Thesis report 2017 by Gaurav Gupta

DECLARATION The thesis titled “SUPER SPECIALITY HOSPITAL” has been carried out by the undersigned as a part of the bachelors program in the department of architecture, ganga institute of architecture and town planning, jhajjar – Haryana , india under the

supervision of Ar. Meghna.. The under signed hereby declares that this is his original work and not been plagiarized in part or full from any source.

Furthermore this work has not been submitted for any degree in this or any other university.

Ar. Amit Garg

Ar. Meghna

[Director]

[Thesis guide]

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

ACKNOWLEDGEMENT

I would like to take this opportunity to express my gratitude to the people who have been instrumental in the successful completion of this thesis. I

would

sincerely

express

deep

gratitude

, for his valuable guidance and insightful discussions during the course of the project.

Name of student

(GAURAV GUPTA)

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Ar.

Meghna

CERTIFICATE

This is to certify that the thesis titled “ SUPER SPECIALITY HOSPITAL (200 BEDED).” has been submitted by GAURAV GUPTA, in partial fulfillment of the requirements for the award of Bachelor’s Degree in Architecture.

Checked By:

Approved By:

(Head of Department)

(AR.AMIT GARG)

May – 2017 Kablana - Jhajjar SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

CONTENTS OF THESIS REPORT PART I : DESIGN INVESTIGATION Chapter 1 1.1 Introduction 1.2 Thesis Intent 1.3 Proposition Chapter 2

PART II : DESIGN TRANSLATION Chapter 6 Concept and design strategy

Chapter 7 Design development

2.1 Hospital Planning 2.2 Hospital Facilities 2.3 Healing Environments Chapter 3 Case Studies 3.1 Fortis hospital, gurgaon, Haryana 3.2 Rockland hospital,Qutub institutional area, New Delhi 3.3 Bronson methodist hospital, kalamazoo, Michigan

Chapter 4 activity program analysis 4.1 area program 4.2 qualitative analysis Chapter â&#x20AC;&#x201C; 5 5.1 Site Information 5.2 climate analysis 5.3 Precinct Study 5.4 Neighbourhood Study 5.5 Site Study

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Chapter 8 Final Thesis Portfolio

CHAPTER â&#x20AC;&#x201C; 1 1.1 Introduction 1.2 Reason of choice 1.3 Search/Hypothesis

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

1.1 Introduction A hospital is a healthcare institution that provides medical, surgical and nursing treatments to the sick or injured through specialized staff and

equipment. Hospital is not just a cure centre, it is a place for cure as well as pleasant, cleanliness, healthy and mind supporting. It provide happiness, calm and make to self control . As we know â&#x20AC;&#x153;health is wealthâ&#x20AC;? healthy mind lives in healthy body and a healthy poor man is richer and happier than a richest seek man. To use the prosperity in efficient way we need a healthy body in this physical world. The human body is most peculiar and advanced machine developed by nature whose efficiency and energy level unknown till now, one cant measure the human mind and body in perfect way. There are hundred of path to cure seek people few of them are commonly used and few are rarely used. It is a sacred place, where most people were born

and die. People are served and taken care of here, when they are mentally or physically ill. It sets the foundation of a stable society. Hence, the concept of hospital goes far beyond the conventional idea of a place for treatment of sick. The rapid and almost uncontrolled growth of population has put the healthcare facilities under severe pressure, that are already in significant deficiency. According to the WHO norm, India's proportion of hospital beds to population is less than one-third of the set standards. Hence, India needs to add more bed and hospital, about two-thirds of which should come up in rural areas. Architecture affects people. The architecture of hospitals contributes to the well-being and recovery of patients. This

bold proposition dates back to the late 18th century and has been a recurring theme in the functional development of hospital architecture ever since.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

