprised of 19 barangays with a population of 49,387.
Land Use and Zoning
Figure 57. Existing Land Use Map of Zaragoza, Nueva Ecija (Source: CLUP Zaragoza 2016-
2026)
The municipality of Zaragoza consists of 55.57% agricultural land use with
6,535 hectares of land area and the rest consists built-up areas with residential being
second to agriculture with 1,228.25 or 10.44% of the municipality’s land area. The rest
are commercial areas, industrial and institutional areas.
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Figure 58. Proposed Land Use Map of Zaragoza, Nueva Ecija (Source: CLUP Zaragoza 2016-2026)
The figure above shows Zaragoza’s vision on their land use. It can be seen that
the proposed site for the development will be situated in a zone that is categorized as
institutional therefore making it appropriate.
Table 11. Existing and Proposed Land Use of Zaragoza (Source: CLUP Zaragoza 2016-
2026)
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The chart above, from the CLUP of Zaragoza shows the present allotment of
lands as well as their plans for the municipality’s proposed land use. From a previous
land appropriation of 47.99 for institutional zones, the municipality proposes a rise to
55.67 hectares. The municipality has expressed their desire for a medical facility to be
provided in their area because all they have so far is an Rural Health Unit (RHU) and
a few clinics (maternal and dental) and if they were to be hospitalized they need to
travel more a minimum of an hour to Cabanatuan.
 Zoning Ordinance
The municipality of Zaragoza provides zoning ordinances depending on
developments, as the development will be a specialty hospital the researcher will be
focusing on Section 13 of the Zoning Ordinance of Zaragoza otherwise known as “Use
Regulations on General Institution Areas” which includes allowable uses for General
Hospitals, Medical Centers, Specialty Hospitals, Medical, Dental and similar clinics.
Building density and bulk regulations include provisions from the National
Building Code and has building height limit of 15 meters. It will also be subjected to
national locational guidelines and standards provided by the agencies concerned
which in this case is the Department of Health.
As stated by the Water Code, for easements on the banks of rivers or
streams and the shores of the sea and lakes throughout and entire zone shall have
three (3) meters for urban areas, twenty (20) meters for agricultural areas, and forty
(40) meters in forested areas. Along these margins, are subjected to easements
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intended for public use such as recreation, navigation, floatage, fishing and salvage.
There is a mandatory five meter easement for fault lines as provided by PHIVOLCS.
Table 12. Road Setback Regulations per Zoning Classification (Source: CLUP Zaragoza 2016-
2026)
The table above shows the setback regulations for roads depending on
zoning classification. For Institutional Zones, major thoroughfares should be provided
a 20-meter setback, secondary provincial roads also have a 20-meter setback, and
tertiary roads having a 10-meter setback.
Two conflicting zones should have a four (4) meter setback (as dictated
by the LGU) so that both zones have a 2 meter setback and should not be encroached
by any building or structure therefore remaining a yard/open space.
For Site Development standards, the municipality shall put the public’s
interest as first priority therefore requiring that developments be designed in a safe,
efficient and aesthetically pleasing manner. These development should adhere to the
environment and limitations of its adjacent sites and properties.
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Circulation
Figure 59. Road Network Map of Zaragoza, Nueva Ecija (Source: CLUP Zaragoza 2016-2026)
The image above shows major roads within the municipality of Zaragoza,
Nueva Ecija. The national road being Sta.Rosa-Tarlac Road, and provincial roads
include Zaragoza-San Antonio Road, Zaragoza-Panabingan Road, Zaragoza-Aliaga
Road, Carmen-Cabanatuan Road and the Zaragoza-Jaen Road. The national road of
Sta. Rosa-Tarlac Road will be passing through the site making the development
easily accessible to future users
Figure 60. CLLEX Phase 1 (Source: DPWH)
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The Central Luzon Link Expressway which is part of the Luzon Spine
Expressway Network will also be having an exit in Zaragoza specifically the barangay
of San Rafael which will then provide the municipality a higher chance of improving
their economy as well as provide possible users of the proposed development better
access.
Figure 61. Typical Traffic Zaragoza, Nueva Ecija (Source: Google Maps)
The typical traffic in Zaragoza ranges from Fast to Slow. With the road networks
colored in green being fast and goes to slow form orange to red. The typical vehicular
traffic along the road that passed through the site is fast and transforms to slower pace
as it approaches the city proper.
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Soil, Geology and Topography
Figure 62. Soil Map of Zaragoza, Nueva Ecija (Source: CLUP Zaragoza 2016-2026)
The soil classifications in Zaragoza includes Anman Clay Loam, Umingan Sandy
Loam, Umingan Loam Deep Phase, and Umingan Sand. These types of soil are found
to be adaptable for agricultural production. These types of soil are found to be
adaptable for agricultural production.
The development is located at a site where the soil type is Zaragoza Clay. Although
clay is a suitable soil for crops it can prove to be challenging for construction because
it acts like a clay which easily absorbs water and retains moisture longer than other
soil. Through engineering innovations such as piles or mat foundations, construction
will be made possible as well recommendations on retaining organic matter such as
trees and grass are present on site to improve water absorption.
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Figure 63. Slope Map of Zaragoza, Nueva Ecija (Source: CLUP Zaragoza 2016-2026)
The topographic feature of Zaragoza is mostly plain with the whole municipality
ranging from a 0-3% slope which is categorized from level to nearly level. The
municipality have nearly no rugged terrain and is mostly composed of plains, a few
rivers, creeks, and streams as sources of water.
Hydrology
Figure 64. Bodies of Water in Zaragoza, Nueva Ecija (Source: Google Maps)
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The municipality of Zaragoza mostly gets its natural water through the means
of rivers and creeks. The municipality has 2 major rivers as water sources for irrigation
purposes, namely: the Rio Chico River and the Talavera River.
Deep and shallow wells are the common sources of water in most of the
barangays of the municipality.
Climate
Figure 65. Climate Types in the Philippines (Source: Researchgate)
According to the Modified Corona Classification of Climate which was devised
by Fr. J. Corona in 1920, there are 4 climate types in the Philippines. With Type 1
having two pronounced seasons which are dry from November to April and wet for the
rest of the year, Type 2 with no dry season but with a very pronounced maximum rain
period from December to February, Type III with no very pronounced maximum rain
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period, with a short dry season lasting only from one to three months, either during the
period from December to February or from March Type IV Rainfall is more or less
evenly distributed throughout the year. This climate type resembles the second type
more closely since it has no dry season. Central Luzon is categorized as having a Type
I climate which then includes the province
of Nueva Ecija.
Table 13. Annual Rainfall and Typhoon Frequencies per Region (Source: https://www.cropsreview.com/climate-types.html)
The table above shows the the average rainfall in mm experienced per region
as well as how many typhoons frequent the area. Region III or Central Luzon
experiences 1800-3800 mm of rain yearly and is frequented by a typhoon 1.7 times
per year.
Table 14. Zaragoza, Nueva Ecija Climate (Source: https://en.climate-data.org/asia/philippines/nueva-ecija-1850/r/january-

1/#climate-table-year)
The table above shows average temperatures and precipitation the municipality
of Zaragoza receives monthly. The municipality experiences their coldest average
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temperature during the month of January at 25.3°C and its hottest in May at 29°C.
Their maximum recorded temperature is 34.2°C also in May and minimum temperature
at 20.3°C in the months of January and February. Highest precipitation is in August at
380 mm and lowest in February at 7 mm.
According to the Comprehensive Land Use Plan of Zaragoza the rainy season
usually starts in the middle of May and usually lasts up is to October. The dry season,
on the other hand, starts in November up to the first half of the month of April.
The summer months, dubbed the Sweating Period, occur in the months of
March up to May. July, August and September, on the other hand, register the heaviest
rainfall where most typhoons occur.
Based on existing weather records, the following were observed: on the
average, there is 154.9 rainfall every month, while the average number of rainy days
is 10.3 during the rainy season.
Temperature ranges from 20°C-36°C. The coldest months of the year usually
start from the second week of December lasting up to February. Humidity ranges from
72% to 87%. Due to climate change during dry season sudden / unexpected rains
occur.
Utilities
I. Power
The municipality of Zaragoza is jointly supplied of electricity by the Tarlac
Electric Cooperative (TARELCO) and the Nueva Ecija Electric Cooperative
(NEECO) II.
The whole of the municipality is provided electricity although some
household could not afford to have them installed due to poverty.
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II. Water
Water supply in the municipality is provided by Balibago Waterworks
System Inc. which was established on April 2005. The central operation is
located at Barangay San Isidro, and is now serving 16 barangays.
Other residents that are not connected with the water provider still
depend on manually operated means of potable water extraction. This is
through the use of three forms of water sources namely deep-well pump, jet-
matic pump and pitcher type pump.
III. Communication
Despite of the latest trends in communication, the people of Zaragoza
still rely on the conventional means provided by the Philippine Postal Office
located within the municipal hall compound. The office has one
administrative staff and 2 letter carriers.
Residents of the Municipality enjoy Cable Television services. However,
due to high cost of materials for expansion, the service is only confined in
10 barangays and near the poblacion area.
Other service providers are PLDT, Bayantel, SMART, GLOBE and Sun
Cellular. Internet access is not a problem in Zaragoza as this big companies
are providing internet and wi-fi services even to the rural barangays.
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Risk and Hazard
I. Flood
Figure 66. Flood Susceptibility Map of Zaragoza, Nueva Ecija (Source: CLUP 2016-2026)
Flood Susceptibility can be predicted both in short term and in long term. With
the effects of climate change it is important that we observe these phenomena to better
understand the environment we will be developing and provide the needed
interventions.
There are areas in the municipality that are susceptible to flooding. Heavy rains,
and rainwater brought about by typhoons are the causes of flooding in the locality.
Overflow of irrigation canals and the Rio Chico River are the primary sources of
flash floods.
Ten (10) barangays of Zaragoza are considered highly susceptible to flooding,
while 2 and the rest of other barangays are considered at medium risk, and the other
barangays are classified as low risk. The site is situated in a highly susceptible
environment. Where the highly susceptible areas flood can reach a height of 1.5
meters.
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II. Earthquake
According to a study made by the
Center for Environmental Geomatics –
Manila Observatory. Nueva Ecija is
among the Top 10 provinces that is at
risk of earthquakes because of its
proximity to Philippine Fault Zone. The
earthquake that will be experienced are
shallow left-lateral strike-slip
earthquakes.
Figure 67. Philippines’ Risk to Earthquakes (Source:

http://vm.observatory.ph/geophys_maps.html)
Figure 68. Seismic Hazard (Source: HazardHunterPH)
The image above shows the site’s proximity to factors that may contribute to
earthquake such as proximity to Mt. Pinatubo and an active fault line (colored in red)
as well as the assessment made by HazardHunterPH which the PHIVOLCS provides
its data regarding earthquake related dangers. It shows that the nearest fault line is
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25.1 km from the site and is essentially Safe from Ground Rupture, Prone to Ground
Shaking and is Generally Susceptible to Liquefaction.
As the municipality of Zaragoza is generally susceptible to earthquakes the local
government has provided measures to increase resiliency when it does occur.
Developments are advised to use various innovative engineering and architectural
techniques to construct earthquake-proof buildings and there should always be a strict
implementation of the National Building and Structural Code of the Philippines.
III. Liquefaction
Figure 69. Liquefaction Hazard Nueva Ecija (Source: PHIVOLCS)
The effects of soil liquefaction on the built environment can be extremely
damaging. Buildings whose foundations bear directly on sand which liquefies will
experience a sudden loss of support, which will result in drastic and irregular settlement
of the building causing structural damage, including cracking of foundations and
damage to the building structure itself, or may leave the structure unserviceable
afterwards, even without structural damage. Where a thin crust of non-liquefied soil
exists between building foundation and liquefied soil, a ‘punching shear’ type
foundation failure may occur.
Zaragoza is prone to liquefaction according to PHIVOLCS, specially the
barangay of Sta. Lucia Old as it will be the most affected if liquefaction were to ever
occur.
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SOCIO-ECONOMIC PROFILE
Figure 70. Population Density Map (Source: CLUP, 2016-2026)
The municipality of Zaragoza has a land area of 11, 760 Hectares and is
comprised of 19 barangays. Four of which are classified as urban which are San Isidro,
San Rafael, San Vicente, and del Pilar, the rest are classified as rural which are then
Batitang, Carmen, Concepcion, Gen. Luna, H. Romero, Macarse, Manaol, Mayamot,
Pantoc, Sta. Cruz, Sta. Lucia (O), Sta. Lucia (Y), Sto. Rosario (O), St. Rosario (Y) and
Valeriana.
The above shows the population density per barangay of Zaragoza, from very
low to very high. Wherein the barangays of San Isidro and Concepcion have the
highest density and Valeriana and H. Romero being the lowest.
Zaragoza has a population of 49,387 based on the 2015 National Census which
is 11.92% higher than the 44,124 of the 2010 Census. The total number of households
is 11, 723. Barangay San Isidro has the largest population with 5,944, followed by
Barangays Concepcion and Sto. Rosario (Young) with 5,534 and 3,914, respectively.
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Valeriana has the smallest population with only 539 representing only 1.09
percent of the total population, and next is H. Romero with 757, approximately 1.53
percent of Zaragoza’s population. Urban population totals 12,356 or 25.02 of the town's
total population and the rural barangays account for 74.98%. Population density for
2015 is 4.2 persons per hectare, .12% higher than the 3.75 persons per hectare record
of 2010.
I. Age-Sex Group
Table 15. Population by Age and Sex Group (Source: CLUP, 2016-2026)
The table above shows Zaragoza’s population per age and sex group in 2015.
It can be seen that the individuals aged 20-24 years old are the highest in number at
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4,839 followed by ages 10-14 years old at 4,827 and 5-9 year olds at 4,761. The
lowest number of individuals are 75-79 year olds at 319, followed by 80 years and
over at 324, and 70-74 year olds at 416. The males at 25,101 also outnumber the
females’ 24,286. Since prior studies done both locally and internationally have shown
that accidents, an occurrence that may lead to physical trauma, is likely to occur to
young people these statistics will be of great help in user analysis. Also according to
the 2016 Health Statistics, accidents have occurred more likely to males than to
females.
II. Education and Literacy
Table 16. Population by Educational Level (Source: CLUP, 2016-2026)
Of the household population 5-24 years old of 37,936 only 25,026 are currently
attending school. Highest number of age group attending school are 10-14 years old
with 4,702 and the lowest number are 20-24 year olds at 572 because some are
assumed to be already part of the work force. Males outnumber females at 6,459 to
their 6,054.
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Table 17. Literacy Rate (Source: CLUP, 2016-2026)
Literacy rate in Zaragoza can be considered high as there are only 210 persons
classified as illiterate. The number constitutes only 0.6% of the total population with
the male population sharing 55.71% of 210 with 117 individuals and the females cover
about 44.29% with 93 people of the total number of illiterates, while the percentage of
literate persons in the municipality is 99.40%.
Part of the Department of Health’s advocacy is to promote prevention first and
foremost before cure in the context of traumatic accidents. With this vision the
researcher has been advised to include lecture areas within the development to
educate immediate possible users on the importance of trauma prevention. With this
in mind it is crucial that a substantial amount of the population where the development
will be located should be educated or literate.
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III. Employment
Table 18. Employment Rate (Source: CLUP, 2016-2026)
The table above shows the number of workers in Zaragoza across different
fields and age groups. The highest number of employed age group is 25-29 years old
with 2,856 and lowest age group being 60-64 year olds with 780 employed individuals.
The field with the highest number of employees are Elementary Occupations at
4,414. According to the European Commision, Directorate-General for Employment,
Social Affairs and Inclusion, Elementary Occupations include work that is mostly
routine tasks that use hand-held tools and require physical effort such as that of
construction work. Followed by workers in the field of agricultural forestry and fishery
at 4,115. The field with the lowest number of workers are Armed Forces Occupations
with 55 individuals.
It is crucial to know the statistics of employment within a jurisdiction because
there is such a thing called Occupational Accidents that in turn may result to
Occupational Injuries. Work such as elementary occupation, armed forces occupation,
and plant and machine operation and assembly which require much of our physical
efforts should have a place to tend to them in the occurrence of an accident.
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IV. Religion
80 % of the Zargozenos are Roman Catholic. The remaining 20% are the
Aglipayans, Methodists, Iglesia ni Cristo, Seventh Day Adventists, Baptists, Born Again
Christians, Jehovah's Witnesses, and other Minority Religious Groups.
Being a God-fearing community but with the diversity of Christian-affiliated
religious groups it is the best interest of the development to provide an ecumenical
chapel within the premises for during trying times, people have historically preferred to
have a line with God, to pray for themselves and their loved ones which can then lead
to their spiritual healing therefore achieving an optimum environment.
V. Crime/Accident Rate
Table 19. Crime Rate (Source: CLUP, 2016-2026)
The table above shows the crime rate within the jurisdiction of PNP-Zaragoza
from 2013-2015. Vehicular Accidents make up the highest in 2015 at 203 accidents.
Crime is defined by the Philippine National Police as index and non-index crimes, index
crimes involve crime that is done against people such as rape, murder, homicide, and
physical injury, as well as crimes against property such as robbery, theft, carnapping
etc. of which 56 cases have been recorded in the municipality. Non-index crimes
include those that are covered by special laws such as illegal logging or local
ordinances, of which 16 have been recorded.
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Table 20. Fire Incident Rate (Source: CLUP, 2016-2026)
Fire Incidents have decreases in occurrence since 2013’s data of 5 to the now
2015 data of only 1 incident.
It is of importance to take into account crime rate because in physical trauma
cases, there is such a thing as interpersonal violence which is violence done with the
motive of causing harm to another individual and then there is also vehicular accidents
and fire incidents that may cause burns which is categorized as a physical trauma.
Some causes even perpetrators can be injured and as a medical establishment there
should not be discrimination for patients, but since it is of sensitive medico-legal cases
there should be isolation areas for these special cases.
4.3 Catchment Area in Central Luzon
The development has primary users from the region of Central Luzon by which
in extension the expressways that are located within its midst. Below are the number
of vehicles that pass through these road networks as posted at the site of the Toll
Regulatory Board.
AVERAGE
AVERAGE
EXPRESSWAY YEAR ANNUAL
DAILY COUNT
COUNT
NLEX 45,742 16,695,830
TPLEX 14,431 5267315
2020
SCTEX 5,170 1887050
TOTAL 65,343 23,850,195
Table 21. Average Daily Vehicular Count (Source: Toll Regulatory Board)
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A study made in 2016 by transport planning expert Dr. Cresencio Montalbo Jr.
of the University of the Philippines School of Urban and Regional Planning has shown
accident rates within 6 expressways in Luzon, including which is NLEX and SCTEX
and has shown that these 2 expressways had the highest accident rates with relation
to vehicles passing through them. NLEX was 16 accidents per 1, vehicles and SCTEX
had 11 accidents per 1,000 vehicles.
NLEX AND SCTEX ACCIDENT PROJECTION
16,695,830 vehicles / 1000 vehicles x 16 = 267,133
1,887,050 vehicles / 1000 vehicles x 11 = 20,757
The projected number of accidents within only NLEX and SCTEX is 287,290,
which is more than the number of users even a Level I Trauma Center is required to
attend because it only requires a 1,200 annual patient admittance.
As for out-patient rehabilitation, users can have access to the development via
private and public transport. Private vehicles can pass through the almost completed
CLLEX Phase which has an exit in San Rafael, Zaragoza as well as the national road
of Zaragoza which is the Sta. Rosa-Tarlac Road. The most common means of public
transportation within and outside the municipality are jeepneys and tricycles. Jeepneys
are a means of transport to adjacent municipalities as well as Nueva Ecija’s
commercial capital through the Zaragoza-Cabanatuan line and Zaragoza-Tarlac Line.
Minor exit points within the municipality can be accessed through their 20 tricyle
operators and drivers’ association. Buses that go to Manila, Tarlac and Baguio also
pass through the national road of the municipality. There is a central terminal for
Jeepneys travelling to Cabanatuan and Tarlac from 5:00 am to 9:00 pm and the buses
that pass through the Zaragoza include Baliwag Transit, ES Transport, Golden B, and
other big bus companies going to Manila.
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Zaragoza is also approximately 58.4 km from Clark International Airport via
Sta.Rosa – Tarlac Road and NLEX and takes about 1 hr of travel time.
4.4 Micro Site Analysis
4.4.1 Site Selection
Figure 71. Site Bearing (Antolin, 2020)
The site is a 3.5 Hectare plot of land located at Sto. Rosario Young, Zaragoza,
Nueva Ecija. It is bounded at the north by the national road, agricultural land on the
west, and a vacant lot on the east. The bearings of the site is indicated at the plan
above.
119
4.4.2 Topography and Elevation
Figure 72. Site Topography Map (Antolin, 2020)
Figure 73. Site with Topography (Antolin, 2020)
120
The site is relatively flat with the lowest portion being at the southwestern portion
at 15 meters above sea level and the highest portion on the northeast at 16 meters
with an average slope of 2-6% in varying areas.
Site Elevation
Figure 74. Site Elevation Cuts (Antolin, 2020)
SITE ELEVATION A
Figure 75. Site Elevation A (Google Earth)
Average Min. & Max Elevation: 14 meters, 16 meters (Road)
Average Slope: 2.0%-2.1%
121
SITE ELEVATION B
Figure 76. Site Elevation B (Google Earth)
Average Min. & Max. Elevation: 14 meters, 18 meters (Road)
SITE ELEVATION C
Figure 77. Site Elevation C (Google Earth)
Average Min. & Max Elevation: 16 meters, 20 meters (Left)
SITE ELEVATION D
Figure 78. Site Elevation D (Google Earth)
Average Min. & Max Elevation: 15 meters
Average Slope: -
SITE ELEVATION E
Figure 79. Site Elevation E (Google Earth)
122
Average Min. & Max. Elevation: 14 meters, 17 meters (Road)
4.4.3 Surface Water Runoff
Figure 80. Surface Water-Runoff (Antolin, 2020)
The image above shows where surface water may possibly go during times of
precipitation. Although the site is relatively flat with some being uneven, the topography
and elevation shows that run-off will flow to the south-western portion of the site
because it is the lowest.
4.4.3 Sun and Wind Path
Figure 81. Sun and Wind Path (Antolin, 2020)
123
Sun and Wind Paths are crucial in determining where structures can be built as
well as the site will be developed so the users can achieve maximum comfort, when
done right can also lead to energy-conservation techniques.
The northeastern part is the most shaded part and mostly receives morning
sunlight, this can be a possible area for putting in-patient facilities as well as
accommodation for in-house medical practitioners. The southwestern portion can be
an area for outdoor activities for users as it is hot and humid where vegetation can be
utilized to serve as buffer in case of extreme heat.
4.4.4 Vegetation
Figure 82. Vegetation Map (Antolin, 2020)
Common Grass Tall Talahib Grass
Palm Tree Acacia Tree
The site is littered with vegetation that have naturally grown overtime. The
northwestern portion is covered with a few palm trees, acacia trees as well as talahib
grass that has grown a significant height due to neglect. Acacia Trees can also be seen
littered across various areas within the site as well common grasses. Due to the
vegetation present in the site it is also being used by farmers to feed their cows.
124
Figures 83-86. Existing Site Condition (Antolin, 2020)
125
4.4.5 Sound and Vistas
Figure 87. Sound and Vista (Antolin, 2020)
The northwestern portion can be a source of noise because of vehicles passing
as well as from commercial establishments on the other side of the road. The western
portion can offer beautiful vista because of unhindered views to the Chico River and
plains the surround the site from west to east save for a few houses. The southern
portion is optimal for rehabilitation structures because it can maximize healing through
nature as well as being a significant distance from the noise the northern portion will
be experiencing.
4.4.6 Accessibility
Figure 88. Road Map (Antolin, 2020)
126
The major road of Sta.Rosa-Tarlac passes through the site making it accessible
to users coming from La Paz, Tarlac as well other municipalities of Nueva Ecija. A
municipal road also connects to the national road which will make the development
accessible to the different barangays of Zaragoza.
4.4.7 Boundaries
Figure 89. Site Boundaries (Antolin, 2020)
The site is bounded by a national road in the north as well as a commercial strip
mostly consisting of small time eateries or restaurants which can also serve the future
users of the development. The western part of the site is bounded by an agricultural
plot of land and a few hundred meters is the Chico River. The eastern part also has a
small restaurant and a vacant lot in the southeastern portion.
127
4.4.8 Vicinity Map
Figure 90. Vicinity Map (Antolin, 2020)
The image shows the vicinity within the proposed site. It has a 1 km radius which
is colored in yellow, a 3 km radius colored in blue, and a 5 km radius colored in red. It
can be seen from the table below the developments within the midst of the site. Most
major structures are inside the 5 km radius.
128
129
Table 22. Existiing Establishments (Antolin, 2020)
130
4.5 SWOT Analysis
STRENGTHS
 The site has an area big enough to accommodate all structures needed for an
insurance of an optimal place for healing as well as future plans of expansion.
 Most of the portions of the site is not prone to noise save from the area directly
adjacent to the road.
 Existing vegetation can help guide the landscaping of the project and is a
testament to its ability to grow a variety of plant life which is crucial to the
design approach.
WEAKNESSES
 The site, although mostly plain in topography still have some undulating
portions that may need grading.
 Some parts of the site is prone to accumulate surface water run-off due to a
portion of it being lower.
OPPORTUNITY
 The site is close enough to the municipal proper to access different
necessities but not too close for it to be disturbed by the ruckus of a more
urbanized area.
 The lack of advanced hospital facilities within the immediate area can help
attract users that are in need of the specialized services of the development.
 The south and eastern portions are a source of beautiful views such as plains
as far as the eyes can see and the Chico River.
THREATS
 Being in a rural area, there is not much accommodation for visitors of patients
or medical professionals that will offer their services.
 Because of its proximity to the Chico River, the lower portions of the site is
prone to flooding.
131
4.5.1 SWOT Matrix
OPPORTUNITIES (O) THREATS (T)
1. Close to city proper but

1. Minimal number of
not too much to cause
accommodation.
ruckus.
2. Lack of hospitals attract 2. Flood Prone due to
users to the
Chico River.
development.
3. Beautiful views to
nature in southern and
eastern parts.
STRENGTHS (S) S2, O2 S1, T1
1. Big enough to For patients undergoing As the site is of adequate size,

accommodate all rehabilitation, proper zoning of the development can offer
structures and spaces to separate trauma care temporary accommodation for
expansion. and rehabilitation plus the both visitors and medical
2. Most areas are tranquil ambience will ensure professionals during on-call duty.
safe from noise. optimal healing space.
S3, T2
3. Presence of
S3, O3
existing Through the utilization of
vegetation. With the incorporation of both vegetation and landscaping,
landscaping and the beauty of plants can have a significant
the natural environment the role effect on the decrease of flood
of external space be utilized to its susceptibility.
maximum capacity.
WEAKNESSES (W) W1, O3 W2, T2
1. Undulating Lowe portions of the site

The flood prone areas can be
portions in need correspond to the beautiful views
landscaped in a way where water
of grading. in the southeastern portions, a
2. Accumulation of raised deck can be utilized so have minimal damage or
water in lower both patients and staff can have
perhaps be transformed into a
areas. a place to relax.
pond.
Table 23. SWOT Matrix (Antolin, 2020)
132
INTERVIEW
The data presented in this portion will be the knowledge gathered by the
researcher through interviews with well-versed individuals.
Dr. Claro Cairo – Former National Focal Person of the Violence and Injury
Prevention Program, Department of Health
Information Gathered:
1. It is definitely in line with the Department of Health’s goals especially since
they aim to provide at least one trauma-capable hospital every region.
2. As much as possible employ rehabilitation, in fact before Dr. Cairo was
moved to another program they were doing work on including rehabilitation
in the benefits of PhilHealth so that even victims that cannot initially afford
be able to receive proper treatment.
3. The department will provide funding for hospitals that they deem are of
crucial need. There is also funding for TRCs or Treatment and Rehabilitation
Centers according to Dr. Cairo.
4. Part of the goal of the program on trauma care by the Department of Health
is above all else prevention is better than cure. To not wait for an accident
to happen and educate the public on the dangers of reckless decisions that
may lead to people getting hurt. With that Dr. Cairo has advised to include
lecture halls where the public can listen to seminars by other people
regarding injury prevention.
Office of Congresswoman Estrellita Suansing – Proponent of the HB 1960
Central Luzon Trauma Center
Information:
1. The bill was able to reach committee level and the office of Rep. Suansing
are also currently undergoing further research to re-file the bill.
133
Ar. Dan Lichauco – Architect specializing in the field of Healthcare Architecture
Information:
1. For the design of medical facilities, it is important to always put into account
the users or the patients and the medical staff and the efficiency of the
development.
2. In the design of emergency facilities, entrance is crucial. Entrance for urgent
cases but otherwise minor injuries should be separate major traumatic cases
such as amputations. Pediatric trauma should also be separated.
3. Proposing a hospital to rise in a rural environment is not a problem as long
as it is close to the municipal center and is in proper zoning.
Ar. Jean Paolo Policarpo – Architect II, DOH – Health Facility Development
Bureau
Information:
1. The development is in line with DOH’s goals of improving trauma-care in the
Philippines as well as lessening the burden of physical trauma.
2. When a certain development is part of the top priorities of the agency,
funding will be provided.
3. Same with Ar. Lichauco, zoning is crucial to the development, separate an
entrance to urgent cases but can otherwise wait and a different area for the
crash bay.
4. The original bill proposes a 50-bed hospital, but Ar. Policarpo advices that
since the development will be a focal point for all traumatic accidents in
Central Luzon and will likely receive patients from other hospitals that are
only capable of initial treatment, it is better to consider designing at least a
100-bed capacity hospital including rehabilitation
134
4.6 User Analysis
The prospective users of this medical institution are the residents of Central
Luzon that have experienced physical trauma, both minor and major, and is in need
of immediate care for better chances of survival. It will also cater users who have
acquired physical inabilities and other disabilities due to physical trauma and are in
need of rehabilitation to acquire a semblance of the life they had before the accident
has happened.
Below is an infographic that shows physical trauma mortality rates from a national
perspective to the limits of Central Luzon to get a glimpse of the gravity of physical
trauma.
Figure 91. Physical Trauma Profile Infographics (Antolin, 2020)
135
Table 24. Top 10 Morbidity Causes 3rd Q 2020 (Source: DOH – Central Luzon)
The Central Luzon Center for Health Development – DOH has provided the
researcher with statistics regarding the top 10 morbidity rates as of the 3 rd quarter
of 2020. The list shows that wounds are ranked 6th affecting 9,371 people. The
researcher also requested data on trauma-capable hospitals within the region to
get a sense of how much trauma care has improved for the users and they have
stated that according to Regulations Licensing and Enforcement Division, the
facilities within the jurisdiction of DOH-Central Luzon Center for Health
Development are not presently categorized as trauma-capable.
136
Table 25. 2020 PWD Census per Region (Source: PSA)
The table shows statistics of Household Populations of PWDs per region from the
PSA 2010 Census. Central
Luzon is third on the list with
139,000. According to
Republic Act 7277 Magna
Carta for Disabled Persons,
persons with disabilities are
“persons who cannot perform
work in the usual and
customary way due to loss of

