Hospital space & engineering services planning basics by season

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HOSPITAL FACILTY PLANNING BASICS
Space Management, Engineering Services
& Facility Correction

The Location
• Plot with sufficient water source
• Two way access road till hospital from main road
• Area not less than double the floor area.
• Three Entrances – Main , Emergency and Service Entries

FLOOR AREA OF HOSPITAL
• Approx. 800 – 1000 Sq Ft per bed/ hospital
FLOOR AREA ALLOCATION
• OPD – 12%-18%
• Wards, Rooms , ICUs & OT s – 37%-45%
• Diagnostic & Therapeutic – 18%-22%
• Administration – 8%-12%
• Service Departments – 15%-20%

Bureau Of Indian Standards -
Recommendations
• IS 10905-1: Recommendations for basic requirements of general
hospital buildings, Part 1: Administrative and hospital services
department buildings
• IS 10905-2: Recommendations for basic requirements of general
hospital buildings, Part 2: Medical services department buildings
• IS 10905-3: Recommendations for Basic Requirements of General
Hospital Buildings, Part 3: Engineering Services Department Buildings

• IS 12433-1: Basic requirements for hospital planning, Part 1: upto 30
bedded hospitals
• IS 12433-2: Basic Requirements for Hospital Planning, Part 2: UP to
100 Bedded Hospital
• Indian Public Health Standards - Governnment of India
• http://www.nhm.gov.in/nhm/nrhm/guidelines/indian-public-health-
standards.html

• CORRIDORS
• Main corridor should allow for passage of two beds with persons on
sides ~2.5 meter width
• Segregation of clean and dirty corridors
• OPD
• For every bed three patients are seen in OPD ( Expected OPD =No.of
Beds x 3 )
• 60% of area should be for waiting & corridors
• Consultation room – 150 sq ft

ICU
• Bed strength – 30% of total beds in a Tertiary care center
• Bed strength – 20% of total beds in a Secondary care center
• Each bed approximate 150 – 200 sq ft
Operation Theatres – Minimum nos.
• One OT per 50 beds
• Approximate 400 Sq.Ft area.
• 10 Feet height

HOSPITAL ENGINEERING SERVICES
PLANNING BASICS

SCOPE OF ENGINEERING SERVICES
• Electrical
• HVAC
• Plumbing and Sanitary
• Medical Gas
• Lift
• STP & ETP
• Boiler
• Incinerator
• Fire protection and Fire fighting
• Pneumatic tube systems

SCOPE OF IT SERVICES
• NETWORKING – Computer systems
• NETWORKING – Medical Equipments
• TV
• CCTV
• Telephones
• ACCESS points
• Nurse Call Systems
• PACS
• Wi Fi

Electrical - Minimum Requirements
• HT Substation with adequate cross ventilation
• Full back up Generator with adequate cross ventilation
• UPS power for all IT related Equipments.
• UPS power for all Critical care Medical Equipments ( which are
recommended to use UPS power)
• Panel rooms in all floors.
• DBs for Power, Lighting , UPS separately.
• Emergency lights in corridors , all critical care areas & fire escape
route staircase.

Regulations
Indian Standards
Electrical Inspectorate & Electricity Board rules.
SP 30 (2011): National Electrical Code of India
International Standards
• Electrical services - Health Technical Memorandum 06-01: Electrical
services supply and distribution ( UK )
• National Electrical Code USA, NFPA 70® & NFPA 90®

HVAC - Minimum Requirements
• Chiller plant room
• Heat rejection - Cooling Tower / Air cooled condensers
• AHU rooms ,Space for CSUs /FCUs
• All Chillers, AHUs and Pumps preferred with VFD starters
• Dedicated shafts for
• Chilled water piping,
• Supply , Return ,Fresh Air & Extract ducting .

HVAC - Minimum Requirements
• 1 Tr of Refrigeration approximate for 150 Sq.Ft.
• 1 Air change per hour ( ACH) Fresh Air for comfort applications.
• Low velocity ducting design ( DW 144 European std. , SMACNA US std.
Ducting Standards)
• Low Velocity Chilled water Design ( CIBSE British Guidelines )
• ASHRAE Guidelines for Air-conditioning & ventilation.
• Room Indoor design conditions – ASHRAE , NABH guidelines

• Chilled water pipe pressure test – Minimum twice the running
pressure.
• Valve selections – Minimum PN 20.
• Control Valves – Pressure Independent type.
• Pumps

Medical Gas - Minimum Requirements
• Medical Gas Manifold – Medical Oxygen
• 100 beds and Above – Main Manifold Minimum 8 x 8 cylinders ,
Emergency 4 cylinders
Emergency 5 cylinders , Liquid Medical Oxygen Tanks with 5000 ltrs
capacity preferred.
Emergency 4 cylinders , Liquid Medical Oxygen Tanks with 10000 ltrs
capacity preferred.

