Maintenance, Management & Planning of Hospital Facilities
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  • 1. 1 Maintenance, Management & Planning of Hospital FacilitiesArch. Allen R. Buenaventura, MCM
  • 2. Objectives 2 • Discuss the process of Planning and Design of a health facility • Discuss the methods of maintenance for a health facility Maintenance, Management & Planning of Hospital FacilitiesArch. Allen R. Buenaventura, MCM
  • 3. 3 End -Users Administrato Nurs r e Clien Functiona t l Planne r Financia l Planners Physica l The Needs Assessment Team Maintenance, Management & Planning of Hospital FacilitiesArch. Allen R. Buenaventura, MCM
  • 4. Other 4 Medical End Specialis The Briefing Team -Users t Administrato Nurs r e Health Officer Clien Functiona t l Planne r Architect Financia l Physica l Planners Mechanica Structural l Engineer Engineer Sanitary Electrical Architects / Engineers Enginee Engineer r Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 5. 5 Limitation Soil Condition Drainage Natural Features Utilities Topography Size Factors Affecting Site Selection Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 6. Recommended Hospital Site • Not at the edge of a slope • Not close to a seismic fault • Not near the foot of a mountain • Not near bodies of water • Not on a reclaimed site • Not in flood prone areas • Not within typhoon zone • Not near active volcano Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 7. 7 Architects Brief Written expression of the clients needs Description of the services to be delivered in the hospital and their requirements Prepared by the user of the hospital in the persons of the hospital administrator. Maintenance, Management & Planning of Hospital FacilitiesArch. Allen R. Buenaventura, MCM
  • 8. 8 Contents of the Architects Brief Functional Content – size and content of departments Philosophy of Service- type of patients, type of service, type of department Workload- number of hours of work Planning Principles- guided by the operational policy and procedures of the hospital Maintenance, Management & Planning of Hospital FacilitiesArch. Allen R. Buenaventura, MCM
  • 9. 9 End The Design Team -Users Administrato r Clien Functiona t l Planne r Architect Financia l Physica l Planners Mechanica Structural l Engineer Engineer Sanitary Architects / Engineers Electrical Enginee Engineer r Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 10. Phases and Outputs of the Architect’s Regular 10 Services and Percentage Completion Per Phase Phase/s % Completion Output/s Schematic Design Phase 10% Consultation with owner Schematic Phase Probable Project Construction Cost Design Development 20% Plans, evaluation other drawings, Phase outline specifications probable construction cost Contract Document Phase 50% working drawings probable construction cost detailed technical specifications bidding and contract document (5sets) Construction Phase 20% the physical form of the hospital (with architect as supervisor) Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 11. The Construction Team 11 Administrato End r -Users Structural Builder Engineer Electrical Clien Engineer t Builder Sanitary Architec Enginee t r Architect Mechanica l Engineer Mechanica Structural l Engineer Engineer Sanitary Electrical Enginee Engineer Engineers r Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 12. 12 The Standard Hospital Plan Zoning Outer Zone Second Zone ● Emergency Service Inner Zone ●Outpatient Service Laboratory Service ● Nursing Service Pharmacy ●Administrative Service Radiology Deep Zone Service Zone ● Surgical Services Twilight Zone ● Dietary Service ● Mortuary ●Delivery Services ●Housekeeping ●Nursery ●Maintenance ●Intensive Care ●Mortuary Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 13. 13 The Standard Hospital Plan Zoning Outer Zone ● Emergency Service ●Outpatient Service ●Administrative Service Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 14. 14 Emergency Services • Satellite Business Office • Accessible to Diagnostic and Treatment Department • Accessible Administration, Business Office, and Medical Records • Operational Accessibility to Outpatient Department • Operational Accessibility to Morgue Outpatient Services • One entry point for Out Patients • Close Proximity with the Main Lobby, Pharmacy, Laboratory, Diagnostic Imaging Services and Physical Therapy • Connected with Medical Records and Pharmacy Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 15. Administrative Services 15 Hospital Lobby • Information Desk • Accounting • Security Desk • Admitting Section • Directional Signs • Cashier • Well Ventilated • Billing • Adequately Lighted Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 16. 