Hospital standards Planning concept Orientation and placement of spaces Hospital relationships Pathways ramps lifts corridors parking OPD Emergency Flowcharts OT ICU Services Fire safety Lighting Electrical Gas supply Information and communication technology Water supply system HVAC Waste management

1. Submitted By:
B.Arch 7th Semester

2. Hospital:
• Hospitals/Healthcare centres are the first contact point between members of the
Public and health workers.
•Medical institutions provide treatment for and care of patients with a wide range of chronic
acute conditions.
•Construction must satisfy the needs of a number of functions: accommodation, research,
teaching, medical activity, storage and administration.
• Most important to remember wihle designing is that you are designing for physically unfit
people.
There are several points that should be considered in the design of a primary healthcare
building. These include –
 Location of the building: should be convenient in relation to the people it serves.
Circulation: Entrance and circulation within the building must consider wheelchair users,
parents with small children and people with disabilities, etc.
 Effective zoning is required: public zone, clinical zone and staff zone.
Privacy and confidentiality are important, especially at the reception desk and clinical rooms
during consultations and treatments.
 Security and supervision in the premises will be necessary, including staff protection against
personal assault and safeguarded against theft and vandalism.
For running costs, efficient staffing, energy efficiency, long-life and low-maintenance
approache should be adopted.
Flexibility and growth should be catered for: flexibility in use of some, and potential for
future extension of the building.

3. Location:
• Site should offer sufficient space for self contained residential areas and hospital departments.
• Should be a quiet location with no possibility of future intrusive developmnet.
• Adequate area should be there for future expansion.
• Should be away from dust, noise and pollution.
Orientation:
• Treatment and operating rooms are preferred between north-west and north-east.
•For nursing ward facades, south and south-east is favourable due to:
-Pleasant morning sun
-Minimal heat build up
-Little requirement for sun shading
-Mild in the evenings
•East and west facing rooms have comparatively deeper sun light, though less winter sun.
• The orientation of wards in hospitals with short average stay is not so important.
•Some departments might require rooms on the north side so that patients are not subjected
to direct sunlight.
PLANNING CONCEPTION

4. Forms of building:
• Spine form with branching sections.
• Radial arrangement, i.e. circulation will be radially outward from the centre of the core.
• Any form that goes with the proper connectivity of all the units.
Effective arrangements:
• Top floor: Helipad, ac plant room, nursing school, laboratories.
• 2nd/3rd floor: Wards can be provided.
• 1st floor: Central sterilisation unit, surgical area, intensive care, maternity, children’s hospital.
• Ground floor: Entrance, radiology, medical services, ambulance, entrance for bed-ridden
patients, emergency ward, information centre, administration, cafeteria.
• Basement: Stores, physiotherapy, kitchen, heating and ventilation plant room, radio therapy,
linear accelerator.
• Sub-basement: Under ground garage, electricity supply.

5. FUNCTIONAL AREAS:
• Intensive Care, Special Care, Normal Care.
Functional Area 1 – Care
Surgery
Recovery area
Rehabilitaion
Physiotherapy
X-raydiagnosis
NMR diagnosis
Radiotherapy
Clinico-chemical laboratory
Clinico-physical laboratory
Clinico-neurophysicallaboratory
Central reception and treatment
Delivery
Dialysis
Specialist anaesthesia department
Specialist eye department
Specialist surgical department
Specialist gynaecologydepartment
Specialist obstetricts department
Specialist ENT department
Specialist internal medicine department
Specialist surgical department
Specialist paediatric department
Specialist neurology department
Specialist psychiatry department
Specialist X-ray area department
Specialist urology department
Functional Area 2 – Examination/Treatment
Functional Area 3 – Research
Functional Area 4 – Pathology
Functional Area 5 – Teaching/Training
Library
Files
Functional Area 6 – Scientific information
Emergencyservices
Blood bank
Functional Area 7 – Special interdisciplinary facilities
Centraladministration
Patient reception
Functional Area 8 – Administration/Management
Staff changingroom
Canteen
Shop
Functional Area 9 – Housekeeping
Food provision
Central store
Central sterilisation
Pharmacy
Laundry
Bed cleaning
Waste disposal
Transportservice
Functional Area 10 – Supply/Disposal
Foyer/Entrance
Cleaningservice
Maintenance
Functional Area 11 – Other functions

6. FUNCTIONAL AREAS FOR VARIOUS DEPARTMENTS -

7. Types of hospitals
According to speciality
General: (which is set up to deal with many kinds of disease and
normally has an emergency department to deal with immediate and
threats to health)
Specialized: (hospitals for dealing with specific medical needs such
as psychiatric problems, certain disease categories such as
cardiac,or orthopaedic problems)
Teaching: (combines assistance to patients with teaching to medical
and nurses and often linked to a medical school, nursing school.
According to size
Small
Medium
Large
Central
(50 beds)
(50-150 beds)
(150-600 beds)
(>600 beds)

8. According to health care level
Primary care hospitals: (health care that is provided at a basic level
with
an initial approach to a doctor)
Secondary care hospitals: (service which is provided by medical
specialist usually provided by cardiologists, urologists and
dermatologists)
Tertiary care hospitals: (specialized consultative health care, usually
inpatients)
According to ownership
Government
Private
District hospitals
A district hospital typically is the major health care facility in its
region with some number of beds for intensive care and long-term

9. Hospital
Basic
sections
Flexibility
Efficiency
Interior
Design
Aesthetic
s
Accessibilit
y
Cleanliness

10. Efficiency
 Minimizing distance of necessary travel between frequently used
space.
 Allow easy visual supervision of patients by limited staff.
 Provide sufficient no. of elevators, staircases etc.
 Include all needed spaces and sharing services, but no redundant one.
 Provide optimal, functional adjacencies, such as locating the surgical
unit adjacent to the operating suite.
Flexibility
 Follow modular concepts of space planning and layout as possible.
 Served by modular, easily accessed,and easily modified mechanical
systems.
 Open-ended design, with well-planned directions for future expansion;
positioning “soft spaces” such as administrative departments, “adjacent
spaces” such as clinical laboratories.

