LIBRARY STUDY

                                                                                                 

HOSPITAL DESIGN

SUBMITTED TO- SUBMITTED BY-

Ar. JASBINDER KAUR RIYA CHATURVEDI (17050)
Ar. SONIA MITTAL SAKSHI RAWAT (17053)
Ar. GURNAZPREET SANJAY (17055)
Ar. RUPINDER KAUR SUBAHSREE DUTTA (17064)
 •The word “hospital “derived from the Latin word hospitalis which in turn derived from french word “hospes” that means “
a host or a guest”
•A hospital is a health care or institution providing treatment to patients with specialized staff and equipment.
•Hospital is an integral part of a social and medical organization ,the functions of which is to provide for the population
complete health care both curative and preventive , and whose outpatients services reach out to the family and its home
environment . The hospital is also a centre for the training of health worker and for bio social researches.
HOSPITAL

Short term
Length of FUNCTIONS OF THE
stay HOSPITAL
•Patient care
Long term
•Diagnosis and treatment of
HOSPITAL disease
•Out patient services
General
Clinical basis •Medical education and training
specialty •Medical and nursing research
Specialty Prevention of disease and
promotion of health

ORIENTATION
• Treatment and Operating rooms are preferred in north-west to north-east direction.
• Some departments in hospital requires placement in north direction so that patients are not subjected to direct
sunlight.
• Nursing stations/wards or Patients ward are preeffered in south or south east as:-
• Pleasant morning sun
• Minimal heat build up
• Little requirement for sun shading
• Mild in evenings
PLANNING
FORM OF BUILDING
• Spine form with branching sections
• Radial arrangement i.e circulation will be radially outward from the center of the core.
• Form should go with the proper connectivity of the units.
EFFECTIVE ARRANGEMENTS
•TOP FLOOR- AC plant room, nursing school.
• 2nd / 3rd FLOOR- Wards can be provided
• 1st FLOOR- Central sterilization unit, surgical area, intensive care, maternity,, children’s
hospital
•GROUND FLOOR-Entrance, radiology, medical services, ambulance, entrance for bed ridden,
emergency ward, information center, administration, cafeteria
• BASEMENT-Stores, physiotherapy, kitchen, heating and ventilation plant room, radio therapy,
laundry
•SUB-BASEMENT- Underground garage, electricity supply

PLANNING
 The different areas of a hospital shall be grouped
Admin
according to zones as follows:
− OUTER ZONE – areas that are immediately accessible to the
public: emergency service, outpatient service, and administrative
service. They shall be located near the entrance of the hospital.
Inpatient − SECOND ZONE – areas that receive workload from the outer
Diagnostic &
  Outpatient zone: laboratory, pharmacy, and radiology. They shall be located
treatment
near the outer zone.
    − INNER ZONE – areas that provide nursing care and management
  of patients: nursing service. They shall be located in private areas
  but accessible to guests.
  − DEEP ZONE – areas that require asepsis to perform the
 Service Research &
prescribed services: surgical service, maternity and intensive care.
Teaching
They shall be segregated from the public areas but accessible to the
outer, second and inner zones.
 
− SERVICE ZONE – areas that provide support to hospital
  activities: dietary service, housekeeping service, maintenance and
motor pool service, and mortuary. They shall be located in areas
away from normal traffic.
Protective zone (A)

 
Disposal or dirty
  ZONES Clean zone (B)
zone (D)
 
Aseptic or
sterile zone (C)

ZONING OF HOSPITAL
Department of Physical Medicine Service Facilities Obstetrical Department

Department of pathology

Surgical Suite Unit

Nursing Unit

INTER-RELATIONSHIP
 Diagnostic facilities

Out patients and healthcare patients

Department of diagnostic and X-ray

Patients & Ambulance Service Staff ,patient ,

Out patients & help visitors
Staff

 Administration Department Out Patient Department

Emergency Department

 
Staff ,Patients , Visitors Out patients
INTER-RELATIONSHIP
 
 
 
 CORRIDORS

Must be designed for the max. Expected circulation

flow.
• Access corridors must be atleast 1.50 m wide.
• Corridors for access by patients and equipment
shall have a min. Width of 2.25 m.
• Suspended ceiling in corridors may be installed
upto 2.40 m.
• Windows for lighting and ventilation should not
be more than 25 m apart.
• Effective width of the corridors must not be
constricted by projections, columns or other
building elements.
• Smoke doors must be installed in ward corridors
in accordance with local regulations

DOORS
Doors must be designed keeping the hygiene
requirements in mind.
• Surface coating must withstand the long term action
of cleaning agents and disinfectants.
• Designed to prevent the transmission of sound, odours
and draughts.
• All doors provided in hospital must be swing doors
for easy access.
• The clear height of doors depends on their type and
function-
(1) normal doors: 2.10- 2.20 m
(2) vehicle entrances, oversized doors: 2.50 m
(3) transport entrances: 2.70 - 2.80 m
(4) min. Height on approach roads: 3.50 m

INTERNAL CIRCULATION
STAIRS
Must be designed in such a way that if necessary
they can accommodate all of the vertical circulation
• Should consist four flights and three landings
between finished floor levels.
• Finishing material should not be slippery
• Handrails must be provided on both sides at a
height of 1000 mm.
• The minimum headroom in a passage under the
landing of a staircase andunder the staircaseshall be
2.2 m LIFTS
• Winding staircase should be avoided for main • Transports people, medicines, laundry, meals, hospital
access. beds/stretchers, etc.
• Doors must not constrict the useful width of the • At least two lifts for transporting beds/stretchers must be provided.
landings and, in accordance with hospital • One multipurpose lift should be provided per 100 beds, with a
regulations, doors to the staircases must open in the minimum of two for smaller hospitals.
direction of escape. • A min. Of two smaller lifts for portable equipment staff and visitors
• Effective width: 1.5-2.5 m • Clear dimensions of lift car: 0.90 x 1.20 m
.Riser: 170 mm • Clear dimensions of shaft-1.25 x 150 m
Tread: 280 mm. • Internal surfaces must be smooth washable and easy to disinfect,
• Riser/tread ratio of 150:300 is preferable. the floor must be non-slip.
• Lift shafts must be fire resistant
RAMPS
• A ramp when provided shall not have a slope greater than 1:12.
• Larger slope shall be provided for special uses but in no case
greater than: 8.·
• Minimum clear width shall be 36" (3 feet), in the basement
using car parking shall be 6.0 mt.
• Handrails shall be provided on both sides of the ramp.
• Ramps shall have level landings at bottom and top of each ramp
and each ramp run.
• If ramps change direction at landings, the minimum landingsize
shall be 60 inches by 60 inches .
• A ramp shall have a nonslip surface.
INTERNAL CIRCULATION
                  1. THINGS TO BE CONSIDERED WHILE DESIGNING HOSPITAL
• Location- should be convenient in relation to the people it serves.
• Circulation- Entrance and circulation within the building must consider wheelchair users, parents with small
children and people with disabilities, etc.
• Effective zoning is required : public zone, clinical zone and staff zone.
Privacy and confidentiality are important, especially at the reception desk and clinical rooms during
consultations and treatments.
• Security and supervision in the premises will be necessary, including staff protection against personal assault
and safeguarded against theft and vandalism.
• For running costs, efficient staffing, energy efficiency, long-life and low- maintenance approach should be
adopted.
• Flexibility and growth should be catered for : flexibility in use of some and potential for future extension of
the building.

2. PLANNING CONCEPTION

• Location:
• Site should offer sufficient space for self contained residential areas and hospital departments.
• Should be a quiet location with no possibility of future intrusive development .
• Adequate area should be there for future expansion.
• Should be away from dust, noise and pollution
• Orientation:
• Treatment and operating rooms are preferred between north-west and north-east.
• For nursing ward facades, south and south-east is favourable due to :
• Pleasant morning sun, minimal heat built up, and mild evenings.
• Some departments might require rooms on the north side so that patients are not subjects to
direct sunlight.

