Hospital literature

Table of content
• INTRODUCTION
• DEFINITION OF HOSPITAL
• HISTORY OF HOSPITAL
• CLASSIFICATION OF HOSPITAL
• KEY ASPECTS IN HOSPITAL
• DESIGN CONSIDERATION OF HOSPITAL DESIGN
• SITE CONSIDERATION OF HOSPITAL DESIGN
• ZONING ARRANGEMENT OF HOSPITAL DESIGN
• ELEMENTS AND DIVISION OF HOSPITAL DESIGN
A. Administration division
B. Out-patient division
C. Diagnostic & treatment division
D. Therapeutic service division
E. Internal medical treatment division
F. Inpatient division
G. General service & division includes
• DEPARTMENTS IN THE HOSPITAL
• CIRCULATION IN THE HOSPITAL
• ARCHITECTURAL FORMS AND STANDARDS
• LOCAL HOSPITAL STANDARDS
• CLINICAL AND TECHNICAL TERMS
• ABBRIVATION
• CONCLUSION
• REFERENCE

Introduction to hospital
Hospitals are unique among building planning and design projects for their
high level of complexity interims on their complex circulation patterns and
constant use as much as for their technical systems.
Health services require a wide range of buildings of very different sizes and
types. The basic components of the total health building estate and the means by
which they are procured vary from country to country. Everywhere the balance
is shifting away from inpatient care, with consequent changes in the location
and content of new buildings, and increasing modification of existing buildings
to serve new needs.
definition
HOSPITAL
A hospital is a place where healthcare services are delivered to patients who
may stay in overnight accommodations or may visit briefly for specific care.
Hospitals were generally charitable places where bed-ridden patients could be
cared for and given simple treatments. Hospitals are unique among building
planning and design projects for their high level of complexity, in terms of their
complex circulation patterns and constant use as much as for their technical
systems.
Fig: 1 Hospital building image
CLASSIFICATION OF HOSPITALS
There are many methods of classification of the hospitals, such as;

According to the level of care:
✓ Primary level hospital: few specialties mainly internal medicine, obstetrics
and gynecology, pediatrics, and general surgery, or just general practice;
limited laboratory services available for general but not specialized
pathological analysis.
✓ Secondary hospitals: District Hospital and some of Specific Hospitals.
✓ Tertiary hospitals: Central High Specialized Hospital, Educational
Hospital and some of Specific Hospitals.
According to the size of the hospital:
✓ Mini size hospital; <50 bed.
✓ Mid-size hospital; 50-250 beds.
✓ Big hospital; 250-500 bed.
✓ Huge hospital; >500 bed.
According to the size of the medical specialists:
✓ Specialist hospital: pediatric hospital, eye hospital. etc.
✓ General hospital: all medical specialists are provided.
✓ University hospital: which provide medical as well as academics and large
general hospitals
✓ Distinct hospital: which is demarcated or isolated from the compound in
the case of infectious disease.
According to the owners of the hospital:
✓ Private hospitals.
✓ Public hospitals.
GENERAL HOSPITAL
The general hospital is divided into operational areas of care provision,
examination and treatment, supply and disposal, administration and
technology. In addition, there are residential areas and possibly areas for
teaching and research as well as support areas for service. All of these areas are
precisely defined within the hospital. Opinions vary concerning the
arrangement of the different areas but it is important to maintain the shortest
practicable horizontal and vertical links while at the same time demarcating the
individual departments as far as possible.
In Ethiopia a general hospital is supposed to serve 50,000 people and
provide all types of clinical service including surgery.

HISTORY OF HOSPITAL
Hospital is unique building type is less than 100 years old in history
hospitals where generally charitable place where bed ridden patients could be
cured for and given simple treatment.
At the start of 20th century new advance in radiology aseptic germ theory
anesthetic surgery and later electronics and communications made the former
nursing care facility to highly specialized workshop for medial service the
hospital took on a new physical form as a larger dense building with many
specialized parts.
History in Ethiopia of healthcare
The ministry of health (MOH) historical account and time line of health care in
Ethiopia reads as follows
✓ The first modern government-run hospital was built by Emperor Menelik II
in 1906 in Addis Ababa with only 30 beds and was named Menelik II
hospital.
✓ In Ethiopia, the quest for modern medicine beyond traditional practice
started during Emperor Lebnedingil’s reign in the 15th century, when the
emperor appealed to the Portuguese king for physicians and surgeons to
cure illnesses. It was only during Emperor Menelik’s time (1889-1913) that
the first foreign-trained Ethiopian medical doctor, Hakim Workneh Eshete,
began practicing medicine in Addis Ababa. Not surprisingly, organized and
sustainable modern medical practice was nonexistent until the Battle of
Adwa in 1886. Given the shortage of modern medicine, traditional medical
practice that has prevailed over many centuries was still accepted and for
many it was a culturally preferred mode of treatment.
Fig: 2 Menelik and St. Paul hospital

KEY HOSPITAL DESIGN GOALS
Clearing the decks for a new approach to the ideas of hospital planning
begins by keeping five key goals firmly in mind:
PATIENT-CENTERED: care and family as part of the care process, since the
patient is the hospital’s reason for being
EFFICIENT: operations, clinical safety, optimal functional relationships, and
value for money, modern systems, and low upkeep requirements.
FLEXIBILITY: for expansion and new technology in unexpected ways over
long useful life
SUSTAINABLE DESIGN: reduced energy usage, intense 24 hr. use and high
occupancy
HEALING ENVIRONMENT: to include art and hospitality, not just science
and technology
Characteristics of hospital
As a place dedicated to health, a hospital building must first be a healing,
life-affirming space that plays an active role in helping patients and their
families return to health. Hospitals of the future will need to plan for higher
patient acuity, shorter stays, and must deal with aging patients (and staff).
Because of their long term operational costs and long life cycle, hospitals have
to be designed for improved performance and work flow, and with a high
degree of flexibility and adaptability for constant change.
Design consideration
Location
HOSPITAL BUILDING’s site location selection plays an important role not
only in building a proper simple earthquake resistant building but also in
creating conducive MEZMERIZING environment. HOSPITAL’S sites should
be evenly distributed to minimize people’s travelling distance from their home
to Hospital.

Fig: 3 hospital building
Building’s Orientation
The building’s layout and orientation must allow the air to flow through the
buildings and the reflected sunlight to penetrate into the buildings without
letting the heat and rain water to come into the building. An ideal buildings’
site should enable the office blocks to be located with the longer facades facing
north and south to minimize the penetration of direct sunlight through the
buildings. Deep verandahs and wide overhangs are also usually used to provide
shadings and better weather protection.
Fig:4 Building orientation image
Set back
When planning the layout of a hospital, certain minimum building set back is
set down to provide noise buffer for the building, and to provide privacy for the
users. Building setbacks may vary according to the environment’s
characteristics. When the building is facing local & arterial roads. The hospital
field and bench of trees can also be used as a buffer area from roads to the
building.

Environment
An environmental strategy will involve looking in detail at acoustics,
lighting, heating and thermal performance, ventilation, hot and cold water
supplies and energy conservation, particularly with regard to carbon dioxide
emissions.
Fig: 5 Hospital with the environment
Forms of Building
The form of a building is strongly influenced by the choice of access and
circulation routes. It is therefore necessary to decide early on whether to choose
a spine form with branching sections (individual departments), or whether
circulation will be radially outwards from a central core. Consideration must be
given to future expansion: this is most easily carried out with an extended main
tract. Self-contained circulation routes should be avoided as they make any
extension work far more costly and disruptive. The vertical arrangement within
a hospital should be designed so that the functional areas - care, treatment,
supply and disposal, access for bedridden patients, service yard, underground
garage, stores, administration, and medical services - can be connected and
accessed most efficiently. An effective arrangement would be as follows:
➢ 2nd
floor & above: wards
➢ 1st floor: surgical area, central sterilization, intensive care, maternity,
children's hospital…
➢ Ground floor: entrance, radiology, medical services, ambulance,
entrance for bedridden patients, emergency ward, information,
administration, cafeteria
➢ Basement: stores, physiotherapy, kitchen, heating and ventilation plant
room, radio-therapy, linear accelerator…
➢ Sub-basement: underground garage, electricity supply…

Acoustic design
The aim should be to enable people to hear clearly without distraction. This is
achieved by:
✓ determining appropriate background noise levels and reverberation times
for the various activities and room types
✓ planning the disposition of ‘quiet’ and ‘noisy’ spaces (separating them
wherever possible by distance, external areas or neutral ‘buffer’ spaces
such as storerooms or corridors)
✓ using walls, floors and partitions to provide sound insulation
✓ optimizing the acoustic characteristics by considering the room volume,
room shape and the acoustic of the room surfaces.
Architectural planning should take into consideration the acoustic conditions
required. Particular problems arise where insulation between spaces needs to be
high and where there is a desire for open-plan arrangements containing a
number of different activities.
SITE CONSIDERATION
Introductions
Site analysis and planning are influential to the success of a project. At the
beginning of the design process, the design team should perform several
preliminary analyses that will affect the final design of the facility. Each project
designer should consider the project specifics that include, but are not limited
to:
A. Site area
B. Site geometry
C. Local zoning
D. Regional and climactic factors
E. Utilities
F. Other site characteristics
Planning
When planning a Hospital, consider the activities of the multiple users
including the patients and patients, staff, visitors, maintenance personnel,
service providers, emergency crews and utility workers. The completed site
should include:

A. Landscaped features
B. Setbacks and buffers
C. Ample parking for staff and visitors
D. Access for emergency vehicles
E. Utility and service entry
F. Signage – way finding
Zoning
Unlike many general aspects of site design such as roadways and parking
aisles, zoning is site specific. In the case of government-owned property, it is
important to consider the zoning and adjacencies for compatibility with
neighboring buildings. Factors for zoning include:
✓ Height
✓ Historic district
✓ Lot occupancy
✓ Number of stories
✓ Setbacks
✓ Parking
✓ Use groups
Topography
Topographical influences may affect the orientation of access points to the
facility such as entrance, service, egress, and parking, perimeter road for
emergency, retaining walls, beams, landscaping and general location of the
structure on the site. During the planning phase of the project, consider what the
impact of the topography of the site will have on the design. Walks, ramps,
outcroppings and roadways are also features that are impacted by site
topography. Where possible, at-grade site access from the facility is desired.
Existing on-site grading is an important consideration when planning and
locating the access points of the facility.
Parking
The patients of inpatient facilities do little driving; therefore, the requirements
for parking are generated by staff, visitors, service technicians and deliveries.
✓ The anticipated peak periods of parking requirement will be from 2pm to
4pm on a weekday.
✓ An average of .37 parking spaces per bed during peak hours between 2 pm
and 4 pm for visitors.
✓ An average of 1.5 spaces per 1,000sf [92.90sm] for a parking facility.