11. Interior Design Aesthetics
 Every effort should be made to make the hospital stay as unthreatening,
comfortable and stress-free as possible.
 Usage of artwork.
 Using cheerful and varied colors for interior finishes and used linens.
 Provide views of the outdoors from every patient bed and elsewhere.
Cleanliness and easy maintaining
 Proper, durable finishes for each functional space.
 Careful detailing of such features as doorframes, casework and transitions
dirt-catching and hard to clean crevices and joints.
 Adequate and appropriately located housekeeping services.
Accessibility
 All areas inside and outside the hospital should be designed to be easy to
use with kind of patients with temporary or permanent handicaps.
 Ensuring grades are flat enough to allow easy movement and sidewalks and
corridors are wide enough for two wheelchairs or stretchers to pass easily.

12. ADMINISTRATION
DIAGNOSTIC
AND
TREATMENTINPATIENTS OUT PATIENTS
SERVICES RESEARCH
AND
TEACHING
EMERGENCY
HOSPITAL RELATIONSHIPS

13. General Medical Practice Premises

14. Main entrance
 Main entrance should be clearly visible,
identifiable and easily accessible, preferably
with a covered setting-down point from cars.
Reception:
 The reception area should be
visible from the main
entrance.
 Allow 1.5m counter length for each
receptionist, and space in front of the counter
for patients to stand without encroaching on
circulation routes.
 Counter design should be open
but providing some protection
for the staff.
 Provision for people with
disabilities should be
incorporated.Record Storage:
 Needs to be close to the reception area, but ideally
not part of it.
 Records should be out of sight of patients and secure.
 GPrecords will be kept centrally near reception.
 Space required needs to be calculated for the selected storage system
(lateral shelving, filling cabinets, carousels)

15.  Waiting area should be visible from reception area.
 6 seats should be allowed for each consulting and
treatment room (1.4 square metre for each).
 This can be reduced for large premises,
particularly when appointment systems are
operated.
 Arrangements can be made to screen off part
of large area to provide space for other
activities at times when it is not all required
for waiting.
 Patients should not wait in corridors nor
outside consulting or treatment room
doors.
 Pram storage and WCs need to be near the reception
and waiting area.
 Part of the waiting area can be
designed and furnished for children.
 Some seatings suitable for the elderly should be
provided.
Waiting Area

16. CORRIDORS, DOORS, STAIRS, LIFTS -
Corridors: Must be designed for the max. Expected circulation flow.
• Access corridors must be atleast 1.50 m wide.
• Corridors for access by patients and equipment shall have a min. width of 2.25 m.
• Suspended ceiling in corridors may be installed upto 2.40 m.
• Windows for lighting and ventilation should not be more than 25 m apart.
• Effective width of the corridors must not be constricted by projections, columns or other
building elements.
• Smoke doors must be installed in ward corridors in accordance with local regulations.
Doors: Doors must be designed keeping the hygiene requirements in mind.
• Surface coating must withstand the long term action of cleaning agents and disinfectants.
• Designed to prevent the transmission of sound, odours and draughts.
• The clear height of doors depends on their type and function -
(1) Normal doors: 2.10 - 2.20 m
(2) Vehicle entrances, oversized doors: 2.50 m
(3) Transport entrances: 2.70 - 2.80 m
(4) Min. height on approach roads: 3.50 m

17. Stairs: Must be designed in such a way that if necessary they can accommodate all of
the vertical circulation.
• Should consist four flights and three landings between finished floor levels.
• Finishing material should not be slippery.
• Handrails must be provided on both sides at a height of 1000 mm.
• The minimum headroom in a passage under the landing of a staircase and under the staircase
shall be 2.2 m.
• Winding staircase should be avoided for main access.
•Doors must not constrict the useful width of the landings and, in accordance with hospital
regulations, doors to the staircases must open in the direction of escape.
• Effective width: 1.5 - 2.5 m.
• Riser: 170 mm.
• Tread: 280 mm.
• Riser/tread ratio of 150:300 is preferable.
Lifts: Transports people, medicines, laundry, meals, hospital beds/stretchers, etc.
• At least two lifts for transporting beds/stretchers must be provided.
• One multipurpose lift should be provided per 100 beds, with a minimum of two for smaller
hospitals.
• A min. of two smaller lifts for portable equipment, staff and visitors.
Clear dimensions of lift car: 0.90 x 1.20 m
Clear dimensions of shaft: 1.25 x 1.50 m
• Internal surfaces must be smooth, washable and easy to disinfect, the floor must be non-slip.
• Lift shafts must be fire resistant.

18. Pedestrian areas :
•Pedestrian space serves two functions :
1. Movement & circulation
2. Relaxation areas.
• They must be busy & colorful, exciting & stimulating, must make
walking enjoyable.
•Trees, fountains, sculptures, murals, as well as architecture of
free standing structures are a vital part of the overall scheme
Ramps :
•A ramp when provided shall not have a slope greater than
1 : 12. Larger slopes shall be provided for special uses but
in no case greater than 1 : 8.
•Minimum clear width shall be 36” (3 feet). in the basement
using car parking shall be 6.0 mt.
•Handrails shall be provided on both sides of the ramp.
Ramps shall have level landings at bottom and top of each
ramp and each ramp run.