1.2 REASON FOR CHOICE There is a remarkable and complex question “how do we evaluate our life and what is values of life”. As I think our duty or responsibility absolute the life and make free from all debits, like debits of mother, father, Guru, society, nature and many others, for whose support and

nurture I am here right now. I want to do something for everything that have helped me in many possible ways. According to my knowledge and intuition , In my districts town kirari there is a lots of problems regarding health, education, employment etc. There is no hospital in range of 100km where people can get good hospital and advanced therapy of cure. The Kirari town has 50 bedded existing hospital which is not fulfil the requirement of the district. It is an opportunity to explore myself in educational and professional life through out my thesis health care architecture. This will help me to provide better service to my society and country. This project is associated with basic need in this modern life every body is suffering from stress due to irregular daily routine , unhealthy food, luxurious life

style, which make our body weaker and seek. So hospital is a basic need of every community level society like school and market. The rate of death of baby born and unnatural is very high in Delhi regarding national rate so as I am belonging from this state it is a great opportunity for me

to do something for myself and my society through this thesis. Hospital as an institution has to respond to changing social environments/attitudes, advancements in medicines, therapy and diagnosis and technologies. Each department of hospital needs its own identity and within its own map, its private and public spaces as well as its front door; this all makes planning of hospital a very complex proposition. Apart from that in today’s hospitals engineering department and support services have assumed greatest ever importance. Thus, as a student of Architecture I take this opportunity to explore and learn the complexities of designing a Hospital.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

AIMS AND OBJECTIVES

• Providing an comfortable, economical and user friendly healing environment to the people of the district. • Patient oriented design strategy. • Understanding the complexities of Hospital Design – How departments are interlinked and equipments and machinery are being used. • Application of Green ideas into Hospital design.

1.3 AREA OF RESEARCH Understanding the functioning of the various departments of hospital and their co-relation with each other. ▪

Circulation pattern.

▪

Typologies in hospital design. .

▪

Understand the local culture and its influence in hospital design

▪

Understanding the components of healing environment which will enhance the healing character of the hospital.

▪

Sustainable principles for energy conservation.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Chapter â&#x20AC;&#x201C; 2 Research 2.1 Understanding Hospital Planning 2.2 Functional Design of Hospitals 2.3 Healing Environments

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

2.1 INTRODUCTION

UNDERSTANDING THE HOSPITAL PLANNING Hospital is the most visible face of healthcare industry. It provide a platform where the practitioners of medicine integrate the healthcare technology with the living process. They can be grouped by various classifications like ownership, type of system, etc. But they all are planned to provide a level of healthcare, which ordinarily cannot be provided at home. Hospitals are amongst the largest and most complex of all modern institutions. Hospital architecture is a part of this complexity. Unlike other organizations, which may be built in various ways hospital building has lesser choices. It differs from other building types in the complexity of

functional relationships that must exist between the various parts of a hospital. Apart from providing the right environment for the patients and the care providers, a hospital building should also be sensitive to the needs of the visitor. The first instruction of Florence Nightingale "The Hospital should do patients no harm."

Must be obeyed forever while Planning & Designing a Hospital

Hospitals are a combination of technologies, processes and human resources. A structure may have functions, and many functions, and any function may be fulfilled by alternative structures or processes. Medical architecture must facilitate the adoption of new technologies besides contributing to the efficiency and transparency of processes. It must provide a seamless integration of clinical requirements with building

planning and designing issues. Strategies must be formulated to cope with varying health needs, cultures, climates and budgets. Design responses must also embrace all parts and aspects of the hospital.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

2.2 Hospital departments and Facilities Outpatient Department An OPD provides primary and well as comprehensive healthcare for patient who come for diagnosis, treatment or follow-up care. It is the point of first contact between a hospital and a patient. Importance of OPD is that it reduces the number of terminally ill patients traffic, as its helps in early detection or timely care of any disease. It is the first point of contact with the hospital. Hence, also referred to as “Shop window” of the hospital according to Shakti Kumar Gupta et al.(2007). Functions •control dieses by early diagnosis and timely treatment •Facilitates treatment and further investigation without admission into the hospital, thus reducing the in-patient load. •Provides follow up care to discharged patients. •Screens cases and investigates if the hospitalization is required. •Facilitates training of paramedical staff, nurses and doctors.

