Hospital case study

1. CASE STUDY
OF HOSPITAL
AND MEDICAL
INSTITUTE

2. SETH G.S. MEDICAL COLLEGE AND
K.E.M. HOSPITAL

3. INTRODUCTION
KEM HOSPITAL
▪ LOCATION- Dr. E Borges Road , Acharya Donge Marg, Parel , Mumbai- 400012
▪ SITE AREA- 37,097.38 sq.m (including nursing , cvtc building and orthopaedic)
▪ BUILT UP AREA- 15,119.02 sq
▪ ARCHITECT – George Wittet ARCHITECTURAL STYLE - BRITISH
Founded in 1926 , the Seth Gordhandas Sunderdas Medical College (GSMC) and the King Edward
Memorial Hospital (KEM) are amongst the foremost teaching and medical care providing
institutions in India. The Medical college provides training to about 2000 students in
undergraduate , post graduate and super speciality medical courses ; in undergraduate and post
graduate physical and occupational therapy ; Masters and PhD courses in various allied
specialities. A nursing school is also maintained .

4. With about 390 staff physicians and 550 resident doctors ,the 1800
bedded hospital treats about 1.8 million out patients and 85,000 in patients
annually and provides both basic care and advanced treatment facilities in all
fields of medicine and surgery.
Funded mainly by the Municipal Corporation of Greater Mumbai, these
institutions render yeomen service –virtually free of cost – mostly to the under
privileged sections of the society.
MAIN AIM OF THE ORGANISATION-

5. APPROACH & CONNECTIVITY
SATELLITE VIEW OF K.E.M.
HOSPITAL
INDIA
PAREL

6. PAREL STATION
ELPHINSTONE ROAD
STATION
NEAREST BUS STOPS
Nearest banks

7. NEAREST ATM’S
NEAREST POLICE STATIONS
NEAREST MEDICAL STORES

8. WADIA CHILDREN’S HOSPITAL
WADIA MATERNITY HOSPITAL
TATA HOSPITAL
GLOBAL HOSPITAL

9. HOSTEL
BUILDING
G.S.MEDICALCOLLEG
K.E.M.
HOSPITAL
NEW
BUILDING
K.E.M. HOSPITAL
MAIN BUILDING

10. • WIDE ROADS.
• HAVE A GOOD
CONNECTIVITY.
• PARKING DOES
NOT DISTURBS
THE CROWD OF
THE STREET.
• LACK OF
SECURITY.
• EXTRAMLY
CROWDED
• LIMITED
PARKING
SPACE FOR
PARKING.
N

11. N
• THE SERVICES AREA OF THE NEW
BUILDING IS TOWARDS SOUTH EAST
DIRECTION.
• THERE ARE LANDSCAPE IN AREA
FACING THE ROAD.
• THE OLD BUILDING IS G+3 STRUCTURE
• NEW BUILDING IS G+13 STRUCTURE.
• THE SITE IS SURROUNDED BY ROADS .
• NOTH SIDE STRUCTURE IS BUILT IN
STONE SO AS KEEP THE STRUCTURE
COOL
• ELEVATION OF NEW BUILDING IS
DESIGNED ACCORDING TO SUN
ORIENTATION

12. DEPARTMENTS
▪ ANATOMY
▪ ANAESTHESIOLOGY
▪ AYURVEDIC MEDICINE
▪ ANIMAL ETHICS COMMITTEE
▪ BIOCHEMISTRY AND CLINICAL
NUTRITION
▪ CARDIOLOGY
▪ CARDIOVASCULAR AND THORACIC
SURGERY
▪ CHEST MEDICINE AND
ENVIRONMENT
▪ POLLUTION RESEARCH
CENTRE(EPRC)
▪ CLINICAL PHARMACOLOGY
▪ COMMUNITY MEDICINE
▪ COMMITTEE ON FOOD,HYGIENE
AND CLEANLINESS
▪ DIAMOND JUBILEE SOCIETY
TRUST
▪ DENTISTRY
▪ EAR ,NOSE AND THROAT
SURGERY

13. ▪ FACULTY – AFTTT KEMH
▪ FORENSIC MEDICINE AND
TOXICOLOGY
▪ GASTROENTEROLOGY
▪ GENERAL SURGERY
▪ GSMC MUHS UNESCO BIOETHICS
▪ GSMC-FAIMER REGIONAL INSTITUTE
▪ GYMKHANA
▪ HEMATOLOGY
▪ INSTOTUTIONAL ETHICS COMMITTEE
▪ LIBRARY
▪ MEDICAL EDUCATION UNIT
▪ MEDICAL HUMANITIES
▪ MEDICINE
▪ MICROBIOLOGY
▪ MULTI DISCIPLINARY RESEARCH
UNIT (MRU)
▪ NEONATALOGY

