500 Bed Hospital

PROFESSIONAL PRACTICE
MEMBERS: LAUREL, ISIP, JAVIER, GALO, DE LEON, DE DIOS, PINEDA
LEVEL 3
HOSPITAL
GROUP 5
(500-BED HOSPITAL)

GROUP 5
HOSPITAL LEVELS USED IN THE
PHILIPPINES
Level 1 Hospital
✔ Emergency hospital
✔ Initial treatment for cases that require immediate
treatment and that provides primary care for prevalent
diseases in the area
✔ General medicine, pediatrics, minor surgeries, and
non-surgical gynecology
✔ Primary clinical laboratory, pharmacy and first level
radiology
✔ Nursing care for patients needing minimal supervised
care

GROUP 5
PHILIPPINES
Level 2 Hospital
✔ Non-departmentalized hospital
✔ General medicine, pediatrics, surgery, anesthesia,
obstetrics and gynecology, first level radiology,
secondary clinical laboratory, pharmacy
✔ Nursing care for patients needing intermediate
supervised care

GROUP 5
PHILIPPINES
Level 3 Hospital
✔ Departmentalized hospital
✔ All clinical services provided by Level 2 hospitals
✔ Specialty clinical care
tertiary clinical laboratory, pharmacy, second level
radiology
✔ Nursing care for patients needing total and intensive
care
✔ Teaching and training Hospital

GROUP 5
GUIDELINES ON
PLANNING AND
DESIGN
DEPARTMENT OF HEALTH
A hospital and other health facilities shall be planned and designed to observe appropriate
architectural practices, to meet prescribed functional programs, and to conform to
applicable codes as part of normal professional practice.

GROUP 5
ENVIRONMENT
A hospital and other health facilities
shall be so located that it is readily
accessible to the community and
reasonably free from undue noise,
smoke, dust, foul
odor, flood, and shall not be located
adjacent to railroads, freight yards,
children's
playgrounds, airports, industrial
plants, disposal plants.

GROUP 5
SAFETY
A hospital and other health facilities
shall provide and maintain a safe
environment for patients, personnel
and public. The building shall be of such
construction so that no hazards to the
life and safety of patients, personnel
and public
exist. It shall be capable of withstanding
weight and elements to which they may
be subjected.

GROUP 5
SAFETY
✔ Exits shall be restricted to the following
types: door leading directly outside the
building, interior stair, ramp, and exterior
stair.
✔ A minimum of two (2) exits, remote from
each other, shall be provided for each
floor of the building.
✔ Exits shall terminate directly at an open
space to the outside of the building.

GROUP 5
PATIENT MOVEMENT
Spaces shall be wide enough for free
movement of patients,
whether they are on beds, stretchers, or
wheelchairs. Circulation routes for
transferring
patients from one area to another shall be
available and free at all times.

GROUP 5
PATIENT MOVEMENT
✔ Corridors for access by patient and
equipment shall have a minimum width of
2.44 meters.
✔ Corridors in areas not commonly used for
bed, stretcher and equipment
transport may be reduced in width to 1.83
meters.
.

GROUP 5
PATIENT MOVEMENT
✔ A ramp or elevator shall be provided for
ancillary, clinical and nursing areas
located on the upper floor.
✔ A ramp shall be provided as access to the
entrance of the hospital not on the
same level of the site.

GROUP 5
LIGHTING
All areas in a hospital and other health
facilities shall be provided with
sufficient illumination to promote comfort,
healing and recovery of patients and to
enable personnel in the performance of
work.

GROUP 5
VENTILATION
Adequate ventilation shall be provided to
ensure comfort of patients,
personnel and public.

GROUP 5
WASTE DISPOSAL
Liquid waste shall be discharged into an
approved public sewerage
system whenever available, and solid waste
shall be collected, treated and disposed of
in accordance with applicable codes, laws or
ordinances.

GROUP 5
SANITATION
Utilities for the maintenance of sanitary
system, including approved water
supply and sewerage system, shall be
provided through the buildings and
premises to
ensure a clean and healthy environment.