✓ The number of beds, the number of staff, and the size of the facility all play
a role in adequately sizing a parking area.
Fig:6 Parking access in the hospital
Road & Accessibility
The access to hospital buildings should be carefully considered and must
avoid busy traffic nodes. Bus turning circles and pick-up points require careful
attention particularly in relation to safety aspects. Also, there should be a
separation between vehicular and pedestrian access roads in public area. An
adequate parking area is also necessary within the area, both for cars and
bicycles.
Fig:7 Road access in the hospital
Road Way
1. Site access: Site access roadways may be located directly at main public
roadways. The location of curb cuts and aprons should be planned in
accordance with local zoning
2. On-site roadways: Width of roads should accommodate traffic in each
direction. A path from the site entrance to entry of the facility should be logical
and easily identifiable. Site roadways to and from parking areas should be

capable of accommodating two-way traffic. Proper signage and direction arrows
may enhance clarity of destinations and paths.
3. Emergency roadways: Emergency access is required on the grounds of the
facility. This access relates to ambulance, fire and rescue, law enforcement and
other emergency related vehicles. The width of the roadway for emergency
purposes should be maintained and unobstructed at all times. At a minimum,
access to every part of the site and facility for emergency vehicles must be
provided.
Fig: 8 Emergency roadway
4. Service road: The service road may better serve the facility by having a
separate access point. Should that not prove feasible due to site restrictions or
other reasons, consider a separation of roadways upon entry to the site.
Circulation
Circulation ways have to be dimensioned for the most important circulation.
✓ Access passages: 1.5mwide,
✓ Passages for lying patients’ transfer: 2.25mwide minimum,
✓ Ceilings in passages: 2.40mhigh minimum,
✓ Maximal distance between two windows in a passage way: 25m,
✓ Width of passage ways mustn’t be reduced by any object or post,
✓ According to the regulations fire doors are required in passage ways. •
Doors:
✓ Coverings have to be resistant to the maintenance and disinfectant
products.
✓ The same sound insulation as the one for walls is required: a leaf with
two walls can absorb noises up to 27 dB minimum.
✓ Height of doors: 2.1-2.2m,
✓ Height of over designed doors for cars: 2.5m,
✓ Height of doors for the passage of transport vehicles:2.7-2.8m,
✓ Minimal height of doors for access to a hall for lying people: 3.5m.

Zoning arrangement
In the hospital building there are 3 basic or major zonings. These are: -
1. Clinical zone
2. Staff zone &
3. Public zone.
1. Clinical zone: - have countless connection with public zone & it’s used
for patients, when they need treatment or diagnosis which further includes
❖ X-ray
❖ Surgery
❖ Laboratories test
❖ Intensive care etc…
2. Staff zone: - is used for staff members such as, doctors, nurses, cleaner,
food makers etc… This unit is frequently connected with clinical zone.
3. Public zone: - is used for customers. This unit is primarily connected
with clinical zone.
Fig:9 Zoning arrangement of the building

Element & division of hospital
TYPES OF HOSPITAL SPACE
For all of these reasons, future hospital planning starts with information
from the organizer about the proposed operational plan and numbers of
procedures and services, projected forward into space needs and relationships.
Planning also needs to consider the very different needs of the five key
components of hospital space
A. Administration division
B. Out-patient division
C. Diagnostic & treatment division
D. Therapeutic service division
E. Internal medical treatment division
F. Inpatient division
G. General service & division includes
ADMINISTRATION DIVISION
The extent of offices provided in the hospital depends on whether they are
also the headquarters of the Trust. Main functions include Trust Board and
Secretariat, finance, personnel, supplies, and senior nursing and other
professional staff. The administration department of hospital shall essentially
look after organized group of people, patients and resources in order to
accomplish the task of providing best patient care. It shall have two main
sections, namely, general and medical records. General section shall deal with
all matters relating to overall upkeep of the hospital as well as welfare of its
staff and patients. Medical records section shall function for professional work
in diagnosis, treatment and care of patients.
Fig:10 Admin division of hospital

Parts and components of this division
✓ Reception hall
✓ Wetting area
✓ Registration
✓ Treasury and accounts Staff offices
✓ General manager office
✓ Staff lounge
✓ Nursing head office
Fig:11 Admin division 3d
Location
Very close to main entrance of the hospital. Entrance area, registration,
accountants should face the entrance while the manager office should be back
for privacy.
Area of the department
1. U.S Public health service:
• 50 Bed hospital area= 214m2
2. World bank estimations (Hopkinson’s & Kostermans)
• 50 Bed Hospital area= 199m2

Out-patient DIVISION
Entrance Area
Physical facilities - The hospital should have entrances as shown in the work
flow analysis
Pharmacy/Dispensary/- The dispensary should be located in an area
conveniently accessible for all clinics. The size should be adequate to contain 5
% of the total clinical ‘visits to the OPD in one session at the rate of 0.8
m2perpatient. The dispensary and compounding room should have multiple
dispensing windows, compounding counters and shelves. The pattern of
arranging the counters and shelves shall depend on the size of the room. The
medicines which require cold storage and blood required for operations and
emergencies may be kept in refrigerator.
Fig:12 Pharmacy
Waiting space - Apart from the main entrance, general waiting, subsidiary
waiting spaces are required adjacent to each consultation and treatment room in
all the clinics. Waiting space for eye clinic should not be subjected to direct-
sunlight or glare. Waiting space in the pediatric clinic should provide for minor
recreation and play facilities for children.
Fig:13 Waiting space in the hospital

Clinics - These clinics include general, medical, surgical, ophthalmic, ENT,
dental, obstetrics and gynecology, pediatrics, dermatology and venereology
(optional), psychiatry (optional), neonatology (optional) and orthopedic.
The clinics for infectious and communicable diseases should be located in
isolation, preferably, in remote corner, provided with independent access and
completely cut off from the rest of the hospital.
Fig:14 Clinic diagram
Medical clinic - The clinic should have a consultation and examination room
depending upon the load of out-patients. The clinic should also have facilities
for cardio graphic examination.
Surgical Clinic - The clinic should have facilities for treatment-cum
dressings. For convenience, this should be placed next to consultation cum-
examination room with adequate waiting space.
Eye Clinic - The clinic should include consultation-cum- refraction and minor
surgery-cum-treatment room. For testing the state of refractive power of the
eye, room length not less than 6m is essential. However, by use of mirror length
can be reduced. Dark room should be placed close to consultation, preferably,
with an intercommunicating door.
Obstetric and Gynecological Clinic- The clinic should include a separate
reception and registration, consulting-cum examination, treatment and clinical
laboratory.
Pediatric Clinic - The clinic should provide medical care for children up to
the age of 12 years. Owing to risk of infection it is essential to isolate the clinic

from other clinics. The clinic shall be provided with a separate treatment room
for immunization.
Family Welfare Clinic - The clinic should provide educative, preventive,
diagnostic and curative facilities for maternal, child health, school health and
health education. Importance of health education is being increasingly
recognized as an effective tool of preventive treatment. People visiting hospital
should be informed of environmental hygiene, clean habits, need for taking
preventive measures against epidemics, family planning, etc. Treatment room in
this clinic should act as operating room for IUCD insertion and investigation,
etc.
Dermatology and Venereology Clinic (Optional) - The clinic should
provide diagnostic and curative facilities for dermatology, sexually transmitted
disease and leprosy. The treatment rooms for dermatology and venereology may
be combined, but treatment for leprosy should always be segregated. The clinic
may also have facilities for superficial therapy and a skin laboratory.
Psychiatric Clinic (Options) - The facilities required for the clinic should
include consultation-cum-examination room, ECT treatment room, recovery,
psychologist and asocial worker room.
Dermatology and Venereology Clinic (Optional) - The clinic should
provide diagnostic and curative facilities for dermatology, sexually transmitted
disease and leprosy. The treatment rooms for dermatology and venereology may
be combined, but treatment for leprosy should always be segregated. The clinic
may also have facilities for superficial therapy and a skin laboratory.
Neonatology Clinic (Optional) - the clinic should include a consultation- cum
-examination, counseling room and waiting facilities.
Orthopedic Clinic - The clinic should include arrangements for plaster
preparation, fracture treatment, besides consultation cum-exanimation.
Nursing Services - Various clinics under Ambulatory Care Area
require nursing facilities in common which include nursing station side
laboratory, injection room, social service and treatment rooms, with bed, etc.