CAMPUS DEVELOPMENT
 
• Minimum approach road and Site area-
                                                                                                 
PUDA NORMS

•
Plot size from 1000 sq. yd up to
2000 sq. yd

Plot size above 2000 sq. yd Up to

4000 sq. yd

Plot size above 4000 sq. yd

12 m (40’)

18 m (60’)

24m ( 80’)

• 40% of site area

• Maximum Ground coverage
• Minimum approach road 12 m
• Maximum Floor Area Ratio 1:1.75
• Minimum approach road 18 m

• Minimum approach road 24 m 1:1.75

And above
1:2.25
• Maximum Floor Area Ratio • 2 Equivalent Car Space/ 100
Square meters of the total covered
areas.
• Maximum up to 2% of covered area shall be allowed to be used for community space/ creche/ chemist
shop/bank counter on hospital sites and also Medical college / Nursing and paramedic institutes sites.
• In case of Hospitals, 25 % of the total covered area ( Floor Area Ratio) may be utilized for residential use of
staff, dormitory/ hostels for attendants of the patients, creche etc.
• Adequate arrangements for disposal of hospital waste have to be made as per the Bio-Medical Waste
(Management and Handling) Rules, 1998, as amended from time along with the instructions/ guidelines
issued
CAMPUS DEVLOPMENT
 
•
Pedestrian areas :
Pedestrian space serves two functions :
                                                                                                 
 Movement & circulation
 Relaxation areas.
• They must be busy & colorful, exciting &
stimulating, must make
• walking enjoyable.
Admin

• Trees, fountains, sculptures, murals, as well

as architecture of free standing structures
are a vital part of the overall scheme DIAGNOSTIC &
INPATIENT OUTPATIENT
Ramps : TREATMENT
• A ramp when provided shall not have a
slope greater than 1 : 12. Larger slopes
shall be provided for special uses but in
no case greater than 1 : 8.
• Minimum clear width shall be 36” (3 SERVICE RESEARCH &
TEACHING
feet). in the basement using car parking
shall be 6.0 mt.
• Handrails shall be provided on both
sides of the ramp. Ramps shall have
level landings at bottom and top of each
ramp and each ramp run.

EXTERNAL CIRCULATUION
• If ramps change direction at landings, the FIG.27: STEPPED RAMP
mini-mum landing size shall be60 inches
(SOURCE : NEUFERT)
by 60 inches . A ramp shall have a non-
slip surface.

• Each ramp shall have at least 180 cm of

straight clearance at

STAIRS
The minimum width of a staircase other than
A fire escape shall be as follow:

 Business, industrial storage, hazardous

buildings
(a) Low rise -1.5
(b) High rise -2.0
 Assembly , institutional buildings(i.E hospital)
(a) Up to 10 beds -1.5
(b) Over 10 beds -2.0

 Step heights of 170mm are permissible

 Minimum required tread depth is 280mm.
FIG.26: RAMP (SOURCE : NEUFERT)
 It is better to have a rise/tread depth ratio of 150:300mm
 Doors must not constrict the useful width of the landings and in accordance with hospital
regulations, doors to the staircases must open in the direction of escape.

EXTERNAL CIRCULATUION
  Parking can be provided in 3 ways

• Short term parking: should be such placed that they can be

used                                                                                                 
by visitors. Can be provided on the ground floor.

• Long term parking: provided for people working in offices

and , can be provided in the basement or on the roof top.
PARKING

• Service core parking: provided for service traffic. Should be

provided on the backside of the building for easy loading &
unloading of goods

• Width of aisle –24‟ for 90˚parking 13‟ for 45˚parking.

POSSIBLE PARKING ARRANGEMENTS

FIG.22: PARKING PARALLEL FIG.23: 30° OBLIQUE

TO THE ROAD SPACES (SOURCE :
(SOURCE : NEUFERT) NEUFERT)
FIG.21:CAR PARKING ARRANGEMENTS
(SOURCE : NEUFERT)
EXTERNAL CIRCULATUION
                                                                                                   

FIG.17: PARKING ARRANGEMENT AND THE SPACES REQUIRED (SOURCE: TIME SAVERS
STANDARD)
EXTERNAL CIRCULATUION
 






EMPLOYEES: ONE ECS FOR EVERY 2 BEDS
VISITORS: ONE ECS FOR EVERY 4 BEDS.
PARKING STANDARD’S:

ONE ECS (EQUIVALENT CAR SPACE) WOULD BE EQUAL TO 23SQ.M FOR OPEN
                                                                                                 
PARKING,28 SQ. FOR PARKING ON STILTS, AND 32 SQ. FOR BASEMENT PARKING.
IN ADDITION, 2 TO 5 SPACES SHOULD BE ALLOCATED FOR DISABLED VISITOR PARKING.
ADDITIONALLY FOR HOSPITALS WITH ACCIDENT AND EMERGENCY (A+E) DEPARTMENTS, 8
PARKING SPACES (9M X 3M) FOR AMBULANCES AND FOR HOSPITALS WITHOUT A+E
DEPARTMENTS, 3 PARKING SPACES (9M X 3M) FOR AMBULANCES.
 PARKING SPACES SHALL BE PAVED AND CLEARLY MARKED FOR DIFFERENT TYPES OF
VEHICLES.
 APART FROM PARKING AT GROUND LEVEL, PROVISION OF UNDERGROUND OR MULTI-
STOREYED PARKING IS PERMITTED. THE PARKING OF VEHICLES AT DIFFERENT LEVEL MAY
 ALSO
APPROPRIATE BE MECHANIZED. DIRECTIONAL SIGNS SHOULD BE CONSIDERED FOR THE EFFICIENT CONTROL
OF TRAFFIC.
 SPACE WIDTH FOR VAN AND AISLE SHOULD BE 4.8 M IN TOTAL.

• MEASURING THE INNER

AND OUTER RADII OF
THE 180° TURN, A
MINIMUM INNER
RADIUS OF 19’4” (5.9 M)
AND MINIMUM OUTER
RADIUS BETWEEN 40’-
40’10” (12.2-12.4 M)
SHOULD BE PROVIDED
FOR MEDIUM-SIZED
EXTERNAL CIRCULATUION SEMI TRUCKS(E.G
AMBULANCE).
                                                                                                   
Dimension of
vehicle:
Car 5.0m x 2.5m
Two wheeler 2.5m
x 0.5m

Turning radius - Inner

radius 3.5m
Outer radius 5.0m

RAMP OF SLOPE

• RADII FOR ONE-WAY STRAIGHT

RAMPS, MINIMUM WIDTH IS 12 FT(3 .
66M);
• FOR TWO-WAY STRAIGHT RAMPS,
WHERE OPPOSING TRAFFIC FLOWS
ARE NOT SEPARATED, 22 FT (6 .71 M)
IS THE RECOMMENDED MINIMUM
WIDTH. WHERE A BARRIER IS USED
BETWEEN LANES TO SEPARATE
TRAFFIC FLOWS, EACH LANE
• SHOULD BE AT LEAST 12 FT (3 .66 M) WIDE
FOR TANGENT LENGTHS. EXTERNAL CIRCULATION
•
•
•
•
 
“THE GARDENS AND GREEN SPACES OF A HOSPITAL SHOULD BE REGARDED AS A COUNTERBALANCE TO

Reduces stress and irritation

THE HOSPITAL ITSELF"

                                                                                                 

5-7 minutes in nature or viewing natural scene can

Reduce physiological indicators of stress
Improve mood
NEED & IMPORTANCE

• Aid in healing
• Tie together a variety of buildings — by function, style, or age — into a campus-like setting.
• Create comfortable spaces for both staff and patients .
LANDSCAPE ELEMENTS
Vegetation which will consist of trees ,shrubs, ground cover ,annual perennials
,vines ,and turf . Serving the below given functions .
•Visual enhancement
•Wind control
•Erosion control
•Noise reduction
•Maintaining micro climate
•Buffer zone ( dust , noise , visual )
•Energy conservation.

TYPES OF SCAPES
•Land Scapes ( greenery)
•Water Scapes
•Pavement / Hard Scapes
•Site amenities
LANDSCAPING
  
 Service Zone – areas that
                                                                                                 

provide support to hospital

activities: dietary service,
housekeeping service,
maintenance and motor pool
service, and mortuary. They shall
CONNECTIVITY

 Inner Zone – areas that

provide nursing care and
management of patients:
nursing service. They shall
be located in private areas
but accessible to guests.
be located in areas away from
normal traffic.
 Second Zone – areas that receive
• CONNECTIVITY workload from the outer zone:
 Outer Zone – areas that are
OF ZONES laboratory, pharmacy, and
immediately accessible to the
public: emergency service, radiology. They shall be located
outpatient service, and near the outer zone.
 Deep Zone – areas that require
administrative service. They asepsis to perform the prescribed
shall be located near the services: surgical service, delivery
entrance of the hospital. service, nursery, and intensive care.
They shall be segregated from the
public areas but accessible to the
outer, second and inner zones.

MAIN
ENTRY CONNECTIVITY
 
1. ENGINEERING SERVICES
BUILDING SERVICES IN HOSPITAL:

                                                                                                 

a)CIVIL ENGINEERING DEPT.