GROUP 5
MATERIAL SPECIFICATION
Floors, walls and ceilings shall be of sturdy
materials that shall
allow durability, ease of cleaning and fire
resistance.

GROUP 5
SEGREGATION
Wards shall observe segregation of sexes.
Separate toilet shall be
maintained for patients and personnel, male
and female, with a ratio of one (1) toilet for
every eight (8) patients or personnel.

GROUP 5
FIRE PROTECTION
There shall be measures for detecting fire
such as fire alarms in walls,
peepholes in doors or smoke detectors in
ceilings. There shall be devices for
quenching
fire such as fire extinguishers or fire hoses
that are easily visible and accessible in
strategic areas.

GROUP 5
ZONING
The different areas of a hospital shall be
grouped according to zones as follows:
1. Outer Zone – areas that are immediately
accessible to the public: emergency
service, outpatient service, and
administrative service. They shall be located
near the entrance of the hospital.

GROUP 5
ZONING
2. Second Zone – areas that receive
workload from the outer zone: laboratory,
pharmacy, and radiology. They shall be
located near the outer zone.
3. Inner Zone – areas that provide nursing
care and management of patients:
nursing service. They shall be located in
private areas but accessible to guests.

GROUP 5
ZONING
4. Deep Zone – areas that require asepsis to
perform the prescribed services:
surgical service, delivery service, nursery, and
intensive care. They shall be
segregated from the public areas but
accessible to the outer, second and inner
zones.
5. Service Zone – areas that provide support to
hospital activities: dietary service,
housekeeping service, maintenance and
motorpool service, and mortuary. They
shall be located in areas away from
normal traffic.

GROUP 5
FUNCTION
The different areas of a hospital shall be
functionally related with each other.
✔ The emergency service shall be located in
the ground floor to ensure immediate
access. A separate entrance to the
emergency room shall be provided
.
.

GROUP 5
FUNCTION
✔ The administrative service, particularly
admitting office and business office, shall
be located near the main entrance of the
hospital. Offices for hospital
management can be located in private
areas.
✔ The dietary service shall be away from
morgue with at least 25-meter distance.
.
.

GROUP 5
FUNCTION
✔ The surgical service shall be located and
arranged to prevent non-related traffic.
The operating room shall be as remote as
practicable from the entrance to
provide asepsis. The dressing room shall be
located to avoid exposure to dirty
areas after changing to surgical garments.
The nurse station shall be located to
permit visual observation of patient
movement.

GROUP 5
FUNCTION
✔ The delivery service shall be located and
arranged to prevent non-related traffic.
The delivery room shall be as remote as
practicable from the entrance to provide
asepsis. The dressing room shall be located
to avoid exposure to dirty areas
after changing to surgical garments. The
nurse station shall be located to permit
visual observation of patient movement. The
nursery shall be separate but
immediately accessible from the delivery
room.

GROUP 5
FUNCTION
✔ The nursing service shall be segregated
from public areas. The nurse station
shall be located to permit visual observation
of patients. Nurse stations shall be
provided in all inpatient units of the hospital
with a ratio of at least one (1) nurse
station for every thirty-five (35) beds. Rooms
and wards shall be of sufficient size
to allow for work flow and patient
movement. Toilets shall be immediately
accessible from rooms and wards.

GROUP 5
POLICIES ON
PROPER WASTE
DISPOSAL
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DEPARTMENT OF HEALTH
The Department of Environment and Natural Resources (DENR) and the
Department of Health (DOH) hereby jointly provide the following guidelines on
the management of health care wastes pursuant to, among others, the
following laws, rules and regulations:

GROUP 5
R.A. 8749
CLEAN AIR ACT OF 1999
DURABILITY
A building should stand up
robustly and remain in good
condition.
BEAUTY
It should be aesthetically
pleasing.
UTILITY
It should be suitable for the
purposes for which it is used.
Republic Act No. 8749, otherwise known as
the Philippine Clean Air Act, is a
comprehensive air quality management policy
and program which aims to achieve and
maintain healthy air for all Filipinos.