14. ▪ NEPHROLOGY
▪ NEUROLOGY
▪ NEUROSURGERY
▪ NURSING
▪ NUCLEAR MEDICINE
▪ OBSTRETICS AND GYNECOLOGY
▪ OCCUPATIONAL THERAPY
▪ OPTHALMOLOGY
▪ ORTHOPEDICS
▪ PATHOLOGY
▪ PEDIATRIC SURGERY
▪ PHARMOCOLOGY AND
THERAPEUTICS
▪ PHYSIOLOGY
▪ PHYSIOTHERAPY SCHOOL ANF
CENTER
▪ PLASTIC AND RECONSTRUCTIVE
SURGERY AND BURNS
▪ PREVENTIVE
▪ PSYCHIATRY
▪ RADIOLOGY
▪ RESEARCH SOCIETY
▪ SEXUALLY TRANSMITTED DISEASES

15. ▪ SKIN (DERMATOLOGY)
▪ SOCIAL SERVICE
▪ SURGICAL
GASTROENTEROLOGY
▪ TRANSFUSION MEDICINE
▪ UROLOGY

16. AREA PERCENTAGE OF ZONES

17. DISTRIBUTION OF SPACES
▪ MEDICAL COLLEGE
▪ OLD HOSPITAL BUILDING
▪ NEW HOSPITAL BUILDING
▪ CVTC BUILDING
▪ NURSING TRAINING CENTRE AND HOSTELS
▪ STUDENTS HOSTELS
▪ STAFF QUARTERS
▪ MORTUARY AND POST MORTEM
▪ BLOOD BANK
▪ ORTHOPAEDIC BUILDING

18. MEDICAL COLLEGE BUILDING
GROUND FLOOR PLAN
1) DEAN’S OOFICE
2) RECEPTION
3) DEAN OFFICE DEP.
4) ADMIN OFFICE
5) BOYS COMMON ROOM
6) GIRL COMMON ROOM
7) GIRLS TOILET
8) BOYS TOILET
9) ELECTRICAL ROOM
10) AUDITORIUM
11) DEPUTY DEAN OFFICE
1
2
3 4 5
6
7
89
11
10
PROFESSORS
STUDENTS
STAFFS
N

19. SECOND FLOOR PLAN
1) AUDIO VIDEO ROOM
2) MICROANOTOMY
LAB
3) DISSECTION HALL
4) LECTURE HALL 1
5) LECTURE HALL 2
6) H.O.D OFFICE
7) TERRACE
8) ANOTOMY MUSEUM
S - STAFF ROOM
PROFESSORS
STUDENTS
1 2 3
4 5
6
8
N
S
S
S
7

20. AUDITORIUM
MAIN ENTRY
BACK EXIT
ACOUSTIC MATERIALS ARE APPILIED ON WALLS
2M PASSAGE
EVERY ROW WAS RAISED BY 0.3 M
4X2 M SMALL STAGE
1ST ROW WAS FOR VIP

21. LECTURE HALL
LECTURE HALL FOR 182 STUDENTS
SPACE WAS LITTLE CONGESTED
SMALL DESK AND SEATS
DUE TO INCREASING HEIGHT OF EACH ROW
VISIBILITY WAS GOOD

22. MICROANOTOMY LAB
THERE WERE TOTAL 10 PLATFORM
FOR EACH PLATFORM 3 BURNER
WAS PROVIDED.
TOTAL 4 LABS WAS PROVIDED IN
COLLEGE.

24. MERITS AND DEMERITS
▪ MERITS
▪ GOOD CONNECTIVITY OF HOSPITAL AND COLLEGE.
▪ CIRCULATION WAS GOOD.
▪ AS BUILDING WAS CONSTRUCTED BY STONE ITS INTERIOR ATMOSPHERE WAS
COOL.
▪ DEMERITS
▪ LACK OF LABS.
▪ CONGESTED CLASSROOM WITH SMALL DESK AND SEATS.
▪ BECAUSE OF MANY ENTRIES, COLLEGE WAS NOT SECURE.

38. Title and Content Layout with List
▪ 13. LABORATORY RESEARCH CENTRE
▪ 12. DOCTOR’S REST
▪ 11. RMO QUARTERS
▪ 10. HEMATOLOGY
▪ 9. GASTROLOGY MALE ANSD FEMALE
▪ 8. UROLOGY AND OPERATION THEATRE
▪ 7. BLOOD TRANSFUSION & MICROBIOLOGY
▪ 6. BLOOD, URINE, SPUTUM SAMPLE, PATHOLOGY
▪ 5. ORHOPEDIC & MICROBIOLOGY
▪ 4. ORTHO (FEMALE), JOINT, OPERATION THEATRE
▪ 3. DEPARTMENT OF ORTHOPEDIC
▪ 2. CHEMICAL PHARMACOLOGY ,GASTROENEROLOGY
▪ 1. MEDICINE OPD,PEDIATRIC OPDECG, THADASSEMIA WARD.

