Hospital Engineering Services is backbone of hospital. The engineering services in a hospital include the Civil assets, Electricity supply, water supply including plumbing and fittings, steam supply, piped medical gases, air and clinical vacuum delivery system, air conditioning and refrigeration, lifts and dumb waiters, public health services, lightening protection, communication system (public address system, telephones, paging system), TV and piped music system, non conventional energy devices, horticulture, arboriculture and landscaping and last but not the least workshop facilities for repairs and maintenance.
A compilation of those areas of IPD which are usually not covered in classrooms. A greater emphasis on the management aspect with examples from existing hospitals in INDIA
Hospital Engineering Services is backbone of hospital. The engineering services in a hospital include the Civil assets, Electricity supply, water supply including plumbing and fittings, steam supply, piped medical gases, air and clinical vacuum delivery system, air conditioning and refrigeration, lifts and dumb waiters, public health services, lightening protection, communication system (public address system, telephones, paging system), TV and piped music system, non conventional energy devices, horticulture, arboriculture and landscaping and last but not the least workshop facilities for repairs and maintenance.
A compilation of those areas of IPD which are usually not covered in classrooms. A greater emphasis on the management aspect with examples from existing hospitals in INDIA
Location and layout of hospital, need of hospital to community,planning,factors and data required in planning,fundamentals and objectives,principles,different stages,equipment planning,icu design and layout,quality quantity and temperature and noise control in hospital,conclusion
OPD is the mirror of the hospital, which reflects the functioning of the hospital being the first point of contact between the patient and the hospital staff.
Patients visit the OPD for various purposes, like consultation, day care treatment, investigation, referral, admission and post discharge follow up. Not only for treatment but also for preventing and promotive services like, health check up, Immunisation, Physio-therapy and so on.
Location and layout of hospital, need of hospital to community,planning,factors and data required in planning,fundamentals and objectives,principles,different stages,equipment planning,icu design and layout,quality quantity and temperature and noise control in hospital,conclusion
OPD is the mirror of the hospital, which reflects the functioning of the hospital being the first point of contact between the patient and the hospital staff.
Patients visit the OPD for various purposes, like consultation, day care treatment, investigation, referral, admission and post discharge follow up. Not only for treatment but also for preventing and promotive services like, health check up, Immunisation, Physio-therapy and so on.
HOSPITAL_MANAGEMENT_STRATEGIES by Dr soumya Patil.pptxDr Soumya Patil
contents
Introduction
Strategic initiatives for Hospitals
Infrastructure of Hospital
Health Information technology
HIT functional units
Benefits of HIT
Essential manpower
Medical equipments for Hospitals
Patient Care
Introduction:
From its gradual evolution through the 18th &n19th centuries the hospital has come of age only recently during the past 50 years
A hospital is an integral part of a social and medical organization, the function of which to provide for the complete health care, both curative and preventive and whose outpatient services reach out to the family and its home environment; the hospital is also a center for training of health workers and biosocial research.
Hospital management is the field relating to leadership, management and administration of public health systems, health care systems, Hospitals and hospital networks in all the primary, secondary and tertiary sectors.
The Clinical Establishments (Registration and Regulation) Act, 2010 has been enacted
by the Central Government to provide for registration and regulation of all clinical establishments in the country with a view to prescribe the minimum standards of facilities and services provided by them.
The minimum standards for Allopathic hospitals Under Clinical Establishment Act, 2010 are developed on the basis of level of care provided, as defined below
General Medical services with indoor admission facility provided by recognised allopathic medical graduate(s) and may also include general dentistry services provided by recognized BDS graduates.
Example: PHC, Government and Private Hospitals and Nursing Homes run by MBBS Doctors etc.
Aims and activities :
Improve the patient experience.
Measure and report quality performance.
Adopt to new payment models.
Address the possible impact of health insurance exchanges.
Work on an approach to population health management.
Focus on clinical integration
Explore new physician alignment strategies.
Respond to an aging population.
some of the strategic issues that must be considered are –
• Regionalization
• Pre- planning consideration
• Need assessment
• Plot ratio
• Design for flexibility and expandability
• Fulfill the demand functions
• Emphasize on patient focused hospital
• Focus on energy conservation
Intelligent buildings
• Create a healing architecture
• Aesthetic – an essential requisite
• Hospital architecture
• Go green
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)
IT App
Planning and Designing for State of Art Healthcare Faciities- Brief Overview ...JIT KUMAR GUPTA
Paper is an attempt to look at the healthcare sector in terms of its context, issues and options for planning and designing a state of art healthcare institutions for delivering quality healthcare at an affordable cost consuming minimum time of hospitable/patient. It defines few basic principles which need to be guide the planning and ,designing of hospitals
A short brief on 'Hospital Acquired Infections' (HAI) or 'Nosocomial Infection' (NI) for M Phil, MPH and Advance Course in Hospital Management/ Administration
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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Hospital Planning
1. HOSPITAL PLANNING
Brig Gen Dr Zulfiquer Ahmed Amin
M Phil, MPH, PGD (Health Economics), Advance Course HA (AIIMS, Delhi), MBBS
North South University (NSU)
2. Hospital Planning
• Planning is the forecasting and organizing the activities
required to achieve the desired goals.