Nursing Station for Ambulatory Care Area - The nursing station shall be,
centered, such that it serves to all the clinics from that place. The nursing station
should be spacious enough to accommodate medicine chest, a work counter for
preparing dressings, medicines, sinks, dress tables with screen in between and a
pedal operated bin to hold soiled material.
Side Laboratory - For quick diagnosis of blood, urine, etc., a side
laboratories required.
Injection Room - For administering injection to patients a central injection
room should be provided in conjunction with the dispensary.
Social Service - A social worker room to render service to the patients may
be provided.
Integral with bed -Bed control (within patient's reach, but with nurse
controlled cut-off feature).
Examination - Treatment Center A large portion of outpatient workload
will be handled in the examination-treatment center rather than in the specialty
clinics.
✓ Each examination room will have not less than 80 net sq. ft. of usable
floor area. Rooms also used for treatment shall not have less than 120
net sq. ft. of usable floor space.
✓ Examination or treatment tables are to be accessible on three sides
allowing for working Space of not less than 30 in clear on each side.
✓ Handwashing facilities for attending staff must be provided.
Fig:16 Examination room

Location Within Building - as all patients receive medical evaluation, the
physician's unit should be near the center's main entrance. For purposes of
admission, and for the keeping of records, location of the unit near the
administrative department is desirable. If an in-patient nursing unit is included,
the physician should have, if possible, convenient access to the nursing unit.
Fig:17 Exam room plan and 3d
Staff-Patient Ratios The physician-patient ratio will depend entirely on the
nature of the program. Centers accommodating in-patients will necessarily need
a greater amount of physician service per patient than the out-patient type of
center.
Physician-patient ratios can be established only on an individual basis
Organization of Space: The physician's unit should form a self-contained area,
with access to the consultation room and the medical ex-amination room by
means of a sub corridor, if possible.
Waiting Room Arrange the furniture to allow space for wheelchair patients.
Also, include coat hanging facilities.
Secretary Include in the furnishings a secretary's desk, writing table, and letter
size file cabinets. As certain records must be available to department heads in
other areas of the center, placement of such files in the central records room of
the administrative area is the usual practice.
Consultation Room: include in the furnishings for the physician's office
and consultation room an executive desk and chair, book-shelves, and film
illuminator. Allow space for two visitors' chairs and a wheelchair. Provide a
convenient coat closet.

Rehabilitation
The rehabilitation (or physical medicine) department includes facilities for
physiotherapy, occupational therapy (OT) and speech and language therapy. It
serves mainly out-patients and day patients, and should thus be at ground
entrance level and conveniently placed for parking, including spaces for people
with disabilities, at least one of which should be under cover to provide a degree
of protection from rain for wheelchair transfer.
Fig:18 Rehab. room
Maternity
The maternity and neonatal care the maternity and neonatal department provides
continual physical medical, physiological, and social care for mothers and new
babies following a hospital delivery. after uncomplicated births the care of new
mothers can be consider part of normal care.
Rooms:-
✓ The rooms are divided in two categories post-natal and neonatal (meaning
before delivery care for the mother and the baby and after delivery care
for the infant as will for the mother.
✓ Before delivers contain post natal (post natal 50m2 with toilet and
shower. Ultrasound with 15m2, examination and treatment-12m2 and
deliveries (two types of delivery special and normal the special includes
surgery room with all functions of operating theater. And midwifery
tanning center -40m2 with skill room-40m2.)

✓ After delivery contains the obestrics for infants (incubator room
minimum 50m2, with nurse station30m2 linen-6m2mothers rest room
with kitchen and toilet).
Parts and components of the division:
✓ Consultation room.
✓ Examination room.
✓ Treatment room.
✓ Waiting area. Staff room wcs Area of the department:
Location
❖ Very close to the main entrance of the hospital.
❖ Close to the diagnostic services (labs and x-ray)
❖ Close the pharmacy.
Emergency activity
A&E AND OUTPATIENTS DEPARTMENT - Accident and emergency
(A&E) The accident and emergency department is for ambulant and bedridden
patients and is accessed via the emergency entrance.
Clear signposting to the drive-in entrance is of life-saving importance for
ambulance drivers. It is convenient to site this entrance on the opposite side of
the building to the main entrance to avoid contact with the visitors and other
patients.
The accident and emergency department consists of emergency treatment
rooms (20-25 m2) equipped with operating tables, small operating lights,
cupboard units with sinks, and patient cubicles.
Fig:19 OPD sample layout

DAY CLINICS; OUTPATIENT SURGERY - The contracting out of
services following health reforms has freed space in many hospitals. Much of
this has been converted into day clinics for patients who are only cared for
during the day and do not require hospital beds, or who have undergone
outpatient surgery. As these patients are divorced from the rest of the hospital
activities, it is necessary to provide a separate entrance for them. The reception
and waiting areas must be designed to a standard equivalent to a doctor's
surgery and should be differentiated from the character of the hospital
Fig:20 surgery room sample layout
Area of the department:
✓ U.S. Public Health Service (USPHS):
• bed hospital area = 215 m2
• 100 bed hospital area = 350 m2
• 200 bed hospital area = 540 m2 2.
✓ World bank estimations (Hopkinson & Kostermans):
Emergency reception:
Fig:21 Emergency room layout

Entrance + waiting area.
Registration.
Staff room.
Mini-surgery.
Test room.
Medical utilities.
Mini sterilization room.
Location:
Very close to the exit door of the emergency.
Very close to the radiology.
Close to the pharmacy, laboratories, and central sterilization.
Direct access to the stairs and elevators.
1. U.S. Public Health Service (USPHS):
• 100bed hospital area = 100m2
• 200bed hospital area = 215m2
Diagnostic service division
Diagnostic imaging This term embraces diagnostic investigations using X-
rays (either as plain films, or making use of contrast media) and the non-X-ray
modalities using ultrasound and magnetic resonance to produce images. The
essential feature about planning ‘imaging departments’ is that, apart from
ultrasound, imaging modalities require specialized protective arrangements,
either from radiation or from magnetic fields.
Fig:21 Diagnostic division

Diagnostic functions, to help identify the cause of a disease or condition,
often include Imaging (X-ray, CT scan, MRI Scan, Ultra Sound, and
Mammography), Clinical Laboratory services, and Non-Invasive testing (EEG,
EKG, Stress Test, Nuclear Medicine).
Treatment functions may be invasive (Surgery, Endoscopy, Interventional
Radiology, Biopsy, all with patient preparation and recovery areas) or non-
invasive services such as physical medicine and respiratory therapy.
Planning for diagnostic and treatment functions typically requires large blocks
of space with multiple circulation paths to separate patients, staff, visitors,
clean, and soiled traffic. While natural light is desirable in waiting, patient
recovery, and staff areas, it is often not permitted in areas which require rooms
with controlled lighting and special environments.
A diagnostic test is any approach used to gather clinical information for the
purpose of making a clinical decision (i.e., Diagnosis). Identify the cause of a
disease or condition, often include: -
1. Radiology or Imaging
• X-ray
• Fluoroscopy
• Endoscopy
• CT scan(3D),
• MRI Scan (soft and brain tissue),
• Ultra Sound (flood and air), and
• Mammography
2. Clinical Laboratory services, and Non-Invasive testing (EEG, EKG,
Stress Test, Nuclear Medicine).
RADIOLOGY DIVISION
Parts and components of the division
✓ X-ray room 14m2
✓ Control room 9m2
✓ Waiting area 12m2
✓ Chief radiologist 5m2/staff
✓ Staff office 5m2
✓ Utility room 2.2m2
✓ Dark room 4.65
✓ Film view 4.65m2
✓ Changing rm. 4m2

✓ common toilet 2.2m2
✓ Store 4.64m2
x-ray
X-rays are a type of radiation called electromagnetic waves. X-ray imaging
creates pictures of the inside of your body. The images show the parts of your
body in different shades of black and white. ... The most familiar use of x-rays
is checking for fractures (broken bones), but x-rays are also used in other ways.
Fig:22 sample x-ray room
ENDOSCOPY
Endoscopy is a procedure that allows your doctor to look at the inside lining
of your esophagus, your stomach, and the first part of your small intestine
(duodenum). A thin, flexible viewing tool called an endoscope (scope) is used.
FLUOROSCOPY
It’s a study of moving body structures. Fluoroscopy is used in many types of
examinations and procedures, such as barium X-rays, cardiac catheterization,
arthrography (visualization of a joint or joints), lumbar puncture, placement of
intravenous (IV) catheters (hollow tubes inserted into veins or arteries),
intravenous pyelogram, hysterosalpingogram.
Fig:23 Internal space of fluoroscopy
MAMMOGRAPHY
During a mammogram, a patient's breast is placed on a flat support plate and
compressed with a parallel plate called a paddle. An x-ray machine produces a

small burst of x-rays that pass through the breast to a detector located on the
opposite side.
Fig:24 mammography
CT-SCAN
A computerized tomography (CT) scan combines a series of X-ray images
taken from different angles and uses computer processing to create cross-
sectional images, or slices, of the bones, blood vessels and soft tissues inside
your body. CT scan images provide more detailed information than plain X-rays
do.
Fig:25 CT scan room
COMPUTED TOMOGRAPHY (CT)
Abdomen and Pelvis. Computed tomography (CT) of the abdomen and pelvis
is a diagnostic imaging test used to help detect diseases of the small bowel,
colon and other internal organs and is often used to determine the cause of un-
explained pain.

