hospital-design-module-8-13-pdf-free.pdf

Hospital Planning & Design
Module 8
Hospital Zones
Hospital planning is grouped in Zones or department according to its function, operation and
uses.
(Note: Color coding of zones was used for easy identification of departments or zones and use
as guide in proper planning of hospital.
Yellow
OUTER ZONE most public oriented such as Emergency Department
(ER), Out Patient Department (OPD), Business Office, Physical
Rehab., etc.
SECOND ZONE: workload from Outer Zone. Non Public section
Ancillaires, Diagnostic/ Therapeutic Department. (Laboratory,
Radiology, Pharmacy, Pulmonary, Cardio Vascular, etc.)
Administration Office: non-public section
Red INNER ZONE: quiet environment, access to public.
(Nursing Service) Nursing wards, Nurse Station
Staff Quarters.
Violet DEEP ZONE: Aseptic areas, off-limits to public. Operating Room,
Surgery, ICU, Delivery, Nursery.
Green SERVICE ZONE: “Dirty and busy area”, grouped around service yard for
supplies and removal. Dietary, Laundry, CSSD, Maintenance, Motorpool
Brown SPECIAL SERVICE (Twilight) ZONE: Morgue
Lt. Blue
Orange
Blue
Inner
Zone
Inner
Zone
Twilight Deep Zone
Deep Zone
Service Zone
Service Zone
Outer Zone
Second Zone
Second Zone
Service
Main Entrance
Emergency
OPD Ent.

Outer Zone
EMERGENCY ROOM (ER)
The Emergency Room (ER) is the most, primary and complex department of the hospital. It
concerned with the reception and out-patient treatment, including follow-up treatment of accident
victims and patients attacked by sudden illness who require hospital care.
E.R. Deals with the immediate resuscitative requirements of dire emergencies prior to their
admission to the wards.
Location of E.R. shall be at the nearest distance, immediately from the entrance. It should be
easily and accessible 24/7 open to public.
Service Offered
 Initial management of emergency and Trauma Cases.
 Ambulance Service
 Injections of Out-patient Cases.
 Disaster response during crises
Flow diagram of Patients
SERIOUS INJURED AMBULANT
STAGE 1
RECEPTION & WAITING
EXAM. DIAGNOSIS, TREATMENT
FURTHER TREATMENT
TRANSFER
In patient, out patient, another hospital,
discharge to house, family doctor, mortuary
STAGE 2
STAGE 3
STAGE 4

DIAGRAMATIC LAYOUT
STAFF AREA
(doctors, nurses, other staff)
AMBULANT
PATIENTS
WAITING
Orthopedic
WAITING
Follow up
RECEPTION
WAITING
“First attendees”
IS
OL
AT
IO
N
Wheelchair/
Stretcher
Stretcher
Entrance
Resuscitation
EXAMINATION, DIAGNOSIS, TREATMENT
Room/ cubicle w/ utility area
MINOR OR & SUPPORT
AREAS
AMB
ULA
NCE
ORTHOPEDIC
&
FRACTURE
PLASTER
ROOM
To
HOSPITAL
WARD
WAITING
Plaster
OBSERVATION
From
HOSPITAL
Ward
Special link to
neuro-surgery,
plastic & thoracic
surgery
ICU
E. R.
E. R.
O. R.
Pharmacy
X-Ray
X- RAY – mobile x-ray available if necessary
processing can be done in X-ray Department.
PHARMACY – easy access to medication.
WARDS – easy transfer of patients who need
prolonged clinical and nursing care.
OR – easy route for patients requiring major
surgery.
ICU – easy route for patients requiring special
intensive care. (monitoring equipment)
SPECIAL LINKS – access to services of
neuro-surgery, plastic and thoracic surgery.
BUBBLE DIAGRAM

SPACE REQUIREMENTS
A. PUBLIC AREA
ROOMS / SPACES NOTES /Sq. mtr.
1. ENTRANCE / STRETCHER
PATIENTS
Double automatic doors, easy access to
Resuscitation Room.
3. m wide
2. DECONTAMINATION/
CLEASING ROOM
For patients involved in industrial or car
accidents who need to be cleaned even while
on stretcher; provide shower bath, hand
spray, deep sink, floor drain.
7.43/ bed
3. ENTRANCE AMBULANT
PATIENTS Adequate lobby, leads patients directly to
Reception-Triage
5.02/
person
4. RECEPTION TRIAGE Receive patients; collect information, decision
on next stage.
5.02/
person
5. INTERVIEW ROOM Further interview of relatives by hospital 5.02/
person
6. ADMISSION Section of hospital admission for admitting
patients from ER
5.02/
person
7. DISCHARGE Section of hospital discharge for discharging
patients from ER
5.02/
person
8. WHEELCHAIR & STRETCHER
BAY Available to patients who need wheelchair or
stretcher on arrival.
1.08/
stretcher
9. WAITING AREA Designate separate waiting area for different
types of patients.
0.65
10. ISOLATION AREA Room directly accessible from outside for
highly-infectious patient (ex. SARS)
7.43/ bed
11. ATENDANTS’ ROOM Room for hospital attendants and drivers of
ambulance.
5.02/
person
12. PUBLIC TOILET
Design according to code 1.67
13. TRIAGE
Prioritization of patients for medical treatment:
the process of prioritizing sick or injured
people for treatment according to the
seriousness of the condition or injury.
9.00
B. PATIENTS-PRODUCTION AREA

1 PATIENTS’ SUB-WAITING AREA
For ambulant patient under treatment but
have to wait for further procedures.
0.65
2 PATIENTS’ TOILET Accessible universally design. (BP 344) 1.67
3 RESUSCITATION AREA
For patients needing immediate resuscitation;
fully equipped; provide medical sink, x-ray
viewing, E-carts, supplies cabinets, piped
oxygen and suction, poison ID and antidote
cabinet, etc.
24.0
4 EXAMINATION & TREATMENT
AREA
Open space divisible into curtained cubicle as
required, flexible usage.
7.43/ bed
5 OBSERVATION AREA
(Recovery)
For patients under observation, recovering
from treatment, preparing for anther
procedure.
7.43/ bed
6 SOUND-DEADNED ROOM
For patient, adult or children who are noisy
and disturbed.
7.43/ bed
7 D.O.A. ROOM For patients who are “dead on arrival” 7.43/ bed
8 MINOR O.R.
For minor procedure; equipped with operating
table , x-ray viewing, piped medical gases,
suction.
30.0
9 PLASTER ROOM
For patients with fractures needing plaster;
plaster mold, and disposal
24.0
10 PLASTER STORE & DISPOSAL
Separate storage for splint, plaster, mold,
disposal
4.65
11 SCRUB-UP & GOWNING Staff gowning and cleaning before procedure. 4.65
12 NURSES’ STATION
General Staff base – separate for
examination and treatment and observation.
5.02/
person
13 CLEAN UTILITY
Provide sufficient shelves for storage for clean
and sterile supplies.
14 DIRTY UTILITY
Rinsing and washing of instruments, towels,
temporary hold for soiled linen, etc.
15 JANITOR’S CLOSET Separate storage cleaning paraphernalia. 3.90
C. STAFF AREA
1 OFFICE OF HEAD with TOILET For head or chair person of the department. 5.02/

person
2 WORK AREA For clerical and administrative staff,
6.00/
person
3 OFFICE
For doctors, nurses – if required. 5.02/
person
4 CONFERENCE ROOM &
LIBRARY
5 STAFF TOILET 1.67
6 STAFF LOCKERS & CHANGING 2.32
7 STAFF LOUNGE 5.02/
8 ON-CALL ROOMS with TOILETS For staff on-call within the hospital premises
5.02/
person
Some design considerations
 Locate not too far for ambulant patient arriving by public transport.
 Car or taxi can drive to entrance door
 Adequate turning and parking for ambulance.
 Segregate fast-paced ambulance route from slower-paces route of ambulant patient.
 Break-up waiting area for different types of patient.
 Provide adequate space for fast-paced operations.
 Circulation routes should consider segregation of staff traffic from the public.
 Provide for rest amenities for staff in between crisis.
 Examination and treatment cubicles should be flexible in use- no hard, permanent partition.
 Children should be protected from witnessing other casualties.
 Septic condition should be isolated.

SAMPLE PLAN

ADMISSION-DISCHARGE
ADMINISTRATION DEPARTMENT
ADMISSION - DISCHARGE
ROOMS/ SPACES DESIGN NOTES AREA
ADMISSION
Admission of in-patient on doctor’s order thru
emergency
5.02/ person
PUBLIC WORK AREA 0.67 person
INTERVIEW AREA
Partition counter section for interview of
patient
6.00
STAFF WORK AREA
Administrative & documentary work, staff
here with close coordination with the staff of
ER admission section.
6.00
HEAD’s OFFICE 5.02/ person
PHILHEALTH Government Health Insurance
Public Waiting Area
Head’s Office
Social Service Office (SWA) Office of the Social Worker
SUPPORT/ FACILITIES
STAFF TOILET 1.67
PUBLIC TOILET 1.67
TOILET FOR DISABLE 2.70
BILLING SECTION
Computation and processing of statement of
account or billing
Public Waiting Area 5.02/ person
Staff Work Area

Head’s Office
CASHIER
Cashier’s Cage
Vault
Staff Work Area
Head’s Office
Finance Officer’s Office
SUPPORT FACILITIES

SAMPLE PLAN:
TRENDS
Designed lobby as a Hotel atmosphere
Provision of Coffee Shop, Restaurant, Bank, Commercial

OUT PATIENT DEPARTMENT
INTRODUCTION
The center of gravity of hospitals has been shifting more and more from wards to the Out-
Patient Department (OPD). This is due to the shift in health policies where old hospitals were designed
to heal or to cure, new ones are placing more importance to disease prevention; thus the emergence of
more complex diagnostic equipment and outpatient services.
Much of the investigation and diagnostic work that formerly necessitated admission to a
hospital can now be carried out in a well-equipped OPD with a saving of expense and avoidance of the
disruption of family life that hospitalization causes.
INFLUENCES ON DEMAND ON AMBULATORY MEDICAL SERVICES:
 Changing role of the hospital from a physician workshop to a community health.
 Growing public awareness and confidence in the hospital as the most appropriate place to
obtain round the clock care for unexpected injury and illness.
ARCHITECTURAL PHILOSOPHY
OPD is the point of contact between the hospital and community. Patient’s impression of the
hospital through the OPD should be a favorable one.
Create an atmosphere of FRIENLINESS and WELCOME by:
 Proper lay-out of the department, its furnishings and décor
 Good attitude of staff
A. Type of Department Services
1. Outpatient Services in the OPD – traditionally described as doctor’s consulting-
examination- treatment services rendered to outpatients where, operationally, the patent pays
the hospital for the services and then, the hospital pays the doctor a salary. This setup
continues to exist in government hospitals and in a limited manner in private hospitals as
specialized centers.
2. Private Clinics in a Medical Arts Building – in more recent developments, the MAB
has emerged as the alternative to traditional OP services in private hospitals where doctors
offer services to outpatients in patient clinic setups where operationally the doctor is paid
directly by the patient and then the doctor pays the hospital rent.
B. Rule and Scope of the Services
MAIN FUNCTIONS OF OPD
1. Prevention
2. Early detection
3. Early treatment and
4. Long term management of sickness and disease of ambulatory patients
To minimize or obviate the need for inpatient care.
o Will the OPD aside from healing sickness of short duration, conduct
diagnostic, therapeutic and rehabilitative programs?
o Will the OPD engage actively in programs of preventive medicine and
disease detection?

o Will the Services be acceptable to every socio-economic group under a
single standard of care?
o Will educational programs be carried out?
o Will Outpatient activity include community medicine activities as home
health activities, as home health education programs a satellite health center, and others?
C. Statement of Change and Growth
Estimates should be made as to future space requirements arising from anticipated changes
in arising from anticipated changes in caseloads, procedures, operations, equipment and staffing.
Projections should identify spaces most likely to be changed or to require expansion and the
degree and direction this may occur.
How could lateral expansion take place for the activities as a whole or for their internal
functional components with minimum coat and disruption in terms of contiguous space and function
affected?
D. Functional Considerations
1. Operations and Interrelationships
In general, what is the range of Intramural ambulatory care? Ex. General medicine, surgery,
obstetrics, pediatrics, EENT, etc.
 Identify the basic Intramural relationships
o Administration
o Medical staffing
o Nursing services
o Medical records
o Admissions
o Support services
o Housekeeping and support
o Registration and business affairs
 Identify extramural relationships ex. Health education, home care, immunization programs,
etc.
Facilities should include provision for diagnostic procedures, outpatient treatment and recovery.
Type of procedures fall broadly into categories.
a. Minor Operating procedures.
b. Time consuming investigations such as those that include the collection of specimen
for analysis over a period of several hours.
 For both these types of procedures, patients may require some form of
preparation, and many of those who have had a minor operation will need a period of
recovery before they are able to return home.

