PLANNING

6.53
AND DESIGNING
PUBLIC AREAS AND STAFF
FACILITIES IN A HOSPITAL
ABOUT US

1. Arshad Alam ( Team Leader)

2. Atul

3. Ayman Khan

4. Arzoo Hussain

21/11/2022 2
OVERVIEW
“CONSUMERS ARE SHOPPING [FOR HEALTH CARE] AS THEY WOULD FOR ANYTHING ELSE”

Public areas in a hospital Staff Facilities

1. Entrance and lobby 1. Library
2. Main waiting area 2. Gymnasium/ fitness facilities
3. Toilets 3. Locker rooms
4. Cafeteria 4. Toilets
5. Prayer room/Meditation room 5. lounges
6. Parking area

3
 ENTRANCE AND LOBBY
The main lobby
To accommodate patients, their families and friends.

“First impression is the last impression”

The interior of the lobby is overall impression of the hospital.

Peace of mind
A friendly and cheerful lobby coupled with caring staff will go long way to
help patients to overcome fear.

7/1/20XX 4
PARKING AREA

• Adequate parking space for

patients.
• Reserved parking space for
medical staff.
• Main public entrance should be
at:-
1. Ground level
2. Sheltered from the weather
3. Designed to handle wheel
chairs and stretchers.

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RECEPTION AND INFORMATION DESK
Positioning-
Conveniently located for the people as they
enter the hospital lobby.

Counters-
Should have counters in accordance with
the patient traffic

Staff training-
Staff should be trained properly to be polite
and empathetic.

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WAITING AREA

• Should be spacious and clean,

• Should have comfortable chairs
and done aesthetically.
• Waiting capacity should be
according to the patient traffic.
• Information display through
screens, charts, etc.

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PUBLIC TOILET FACILITIES Water coolers or drinking water
• Clean and weather according water should
• Should be separate for men and women. be made available to the patients and
• attendants.
Well maintained
• Disposables should be available at all
• Should be in accordance to the times.
accreditation. • Regular quality checks of water quality
should be done.

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 VENTILATION
• Ventilation should be planned in the
public spaces to minimise infection
spread.
• Planning and designing should be done
ain accordance to patient traffic,
• Air doors should be installed at required
entrance and exits.

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EASY TO FOLLOW SIGNAGE SYSTEM
• Directional graphics should be
placed for navigation of the
patients across the hospital.
• Emergency exit doors should be
marked properly.
• Floor evacuation plan should be
visible to the patients.

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IMPORTANCE OF PUBLIC SPACES

11
 Maintenance
management

Environment control Electrical system

PLANNING AND
DESIGNING
HOSPITAL
Solid waste
Engineering system
management

SERVICES

Air conditioning Water supply and

system sanitation

Centralized
Communication
mechanical gas syste
system
m

TEACH A COURSE 12
MAINTENANC
E
MANAGEMENT
INTRODUCTION
MAINTENANCE IS A SET OF ORGANIZATION ACTIVITIES THAT ARE CARRIED OUT IN ORDER TO KEEP THE ITEM IN ITS BEST OPERATIONAL
CONDITION WITH MINIMUM COST REQUIRED.

 Objectives
 Failure analysis
 Benefits of failure statics
 Limitation
 Type of maintenance

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OBJECTIVE
 Maximize the useful
life of equipment.
 To minimize the
frequency of
interruption.
 Safety of manpower
 Increase production of
facilities
 Correctly adjust,
service, operated
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FUNCTIONS

 Inspection
 Repair
 Overhaul
 Lubricant

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MAINTENANCE COST

 Breakdown services
 Delay in services
 Re-Maintenance exceed
 Loss Warranty
 Capital requirement for replacement
of machine

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FAILURE ANALYSIS

Preventive
Anticiated failure
maintenance based
and prepared to
on condition
remedial measure
monitoring

sudden failure Gradual Failure

Failure

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BENEFITS OF FAILURE STATICS

 Help in diagnosed failure when they

occur
 Provides valuable information
regarding the life of reliability of
equipment
 Helps to take maintenance policy
 Information for spare department