GROUP 5
R.A. 6969
TOXIC SUBSTANCES, HAZARDOUS WASTE, AND
NUCLEAR WASTE CONTROL ACT OF 1990
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY
This Act shall cover the importation, manufacture, processing, handling,
storage, transportation, sale, distribution, use and disposal of all
unregulated chemical substances and mixtures in the Philippines,
including the entry, even in transit as well as the keeping or storage and
disposal of hazardous and nuclear wastes into the country for whatever
purpose.

GROUP 5
R.A. 9003
ECOLOGICAL SOLID WASTE MANAGEMENT
ACT OF 2000
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY
This act declares the policy of the state in adopting a systematic,
comprehensive and ecological solid waste management program
that ensures the protection of public health and the environment
and the proper segregation, collection, transport, storage, treatment
and disposal of solid waste through the formulation and adoption of
best environmental practices..

GROUP 5
P.D. 856
REFUSE DISPOSAL OF THE SANITATION
CODE OF THE PHILIPPINES
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY
The health of the people, being of paramount importance, all
efforts of public services should be directed towards the
protection and promotion of health and with the advance in
the field of sanitation in recent years, there arises the need for
updating and codifying our scattered sanitary laws to ensure
that they are in keeping with modern standards of sanitation
and provide a handy reference and guide for their
enforcement.

GROUP 5
R.A. 9275
CLEAN WATER ACT OF 2004
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY
The act aims to protect the country’s water bodies from
pollution from land-based sources (industries and commercial
establishments, agriculture and community/household
activities). It provides for a comprehensive and integrated
strategy to prevent and minimize pollution through a multi-
sectoral and participatory approach involving all the
stakeholders.

GROUP 5
P.D. 1586
ENVIRONMENTAL IMPACT STATEMENT
(EIS) SYSTEM
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY
The pursuit of a comprehensive and integrated environment
protection program necessitates the establishment and
institutionalization of a system whereby the exigencies of
socio-economic undertakings can be reconciled with the
requirements of environmental quality.

GROUP 5
R.A. 4226
HOSPITAL LICENSURE ACT
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY
An act requiring the licensure of all hospitals in the Philippines
and authorizing the Bureau of medical services to serve as the
licensing acency.

GROUP 5
DENR
ENVIRONMENTAL
MANAGEMENT
BUREAU
ENVIRONMENTAL COMPLIANCE REQUIREMENTS

GROUP 5
1. ENVIRONMENTAL COMPLIANCE
CERTIFICATE (ECC)
2. PERMIT TO OPERATE (P/O)
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY
- For the establishment of hospitals, health care facilities
covered by the provisions of PD 1586 from the EMB Central
Office or its Regional Offices.
- For Air Pollution Source and
Control Installation from the EMB Regional Office.

GROUP 5
3. DISCHARGE PERMIT
4. HAZARDOUS WASTE
GENERATOR’S REGISTRATION
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY
- Will be issued by the EMB Regional
Office and the Laguna Lake Development Authority
(LLDA) based on RA 9275 or the Clean Water Act of 2004.
- In compliance with the implementing rules and
regulations of RA 6969 (DAO 29 series of 1992 and DAO 36
series of 2004) from the EMB Regional Office.

GROUP 5
DOH
BUREAU OF HEALTH
FACILITIES AND
SERVICES
ENVIRONMENTAL COMPLIANCE REQUIREMENTS

GROUP 5
1. LICENSES
2. CERTIFICATE OF
ACCREDITATION
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY
- For hospitals, laboratories, dialysis clinics,
birthing homes, infirmaries, psychiatric hospitals, dental
prosthetic laboratories, blood banks, ambulatory clinics,
and drug treatment and rehabilitation centers.
- For Overseas Filipino Workers (OFW) medical clinics,
surgical clinics, drug testing laboratories, HIV testing
laboratories, water testing laboratories, medical
technologist intern training centers and training centers for
embalmers.

GROUP 5
FIRE CODE OF THE
PHILIPPINES
R.A. 9514
In order to effect a meaningful reduction of the alarming fire losses, there
is a need to develop national consciousness and involvement of all
persons in the prevention and suppression of fires.