 The development of these facilities should ease the demand on inpatient
accommodation.
2. Location, Communication, and Traffic
What are the requirements of the site with regards to the OPD?
 Consider the physical relationship of the department as a whole to the main internal
circulation system both lateral and vertical circulation.
 Consider the physical relationships of the departments as a whole to other departments
such as the radiology, laboratories, pharmacy, administrative and medical records.
There should be one entry point for out-patients.
The Main Lobby, Pharmacy and Laboratory, Diagnostic Imaging Services, and Physical
Therapy should be in close proximity to the OPD.
For diagnostic purposes, great use is made of the Laboratory Department, but although a
proportion of out-patients will have to attend the department, ease of communication is less
essential than in the case of the Radiology Department, especially if facilities are available within
the OPD for the collection of specimens.
The Medical Records Department and Pharmacy should be planned in close association with
the OPD. In cases where it is impractical for the Pharmacy to be directly related to the OPD, it will
generally be necessary to provide a separate dispensary for outpatients within the department
itself.
3. Schedule of Accommodations
A. Consulting Facilities
 Combined Consulting- Examination (C-E) Rooms
 Consulting with Examination Rooms
The C-E should be equipped with a consultants desk, chairs, lavatory, weighing scale,
adjustable light and other standard equipment, such as an examination table or a couch for the
patient and a trolley for instruments will also be required.
Some specialties will need storage for additional equipment for their clinics; such as sight
testing apparatus, ultrasound and electrocardiography machine.
B. Treatment Room
For minor treatments carried out by doctors and for reapplication of patient’s dressing after
attendance at a clinic. Equipped with a bed and chair, adjustable lighting fitting and surgeon’s
lavatory.
C. Clean Utility Room
For reception, storage, and issuing of sterile supplies and other clean supplies and equipment.
D. Dirty Utility Room
For reception of used instruments and bowls, and the disposal of dressings. Should be fitted
with a sink, skip sink, drawer and working counter.
E. Waiting Area/ Reception area
OPD Waiting Area may be shared with the Main Lobby of the Hospitals. In case where the OPD
has highly departmentalized clinics, another waiting area should be provided exclusively for the
OPD.
RECEPTION COUNTER – in prominent position near the entrance where clerks will deal with
the registration of patients, appointments and transport facilities.

A sub-waiting area should be provided outside groups of consulting rooms may also double as
a sub-waiting area.
F. Minor Operating Room
A surgical treatment room finished like the minor operating room of the surgical department is
usually examining table, lavatory with knee or foot control and gooseneck spout for scrubbing,
small sterilizer, spotlight, chair, stool, footstool and a small instrument or work table.
G. Janitor’s Room – a standard utility room.
H. Toilet Facilities
For Patients – should be planned in groups at convenient points. Approximately 1 WC, 1 Lav.
for every 20-30 female patients, and 1 WC, 1 Lav., 1 Ur for every 20-30 male patients.
I. Specialized Rooms
Audiometry Room – a sound insulated room needed for audiometry testing during EENT
clinic.
Electrocardiography Room for cardiological clinic.
Refractoinist Room – sight testing for an ophthalmic clinic which will require a minimum length
of 6.5 meters. And others
4. Fixed Equipment & Mechanical Requirements
A list of fixed equipment and their mechanical requirements shall be necessary for each of the
rooms and spaces. An occupancy plan is helpful for interior design purposes.
5. Communications and Transportation
Consideration for public telephones, intercoms, public paging, piped music, light signal
systems, computers, messenger services, patient-escort, linen and trash delivery and pick-up,
etc.
Public telephones should be available in main waiting areas like the Main Lobby, OPD main
waiting areas and in the concession area.
6. Workload and workflow
TRAFIC FLOW

7. Staffing
Adequate number of professional and non-professional and non-professional staff on a per shift
basis should be considered.
E. Architectural Considerations
1. Accessibility
 An approach road with a wide pedestrian path should lead to the main entrance of the
department.
 Accessibility for patients arriving from the parking area is of paramount importance. Provision of
a canopy to shelter patients in case of rain, a wheelchair ramp and parking for the disabled near the
entrance to OPD. Comply with the requirements of B.P 344 Accessibility Law.
 Provide enough parking areas for patients and staff parking areas for disabled.
 Segregation of entrance to OPD from Ambulatory Emergency Entrance and main entrance to
the whole hospital.
 The C-E rooms preferably should be located away from the noise of cars.
 It is desirable for the OPD to be planned on one floor at ground level, as patients may have
difficulty in climbing stairs and some may require the use of trolleys and wheelchairs and easier to
MAIN HOSPITAL ENTRANCE
NEW PATIENT
MAIN LOBBY –
INFORMARION DESK
OUT-PATIENT DEPARTMENT LOBBY
(TRIAGE)
OPD WAITING AREA
CONSULTATION EXAMINATION ROOMS
ROUTINE INVESTIGATION, BP, WEIGHT
TREATMENT ROOM
OTHER DEPARTMENT
RADIOLOGY, LABORATORY, & SOCIAL SERVICE
OUT PATIENT DEPARTMENT WAITING AREA
NEW APPOINTMENT
PHARMACY
RETURNING PATIENT

enlarge the department if the building is of single story construction. But it may necessary in some
circumstances to have more than one story with elevators.
 Consider maintenance and security.
2. Movement System
 A careful study and analysis must be made as to origin and destination of each of the three basic
movement categories: people; materials; and communication
a. PEOPLE
 Patients – New Patients; Returning Patients.
 Professional Staff – Physicians; Nurses; Paramedical;
 Non- Professional Staff – Volunteers; Aides; Messengers; Maintenance;
Security
 Visitors
b. MATERIALS
 Supplies For Patient Care
o Medical and Surgical
o Medical Records
o Radioactive Materials
o Linen
o Portable Equipment
 Support Supplies and Services
o Dietary
o Collection and Disposal medical and radioactive waves
o Removal of medical supplies and equipment
c. COMMUNICATIONS
Basically communication occurs between individuals with immediate response or it may be
recorded and transferred with a short time lag, or it may be deposited for future use and reference.
The modes of communication are electronic, physical transfer of paper forms and others, face to
face interaction between individuals and used in hospitals are the telephones, intercom,

3. Methods of Running Clinics
PLAN: RUNNING CLINIC)

Interdepartmental Relationships
4. Efficiency and Cost-effectiveness
The layout of the clinic should promote staff efficiency by minimizing the distance of
necessary travel between frequently used spaces.
INSERT PLAN HEALTH CENTER
STORAGE
KITCHEN
STAFF DINING
LAB.
OUT PATIENT DEPT.
PHYSICAL
THERAPY
PHARMACY
E. R.
STAFF
FOOD
SERVICE
PATIENT
MEDICAL
IMAGING
TRAFFIC FLOW

5. Flexibility and Expandability
As medical needs, modes of treatment, and workload will continue to change, outpatient facilities
should:
 Follow modular concepts of space planning and layout.
 Use established standard room size and plans as possible, rather than tight and highly
specific one
6. Cleanliness and Sanitation
Both sanitation and the appearance of it are important goals for outpatient facilities. They are
promoted by:
 Appropriate, durable finishes for each functional space.
 Antimicrobial surface might be considered for appropriate locations.
 Proper detailing of such features as doorframes, casework, and finish transitions to avoid dirt-
catching and hard-to-clean crevices and joint.
 Adequate and appropriately located housekeeping spaces.
7. Easy Visibility
To encourage its use, the facilities should be:
 Easy to find, clearly visible from the approach road, with good directional signage from nearby
major roads.
 Easy to recognize, with a welcoming image and clear, appropriate located directional signage.
 Easy to enter, with visible, well-identified entrance, and a clear route from parking.
8. Therapeutic Environment
Although the needs of outpatients are less intense than those of hospital Inpatients, an individual’s visit
still be very stressful. Every effort should be made to make the outpatient visit as unthreatening and
comfortable as possible, and to make the patient’s experience move like going to a doctor’s office than
to a hospital. This can be accomplished by:
 Using familiar and non-institutional materials with cheerful and varied colors and textures.
(Pastel & bright colors)
 Opening up an inwardly directed environment with views of landscaped courtyards and other
outdoor spaces, particularly from waiting spaces, taking into consideration, temperature, air and
noise control.
 Admitting ample natural lighting and natural ventilation wherever feasible, considering
orientation based on sun path and wind flow and using color corrected lighting in the interiors
which closely approximates natural daylight.
 Promoting patient dignity and privacy by visual screening within exam rooms and sound
insulation between exam and consultation rooms and other offices.
 Providing quiet areas for meditation/ spiritual renewal, such as, in larger facilities, quite rooms
and meditation garden.
 Ensuring grades are flat enough to allow easy movement and sidewalks and corridors are wide
enough for two wheel chair to pass easily.

 Ensuring entrance are designed to accommodate patient with slower adaptation rates to dark
and light marking glass walls and doors to make their presence obvious.
9. Aesthetics
Aesthetics is closely related to creating a therapeutic environment (homelike, attractive). Also,
aesthetics is important to the clinic’s public image and is thus an important marketing tool, both for
patients and staff. Aesthetics considerations include:
 Increased use of natural light, natural materials, and textures.
 Use of artworks.
 Attention to detail, proportion, color and scale.
 Bright, open, generously scaled in public areas.
 Homelike and intimate scale in patient rooms and offices.
 Signage that promotes optimal way-finding, satisfies the orientation needs of the first-time
patient, allows easy navigation, and provides highly visible reference points immediately
adjacent to each major entrance.
 Use mechanical door openers to assist entry and exit.
10. Security and Safety
In addition to general safety concerns of all buildings, clinics have several concerns:
 Protection of clinic property and assets, including drugs.
 Protection of patients, including incapacitated patients and staff.
 Violent or unstable patients need to be controlled safely.
 Large, prominent, publicly-owned clinics may be potential Terrorism targets.
End of Module 8

ADMISSION-DISCHARGE
ADMINISTRATION DEPARTMENT
Category: Semi-Private.
ROOMS / SPACES DESIGN NOTES Sq. Mtrs.
ADMISSION Admission of In-patient on doctors order thru
emergency
Public Waiting Area 0.65
Interview Area 5.02
Staff Work Area 5.02
Head’s Office 5.02
PHILHEALTH Government Health Insurance 5.02/ person
Records Room 0.65
Staff Work Area 5.02
Special Service Office 5.02
SUPPORT FACILITIES
Staff’s Toilet 1.67
Public Toilet 1.67
Disabled Toilet 1.67
BILLING Computation and processing of statement of account

or billing
Public Waiting Area 0.65
Staff Working Area 5.02
CASHIER Payment point of hospital Bill
Cashier’s Cage 5.02/ staff
Vault
Staff Working Area 5.02
Finance Officer’s Office
SUPPORT FACILITIES
Staff Toilet 1.67
Public Toilet 1.67
Parking Area for Transport Vehicle 9.29
Supply Room 5.02/ staff
(Not yet finished)