Ultra-sound
✓ Sound or other vibrations having an ultrasonic frequency, particularly
as used in medical imaging.
✓ "an ultrasound scanner"
✓ an ultrasound scan, especially one of a pregnant woman to examine the
fetus. plural noun: ultrasounds.
Fig:26 Ultra-sound room
MRI technologists
are radiologic technologists who specialize in magnetic resonance imaging.
Magnetic resonance imaging uses magnetic field and radio waves to produce
images of the inside of the human body.
Fig:27 MRI room
CLINICAL LABORATORY SERVICE
Laboratory
Laboratory: - is a facility that provides controlled conditions in which
scientific or technological research, experiments & measurement may be
performed.
Laboratory relationship with other departments: -
Very close to the emergency department
Easily accessible for internal division

Easily accessible for Maternity and surgery
Accessible from central storage
Fig:28 Sample laboratory design
Most important lab in hospital
✓ Chemical lab
✓ Bacteriology lab
✓ Histology lab
✓ Pathology lab
✓ Serology lab
✓ Hematology lab
✓ Micro-biology lab
Laboratory Component & Part
✓ Work area
✓ Waiting area
✓ Sample room
✓ Cleaning room
✓ Staff room
The laboratory department is concerned mostly with the preparation and
processing of blood, urine and fecal samples. It is often separated from the
treatment and nursing areas, the connection to the other departments being
through a special pneumatic tube dispatch system.
The laboratory itself should be in a large room with built-in work surfaces
(standing work places) to offer a high level of flexibility.
Specialist laboratories are added on as separate rooms.
Subsidiary rooms include rinsing rooms, sluice rooms, disinfection rooms,
cool rooms, rest rooms and WCs for staff. The size of the department depends
on the demands of the hospital.

Sometimes the laboratory departments are completely separate and serve a
group of several hospitals.
There are some important lab technical areas are needed in
hospital: -
PATHOLOGISTS UNIT
The pathologist's office is located so that he may have easy access to the
technical areas of the laboratory, particularly the histology unit.
This office is separated by a glass partition which permits the pathologist to
observe the technical work areas. A draw curtain may be used when he desires
privacy. Those who wish to consult the pathologist have access to his office
through an entrance from the administrative area.
WAITING AREA
A waiting area, with conventional waiting room furnishings, is provided for
the ambulant patients.
In this area, a desk is provided for a clerk-typist. An intercommunication
system between the technical areas of the laboratory and the clerk-typist is
recommended. This enables her to quickly notify the technical personnel when a
patient arrives and also to transfer phone calls for information concerning a
laboratory report.
The pathologist's secretary is also located in this area, near the pathologist's
office. She takes dictation and handles all the pathologist's correspondence,
surgical pathological reports, and autopsy protocols.
HISTOLOGY UNIT
The histology unit is assigned a standard module, separated from the other
units by a partition to prevent odors from spreading to other areas. It is located
near the pathologist's office since the medical technologist here works under his
direction and supervision.
Along one half of the module, an area is utilized by the pathologist to examine
surgical and autopsy specimens and to select the tissues for slide sections to be
prepared by the technologist.
Knee spaces are provided, one at each of the specialized work areas. -deep
working area, cabinets and drawers below the counter, and a reagent shelf.

URINALYSIS UNIT
The urinalysis unit is assigned one half of a standard module, consisting of a
workbench, 12 linear long and 30 in. high, and serves as the work area for the
microscopic and chemical examinations. Five linear of the workbench and s
knee space are provided for personnel performing the microscopic
examinations; the remainder of the workbench is used for the chemical
examinations. A sink located at one end of the workbench provides a
continuous working surface for the technologists.
HEMATOLOGY BLOOD-BANK UNIT
A standard module is assigned to the hematology-blood bank unit. One half
of this module is provided with a workbench for procedures such as hemoglobin
tests, sedimentation rates, staining, and washing of pipettes (in Plan A, counter
No. 7 on left side of unit). Knee apace and storage cabinets are provided below
the counter. In the other half of the module, a workbench 30 in. high, with three
knee spaces, is provided for technologists who are seated during tests, such as
those involving microscopic procedures.
SEROLOGY - BACTERIOLOGY UNIT
The serology and bacteriology work is combined in one standard laboratory
module, where a half module is assigned to each unit. Culture media for use in
bacteriology are prepared in the bacteriology work area and sent to the
sterilizing unit for sterilization.
The workbenches are 30-in. high with a 22or 23-in. deep working area, and
are provided with reagent shelves. A knee apace is provided in each workbench
since most of the procedures are done in a sitting position.
A utility sink is provided for the personnel in both units, but the bacteriology
unit also requires a sink for the staining of slide*. A fume hood is provided to
prevent the spread of possible infection to personnel when preparing specimens
from suspect cases of tuberculosis, fungus, or virus diseases.
A centrifuge, refrigerator, and incubator are provided along the interior wall
within the unit. A desk is also conveniently located for the use of the personnel.
BIOCHEMISTRY UNIT
The biochemistry unit requires an area that occupies one and a half standard
laboratory modules. The half module is shared with the urinalysis unit and is
used for the necessary preliminary procedures that are done prior to the actual
chemical analyses.

A knee space is provided in this workbench for personnel who perform
titrations and other procedures while seated. The adjoining module provides
workbench area where a variety of chemical procedure* may be performed and
includes a fume hood for removal of vapors and gases.
The workbenches for the chemical procedures are about 36 in. high, with
drawers and cabinets below.
Along the interior wall opposite this unit where chemical apparatus, such as
colorimeter, flame photometer, spectrophotometer, and carbon dioxide gas
apparatus are placed. Adjacent to the instrument table is an analytical balance
on a vibration-free table or other type of support.
The desk and refrigerator are shared with the urinalysis and the hematology
units. The reagent shelves are used to hold the chemicals needed during the
procedures. Two utility sinks are provided, one in each chemistry work area.
Therapeutic service division
Radiology
Radiology includes the specialist areas which use ionizing radiation for
diagnostic and therapeutic purposes. This includes X-ray diagnosis,
radiotherapy and nuclear medicine. The radiology department should always be
close to the ambulance entrance and, because of the great weight of the
equipment.
The size of the rooms depends on their use and what they contain: for
example, sonographer, mammography and jaw X-ray require about 12-18 m2
whereas standard X-ray and admission rooms need to be 20-30 m2.
Fig:29 Radiology design
The rooms of the individual diagnostic areas must be so arranged as to
minimize the distance between them. A connecting corridor which can be used

simultaneously as a store, dictating room and, possibly, a switch room as well as
for staff circulation, is desirable.
•Radiology division: • Parts and components of the division:
✓ X-ray rooms.
✓ Control room.
✓ Waiting area.
✓ Staff office.
✓ Utility room.
✓ Dark room.
✓ Film view.
✓ Store.
Location
Very close to the emergency department and external clinics.
Easily accessible from internal division.
Ground floor is preferred.
• 50-100 bed hospital area = 65-104 m2
• 200 bed hospital area = 220-240 m2
Radiotherapy
In radiotherapy, conditions diagnosed in the radiography department (e.g.
tumors) are treated. The radiotherapy department comprises a reception and
waiting area, doctors' rooms, a switch room, possibly a localization room, a
service room, a film developing room, stores and a cleaners' room. Each
treatment room requires a changing cubicle for patients.
The safety requirements are particularly strict for radiotherapy departments
and must satisfy all applicable national and international regulations. Structural
shielding from radiation can be achieved by using lead inserts or with thick
concrete walls.

Physiotherapy
The physiotherapy department contains a 'wet area' consisting of an exercise
pool (approximately 4 x 6 m). a 'four cell bath', a 'butterfly bath', inhalation
rooms, a massage bath, hand and foot baths as well as the necessary subsidiary
rooms. It is, obviously, important to use slip- resistant tiles in this area.
Additional rooms to be planned include changing rooms for men and women,
wheelchair users' WC, staff and patient WCs, rest rooms, linen stores, waiting
areas, cleaners' room and service rooms for the exercise pool.
Ideally, the physiotherapy rooms should be arranged on the basement floor
where natural lighting can be admitted through roof lights and light shafts. The
department should be accessed through a main reception area and the division
between wet and dry areas must be obvious.
A gymnasium is often included in the physiotherapy department. This will
require a clear height of at least 3.00 m, the provision of a sprung floor and the
installation of impact resistant lighting. Because of the high internal.
Fig: Physiotherapy service
Therapeutic services division (Physical therapy division)
Waiting area.
Office.
Hydrotherapy.
Exercise room.
WCs.
Location
Close to the main entrance of the hospital.
Easy accessible from external clinics.
Easy accessible from internal division.
Must be in the ground floor.

Area of the department: -
• 50-100 bed hospital area = 65-104 m2
• 200 bed hospital area = 155-225 m2
Internal medical treatment division
Surgical Department Function
In the surgical department, treatment is given to the patients whose conditions
have been diagnosed but cannot be cured solely with medication. It should be
close to the intensive care department, the recovery room and the central
sterilization area because there is extensive interaction between these
departments and so easy access must be assured. The hygiene precautions
require the surgical unit to be isolated from the rest of the hospital operations.
This is achieved by a demarcation system using lobbies.
Surgical departments are best located centrally in the core area of the hospital
where they are easy to reach. The reception area for emergency cases
(casualties) must be as close as possible to the surgical area since such patients
often need to be moved into surgery immediately.
Advantage and dis- advantage of centralization
Advantage: - (for better utilization of space equipment and staff, better patient
supervision under management of specialists, for better accessibility from other
departments and functionally preferable).
Dis advantage: - (high organizational costs, increased risk of infection because
of large number of people brought together, the combination of septic and
aseptic waste).
Fig: Surgical department