GROUP 5
APPLICABILITY OF THE CODE
The provisions of the Fire Code shall
apply to all persons and all private
and public buildings, facilities or
structures erected or constructed
before and after its effectivity.

GROUP 5
GRACE PERIOD
The owner, administrator or occupant of buildings or
structures existing at the time of the effectivity of the Fire
Code is given two (2) years to comply with the provisions
thereof on fire safety constructions and on protective and
warning systems. However, the Director General of the
Integrated National Police may prescribe a shorter period
depending upon the degree of hazard to be recorded and
the cost and extent of the work to be done.

GROUP 5
INSPECTIONS, SAFETY MEASURES, FIRE SAFETY,
CONSTRUCTIONS, AND PROTECTIVE AND
WARNING SYSTEMS
As may be defined and provided in the Rules and
Regulations, owners, administrators or occupants of
buildings, structures and their premises or facilities and
other responsible persons shall be required to comply
with the following, as may be appropriate:

GROUP 5
WARNING SYSTEMS
A. Inspection Requirement

A fire safety inspection shall be conducted by the Director General or his duly
authorized representative as prerequisite to the grants of permits and/or licenses
by local governments and other government agencies concerned, for the:
(1) Use or occupancy of buildings, structures, facilities or their
premises including the installation or fire protection and fire safety
equipment, and electrical system in any building structure or facility;
(2) Storage, handling and/or use of explosives or of combustible,
flammable, toxic and other hazardous materials;

GROUP 5
WARNING SYSTEMS
B. Safety Measures for Hazardous Materials
Fire safety measures shall be required for the manufacture, storage, handling
and/or use of hazardous materials involving:
(1) Cellulose nitrate plastic of any kind;
(2) Combustible fibers;
(3) Cellular materials such as foam, rubber, sponge rubber and
plastic foam;
(4) Flammable and combustible liquids or gases of any classification;
(5) Flammable paints, varnishes, stains and organic coatings;

GROUP 5
WARNING SYSTEMS
D. Provision on Fire Safety Construction, Protective and Warning System Owners
Buildings, structures and their premises or facilities, except such other buildings or
structures as may be exempted in the rules and regulations to be promulgated
under Section 6 hereof, shall incorporate and provide therein fire safety
construction, protective and warning system, and shall develop and implement fire
safety programs, to wit:

GROUP 5
WARNING SYSTEMS
(1) Fire protection features such as sprinkler systems, hose boxes, hose reels or
standpipe systems and other fire fighting equipment;
(2) Fire Alarm systems;
(3) Fire walls to separate adjoining buildings, or warehouses and storage areas
from other occupancies in the same building;
(4) Termination of all exits in an area affording safe passage to a public way or safe
dispersal area;

GROUP 5
WARNING SYSTEMS
(5) Stairway, vertical shafts, horizontal exits and other meals of egress sealed from
smoke and heat;
(6) A fire exit plan for each floor of the building showing the routes from each other
room to appropriate exits, displayed prominently on the door of such room;
(7) Self-closing fire resistive doors leading to corridors;
(8) Fire dampers in centralized air-conditioning ducts;
.

GROUP 5
WARNING SYSTEMS
(9) Roof vents for use by fire fighters; and
(10) Properly marked and lighted exits with provision for emergency lights to
adequately illuminate exit ways in case of power failure.

GROUP 5
PROHIBITED ACTS
(a) Obstructing or blocking the exit ways or across to buildings clearly marked for fire
safety purposes, such as but not limited to aisles in interior rooms, any part of
stairways, hallways, corridors, vestibules, balconies or bridges leading to a stairway or
exit of any kind, or tolerating or allowing said violations;
(b) Constructing gates, entrances and walkways to buildings components and yards
which obstruct the orderly and easy passage of fire fighting vehicles and equipment;
(c) Prevention, interference or obstruction of any operation of the Fire Service, or of
duly organized and authorized fire brigades;