*BUILDING MAINTANANCE
2. NON- CLINICAL SERVICES
a) STERILIZATION
b) DIETRY SERVICE
*HORTICULTURE c) HOUSEKEEPING DIVISION
*WATER SUPPLY & PLUMBING d) GENERAL STORAGES
*DRAINAGE AND SANITATION e) MORTUARY DIVISION
b)MECHANICAL ER. DEPT. f) MAINTENANCE WORKSHOPS
*AIR-CONDITIONING
*REFEIGERATION
c)ELECTRICAL ER. DEPT.
*ILLUMINATION
*VENTILATION
d)MISCELLANEOUS
*GAS SUPPLY
*TEANSPORT AND
COMMUNICATION
*FIRE PROTECTION
*WASTE DISPOSAL
BUILDING SERVICES
 
1. ENGINEERING SERVICES:
a) CIVIL ENGINEERING DEPERTMENT:
i) BUILDING MAINTANANCE: *An office-cum store should be provided to handle day to day maintenance works
                                                                                                 
of the building.
ii) HORTICULTURE: *To maintain hospital landscape there is a room to store garden implements,
Seeds etc.
iii) WATER SUPPLY AND PLUMBING: *Arrangement shall be made to supply 350 liters of potable water per bed
per day to meet the requirements.
*Storage capacity for 2 days requirements should be on the basis of above consumption.
*The laying and distribution of the water supply system shall be according to the provisions of IS: 2065-1983
(Code of practice for water supply in building).
*Cold and hot water supply piping should run in concealed form embedded into wall with full precautions to
avoid any seepage.
REQUIREMENTS OF WATER CATEGORY OF HOSPITAL
350 liters A and B
400 liters C
450 liters D and E
*HOT WATER: Supply to wards and departments shall be
provided by means of WATER HEATER or CENTRALIZED
HOT WATER SYSTEM depending upon the needs of
consumption.
*FILTERED AND SOFT WATER: Supply is required to
PATHOLOGY LABS and as required.
*COLD WATER: Supply is needed for processing tanks in film developing room or as required.
iv) DRAINAGE AND SANITATION: *Design, construction and maintenance of drains for waste water, surface
water, sub-soiled water and sewerage shall be in accordance with IS: 1742-1983.
* The selection, installation & maintenances of sanitary appliances shall be in accordance with IS: 2064-1973.
* The design and installation of soil, waste and ventilating pipes shall be as given in IS: 5329-1983.

BUILDING SERVICES
 
*SOME OF THE REQUIREMENTS FOR DRAINAGE AND SANITATION IN GENERAL HOS[PITALS ARE LISTED BELOW-
FITMENTS
1. WC

2. URINALS
3. WASH

4. BATH
BASINS

b) MECHANICAL ENGINEERING DEPERTMENT:

IPD
1 FOR 8 BEDS(M)
1 FOR 6 BEDS(F)

1 FOR 12 BEDS
1 FOR 12BEDS
1 FOR 12 BEDS
                                                                                                 
OPD
1 FOR EVERY 40 PRSN(M)
2 FOR EVERY 50 PRSN (F)
1 FOR EVERY 25 PRSN
1 FOR EVERY 50 PRSN (M)
1 FOR EVERY 50 PRSN (F)

i) AIR- CONDITIONING: * Essential to ensure the comfort for patients, sterile and comfortable conditions in OT,
maintenance of essential sophisticated instruments and equipment and to help in speedy recovery and
treatment of seriously ill patience.
*If possible air- conditioned the entire hospital.
*Introduce fresh, uncontaminated, dehumidified and cool air.
*Exhaust the air contaminated during surgery.
*Provide working comfort for the surgical team.
*Prevent contamination from adjacent areas.
* The following departments/ wards are essential and recommended for Air- Conditioned-
1. OPD BLOOD BANK
2. OT
3.REDIOLOGY DEPT.
4. CERTAIN NO OF BEDS IN WARD UNITS OF PARTICULAR SPECIALITIES
5. ALL ROOMS IN STERILE ZONEOF DELIVERY SUITE
6. ICU
7. AUTOPSY ROOM MORTUARY.
* It may also be achieved with room AC, desert cooler, chilled beam system, packaged AC.
SOME OF THE DESIGN PARAMETERS CONSIDERED FOR OT’s ARE: *Temperature range should be between 23-
24℃.
*The relative humidity shall be maintained at 55±5%.
*A typical OT uses low turbulence displacement with an even speed of moving air i.e. 0.45m/s to produce a
laminar flow . *The exhaust air should be taken through lower level extract grills at peripheral walls.

BUILDING SERVICES
 
ii) REFRIGERATION: *Hospitals shall be provided with water cooler and refrigeration in wards and departments (IS:
1474-1959).
*Freezers in pathology (IS: 7872-1975), and cold storage plants for pathology, mortuary, medical stores and dietary
dept. with voltage stabilization respectively.
c) ELECTRICAL ENGINEERING DEPARTMENT:
                                                                                                 
i) ILLUMINATION

IS: 4347- 1967.

:
GENERAL: *The level of illumination for various visual tasks shall be provided in accordance with

* General lighting for all hospital areas except stores and laboratory block shall be fluorescent.
* In other areas recommended to be of incandescent lamp.
SHADOWLESS LIGHT: *Shall be provided in operation theaters, operating delivery rooms, operations of minor nature.
CALL BELLS: Switches should be provided for all beds in all type of wards with indicator lights and location indicator.
EMERGENCY LIGHTING: *Emergency portable light units for wards and departments to serve as alternative source of
light in case of power failure.
*Nominal lighting strength for operating theatres as 1000 lux and 500 lux for auxiliary surgical rooms (NFRT).
*The general illumination should be not less than 10 foot-candles in corridors and in rooms (non-reading).(NFRT)
*Waiting room should have 15 foot-candles, with supplemental lighting for reading.(NFRT)
*Offices and areas where clerical work is performed should have at least 50 foot-candles, preferably 70.(NFRT)

ii) VENTILATION : *Ventilation may be achieved by either natural supply and natural exhaust of air, or natural supply
and mechanical exhaust of air.
*The general principles of natural ventilation shall be in accordance with IS: 3362-1977.
* The following standards of general ventilation are recommended for various areas of the hospital building to maintain
oxygen, carbon dioxide and other air quality levels and many more.
SPACE TO BE VENTILATED AIR CHANGES PER HOUR
BATHROOMS/TOILETS 6-12
WARDS 8-12
KITCHENS 6-9
OTHER AIR CONDITIONED PLACE 8-10
OPERATION THETRES 15-20

BUILDING SERVICES
                                                                                                    
d)MISCELLANEOUS:
i) GAS SUPPLY:
MEDICAL GAS: * Comprises of oxygen and nitrous oxide.
*Necessary pipe line network should be laid in departments and wards to connect them to the manifold room.
*A compressor should also be provided in separate room adjoining to the manifold room to provide suction along
with medical gas supply pipe.
*All these three pipes should be of different color conforming to a laid down standard and mounted on wall or
ceiling surface.
COOKING GAS: *The cylinder supply should be made available. For better hygienic conditions use of LPG
cooking gas cylinders are recommended.
*These should also be kept in a room from where necessary pipe line with gas outlets as required may be
provided to hospital kitchen and ward pantries.
LABORATORY GAS: *LPG cylinders should also be made available for laboratory.
*Pipe line network should be laid in pathology laboratories and other laboratories of
sub-speciality clinics where extensive laboratory benches are provided.
ii) TRANSPORT AND COMMUNICATION:
LIFTS: *Electrically operated automatic control lifts shall be provided in all category of hospitals having more than
one storey.
*The installation, operation and maintenance of lifts shall be as given in IS : 1860-19807.
*The outline dimensions of machine room, pit depth and total headroom, shall be in accordance with IS : 3534-
1976:.
*RECOMMENDED CAE SPEED ARE-
OCCUPENCY NO. OF STOREY CAR SPEED, m/sec
a) Short travel lifts 2 or 3 0.25
b) Medium travel lifts 4 or 5 0.50
c) Long travel lifts 6 and above 1.00

BUILDING SERVICES
 * Should easily accessible from all entrance of the hospital.
*Should place near to staircase, ward and operation theatre department entrance.
*There shall be sufficient space near the landing door for easy movement of stretcher trolley.
RAMP: *The standard ratio is 1:12.
*A ramp leading to the topmost floor of hospital of two or more storey's may be provided in addition to the
stairs needed at places.
                                                                                                 