End of Module 8C
Ward
E. R.
E. R.
O. R.
O. P. D.
Admin.
SERVICE

Module 9
Second Zone
ANCILLARIES, DIAGNOSTIC/ THERAPUTIC DEPARTMENT
IMAGING CENTER
IMAGING MODALITIES
Level 1 (Gen. Hospital) Radiology Fluoroscopy (R/F) Diagnostic
Ultra Sound Diagnostic
Computer Tomography (CT Scan) Diagnostic
Level 2 Mammography Diagnostic
Nuclear Medicine Diagnostic
Magnetic Resonance Imaging (MRI) Diagnostic
Positron Emission Tomography (PET) Diagnostic
Level 3 Extra Corporeal Sound Wave Lithotripsy
(ECSWL)
Therapeutic
Radiation Oncology Therapeutic
Gamma Knife Therapeutic
REQUIREMENT FOR DESIGN
The most important factor in describing Laboratory in for the designer fully understand what
goes on in it.
FUNCTION:
Who are the Users of the Laboratory?
(General practitioners, the hospital other hospital, Health Centers.
What are the services to be provided?
Ward
Imaging
O. P. D.
O. R.
E. R.
IMAGING – receives work load from:
Outer Zone – OPD, ER;
Inner Zone – Wards;
Deep Zone – O. R.
Therefore, IMAGING should be:
close to OPD;
Adjacent or close to E. R.;
Within easy access of Wards

OPERATIONAL PROCEDURES:
 Sequential procedure/ Operational steps per activity.
 Where/ in what spaces would these activities occur?
 (Output would be useful in coming up with proper space provision in organizing in their
proper relationship)
EQUIPMENT LISTING:
List of
RADIOLOGY
RECEPTION/ PUBLIC AREA SQ. MT. SUPPORT AREA
WAITING AREA 0.65/ person
PUBLIC TOILET 1.67 DARK ROOM 4.00
FILM EVALUATION
STAFF AREA (PRIVATE) REPORTING
HEAD OFFICE 5.02/ staff SECRETARIAT
GENERAL OFFICE AREA 5.02/ staff RECORD SECTION 21.00
CONFERENCE ROOM 15.75 RECORD RELEASE COUNTER
STAFF LOUNGE with PANTRY CLEAN UTILITY
STAFF TOILET 1.67 DIRTY UTILITY
LOCKER JANITOR’s CLOSET
LINEN STORAGE
PATIENT’S/PROCEDURE AREA MOBILE X-RAY STORAGE
CHANGING ROOM (1.20 x 1.20) 1.44 GENERAL STORAGE
CONTRAST MEDIA
PREPARATION RM. (2.40 x 3.0 M)
7.20
TOILET (BARIUM ANEMIA
PATIENTS)
1.67

RADIOLOGY RM. (4.50 x 5.50) 24.75
FLUROSCOPY RM. (4.50 x 5.50 ) 24.75
RADIOLOGY/ FLUROSCOPY RM. 30.00
The Radio- Fluoroscopic Technique

ULTRA SOUND
SPACE REQUIREMENTS
RECEPTION/ PUBLIC AREA SQ. MT. PATIENT’ AREA(PROCEDURE
(AREA)
RECEPTION AREA C T SCANNER Room (5 x 9 m) 45.00
OUT PATIENT WAITING AREA 0.65/ person CONTROL ROOM
IN PATIENT WAITING AREA 0.65/ person PHYSICIIAN VIEWING CONSOLE 1.60
PUBLIC TOILET 1.67 COMPUTER ROOM 5.08
EQUIPMENT ROOM.
STAFF AREA (PRIVATE)
HEAD OFFICE 5.02/ staff SUPPORT AREA
CONFERENCE/ LIBRARY DARK ROOM
STAFF LOUNGE with PANTRY FILM VIEWING AREA
STAFF TOILET LASER PRINTER HARDCOPY RM.
LOCKER 1.67 LINEN
GENERAL STORAGE
MRI –Magnetic Resonance Imaging. Radio wave equipment and proton in the body intersect
in the presence at a strong magnetic field.
CT SCAN
A. PUBLIC AREA/ RECEPTION AREA PROCEDURE AREA Sq. m.
RECEPTION COUNTER CT SCAN ROOM (5.0 x 9.0m) 45.0
WAITING AREA CONTROL ROOM 12.00
PUBLIC TOILET PHYSICIAN’S VIEWING
CONSOLE
FILM FILES EQUIPMENT ROOM 6.00
OFFICE
SUPPORT AREA
PATIENTS AREA DARKROOM 4.40
PATIENTS CHANGE 1.50 FILM VIEWING ROOM
PATIENT’S TOILET LASER PRINTER/ HARDCOPY
ROOM
ON DECK PATIENT WAITING LINEN
GENERAL STORAGE

STAFF AREA
HEAD OFFICE
STAFF WORK AREA
5 Radiology - Fluoroscopy 28.80
CONFERENCE & LIBRARY
6 Radiology Room 24.00
STAFF LOUNGE with PANTRY
TOILET & LOUNGE

PLANNING CONCEPTS and PRINCIPLES
Emergency from OPD, Doctor’s Office & FROM WARDS
Other referrals
PROCEDURE ROOMS
Radiology, Ultrasound, CTScan rooms
SUB-WAITING & CHANGING
Patients’ Ancillary Accommodation
MAIN WAITING & RECEPTION

FLOW CHART FOR PROCEDURE with FILM
TYPES OF LAYOUT
ONE ON ONE
LINEAL PLAN
CLUSTER PLAN
INSERT PLAN
DARK ROOM
FILM EXPOSED
INTERPRETATION
Routine reporting film &
reports are dispatched to
OPD or doctor.
FILM SORTING &
VIEWING
Some immediate helping
done communicated
directly to the patient.
FILM EXPOSED
FILM REPORT,
RECORD STORE
FILM REPORT,
RECORD STORE
Study report & file then
refer from to record store.
DARKROOM
PROCEDURE
STORAGE
PROCEDURE
PROCEDURE
DARK
ROOM
DARK
ROOM

SANDWICH PLAN
INSERT PLAN
SAMPLE PLANS
SHIELDING REQUIREMENTS:
INSERT DETAIL SECTION LEAD STRIP
CURENT TRENDS:
COMPUTERIZED and DIGITALIZED
PACS – Picture Archives Communication System
Use of Imaging for both diagnostics and Therapeutic procedures.
Human centered patient design.
New Feature, use of Colors,
Use of Environment (Green Architecture)

LABORATORY
SITE LAYOUT
DIRECT ACCESS TO AND FROM E.R., O.P.D,, Wards, and MORGUE.
REQUIREMENT FOR DESIGN
THE MOST IMPORTANT FACTOR IN DESIGNING A LABORATORY IS FOR THE DESIGNER TO
FULLY UNDERSTAND WHAT GOES ON IN IT.
FUNCTION
 Who are the users of the Laboratory.
(General Practitioners, the hospital, other hospital, health centers)
 What are the services to be provided.
OPERATIONAL PROCEDURES
 Sequential procedure/ operational steps per activity
 Where/ in what spaces would these activities occur (outputs would be useful in coming up with
proper space provision in preparing the spaces in their proper relationship)
EQUIPMENT LISTINGS:
 List of all equipment for determining engineering provision. Utility connections, electrical power,
plumbing/ sewer, drainage, water supply, communication,
DEVELOPMENT OF REQUIREMENTS
1. List procedures to be performed.
2. Analyze space in terms of Equipment and personnel in 3 areas:
a. Administrative; b) Technical; c) Support
3. Review size and specifications major prices of equipment
a. Determine required countertop work area.
b. Determine special plumbing, electrical and temperature requirements.
4. Determine procedure that may be combined in same Work Area.
5. Divide technical area by functional units.
a. Morbid Anatomy
b. Hematology
c. Chemical Pathology
d. Microbiology
6. Obtain number of Work standing method from client.
Ward
LABORATORY
LABORATORY
O. P. D.
O. R.
E. R.
MORGUE

7. Review desirable functional advances.
8. Allow for future expansion.
9. Review utility requirements for all equipments.
a. Electrical outlets
b. Water source
c. Drainage d. mechanical requirements
10. Electrical outlet, Water source, drainage, mechanical equipments
11. Allot Storage for Supplies.
12. Storage of supplies in daily basis, storage for bulk purchase.
13. Consider Environmental Factors: ventilation, light, insulation for noise, or heat producing
equipments.
LABORATORY SERVICES (MEDICAL TECHNOLOGIST)
MORBID ANATOMY – study of the direction of the deceased human body.
HISTOPATHOLOGY – study of the microscopic structure of diseased tissue.
CYSTOLOGY – study of individual cells from the surface of an organ to arrive at a diagnosis.
HEMATOLOGY – medical specialty concerned with the study of blood and blood-forming tissues. They
study, diagnose, and treat blood disorders such as leukemia, anemia, and hemophilia, as well as
diseases of the organs that produce blood, including the lymph nodes, bone marrow, and spleen.
CHEMICAL PATHOLOGY – study of the chemistry of the living tissue and fluids of the body. i.e.
phlegm, urine, stool, blood.
MICROBIOLOGY – study of the nature, life and actions of microorganism.
LABORATORY ACTIVITIES
MORBID ANATOMY
 HISTOPATHOLOGY – specimen received in jar of formalin. If not prepare are dissected, block in
paraffin wax. Out in section, transferred to slide, examine under a microscope.
 CYSTOLOGY – specimen received mounted, if not prepared are mounted, stained, examined
under microscope.
 HAEMATOLOGY –
o GENERAL HEMATOLOGY – hemoglobin estimation, particle counting, conjuration, etc.
o BLOOD TRANFUSION – compatibility test, grouping and cross matching.
 CHEMICAL PATHOLOGY –
o NON- MECHANIZED SECTION – non-mechanized test in bio-chemistry both routine and
special.
o MECHANIZED SECTION – mechanized test, mostly using mechanized equipments.
 MICROBIOLOGY –
o CLINICAL MICROBIOLOGY – specimen on side preparation, examined on microscope.
Inspection of serology test, bacteriology, spots, urine, virology works.

MORBID ANATOMY SPACE REQUIREMENTS
SPACE ACTIVITIES DESIGN NOTES
HISTOPATOLOGY
Specimen cutting & processing Dissection of specimen, note taking,
automatic processing of specimen in
machines, block molding, processing
and trimming, preparation of museum
specimen.
Partition off, mechanically
ventilated due to formalin
vapor.
Formalin Storage Tissue Specimens stored in formalin &
placed in a glass jar.
Partition off, mechanically
ventilated due to formalin
vapor.
Sections, cutting and Staining Cutting of Specimens, routine of
special staining of specimens.
S pace for Microscope,
water baths, hot plates,
stain-proof work table.
Frozen Sections & Special
Techniques
Freezing & cutting of specimen of
urgent specimen from OR.
Space for cryostat or
freezing of microtome,
Stain-proof work surfaces.
Office Waiting for notes and reports
CYSTOLOGY
Reception & Staining Reception/ Recording of specimens,
preparation & preparation of slides
Stain-proof work surfaces
Microscopy Examination of Slides under
Microscope
Anthropometric Design
Office Waiting for notes and reports
HAEMATOLOGY SPACE REQUIREMENTS
GENERAL HEMATOLOGY
Reception, Recording &
Preparation of Specimen
Special and General Test Special Test, routine Hemoglobin
estimation & particle counting,
preparation of slides; examination
Stain-proof surface, quiet
and undisturbed
environment.

under Microscope.
Microbiological Assays Special technique, usually test are by
batched
Coagulation Checks abnormal condition by
comparing specimens against normal.
Electrophoresis Special test
MECHANISIZED SECTION
BLOOD TRANSFUSION Blood grouping, cross marking
Serology test; preparation of packed
red code.
Partition off to avoid
disturbance and risk of
errors; space for
refrigerated cartridge and
positive pressure hood.
GENERAL OFFICE Office work, writing of notes and
reports for medical and academic stuff.
Space should allow for 3
working at the same time.