19. Cafeteria
 The first aspect that hospital cafeterias must
address is design.
 Cafeteria should include high windows that
look out upon sunset and other natural scenes.
 Paint in bright, warm colours and avoid using
fluorescent light and install bright but warmly
toned lights.
 Vary the light fixtures, rather than relying on
 standard overheads.
Seating:
 Seats should be arranged to foster intimacy and
to create comfortable, lounge-like feel.
 Place plants or dividing walls between seating areas.
 Design separate sections for hospital employees.
 Prevent crowds from hovering over tables by
placing ordering areas separate from seating sections.

20. MEDICAL AND ANCILLARY SERVICES -
OUT PATIENT DEPARTMENT(O.P.D): The O.P.D provides consultation, investigation
and diagnostics for patients who require little or no recovery services afterwards.
Outpatient : Any person given general or emergency diagnostic, therapeutic or preventive
health care and who at that time is not registered as an in-patient in the hospital.
Location: Should be located on the ground level preferably.
• Should be close to vital adjecent services such as registration and medical records, admitting,
emergency and social service.
• Should be easily accessible to the laboratories, radiology, pharmacy and physical departments.
• Should have a separate entrance and adequate parking facilities.
Organization: The staff is made up of four major organizational components –
Medical staff (It is central to the organization)
 Nursing staff (Consists of registered nurses, nursing and hospital aides)
 Ancillary staff (Includes radiology, laboratory and ECG technicians)
 Clerical staff (Carries out registration, patient’s billing, receiving cash, secretarial, records, etc)

21. FUNCTIONS OF OPD:
• Early diagnosis, curative, preventive and rehabilitative care on ambulatory services.
• Effective treatment on ambulatory basis.
• Screening for admission to hospital.
• Follow up care and care after discharge.
• Promotion of health by health education.
• Rendering of preventive health care.
SIZE OF O.P.D (GENERAL REQUIREMENT):
Recommendations a/c to BIS(Bureau of Indian Standards) -
• For entrance zone - 2 sq. m./bed.
• Ambulatory zone - 10 sq. m./bed.
• Diagnostic zone - 6 sq. m./bed.
• Total hospital area - 60 sq. m./bed.
Sub-waiting area - should be 1/3rd of total patients visiting clinic per day.
Consultation room - Space for doctor’s chair, patient’s stool, follower seat, wash basin,
examination couch and equipment for examination.
Area - 15-17 sq. m. and each clinic should handle 100 cases per day.
Special examination room - Required for certain departments.

22. IMPORTANCE OF OPD:
• First point of contact.
• Facilitates teaching.
• About twice the in-patients attend O.P.D everyday.
• A good O.P.D service can reduce the work load on in-patient services.
• It is a place for implementing preventive and promotive health activities.
FACILITIES AND SPACE REQUIREMENTS -
Public Areas and Administration:
• Wheelchair and stretcher storage alcove.
• Reception and information desk.
• Registration counter and cubicle for staff.
• Lobby and waiting lounge.
• Public toilet facilities.
• Public telephone(s)/room with assisted STD/ISD call facilities, etc.
• Water coolers or drinking fountains.
• Space/office(s) for supplies, equipment, etc.
• Multipurpose room(s) for conferences, meetings, health education programmes, etc.
• Employees facilities including lockable drawers and cabinets and for personal belongings.
• General storage for supplies, equipment, etc.
• Coffee shop/snack bar in the vicinity.
• Meditation room/retiring room.
• Doorman’s station.

23. Clinical Facilities:
• General purpose examination rooms – min. floor area 7.43 sq. m, excluding vestibules, toilets,
closets, etc. Wash basin and a counter top for writing.
•Special purpose examination rooms – for speciality clinics such as eye(dark room required), ear,
nose, throat – facilities as required for special procedures and equipment. Wash basin,
counter/work top, etc.
• Treatment room for minor procedures and cast work.
•Nurse’s station with work counter, communication system, space for charting, supplies,
refrigerator, locked storage for drugs, etc.
• Clean storage for storing clean and sterile supplies, cabinets and shelves.
• Containers for storing clean and sterile supplies, cabinets and shelves.
• Containers for collection, storage and disposal of soiled materials.
• Sterilizing facilities.
• Wheelchair storage space out of the direct line of traffic.

24. Registration
Medical Records
Reception/Enquiry
Outpatient
Entrance
WaitingWaiting
Consultation/Examination
Minor Treatment and
Procedures
Admitting
Office
Hospital
Inpatient
X-ray Lab Other Investigations and
Therapeutic Facilities
Dispensing
Pharmacy
Injection
Dressing

25. MAIN
ENTRANCE TO
HOSPITAL
WALKING EMERGENCY
CASUALITIES ENTRANCE
TO
I.C.U/O.T.
RELATIONSHIP
DIAGRAM
RECEPTIO
N AND
WAITING

26.  SURGICALDEPARTMENT
 FUNCTION AND LAYOUT
• SHOULD BECLOSETO THE INTENSIVE CARE DEPARTMENT , THE RECOVERY
ROOM AND THE CENTRAL STERILISATIONAREA BECAUSEOF EXTENSIVE
INTERACTION BETWEENTHESEDEPARTMENTS .
LOCATION
•BESTLOCATED CENTRALLY IN THE COREAREAOF HOSPITAL WHERETHEY
AREEASYTO REACH.
•THE RECEPTIONAREAFOR EMERGENCYCASESMUST BEAS CLOSEAS
POSSIBLETO THE SURGICALAREASINCE SUCH PATIENTS OFTEN NEED TO BE
MOVED INTO SURGERYIMMEDIATELY.
ORGANISATION OF THE SURGERY DEPARTMENT
• EVERYSURGICALDEPARTMENT REQUIRESTHE FOLLOWING
ROOMS:
I. OPERATING THEATRE
40-48MSQ
II. ENTRY ROOM
15-20MSQ
III. EXIT ROOM
15-20MSQ

