hospital case plus

8/2/2019 Hospital Case Plus

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C A S E S T U D Y

&

L I T E R A T U R E S T U D Y

H O S P I T A L d e s i g n

Submitted by:

ASHISH RANA - A081009

RISHI VERMA - A081026

SHREY SHARMA - A081032

SUNAINA NANDWANI - A081036



I N T RO D U C T I O N

A hospital is a health care institution providing patient treatment by specialized staff and equipment.

Types of hospitals(as per function)

University hospitals:They are the most broad

hospitals as they are alsoa college for medicinal

studies.

Specialty hospitals:Have specialized departments

as in cardiology, neurology ,

etc. which specialize in a

particular sphere of medicine.

General hospitals:General hospitals diagnose and

treat major all the major ailments

with facility to hospitalize patients

for scrutiny and care.

Types of hospitals (as per no of beds)

Smallest acute(upto 50 beds)

Small(upto 150 beds)

standard(upto 600 beds)

large(more than 600 beds)



PLANNING CONCEPTION

Location:

• The site should offer sufficient space for self contained residential areas and hospital departments.

• It should be a quiet location with no possibility of future intrusive development not excluded by

regulations on adjacent sites.• Adequate open areas for later expansion must also be planned.

Orientation:

• Treatment and operating rooms - north-west and north-east.

• nursing ward facades - south to south-east is favorable

• East and west facing rooms have comparatively deeper sun penetration, though less winter sun.

• The orientation of wards in hospitals with a short average stay is not so important.

• Some specialist disciplines might require rooms on the north side so that patients are not subjectedto direct sunlight.



HEALTH

CENTRE OPD

EM

RADMINISTRA

TION

SURGERY

DIAGNO

STIC

FAC.

DELIE

VERY

NURSING

SERVICES

LAUNDRY

KITCHEN

DINING

HELPERLOCKER

NURSESBLOCK

STORAGE

MECHANICALPLANT

A/CPLANT

PARKING

NU

RSER

Y

P A T I

E N T S

P A T I E N T S

S T A F

F

O

U T

P A T

I E N T S

A M B U L E N C E

S T A F

F

V I S I T

O R S

S E R V

I C E

A N D

H E L P

BASIC CIRCULATION FLOW CHART OF A HOSPITAL



Registration/

payment

Check-in

examination

Doctor’scheck up

payment

Lab tests

X-rayECG

Ultrasound

hospitalization

pharmacy

exit

OUTDOOR PATIENT DEPARTMENT : CIRCULATION

surgery

emergency

delivery

hospitalization

EMERGENCY : CIRCULATION



OT :

1 OT for every 50 general impatient beds and 1 OR for every

25 surgical beds

ICU beds:

5-10% of total beds

FLOOR SPACE FOR EACH ICU BED :

25-30 M2/BED

FLOOR SPACE FOR EAH PEDRIATIC ICU BED :

20-24M2/BED

FLOOR SPACE FOR HOSPITAL BED :

15-18M2/BED

BED SPACE IN WARDS:

7M2/BED

C/C DISTANCE BETWEEN TWO BEDS:

2500mm

CLEARANCE AT FOOTEND OF EACH BED :

1200mm

WAITING AREA IN OPD :0.5 – 1 M2 / PATIENT

ELECTRICAL REQUIREMENT/BED/DAY:

3-5 KW

WATER REQUIREMENT/BED/DAY :-

400-500 LITRES

LAUNDRY:

1 - 1.5 M2/BED

OPD REGISTRATION SPACE :

0.5 M2/BED

DOOR OPENINGS PATIENT BEDROOMS:MINIMUM : 1500MM WIDE & 2100 MM HIGH

CORRIDORS :

• With frequent trolley movement : 2100-2400 mm

• Without frequent trolley movement : 1800 mm

• No transportation : 1200 mm

• Major inter department corridors : 2100mm

Ceiling heights :

• Minimum ceiling heights in occupied areas . Corridors,

passages and recesses : 2400mm

• Ceiling heights : therapy rooms, ICU and kitchen : 2700

mm

• X-ray rooms , OT’s : 3000 mm

Bed/service lifts :

• Clear door opening : 1200mm X 2000 mm

• Car dimensions : 1300mm X 2400 mm(deep)

Passenger Lifts :

• Clear door opening : 800 mm X 2000 mm

• Car dimensions : 1300mm X 1100 mm



DOCTOR’S ROOM, TREATMENT ROOM , NURSE’S

WORKROOM AND STATION SUPERVISION ROOM

BED LIFT FOR PATIENTS

BED LIFT FOR PATIENTS



CORRIDORS

• Corridors must be designed for the maximum expected

circulation flow.