CHEMICAL PATHOLOGY
GENERAL BIOCHEMISTRY
Reception, Recording,
Preparation of Specimen
Use of automatic shakers and
centrifuges for test.
Soundproof due to noise level of
machines.
Specimen General Test Preparation of facial emulsions,
chromatography works; flame
photometry.
Space for apparatus, special
fluids, combined for facial
preparations, stop hopper for
disposal of urine, fume hood
and fume extract.
Trace and Elements &
Toxicology
Presence of toxic, etc. Fume cupboard
Steroid Steroid Work Special room due to smelly and
inflammable solvents.
MECHANICAL SECTION Mechanical Biochemical
Techniques
Shelves or workshop for
mechanize equipment, adequate
electrical outlets, continuous
flushing of corrosive effluents.
GENERAL OFFICE Office works, filing of notes and
reports for medical and scientific
staff.
Space should allow for it working
at the same time
MICROBIOLOGY
CLINICAL MICROBIOLOGY
General Bacteriology Examination of cultures Space for equipment and
apparatus, such as centrifuge,
microscope, water bathe, local
adjustable lighting for culture
examination.
Media Preparation & Plate
pouring.
Preparation of bulk media, pouring of
plates
Level laboratory tope, draft
free conditions, close to central
wash-up and sterilizing room.
Serology Examination to discover presence of
antibodies in serums.
.Space for water bathes,
incubators, table centrifuge,

mechanical shaker; space for
report writing.
TB Bacteriology Preparation and incubation of
cultures, examination.
Separate room or use of hood
to control infection
VIROLOGY Identification of Viruses, heating of
cultures materials
Use of Hoods
GENERAL OFFICE Office work, writing of notes and
reports for medical and scientific
staff.
CLASSIFICATION OF EQUIPMENTS
Group 1 – require engineering terminal outlets, supplied and fixed within the building
construction contract.
Group 2 – do not require engineering terminal outlet but must be considered in design
due to their size such as huge, portable, rolling equipment.
Group 3 – are small and hand held and have storage implication.
Equipment Specialist – Centrifuge, Hematology, Blood drew chair, Bench top
Chemistry Analyzer, Chemistry Analyzer.
TABLE OF ENGINEEING TERMINALS
LOCATION EQUIPMENT ELEC. SANI. MECH. OTHERS
CLINICAL
CHEMISTRY
Spectrophotometer 115V, 50/60Hz,
140VA
General
Transformer
Oven dry Heat
Electric Stove
120V, 1100W, 10A do
Flame, Photometer,
or Compressor
220V, 50/60Hz,
0.1A.
Gas Line do
Precision Water
Bath
120V, 500W,
50/60Hz, 4.7 A
do
Dymo Centrifuge 120v, 60 Hz, 2.6 A UPS, Gen.
Transformer
Chemical Chemistry
Auto-Analizer
230V, 5A General
Transformer
5 cu.ft. Refrigirator

FLEXIBILITY OF SPACE
Laboratory is a money earner; fast growing Department design must be flexible so that spaces can be
easily converted with a minimum of disturbance.
SPACES HAVE HIERARCHIES:
A. PRIMARY SPACES – occupied by professional and technical staff, this is where laboratory
functions are undertaken in LSU’s (Laboratory Space Units)
B. SECONDARY SPACES – supportive activities such as storage, administrative.
C. CIRCULATION SPACES – for movement of goods and personnel.
D. Flexibility means that it should be easy to convert secondary spaces to primary spaces in
necessary.
TYPES OF FLOOR PLANS
DUAL CORRIDOR PLAN
Laboratories along peripheral wall areas; Support facilities at center core, with corridor between primary
& secondary space.(Primary, corridor secondary corridor Primary),Advantage: direct ventilation and
lighting for staff. Disadvantage: access to support facilities is across corridor.
SINGLE CORRIDOR PLAN
Central corridor, support facilities arranged immediately adjacent they serve.
Advantage: support facilities accessible.
THE LSU (Laboratory Space Unit)
The LSU is a basic unit planning, a module;
 Lends itself to open planning.
 Designed for basic group of technicians and equipment.
 Can be multiplied and rearrange in BENCH PLANNING.
KEY DIMENSION
The LSU designed with proper dimensions considering: limits of human reach; Clearance between
benches (1.50m); General traffic inside modules.
SERVICE SPINE FOR LSU
The LSU is a work bench for a work team provided with the following service contained in a SERVICE
SPINE. Such as: Cold and hot water line; Gas Line; Compressed air line; Electrical power source;
Adjustable connection; other service/ utilities.
FLEXIBILITY OF SPACES
The LSU can be multiplied and rearrange in Bench Planning.
SERVICE SPINE
SERVICE PENDANT
SERVICE BOLLARD
SUMMARY OF DESIGN CONSIDERATIONS
1. SITE or LOCATION

2. FLEXIBILITY OF SPACES
3. PROVISION FOR SERVICES
4. PROVISION FOR STORAGE SPACE
5. GOOD VENTI LATION
6. SERVICES PLANNED FOR MAINTENANCE
A COMPACT LAB LAYOUT
Sample Plan required
SAMPLE PLAN

PHARMACY
SERVICES
IN PATIENT SERVICE
OUT-PATIENT SERVICE
INFORMATION EDUCATION COMMUNICATION SERVICE
Health Promotion
Counseling
Advisories – available drugs and cost, alternative Medicine
CUSTODY OF DRUGS/ PHARMACEUTICAL PRODUCTS.
GENERAL CONSIDERATION FOR DESIGN
 LOCATION
 SIZE
 SECURITY
 SAFETY OF HIGHLY FLAMABLE LIQUIDS
 MATERIALS AND MAINTENANCE
 DESIGN FEATURES
LOCATION
Location of Pharmacy should be adjacent or near to ER, OPD, and accessible to Ward (Nursing Units)
SIZE
DETERMINED BY ORGANIZATION EXTENT OF SERVICES.
Manufacture of preparation? No
Dispensing of prescriptions for in and out-patients? Yes
Supply of drugs to wards and department? Y
Custody of drugs Y
Information services? Y
Training? Y
Example: If supply of drugs only, spaces required would be:
Storage for drugs
Dispensing of drugs
Receiving of drugs
Ward
Pharmacy
O. P. D.
E. R.

SECURITY
Security of dangerous drugs, poisons, and drugs liable to misuse
SAFETY OF HIGH FLAMMABLE LIQUIDS
Security locks, no illicit entry
Protection of persons handling
Manner of storage
Markings of storage spaces and vessels
Fire and explosion precautions
Amount for storage
MATERIALS and MAINTENANCE
FLOOR – of impervious surface
WALL – washable (Tiles)
Countertops, work surfaces – Stainless Steel
SOME DESIGN FEATURES
DOORS – wide enough for trolley/ carts to enter. (1.20m Double leaf)
DOOR – with Glass Panel for visibility from the outside.
Space provision for boxes and empties.
SPACE REQUIREMENTS
PUBLIC AREAS Sq. m. Remarks
Reception
General Waiting 5.12 per person
Dispensing Counter & Drug Information area 18.00 Provide counter w/ computer, pharmacy.
Refrigerators for storage
Replacement Counter 6.00
Gondola Area
Public Toilet
STAFF AREA
Cashier
Chief Pharmacist Office 12.00 Narcotic drugs Cabinet
Conference & Library for Level 3
Staff Work area 6.00 Locker
General Office for Level 3

Staff Lounge with Pantry
Staff Toilet and Locker 3.75
WORK AREA
General Work Area
Compounding
Laminar Flow Room
Research
Dangerous Drug Store
PHARMACEUTICALS AREA
Delivery/ Unpack
Containers
Issue Counter
General Pharmacy Storage
Refrigerator Bay
Fluids
Bulk Storage 24.00
Receiving/ Breakout/ inspection 6.00
SAMPLE COMPACT PLAN
Level 1

1.20- 1.50m Wide Countertop work space for compounding.
o.60 – 0.90m Countertop for typing and labeling.
Space required for computer printer and Fax machine.
Full-size Refrigerator.
Built-in cabinet with double sink
Adjustable Open shelving 8 to 10” deep..

ROOM DATA SHEET (1)
Functional Design Requirements
ACTIVITY FLOW
PEOPLE INVOLVED
PLANNING RELATIONSHIP
EQUIPMENT AND ACCESSORY CHECKLIST
FURNITURE AND FUTURE CHECKLIST
ADDITIONAL EQUIPMENT & ENGINEERING TERMINALS
ROOM DATA SHEET (2)
Technical Design Data
DESIGN DATA FOR ENVIRONMENTAL CONDITIONS
AIR
Outdoor air temperature (deg. C)
Room temperature (deg. C)
Mechanical Ventilation
Volume (cu. m./hr-person)
Velocity (m./ hr.)
Pressure
Exhaust (psi)
Inlet (psi)
% dust filtration
Humidity (% RH)
Cooling Load (TR)
SOUND
Acceptable sound level (db)
Speech Privacy
Intolerable quality of sound
LIGHTING AND VISUAL
General illumination (lux )
Night illumination (lux)
Task illumination (lux)
Color rendering
Standby light
Emergency light
Daylight
View out
Privacy
Black out
SAFETY
Acceptable hot surface
Maximum temperature (deg. C)
Domestic hot water
Maximum temperature (deg. C)
Access limit
Fire risk
Other risk
End of Module 9
DETAILED LAYOUT OF ROOM SHOWING
EQUIPMENT, FURNITURE AND FIXTURES;
LOCATION OF UTILITIES OUTLET, ETC.

Module 10
INNER ZONE
NURSING UNITS
 IMPORTANCE OF THE NURSING DEPARTMENTS
The Inpatient area is the distinguishing characteristic of a hospital as district from other
types of health facilities.
With the exception of the Outpatient Departments, each major hospital operational
function relates to the Nursing Department.
It is generally the largest single component of a hospital, although the proportion of space
they occupy and the area allocated to each bed varies between countries.
 FUNCTIONAL CONSIDERATIONS
Prime Function: To provide accommodation for patients at the point in an illness when
dependence on other is at its highest. (to be seen by trained personnel. i.e. doctor, nurses)
Three (3) broad functions are to be observed in all inpatient units:
1. Normal Body activities. (eating, sleeping, toilet activities) for which the inpatient Unit
serves as a substitute for the home;
2. Treatment: including examination, drug preparation.
3. Preparing the patient to return to domestic life, including rehabilitation and retaining.
VARIETY OF ACCOMODATION NEEDED (Different type of need)
According to Medical Need
1. Communicable diseases (Tuberculosis, Leprosy)
2. Units for recognized special categories (i.e. Pediatrics, Psychiatry, Obstetrics)
3. Units where specialist and missing treatment may be called for (burns, internal organ
transplants)
According Nursing Care
1. GENERAL CARE – common for those who require basic nursing attendance.
2. INTENSIVE CARE – constant intense nursing.
3. PSYCHIATRIC CARE – rendered to patients with disturbed mental equilibrium.
4. REHABILATIVE CARE – rendered to assist psychological adjustment, vocational evaluation,
retraining and to provide physical therapy to crippling disease or injury.
5. EXTENSIVE CARE – rendered to patients requiring prolonged convalescent and restorative
services.
6. SELF CARE – rendered to residents within the hospital who attend themselves are ambulatory,
and require only occasional scheduled contact with the clinical adjunct hospital facilities.
According to Sex and Class
Expensive pay, Charity