• Hospital Planning is deciding in advance the structural and
functional components of a hospital that responds to the
present needs of the patients, the healthcare workforce and
the society, while anticipating the future changes.
• All successful hospitals, without exception are built on a triad
of good planning, good design & construction and good
administration.
3. • Hospital building differs from other building types in the complex
functional relationship between the various parts of the hospital.
• Apart from providing right environment for patients and care
providers, it should also be sensitive to the needs of visitors.
• It is thus imperative to examine the emerging issues, impacting
factors and study the various strategic essentials for planning,
designing and construction of a hospital.
4. Efficiency and Cost-Effectiveness
An efficient hospital layout should promote staff efficiency by
minimizing distance of necessary travel between frequently used
spaces; allow visual supervision of patients; provide an efficient
logistics system for supplies and food (and removal of waste); make
efficient use of spaces.
Flexibility and Expandability
Medical needs and modes of treatment will continue to change.
Therefore, hospitals should follow modular concepts of space planning
and layout; with well-planned directions for future expansion.
Factors to Consider in Hospital Design and Construction
5. Therapeutic Environment
Patients and visitors should perceive a hospital as unthreatening,
comfortable, and stress-free. The interior designer plays a major role
in this effort to create a therapeutic environment. For example,
allowing ample natural light, and by providing views of the outdoors
from every patient bed.
Cleanliness and Sanitation
Hospitals must be easy to clean and maintain. This is facilitated by
appropriate, durable finishes for each functional space; careful
detailing to avoid dirt-catching and hard-to-clean crevices and joints.
6. Accessibility
All areas, both inside and out, should ensure grades are flat enough to
allow easy movement and sidewalks and corridors are wide enough
for two wheelchairs to pass easily.
Security and Safety
Hospitals have several particular security concerns, such as protection
of patients and staff, hospital property and assets (including drugs).
Security and safety must be built into the design with these things in
mind.
Sustainability
Hospitals are heavy users of energy (380 kwh/sq.mt/year) and water
(350-400 L/bed/day) and produce large amounts of waste (1-2
kg/bed/day). Because of this, sustainable design must be considered
when designing and building hospitals.
7. Planning involves seven questions:
• What we expect to do?
• Why it will be done?
• Where will it be done?
• When we expect to do it?
• Who all are going to do it?
• How will it be done?
• Are we looking into changes in future?
8. Strategic Essentials
• Regionalization
• Pre-planning consideration
• Need Assessment
• Plot Ratio
• Design flexibility and expandability
• Fulfill the demand functions
• Patient-Focused hospital
• Energy and water conservation
• Intelligent Building
• Healing architecture
• Aesthetic
• Hospital Architecture
• Go Green
9. Regionalization of Hospital
Regionalization of Hospital refers to establishing an hospital in a
defined politico/ administrative/ geographical area with
interconnectivity to other hospitals for triage in the same region with
a regulatory body.
Pre-planning consideration
Emerging and strategic issues that influence a hospital’s service and
infrastructure requirements like, demographics, epidemiology,
healthcare statistics, site conditions, regulatory criteria, technological
opportunity, and financial feasibility should be considered before
planning for a hospital.
10. Need Assessment
It is a systematic method of identifying unmet health and healthcare
needs of a population.
Plot Ratio/ Floor Area Ratio (FAR)
Plot Ratio is the ratio of a building's total floor area (gross floor area)
to the size of the piece of land upon which it is built. 2:1 ratio is the
highest FAR a hospital can have.
11. Flexibility and Expandability
Expandability and Flexibility refers to the ability of the health
infrastructure to expand horizontally or vertically as per changing
needs of the healthcare.
Fulfill Demand Functions of Hospital
Demand of healthcare function refers to the quantity, quality, and
type of healthcare the consumer wants, which depends on factors
like health condition, prices, personal income, and preferences,
should be fulfilled.
Patient-Focused Hospital
A patient-centered hospital creates a home-like environment that not
only meets the needs of the patient, but also meets the needs of
family members.
12. Energy and water conservation
Average energy consumption in a hospital is 1 kw/bed/day, and
water consumption is 300-400 liters/bed/day. Healing Architecture:
Architecture and design can promote the healing process by giving
patients a psychological and physical lift.
Intelligent Building: A building that integrates technology and
process to create a facility that is safer, and more comfortable for its
occupants, and efficient for its owners.