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LIMITATION

 When the failure is due to quality of the

product
 Manufacturing defects
 Poorly installed equipment
 Damage due to handling

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 Maintenance

Planned Unplanned
maintenance maintenance

Emergency
Corrective Preventive Predictive Running Shutdown Schedule Breakdown
maintenance

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HOSPITAL ENGINEERING SERVICES

 The engineering services of a healthcare facility support the delivery of patient care and help to maintain a healing
and safe environment.
 • Engineering services are integral part of hospital infrastructure
 • Engineering services account for approximately 35-40% of the capital costs in the construction of health care
facilities
 • The requirement for the healthcare design is that it facilitates high quality patient care for the most cost-effective
capital and recurrent cost
 • Engineering services have large contribution towards shaping the environment of care
 • The goal of Environment of Care is to provide a safe, functional and supportive environment for patients, staff
and visitors
 • The environment of care is composed of the building, the equipment and the people

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COMPONENTS OF ENGINEERING SERVICES
 • Engineering services of a hospital
include: – The civil assets - Includes:
 • Building, Roads, Storm Water
Drainage, Wastewater drainage, Sewage
Treatment Plant
 – Electricity supply
 – Water supply including plumbing and fixture
 – Steam supply
 – Acoustics and Lighting
 – Piped medical gas and vacuum system (PMGV)
 – Air conditioning and refrigeration
 – Lifts, pneumatic tube system and dumbwaiters
 – Public health services
 – Communication system, paging, CCTV
 – Building management system
 – Workshop facilities for repair and maintenance
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CIVIL ASSETS

 • Hospital building is a complex structure

 – The layout, space, circulation should conform to
national and international guidelines
 – The form of the building should follow function
 – The design and construction of the building should
be environmentally sustainable
 – It should provide a safe, patient friendly and
healing environment
 – The design should be evidenced based

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MAINTENANCE SERVICES

 – Fire systems
 • Objective of building maintenance is to always  – Bio-electronic equipment
provide an optimum medical and operational  – Any life-support systems
environment
 – Boiler plant
 • The maintenance service may be in-house or
outsourced with an on-call repair service  – Telecommunication system including:
 • Following areas require 24 hour per day, 7 day per  • Emergency warning and Intercommunication
week on call maintenance service system
 • Nurse call

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 ELECTRICAL SYSTEM

 • Electricity is vital to hospital operation and patient

safety
 • Electrical services shall include:
 – Provision of normal, vital (30 sec.), instantaneous (1
sec.), and uninterruptible (no break) electricity supplies
 – Switchgear and circuit protection to safely operate
and control the supplies

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ELECTRICAL SERVICES

 –Distribution arrangements to supply

electricity to each end use
 – Equipment to transform and
condition voltage from supply
voltage to end use voltage and within
voltage and frequency tolerances
 – Equipment to use the electricity for
lighting, heating and motive power

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ENGINEERING SERVICES FOR FIRE

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 Cont.
 • Fire services shall be provided to comply with
requirements of National Building Code, 2005  – Provision of escape route air pressurization

 • These shall include (but not limited to):  – Provision of hose reel and hydrant fire
extinguishing equipment
 – Provision of materials and methods of construction
to comply with codes and regulations  – Provision of automatic fire extinguishing systems

 –Compartmentation of the buildings into fire and  – Provision of portable fire extinguishers
smoke compartments  – Provision of equipment to aid transportation of
 – Provision of complying fire egress arrangements disabled persons
 – Provision of fire and smoke alarms  – Provision of escape diagrams

 – Storage arrangements for fire fighting water

 – Fire fighting water pressure boosting arrangements

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ENGINEERING FOR WATER

 • Extent of Services
 – Cold potable water service
 – Hot potable water service
 – Warm potable water service
 – Water filtering and conditioning equipment
 – Water storage tanks – Gardens and ground irrigation
 – Bore water supplies
 – Sanitary drainage service
 – Process wastewater discharge conditioning facilities

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CONT.