Table 26. 2020 PWD Census Region III (Source: PSA)
limbs or any part of the body by injury
or absence thereof by birth.”
Further broken down to age group and sex males have the higher population of
PWDs compared to females. Age group with the highest are 10-14 year olds with
10,718 followed by 15-19 year olds.
SURVEY
For better user understanding the researcher has conducted a survey with
samples from a population of physical trauma survivors. The most relevant questions
137
includes whether or not they have received rehabilitation for their injuries and how it
has affected them, what accident did they experience, the number of hospitals they
had to go before being attended, and their experiences in the medical institution they
were taken to receive proper treatment. The survey was answered by 46 individuals,
2 of which did not actually experience an accident therefore being invalid, which brings
the number to 44. The results were analyzed and can be seen in this study’s annex.
ANALYSIS OF SURVEY
Although some accidents only include superficial wounds that only need time to
heal, major traumatic accidents can cause critical wounds to bones as well as
organs of the body where time by itself cannot deal with. This is where rehabilitation
comes in and helps patients regain the skills they have lost through different
medical interventions. Through this survey the researcher has received insight on
the true role of rehabilitation for a patient’s well-being and how important immediate
response to accidents are to patients that have experienced them. The proponent
will ensure a development that will meet all the needs of its patients to ensure that
an outstanding review will be given in the future.
4.6.1 User Identification
This portion identifies the specific users of the development.
USER DESCRIPTION
PATIENT
Major Trauma Patients These are patients that need immediate
attention and is usually in a life threatening
situation. This may include fatal injuries to the
head, organs, or even amputations.
Minor Trauma Patients These patients although experienced physical
trauma can usually be attended by non-
138
invasive procedures. May include superficial
cuts to the skin or minor burns.
Pediatric Trauma These patients include children and is in need
Patients of delicate procedures.
In-Patient Rehabilitation These patients stay at the grounds of the
medical facility during the duration of their
rehabilitation. They have accommodation on
site.
Out-patient These patients only go to the hospital to
Rehabilitation receive rehabilitation, after sessions they can
stay at their own residences.
Visitors This includes the family or kinship of the
parents that have authority to stay with the
patient during treatment or during visiting
times.
MEDICAL STAFF
Trauma Specialist These specialists are well-versed in the
treatment of traumatic injuries. When two or
more organs are hit critically, trauma
specialists are needed. These include the
Trauma Surgeons or Pediatric Trauma
Surgeons.
General Surgeon These are highly-skilled individuals that
specializes in commonly performed
procedures most specially in the abdominal
area. They attend and assess a trauma patient
and decide whether a trauma surgeon is
needed.
139
Emergency Medicine These are the first-line providers, with
Physicians specialties in providing immediate care to
illnesses and injuries. They often stabilize a
patient in time before a specialist can take care
of them.
Surgical and Emergency These include specialists on neuro-surgery,
Residents orthopedic trauma, plastic surgery, oral and
maxillofacial that are called upon a case that is
need of further expertise on their respective
fields.
Anesthesiologist They are concerned with the patient before,
during and after surgery. They often employ
anesthesia, intensive care medicine, critical
emergency medicine, and pain medicine.
Lab Technicians They examine specimens from patients under
the orders of doctors or other healthcare
providers in order to provide diagnosis.
ER Nurse They assist medical professionals, patients,
and immediate kin of the family in the
emergency room.
OR Nurse They assist surgical specialists inside the
operating room.
Ward Nurse They assist and check-on patients. They often
round the wards during their shifts.
Emergency Medical They are the responders of an out-of-hospital
Dispatch incident. They employ first-aid on site and
operate the ambulance.
140
Physical Therapist They offer rehabilitation programs for patients
that have acquired physical inabilities due to
physical trauma. It often includes programs on
orthopedic rehabilitation, neurological physical
rehabilitation, aquatic therapy, or Tai Chi, all
with the goal of restoring lost skills of the body.
Speech Therapist They help with communication and swallowing
problems that may have resulted from
transport accident injuries.
Medical Social Worker They assist families and individuals in a
healthcare setting. They often provide grief
counseling, psychotherapy, supportive
counseling or help. Social workers can also
intensify a patient’s network of social
assistance.
Medical Research They conduct studies on the hospital
environment with the goal of using the data for
program improvement. This include the
Trauma Registrar, which collates data on
trauma accidents that has the hospital has
attended.
Administrative Office
Administrative Officer They manage the staff as well as the over-all
operations of the development.
Housekeeping Maintains cleanliness of the wards and offer
other special services such as sterilization of
different parts of the hospital.
141
Security They maintain safety and security within the
development. They can also be tasked with
guarding specific patients that are related to
medico-legal cases until proper authorities
arrive.
Table 27. User Identification (Antolin, 2020)
142
4.7 Organizational Structures
Figure 92. Organizational Structure (Antolin, 2020)
Note: Organizational Structure has been based on the Department of Budget
and Management PH “Revised Organizational Structure and Staffing Standards for
Government Hospitals 2013 Edition” and the Committee on Trauma – American
College of Surgeons “Resources for Optimal Care of the Injured Patient”
143
4.9 Behavioral Patterns
Crash Bay
- Arrive at
hospital
Trauma Bay
- Attended by
Discharge the Trauma
Resuscutatio
n Team
Major Trauma
Patient
Operating
Therapy
Room
Room
- operated by
-
designated
Rehabilitatio
surgical
n activities
specialist
Ward Critical Care

- Unit
Assessment - Transfer to
for Critical Care
rehabilitation Ward
Emergency
Entrance
- Arrive at
hospital
Emergency
Room
Discharge - Attended
by
Minor Trauma Emergency
Physician
Patient
Physician's Pharmacy
Office - Go to
- Follow-up pharmacy
Check-up for medicine
144
Lobby
- Arrive at
hospital
Rehabilitation
Wards
Discharge - Arrive at
temporary
accomodation
Therapy
Therapist's Rooms
Office
In-patient - Attend
- Final
assessment rehabilitation rehab
sessions
Rehabilitation Cafeteria/
Ward
- Return to Room
room - Eat/Rest
Outdoor
Areas
- Tour
grounds
Lobby
- Arrive at
hospital
Locker
Area
Leave - Store
things at
lockers
Out-patient
Locker rehabilitation Therapy
Area Rooms
- Retrieve - Attend
things from rehab
lockers sessions
Outdoor
Areas Cafeteria
- Outdoor - Eat/Rest
Session
145
Lobby
- Arrive at
hospital
Waiting
Area/
Leave Visitor's
Lounge
- Wait for
patients
Rehabilitation
Visitors
Therapist's Pharmacy
Office - Pick-up
- Updates patient's
on patients medicine
Outdoor
Grounds
- Tour
grounds
Emergency
Room
- Arrive at
hospital
Waiting
Area
Leave - Wait for
procedures
to finish
Wards Wards
- Stay until Family/Kin - Visit
after visiting
hours patients
Physician's
Cashier Office/
- Pay Hallway
medical - Talk to
fees attending
physician
Pharmacy
- Pick-up
medicine
146
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff
room
- Time-in
Emergency Emergency
Office Room
Physician
- Time-out - Attend
patients
Office Staff
Lounge/
- Manage
medical Cafeteria
records - Eat/Rest
Emergency
Room
- Attend
patients
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff
room
- Time-in
Office
Resident
Office - Get
- Time-out Physician medical
records
Office
Wards
- Manage - Assess
medical patients
records
Staff
Room
- Eat,rest
147
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff room
- Time-in
Office
Office Operating - Get
- Time-out Room Nurse medical
records
Operating Nurse's
Room Station
- Assist - Be on-call
for
surgeons operations
Staff
Room
- Eat,rest
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff room
- Time-in
Emergency Office
Office - Get
- Time-out Room Nurse medical
records
Emergency Nurse's
Room Station
- Assist - Assist
emergency patients or
physicians visitors
Staff
Room
- Eat,rest
148
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff
room
- Time-in
Nurse's
station
Office Ward Nurse
- Time-out - Get
medical
records
Office Wards
- Manage - Do rounds
medical to check on
records patients
Staff
Room
- Eat,rest
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff
room
- Time-in
On-call Room/
Office Doctor's Office
- Time-out - Be on-call
Surgical for surgeries
Specialist
Wards Cafeteria/
- Check Staff Room
on - Eat,rest
patients
Operating Lecture
Room Rooms
- perform - Conduct
surgery on lectures and
patients seminars
149
Employee's
Entrance
- Arrive at
hospital Office/
Leave Staff
room
- Time-in
Office
Office
- Get
- Time-
out Physical medical
records
Therapist
Therapy
Office Room/
- manage Office
medical
records - Patient
assessment
Staff Therapy
Room/ Room
Cafeteria - Therapy
- Eat,rest session
Employee's
Entrance
- Arrive at
hospital Office/
Leave Staff
room
- Time-in
Office
Office - Get
- Time-out Speech medical
Therapist records
Therapy
Office Room/
- manage Office
medical
records - Patient
assessment
Staff Therapy
Room/ Room
Cafeteria - Therapy
- Eat,rest session
150
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff room
- Time-in
Rehabilitation
Office Caregiver wards
- Time-out - Check-on
patient
Outdoor Rehabilitation
grounds Wards
- Be on - Assist
standby for patient
assistance needs
Staff
Room/
Cafeteria
- Eat,rest
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff room
- Time-in
Ambulance
Office Emergency Parking
- Time-out Medical Dispatch - Vehicle
assessment
Out-of-
Staff Room hospital
- Be on-call - Respond to
accidents
Out-of-
hospital
- Conduct
first-aid
151
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff room
- Time-in
Office Administrative Office

- Time-out Officer - Office works
Office
Office
- Patient/
- Manage
visitor
records assistance
Staff
Room
- Eat,rest
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff room
- Time-in
Communal
Office Areas
Housekeeping - Clean and
- Time-out
organize
MRF/ Wards
Garbage - Clean,
- Waste organize and
Disposal sterilize
Staff
Room
- Eat,rest
152
Employee's
Entrance
- Arrive at
hospital
Office/
Leave Staff
room
- Time-in
Outdoor
Office Grounds
Security Officer
- Time- - Conduct
out security
rounds
Isolation
wards Indoor
Facilities
- Attend - Conduct
special security
security rounds
cases Staff
Room
- Eat,rest
Figure 93-111. Behavioral Patterns (Antolin, 2020)
153
CHAPTER 5
ARCHITECTURAL PROGRAMMING
5.1 SPATIAL IDENTIFICATION AND STAFFING REQUIREMENTS
This portion of the study will be discussing the spaces that will be incorporated
in the development as well as the staffing requirements. The spaces were based
upon the following guidelines:
1. Department of Health – Philippines “Manual on Technical Guidelines for Hospital
Planning and Design 100-Bed Hospital”
2. Department of Health – Philippines “Checklist for Review of Floor Plans Level 2
Hospital”
3. Philippine Academy of Rehabilitation Medicine “Clinical Practice Guidelines on
Diagnosis and Management”
4. Department of Budget and Management – Philippines “Revised Organizational
Structure and Staffing Standards for Government Hospitals”
5. World Health Organization “Guidelines for essential trauma care”
6. Committee on Trauma – American College of Surgeons “Resources for Optimal
Care of the Injured Patient”
7. Department of Veteran Affairs – Veterans Health Administration, Washington
“Physical Medicine and Rehabilitation Service”
8. New Jersey Department of Health and Senior Services “Licensing Standards for
Rehabilitation Hospitals”
9. Time Saver Standards for Building Types – Joseph De Chiara & John Callender
9. Existing Physical Trauma Treatment and Rehabilitation Centers
154
SPACE DESCRIPTION
EXECUTIVE DEPARTMENT
Office of the Medical Center Chief This room houses the chief of the
medical center, where he/she may
conduct private meetings and do
paperwork. This space typically house
a work space as well as a private toilet
room.
Conference Room The room houses meetings take place
with attendees ranging from clinical
department heads to board of
directors.
Visitor’s Lounge This room is where visitor’s with
business with the medical center chief
wait.
Office of the Administrative Assistant This is where the administrative
assistant to the medical center chief do
most of their work.
Toilet Area (M/F/Disabled) A public area for sanitary services,
consists of water closets, urinals and
lavatories
ADMINISTRATIVE ZONE
Lobby Usually consists of a waiting area,
reception area, a toilet area for public
use and another for staff only.
Admitting and Social Service Office This area takes care of patient’s
admittance and provides them with
social welfare services.
155
Business Office Where the billing, cashier, budget and
finance are housed.
Medical Records Section Where patient information are stored.
Personnel Office Where administrative office workers
stay day-to-day to do officeworks.
Prayer Room A space where users can go to
communicate with a higher being.
Office of the Administrative Officer A room for the chief administrative
officer to analyze programs in order to
apply improvements on current
administrative techniques.
Office of the Chief of Clinics A room where the head of the different
departments are housed to improve
teamwork among different fields of
medicine.
Conference and Lecture Room Where meetings or gatherings are
taken place. A room that can
accommodate a number of people with
the goal of educating them on a
specific topic such as trauma
prevention and for medical
professionals, innovative medical
techniques.
Staff Toilet (M/F/PWD) A space for sanitary purposes intended
for staff members. Usually includes
water closets, urinals and lavatories
156
Library A room where medical journals
imperative to medical techniques are
stored.
Laundry and Linen Office A space intended for the cleaning linen
from the wards of the hospital as well
as other areas. Includes a space for
sorting and washing, pressing and
ironing, and a storage area.
Maintenance Office A space for maintenance and
housekeeping staff can stay after
duties. Includes a space for work, a
housekeeping area, a motorpool and
ambulance parking area with a space
to make repairs.
Property and Supply Office Where office supplies are stored.
Waste Holding Room Where waste from the administrative
office are held before picked up by a
central disposing service.
Dietary This space is intended for the
preparation and serving of proper
meals for both patients and medical
workers. Includes the dietitian’s office,
supply receiving area, cold and dry
storage area, food preparation area,
cooking and baking area, serving and
food assembly area, washing area,
garbage disposal area, a dining area,
and a toilet.
157
Morgue A morgue holds cadavers and
conducts services which include an
autopsy. It also has a shower area and
toilet.
MEDICAL SERVICE
Emergency Room This area provides immediate care to
patients. This includes a waiting area
for family members, toilet, ER Nurse’s
station, triage, a minor OR/Area to
conduct initial surgical treatment to
patients to stabilize conditions,
examination and treatment area, an
observation area, an isolation room,
equipment and supply area, a wheeled
stretcher area, with separate entrances
for patients with minor cases and
victims that need urgent attention.
Outpatient Department This is an area where patients go to
receive diagnosis or treatment but do
not immediately require overnight
admittance. This area includes a
waiting area, toilet, admitting and
records area, consultation area,
respiratory unit, examination and
treatment area, office of department
head for medicine, pediatrics,
obstetrics and gynecology, and
surgery and anesthesia.
158
Surgical Service This area is where surgeons perform
and prepare for surgery. This includes
major operating rooms, recovery
rooms, sub-sterilizing area, equipment
storage area, scrub-up area, clean-up
area, dressing rooms and toilets,
nurse’s station, a wheeled stretcher
area, and a janitor’s closet.
Obstetrical Service This area provides services for patients
giving birth.
Neonatal Intensive Care Unit This is an area where newborn babies
are taken to receive initial care.
Nursing Unit This area is where patients with similar
needs are grouped together to facilitate
the care provided by healthcare
professionals. Includes patient room
with toilet, isolation rooms with toilet,
nurse’s stations, and a treatment and
medication area.
Intensive Care Unit This area provides care to patients with
life-threatening illnesses or injuries
which require constant supervision by
healthcare professionals. This are
includes a nurse’s station, medication
preparation area, toilet, patient area,
dressing area, and an equipment and
supply storage area.
159
Central Sterilizing and Supply Room This is where equipment are first
receives to be sterilized. Includes an
area for receiving and cleaning,
inspection and packing, a sterilizing
room, and a storage and releasing
area.
Staff Room This is where medical staff go to either
eat their meals or rest.
Doctor-on-Duty Room This area is where on-call doctors stay
during duty whenever their services
are not yet called upon.
Single-bed Ward This room is where admitted patients
stay and is intended for use of only one
patient and has its own toilet.
Multiple-bed Ward This room has multiple beds, maximum
of 4 patients share one room that has
its own toilet.
Acuity-Adaptable Rooms This room is intended for the use of
only one patient is cared for throughout
their stay until discharge due to the
severity of their illness or injury.
Storage and Supply Room This room contains equipment used for
the medical department.
Toilet (M/F/PWD) A public area for sanitary services,
lavatories
NURSING SERVICE
Office of the Chief Nurse This is where the head of the nurse
department stays to analyze patient
160
and his/her subordinates situations to
improve patient care and teamwork.
Nurse Department This is where nurses stay during
breaks to eat or rest.
Nurse’s Station This is where nurses stay when they
aren’t doing ward round. They can
assist both patients and visiting
individuals.
Toilet A public area for sanitary services,
lavatories
TRAUMA CARE SERVICES

Office of the Trauma Medical Director This room is where the trauma medical
director creates strategies to lead a
trauma program effectively and
efficiently. The trauma medical director
has work that extends beyond
technical skills on trauma surgery.
Office of the Trauma Program This room houses the trauma program
Manager manager where they develop,
implement, and evaluate the trauma
program. This is where the trauma
medical director and trauma program
manager collaborate for the common
goals of providing optimal trauma care.
Trauma Department This includes areas for the trauma
resuscitation team. Where these
medical professionals stay before
activation.
161
Major Trauma This is where patients with life-
threatening situations receive initial
treatment in a different area from
where patients with minor injuries
receive treatment.
Neurology Clinic This is where the neurosurgeon stay
during duty and where they receive
patients for follow-up treatment after
procedures.
Oral and Maxillofacial Clinic This is where patients who need
reconstructive work done on their faces
go for consultation with the surgeon
who specializes in their cases.
Orthopedic Clinic This is the area where orthopedic
surgeons and specialist stay before
activation in cases where they are
needed and where they receive
patients for follow-up check-ups.
Burn Specialist Clinic This is where burn specialists stay
when they are on duty and provide
patients with updates on their
situations.
Emergency Medical Dispatch This is where experts in pre-hospital
care stay whenever they stay at the
hospital.
REHABILITATION SERVICES
Lobby This area is where patients stay before
treatment to be admitted and where
visitors stay to wait. This area also has
162
a reception and assistance area with
toilets.
Office of the Chief Rehabilitation This room is where the chief of the
Physician department of rehabilitation medicine
oversee the activities the sector is
handling.
Therapist’s Department An area that houses the different
therapists present in the department
which includes, physical therapists,
speech therapists, etc.
Consultation Room This is where therapists and patients
initially meet to assess the program to
be done to assure full recovery.
Treatment Area This room offers light treatments for
patients that mostly include medicines
and light sessions.
Physical Therapy Room This can range from a private, semi-
private, or public room where a session
of physical therapy is conducted.
Multimodal Therapy Room A room where a range of individual
treatments can be done to a patient as
part of a package to address all patient
deficits.
Vocational Rehabilitation Therapy This is a room where a therapist helps
Room a patient determine the job that is best
suited for them. An interview,
evaluation of abilities, and a test for
163
their manual and physical needs is
usually done.
Occupational Therapy This room is where sessions of therapy
that help patients recover skills needed
for everyday activities they have lost
during a mental or physical change.
Pediatric Physical Therapy This is a room where physical therapy
is conducted for children.
Speech Therapy This is a room that helps patients
recover skills for communication and
swallowing.
Aquatic Therapy This area includes a pool where
aquatic exercises with the goal of pain
relief and improved functions are done.
Patient Locker Areas This is where patients leave their
belongings during therapy sessions.
Dressing Room/Cubicle Is an area where patients can change
their clothing depending on the activity
they need to perform
Balneotherapy Room Is an area where baths containing
thermal mineral waters at a
temperature of at least 20°C
(commonly 34°) and a mineral content
of at least 1 g/1.
Ultrasound Therapy Is a room for therapy which employs
heating of muscles and tissue.
164
Cryotherapy This room helps relieve tissue
damages through the use of cold water
or freezing temperature.
Kinesiology Therapy This room is where therapy that uses
Traditional Chinese techniques and
employs the concept of chi or energy
flow throughout the body.
Tai Chi Room This room is where the traditional
Chinese graceful form of exercise is
performed. Where patients do a series
of movements is a slow, focused
manner accompanied by deep-
breathing.
Electrophysiology Physical Therapy This is where Electronic Muscle
Stimulation (EMS) and
Transcutaneous Electrical Nerve
Stimulation is performed which uses
electrical energy to either elicit
muscular contraction (EMS) or modify
pain perception (TENS).
Paraffin Therapy A room where a therapy that is for
chronic joint pain, muscle pain, and
enhancing blood flow is performed.
Orthotics and Prosthetics Services This is a room where patients in need
of orthoses (external braces) to help
weakened parts of the body during
healing process and prostheses
(artificial limbs) that can help them in
165
their daily activities receive
consultations and receive their
services.
Visitor’s Lounge This is an area where visitors can stay
a significant amount of time while
waiting for out-patient rehabilitation.
Single-bed Ward This is where in-patient rehabilitation
individuals stay during the duration of
their treatment until discharge.
Out-patient Locker Room This is where out-patients leave their
belongings during sessions.
Patient Toilet Area A public area for sanitary services,
lavatories
Equipment Storage This is where equipment are stored.
Utility Area This is essentially where cleaning
supplies are stored. And utility
personnel stay during breaks.
ANCILLARY SERVICES
Clinical Laboratory This is where clinical tests are
conducted to aid in patient diagnosis.
Typically includes a clinical work area,
a pathologist area, microbiology room,
extraction area, and a toilet.
Blood Station This is where blood is stored and can
be extracted for transfusion.
Radiology This is where scans of organs and
structure of the body are made. It
166
includes spaces for Xray with a control
booth, dressing area, and a toilet. It
also has a dark room, film file and
storage area and a radiologist area.
Pharmacy This is where patient’s medicine is
stored and provided. It typically has a
counter with a sink.
Helipad This is intended for air transfer of
trauma patients to the hospital.
Healthcare Staff Accommodation This an area where healthcare staff
can stay during long periods of time.
OUTDOOR AREAS
Gardens “Horticulture Therapy” Gardens that offer experiential therapy
through landscaping that helps in the
patient’s relaxation and healing.
Walkways This area is where patients can use to
tour the grounds during treatment.
These are properly designed to
promote individual movement with
minimal guidance.
Pavilion Is an outdoor area that can host a
variety of social events such as
seminars for trauma prevention, mass,
and other significant celebrations.
Roof Garden This is an area where both staff and
patients and go to rest. This will also
offer farming for users.
167
Sheds This is covered areas where patients
can sit and rest while maintaining
outdoor experiences.
Parking Areas This is where vehicles will be left by
both employees and patients.
SUPPORT SERVICES
Pump Room A room for pumps used to regulate the
supply of water to the pools and the
structures.
Generator Set A room that houses the generator that
is used when there is power
interruptions.
Power Room A room that contains the electrical
equipment such as control panels.
Warehouse/Repair Room A room where general materials are
stored and where repairs can be done.
AHU A room that stores the HVAC system.
Materials Recovery Facility An area that stores and collects
garbage for sorting before complete
disposal.
Hospital Waste Management This is where hospital waste is stored
before pick up by proper services.
168
STAFFING REQUIREMENT
SPACE PERSONNEL NO.

EXECUTIVE AND ADMINISTRATIVE DEPARTMENT
Office of the Medical 1. Medical Center Chief
Center Chief 2. Administrative Assistant

4
3. Computer Maintenance
Technologist (2)
Office of the 1. Supervising Administrative Officer

2
Administrative Officer 2. Administrative Aide VI
Human Resource 1. HR Officer
Management 2. Recruitment Agent

4
3. Payroll Staff
4.Labor Relations Officer
Procurement 1. Procurement Clerk
2. Procurement Agent 4
3. Administrative Assistant (2)
Materials Management 1. Supervising Manager
2. Warehouseman
5
3. Administrative Assistant
4. Administrative Aide (2)
Engineering and 1. Engineer/Architect (2)
Facilities Management 2. Medical Equipment Technician (2)
a. Housekeeping and Laundry
1. Hospital Housekeeper (4) 48
2. Laundry Worker (2)
3. Seamstress
b. Maintenance
1. Indoor (5)
169
2. Outdoor (10)
c. Safety and Security
1. Chief of Security (1)
2. Security Guards (6)
Budget 1. Administrative Officer (2)

3
Accounting 1. Accountant (2)
a. Billing and Claims

10
1. Administrative Officer
Cash Operations 1. Administrative Officer (2)

3
TOTAL 83
MEDICAL DEPARTMENT
Office of the Chief of 1. Chief of Medical Professional Staff
2
Professional Staff 2. Administrative Assistant
Outpatient Department 1. Medical Specialist (2)
2. Medical Officer
3. Nurse (2)
4. Psychologist 9
5. Health Education and Promotion
Officer
6. Nursing Attendant
Emergency Medicine 1. Medical Specialist (2)
Department 2. Medical Officer (5)

19
3. Nurse (8)
4. Nursing Attendant (4)
170
Neurology 1. Neuro-surgeon
2
Orthopedics 1. Orthopedic Surgeon (2)

3
Trauma 1. Trauma Surgeon (3) – 24 hour
availability
2. Pediatric Trauma Surgeon (2)

8
3. Trauma Medical Director
4. Trauma Program Manager
5. Trauma Registrar
Oral and Maxillofacial 1. Oral and Maxillofacial Surgeon

2
Burn Unit 1. Burn Specialist (2)

2
Special Care Areas 1. Medical Specialist (2)

4
2. Medical Officer (2)
Department of Pathology 1. Medical Specialist
2. Administrative Aide
a. Blood Bank
1. Medical Specialist
2. Medical Technologist (3)
3. Nurse (2)
21
b. Anatomic and Clinical Laboratory
1. Medical Specialist
2. Medical Technologist (6)
3. Chemist
4. Medical Laboratory Technician (2)
5. Laboratory Aide (3)
171
Health Information 1. Administrative Officer (3)
Management 2. Statistician
3. Data Controller
10
b. Admitting/Information
1. Administrative Officer
Nutrition and Dietetics 1. Nutritionist-Dietitian (2)
2. Cook (3) 9
Pharmacy 1. Pharmacist (6)

7
Medical Social Work 1. Social Welfare Officer (3)

4
2. Social Welfare Assistant
Office of the Chief Nurse 1. Nurse (3)

4
2. Administrative Aide
Wards 1. Nurse (1:12 nurse to bed ratio 3

20
work shifts in 24 hours)
Operating Room 1. Nurse (10)

14
2. Nursing Attendant (4)
Delivery Room 1. Nurse (8)

11
2. Midwife (3)
Post Anesthesia Care 1. Nurse (5)

7
Unit 2. Nursing Attendant (2)
Intensive Care Unit 1. Nurse (5)

6
2. Nursing Attendant
Neonatal Intensive Care 1. Nurse (10)

14
Unit 2. Nursing Attendant (4)
172
Pulmonary/Respiratory 1. Respiratory Therapist (3)
5
Unit 2. Laboratory Aide (2)
Central Supply and 1. Nurse (1)

6
Sterilization 2. Nursing Attendant (5)
TOTAL 189
REHABILITATION DEPARTMENT
Office of the Head of 1. Head of Rehabilitation Medicine
2
Rehabilitation Medicine 2. Administrative Assistant
Lobby 1. Receptionist 1
Rehabilitation Therapy 1. Physical Therapist (1:7 ratio - 5)
2. Speech Therapist (1:15 ratio – 2)
3. Kinesiology Specialist
4. Tai Chi Specialist
5. Ultrasound Therapist
6. Balneotherapy Specialist
7. Cryotherapy Specialist 23
8. Aquatic Therapist (1:5 ratio - 7)
9. Paraffin Therapy Specialist
10. Electrophysiology Therapy
Specialist (2)
11. Orthotics and Prosthetics
Specialist
Wards 1. Nurse (1:12 ratio per bed 3 shifts in
24 hours) 11
2. Caregivers (1:5 ratio - 6)
Maintenance 1. Housekeeping (2)
2. Laundry and Linen (2) 5
3. Maintenance
TOTAL 42
GRAND TOTAL : 314 PERSONNEL
173
5.2 Space Programming
Spaces provided in this section is from correlated literatures regarding trauma care
as well as manuals from the Department of Health on the design of 100-bed
hospitals. Furniture, fixtures, and equipment dimensions are taken from standards
in different product brochures.
174
A. Executive Department 0
QUALITY OF NO. OF AREA/ AREA GRAND REQUIRED

AREA NO ZONING ACTIVITY ADJACENT SPACES USERS NET AREA FURNITURES/FIXTURES TOTAL CONTINGENCY CIRCULATION
SPACE USERS USER TOTAL SQM
DIMENSION TOTAL
3-seater Sofa 1.26
Desk 1.05
Side table 0.375
Bookshelves 0.27
Office of the Medical Professional, Medical Center Chief does Medical Center Chief Desk Return Extension 0.48
Center Chief
1
Sleek
Semi-Private
office work.
Administrative Offices
Visitors
3 5.02 15.06 Whiteboard 0.593 7.96 28.04 2.8038 8.4114 39.2532 39
Senior Executive Chair 0.5025
Visitor's Chair (2) 0.405
Conference Table 1.08
Conference Chair (5) 1.9425
Medical Center Chief - Clean and well- Medical Center Chief uses Water Closet 0.35
Toilet
1
ventilated
Private
toilet facilities.
Medical Center Chief Office Medical Center Chief 1 1.2 1.2 Sink with Cabinet 0.3 0.65 3.05 0.305 0.36 3.715 4
Desk 1.05
Secretary of the Medical
Desk Return Extension 0.48
Secretary's Area 1 Functional Public Center Chief does clerical Visitor's Lounge Administrative Assistant 1 5.02 5.02 Bookshelves 0.27 2.16 12.2 1.22 1.506 14.926 15
work and receives visitors
Clerical Chair 0.36
Medical Center Chief Conference Chairs 3.6
Medical Center Chief, Staff, TV Console 0.36
Conference Room 1 Formal Semi-Public
and visitors have meetings.
Visitor's Lounge Department Heads 10 1.4 14 6.17 21.57 2.1573 4.2 27.9303 28
Administrative Assistants Whiteboard 0.593
Cabinets 0.54
Sofa 1.26
Visitors wait for time with Secretary's Area
Visitor's Lounge 1 Accommodating Public
Medical Center Chief. Toilets
Visitors 5 0.65 3.25 Table 0.54 2.18 6.075 0.6075 0.975 7.6575 8
Sidetable 0.375
Water Closet 0.35
Clean and well-
Toilets 1
ventilated
Private Visitors use toilet facilities. Visitor's Lounge Visitors 1 1.2 1.2 Urinal 0.162 0.76 3.16 0.31595 0.36 3.83545 4
Lavatory 0.2475
97.3175 97
B. Administrative Department
SPACE USERS USER DIMENSION TOTAL TOTAL SQM
Sofa 1.5
Arm Chairs 0.5625
Reception/Waiting Area for Center Table 0.81
Entrance
Main Lobby 1 Accommodating Public patients, relatives and
Administrative Offices
Public/All Users 20 0.65 13 Side Table 0.42 3.29 16.29 1.62925 4.88775 22.8095 23
visitors
Desk 1.05
Workers do officer works
Business and Finance Offices Filing Cabinets 0.324
and receives visitors. Chief Administrative 5.02/staff
Office of the Medical Center Chairs 0.27
Office of the Chief Administrative Officer Officer
Administrative Officer
1 Formal Private
plans, directs, controls, and
Chief
Clerks
4 1.40/visito 12.84 Swivel Chairs 0.5936 4.58 17.42 1.74176 5.22528 24.3846 24
Human Resource Dev't Office r 2-Seater Sofa 1.32
organizes workplace Visitors
Property and Supply Table 0.54
system.
Water Closet 0.35

Chief Administrative
Office of the Chief Lavatory 0.2475
Clean and well- Office of the Administrative Office of the Chief Officer
Administrative Officer - 1
ventilated
Private
Officer uses toilet facilities Administrative Officer Clerks
1 1.4 1.4 0.6 1.998 0.19975 0.59925 2.7965 3
Toilet
Visitors
Receives queries from Receptionist 5.02/staff Information Counter 1.82