Go Green
"Go Green”. Going “Green” means taking measures to become
environmentally conscious in making decisions. For hospitals, it mean
“energy saving (20-40%), better indoor air quality, and water saving
(35-40%)."
13. Emerging Issues for Hospital Planning
-Epidemiological and demographic changes
-Increased expectation of patients
-Emphasis on ambulatory care (Day Care)
-Enhanced standards
-Changing functions of hospitals
-Advancements in medical technologies
-Concept of outsourcing of hospital utility services
14. Impacting Factors for Hospital
-Socio-economic profile of community
-Health status profile of the region
-Local regulations
-Source of finance
-Choice of technology
-Climatic zone
15. Hospital Designing
-The main guideline while designing the hospital is ‘Form Follows
Function’. ‘Form follows function’, is a principle associated with
modern architecture and industrial design that the purpose of a
building should be the starting point for its design.
-All architectural and aesthetic design should be secondary in
nature.
-According to the function of the department, the designing to be
made.
‘Form Follow Function’: Function is to work
with computer. So forms (Facilities), like
table and chair should facilitate working
with computer. It should not be mere
ornamentation.
16. Principle of Hospital Planning
Protection:
Protection from unhealthy environment in order to help speedy
recovery.
Separation:
Separation of dissimilar activities.
Control:
The nurses station should be positioned strategically to enable
proper visual monitoring of patients and control all clinical activities.
Circulation:
All the departments of a hospital must be properly integrated for
human traffic, by sufficient corridors, stairways, elevators, escalators,
and lobbies. Circulation spaces may constitute up to 25% of hospital
area.
Light and air:
Natural light and air should be allowed in the vicinity.
17.
18. Objectives of Planning Team
-Examine existing facilities and its adequacy
-Assess the needs of the area
-Need for new facilities/expansion, so as to provide adequate
quantitative and qualitative healthcare services to people.
23. Feasibility Study
Demographic pattern:
Type of residents- High, Middle, Low Class.
Affordability status.
Extent of people to be covered
Peoples beliefs, attitude, practices and culture.
Availability of Rest House, hotels etc.
Need Assessment:
Type of healthcare need.
Population pattern- Age, gender, education, vulnerability.
Economic status, source of income
Utilization pattern of existing healthcare facility
Level of leadership and motivation among people.
Accommodation and training facilities for hospital staffs.
24. Need Assessment
How many beds in a new hospital will be needed for a particular
area, will be calculated as per following formula:
WHO standards, a minimum of 3 beds per 1000 population is required
25. Site Selection:
The site for the hospital should be carefully selected by the Hospital
Planning Team keeping in mind the various factors like accessibility,
geographical location, size of the plot, good approach road etc.
Expert healthcare consulting firms can help in identifying the right
location for the hospital.
Land requirement (Approx):
26. -Soil condition suitable for construction, not land-fill area.
-Subsoil water and mineral level.
-Availability of public utilities.
-Proper elevation for drainage & general sanitary measures.
-Freedom from smoke, noise, vapour, and other annoyances.
-Potential for future expansion.
27. Environmental Study:
Area must have clear sun shine, avoid big buildings, trees near-by.
Climate should be moderate.
No near-by noise emitting industries.
Flow of fresh air.
Away from roads with heavy traffic.
Availability of sun light.
(East-West Facing indoor)
Availability of Electricity:
Electric sub-station in close vicinity.
Availability of 3 phase-electric supply with adequate load (1
kw/bed/day)
Dedicated electric supply line.
Stand-by generator.
28. Water Supply & Sanitation:
Availability of deep table subsoil water.
Adequate water supply (300-400 liter/bed/day).
Good maintained sewerage system.
Easy access to sewerage treatment plant.
Availability of safe Bio-Medical Waste Disposal facility.
Transportation & Communication:
Close access to Rail Station or Bus Stand.
24-hours public transport and private taxis available.
34. The cost to set up a hospital depends on :
1. The intended capacity of the health care facility.
2. The level of health care the facility intends to offers.
In Bangladesh, establishing a tertiary care Hospital-Bed, needs almost
1 crore (10 million) taka to facilitate its every bed with advanced
health care, including expenditure on civil (building), medical
equipment, human resources, utility capacity, safety standard and
administration. In USA, per hospital bed construction cost ranges
from $500,000 to $1,500,000.
The land and construction cumulatively require 50-60% of the total
capital cost. In addition, another 10% of the total estimated cost is to
be set aside for contingency and cost-build up due to processing lags
in the hospital setup.
