This document provides information on the requirements and design considerations for a 200-bed multi-specialty hospital. It includes sections on data collection from various sources on hospital design guidelines. It outlines the key departments and units required such as ICU, surgery, pathology, inpatient and outpatient areas. It also discusses infrastructure needs like accessibility, utilities, and parking. Design criteria from sources like BIS and Neuferts are referenced for space requirements of areas like wards, ICU, orthopedics clinic, dental clinic, kitchen and engineering services.

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Hospital design
Data Collection & literature Case Study

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Table of contents .
Data Collection - BIS data,
Neuferts data, TIme Saver’s
Data, KMBR
Data collection - IPHS
guidelines for hospital
design
Literature Case Study:
Fortis Hospital, Gurgaon
01 02
03 04
Introduction - Multispeciality
Hospital (200 bedded)

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01 Introduction

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REQUIREMENTS
• RECEPTION
• ADMINISTRATION
• CARE DEPARTMENT
• SURGERY
• ICU
• STERILISATION
• MATERNITY
• A AND E DEPARTMENT
• PATHOLOGY
• NUCLEAR MEDICINE
• OUTPATIENT DEPARTMENT
• IN PATIENT DEPARTMENT
• X RAY DEPARTMENT
• DIALYSIS
• CASUALTY
• X RAY DEPARTMENT
• DIALYSIS
• CASUALTY
• PHARMACY
• CAFETERIA
• MISC (WIFI,VALET PARKING,LIBRARY,MORTUARY)
• SUPPLY,SERVICE AND DISPOSAL
• STAFF HOSTEL
• LECTURE HALLS
• PARKING
• DIAGNOSIS AND TREATMENT
• FREQUENT ADDITIONAL UNIT
• EDUCATION AND RESEARCH
WHAT IS A HOSPITAL ?
An institution providing medical and surgical treatment and nursing care for sick or injured
people.

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PROJECT REQUIREMENTS
● INTERNAL MEDICINE
● ANAESTHESIOLOGY
● SURGERY
● RADIOLOGY/ DIAGNOSTICS
● GYN-OBSTETRICS
● ENT
● PEDIATRICS
● ORTHOPEDICS
● RADIO THERAPY
● IMPATIENT DEPARTMENT
● OUTPATIENT DEPARTMENT

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INFRASTRUCTURE
● Accessibility to the public (with good road connectivity)
● Ensuring the facility is not in a low-lying flood-prone area
● Ensuring it is adequately serviced by public utilities such as water,
electricity and telephone connectivity, sewage and stormwater Disposal.
● generators for electricity and radio communication for telephony
● Ensuring elderly and disabled-friendly access
● Minimizing exposure to air, noise, water and land pollution and having facilities with
vector-breeding proof buildings
● Reviewing land utilization in adjoining areas, the general topography, proximity to the local bus
stands, railway station and other modes of transport and obtaining the necessary environmental
(including seismic safety), fire safety and administrative clearance.

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● 60% of the total area of the facility should be reserved for landscaping, play area, circulation
area etc. and the remaining 35-40% should be the plinth area (including residential areas).
● The built-up portion will include areas for core clinical services, support services such as the
Central Sterile Services Department (CSSD), kitchen and mechanised laundry, residential areas
and the knowledge hub (teaching and training sites).
● An estimated 80% of the built-up areas should be dedicated to core patient services and
clinical areas.
● Use of this space for administrative and related services (e.g., offices and general stores) should
be avoided.
● New buildings should be constructed vertically than horizontally (within state norms and
compliant with the National Building Code) so that there is more space available for creating
green spaces.
● As per the Noise Pollution (Regulation & Control) Rules, 2000; an area of 100 metres around the
hospital should be defined as a “Silence Zone”.
● Clear access to vehicles should be maintained.
● No vehicle should be parked outside the gate.

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Data collection
BUREAU OF INDIAN STANDARDS

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FUNCTIONAL PROGRAMME
HOSPITALS
● In consideration of the medical programme
outlined in section 1. The hospital is to have
a balanced combination of the following
functional area and services.
● Entrance area,
● Ambulatory care area,
● Diagnostic services,
● Intermediate care area,
● Intensive care area,
● Critical care area,
● Therapeutic services,
● Hospital services,
● Engineering services,
● Administrative/Ancillary
services.
, the hospitals have been divided into the following
five categories:
● Category A 25 to 50 beds
● Category B 51 to 100 beds .
● Category C 101 to 300 beds
● Category D 301 to 500 beds
● Category E 501 to 750 beds
IS CODE

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Functional analysis
3 independent entrance zones
1. Main entrance - for ambulatory care, diagnostic
services and therapeutic services, pharmacy services.
2. IPD (in-patient department) or Emergency entrance
for intermediate care, intensive care and critical
care(emergency services) as well as to include
accommodation for arcade.
3. service/ staff entrance for hospital and engineering
services, hospital supplies, medical para-medical and
administrative as well as ancillary staff.
● Intermediate care area - general ward,private ward,
private ward (AC /non AC),dedicated wards like
maternity and paediatrics with following bed
distribution.
IS CODE

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SPACE REQUIREMENTS
(Source neuferts )
MEDICAL SUPERINTENDENT ROOM
◉ Meant to address various administrative issues encountered during hospital operations.
ADMINISTRATIVE OFFICE
◉ Administration offices are divided into those dealing directly with patients, and other offices. Offices for
patient admission and dealings with friends and relatives should be provided near the main entrance.
◉ The offices for internal hospital business are: administrative director's office with secretarial support,
accounts department and personnel department
CONFERENCE ROOM
◉ For gathering of employees to collaborate, conduct conferences, or brief team meetings. These
spaces can be open teaming areas or closed dedicated rooms and are strategically placed to support
the Office
WAITING ROOM
◉A room provided for the use of people who are waiting to be seen by a doctor.
◉It is a room with numbers of chairs and resting area for people accompanying the patients.