• General access corridors

1.5m wide

• Corridors in which patients will be transported on trolleys2.25m wide

• The suspended ceiling in corridors may be Installed up to

2.40 m.• Windows for lighting and ventilation should not be further than

25m apart.

BED REQUIREMENTS In the planning of new buildings, about 70-100 m2 must be

allowed per sick bed, and roughly 200-280 m3 per bed mustbe allowed for alterations (which includes all ancillary spacessuch as environmental controls and storage)



AN EFFECTIVE ARRANGEMENT FOR A HOSPITALWOULD BE AS FOLLOWS:

top floor: helipad, air-conditioning plant room,nursing school, laboratories

2nd&3rd floor: wards 1st floor: surgical area, central sterilization,

intensive care, maternity, children'shospital

ground floor: entrance, radiology, medical services,ambulance, entrance for bedridden patients, emergency

ward, information, administration, cafeteria basement: stores, physiotherapy, kitchen, heating

and ventilation plant room, radio-therapy,linear accelerator

sub-basement: underground garage, electricity supply



FUNCTIONAL AREAS OF A HOSPITAL :

Supply/disposal 6 - 14m2 PA/planned bed care area

nursing area 4 - 5m2 PA/planned bed care area

Intensive therapy 5 – 8m2 PA/bed

Surgical area 21 - 28m2 PA/surgical unit

Rehabilitation 4 – 5 m2 PA/treatment unit

Physiotherapy 11 – 12.5m2 PA/treatment place

X-ray 10 – 12m2 PA/diagnosis room

Radiotherapy 50 – 60m2 PA/equipment

Recovery area 4 – 6m2 PA/recovery bed

NMR diagnosis 16 – 25m2 PA/diagnosis room

Clinical physiology 13 – 16m2PA/diagnosis room

Clinical neurophysiology 13 – 16m2 PA/diagnosis room

Central reception 23 – 27m2 PA/examination/treatment room

Delivery area 14 – 16m2 PA/delivery room

Dialysis 12 – 13m2 PA/dialysis bedSpecialist departments 9 – 13m2 PA/examination/treatment room



SURGICAL DEPARTMENT

operating theatre 40-48 m2entry room 15-20 m2exit room 15-20 m2washroom 12-15 m2

equipment room 10-15 m2

The image displays an Ideal floor plan of an externalsurgical area with a direct link to the main building. The

corridor system IS separated into staff corridors with links tothe functionalrooms and pre-operative and post-operative patientcorridors. A requirement when planning a new building IS

that it must be expandable on at least one side.

MAIN SURGICAL ROOMS 6.50 x 6.50mwith a clear height of 3.00m and an extra heightallowance of roughly 0.70m for air conditioning andother services.

ANAESTHETICS ROOM The anaesthetics room should be approximately3.80 x 3.80m

WASHROOM The minimum width of the room should be 1.80m.For each operating theatre there should be threenon-splash wash-basins with foot controls.

STERILE GOODS ROOM 10m2 is required per operating theatre.

EQUIPMENT ROOM A room size of approximately 20m2 should beallowed.



POST OPERATIVE FACILITY

• Beds must not be too close together in the recovery room and allowenough space for the anaesthetist and his equipment to reachat least three sides.

• The route between the recovery room, the operating theatre and theward should contain several doors and be as short as possible so the

anesthetist can get to the patients quickly in case of emergency.

Recovery room requirements The number of beds required is calculated as1.5 times the number of operating theatres.