Organization of the surgery department
Every surgical department requires the following rooms:
➢ Operating theatre 40-48 m2
➢ Entry room 15-20m2
➢ Exit room 15-20m2
➢ Washroom 12-15m2
➢ Equipment room 10-15m2
Main Surgical Rooms
A number of necessary supply and workrooms adjoin the operating theatre
directly. The operating theatre should be designed to be as square as possible to
allow working whatever direction the operating table is turned in.
A suitable size would be 6.50 x 6.50 m, with a clear height of 3.00 m and an
extra height allowance of roughly 0.70 m for air conditioning and other
services. Operating theatres should be fitted out as uniformly as possible, in
order to offer maximum flexibility, and center on a transportable operating table
system which is mounted on a fixed base in the middle of the room.
Fig: Main surgical room
Natural lighting in the operating theatre is psychologically advantageous but
often cannot be provided because of the layout. Where it is, there must be the
means to shut out the light completely (e.g. eye operations are carried out in
very dark rooms).
Organization of surgical department
Every surgical department require the following room o
Operating theater :- minimum area of 42 m2
Anesthetics rooms :-should be approximately 3:80x3:80m,have electric
sliding door in to operating theater, these doors must have windows to
give a visual link with the operating theater, the room should be equipped

with refrigerator draining sink rinsing line cupboards for cannula
connections for Anastasia equipment and emergency power.
Dictation room :- no larger than 5m2,a place where doctors prepare
report following an operation , they are not absolutely necessary
Nurse workstation: - should located centrally, must have large glass
screen to allow the working corridor to be viewed.
WCs :-for hygiene reason toilets should be located only with in the
lobbies and not in the surgical area
Standing areas for clean bed: - close to patient demarcation lobby, the
requirement is for one additional clean bed for each operation.
Recovery room: - 30 m2 minimum, adjoining is a small sluice room with
drainage sinks.
Pharmacy :-a 20m2 pharmacy can supply a combination of anesthetics
and surgical medication and other material’s
Sterile goods room:-one room of roughly 10m2 required for operating
theater, it must be directly accessed from Operation Theater, sufficient
shelf and cupboard space.
Cleaning room: - a size of 5m2 s sufficient
Equipment room size of approximately 20m2,although direct access to
the operating theater is preferable it is not always feasible
Sub sterilization room: -25 m2 minimum, this room may or may not be
connected directly to operating area, it should be equipped with sink
storage surface and steam sterilizer’s
Routiening:-a way or road taken in getting from the starting point to a
destination, different activities should be separated in order to reduce the
transmission of germs through contact. The single corridor system in
which the pre-operative and post-operative staff clean and non-clean
goods use a single working corridor without segregation .it is better to
have dual corridor system in which patients and staff or patients and non-
clean materials are separated (dirt corridor & clean corridor)
Anesthetics discharge room: - is set out identically to the anesthetics
room .the door to the working corridor should be designed as door with
clear width of 1:25 m.
SURGERY SAFETY REQUIREMENTS
The operating theatre should be connected to the an anesthetics room,
discharge room, a wash room and sterile materials room via electric sliding
doors, fitted on the outer side of the theatre so as not to constrict the space
within. The opening mechanisms must be operated by foot switches for hygiene

reasons. In the rooms for auxiliary functions, swing doors with a clear width of
1.00-1.25 mare sufficient.
Protective measures in the main an anesthetics rooms are:
• avoid materials which produce large electrostatic charges when rubbed
or separated (e.g. plastic cloth)
• use conductive materials (e.g. conductive rubber) • equalize charges
through conducting floor • maintain constant humidity between 60 and
650/0
A back-up power supply is required for surgical equipment so that, in the event
of a power cut, the operation can be continued and completed. Among other
things, the following must continue to be operable:
• at least one operating lamp at each operating table, with a supply which
will last for at least three hours
• equipment for maintaining vital bodily functions (e.g. for respiration, an
aesthesia and resuscitation)
LIGHTINGS
Guidelines for lighting in hospitals recommend the nominal lighting strength
for operating theatres as 1000 lux and 500 lux for auxiliary surgical rooms.
Lighting in the operating area must be adjustable in order to provide light at
different angles according to the position of the surgical incision.
Fig: Lighting in surgical room
CENTRAL STERILIZATION
This is where all hospital instruments are prepared. The majority of instruments
are used by the surgical department, surgical intensive and internal intensive
care. For this reason, central sterilization should be installed close to these
specialist areas.
Central sterilization division:

✓ Work space.
✓ Receiving area.
✓ Washing area.
✓ Supplies storage.
Location:
✓ Very close to the operation theatre and maternity division.
✓ Can be easily accessible from the emergency division, laundry and
central storages.
Fig: central sterilization room
DEMARCATION
A 'demarcation area' is formed by the intermediate zone ('lobby') between the
care area and the examination/treatment area. Demarcation may be achieved in
different ways depending on the required function and specialist area:
• patient lobby,
• staff lobby,
• combined staff and visitor lobby,
• supply and disposal lobby,
• gown lobby,
• Lobbies before intensive care rooms.
Maternity and Neonatal Care
The maternity and neonatal department provides continual physical, medical,
psychological and social care for mothers and new babies following a hospital
delivery.

Neonates are carried into the mother's room on trolleys or by hand for breast
feeding. This achieves more frequent and more intensive contact between
mother and child than in previous designs with central feeding rooms.
Fig: maternity and neonatal care
Intensive Care Area
The task of intensive care is to prevent life-threatening disruption of the vital
bodily functions: for instance, disruption of breathing, cardiovascular and
metabolic disturbances, infections, severe pain and organ failures (e.g. liver,
kidneys). The services of intensive care include monitoring and treatment as
well as care of the patient.
The services of intensive care include monitoring and treatment as well as
care of the patient. Special constructional and medical organizational measures
are required for patients with paraplegia, burns and mental problems, which
differ from usual intensive medicine.
Fig: ICU internal design
Arrangement Intensive Care Unit (ICU)
The intensive care department must be a separate area, and only accessible
through lobbies. Note that according to hospital regulations, each intensive care
unit must be a separate fire compartment.

The central point of an intensive care unit must be an open nurses'
workstation from which it is possible to oversee every room.
The recovery room of the operating department is often located in the
intensive care unit so the patients can economically be cared for by the same
staff.
Arrangement of the bed spaces
The beds may be placed in an open, closed or combined arrangement. With an
open arrangement a large floor area is required. All the beds must be in clear
view of a central nurses' duty station and the patients are separated by moveable
half-height partitions which should be lightweight and easy to move. With a
closed arrangement the patients are accommodated in separate rooms which,
again, must be in sight of a central nurses' workstation.
EXTRA functions
Extra functions the following areas and rooms should be planned in:
✓ Operating theatre for minor interventions
✓ laboratory space,
✓ kitchenette,
✓ Sub sterilization
✓ non-clean workroom,
✓ cleaning room,
✓ lounge for relatives,
✓ duty doctor's room,
✓ documentation room,
✓ possibly a consulting room, and
✓ sanitary facilities
The intensive surgical medicine ward should be close to and preferably on the
same level as the surgical department and internal intensive medicine ward. It
should also be close to reception and the emergency service operations center.
Intensive wards which are not associated with a specialist area should be close
to the outpatients and surgical department.
Intradepartmental Relationships
Since they share some supportive facilities, the emergency and outpatient
facilities are adjacent to each other. Good planning practice requires that the
Emergency Activity be easily accessible to the hospital's surgical suite,
coronary intensive care unit, and the primary radiological facilities. The
relationships within any Emergency Activity may be arranged according to

individual preference and needs The following should be considered for any
complete emergency activity:
✓ PUBLIC SECTOR AREAS: Entrance for patients arriving by ambulance,
other modes of transportation, or conveyances. Entrance for walk-in
patients. Control station. Public waiting space with appropriate public
amenities
✓ TREATMENT FACILITIES: Patients are treated in spaces surrounding
the nursing station, the hub of all activities. This station is backed up by
the medical preparation room and the office of the chief nurse who
supervises all operations. Therefore, a glazed partition is provided which
ensures acoustical privacy and affords visual control.
INPETIENT DIVISION
A patient who is formally admitted (or “hospitalized”) to an institution for
treatment and/or care and stays for a minimum of one night in the hospital or
other institution providing inpatient care.
A patient who has gone through the full admission procedure and is occupying a
bed in a hospital inpatient department.
General - Inpatient nursing units, that is, ward concept is fast changing due to
policy of early ambulation and in fact only a few patients really need to be in
the bed.
Fig: Inpatient division pictures
Normal care units are used for general inpatient care (the main function of
general hospitals), particularly for short- term and acute illnesses. Primarily
with a short length of stay. These units can be stacked depending on the space
requirement and organizational structure. Seriously ill patients are moved from
normal care groups to intensive care groups.

ADULT ACUTE WARD
Accommodate general medical or general surgical patients. Although a ward
generally will accommodate either one or the other (for doctors’ convenience
and efficiency of location) there is no significant difference in their facility
needs and the ward is standard in its area provision and layout. Between half
and three quarters of a hospital’s beds are to be found in these wards. Stroke
rehabilitation wards would also significantly more space is required around the
bed for monitoring and other equipment
Fig: Adult acute ward
CHILDREN’S WARDS
Vary from adult acute wards in the greater areas devoted to day/play space
and the need for access to an outside play area, the provision of education
facilities and, of course, the specially designed fittings and furniture. Separate
provision for adolescents is an important consideration as educational and
recreational provisions are not compatible with lower age ranges. Provision for
separate accommodation for males and females becomes significantly more
important for this age range
Fig: Children ward design

WARDS FOR ELDERLY PEOPLE
Again, have more day space than adult acute wards because these patients
spend longer in hospital and are ambulant for more of the time. Providing
dignity and separation of sexes can be preserved, accommodation for elderly
patients may benefit from a limited provision of multi-bed accommodation.
Fig: Elderly People
The basic considerations in placement wards is to
✓ ensure sufficient nursing care,
✓ locating them according to the needs of treatment,
✓ in respective medical discipline and checking cross infection.
Nursing care should fall under the following categories: -
General Wards: - Wards of traditional type for patients who are not critically
ill but need continuous care or observation and have to be in bed. These include
wards for medical, surgical, ENT and eye disciplines, etc.
Private Wards (Optional): - Wards for patients who are in a position to pay
high towards Medicare. These may be air-conditioned or non-air conditioned.
Wards for Specialties: - Wards for patients who are suffering and need
hospitalization in particular specialties, like, pediatric, obstetrics, gynecology
dermatology, venereology, psychiatry, etc.
General Ward Facilities
Each ward unit should have a set of ward ancillaries as given below Nursing
station (Nurses desk and clean utility) - It should be positioned in such a way
that the nurse can keep a continuous watch over the patients.
Ward pantry - For collection and distribution of meals and preparation of
beverages, a ward pantry shall be provided. It should be fitted with a hot-water
supply geyser, refrigerator and a hot case and should have the facilities for
storing cutlery, etc.