Planning and Design Parameters

Flow diagram

An OPD should be a separate complex within a hospital and location should be such that it shares diagnostics, laboratory etc. hospital services. •The Traffic of OPD should be totally separated from rest of the hospital, especially from the IPD and Accident and Emergency Department. •It should be readily accessible from main entrance. •OPD should have easy accessibility to medical imaging, laboratory and Pharmacy. •In a general hospital it all the polyclinics should be accommodated in a single OPD. However, in specialty hospitals, there may be separate OPD’s for varying specialties. •OPD should be located such that it can be shut down during evening hours. •OPD should be oriented such that it is impossible to look into the treatment and examination room. •Design should cater to future expansion, in case the number of departments is increased. •Waiting areas should be large enough to accommodate patients and accompanying friends and attendants. Space recommended for waiting areas is 0.8 m2 per patients for one third of the average daily number of patients attending OPD in one session. •It is desirable to provide a good view of the outside. Waiting area must have a warm environment with natural lighting and good ventilation.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

PHYSICAL FACILITIES The main physical facility •Public Areas •Clinical Areas •Consultation Rooms •Special examination Rooms •Administration Area The subsidiary facility •Injection Rooms •Treatment and dressing rooms •Pharmacy •Medical record room, exclusive or combined with IPD. The additional facilities include: •Laboratory •Medical Imaging Services •Screening Clinic •Medico-Social Services •Health Education facility Consultation Room There may be a private consultation room or combined. A room of about 12.5 m2 is adequate for consultation as well as examination. It includes space for doctor, patients, attendant, washbasin, X-ray viewing screen, instrument trolley, desk chair, examination bed. Two types of consultation room are depicted in the figures on the right. Waiting Area Waiting Area It should be designed to accommodate more than number of people expected at peak hours. Waiting area may be combined for various OPD, or each OPD clinic can have it own waiting space. The distance from waiting and OPD clinic should be close, easily visible and marked properly.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Accident and Emergency Emergency medical services is an integral part of any hospital. Emergency has been defined by the WHO as a condition determined clinically or considered by the patient or his/her relatives as requiring urgent medical services. Emergency department is considered as the “Front Door” of the hospital, as it accounts for highest number of all hospital admissions. It is vital for functioning of a hospital, especially in cases of disasters or any uncalled for events. It is the screens the patients for first aid, minor operations, major operations or admissions. It provides the first step of treatment in a trauma case or any emergency.

Functions •Provides fast and effective relief and management during disaster situations. •Initiate interaction with police in medico-legal cases. •Provision of ambulance services. •Provision for life saving and immediate treatment at all the times. •Works throughout the day, can be accessible anytime in case of emergency. Design and Planning Parameters •It should be easily accessible by patients, ambulances and the general public. It should have distinct and visible entrance, ideally separate for ambulance and ambulatory patients. •The movement of staff, patients and equipment should not impede each other. •The treatment areas should provide privacy to each patients. •The patient traffic of emergency department should not criss-cross with any other department. It should be unidirectional and smooth.

PHYSICAL FACILITIES

•It should directly to ICU’s and OT’s. •Should bebe located atconnected ground level, providing easy access to patients and ambulance.

Public Areas

disaster situations. •It should have an expandable waiting area and a triage area in case of emergency or

control station ••entrance

be planned around thehave mainexposure nursing work area. daylight and acute care areas should •Clinical areas should to maximum

facilities •Treatment public waiting space

along with a laboratory if the of theand hospital in not examination located nearby. •Emergency departmentrom, must havelaboratory its own X-Ray ultrasound facility,

examination and treatment •patient observation area cubical

•The emergency should be self contained in itself, to avoid any time lapses •Blood bank mustdepartment be directly accessible for faster reach.