16 The Standard Hospital Plan Zoning Second Zone Laboratory Service Pharmacy Radiology Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 17. Laboratory Services 17 Laboratories Haematology - Blood Bank Unit Urinalysis Unit Biochemistry Unit Histology Unit Serology – Bacteriology Unit Administrative Area Waiting Room Cubicle Specimen toilet Basal Metabolism Electrocardiography Room Pathologist’s Office Ancillary Service Area Glass Washing and Sterilizing unit Locker and Toilet Facilities Optional Services Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 18. 4.3.2 Biosafety Level 2 (BSL-2) practices, safety equipment, and facility design 18 and construction are appropriate for work done with moderate-risk agents that are present in the community and associated with human disease of varying severity. With good microbiological techniques, these agents can be used safely in activities conducted on the open bench, provided splashes or aerosol productions are unlikely. Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 19. 19 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 20. 20 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 21. Pharmacy 21 STAFF SERVICES Out Patients Pharmacy Ward Out-Patient ER Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 22. 22 Pharmacy Safety of Flammable Liquids Wall – Washable Floor – impervious surface Countertops , work surfaces – stainless steel Door- large enough for trolleys and carts, with glass panels Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 23. 23 The Standard Hospital Plan Zoning Outer Zone Second Zone ● Emergency Service Inner Zone ●Outpatient Service Laboratory Service ● Nursing Service Pharmacy ●Administrative Service Radiology Deep Zone Service Zone ● Surgical Services ● Dietary Service ●Delivery Services ●Housekeeping ●Nursery ●Maintenance ●Intensive Care ●Mortuary Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 24. 24 The Standard Hospital Plan Zoning Inner Zone ● Nursing Service Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 25. 25 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 26. 26 Nursing WardsNURSING FACILITIES SPACE ACCOMMODATION• One-Bed Room - Furnished with lavatory, toilet and bath, side table, locker. When possible, it should be of such size to accommodate two beds in emergencies.• Two-Bed Room - Similar to one-bed rooms but provided with cubicle curtains for privacy when needed.• Four to Six-Bed Room - Similar to above. Furnished with common toilet and bath facilities.• Isolation Unit - One-bed room designed for use by known infections or communicable disease patients under observation that will require separate utility room facilities equipped with sink and utensil sterilizer. Advisable at end of corridor or off a sub corridor. Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 27. WARDS INTERDEPARTMENTAL RELATIONSHIP 27 BULK STO. OPD & KITCHEN SURGERY ER RADIOLOGY STAFF DINE WARDS CSSD PHARMACY PHYS LABORATORY THER STORAGE PATIENTS STAFF SERVICES VISITORS FOOD Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 28. 28 Nurses Station NURSES’ STATION PHYSICAL REQUIREMENTS• SHOULD BE OPEN TO THE CORRIDOR, PREFERABLY IN THE CENTER OF NURSING UNIT WHERE VISITOR ENTRY CAN BE CONTROLLED.• EQUIPPED WITH NURSES’ CALL ANNUNCIATOR, MEDICINE CABINET WITH SEPARATE LOCKED SECTION, SMALL INSTRUMENT STERILIZER, AN ACID-RESISTANT SINK BELOW THE MEDICINE CABINET WITH KNEE OR ELBOW CONTROL, CLOCK, BULLETIN BOARD, TOILET, INTERCOM. Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 29. Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 30. Obstetrical-Gynaecological Ward 30 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 31. 31 The Standard Hospital Plan Zoning Outer Zone Second Zone ● Emergency Service Inner Zone ●Outpatient Service Laboratory Service ● Nursing Service Pharmacy ●Administrative Service Radiology Deep Zone Service Zone ● Surgical Services ● Dietary Service ●Delivery Services ●Housekeeping ●Nursery ●Maintenance ●Intensive Care ●Mortuary Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 32. 32 The Standard Hospital Plan Zoning Deep Zone ● Surgical Services ● Intensive Care ●Delivery Services ●Nursery Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 33. Surgical Services 33 Operating Department • Outer Zone - Conference, classroom, locker spaces, outpatient reception • Intermediate Zone – Work and Storage areas, recovery suite. • Inner Zone – Operating room Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 34. 34 Intensive Care Unit Most unstable patients Requiring technical/ and or artificial life support Continuous invasive monitoring 1:2 ratio nursing ratio Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 35. 