38. Sufficient space are planned for future expansion of a hospital
Construction Plan
39. Space Requirement for Some Basic Department
Construction Plan
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
Central Sterile Supply
Dept
8-25
Dietary 25-35
Medical record 8-15
40. Construction Plan
Area Sq ft/Bed
House keeping 4-5
Laundry 12-18
Mechanical Installation 50-75
Workshop 4-6
Stores 25-35
Public Area 8-10
Administration 40-50
Total 567-751
Circulation 8-25
Total Net Area 682-891
42. An architect brief is a written document of a complete construction
plan, prepared by a person or a team in consultation with the client,
that includes all of the things on the "wishlist“ of the owner. It
explains types of services to be provided, interrelationship and
interdependency of each department, special requirements and
facilities need to be available.
It includes:
Architect Brief
- Site Information
- Functional Content
- Workload
- Staffing
- Equipment
- Policies and Procedures
- Accommodation
- Zoning
- Financial Aspects
- Provision of Air-Light-Water
43. Project Planning and Implementation
- When design is finalizes, bidding process starts.
- A tender is issued in two bid system (Technical and Price Proposal)
- Bids are examined by the planning team.
- Finally, contract is awarded to prospective contractor/agency.
Tendering and Award of Contract
44. Manpower Planning and Recruitment
While construction is on progress simultaneous manpower plan and
subsequent recruitment is undertaken.
-Clinical Personnel
-Administrative Personnel
-Nursing Staffs
-Paramedics
-Medical Technicians
-Electro-Medical Technicians
-Clerical Staffs
-IT Personnel
-Kitchen personnel
-Sanitary Personnel
-Other staffs
46. Equipment Planning & Purchase
-There are Built-in, depreciable and non-depreciable equipments in a
hospital.
-A room by room equipment list is prepared and reviewed by the
admin and clinical staffs.
-It is necessary to consult with the architect who is designing the
building early, so that the facilities planned will be of sufficient size to
accommodate the equipment and render necessary service.
-During purchase of costly equipments, warranty period and post-
warranty services should be ensured.
-Latest version of equipments, as far as possible should be
purchased.
-Provision of workshop for minor repair should be considered.
-Before acceptance of equipment, trial-run should be done.
47. Built-In
Equipments
This includes counters, and cabinets in laboratory,
pharmacy; elevators, incinerator, washing-facility,
fixed sterilizer etc. These are included in the
construction contract and planning of these
equipments is the architect’s responsibility.
Depreciable
Equipments
This include any equipment that has life for five
years or more, and not purchased through
construction contract. Diagnostic and therapeutic
equipments (MRI, CT Scan, Ultrasonogram
Machine, RT-PCR Machine etc)
Non Depreciable
Equipments
Small items with low unit cost, and life span less
than five years, and not purchased through
construction contract. eg, surgical instruments,
linen, kitchen utensils etc
48. A patient-centered environment considers the needs of patients both
architecturally and through material selection. It fulfills:
-Infection control standards
-Aesthetic value
-Healing environment
-Physical environment
Interior and Furnishing
49. Commissioning
Building commissioning:
It is process by which a new equipment, facility, or plant is tested to
verify, if it functions according to its design objectives or specifications
and as intended by the building owner, done by test-running.
Commissioning of an establishment is done, when:
-Construction is completed
-Equipment and machineries are installed
-Recruitment of staffs are done
-Advertisement in mass media is given for its operation
-Date of inauguration is finalized.
50. Shakedown Period
After the commissioning of hospital, some time is taken for full
operation to public, due to functional integration of different units,
services, staffs, patients and the community. This period is called
‘shake-down’ period.
It involves:
-Machines are tested.
-Staffs are recruited and trained
-Standard operating procedures are made
-Maintenance service is put in place
-Materials, line, and stationary are procured.
Then begins the routine and regular functioning of the hospital.
51. The average hospital needs roughly 2,500 sq.ft. per bed in USA. The
average cost of hospital construction per bed, ranges from $500,000 to
$1,500,000, and $200 to $625 per sq.ft, which usually depends on the
type of hospital, and encompasses cost of affiliated administration,
utility, medical units and safety measures.
In Bangladesh, establishing a tertiary care Hospital needs almost 1
crore taka per bed, inclusive of men, material, equipment, and capital
cost.
Thus, hospital is a very costly project. We should plan a hospital with
due vigilance and pre-planning efforts, so that we can avoid any costly
repair or amendment after the building is erected.
52. Conclusion
Medical facilities and hospitals need to stay on the cutting edge of
technology to do their jobs properly. Advancements are being made
all the time, which means that the hospital needs to be flexible
enough to update and change when needed. This may be why, many
older hospitals are renovated, with new sections added on, rather
than simply building a completely new hospital. Leaving some room
for growth in our hospital layout and build-site ensures that we can
continue making upgrades as needed for the life of the building.
We need to be aware that hospital planning should not be such that
either any future development becomes impossible, or it needs to
make a hospital completely new.