The supportive services •critical care rooms

Ground level best since its easily accessible. in transfer of location patients is forthe one point to another.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Flow diagram

•staff room along with amenities 7

▪ Entrance – It should be well marked and well located with a spacious lobby to enter. It should have a covered porch for comfortable entrance/exit of patients in harsh weather/rain. ▪ Reception and Information Area – It should be close to waiting area and adjacent to triage area. ▪ Waiting Area – It must have comfortable seating for patients and relatives/attendants. Must be visible from triage and reception area. Can have Value added services such as coffee/tea vending machines, public phones, ATM etc. ▪ Nurse work station – It is centrally located to monitor all the patients care areas. Must include central cardiac monitor station. It should have communication link to triage and resuscitation areas. ▪ Doctors work area – Must have privacy yet centrally located for facilitating response during emergency. ▪ Acute Treatment Areas – It is used for patients with acute illness. It should be able to fit standard mobile bed with ample storage , service panel, examination light, and other equipment. ▪ Resuscitation Room – It is the room wherein a patient is stabilized, given immediate attention. The bay area in this room should allow 360 degree access to all parts of the patients, for monitoring. An OT light must be available along with imaging facilities readily accessible. Patient privacy is must and it should be visible from nurse station, if not then alarm system be introduced. ▪ Observation Ward – It is utilized for patients who need extended treatment, observation and re-evaluation. A 6-8 bedded ward is recommended.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

emergency dept. plan

Core – Treatment spaces are situated Arena – Its similar to core Corridor – This type is around a central point where plan, without the periphery preferred for larger department personnel work. It has a corridor, used for smaller A emergency departments. running clear corridor around the & E departments. This It provides for larger areas central area for easy access, provide design provides a good for each type of space. freedom of movement view of treatment rooms.

DAY CARE SERVICE It is a unit where treatment / operative procedures are provided in a way that patients can return home in a day. The procedures may be diagnostic or minor surgical. It is also known as ambulatory service. In principle such a unit is provided with almost all the facilities available to the in-patient unit. It provides a fast treatment to the patient, and help them to resume normal life without loss of time. It is cost effective for the patient as well as the hospital. It aids in reducing hospital infections, as only primary treatment is given and the recovery happens at home. It might be a stand alone service or attached with the hospital.

Planning and Design Parameters •The waiting area for recovery and procedure area should be different. •The facilities provided should be comparable to the inpatient unit. •The patients beds should have privacy and space for one attendant to sit next to the patient. •Arrangement must be made for 10% patients to spend overnight following the procedure/treatment, in case longer observation is required. Physical requirements •Entry Area •Holding Area •Pre-Operative holding area

•Operation/procedure Rooms •Patient Change Area •Treatment Room

Flow diagram

•Preparation Room •Recovery Room. Day care Units provide faster/effective recovery and reduce the risk of hospital acquired infections. It also permits efficient use of hospital facilities and minimizes the psychological burden on the patients for being admitted into a hospital.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

INPATIENT DEPARTMENT The inpatient department is the place where patients are admitted for longer duration or may be even for a day in case a day care facility is not available in a hospital. It is most important for this part of the hospital to be designed holistically keeping in mind the psychology of the patients. As it is also a home away from home, the environment of this unit must be warm, flexible and allow of freedom of use of space according to one’s need and suitability, while keeping health safety in mind. Its is also called as nursing unit or surgical care unit.

