book name- new directions in hospital and healthcare facility design, written by- BY:-RICHARD L. MILLER, EARL S. SWENSSON

1. Book Review
SUBMITTED BY:Vikas Jangir
Harshad Patel
Sayali Darakh
Nishant Rathod
Kiran Bang
Kekhrieneizo Tetso
GUIDED BY:-
AR. Vaibhavi Ayre

2. BY:RICHARD L. MILLER
EARL S. SWENSSON

3. CONTENTS
 Principles :New Paradigms For A New Century
 The Traditional Hospital :A Warehouse For The
Sick
 New Market ,New Design Principles
 Making Yesterday’s Hospitals Work Today
 The Emergency Unit
 Diagnostic Imaging
 Surgery Facilities
 Critical Care
 The Patient Care Unit
 Ambulatory Care And Professional Offices

4. OUR REVIEW
This forward –looking book
stands the art blueprint for
new directions in hospital and
healthcare facility design
Among the design challenges
explored :
 Emergency care design Differentiation among
critical care ,chronic care
and community-based
ambulatory care.

5. Drawing on more than 30 years of
experience in this challenging ,
highly specialized field , the
authors did following things1)explore current and emerging treads
in medical treatment
2) technology and delivery
3) discuss practical issues facing
contemporary and future designers
and
4)present a rich cross-section of
innovative examples and case studies
from around the country .

6. Principles :New Paradigms For
A New Century
reality of paradigm shift, major transitions are:
 from youth to maturity:
 remediation to health:
 reaction to anticipation
 exclusivity to system
 sickness to wellness
 fragmentation to integration
 hierarchical to functional
 nursing home to subjacute center
 institutional dependency to self care
Architecture is a profession of wellness-a sister,
in fact, to the medical profession.

7. The traditional hospital: a
ware house for the sick
 The architecture of a
hospital is an
expression of a cultural
and emotional dynamics
of the institution.
 The growth of
technology and further
Many hospitals built during 1950’s and 60’s
development of the
partake more of a functional modernism,
germ theory and
deliberately stripping away such ecclesiastical
reminders as gothic ornamentation in order to
antisepsis, architecture
present efficient professional and sterile
having challenge.
figuratively as well as laterally.

8. NEW MARKET,NEW DESIGN
PRINCIPLES
 ADDRESING THE EMERGING
SHAPE OF THE MARKET FOR
HEALTH CARE.
 FLEXIBILITY IS INTENSIFIED
BY THE TECCHNOLOGICAL
NATURE OF THE HEALTH
CARE.
 AGING POPULATION IS
IMPORTANT ASPECT SINCE
IT WILL MAKE INCREASINGLY
EXTENSIVE USE OF HEALTH
AND HOSPITAL FACILITIES.

9. Aging population: guidelines:

10. fIVE CHARACTERISTICS FOR
SOCIALLY RESPONSIBLE DESIGN
FLEXIBLE DESIGN IS DYNAMIC DESIGN,A PROCESS THAT PART OF
WHAT JANET R. CARPMAN WRITING IN „GROUP PRACTICE
JOURNAL,CALLS “ SOCIALLY RESPONSIBLE HEALTH FACILITY
DESIGN”,WHICH SHE IDENTIFIES AS A MAJOR NEW DIRECTION FOR
THE INDUSTRY.
 VALUE SYSTEM
 INFORMATION.
 PARTICIPATORY DESIGN PROCESS
 PERIODIC SYSTEMATIC DESIGN
REVIEW.
 PERIODIC EVALUATION OF THE
FINISH PROJECT.

11. MAKING YESTERDAY’S HOSPITALS
WORK TODAY.
 THE IDEOLOGICAL ,TECHNICAL AND MARKETING
REASONS FOR RETHINKING HOSPITAL DESIGN ARE
AMPLE AND MANIFESTED.
 TO RENOVATE OR TO BUILT TO CONSIDER THE
FOLLOWING ISSUES:
DETERMINE IF THE RENOVATION IS COSMETIC OR
FUNCTIONAL.
CONSIDER THE AGE OF FACULTY.
EVALUATE THE DIFFERENT LEVEL OF USE THAT
EFFECT THE CHOICE TO RENOVATE VERSUS
COMISSION NEW CONSTRUCTION.
THINK FOR BUILDING’S CODE STATUS.
PERIODIC UTILITY DISRUPTION TO FORCE TEMPORARY
DEPARTMENTAL RELOCATIONS.

12. EMERGENCY UNIT
 A 1988 national public health and
hospital institute joint study with
association of American medical
college revealed that, of 277 urban
hospitals responding, 38% experienced
emergency room crowding so severe
that patients or sometimes forced to
wait for 12 hours for a bed.
 These numbers in themselves are
sufficient to suggest the magnitude of
the work load weighing on emergency
dept.
 Architects’ role to put attention to the
emergency entries and other units is
important.

13. The principle design issues of
majority of hospitals areas
are :
-helicopter access
-access and evaluation (triage)
-the waiting area
-staff and support spaces
-accommodation of data and
diagnostic technologies
-flexible design for flexible response
-specialty emergency treatment
spaces or units
-security
- Near by parking
-prominent signage and access

14. Diagnostic imaging
The field of contemporary
diagnostic imaging technology
are of
-CT (computed tomography)
-MRI ( magnetic resonance
imaging)
-US (ultra sonography)
-DSA ( digital subtraction
angiography)
-PET ( positron emission
tomography)
-SPECT ( single photon emission
computed tomography )

15. Surgery Facilities
 The use of color in the procedure
should be consider not only from the
point of view of improving staff
performance by reducing fatigue and
enhancing concentration but also from
the point of view of well being of
patient
 The current standards for the operating
room environment address air exchange
rate, filtration, temperature, humidity, and
the maintenance of positive pressure .
 Two types of illumination are required in
operating room:
1)general(ambient) room lighting
2)task lighting.

16. Surgical unit: design
guidelines:

17. Critical care
 Critical care unit
should be excluded
from traffic.
 Design should allow
for adequate privacy
without, however
isolating the patient.
Ceiling materials should be chosen
with care to reduce glare and to
provide an interesting texture that
promotes a sense of orientation in the
supine occupant of the room.
 An adequate lounge
area adjacent to
critical care area is
essential for relatives
of patient.

18. The patient care unit
 the patient room should
be the most intensive
focus of the patient care.
 Architect customarily
conceal functional items
,especially toilets.
Architect and designers must be
sensitive to balancing the perceptions
and expectations of the patient’s family
on the one hand with building features
that benefit the patient on the other .
 Even acute environment
may be inappropriate for
long term care facilities.

19. FOR DESIGN PURPOSE , PHYSIcIANS’
needs  Bed availability
 Accommodation for all types of
payers
 Accommodation for any
specialty or subspecialty.
 Cutting edge care setting
 Care giver easy to find
 Patient easy to find
 Chart easy to find
 Ability for all care providers to
confer in privacy
 Quiet place for dictation or
direct data entry, data retrieval,
reference
 Access to properly equipped
procedure room

20. Ambulatory Care And
Professional Offices

21. Principles of hospital planning•
•
•
(“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)
•
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.

22. THANK YOU