27. Diagram illustrating the relationships between an operating
theatre and other hospital services.

28. NURSES WORKSTATIONS
•THESE SHOULD BE LOCATED CENTRALLY AND SHOULD HAVE
VISUAL CONNECTION WITH THE WORKING CORRIDOR.
PHARMACY
A 20MSQ PHARMACY CAN SUPPLYA COMBINATION OFANAESTHETICS
AND SURGICAL MEDICATION AND OTHER MATERIALS.
CLEANING ROOM
A SIZE OF 5MSQ IS SUFFICIENT FOR CLEANING ROOMS . THEY SHOULD
BE CLOSE TO THE OPERATING THEATRE SINCE CLEANING AND
DISINFECTION ARECARRIED OUT AFTER EACH OPERATION.
LIGHTING
•LIGHTING IN OPERATION THEATRE
SHOULD BE ADJUSTABLE TO
PROVIDE LIGHT AT DIFFERENT
ANGLES.
•MOST FREQUENT LIGHTING
SYSTEMIS MOBILE CEILING
PENDANT OPERATING LIGHTS.
•EGG SHAPED OPERATING THEATRE

29. INTENSIVE CAREAREA
ARRANGEMENT
•THE INTENSIVE CARE DEPARTMENT
MUST BE A SEPARATEAREA,AND ONLY
ACCESSIBLE THROUGH LOBBIES .
•THE CENTRAL POINT OFAN
INTENSIVE CARE UNIT MUST BE AN
OPEN NURSESWORKSTATION FROM
WHICH IT ISPOSSIBLETO OVERSEE
EVERY ROOM.
•NO.OFPATIENTSPERUNITSHOULD BE
BETWEENSIX TO EIGHT TO AVOID
CROWDING.
ARRANGEMENTS OF BEDS
•THE BEDSMAY BE PLACED IN AN
OPEN,CLOSED OR COMBINED ARRANGEMENT.
•ALL THE BEDS MUST BE IN CLEAR VIEW OFA
CENTRAL NURSES DUTY STATION .
•WITH A CLOSEDARRANGEMENT THE
PATIENTSAREACCOMMODATED IN SEPARATE
ROOM WHICH MUST BEIN SIGHT OFA

30. AUXILIARY FUNCTIONS
• FOLLOWING AREASSHOULD ALSO BEPLANNED
IN
1. MINOR OPERATING THEATRE(25-30m SQ)
2. LAB SPACES
3. KITCHENETTE
4. STERILISATION(20 Msq)
5. DUTY DOCTOR’S ROOM
6. SANITARY FACILITIES
Eight-bed intensive care subgroup; glazed individual rooms

31. SIZE OF THE PATIENT
ROOM
•PATIENT’S BEDMUST BE
ACCESSIBLE FROOM
THREE SIDES.
•SIZEOF SINGLE BED-
ROOM =10M SQ
•FORTWO OR THREE BEDROOMS MIN
OF 8M SQAREAPER BEDSHOULD BE
ALLOWED.
ED.
3910Double room ,must be wider to allow
beds to pass.
SIX BEDROOM

32. PATIENT BATHROOM
AREAOFABOUT5.5 m sq
should BEALLOCATED TO
BATHROOMS.
WET CELLS
•NO. OF SHOWERSOR
BATHSAND WCS ARE
KEPT TOGETHER KNOWN
AS WET CELLS.
LAYOUT PLAN AND
ELEVATION OF BATHROOM
CLEAN WORKROOM
•AREAAPPROX. 10 M SQ.
•EQUIPPEDWITH FIXED SHELVES
600MM DEEP.
•USEDFOR STORAGE.
NON-CLEAN WORKROOM
•AREAAPPROX. 10 M SQ
•FOR HANDELLING SOILED
MATERIALS
•CONTAINS SINK AND SLUICE,MADE
OF STAINLESS STEEL.

33. EMERGENCY SERVICES:
Purpose: Totreat patients who seek emergency services for situational medical conditions other
than acute medical services.
Location: Should be located on the ground floor with easy access for patients and ambulances.
• Should have a separate entrance to the department, which is away from the main hospital and
the outpatient entrances.
• The department should be close to the admitting department, medical records and cashier’s
booth.
• Should be close to radiology unit, laboratory services, including the blood bank.
• Should be close to elevators so that one can proceed to surgery without loss of time.
Design: The entrance to the emergency should be sheltered to protect ambulance patients from
the weather while unloading.
• Adequate reserved parking space for ambulances and cars of patients and medical staff.
•Entrance should be large enough to admit one or more ambulances negotiating with
stretchers.
• Ramps should be provided for wheelchair and pedestrian access.
•Design should facilitate good public relations and quick access to the patients by staff and
supplies.