40. C.V.T.C BUILDING
5 STORY BUILDING
GROUND FLOOR HAS OPD , RECEPTION
,WATING AREA , DOCTOR CLINIC ,
1ST FLOOR IS CONNECTED TO OLD BUILDING
2ND FLOOR CVTC –OPD , HEART SURGERY
THEATHRE SMALL COUNTER
3RD FLOOR , ECG , PHARMACY , SISTERS
OFFICE , CARDIOLOGY REASERCH ROOM
5TH FLOOR IS THE ADMINISTRATION
DEPARTMENT
CONGUSTED BUILDING
NO PLACE FOR REFRESHMENT

41. CHILLER PLANT

42. COOLING TOWER

43. CONTROL ROOM

44. COOLING UNITS

47. AHU ROOM

51. PUMPS: all pumps should regularly in maintained.
FIRE SAFETY: smoke alarm to be tested regularly to find functional
status.
- regular filling up of fire extinguisher. Fire safety drills
WATER SUPPLY:
-periodic testing of water quality.
-chlorination before supply.
-all tanks must have covers.
-water coolers and purifiers to be cleaned regularly.

52. CANTEEN
PLAN

53. BIOHAZARD WASTE
MANAGEMENT

54. DEFINITION
 Hospital waste are the waste produced in the course of
health care activities during Treating,Diagnosing,and
Immunizing Human being or animals or while doing
Study/Research activities.
 75-90% Non-Hazardous/General Waste.
 10-15% -Hazardous

55. GENERATION,SEGREGATION,COLLECTION,STO
RAGE,TRANSPORTATION AND TREATMENT OF WASTE
TYPE:
Hazardous (Infectious & toxic waste)
Non-Hazardous waste/General waste
Site of Generation:
Office,Kitchen,Admini stration,Hostels,Stores,Rest rooms etc.
Wards, Treatment room, Dressing room, OT, ICU,Labour
room, Laboratory, Dialysis room, CT scan, Radio-imaging etc.
Disposal By:
Municipal/Public Authority and Hospital itself.

56. SEGREGATION:
▪ Done at point of Generation of waste and
put in separate coloured bags.Color coding
varies from nation to nation. For e.g. In
AIIMS hospital, New deli, Following color
code bags are practiced

57. GENERAL WASTE

58. INFECTIOUS WASTE/PATHOLOGICAL WASTE

59. SHARP AND DISPOSABLE WASTE

60. SEGREGATE MEDICAL WASTE

61. COLLECTION OF WASTE
Centralized sanitation staffs or any other sanitation
staffs should collect the waste during morning
afternoon or evening under the supervision of
nursing staff and sanitation supervisor;
documentation should be done in register; Garbage
bin should be cleaned and disinfected regularly.

62. STORAGE OF WASTE
 Waste should not be stored in the generation area for more than a
period of 4-6 hours.
 It is responsibility of paramedic/sanitation staff to check for
segregation
Waste collected in various areas should be trasported for
disposal/Treatment.

63. TRANSPORTATION:
There should be separate corridor and lift in hospital to
carry and transport waste.
 General waste are deposited at municipal dumps.
 Waste for autoclaving and incineration are dumped at
separate site for external transport (should have
separate coloured plastic bag for these waste)
 Transportation should be done in sealed
container/sanitation supervisor should ensure for
leakage.

64. TREATMENT & DISPOSAL:
 General waste should be dumped at municipal dumping
site. Sanitation officer should be responsible for proper
coordination between municipal and hospital.
 Use of label/symbols is useful in identifying waste for
treatment .e.g. : Risk of corrosion, Danger of Infection,
Toxic hazards, Glass Hazards, Radioactive materials etc.

65. TREATMENT & DISPOSAL TECHNOLOGIES
 Incineration
 Chemical Disinfection
 Wet and dry thermal treatment
 Microwave irradiation
 Land disposal
 Inertization

66. INCINERATION:
 High tempreture dry oxidation process that reduce
organic and combustible waste into inorganic
incombustible matter. Resulting in significant reduction.
Process is selected to treat waste that cannot be
recycled,reused or can be disposed in land. ignificant
reduction in waste volume and weight.

67. CHEMICAL DISINFECTION:
 Commonly Used for treatment of liquid infectious
waste eg.blood,urine,stool and hospital sewage
Chemicals are added to waste to kill or inactivate
the pathogen it contains

68. WET AND DRY THERMAL TREATMENT:
Wet thermal treatment/steam disinfection is based on
exposure if infectious waste to high tempreture and high
pressure steam similar to process of autoclaving,
inapropriate for treating anatomical waste, chemical and
pharmaceutical waste.
 Screw feed technology: Dry thermal treatment in which
waste is shredded and heated in rotating auger.80%
volume and 20-35 weight is reduced, suitable for
infectious waste and sharps.

69. MICROWAVE IRRADIATION
 Microwave of frequency 2450MHZ and wave length
12.24cm used to destroy the microorganism. water
contained in the waste is rapidly heated by microwave
and infectious components are destroyed by heat
conduction.

70. LAND DISPOSAL:
 Open Dumps: risk for public health
 Sanitary landfills: designed and constructed to
prevent contamination of soil,surface,ground water and
direct contact with public.

71. INERTIZATION
 Process of mixing waste with cement and other
substances before disposal in order to minimize the risk
of toxic substance migrating into surface water or ground
water and to prevent scavenging.
proportion of 65% waste 15%lime 15% cement and 5%
water is used.