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SPACE REQUIREMENTS
CARE AREA
● General inpatient care are the main function of general hospital
● Particularly for short term and acute illness
● Units can be stacked depending on the spacial requirements and the organisational
structure
● Seriously ill patients are moved from normal care groups to intensive care unit
SIZE OF PATIENT ROOMS
● The patient bed must be accessed from three sides and this sets the limit for overall room
sizes
● The smallest size for one bedroom is 10 m²
● For two or three bed, minimum of 8m² per bed should be allowed
● Room must be wide enough for second bed to be wheeled out (width 3.20 m)
(Source neuferts )

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SPACE REQUIREMENTS
I C U (INTENSIVE CARE UNIT)
◉ This unit should be located close to operation theatre department and other essential
departments, such as, X-ray and pathology so that the staff and ancillaries could be
shared.
◉ Easy and covenient access from emergency and accident department is also essential.
◉ This unit will also need all the specialized services, such as, piped suction and medical
gases, continuous electric supply, heating, ventilation, air-conditioning and efficient lift
services.
◉ A good natural light and pleasant environment would also be of great help to the
patients and staff as well.
◉ Each unit requires a duty station, a clean workroom (preparation of medication and
infusions) and a materials and equipment room
◉ All beds in this unit are to be arranged in glazed cubicles with centrally located nurses
station. The area per bed in this unit should be 10.5m to cater for free movement, check
against infection and at time utilization of specialized bulky equipment

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SPACE REQUIREMENTS
„LAYOUT
◉ The beds can be arranged in an open, closed or combined
layout.
◉ The open layout requires a spacious area. The patients are
separated visually by half-height partitions with glazed window
elements.
◉ In the closed arrangement, the patients are separated into
different rooms.
„EQUIPMENT ROOM AND INTENSIVE CARE LABORATORY-
◉ This should provid for immediate clinical tests and
investigations. All essential testing equipment should be housed
in it
(Source neuferts )

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SPACE REQUIREMENTS
GAS SUPPLY PLANT
◉ In order to ensure short transport distances, direct access to the service yard is sensible, e.g. for delivery and collection of the
cylinders.
◉ The storage of the cylinders can be combined with the air/gas pumps (vacuum, nitrogen, compressed air) in order to enable
centralized control (possibly computer-controlled).
◉ The gas cylinders are being replaced nowadays with bulk tanks, which must be situated in the open air and at least 5.0 m from
buildings
CATERING/KITCHEN
„◉ The processing of food is separated into normal and diet recipes. ENGINEERING SERVICES –
„◉ The cafeteria for staff should be very close to the central kitchen.
„◉ The clear ceiling height in the kitchen is 4.00 m, and the size depends on the requirements and the number of patients in the
hospital.
„◉ It should be located such that the noise and cooking odours emanating from the department do not cause any inconvenience to
the other departments

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SPACE REQUIREMENTS
ORTHOPEDIC CLINIC
•The clinic should include arrangements for plaster preparation, fracture treatment, besides consultation-cum-examination. For
X-ray facilities the clinic should be in close proximity of radiology department, emergency and accident, in order to make the
maximum use of equipment and to reduce the circulation.
• Plaster and splint storage room is necessary for storing plaster materials, splints and other therapeutic aids and for preparing
plaster, bandages, etc.
• Fracture and treatment should be spacious enough to accommodate a dressing couch and a mobile X-ray unit, A recovery
room adjacent to the fracture and treatment room is essential.
DENTAL CLINIC
The dental clinic may have facilities for dental hygiene and room for patient’s recovery. Consultation-cum-examination room
should serve as combined purpose room for consultation, examination, dental surgery and treatment.
This treatment room needs to be 25-30 m2 in size and contain a treatment chair with dental unit, a desk, a washbasin, x-ray
and anesthetic equipment.

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SPACE REQUIREMENTS
LABORATORIES
• a room or building that is used for scientific research, testing,
experiments, etc. or for teaching about science.
Laboratory medicine
The laboratory is mostly concerned with the preparation and
processing of blood, urine and stool samples. The laboratory
should be a large room with standing and sitting workstations.
Specialist laboratories are added on as separate rooms.
Subsidiary rooms include the rest rooms for staff, rinsing room,
sluice room, disinfection room, cold room. Quick connection to
the other departments is provided by a pneumatic delivery
system. Laboratory areas can also be completely off-site and
serve several hospitals.

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SPACE REQUIREMENTS
STANDARDS – CLINICAL LABORATORIES
• The clinical laboratory should be provided with 600 mm wide and 900 mm high bench of length about 2
m per technician and to full width of room for pathologist in charge of the laboratory.
• Laboratory bench shall have laboratory sink with swan neck fittings, reagent shelving, gas and power
point under -counter cabinet.
• Top of the laboratory bench shall be of acid, alkali proof material .
•
SAMPLE COLLECTION ROOM
• For quick diagnosis of blood, urine, etc, a small sample collection room facility shall be provided.
PATHOLOGY LAB
• The pathology department of a hospital includes rooms for storage of bodies, dissection, refrigeration
of bodies, laying out, placing into coffins, coffin storage and changing rooms for the pathologists.
• Separate access for relatives and the shortest possible road access for undertakers are important.
This department should not be in the vicinity of the service yard

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SPACE REQUIREMENTS
MORTUARY
The design must address the following:
● „ number of bodies to be stored;
● method of storage i.e. refrigerated cabinets, cool room, freezing capacity;
● „separation of entries for families to view/identify bodies, and
● delivery of bodies from inside the hospital and external delivery (if applicable).
External
„Mortuary / Holding facilities shall be accessible through an exterior entrance and shall be
located to avoid the need for transporting bodies through public areas. It should also be
located in close proximity to Anatomical Pathology laboratories and relevant clinical areas for
transportation of laboratory specimens.
Internal
„The Waiting Area and Viewing Area should be collocated however there should be no
access to other sections of the Morgue for viewers.
„Entry Lobby, Exit Lobby and Administrative Area form part of a single area

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RADIOLOGY
● It should be near the outpatients department and the
ambulance approach road.
● The heavy weight of the equipment means that this department
is better located on the ground or first basement.
● The size of the departments' rooms is determined by the large
medical equipment and related technology.
● Sonography, mammography and jaw radioscopy need room
sizes of approx. 15-18 m2, radioscopy and exposure rooms
approx. 20-30 m2.
● The access for patients should be through two changing
cubicles for each radioscopy room and a wide (1.25 m) door for
beds is also necessary.
● WCs for patients should be attached to the radioscopy rooms.