Information/Reception Computer Table 0.3
& Communication Area
1 Accommodating Public clients, patients and guests Lobby Patients 5 0.65/visito 11.99 2.71 14.7 1.47036 4.41108 20.585 21
and provides directions Guest Swivel Chair 0.5936
r
175
Sofa 2.52
Arm Chairs 1.44
Center Table 0.81
Side Table 0.42
Admitting of patients and Administrative Officer
Desk 4.5
assigns the service needed. Lobby Computer Operator 5.02
Admitting Office 1 Formal Semi-Public
Encoding data of inpatient Reception Area Patients and
15
1.4
39.1 Desk Return Extension 2.4 16.3 55.36 5.5358 16.6074 77.5012 78
Transaction Counter 1.82
records. Companions
Swivel Chairs 1.484
Cabinet 0.54
Steel Filing Cabinets 0.324
Desk 1.2
Clerical Desk 2.16
Workers compute billing Steel Filing Cabinet 0.324
Accessible by Office of Chief
charges and sorts charge Chief Billing Officer Computer Table 0.3
Billing and Claims 1 Formal Semi-Private
slips, store file, and retrieve
Administrative Officer and
Clerks
4 5.02 20.08
Wall-mounted filing cabinet 0.352
6.16 26.24 2.6236 7.8708 36.7304 37
Business and Finance Office
billing records. Counter 1.82
Counter 1.82
Desk 2.1
Collects payments Computer Table 0.6
Issues checks to claimants Desk Extension 0.96
Prepares monthly report of Swivel Chair 0.8904
Chief Cashier Vault 0.15
Formal, collection and deposit Billing and PhilHealth Section
Cashier's Office 1
Organized
Semi-Public
Prepares checks and Medical Social Worker Office
Collecting and 2 5.02 10.04 Chairs 0.2025 7.32 17.36 1.73559 5.20677 24.2983 24
Disbursement Clerks Whiteboard 0.593
statement of collection and
disbursement
Maintain records
Is in close relationship with Head Medical Social Executive Chair 0.5025

the patient and their Worker Desk 3.6
Admitting Office
families. Conducts private Clerk 5.02/staff Steel Filing Cabinet 0.324
Business and Finance Office
Medical Social Work consultations on various Patient, Family or Table 2.88
Office
1 Accommodating Private
situations of the family such
Accessible via ER, Outpatient
Significant others
6 1.40/visito 22.88
Counseling Chair 1.0125 8.68 31.56 3.1559 9.4677 44.1826 44
Dept and Office of the r
as their socio-economic Medical Team Desk Return Externsion 0.36
capabilities and NGOs, GOs, other
psychosocial conditions. stakeholders
Medical Social Work Clean and well- Counseling Room Staff and Water Closet 0.35
Office - Toilet
1
ventilated
Private
Clerical Area Patients/Visitors
1 1.2 1.2
Lavatory 0.2475
0.6 1.798 0.17975 0.53925 2.5165 3
Makes arrangements on Desks 3.6
the purchasing of Swivel Chairs 0.99
Procurement & Procurement Clerk
necessary materials for the Steel Filing Cabinets 0.324
Materials Management 1 Formal Private
function of the
Budget and Finance Office Procurement Agent 4 5.02 20.08 4.91 24.99 2.4994 7.4982 34.9916 35
Office Administrative Assistants
development. Makes
reimbursements
Desk 1.845
Back Cabinet 0.6
5.02/staff Swivel Chair 0.495
Commission on Audit does Billing and Finance COA Auditor
Auditing 1 Formal Private office work, receives Office of the Chief Clerk 10 1.40/visito 21.24
7.9 29.14 2.9139 8.7417 40.7946 41
visitors, and process data. Administrative Officer Visitors r Conference Chair 3.15
Steel Filing Cabinet 0.324
Executive Chair 0.5025

Desk 2.79
Process funding and Office of the Chief Chief Budget Officer
payment, payroll, contract Administrative Officer Bookeeper
Budget and Finance 1 Formal Private
and other financial Office of the Medical Center Budget Clerk
3 5.02 15.06 Swivel Chair 0.495 6 21.06 2.10645 6.31935 29.4903 29
Armchair 1.30
transaction of the hospital. Chief
Whiteboard 0.593
176
Workers do officer works, Desk 2.79
Office of the Chief Chief Accountant
receives visitors, and Swivel Chair 0.495
Accounting 1 Formal Private
stores, files, and retrives
Administrative Officer Accounting Clerk 3 5.02 15.06
Steel Filling Cabinet 0.486 5.89 20.95 2.09535 6.28605 29.3349 29
Budget and Finance Office Bookeeper
records Side Cabinet 0.32
Armchair 1.30
Desk 3.51
Computer Table 0.3
Prepares comprehensive Steel Filing Cabinet 0.81
Personnel Officers
Human Resource manpower development Lobby Swivel Chair 0.7425
Development Office
1 Formal Private
program from selection to Administrative Service Offices
Administrative Clerks 6 5.02 30.12 8.26 38.38 3.8383 11.5149 53.7362 54
Applicants/Employees Chair 0.405
separation. White Board 0.593
Back Cabinet 0.32
Desk 2.16
System Administrator Desk Return Extension 1.08
organizes libraries for Swivel Chair 0.7425
Integrated Hospital Office of the Medical Center Information Technologist
diseases, drugs and Cabinet 0.675
Operations and 1 Formal Private
medicine, prepares
Chief Computer Engineer 3 5.02 15.06 Server Cabinet 1.0 5.33 20.39 2.03925 6.11775 28.5495 29
Management Program Administrative Offices Systems Administrator
directories of medical
personnel
Office of the Medical Center Conference Table 5.1

Chief Conference Chairs 6.3
Hospital Staff hold meetings Office of the Administrative Hospital Staff Side Table 0.42
Conference Room 1 Formal Semi-Public
or special lectures Officer Visitors
12 1.4 16.8
Podium 1.016 13.2 29.96 2.9956 8.9868 41.9384 42
Office of the Chief Nurse Cabinet 0.32
Office of the Chief of Clinics
Workers do officer works, Desk 1.89
Chief of Clinics
Office of the Chief of receives visitors, and Office of the Medical Center 5.02/staff Cabinet 0.6
Clinics
1 Formal Private
stores, files, and retrives Chief
Clerk 6
1.4/visitor
12.84
Swivel Chair 0.2475
3.74 16.58 1.658 4.974 23.212 23
Visitors
records Visitor's Chair 0.5
Chief of Clinics Water Closet 0.35

Office of the Chief of Clean and well- Office of the Administrative
Clinics - Toilet
1
ventilated
Private
Officer uses toilet facilities
Office of the Chief of Clinics Clerks 1 1.4 1.4 Lavatory 0.2475 0.6 1.998 0.19975 0.59925 2.7965 3
Visitors
Desk 4.005
Workers do officer works, 5.02/staff Desk Return Extension 0.72
Chief Nurse
Office of the Chief receives visitors, and Office of the Medical Center Bookshelves 0.27
Nurse & Nursing Office
1 Formal Private
stores, files, and retrives Chief
Clerks 4 1.40/visito 26.5
Swivel Chair 0.99 8.03 34.53 3.453 10.359 48.342 48
Visitors r
records Visitor's Chair 0.5
2-Seater Sofa 1.32
Chief Nurse Water Closet 0.35

Office of the Nurse - Clean and well- Office of the Administrative
Toilet
1
ventilated
Private
Officer uses toilet facilities
Office of the Chief Nurse Clerks 1 1.4 1.4 Lavatory 0.2475 0.6 1.998 0.19975 0.59925 2.7965 3
Visitors
Dining Chair 0.81
Dining Table 1.35
Administrative Staff makes Cupboard 0.675
Staff Lounge 1 Relaxed Semi-Private
use of pantry. Staff rests
Administrative Offices Staff 6 1.4 8.4
Sink with Drainboad 0.4185 5.11 13.51 1.35135 4.05405 18.9189 19
2-seater Sofa 1.32
Center Table 0.54
Water Closet 1.05
Clean, Administrative staff make Urinal 0.162
Staff Toilets 1
well-ventilated
Private
use of toilet facilities.
Billing and Claims Office Staff 3 1.2 3.6
Lavatory 0.99
2.2 5.802 0.5802 1.7406 8.1228 8
Patients, Visitors and Patients Water Closet 1.05

Clean,
Public/PWD Toilets 1
well-ventilated
Public Relatives make use of toilet Main Lobby Visitors 5 1.2 6 Lavatory 0.99 2.2 8.202 0.8202 2.4606 11.4828 11
facilities Relatives Urinal 0.162
630.312 630
177
C. Administrative - Health Information Management Systems
Receiving and issuance of
Counter Chair 0.405
Receiving/Releasing medico/medico-legal Clerks 5.2/staff
Area
1 Accomodating Public
certificate, birth and death
Administrative Department
Visitors/Clients 7 0.65/client
14.3 Steel Filing Cabinet 0.324 4.49 18.8 1.8794 5.6382 26.3116 26
Cabinet 1.35
certificates
Waiting Chairs 1.215
Cabinets 0.9
Workers do office works.
Desk 4.32
Process medical records
Swivel Chair 1.485
from ER, OPD and OR Statistician
Work Area 1 Functional Private records. Transcripts death Administrative Department Data Controller 6 5.02 30.12 6.71 36.8 3.6825 11.0475 51.555 52
and birth certificates. Staff Researchers/Doctors
assembles inpatient charts
and updates death registry.
Workers discuss and Researchers/Doctors Conference Table 1.125
finalize data related to Administrative Office Swivel Chairs 1.485
Completion Room 1 Functional Private
medical records requested
HIMS 6 1.4 8.4 1.61 10 1.001 3.003 14.014 14
by clients Clinical Coder
Desk 0.72
Head Officer of HIMS do Desk Return Extension 0.36
Head Officer
office works and 5.02/staff 2-seater Sofa 1.32
Head's Office 1 Functional Formal
coordinates with other
Administrative Department Researchers 4 1.4/visitor
9.22
Visitor's Chair 0.2025 3.17 12.4 1.239 3.717 17.346 17
Visitors/Clients
authorized personnel. Swivel Chair 0.2475
Cabinet 0.32
Steel Open Shelving 26.25
HIMS staff stores and HIMS Staff
Filing Room 1 Neat, Organized Private
retrieves active cases.
Clerical Room
Researchers/Doctors 10 1.4 14 Transaction Counter 1.2 27.7 41.7 4.1718 12.5154 58.4052 58
Ladder 0.268
Workers store inactive Steel Open Shelving 8.75
Storage Room 1 Neat, Organized Private
cases.
Filing Room HIMS Staff 2 1.4 2.8 Ladder 0.268
9.02 11.8 1.1818 3.5454 16.5452 17
184.177 184
C. Emergency Service Facilities
Medical Doctor Adjustable Stool 0.8
Patient may arrive on foot, Nurse 5.02/staff Counters 1.62
Functional and Outpatient Department
Lobby and Triage 1
Sterile
Public wheelchair or stretcher and
Waiting Area
Nursing Attendant 10 1.4/patien 33 Computer Table 0.3 4.97 37.97 3.797 11.391 53.158 53
is evaluated. Clerks t Chair 2.25
Patient
Swivel Chair 0.495
Counter 1.62
Nurses receives patients to
Wall-hung cabinets 0.352
ER and makes inquiries and Emergency Entrance
Functional, Nurse Storage Shelves 0.45
Nurse Station 1
Accommodating
Public records necessart Treatment and Minor
Nursing Attendant
2 5.02 10.04
Whiteboard 0.593
4.95 14.99 1.499 4.497 20.986 21
information from/about Operating Rooms
Sink in counter 0.9
patients.
Lockers 0.54
Water Closet 0.35

Nurses and Emergency Nurse
Lavatory 0.2475
Nurse Station -Toilet Clean Private Physicians use toilet Nurse's Station Nursing Attendant 1 1.2 1.2 Sink in Counter 0.72 1.32 2.518 0.25175 0.75525 3.5245 4
facilities Physicians
i 0.2475
Social Worker/Physician 0.72
Family Physician
interview patient. Patients 0.352
Nurse
Women and Children wait their turn to be ER Lobby 0.45
Protection Unit
1 Safe and Secure Private
interviewed. Family OB-Gyne Department
Social Worker 5 5.02 25.1
0.2745 4.01 29.11 2.9106 8.7318 40.7484 41
Patient
Physician assists patient for 1.287
Companion
check-up 0.27
0.405
178
Family Physician Water Closet 0.35
Nurse Lavatory 0.2475
Women and Children Staff and patient use toilet Women and Children
Protection Unit - Toilet
1 Clean Private
facilities Protection Unit
Social Worker 1 1.2 1.2 0.6 1.798 0.17975 0.53925 2.5165 3
Patient
Companion
Patient may arrive on Examination Table 7.43
wheelchair or stretcher.
Resident Physician
Functional and Collecting of specimen via Emergency Exit
Respiratory Unit 1
Sterile
Private
nasopharyngeal swab prior Nursing Wards
Nurse 3 1.4 4.2 7.43 11.63 1.163 3.489 16.282 16
Patient
to admission and laboratory
tests.
Footstool 0.4484
Patient may arrive in foot, Resident Physician Examination Table 7.43
Treatment Cubicle - Functional and wheelchair or stretcher. Nurse Station Nurse Side Table 0.206
Resuscitation
1
Sterile
Semi-Private
Use of diagnostic Minor Operating Room Nursing Attendant
6 1.4 8.4 Sink 0.2475 8.33 16.73 1.67319 5.01957 23.4247 23
equipment Patient
Footstool 1.3452
Patient may arrive in foot, Resident Physician
Examination Table 22.29
Treatment Cubicle - Functional and wheelchair or stretcher. Nurse Station Nurse
Pediatrics
1
Sterile
Semi-Private
6 1.4 8.4 Side Table 0.618 24.5 32.9 3.29007 9.87021 46.061 46
Sink 0.2475
equipment Patient
Footstool 1.3452
Treatment Cubicle - OB- Functional and wheelchair or stretcher. Nurse Station Nurse
Gyn
1
Sterile
Semi-Private
4 1.4 5.6 Side Table 0.618 24.5 30.1 3.01007 9.03021 42.141 42
Sink 0.2475
equipment Patient
Footstool 1.7936
Medical
1
Sterile
Semi-Private
7 1.4 9.8 Side Table 0.824 32.6 42.39 4.23851 12.71553 59.3391 59
Sink 0.2475
equipment Patient
Footstool 1.3452
Surgical
1
Sterile
Semi-Private
7 1.4 9.8 Side Table 0.618 32.6 42.39 4.23851 12.71553 59.3391 59
Sink 0.2475
equipment Patient
Physicians and nurses rinse Shelves 0.72
Resident Physician
arms and hands. Sink and drainboard 0.837
Scrub-Up/Sub-Sterile 1 Sterile Private
Preparation and sterilization
Minor Operating Room Nurse 3 5.02 15.06
Counter 0.54
2.34 17.4 1.74045 5.22135 24.3663 24
Nursing Attendant
of equipment. Scrub-up Sink 0.2475
Shelves 0.72
Double Basin Stand 0.245
Instrument Table 0.549
Operating Table 0.95
Patient arrives via Resident Physicians
Footstool 0.4484
stretcher. Surgical Sub-Strerilizing Room Nurse
Minor Operating Room 1 Sterile Private
procedures are Scrub-Up Nursing Attendant
5 5.02 25.1 Kick bucket 0.105 6.17 31.27 3.12733 9.38199 43.7826 44
Single Basin Stand 0.1225
administered. Patient
Anesthesist Table 0.175
Lighting 2.4384
Screen + Stand 0.39
Storage of Supplies for Shelves 9

Health Emergency Sterile and public health emergency
Management Supply
1
Organized
Semi-Private
preparedness and
Emergency Department Medical Doctor 1 5.02 5.02 9 14.02 1.402 4.206 19.628 20
response unit
3-seater Sofa 1.26
Doctor on duty does
Easy Chair 0.84
paperwork, rests while Major Operating Room Resident Physicians
Sink in counter 0.9
Doctor's Call Room 1 Clean Private waiting for emergency calls. Nurse Station Nurses 6 5.02 30.12
Filing Cabinet 0.324
5.84 35.96 3.5964 10.7892 50.3496 50
Doctor on duty stores Treatment Cubicles Nursing Attendants
Table 0.54
personal belongings
Bunk Beds 1.98
Resident Physicians Water Closet 0.35
Doctor's Call Room - Clean and well- Emergency Room Staff use
Toilet
1
ventilated
Private
toilet facilities
Doctor's Call Room Nurses 1 1.2 1.2 Lavatory 0.2475 1.41 2.608 0.26075 0.78225 3.6505 4
Nursing Attendants Shower Area 0.81
179
Emergency Department Swivel Chair 0.495
Department Head does
Department Head's Chief 5.2/staff Desk 1.125
Office
1 Formal Private office works and receives ER Treatment Cubicles
Secretary
5
1.4/visitor
13.2
Visitor's Chair 0.405 2.57 15.77 1.5765 4.7295 22.071 22
visitors.
Visitors Bookshelves 0.54
Emergency Department Water Closet 0.35
Department Head's Clean and well- Department Head does Chief Lavatory 0.2475
Office - Toilet
1
ventilated
Private
uses toilet facilities
Department Head's Office
Secretary
1 1.2 1.2 0.6 1.798 0.17975 0.53925 2.5165 3
Visitors
Examining Table 7.43
Shower Area 0.81
Consultation Table 1.125
PPE Rack 0.9
Patient is decontaminated Medical Doctor Chair 0.405
Ambulance Entrance 5.02/staff
Isolation Room 1 Sterile Private by chemical solutions and Nurse 3
1.4/visitor
11.44 Linen Storage 0.72 15.8 27.28 2.7278 8.1834 38.1892 38
then treated. Patient Linen Hamper 0.25
Lavatory 0.2475
Water Closet 0.35
Wash Area 3.6
Shower Area 2.25

Patient arrives and
Ambulance Entrance Resident Physician Stretcher 7.43
Decontamination Room 1 Sterile Private decontaminated by
Patient
2 1.4 2.8
Linen Storage 0.72 10.7 13.45 1.345 4.035 18.83 19
chemical solutions
Linen Hamper 0.25
Water Closet 2.1
Patients, their Patients
Clean and well- Lavatory 2.2275
Patient/PWD Toilet 1
ventilated
Public companions/visitors use Emergency Room Companions 10 1.2 12 Urinal 0.648 5.72 17.72 1.7718 5.3154 24.8052 25
toilet facilities Visitors
Slop Sink 0.7425
615.709 616
E. Trauma Department
Desk 1.845
Trauma Medical Director Trauma Medical Director
Office of the Trauma Formal, Administrative Offices 5.02/staff Swivel Chair 1.7325
Medical Director
1
Professional
Private does office works and
Office of the Chief of Clinics
Secretary 8
1.4/visitor
18.44
Armchair 0.84
7.17 25.61 2.561 7.683 35.854 36
receives visitors Visitors
Center Table 0.54
Workers compile trauma Swivel Chair 0.99

Trauma Program
registry and trauma Administrative Offices Desks 2.88
Office of the Trauma Manager
Program Manager
1 Formal Private program director organizes Office of the Trauma Medical
Trauma Analyst
4 5.02 20.08 Desk return Extension 0.72 5.32 25.4 2.5399 7.6197 35.5586 36
projects for better Director Chairs 0.405
Clerks
teamwork Steel Filing Cabinet 0.324
Cabinets 2.88
Pediatric Cart 0.72
Patient bypasses waiting
Blood Refrigerator 0.54
room and immediately the
Linens Hamper 0.72
Sterile and Trauma Resuscitation Trauma Resuscitation
Trauma Bay 2
Functional
Semi-Private
Team perform a fast,
Minor Operating Room
Team
10 1.4 14 Laundry basket 0.25 16.4 30.36 3.03584 9.10752 72.8602 73
Mayo Table 0.2745
intense, full-body exam and
Countertop 0.54
initiates treatment of injury
Anethesist Table 0.175
Lighting 2.4384
Screen + Stand 0.39
180
Swivel Chair 0.495
Counter 1.62
Nurses assist trauma Wall-hung cabinets 0.352
Functional, Trauma Bay Entrance Nurse
Nurse Station 1
Accommodating
Public resuscitation team in
Trauma Bay Nursing Attendant
2 5.02 10.04 Storage Shelves 0.45 4.95 14.99 1.499 4.497 20.986 21
treatment Whiteboard 0.593
Sink in counter 0.9
Lockers 0.54
3-seater Sofa 1.26
Doctor on duty does
Easy Chair 0.84
paperwork, rests while
Major Operating Room Sink in counter 0.9
Trauma Call Room 1 Clean Private waiting for emergency calls.
Trauma Bay
Trauma Surgeons 2 5.02 10.04
Filing Cabinet 0.324
5.84 15.88 1.5884 4.7652 22.2376 22
Doctor on duty stores
Table 0.54
personal belongings
Bunk Beds 1.98
Desk 2.565
Surgical Specialist stay
Surgical Specialist 5.02/staff Visitor's Chair 0.405
while waiting for emergency
Surgical Specialty Sterile and Clerks Examination Table 7.43
Clinics
4
Functional
Semi-Public situations. Surgical Outpatient Department
Patients
5 1.4/patien 17.86
Mayo Table 0.2745 12.5 30.36 3.03565 9.10695 133.569 134
specialist receive patients t
Companion Cabinets 0.352
for follow up check ups
Sink in counter 0.2475
Counters
Foot stool
321.065 321
F. Outpatient Service Facilities

Waiting Bench 1.62
Computer Table 0.3
Patients await their turn to Counter 1.62
Functional, OPD Registration Counter Outpatients and 5.02/staff
Lobby/Triage Area 1
Sterile
Public be assessed and
OPD Entrance Companions
10
1.4/visitor
29.3 Adjustable Stool 0.8 11.4 40.68 4.06825 12.20475 56.9555 57
interviewed. Stretcher 3.24
Wheelchair 3.8025
Patients wait their turns to Waiting Bench 8.1
OPD Registration Counter Outpatients and
Waiting Area 1 Accommodating Public be attended in any of the
OPD Entrance Companions
40 1.4 56 8.1 64.1 6.41 19.23 89.74 90
treatment rooms
Adjustable Stool 0.8
Counters 4.86
Registration/Admitting Data encoding of patient's OPD Waiting Area Administrative Office
Counter
1 Accommodating Public
information to system OPD Records Room Data Controller
2 5.02 10.04 Steel Shelving 2.16 8.87 18.91 1.8905 5.6715 26.467 26
Computer Table 0.64
Chair 0.405
Counter 1.62
Desk 2.16
Nurse provides medicine to Consultation Rooms Supervisor Nurse Chair 0.75
Nurse Station 1 Accommodating Public
OPD patient OPD Records Room Nurses
3 5.02 15.06
Adjustable Stool 0.8 6.87 21.93 2.193 6.579 30.702 31
Computer Table 0.64
Sink in counter 0.9
OPD Staff reads, writes, Steel Open Shelves 1.458
Clean and OPD Registration Counter Records Officer
OPD Records Room 1
organized
Private and retrieves records of
OPD Waiting Area Clerk
2 5.02 10.04 Steel Filing Cabinet 0.324 4.2 14.24 1.4242 4.2726 19.9388 20
patients Adjustable Stool 0.8
181
Computer Table 0.3
OPD Chief does office OPD Chief Swivel Chair 0.495
OPD Consultation Rooms
Office of the OPD Chief 1 Formal Private works and receives visitors
OPD Regustration Counter
OPD Staff 4 5.02 20.08 Desk 1.35 3.17 23.25 2.3245 6.9735 32.543 33
for consultation. Visitors Desk Return Extension 0.72
Cabinets 0.352
OPD Chief Water Closet 0.35
Office of the OPD Chief Clean and well- OPD Chief, Staff and
- Toilet
1
ventilated
Private
visitors use toilet facilities.
Office of the OPD Chief OPD Staff 1 1.2 1.2 Lavatory 0.2475 0.76 1.96 0.19595 0.58785 2.7433 3
Visitors Urinal 0.162
Conference table 1.8
OPD Staff and Physicians OPD Staff
Staff Area Swivel Chairs 2.475
Conference Room 1 Formal Semi-Public hold meetings and special
Office of OPD Chief
OPD Doctors 10 1.4 14
Sink in Counter 0.9
6.8 20.8 2.0795 6.2385 29.113 29
lectures. Visitors
Counter 1.62
Physician Shelves 1.8
Scrub-Up/Sub- Physicians and Nurses rinse Minor Operating Room Nurse Sink and drainboard 1.35
sterile/Patient Dressing
1 Sterile Private
hands and arms. Dressing Room Nursing Attendant
3 5.02 15.06
Counter 1.62
5.27 20.33 2.0325 6.0975 28.455 28
Patient Scrub-up Sink 0.495
Resident Physicians
Foot Stool 0.4484
Sterile and Physician and Nurses treat Sub-sterilizing Room Nurse
Minor Operating Room 1
Functional
Private
patient with minor surgery. Scrub-Up Area Nursing Attendant
4 5.02 20.08 Kick bucket 0.105 11.9 31.95 3.19538 9.58614 44.7353 45
Patient
Anesthesist Table 0.175
Screen + Stand 0.39
Lighting 2.4384
Foot Stool 0.4484
Medical, surgical, nursing Desk 0.9
and first aid activities. Use Resident Physician Chair 1
of monitoring/diagnostic Ancillart Services Nurse Counters 4.86
Consultation Room 5 Formal Private
equipment. Provides OPD Minor OR Nursing Attendant
4 5.02 20.08
Table 0.2
15.7 35.82 3.58184 10.74552 193.419 193
facilities for general patient Patient Examination Table 7.43
care Sink in counter 0.9
Dining Table 1.125

Dining Chair 1.215
OPD Staff use toilet
Wall-hung cabinet 0.352
faciities. OPD Staff take
Staff Lounge and Toilet 1 Relaxing Semi-Private
breaks and rests during
Outpatient Department OPD Staff and Doctors 6 1.4 8.4 Sink in counter 0.9 4.35 12.75 1.27515 3.82545 17.8521 18
Water closet 0.35
shifts.
Lavatory 0.2475
Urinal 0.162
Water closet 0.7
Lavatory 0.2475
Clean and well- Patients make use of toilet
Patient Toilet 1
ventilated
Public
facilities.
OPD Consultation Rooms Patients 6 1.2 7.2 Lavatory in counter 0.495 1.77 8.967 0.89665 2.68995 12.5531 13
Urinal 0.324
.
Water closet 2.45
Lavatory 0.7425
Patients, patient's Patients
Clean and well- Accessible via all OPD Lavatory in counter 0.99
Public Toilets/PWD 2
ventilated
Public companion, and visitors
Facilites
Patient Companions 15 1.2 18 Urinal 0.648
7.74 25.74 2.57405 7.72215 36.0367 36
make us of toilet facilities. Hospital Visitors
Slop Sink 0.66
2.25
621.254 621
182
G. Ancillary Service Facilities
I - PHARMACY
Desk 1.125
Visitor's Chair 0.405
Distribution Area Steel Filing Cabinet 0.648
Office of the Chief Pharmacist does office Chief Pharmacist 5.02/staff
Pharmacist
1 Functional Private
work.
Patient Dispersing Area
Visitors
3
1.4/visitor
7.82 Book Shelf 0.54 4.8 12.62 1.262 3.786 17.668 18
Staff Area Desk Return Extension 0.36
Wall-mounted Cabinet 0.352
Water Closet 0.35
Lavatory 0.2475
Pharmacist evaluates Desk 0.72
appropriateness of drug Swivel chair 0.2475
therapy used by patient. Patient Dispersing Area Chief Pharmacist 5.02/staff Visitor's Chair 0.405
Counseling Area 1 Formal Semi-Private
Pharmacist gives instruction Chief Pharmacist's Office Visitors
3
1.4/visitor
7.82 1.37 9.193 0.91925 2.75775 12.8695 13
and knowledge about
medication.
Screens,fills, dispenses Stool 0.8
drugs, medicine and Open shelving 0.9
Clean and biological. Supplies Inpatient Nursing Wards Pharmacists Transaction Counter 1.62
Dispensing Area 1
Organized
Semi-Public
medicine. Preparation of IV OPD and ER Pharmacist Aide
3 5.02 15.06
Computer Table 0.3 3.62 18.68 1.868 5.604 26.152 26
mixtures. Displays stocks
on shelving
Counter 1.62
Pharmacist
Sink in counter with 0.9
receives/inspects deliveries.
Receiving/Breakout./Ins Pharmacist drainboard
pection Area
1 Functional Semi-Public Records data of stocks Bulk Storage
Storekeeper
2 5.02 10.04
Chairs 0.405
3.28 13.32 1.3317 3.9951 18.6438 19
transferred to eiher active
storage or bulk storage.
Shelving, adjustable. Rail 5.4
Clean and Receiving/Breakout/Inspection Pharmacist
Bulk Storage 1
Organized
Private Storage of Pharmaceuticals
Area Utility Worker
2 5.02 10.04 mounted 1.62 7.02 17.06 1.706 5.118 23.884 24
Table
Dining Table 0.81
Accommodating, Staff eat their meals and Chairs 0.81
Staff Lounge 1
Relaxing
Private
rest.
Pharmacy Departmen Pharmacy Staff 4 1.4 5.6
Steel Lockers 0.36 2.82 8.417 0.8417 2.5251 11.7838 12
Sink with drainboard 0.837
II - LABORATORY
Patients wait for their turn 3-seater Bench/Gang Chair 3.78
to be examined. Patients Waste Bin 0.25
Blood Donor's Room Laboratory Aide
Waiting Area 1 Functional Public wait for their turn for their
Pathologist's Office Patients/Relatives
10 1.4 14 Toilet 5.28 9.31 23.31 2.331 6.993 32.634 33
specimens to be extracted.
Patients wait for results.
Medical Laboratiry Aide Revolving Stool 0.8
attends to patients. Staff Computer Table 0.6
receives specimen to be Medical Laboratory Aide Transaction Counter 1.62
Receiving/Releasing Pathologist's Office
and Clerical Room
1 Functional Public examined. Staff stores, files
Main Laboratoy
Clerk 2 5.02 10.04 Steel Filing Cabinet 0.35 4.99 15.03 1.503 4.509 21.042 21
and retrieves records. Staff Patients and relatives Counter 1.62
releases examination
results to patients.
Bed 1.33
Desk 0.9
Medical Technilogist
Sterile and Swivel Chair, Adjustable 0.8
Phlebotomy Clinic 1
Functional
Private Extraction of Blood Screening Area Laboratory Technician 3 5.02 15.06
Stool 0.8 4.64 19.7 1.96984 5.90952 27.5778 28
Patient
Footstool 0.4484
Desk return extension 0.36
183
Desk 0.72
Swivel chair 0.7425
Pathologist Desk return extension 0.36
Pathologist does office 5.02/staff
Pathologist's Office 1 Functional Private
work and receives visitors.
Donor's Screening Area Visitors/Consultants 4
1.4/visitor
16.46 Steel filing cabinet 0.35 4.3 20.76 2.0757 6.2271 29.0598 29
Medical technologist Bookshelves 0.49
Working Counter 1.08
Wallhung Cabinet 0.352
Urinalysis Chemistry 10.5

Biochemist Serology/Immunology 10.5
Microscopist Hematology 10.8
Laboratory Examinations Bacteriologist Microscopy 18
Sterile and
Work Areas 6
Functional
Private Clinical analysis, titrations Phlebotomy Clinic Pathologist 5.02 Microbiology 18 85.8 85.8 8.58 25.74 120.12 120
and othe procedures. Medical Technologist Histopathology 18
Medical Laboratory
Technician
Laboratory Aide
Plebotomist's Chair 0.558
Medical Table 0.9
Collecting blood samples Technologist/Phlebotomi Swivel Chair 0.2475
for testing of potential st 5.02/staff Shelves 1.8
Examination and Waiting Area
Screening
1 Sterile Semi-Public infectious diseases and
Staff Room
Patient 10 1.4/patien 12.02 File Cabinet 0.35 6.57 18.59 1.85884 5.57652 26.0238 26
screening potential blood Clerk'Staff t Desk 0.72
donors Blood Bank Nurse Phlebotomy Cart 0.175
Blood Donor Footstool 0.4484
Bed 1.425
Phlebotomist's Chair 1.116
Medical Technologist Chairs 0.405
Laboaratory Technician Desk 0.72
Blood extraction/donation
Doning Room 1 Sterile Semi-Public
from eligible donors.
Screening Area Blood Bank Nurse 5 5.02 25.1 Adjustable Swivel Chair 0.2475 2.66 27.76 2.77635 8.32905 38.8689 39
Patient
Utility Worker
Sink with drainboard 0.837