Types of nursing units are as follows: •General Wards •Private Wards •Isolation Room •Emergency Wards •Paediatric Ward Planning and Design Parameters

•Ensure privacy and safety for patients •Areas pertaining to adaptability that have physical design implications: peer line of sight, patient visibility, multiple division/zoning options, proximity of support, resilience to move/relocate/interchange units, ease of movement between units and departments, and multiple administrative control and service expansion options. •The nursing fatigue factor is a major design issue while planning for an IPD. Thus, nursing stations must be visible and at an optimum distance from each room. •Its should provide a humanized environment for faster healing and a comfortable stay. •It is vital to provide view of the outdoors and natural elements. •The facility may have wards, or multiple bed rooms , private rooms. •It should also provide for appropriate waiting/ accommodation space for at least one attendant, along with a pantry and other value added services easily accessible. •Separate provision for isolation rooms to avoid hospital induced infection in vital cases or communicable disease.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Flow diagram

Nightingale/ Pavilion Ward: The beds are longitudinally perpendicular to the walls, nursing statin in in the middle, with view to all the beds. The patients have no privacy. This type of ward is most economical to construct.

Rack track Ward: In this typology beds are arranged in private rooms, as 6 bedded, 3 bedded, double or single rooms. With nursing station in middle of the corridors.

T- shaped ward: In this type of wards, the bed bays are located right in front of the nursing station. The ancillary services are behind the nursing station

Courtyard Type: In this type, courtyard of varying sizes are inserted in the rack track ward type, for natural light and ventilation.

Circular Ward: In this the beds are with ancillary services in the middle.with nursing Station in the center. Thismaximum view of the patients, and

beds and reduces nurse fatigue. each patient has an equal view to outside.

Typical IPD PLAN

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Cruciform Ward: This has Cruciform Shape arranged all around a nursing station, In such type, nurses have the typology also provides equal view o all the

Operation Theatres Operation Theatre is a specialized facility in a hospital where life saving or life improving procedures are carried out on human body by invasive methods under strict sterile environment maintained mechanically to provide for safe and infection free results. According to thumb rules by IPHS, 2 OT’s are sufficient for every 100 beds in a hospital. Assuming the in a day 6 operations can be carried out in an OT. A major OT can be used for neurosurgical, thoracic, orthopaedic, gynaecological, urological operations, etc. All operation theatres have be compulsorily be septic and restricted for outside people or even the attendants to maintain its sterile environment.

Planning and Design Parameters ▪ Avoidance of unrelated hospital traffic flow in the O.T area. ▪ Convenient linkages with surgical ward, ICU, CSSD, Blood Bank, radiology department, Laboratory, accident and emergency department. ▪ Avoidance of out door source of noise. ▪ Exclusive zoning to avoid contamination from the outside. ▪ It does not require daylight or natural ventilation, as the air has to be mechanically ventilated and kept sterile to have a controlled environment. Corridors should not be less than 2.85 m in width to facilitate the movement of trolley and stretchers. ▪ In operating rooms, anaesthesia room, holding area, the colour of walls and ceiling should not alter the skin colour of the patient. ▪ Essential pharmaceutical storage should be available within the room. ▪ There should be a waiting room with toilet facilities for the patient’s attendants. ▪ Provision for future expansion/alteration. ▪ Door should be of the sliding type with minimum 1.2 m width. ▪ Corridor should not be less than 2.85 m. Protective zone