 SIZE OF NURSING UNITS
The size of the Nursing Units (number of beds) depends on the most effective deployment of
available staff and helpers. In some countries, skilled nursing staff is scarce. In such cases it is
probable that much reliance must be placed on semi-skilled labor and the patients’ own families.
The size and layout of the inpatient areas should therefore take into account the need for
supervision of helpers by scarce fully trained staff. Acknowledging this wide variety of nursing skills,
nursing skills, nursing units nursing units normally consist of 20-30 beds each, the lower number
suitable for nursing where only one trained nurse is available.
Below 20 beds, the units is limited in flexibility it can offer and is inefficient units use of skilled staff.
Above 30 beds, it is unlikely that a single nursing team could cope with demands of all the patients.
In general, the size of the Nursing Units is affected by the following factors:
 The condition of the patient.
 The number of patients that can be effectively cared for by the nursing teams.
 The presence of family members who can assist in the care of patients.
The consideration of these factors usually results in a unit size of approximately 25 beds. Usually,
there will be 1-, 2-, and 4- bed accommodations in each nursing unit in order to facilitate nursing
service. This makes for the flexibility necessary to group patients on a basis of their medical or
surgical conditions.
In allotting beds, unless there is a definite local reason for not doing so, the customary relationship
is about 1/3 in 1- bed rooms, 1/3 in 2-bed room, 1/3 in 4 bed rooms. A number of one-bed rooms
should be designed to permit accommodation of two bed in emergencies.
 DISTRIBUTION OF PATIENTS IN A GENERAL HOSPITALS
The determination of the expected distribution of patients will require a special study in each individual
instance. Normal expected distribution might be seriously affected by the presence in the community of
a specialty hospital, such as specialties on the staff of the proposed hospital or of other hospital in the
area.
Studies have shown that the normal distribution of patients in General Hospital might expected to be:
Surgical 45 – 50%
Medical 20 – 25%
Obstetrics 12 – 25%
Pediatrics (excluding newborn) 10%
Miscellaneous (including Eye, Ear, Nose & Throat) 9 – 15%
Note: bassinets for newborns are not included in the counts.
PATIENTS ROOM
Within nursing units, accommodations vary from one large room containing all beds in a unit, to the
opposite extreme, where each patients who need it, combined with ease of observation of the largest
number by nursing staff.
A combination of single and multi-bed rooms can afford privacy to individual patients who need it,
combined.
The larger the number of single rooms, the more expensive the unit will be. A room for one patient
cannot be planned adequately in less than 6.5 sq. m. exclusive of all service rooms and corridors,
whereas an open ward can reasonably be planned with as little as 6 – 8 sq. m. per bed inclusive of
circulation and ancillary rooms.
A ward with large number of single rooms will also be more expensive to run.

 WARD DESIGNS
The history of ward design is one of change from large open wards with beds, head to the windows,
arranged along both long walls, to a ward consisting of smaller groups of beds in rooms.
For a long time, wards known as the “nightingale ward” in many countries were universal. That
type of ward was followed by a modification in which beds are placed parallel with the windows. At
first, these beds were in open bay on either side of a central corridor, called “rig ward”, an in later
hospitals, the bays were often endorsed so that they became rooms.
There are many versions of the basic idea which combines 4-, 5- and 6- bed rooms with single
bedrooms in varying proportions. In some countries, notably the US, the supposed demand for
privacy has led in some cases to the provision of all beds in single rooms.
It is important that the choice of ward for hospitals in developing countries is made after full
consideration of the implications in terms of:
STAFFING;
Cost of Construction;
Cost of Maintenance;
Climate;
Patient Expectation (Amenities- and Economic-wise or affordability)
The change from open wards to small rooms has incurred losses as well as gains, notably in the
loss of direct supervision of patients by staff, and more importantly, in the inability of patients to see
staff in the wards.
 MULTI-BED WARDS
The plan was directed to:
-separate men from women patients.
- Segregate patient by nature of their illness
- Create a manageable unit, called “ward”
ADVANTAGE
 Cheapest to construct.
 Easiest to supervise.
 Easy and direct access to each bed.
DISADVANTAGES
 Inflexible as to sex differentiation & medical needs.
 High noise level.
 Risk of glare from opposite windows.
 Longer distance from beds to service rooms.
SAMPLE PLAN: (NIGTHINGGALE LAYOUT)
PLAN SAMPLE

 PRIVATE ROOMS (SINGLE BED)
ADVANTAGE
 Greatest flexibility (to medical needs,
privacy social needs, sex differentiation.
 Quiet environment.
DISADVANTAGES
 Most expensive to built.
 Most experience to run. (need greater number of staff)
SEMI-PRIVATE ROOMS
Disadvantage:
Sometimes the least private.
Sometimes the most noisy.

5 –BED ROOMS
ADVANTAGE
 Flexibility to medical needs privacy social
needs, Sex, differensation.
 Greatest compactness.
 Better lighting environment.
 Measure of privacy.
 Greater quiet
 Less busy appearance
 Beds are in open for cross ventilation
and the seriously ill or terminal patients
are grouped closer to the Nurse Station.
DISADVANTAGES
 Need deeper building space.
 Not the cheapest to built.
 Separate bed compartments are less easy to clean.

PLANNING CONSIDERATIONS
1. PROGRESSIVE PATIENT CARE IN WARDS
Depending upon nursing, medical and social needs, patients can be grouped according to
specially and/or their nursing dependency, and each nursing section has the requisite provision to
care for patients in high and intermediate dependency categories, those on high dependency
being allocated to a bed close to the staff base.
2. PRIVACY vs. SUPPORT
Privacy is usually rated very highly by many patients and some are prepared to pay for it in terms
of accommodation in single rooms. However proper provision must nevertheless be made for the
nursing supervision, either through glazed/ screen windows in doors or wide openings in the
Philippines support is mainly given by a family member called the “Bantay”.
For those who cannot afford it, the placing of beds in open bays provides a good solution to
effective nursing care.
Cross ventilation also is easily obtained through open bays. Except in the case of grossly-
infectious conditions, it has not been established that the planning of beds in open bays has any
measurable effect on cross-infection rates, provided that nursing regimes are carefully designed
and supervised.
In the US, single bed accommodation in enclosed rooms has resulted in the need for electronic
devices to enable a patient to call a nurse, some of which are very complex, providing two-way
communication, and all of which are expensive to install, need experience in the use of electronic
systems to be effective, and require regular and skilled maintenance.
3. WARDS INTERDEPARTMENTAL RELATIONSHIP
4. AMENITIES
Most patients in an inpatients unit will be able to get but out of bed for short periods everyday. This
means that they will have need for toilet accommodation close by, access to a table and chair for their
meals, a refrigerator, a microwave oven, an easy chair, and a sofa for the “Bantay”.
WARDS
Ward
WARDS
Ward Laboratory
Morgue
O. R.
Physical
Therapy
X-Ray
O. P. D. &
E.R.
CSSR
Pharmacy
Bulk
Storage

5. FOOD
In some countries, patients relatives customarily feed them and several relatives may spend much of
the day close to the patient. If this is to be encouraged, it must be recognized during the design of areas
inpatient accommodations.
It is difficult to make arrangements for such habits in a multi-storey building, but shaded verandah for
the use of relatives as an extension of the patients’ rooms are easily provided in a single storey
building.
6. COMMUNICATIONS
There must be easy communication with diagnostic departments and treatment areas for both patients
and staff, and with service departments for staff and materials.
7. ORIENTATION, NOISE
Sunlight is important to produce a pleasant environment, with architectural design methods eliminating
excessive heat gain and glare. It is very important to exclude external noise from bed areas.
Orient the ward align with the sun light and the prevailing wind.
8. THE NEED FOR FLEXIBILITY
The more specialized and inflexible the ward units becomes, the more difficult it is to make full use of it.
It should therefore be designed so that it can, without major structural changes, be altered with respect
to medical specialty, size of nursing unit and degree of nursing care.
Patterns of medical need, systems of patient care, methods of reducing infection and many other
factors relating to ward planting are bound to change. It is essential that hospitals be capable of
accommodating these changes. This need cannot be met by the provision of separate ward units which
can only be operated independently and which cannot fluctuate in size.
It is essential that the distribution of ancillary rooms is such that a large floor of beds can be broken
down into fully functional individual beds.
Schedule of Accommodations
Nursing Facilities Space Accommodation
One Bedroom Furnished with laboratory, toilet and bath, side table, locker. When
possible it should be of such size to two bed in emergencies.
Two Bedroom Similar to one bedroom but provided with cubicle curtain for privacy when
needed.
Four to Six Bedroom Similar to above. Furnished with common toilet and bath facilities.
Isolation Unit One-bed room designed for use by known infection or communicable
disease patients under observation that will require separate utility room
facilities equipped with sink and utensil sterilizer. Advisable located at and
of corridor or off a sub corridor.

NURSE STATION
MAIN FUNCTION
 Nursing administration and clerical control point for the ward units
 Storage area for patients’ records issuing and receiving point for all written and much verbal
information concerning nursing and medical care of the patient.
 Information point.
 Visual control point for high dependency patient activity zone in an open defined space.
 Co-ordination point for a ward communication system
 Storage area for medicines.
 Staff base will be in use day and night.
Physical Requirements
Should be open to the corridor, preferably in the center of nursing unit where visitor entry can be
controlled.
Insert Nurse Station Plan Detail
Equipped with nurses’ call annunciator, medicine cabinet with separate locked section, small instrument
sterilizer, an acid- resistant sink below the medicine cabinet with knee or elbow control, clock, bulletin
board, toilet, intercom.
Treatment Room
Provided with one treatment bed, closet and table to hold large medicine basin.

Clean Utility Room
MAIN FUNCTIONS
Serves as the holding point and preparation area for all clean and sterile materials used in the treatment
of patients within the department it serves.
Stores the following materials: CSSD procedure packs; sterile syringes and needles; sterile disposal
items commercially produced; clean items; sterile fluids; external lotions; disinfectants.
Clean Utility
 Centrally located in nursing units.
 Requires ample cabinet and counter spaces, instrument and utensils sterilizers, utensil cabinet,
clinical sink, double compartment laundry tray lifted with drain board and gooseneck hot and
cold water supply with elbow or knee control.

Insert Clean Utility Plan Detail
Dirty Utility Room
MAIN FUNCTIONS
Serves as the
Insert Dirty Utility Plan Detail
Floor Pantry
Toilet, Bedpan and Bathroom
Closet
 Linen closet for one day’s supply
 Stretcher closet to accommodate at least one stretcher and one wheelchair with cupboard
above.
 Janitor’s closet for cleaning equipment, hangers for mops and brooms and shelves for cleaning
materials.
 Provide automatic lighting and adequate ventilation.

BASIC SPACE FOR NURSES
Space Requirements AREA (sq. m.)
Nurse Station 12.00
Treatment Area
Clean Utility 10.50
Dirty Utility 10.50
Floor Pantry
Toilet, Bed Pan & Bathroom
Clean Linen
Soiled Linen Dirty Utility 9.00
Closets
Isolation Room
Corridor
Sample Plans
(Not yet finished)
End of Module 10

Module 11
Deep Zone
OPERATING SUITE
MINIMUM REQUIREMENT FOR SURGERY
ESSENTIAL to carry out operation
1. A place in which to work – minimum (36 sq. m.), no obstruction, easily cleaned.
2. Basic service requirements – water, gases, light (artificial/ natural sun light)
3. Instruments – about 50 pcs.
CONDITIONS for carrying the operation
1. Wound must be healed – aseptic technique.
2. Blood loss must be replaced – intravenous infusion.
3. Incident must be painless.
GENERAL CONDITION FOR DESIGN
1. Condition of Operating and Sterilizing Facilities
a. Economy in the provision of engineering lines.
b. Ease in segregating department from general traffic.
c. Simplification of supply and disposal procedures.
d. Space economy.
2. Location of the department with in the hospital
a. Whole department only One Floor.
b. Higher floor versus lower floor location.
c. Direct and easy communication with surgical ward.
d. Department must be located in a cul de sac with thru traffic.