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OPERATING DEPARTMENT
● The location of the operating department in the overall
organisation of the hospital is of great significance.
● The following rooms or room zones belong in every operating
department:
-operating theatre, preparation, transfer, scrub room, sterile
goods store, with a total area of approx. 80m2.
● The operating theatre should be as square as possible to enable
proper working with the operating table (size approx. 6.50 ×6.50
m) turned in any direction.
● The clear ceiling height must be 3.00 m with a space above the
ceiling of approx. 70-80 cm for air conditioning and other
services.
● The doors to the operating theatre operate automatically.

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PHYSIOTHERAPY
● This department can be placed on the ground floor, but should
have adequate natural ventilation through rooflights or light
shafts.
● It must be accessed through a reception area.
● Physiotherapy is divided into a dry and a wet area.
● In the dry area, there are gymnastics rooms (approx. 40-50 m2).
● The clear ceiling height must be min. 3.00 m.

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AREA REQUIREMENTS
● Area requirement for hospital is to be derived
from carpet area of various services and functions
by applying conversion factor for circulation space. The
circulation space will include corridors, stairs, fire escapes,
walls, ramps and lifts, etc.
● While applying 40 percent conversion factor over
carpet area of 66 mzper bed, the covered area of the
hospital works out to 92.5 mzper bed.
● Total area of hospital depends on availability of land,
Area of 1 hectare for every 25 bed is recommended
● Land requirement can be reduced or increased if the
hospital is intended to be high or low rise building
contrary to parameters.
Since ground coverage area allowed is 25
percent , plotarea will be 4 times of 3700m^2
Total number of beds = 200
Ground cover permitted: 25%
Covered area per bed: 92.5 sqm
Total covered area: 92.5 x 200 = 18,500
sqm
40% of the covered area = 7,400 sqm

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SITE PLANNING
● High degree of sensitivity to outside noise should be avoided,
● accessibility and availability of services.
● The buildings should be so planned that sensitive areas, like,
wards,consulting and treatment rooms and operation theatres are placed
away from the outdoor source of noise.
● While planning the hospital building, the importance of landscape
elements, such as, open areas, horticulture to increase the comfort
conditions within the recommendations contained in IS 7662 (Part 1).

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WORK-FLOW ANALYSIS

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VERTICAL WORK-FLOW
An example of a vertical structure:
-top floor: helipad, air conditioning plant
- 2nd-3rd floors: care wards
- 1st floor: operating theatre area, central sterilisation, intensive
care, maternity, nursing mothers, children's ward
- ground floor: entrance and information, radiology, clinical
medical service, outpatients, delivery of stretcher patients,
emergency cases, administration, cafeteria
- basement: archive, physiotherapy, linear accelerator, radiation
therapy, laboratory, kitchen with service yard

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FLOW OF PATIENTS IN
AN EMERGENCY
IPHS DATA

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ADMITTING DEPARTMENT FUNCTIONAL FLOW CHART

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BUILDING REQUIREMENT
● Corridors, staircase etc. not more than 40 percent of floor area of building.
CIRCULATION AREAS
● The height of all the rooms in the hospital should not be less than 3.00 m and not
more than 3.65 m measured at any point from the surface of the floor to the lowest
point of the ceiling. The minimum head-room, such as, under the bottom of beams.
fans and lights shall be 2.50 m measured vertical under such beam, fan or light
FLOOR HEIGHT

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ENTRANCE AREA AMBULATORY CARE AREA
PHARMACY
● Dispensary should be located in an area
conveniently accessible from all clinics.
● The size should be adequate to contain 5 percent
of the total clinical’ visits to the OPD in one session
at the rate of 0.8 m2 per patient.
● The dispensary and compounding room should
have multiple dispensing windows, compounding
counters and shelves.
● The medicines which require cold storage and
blood required for operations and emergencies
may be kept in refrigerators.
WAITING SPACES
● 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.
NURSING SERVICES
● Includes nursing station side laboratory, injection
room, social service and treatment rooms, etc.

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CLINIC
● 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.
● Surgical clinic should be placed next to
consultation-cum-examination room with
adequate waiting space
● EYE CLINIC: For testing the state of refractive
power of the eye, room length not less than 6m is
essential.
● Dark room should be placed close to consultation,
preferably, with an intercommunicating door.
● For testing the state of hearing power, room length
of 6 m is advisable.
DIAGNOSTIC SERVICES.
● should be located at a place which is easily
accessible to both OPD and wards and also to
operation theatre department.
● Ultrasound, a scanning device of imaging
department, also requires a small room for use
mainly by gynecology and obstetric clinic.

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INTERMEDIATE CARE AREA.
● Wards should be relegated at the back to
ensure quietness and freedom from unwanted
visitors.
● The ward unit may be made of desired number
of beds at the rate of 7 m² per bed
● should be arranged with a minimum distance
of 2.25 m between center of two beds and a
clearance of 200 mm between the bed and
wall.
INTENSIVE CARE UNIT.
● The number of patients requiring intensive care may
be about 2 to 5 percent of total medical and surgical
patients in a hospital.
● The unit shall not have less than 4 beds nor more than
12 beds.
● This unit should be located close to operation
theatre department and other essential departments,
such as, X-ray and pathology so that the staff and
ancillaries could be shared.
● The area per bed in this unit should be 10.5m² to cater
for free movement check against infection and at
time utilization of specialized bulky equipment.

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CRITICAL CARE AREA (EMERGENCY
SERVICES)
● It should preferably have a distinct entry
independent of OPD main entry.
● It should be located in the complex of the OPD
for reasons of easy accessibility and sharing
medical facilities with the OPD.
● There should be an easy ambulance approach
with adequate space for free passage of
vehicles and covered area for alighting patients.
● Separate toilet facility for men and women
should be provided.
THERAPEUTIC SERVICES.
● For operation theatres, all doors should be two
leaf type with a minimum 1.5 m width and shall
have self closing devices.

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HOSPITAL SERVICES
Hospital kitchen:
● 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.
● Central sterile and supply department: should be
easy access to operation theatre department.
● Medical and general stores
● 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 patient.