Ward store - A store shall be provided for storing the weekly requirements of
clothes, bed sheets, and other ward equipment. Treatment room - Major
dressing and complicated treatments & should be carried out in the treatment
room to avoid the risk of cross-infection.
Sluice room - A room shall be provided for emptying and cleaning bed pans,
urine bottles, and sputum mugs, disposing of used dressing and similar material,
storage of stool and urine specimen, etc.
Day space - For those patients who are allowed to sit and relax, room shall be
provided in the ward unit itself. It should afford an easy access to patients and
supervision byte nursing staff and should be provided with easy chairs, book
shelves and small tables. It may also serve dining space.
Patient conveniences - Toilet for an individual room (single or two bedded) in
ward unit shall be 3.5 m2 comprising a bath, a washbasin and WC. Toilet
common to serve two such rooms shall be 5.25 m2 to comprise a bath, a WC in
separate cubicle and a wash basin.
Location of Ward
Wards should be relegated at the back to ensure quietness and freedom from
unwanted visitors. General ward units are of repetitive nature and hence they
maybe conveniently piled up vertically one above the other which will result in
efficiency, easy circulation and service economy.
Wards for particular specialties
However, should be located closer to their respective department to act as
self-contained centers. In such case, post-operative ward may be placed
horizontal to operation theatre and maternity ward to the delivery rooms.
Ward Unit
In planning a ward, the aim should be to minimize the work of the nursing
staff and provide basic amenities to the patients within the unit. The distances to
be travelled by a nurse from bed areas to treatment room, pantry, etc., should be
kept to the minimum.
WARD UNIT FOR PARTICULAR SPECIALTIES
The provisions recommended for general ward unit shall apply with additional
requirements as described below.
Obstetric Ward - Maternity service includes antenatal care, delivery and
postnatal care. Before and after child birth, the patient should be attended to in

the out-patient clinic and during labor the patient is confined to bed in the
nursing unit. The out-patient clinic should also provide diagnostic facilities for
gynecology patients. Since these services are cyclic, it is recommended to place
the in-patient up it close to the out-patient clinic making it easily accessible to
the childbearing women. The inpatient unit shall comprise –
Delivery suite unit
Nursing unit, and
Neonatal unit, and they should be placed on the same floor.
Nursing Unit - Nursing unit for the department shall include antenatal,
postnatal, eclampsia, post-operative, and gynecological units.
Prenatal Beds - The female patients admitted for treatment during the
period of their pregnancy should be housed in a ward separate from those who
have undergone the labor.
Toxemia Beds - These patients fall under prenatal and postnatal category.
The ward should either form part of antenatal nursing unit or placed close to
delivery suite unit. Number of beds shall be one in every 20 postnatal beds.
Single and two-bedded rooms with attached toilet should be provided.
Postnatal beds - Patients who have had normal deliveries and do not suffer
any complication, calling for medical care are admitted to this ward. The size of
the ward depends upon whether the babies are kept with the mothers or all
babies are kept in the central nursery.
Post-operative Bed - The post-operative bed for the patients who have
undergone operation shall be able to accommodate two beds per delivery room
including operating delivery room. Area per bed maybe 8.75 m2.
GENERAL SERVICE AND DIVISION
CENTRAL STERILE AND SUPPLY DEPARTMENT (CSSD)
Sterilization, being one of the most essential services in a hospital, requires
the utmost consideration in planning. Centralization increases efficiency, results
in economy in the use of equipment and ensures better supervision and control.
The materials and equipment dealt in CSSD should fall under three categories:-
those related to the operation theatre department,
common to operating and other departments, and
Pertaining to other departments alone.

Location - Since the operation theatre department is the major consumer of
this service, it is recommended to locate the department at a position of easy
access to operation theatre department.
MEDICAL AND GENERAL STORES
Hospital stores comprise of stores needed for various hospital functioning and
should be grouped centrally in the service complex. The area for each type of
stores should be utilized to the optimum by providing built in shelves at
different heights according to the type of stores. Adequate ventilation and
security arrangement shall be provided. Stores should also be provided with
firefighting arrangement.
HOSPITAL KITCHEN
Hospital Kitchen (Dietary Service) - The dietary service of a hospital is an
important therapeutic tool. Properly rendered, it shall be a clinical and
administrative means of stimulating rapid recovery of patients thereby
shortening patients stay in the hospital.
The aim in hospital catering, therefore, should be to produce well cooked,
appetizing and nutritious food as economically as possible. The achievement of
this objective shall depend on administrative efficiency of the staff, planning
department, layout and equipment.
The hospital kitchen could be alone responsible for spreading diseases if
hygienic conditions are not maintained. Use of cooking gas and electricity will
definitely improve the hygienic conditions of a hospital kitchen. Good natural
light and ventilation is of great importance.
Location - Location should ensure that any noise or cooking odors emanating
from the department do not cause any inconvenience to the other departments.
At the same time the location should involve the shortest possible time in
delivering food to the wards.
MORTUARY
Mortuary shall provide facilities for keeping of dead bodies and conducting
autopsy. It should be so located that the dead bodies can be transported
unnoticed by the general public and patients. Relatives and mourners should
have direct access to the mortuary. The mortuary shall have facilities for
walking cooler, post mortem area, etc.

HOSPITAL LAUNDRY
Laundering of hospital linen shall satisfy two basic considerations, namely,
cleanliness and disinfection. Manual/electric laundry can be provided with
necessary facilities for drying, pressing and storage of soiled and cleaned linens.
Air change in laundry area maybe 10 times per hour.
ENGINEERING SERVICE
PUBLIC HEALTH ENGINEERING
Water Supply - Arrangements shall be made to supply 10000 liters of
potable water per day to meet all the requirements (including laundry) except
firefighting. Storage capacity for 2 days’ requirements should be on the basis of
the above consumption.
Round the clock water supply shall be made available to all wards and
departments of the hospital. Separate reserve emergency overhead tank shall be
provided for operation theatre. Necessary water storage overhead tanks with
pumping/boosting arrangement shall be made. Cold and hot water supply piping
should be run in concealed form embedded into wall with full precautions to
avoid any seepage.
Drainage and Sanitation - The design, construction and maintenance of
drains for waste water, surface water, sub-soil water and sewerage shall be in
accordance with international standards.
The selection, installation and maintenance of sanitary appliances shall be in
accordance with IS the design and installation of soil, waste and ventilating
pipes shall be as given in
Waste Disposal System - The guidelines provided by Central Pollution
Control Board, Ministry of Environment and Forests shall be followed.
MECHANICAL ENGINEERING
Air conditioning and Room Heating - Air conditioning units shall be
provided only for the operation theatre and neonatal unit. However, air coolers
or hot air connectors may be provided for the comfort of the patients and the
staff depending upon the local needs.
Refrigeration - Hospitals shall be provided with water coolers and
refrigerator inwards and departments depending upon the local needs.
ELECTRICAL ENGINEERING

Sub Station and Generation - Electric substation to accommodate
transformer, HT/LT panel and generating set to meet the electrical lead
requirements of the hospital shall be provided. Stand by generators should be
provided to generate power requirements for essential and critical areas of the
hospital, like, OT/LR radiology department, etc.
Illumination - General lighting of all hospital areas except stores and lavatory
block shall be fluorescent. In other areas, it is recommended to be of
incandescent lamps.
Shadow less Light Shadow less light (mountable type) shall be provided in
operation theatres and operating delivery rooms whereas in other areas, where
operation of minor nature are carried out, shadow less light(portable type) shall
be provided.
Emergency Lighting - Emergency portable light units should also be
provided in the wards and departments to serve as alternative source of light in
case of power failure.
Lighting Protection - The lighting protective system of hospital buildings
shall be in accordance with IS 2309.20.1.6 Call Bells Call bells (see IS 2268)
with switches for all beds should be provided in all types of wards with
indicator lights and location indicator situated in the nurse’s duty room of the
wards.
Ventilation - Ventilation of hospital buildings maybe achieved by either
natural supply and natural exhaust of air, or natural supply and mechanical
supply and mechanical exhaust of air.
DEPARTMENTS IN THE HOSPITAL
Angiography or arteriography: - A medical imaging technique
used to visualize the inside, or lumen, of blood vessels and organs of the body,
with particular interest in the arteries, veins and the heart chambers.
Dermatology: - It is the branch of medicine dealing with the skin and its
diseases Ear nose and throat (ENT) General ear, nose and throat diseases
Gastroenterology: - Investigates and treats upper and lower
gastrointestinal disease, as well as diseases of the pancreas and bile duct system.
Gynecology: - Investigate and treat problems of the female urinary tract
and reproductive organs, such as endometritis, infertility and incontinence.
Hematology Work closely with the hospital laboratory, linked to the blood.