GROUP 5
PROHIBITED ACTS
(d) Obstructing designated fire lanes or access to fire hydrants;
(e) Overcrowding or admission of persons beyond the authorized capacity in movie
houses, theaters, coliseums, auditoriums or other public assembly buildings, except
in other assembly areas on the ground floor with open sides or open doors sufficient
to provide safe exits;
(f) Locking fire exits during period when people are inside the building;
(g) Prevention or obstruction of the automatic closure of fire doors or smoke
partitions or dampers;

GROUP 5
PROHIBITED ACTS
(g) Prevention or obstruction of the automatic closure of fire doors or smoke
partitions or dampers;
(h) Use of fire protective of fire fighting equipment of the Fire Service other than for
fire fighting except in other emergencies where their use are justified;
(i) Giving false or malicious fire alarms;
(j) Smoking in prohibited areas as may be determined by Fire Service, or throwing of
cigars, cigarettes, burning objects in places which may start or cause fire;
(k) Abandoning or leaving a building or structure by the occupant or owner without
appropriate safety measures;

GROUP 5
FREQUENCY OF FIRE EXIT DRILLS
ACCORDING TO TYPE OF OCCUPANCY
Educational – Quarterly
Healthcare – Quarterly on each shift
Residential – Twice a year
Hotels, Dormitories, Lodging, and Rooming Houses
Mercantile, Business and Industrial – Twice a year

GROUP 5
LOCATION OF PROPERTY
FIRE RESISTANCE OF WALLS
Exterior walls shall have the fire resistance and opening protection in accordance
with the requirements set forth by the Secretary. Projections beyond the exterior wall
shall not exceed beyond a point one-third the distance from an assumed vertical
plane located where the fire-resistive protection of openings is first required to the
location on property whichever is the least restrictive.

GROUP 5
FIRE RESISTIVE REQUIREMENTS
IN CONSTRUCTION

GROUP 5
SECTION 601. FIRE- RESISTIVE RATING DEFINE
SECTION 602. FIRE- RESISTIVE TIME PERIOD RATING
DURABILITY
condition.
BEAUTY
UTILITY
Fire-resistive rating means the degree to which a material can
withstand fire asdetermined by generally recognized and accepted
testing methods.
Fire-resistive time period rating is the length of time a material can
withstand beingburned which may be one- hour, two- hours, four- hours,
etc.

GROUP 5
SECTION 603. FIRE-RESISTIVE STANDARDS
DURABILITY
BEAUTY
pleasing.
UTILITY
All materials of construction, and type of materials and assemblies or
combinationsthereof shall conform to the following fire-resistive
ratings:

GROUP 5
DURABILITY
condition.
BEAUTY
pleasing.
UTILITY

GROUP 5
SECTION 604. FIRE- RESISTIVE REGULATIONS
DURABILITY
BEAUTY
pleasing.
UTILITY
The Secretary shall prescribe standards and promulgate rules and
regulations on the testing of construction materials for flame-spread
characteristics, tests on fire damages, fire tests of building construction and
materials, door assemblies and tin clad fire doors andwindow assemblies,
the installation of fire doors and windows and smoke and fire detectors for
fire protective signaling system, application and use of controlled interior
finish, fire-resistive protection for structural members, fire-resistive walls and
partitions, fire-resistive floor or roof ceiling, fire-resistive assemblies for
protection of openings and fire-retardant roof coverings.

GROUP 5
CLASSIFICATION
OF BLDG.
GROUP D
INSTITUTIONAL
DIVISION 2
Nurseries for full-time care of
children under kindergarten
age, Hospitals, Sanitaria,
Nursing homes with non-
ambulatory patients
BY USE OF OCCUPANCY

GROUP 5
REQUIREMENT FOR
FIRE ZONES

GROUP 5
SECTION 501. FIRE ZONES DEFINED
SECTION 502. BUILDINGS LOCATED
IN MORE THAN ONE FIRE ZONE
Fire zones are areas within which only certain types of
buildings are permitted to be constructed based on their use
or occupancy, type of construction, and resistance to fire.
A building or structure which is located partly in one fire zone
and partly in another shall be considered to be in the more
highly restrictive fire zone, when more than one-third of its
total floor area is located in such zone.