3. Relationship with other departments.
4. Function within the department which affects design
a. Those that affect layout and facilities
OR independent of general traffic for the rest of the hospital, The Cul de sac principle. Clean
and dirty stream of traffic segregating as much as possible.
Room arrange from entrance to OR on the principle of Asceticism. Direction of air flow must
always be from cleaner to less clean area.
Those that affect in-out of space and facilities.
Staff working with in the department moves from one clean area to another without having to
pass through a dirty /unclean area. Dirty materials from department without passing through a
clean area.
b. Entrance to the department.
Patient, Staff, and other service personnel should have ONLY ONE ENTRY POINT to
discourage unauthorized entry.
If Service entrance/ supplies entrance is provided, prevent from becoming a “back
door” for the department.
Ward
Lab.
O. R.
O. R.
ICU
X-Ray E. R
CSSR
WARD- O.R. function mostly for In-patient transport
routs must be simple.
E. R. - easy route for patient requiring major
operation is important.
X-RAY – Mobile x-ray suitable if necessary
preceding can be design in X-ray Department.
LAB. – specimen must be easy to be sent to the
laboratory staff/ attendant. Laboratory should not be
remote.
ICU – locate near, in fact adjacent with direct access
from Recovery Rm. So that staff & equipment may
serve with.
CSSR - OR and CSST relationship important
especially if no department sterile supply units is
provided; close physical relationship is important.

c. Circulation within the department.
Main traffic flow generated by Patient, Staff & Equipment/ Supplies
Main traffic flow generated by patients, staff, equipment & supplies
d. Transport to the department
 Number of times of transfer of patient must be limited.
 Contamination of the clean zones, when bed from wards is wheeled in must be avoided.
 No built-up infection in transfer zone and recovery areas.
e. Pre Operative Care of Patients
1. In the Philippines, patients pre-medicated in
the ward and anesthesia is given in the operating table.
2. In Britain, patients are brought to an
anesthesia room, where anesthesiologist, administer inside O.R. being cleaned
and prepared in between 2 successive operation.
f. Post-Operation Care.
1. Recovery area located accessible from
outside hospital corridor without passing clean zone, but also accessible form
clean zone to permit access by a surgeon or anesthesiologist.
2. Provide 1- ½ bed per Operating Room.
g. Use of Staff Room.
1. Changing rooms accessible from Outer
corridor.
2. Lounge close to Changing room but
accessible from Clean corridor only.
h. Engineering Service.
Air movement within the air ducts should be from sterile zone to less sterile zone.
Preferred temperature of surgeon: 18-21degrees C or 65-70 °F.
Relative Humidity: 60% is desirable to prevent/ reduce built up of electro-static
changes.
STAFF
CHANGE/
LOUNGE
STAFF
CHANGE/
LOUNGE
PATIENENTRY
STERILE
SUPPLY
O.R. & SURGERY AREA
DIRTY ITEMS
CLEAN
SUPPLIES

Ventilation: provide comfortable environment so that there will less fragile for staff.
There should be no re-circulated air from other part of the hospital.
Provide hot and cold water services.
Provide Suction, Medical Gases services.
Electric Power source: distributed around O. R. wall rather than concentrate.
i. Anti-static/ anti-explosive precaution.
T.S.S.U. – Theater Sterile Supply Unit

GROUPING OF BASIC ACCOMODATIONS:
PATIENTS ENTRY AREA –
Entrance – control point; provide double doors
Reception/ Patient Transfer – from “dirty to clean” area
Pre-Operative Area – provided if OR, schedule is very full
Post Operative/ Recovery Area
- Patient hold until vital signs stabilize
- Under supervision of anesthesiologist
- Glazed wall panel between Recovery and Anesthesiologist’s room.
STAFF ENTRY AREA
Changing Rooms and Lockers
From street clothes to OR gowns
Provide dressing spaces
Provide closets/ lockers
Toilet and bath: 1- WC, 1-Lavatory, 1-Shower per 8- 12 users.
Lounge area
rest area within “clean” spaces
with coffee/ snack counter
place for discussion cases over coffee within “clean” area
STORAGE AREA
Linen – for linen usually used in recovery Area
Mobile X-Ray – only a niche if there is a mobile equipment.
Bulk – for bulky equipment if any, at least 14 sq. m.

SUPPORT AREA
Clean Utility – 8-10 sq. m.; used in Recovery Area
Dirty Utility – 10 sq. m.
Cleaner’s Room – 10 sq. m.
Disposal – 5 sq. m.; immediately outside door from OR to disposal corridor.
Disposal Corridor – links OR to OR Sterilizing unit; exit for used materials.
Equipment Room – room for mechanical ventilation; electrical distribution.
TEATER TERILE SUPPLY UNIT (TSSU)
Receiving and Cleaning – of non-disposable items from OR
Examining and Storing – of cleaned items
Packing – of clean instruments before sterilization or preparation of pre-set trolleys.
Sterilizing – of packs in autoclaves.
Clean and Sterile Storage – of sterilized packs and items from laundry and pharmacy.
Dispatch – for loading clean trolleys with sterile packs.
OPERATING AREA
Scrub-up – 10sq. m.; single door from corridor to the OR glazed panel for wall between OR and
scrub-up.
Preparation Room – 12 sq. m.; preparation of trolleys for use.
Operating Rooms – 36 sq. m. minimum area each; 3.00 m. minimum clear ceiling height.

DAY SURGERY
DAY (AMBULATORY) SERVICES:
Scheduled surgical procedures provided to patients.
TYPE OF DAY SURGERY
A. OFFICE BASE – undertaken in a physician’s office.
B. AMBULATORY FACILITY BASED – undertaken in a free-standing facility.
C. HOSPITAL BASED – undertaken in the Day Surgery facility of a hospital.
ADVANTAGE OF DAY SURGERY
 Staff trained to meet specific needs of patients.
 Patients and family do not mingle with more serious in-patient surgery patients.
 Psychologically less stressful for patients.
 Operationally simple than hospital surgery suites
 Greater flexibility in scheduling procedures.
 Allows for better utilization of hospital beds.
 Less costly because of the elimination of a hospital stay.
 Less Modification both pre- and post-operatively.
 Patients return to work sooner than in-patient.
 Promote a wellness philosophy, treating patients as if they are healthy.
TRENDS AND INNOVATION
 ADVANCE IN PHARMACOLOGY
o Short acting anesthesia agents that wear off in minutes
o Fast-acting agents for pain and postoperative nauseas.
o Anesthetic agents that enable “fast-tracking”
 MINIMALLY INASIVE SURGERY
o Surgery without large incisions.
o Less scaring, shorter recovery time, less disability, reduced cost.
o Endoscopic surgery performed in “videoscopy suites”
 HARMONIC SCAPEL
o Using Ultrasound technology
o Cuts tissue and seals blood vessels at precise point of impact.
o Scalpels’ vibration clots the blood to stop bleeding.
 LASER – D
o Operates at very high temperature to vaporize or burn tissue.
CURRENT TRENDS
Adjoining OR for transplant clean Hallway or Corridor.
OR ceiling decorated with view of sky and tree tops to ease patient’s fear.
Day surgery patients in pre operative area and recovery bays enjoy of nature overhead thru use of
back lit film transparency.

SPACE REQUIREMENTS
PUBLIC AREA Sq. m. PROCEDURE
Waiting Area 0.65/ person Scrub-up 10 sq. .m
Reception 5.02 Operating Room 36. sq. m.
File Room 4.65
Triage Station 5.02 SUPPORT AREA
Examination Room 7.43/ bed Anesthesia Work Area 5.02 sq. .m
Public Toilet 1.67 Clean Work Room 5.02
PATIENT AREA Clean Utility 10
Dressing 2.32 Dirty Utility 10. Sq. m
Examination Room 7.43/ bed Janitor’s Room 3.90
Nurse Station 5.02 Sterilizer Room 4.65
Pre-Operative Ward 7.43/ bed Disposal 5.0
Recovery Ward 7.43 STAFF AREA
Patient’s Toilet 1.67 Head’s Office
General Office & Conference 1.67/ person
Patient Entry Control (double
Door)
Staff Change, Toilet, Lockers 2.32
Reception/ Patient transfer Staff Lounge & Pantry 8-12
person
0.65/ person
Post Operative/ Recovery area
Ceiling height 3.00m
SAMPLE PLANS
See plans

Figure 1

DELIVERY
GROUPING OF BASIC ACCOMODATIONS
PATIENTS ENTRY AREA
The same as OR Suite, or may be shared with OR Suite.
Provide for Nurse Station.
Provide for Supervising Nurses’ Office
STAFF ENTRY AREAS
The same as OR Suite
STORAGE AREAS
Linen Bay – for stock of day to day linen
Equipment – for anesthetic apparatus; other equipment
SUPPORT AREAS
Clean Utility – 10 sq. m., for supplies from CSSD, preparation of instruments, sterile packs;
with lavatory basin with elbow- operated taps.
Dirty Utility – 10 sq. m.;
Fixtures: flushing sink, bed pan washer, storage, lavatory open shelves for stool and
urine specimens.
Janitor’s Rooms – planned in association with clean utility and delivery rooms.
Fixtures: sink flexible hose tap
DELIVERY AREA
Scrub-up – 6 sq. m.
Labor Room - 12 sq. m. per patient; provide 1 per 10 post natal beds; fitted with glazed
observation window.
Toilet Facilities – provide at least 1- water closet for each pair of labor rooms.
Delivery Rooms
36 sq. .m – to accommodate Caesarian Section.
25 sq. .m – for normal delivery.
Wide enough doors to take in bed. (1.20 m. wide)
Wide observation windows.
Ample space at the foot of the bed.
Engineering Service – oxygen, suction for mother and baby, X-ray viewing screen,
blood pressure apparatus, sink with elbow-operated taps.
CURRENT TREND: LDRP.
Labor Delivery Recovery Postpartum (LDRP) – special ward convertible from ward to labor, delivery,
recovery room

NURSERY
FUNCTION:
CHARACTERISTIC/ TYPE:
DESIGN CONSIDERATION:
 Size or location in hospital

INTENSIVE CARE UNIT
FUNCTION OF ICU
The Intensive Care Unit is a place where critically ill patient can be brought together and given
constant and undivided attention by highly specialized medical and nursing staff using highly
specialized equipment.
CHARACTERISTIC OF ICU
 Controlled Environment. Clean/ aseptic room.
 Strict infection control procedures.
 Use of special equipment needing various types of engineering services.
 Highly trained medical and nursing staff. Different and has special training for nurses, doctors and
staff.
JUSTIFICATION FOR THE UNIT
 Better nursing care for critically ill constant and undivided attention and use of special equipment.
 Better nursing care for other patients in the general wards- attention is not taken away by the
critically ill patients.
 Focus and best use of human resources- in particular, the specially trained nursing and medical
staff.
DESIGN CONSIDERATION
 Size of unit
 Approximately 1% to 2% of total acute beds
 6 to 8 beds/ unit for efficient management; less than 6 beds is not economical.
 One central ICU preferred (for 100 beds hospital – 2 ICU)
 If coronary cases is substantial, a Coronary Care Unit may be provided in association with ICU.
 Size or location in hospital
 Ideally same floor as Operating Room
 For concentration of engineering services.
 for ease communication.
 Sharing of staff and support facilities if planned adjacent to post-operative.
 Easy acces to Emergency, OR and Wards.
 Type of Specialization
C.C.U. – Coronary Care Unit
MICU – Medical Intensive Care Unit
PICU – Pediatric Intensive Care Units
CVCU – Cardio Vascular Care Units
NICU – Neonatal Intensive Care Units
SICU – Surgical Intensive Care Unit

 Accommodation
 Patients areas
 Staff base/ Nurse Station
 Clean Utility
 Dirty Utility
 Equipment Storage
 Overnight Rooms (for relatives)
 Cleaning Rooms
PATIENTS AREA
Arranged as 1 large multi-area with 2 single room
Single bed room = minimum of 26 sq. m. (roughly square with airlock)
Multi-bed area = with bed spacing positioned @ 3.30 to 3.60 m c/c.
Natural daylight, but not glare consider position/ orientation of beds. (bed parallel to
window)
Position of fittings, outlets important:
Overhead rail or shelves for equipment at least 0.40m deep. Equipment can be
removed and stored after use.
Medical sinning to give privacy k, elbow-operated taps for each single bed room, 2 at
multi-bed areas.
Alternative for curtaining to give privacy for patient but allow staff observation. Outlets
locate 0.90 to 1.20 m from floor.
ENGINEERING SERVICES:
Heating – not relevant in tropical condition.(i.e. Philippines)
Ventilation: Supply and extraction . Ventilation rate of 15 air exchanges/ hours.
Air-conditioning temperature: 16- 27 degrees C, controlled humidity.
Lobby airlocks.
Hot and cold water, with lever-arm taps for medical sinks.
Oxygen – 20 liters/ min., pressure of 3.4 to 4.0 bar (for each bed)
Medical vacuum – 2 outlets per bed
Compressed air
Nitrous Oxide
Power outlets – 8 per bed (height of C. O. @ 0.90 – 1.20 m. from floor.