Clean zone

Sterile zone

Disposal zone

Reception, waiting area, trolley bay, changing room

Pre operative zone, recovery room, plaster room, staff room, store

Operating suite, scrub room, anaesthesia induction room, set-up room

Dirty utility, disposal corridor

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

INTENSIVE CARE UNIT ICU is a dedicated facility to critically ill patients who require invasive life support, high level of medical and nursing care and complex treatment. It is a unit equipped to treat critical sick patients promptly and efficiently. Depending on the Size of a hospital there may be separate ICU for each speciality such as: Cardiac, Neonatal, Paediatric, Neurology, Neurosurgery, Burn care centre, organ transplant. Planning and Design parameters •Location: Should be in close proximity to operation theatres, emergency department, imaging unit. •Number of Beds: as per IPHS that 5% - 10% of the hospital beds be designated for ICU. Though the number may vary depending on the size of the hospital. •Size of Unit: The no. of beds in one ward of ICU varies from 6 to 12. A unit lesser than 6 beds is not economically viable. • Each cubicle/ bed space should have an area of 4 m x 4m. Usually 20 sq.m. of area is taken in account for multiple bed unit. and 22 sq.m. for single bedded unit. •Lighting: The patient area should have 300 lux of light, and should be anti glare. Thus, daylight should be maximized while cutting the glare. It also provides for a much healthy environment for the patients. Thus, windows should constitute 15% of the floor area and should provide visual connect to the outside environment, preferably a natural setting. •Environment Controls: The air inside is mechanically controlled to have a sterile environment. •Space allocation for Beds: There should be 0.9 m space between the head end and the wall and 1.2 m between the foot end and the wall. The center to center distance between two beds should be 3.5 m. These spaces are used to facilitate procedures. •Patient visibility: They should be visible from nursing station for continuous observation. However, privacy is must if required, each bed should have its own privacy arrangement. •Isolation Rooms: There should be at least one isolation room per ICU. •Waiting Rooms: The location should provide optimum visual observation of patients yet kept away from the movement of patients to avoid any infection. It should be comfortable with overnight room facility for the relatives or attendant. •Nursing Station : the nurses fatigue factor is important while planning the ICU like in wards. U shape or a semi-circular ICU plan minimizes the movement required by the nurses and also provides maximum visibility of the patients. •Doctors Room: Room for duty doctors along with provision for overnight stay. •Staff Room: facility for locker and change for the staff, might include a pantry of its own.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

ICU DEPT. PLAN

DIAGNOSTICS Diagnostic Department consists of medical imaging services and also sample collection for blood, urine tests. It basically deals with any kind of tests required for diagnosis of disease. Depending on the type and size of the healthcare facility, the medical imaging unit may provide for X-ray, C.T scan, diagnostic investigations, fluoroscopy, ultrasound, ultrasonography, mammography, radiation procedures, MRI, etc. Planning and Design Parameters Flexibility in Design must ensure future expansion as technology keeps changing. Thus, room sizes should be flexible to allow for upgrading of machines and equipment. The imaging unit may consist of the following functional areas. • Reception • X-ray and screening room • Support areas like preparation areas, storage, disposal and utility room. • Film processing areas. • Film storage areas • Viewing and reporting areas. • Administrative area. • Staff amenities. Location •Should be ideally located on ground floor and be connected to IPD services, OPD and Emergency and Accident. •There should be a separate entrance for accident and emergency department.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

DIAGNOSTICS DEPT PLAN

LABORATORIES Modern medicine is becoming increasingly dependent on laboratory services for prevention, diagnosis and control of disease.it generate patient related information that enhance the delivery of healthcare. The hospital laboratory conduct tests for the diagnosis, progress and response to therapy.

• There should be scope of future expansion. Modular structural system ensure ease in future flexibility. • Special Plumbing, electrical and anti vibration measures should be incorporated. • Daylight to be utilized maximally. • It should be located close to acute patient care and ambulatory care. • The processing areas need not be accessible to the patients/public but the collection point should be. • The main determinants of space in a laboratory are the extent of automation and type of technology used in it. A standing human body requires 4 square feet space, whereas a sitting postures requires 6 square feet space.

Flow Chart of Laboratory

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

SERVICES

Services Flow diagram

CENTRAL KITCHEN

Kitchen should preferably be located at the ground floor. •The storage Area should be close to unloading bay. •Receiving Area should have easy access to outside for easy loading, unloading of disposals and supplies •Separate veg and non veg preparation and cooking areas. •Dietician’s office should be located close to the main kitchen. •Sufficient loading space for trolleys to be provided.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Central kitchen diagram

LAUNDRY The main functions of the laundry service are as follows: •Collection and receipt of soiled and infected linen. •Sorting, sluicing, disinfecting, washing and ironing of the linen. •Repair of damaged linen •Assembling and packaging specialty items and linen packs for sterilization. • Distribution of linen to the user departments. Location The location of the laundry should be convenient to the user units and close to the service elevator. Depending on the type of heath care building, it may be located in the basement with proper drainage. If possible, it should be n close proximity to CSSD and dietary services due to common requirement of steam from boiler plant. Also, material from laundry is also sent to CSSD for sterilization.