 – Sanitary fittings and fixtures

 – Roof plumbing
 – Storm Water Drainage
 – Sub soil drainage
 – Sewage treatment facilities
 • Drinking Water Specification (Indian Standard)
– IS 10500: 2012
 • Water requirement – 450 Lit per bed per day

31
ENGINEERING SERVICES FOR LIFTS

 • Any building of more than one story shall have adequate lifts to provide safe and reliable vertical transport for
persons and goods
 • The number of lifts and their size, speed and load carrying capacity shall be determined by a professional analysis
 – They provide an efficient, fast, comfortable, safe and reliable vertical transportation for movement of staff,
patients, visitors, medical equipment and ancillary services items
 • Location
 – Should be based on medical function and service function such as goods.
 – Lifts should be located away from sensitive areas
 – Wherever possible lifts should be provided, at least in pairs, to provide service in the event of breakdown or
unavailability for maintenance or inspection
 • Types – Passenger, goods/passenger and goods only

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 FACILITY MANAGEMENT TEAM

TEACH A COURSE 33
WATER SUPPLY
AND
SANITATION

Arzoo hussain

34
THE SCOPE OF THE PROBLEM

Source: Cronk, R., & Bartram, J. (2018). Environmental conditions in health care facilities in low-and
middle-income countries: coverage and inequalities. International journal of hygiene and
environmental health, 221(3), 409-422.
35
WATER SUPPLY AND SANITATION

For the health Hospitals should The quality of water

facilities having beds ensure that they have should be ensured for
less than 100, the enough provisions drinking purpose.
water requirement is for storage of water
around 350 litres per
bed per day

36
THE BASIC MEASURES THAT CAN BE UNDERTAKEN
TO CONTROL THE QUALITY OF WATER ARE:
Regular cleaning of
water tanks and
reservoirs.

Regular maintenance
Retaining results of
of RO plants and
water testing and
water dispensing
cleaning of tanks.
machines.

Regular water testing

Chlorination of water for any growth of
micro-organisms.
37
SANITATION REQUIREMENTS
Water closets
1 for every 8 beds
1 for every 6 beds
Baths
1 bath with 12 beds for economy rooms.
Attached let-bath for private deluxe and suites.

Urinals Cleaner’s sinks and kitchen sink

1 for every 12 beds 1 for each ward in dirty utility room.
1 for each ward in dish washer’s pantry

Wash basins
1 for every 12 beds.
1 for every nursing station.
1 for every intensive care unit.
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COMMUNICATION
SYSTEM

Arshad Alam

39
 COMMUNICATION SYSTEM

Wiring in conduits Communication system Nurse call system

for outlet in Rooms, to alert people involved
wards and stations. for patient care and
during emergency.

40
EXCHANGE OF INFORMATION

People to people People to machine or Machine to machine

machine to people .

41
TYPES OF COMMUNICATION
Telephone system
Gives greater accessibility and speed of communications, patient
safety and triage management and flexibility.

Integrated service digital network (ISDN)

Transferring patient records such as imaging or files or reports.

Public address system

very useful in case of any kind of emergency when everyone needs to be alerted.

Television
Advertise or communicate about the facilities of hospital using
Televisions.

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 EMERGENCY COMMUNICATION

An emergency plan

A dedicated set of procedures and

policies regarding crisis situations A communication plan

A system to train staff on

these protocols and to test
the emergency plan

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 HVAC SYSTEM
(HEATING
VENTILATION
AND AIR
CONDITIONING)

Arshad Alam

44
 COMPONENTS OF HVAC SYSTEM

Outdoor air Air handling Air

intake and air
exhaust ducts units (AHU) distribution
and controls systems

Dampers are used to cut off It can be of full fresh air or

central air-conditioning to Its function is to take in outside single-pass system
unused rooms and for air, re-condition it and supply as (displacement ventilation) or
regulating the air supply room- fresh air the traditional re-circulation
by-room. type system.

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BASIC STRUCTURE OF AIR HANDLING
UNIT

46
 “Hospitals must consider the spread of air borne diseases and the exact temperature and humidity conditions required for
intensive care units and other hospital areas when designing their air conditioning system”

COVID-19, Air Ventilation, and HVAC Systems.

• The importance of indoor air quality and ventilation systems in regard to public
health has never been greater.
• Wards with COVID-19 patients must be well ventilated to prevent the spread of
disease and to protect both patients and staff.