• OT : Oxygen , Nitrous oxide, Carbon Di oxide ,Medical Air ( 4 Bar)
,Surgical Air ( 7 Bar) ,Vacuum , AGSS.
• ICUs : Oxygen , Medical Air ( 4 Bar) ,Vacuum.
• Rooms & wards : Oxygen , Vacuum.
• Medical Oxygen usage : ( Qty. to be specified by Doctor)
• Normal patients : 2 ltrs per Hour.
• Ventilator patients : Approx. 10 ltrs per Hour.(if 100 % )

• Liquid Medical Oxygen Plant – As per specs of PESO ( Petroleum &
Explosives Safety Organisation)
• Manifold room and Compressor Rooms - As per HTM 02-01
standards,ISO 7396 -1:2007
• Pressure Control Stations - As per HTM 02-01 standards , ISO 10524 -
2:2007

Medical Gas - Pressure @ Area Valve Control Unit
• O2 , N2O , Co2 , Medical Air -
Minimum pressure 45 PSI ( 3.16 Kg/ Cm3) & Maximum pressure 75 PSI
( 5.27 Kg/ Cm3)
Surgical Air - Minimum pressure 95 PSI ( 6.67 Kg/ Cm3) & Maximum
pressure 105 PSI ( 7.38 Kg/ Cm3)
Vacuum - Minimum suction pressure 12 mm / Hg & Maximum Suction
pressure 32 mm / Hg.

Plumbing & Sanitary - Minimum Requirements
• Minimum of two water sources
• Water storage capacity for two days(approximately 1000 ltrs per bed
* 2 days)
• Water tanks with stand by for each domestic, flush & fire tanks
• Disinfection of water tanks and supply lines
• Water Treatment Plant
• Pumping system with standby
• R.O Water for Dialysis and for sterlization
• Hot water system for rooms & kitchen

Sewage & Effluent Treatment.
• As per Central Pollution Control board – Each bed produces 450 ltrs of
Soiled water. ( in kerala our normal usage is 800 Ltrs to 1000 Ltrs)
• Minimum Size of STP/ETP = No.of Beds x 450 ltrs.
• Separate pipelines of Sewage , Laundry and Kitchen
• Separate treatments for Sewage , Laundry and Kitchen .
• STP output water preferred characteristics :
Sl No. Parameters Treated water KSPCB Standards
1 PH 6.5-7.5 5.5-9.0
2 BOD 3 days at 270c <15 mg/l 30 mg/l
3 COD, mg/l < 50 mg/l 250 mg/l
3 Suspended Solids <50 mg/l 100 mg/l
4 Oil & Grease <1mg/l 10 mg/l

LIFTS minimum nos. required
• Depends upon number of beds above groundfloor
• Up to 50 – one; Every 50 beds 1 No. Lift each.
• Lift Car Size – >2280X1600X2300 mm ; with door size >1300X2100
mm
• ARD for each Lift
• Machine room : With adequate Light , Ventilation and dust free
condition with suitable nos. of Rope holes, Ceiling Hooks. Dedicated
power supply with ELCB.

LIFTS minimum nos. required
• Lift Shaft size : Depth more than 700mm Lift Size.
• Lift Shaft size : Width more than 300 mm in each side than Lift size.
• Lift Shaft size : Entrance opening more than 200 mm than lift size.
• Lift Shafts to be with Lights in each floors ,Pit ladder and without
plumb.
• Pit depth depending upon Lift size ,speed and Manufacturer.