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ENGINEERING SERVICE DEPARTMENTs
● Civil Engineering
i) Building maintenance;
ii) Horticulture;
iii) Water supply - Normal water, hot water, filtered and soft water; and
iv) Drainage and sanitation
● Mechanical Engineering
i) Air conditioning - Air cooling and heating; and
ii) Refrigeration - Cold storage, water coolers, deep freezers, etc.
● Electrical Engineering
i) Lighting - General, individual and night lighting, call bells, emergency lighting, voltage stabilizers, stand
by generators, etc; and
ii) Ventilation - Ceiling fans, table fans, exhaust fans, etc.
● Other Services
i) Gas supply - Medical, cooking and laboratory gas;
ii) Transport and communication - Ramp, lift, telephone, intercoms, public address, etc;
iii) Fire protections - Safety against fire, first-aid fire equipments, fire alarm and fire detection system; and
iv) Waste disposal system - Incinerators.
v) oxygen supply

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OXYGEN SUPPLY

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PROVISION FOR VARIES FLOOR
AREAS IN ENGINEERING SERVICE

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SERVICES
HORTICULTURE
- To maintain the hospital landscaping, a room to store garden implements, seeds, etc, should be
provided.
WATER SUPPLY
● NORMAL WATER
- Arrangement shall be made to supply the following quantities of potable water per bed per day
to meet all requirements ( including laundry ), except fire-fighting, in all categories of hospital:
● Storage capacity fbr 2 days requirement should be made on the basis of above consumptions. 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.
● The laying and distribution of tile water supply system shall be according to the provisions of IS : 2065-
1972*. Cold and hot water supply piping should be run in concealed form embedded into wall with full
precautions to avoid any seepage.

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● Hot water -
water supply to wards and departments of the general hospital shall be provided by means of
electric storage type water heaters or centralized hot water system of capacity depending upon
the need of hot water consumption.
● Filtered and soft water -
Filtered and soft water supply is required in pathology laboratories and shall be supplied as
required.
● Cold water -
Cold water supply is needed for processing tanks in film developing room and shall be supplied as
required.
● Drainage and Sanitation -
The design, construction and maintenance of drains for waste water, surface water, subsoil water
and sewerage shall be in accordance with IS : 1742-19727. The requirements for the fitments for
drainage and sanitation in general hospitals shall be in accordance with Tables 2 and 3.

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Air-conditioning -
The following department/ wards are considered essential and recommended for air-conditioning:
● Blood laboratory in blood bank of out -patient department;
● Operation theatre complex in emergency and casualty department;
● Certain laboratories in pathology department;
● Radiography and radio -therapy rooms in radiology department;
● Fracture-cum-casualty theatre, recovery, frozen section of clear zone and all rooms in sterile zone of
operation theatre department;
● Certain number of beds in ward units of particular specialities;
● Al1 rooms in sterile zone of delivery suite;
● Intensive care unit; and
● Autopsy room in mortuary.
Refrigeration
● Hospitals shall be provided with water cooler and refrigerators ( see IS : 1474-19597 ) in wards and
departments, freezers in pathology, and cold storage plants for pathology, mortuary, medical stores and
dietary department.
● All these, power consuming units shall be provided with voltage stabilizers

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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.
● Electrical installation except for artificial illumination, shall be in accordance with IS : 732-1963$, IS :
2032 ( Part 11 )-1969s and IS : 2274-1963)
● Shadowless light - Shadowless light (mountable type) shall be provided in operation theatres and
operating delivery rooms whereas in other areas, where operations of minor nature are carried out
shadowless lamps ( portable type ) shall be provided.
● Call bells - Call bells switches should be provided for all beds in all types of wards with indicator
lights and location indicator situated in the nurses duty room of the wards.
● 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.
● Standby generators - Standby generators should be provided to generate electric and power
supply to water supply, air-conditioning units, and plants, cold storage units, and radiography units.
● Lighting protection - The lighting protective system of hospital buildings shall be in accordance with
IS : 2309- 1’369**.

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LIGHTING OF PATIENTS' ROOMS
● The total lighting effect should be such as to contribute to the general decor and should be free of
glare to the recumbent patient.
● For the patients in the wards the lighting should create a cozy and pleasant atmosphere.
Illumination level shall be as specified in IS 3646(Part 1).
● Some of the patients may like to sleep before the scheduled time of lights out' for which a provision
shall be made for switching off and/or dimming of the lights.
● Apart from general lighting, individual patients should be provided with additional lighting for any
occasional reading or other handiwork that they may choose to do. This should be in the form of bed
head lights which can be switched on or off by the patients themselves.
● An additional examination light capable of achieving 500 to 1 000 lux may be provided.
● A night lighting system which gives enough illumination (about 1 lux) for this purpose but which does
not disturb the sleeping patients is also, therefore, necessary in a ward
● The lighting installation in a ward, therefore, calls for:
– a) general lighting;
– b) reading lamps;
– c) examination lighting; and
– d) night lighting.
OPERATION THEATRES AND OTHER AREAS
● For the general lighting of the operation theatre suite, tubular fluorescent lamps that have the colour
temperature about 4 000 K and CRI over 90 are recommended

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Illumination
Illumination levels for various spaces within the hospital

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VENTILATION
The following standards of general ventilation are recommended for various area of the
hospital building based on maintenance of required oxygen, carbon dioxide and other
air quality levels and for the control of body odours when no products of combustion or
other contaminants are present in the air or anaesthesia gases which are highly
explosive are present:

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GAS SUPPLY
● Medical gas - Medical gases comprise of oxygen and nitrous oxide. Necessary pipeline
network should be laid in departments and wards to connect them to the manifold room
( where gas cylinder of bulk supply will be mounted on wall ).
A compressor should also be provided in separate room adjoining to the manifold room
to provide suction along with medical gas supply pipe. All these three pipes should be of
different colour conforming to a laid down standard and mounted on wall or ceiling
surface.
● Cooking gas - For better hygienic conditions use of cooking gas LPG ( liquefied
petroleum gas ) is recommended. These should also be kept in a room from where
necessary pipe line with gas outlets as required may be provided to hospital kitchen and
ward pantries.
● Laboratory gas - Pipeline network should be laid in pathology laboratories and other
laboratories of sub-speciality clinics where extensive laboratory benches are provided.
This network should be connected to gas plant room or gas storage room wherein either
LPG ( liquefied petroleum gas ) cylinders are stored or gas plant is instaIled to
manufacture lab-gas from kerosene oil medium.