34. Organization: An efficient, prompt, well-equipped ambulance service with
competent personnel in charge.
• A well equipped emergency operating room with supplies always ready for use.
• A small recovery room.
•Efficient personnel including at least a component physician, nurse, and attendant on
round-the-clock duty or on call.
• Supervision of treatment of fractures and other injuries by qualified and competent surgeons
in their respective fields.
• Adequate diagnostic and therapeutic facilities under competent medical staff.
•A well documented medical record for every patient that includes immediate record of all
injuries, physical findings, treatment, etc.
FACILITIES AND SPACE REQUIREMENTS –
Facilities in the emergency department can be considered broadly under two categories:
Administrative and public areas
 Clinical facilities

35. Administrative and Public Areas:
•Reception-control: For observation and control of access to the treatment area, public waiting
area, and pedestrian and ambulance entrance area. Should be equipped with a communication
system including intercommunication.
• Waiting patients and their relatives should be better shielded from what is going on in the
treatment area.
• Space for stretchers and wheelchairs adjacent to the entrance but out of the stream of traffic.
• Stretchers should be provided with wheel locks.
•Waiting area should be separated from the working or treatment area and should be provided
with toilet facilities, water coolers, or drinking fountains, public telephones, STD and ISD
call facilities and vending machines if possible.
• Space/room for security staff, police, ambulance driver and attendant.
• Office for the night adminnistrator/night supervisor – can be off site but not too far away.
• Coffee snack bar in close vicinity.
Clinical Facilities: Four major functional areas can be identified. These are -
• Trauma care area where the severely surgical cases are handled.
• Medical examining area.
• Splintage and casting area for orthopaedic cases.
•Observation beds for patients who need to be kept under observation for neurological and
other medical reasons.

36. Facilities Required:
•Trauma rooms for emergency trauma procedure or where the severely injured surgical cases
are handled.
•Resuscitation and life support equipment and drugs, medical gas outlets, examination table,
examination lights, X-ray film illuminators, cabinets and supply shelves.
•For orthopedic and cast work, it is necessary to have closed storage space for splints and other
orthopedic supplies, a plaster sink, traction hooks, etc.
•Examination/treatment rooms with examination tables, examination lights, work counters,
cabinets, wash basins, X-ray film illuminators, medication storage facilities and medical gas
outlets.
• Scrub stations conveniently located to each trauma and orthopaedic room.
•Additional adjustable space for triage, treatment, observation, etc. in the event of disaster
handling.
•Staff work area and charting space with counters, cabinets, medication storage facilities,
dictating facilities, etc.
•Storage space for equipment such as portable X-ray and “crash carts” (cardio-pulmonary
resuscitation emergency carts) which should be easily accessible.
• Separate soiled and clean utility rooms.
• public toilets and janitor’s closet.
• Rooms for duty/on-call doctors, separate for men and women, with sleeping accommodation,
shower and toilet facilities.
• Locked cabinets, etc. for staff’s personal effects.

37. OTHER CONSIDERATIONS –
Triage Area: The emergency department has an active role to play in situations when several
emergency cases arrive in the hospital simultaneously, for example, victims of bus
or train accident, major fire or other disaster.
•The emergency staff are trained to recognize the nature and relative severity of a patient’s
condition. In what is called the “triage area”, patients are rapidly sorted sent to appropriate
treatment areas.
•For example, hyper acute(life threatening) cases are sent to the emergency room, serious
casualties are sent to surgery area, ambulatory care(non-life threatening) cases to outpatient
department, waiting room or observation area, the emotionally disturbed cases to the chapel
or meditation room, and the dead on arrival to the morgue.
•A triage sorting system establishes priorities for treatment of critical patients. Priorities are
based on the degree to which the patient’s life is threatened.
Typically, patients are classified as follows:
Emergency: Patient requires immediate medical attention; life, limb or sight is threatened.
 Urgent: Patient requires medical attention within a reasonable time and will be in danger if not
attended.
Non-emergency: Disorder is minor, not acute and can wait.

39.  The entry to the emergency should
be shielded from the main hospital
entrance preventing general patients
from being a witness to ghastly
sights or to tattered limbs.
 In planning the Emergency Activity,
particular attention must be paid to
movements of people (patients and
staff) and material (equipment and
supplies)
 Supportive services such as laboratory,
diagnostic x-ray, electrocardiographic
and pulmonary function facilities will
be located at the boundary between
the Emergency and Outpatient
Activities, assuring easy access to
both .
 The door to the room and to its
toilet must open outward to prevent
the patient from locking
himself/herself in .

40. • Treatment cubicles have curtains for privacy, if necessary, and are
equipped to handle examinations and minor treatments . More severe
injuries are treated in critical care rooms which are of two sizes.
• For a coronary patient, the emergency team may consist of a number of
specialists using numerous kinds of portable equipment: therefore,
larger space is required to accommodate both .
• The cast room, used for closed reduction of fractures, is equipped
similarly to a treatment cubicle with the addition of a plaster sink and
trap.
• A blood bank should be accessible by the shortest route within the
emergency.
In particular there should be direct access – by separate entrance if
necessary – the x-ray department for speedy diagnosis. Alternatively
separate x-ray facilities can be provided.
Because of the urgent nature of high proportion of accident cases,
the relationship with supporting department is crucial .
The door must allow passage of a patient on a stretcher who, after
treatment, may be immobilized by means of orthopedic accessories and
attachments to the stretcher . We have already mentioned that out-
patients should have access to the OPD directly through the Main
Entrance.

41. INTER- DEPARTMENTAL
RELATIONSHIP SCHEME
INTERNAL BASIC LAYOUT FOR
EMERGENCY

42. CLINICAL LABORATORIES:
Purpose: Primary function is to perform tests in the six main fields of bacteriology, biochemistry,
histology, serology, haemotology and cytology to assist medical staff in making or
confirming diagnoses and in the treatment and prevention of disease.
Location: Should be conveniently located on the ground floor to serve the outpatient, emergency,
and admitting departments. It should also be close to or easily accessible to surgery,
intensive care, radiology and obstetrics.
FACILITIES AND SPACE REQUIREMENTS -
• Work counter with space for equipments.
• Workstations should be equipped with vaccum, gas, electrical services, sinks and water.
• Specimen collection area for blood, urine and faeces.
• Work counter, space for patient’s seating and a wash basin.
• Toilets with a washbasin for urine and faeces collection area.
• Storage facilities for reagents, standards, supplies and stained specimen microscopic slides.
• Admin. areas, offices for pathologists, secretarial and clerical work area, space for records.
• Staff facilities.
• Sterilizing area.
• Glass washing area – dirty area that should be separated and closed.
• Storage for surgical specimens.