Hospital HVAC Systems Affect Air Quality, Comfort, and Health for All
“it is easier to take indoor air that’s cool and comfortable for granted, but heating,
ventilation, and air conditioning systems are critical to air quality, comfort and
safety.”
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WHY HVAC IS VITAL ?
Preventing cross- contamination
Patients can pick up airborne particles and
pathogens, making them sicker.
Filtering air
High-efficiency particulate (HEPA) air filters
can remove pollutants and microbial particles
that are as small as .3 microns.
Better patient outcomes
Concerning the body, heat stress protection and
proper thermoregulation rely on environmental
temperatures and conditions.
Comfort
Air that’s kept at a comfortable temperature and
humidity level is simply easier to breathe and
helps staff focus on healing.
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OTHER HEALTH CARE FACILITIES NEEDING WELL-
FUNCTIONING HVAC

•Inpatient and
outpatient Doctors Research
clinics offices facilities

Medical billing
Mortuary
centres

49
MAINTENANCE SUGGESTIONS FOR HVAC
SYSTEM
Ensure proper labelling of parts of HVAC plant including the direction of airflow

Outside air intakes must be examined for any dust and moisture.

Drain pans and pipes checked for any accumulation of condensate water

Clean condenser and evaporator coils.

Indoor air quality should be frequently checked usually every 6 months

HEPA filter efficiency tests and efficiency rating label every 6 months

Lubricate motors bearings, fans and moving parts.

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HOSPITAL WASTE
MANAGEMENT
SYSTEM

Ayman Khan

51
HOSPITAL WASTE MANAGEMENT
Waste generated from the healthcare facility
is classified as:
• Bio Medical Waste BIOMEDICAL
• WASTE
General Waste 15%
• Other Wastes
BIOMEDICAL WASTE
GENERAL WASTE

GENERAL
WASTE
85%

"Bio-medical waste" means any waste, which is generated during the diagnosis,
treatment or immunization of human beings or animals or research activities pertaining
thereto or in the production or testing of biological or in health camps.
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CATEGORIZATION & CLASSIFICATION OF WASTES IN HEALTH CARE
FACILITIES

53
BIO MEDICAL WASTE SEGREGATION
Biomedical waste generated from a healthcare facility is required to be segregated at the point of
generation as per the color coding stipulated under BMWM Rules, 2016.

• Posters/placards for bio-medical waste segregation should be

provided in all the wards and waste storage areas.
• The Adequate number of color-coded bins/containers and bags
should be available at the point of generation of bio-medical waste.
• Provide Personnel Protective Equipment to the bio-medical waste
handling staff.

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BIO MEDICAL WASTE
COLLECTION
• Bio-medical waste should be collected daily from
each ward of the hospital at a fixed interval of time
• Contaminated waste bins should be in strategic
collection points. Collection points such as Disposal
Rooms or Dirty Linen Holding in each unit need to
be easily accessible to the staff responsible for
disposing of wastes, as well as to those servicing the
facility in removing and replacing the bins.
• A Dirty Corridor should be provided for transport of
waste which should not be used for transport of
clean materials such as food items and general
supplies for the facilities.
INTERIM STORAGE
• If waste is needed to be stored on an interim
basis in the departments, it must be stored in
the dirty utility/sections.
• No waste should be stored in patient care areas
and procedures areas such as Operation
Theatre. All infectious waste should be
immediately removed from such areas.
• In absence of dirty utilities/ sections such as
BMW must be stored in a designated place
away from patient and visitor traffic or low-
traffic area.
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ROUTE OF INTRAMURAL
TRANSPORTATION OF BIO-MEDICAL
WASTE
Route of transportation preferably is planned in such a way that:
• Transportation does not occur through high-risk areas
• Supplies and waste are transported through separate routes.
• Waste is not transported through areas having high traffic of patients
and visitors
• Central Waste collection area can be easily accessed through this
route
• Safe transportation of waste is undertaken to avoid spillage and
scattering of waste

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CENTRAL WASTE COLLECTION ROOM FOR
BIO-MEDICAL WASTE
• The location of the central waste collection room must be away from public/ visitor's access.