Central sterilization - 40-120 m2. Approx.Dictation room - 5m2 approx.Patients' room

1 bedded room - 10m22 and 3 bedded room -8m2 (per bed)

Non clean work room 10m2Nurse’s work area 25-30m2Rest room/kitchenette 15m2Station doctor 16-20m2Clean workroom 10m2

Plant room 8m2

Patients lounge 20-25m2

Internal medicine treatment area Examination room 25m2Physician’s room 25m2

Radiology 18-30m2



INTENSIVE CARE UNIT

Arrangement:• The intensive care department must be a separate area, and only accessible through lobbies (for hygiene

reasons).•

The central point of an intensive care unit must be an open nurses' workstation from which it is possible tooversee every room.• The number of patients per unit should not be more than 6-10.• Following should be included in the plan :1. One nurse's duty station,2. a sterile workstation(medication and infusion preparation),3. one materials room and4. one equipment room per unit (six to ten beds)

Arrangement of the bed spaces:• The beds may be placed in an open, closed or combined arrangement.• All the beds must be in clear view of a central nurses' duty station.• The patients are separated by moveable half-height partitions which

should be lightweight and easy to move.• The ideal plan is star shaped, with rooms radiating out from the

nurses' workstation, but this is often not feasible because of space

restrictions so more traditional arrangements are used.



ENTRANCE

RECEPTION

C-T SCAN

CHEMIST

DOCTOR

CHAMBERS

RETIRING

ROOM

DOCTOR’S

CHAMBER WAITING HALL

CASUALTYRAMP

TOILETSULTRA

SOUND

DOCTOR’S

CHAMBER

WAITING HALL

SAMPLE

ROOM

X-RAY

ADMINISTRATION

ICU

LIFT &

STAIRS



PRIVATE

WARD

GENERAL

WARD

WAITING HALL

PRIVATE

WARD

AUTOCLAVEPRIVATE WARD

PRIVATE WARD

GENERAL

WARD

PRIVATE WARD

LIFT &

STAIRS

KITCHEN

PRIVATE

WARD

COMMON

ROOMO.T

O.T

FOYER



RAMP

LAB

CONFERENCE

MANAGER

PHYSIOTHERAPY

FOYER

Sarvodaya Hospital , Hisar



y p ,

Physiotherapy 40 ‘ x 16 ‘

Conference room 25 ‘ x 16 ‘

Manager room 10 ‘ x 10 ‘

Laboratory 12 ‘ x 15 ‘

Patient ward 9 ‘ x 16 ‘ , 9 x 12 ‘

Common room 11 ‘ x 16 ‘

O.T 14 ‘ x 13 ‘

Autoclave 11 ‘ x 13 ‘

General ward 17 ‘ x 12 ‘ , 17 ‘ x 15 ‘

Corridor 7 ‘ wide

Lift 6 ‘ x 8 ‘

I.C.U 40 ‘ x 30 ‘

Ultrasound 10 ‘ x 6 ‘

X – Ray 11 ‘ x 14 ‘ , dark room – 7 ‘ x 3 ‘

Waiting 12 ‘ x 12 ‘

C. T.scan 11 ‘ x 16 ‘+ console= 8 ‘ x 12 ‘

D. chamber 9 ‘ x 12 ‘ , 16 ‘ x 10 ‘

Chemist 9 ‘ x 13 ‘

Ramp 5 ‘ wide

Standards



Corridors 1.5 m least

2.25 m for trolleys

3.00 m main corridors

Doors 2.1 – 2.2 m normal doors

2.5 m vehicle entrance

2.7 – 2.8 m transport entrance

Stairs effective width of stairs and landing in essential stairscase

Must be a minimum of 1.5 m and should not exceed 2.5 m.

Step height of 170 mm permissible and minimum required

Tread is 280 mm.

Rise : tread = 150 : 300 mm

room size 117 – 172 sq.ft single bedroom

157 – 210 sq.ft double bedroom

308 – 401 sq.ft four bed room

Major difference is found in room depths.

Depth 14 ‘ 6 “ for single

15 ‘ for double

21 ‘ 8 “ for four

Typical bed side table = 16 “ x 20 “

Surgical department

Ot 40 48 sqm



Ot 40 – 48 sqm

Entry room 15 – 20 sqm

Exit room 15 – 20 sqm

Wash room 12 – 15 sqm

Equipment room 10 – 15 sqm

Ot should be designed as square as possible to allow working whatever direction the

operation table is turned in.

Suitable size of ot is 6.5 x 6.5 m with height of 3 m.

Extra height allowance is 0.7 m for air conditioning.

Anaesthetic room

Approx. size 3.8 x 3.8 m

Electric sliding door 1.4 m clear width Washroom

1.8 m min. width

For each ot there should be 3 non splash wash basin with foot control.

Sterile room

Approx. size 10sqm required for ot and should be accessible directly

from ot.

Equipment room

Approx. area 20sqm.

Directly access from ot.