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LIFT
● The outline dimensions of machine room, pit depth and total headroom, shall be in
accordance with IS : 534-1976:. The recommended car speed for hospital bed lifts are given
below:
● The passenger lifts should be so arranged that they are easily accessible from all
entrances of the hospital.
● It is convenient to place the lifts near the staircases.
● Hospital lifts should be situated conveniently near the ward and operation theatre
department entrances.
● There shall be sufficient space near the landing door for easy movement of stretcher
trolly.
● Service lifts should be situated so as to secure convenient and easy access at each floor
and shall be installed.
VERTICAL TRANSPORTATION

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FIRE AND SAFETY
● First-aid fire fighting equipment - Adequate first-aid, firefighting equipment shall be provided
and installed in accordance with IS : 2217-1982f, and IS : 2190-1979s.
● Fire alarm - Manually-operated fire alarm facilities shall be provided in hospital buildings which
sound an audible alarm in administrative department, engineering service, offices, fire office and
such other locations where gongs, sirens, whistles or bells do not disturb the patients.
Hospitals may also be equipped with automatic fire alarm system conforming to IS : 2189-19761;
in hospital of category D and E.
An approved type of automatic explosive venting device providing the required amount of
venting area may also be provided in hospitals of category D and E, specially in rooms where
medical gases, compressed air and electrical equipments are stored and used.
● Fire detection - In hospitals of category D and E, an automatic fire detection system will be an
added advantage.
● WASTE DISPOSAL SYSTEM
All hospitals up to category C shall be provided with one incinerator consisting of a burning
chamber and chimney. Hospitals of category D and E should, in addition have an electrically
operated incinerator of capacity to burn 1 kg/bed/day of refuge.

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Data collection
INDIAN PUBLIC HEALTH STANDARDS
FOR DISTRICT HOSPITAL

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PlACEMENT & FACILITIES
● An estimated 80% of the built-up areas should be dedicated to core patient services and
clinical areas.
● At least 10 metre of space all around the boundary wall should be left open. Adequate
width to allow easy access to the fire engine should be provisioned for and in no case
should it measure less than 6 metre.
● Clinical areas especially Emergency services, LDR complex, OPD should be on the ground
floor. Administrative offices, teaching and training areas and general store rooms should be
located on higher floors the use of rainwater harvesting, solar energy and energy-efficient
bulbs/equipment should be encouraged.
● Use of low-energy LED lighting or alternate low-energy option to save indoor lighting
energy costs is recommended

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PARKING
VEHICULAR MOVEMENT
● Clear access for vehicles and ambulances should be maintained, especially near the
emergency department.
● Inside the premises, there should be an open space available in line with the average
expected load of vehicles for parking.
● Wherever possible, separate parking spaces should be allotted for staff parking and
visitor parking.
● Fringe parking can be created, if such space is available.

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CIRCULATION
● Flooring of circulation areas such as corridors, lifts, ramps, staircases and other common
spaces should be anti-skid and non-slippery.
● Size of corridors, ramps, and stairs should be conducive to the maneuverability of wheeled
equipment.
● Corridors should be at least 3 metres wide. Corridors should follow fire safety norms
● and be wide enough to accommodate two passing trolleys easily along with some additional
space for equipment.
● All two-way swing doors or doors in general circulation areas should be provided with vision
● panels giving visibility from a height of 800 mm to 1500 mm. Also, there should be clear
headroom of at least 2100 mm height above the tactile guiding blocks. This will enable both
the wheelchair user and the ambulatory disabled to be noticed by a person on the opposite
side and hence prevent him/her from being accidentally struck by the door.
● Ramps shall have a slope of 1:15 to 1:18 and should be checked for maneuverability of beds and
trolleys at turning points

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WAITING AREA
● The waiting area should be organized in designated areas such as near the registration
counter, OPD, and outside critical areas.
● This should be built to a scale of 1 sq. ft. per one-third of peak hour load for the registration
area and about one-half of peak hour load for OPD areas.
● Essential amenities
Fans
Clean drinking water
Clean and gender-sensitive toilets
● Desirable amenities
Air-conditioning
Television/LCD in waiting area displaying facility-related information health related

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NURSES STATION & CONSULTATION
ROOMS
● Common nursing station for the remaining OPD clinics should also be made available.
● The stations should have space to seat nurses, keep equipment/consumables to
measure vitals, and maintain records.
● Digital record-keeping is preferred.
● Consultation room should have enough space with a minimum area of 12 sq. m.to
accommodate the required furniture and examination equipment.
● Should be well lit and ventilated with minimum furniture in the room which is compact so
that there is adequate space for the patient and/or attendants.
● An examination table, X-ray view box, single curtain screens and hand washing facilities
should be provided, as needed.

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EXAMINATION ROOM
● Co-located with the consultation room or both can be part of the same room with
arrangements for privacy for examination of the patient
● Larger examination rooms/OPDs will be needed for certain specialities, e.g., Dentistry (for
dental chair) and Eye care (for vision testing).
● Ultrasound services, nursing station and separate toilet should be attached/at one place
for obstetrics and gynaecology services.
● Toilet should be attached to the ultrasound room.
● Immunization clinic with waiting room having an area of 3 m × 4 m and cold chain facility in
Maternity Wing/Paediatric Clinic should be provided.

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Emergency care

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CRITICAL CARE
● Unit should be located close to the
operation theatre complex and other
related departments such as imaging
and laboratory so that the staff and
ancillaries could be shared.
● Heating, Ventilation and Air
conditioning system (HVAC) should be
such that 10-12 Air Changes Per Hour
(ACPH) with 4 – 5 fresh air changes can
be provided in the unit.
● Heating, Ventilation and Air
conditioning system (HVAC) should be
such that 10-12 Air Changes Per Hour
(ACPH) with 4 – 5 fresh air changes can
be provided in the unit.
● Ceilings, flooring, and walls should be constructed
of materials with high sound absorption
capabilities. The recommended noise level should
be in the range of 35-50 decibels

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OPERATIONAL THEATRE
● Close linkages with the surgical ward, high dependency/ICU, imaging, laboratory, blood
bank/storage unit, CSSD/TSSU, and mechanised laundry should be ensured
● There should be four well-defined zones of varying degrees of cleanliness/asepsis namely,
Protective Zone, Clean Zone, Aseptic or Sterile Zone, and Disposal or Dirty Zone.
● An Operation Theatre Complex should also have a Reception, Pre-operative Room, and
Post-Operative Resting Room
● The temperature should be maintained at 21 + 3 degrees Celsius inside the theatre at all
times. Corresponding relative humidity should be between 50-60%. Ideally, 20 air
exchanges, and out of these, four should be fresh air exchanges per hour.