STAIRS:
TELEPHONE AND INTERCOM: *Wiring in conduits shall be provided to give telephone outlet points in rooms,
wards and departments as desired by authority.
*An intercom system should also provide.
* The communication system is essential for emergency alert and shift changes of employees.
* The alerting system shall be capable of being operated from the telephone switch boards and the
administrative office.
iii) FIRE PROTECTION:
FIRST-AID, FIREFIGHTING EQUIPMENT: *Adequate first-aid, fire fighting equipment shall be provided &
installed in accordance with IS: 2190-1979 (Code of practice for selection, installation and maintenance of
portable first aid fire extinguishers).
FIRE ALARM: * Manually operated fire alarm facilities.
* Sound of the alarm should be audible in administrative department, angering service, offices, fire office.
* The gongs, sirens, whistles or bells should not disturb the patients.
* Distinctive visual or audible alarm shall be there in nursing stations.
WATER SPRINKLER
SMOKE DETECTOR
ESCAPE ROUTE: : As per section 8.2.5 of part IV of NBC, the escape route should be marked with a
sign board on the corridor & passage to guide evacuation.
*Normally, the escape route sign board must be written in luminous paint for easy identification.
This is to guide every occupant of the building who is bound to panic in the event of accident.
iv) WASTE DISPOSAL SYSTEM : * Nursing Home may be provided with an incinerator consisting of a burning
chamber and chimney
* Hospitals may have an electrically operated incinerator of capacity to burn 1 kg/bed/day of refuge.
BUILDING SERVICES
 
2. NON-CLINICAL SERVICES:
a) STERILIZATION:
*Requires the utmost consideration in planning.
*Recommendation says these area be situated in areas with relatively low volumes of traffic(people &
materials)
                                                                                                 

*Centralization increase efficiency results in economy in the use of equipment and ensures better supervision
and control.
*No of sterilizers is dependent on the size of the hospital and surgical department & can occupy area of 40-120
sqm approximately.
*The materials and equipments dealt in for those related to surgical cum
obstetric suite, in-patient wards & out patient clinics.
Central sterilization division:
Parts and components of the division:
i) Work space.
ii) Receiving area.
iii)Washing area.
iv)Supplies storage.
LOCATION:
*Very close to operation theatre and maternity division.
* Can be easily accessible from the emergency division, laundry and central storages.
b) DIETARY SERVICE:
Spaces includes:
i) Storage Room,
ii) Kitchen,
iii) Preparing and supply area,
iv) Cleaning.
LOCATION:
*Should be in the Ground floor and Basement.
*Should have direct opening to service entrance.
*Should be easily accessible to wards.
* Must have proper drainage system. BUILDING SERVICES
 
** Properly rendered, it should be a clinical and administrative means of stimulating rapid recovery of
patients thereby shortening patients stay in the Nursing Home.
c) HOUSEKEEPING DIVISION:
SPACES INCLUDE:
                                                                                                 
* Office
* Dirty Linen
* Clean Linen
* Storage

* Laundry Service: *Should satisfy two basic considerations i) Cleanliness & ii) Disinfection.
* Should provided with facilities for washing, drying, pressing, and storage of soiled &
cleaned linen.
* Mechanical Room
d) STORES:
*Comprises of stores needed for medical and non medical purposes.
*The space for each type of stores should be utilized to the optimum by providing storage racks.
*Adequate ventilation and security arrangement shall be provided.
Can be divided in six part:
i) Medicine Storage
ii) Furniture Storage
iii) Food storage
iv) Utility Storage
v) Achieve
vi) General Storage
LOCATION:
* In the ground floor and basement floor if easy access is possible.
* Should close to Housekeeping and Dietary Division,
* Direct access to the Service entrance.
BUILDING SERVICES
 
e) MORTUARY DIVISION:
*The room or building in which dead bodies are kept for hygienic storage or for examination until burial or
cremation.
LOCATION:
                                                                                                 
i) Should be in the ground floor or basement floor.
ii) Exit from emergency entrance or service entrance.

FOR 200 BED

f) MAINTANANCE WORKSHOP:
*Daily Maintenance
*Annual Maintenance Contract
*Breakdown Maintenance in authorized Garage
*Wash area for ambulance along with water and
drain facility.
*Daily inspection of vehicle
*Daily inspection and checking of equipment.
*Entrance must be clearly marked for relatives and should have a
short drive-in entry point for the undertakers.
LOCATION: * In the ground or basement floor.
*Direct relation with service entrance.

BUILDING SERVICES
 
i) DIAGONASTIC & THERAUPETIC SERVICE:

PATHOLOGY
RADIO- DIAGNOSIS
PHYSIOTHERAPY
                                                                                                 

SURGICAL SUITS
PATHOLOGY: *Concerned with the analysis of diseased tissue or fluid and other elements in the body.
Comprises of 4 different laboratory:
*BIOCHEMISTRY LABORATORY (Chemical analysis of body tissue and fluid).
*MICRO-BIOLOGY LABORATORY (Bacteria or pathogen found in body or in environment).
*CLINICAL PATHOLOGY AND HAEMATOLOGY LABORATORY (Urine, stool & blood specimens).
*HISTOLOGY AND CYTOLOGY LABORATORY (Structural composition, function and preparation of tissues).
*Each laboratory must have a 0.6 m wide, 0.8 m high and 1.6 m length bench per technician.
*Each laboratory bench shall have laboratory sink with swan neck fittings, reagent shelving, gas, power
point and under
counter cabinet.
*Top of the laboratory bench shall be acid and alkali-proof material.
*PARTS AND COMPONENTS OF THE DIVISION: *LAB LOCATIONS:
• WORK AREA *VERY CLOSE TO EMERGENCY DEPARTMENT AND EXTERNAL CLINICS
• WAITING AREA *EASILY ACCESSIBLE FROM INTERNAL DIVISION
• SAMPLE ROOM * EASILY ACCESSIBLE FROM MATERNITY AND SURGERY DEPT.
• CLEANING ROOM * ACCESSIBILITY FROM CENTRAL STORAGE
• STAFF OFFICE
AREA ACCORING TO U.S PUBLIC HEALTH SREVICE: A. 50 Bed hospital area= 25 sqm
B.100 Bed hospital area= 60 sqm
C.200 Bed hospital area= 103 sqm
Area can be counted by the number of the beds, 0.7-0.8 sqm / bed.

DIAGNOSTICS
                                                                                                   

RADIO- DIAGNOSIS: *Generally deal with

Radiography and Ultrasound.
*Beside these a film developing cum processing
room, and a room for the Radiologist /
technician should be provided
for the unit.
* Should always close to the ambulance
entrance.
*Because of the great weight of the equipment
sensible to plan these areas on the ground floor
or first basement floor.
* Standard X-Ray and admission rooms need to be
20-30 sqm.
*Access route for patience should be through two
changing cubicles and a wide door (≥1250mm)
for beds in necessary. DIAGNOSTICS
 
RADIOGRAPHY ROOM: * The radiography room comprises-
•
•
•
•
Reception
Administration area
Waiting area
                                                                                                 

•
•
•
•
Doctors’ room, 18sqm
Radiologist’s office
Switchroom, 15 sqm
Localization room, 20-25 sqm
Service room, 20 sqm
• Film developing room, 10 sqm
• Store and cleaner’s room
• Workshop of 15 sqm
• Physical laboratory of 15-18 sqm
*Clear height of radiation room 4.30 M
*Well ventilation must be provided for hygiene reason in patience waiting area, examination, localization,
preparation and radiation room.
*Thickness of walls constructed in concrete should be- 3.00 M for examination and treatment rooms in primary
radiation area
1.50 M rooms in secondary radiation area a/c to type of equipment.
*Consultation area is an appropriate area for individual consultation with referring clinicians and for quality
control i.e., for viewing film shall be provided.
*Ultrasound room
OTHER GENERAL FACILITIES:
* Dressing room: Should be equipped with straight-back chair, cloth’s hook, mirror and shelf.
Door must be equipped with lock and for wheel chair patient provide an outsized dressing room
equipped with curtain.
* Patient’s toilet room: At least one toilet must be accessible from X-Ray room,
*Technician’s toilet and locker:

DIAGNOSTICS
 
PHYSIOTHERAPY: * Provides treatment facilities to patients suffering from crippling diseases and disabilities.
* Contains a wet area consisting of an exercise pool of 4 x 6 M, a four-cell bath, a butterfly bath, inhalation
room,
massage bath, hand and foot bath as well as the necessary subsidiary room.
*Classified as physical and electro-therapy, and exercise.
*Should be located at a place which may be at convenient access
                                                                                                 
to both outdoor and indoor patients.
* Availability of natural light, fresh air and adequate ventilation are of
extreme importance for the department. *Physiotherapy demands
complete privacy.
*Accommodation should therefore be provided in the form of cubicles.
*A long room provided with curtains which could be drawn to form
cubicles and afford adequate privacy should
be suitable.
*If a gymnasium is included then clear height of 3 M will be needed.