43. Blood Bank: The functions of the blood bank encompass donor selection, collection of blood,
grouping and cross matching, testing for transmittable diseases, blood component
separation, storage of blood components, issue of components and data management.
According to the Government of India Drugs and Cosmetic Rules, existing blood banks and those
that intend to apply for a license to operate a blood bank are required to fulfil the conditions set
out in the amendments. The salient features of the conditions are –
• Seven rooms within a space of 100 sq. m.
•Registration and medical examination room and blood collection room with suitable furniture
and facilities.
• Two laboratories, one for blood group serology and another for screening the blood for Hbs Ag,
HIV antibodies and syphilis. These should be air conditioned.
• Two refrigerators for maintaining temperature between 4 to 6 degree C with recording
thermometer and alarm device, one for the blood collection room and another for laboratory.
• Sterilisation and washing room.
• Store and records room.
RADIOLOGICAL SERVICES :
The main function of the radiological services is to assist clinicians in the diagnosis and
treatment of diseases through the use of radiography, fluoroscopy, radioisotopes and high
voltage acceleration.

44.  TREATMENT AREAS
TREATMENTAREASINCLUDE :
•RADIOLOGY
•RADIOTHEARPY
•INTERNAL MEDICINE TREATMENT AREA
•RADIOLOGY
INCLUDES :
I. XRAY ROOM+ADMISSION ROOM(25-30 MSQ AREA)
II. SONOGRAPHY (12-18 M SQ)
III. MAMMOGRAPHY (12-18 M SQ)
IV. CT SCAN ROOM VC (35 M SQ)
V. ANGIOGRAPHY ROOM
VI. CHANGING ROOM
VII. WCs (FOR STOMACH INSPECTION)
VIII. ULTRA SOUND ROOM

45. RADIOLO
GY

46. •RADIOTHERAPY
FUNCTION:
CONDITIONS DIGNOSED IN RADIO THERAPY DPT. ARETREATED HERE
INCLUDES:
1. RECEPTION +WAITING AREA
2. DOCTORS ROOM (18 SQ M )
3. LOCALISATION ROOM (25 SQM )
4. SERVICE ROOM
5. FILM DEVELOPING ROOM (10 SQ M)
6. STORE
7. TREATMENT ROOM(CHANGING ROOM) (15 SQM)
8. LAB (15-18SQ M )
•INTERNAL MEDICINE TREATMENT
AREA
COMPRISES OF:
1. EXAMINATION ROOM(25M.SQ)
2. SECRETARIAL/ADMN OFFICE 20 M SQ
3. SENIOR PHYSICIAN ROOM (15 M SQ)
4. CHEIF PHYSICIAN ROOM (20 M SQ)

47. Minnimum requirements for fire fighting installations.
less than 15 m
house reel,wet riser,down comer,manually operated electric fire alarm
system,automatic detection and alarm system are required.
• 10,000l under ground water tank upto 750sqm and 10,000l for every additional 250sqm
is required.
• 2,500 overhead water tank is required in case of hose reel, 20,000l in case of down
comer is required.
15m and above but not excceding 30m
• in addition to above mentioned installations yard hydrant and automatic operated
electric fire alarm system are required.
• 2,00,000l underground water tank is required
• 20,000l overhead water tank is required.
LOCATION AND SIZE OF FIRE DUCTS
• fire duct of 1.2m by 0.6m is to be placed near each fire exit, lift lobby.
LOCATION OF FIRE ALARMS
• alarm should be audible in administrative block,engineering service block, offices,
fire office and such other locations where gongs,
FIRE SAFETY |Installations
SERVICES

48. FIRE SAFETY | EscapeRoutes
Staircase
fire exit staircase after every 30m in building is to beprovided.
• Staircase shall be of enclosed type to prevent entry of smoke & fire to the staircase & vice versa.
• Access to the basement from the ground should be through a separate staircase, which is not connected to
main staircase
• stair pressurization fan shaft is to be provided in fire escape staircase to push smoke back.
RAMPS
• The slope of a ramp shall not exceed 1 in 10. in certain cases steeper slopes may be permitted but in no case
greater than 1 in 8
• Ramps shall be surfaced with non slipping material
Emergency and escapelighting
• Emergency lighting shall be powered from a source independent of that supplying the normal lighting
• Escape lighting shall be capable of:
• indicating clearly and unambiguously the escape routs.
• Providing adequate illumination and illumination along such routs to allow safemovement
ensuring that the fire alarm call points and fire fighting equipment provided along escape routes can be readily located
• Horizontal luminance at the floor level on centreline of escape rout shall not be less
than 10 lux
• Emergency lighting system shall be capable of continue operation for minimum
duration of 1 hr 30 mins

49. LIGHTING
ILLUMINATION
daylight isextreemly important in hospital for hygine maintaince.
• only radiology labs and O.T. rooms are kept in dark areas.
• artificial lighting
• The occupancy of hospital is quite varied and very dynamic.
• Lighting need for every occupant is very different from the other, and sometimes even conflicting.
• Physical and visual environment of hospitals impacts the psychological senses of the patient, the staff and the
relatives.
• Efficiently designed lighting system satisfies the visual, biological and emotional needs of the user, and
caters to different dimensions of the human needs.
• Affects biological activity of a person, influencing body functions, concentration and creating relaxed
environments.
• Dynamic white light: ceiling modules that provide daylight rhythm are mainly povided.
-shadowless lights shall be provide in operation theaters and operating delivery rooms whereas in
other areas, where operations of minor nature are carried out shadowless lamps shall be provided.
-emergency lighting- portable light units should also be provided in the wards and departments to
serve as alternative source of light in case ofpower faliure.
-call bells switches should be provided for all beds in all types of wards with indicator lights and location
indicator situated
in the nurse duty room ofwards.