Registered Medical Counter 7.5
Hematology
Storing of whole blood and Technologist Computer Table 0.3
Blood Bank 1 Sterile Private
blood components.
Immunology/Serology
Medical Laboratory
2 5.02 10.04
Swivel Chair 0.2475 9.95 19.99 1.99865 5.99595 27.9811 28
Pathologist's Office
Technician Desk return extension 0.36
Filing Cabinet 0.35
Shelves 5.4
Srorage of laboratory
Sink in Counter 0.9
instruments, glasswares
Clean and
Storage 1
Organized
Private and PPE with proper poison Main Clinical Laboratory Laboratory Staff 2 5.02 10.04 6.3 16.34 1.634 4.902 22.876 23
labeling and padlock.
Sterilization of equipment.
Storage Cabinet 0.75
Glasswashing and Clean and Washing of instruments and Locker Room and Toilet Counter 2
Storage
1
Organized
Private
glasswares Storage Room
Laboratory Aide 1 5.02 5.02
Two-compartment sink 1.482
4.23 9.252 0.9252 2.7756 12.9528 13
184
III - RADIOLOGY
Wooden Bench 8
X-Ray Clerk Desk 0.72
Frontline of Radiology
Waiting Area 1 Accommodating Public Patients wait to be x-rayed.
Department
Patients 20 1.4 28 Chair 0.2025 12.3 40.25 4.02525 12.07575 56.3535
Companions/Visitors Wheelchair 2.25
Stretcher 1.08
Water Closet 0.7
Lavatory 0.7425
Clean and well- Patients/Companions make Patients/Companions Urinal 0.162
Public Toilet 1
vetilated
Public
use of public utilities
Waiting Area
Janitorial Services
8 1.2 9.6
Janitor's Cabinet 2.25 4.51 14.11 1.41145 4.23435 19.7603
Slop Sink 0.66
Desk 2.565
Clerk receives patients to
be x-rayed. X-ray Radiologic Technician
Clerical Room 1 Functional Semi-public technician schedules patient Film Storage Clerks 4 5.02 20.08
Swivel Chair 0.7425 6.89 26.97 2.697 8.091 37.758
for procedures. Clerk does X-ray interns
office works.
Information Counter 1.62
Radiologist interprets x-ray Desk 1.8
Radiologist
Office of the Chief film and/or ultrasound Desk return extension 0.36
Radiologist
1 Formal Private
images. Receives visitors
Radiology Department X-ray Clerk 2 5.02 10.04
3.01 13.05 1.3045 3.9135 18.263
Companions/Visitors
and does office work Swivel Chair 0.495
Staff stores radiographs Open shelving 4.725
Clean and
Files Room 1
Organized
Private and retrieves for follow-up Clerical Room Radiology Department Stsff 1 5.02 5.02 Ladder 0.268 4.99 10.01 1.0013 3.0039 14.0182
patient information.
X-ray Radiologic Mobile X-ray machine 1.6965
For storage and recharging
Mobile X-ray Room 1 Clean Private
of mobile X-ray machine
Radiology Department Technicians 1 5.02 5.02 1.7 6.717 0.67165 2.01495 9.4031
X-ray Interns
Footstool 0.4484
Swivel Chair 0.2475
Adjustable Chair 0.2475
Ultrasonologist performed Ultrasonologist
Ultrasound Room 1 Functional Private
specified examination
X-ray Room
Patient
2 5.02 10.04 Desk 0.9 3.74 13.78 1.37758 4.13274 19.2861
Bedside Table 0.42
Steel filing cabinet 0.35
Ultrasound Table 1.1224
Ultrasound Room - Clean and well- Patient and Ultrasonologist Ultrasonologist Water Closet 0.35
Toilet
1
ventilated
Private
use toilet facilities
Ultrasound Area
Patient
1 1.2 1.2
Lavatory 0.2475 0.6 1.798 0.17975 0.53925 2.5165
Storage Cabinet 1.6
X-ray Technologist
Footstool 0.4484
Outpatient Department Patient
Radiographic X-ray Patient undergoes Dressing Cubicle 2.25
Room
radiographic examination
ER Department Nurse 5 5.02 25.1
Water Closet 0.35
5.06 30.16 3.01579 9.04737 42.2211
Ancillary Services Institution Worker
Lavatory 0.2475
X-ray interns
Urinal 0.162
Radiology Department Film loading counter 1.62
X-ray technician prepares Staff Wall Cabinet 0.352
Dark Room 1 Functional Private
processing of film.
Control Booth
X-ray Technologist
2 5.02 10.04
Sink in counter 0.9 2.87 12.91 1.2912 3.8736 18.0768
X-ray Intern
X-ray Technicians Cassette Rack 0.038
X-ray Radiologic
RT Interns Swivel Chair 0.495
Control Booth 1 Functional Private Technologist sets X-ray Rooms
Radiologist
2 5.02 10.04
Table 1.44 4.22 14.26 1.4263 4.2789 19.9682
radioscopic techniques.
Resident Physician Control Console 2.25
Radiologic Open shelving 4.725
Clean and
Supply Room 1
Organized
Private Technologist/Clerk stores Clerical Room Radiology Department Staff 2 5.02 10.04 Ladder 0.268 4.99 15.03 1.5033 4.5099 21.0462
and retrieves supplies
CT-Scanner 13
Radiologic Technologist
Lavatory in counter 0.495
OPD Radiologist
Patient undergoes CT- Storae Cabinet 0.54
CT-Scan 1 Functional Private
scanning techniques.
ER Patient 3 5.02 15.06
Sink in counter 0.9
17.3 32.38 3.2377 9.7131 45.3278
Auxillary Services Patient's Companion
Dressing Booth 2.25
RT Intern
Lead Apron Hanger 0.132
185
X-Ray Radiologic Computer Table 0.3
X-Ray Radiologic Technologist Chair 0.6
CT-Scan - Control
Booth
1 Functional Private Technologist views patient CT-Scan RT Interns 4 5.02 20.08 Cabinet 0.54 1.44 21.52 2.152 6.456 30.128 30
during examination Radiologist
Residet Physician
Radiologist technicians Dining Table 1.125
Lounging area for radiology
Ultrasonologist Dining Chair 0.81
Relaxing, staff
Staff Lounge 1
Accommodating
Private
Staff stores personal
Radiologist Office Clerk 10 1.4 14 Locker 1.5 4.34 18.34 1.8335 5.5005 25.669 26
X-ray Interns Sink in counter 0.9
belongings.
Resident Physician
Water Closet 0.35
Staff Lounge - Toilet Clean and well-
and Bath
2
ventilated
Private Staff uses toilet facilities Staff Lounge Radiology Staff 1 1.2 1.2 Lavatory 0.2475 2.85 4.048 0.40475 1.21425 9.714 10
Shower Area 2.25
859.647 860
H. Nursing Service Facilities

Desk 0.84
Department Head does
Department Head Executive Chair 0.5025
office works. Dept. Head
Office of the Formal, Department Main Entrance Physicians 5.02/staff Side Table 0.375
Department Head
1
Functional
Semi-Private receives visitors such as
Nurse Station Nurses
10
1.4/visitor
21.24
Visitor's Chair 0.405 5.53 26.77 2.67735 8.03205 37.4829 37
patient or patient's relatives
Visitors Conference Chair 2.331
for consultation.
Nurse Counter 2.25
Computer Table 0.3
Nurse does their job to
Counter 2.7
assist patients. Entertains
queries from Chief Nurse
Utility and Linen Rooms Storage Shelves 0.72
Centralized Nursing Accommodating, guests/visitors. Nurses Staff Nurse
Station
1
Sterile, Quiet
Public
make proper inventory of
Nursing Wards
Nursing Attendant
6 5.02 30.12 Sink in counter 0.9 10.8 40.92 4.0924 12.2772 57.2936 57
Treatment Rooms Laundry Hamper 0.25
supplies to be given out Physicians
such as medication and
Utility Sink 0.2475
supplies.
Water Closet 0.35
Lavatory 0.2475
Urinal 0.162
Provides immediate Work Counter with shelves 1.35
assistance to patients. Swivel Chair 0.2475
De-centralized Nursing Provide all required patient
Station
20 Functional Public
information and medicine
Nursiing Wards Nurse or Nursing Aide 1 5.02 5.02 1.6 6.618 0.66175 1.98525 134.997 135
without being tethered to
central nursing station
Mayo Table 0.2745
Footstool 0.4484
Dressing Cart 0.3015
Physician or Nurse
Physician Counter 0.54
administers necessary
Treatment Room 1 Sterile Semi-Private
medical, surgical first aid to
Nurse Station Nurse 3 1.4 4.2 Cabinet 2.88 17.5 21.71 2.17068 6.51204 30.3895 30
Patient Wall hung cabinets 0.352
patient.
Bulletin Board 0.593
Sink in Counter 0.9
Examining Light 2.4384
Examining Table 7.43
186
Adjustable Hospital Bed 7.43
Overbed Table 0.3825
Chair 0.405
Patient Footstool 0.4484
Patient receives treatment Visitors Bedside Cabinet 0.3075
Single-Bed Ward 30 Sterile Private
and recovers.
Nurse Station
Resident Physician
5 1.4 7
Cushioned bench 0.825
13 19.99 1.99942 5.99826 607.824 608
Nurse or Nursing Aide Closet 0.3483
Water closet 0.35
Lavatory 0.2475
Shower Area 2.25
Overbed Table 1.53
Chair 0.84
Patients Footstool 1.7936
Sterile, Patient receives treatment Visitors Bedside Cabinet 1.23
Multiple-Bed Ward 10
Functional
Semi-Public
and recovers.
Nurse Station
Resident Physician
10 1.4 14
Cushioned bench 3.3
42.4 56.4 5.64004 16.92012 586.564 587
Nurse or Nursing Aide Closet 1.3932
Water closet 0.35
Lavatory 0.2475
Shower Area 2.25
Foot Stool 0.4484
Kick bucket 0.105
Almost all medical
Patient Screen + Stand 0.39
treatments to be
Acquity-Adaptable Sterile, Nurse Station Visitors Lighting 2.4384
Rooms
3
Functional
Private administered to critical-care
Medical and Surgical Services Resident Physician
5 1.4 7
Chair 0.405 19.7 26.73 2.67283 8.01849 90.8762 91
patients in one room to
Nurse or Nursing Aide Computer Table 0.3
increase quality of care.
Swivel Chair 0.2475
Bedside Cabinet 0.3075
3-seater Sofa 1.26
Closet 2.25
Water closet 0.35
Lavatory 0.2475
Shower Area 2.25
Chair 0.2025
Footstool 0.4484
Patient
Patient receives treatment Visitors
Isolation Room 2 Sterile Private
and recovers.
Nurse Station
Resident Physician
5 1.4 7 Closet 0.3483 12.2 19.21 1.92142 5.76426 46.1141 46
PPE Cabinet 0.3483
Nurse or Nursing Aide
Sink 0.2475
Water closet 0.35
Lavatory 0.2475
Shower Area 2.25
1591.54 1592
187
J. Service Facilities
I-OPERATING ROOM COMPLEX
Patient scheduled for Ward Stretcher 1.08
operation is transferred Entrance of the Operating Nursing Attendants Surgical Suite Stretcher 1.2672
Transfer Area 1 Sterile Semi-public
from ward stretcher to Room Patient
3 5.02 15.06 2.35 17.41 1.74072 5.22216 24.3701 24
surgical suite stretcher.
Lockers 1.8
Bench 0.9
OR staff use toilet and
Lockers and Toilets and Water Closet 0.35
Baths
2 Sterile Private bathroom. OR Staff change OR Suite Resident Physicians 6 5.02 30.12
Urinal 0.162 5.71 35.83 3.58295 10.74885 85.9908 86
clothing.
Lavatory 0.2475
Shower 2.25
3-seater Sofa 1.26
Easy Chair 0.42
Resident Physician takes Resident Physicians and Corner Table 0.36
Lounge 1 Relaxing, Sterile Public
rest between surgeries
OR Suite
OR Staff
10 1.4 14
Dining Chair 1.215 4.63 18.63 1.86275 5.58825 26.0785 26
Dining Table 1.125
Sink 0.2475
Anesthesiologist Footstool 1.3452
Patient is prepared for
Anesthesia Office Nurse Examination Bed 4.0779
Pre-Operative Room 1 Sterile Private surgery. Anesthesia is
Transfer Area Nursing Attendant
7 1.4 9.8 5.43 15.23 1.52321 4.56963 21.3249 21
administered
Patient
Chair 0.81
Counter 2.25
Surgical Supervisor Computer Table 0.3
Surgical Supervisor's Surgical Supervisor does
Area
office works.
Operating Room Nurse or Nursing 2 5.02 10.04 Cabinet 2.88 6.5 16.54 1.65355 4.96065 23.1497 23
Attendant Glass Board 0.593
Shelving 1.125
Sink in Counter 0.9
Chair 0.405
Anesthesiologist
Anesthesiologist's Anesthesiologist does office Counter 1.08
Office
work.
Operating Room Nurse or Nursing 2 5.02 10.04
Computer Table 0.3
4.67 14.71 1.4705 4.4115 20.587 21
Attendant
Cabinet 2.88
Storage of materials Resident Physician/ Shelving 4.725
Anesthesia Storage 1 Organized Private
retlated to anaesthetics.
Surgical Supervisor's Area
Anaesthesiologist
2 5.02 10.04
Sink in Counter 0.9 5.63 15.67 1.5665 4.6995 21.931 22
Sterile Instrument and Sterile and Staff prepare needed Nurse Shelving 2.7
Supply Storage
1
Organized
Private
supplies.
Surgical Supervisor's Area
Nursing Attendant
2 5.02 10.04
Instrument Cabinet 0.768
3.47 13.51 1.3508 4.0524 18.9112 19
Shelves 0.45
Physicians and nurses rinse
Physician Scrub up sink 0.7425
Scrub-Up 1 Sterile Private arms and hands prior to Operating Room
Nurse
4 1.4 5.6 1.19 6.793 0.67925 2.03775 9.5095 10
and after surgical operation
Preparation of surgical Physicians Sink and drainboard 0.837
Operating Room
Sub-sterile 1 Sterile Private instruments and minor
Scrub-up Room
Nurse or Nursing 3 1.4 4.2 Counter 1.08 1.92 6.117 0.6117 1.8351 8.5638 9
sterilizing works. Attendant
Mayo Table 0.2745
Footstool 0.8968
Kickbucket 0.21
Physicians
Sponge rack 0.03
Scrub Nurses
Patient is surgically Sub-sterilizing room Single basin stand 0.1225
Operating Room 4 Sterile Private
operated Scrub-up Room
Circulatory Nurse 8 1.4 11.2
Anesthetist's Stool 0.2544 17.7 28.9 2.88976 8.66928 40.4566 40
Anesthesiologist
Anesthesist' table 0.175
Patient
Pack table 1.44
Adjustable open shelving 1.125
OR instrument cabinet 0.768
Screen + Stand 0.39
Lighting 2.4384
188
Counter 1.5
Nurse/Nursing Attendant Linen Hamper 0.72
Nurse
Clean-Up Room 1 Sterile Private perform post-surgeru clean- Operating Room
Nursing Attendant
2 5.02 10.04 Sink with drainboard 1.674 4.32 14.36 1.43615 4.30845 20.1061 20
up activities. Clinical Sink 0.2475
Waster Bins 0.18
Stretcher Bed 6.46
Desk 0.9
Chair 1.0125
Wall cabinet 0.352
Physicians
Patient's vital signs is 5.02/staff Shelf 0.45
Post-Anethesia Care Nurse
Unit
1 Sterile Private monitored at regular Operating Room
Nursing Attendant
8 1.4/patien 22.06 Work Counter 1.125 13.5 35.54 3.55355 10.66065 49.7497 50
intervals t Storage cabinet 0.384
Patients
Lavatory 0.2475
Clinical Sink 0.2475
Water closet 0.35
Urinal 0.162
Lavatory 0.2475
Clean and Storage of Janitor's Slop Sink 0.66
Janitor's Closet 1
Organized
Private
Cleaning Tools
Delivery Room Janitor 1 5.02 5.02
Open Shelving 0.9 1.56 6.58 0.658 1.974 9.212 9
3-seater sofa 3
2-seater sofa 3.375
Single seater 1.125
Center Table 1.8
Companions of patients
Patients, Companions Corner Table 1.47
Family/Worship Room 1 Tranquil Private await news of patient ICU, PACU
and visitors
10 1.4 14
Sink 0.2475 12.5 26.54 2.65365 7.96095 37.1511 37
status.
Urinal 0.324
Lavatory 0.495
Water Closet 0.7
II - INTENSIVE CARE UNIT

Bedside monitor 0.208
Central monitor 0.1836
Volume Respirator 0.5808
Patients Oxygen Tank Holder 0.04
Patient's vital signs is Visitors Mechanical Bed 29.72
Patient Treatment Area 1 Sterile Semi-private monitored at regular Operating Suite Resident Physicians 10 1.4 14 Counter 2.25 37.8 51.84 5.18435 15.55305 72.5809 73
intervals Nurse Sink in counter 0.9
Nursing Attendant Adjustable Stool 0.2475
Footstool 1.7936
Overbed Table 1.53
Screen 0.39
Bedside monitor 0.208
Central monitor 0.1836
Patients
Patient's vital signs is Volume Respirator 0.5808
Resident Physician
Isolation Room 1 Sterile, Isolated Private monitored at regular Operating Suite
Nurse
6 1.4 8.4 Oxygen Tank Holder 0.04 17.5 25.93 2.59342 7.78026 36.3079 36
intervals in isolation. Mechanical Bed 14.86
Nursing Attendant
Footstool 0.8968
Overbed Table 0.765
Desk 0.72
Resident Physician does Operating Room Swivel Chair 0.2968
Office 1 Functional Private
office work. ICU
Resident Physician 1 5.02 5.02
Steel Filing Cabinet 0.324 1.34 6.361 0.63608 1.90824 8.90512 9
189
Desk 0.72
Resident Physician updates
Family Counseling Resident Physician Swivel Chair 0.2968
Room
1 Accommodating Private relatives/companions on Nurse Station
Family/Companions
3 1.4 4.2
Visitor's Chair 0.405 1.42 5.622 0.56218 1.68654 7.87052 8
patient's status.
Patient's family/relatives Shelves 0.54
Visitors
Visitors' Dressing Room 1 Sterile Semi-private change into a mask and Corridor
Patient's family/relatives
2 1.4 2.8 Closet 0.9 2.16 4.96 0.496 1.488 6.944 7
gown. Hamper 0.72
Lockers 1.8
Staff store personal effects Resident Physicians
Lavatory 0.2475
Staff Room 2 Relaxing, Sterile Private and changes clothing. Staff Corridor Nurses 6 1.4 8.4
Water Closet 0.35 4.81 13.21 1.32095 3.96285 19.8143 20
uses toilet facilities. Nursing Attendants
Shower Area 2.25
Holding area for soiled Sink in Counter 1.2
Nurses
materials including linen, Wall hung cabinets 0.352
Soiled Utility/Linen 1 Organized Private
trash, and hazardous
Nurse Station Nursing Attendants 1 5.02 5.02
Medical Hamper 1.44 2.99 8.012 0.8012 2.4036 11.2168 11
Janitor
waste.
III - CENTRAL STERILIZING AND SUPPLY ROOM
Counter 1.8
Receiving of instruments for Sink in counter with 0.837
Central Supply Service
Receiving Area 1 Sterile Private washing and sterilizing from Operating Room Suite
Worker
1 5.02 5.02 drainboard 4.19 9.21 0.92095 2.76285 12.8933 13
different departments. Chair 0.2025
Counter 1.575
Disassembling and
Central Supply Service Table 2.75
arrangement of
Sterile and Operating Room Suite Worker Sterile Supply Cabinet 2.25
Work Area 1
Functional
Private instruments. Washing and
Sub-sterilizing room Nurse
5 5.02 25.1
Chair 1.215
14.4 39.51 3.9514 11.8542 55.3196 55
sterilizing of instruments.
Nursing Attendant Desk 3.6
Preparation for future use.
Sink double compartment 1.674
with drainboard
Sterilization of Central Supply Service Instrument Sterilizer 0.225
Auto-Clave Room 1 Sterile Private
equipment/glasswares.
Work Area of CSSR
Worker
1 5.02 5.02
Heavy duty Autoclave 1.2512 1.48 6.497 0.64965 1.94895 9.0951 9
Table 2
Storage of Operating Room Suite
Sterile and Central Supply Service Sterile Supply Cabinet 3.84
Storage Room 1
Organized
Private sterilized/washed Accessible by other
Worker
2 5.02 10.04 Distribution Counter 0.48
6.52 16.56 1.65625 4.96875 23.1875 23
instruments departments
Chair 0.2025
681.227 681
K. Rehabilitation Service
3-seater Sofa 1.26
Bench 3.6
Patient waits for sessions. Patients Center Table 1.8
Treatment Rooms
Visitors/companions wait Visitors Side Table 1.5
Lobby 1 Accommodating Public
for the patients to finish
Office of the Rehabilitation
Therapists
20 1.4 28
Wheelchair 3.4375
15.1 43.09 4.30911 12.92733 60.3275 60
Chief
sessions. Nurse Stretcher 1.08
Swivel Chair 0.5936
Desk 1.56
Swivel Chair 0.2968
Desk return Extension 0.36
Rehabilitation Chief Visitor's Chair 0.405
Rehabilitation Chief does
Office of the Chief Professional, Lounge Clerk 5.02/staff Examination Table 1.3593
Rehabilitation Physician
1
Functional
Semi-public office work. Receives
Therapist's Department Therapists
4
1.4/visitor
12.84
8.65 21.49 2.14941 6.44823 30.0917 30
visitors for consultations.
Patient/Visitors Conference Chairs 2.331
Water Closet 0.35
Urinal 0.162
Lavatory 0.2475
190
Desk 7.2
Swivel Chair 2.968
Computer Table 0.9
Therapists does office
Office of the Rehabilitation Therapists Chair 0.405
work. Therapists study
Therapist's Department 3 Professional Semi-public
patient situations and
Chief Nurses 10 5.02 50.2 3-seater Sofa 1.26 21.9 72.13 7.2134 21.6402 245.256 245
Staff Room Caregivers Center Table 0.9
convene with colleagues.
Cabinet 2.25
Shelving 3.375
3-seater sofa 1.26

Easy Chair 0.84
Center Table 0.9
Side Table 0.49
Dining Table 1.35
Rehabilitation Staff takes
Dining Chairs 1.215
breaks between shifts and Therapists
Therapists' Department Sink In Counter with 0.837
Staff Room 2 Relaxing Private sessions. Staff uses toilet
Treatment Areas
Nurses 10 1.4 14
drainboard
10.2 24.2 2.42015 7.26045 58.0836 58
facilities and changes Caregivers
Lockers 0.3
clothing.
Water Closet 0.35
Lavatory 0.2475
Urinal 0.162
Shower Area 2.25
Patient have initial Table 1.35

Therapist
assesment on possible Chairs 0.81
Consultation Room 3 Functonal Private
treatment techniques for
Treatment Rooms/Cubicle Patient 3 1.4 4.2 2.16 6.36 0.636 1.908 21.624 22
Companion
rehabilitation
Treatment table 7.43
Wheelchair 0.6875
Patients have individual Therapist Instrument Table 0.549
Treatment Cubicles 5 Functional Private
rehabilitation sessions
Physical Therapy Room
Patient
2 5.02 10.04
Equipment storage 2.88
12.8 22.83 2.28348 6.85044 123.308 123
Linen Cabinet 0.3483
Sink in counter 0.9
Exercise mats 2
Wheelchairs 2.0625
Shoulder wheel 0.189
Shoulder ladder 0.00483
Steps 2.4288
Step Ramp 5.4
Curbs 0.81
Ramps 2.6862
Patients are rehabilitated in Therapists
Wall weights 0.105
Physical Therapy Room 1 Functional, Wide Public a gym setting with other Treatment cubicles Therapist's Aide 10 1.4 14
Parallel bars 2.5915
27.7 41.72 4.17175 12.51525 58.4045 58
patients. Patients
Posture mirror 0.297
Stationary bicycle 1.1978
Weight Storage 1.1857
Equipment Storage 6
Water Closet 0.35
Urinal 0.162
Lavatory 0.2475
Multiple modes of Treatment Table 7.43

rehabilitation is Table 1.35
Multi-modal Therapy administered to one patient. Therapist Chairs 0.405
Room
2 Functional Semi-Private
From physical therapy,
Patient
2 5.02 10.04
Equipment Cabinet 2.88 13 23.01 2.3005 6.9015 55.212 55
speech and Sink in counter 0.9
electrophysiological.
191
Wheelchairs 6.875
Exercise Mats 10
Multi-use Court 116.1288
Group rehabilitation and Therapists
Functional, High- Equipment Storage 12
Gymnasium 1
ceiling
Public recreational programs are Rehabilitation Department Therapist's Aide 30 1.4 42
Lockers 3
152 194.1 19.40748 58.22244 271.705 272
to be done. Patients
Water Closet 2.1
Lavatory 1.485
Urinal 0.486
Treatment Table 7.43
Patient receives
EMS + TENS Unit Storage 0.3483
electrophysiological therapy
Equipment Cabinet 2.88
Electrophysiology such as Electronic Muscle Therapist
Simulation (EMS) and
Treatment Areas
Patient
2 5.02 10.04 Instrument Table 0.549 12.8 22.83 2.28348 6.85044 31.9687 32
Wheelchair 0.6875
Transcutaneous Electrical
Sink in counter 0.9
Nerve Simulation (TENS)
Patient is counseled by Examination Table 7.43
therapists to help them Table 1.35
Vocational Counseling return to work after an Therapist Chairs 0.405
Room
injury. Evaluation of
Treatment Areas
Patient
2 5.02 10.04
Swivel Chair 0.2968
3.32 13.36 1.33618 4.00854 18.7065 19
patient's abilities, interest, Desk 0.84
and training.
Skilled and Semi-skilled
workshops
A. Sewing & Tailoring
•Pressing table 0.4712
•Cutting Table 1.555
•Sewing Machine 1.8952
B. Drafting
•Drafting Table 1.1148
•Drafting Chair 0.4232
•Computer Tables 0.6
•Easels 1.586
•Chairs 0.6396
Vocational Training C. Arts and Crafts
Patients receive vocational Trainers
Rooms - Skilled and 1 Functional Public Vocational Counseling Room 10 1.4 14 •Work Bench 0.576 20.6 34.63 3.46326 10.38978 48.4856 48
training after counseling Patients •Damp Storage 2.25
Semiskilled
•Pottery Wheel 0.84
•Kiln 2.1609
•Sink 0.2475
•Chairs 0.405
D. Construction and Building
•Work Benches
•Chairs 1.152
•Tool Closet 0.81
•Electrical Assembly Table 2.25
1.6562
Unskilled
A. Building Material Handling
•Work Benches
•Chairs 1.152
Vocational Training Patients receive vocational Trainers
Rooms - Unskilled
1 Functional Public
training after counseling
Vocational Counseling Room
Patients
8 1.4 11.2 B. Horticulture 0.81 3.64 14.84 1.4836 4.4508 20.7704 21
•Work Benches
•Corsage Bench 0.576
•Chairs 0.288
0.81
192
Parallel Bars 1.3992
Rubber Mat 5.1546
Steps 1.083
Wheelchairs 2.0625
Desk 1.05
Children ages 5-15 years Therapist
Pediatric Physical Chair 0.405
Therapy Room
1 Functional Semi-public old receive physical therapy Treatment Areas Patient 10 1.4 14
Observation Area 6
24.9 38.94 3.89375 11.68125 54.5125 55
in a gym setting. Guardian
Water Closet 0.35
Lavatory 0.2475
Weight Cabinet 1.1857
Equipment Storage 6
Table 2.25
Patients receive speech Therapist Chairs 0.81
Speech Therapy Room 2 Functional Private
therapy
Treatment Areas
Patient
2 5.02 10.04
Equipment Closet 0.3483
4.1 14.14 1.41358 4.24074 33.9259 34
Wheelchair 0.6875
Indoor Pool Large 30.6
Indoor Pool Small 9.0738
Hubbard Tank 4.2672
Well-ventilated Patients receive aquatic Patient Locker Areas Therapist Pool Benches 3.6
Aquatic Therapy Room 1
and light
Semi-public
therapy Dressing Rooms Patients
10 1.4 14
Pump Room 6
61.8 75.77 7.5766 22.7298 106.072 106
Linen and Towel Room 6
Counter 1.82
Chairs 0.405
Lockers 3
Aquatic Therapy Room
Patient Locker Areas 2 Clean Private Patient stores belongings.
Patient Dressing Room
Patients 10 1.4 14 Benches 3.6 7.59 21.59 2.159 6.477 51.816 52
Lavatory 0.99
Patient dresses/showers Shower Stalls 10
Aquatic Therapy Room
Patient Dressing Room 2 Clean Private before and after aquatic
Patient Locker Areas
Patients 10 1.4 14 Water Closet 1.75 12.5 26.49 2.64925 7.94775 63.582 64
therapy session Lavatory 0.7425
Thermal Baths 1.12
Patient receives
Functional and Therapist Stools 0.3198
Balneotherapy Room 1
clean
Private balneotherapy with thermal Aquatic Therapy Room
Patient
5 1.4 7
Sink in counter 0.9 4.59 11.59 1.15898 3.47694 16.2257 16
mineral baths.
Cabinet 2.25
Paraffin Baths 0.164
Treatment Chair 2.21
Patient receives paraffin Stools 0.3198
Paraffin Therapy 1 Clean, Functional Private
baths.
Balneotherapy Room Therapist Patient 5 1.4 7
Sink in Counter 0.9
5.84 12.84 1.28438 3.85314 17.9813 18
Cabinet 2.25

Ultrasound Therapy Clean and Patient receives ultrasound Therapist Adjusting Stool 0.2745
Room
1
Functional
Private
therapy.
Treatment Areas
Patient
2 1.4 2.8
Sink in Counter 0.9
10.9 13.65 1.36545 4.09635 19.1163 19
Equipment Cabinet 2.25
Cryo Baths 1.12
Cryo Cabins 2.805
Patient receives therapy
Clean and Therapist Linen Cabinet 0.3483
Cryotherapy Room 1
Functional
Private through baths/cabins with Treatment Areas
Patient
2 1.4 2.8
Sink in counter 0.9 7.72 10.52 1.05201 3.15603 14.7281 15
freezing temperature.
Stool 0.2968
Equipment Storage 2.25
Clean and Patient receives kinesiology Therapist Stool 0.2968
Kinesiology Room 1
Functional
Private
therapy
Treatment Areas
Patient
2 1.4 2.8
10.3 13.08 1.30843 3.92529 18.318 18
Group therapy where Mats 15
Wide and well- Tai Chi Expert
Tai Chi Room 1
ventilated
Semi-public patients perform a graceful Treatment Areas
Patients
16 1.4 22.4 Benches 5.4 22.7 45.05 4.505 13.515 63.07 63
form of exercise. Equipment Storage 2.25
193
Fitting Table 7.43
Patients receive evaluations Desk 0.72
Patient
from orthetists and Chair 0.405
Orthotics and Therapists' Department Therapist
Prosthetics
1 Functional Private prosthetist and fitting of
Treatment Areas Resident Physician
4 1.4 5.6 Cabinets 0.3483 15.9 21.48 2.14783 6.44349 30.0696 30
orthotic and prosthetic Equipment Storage 2.25
Commercial Distributor
equipment. Shelves 4.725
Outpatient rehabilitation Lockers 4.5