Physical and Electrotherapy: The nature of treatment may be of various kinds such as diathermy, ultra-violet,
combined treatment, infra red etc.

Surgical cum Obstetrical suite: A high degree of asepsis should be ensured to provide environment for staff and
patients.
*Zoning shall be done to keep the suite free from micro organisms.
*There shall be four well defined zones of varying degree of cleanliness.
*These are i)Protective, ii)Clean, iii)Sterile, and iv)Disposal zones.
*Should comprise of an operation theatre unit for conducting general surgical and Gynecological operations, and
Obstetrical suite should include facilities described here after.
*Since delivery and operating rooms are in the same suite, access and service arrangements shall be such that
neither staff nor patients need to travel through one area to reach the other.
i)Zoning Traffic flow: Flow of traffic from one zone to another is arranged through proper barrier nursing.
*Disposable and non disposable material should move without crossing the sterile and clean zone.
ii)Circulation: Three types of traffic flow, namely a) patients, b) staff, and c) supplies.
*All these should properly channelized.
DIAGNOSTICS
 
*Patients are brought from ward and should not cross the transfer area in their ward clothing which is great
source of infection.
iii) Comfort Condition: *Temperature between 160 C, to 210 C, with 50% humidity shall be maintained
through air-conditioning.
*Ventilation should be of 15 to 20 air changes per hour.
iv)                                                                                                  
Reception Bay & Relative Waiting: *Shall be provided close to the suite.
* Waiting room with toilet facility for the relatives.
v) Change Rooms: Separate change rooms for doctors, nurses and technicians should be provided, with
arrangement for lockers & toilet facility.
vi) Storage: Store room should be provided for storing theatre supplies like stretcher, trolley, sterile
material, medical gas cylinders, instruments and linen
vii) Theatre Pack Preparation Room: It should be a work room for arranging of sutures, dressings and all
other surgical items.
viii) Pre-operative Room: Patients are transferred from ward to this room for premedication before surgery/
delivery. The room should have toilet facility.
ix) Recovery Room: Immediately after the operation, the patients are kept in this room until such time they
are found fit to be taken back to their parent ward / room.
x) Labour room(s) (LDR): A minimum of two labour beds shall be provided for each caesarean / delivery
room.
*Should contain hand washing fixture and to have access to toilet.
xi) Operation Theatre / Delivery Room: *Should be made dust-proof, moisture proof, corners and junctions
of walls, floor and ceiling coved to prevent accumulation of dust and to facilitate cleaning.
*Its door should be two leaf type with a minimum 1.5 m width and shall have self closing devices.
*Natural lighting and general illumination should be provided.
*The operating room / delivery room should be normally arranged in pairs with scrub-up and instrument sub-
sterilizing lay-up room.
xii) Scrub-Up: *In this space the operating team washes and scrub-up their hands and arms, put on their
sterile gown, gloves and other covers before entering the operation theatre/ delivery room.
*It should have a single leaf door with self closing door with self closing device.
*A pair of elbow or knee operated taps for a suitably designed scrub-up unit should be provided.

DIAGNOSTICS
 
Xiii) Instrument Sterilization: *It is a sub-sterilization unit attached to the operation theatre / delivery room
limiting its role to sterile operating instruments on an emergency basis only, and lay-up instrument trolley.
*This room should be equipped with high pressure, quick sterilization apparatus, work top with sink and
storage cabinets.
                                                                                                 
xiv) Dirty Utility: *Theatre / Delivery refuse such as dirty linen, used instruments and other disposable/
non-disposal stuff is removed to this room after each procedure.
*Non disposable instruments after initial wash is given back to instrument sterilization and rest of the
disposable items are disposed and destroyed.
*Dirty linen is sent to laundry through a separate exit.
*The room should be provided with a sink, drain board, bed pan sink, and work top.

STORAGE FACILITIES:
GENERAL STORAGE: For bulk supplies, a storage cabinet
equipped with sliding doors and adjustable shelves is located
inside each patients' corridor near the entrance.
i) Daily Linen Supplies: Clean linen, requisitioned from
the hospital Central supply, is stored on a cart (No . 66) in
each x-ray room ; soiled linen is placed in a hamper (No . 65) .
Ii) Gown storage: *Open adjustable shelves for gown storage are
placed next to each general bulk supply cabinet, just inside the
corridor entrance .
*The shelving for clean gowns starts about 4 ft from the floor,
leaving space beneath for a linen hamper (No . 65) for soiled gowns.
iii) Janitor's Closet: *Must be readily available for emergency cleaning and should be convenient to the x-ray
rooms and toilets .
*The closet should contain a floor receptor with a curb or a janitor's service sink, a mop-hanging strip and a
shelf, and provide space for parking the mop truck .

DIAGNOSTICS
 
Diagnostic X-Ray Room Storage:
iv) X-Ray Equipment: *The optimum size of the x-ray room is about 14 by 18 ft .
*Ceiling height requirements vary for different x-ray machines, but a minimum of 9 ft 6 in . is recommended.
*Sufficient clearances (at least 2 fl above the transformer) for servicing the transformer should be provided .
*The sink and dreinboard, for hand washing and rinsing utensils and barium equipment, is equipped with a
                                                                                                 

gooseneck spout and is located near the foot of the x-ray table .
*The dreinboard can also be used as a barium counter .
v) Control booth: It is essential that the control booth be located to the right of the machine so that the
patient may be observed when the table is inclined, since machines with end . pivoted tables tilt to the
right .
vi) Storage Cabinet and Writing Counter: * A storage cabinet
(No . 62), with a safety light above, serves also as a writing
counter for the radiologist and technicians .
*Shelves in the cabinet provide space for storage of accessory
items such as handbags, measuring devices used with x-ray
machine, and disposable items needed for patients' examinations.
Film Processing and Distribution Area:
Vii) Darkrooms: *Space should be provided for loading and
stacking cassettes at both ends of the counter .
*A utility sink with a drainboard (No . 24), located opposite the processing tank, is provided for mixing
chemical solutions and hand washing .
*A refrigerating unit (No . 25) for the tank is located in the space beneath the drain board.
*X-ray films are processed in an area separated from the loading counter by a partition
at the end of the developing tank which helps to avoid accidental splashing
and damage to the screens and films on the loading counter.
viii) Collection and Distribution Area:
*Film sorting bins should be provided above the counter in the collection and distribution
area for temporary filing.

DIAGNOSTIC
 
ix) Barium Mixing Facilities: *A two-compartment sink should be in a counter, located in the technicians'

*Barium
corridor
and should accessible to both x-ray rooms, is provided for mixing barium .
*A duplex outlet for plugging in an electric mixer or a heating element is located above the counter unit.
                                                                                                 
supplies for daily use are stored in cabinets under the counter ; the bulk supplies can be stocked in
one of the general storage cabinets located in the patients' corridors .
x) Archive and store rooms:
* A short route between archives and work areas is advantageous
but generally difficult to provide.
*Possible when placed in basement and connected with a flight of
Stairs.
*Distinctions should be made between them for files,
Documentations and film from administration, X-Ray dept. etc,
supplies, and equipments.
*The necessary depth of shelves and cup-boards depends on the goods’ store.
*For files, books and films 250-400 mm,
*For, equipment, china spare parts 400-600 mm is needed.

DIAGNOSTICS
 
Inpatient Department consists of a wards with Nursing
station, Beds, and all other facilities and services
necessary for good patient care.
                                                                                                 

Patient are admitted to inpatient ward for short and

long term based on severity of their disease.

Objective of IPD:
To provide the highest possible quality of medical and
nursing care for an admitted patient.
To make provision for essential equipment’s , drugs
and all other items for patient care in an organized
manner.
To provide most comfortable and desirable
environment on temporary substitution of home.
To fulfill all basic needs in the hospital like eating,
toiletry, sleeping, entertainment etc.
To facilitate the visit of attendants and visitors.

IPD-WARD DESIGN ,PLANNING ,LAYOUT

 
Location:
                                                                                                 
1.Should be at the backside of Hospital complex to
avoid traffic flow and congestion.
2.Must have direct access from OPD , Emergency and
OT.
3.Single door to ward complex to restrict traffic and
visitors.
4.Wide corridors , ramp of 1:12 ratio and lifts must be
there for effective transportation.

Forms of Inpatient Ward:

There are different types of ward design;
1.Open ward or Nightingale ward.
2.Rigs Pattern ward (unilateral or bilateral)
3.Modified Rigs pattern ward
4.T & Y shaped ward.
5.L, H,E shaped ward.