Central sterilization

Usage by surgical dept. 40 %

Surgical intensive and i.c.u 15 % each

Approx. area 40 – 120 sqm



Nurse area

Area 25 – 30 sqm

Rest room 15 sqm

Station doctor 16 – 20 sqm

Clean workroom 10 sqm

Patient’s lounge 22 – 25 sqm

Toilet size for rooms

Single toilet 2 ‘ 10 “ – 3 ‘ 2 “ , 3 ‘ 10 “ – 4 ‘ 10 “

Door size

Std. bedroom door width 3 ‘ 10 “ - 4 ‘

Lifts

One multipurpose lift should be provided per 100 beds.

Min. of 2 smaller lifts for portable equipment , staff and visitors.

Lift car- 0.90 m x 1.20 m

Shaft- 1.25 m x 1.5 m



GENERAL HOSPITALSECTOR – 6, PANCHKULA



SERVICESTANDARDS

DOCTORS 47NURSING SISTERS 11STAFF NURSES 69PHARMACISTS 15TECHNICIANS 14

O.T. ASSISTANTS 04DRIVERS 07CLASS 4 20SWEEPERS 10CONTRACT WORKERS 50

FIRST FLOOR

GYNAECOLOGY

EYEANTENATALREGISTRATIONBIRTH & DEATH REG.PP CENTREDOT CENTREIPD REGISTRATIONEMERGENCY

MEDICINESURGERYLABOUR ROOMGYNAE/OBS.PAEDIATRICSINJECTION ROOMMAJOR O.T.

GROUND FLOOR

OPD REGISTRATION

GENERAL OPDIPD REGIDTRATIONEMERGENCYPHYSIOTHERAPYSURGERYORTHO PEDICSMEDICINEPAEDIATRICS

GENERAL OPDSURGERYEYEEMERGENCYLITHOTRIPSYULTRASOUND & CT SCANX-RAYSPHARMACY

ECGSAMPLE COLLECTIONPATHOLOGY/EMG LABCASH COUNTERINJECTION ROOMVCTC

SECONDFLOOR

DENTALCHEST & TBENTTMTSKIN/LASERPSYCHIATRYEEGBIRTH &DEATH REG.PP CENTERPHOTOTHERAPY

CSO BUILDING

Blood BANKMORTUARY ( BEHIND)INCINEARTOR ( BEHIND )

THIRD

FLOOR

ADMIN. OFC.CCUPRIVATE

AREAS ON DIFFERENT FLOORS



GROUND FLOOR PLAN



FIRST FLOOR PLAN

ENTRY AND ADMINISTRATION IN PATIENT DEPARTMENT



As emergency entry is not provided ,stretchers are kept at the entrance itself.

NURSE STATION

( 45 SQ. FT. approx. )

DISPOSAL OF DIFF.

TYPES OF WASTES

WHITE PAINTED

WALLS ADDED

LIGHT TO THE

SPACE

MANY WINDOWS

WERE PROVIDED

FOR LIGHT &

VENTILATION

MOSAIC

TILED

FLOORING

ADMINISTRATION B LOCK AT A DISTANCE

FROM THE MAIN BLDG.

PHARMACY RADIOLOGY AND IMAGING



7’

12’

RECORD ROOM( 22’ X 18’ approx. )

CLADDED WALLS

X RAY ROOM( 23’ X 20’ approx. )

Anti-skit TilledFlooring3’

MOSAIC TILEDFLOORING

ECG ROOM( 10’ X 10’ )

DARK ROOM( 12’ X 18’ )

ICU

WELL FURNISHED

ROOM, 5 BEDS.

OPD ORTHOPAEDIC MINOR OT



CHECK UPAREA

CONSULTATIONAREA

PARKING AREA



10’ 10’

23’

SERVICES



Service pipes running along

the ceiling.

PLUMBINGSHAFTS

INFERENCES



INFERENCES:

• The hospital is being re-constructed, therefore, there are someproblems being faced.

• The fire fighting system is not adequate. But provisions are beingmade for the same in the new construction.

• The arrangement of the spaces is not proper. E.g.. Emergency wardhas got no direct entrance.

• The blood bank was quite far from the main hospital building.

• The area provided for each space was ample but not planned.

• No lack in services was seen. Proper vacuum, oxygen, and otherrequirements were fulfilled.

• The radiology room space was well planned.

• I.C.U. was a single unit. No separate cabins for the patients wereprovided.

• Proper facilities for handicaps were provided.

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