Outpatient Locker Clean and patients store their Benches 3.375
Room
2
Organized
Public
belongings during session
Lounge Patient 10 1.4 14
Lavatory 1.2375 19.1 33.11 3.31125 9.93375 79.47 79
and retrieve them after. Dressing Stall 10
Hospital Bed 7.43
Wheelchair 0.6875
Console 0.36
Patient
Inpatient Ward - Single Clean and Inpatient stays during Cabinet 2.25
Bed
9
Relaxing
Private
treatment until discharge
Nurse Station Visitors 3 1.4 4.2
2-seater Sofa 1.125
16.7 20.9 2.0895 6.2685 196.413 196
Therapist
Chair 0.405
Center Table 0.9
Water Closet 0.35
Lavatory 0.2475
Shower Area 2.25
Hospital Bed 29.72
Overbed Table 1.53
Wheelchair 2.75
Console 0.36
Inpatient stays with other Patient
Inpatient Ward - Clean and Cabinet 2.25
Multiple-Bed
4
Relaxing
Semi-public inpatients during treatment Nurse Station Visitors 10 1.4 14
2-seater Sofa 1.125 43.5 57.52 5.75225 17.25675 253.099 253
until discharge Therapist
Chair 0.81
Center Table 0.9
Water Closet 0.35
Lavatory 0.2475
Shower Area 2.25
Swivel Chair 0.8904
Computer Table 0.3
Receives queries from
Nurse/Caregivers Sink in Counter 0.9
Nurse Station - Functional, visitors and provides
Centralized
1
Accommodating
Public
assistance to other staff
Wards Rehabilitation Staff 5 5.02 25.1 Cabinets 2.25 11.6 36.74 3.67449 11.02347 51.4429 51
Visitors Shelving 4.725
and patients
Water Closet 0.35
Lavatory 0.2475
Urinal 0.162
Nurse Station - Functional and Nurse provide undivided Desk 1.125
Decentralized
6
Accommodating
Public
attention to patient wards.
Wards Nurse/Caregivers 1 5.02 5.02
Swivel Chair 0.2968 1.42 6.442 0.64418 1.93254 41.2275 41
Water Closet 1.75
Clean and well- Lavatory in counter 1.485
Patient Toilet 4
ventilated
Semi-public Patients use toilet facilities Rehabilitation Department Patients 5 1.4 7
Urinal 0.324 4.88 11.88 1.1879 3.5637 52.2676 52
Slop Sink 1.32
Water Closet 1.75
Clean and well- Lavatory in counter 1.485
Public/PWD Toilet 2
ventilated
Semi-public Visitors use toilet facilities Lounge Visitors/Companions 5 1.4 7
Urinal 0.324
4.88 11.88 1.1879 3.5637 28.5096 29
Slop Sink 1.32
Work Counter 1.82
Swivel Chair 0.5936
Equipment Storage Clean and Equipment are stored and
Room
1
Organized
Private
retrieved.
Treatment Areas Rehabilitation Staff 2 5.02 10.04 Equipment Cabinet 2.25 9.69 19.73 1.97286 5.91858 27.62 28
Open shelving 4.725
Computer Table 0.3
Linens are stored. Clean Open Shelving 4.725
Clean and
Linen Storage 2
Organized
Private and soiled linens are Nurse Station Nurse/Caregivers 2 5.02 10.04 Sink in counter 0.9 5.63 15.67 1.5665 4.6995 37.596 38
separated
Janitor's Closet 2.25
Clean and Housekeeping keeps
Utility Room 2
organized
Private
equipment.
Nurse Station Janitor/Housekeeping 1 5.02 5.02 Open shelving 0.675 3.83 8.845 0.8845 2.6535 21.228 21
Sink in counter 0.9
2322.23 2322
194
L. Nutrition and Dietetics Service
Dining Table 7.2
Dining Chairs 6.48
Lavatory in counter 0.9
Hospital Staff Dining Hospital diners take their Tray and Utensil Truck 2.196
Room
1 Clean Public
meals
Serving Area Hospital Staff/Personnel 32 1.4 44.8
Cashier's Counter 1.82
18.3 63.07 6.30735 18.92205 88.3029 88
Sink in counter 0.9
Water Closet 0.35
Lavatory 0.2475
Lockers 1.8
Food Service Workers Food Service Workers
Locker Room and Clean and Water Closet 0.35
Toilets
2
Oranized
Private change clothes and store Food Assembly Area Cook 10 1.4 14
Lavatory 0.162
4.56 18.56 1.8562 5.5686 44.5488 45
belongings. Food Supervisor
Shower 2.25
Desk 2.34
Desk side extension 0.72
Chief Dietician and staff
Chieft Swivel Chair 0.5936
prepare monthly menus. Chief Dietitian
Nutritionist/Dietitian's 1 Professional Semi-private
Chief Dietician does office
Kitchen Area
Staff
3 5.02 15.06 Visitor's Chair 0.405 7.41 22.47 2.24686 6.74058 31.456 31
Office Cabinet 2.25
work.
Water Closet 0.35
Lavatory 0.2475
Desk 0.9
Desk side extension 0.36
Dietitian/Nutrionist gives
Dietitian/Nutrionist Swivel Chair 0.2968
Nutrition Clinic 1 Professional Private individual food-related Dietitian's Office
Patient
2 5.02 10.04
3.82 13.86 1.38618 4.15854 19.4065 19
counseling.
Cabinet 0.6
3-seater sofa 1.26
Food Preparation Counter 2.7
Dietitian Double Compartment sink 0.7
Clean and Food Service Staff
Food Preparation Area 1
Functional
Private
prepares food.
Staff Dining Cook 4 5.02 20.08 with drainboard 3.82 23.9 2.39 7.17 33.46 33
Food Service Workers Single Compartment sink with 0.42
drainboard
Range with oven 0.5183
Range with broiler 0.544
Counter 6.825
Dietitian Double Compartment sink 0.7
Cooking and Baking Clean and Cooking and Baking of
Area
1
Organized
Private
Food
Staff Dining Cook 4 5.02 20.08 with drainboard 10.8 30.85 3.08473 9.25419 43.1862 43
Food Service Workers Single compartment sink with 0.42
drainboard
Nutririonist/Dietitian prepare Food Assembly Counter 2.7

Therapeutic Diet Clean and Blenderized & Tube Feeding Nutritionist/Dietitian
Preparation Area
1
Organized
Private therapeutic diet modified
Area Food Service Area
1 5.02 5.02 Chair 0.405 3.46 8.477 0.8477 2.5431 11.8678 12
from regular diet. Wall-hung cabinet 0.352
Preparation of food for Sink in counter 0.9
Blenderized & Tube Clean and Nutritionist/Dietitian
Feeding Area
1
Organized
Private blenderized and tube Dietitian's Office
Food Service Worker
2 5.02 10.04 Preparation Counter 2.7 3.6 13.64 1.364 4.092 19.096 19
feeding
Double compartment sink 0.7
Washing and storage of
Pots/Pans Washing and with drainboard
Storage
1 Clean Private pots, pans and utensils Baking and Cooking Area Food Service Workers 2 5.02 10.04
Counter 6.825
9.29 19.33 1.9325 5.7975 27.055 27
used in cooking and baking.
Storage of kitchen Open shelving 2.52
Storage for Utensils 1 Organized Private
utensils/silverware.
Washing Area Food Service Workers 2 5.02 10.04
Wall-hung cabinet 0.352 1.48 11.52 1.15184 3.45552 16.1258 16
Washing of pots, pans,
Food Preparation and Double compartment sink 0.7
Dishwashing Area 1 Clean Private trays, dishes and other
Conveying Area
Food Service Workers 2 5.02 10.04
with drainboard 3.78 13.82 1.3815 4.1445 19.341 19
kitchen utensils.
Dishwashing Machine 1.5375
Washing of food tray Food Conveyor 0
Food Conveyor Parking 1 Functional Semi-public
truck/conveyor.
Food Assembly Area Food Service Workers 2 5.02 10.04 0 10.04 1.004 3.012 14.056 14
195
Food Preparation Counter 2.7
Food Service Workers set-
Serving and Food Functional and Nutritionist/Dietitian Single Compartment sink with 0.42
Assembly Area
1
Clean
Public up and assemble cooked Staff Dining
Food Service Worker
3 5.02 15.06
drainboard 3.82 18.88 1.8884 5.6652 26.4376 26
food.
Dietitian on duty and auditor Dietitian Platform Scale 0.2
witness and inspect Auditor Push Cart 1.0556
Receiving Area 1 Organized, Clean Semi-public
foodstuff delivered by
Dietitian's Office
Food Service Worker
5 1.4 7
Counter 2.7 4.46 11.46 1.14596 3.43788 16.0434 16
supplier. Agency Inspector
Refrigerator 1.7412
Freezer 0.9424
Storage of poultry, meat, Chiller 0.9727
Clean and Dry Storage Room
Cold Storage 1
Organized
Private and dairy products. Storage
Dietitian's Office
Food Service Worker 1 5.02 5.02 Push Cart 1.0556 5.95 10.97 1.09744 3.29232 15.3642 15
of easily perishable goods. Weighing Scale 0.2
Table 0.84
Chair 0.2025
Step Ladder 0.268
Push Cart 1.0556
Clean and Storage of foodstuff that do Cold Storage Room Open Shelving 0.675
Dry Storage 1
Oranized
Private
not spoil easily. Dietitian's Office
Food Service Worker 1 5.02 5.02
Cabinet 0.675 4.68 9.696 0.96961 2.90883 13.5745 14
Chair 0.2025
Counter 1.8
Dining Table 1.125
Dietetics Staff Dining Dietetics Staff take their
Room
1 Organized Semi-public
meals
Dietetics Area Dietetics Staff/Personnel 6 1.4 8.4 Dining Chairs 1.125 3.24 11.64 1.164 3.492 16.296 16
Lavatory in Counter 0.9
Food Service Workers sort Garbage Bin 1
Waste Holding Area 1 Organized Private
garbage accordingly.
Dietetics Area Food Service Worker 1 5.02 5.02 Sink in counter 0.9 1.9 6.92 0.692 2.076 9.688 10
465.306 465
196
M. Outdoor Facilities
Staff and authorized Vegetable Plots 18
patients tend to Staff Tables
Vegetable Garden 1 Relaxing Public
flowers/plants for use in the
Flower Garden
Patients
5 5.02 25.1 Chairs 2.25 21.3 46.36 4.63625 13.90875 64.9075 65
development 1.0125
Plant Beds 18
Staff and authorized Greenhouse
Staff Tables 5.55
Flower/Plant Garden 1 Relaxing Public patients tend to vegetables Vegetable Garden
Patients
5 5.02 25.1 26.8 51.91 5.19125 15.57375 72.6775 73
for use in the development Chairs 2.25
1.0125
Staff and authorized Staff Plant Beds 18
Roof Garden 1 Relaxing Public
patients take care of plants
Roof Deck
Patients
5 5.02 25.1 Benches 22.1 47.23 4.7225 14.1675 66.115 66
4.125
Chairs 10.125
Events relevant to the
Staff Podium
Pavilion 1 Functional Public hospital staff and patients Gardens
Patients
50 1.4 70 1.016 11.4 81.41 8.141 24.423 113.974 114
take place.
Bench 1.35
Sheds 5 Relaxing Public Patients have places to rest Walkways Patients 2 1.4 2.8 Table 2.48 5.275 0.5275 1.5825 7.385 7
1.125
Multi-purpose Court 116.1288
Patients do sport activities
Staff Benches
Open Court 1 Fun Public and exercise as part of Gardens
Patients
6 1.4 8.4 4.125 120 128.7 12.86538 38.59614 180.115 180
rehabilitation.
Functional and Patients exercise with Staff Guide Bars 0
Walkways 1
Accessible
Public
minimal guidance.
Outdoor Facilities
Patients
1 1.4 1.4
Path
0 1.4 0.14 0.42 1.96 2
Picnic Tables 8.0864
Staff
Patients and comanions Benches
Picnic Area/Deck 1 Relaxing, Fun Public
spend time together
Gardens Patients 20 1.4 28 Viewing Deck 4.125 27.2 55.21 5.52114 16.56342 77.296 77
Companions
15
Parallel Bars 5.1902
Patients do outdoor Steps
Outdoor Physical Staff Curbs 2.4288
Therapy Area
1 Functional Public physical rehabilitation Gardens
Patients
10 5.02 50.2 11.1 61.32 6.13152 18.39456 85.8413 86
activities Ramps 0.81
2.6862
Patients leave their Wheelchair 6.875
Wheelchair parking 1 Organized Public
wheelchairs if possible
Outdoor Facilities Patients 10 0.65 6.5 6.88 13.38 1.3375 4.0125 18.725 19
688.997 689
N. Engineering and Maintenance Service
Parking Area 37.5
Work Area 25
Hydraulic Lifter 1.3527
Garage, Work and Mechanic/Driver checks Mechanic
Parking Areas
and repairs vehicles
Driver's Lounge
Driver
2 5.02 10.04 Work Bench 0.288 67.3 77.31 7.73082 23.19246 108.231 108
Chair 0.2025
Shelves 0.675
Cabinet 0.5
Corner Table 0.49
Armchair 0.5625
Driver rests and stores
Driver 3-seater sofa 1.5
Driver's Lounge 1 Relaxing Private belongings while waiting for Parking Areas
Mechanic
5 1.4 7
Sink in counter 0.9
4.71 11.71 1.1712 3.5136 16.3968 16
transport service.
Toilet 0.35
Lavatory 0.2475
Urinal 0.162
197
Swivel Chair 0.2968
Security Officer does office Chair 0.405
work. Watch CCTV Desk 1.125
Engineering and Maintenance Chief Security
Security Office 1 Professional Private footages. Storage of
Building Security Guards
3 5.02 15.06 Shelves 4.725 9.45 24.51 2.45098 7.35294 34.3137 34
firearms and confiscated Steel Filing Cabinet 0.648
materials. Cabinet 2.25
Swivel Chair 0.2968

Chair 0.405
Desk 1.125
Janitorial Staff does office Engineering and Maintenance Supervisor
Housekeeping Office 1 Functional Private
work and stores equioment. Building Janitorial Staff
3 5.02 15.06 Shelves 4.725 9.45 24.51 2.45098 7.35294 34.3137 34
Cabinet 2.25
Counter 1.6
Stool 0.1599
Functional and Repair of medical Engineering and Maintenance Work Bench 1.8
Workshop - Biomed 1
Organized
Private
equipment. Building
Biomed Technician 1 5.02 5.02
Cabinet 2.88 8.16 13.18 1.31849 3.95547 18.4589 18
Bench 0.825
Sink in counter 0.9
Counter 6.4
Stool 0.3198
Functional and Engineering and Maintenance Carpenter Work Bench 3.6
Workshop - Carpentry 1
Organized
Private Repair of hospital furniture.
Building Painter
2 5.02 10.04
Cabinet 2.88 15.7 25.79 2.57898 7.73694 36.1057 36
Bench 1.65
Sink in counter 0.9
Counter 1.6
Stool 0.3198
Workshop - Electrical Functional and Repair of aircons and Engineering and Maintenance
and Mechanical
1
Organized
Private
refrigerators. Building
Electricians 3 5.02 15.06 Work Bench 1.8 13 28.1 2.80998 8.42994 39.3397 39
Cabinet 2.88
Shelves 6.44
Swivel Chair 0.2968
2-seater sofa 1.125
Chair 0.405
Engineering and Staff Office Engineering Head Desk 1.125
5.02/staff
Head's Office 1 Professional Semi-private Maintenance Head does Conference Room Visitors 3
1.4/visitor
7.82 Desk return extension 0.36 5.15 12.97 1.29703 3.89109 18.1584 18
office work. Storage Engineering Staff Steel Filing Cabinet 0.648
Whiteboard 0.593
Water closet 0.35
Lavatory 0.2475
Swivel Chair 1.1872
Dining Table 0.81
Maintenance Supervisor
Engineering and Maintenance Dining Chair 0.81
Staff Office 1 Functional Semi-private Staff does office work.
Building
Mechanic/Carpenter 4 5.02 20.08
Desk 2.88 8.53 28.61 2.86112 8.58336 40.0557 40
Technicians
Sink in counter 0.9
Conference Chair 3.108
Engineering staff hold Maintenance Supervisor
Engineering and Maintenance Conference Table 1.35
Conference Room 1 Functional Semi-public meetings or special
Building
Engineering Staff 8 1.4 11.2
White board 0.593
6.93 18.13 1.8131 5.4393 25.3834 25
lectures. Visitors
Corner Table 0.98
Counter 1.35
wall-hung cabinets 1.408
Engineering staff store
Engineering and Maintenance Sink in counter with 0.9
Staff Pantry 1 Clean Private cooked or uncooked food.
Building
Engineering Staff 6 1.4 8.4
drainboard 5.83 14.23 1.4233 4.2699 19.9262 20
Staff prepares their meals.
Table 0.96
Chairs 1.215
Bunk Beds 4.86
Maintenance Staff
Night Tables 0.9225
rests/sleeps and stores
Quarters 2 Clean Private
clothing and other personal
Staff Toilets and Bath Engineering Staff 6 1.4 8.4 Closet 1.08 7.79 16.19 1.6185 4.8555 38.844 39
Chair 0.2025
belongings
Desk 0.72
Water Closet 0.7
Lavatory 0.7425
Engineering Staff use toilet
Toilets and Bath + Clean and well- Engineering Staff Urinal 0.162
Janitor's Closet
2
ventilated
Private facilities and change Quarters
Janitor
5 1.4 7
Shower Enclosure 2.4 6.78 13.78 1.3779 4.1337 33.0696 33
clothing.
Shelves 0.6
198
Storage of carpentry tools Open Shelving 3.6
Clean and Maintenance/Engineering
Storage Room 1
Organized
Private and equipment for Workshop
Staff
2 5.02 10.04 Cabinet 2.52 8.82 18.86 1.886 5.658 26.404 26
maintenance. Counter 2.7
Distributes power and Control Panel 7.5
Proximity of Engineering and
Power House 1 Clean Private electricity within the
Maintenance Building
Technician 1 5.02 5.02 7.5 12.52 1.252 3.756 17.528 18
development.
Distributes water Water Pump 12.5
Pump Room 2 Clean Private throughout the
Technician/Plumber 1 5.02 5.02 12.5 17.52 1.752 5.256 42.048 42
development.
Supplies power and Generator Set 20
Generator Room 1 Clean Private electricity in case of
Technician 1 5.02 5.02 20 25.02 2.502 7.506 35.028 35
emergency black-outs.
583.605 584
O. Support Service Facilities

I - LINEN AND LAUNDRY
Sorting Bin 1.503
Dirty Linen Trolley 1.402
Basin 1.5
Receiving/Sorting/Disinf Clean and Laundry worker sorts soiled
ection Area
1
Organized
Private
linen prior to washing.
Washing Area Laundry Workers 4 5.02 20.08 Tiled Washing Trough 1.128 7.56 27.64 2.76412 8.29236 38.6977 39
Locker 0.9
Sorting Table 0.72
Chair 0.405
Washing Machine 5.07
Dryer 3.3372
Double Compartment 0.209
Laundry Tub 1.5
Sorting Area Shelvings 2.25
Clean and Linens are washed by
Washing/Drying Area 1
Organized
Private
laudry workers
Pressing and Ironing Area Laundry Workers 4 5.02 20.08 Shakeout Table 3.9 22.8 42.9 4.2898 12.8694 60.0572 60
Linen Office and Workroom Supply and Storage Cabinets 2.88
Table 2.25
Adjustable stool 0.72
Chairs 0.2968
0.405
Mushroom Press 0.8789
Press 1.378
Laundry worker inspects
Ironing Board 0.5175
linen and separates torn
Pressing and Ironing Clean and Uniform Rack 1.9
Area
1
Organized
Private linen to be mended. Worker Linen Office Workroom Laundry Workers 3 5.02 15.06
Flatwork Ironer 2.809
13.5 28.57 2.85734 8.57202 40.0028 40
shakes out, presses and
Table 2.745
irons clean linen.
Chair 0.405
Cabinets 2.88
Sewing Machine 1.8952
Trolley 1.402
Chair 0.405
Counter 1.82
Laundry worker classify, Central Linen Storage Laundry Unit Head
Linen Office/Workroom Functional and Shelviing 1.8
and Storage
1
Organized
Private count and record clean linen Receiving Area Laundry Worker 5 5.02 25.1
Desk 0.9
15.5 40.57 4.05674 12.17022 56.7944 57
in logbooks. Pressing and Ironing Area Seamstress
Working Table 1.89
Step Ladder 0.268
Linen Closet 3.9
Lockers 1.5
Laudry Employees store Water Closet 0.7
Toilets and Locker Clean and
Room
1
Organized
Private clothing or belongings and Laundry Department Laundry Unit Workers 8 1.04 8.32 Lavatory in counter 1.8 5.96 14.28 1.4282 4.2846 19.9948 20
use toilet facilities. Urinal 0.162
Shower 1.8
199
II - PROPERTY AND SUPPLY
Property supply officer Desk 1.125
makes requisition, Desk return extension 0.6
inventory, distribution and 2-seater sofa 0.84
control of tools, equipment, Side Table 0.27
Staff Office Property Supply Officer 5.02/staff
Head's Office 1 Professional Semi-private material and supplies for
Storage/Warehouse Visitors/Ventors
3
1.4/visitor
7.84 Steel Filing Cabinet 0.3 4.04 11.88 1.18825 3.56475 16.6355 17
the hospital. PSO receives Executive Chair 0.5025
sales agents and reviews Visitor's Chair 0.405
product offers and
availability.
Desk 1.8
Functional and Staff does office work and PSO's Office Clerks 5.02/staff 3-seater sofa 1.26
Staff Office 1
Organized
Semi-Public
receives visitors Storage/Warehouse Visitors/Ventors
5
1.4/visitor
14.24
Swivel Chair 0.5936
4.88 19.12 1.91161 5.73483 26.7625 27
Dining Table 2.83
Dining Chair 0.81
Propert and Supply staff Property and Supply
Staff Pantry 1 Clean Private
eat their meals.
Property and Supply Building
Staff
4 1.4 5.6 Sink in counter 0.9 7.33 12.93 1.293 3.879 18.102 18
Counter 0.54
Water closet 0.7
Property and Supply staff Lavatory in counter 1.8
change their clothes and Urinal 0.324
Toilets/Baths, Lockers Clean and well-
and Janitor's Closet
1
ventilated
Private take baths in T&B. Staff Staff Pantry Property Supply Staff 5 1.4 7 Shower Set 3 7.08 14.08 1.4084 4.2252 19.7176 20
store clothing and other Shelves 0.96
belongings. Slop Sink 0.66
Lockers 1.8
Plastic Palettes 15
Storage of tools,
Shelving 9.6
equipment, instruments,
Clean and Staff Head Office
Storage/Warehouse 1
Organized
Semi- Public materials and other
Delivery Area
Property and Supply Staff 5 5.02 25.1 24.6 49.7 4.97 14.91 69.58 70
supplies needed by the
departments of the hospital.
Equipment, materials, Property and Supply Truck Parking 52.5
Delivery Truck Parking Functional and
Area, Loading Platform
1
Organized
Semi-Public instruments, and materials Storage/Warehouse Staff 5 5.02 25.1 Loading Platform 54 107 131.6 13.16 39.48 184.24 184
are delivered. Delivery Agents
III - MORGUE
Tiled Counter 4.8
Overhead shelves and 4.8
cabinets
Footstool 0.4484
Pathologist performs Scrub-up sink 1.8
Locker Room and Toilet Pathologist
Autopsy Room 1 Sterile Private procedure on dead
Morgue Medical Technologist
3 5.02 15.06 Autopsy Table 7.43 25.3 40.34 4.0344 12.1032 56.4816 56
patients. Sink 0.2475
Mayo Table 0.2745
Kick bucket 0.105
Instrument Cabinet 2.88
Autopsy Transfer Bed 1.55
Storage of dead bodies Morgue Technician Mortuary Refrigerator 6.9
Morgue 1 Sterile Private waiting to be claimed by Autopsy Room Pathologist 3 5.02 15.06 Morgue Table 1.55 8.45 23.51 2.351 7.053 32.914 33
relatives Medical Technologist
Locker 0.9
Mortuary Staff stores Morgue Technician
Locker Room And Water closet 0.35
Toilet and Bath
1 Clean Private belongings and use toilet Autopsy Room Pathologist 3 1.4 4.2
Lavatory in counter 0.9 3.65 7.85 0.785 2.355 10.99 11
facilities. Medical Technologist
Shower 1.5
200
IV - CENTRAL WASTE STORAGE
Shelves 0.8
Clean and Janitor places places waste Waste Trolleys 4.206
Work Area 1
Organized
Semi-public
bins carts/trolleys
Central Waste Storage Facility Janitor 4 5.02 20.08
Slop Sink 0.66 6.41 26.49 2.64885 7.94655 37.0839 37
Sink 0.7425
Sterile and Storage of Hazardous Yellow Waste Bins 3.2
Hazardous Waste 1
Organized
Private
Waste before treatment.
Central Waste Storage Facility Janitor 1 5.02 5.02
Refrigerator 1.2
4.4 9.42 0.942 2.826 13.188 13
Cabinets 2.4
Storage of mercury
Mercury-Containing Sterile and containing devices/lamps
Devices
1
Organized
Private
before being hauled by
Central Waste Storage Facility Janitor 2 5.02 10.04 2.4 12.44 1.244 3.732 17.416 17
proper authorities.
Storage of biodegradable Waste Bins 3.2
waste before being picked- Trolley 1.402
Biodegrapdables 1 Organized Private
up by local waste
transporter.
Storage of non- Waste Bins 3.2
biodegradables before Trolley 1.402
Non-biodegradables 1 Oranized Private
being sold to junk shops or
recycled.
561.36 561
201
TOTAL FLOOR AREA SQM
Executive Department 97
Administrative Department 630
HIMS 184
Emergency Room 616
Trauma Department 184
Outpatient Department 621
Ancillary Services 860
Nursing Services 1592
Operating Services 681
Rehabilitation Service 2322
Nutrition and Dietetics 465
Outdoor Facilities 689
Engineering and Maintenance 584
Support Service Facilities 561
10087
5.2.1 Parking Requirements
The development falls under the Group D-2 division of the national building code of the Philippines and is a Public Hospital. It has a
minimum requirement of 1 parking slot for every 25 beds, but according to an article published on November 1, 2018 by SpaceMed Essentials,
parking spaces for inpatient admissions especially for an acute care facility such as the proposed development should have 1 parking slot for
202
every 5 hospital beds. And should also have a passenger loading space for public transport that will fit atleast two queued jeepney/shuttles. One
loading slot for an articulated vehicle and one loading slot for a standard truck every 5,000 sq. meters of GFA.
For Patient Parking:
100 beds / 5 beds = 20 parking slots
Ambulance Parking:
5 allotted parking slots
For Administrative and Hospital Staff
10 allotted parking slots
For loading trucks:
1 articulated vehicle parking slot
9,621 sq.meters. / 5,000 square meters = 1.9 or two loading truck parking
Shuttle Loading Space:
2 loading spaces
203
TOTAL: 20 Patient Parking Slots + 5 Ambulance Parking + 10 Staff Parking + 3 Truck Parking + 2 Shuttle Parking = 40 Parking Slots
5.3 Graphical Spatial Translations
5.3.1 Matrix Diagram
LEGEND:
Proximity Essential Semi-essential Proximity not essential
H – HIGH M – MEDIUM L – LOW Y – YES N – NO/NONE
204
A. Executive Department
B. Administrative Department
Daylight/ Public Proximity Space
Views Access
Y H 2,3,19 1. Main Lobby
Y L 13,14,15 2. Chief Administrative Officer
N H 4,1 3. Information/Reception
Y H 3 4. Admitting Office
Y M 6,11 5. Billing and Claim
N H 5 6. Cashier’s Office
Y L 15,16 7. Medical Social Work Office
Y L 10,11 8. Procurement
Y L 10,11 9. Auditing
Y L 11,9,8 10. Budget and Finance
Y L 10,9,8,5 11. Accounting
Y M 17 12. Human Resource Dev’t
Y L 2 13. IHOMP
Y H 15,16,2 14. Conference Room
Y L 16,14,2 15. Chief of Clinics
Y L 18,15,14,2 16. Chief Nurse
N L 18,12 17. Staff Lounge
Y L 17,16 18. Staff Toilets
Y H 1 19. Public/PWD Toilets
205
C. Administrative – Health Information Management Systems
Daylight/ Public Proximity Space

Views Access
Y H 2,3 1. Receiving/Releasing Area
Y L 3,4,1 2. Work Area
Y L 5,2,1 3. Completion Room
Y L 2 4. Head’s Office
N L 6 5. Filing Room
N L 5 6. Storage Room
D. Emergency Service Facilities
Daylight/ Public Adjacency Spaces

Views Access
Y H 2,3 1. Lobby/Triage
Y H 3,1 2. Nurse Station
N L 2,1,5 3. Women and Children
N L 5,8 4. Respiratory Unit
Y M 4,3,7,8,13 5. Treatment Cubicles
N L 7 6. Scrub-up/Sub-Sterile
Y L 6,7 7. Minor OR
N L 5,4 8. Health Emergency
Y L 10 9. Call Room
Y L 9 10. Dept. Head Office
N L 12 11. Isolation Room
N L 11 12. Decontamination
Y H 5 13. Patient/PWD Toilet
206
E. Trauma Department

Views Access
Y L 2,7 1. Trauma Medical Director
Y L 1 2. Trauma Program Manager
N H 4 3. Trauma Bay
Y L 3 5. Trauma Call Room
Y M 1 6. Surgical Specialty Clinics
F. Outpatient Department

Views Access
Y H 3 1. Lobby/Triage
Y H 3,5,13 2. Waiting Area
Y H 1,2,5,6 3. Registration/Admitting
N L 4,3,2 5. OPD Records Room
Y L 3,7 6. Office of OPD Chief
Y M 6,11 7. Conference Room
N L 9,12 8. Scrub-Up/Sub-sterile
Y L 8,10,12 9. Minor Operating Room
Y H 9,4 10. Consultation Room
Y L 7 11. Staff Lounge + Toilet
Y H 8,9 12. Patient Toilet/Dressing
Y H 2 13. Public/PWD Toilets
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G. Ancillary Service Facilities

Views Access
Y M 3,4,6 1. Chief Pharmacist
Y H 3 2. Counseling Area
N H 1,2,4 3. Dispensing Area
N H 1,3,5 4. Receiving/Inspection
N L 4 5. Bulk Storage
Y L 1 6. Staff Lounge
Y H 8,10,13 7. Waiting Area - Laboratory
N H 7,10,11,13 8. Receiving/Releasing Area
N M 11,12 9. Phlebotomy Clinic
Y M 7,812 10. Pathologist’s Office
Y L 8,9,15 11. Work Areas
Y H 8,9,10,13 12. Examination and Screening
N H 7,12 13. Doning Room
N L 13 14. Blood Bank
N L 11,16 15. Storage
N L 15 16. Glasswashing & Storage
Y H 18,19 17. Waiting Area - Radiology
Y H 17 18. Public Toilet
Y H 17,21 19. Clerical Room
Y M 29 20. Chief Radiologist
N L 19,22 21. Files Room
N M 21,23,25-27 22. Mobile X-ray Room
N M 22,24 23. Ultrasound Room
N M 23,25,26 24. Radiographic X-ray
N L 24,22,26 25. Dark Room
N L 24,25,22,28 26. Control Booth
N L 22 27. Supply Room
N M 26 28. CT Scan
Y L 20 29. Staff Lounge
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H. Nursing Service Facilities