IPD
 
Nightingale Ward:
Patient bed in two rows at right angle to the
longitudinal wall.
It may have side rooms for utilities and
                                                                                                 

perhaps one or two side rooms , that can be

used for patient occupancy when patient
isolation is important.
Nursing station , Doctor’s room and other
facility at one end .bathroom and WC at the
other end.
Good visibility and economical and easy to
construct.

Rig’s Ward:
Ward unit is divided into small compartments
separated from each other .each
compartments will have 4-6 or more beds
arranged parallel to the wall.
Bed can be on both or one side of the nursing
station.
It is less noisy and patient can have more
privacy.
Direct observation and communication b/w
patient and nurse is difficult. IPD
 
Patient Housing Area and
measurements:
                                                                                                 
It may divided into various cubicles as per patient
requirement.
Room single bed
Room doubled bed -
- 120 sq feet.
160 sq feet.
Room with 4 bedded - 320 sq feet.
Room with 6 bedded - 400sq feet.
Room ICU - 125-150 sq feet.

In an open ward width should be20 feet.

Bed area - 70 sq feet.

Space between 2 row of beds - 5-6 feet .
Space between two beds - 3 - 4 feet.
Clearance of the bed head from the wall - 2 feet.
Size of each bed – 6ft x 3ft 6 inch.

IPD
 
General requirements:
                                                                                                 
Ceiling height; at least 3m.
Windows; if only one wall it should be 20 percent of
floor area , if multiple wall then 15 percent of floor
area.
Corridor; the width of corridor recommended is 2.4 m
to faciliate movement of trollery , bed and stretchers.
Door; should not be less than 1.2 m wide and 2.5 m
tall.
Sitting facilities for visitors.
Store room; 200 sq feet
Clean utility room; 80 sq feet
Word pantry; 100 sq fert.

Nursing Station
requirements:
Minimum area 20ft x 20ft.
Sisters changing room and toilet.
Cupboards for medicines.
Hanging pockets for forms and case sheets.
Case sheets racks.
Table, stool, chairs etc. IPD
 
Types of ward:
Liner ward; large single space , 20-30 beds
supported
sluice and WC at other.
by nurse working room at one end,
                                                                                                 

Deep ward; it is complete contrast to liner

ward , patient share nothing larger than 4 bed
Deep ward or rack track.

ward.
Courtyard plan; attempts to reduce internal
working room and provide good patient
Courtyard plan.
observation.

Liner ward.

IPD
 
Nurse Station:
Figure shows ,dimensions and equipment
                                                                                                 
required for main nurse working room in
standard word.
Variation in size and shape of room may be
decided by ward plan , but work pattern and
critical clear working spaces round beds and
other eqp should be maintained.

Dirty Utility:
14Sq m equipped for disposal bedpans ; if no
disposable used washer replaces destructor ,
no disposable stool needed 1 rack for bedpan
cradles 2 slop sk and drainer 3 bedpan
destructor 4 space for disposable bedpan box
5 disposable bag 6 hb unit 7 space for
disposable bedpan box etc.

IPD
  Basic furniture required in ward designing:
                                                                                                 

IPD
 
Sanitary Accommodation:
Toilet with washroom/ bathroom and WC --
50-70 sq feet.
                                                                                                 

Only WC -- 4-5 sq feet.

Only showers-- 6.5 sq feet.
Dirty utility-- 120 sq feet.
Jointer closet-- 7 sq feet.

Recommendation:
Urinal; 1/16 beds.
WC; 1/8beds.
Bathroom; 1/12 beds.
Wash basins; 1/10 beds.
Water supply 300 lt./bed/day.
Ramp; 1.5 m wide ,1:12 ratio.

IPD
  DEFINITION
• OPD is defined as a part of the hospital with allotted physical facilities
                                                                                                 
and medical and other staffs, with regularly scheduled hours, to
provide care for patients who are not registered as inpatient.
• A hospital department where patients receive diagnosis or treatment but
do not stay overnight.
• The OPD provides consultation, investigation and diagnosis for patients
who require little or no recovery services afterwards; they generally
attend by appointment.
• There is usually a main waiting area, with registration and enquiry
point, but , preferably, it should be relatively small, with patients sent
onwards to sub- waiting areas near clinic they are to attend.
• The clinics are arranged in a long row or strings of combined consulting
and examining (CE) rooms, in which the patient remains in one room,
but the doctor may move between two or three adjoining rooms. Each
should be with sound resisting intercommunicating doors.

O.P.D(OUT PATIENT DEPARTMENT

 
• Provide quality of care.
• Good public relation.
OB J E C T I V E S

                                                                                                 

• Facilities for total patients

satisfaction.
• Modern techniques for investigation
and treatment

I MPO RTA N C E
• First point of contact.
• It is the shop window for the hospital.
• Makes the image of the hospital.
• Good OPD service can reduce the load on IPD services.
• It is the place for implementing preventive and primitive health activities.
• Stepping stone for health promotion and disease prevention. O.P.D
  1. CENTRALISED OUTPATIENTS SERVICES- All the services are provided in
TYPES OF O P D
• ON THE BASIS OF SERVICES
                                                                                                 

a compact area which includes all diagnostic and therapeutics facilities

being provided in same place.

2. DECENTRALIZED OUTPATIENTS SERVICES- services are provided in the

respective departments.

• ON THE BASIS OF TYPE OF PATIENTS

1. GENERAL OUT PATIENT- All the patients other than emergencies who report
directly to the OPD.

2. EMERGENCY OUT PATIENT- a person given emergency medical care

for condition which is real or perceived emergency.

3. REFFERED OUT PATIENT- A person referred to an OPD by his/her attending

medical/dental practitioner for specific diagnostic/treatment procedure.

O.P.D
•

 O R G A N I Z AT I O N A L C O M P O N E N T S O F O P D

                                                                                                 

OPD
MEDICAL
STAFF

NURSING
STAFF
CENTRAL TO
ORGANIZATION

REGISTERED
NURSES, ANMs AND
NURSING AIDS

RADILOGY,
ANCILLARY
LABORATORY, ECG
STAFF
TECHNICIANS

CARRIES OUT REGISTRATION,

CLERICAL
BILLING, RECEIVING CASH,
STAFF
MEDICAL RECORDS FUNCTIONS
GENERAL REQUIREMENTS FOR OP D
Recommendations a/c to BIS (Bureau of Indian Standards)
• For entrance zone- 2 Sq.m/bed
• Ambulatory zone- 10 Sq.m/bed
• Diagnostic zone- 6 Sq.m/bed
• Total area- 60 Sq.m/bed
• Sub-waiting area- should be 1/3rd of total patients visiting clinic per day.
• Consultation room- Space for doctor’s chair, patients stool, follower seat, wash basin,
examination couch and equipment for examination.
• Area- 15-17 Sq.m and each clinic should handle 100 cases per day.
• Special examination room- Required for every departments. O.P.D
 
• MINIMUM SIZE FOR CONSULTATION AND EXAMINATION ROOM=17.5
sq.m
• Minimum space required for O.P.D. WAITING AREA=21 SQ.M Nursing
station for OPD-Small allocated block with clean and dirty utility area
17.5 sq.m
                                                                                                 

• Treatment and dressing area 21 sq.m

• Injection room: 17.5 sq.m

Janitor's closet
An area of 3.5 sq. m should be allocated for this function. The outpatient department should be
located such that patients visiting the outpatient department need not pass through inpatient areas.

O.P.D
  KEY P L A N N I N G A N D D E S I G E N
PARAMETERS
                                                                                                 
• Readily accessible from main entrance of hospital so that people should not
have to pass through wards.
• Proper signage should be provided.
• For more convenient for patients, the staffs and community, an OPD should
be a separate complex within a hospital.
• Close to diagnostic services (x-rays, laboratory, blood bank etc.) and
pharmacy.
• 1-2 WCs for every 100 patients attending OPD and 1 urinal for every 50
patients must be provided. Toilets for staff should also be separate from those
of patients.
• Entrance should be near the reception.
• Design should cater for future expansion.

O.P.D
  OPD PROCESS
                                                                                                 

ISSUE OF
ARRIVAL AT OPD RECEPTION REGISTRATION
TOKEN
NUMBER

INVESTIGATIONS WATING ROOM

REFFERAL TO
SPECIAL CONSULTATIO
N WITH
DOCTOR

ISSUANCE OF MED.
CHIT

DEPARTURE COLLECTION OF PHARMACY

MEDICIENES

O.P.D
                                                                                                   

O.P.D
  P H Y S I C A L FACILITIES
                                                                                                 

O.P.D
  1. CLINICAL AREA
• Consultation room.
• Examination room.
• Treatment room.
• Waiting area.
• Staff room.
P H Y S I C A L FACILITIES

Parts                                                                                                 
and components of the division:

• WCs.