• The planned space must be sufficient so as to store at least two days’ generation of waste.

• It should be under lock and key under the responsibility of the designated person.

• The entrance of this centre must be accessible through a concrete ramp for easy transportation of waste collection trolleys.

• Flooring should be of tiles or any other glazed material with a slope so as to ease the cleaning of the area.

• Exhaust fans should be provided in the waste collection room for ventilation

• Sign boards indicating relevant details such as contact person and telephone number should be provided.

• The entrance of this station must be labelled with “Entry for Authorized Personal Only” and the Logo of Bio-Medical
Waste Hazard

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PLANNING A WASTE MANAGEMENT UNIT
The Waste Management Unit should have the following features:

Fitted with
security fittings
such as door Located away
Easily accessible Accessible from
locks, from food and Not accessible to
from all within the unit
keypad/card clean storage the public.
functional areas and externally
access, CCTV areas
and motion
sensors

58
BUILDING SERVICE REQUIREMENTS

Building service requirements for the Waste Management Unit will include the following:

• Temperature monitor and alarm should be connected to Biomedical Services to alert staff of any malfunction.

• A high-pressure wash-down unit should be provided for the adequate cleaning of the area.

• Drainage from this area may include disinfectants; therefore liquid wastes may require special treatment prior to
discharge.

• Walls and floors should be sealed to withstand the frequent wash downs and the floors graded to allow runoff.

• All power points provided in the waste storage, equipment washing and disposal area should be waterproof .

• Lighting should be adequate.

59
ENVIRONMENTA
L CONTROL

Ayman Khan

60
The design, construction, renovation, expansion, equipment,
and operation of hospitals and medical facilities are all subject
to provisions of several government environmental pollution
control laws and associated agency regulations
The principal environmental laws under which hospitals and medical facilities may be regulated include, most
notably, the following:
• Biomedical medical waste management handling rules 2006 (Amended in 2018)
• Water ( prevention and control of pollution ) Act 1974
• The Noise Pollution (Regulation and Control) (Amendment) Rules, 2010.
• The Air (Prevention and Control of Pollution) Rules, 1987
• Environment Protection Act, Amendment 2022.

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 HEALTHCARE WITH DESIGN OF THE GREEN HOSPITAL
Green Hospital" is a concept that is beginning to redefine how healthcare facilities are built to protect the
environment while saving human lives.

FOCUS AREAS IN THE DESIGN OF HEALTHCARE

STRUCTURES
LIGHTING
• A good design of a healthcare facility should maximize day light and optimize the artificial lighting requirement.
• Use of light-emitting diode (LED) lighting is another green.
• Large windows should be a part of the total hospital experience.
INDOOR AIR QUALITY
• During the design stage it’s necessary to use special care for space design for infection control.
• Proper space planning, routine monitoring of various parameters of HVAC systems.

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CLEAN AND GREEN INTERIOR BUILDING MATERIALS

• Interior surfaces of Healthcare Buildings should be from materials that are capable of repelling, resisting or
even discouraging growth of pathogenic germs and bacteria on them.

• The use of copper based interior materials for door handles, light switches, faucets, worktops is encouraged

63
GARDENS AND LANDSCAPING

Water-efficient, low-maintenance landscaping should be used, with water conservation achieved by

managing storm water runoff in the site. Keeping up and using green spaces around hospitals lowers the
costs associated with recovery and also contributes positively to patients’ survival chances and quality of
life during their stay

64
 CONCLUSION

• Planning and designing of hospital services initiates at the time of designing the blueprint of the
hospital.
• All the services are not functional during early phases but spaces and arrangements have been
places way before they become functional.
• All these services work inter-dependently with each other and together make the hospital a system
in whole.
• Non-functionality of even one service can hamper the working of several other services and
ultimately may damage the patient satisfaction.
• Proper management and maintenance of all the services is vital for the proper functioning of the
hospital.
• Patient satisfaction relies on clinical as well as non-clinical services.
MEET THE TEAM

Arshad Alam Ayman Khan Arzoo Hussain Atul Kumar

Team leader

66
THANK YOU
We would love to answer your
queries 

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