50. NATURAL LIGHTING
• each block shouldbeprovided
with open to sky cut out for
natural lightventillation
• large windows should be
provided in entrancelobby
• ramps and staircase
should have sufficient
natural light.
ARTIFICIALLIGHTING
• wards, waiting areas andlift
lobbies, etc where natural light is
not reachable.

51. ELECTRICAL
ELECTRICAL PANELROOM
• l.v. rooms of 12sqm are to be provided at each
floor.
• minimum 2 pannel rooms are required of 17.5
sqm.
• electrical rooms are kept distant to gas supply
room.
• electrical shaft with l.v.shaft is 2m by 0.5m.

52. Introduction
A complete system that comprises a supply system, a monitoring and alarm system, and a distribution system with
terminal units at the points where medical gases or vacuum is required.
Color Coding
Medical gases as a definition they are specific gases that separate from
the air individually and the commonly used in hospitals are:
1 Oxygen O2 - White colored pipes
2 Nitrous Oxide N2O - Blue colored pipes
3Medical air (4 Bar) - White/salmon pink colored
pipes 4- Medical air (7 Bar) - Black/white colored
pipes
5 Medical Vacuum - Yellow colored pipes
6Carbon Dioxide CO2 - Grey colored
pipes 7- Nitrogen N2 - Black/Green
colored pipes
GAS SUPPLY | Medical Gas Pipeline System (MGPS)

53. Components
1- Medical gas
pipeline 2- Medical
Oxygen plant
3 Medical Nitrous oxide
4-Medical compressed air
plant 5- Vacuum plant
6 Terminal units
7 Regulators
8 Shutoff valves
9 Bedhead unit
10 Ceiling pendant
11Warning and alarm
system 12- Accessories

54. Location of SupplySystem
- Liquid oxygen supply systems or storage facilities should be provided in area more than 570 m3 (20 000 ft3).
- Rooftop locations should be avoided.
- Services containing combustible gases or liquids shall not be in the same room or enclosure as medical gas supply
systems.
- Outdoor Enclosures:
a. where constituted of fences, walls, or similar constructions, have a minimum height of 1.8 m (6 ft)
above grade surrounding the enclosure
b. be located at least 5 m (16 ft) from electrical utility services and any transformers that are not part of the
source unit
c.not be located within 8 m (26 ft) of storage tanks containing flammable gas or locations where flammable
gases can be discharged (i.e., from a relief valve)
- Compressor:
a. at least 3m from any door or operable window and 15 m from any exhaust, such as vacuum pump
discharge or sanitary vent exhaust
b. in a location where it will not draw in contamination from exhaust systems (for eg. Contamination from
furnace, diesel or gasoline engines, vacuum systems etc.)

55. Design
- The outside walls of rooms for cylinder supply
systems shall be built of materials having a
fire rating of at least 1 hour.
- Doors to the room shall open outwards andpersonnel
shall be able to open the doors from the inside
without a key.
- Electrical wall fixtures in rooms for supply systems
shall be positioned at least 1.5 m (5ft) above the floor
to avoid physical damage.
- The ambient temperature in rooms for supply systems
shall not exceed 40°C for any gas and shall not be less
than 15°C for nitrous oxide and carbondioxide.
- Ventilation: Provided that the room has venting witha
total free area of at least 465 cm2.
- The outlets of pressure relief vent pipes shall be at least
3 m from any door, operable window, or ventilationintake
and located so that discharges will not endangerpassersby.

56. Manifold Room
- In case of breakdown of control panel ofoxygen
and nitrous oxide, an emergency kit ensures
supply of gas through thepipes.
- Emergency kit comprises a regulator andhigh
pressure tubing to a bulkcylinder
- The gas is fed directly to the pipeline througha
service outlet.

57. Introduction
Health Information & Communication Technology (ICT) is the
use of the information technology to improve the process of
healthcare delivery and is concerned primarily instreamlining
administration and putting information into the hands of
point-of-care professionals.
- Telephones
- Wireless
- Security Systems
- Computers
- Office Equipment
- Fax
- Photostat
INFORMATION & COMMUNICATION TECHNOLOGY(ICT)

58. Introduction:
Water is one of the critical utilities in a hospital, yetit isoften taken
for granted. Much of the hospital engg. Services is concerned
with installing, repairing and maintaining the system thatdeliver
utilities and services.
Sources of Water Supply:
- Bore Wells
- Tanker Supply
- Recycled Water
WATER SUPPLY SYSTEM

59. Types of Water Supply:
Normal water -Arrangement shall be made to supply the following quantities of potable water per bed per day to meet all
requirements ( including laundry ),except fire-fighting, in all categories of hospital:
Hot water -Hot water supply to wards and departments of the general hospital shall be provided
by means of electric storage type water heaters or centralized hot water
Filtered and soft water -Filtered and soft water supply is required in pathology laboratories and shell be supplied as
requirements.
Cold water -Cold water supply is needed for processing tanks in film developing room and shall be supplied as required.
The minimum requirement of any hospital shall be
in accordance with the National Building Code:
LAUNDRY
• Laundry generates steam as well as sound. So it is segregated
from the main areas. Twowashing machines are kept here,
with capacity of 50 kg per cycle & 45 mins/cycle.
•Amachine capacity is 250bed sheets pressed per hour
• Rinsing, drying and ironing are also provided in this area

60. HVAC | Introduction
Importance OfAHospital HVACSystem
Hospital air conditioning and hospital ventilation systems are required to meet higher standards of performanceand
serve a greater function than those in standardbuildings.
Hospital HVAC system design presents unique challenges due to the level of demands placed on the it, the heating and
cooling loads and the requirements for dependability andhygiene.
A hospital air conditioning system also has the added challenge of integrating with a number of other complex systems
not present in conventional buildings.
These specifications cover the following types of air-conditioning, heating, ventilation and cold room works:
i) Window AC ,SplitAC
ii)VRV/ VRF typeAir-conditioning System
iii)Packaged typeAir- conditioning plants
iv) Central air-conditioning system
v) Central heating system.