Maternity departments: - Maternity wards provide antenatal care,
care during childbirth and postnatal support.
Microbiology: - The microbiology department looks at all aspects of
microbiology, such as bacterial and viral infections.
Neonatal unit: - Neonatal units have a number of cots that are used for
intensive, high-dependency and special care for newborn babies.
Nephrology: - this department monitors and assesses patients with kidney
(renal) problems. Neurology Deals with disorders of the nervous system,
including the brain and spinal cord.
Nutrition and dietetics: - a sub-discipline of Medicine, is the science
that focuses on everything related to food and its effect on our health and
overall wellbeing. Nutritionists and dietitians aim to improve people's health
and help them make better dietary choices
Oncology: - Provides radiotherapy and a full range of chemotherapy
treatments for cancerous tumors and blood disorders.
Ophthalmology: - It’s an eye focused department providing, general eye
clinic appointments, laser treatments, optometry (sight testing), orthotics (non-
surgical treatments, e.g. for squints), prosthetic eye services, ophthalmic
imaging (eye scans)
Orthopedics: - Treat problems that affect your musculoskeletal system.
That's your muscles, joints, bones, ligaments, tendons and nerves.
Pharmacy: - It’s responsible for drug-based services in the hospital
Physiotherapy: - Physiotherapists promote body healing, for example
after surgery, through therapies such as exercise and manipulation.
Renal unit: - Closely linked with nephrology teams at hospitals, these
units provide hem dialysis treatment for patients with kidney failure.
Sexual health (genitourinary medicine): - This department
provides a free and confidential service offering including advice, testing and
treatment for all sexually transmitted infections (stis) family planning care
(including emergency contraception and free condoms) pregnancy testing and
advice
Urology: - Investigates all areas linked to kidney and bladder-based
problem

CIRCULATIONS IN HOSPITALS
There are two types of circulation (vertical and horizontal)
1. Horizontal circulation(corridors)
Types of corridor’s (depending up on the swinging direction of the door)
✓ When the swinging direction of the door towards the corridor (un
recommended for hospitals)
✓ Vice-versa of number one (recommended for hospitals due to light
traffic)
✓ Corridors must be designed for maximum expected circulation flow
✓ Generally, access corridor’s must be at least1.50m width
✓ Corridors in which patients will be transported on trolleys should have
a minimum effective width of 2.5 m
✓ Windows for lighting and ventilation should not be further than 25m
apart
✓ Main corridor 3.00m, medical service corridor 1.5-2.25m, service
corridor deliveries storage areas 3.05-4m, working corridor surgical
area 2.25m,ward corridor intensive care.
Fig: Hospital corridor design
2. Vertical circulations (lift, stair, ramp)
Lifts
Lifts transport people, medicines, laundry, meals and hospital beds between
floors, and for hygiene and aesthetic reasons separate lifts must be provided for
some of these. In buildings in which care, examination or treatment areas are
accommodated on upper floors, at least two lifts suitable for transporting beds
must be provided.

The elevator cars of these lifts must be of a size that allows adequate room
for a bed and two accompanying people; the internal surfaces must be smooth,
washable and easy to disinfect; the floor must be non-slip.
Lift shafts must be fire-resistant. One multipurpose lift should be provided
per 100 beds, with a minimum of two for smaller hospitals. In addition, there
should be a minimum of two smaller lifts for portable equipment, staff and
visitors.
Fig: Hospital lift
Stairs
For safety reasons stairs must be designed in such a way that if necessary,
they can accommodate all of the vertical circulation. The relevant national
safety and building regulations will, of course, apply. Stairs must have handrails
on both sides without projecting tips. Winding staircases cannot be included as
part of the regulatory staircase provision. The effective width of the stairs and
landings in essential staircases must be a minimum of 1.50 m and should not
exceed 2.50 m. 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. Step heights of 170 mm are permissible and the minimum
required tread depth is 280 mm. It is better to have a rise/tread ratio of
150:300mm.
Fig: Hospital stair

Ramps
An exterior location is preferred for ramps. Indoor ramps are not
recommended because they take up a great deal of space. Ideally, the entrance
to a ramp should be immediately adjacent to the stairs.
Ramp configuration
Ramps can have one of the following configurations: -
(a) Straight run
(b) 90 turn
(c) Switch back or 180turn
Width
Width varies according to use, configuration and slope.
The minimum width should be 0.90m.
Slope
The maximum recommended slope of ramps is 1:20. Steeper slopes may be
allowed in special cases depending on the length to be covered.
Landings
✓ Ramps should be provided with landings
for resting, maneuvering and avoiding
excessive speed.
✓ Landings should be provided every 10.00
m, at every change of direction and at the
top and bottom of every ramp.

✓ The landing should have a minimum length of 1.20 m and a minimum
width equal to that of the ramp.
FIRE PROTECTIONS
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.
FACILITIES FOR DISABLED
Circulation for handicapped people
Circulation in a wheelchair requires a specific design of the circulation ways
➢ Passages: 1.30m wide minimum, better if 2m wide,
➢ Doors: 0.95m wide minimum, a magnetic closure is advised,
➢ Switches, handles, windows closure... have to be within easy reach: 1-
1.05m high,
➢ Wide pushbuttons are required,
➢ Access ways: 1.20-2m wide,
➢ Slopes: 5% maximum, 6m long maximum, Width between handrails:
1.20m.
BY DESIGN AND PLANNING FOR DEAF PEOPLES
A. Provide the best possible visual access to others with in a space as well
as to the space beyond
B. Create and allow easy way-finding and orientation
C. Design perceptually calm space to minimize eyestrain
D. Reduce barrier to visual communication especially in gathering spaces
where clear sightlines to a wide variety of activities must be maintained.
E. Control vibration, sound reverberation and noise transmission
between spaces.

ARCHITECTERAL FORMS AND STRUCTURES
Functional relationships and design were translated in the relevant period or
are currently being translated into the building structure of the hospital. The
following models will be dealt with: -
• The Breitfuss model
• The double comb structure
• The arcade model
• The cross structure
• The branched structure
• The linear structure
• The pavilion structure
The building structure of a hospital has undergone a development that shows a
decreasing dominance of the ward block. The treatment and outpatient
departments and the flexibility and design of the main traffic areas have had an
increasing impact on the main design of the hospital.

Local hospital design standard/federal ministry of health 2016-
2020/
A. Site considerations
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
1. 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.
2. Occupancy: a building designed for other purpose shall not be converted
into a hospital. The location of a hospital shall comply with all local
zoning ordinances.
3. 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.
3.1 exits shall be restricted to the following types: door leading directly
outside the building, interior stair, ramp, and exterior stair.
3.2 a minimum of two (2) exits, remote from each other, shall be
provided for each floor of the building
3.3 Exits shall terminate directly at an open space to the outside of the
building.
4. Security: a hospital and other health facilities shall ensure the security of
person and property within the facility.
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.
5.1 corridors for access by patient and equipment shall have a minimum
width of 2.44 meters.
5.2 corridors in areas not commonly used for bed, stretcher and
equipment transport may be reduced in width to 1.83 meters.
5.3 A ramp or elevator shall be provided for ancillary, clinical and
nursing areas located on the upper floor.

5.4 A ramp shall be provided access to the entrance of the hospital not
on the same level of the site.
6. 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.
7. Ventilation: adequate ventilation shall be provided to ensure comfort of
patients, personnel and public.
8. Auditory and visual privacy: a hospital and other health facilities shall
observe acceptable sound level and adequate visual seclusion to achieve
the acoustical and privacy requirements in designated areas allowing the
unhampered conduct of activities.
9. Water supply: a hospital and other health facilities shall use an approved
public water supply system whenever available. The water supply shall be
potable, safe for drinking and adequate, and shall be brought into the
building free of cross connections.
10. 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.
11. 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.
12. Housekeeping: a hospital and other health facilities shall provide and
maintain a healthy and aesthetic environment for patients, personnel and
public.
13. Maintenance: there shall be an effective building maintenance program
in place. The buildings and equipment shall be kept in a state of good
repair. Proper maintenance shall be provided to prevent untimely
breakdown of buildings and equipment.
14. Material specifications: floors, walls and ceilings shall be of sturdy
materials that shall allow durability, ease of cleaning and fire resistance.
15. 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 forever eight (8) patients or personnel.
16. Fire protections: 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.
17. Signage. There shall be an effective graphic system composed of a
number of individual visual aids and devices arranged to provide

information, orientation, direction, identification, prohibition, warning and
official notice considered essential to the optimum operation of a hospital
and other health facilities.
18. Parking. A hospital and other health facilities shall provide a minimum
of one (1)parking space for every twenty-five (25) beds.
19. Zoning: the different areas of a hospital shall be grouped according to
zones as follows:
19.1 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.
19.2 Second zone– areas that receive workload from the outer zone:
laboratory, pharmacy, and radiology. They shall be located near the outer
zone.
19.3 inner zone – areas that provide nursing care and management of
patients: nursing service. They shall be located in private areas but
accessible to guests.
19.4 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
19.5 service zone– areas that provide support to hospital activities: dietary
service, housekeeping service, maintenance and motor pool service, and
mortuary. They shall be located in areas away from normal traffic.
B. Perception and interiors
I. Function: the different areas of a hospital shall be functionally related with
each other.
2.1 The emergency service shall be located in the ground floor to ensure
immediate access. A separate entrance to the emergency room shall be
provided.
2.2 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.
2.3 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.
2.4 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.
2.5 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
II. Space: adequate area shall be provided for the people, activity, furniture,
equipment and utility.
• All horizontal and vertical circulation areas that include stairs, doors,
windows, corridors, exits and entrances of the hospital shall be kept clear
and free of obstructions and shall not be used for other functional
purposes that include storages.
• Rooms: all room size and space allocation shall consider room loadings
based on the current staff, clients involved, usable medical equipment's,
furniture and applicable functions.
• The hospital circulation (main and sub corridors): shall be wide
enough to allow passage for its function
• Patient serving corridors: should not be less than 240cm wide, and
proportionally the openings to the corridor needs to be designed to allow
easy movement of coaches and be equipped as needed by the patient with
safety and all assistive devices (it includes: door stopper, protecting
girders, alarms, self-opening electronic devices, etc).
• Doors: all doors shall be able to easily open and close, doors swing into
corridors shall be avoided.
• Patient rooms: each patient room shall meet the following requirements:
a. All patient functioning rooms, toilet, and bathing room doors shall
provide privacy yet not create seclusion or prohibit staff access for
routine or emergency care.
b. Area: shall contain 9.20m2 (100ft2) of floor area for a single
bedroom and7.50m2 (80ft2) per bed in multi bed rooms.
c. Ceiling height: ceiling height needs to be determined based on the
functional requirements considering air space, technical requirements,
room size proportions, number of occupants and other parameters.