Views Access
Y M 2 1. Department Head Office
Y H 1,4,5 2. Central Nursing Station
N H 5-8 3. Decentralized Nursing Station
Y H 2,7 4. Treatment Room
Y M 3,2,6 5. Single-bed Ward
Y M 5,3 6. Multiple-bed Ward
Y L 3,4 7. Acuity-Adaptable Rooms
Y L 3 8. Isolation Room
I. Service Facilities
a. Operating Room Complex

Views Access
Y M 4,15 1. Transfer Area
Y L 3,5,6 2. Lockers, Toilets and Baths
Y L 2,4,5,6 3. Lounge
Y L 1,3,6 4. Pre-Operative Room
Y L 3,2,6,8-11 5. Surgical Supervisor’s Area
Y L 4,5,7,9-11 6. Anesthesiologist’s Office
N L 6 7. Anesthesia Storage
N L 5 8. Sterile Instrument Storage
N L 5,6,10,11 9. Scrub-Up
N L 9,5,6,11 10. Sub-sterile
Y L 9,10,5,6 11. Operating Room
N L 11 12. Clean-Up Room
Y L 11 13. Post Anesthesia Care Unit
N L 2 14. Janitor’s Closet
Y H 1 15. Family/Worship Room
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b. Intensive Care Unit

Views Access
N L 2 1. Patient Treatment Area
N M 1,5,7 2. Isolation Room
Y L 4,6 3. Office
Y H 3 4. Family Counseling Room
N H 2 5. Visitors’ Dressing Room
Y L 3 6. Staff Room
N L 2 7. Soiled Linen/Utility
c. Central Sterilizing and Supply Room

Views Access
Y L 2 1. Receiving Area
Y L 1,3,4 2. Work Area
N L 2,4 3. Auto-Clave Room
Y L 2,3 4. Storage Room
210
J. Rehabilitation Service Facilities

Views Access
Y H 3,5,28 1. Lobby
Y M 1 2. Chief Rehabilitation Office
Y L 2,4,5,23 3. Therapists’ Department
Y L 3 4. Staff Room
Y H 1,3,6,27 5. Consultation Room
Y H 5,7,10 6. Treatment Cubicles
Y H 6,8,9,13,29 7. Physical Therapy Room
Y H 7 8. Multi-modal Therapy Room
Y H 7,15,22 9. Gymnasium
Y H 6 10. Electrophysiological Therapy
Y H 12 11. Vocational Counseling Room
Y H 11 12. Vocational Training Rooms
Y H 7,14 13. Pediatric Physical Therapy
Y H 13 14. Speech Therapy Room
Y H 9,16-18,29 15. Aquatic Therapy Room
N H 15,17,18 16. Patient Locker + Dressing
Y H 15,16,18 17. Balneotherapy Room
Y H 17 18. Paraffin Therapy Room
Y H 20 19. Ultrasound Therapy Room
Y H 19 20. Cryotherapy Room
Y H 22 21. Kinesiology Room
Y H 21,9 22. Tai Chi Room
Y H 3 23. Orthotics and Prosthetics
N H 27 24. Outpatient Locker
Y H 26 25. Inpatient Wards
N H 25 26. Nurse Station
Y M 24,5 27. Patient Toilet
Y H 1 28. Public Toilet
N L 7,15,26 29. Storage + Utility Room
211
K. Nutrition and Dietetics Department

Views Access
Y L 5,13 1. Hospital Staff Dining Room
Y L 3,13,17 2. Locker Room + Toilet
Y M 2,4-6,8 3. Chief Dietitian Office
Y M 3 4. Nutrition Clinic
N L 1,3,11,13 5. Food Preparation Area
Y L 3,7-9,18 6. Cooking/Baking Area
N L 6,8 7. Therapeutic Diet Preparation
N L 6,7,3 8. Blenderized/Tube Feeding
Y L 6,10,11 9. Pots/Pans Washing Area
N L 9,11 10. Utensils Storage
Y L 9,10 11. Dishwashing Area
Y H 14-16 12. Food Conveyor Parking
N L 1,2,5,17 13. Serving and Food Assembly
N H 12,15,16 14. Receiving Area
N L 12,14,16 15. Cold Storage
N L 12,14,15 16. Dry Storage
Y L 13,2 17. Dietetics Staff Dining
N L 6 18. Waste Holding Area
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L. Outdoor Facilities

Views Access
Y H 2,5,7,9 1. Vegetable Garden
Y H 1,5,7,9 2. Flower/Plant Garden
Y H 7,10 3. Roof Garden
Y H 7,8 4. Pavilion
Y H 1,2,7,8 5. Sheds
Y H 7,8 6. Open Court
Y H 1-10 7. Walkways
Y H 4-7 8. Picnic Area/Deck
Y H 1,2,7,10 9. Outdoor Physical Therapy
Y H 3,7,9 10. Wheelchair Parking
M. Engineering and Maintenance Facilities

Views Access
Y M 2,6 1. Garage, Work and Parking
Y L 1,9,10 2. Driver’s Lounge
Y L 4,6,10,11 3. Security Office
Y L 3,7,10,11 4. Housekeeping Office
Y L 12-14 5. Workshop
Y M 1,3 6. Head’s Office
Y M 4,6,8,9 7. Staff Office
Y M 6,7 8. Conference Room
Y L 2,7,10 9. Staff Pantry
Y L 2,3,4,9,11 10. Quarters
Y L 3,4,10 11. Toilet & Bath + Janitor Closet
N L 5 12. Storage Room
N L 14,5 13. Power House
N L 13,5 14. Pump, Generator Room
213
N. Support Service Facilities
a. Linen and Laundry

Views Access
Y M 2,4,5 1. Receiving/Sorting/Disinfection
Y L 1,3,4 2. Washing/Drying Area
Y L 2,4 3. Pressing and Ironing Area
Y L 1,2,3 4. Linen Office/Workroom
Y L 1 5. Toilets and Locker Room
b. Property and Supply
Daylight/ Public Adjacency Space

Views Access
Y M 2,5 1. Head’s Office
Y L 1,3 2. Staff Office
Y L 2,4 3. Staff Pantry
Y L 3 4. T&B, Locker, Janitor’s Closet
Y H 1,6 5. Storage/Warehouse
Y H 5 6. Deliver Parking and Platform
c. Morgue

Views Access
N L 2,3 1. Autopsy Room
N M 1,3 2. Morgue
Y L 1,2 3. Locker Room, T&B
214
d. Central Waste Storage

Views Access
Y L 2-5 1. Work Area
N L 1 2. Hazardous Waste
N L 1 3. Mercury-Containing Devices
N L 1,5 4. Biodegradables
Y L 1,4 5. Non-biodegradables
215
5.3.2 Bubble Diagrams
LEGEND:
PROXIMITY ESSENTIAL
PROXIMITY SEMI-ESSENTIAL
A. EXECUTIVE DEPARTMENT
216
B. ADMINISTRATIVE DEPARTMENT
C. ADMINISTRATIVE DEPARTMENT – HIMS
217
D. EMERGENCY SERVICE FACILITIES
E. TRAUMA DEPARTMENT
218
F. OUTPATIENT DEPARTMENT
219
G. ANCILLARY SERVICE FACILITIES
a. Pharmacy
b. Laboratory
220
c. Radiology
221
H. NURSING SERVICE FACILITIES
222
I. OPERATING ROOM COMPLEX J. INTENSIVE CARE UNIT
223
K. CENTRAL STERILIZING AND SUPPLY
224
L. REHABILITATION SERVICE FACILITIES
225
CHAPTER 6
ENVIRONMENTAL SYSTEMS
6.1 Structural Systems
A. Waffle Mat Foundation
Waffle Mat
Foundations are a
reinforced concrete footing
and slab system which
consists of a perimeter
footing and narrow internal
beams that are one meter
apart. This whole system
sits directly on grade and uses

Figure 112. Waffle Mat Foundation (Source:
https://louiesportsmouth.com/wafflemat-foundation/)
polystyrene pods which create voids
between the strip footings. Waffle Slabs are usually used for almost level grounds
that are of clay type soils. This foundation
offers superior performance because the
voids formed by the “waffleboxes” acts as
relief valves that absorb heaving soils and
therefore eliminates significant structural
cracking. It also has a lesser contact area on

Figure 113. Typical Waffle Mat Foundation Plan
the soil than other foundations which (Source: http://florsystems.com/t-waffle-slab)
means that left pressure when soils do move. The soil type in the development in
particular is regarded as Zaragoza Clay according to the Comprehensive Land
Use plan of the municipality where the site is located, therefore this type of
foundation system is fitting.
226
B. Steel Framing
Healthcare building
construction should be characterized
by their ability to be flexible and
adaptable. The use of steel in
construction enables designers meet
a diverse range of requirements while
still ensuring cost-effectivity. Through

Figure 114. Steel Framing (Source:
the use of steel ensure a speedy https://www.steelconstruction.info/Healthcare_buildings)
construction. As a development that has heavy traffic and is very busy, during
times of expansion, it is crucial to have minimal disruption while also reducing noise
because steel can be pre-fabricated off-site. Steel construction methods can also
reduce construction periods making it easier to be used for service especially in
crucial areas such as the proposed development. IN addition to this, steel also has
environmental benefits because it is resource efficient. Steel has minimal waste
during construction and most of the time it can be recycled multiple times.
C. Pre-tensioned Concrete
Pre-tensioning is
accomplished by stressing wires or
strands, called tendons, to
predetermined amount by stretching
them between two anchorages prior
to placing concrete. The concrete is
then placed and tendons become
Figure 115. Concrete Pre-tensioning (Source:

https://www.steelconstruction.info/Healthcare_buildings
227
bonded to concrete throughout their length.
It is fabricated off-site and is therefore reduces
the noise of construction.
Concrete is a superior building material in
terms of acoustical qualities it is suitable for

Figure 116. How Pre-tensioning works
(Source: http://www.ucdc-om.com/overview/) healthcare development where noise
reduction is crucial to optimal patient healing. And because hospitals have a great
amount of equipment they use for procedures, concrete is great at handling
vibration which in turns dampen it. And while concrete has many different
advantages, using it in partner with steel will ensure strength because of concrete
is only high in compression but low in tension while steel is quite the opposite being
strong in tension and weak in compression and is more cost-effective
D. Building Vibration Insulation
Vibration control
insulations are used to support
buildings and building
structures in order to provide
protection from low-frequency
Figure 117. Metal Spring-type Vibration Insulator (Source: vibration from external
https://www.acoustic-group.com/products/vibration_insulation/
forces such as that
generated from hospital
machineries. This structural system
can be used in spaces that especially
have a large number of machineries
needed for hospital

Figure 118. Diagram of Noise and Vibration Insulation (Source:
https://www.farrat.com/vibration-control/cinema-acoustic-
isolation/farrat-acoustic-floating-floors-01) procedures. The
228
development will be having a helipad as part of it being a trauma center that can
cater to patients from places that cannot be reached by conventional means, and
the vibration that will result from the landing of a helicopter should be isolated.
E. Double-stud Wall System
Double-stud wall system in
simpler terms is a system uses two
standard walls but instead of joining
them together, a space left in the
middle instead. It is mostly used for
soundproofing. The proposed

Figure 119. Double-stud Wall System Source:
development will be using a same- https://njhardhat.blogspot.com/2010/12/commercial-
site-visit-undergraduate.html)
handed room approach for patient
wards so that patient doors are farther from each other to avoid noise transmission
even when doors are left open, but with this approach comes a setback, oxygen
and plumbing pipes from a patient’s
room wall will be attached to
another’s non-noise walls.
Because of this the usage of
double-stud wall system will be
beneficial as both acoustical and
thermal insulation.
Figure 120. Lstiburek’s Ideal Double-stud Wall Design
Source: https://www.energyvanguard.com/blog/77996/Joe-
Lstiburek-s-Ideal-Double-Stud-Wall-Design)
229
F. Aluminum Fins
Also called architectural fins,
these system extrude from the building
façade and is much about it benefits as
it is about providing aesthetical appeals.
These fins help in solar shading and in
recent studies have shown to also help
in building ventilation by harnessing Figure 121. Aluminum Fins

Source: https://www.metalline.co.uk/product/cills-
fins-general-pressings/)
natural wind pressure and in turn also
increases airflow within a space. This will help in the development cost-
effectiveness.
6.2 Mechanical Systems
A. Hydraulic Elevator
For hospital
elevators, it is imperative
to install ones that offer
smooth rides that have a
minimal exposure to jolts
for patients that are
travelling from one floor
to another on
Figure 122. Hydraulic Elevator Figure 123. Diagram of
Source: Hydraulic Elevator
https://www.archiexpo.com/pr Source: wheelchairs or
od/kleemann/product-56802- https://schmelevator.wordpres
361912.html s.com/541-2/ stretchers so that they
do not have a feeling of uneasiness. A Hydraulic Elevators do not use hoist
systems, it uses a pistons that is powered by a motor that pumps oil in order to
generate movement. Hydraulic Elevators are quicker to install than other types and
offers an option for machine room-less configuration. It also installs an electrical
230
valve to control the release of oil which then ensures a gentle ride. The
development will only be 3-4 stories high so the height limit of hydraulic elevators
will not be a problem.
B. Centralized Air-conditioning System - Air Handling Unit
Figure 124. Diagram of a Centralized Air Handling Unit for a Healthcare

Setting
Source: https://www.coroflot.com/michaelschrader/engineering-componets
Centralized Air-conditioning
systems is a type of structural cooling in
which a central unit processes air before
circulating it in a structure. In the case of
healthcare facilities, where air sanitation
is important to avoid hospital acquired
infections, this is system is beneficial.
Figure 125. Centralized Air-Handling Unit An air handling unit controls pressure
Source:
https://www.weatheriteac.com/product/wispair-
range-air-handling-units and temperature in spaces, for
example, studies conducted have shown that healthcare providers that provide
extensive procedures such as ones done in orthopedic surgery that often take a
long time need colder temperature that other areas because surgeons usually
have layers of scrubs that contribute to the heat that they feel. These centralized
231
units offer better air filtration methods that help a patient heal because cleaner
indoor air improves recovery and helps decrease physiological stress.
6.3 Electrical System
A. TARELCO
Tarlac Electrical Coorperative (TARELCO) will be supplying the power
needed by the development. Some parts of the municipality where the
development will be situated are supplied power by TARELCO by which includes
where the site is located.
Figure 126. Electrical Power Supply System

(Source: https://electrical-engineering-portal.com/electric-power-systems)
B. Generator Set
A generator set is a back-up
power supply that runs on fuel. It is
used when the main power supply
system has failed to provide
electricity. Having a generator set in a

Figure 127. Generator Set
healthcare setting is especially crucial (Source: https://www.cat.com/en_ZA/products/new/power-
systems/electric-power/diesel-generator-
sets/1000001191.html)
because some equipment that help
patients stay alive are electrically-powered such as ventilators, monitoring
equipment, and electronic medicine dispensers. Certain procedures cannot be
232
halted just because there is failure of power supply. A few minutes, even seconds,
can be a decisive moment on a person’s life and death
C. Solar Panels
Solar Panels
harvest energy from
sunlight and
converts it to
electrical power.
Solar energy is a
Figure 128. How Solar Panels Work renewable source that is in no

(Source: https://www.solarreviews.com/blog/solar-power-
comprehensive-guide) way harmful to the
environment and although installation is expensive, they will in the long run start
paying for themselves. The solar panel system that will be installed in the
development will have a relationship with the grid, where the solar energy
harvested will be sold to the grid, when the sun isn’t shining, they can easily buy
power from the power supply but when there are excessive amounts of solar
energy they can sell it to the grids instead.
D. Photovoltaic Glass
Photovoltaic Glass are
almost clear to clear glass
panels that harnesses
energy from the sun to use
as electrical supply. One

Figure 129. Photovoltaic Glass (Source: jewishlifenews.com)
such technology is the
Energy Glass which is a clear window system that produces energy from the sun
through direct sunlight, diffused, ambient light and ground reflectance. It produces
1-2 watts per sq.ft. per hour during the day and if oriented correctly where it is
233
placed in an area that receives the
greatest amount of sunlight, it can go to 3-
4 watts.
Figure 130. Photovoltaic Glass Diagram (Source:

http://www.costofsolar.com/see-thru-solar-transparent-solar-
windows-generate-electricity/)
6.4 Water Supply
A. Balibago Waterworks System Inc.
Figure 131. Typical Water Supply System, Freshwater (Source:

https://www.wsd.gov.hk/en/core-businesses/operation-and-
maintenance-of-waterworks/index.html)
According to Comprehensive Land Use Plan of the municipality of
Zaragoza, the supplying of water will be done by a company named Balibago
Waterworks System Inc. that supplies most of the water among the barangays in
the municipality.
234
B. Stainless Steel Modular Water Tank
A steel modular water tank allows
the storage of water that has the capacity
to comply with any requirements. This type
of water tank is a multi-panel system that
can be assembled to any length and width
that can store any volume that the
development may need. It can store Figure 132. Bestank Steel Modular Water Tank
(Source: https://bestank.com/products/stainless-
steel-water-storage-tank/stainless-steel-
water that ranges from 50,000 liters to 1 modular-tank/)
million litters. As the development incorporates different spaces that will need
extensive supplies of water, it is crucial that there is a water storage system that
can cater to its demands.
C. Pool Ozone Generator
Figure 133. Pool Ozone Generator Figure 134. How a Pool Ozone Generator
(Source:https://www.ozonegeneratorsupplier.co Works
m/sale-3846658-industrial-swimming-pool- (Source: https://www.damagecontrol-
ozone-generator-swimming-pool-ozonator.html) 911.com/ozone-generators-for-pools/)
A pool ozone generator is a device that introduces ozone into a pool in order
to clean and filter it. The use of a pool ozone generator is more beneficial than the
usage of harsh chemicals like chlorine. Multiples studies have shown that a pool
ozone generator effectively cleans a pool by freeing it from molds, mildew,
bacteria, yeast and fungi. In a hospital setting, where the pool will be used by highly
susceptible patients multiple times a day, it is crucial that the pool they will be using
continues to be sterile. In addition to its prior benefits, a pool ozone generator also
235
cuts maintenance costs of pools and since it is not as harsh as other chemicals,
repairs will be minimal.
D. Water Filters
Figure 135. Typical Water Filtration System

(Source:
http://www.authorstream.com/Presentation/
WaterProfessionals-2605901-basics-mulit-
media-filters/
Water filters aid the pool ozone generator
in keeping the water clean from any

Figure 136. Industrial Water Filter
(Source:
https://www.forstafilters.com/industrial- impurities that is not wanted through the use
water-filters/
of physical barriers such as sand.
E. Water Pump
Figure 137. Water Pump Figure 138. Water Pumping System

(Source: (Source:
https://www.ebay.com/c/19014162677#oid13 https://www.poolwarehouse.com/aqua-genie-
2490139731) for-inground-pool-kits/)
The water pump will aid in the circulation of water throughout the pool, along
with a jet pump that usually gives off bubbles in pools that will be used for
hydrotherapy massages.
236
F. Temperature and Pressure Gauges
Temperature gauges regulate the
hotness and coldness of a pool. And
because the development employs services
of aquatic therapy that have varying
temperatures depending on procedures for
Figure 139. Temperature and Pressure rehabilitation, this gauge is important. The
Gauge
(Source: http://media.wattswater.com/F-
Gauges.pdf) pressure gauge on the other hand helps
the technicians know whether or not their sand filters are close to fully
accumulating dirt and debris. This will help ensure that the water that is being
supplied in the pools are as clean as they can be.
D. Gray Water Recycling System
Graywater is defined as
domestic wastewater accounts
for 30-50% of wastewater
discharged into our sewage
systems and instead of letting it
go to waste we can use a
greywater recycling system.
Gray water recycling system is
designed to with a combination
of a range of purifying processes
that will remove all the

Figure 140. Typical Graywater recycling
process contaminants and help make the
(Source: https://aquacell.com.au/commercial-
water-recycling-systems/greywater/)
gray water ready to use once more.
It combines a treatment process that is physical, microbiological and oxidative in
a single package. It can be used in the development for the irrigation system of
plants instead of using newer water supply.
237
H. Rainwater Harvesting System
Rainwater harvesting involves collecting
rainwater through a roof or other forms of
surface that includes permeable paving or
lawns. The rainwater passed through a
filter which then eliminates debris and is
then store in a holding tank for future use.
Since the Philippines experiences
bountiful amounts of rainfall on certain
times of the year, collecting rainwater can

Figure 141. Rainwater Harvesting Diagram
(Source: https://waterscan.com/rainwater- be a cost-effective way of supplying water
harvesting/)
for the development. These collected
water are to be used for non-potable means such as vehicle washing, toilet flushing
and irrigation.
6.5 Fire Fighting System
A. Water Mist Sprinkler System
A water mist sprinkler system
works essentially the same as a
regular water sprinkler system, the
difference is that the water mist
sprinkler system spray smaller
water droplets. Regular fire

Figure 142. Water Mist Sprinkler Nozzle
(Source:
sprinkler systems put out fire by
https://www.integratedfiresystems.com/water-
mist-fire-sprinkler-systems/water-mist/) drenching a space with water to remove
heat and fuel sources while the water mist sprinkler system works more effectively
because it actually lowers a room’s temperature and displaces oxygen through the
238
steam that forms.
Because of the
displaced oxygen, the
fire then suffocates and
dies. Steam also
absorbs more heat per Figure 143. Water Mist Sprinkler System Diagram
(Source: https://www.qrfs.com/blog/175-what-are-water-mist-fire-
sprinkler-systems/)
unit time than larger
water droplets therefore reducing the temperature of the flames faster. Hospital
settings are a great place to install these fire protection system because it has
faster clean-up time and therefore lessens downtime in an otherwise busy
development.
B. Smoke Detectors
Smoke detectors are alarms that sound
in the presence of smoke. These devices are
usually installed in ceilings.
Figure 144. Smoke Detector

(Source:
https://www.healthcarefacilitiestoday.co
m/posts/Regulations-Codes-Standards-
QA-Smoke-detectors--22560)
C. Sound and Light Fire Alarms
Fire alarms save lives, it reduces the
amount of injury and death. Usual fire alarms
emit sound to warn people on the impending
danger, and this is useful for the regular
person, but not so much for hearing impaired
Figure 145. Sound and Light Fire Alarm

individuals. As some patients may have
(Source: https://alarms4life.com/smoke-
alarms-for-deaf/) affected hearing due to injuries sustained, it
is important to consider them as well so the proponent will be using a sound and
fire alarm to alert all possible users.
239
D. Dry Chemical Fire Extinguisher
Fire extinguishers works essentially by
removing one of three things that makes fire
thrive. In the case of dry chemical fire
extinguishers can use another non-oxidizing gas
such as carbon dioxide or nitrogen to replace
oxygen to stop fire from spreading. Dry chemical
fire extinguishers are the most commonly used

Figure 146. Dry Chemical Fire Extinguisher
(Source:
fire extinguishers because it offers a wide https://www.envirosafetyproducts.com/5-lb-
dry-chemical-extinguisher.html /)
range of fire classes it can be used against.
6.6 Security System
A. Closed Circuit Television (CCTV)
This is a common type of surveillance system
that monitors user movement in a development. It
records images and videos for security purposes and
in times where the security of the development is
challenged, revisiting is easily done to prevent further
damages. This monitoring system will be installed in Figure 147. CCTV (Source:
https://www.secureworldme.com/cct
v.html
all parts of the development especially crucial areas
such as storage rooms or warehouses.
B. Electronic Access Systems
This security system includes an identity
management system like an access card provided
only to individuals that are authorized to enter a
certain room. This lessens the cases of theft of

Figure 148. Keycard Access
specialty equipment and supplies such as (Source:
https://www.indiamart.com/proddetai
l/key-card-access-control-
medicine. It also includes a remote access for 14142713497.html)
240
rooms which enables a user to control
facilities from other locations, such as
lockdowns, which is critical in
emergencies.
Figure 149. Remote Access (Source: https://www.nextofwindows.com/3-

free-tools-to-remote-access-your-home-pc-without-changing-firewall-
settings)
C. “Panic Button” Emergency System
Trauma Centers are high stress
healthcare environments where
violence is sadly common and all the
while healthcare professionals
should be able to provide help
despite this difficult environment.

Figure 150. Panic Button (Source:
http://www.meeyicall.com/Hospital-Call- These “panic buttons” are to be
System/Wireless-Nurse-Call-System/Y-SW-G33-
Wireless-Nurse-Call.html#prettyPhoto)
installed in different parts of the
development in regular orders to ensure that care can be provided anywhere,
panic buttons also help healthcare providers that are in need of assistance if a
patients because a danger to both himself and any other person in the room. This
will show other healthcare workers as well as security staff exactly where in the
development their assistance is needed.
6.7 Landscaping System
A. Carabao Grass
This type of grass is the perfect one to consider when landscaping in the
Philippines, it thrives very well in the tropical Philippine climate which ranges from
241
extreme heats to powerful storms. It is also
less slippery than other grass types which
is beneficial to the development because it
will mostly cater to patients that have
restricted physical abilities due to their
circumstances. It is also a cheap option

Figure 151. Carabao Grass (Source:
which crawls by itself. https://pidjanga.blogspot.com/2006/02/milig
oy-carabao-grass.html)
B. Roof Farming
Figure 152. Rooftop Vegetable Garden (Source: Figure 153. Rooftop Farming System
https://christianduvernois.com/portfolio/ascension-school- (Source:
rooftop-garden-new-york-ny/) https://balconygardenweb.com/roof-
garden-construction-step-by-step-details/)
A roof garden, otherwise
known as a green roof can offer
many benefits. In the case of the
development, it will be applying
urban rooftop farming of different

Figure 154. Rooftop Farming Layers (Source:
https://zinco-greenroof.com/systems/urban-rooftop- vegetables that will thrive with the
farming)
aid of the staff as well as patients who are undergoing a vocational skill therapy.
This system offers many environmental benefits because emissions are minimized
and a closer garden will ensure that a number of goods will be delivered in a fresher
state and therefore supplying will be lesser. The plants also filter pollutants
therefore improving climate in towns. These garden systems also delay stormwater
runoff and improve air qualities. It also effective in insulating buildings from both
the heat and the cold.
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C. Vegetable/Flower Garden
Vegetable and Flower
Gardens are beneficial to
interconnect with each other,
while then it was only either a
vegetable or flower garden
separated on different patches,
in modern times it is now Figure 155. Vegetable and Flower Garden (Source:
https://www.daviddomoney.com/what-plants-to-use-in-a-
potager-garden-veg-plot/)
beneficial to plant them with
relations to each other. One, using flowers patches to border vegetable patches is
beneficial because they attract pollinators, and some vegetables need pollinators
in order to grow vegetables. The smell of vegetables and flowers together also
confuses critters therefore reducing the chance of pest infestations on our gardens.
Gardens have been proven to aid a patient’s healing. This transforms a patient’s
view from one of other structures to a view that is life-affirming. This effect on a
patient’s physical, mental and emotional healing is more than enough to affirm that
the provision of a garden within the premises of the development is crucial.
D. Sustainable Draining Systems – Permeable Paving
Conventional means of hard-
surfaced parking have become less
desirable due to their disadvantages
which include their poor surface
water run-off management and the
heat they may contribute to the
development due to larger spans of

Figure 156. Permeable Paving Grids (Source:
http://www.abg-geosynthetics.com/schools-university- paving. Permeable paving allows
hospital-parking
surface water runoff through the fills into the subsoil which is ideal for schools and
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hospitals. An interlocking paving grid that are filled with gravel are used along with
a porous sub-base that is situated above grade.
E. Drip Irrigation System
In a drip irrigation
system, which allows a
slow application of water
consistently over a long
period of time. Through
this there is an even
application of water
Figure 157. Drip Irrigation System (Source:
https://greencamp.com/drip-irrigation/)
throughout all the
plants in the field. Since different plants have different needs of water content and
this system can cater to any of those demands. Since water is applied directly onto
the roots, water is soaked by the plants before any of it turns to vapor or surface
run-off. This system is very cost effective and will be applied in all gardens in the
development.
F. Green Wall Systems
Figure 158. Diagram of a Green Wall System (Source:

https://www.researchgate.net/figure/Vertical-greening-systems_fig1_280232473/download)
According to the Staffordshire University Green Wall Centre, a Green Wall
is defined as vegetation grown on or against a vertical surface. They are also called
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plant walls, living walls or living gardens and whether indoor or outdoors, may it be
free-standing or attached to a wall, there is a suitable green wall for any design
needed. Green wall systems in this development will be used in this development
as part of a landscaping design and boost experience of the users for these have
been proven by numerous studies to have a positive effect on psyche. On a
practical note, these will also be used as part of partitions for spaces that are
transitioning, making it both functional and still aesthetically pleasing instead of the
usual concrete wall of mesh fencing.
6.8 Acoustics
A. Acoustic Ceiling Tiles
Figure 160. Acosutical Ceiling Tile (Source:

https://www.ceilingtiledistributor.com/rockfon-
Figure 159. Acosutical Ceiling Tile parts products-acoustical-ceiling-panels-drop-ceiling-
(Source: http://gebainteriors.com/acoustical- tiles)
ceiling)
Acoustical ceiling tiles lay in a grid like
system of T-bars. Suspended ceiling were originally constructed to hide ductwork,
wiring or plumbing but acoustical ceiling tiles has the purpose of sound absorption.
These tiles are made from various acoustical materials such as fiberglass, foam,
wood, polyester and other substrates. Healthcare settings need to stay in a
recommended noise level so that it does not negatively affect both staff and
patients.
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B. Rubber Flooring
Hospital floorings
need to be characterized
by having a smooth
surface for wheeled
traffic, slip resistant to
avoid accidents, lower
Figure 161. Rubber Flooring (Source: sound transmission for

https://usa.sika.com/en/construction/floor-wall/resource-
center/guides/floor-guides/hospital-finishes.html)
controlled noise levels,
low porosity and seams to avoid accumulation of bacteria that may cause
infections, and must be resistance to chemicals that may be present in hospitals.
Rubber Floorings provide minimum seams that is a resilient smooth surface that is
comfortable, sound damping and is good for wheeled traffic. Although linoleum is
another possible material for flooring, its replacement is more expensive that initial
installation cost. Rubber Floorings offer great acoustical properties.
C. Decorative Acoustic Wall Panels
A hospital setting is full of
bustling people day in and day out.
It is imperative to provide a good
sound reduction system that
ensures a controlled noise levels
for optimal patient healing. With
ceilings and flooring covered, the

Figure 162. Decorative Acoustic Panels (Source:
use of acoustic wall panels is https://kireiusa.com/blog/decorative-acoustic-panels)
imperative. These elements can be installed in places that have a high number of
patient-staff interaction such as nurse stations, admitting and information counters,
and conference rooms. Decorative wall panels get the job done, providing
soundproofing techniques without sacrificing design and aesthetics.
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6.9 Accessibility
B. Side-walks
Sidewalks will be provided for
accessibility of patients in wheelchairs,
it will not be limited to the minimum
requirement of 1.2 meters, but instead
will be using 1.65 meter width for access
of individuals in wheelchairs and

Figure 163. Wheelchair Accessible Sidewalk
crutches. It will also be provided with (Source:
http://www.pedbikesafe.org/PEDSAFE/guide_back
ground.cfm)
ramps for better accessibility.
C. Elevated Walkways
Elevated walkways ensure
that the landscaping below need
not be disturbed, and it also has
benefits for patient healing.
According to phenomenological
studies, wherein through
phenomenology we take answers Figure 164. Elevated walkway with railing (Source:
http://www.chanticleergarden.org/garden_guide.html)
to different experiences rather
than theoretical understandings to formulate structures that are truly evidence-
based on experiential means, patients have a higher degree of accomplishment
and feel good about their process when they have travelled downward on a
pathway. This can be achieved through the provision of elevated walkways instead
grading the soil, and the provision of guardrails and ramps will ensure that patient
safety is still a priority.
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6.10 Way-finding
A. Hedge Design
One of the concepts of optimal
healing environments is the provision
of an external environment that will
beyond superficial benefits. Through
the provision of Hedge Designs, that

Figure 165. Hedge Design (Source: will guide patients to certain areas of
https://cooganslandscape.com/landscaping/5-great-
reasons-to-hire-a-professional-landscape-designer/)
the development, the external
environment will have provided a more extensive use to the users.
B. Landmarks
Landmarks help users navigate from
one area to another. Through this distinct
features, they are able to locate different
departments easily with minimal assistance.