35 Intensive Care Unit • Ideally same floor as OR • Easy access to Emergency, OR and Wards • 6 to 8 beds / unit • Single patient ICU • Natural daylight but no glare • Controlled Humidity • 16-27 degrees C • Lobby Airlocks • Hot and cold water • 8 Power Outlet per bed • HEPA Filter Recommended Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 36. Delivery Department 36 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 37. Delivery Department 37 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 38. Nursery Department 38 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 39. 39 The Standard Hospital Plan Zoning Outer Zone Second Zone ● Emergency Service Inner Zone ●Outpatient Service Laboratory Service ● Nursing Service Pharmacy ●Administrative Service Radiology Deep Zone Service Zone ● Surgical Services ● Dietary Service ●Delivery Services ●Housekeeping ●Nursery ●Maintenance ●Intensive Care ●Mortuary Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 40. The Standard Hospital Plan Zoning 40 Service Zone ● Dietary Service ●Housekeeping ●Maintenance ●Mortuary Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 41. Dietary Service 41 • Food receiving area • Food Preparation area • Cooking Area • Food Service Area • Dish washing • Refrigerated storage • Day storage • Cart cleaning facilities • cart storage area • waste disposal area • dining facilities Dietary Department Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 42. Housekeeping Department • floor supply closet 42 • floor equipment storage space • floor service closets with sinks • linen supply rooms and closets • office • locker • sewing room and sewing machine • proper shelving Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 43. Laundry Department 43 • soiled linen room • clean linen room • laundry cart storage room • laundry processing room • janitors closet • storage space Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 44. Storage 44 • pharmacy • furniture • anesthesia • records section • central store room ( 2 square meter/ bed) Pharmacy / chemical storage Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 45. Mortuary 45 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 46. Engineering 46 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 47. 47 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 48. 48 The Commissioning Team Other Medical Specialis t Administrato Nurs r e Health Officer Clien t Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 49. 49 The Needs Assessment Team Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 50. Other 50 Medical Specialis t Administrato Nurs r e Health Structural Officer Engineer Electrical Clien Functiona Engineer t l Builder Planne r Sanitary Architect Enginee Financia r l Mechanica Physica l l Engineer Mechanica Structural l Engineer Engineer Sanitary Electrical Enginee Engineer r The Planning Team Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 51. Health Facility Maintenance 51 Preventive Maintenance – Consist of planned, scheduled and cyclic tasks of parts replacement, condition, monitoring, and general gathering of data in order to: e. Prevent untimely breakdown of building elements and equipments. f. Maintain desired operating performance levels g. Generate structured and coherent data needed for planning and decision making Corrective Maintenance – involves minor repair of building elements and minor servicing of equipment to correct confirmed abnormalities or deteriorating conditions Major Repair/Rehabilitation – involves major repair/rehabilitation of building elements and major servicing or overhauling of equipment and utility systems requiring substantial replacements and restructuring of such building elements and system. Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 52. Problems in Health Facility Maintenance 52 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 53. 53 Building Inspection Schedule Preventive Maintenance Program Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 54. 54 Building Inspection Schedule Preventive Maintenance Program Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 55. Preventive Maintenance Program 55 Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 56. Corrective Maintenance Program 56Job Order Request Form Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 57. 57Major Repair/ Rehabilitation Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities
  • 58. Health Facility Maintenance 58 Annual building inspection must be conducted by Engineers and Architects. As built plan must be kept on record. Building permit and Occupancy Permit issued by building official. Maintenance, Management & Planning of HospitalArch. Allen R. Buenaventura, MCM Facilities