The height of the ceiling of the rooms shall not less than 240cm high
for support services, 220cm for technical corridors n(operation
theater 320 cm, x-ray 320 cm, room requiring interstitial floor needs
to be more than 580cm) and280cm for other clinical rooms.
• Windows: all rooms housing patients shall have access to natural light
and ventilation, or prove the availability of artificial ventilation and light
at all times. Rooms shall have window area proportional to that of floor
areas which is equal to 1/8th of the floor area.
• Storage: each patient shall be provided with a hanging storage space of
not less than 40.cm x 60.cm x 130cm (16" x 24" x 52") for his personal
belongings.
• Furnishings: a hospital shall provide comfortable patient trigonometric
designs, applicable functions, and technical requirements. They have to
be hygienic (washable, dust and bacteria protective and resistant for
cleansing reagents) durable that can control vandalism and avoid
accidents.
• Curtains: rooms shall be equipped with curtains or blinds at windows.
All curtains shall have a flame spread of 25 or less or as per the national
fire protection code. And all as per the national infection prevention guide
lines requirements.
• Finishing: Walls, floors and ceilings of procedure rooms, isolation
rooms, sterile processing rooms, and work room, laundry and food-
preparation areas shall be suitable for easily washing. All floors of the
hospital clinical service areas shall be washable, smooth, non- adsorptive,
surfaces which are not physically affected by routine housekeeping
cleaning solutions and methods. Acoustic lay-in ceilings, if used, shall be
no perforated. Public spaces such as reception areas, waiting areas,
cafeterias, areas requiring silence and sub specialty areas like psychiatry
shall be designed with acoustic control and the lamination/lay shall be no
perforated.
• Sanitary finishing: A lavatory equipped with wrist action handles, shall
be located in the room or in a private toilet room. For hospitals with
multiple bed wards without private toilet room shall provide bedpan
washer. All sanitary room facilities floors, walls and ceilings shall be
completed with washable finishing materials Floors and walls penetrated
by pipes, ducts and conduits shall be tightly sealed to minimize entry of
rodents and insects.
• Electrical finishing: Patient bed light shall be controlled by the patients.
Room light luminescence shall be bright enough for staff activities but

needs to be controlled not to disturb the patients. All electrical fixtures
inlets, outlets shall fulfill Ethiopia electrical safety requirements and if
applicable fitted with guards For psychiatry service area light fixtures,
sprinkler heads and other apparatus shall be of a temper resistant type.
• Outdoor areas: the hospital outdoor area shall be equipped and situated
to allow for the safety and abilities of patients, care givers, staff and
visitors.
a. The landscape shall be designed with patient room visual acquit or
access
b. Walkways, connection roads and elevation differences shall be
designed to allow movements of coaches/stretchers and persons
with disabilities.
c. The outdoor traffic arrangement shall not cross each other to avoid
accidents
• Windows: in all rooms, windows shall comply with lax requirements of
room space without compromising room temperature and ventilation.
a. Windows shall be a minimum of 50 cm wide x 100cm high.
However, in case of hot climate areas, this may not be applicable
b. No window shall swing inside the room except those which
require security and safety measures such as grid for theft and
insect mesh for malaria porn areas.
c. Windows that frequently left open for cross ventilation purpose
(like tb clinic room windows) shall be equipped with insect screen.
At least a top portion of a window shall be left open fitted with
insect mesh for uninterrupted circulation of air.
d. Safety glass, tempered glass or plastic glass materials shall be used
for pediatrics and psychiatric service units to avoid possible
injuries.
• Vertical circulation: all functioning hospital rooms shall be accessible
horizontally.
A) Stairs: all stairways and ramps shall have handrails and their
minimum width shall be 120cm. All stairways shall have a 2-hour
fire enclosure with a (1.5 hour) label door at all landings or as per
the national fire protection code. All stairways shall be fitted with
non-slippery finishing materials All stair threads, riser and flight
shall comply with patient type as per the Ethiopia building
proclamation

B) Elevators: at least one hospital type elevator shall be installed
where 1-100 patient beds are located in the upper floors. In case of
more than 100 beds, the number of elevators shall be determined
from a study plan and expected vertical transportation
requirements. Minimum cab dimensions required for elevators
transporting patients is 195cm x 130cm inside clear measurements
and minimum width for hatchway and cab doors shall be100cm.
C) Ramp: ramps shall be designed with a slope of 6 to 9 percent,
minimum width of 120 cm and the landing floor of 240cm wide on
both sides.
D) Shoots: hospital buildings having services in the upper floor shall
have shoots facility. Shoots shall be free of possible accidents and
the inlets and outlets shall be confined in a lockable room.
• Fire safety considerations:
A) one-story building: wall, ceiling and roof construction shall be of 1-
hourfire resistive construction as defined by national fire protection
"life safety code or laws. Floor systems shall be of non-combustible
construction.
B) Multi-story buildings: must be of two-hour fire resistive construction
as Defined in national fire protection "life safety code or laws.
C) Travel distances and alternative vertical circulation: hospital facilities
travel distance from service giving room to the stairs should be as
specified in the national fire protection "life safety code or laws.
Alternative fire escape stair should be provided otherwise.

CLINICAL AND TECHNICAL TERMS
Angiography – X-ray imaging of heart and blood vessels after introduction of a
radiopaque contrast medium into bloodstream.
Biochemistry - the chemistry of living organisms and life processes; a
discipline within a hospital pathology laboratory.
Cardiography – graphically recording the movement of the heart by means of a
cardiograph.
Diagnostic imaging - all the types of imaging used for diagnosis: e.g. Radio-
diagnosis (X-ray); Ultrasound; Magnetic Resonance Imaging(MRI).
Endoscope - an illuminated optic instrument for viewing the interior of a body
cavity or organ.
Endoscopy - use of an endoscope inserted via either a natural orifice or an
incision for internal examination and/or treatment.
Hematology (hematology) - study of blood and blood-forming tissues; a
discipline within a hospital pathology laboratory.
Histology - the study of microscopic identification of cells and tissue and the
structure and organization of the same; a discipline within a hospital pathology
laboratory.
Laparoscope - type of endoscope consisting of an illuminated tube and used to
examine the peritoneal cavity.
Laparoscopic surgery - ‘keyhole’ surgery using, for example, endoscopic
penetration either through a natural orifice or via an incision.
Microbiology - the study of micro-organisms; a discipline within a hospital
pathology laboratory.
Nuclear Medicine - use of a gamma camera and injected radioactive isotopes to
acquire images of body parts such as the liver and kidneys.
Orthotics- provision of orthopedic appliances such as braces for limbs.
Phlebotomy - the incision of a vein (venipuncture) for taking blood for samples
etc.

Pyelogram - (or intravenous pyelogram) an X-ray picture of the kidneys,
ureters and bladder taken after the injection of a radiopaque dye. Stent - A mold
or device made of stent (a compound used for making medical and dental
molds) used for supporting body openings cavities during grafting of vessels
and of tubes of the body during surgical joining of ducts or blood vessels.
Telemedicine - medicine practiced at a distance by use of communications
technology such as videoconferencing, multimedia communications, internet
and intranet.
Triage - process of assessing, prioritizing and directing a number of patients for
appropriate treatment according to the relative severity of the injury and
urgency of treatment; historically, in the case of accidents and emergencies, but
the term is now applied more widely to the initial assessment and care
management of a group of patients needing treatment.
Ultrasound (imaging) - use of high-frequency sound to produce an image of
internal structures that differ in the way they reflect sound waves.
Obstetrics - is the field of study concentrated on pregnancy, childbirth and the
postpartum period. As a medical specialty, obstetrics is combined with
gynecology under the discipline known as obstetrics and gynecology
(OB/GYN), which is a surgical field.
Mortuary - a room or building in which dead bodies are kept, for hygienic
storage or for examination, until burial or cremation.
Maternity - being or providing care during and immediately before and after
childbirth.

Conclusion
• Hospital is a vital building which need to be designed and constructed
carefully with efficient internal lay out of rooms (function) conceding with light
and ventilation but there are so many recommendations that have to be kept in
mind as the hospital is to satisfy the health care delivery of the society it should
be very easy to use easily accessible for the vehicle’s and so on.
• Beginning from the site the location should be silent no pressure of users
provides an access without traffic of vehicles
• There are so many departments in designing of general hospital but the
obligatory departments are OPD, A&E in-patient maternity surgical department
rehabilitation and ICU
• With supply services such as laboratory pharmacy administration café morgue
etc.
• There are also treatment areas that have to be provided under general hospital
which gives the purpose of identifying the case such as laboratory, x-ray,
radiotherapy, ultrasound, radiology, ENT treatment, and city-scan.
• Conceding the above description, the general hospital can be built.

REFERENCE
• Healthcare in Ethiopia – Wikipedia
• History of General Hospital – Wikipedia
• hospital -- Britannica Online Encyclopedia
• literature review misses D.docx table
• Medical and Dental Space Planning
• Neufert (2) P & D of Modern Hospitals
• pdfcoffee.com_hospital-design-guide-pdf-free
• Understand the Design of General Hospital
• Other senior literature review paper

Hospital literature

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Hospital literature

Similar to Hospital literature (20)

Recently uploaded

Recently uploaded (20)

Hospital literature