Figure 166. Landmark Sculpture (Source:
http://www.pasadenaviews.com/day-27-huntington-
hospital-sculpture/)
C. Hand Rails
For the benefit of people
that have obtained physical
inabilities due to their
circumstances, a hand rail that will Figure 167. Handrails for PWDs (Source:
https://www.un.org/esa/socdev/enable/designm/AD2-
serve as their guides should be 05.htm)
installed. According to the standards from the United Nations, hand rails should be
installed in a number of places which includes, stairs, ramps, balconies and raised
platforms with more than 0.40 meter above the ground. It should be mounted at
0.85 to 0.95 meters above the finished floor line and for the accessibility of users
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on wheelchairs a second hand rail should be installed at 0.70-0.75 meters. For
short people or children a third handrail will be mounted at 0.60 meters and for
people with canes, another handrail should be installed at 0.10-0.15 meters. It
should also not penetrate abruptly to protect people with difficulty in seeing.
D. Signage
Along with
hedges, signage
can provide
improved
wayfinding for
Figure 168. Signage Height (Source: BP 344, Accessibility Law) users. Signage should be
located at a height where even a person on a wheelchair will be able to see it. And
should be using contrasting colors for higher visibility.
Table 28. Signage Height (Source: BP 344, Accessibility

Law)
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The table above shows
required sizes of signage and
letters with respect to their viewing
distance. With the colors being of
United Nation Blue background

Figure 169. Room Signage Height (Source: BP 344,
and white symbols. For signage on Accessibility Law)
rooms, it should be placed at 1.5 meters from the finish floor line and should have
protruding letters and symbols at 1 mm minimum height.
6.11 Waste Management
A. Materials Recovery Facility
A materials recovery
facility, or an MRF, is an
important component to any
development. This facility
receives combined materials
and is separated through the
Figure 170. Materials Resource Facility (Source: use of equipment or manual labor.
https://rgt020663.blogspot.com/2014/03/ra-9003-
impossible-to-implement.html)
The materials are separated and
some are shipped for recycling. These materials are usually reclaimed and re-
used, usual materials include ferrous metal, aluminum, PET, HDPE, mixed paper,
and other non-biodegradable materials.
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B. Composting
Composting is an easy, cost-effective,
and environmentally beneficial way of
fertilizing plants. All non-hazardous organic
biodegradable wastes are layered in
alternating manners. Layers of compost
includes browns (dead leaves, branches, and
twigs), greens (grass clippings, vegetable and
fruit scraps), and water.

Figure 171. Composting Process (Source:
https://sundevildining.asu.edu/sustainability-
dining/green-thread-pillars/waste-minimize)
C. Waste Segregation
Waste segregation bins should be
distributed all throughout the development
to ensure a space that is continuously
clean.
Figure 172. Waste Segregation Bins (Source:

https://wastewise.be/2015/10/segregation-first-
step-keeping-60-waste-landfill/)
D. Hazardous Waste
Hospital waste management is on the major concerns of authorities.
Although most of wastes from hospitals come from administrative and
housekeeping zones, there are still wastes that come from hazardous wastes.
Hazardous wastes include infectious wastes which come from pathogens like
bacteria, viruses, or fungi. The second category is pathological wastes which
include tissues, organs, fetuses, blood and bodily fluids. The next category are
sharp objects such as needles, scalpel, blades, knives, saws, broken glass and
nails. The fourth category are wastes from pharmaceutical products such as
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expired drugs, vaccines, and discarded gloves, masks, and drugs vials. Another
waste which is particularly hazardous to society are genotoxic wastes such as
vomit, feces, urine from patients being treated with cytostatic drugs for
chemotherapy and other carcinogenic diseases.
Segregation of
hazardous waste
from medical
institutions and
should be done in
techniques such as
proper labeling of
bins for toxic

Figure 173. Segregation of Hazardous Waste (Source:
https://hendrorsudnganjuk.blogspot.com/)
materials to avoid risks for both the
users of the development and the surrounding areas.
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CHAPTER 7
DESIGN FRAMEWORK
7.1 DESIGN PHILOSOPHY
BIOPHILIA HYPOTHESIS
Biophilia Hypothesis is a philosophy that generally states that human beings
are genetically predisposed to be attracted to nature and other forms of life. The
word Biophilia literally translates to Bio- “life” and philia, unlike phobias, is the
“attraction or positive feelings towards something”, it is then “love of life”. Biophilia
was first used by German-born American psychoanalyst Erich Fromm which he
then describes it as “the passionate love of life and of all that is alive”, but biophilia
as we know it today as a genetic response of human beings was popularized by
American biologist Edward O. Wilson in 1984.
In a case study entitled “Biophilia and Architecture” by Dan Kalkman, LEED
GA has stated that the essence of Biophilia is that plants, animals and ecosystems
assume higher priority than our own constructions because of its massive effects
on our lives as a mobile animal species. And in one study presented in the same
research paper has showed that there is greater benefit in one’s physiological and
psychological stress to be exposed to natural settings rather than built structures.
Since its conception,
multiple research have shown that
by simply spending time in nature
for a limited amount of time can
have astronomical benefits to
one’s health. One of which are the
Figure 174. Roger S. Ulrich, Ph.D., EDAC papers published by Roger Ulrich.
(Source: https://naturesacred.org/natural-design-for-
better-health-an-interview-with-dr-roger-ulrich/) Roger S. Ulrich is the most
frequently cited researcher for Evidence-Based Design (EBD) because of his
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successful research such as how views to nature can affect patient healing by
reducing stress and how patients with connections to nature have lower needs for
pain medication. Not only has his papers proven the effects of nature on patients,
it also encompasses its role to the patients’ family members and companions as
well as hospital staff such as nurses that experience a great deal of stress due to
their workloads. Dr. Roger Ulrich is a guest professor of Architecture for the Center
for Healthcare Architecture at Chalmers University of Technology in Gothenburg,
Sweden. He is one of the big names in the industry that has proven some
semblance of proof that Biophilia is more than just a hypothesis, or a theory if you
will, but a need that we have evolved to have.
Dr. Ulrich has once stated that: “Designers and healthcare providers
understand how gardens, views, and daylighting make for more pleasant spaces,
but they may not understand how subtler elements like natural materials, water
features, or refuge conditions can dramatically influence people’s psychological
and physiological responses to spaces.” With this the researcher has come up with
the guiding principle in the case of a healthcare development that:
“In order to ensure that architecture is optimal, we must be able to
manipulate space and nature sustainably with the intention of cultivating a user’s
innate abilities to heal or experience a space through techniques proven by
scientific research.”
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7.2 GENERAL DESIGN CONCEPT
BIOPHILIC DESIGN
Figure 175. The role of Biophilic Design in the concept of EBD (Source: Antolin, 2020)
The interest of design has always been to put the needs of users as our top
priority. Evidence-based Design (EBD) essentially means bridging art or design
with research and has become a resource for architects, designers, and planners
to ensure that their development will provide optimal results for user experience. It
is especially useful in the design of healthcare facilities because these facilities
often provide care, treatment, and medical procedures based from well-researched
empirical data. Through the use of evidence-based design multiple research has
documented that the use of nature has shown its effects on stress reduction, the
improvement of health outcomes, its support on the patient’s pain management
and promote an over-all sense of well-being felt by all its users such as the
patients, their visitors or companions, and the hospital staff.
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Because of the
overwhelming role of nature
and the environment in the use
of evidence-based design, the
researcher has deemed it fit to
employ architectural
Figure 176. Khoo Teck Puat Hospital, Singapore interventions geared towards
(Source: https://www.architecturalrecord.com/articles/13103-
living-future-institute-announces-biophilic-design-award-at- Biophilic design strategies.
greenbuild-2017)
Wherein as stated above, biophilia appeals to human beings’ innate love for
nature, in turn Biophilic design is the applied solutions through architecture that
harnesses this desire through the integration of natural elements into the built
environment. Wherein, as humans we have the a genetic connection to the natural
environment because of generations of living on land filled with greeneries and
because the development is a healthcare setting and healing is a biological
process, the use of nature will prove to be beneficial. Evidentially, Biophilic design
has contributed an 8.5% decrease in recovery time for post-operative procedures
and a 22% reduction rate for the need of pain medication.
A paper entitled “Biophilic Design: The Theory, Science, and Practice of
Bringing Buildings to Life” by Keller et.al shows different elements and attributes
of Biophilic Design which will then be useful in the researcher’s endeavor to ensure
that the design of the environment the users will be exposed to will be designed in
a way that greatly benefits a patient’s healing capabilities, staff members ability to
stay functional and the companions of the victims have better experience and
managed stress levels. The elements and attributes are presented in the table
below:
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Table 29. Elements and Attributes of Biophilic Design
(Source: https://issuu.com/dkalkman/docs/kalkman_biophiliaandarchitecture)
“Active Integration” of the External Environment
Previous research on Evidence-based Design has proven what effects the
external environment have on user experience. In this research, incorporating
design interventions based upon documented research will all be incorporated
such as views to nature and the role of gardens on patient healing and managing
user stress, but it will also be focusing on active integrations on the external
environment beyond what is superficial. Designing spaces that will not only be
psychologically beneficial but also benefit how the space is used such as improved
wayfinding, harnessing daylight as a means of disinfection, ventilation as a means
of better air quality within inpatient wards, de-centralized nurse stations for better
patient care and lower noise levels all of which have empirical data as back-up
which essentially exists outside the sphere of Evidence-based Design but can still
benefit from the data.
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This research paper essentially aims to provide architectural interventions
on the external environment or nature and the built structures beyond what is
superficial and actually physically manipulate this environment to aid its users.
7.3 SUB-CONCEPTS
7.3.1 PLANNING CONCEPT
The planning concepts that will be used in this development would be
functional zoning, user accessibility zoning, wayfinding design, lighting and
ventilation design strategies and natural site design.
A. Functional Zoning
Functional zoning is divided depending on the activities that will be done in
the space such as treatment zone, nature zone, and rehabilitation zone.
Treatment Zone
This space will otherwise be known as the place where trauma patients
receive initial treatment directly after the accident has occurred and where they
stay during they heal until they are deemed fit for discharge or scheduled for
rehabilitation as advised by medical professionals. It is important to have different
zoning for these type of procedures because physical trauma accidents tend to not
be a pretty sight especially to a recovering patient under rehabilitation where hope
for full recovery is supposed to be high and stress is kept at minimum.
Nature Zone
This will be a crucial part of the development as it will not only be providing
spaces for other activities for healing and recreation for the patients but will also
be an integral part for the achievement of a biophilic design strategies. This zone
will be a buffer between patients receiving initial treatment for their injuries and
patients that are already undergoing rehabilitation programs. The mere sight of
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nature has been proven numerous times through different studies to have
significant impact not just on the patients but also throughout the users.
Rehabilitation Zone
This zone is where patients will be receiving rehabilitation for the injuries
and inabilities they have acquired. Although rehabilitation is also a form of
treatment administered to patients, they require a different level of care and
encouragement than patients that is still in the initial stages of healing. Stress have
a great impact on patient healing, the least we want to do is to expose rehabilitation
patients to situations that will remind them of their prior experiences.
B. User-accessibility zoning
In user-accessibility zoning spaces are designed with user’s limitations on
the spaces they can have access to or enter. This will include public zones, semi-
public zones, private zones, and semi-private zones.
Public Zone
This is the space where the general public can enter without limitations,
such as waiting areas for the outpatient departments, outdoor gardens, and certain
offices that offer assistance and information to visitors and companions such as
admitting offices or reception desks.
Semi-public Zone
In this zone, certain outsiders are permitted to access but with limitations.
Such spaces include conference rooms, waiting areas for immediate family
members during medical procedures, waiting areas for administrative and
executive departments, and where deliveries are received.
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Semi-private Zone
These areas only allow certain people to enter, often authorized staff, with
limited numbers and where matters that are not for public knowledge are to be
discussed. Such areas include the offices of executive offices, inpatient wards,
medical records rooms and storage areas.
Private Zone
Private zones cannot be accessed by anyone that has not been authorized
and is usually where medical procedures are done to avoid asepsis, infections,
and contaminations. Such spaces include operating rooms, treatment rooms,
medical social work office, laboratories, and isolation wards.
C. Wayfinding Design
A paper published entitled “What
Constitutes a Main Staircase?” which collates
data from a talk session with experts Martin
Brosamle, Magda Mavridou, and Christoph
Holscher with expertise in Congnitive Science,
Architecture, and Cognitive Psychology
respectively, have presented data coming from
users through interviews what issues poor
wayfinding and navigation presents and where Figure 177. Main Staircase Atrium
(Source:
the problem originates. All data collected have http://sss7.org/Proceedings/10%20Arc
hitectural%20Research%20and%20Ar
chitectural%20Design/011_Broesamle
been analyzed and has shown that users have _Mavridou_Hoelscher.pdf)
difficulty in navigation with the lack of a presence of a distinct main staircase.
Solutions presented include widening of corridors, moving staircases towards
more visible locations, and straightening zigzag turns. All these interventions with
the main goal of making crucial parts of the development visible to key point such
as entrances and foyers, this is just not possible when developments are
260
composed of hallways that turn on linear paths and therefore hide certain spaces.
The main “invasive” solution though that directly addresses the issue of the lack of
a distinct main staircase is the inclusion of an atrium in a foyer, which then makes
this staircase easily the main staircase which then connects the ground floor to the
upper floors.
Better wayfinding techniques
include designing a master plan that
considers future expansions to avoid
growing facilities over time that interrupts
originally clear pathways and confusing
prior circulations. Landscaping that will
guide users to their destinations such as
trees, planting, water features, and outdoor
furnishings that will provide memorable
landmarks. Interior Architecture which Figure 178. Building Blocks for

Successful Wayfinding
includes essential architectural elements (Source:
https://www.healthdesign.org/sites/default/fil
such as entrances, clear pathways, visitor es/WayfindingPositionPaper.pdf)
elevators, and visual cues. Interior design also plays a role such that it employs
variations on color palettes, materials, and lighting that depends on the space.
Signage are also important and should offer different types depending of function,
for example some can be informational (where to find assistance, hours of
operation etc.), directional (for radiology department, turn left), identifying
(indentifies an area), and regulatory (radiation in use). Graphics such as symbols
for “no entry” or “bathroom” should also be disseminated within the development
for the inclusions of users that cannot read such as little children because these
even they can understand these symbols. And finally, ensure that staff and spaces
for inquiries are warm and welcoming so that visitors do not feel uncomfortable
asking questions.
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All interventions provided above will be the main guiding principle for the
design of the development be it interior spaces or exterior to ensure a space that
is optimal for healing for patients and also provide optimal experiences inclusive
of all its other users.
D. Daylight and Ventilation Design for Infection Control
A recent study conducted by Udomiaye Emmanuel, Eze Desy Osondu and
Kalu Cheche Kalu entitled “Architectural design strategies for infection prevention
and control in healthcare facilities: towards curbing the spread of Covid-19” has
Figure 179. Open-ended corridors Figure 180. Courtyard Approach

(Source: (Source:
https://link.springer.com/article/10.1007/s40201- https://link.springer.com/article/10.1007/s40201-
020-00580-y) 020-00580-y)
shown different design interventions towards the goal of reducing infection control
through the use of natural daylight and ventilation as well as evidence that supports
their role in healthcare facilities.
Numerous studies have shown how natural ventilation effectively
decreased the cross-infection risk of air-borne infections all the while having a
higher ventilation rate than mechanical counterparts and is ensuring energy-
efficiency. In a study done by Escombe et.al., where they examined Tuberculosis
transmissions in a pre and post modified naturally ventilated consultation and
waiting rooms and has shown results that transmission has decreased 72% which
then proves what natural ventilation can do. This study will then be using design
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measures such as adequate cross ventilation, corridors with open-end and a upper
ventilation windows or doorstops for dividing walls in hallways, and integrate
courtyard designs for a cohesive ventilation passage. The use of courtyard and
open-ended corridors have proven to increase ventilation rates or the change air
per hour thereby reducing the risk of infection significantly. Although some crucial
spaces still require mechanical means of ventilation, for spaces that can be
avoided, this development would aim to integrate natural ventilation techniques
because some studies have proven that there are a wide variety of micro-
organisms that have been found in vent outlets.
Daylight has been proven
to provide a wide variety of
benefits towards health, visual
comfort, aesthetics, and energy
saving. But beyond these proper
daylighting techniques also has

Figure 181. Treatment Room with Clerestory Windows
(Source: the capability to inhibit the
https://www.healthcaredesignmagazine.com/projects/acute-
care/first-look-caprock-health/#slide-2)
spread of infection within a
hospital. According to the same study by Emmanuel et.al, good fenestrations and
daylight in structures have been proven to lessen the spread of air-borne
pathogens. So much that during older times, daylight was used as a disinfectant
before the time of antibiotics. Numerous studies have shown that sunlight can kill
a wide variety of bacteria which includes anthrax, tuberculosis etc. It is so effective
that according to a study by Strong, direct sunlight from a north facing window is
very effective in killing hemolytic streptococci without the aid of antibiotics.
Although the most effective means of killing infectious bacteria is through
ultraviolet C that earth only receives a small percentage of as it is being absorbed
by the ozone layer sunlight itself that includes solar radiation proves to be an
effective natural virucide. Due to evidences that have shown the effectiveness of
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daylight as a disinfectant this development will be incorporating an adequate
number of openings that will allow daylight into wards, consultation rooms, waiting
areas, treatment rooms, offices, corridors and stairwells.
E. Natural Site Design
Development of the site plan should take into consideration all of the
information collected during the site assessment and data collection process.
When making planning, design, and layout decisions, it is extremely important to
take advantage of the strengths and overcome the limitations of project site
features identified in the assessment process.
Figure 182. Natural Site Design

(Source: https://www.discountpdh.com/natural-site-design-
preservation-protection)
Adapting a plan design to existing site conditions and the natural features
of the landscape can greatly reduce the project’s environmental impacts.
The different guiding principles for the achievement of a natural sitedesign
approach includes:
1. Preservation and Protection
2. Land/Site Utilization
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a. Soil Properties
b. Reduce limits of clearing and grading
c. Fit the design to existing terrain
d. Utilize undisturbed areas and natural buffers
3. Planning Principles
a. Creative development design
b. Roadway Design
c. Building footprints
d. Setbacks and frontages
e. Natural drainage ways vs. Storm sewers
7.3.2 STRUCTURAL CONCEPT
Rectangular Columns
Columns can be classified to their shapes depending on the load that is
needed to be carried as well as the activities that need to be done in the space.
Rectangular columns are the most efficient because they are the easiest to cast
and helps the space be flowier unlike circular columns that are only ideal in spaces
that do have an extensive amount of space and user movement cannot be
hindered.
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Floor-to-Ceiling Windows
As provided with the
extensive amount of evidence
presented above and the
previous chapters of this book,
daylight has massive positive
effects of patient healing and
Figure 183. Ward with Large Windows overall function of a space.

(Source: https://www.scripps.org/news_items/5172-new-
heart-hospital-will-have-plenty-of-patients)
Therefore, some spaces will be
incorporating floor to ceiling windows for maximum views to nature as well as
ensure the entrance of a safe amount of daylight and daylighting techniques to
avoid glare that may result in harm. These floor to ceiling windows are non-load
bearing.
7.3.3 MATERIALS CONCEPT
A. User-Sensitive Inclusive Design
The concept of User-Sensitive Inclusive
Design touches on design techniques geared
towards “inclusivity” rather than the more used
term “universal” design in the context that
according to researchers Newell, Gregor,
Morgan, Pullin, and Macaulay may be more
achievable. Where users with disabilities, such
as the patients that will be using the
development will have to difficulty using and at

Figure 184. Textured Walls
(Source: the same time others without inabilities can use
https://www.arch2o.com/architecture-
design-disabled/) the same space without feeling uncomfortable.
According to the study by Newell et.al, a user is only as abled depending on the
266
environment they are in, for example, an astronaut in a space station is by all
accounts a healthy human being but leave them in an uncharted territory they
experience difficulties. In the context of individuals with disabilities, one example
in the paper has stated that although textured floorings are a great help to visually
impaired individuals, same does not go for individuals who are using a wheelchair.
With the use of User-Sensitive Inclusive Design for the materials in the
development, this research will have a higher chance of designing a space that is
of comfortable use for ordinary (visitors, companions, and staff) and extra-ordinary
(disabled individuals) users. Such materials will include textured walls, non-skid
floorings that will be of benefit to both patients and staff in high traffic areas,
adjustable equipment heights, and multi-tiered guiderails.
7.3.4 ARCHITECTURAL DETAILS
The architectural details presented in this study will include strategies for
better experiences of all the users in the development.
A. Lighting Design
Luminance-based Lighting Design
Luminance is defined as the intensity of
emitted light from a surface per unit area.
The luminance of the surface depends on
the nature of the surface, and the
luminous flux per unit area of a surface. It
Figure 185. Hospital Hallway describes that reflection of light depends

(Source:
https://www.ledinside.com/lighting/2014/8/iran_ on color and the type of surface within a
hospital_brightens_up_with_zumtobel_lights)
space. In Luminance-based Lighting
Design the brightness of a space will depend largely on a color of the surface light
267
reflects on. The colors within the development will likely range from white, off-
white, and other lighter colors because they have higher Light Reflectance Value
(LRV) which shows how light or dark a paint will look. With this method, a space
will look much brighter without the need of putting large amounts of light fixtures
and reduce glares.
Indirect or Integrated Lighting Layout
A strategy proposed by Jennifer
Kenson, the principal of healthcare
interiors in Francis Caufmann in
Philadelphia, is the use of indirect or
integrated lighting to reduce the harsh
effects of direct downlighting especially

Figure 186. Indirect Lighting
(Source:
with patients who have developed a https://www.hubbell.com/litecontrol/en)
sensitivity to glare. For architecturally integrated lighting, lighting fixtures are
usually custom built in cabinetries or trims, and may also include coves, soffits,
and valances. This type of lighting design is unobtrusive and is usually for diffusing
ambient light but for other spaces may be accompanied by proper task lighting.
Hiding lighting in architectural details results in ambient light that accentuates the
design rather competes with it. Indirect lighting refers to incorporating fixtures that
direct light upward and relies on light bouncing on surfaces to light up a room. With
this technique glare is less likely to occur. These lighting techniques will usually be
placed in spaces where there is little task occurring such as waiting areas and
hallways.
Dimmable Lighting
Dimmable Lighting is also proposed by Jennifer Kenson, especially in
places where visitors gather or where noise is usually more frequent because
268
through the dimming of lights in the evening signals that it is time to quiet down
and let the patients have their rest.
B. Main Staircase
Providing the development with a
main staircase and atrium allows for
users to have better luck in
wayfinding. The staircase will be
provided at the areas where initial
conjunctions take place so that
multiple floors of the structure will

Figure 187. Main Staircase
(Source: have a visual connection to the
https://www.pinterest.ph/pin/581316264382072647/ )
user. Also, providing a main
staircase which is otherwise a landmark will make it easier for taking directions
(eg. Third door on the left from the main staircase).
C. Courtyards
Courtyards are a great help for natural
ventilation of a space. And as established
with the role of nature to patient healing and
mental well-being of hospital staff, the
provision of courtyards within the structure

Figure 188. Courtyard
will be beneficial.
(Source: https://inhabitat.com/herzog-de-meuron-
wins-bid-to-design-nature-infused-hospital-in-
denmark/)
D. Ramps
Ramps are a basic provision within a development that promises to be
inclusive and accessible to all kinds of users. The ramp features below are some
of details the proponent will include in the development.
269
Ramp Stairs
A ramp-stair is accessible to both
less abled and abled individuals. It is a
creative way of infusing two structures
into a singular unit instead of separating
a ramp in some remote corner.
Figure 189. Ramp-Stair Combination

(Source: https://blog.miragestudio7.com/ramp-
stairs-for-the-able-and-disable-less-able/3979/)
Floor-to-Floor Ramps
Floor-to-Floor Ramps are
beneficial for users who have difficulty
navigating from one floor to another with
the use of stairs. This can be useful to
patients who are using wheelchair and Figure 190. Spiral Floor-to-Floor Ramp
(Source:
the transfer of patients in wheeled https://www.pinterest.ph/pin/521995413030467
422/)
stretchers without the use of an elevator.
Pool Ramps
With the development
having structures for aquatic
activities, it is important to
incorporate elements that will be
helpful to individuals who have
Figure 191. Pool Ramp

acquired physical inabilities to have
(Source:
https://www.geelongaustralia.com.au/leisurelink/article means of access. One helpful way is
/item/)
the inclusion of pool ramps.
270
7.3.5 TIME CONCEPT
The development will be supporting the Department of Health vision on the
reduction of deaths and morbidity due to violence and injury. This development will
also be upholding the goals of the Philippine Health Facility Development Plan of
2017-2022 which includes the provision of more Trauma Centers that can cater to
these situations in the country. In the long run, the increasing percentage of
mortality and morbidity due to trauma in the previous years will be brought to a
manageable rate.
7.3.6 SUSTAINABILITY CONCEPT
Sustainability in architectural developments are a staple and should always
be considered for every decision. This development is no exception, it will be
incorporating elements for energy conservation and harnessing. With nature
proving to be a large variable for the success of the functions in the development,
the researcher has incorporated systems that will not deter the environment and
otherwise bring it harm. Through the concept of sustainability, the elements and
materials used in the development will not be harsh financially in the long run and
have longer life spans.
7.4 DESIGN CONSIDERATIONS
Accessibility. The development will be used by patients that have acquired
inabilities due to physical trauma accidents, some sensory, others physical, some
may also acquire intellectual inabilities such as speech difficulties and slow
response times. This has been considered by the researcher and has provided
different architectural interventions such as ramps, textured surfaces, guardrails,
technological help monitors, visual and auditory gadgets at their disposal.
User Comfort. All concepts presented in this proposal are geared towards
the comfort of all users. Spaces are to be designed so that their day-to-day
activities are not hindered and are made to help them.
271
Circulation. Healthcare developments experience a great amount of traffic
and is busy no matter what time of day. It is crucial that spaces are designed not
to hinder movement and ensure that users do not clash with one another. An
element as simple as the shape of columns are a solution to circulation. Movement
from one place to another without difficulty in wayfinding also includes staircases,
ramps, and elevators. Spaces are also designed depending on their function so as
to reduce unwanted traffic from users that have no business being in a certain
space.
Functionality. Different activities are to be done in this development and
spaces will be planned in a way that different functions are separated with one
another. Spaces are also designed depending on the activity that will be done.
Security. Hospitals are developments that cater to a wide range of users,
therefore it is important to designate places that different users have authorization
to access. Spaces that have restrictions should only be accessed using keycards.
Crucial materials are stored in medical facilities such as pharmaceuticals and
medical equipment that should be stores in secure areas. Trauma centers also
receive patients that are sometimes involved in crime such as interpersonal
violence or car accidents and they should not be denied care but should be isolated
from other patients and guarded by proper authorities.
Climate Response. Nature plays a large part in the development but we
should acknowledge that nature may not always be on our side. Because of this
the researcher has considered different architectural interventions that will help the
development be more climate responsive to natural calamities such as floods and
heat waves.
272
7.5 ARCHITECTURAL STYLE GUIDE
Tropical Modernism
Figure 192. Tropical Modernism Structure Figure 193. Tropical Modernism Structure
(Source: http://www.designcues.lk/health-care/health- (Source: http://architect.imagebali.com/)
care-hospital-for-sri-lanka-navy/)
Figure 194. Wanica Health Center

(Source: https://seedarchitects.nl/nl/projects/wanica-health-center-suriname/)
Tropical Modernism is a style that infuses modern architectural design
styles and make a structure responsive to climatic and environmental conditions
seen in tropical climates. Like modernism, it focuses in the functionality of a
structure rather than ornamentation. It is a regional approach to modernism,
tropical modernism employs wide overhangs, glazed openings are shaded by
louvers or screens and finishes are often in wooden or stone textures. Symmetry
is not the focus of this architectural style, rather walls, doors, and windows can be
273
purposefully located so that light and natural ventilation can be present around the
development. Architect Joyce Owens presents the five hallmark features that can
be seen in tropical modern architecture which includes the following:
1. Light - Water, exterior courtyards, open floor plans, white surfaces
reflecting the sun and shade are consistent elements of Tropical Modern.
2. Shade - Creating protective shade is paramount. Deep porches, extra-
wide eaves, verandas, covered walks, lanais and canopies are incorporated to
offset the heat. Shelter from the sun also means shelter from summer rains.
3. Ventilation & Views - Encouraging cross-breezes is a critical component
of the design. Strategically located windows and large sliding doors facilitate
ventilation while providing transparency, views and daylight.
4. Seamless Space - Living areas extend outside onto porches, gardens
and breezeways, creating a seamless transition between indoor and outdoor
space.
5. Simple & Natural - Tropical Modern differs from the traditional by
incorporating simple clean lines. And unadorned details are made richer — inside
and out — by combining sensuous local materials with metal, stucco, glass and
dark woods.
Nature is a recurring element in this development and with Tropical
Modernism, this will create a structure that easily integrates itself with the
environment and will create a harmonious relationship with its surroundings.
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CHAPTER 8
MANNER OF FINANCING
8.1 Source of Funding
This development will be funded by the Philippine Government,
specifically the Department of Health. Through the conduction of several interviews
by the researcher, some of which include Dr. Clarito U. Cairo, Jr., the National
Focal Person for the Violence and Injury Prevention Program, and Architect Jean
Paolo Policarpo, an architect with the Department of Health’s Health Facility
Development Bureau, have stated that this type of development is within the vision
of government to reduce mortality and morbidity due to physical trauma and will
therefore receive funding to uphold their mission for the welfare of the people. It is
also worth noting that Trauma Center, according to the Philippine Health Facility
Development Plan of 2017-2022, is included in the list for Specialty Hospitals that
require a 40 billion peso investment. Through the construction of this development
solely for the purpose of serving the Filipino people, immediate critical care will be
sought out by the public as soon as accidents occur and therefore ensure higher
rates of survival and lower rates of morbidity.
8.2 Probable Project Development Cost
8.2.1 Land Acquisition Cost
The land that will be used for the development is a 3.5373 Hectare lot
located in the municipality of Zaragoza, Nueva Ecija and is privately owned by Ima
Corazon B. Vallarta.
As per the Zonal Value of the Sto. Rosario Young of lots along the national
highway, which is the case of the acquired lot, priced at Php 700/ SQ.M the lot Is
then priced at:
Lot Area x Zonal Value/SQ.M = Land Acquisition Cost
275
35,373 SQ.M x Php 700 = Php 24,761,100
8.2.2 Building Cost
The estimated building cost of this development was based on construction
costs per square meter from the Construction Cost Handbook Philippines 2020 by
ARCADIS Philippines Inc. The construction costs include the building cost as well
as the M&E service cost.
Formula:
Estimated Floor Area x Construction Cost = Building Construction Cost
APPROX.
ESTIMATED FLOOR CONSTRUCTION
CONSTRUCTION
SPACE AREA COST
COST
(SQM) (Php)/SQM
(Php)
Executive 4,743,300
48,900
Department 97
Administrative 39,804,600
48,900
Department 814
Emergency Room 615 85,000 52,275,000
Trauma Department 184 85,000 15,640,000
Outpatient 52,785,000
85,000
Department 621
Ancillary Services 859 85,000 73,015,000
Nursing Services 1592 85,000 135,320,000
Service Facilities 681 85,000 57,885,000
Rehabilitation 197,370,000
85,000
Service 2322
Nutrition and 39,525,000
85,000
Dietetics Service 465
Engineering and 43,142,000
74,000
Maintenance 583
Utilities 561 74,000 41,514,000
753018900
Table 30. Building Construction Cost
Note:
Construction costs includes fit-out for nursing rooms and hospital facilities;
services such as oxygen piping, A/C, generator set, ultrapure water system, fire
suppression system and special type plumbing fixtures; fit-out for the doctors’
offices (Executive and Administrative Department) are excluded.
276
8.2.3 Ancillary Facilities Cost
Description Quantity Approx. Cost