SPACE REQUIREMENT
ENTRY AREA AREA
Reception 5.02/ person
Stretcher Alcove 1.08
Relative’s Room , Ante-room , 5.02/ person
Public Toilet 2.2
INTENSIVE CARE UNIT
ICU Room 24.00
Private ward single bed 26.00
Nurse Station 5.20
ICU Bed Wards (4) 3.30 – 3.60m space between bed c/c 40
Disposal Room 1.67
Janitor’s Closet 3.90
STAFF AREA
PACU
Anesthesia Room Office & Storage 21.00
Dressing Area
Staff Locker Area
Sterile Corridor 2.50 wide
Supervisor’s Room 7.00

SUPPORT AREA
General Storage 4.65
Utility Room 3.2
Mini-Laboratory 10.00
Procedure Room 5.02/ person
Linen Storage 5.02
Equipment Storage
Workroom 5.02

SAMPLE PLAN
CURRENT TRENDS
Patient Circadian Rhythm – Artificial window with

ROOM DATA SHEET
End of Module 11
ROOM DATA SHEET (1)
FUNCTIONAL DESIGN REQUIREMENTS
ACTIVITY FLOW
PEOPLE INVOLVED
PLANNING RELATIONSHIP
EQUIPMENT AND ACCESORY CHECKLIST
FURNITURE AND FIXTURES
ADDITIONAL ENALQUIPMENT & ENGINEERING TERMINAL
DETAILD LAYOUT OF ROOM SHOWING
EQUIPMENT,FURNITURE AND FIXTURES
LOCATION OF UTILITIES OUTLETS, ETC.
ROOM DATA SHEET (2)
TECHNICAL DESIGN DATA
DESIGN DATA FOR ENVIRONMENTAL CONDITIONS
AIR LIGHTING AND VISUAL
Outdoor air temperature (deg. C) General Illumination (lux)
Room temperature (deg. C) Night illumination (lux)
Mechanical Ventilation Task illumination (lux.)
Volume (cu. M./hr. / person) Color rendering
Velocity (m/ hr.) Standby light
Pressure Emergency light
Exhaust (psi) Day light
Inlet (psi) View out
% dust filtration Privacy
Humidity (&RH) Black out
Cooling Load (TR)
SAFETY
SOUND Accessible hot surface
Acceptable sound level (db) Maximum temperature (deg. C)
Speech privacy Domestic hot water
Intolerable quality of sound Maximum temperature (deg. C)
Access limit
Fire risk
Other risk

Module 12
Service Department
CENTRAL SUPPLY(GENERAL STORAGE)
DESIGN CONSIDERATIONS
1. Primary Function
The receipt, storage, issue, inventory control and security of all materials under its custody and security
of all materials under its custody.
2. Location
 Direct access to each department in the hospital is required access to a loading dock where
supplies and equipment are received, inspected, and inventoried
3. Space Consideration
a. Design for storage must be in accordance with local purchasing practice and needs.
b. Minimum requirements for an average hospital for the Central Storage are 2 sq. m.
per bed.
c. Receiving Corridor should be wide enough to allow uncrating and unpacking some of
the goods before they are taken into the store room. Three meters is minimum width.
d. A Storage Office is placed off the receiving corridor with a counter and window
opening for requisition;
e. The General Storage cleaning space maybe made up of a series of interchangeable
shelving units, the bottom shelf 6” above the floor the protect goods from the moisture and
damage during cleaning.
4. Layout
From the loading dock, the equipment and a supplies are unpacked, inspected, and inventoried.
Most of the equipment are normally issued to the user soon after being received. Supplies and
remaining equipment are then moved to the general storage, refrigeration storage flammable
storage and security storage.
C.S.S.R. Central Sterilizing & Supply Room.
 Receiving& Dispensing Space/ Counter
 Working Area
 Sterile Supply Storage.
 Sterilizing Area (Autoclave 1200 watts, 3Ø 220 V)
SPACE ACCOMODATION
1. Dirty Utility Room
a. To provide facilities for the collection and holding of all materials awaiting disposal from
the department.
b. To provide facilities for storage, emptying and cleaning of bed pans, vomit bowls, etc
c. To provide facilities for urine testing and inspection and storage for pathology and
specimens.
d. To provide facilities for staff hand washing.
2. Clean Utility Room

a. The Clean Utility Room is the holding point and preparation area for all clean and
sterile materials used in the treatment of the patients within the department.

3. Janitor’s Room
a. The storage of cleaning materials required for ensuring an adequate standard of
cleanliness in the department.
b. The storage of cleaning equipment accessories and the servicing of both mechanical
and non-mechanical equipment.
c. The emptying and cleaning of equipment (vacuum cleaner, duster, etc.)
d. The storage of cleaner’s trolleys.

DIETARY DEPARTMENT
STAGE OF PLANNING and DESIGN
1. Establish the workload in main kitchen (Number of patients)
2. Decide type of service for patients and staff. (centralized or bulk)
3. Prepare flow diagram.
4. Prepare schedule of accommodations
5. Prepare plans for consultations, modifications with Dietician consultant.
6. Prepare list of equipments needed. Stove, oven, refrigerator, freezer, etc.
7. Layout equipment on plan.
8. Refine/ modify plans for finalization
TYPE OF FOOD SERVICE FOR PATIENTS
1. Central Tray Service
 Patients’ tray completely served in the main kitchen under supervision of
dietician.
 Loaded on dumbwaiter or tray trolleys and transported to various floors.
 Soiled dishes collected and returned to the dishwashing area
 System requires fewer a better trained employees.
2. Bulk Service
 Bulk food loaded into an insulated cart and transported to the patients’ area.
 Trays are prepared and served in the floor pantry or from the bulk cart direct
to patients’ room.
 Soiled dishes are handled in a dishwashing area in the floor pantry. Provide
biodegradable waste bin.
 System requires more but less experienced personnel and ensures food
served hot.
TYPE OF FOOD SERVICE FOR STAFF
1. Cafeteria Service (Self service) – 2-1/2 to 3 times turnover.
2. Waiter Service – 2 times turnover
Ward
Dietary
Dietary
Morgue O. R.
Pharmacy
O. P. D. Admin.

SPACE ACCOMODATION
1. Delivery and Receiving area - Must be provided with a loading platform and work
area for checking.
2. Dry Storage for non-perishable items.
 For short time storage (daily, weekly)
 Must be rat proof. (for weekly)
3. Cold Storage
 Three (3) Walk-in compartments with different temperature ranges; one each
for meat (-18°C); vegetables and fruits (2-4°C); and dairy products (4°C) with in
the Kitchen size: 8 sq. m.
4. Main Kitchen:
a. Food Preparation
 Two main spaces; meat and vegetable preparation
 May have separate preparation for baking and salad making.
b. Cooking Area
 Consists of ranges, fryers, broilers, oven, and steamers.
 These equipment are best placed in a central location convenient wall where
the cleaning problem is more difficult.
c. Pot Washing
 Located off the main traffic lines but near the ranges from which most of the
work comes from.
 May be closed in a separate room since this is a noisy and steamy area.
 A 2 or 3-compartment deep SS sink with 2 drain boards and pot racks will be
required.
d. Other area such as Baking area & Salad preparation area.
5. Special Dietary Kitchen
 Located off the main kitchen and may be separated from it by a low partition.
 The Dietician’s Office is adjacent to the Special diet kitchen.
6. Patient’s Food Service Area
 Includes space for tray setup work counter and tray truck parking.
 Where food were serve park tray track, conveyor belt.
7. Dish Washing Room
 Located at the entrance to the kitchen adjoining the tray setup area and on an
exterior wall for natural ventilation.

 Located where noise will not audible in patients’ and dining room.
 Includes China wares, silver wares, utensils and other kitchen equipment
storage.
 Space is allowed for trolley washing.

8. Dining Area for Personnel
 Provide washing sink.
9. Garbage Disposal Room
 A refrigerated room for garbage storage should be located at the delivery door
for easy handling and when possible, close to dishwashing room..
10. Dietician Office
WORK FLOW DIAGRAM
Show flow diagram
RELATIONSHIP w/ SERVICE DEPARTMENT
(Provide Flow Diagram)
COOKING
Daily
Delivery
STORAGE
SCALARY
Meat / Vegie
PREPARATION
BAKING
Coffee, Eggs,
Ice Cream
SERVING
DISHWASH
DIET
OFFICE
KITCHEN
HOSPITAL
COOKING

SAMPLE PLAN
LOCATION:
 Preferably at ground floor level
 Same level as Main Dining Room
 Accessible to nursing units (Dumb waiter elevator).
 Accessible from bulk Storage. No traffic allow thru other departments.
 Noise and odor must not affect other department.
 With adequate natural lighting and ventilation.
 Must consider fire safety, the kitchen being a fire risk area, general sanitation, rat proof.

LAUNDRY
WORK FLOW DIAGRAM
LOCATION
 Preferably at Ground fl
 oor level.
 Must be accessible from and to the Nursing Unit. (thru ramp, Elevator, Dumb Waiter)
 Must have sufficient space with acoustical treatment. Use of sound proofing materials, sound –
insulated equipment, proper ventilation and adequate supply of water.
SPACE FACILI TIES
SOILED LINEN AREA
 From the wards soiled linen are place in the placed in the Linen Room where these are
sorted.
WASH LAUNDRY PROCESSING
 With washing machines, steam dryers, Ironing; fire extinguishers and clock are needed.
CENTRAL LINEN ROOM WITH SERVING AREA
 Need large closet for storing clean line.
EMPLOYEE FACILITIES
 Locker rooms inside area with bulleting boards, toilets, mirrors, and shower baths.
WASH &
RINSING
RECEIVING SORTING
WARDS, OTHER
ROOMS THAT USE
LINES
STORING
SORTING &
FOLDING
PRESSING
DISTRIBUTING
SEWING
AREA
Outside
Drying Area

SERVICES DEPARTMENT
SPACES and FACILITIES
Provide for supervision and management of housekeeping activities, utilities services, and maintenance
of the physical plant and installed equipment.
HOUSEKEEPING
SPACE FACILITIES
 Primary function is to provide janitorial, cleaning and related service for hospital.
Janitor closet,
 Facility requirements include space for storage of bulky housekeeping equipment, plus janitor’s
closets and equipment storage throughout the hospital.
 Each department or zone should have 3 sq. m. with Slop sink, mop, storage for cleaning
materials of Janitor closet-