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OPERATION THEATRE
● Following parameters needs to be assessed and monitored regularly to ensure effective
management of OT complex:
○ Temperature, humidity inside the OT
○ Differential pressure inside and outside OT
○ Maintenance record of Air Handling Unit, frequency of air exchange per hour and
cleaning its filter
○ Last HEPA filtration report and HEPA validation report
○
● Laminar flow should be maintained in the operation theatre. It should have a single leaf
door with a self-closing device and a viewing window for communication.
● Operation Theatre Complex should also have a Sub-Sterilizing Unit (TSSU) attached to
the operation theatre limiting its role to cleaning of surgical instruments on an
emergency basis only

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OPERATION THEATRE

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LABOUR ROOM COMPLEX
● Area requirement for one LDR unit (consisting of one labour bed and space for alternate
birthing positions) is 225-350 sq. ft.
● Natural light and views by means of a window are Essential as windows are an important
aspect of sensory orientation and psychological well-being of mothers.
● Suite should be located in the labour room complex near the obstetric operation theatres and
preferably on the ground floor.
.
Special New-born Care Unit & Mother and New-born Care Unit
● Close linkages with the labour room complex, nutritional rehabilitation centre, and district early
intervention centre should be ensured. The unit should comprise of Triage and Reception area
for receiving cases and assessing in the triage area.

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INPATIENT WARDS

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Special New-born Care Unit & Mother and
New-born Care Unit
Nutritional Rehabilitation Centre (NRC)

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RECORD KEEPING ROOM
● The room should be spacious, well ventilated, and have adequate protection from pests and
rodents. It may be prudent to have air-conditioning so as to control humidity and improve
comfort levels.
● Compactor system for storage areas effectively increases the storage space as compared
to conventional racks. Fire sprinklers and smoke detector systems must be installed as a
safeguard against fire
● Sewerage systems from toilets should be away from storage areas, so as to prevent
accidental seepage in walls.

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ADMINISTRATIVE UNIT
Administrative block with the provision of the Medical Superintendent's
Office and the following areas should be provided: Office including
administrative rooms for MS, Nursing I/c, Hospital Manager.
● Meeting Hall
● Record Room
● Staff Room/cubicles including Establishment and Accounts (number to
be based on number of administrative staff)
● Pantry

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SUPPORTING STAFF

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SUPPORTING STAFF

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STAFF NURSES

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STAFF NURSES

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Number of bed required for various spaces:
BED DISTRIBUTION
● Number of Staff Nurse in Emergency for three shifts:
For 200 bedded DH(No of Beds- 21)= 21 (Triage area 1 + Red 1+ Yellow 2 + Green 1 +
Paediatric 1+ Isolation 1)
● Operation Theatre:
For 200 bedded DH= 22 (2 routine + 2 round the clock OT +1 pre and post op. + 1
in-charge)
● Area Wise Beds Distribution
For 200 bedded DH= 113 Beds in General IPD, 8 Beds in HDU, 4 Beds in ICUs, 8 Beds in
OBGY HDU, 2 Beds in OBGY ICU, 16 Beds in SNCU, 4 Beds in NICU & 30 MNCU& 15 Beds in
NRC

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SPECIALISTS & MEDICAL OFFICERS

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SPECIALISTS & MEDICAL OFFICERS

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ADMINISTRATIVE STAFF

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OPEN SPACE
● The width of such entrances shall not be less than 4.5 metres with clear
headroom not less than 5 metres.
● The width of the access road shall be a minimum of 6 metres.
● A turning radius of 9 metres shall be provided for fire tender movement.
● The setback area shall be a minimum of 4.5 metres

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SERVICE AREAS

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NURSES
Critical care area
● There should be one nurse for every six beds on the general wards.
● In adult critical care areas, the nurse: bed ratio should be 1:1 for ICU and 1:2 for HDU.
● For paediatric critical care beds, a nurse to bed ratio of 1:3 for SNCU and 1:2 for
NICU/PICU/Paediatric HDU is to be maintained.
Operation theatre
● Two nurses will be needed to cover every OT shift.
Emergency
● There should be one nurse each to cover the triage area, paediatric area and isolation area.
Apart from these at least two to cover the red, yellow zone and green zones each.
Labour room complex
● One nurse/midwife will be needed to monitor every two LDR beds. In addition, one trained
neonatal nurse will also be needed to monitor every four neonates.

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● Nursing In Charge for every 30 beds. One each for critical care area, OT, and LDR
(for more than 20-bed unit).
● Assistant Nursing Superintendent for every 10 Nursing In-Charges and at least
one in each DH from 50 to 200 beds.
● To avoid electric and fire hazards it is important to have a Fire Safety Officer at
the facility particularly for the hospitals having 200 or more beds.
NURSES

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OXYGEN REQUIREMENT

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NEUFERTS, TIME SAVERS
DATA, KMBR & NBC

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CORRIDORS
● Generally accessible corridors should be at least 1.50 m wide.
● Patients which are transported on beds must have a usable
width of at least 2.25 m.
● The suspended ceiling in corridors can be lowered down to a
height of 2.40 min. in order to provide room for service runs.
● Windows for lighting and ventilation should not be wider than
25 m apart.
DOORS
● The construction and quality of room doors must meet the
requirements of sound reduction and fire protection, and the
surface cladding must resist long-term cleaning and
disinfection.
● The clear opening height of doors is according to type and
function:
- standard door (unfinished): 885 x 2135 mm
- doors through which beds pass: 1260-1375 x 2135 mm
- corridor doors, double: 2400 x 2400 mm

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LIFTS
● The cars of bed lifts require sufficient space for a bed and two accompanying
people.
● The internal surfaces of the lift car must be flat, capable of being washed and
disinfected, and the floor must be non-slip. Lift shafts must be fire-resistant.
● A multi-purpose lift for beds, ambulant patients and visitors should be provided
for every 100 beds
● there should be suitably located smaller lifts to transport equipment and staff:
- car, clear dimensions: 0.90 x 1.20 m
- shaft dimensions: 1.25 x 1.50 m
STAIRS
● The usable width of emergency stairs and their landings must be at least 1.50 m
and not more than 2.50 m.
● Risers of 17 em are permissible and treads of 30 em are recommended.
● Doors to the stairwells must open in the direction of the escape route.