Swimming Pool - Half Olympic (16x25m) 6
lanes indoor swimming pool with suspended
structure (enclosing structure not included)
fully tiled and completed with 5m wide deck, 1 18,000,000
including mechanical ventilation and
associated equipment.
Swimming pool - extra for heating
equipment 1 1,500,000
Swimming pool - extra for ozone generator 1 500,000
Helipad 1 19,702,550
Multi-purpose court - outdoor, including
player benches 1 740,000
40,442,550
Table 31. Ancillary Facilities Cost
8.2.3 Medical Equipment Cost
According to an article written by Scott Nolin, a Senior Director of
Project Management for CBRE Healthcare, on March of 2017, there are
different steps to successfully develop a complete and well thought out Total
Project Budget for a healthcare facility. One of his steps include budgeting
for medical equipment, furniture, and technology. The costs below is based
on his budget of 10-15 US dollars per square foot or roughly 4,800-7200
pesos per square meter. The estimate of the cost of the equipment, unlike
building costs, are not driven by area but rather it is driven by the type of
program that will be done in the space.
Formula:
Estimated Floor Area x Approx. Cost = Medical Equipment Cost
Estimated Floor
Space Approx. Cost/Sqm Total
Area
Emergency Room 615 7,200 4,428,000
Trauma Department 184 7,200 1,324,800
Outpatient
621 4,800 2,980,800
Department
Ancillary Services 859 7,200 6,184,800
Service Facilities 681 7,200 4,903,200
Consultation Room 63 4,800 302,400
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Physical Therapy 58 7,200 417,600
Room
Multi-modal therapy 55 4,800 264,000
room
Electrophysiological 32 4,800 153,600
Therapy room
Vocational Therapy 48 7,200 345,600
Room
Vocational 18 4,800 86,400
Counseling Room
Pediatric Physical 55 7,200 396,000
Therapy Room
Speech Therapy 34 4,800 163,200
Room
Balneotherapy
16 7,200 115,200
Room
Paraffin Therapy 17 4,800 81,600
Ultrasound Therapy 19 6,000 114,000
Room
Cryothetherapy
15 7,200 108,000
Room
Kinesiology Room 18 4,800 86,400
Tai Chi Room 63 4,800 302,400
Orthotics and 30 4,800 144,000
Prosthetics
22902000
Table 31. Medical Equipment Cost
8.2.4 Fit-Out Cost
Fit-out cost was based on the Construction Cost Handbook Philippines
2020 by ARCADIS Philippines Inc. Fit outs include furniture, floor, wall, and ceiling
finishes, draper, sanitary fittings and lightings. Since the executive, administrative
department and lobbies are excluded for the fit outs computation on the building
cost for hospitals unlike other spaces, this part will focus on those areas.
Estimated Floor
Approx. Cost/Sqm Total
Space Area
Executive Department
Office of the Medical 43 52,800 2,270,400
Center Chief
Secretary's Area 15 30,400 456,000
Conference Room 28 20,000 560,000
Waiting Area 8 54,000 432,000
Main Lobby 23 62,000 1,426,000
Office of the Chief 24 52,800 1,267,200
278
Information/Reception 21 30,400 638,400
Area
Admitting Office 78 30,400 2,371,200
Billing and Claims 37 30,400 1,124,800
Cashier's Office 24 30,400 729,600
Medical Social Work 44 30,400 1,337,600
Office
Procurement and
Materials 35 30,400 1,064,000
Management Office
Auditing Office 41 30,400 1,246,400
Budget and Finance 29 30,400 881,600
Office
Accounting Office 29 30,400 881,600
Human Resource and 54 30,400 1,641,600
Development Office
Integrated Hospital
Operations and
29 30,400 881,600
Management
Program
Conference Room 42 20,000 840,000
Office of the Chief of 26 52,800 1,372,800
Clinics
Office of the Chief 48 52,800 2,534,400
Nurse
Staff Lounge 19 30,400 577,600
Health Information
Management 184 30,400 5,593,600
Systems Office
26,410,000
Table 31. Fit-out Cost
8.2.5 Land Development Cost
Land Development Cost is estimated to amount 30% of the total building
construction cost. This includes the provision of landscapes such as softscapes
and open spaces.
Building Construction Cost x 30% = Land Development Cost
Php 753,018,900 x 30% = Php 225,905,670
8.2.6 Contingency
Contingency funds are essential for allowances in spaces or other
elements. Allotted budget for the contingency is 10% of the total building
construction cost.
279
Formula:
Building Construction Cost x 10% = Contingency Cost
Php 753,018,900 x 10% = Php 75,301,890
8.2.7 Summary of Probable Project Development Cost
Task Estimated
Construction Cost
Land Acquisition
24,761,100
Cost
Building Cost 753018900
Ancillary Facilities 40,442,550
Cost
Medical Equipment 22902000
Cost
Fit out Cost 26410000
Land Development 225,905,670
Cost
Contingency 75,301,890
1,168,742,110
Table 32. Summary of Probable Project Development Cost
8.2.8 Professional Fees
According to SPP 202, the professional fee of individuals involved in the
project is not included in the probable construction cost, which includes the
architect’s fee. The code of ethics for architects therefore provide us with a
minimum basic fee to help the clients/owners foresee the money they will need to
compensate the professionals that will use their expertise on the said project.
This development belongs to the Group 3 type of structures according to
SPP 202. Group 3 developments are “buildings with exceptional character and
complexity of plan/design” which then states that a project has an estimated
construction cost of Php 500,000,000 – Php 1,000,000,000 the minimum basic fee
is Php 28,500,000 plus a 4% additional of the excess of the Php 500 Million. The
professional fee is therefore,
280
Php 28,500,000 + [(Php 1,168,742,110 – Php 500,000,000)(4%)] = Architect’s
Professional Fee
Php 28,500,000 + (668,742,110)(4%) = Architect’s Professional Fee
Php 28,500,000 + Php 26,749,684.4 = Php 55,249,684.4
According to UAP Doc 203, Civil Works which include preparation of
detailed engineering drawings and specifications, roads, drainage, sewerage,
power and communication amounts to 4% of cost of the development. Therefore,
Estimated Construction Cost x 4% = Civil Works Fee
Php 1,168,742,110 x 4% = Php 46,749,684.4
According to the UAP Doc 204 Construction Services, the construction
management – either team or individual with scope of work which include time and
cost control, coordination and supervision – which are present during the
construction amounts to a fee of 1.5-3% of the construction cost.
Estimated Construction Cost x 1.5% = Construction Management Fee
Php 1,168,742,110 x 1.5% = Php 17,531,131.65
Since the development will rely on the effect of the design of the natural
environment for the experience of its users, this development may employ the
services of Landscape Architect/s. According to the UAP Doc 203 Specialized
Allied Services the fee for a landscape design is 10-15% of the cost of work. In
this case,
Land Development Cost x 10% = Landscape Design Fee
Php 225,905,670 x 10% = Php 22,590,567
TOTAL ESTIMATED PROFESSIONAL FEES =
Architect’s Fee + Civil Works + Construction Management + Landscape Design
281
55,249,684.4 + 46,749,684.4 + 17,531,131.65 + 22,590,567 = 142,121,067.45
8.2.9 Total Project Development Cost
Project Construction Cost + Professional Fees = Total Project Development Cost
Php 1,168,742,110 + Php 142,121,067.45 = Php 1,310,863,177.4
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CHAPTER 9
FINDINGS AND CONCLUSION
This chapter summarizes all findings and conclusions that the researcher
has gathered throughout the course of study. This chapter aims to concisely
present all the data that has been gathered and analyzed.
9.1 Findings and Conclusion
The situation of mortality and morbidity due to trauma not just worldwide but
also on a national level has inspired the researcher to conduct this study. Through
various articles, studies, info graphical data, statistics, etc. as well as the Philippine
government’s on-going pursuit to lowering the country’s growing problem on
mortality and morbidity due to physical trauma as seen through its implementation
of Administrative Order 2014-0020 otherwise known as the Revised National
Policy on Violence Injury and Prevention, has led to the conception of the proposal
of a Trauma Center with the goal of not only treating ailments caused by physical
trauma but seeing the patient’s journey until rehabilitation and re-assimilation to
society.
Through the studying of the context of physical trauma, the researcher was
able to conceptualize a project that includes programs and treatments for different
types of accidents such as those that have experienced road-traffic accidents,
burns, gunshot and knife wounds, violence, and drowning. Different rehabilitation
therapies geared towards the betterment of inabilities physically, motor, and
acquired traumatic brain injuries as well as consultations for prosthetics and
orthotics that some patients may be in need of. And that trauma center should be
able provide 24-hr availability for general surgeons and immediate availability for
specialties such as orthopedic surgery, neurosurgery, anesthesiology, emergency
medicine, radiology, internal medicine, plastic surgery, oral and maxillofacial,
pediatric and critical care. It must be able to provide services not just on within its
283
vicinity but also receive patients referred by hospital that are trauma-receiving but
not trauma-capable.
It is important to note that hospitals which are trauma centers should be
able to provide treatment within the span known as the “golden hour” or the 60
minute span from when the accident has taken place and because the because
our country’s healthcare system has been dubbed as fragmented some individuals
do not receive that treatment in time and therefore their bodies have already
acquired lifetime consequences. The Philippine health system is problematic in the
sense that we do not have sufficient bed-to-patient ratio that leads to subpar care
to users when hospitals become overwhelmed and only a few institutions can
provide complex trauma and major emergency situations.
This development is situated in the region of Central Luzon because of their
statistics on mortality, it is the region with higher deaths not attended by medical
professionals compared to deaths attended, it is third on the list of mortality rates
right behind NCR and CALABARZON but these two regions have higher deaths
attended to than not. It also ranks high in deaths caused by physical trauma such
as interpersonal violence, drowning, road traffic accidents, and falls. It is also the
location of major expressways included in the Luzon Spine Expressway Network
which are prone to a large number of road traffic accidents which are the major
contributors for physical trauma injuries which range from penetrating traumas to
blunt-force traumas.
This proposal has used the sequential transformative type of mixed
methods research which use both qualitative and quantitative data and use them
into an interpretation phase. Through this research method, the researcher has
used different maps from the municipality of Zaragoza for the micro and macro
analysis of the site as well as different laws and ordinances that will be of use to
the development. Different articles, journals, and studies are presented in the
related literature part of this proposal that is used as basis for the design approach
284
and user data for the development. It also presents different case studies that are
of same context to the development to ensure better understanding of the
proposed development.
285
CHAPTER 10
RECOMMENDATIONS
This part of the study offers recommendations that can help improve and
advance this proposal. Through this part, future researchers can foresee possible
issues and have strategies that can address them.
10.1 Recommendations
After all data gathering through the use of literature reviews, interviews,
statistical data, and surveys the researcher was able to provide a more in-depth
knowledge on what makes a trauma center an optimal space for healing. It is
recommended that in order to achieve this goal, researchers should conduct more
thorough investigations on user need specially ones that have been critically
injured and due to attend some sort of rehabilitation program when the situation
permits and a pandemic is not in the way. It is important that designers understand
their users, and in the case of a healthcare facility not just patients and the
healthcare providers but also the companions of individuals that have been injured
either fatal or minor and how we as architects can make their experiences better,
functional, and comfortable.
The researcher recommends the use of Evidence-based Design strategies
for it has the ability to provide arguments that are not just functional in theory but
also empirically. Evidence-based Design solutions gear towards the use of nature
and its effects on patient healing, staff functionality, and visitor experience but as
mentioned prior it has the tendency to use nature through superficial means. With
this, the researcher recommends that future researchers find design strategies that
go beyond the active integration of nature as presented in this study while ensuring
it to have basis.
286
It is recommended that like some of the spaces in this study, there should
be spaces to educate the public and the professional themselves not just on
trauma care but also for trauma prevention because like many other things
regarding health, prevention is better than cure. Through the integration of such
spaces, the proposed developments will not only be a space optimal for healing
but can also actively have a hand in the reduction of trauma cases itself because
of a society that is better-versed on the dangers of situations that are otherwise
highly preventable.
Through the research of this proposal, other places that are in dire need of
a facility that is not only trauma-receiving but trauma-capable can use it as basis
for the structures needed for their situations. This study has shed the light on the
importance of treatment and rehabilitation for patients of physical trauma.
As time passes by, and trauma care has hopefully improved, multiple programs on
physical trauma treatment can be employed and these innovative strategies can
be incorporated for future trauma centers. The use of biophilic design as a means
of ensuring a space that actively uses nature in a sustainable way is only one of
many and the researcher recommends that future endeavors can give way to
architectural strategies that have the goal of creating an optimal space for healing
for its patients, because after the unfavorable events that they have experienced
they deserve care that is the best there is.
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ANNEX
FIGURES
Figure 1. Trauma Statistics

Image Source: https://www.nattrauma.org
Figure 3. Patient Flow of the Emergency Department at Cheyenne Regional

Medical Center
Image Source: Center for Health Design
288
Figure 4. Framework on Creating Optimal Healing Environments
Image Source: Sakallaris, Bonnie et.al.
Figure 5. Mortality rates per region

Image Source: 2016 Philippine Health Statistics, Department of Health
Figure 6. Top 10 Leading Causes of Death, Philippines

289
Figure 7. Top 10 Leading Causes by Attendance, Philippines
Figure 8. Trimodal Pattern of Death in Injury

Image Source: Committee in Trauma, Philippine College of Surgeons
Figure 43. Map of Nueva Ecija showing the location of Zaragoza
290
Figure 44. Image showing the CLLEx Phase 1
Image Source: https://www.pressreader.com/philippines/business-
291
Figure 45. Infographics on Trauma Profile in the Philippines
292
Source: Made by the Researcher
TABLES
293
Table 4. Spaces with Area requirements per user
Source: Department of Health (2004)
Table 5. Selected Causes of Death per Region, Central Luzon

Source: 2016 Philippine Health Statistics, Department of Health
294
Table 6. Selected Causes of Death per Region, NCR, Central Luzon,
CALABARZON
Source: 2016 Philippine Health Statistics, Department of Health
Table 7. 20 Injury deaths rise in rank

Source: Global Health Estimates 2016, WHO
295
Table 8. 20 Injury deaths rise in rank
Source: Injury and Violence: The Facts, WHO
296
SURVEY RESULTS
Q2. Age. Edad.
Highest number of respondents are ranged from the ages of 21-24 years
old.
Q3. Gender. Kasarian.
Females are
of higher
percentage at
60.9% with males
at 39.1%
Q6. Please choose the type of accident. 𝘈𝘯𝘰𝘯𝘨 𝘬𝘭𝘢𝘴𝘦𝘯𝘨 𝘢𝘬𝘴𝘪𝘥𝘦𝘯𝘵𝘦 𝘢𝘯𝘥 𝘪𝘺𝘰𝘯𝘨
𝘯𝘢𝘳𝘢𝘯𝘢𝘴𝘢𝘯? 𝘱𝘶𝘮𝘪𝘭𝘪 𝘯𝘨 𝘴𝘢𝘨𝘰𝘵.
297
Most of accident that has occurred are Road Traffic Accidents at 47.8%
followed by Falls at 23.9%.
Q7. Please state the injury sustained from the accident (eg. knife wound,
broken bones, bullet wounds, sprain etc.) 𝘐𝘩𝘢𝘺𝘢𝘨 𝘢𝘯𝘨 𝘮𝘨𝘢 𝘱𝘪𝘯𝘢𝘴𝘢𝘭𝘢𝘯𝘨
𝘯𝘢𝘵𝘢𝘮𝘰 𝘮𝘶𝘭𝘢 𝘴𝘢 𝘢𝘬𝘴𝘪𝘥𝘦𝘯𝘵𝘦 (𝘦𝘨. 𝘴𝘢𝘬𝘴𝘢𝘬, 𝘣𝘢𝘭𝘪𝘯𝘨 𝘣𝘶𝘵𝘰, 𝘯𝘢𝘣𝘢𝘳𝘪𝘭, 𝘱𝘪𝘭𝘢𝘺 𝘦𝘵𝘤.)
For this question respondents had the freedom of stating what injuries
they have acquired and therefore have varying answers.
But the survey showed that most of the injuries are broken bones with
bruising or pierced skin. Other injuries that they have acquired are a blow to
their organs such as heart and lungs.
Q8. Did you receive rehabilitation for the injury? 𝘐𝘬𝘢𝘸 𝘣𝘢 𝘢𝘺 𝘯𝘢𝘬𝘢𝘵𝘢𝘯𝘨𝘨𝘢𝘱
𝘯𝘨 𝘳𝘦𝘩𝘢𝘣𝘪𝘭𝘪𝘵𝘢𝘴𝘺𝘰𝘯 𝘱𝘢𝘳𝘢 𝘴𝘢 𝘱𝘪𝘯𝘴𝘢𝘭𝘢𝘯𝘨 𝘯𝘢𝘵𝘢𝘮𝘰?
27 people have
stated they did
not receive any
rehabilitation for
their injuries
which is at 63%
298
while 17 people said they did which counts for 37% of the sample size. This will
become relevant for the following questions.
Q9. Please state the rehabilitation/therapy you have received. 𝘐𝘩𝘢𝘺𝘢𝘨 𝘢𝘯𝘨
𝘳𝘦𝘩𝘢𝘣𝘪𝘭𝘪𝘵𝘢𝘴𝘺𝘰𝘯/𝘵𝘩𝘦𝘳𝘢𝘱𝘺 𝘯𝘢 𝘯𝘢𝘳𝘢𝘯𝘢𝘴𝘢𝘯
The respondents who received rehabilitation mostly has physical therapy
to return the motor skills that they have lost. Other therapies include speech
therapy and operational therapy.
Q10. If 𝗬𝗲𝘀 is answered in no.𝟴, Do you think the rehabilitation has helped
your injury fully heal and therefore help you experience no difficulties?
𝘒𝘶𝘯𝘨 𝘰𝘰 𝘢𝘯𝘨 𝘴𝘪𝘯𝘢𝘨𝘰𝘵 𝘴𝘢 𝘣𝘭𝘨. 𝟴, 𝘚𝘢 𝘵𝘪𝘯𝘨𝘪𝘯 𝘮𝘰 𝘣𝘢 𝘢𝘺 𝘯𝘢𝘬𝘢𝘵𝘶𝘭𝘰𝘯𝘨 𝘢𝘯𝘨 𝘳𝘦𝘩𝘢𝘣𝘪𝘭𝘪𝘵𝘢𝘴𝘺𝘰𝘯
𝘶𝘱𝘢𝘯𝘨 𝘵𝘶𝘭𝘶𝘺𝘢𝘯 𝘬𝘢𝘯𝘨 𝘨𝘶𝘮𝘢𝘭𝘪𝘯𝘨 𝘢𝘵 𝘯𝘢𝘨𝘪𝘯𝘨 𝘥𝘢𝘢𝘯 𝘶𝘱𝘢𝘯𝘨 𝘸𝘢𝘭𝘢 𝘯𝘨 𝘩𝘪𝘳𝘢𝘱 𝘯𝘢
𝘮𝘢𝘳𝘢𝘯𝘢𝘴𝘢𝘯 𝘮𝘶𝘭𝘪?
299
Question 10 is only required to be answered by the 17 individuals that
received therapy.
It was answered by 20
therefore the 17 individuals
that have received
rehabilitation definitely
helped restore most if not
all their motor skills.
Q11. If 𝐍𝐨 is answered in no. 𝟴, Is the injured part of your body still
functioning as it was with no pain or hardship before you experienced
an accident? 𝘒𝘶𝘯𝘨 𝘩𝘪𝘯𝘥𝘪 𝘢𝘯𝘥 𝘪𝘴𝘪𝘯𝘢𝘨𝘰𝘵 𝘴𝘢 𝘣𝘭𝘨. 𝟴, 𝘈𝘯𝘨 𝘯𝘢𝘱𝘪𝘯𝘴𝘢𝘭𝘢𝘯𝘨 𝘱𝘢𝘳𝘵𝘦 𝘣𝘢 𝘯𝘨
𝘪𝘺𝘰𝘯𝘨 𝘬𝘢𝘵𝘢𝘸𝘢𝘯 𝘢𝘺 𝘯𝘢𝘨𝘢𝘨𝘢𝘮𝘪𝘵 𝘮𝘰 𝘱𝘢 𝘥𝘪𝘯 𝘯𝘢𝘯𝘨 𝘸𝘢𝘭𝘢𝘯𝘨 𝘩𝘪𝘳𝘢𝘱 𝘢𝘵 𝘴𝘢𝘬𝘪𝘵 𝘯𝘢
𝘯𝘢𝘳𝘢𝘳𝘢𝘯𝘢𝘴𝘢𝘯?
Individuals who
have not received
therapy, the
majority stated that
the injured part of
their body did not
feel any different when fully-healed, upon further scrutiny these respondents
are mostly the ones who experienced superficial wounds on the skin.
Q12. How long did it take before your injury healed? 𝘎𝘢𝘢𝘯𝘰 𝘬𝘢𝘵𝘢𝘨𝘢𝘭 𝘣𝘢𝘨𝘰
𝘵𝘶𝘭𝘶𝘺𝘢𝘯𝘨 𝘨𝘶𝘮𝘢𝘭𝘪𝘯𝘨 𝘢𝘯𝘨 𝘪𝘺𝘰𝘯𝘨 𝘯𝘢𝘵𝘢𝘮𝘰𝘯𝘨 𝘱𝘪𝘯𝘴𝘢𝘭𝘢?
300
The time it took for their injuries to heal ranges from days to months to years.
Longest time is 3 years followed by a year while the highest number of time
duration is one month. This shows that healing from a traumatic injury takes a
significant amount of time and the medical facilities that will attend to them
should be equipped to house these users for however long it takes for them to
heal.
Q13. From a scale of 1-5, Rate your experience from the time of your
accident to your admittance to the hospital and your discharge. 𝘗𝘪𝘭𝘪𝘪𝘯 𝘢𝘯𝘨
𝘯𝘢𝘢𝘺𝘰𝘯 𝘯𝘢 𝘳𝘢𝘵𝘪𝘯𝘨 𝘬𝘶𝘯𝘨 𝘨𝘢𝘢𝘯𝘰 𝘬𝘢𝘺𝘰 𝘬𝘢-𝘬𝘶𝘯𝘵𝘦𝘯𝘵𝘰 𝘣𝘢𝘴𝘦 𝘴𝘢 𝘪𝘺𝘰𝘯𝘨 𝘬𝘢𝘳𝘢𝘯𝘢𝘴𝘢𝘯 𝘮𝘶𝘭𝘢
𝘴𝘢 𝘱𝘢𝘯𝘨𝘺𝘢𝘺𝘢𝘳𝘪 𝘯𝘨 𝘢𝘬𝘴𝘪𝘥𝘦𝘯𝘵𝘦 𝘩𝘢𝘯𝘨𝘨𝘢𝘯𝘨 𝘴𝘢 𝘪𝘺𝘰𝘯𝘨 𝘱𝘢𝘨𝘭𝘢𝘣𝘢𝘴 𝘴𝘢 𝘰𝘴𝘱𝘪𝘵𝘢𝘭.
This portion shows the experience these users have before, during, and
after hospitalization. With the scale:
5 – Outstanding
4 – Satisfactory
3 – Fair
2 – Poor
1 – Very Poor
𝗮. Time it took before someone responded to your accident. 𝘖𝘳𝘢𝘴 𝘯𝘢
𝘭𝘶𝘮𝘪𝘱𝘢𝘴 𝘣𝘢𝘨𝘰 𝘯𝘢𝘵𝘶𝘨𝘶𝘯𝘢𝘯 𝘢𝘯𝘨 𝘢𝘬𝘴𝘪𝘥𝘦𝘯𝘵𝘦𝘯𝘨 𝘯𝘢𝘵𝘢𝘮𝘰.
301
The graph above shows that most of the respondents feel that it took a fair
amount of time before someone came to their aid during their accident.
𝗯. Time it took before you received medical attention the moment you
stepped foot in the hospital. 𝘓𝘶𝘮𝘪𝘱𝘢𝘴 𝘯𝘢 𝘰𝘳𝘢𝘴 𝘣𝘢𝘨𝘰 𝘮𝘢𝘺 𝘵𝘶𝘮𝘶𝘨𝘰𝘯 𝘯𝘢
𝘥𝘰𝘬𝘵𝘰𝘳/𝘯𝘢𝘳𝘴 𝘴𝘢𝘺𝘰 𝘶𝘱𝘢𝘯𝘨 𝘨𝘢𝘮𝘶𝘵𝘪𝘯 𝘢𝘯𝘨 𝘱𝘪𝘯𝘴𝘢𝘭𝘢𝘯𝘨 𝘯𝘢𝘵𝘢𝘮𝘰.
The graph above states that most respondents feel that they have been
immediately taken care of in a hospital some. Although some have felt, a total
number of 10 respondents, feel that that the service was poor.
𝗰. The facilities and services of the hospital you were taken to. 𝘔𝘨𝘢
𝘱𝘢𝘴𝘪𝘭𝘪𝘥𝘢𝘥 𝘢𝘵 𝘴𝘦𝘳𝘣𝘪𝘴𝘺𝘰 𝘯𝘨 𝘩𝘰𝘴𝘱𝘪𝘵𝘢𝘭 𝘯𝘢 𝘱𝘪𝘯𝘢𝘨𝘥𝘢𝘭𝘩𝘢𝘯 𝘴𝘢𝘺𝘰.
302
The facilities of the establishment they were taken to mostly range from
having fair to satisfactory services.
How many hospitals / medical facilities were taken to? 𝘐𝘭𝘢𝘯𝘨 𝘰𝘴𝘱𝘪𝘵𝘢𝘭
𝘢𝘯𝘨 𝘱𝘪𝘯𝘢𝘨𝘥𝘢𝘭𝘩𝘢𝘯 𝘴𝘢𝘺𝘰 𝘣𝘢𝘨𝘰 𝘬𝘢 𝘯𝘢𝘨𝘢𝘮𝘰𝘵?
Most of the respondents only had to be taken to one hospital to receive
treatment, followed by 11 respondents that had to be taken to another after
their initial hospital with one going as far as 6 hospitals just to receive proper
treatment.
𝗲. Your overall experience inside a medical facility during the treatment
of your injury. 𝘈𝘯𝘨 𝘪𝘺𝘰𝘯𝘨 𝘱𝘢𝘯𝘨𝘬𝘢𝘣𝘶𝘰𝘢𝘯𝘨 𝘬𝘢𝘳𝘢𝘯𝘢𝘴𝘢𝘯 𝘴𝘢 𝘪𝘴𝘢𝘯𝘨 𝘰𝘴𝘱𝘪𝘵𝘢𝘭 𝘴𝘢 𝘣𝘶𝘰𝘯𝘨
𝘪𝘵𝘪𝘯𝘢𝘨𝘢𝘭 𝘯𝘨 𝘱𝘢𝘨𝘨𝘢𝘨𝘢𝘮𝘰𝘵 𝘴𝘢𝘺𝘰𝘯𝘨 𝘯𝘢𝘵𝘢𝘮𝘰𝘯𝘨 𝘱𝘪𝘯𝘴𝘢𝘭𝘢
303
Respondents mostly had a fair to satisfactory experience in a medical
institution.
INTERVIEW QUESTIONS
Dr. Claro Cairo – Former National Focal Person of the Violence and Injury
Prevention Program, Department of Health
Questions:
1. Is the development in line with the Department of Health’s goals to reduce
mortality and morbidity?
2. Plans for trauma care in the Philippines.
3. Importance of rehabilitation after a major physical trauma accident.
4. Funding for government hospitals.
5. Advice to the researcher on possible inclusions to the development to
ensure all goals are met.
Office of Congresswoman Estrellita Suansing – Proponent of the HB 1960
Central Luzon Trauma Center
Question:
1. Current status of the bill.
Ar. Dan Lichauco – Architect specializing in the field of Healthcare
Architecture
Questions:
1. What are the key principles in designing a medical facility?
2. Advice on designing an emergency care facility.
3. Thoughts on designing an advanced hospital in a third class municipality.
304
Ar. Jean Paolo Policarpo – Architect II, DOH – Health Facility Development
Bureau
Questions:
1. Thoughts on the proposed development.
2. Funding for the development.
3. How to design trauma hospitals?
4. Advices to the researcher to ensure a successful medical institution.
305
306
307
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Republic of the Philippines

POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

CENTRAL LUZON TRAUMA CENTER:

CREATING AN OPTIMAL HEALING ENVIRONMENT FOR A PHYSICAL

TRAUMA TREATMENT AND REHABILITATION CENTER THROUGH

ANTOLIN, KIM LEANNA C.

AR. MELBA A. PAUAL

Background of the Study………………………………………………………….1

Statement of the Problem…………………………………………………………3

Significance of the Study………………………………………………………….4

Goals and Objectives………………………………………………………………5

Scope and Delimitation…………………………………………………………….6

Justification of the Study……………………………………………………………8

Tools/Materials used in Research………………………………………………..24

Chapter 3 – Review of Related Literature……...……………………………..25

Optimal Healing Environment………………………………………………..…...35

1. East Avenue Medical Center……………………………….....58

2. Las Pinas General Hospital and Satellite Trauma Center....63

3. Landstuhl Regional Medical Center……………………….....69

4. Bristol Southmead Hospital…………………………………...71

5. Queen Elizabeth National Spinal Injuries Unit……………...74

Chapter 4 – Presentation and Analysis of Data……...………………………..25

Site Selection Criteria…………………………………85

Macro Site Analysis………………………………………………………………….95

Land Use and Zoning………………..………………..96

Soil Geology and Topography……………………...102

Risk and Hazard………………………………………108

Education and Literacy……………………………….113

Micro Site Analysis………………………………………………………………….119

Topography and Elevation……………………………120

Surface Water Run-Off………………………………..123

Sun and Wind Path……………………………………123

Sound and Vistas………………………………………126

Chapter 5 – Architectural Programming……...………………………………..154

Administrative Department – HIMS………………….177

Emergency Service Facilities…………………………177

Outpatient Service Facilities………………………….181

Ancillary Service Facilities……………………………183

Nursing Service Facilities…………………………….186

Nutrition and Dietetics Service………………………..195

Engineering and Maintenance Service Facilities……197

Support Service Facilities……………………………...199

Total Floor Area…………………………………………202

Graphical Spatial Translations………………………………………………………204

Chapter 6 – Environmental Systems………….………………………………..226

Waffle Mat Foundation…………………………………226

Building Vibration Insulation…………………………...228

Double-stud Wall System………………………………229

Air handling Unit………………………………………...231

Balibago Waterworks System Inc…………………....234

Stainless Steel Modular Water Tank…………………235

Pool Ozone Generator…………………………………235

Temperature and Pressure Gauges………………….237

Gray Water Recycling System…………………………237

Rainwater Harvesting System…………………………238

Water Mist Sprinkler System…………………………..238

Sound and Light Fire Alarms…………………………..239

Dry Chemical Fire Extinguisher………………………..240