GROUP 5
STAIRS, EXITS,AND
OCCUPANT LOADS

GROUP 5
1. EXIT REQUIREMENTS
2. NUMBER OF EXITS
Exit requirements of a building or portion thereof used for different purposes
shall be determined by the occupant load which gives the largest number of
persons. No obstruction shall be placed in the required width of an exit except
projections permitted by this Code.
Every storey or portion thereof, having an occupant load of
500 to 999 shall have at least three exits. Every storey or
portion thereof having an occupant load of 1000 or more
shall have at least four (4) exits.

GROUP 5
3. EXIT WIDTH
4.DISTANCE TO EXITS
The total width of exits in meters shall not be less than the total occupant load
served divided by 165. Such width of exits shall be divided approximately
equally among the separate exits.
No point in a building without a sprinkle system shall be more than 45.00
meters from an exterior exit door, a horizontal exit, exit passageway, or an
enclosed stairway, measured long the line of travel. In a building equipped
with a complete automatic fire extinguishing system the distance from exits
may be increased to 60.00 meters.

GROUP 5
5. STAIRWAYS WIDTH
6. SMOKEPROOF ENCLOSURES
Stairways serving an occupant load of more than 50 shall not be less than 1.10
meters. Stairways serving an occupant load of 50 or less may be 900 millimeters
wide. Private stairways serving an occupant load of less than 10 may be 750
millimeters. Trim and handrails shall not reduce the required width by more than 100
millimeters.
A smokeproof enclosure shall consist of a vestibule and a
continuous stairway enclosed from the highest point to the
lowest point by walls of two-hour fire-resistive
construction. In building five storeys or more height, one
of the required exits shall be a smokeproof enclosure.

GROUP 5
PHOTOGRAPHIC
AND X-RAY FILMS

GROUP 5
SECTION 1401. STORAGE AND HANDLING
Storage rooms of unexposed photographic and X-ray films
shall be provided with automatic fire extinguishing systems.
(c) Film negatives shall be kept in properly insulated vented
cabinets, vented storage vaults or outside storage houses.
Not more than 110 kilograms shall be stored in any single
cabinet. Where the film stored exceeds 450 kilograms, it
shall be in vented storage vault or in a detached structure
or roof vault. Door openings in vault shall be of four-hour
fire-resistive construction and shall be kept closed except
when in use.

GROUP 5
SECTION 1401. STORAGE AND HANDLING
(d) Only incandescent electric light shall be permitted:
protected with substantial wire guards or vapor roof globes
or both. Portable lights on extension cords are prohibited.
Conspicuous "NO SMOKING" signs shall be posted.
(e) No films shall be stored within 600 millimeters of steam
pipes, chimneys, or other sources of heat.
(f) There shall be first aid provisions of types using water or
water solutions. Discarded films shall be stored and
handled in the same manner as other films until removed
from the premises.

GROUP 5
FIRE-
EXTINGUISHING
SYSTEMS

GROUP 5
(1) In every storey, basement or cellar with an area
of 200 square meters or more which is used for
habitation, recreation, dining, study, or work,
and which has an occupant load of more than 20.
(3) In all rooms used for storage or handling of
photographic x-ray nitrocellulose films and other
inflammable articles.

GROUP 5
DRY STANDPIPES

GROUP 5
(1Every building four or more storeys in
height shall be equipped with one or more dry standpipes.
(3) Number Required. Every building four or more
storeys in height where the area of any floor
above the third floor is 950 square meters or
less, shall be equipped with at least one dry
standpipes and an additional standpipe shall be
installed for each additional 950 square meters
or fraction thereof.

GROUP 5
(4) Location. Standpipes shall be located within
enclosed stairway landings or near such stairways
as possible or immediately inside of an exterior
wall and within 300 millimeters of an opening in
a stairway enclosure of the balcony or vestibule
of a smokeproof tower or an outside exit
stairway.

GROUP 5
THANK
YOU!

500 Bed Hospital

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500 Bed Hospital