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LIFTS
● Hospital Lift A lift normally installed in a hospital, dispensary or clinic and
designed to accommodate one bed or stretcher along its depth, with sufficient
space around to carry a minimum of three attendants in addition to the lift
operator. -(NBC)
RAMP
● The minimum width of ramp shall be 120 cm. and provided with handrails of 80
cm height on both sides.
● Minimum gap from the adjacent wall to the hand rail shall be 50mm.
● Entrance landing shall be provided adjacent to ramp with the minimum
dimension 120 cm x 150 cm. -(KMBR)

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● Group C—Medical or Hospital Building shall include any building or part thereof,
exceeding 200 sq. metres of built up area which is used for purposes such as
medical or other treatment or care of persons suffering from physical or mental
illness, disease or infirmity, care of infants, hospitals, sanatoria, clinics, homes for
the infirm, convalescent homes, mental hospitals etc, are included in this group.
KMBR

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SANITATION REQUIREMENTS FOR
MEDICAL/HOSPITAL OCCUPANCY
KMBR

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KMBR
PARKING
● Area of each off-street parking space provided for parking motor cars shall not be less
than 15 sq. metres, length of the parking bay shall not be less than 5.5 m.

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LITERATURE CASE STUDY
FORTIS HOSPITAL
GURGAON

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ROAD CONNECTIVITY MAP NEAREST GURGAON BUS STAND
NEAREST METRO STATION
NEAREST BUS STOP
NEARBY HOSPITALS NEAREST AIRPORT
INDIRA GANDHI INTERNATIONAL
AIRPORT 120 KM
NEAREST RAILWAY STATION
HUDA CITY CENTRE BUS STOPS 120M
GURGAON RAILWAY STATION 9.7KM
HUDA CITY CENTRE
400 M VIA SECTOR ROAD
FORTIS HOSPITAL
30 M WIDE
SECTOR MAIN.R
NETAJI SUBHASH
MARG
SECTOR 44
ROAD
ROAD WITHIN SECTOR 6.6 KM VIA MEHRAULI-
GURGAON ROAD
FORTIS
MAX HOSPITAL
PARAS .H
MEDANTA .H
SHEETLA .H
ARVY .H
UMKAL .H

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FORTIS
RESIDENTIAL
SCHOOL
VIVANANTA
METRO
OYSTER PARK
AMITY SCHOOL
VIVANTA BY TAJ
GURGAON
METRO
OYSTER PARK

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FORTIS HOSPITAL GURGAON
LOCATION
FAR
SECTOR 44 , GURGAON
BUILT UP AREA
1.52
SITE AREA
PRINCIPAL ARCHITECT
43,303 SQM
AR .RAJINDER KUMAR,
RAJINDER KUMAR ASSOCIATES ,
NEW DELHI
65,961 SQM.

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FORTIS hOSPITAL GURGAON
FLAGSHIP HOSPITAL OF THE FORTIS HEALTHCARE LIMITED
FORTIS is a multi super speciality hospital
430 functional beds - general care beds : 250
- ICU beds : 100
-OPD chamber : 80
Easily accessible by road , can also be reached using Delhi Metro
Located opposite to the Huda city metro station
CENTRE OF EXCELLENCE
● Oncology
● Trauma
● Pediatric oncology
● Cosmetology
● GI & renal
● Orthopedics

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SITE PLAN
SITE AREA :43,303 SQM
BUILT UP AREA :65,961 SQM
FAR :1.52
SURFACE PARKING :143 cars
TOTAL NO.OF ENTRY/EXIT IN THE BUILDING
OPD ENTRY at lower ground floor
MAIN ENTRY at upper ground floor
EMERGENCY ENTRY at lower ground floor
SERVICE ENTRY at upper ground floor
ONCOLOGY OPD ENTRY at upper ground floor
OPD
Entry/Exit
Maternity
Entry/Exit
Service
Entry/Exit
Service
yard
Emergency
entry /exit
MAIN ENTRY

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Main OPD
drop off
Ramp up and
down for
parking
Oxygen
plant
Maternity ward
drop off
Maternity ward
parking (71 cars)
Emergency
parking( 36
car park)
Oncology
drop off
Emergency
drop off
Service entry
Drop off
Emergency
parking

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BUILDING ORIENTATION STUDY
● MAIN FACADE of building is facing North - west
direction
● SERVICE AREAS south-east direction
● BED TOWER extending upto G+5 is providing shade
to the rest portion of building from sunrays south
direction
● ATRIUM in the center of building receiving diffused
light from north direction
● HEALING GARDENS at south corner for patient ,
recuperation & areas of respite for staff and
families
● HEAVY PLANTATION at site boundaries to absorb
noise from vehicles outside

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FAMILY CENTRED CARE CREATED BY
WELCOMING , HEALING ENVIRONMENT
FOCUSED ON COMFORT AND
CONVENIENCE
PERIMETRE PLACEMENT OR CORRIDOR
ADMIT NATURAL LIGHT IN MOST AREAS &
OFFERING VIEWS TO OUTDOORS
IMPROVED & INDEPENDENT ENTRY
EXPERIENCE TO THE BUILDING PROVIDES
FLEXIBILITY FOR FUTURE EXPANSION AND
MEDICAL DISCIPLINES
DESIGN CONCEPT