MEDICAL GASES A medical gas system involves a highly sophisticated life support network, which supplies medical air and oxygen for patient breathing, nitrous oxide for anaesthesia, medical air for driving orthopaedic tools and vacuum for suction. Planning and Design Parameters •Designated Area should have proper ventilation. •Location must permit delivery vehicles to load, dock and also clear passage for cylinders. •If gases are planned indoors, care must be taken to avoid: •Areas involved in critical patient areas. •Anesthizing locations •Locations storing flammables •Rooms containing open transformers or electrical points •DH sets •Kitchen •In the outdoor facility, an enclosure wall must be constructed of noncombustible materials. •Perimeter should be enclosed by fence up to 2 m high. •The oxygen cylinder should always be in open.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Laundry Flow diagram

CSSD A Central Sterile Supply Department (CSSD) is a hospital support service, which is entrusted with processing and issue of supplies including sterile instruments and equipment used in various departments of a hospital.

Planning and Design Parameters •There should be no Back tracking of sterile goods •The clean, sterile and dirty areas should be separated by physical barriers. •Space requirement depends on the total number of beds. It varies from 0.7 to 1 square meter per bed

MORTUARY CSSD PLAN

The main objective of this facility is to provide for a suitable place for temporary holding of a dead body. Location •the need for adequate vehicular access from the service road; • where the facility is located on a hospital site, the functional layout of the hospital and the need for the mortuary to be discreetly sited away from clinical, kitchen and dining areas, with no direct entry to public and staff thoroughfares; • the desirability for the mortuary to be located at ground level; • the need for convenience of access by the various users (staff, visitors and undertakers); • the need for the mortuary to be associated with/or near a histopathology laboratory;

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Mortuary plan

TYPOLOGIES

NAME

Street typology

Campus

DIAGRAME

DISCRIPTION

ADVANTAGE

DISADVANTAGE

EXAMPLES

The pavilions would often have clinical spaces on lower levels with wards above.

Flexibility and extendibility as well as legibility that the street itself offers to patients.

Large area needed for circulation

Wythenshawe Hospital, Manchester; Northwick Park Hospital, London; Westmead Hospital, Sydney.

Individual Buildings disposed around the site with or without enclosed circulation network.

Flexibility. Segregation of traffic flow

Large area needed for circulation

It is a pattern of segregation of the diagnostic ant treatment on the one hand, and on the other the nursing functions along a shared circulation.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Efficient circulation

Artificial ventilation needed.

Hospital sites that have been built up over the years with successive additions.

Norfolk and Norwich Hospital

2.2 HOSPITAL TYPOLOGIES NAME

Linked Pavilion or Finger Plan

Low-rise multicourtyard or Checkerboard

Monoblock

DIAGRAME

DISCRIPTION

The oldest typology and still in common use. The pavilions would often have clinical spaces on lower levels with wards above.

ADVANTAGE

▪ Flexibility ▪ Segregation of traffic.

DISADVANTAGE

EXAMPLES

Large area needed for circulation

Woolwich Hospital and St Thomas’s Hospital, London.

This typology can offer a human scale in contrast to the institutional character that tends to overwhelm most Hospital design.

▪ Flexibility ▪ Segregation of traffic.

The small atria/lightwells can take many forms and the lower floors may have fewer, with deep planning for non-patient areas or operating theatres..

• Circulation efficient. • Opportunity to incorporate Interstitial Service Floors

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

It will tend to apply to the larger, nonurban sites or smaller hospitals.

Artificial Ventilation needed.

