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Construction of hospital facilities


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Construction of hospital facilities

  1. 1. SUBMITTED TO : Dr. KICHA .D.
  2. 2. There are two methods to estimate the need for hospital in a population:  Analytical method : Taking feedback and analysis of data collected through survey e.g. distributing questionnaire.  Estimation method
  3. 3. Planning (also called forethought/forecasting) is the process of thinking about and organizing the activities required to achieve a desired goal.
  4. 4. 1.What are we expect to do? 2.Why it should be done ? 3.Where will it be done ? 4.When are we expect to do it? 5.Who are those going to do it ? 6.How will it be done ? Excellent firms don’t believe in excellence – only in constant improvement and constant change – Tom Peters
  5. 5. Community interest over individual interest Preventive services over curative services Services catering to the weaker sections of the community Rural over Urban Regionalized Planning
  6. 6.       Geographic Data Morbidity & Mortality Status Need & Demand Details of existing Facilities Financial Feasibility Demographic Details Population Strength Sex & Age Ration Social Status Educational level
  7. 7. Must meet the needs of the patient that it is going to serve adequately. It must be in a size and proportions which the owners or promoters will be able to build and operate
  8. 8. Sound architectural plan Economic viability Effective community orientation Quality of patient care
  9. 9. Protection from unwanted and unnecessary disturbances in order to help speedy recovery Separation of dissimilar activities Control – the nurses station should be positioned strategically to enable proper monitoring of visitors entering and leaving the ward, infants and children should be protected from theft and infection etc. Circulation- all the departments of a hospital must be properly integrated. (“separate all departments, yet keep them all together; separate types of traffic, yet save steps for everybody; that is all there is to hospital planning “– Emerson Goble)
  10. 10. Needs of the community Ease of accessibility Range of services offered Availability of specialists Availability of technology Study of existing hospital(if any) Requirements of staff and services
  11. 11. Bed: Population = A x S x 100 365 x PO A= number of inpatient admissions/1000 population/year S= average length of stay PO= percentage occupancy
  12. 12. Planning of financesFunds required for constructing, furnishing and equipping the hospital. Operating funds- salaries, loans and interest, other maintenance expenses. Arranging financial assistance-patient fees, bed charges, and other modes of revenue generation process.
  13. 13. Stage A Functional content: Outline brief: Stage B Operational policies: Developmental plan: Project team Assessment of functional content Submission of owners( Govt,private organization etc.)for approval Site appraisal, gross floor areas Building space. Draft master plan Estimation of cost and phasing Appraisal of work by owners Operational policies Departmental and inter related activities Departmental and hospital policies Development control plan Budget cost Continuous informal discussion with owners
  14. 14. Stage C Schedules of accommodation, sketches, Final cost estimate: Stage D Detail design working drawings, tender action: Stage E Contract and construction: Stage F Commissioning: Schedules of accommodation Sketch drawing Equipment schedules component estimates Cost revenue and staffing estimates Final cost approval Working drawings Engineering details Bills of quantities Calling tenders Assessments of tenders Award of contract Construction Engineering commissioning Staff assembly and training Equipment and supplies assembly Testing of installation
  15. 15. Equipment planningBuilt in equipment These include counters and cabinets in laboratory, Pharmacy and other parts of the hospital , elevators , incinerators , coolers , fixed sterilizing equipment etc. These are usually included in the construction contract and the planning of these equipments is the architect's responsibility. Depreciable equipment This includes equipment that has a life of five years or more and is not purchased through construction contracts. These are large pieces of furniture which have a relatively fixed location and are capable of being moved e.g., diagnostic and therapeutic equipment, laboratory instruments, office furniture etc.
  16. 16. Non depreciable equipment These are small items with a low unit cost and life span of less than five years. These are generally under the control of the store room and are bought through other than construction contracts. They include kitchen utencils,surgical instruments,linen,waste baskets etc.
  17. 17. Operation program Admission Human resource Administration Stores General engineering Purchasing Laundry Maintenance Clinical services Waste disposal plant Pharmacy Fire and safety Nursing services Disaster plan House keeping information Records Dietary services Public relations Clinical engineering Employee facilities Sanitation
  18. 18. Intensive critical care unit (ICCU)Should preferably be located on the ground floor with convenient access from the operation theatre suit and emergency department and easy accessibility for wards. It consists patient area, staff area, support area. Four basic requirementsDirect observation of the patient by nursing and medical staff Surveillance of physiological monitoring Provision and efficient use of routine and emergency diagnostic procedures and interventions. Recording and maintenance of patient information
  19. 19. Design and Layout of ICCU Design should take into consideration the integration and smooth functioning of three areas 1. The Patient Area 2. The Staff Area 3. The Support Area Total area ranges from 350 to 500 sq. feet per bed which includes 1. Circulation Area 2. Nursing Station 3. Sanitary and Ancillary Accommodation
  20. 20. Ancillary & Support Services It should be centrally air conditioned. Overall lighting Requirement in ICCU is for subdued illumination for the patient bed with capacity for increasing it in case of need. Main light at the bed head should be fitted with dimmer switch. A high intensity emergency light or spot focusing light should also be provided. Emergency buzzer switch connected to central buzzer and location panel at central nursing station. Multiple electrical gadgets required. Stand by generator is also required. Diagnostic Support Should have round the clock access to Laboratory services Radiology Imaging Physiotherapy. Equipment maintenance Visitor Lounge
  21. 21. Area Sq .ft / bed Nursing unit 250-280 Nursery 12-18 Delivery suite 15-20 Operation theatre 30-50 Physical medicine 12-18 Radiology 25-35 Laboratory 25-35 Pharmacy 4-6 CSSD 8-25 Dietary 25-35 Medical record 8-15
  22. 22. Area Sq .ft / bed House keeping 4-5 Laundry 12-18 Mechanical installation 50-75 Maintenance work shop 4-6 Stores 25-35 Public areas 8-10 Staff facilities 10-15 Administration 40-50 Total 567-751 Circulation 115-751 Total net area 682-891
  23. 23. Hospital administrators and staff have an ongoing concern with controlling unwanted noise in their facilities. Patient comfort, employee satisfaction and environmental concerns are always at the forefront in the continuous design and maintenance of a wide array of systems that keep a medical facility running efficiently.
  24. 24. Quantity Price Source Quality
  25. 25. Technology requirement must be met Clinical needs must be considered Safety is a major factor Standards and Guidelines are essential Importance of the role of Hospital Staff in construction and design.
  26. 26. A hospital is a living organism, made up of many different parts , having different functions, but all these must be in due proportion and relation to each other and to the environment to produce the desired result - Dr S Billings