Location:
•Close to the main entrance of the hospital.
• Close to the diagnostic services (labs and x-ray).
• Close the pharmacy.

Area of the department:

1. U.S. Public Health Service (USPHS):
• 50 bed hospital area = 215 m2
• 100 bed hospital area = 350 m2
• 200 bed hospital area = 540 m2
2. World bank estimations (Hopkinson & Kostermans):
• 100 bed hospital area = 345 m2
• 200 bed hospital area = 505 m2

O.P.D
  2. AUXILLARY AREAS
Parts and components of the
division:
                                                                                                 
• Central collection
• Physiotherapy
• Diet counselling nutrition
• ECG room
P H Y S I C A L FACILITIES

• Health education and

counselling
3. ADMINISTRATIVE AREA
Parts and components of the division:
• Reception hall.
• Waiting area.
• Registration.
• Treasury and Accounts.
• Staff offices.
• General manager office.
• Staff lounge.
• Nursing head office.
• WCs.

Area of the department: Location:

1. U.S. Public Health Service (USPHS): •Close to main entrance of the hospital.
• 50 bed hospital area = 214 m2 • Entrance area, registration, accounts should
• 100 bed hospital area = 363 m2 face the entrance, while the manager office
• 200 bed hospital area = 567 m2 should be back for privacy.
2. World bank estimations (Hopkinson & Kostermans):
• 50 bed hospital area = 199 m2
• 100 bed hospital area = 328 m2
• 200 bed hospital area = 409 m2
O.P.D
  4. ANCILLARY AREAS
                                                                                                 

INJECTION ROOM
P H Y S I C A L FACILITIES

ANCILLARY AREA
DRESSING ROOM

PHARMACY FAMILY PLANING

IMMUNIZATION

INJECTION ROOM
- Should be with waiting area for 10-12 patients with 0.6-0.8 sq. m /patient.

DRESSING ROOM
- About 12-16 sq. mt.

PHARMACY
- Should accommodate 5% of total clinical visits to OPD in one session.

O.P.D
  CI RCULATI ON I N O P D
                                                                                                 

REGISTRATIO
N RECORDS
WATING RECEPTION SHOPS etc. ENTRANCE

CONSULTING
OPERATING
AND
THEATRE SUITES
EXAMINATIO
DAYROOM MEDICO- WATING
N ROOM
SOCIAL
DEPT.
X-RAY, PATHOLOGY etc. DISPENSA- WATING
RY

O.P.D
 PUBLI C AREA

 
ENTRANCE,
WIDE RECEPTION &
RAMPS & INFORMATION
STEPS

DRINKING REGISTRATION
WATER                                                                             COUNTER

PUBLIC AREA
TOILETS &
WASH SNACK BAR

WAITING
AREA( 0.1
Sq.m/PATIENT PORTER
VISITED) SERVICE

O.P.D
 
What is OT?
Complex environment of varying
degree of sterility , integrating
                                                                                                 

surgical and anesthetic equipment

for the safe conduct of surgery.

Location:
All OTs in an OT complex.
Emergency.
Blood bank.
Radiology.
Intensive care unit.
Central sterile supply department.
Laboratory.

OT- Design, Circulation and Layout:

  
Four zones can be described in OT:
1.Protective zones: it includes
Change rooms for all medical and paramedical
staff.                                                                                                  
Transfer bay for patient, materials and eqp.
Rooms for administrative staff.
Store and records.
Pre and post operative rooms.
ICU and PACU.
Sterile stores.

2.Clean zone: connects protective zone to

aseptic zone and has other area also like-
Stores and cleaner room, Eqp store,
Maintenance workshop, Pantry, Firefighting
device room, service room for staff and close
TV control area.

Aseptic zone: includes operation rooms.

Disposal zones :
Refers to from each OR and corridor lead to
disposal zone. OT
 
Design elements;
Considered patient flow; entrance, control, holding
pre-anesthesia, operating, recovery.
                                                                                                 
Consider staff; control, clean-up.
Particularly instruments and other goods which
must be sterilized between each use; done locally
or centrally. consider testing function; quick lab
test, x-ray etc.
This all consideration has to be keep in mind while
designing OT.

Space needs:
Generally 28-46sq m for each OT. Space for
circulation, nursing and medical staff and non-
functional bldg element such as Acs eqp usually
high ratio in this setting, perhaps 80 percent above
individual room needs.
If processing goods done within suite 28-37 sq m/OT
or delivery room must be added.
Locker room, showers and rest room for staff should
be provided based on number staff expected.
OT
 
Circulation :
Crucial to design of high technology
operating
Basic types:
and delivery suits;
                                                                                                 

corridor leading to all operating/delivery

room, used for patients, staff and eqp:
sterility maintained in each user of corridor
and within theatre itself;
Each room preceded by scrub-up area and
provision for fashion with outside corridor
or room for staff and eqp, presumed
sterile; locker room bridge corridors; staff
and eqp leave with patient; staff bridge
back through room and showers.
Corridor for trolleys 4.5 m wide and for
others 1.5 m wide.

OT
  
Cleaniness:
All material , surfaces, joints etc must be easily cleanable and durable for repeated
                                                                                                 

washings.
Anti-static materials should be used where patients likely be connected anaesthetic
machines.

OT
  ADVANTAGE OF GROUPING OF OTs

                                                                                                 

OT
 
Types of OT:
                                                                                                 

Major OT;
Minimum size : 38 sq m.
Minimum ceiling height : 2.7 m.
Minimum clear area : 33 sq m
(inclusive of cabinet and shelves)

Minor OT:
Minimum size ; 4.6 m.
Minimum clear area : 25 sq m.
(not including cabinet and
shelves)
OT
  Basic equipment
requirement.
                                                                                                 

OT
  Layout of operation theatre :

                                                                                                 

OT
LOCATION
Located at the front side
of the hospital where it
can be easily accessible.
• It should be well marked with proper
lighting and signs and should be easily visible
and accessible from the street.
• Since the emergency department becomes
the main entrance for the hospital at night, it
must relate to public and vehicular
transportation.
• The department should be close to the
admitting department, medical records and
cashier's booth

The emergency department should be located on the ground

floor with easy access for patients and ambulances.
There should be a separate entrance to the department, which
is away from the main hospital and the outpatient entrances.
• Laboratory services, including the blood bank,
should also be accessible to the emergency since a
sizable number of patients need this service.
• By designing the radiology department and the
laboratories close to the emergency, both the
operational cost and the critical time of travel can be
reduced. The department should be close to elevators
so that one can proceed to surgery without loss of time.

• Wherever possible, registration of new patients

and creation of their medical records, receiving of
cash and admitting functions should be done in the
department.

EMERGENCY
CONNECTIVITY
PUBLIC SECTOR AREAS:- LAB SERVICES
• Entrance for patients arriving by
ambulance, other modes of
transportation, or conveyances.
EMERGENCY RADIOLOGY
• Entrance for walk-in patients.
• Control station.
• Public waiting space with
amenities.

TREATMENT FACILITIES:-
• Patients' observation room.
• Treatment cubicles.
• Examination rooms.
• Trauma rooms (if required).
• Critical care rooms.

An Emergency Activity Centre may

also include a patient's security
room and areas providing supportive
services and staff accommodations.

CONTROL CENTRE
• The control centre is placed strategically to provide
visual control of all incoming traffic and observation of
the public waiting area so personnel may he aware of any
medical emergency that may arise there.
• Near the entrance, the control centre has an
external window so an approaching ambulance may be
observed.
• Vestibules to eliminate drafts at the entrances
provide a certain amount of comfort for control centre
personnel.

EMERGENCY
DESIGN
TRIAGE: It’s the process by which patients classified according to
the type of urgency of their conditions to get the.
RIGHT PATIENT to the RIGHT PLACE at the RIGHT TIME with the
RIGHT CARE provided.

FLOW OF THE PATIENTS FROM THE EMERGENCY WARD TO EXIT

THE TRIAGE AREA OR THE AREA WHERE THE PATIENT IS DIRECTLY

CARRIED AFTER THE ENTRANCE OF AN EMERGENCY.

EMERGENCY
PLANNING
• Sub-sterile room:- Sub-sterile
rooms, meaning support
spaces with a flash sterilizer
and sink, should be eliminated
from use in surgical suites.

MINOR OT
• A small operation theatre for
emergency department.
SURGEON UNIT
• Provides general medical care
for a wide variety of acute
illnesses, as well as post-
operative surgical care for
GYNAECOLOGY TRAUMA,CASUALITY, adult and pediatric
CENTRE OTHERS populations.
• Both should preferably have
separate entries.
• CARE UNIT:- Care units
cater to patients with severe
or life- threatening illnesses
and injuries, which require
constant care, close
supervision from life support
equipment and medication in
order to ensure normal
bodily functions.