Engineering Services - Requirements
•Electrical Substation ,Panel room Space for Panels,DBs Shaft Cabling
•HVAC Chiller plant Space for AHUs & Panels
Shaft Cabling
Piping ( Chilled water in &
out , Drain pipes Ducting
•Plumbing and Sanitary Pump room ,Tanks
Accees point / Shaft doors / Ceiling
trap doors
Shaft Piping
•Medical Gas
Med.Gas Manifold room ,
Compressor room.
trap doors
Shaft Piping
•Lift Lift roooms , Lift pit. Lift rooms Shaft/ lift well Cabling
•Boiler Plant room Ceiling trap doors Shaft Piping
•Fire protection and Fire fighting Pump room ,Tanks
trap doors
Shaft Cabling Piping
•Pneumatic tube systems Plant room Accees points /Ceiling trap doors
Shaft Cabling Piping
•NETWORKING – Computer systems
Server room , Floor wise IT rooms. Ceiling trap doors
Shaft Cabling
•NETWORKING – Medical Equipments Shaft Cabling
•TV Shaft Cabling
•CCTV Shaft Cabling
•Telephones Shaft Cabling
•ACCESS points Shaft Cabling
•Nurse Call Systems Shaft Cabling
•PACS Shaft Cabling
•Wi Fi Shaft Cabling

FIRE MANAGEMENT SYSTEMS
• Fire fighting is the act of extinguishing fires to protect lives and to prevent
the destruction of property and of the environment
System consist of
• Fire Pump and Fire Tanks
• Fire Hydrant Systems
• Sprinklers
• Fire Extinguishers
• FM200/ Clean Agents (such as Novec systems…)

Exit Facilities:
In buildings or sections occupied by bed-ridden patients where the floor area is over
280 m2, facilities shall be
• provided to move patients in hospital beds to the other side of a smoke barrier
from any part of such building or
• section not directly served by approved horizontal exits or exits from the first
floor (floor 2) of a building to the outside.
Not less than two exits of one or more of the following types shall be provided for
every floor, including basement, of every building or section:
a) Doors leading directly outside the building;
b) Stairways;
c) Ramps;
d) Horizontal exits; and
e) Fire tower.

Exit Facilities
• All required exits that serve as egress from hospital or infirmary sections
shall be not less than 2 m in clear width
• All patient bedroom doors to permit transportation of patients on beds,
litters, or mattresses.
• Min. width of corridors to serve patients bedrooms shall be 2500 mm.
• UPS Lighting in fire stairs to be provided for use when the raw power
supply fails.
• That part of emergency lighting ( With UPS power ) is provided to ensure
that the escape route is illuminated at all times or at times the main
lighting is not available, either for the whole building or the escape routes.

Fire Exit Doors
• DOOR: The door with a fire resistance rating 2 hrs.
• SIGNAGES: Fire exit doors and way to the Fire exit doors
are marked in WHITE letters in GREEN background and
are either marked with self-luminous material or
illuminated with battery back up.
• SMOKE FREE: It is Fire/smoke free area through which
the personal in the building can be evacuated safely.
• PANIC BAR: The Fire exit doors have a panic bar hard
ware provided on the door.
• ACCESS CONTROL: Fire doors to have Fail safe access
control options

S.N o
Type of
building /
Occupancy
Type Of Installation Water Supply (in liters) Pump Capacity (inL/min)
Fire
Extinguis
her
Hose
Reel
Dry
Riser
Wet Riser Downcomer
yard
Hydrant
Automatic Sprinkler System
Manually Operated Eletric
Fire Alarm System
Automatic
Detection
& Fire
Alarm
System
Undergrou
nd Static
Water
Storage
Tank
Terrace Tank
pump near
underground
static water
storage tank
with min
pressure
3.5kg/cm2at
terrace level
At the
terrece
tank level
with min
pressure
2kg/cm2
1
Ground Plus
2 or more
storeys,with
bed
R R NR R NR NR R R R 50000 5000 NOTE 3 NR
2
Less than
15m in
height with
plot area
more than
1000m2
R R NR R NR R R R R 10000 10000 NOTE 3 NR
3
Above 15m
height but
not
exceeding
24m in hight
4
Above 15m
height but
not
exceeding
30m in hight
Note 3 One electric & one diesel pump of capacity 1620 ipm and one electric pump of capacity 180 Ipm
R = Requried / NR = Not RequriedNote 4 One electric & one diesel pump of capacity 2280 ipm and one electric pump of capacity 180 Ipm
Note 5 One electric & one diesel pump of capacity 2280 ipm and one electric pump of capacity 180 Ipm

Recommended to refer :
• National Building Code of India – Part 4 Fire & Life safety
• National Disaster Management Guidelines – Hospital Safety
• ( National disaster Management Authority, Govt.of India)
• Indian Standard Code of Practice for Fire Safety
• NABH & FIRE SAFETY
• NFPA standards

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