ENGINEERING and MAINTENANCE
SPACE FACILITIES
 Primary function is to provide utility services and to maintain the hospital plant and installed
equipment in serviceable conditions.
 This service has three (3) functional areas:
o UTILITIES – operates the A/C plant, maintains standby generator, and provide pother
associated services (Sewage disposal, storm drainage, water supply, hot water system,
fire stand pipe, gas piping, sterilizer.
o SHOPS – maintains repair of building structures, equipment and utility. Requires space
for various shops, such as carpentry, painting, plumbing, electrical and machine shop.
o GROUNDS – supervision of landscaping of grounds, collection of disposal of garbage
and trash, operation of trucks and other heavy equipment, and all other activities
associated with roads and ground. A variety of shops, vehicle storage area (motor
pool), and storage for heavy equipment is required in support of this function.
Parking space requirement
End of Module 12

Module 13 A
Mechanical Works
Mechanical Works – Codes
 National Building Code of the Philippines (P.D. 1096) and its IRR.
 Fire Code of the Philippines (R.A. 1185)
 Mechanical Engineering Code of the Philippines (ME Code)
 Existing Local Codes and Ordinances
Standards
 Bureau of Product Standards (BPS)
 Philippine National Standards (PNS)
 Underwriters Laboratory (UL) and Factory Manual (FM)
 International Electro technical Commission (IEC) 1988
 National Fire Protection Association (NFPA)
 NFPA Standards for Health Care Facilities
 American Society of Heating, Refrigeration and Air Conditioning Engineering
(AHSRAE)
 Center for Disease Control and Prevention Manual
Site Works
 For Automatic Fire Sprinkler System, Site Plan indication the location of the buildings,
firewater reserve tank, firewater line, yard loop and private fire hydrant.
 For Medical Gases and Vacuum System, Site Plan indicating the location of the
building, medical gases manifold and vacuum housing.
Building Sanitary Systems
1. Automatic Fire Sprinkler System
o Provide in all hospital buildings except for one (1) storey structure built with fire
resistive materials.

o Hazard Classification – Light hazard occupancy.
o Area of coverage 146 sq. mtrs, water supply density 4.07 lps/ sq. mtrs.
o Protection area per sprinkler head 20 sq. mtrs at 2.20 m. minimum distance and 4.20
m. distance between sprinklers. Average dist. 3.00m (see sample plan )
o All floor control valves equipped with supervisory switch with flow detector and drain
system.
o Water supply horizontal split case centrifugal fire pump diesel engine or AC motor,
vertical in-line jockey pump with controller.
o Firewater reserve tank ground level monolithic concrete tank sized for a min. supply of
30 minutes.
o Hydraulic calculations report based on NFPA-13.
o Hazard Classification – Light Hazard Occupancy
o Area Coverage – 146 sq. m.
o Protection area Sprinkler 20 sq. m./ 2.20 mtr. Min.
o 4.20 m. max. space between sprinkler
2. Ventilation and Air Conditioning System
o Provided in all patient private rooms, radiological and imaging areas, operating rooms,
delivery rooms, critical care areas, laboratories, drug storage, and offices.
o Split type air conditioners for large capacity areas (interior area). 25 sq. m. minimum.
o Window type A Cs for area with exterior wall exposure.
o Centralized air conditioning only when feasible.
o Design Temperature 25° Centigrade at 50% (RH) Rate Humidity.
o Design of critical care areas laminar or positive pressure- supply air is 10% more than
exhaust air.
o Isolation room for highly infectious diseases like TB and SARS negative pressure –
exhaust air is 10% more than supply air. (Block out for pipes X-ray 45° inwards.
o Ceiling cassette type exhaust fans with integral air diffuser shall be provided in all
toilets.
o Ceiling fan, orbit type with 360° oscillation shall be provided in all non air conditioned
rooms, such as patient wards, nurse station, etc.

o Maintain air change rate greater than or equal to 12 air changes per hour or 145 liters
per second per patient.
o Provide ceiling cassette type exhaust fan with integral air diffuser in all toilet.
o Location of window type AC units shall be not higher than 2 meters.
o Provide all doors, especially toilet doors air vent louvers at the lower portion to prevent
air vacuum.
o Provide orbit type ceiling fan 360 degrees oscillation in all non air conditioned rooms
such as patient wards, nurse station, work areas, OPD waiting area.
Provide Ante-Room for Negative/ Positive air control.
Window Type ACU location not higher than 2.M
3. Medical Gases and Vacuum System
o Medical gases and vacuum system – provide throughout the hospital. Pressure 2000
psi.
o Medical Gas supply – provided through manifold system and bulk system. Bulk
Storage locates outside ground floor of the building.
o Area of coverage 146 sq. mtrs, water supply density 4.07 lps/ sq. mtrs.
o Pipe line system shall be equipped with zone valve and alarm system (see sample
plan )
o Vacuum pumps – duplex type each- capacity to handle the total load without loss
vacuum in the system.
o Gas outlets – single, double, triple or more units for the following gas service: Oxygen,
Air, Nitrous Oxide and Vacuum,
o Flow calculations NFPA standards for hospitals.
o Piping – seamless type “K” or “L” tempered copper tubing suitable for silver brazing.
Joint and fittings for copper tubing cast bronze for brazing.
OFFICE PATIENT
ROOM
ISOLATION
ROOM
Exhaust typically
10% of total room air
ventilation.
CORRIDOR
PATIENT
ROOM
PATIENT
ROOM
PATIENT
ROOM
Specific areas should be under negative pressure to
prevent cross contamination to other areas of the
building (0.001° W G or 100 FPM inward velocity.

4. Elevator System
o Hospital bed elevator – provide in all multi storey hospital buildings, separate
elevators for patients, service elevators.
o Minimum car size- 1. 50 meters width and 2.15 mtrs. Length.
o Car door opening- not less than 1.10 mtrs. And 2.0 mtrs. Height.
o Elev. Weight capacity 1000 kg. ± 24 persons.
Elevator Room Height 4.40m
5. Summary of Materials
Automatic Fire Sprinkler
 Sprinkler Head – UL listed/ FM approved pendant, upright or sidewall nit, 83 LPM flow
capacity per head and temperature fusing at 57.5 deg. C to 74 deg. C.
 Fire Pump – UL listed/ FM approved diesel engine or electric motor driven – designed for
automatic water sprinkler protection system.
 Jockey Pump – UL listed/ FM Approved diesel engine or electric motor driven – designed for
automatic water sprinkler protection system.
 Alarm assembly – UL listed/ FM Approved, so installed that any flow of water from the
sprinkler single equal to or greater than that from the single automatic head shall result in an
audible and visual sign in the building vicinity.
 Water Sprinkler alarm and supervision system – includes the monitoring water flow switch
of each building floor, fire pump and jockey pump running condition and power supply water
level of reservoir and control valves.
 Pipes- B.1 Schedule 40, Screw fittings – used for inside piping.
Air Conditioning and Refrigeration System
 Refrigerant pipes – copper tubing, Type L or K black steel pipe. Schedule 40 for 100 mm
diameter and less. Pipes over 100 mm diameter Schedule 40.
 Black Steel pipes – standard seamless, lap welded or electric resistant welded for size 50
mm diameter and larger, screw type for size 38 mm diameter and smaller, fitting for copper
tubing – cast bronze fittings designed for brazing.
 Pipe insulation – preformed fiberglass or equivalent. Insulating materials covered with 100
mm x 13 mm thick polyethylene film overlapped not les than 50 mm.
 Ducts – galvanized steel sheets of standard gauges.
 Ductwork Insulation – rigid styropor or equivalent 25 mm thick for ground and top floor, 13
mm thick for intermediate floor.
Medical Gases and Vacuum System
 Gas outlet stations – UL listed/ FM approved quick connect type or Diam. Index Service
System (DISS) type, stainless or PVC faceplate mounted on chrome- plated zinc die- cast
cover plate.
Elevator System
 Hospital bed elevator and passenger elevator machine room-less or traction type only.

 Elevator System – UL listed/ FM approved.
End of Module 13A

Module 13 B
Structural & Civil Works
Structural Works – Codes
 National Structural Code of the Philippines (NSCP) 2001
 National Building Code of the Philippines (P.D. 1096) and its IRR.
 Accessibility Law (BP 344)
 Local Codes and Ordinances
Standards
 Philippine National Standards (PNS)
 DPWH Blue Book
 American Concrete Institute Code (ACI)
 American Society for Testing Materials (ASTM)
 American Welding Society (AWS)
Site Works
 Reference: Hospital Master Site Development Plan.
 Main hospital road capable of two way traffic; 6.00 m. Minimum width, 150 mm thickness.
Concrete strength should be at least 3000 psi. Interior roads leading to support facilities shall
be designed to accommodate delivery trucks, fire trucks, and waster collection van.
 Fence should be see-through for the front of the hospital while the three other sides should be
made of concrete hollow blocks. Minimum height 2.00 m. Provide perimeter lighting. See-
through fence will be made of 32 mm square bars spaced at 100 mm on center and provided
with three (3) Concrete Hollow Block (45 mm high) bottom wall.
Building Structural Systems
Buildings
 Verify with PHILVOCS the distance of proposed Hospital to nearest active fault lines and with
the DENR for Geo-hazard Map of the area.
 Conduct Soil investigation capacity (at least three bore holes) and to recommend foundation
design. Applicable even for one storey structures.
 Use Seismic importance factors of 1.25
 Immediate occupancy category.
 Designed in accordance with NSCP requirements up to magnitude 7 for those near seismic
source Type A.
 Observe seismic gaps between buildings (old and new)

 Use wind importance factor of 1.15 (specifically for roofing system)
 Use concrete gutters and parapet walls as additional protection to the roofing system in strong
typhoons.
 Use fire-resistive and non-toxic materials.
 Verify with PHILVOCS the distance of the proposed hospital to nearest active fault lines and
with DENR for geo-hazard map of the area.
 Conduct Soil investigation to determine actual Soil Bearing Capacity (at least three bore holes)
and to recommend foundation design. Applicable even for one storey structure. (location of
bore holes at elevator shaft, tower building area)
Details
 Provide details of connection of beams and columns following requirements of NSCP for
confined area.
 Provide connection of trusses to beams and columns.
 Provide splicing details of reinforcing bars on columns and beams and the required bar cut-off
points.
Summary of Materials
 Concrete shall be Portland Cement and conforming to ASTM specification C150, Type 1 to
Type II.
 Coarse aggregates shall consist of washed gravel, crushed stone or rock or combination
thereof conforming to ASTM C33.
 Concrete Hollow Blocks (CHB) shall a standard product of recognized manufacturer conforming
to PNS 16 with at least 350 psi strength.
 Reinforcing Steel Bars shall conform to PNS Grade 60 for 16 mm diameter and above and PNS
Grade 40 for 12 mm diameter and below. (structural grade to minimize size of RC column)
 Structural Steel shall conform with ASTM A36/A6M.
 Bolts and Studs shall be Cast Iron (asero) conform with ASTM A 325.
new
Old bldg.
Provide Seismic Gap of 100
mm, ASEP recommend (See
Detail)

 Welding electrodes shall be E 60 or E 70 and conform with AWS D.1.1.
Engr. Maximo A. Adan, Jr. Engr.V DOH
End of Module 13B

Module 13 C
Electrical Works
Electrical Works – Codes
 Philippine Electrical Code (2000)
 Fire Code of the Philippines (new 2005)
 National Building Code of the Philippines (P.D. 1096) and IRR
 Existing Local Codes and Ordinances
Electrical Standards
 Underwriters Laboratory (UL)
 International Electro-Technical Commission (IETC)
 Illumination Engineering Society (IES)
 National Electrical Manufacturer’s Association (NEMA)
Site Works
Master Site Development Plan should show –
 Substation/ Power Houses
 KVA rating and other specifications of transformers
 Switch gear requirements
 Panel board Layout
 Electrical Metering devices
 Service Conductors and Conduit Layout
 Grounding System
 Emergency Stand by Generators
 Street and Perimeter Lighting System
Building Electrical Systems
1. Lighting System
 Provide adequate normal branch circular to all areas using standard lighting design
analysis.
 Utilize standard illumination requirements per luminaire.

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