Location and layout of hospital, need of hospital to community,planning,factors and data required in planning,fundamentals and objectives,principles,different stages,equipment planning,icu design and layout,quality quantity and temperature and noise control in hospital,conclusion
There are two methods to estimate the need forhospital in a population: Analytical method : Taking feedback andanalysis of data collected through survey e.g.distributing questionnaire. Estimation method
Planning (also called forethought/forecasting) is theprocess of thinking about and organizing the activitiesrequired to achieve a desired goal.
1.What we expect to do? 2.Why it will be done ? 3.Where will it be done ? 4.When we expect to do it? 5.Who all are going to do it ? 6.How will it be done ?Excellent firms don’t believe in excellence – only in constant improvement andconstant change – Tom Peters
Community interest over individual interestPreventive services over curative servicesServices catering to the weaker sections of the communityRural over UrbanRegionalized Planning
Geographic Data Morbidity & Mortality Status Need & Demand Details of existing Facilities Financial Feasibility Demographic Details Population Strength Sex & Age Ration Social Status Educational level
Must meet the needs of the patient it is going to serve adequately.It must be in a size and proportions which the owners or promoters will be able to build and operate
Sound architectural planEconomic viabilityEffective community orientationQuality patient care
Protection from unwanted and unnecessary disturbances inorder to help speedy recoverySeparation of dissimilar activitiesControl – the nurses station should be positioned strategicallyto enable proper monitoring of visitors entering and leavingthe ward, infants and children should be protected from theftand infection etc.Circulation- all the departments of a hospital must beproperly integrated.(“separate all departments, yet keep them all together;separate types of traffic, yet save steps for everybody; that isall there is to hospital planning “– Emerson Goble)
Needs of the community Ease of accessibility Range of services offered Availability of specialists Availability of technologyStudy of existing hospital(if any)Requirements of staff and services
Bed: Population = A x S x 100 365 x POA= number of inpatientadmissions/1000 population/yearS= average length of stayPO= percentage occupancy
Planning of finances-Funds required for constructing, furnishing and equipping the hospital.Operating funds- salaries, loans and interest, other maintenance expenses.Arranging financial assistance-patient fees, bed charges, and other modes of revenue generation process.
Stage AFunctional content: Project teamOutline brief: Assessment of functional content Submission of owners( Govt,private organization etc.)for approval Site appraisal, gross floor areas Building space. Draft master plan Estimation of cost and phasing Appraisal of work by ownersStage BOperational policies: Operational policiesDevelopmental plan: Departmental and inter related activities Departmental and hospital policies Development control plan Budget cost Continuous informal discussion with owners
Stage CSchedules of accommodation, sketches, Schedules of accommodationFinal cost estimate: Sketch drawing Equipment schedules component estimates Cost revenue and staffing estimates Final cost approvalStage DDetail design working drawings, tender Working drawingsaction: Engineering details Bills of quantities Calling tendersStage EContract and construction: Assessments of tenders Award of contract Construction Engineering commissioningStage FCommissioning: Staff assembly and training Equipment and supplies assembly Testing of installation
Equipment planning-Built in equipment These include counters and cabinets in laboratory, Pharmacy and other parts of the hospital , elevators , incinerators , coolers , fixed sterilizing equipment etc. These are usually included in the construction contract and the planning of these equipments is the architects responsibility.Depreciable equipment This includes equipment that has a life of five years or more and is not purchased through construction contracts. These are large pieces of furniture which have a relatively fixed location and are capable of being moved e.g., diagnostic and therapeutic equipment, laboratory instruments, office furniture etc.
Non depreciable equipment These are small items with a low unit cost and life span of less than five years. These are generally under the control of the store room and are bought through other than construction contracts. They include kitchen utencils,surgical instruments,linen,waste baskets etc.
Operation programAdmission Human resourceAdministration StoresGeneral engineering PurchasingLaundry MaintenanceClinical services Waste disposal plantPharmacy Fire and safetyNursing services Disaster planHouse keeping informationRecords Dietary servicesPublic relations Clinical engineeringEmployee facilities Sanitation
Intensive critical care unit (ICCU)- Should preferably be located on the ground floor with convenient access from the operation theatre suit and emergency department and easy accessibility for wards. It consists patient area, staff area, support area. Four basic requirements- Direct observation of the patient by nursing and medical staff Surveillance of physiological monitoring Provision and efficient use of routine and emergency diagnostic procedures and interventions. Recording and maintenance of patient information
Design and Layout of ICCUDesign should take into consideration the integrationand smooth functioning of three areas 1. The Patient Area 2. The Staff Area 3. The Support Area Total area ranges from 350 to 500 sq. feet per bed which includes 1. Circulation Area 2. Nursing Station 3. Sanitary and Ancillary Accommodation
Ancillary & Support ServicesIt should be centrally air conditioned.Overall lighting Requirement in ICCU is for subdued illumination for the patient bed withcapacity for increasing it in case of need.Main light at the bed head should be fitted with dimmer switch.A high intensity emergency light or spot focusing light should also be provided.Emergency buzzer switch connected to central buzzer and location panel at central nursingstation.Multiple electrical gadgets required.Stand by generator is also required.Diagnostic SupportShould have round the clock access toLaboratory servicesRadiologyImagingPhysiotherapy.Equipment maintenanceVisitor Lounge
Area Sq .ft / bedNursing unit 250-280Nursery 12-18Delivery suite 15-20Operation theatre 30-50Physical medicine 12-18Radiology 25-35Laboratory 25-35Pharmacy 4-6CSSD 8-25Dietary 25-35Medical record 8-15
Area Sq .ft / bedHouse keeping 4-5Laundry 12-18Mechanical installation 50-75Maintenance work shop 4-6Stores 25-35Public areas 8-10Staff facilities 10-15Administration 40-50Total 567-751Circulation 115-751Total net area 682-891
Hospital administrators and staff have an ongoingconcern with controlling unwanted noise in theirfacilities. Patient comfort, employee satisfactionand environmental concerns are always at theforefront in the continuous design andmaintenance of a wide array of systems that keepa medical facility running efficiently.
Technology requirement must be metClinical needs must be consideredSafety is a major factorStandards and Guidelines are essentialImportance of the role of Hospital Staff in construction and design.
A hospital is a living organism, made up ofmany different parts , having differentfunctions, but all theses must be in dueproportion and relation to each other and tothe environment to produce the desiredresult - Dr S Billings