EMERGENCY
PLANNING

SIZES OF ROOMS

EMERGENCY
LAYOUT
• An efficient, prompt, well-equipped ambulance service with competent personnel in charge .
A well-equipped emergency operating room with supplies always ready for use.
• A small recovery room.
• Efficient personnel including at least a competent physician, nurse, and attendant on
round-the-clock duty or on call.
• Supervision of treatment of fractures and other injuries by qualified and competent surgeons in
their respective fields.
• Adequate diagnostic and therapeutic facilities under competent medical staff.
• A well documented medical record for every patient that includes immediate
record of all injuries, physical findings, treatment, etc.

ORGANIZATION
 As mentioned earlier, levels of emergency care range from
elementary first aid to sophisticated surgical procedures.
 Not all hospitals can maintain an emergency department that will
offer full-scale trauma services.
 However, emergency first aid should be available at every hospital.
It is important to remember that having a full-scale emergency
trauma facility without proper equipment and competent staff
round-the-clock may be more dangerous than not having the
facility and that lives may be lost because, in the absence of
specialists, staff and equipment, no reasonable care can be
provided.
 Either the casual staff will mismanage cases or by the time they
direct the patients to other hospitals, it may be too late.

EMERGENCY
 Requirements In a Orthopedic Department

•Reception
•Treatment area.(Orthopedist)
•P.O.P room..(For band aid..)
•O.T…(surgery purpose)
•Wash rooms
•Waiting halls..(Two no's)
•Corridors
•Pharmacy

• Treatment area consisted of…table , bed, x-ray reader, chairs…

• A waiting space allotment for guardians of the patients.
• A easy accessible space for about a regular check up person and two
emergency cases
• Wash room
• Waiting hall 2 no's….For normal check up and P.O.P band (fracture)
• Wash rooms
• Corridors Provided with accessible space for about 2 Person and two
stretchers at a time (its about 4 meters)
• Notice boards.
• Direction sign boards.
• Provided with stretchers and wheel chairs.

Emergency Orthopedic Care-

Emergency orthopedic care includes acute trauma care and

urgent general orthopedic care delivered in hospital emergency
rooms.
Hospitals must provide facilities and resources to allow
orthopedic surgeons to provide safe, high quality emergency
orthopedic care.

ORTHOPEDIC
                                                                                                   
Orthopedic ICU

•Layout: Adequate space should be provided for the movement

of medical equipment, wheelchairs and furniture. It’s better to
create a room large enough to absorb additional functions as
time moves forward can ensure functionality in the long-term.

• Storage: Space should be provided for storage of devices and

common medical supplies like linens and medications. Often
used supplies should be located near the patient to promote
efficiency.

• Lighting: Enough lighting should be provided between the bed

and bathroom to reduce the likelihood of patient falls. Also,
sufficient lighting in the medication prep zone can allow
providers to better check patient arm bands to ensure proper
care delivery.

•Family zone layout : Situate family space in the line-of-sight of

providers to facilitate inclusion into the care conversation. Also,
position furniture out of the way of the caregiver zone in an area
that allows visitors to see and hear the TV without disturbing the
patient. Furniture should also be in place to allow visitors to
make physical contact with the patient when desired.

•Surgical ICU: Separate space should be provided for SICU. It

should be located nearby to regular orthopedic ICU. The Surgical
Intensive Care Unit (SICU) is the area for critically ill patients
who require orthopedic surgery or are recovering from
orthopedic surgery.

ORTHOPEDIC
 
A ‘pediatric hospital’ or
‘children’s hospital’ is a hospital
                                                                                                 

 which offers its services

exclusively to children and 
adolescents.

• In children’s hospital case, the hospital design

became especially important because children
are in a singular condition of learning and
interact with the world around, requiring
specific activities for a normal development.
Thus, hospital design should offer a homely
comfort while bringing the outside facilities
(school, playground areas, social rooms, etc.)
To the inside.

• PICU SHOULD BE A SEPARATE UNIT FROM

THE NEONATAL AND ADULT ICU DEDICATED
TO INFANTS AND CHILDREN.
• UNIT DESIGN SHOULD TAKE INTO
CONSIDERATION FUTURE ADAPTABILITY
AND EXPANSION AND MUST MAXIMIZE THE
RESOURCE OF SPACE, EQUIPMENT, AND
PERSONNEL IN A MOST AFFORDABLE WAY
FOR INDIVIDUAL INSTITUTIONS.
• NO TRAFFIC TO OTHER DEPARTMENTS
SHOULD PASS THROUGH THE UNIT.

PAEDIATRIC DEPARTMENT
  PAEDIATRIC INTENSIVE CARE UNIT(PICU)
                                                                                                 

•THE IDEAL PICU SIZE CANNOT BE STATED

BUT SIX TO TEN BEDS IS DESIRABLE. PICUS
WITH LESS THAN 4 BEDS RISK
INEFFICIENCY AND PICUS WITH GREATER
THAN 16 BEDS MAY BE DIFFICULT TO
MANAGE, IF NOT PROPERLY DIVIDED.
•FOR THE TOTAL PEDIATRIC WARD, BEDS UP
TO 25 AND A PICU OF SIX TO EIGHT BEDS IS
ROOM
IDEAL. LAYOUT

UNIT
PLAN
• PATIENT AREA IN OPEN PICU SHOULD BE 150 TO
200 SQ FT.
• IN A CUBICLE, THE MINIMUM AREA SHOULD BE
200 TO 250 SQUARE FEET WITH AT LEAST ONE
WASH BASIN FOR TWO BEDS.
• AT LEAST ONE, PREFERABLY TWO ROOMS
SHOULD HAVE AN ISOLATION CAPABILITY
WITH AN AREA OF 250 SQUARE FEET WITH AN
ANTE ROOM (SEPARATE AREA AT LEAST 20
SQUARE FEET FOR HAND WASHING AND
WEARING MASK AND GOWN) AND SEPARATE
VENTILATION.
PAEDIATRIC DEPARTMENT
  
Sl. no. Description of functions

Dermatology and Allergy Clinic

Doctor’s Chamber with Checkup 1
Facilities

Plastering Room
Plaster preparation Room
Neurology Clinic
Neurologist’s Chamberwith
Check up Facilities
1
1

1
Quantity Unit areain
sqm andsft

18 – 200

                                                                                                 
Orthopedic Clinic
Doctor’s Chamber 2 13.5 – 150
13.5 – 150
9 – 100

18 – 200
Total areain
sqm and sft

18 –200

27 – 300
13.5 – 150
9 – 100

18 – 200
 
Pediatrics Clinic
Nurse Station
Specialist’s and Doctor’s
Consulting Chambers
Immunization Program Centre
Counseling Room
Treatment Room
Store
Nutrition Rehabilitation Unit
Counseling Room
Store
1
2

1
1
1

1
1
13.5 – 150
18-200

36 – 400
18 – 200
9 – 100

36 – 400
9 -100
13.5 – 150
36-400

36 – 400
18 – 200
9 – 100

36 – 400
9 – 100
 
 

 
 
 

 
 
 

Waiting & Children PlayArea 1 83.5 – 900 83.5 – 900  

Otolaryngology or ENT Clinic
Family Planning & CounselingClinic
ENTspecialist’s Chamber 1 18- 200 18 – 200 Doctor’s Chamber 1 23.5-250 23.5-250
 
Audiology Room 1 9 – 100 9 – 100
Nurse Station 1 13.5-150 13.5-150
 
Procedure Room 1 13.5 – 150 13.5 – 150

:
Cardiology Clinic
Nurse Station 1 9 – 100 9 – 100 (ENT) Treatment
Cardiologist’s Chamber 1 13.5 – 150 13.5 – 100
Stress Test and ECG 1 9 – 100 9 -100 • ENT treatment can be carried out I
Gastroenterology • For inpatient in their own care area.
Gastroenterologist’s
Chamber with Check
1 18 – 200 18 – 200 • The treatment room 25-30 sq m , which can be
up Facilities darkened .
Common Nurse Station (for 1 9 – 100 9 – 100 • Should contain a treatment table for examinations, a
gastroenterology, Endocrinology,
Lungs Function and General Surgery
treatment chair, a sterilizer, a sink and wash basin,
clinic) storage spaces for portable eqp.
• 4- 6 Volt power points and compressed air/suction
Dental Clinic
Nurse Station 1 9 – 100 9 – 100
lines must be provided.
Dentist’s Chamber with 2 18 – 200 36 – 400 • Adjoining the treatment room should be a rest room
Checkup Facilities
and a patients waiting room.
                                                                                                   

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