61. vi)Mechanical ventilation system :
a) General Ventilation
b) Basement Parking & Shaft Ventilation
vii)Evaporative typeAir Cooling Plant.
viii)Cold rooms.
Colour scheme for the equipment's and components
i) Colour scheme for equipment like chilling unit, pumps, AHUs, cooling tower etc. shall be as per manufacturer‘s
standard colour scheme.
ii)The scheme of colour code painting of pipe work services for air conditioning installation shall be asper National
building code and is indicatedbelow:
Description Ground colour Lettering colour First colour band
Condenser water piping Sea Green Black French Blue
Chilled water piping Sea Green Black Black

62. Description Ground colour Lettering colour First colour band
Central heating piping Sea Green Black Canary Yellow
Drain pipe Black White
Valves and pipe line
fittings
White with black
handles
Black
Belt guard Black &
Yellow
diagonal
strips
Black
Machine Bases, Inertia
Bases and Plinth
Charcoal Grey Black
iii) Colour bands shall be 150mm wide, superimposed on ground colour to distinguish type and condition of fluids.
The spacing of band shall not exceed4.0m.

63. ARCHITECTURAL AND STRUCTURALREQUIREMENTS
Scope -This outlines the general guidelines for planning space requirements, equipment location, floor loading & other structural
requirements for various types of HVACsystems.
Heating
Heaters are appliances whose purpose isto generate heat (i.e.warmth) for the building. This can be done via central heating.
Central heatingsystem
Space Requirements-
i)The space requirement shall depend upon the type and capacity of the hot water generator chosen for thework and its overall
dimensions.
ii) Sufficient space shall be left all around the hot water generator for maintenance and operationpurpose.
iii) Space shall also be provided for the auxiliary equipments such as hot water circulating pumps and electrical control
panels.
iv) The minimum clear height of hot water generator room shall be 4.5m
v)Sufficient space should also be provided for the storage of fuel in case of oil fired hot water generator. Though the daily service tank
shall be provided within the room, bulk storage tank may be provided outside the buildings, either above or below ground level.
vi) Use of HSD/ LDO oil fired hot water generator hasbeen discontinued due to pollution & fire safety considerations.
Equipment Location -
i)The hot water generator room shall preferably be located in a separate service building from the fire safety pointof view.The room
shall have easy accessibility formoving in and out theequipments.
ii) Electrically operated hot water generator shall preferably be located in close proximity to the electrical substation,
especially in the case of large capacity hot watergenerator.
Structural Requirements -
i) The floor loading of the hot water generator room shall be 2000 Kg/sq m.

64. Waste Management |Introduction
Hospital waste is “Any waste which is generated in the diagnosis, treatment or immunization of human beings or
animals or in research” in a hospital. This is also called ‘Bio-Medical Waste’ (BMW).
75-90% Non-Hazardous/General Waste
10-15% -Hazardous
Waste Categories
1.General Waste
2.Pathological Waste
3.Sharps Sharpwaste
4.Infectious waste
• Description andExamples
• No risktohuman healtheg:officepaper,wrapper,kitchenwaste,generalsweeping etc.
• Human Tissue orfluideg:bodyparts,blood,bodyfluidsetc.
• eg:Needle, staples, knives, bladesetc.
• Whichmaytransmitbacterial,viralorparasiticdisease tohuman being, waste suspected tocontain
pathogen eg :laboratory culture,tissues(swabs)bandageetc.
eg.Laboratoryreagent, disinfectants,FilmDeveloper
• eg:unusedliquid fromradiotherapy orlab research, contaminated
• glassware'setc.
5.Chemical waste
6.Radio-activewaste

65. Placements ofBins

66. Parking can be provided in 3 ways
 Short term parking: should be such placed that they
can be used by visitors. Can be provided on the ground
floor.
 Long term parking: provided for people working in
offices and , can be provided in the basement or on the
roof top.
 Service core parking: provided for service traffic.
Should be provided on the backside of the building for
easy loading & unloading of goods.
Parking

67. •Ramp Slopes
The maximum ramp slope should be
20 percent.
For slopes over 10 percent , a
transition at least 8 ft long should be
provided at each end of the ramp at
one half the slope of the ramp itself .
Radii for one-way straight ramps,
minimum width is 12 ft(3 .66m);
for two-way straight ramps,
where opposing traffic flows are
not separated, 22 ft (6 .71 m) is
the recommended minimum
width. Where a barrier is used
between lanes to separate traffic
flows, each lane should be at
least 12 ft (3 .66 m) wide for
tangent lengths.

68. Turning radius -
Inner radius
3.5m
Outer radius
5.0m
Dimension of vehicle
Car 5.0m x 2.5m
Two wheeler 2.5m x
0.5m

69. POSSIBLECAR PARKING
ARRANGEMENTS
Width of aisle –24‟ for 90˚parking
13‟ for 45˚ parking
PARKING PARALLELTO THE
ROAD
30° OBLIQUE
SPACES