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Air conditioned area : 26,254 sqm
Non air conditioned area : 44,612 sqm
● Teri griha provisional rating : 4 stars
STRATEGIES ADOPTED TO REDUCE BUILDING IMPACT ON NATURAL ENVIRONMENT
SUSTAINABLE SITE PLANNING
● TOP SOIL stacked ,preserved made fertile with addition of manure ; relaid on landscape areas
● CONSOLIDATION of all site services along transportation corridors minimize site disturbance
● SURFACE PARKING provided with 100% grass pavers reduce heat island effect
● SUFFICIENT PLANTATION reduces noise levels & enhance exterior environmental quality
REDUCTION IN WATER CONSUMPTION
● LOW FLOW PLUMBING fixtures minimize building water consumption reduction by 63%
● DRIP IRRIGATION system along with native plant species to cut short landscape water
consumption by 50%
● 100% treated water from sewage treatment plant reused for cooling towers & irrigation

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REDUCTION IN ENERGY CONSUMPTION
● INCREASE OF DAYLIGHT in patient areas & waiting areas
● Thermal comfort
● Use of AAC blocks, double glazing & roof insulation
RENEWABLE ENERGY TECHNOLOGIES
● SOLAR PHOTOVOLTAIC panels 25KWp
● SOLAR WATER HEATERS for 8000 litres to meet the surplus hot water
requirement after heat recovery system
USE OF LOW ENERGY MATERIALS
● AUTOCLAVED AERATED concrete blocks
● Cement with sufficient percent of fly ash
● Low embodied energy construction materials and finishes in interiors

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TOTAL NO.OF FLOORS
● BASEMENT
● LOWER GROUND FLOOR
● UPPER GROUND FLOOR
● FIRST FLOOR
● SECOND FLOOR
● THIRD FLOOR
● FOURTH FLOOR
● FIFTH FLOOR
CIRCULATION
● NO .OF STAIRCASE - 10
● NO.OF LIFTS - 10
● ESCALATORS - 2
● NO.OF BEDS -430
GENERAL CARE -250
ICU BEDS -100
OPD CHAMBER -80
● NO.OF ICU -14
● AREA OF ICU -200 SQ FT
● OPERATION THEATRE-14

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FIRE FIGHTING
FIRE FIGHTING
INSIDE THE
BUILDING
In case of fire
Smoke detector
detect the fire and
raise the alarm
Then the sprinklers
get activated having
access from overhead
tank
Then the sprinklers
jockey pump gets
activated
If not sufficient
,then 2nd jockey
pump starts
FIRE FIGHTING
OUTSIDE THE
BUILDING
Hydrant pump
get activated
If not
sufficient ,
second
hydrant
pump gets
activated
If electricity
switched
down then
diesel pump
starts the
hydrant
pump
If
electricity
switched
down then
diesel tank
starts
pump
FHC
outlets
are given
on the
periphery
of site
If not
sufficient FHC
is used
Fire tank capacity 1.5
lakh litre
Fcs tells in which
zone fire is spread
AND RAISE ALARM
FCS
PIPELINES TO CARRY
WATER FROM UG TANK
Exhaust ducts
Fhc is
operated
manually
by fireman

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BASEMENT (PARKING , PLANT
ROOMS
LOWER GROUND (DIAGNOSIS
,OPD , ER )
UPPER GROUND (MATERNITY ,
ATRIUM LOBBY )
1 ST FLOOR(MATERNITY ICU
62 BEDS,WARDS,ICU )
2ND FLOOR (SURGICAL FLOOR
10 OT , ICU BEDS 92 )
THIRD FLOOR (PATIENT BEDS 67)
TYPICAL FLOORS
SECTION

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bASEMENT PLAN
BASEMENT IS USED FOR
● Engineering services plant
room like HVAC ,LT panel
room ,DG room ,pump
rooms etc
● Radiation therapy used in
oncology treatment
● Parking and HR dept and
staff areas
TOTAL PARKING IN BASEMENT
● 280 cars parking
● 51 two wheeler parking
LT PANEL
ROOM
DG ROOM
LINAC RADIATION
HVAC PLANT
ROOM
WATER SUPPLY AND
FIRE FIGHTING
PUMP

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LOWER GROUND FLOOR
USED FOR
● OPD
● Oncology OPD
● Laundry
● CSSD (CENTRAL STERILE
SERVICE DEPARTMENT)
● Radiology
● Emergency
● Physiotherapy dept
TOTAL AREA OF LOWER GROUND
FLOOR
7864.89 SQM
CSSD
EMERGENCY
ENTRY
PHYSIOTHERAPY
GYM
SWIMMING POOL
OPD ENTRY
LAUNDRY

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USED FOR
UPPER GROUND FLOOR
● Maternity ward
● SPA
● Kitchen
● Food court
● Finance dept
● Shop arcade
● Health check-up area
HEALTH
CHECK UPS
SHOPS
RECEPTION
SHOPS
FOOD COURT
WAITING AREA
FINANCE
DEPT
KITCHEN

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FIRST FLOOR
USED FOR
● Maternity surgical & LDR
● Chemo and dialysis
● Auditorium
● General wards
● Blood bank / lab
TOTAL AREA OF FIRST FLOOR
6828.19 SQM
AUDITORIUM

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SECOND FLOOR
USED FOR
● Surgical suite
● ICU
● Cath labs
TOTAL AREA OF SECOND FLOOR
6828.19 SQM
POST OT

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THIRD & FOURTH FLOOR
USED FOR
● Single patient room
● Double patient room
TOTAL AREA OF THIRD AND
FOURTH FLOOR
1944 SQM
TOTAL NO.OF BEDS ON BOTH
FLOOR
140
CORRIDORS
RR LOUNGE

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FIFTH FLOOR
USED FOR
DELUXE ROOM
PRESIDENTIAL SUITE
SUITE ROOM

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FORTIS HOSPITAL GURGAON
Retaining newly established architectural image of existing city
Architecture that complements yet adds new dimension forward
Careful massing , choice and placement of materials , detailing of facade , new technology
● Modular planning of clinical floors ; flexibility
● Clear organisation & simple circulation system
● Maximum utilisation of available areas
● Natural daylight in all major spaces
● Refreshing & congenial environment by creating a modern , upmarket & plush interiors
● Improved and independent entry experience provide flexibility
● Perimeter placement or corridor admits natural light ; orienting views to outdoors
● Healing garden - calm & peaceful environment
ANALYSIS

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Thank you!
GROUP 5
ASMITHA SHAMS
ARSHAQ KN
HAFNA M
HISHAM MUSTAFA
MINHA KABEER
SHIRIN SHERIEF
ZAMEELA ZULFIKAR