Wexham Park Hospital; Venice Hospital(unrealized design by Le Corbusier); Homerton Hospital, London.

Greenwich Hospital, London(demolished); Boston City Hospital; McMaster University Hospital, Ontario.

NAME

DIAGRAME

DISCRIPTION The wards are

ADVANTAGE Effective on

tower with clinical Hospital, Generally in the in the slab. and technical areas

urban sites

Podium

The wards are

Effective on

or more with two towers

towers with clinical Generally in the in the slab. and technical areas

Avoids some of urban sites

Podium and tower

DISADVANTAGE Upper floors can be travelling distance.

travel distance. the potential

problematic in terms of

EXAMPLES Bridgeport Hospital, of Wales Connecticut; Prince Hospital, London. Sydney; Royal free

Require large site area

between two blocks. for proper distance

The clinical and

Day light can

Cellular Character of

generally in lower technical areas are upper levels. levels with wards on

working floors penetrate sides. from both

makes this a less hospital building obvious solution

Hospitals (PFI). Birmingham

New Childrenâ&#x20AC;&#x2122;s Hospital, Sydney;

Westminster Chelsea and Hospital for Sick Hospital, London; Children, Toronto.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

THE HEALING ENVIRONMENT The word healing comes from Anglo-saxon word haelen, which means to harmony of mind, body and sprit. Healing is not the same as curing, which is about fixing problems eradicating dieses and decreasing symptoms. People can be healed even if they are not cured. Such environment can reduce stress and anxiety, which positively affects our health in a number of ways. Neuroscience is showing that our brain and nervous, endocrine and immune system are constantly interacting. As neuroscientist said that “what you are thinking at any moment is changing your biochemistry of body”. Thus a noisy, confusing hospital room might leave a patient not only feeling worried, sad or helpless but also raise his/her blood pressure, heart rate and muscle tension. The samueli institute, has developed a model that suggest that healing is the result of intension, personal wholeness, relationships, healthy lifestyle, collaborative medical care and healing spaces. Thousands of year ago, the Greeks designed temple that surrounded patient with nature, music, and art to restore harmony and promote healing. In 19th century, Florence nightingale spoke of the importance of natural light, fresh air and quiet for healing , saying that health care providers should put patient in the best possible condition so that nature can act and healing can occur. THERAPEUTIC ENVIRONMENT It is the environment which aids healing, thus becomes part of the therapy process. Characteristics of Therapeutic Environment are ▪

It is safe. (No Hospital infections)

▪

It is appropriate for Healing, in fact it aids healing. (Environmental factors do not create too hot or too cold temperatures; too hot temperatures lead to sweating, makes a person susceptible to secondary infection, too cold temperatures lead to vasoconstriction of surface vasculature, again making the person susceptible to secondary infection) It means controlling all Environmental parameters.

▪

It is secure. (No Stress) Every effort should be made to make the Hospital stay as unthreatening, comfortable, and stress-free as possible. Hospital patients are very anxious, confused and apprehensive. Their attendants are even more anxious. These feelings impede recovery to good health and may prolong patient’s stay in the hospital. A Hospital's interior design should be based on a comprehensive understanding of the facility's mission and its patient profile. The characteristics of the patient profile will determine the degree to which the interior design should address specific problems related to aging, loss of visual acuity, other physical and mental disabilities. A proper design provides physical, mental and psychological comforts when using the Hospital facility thereby reducing conflict between Hospital staff and patients (including their attendants) and specifically addresses the abusiveness tendencies. It must meet the expectations of the majority of Hospital Users. Do not provide air-conditioned interiors to tribal, villagers or Guzzars; just as you would not provide the South Indian meals in a Hospital located in North India.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Some important aspects of creating good therapeutic interior are: 1.

Use familiar and culturally relevant materials wherever consistent with sanitation and other functional needs

Use cheerful and varied colours and textures

Use natural light and ventilation wherever feasible

Wherever possible, provide the outdoor view from every patient bed

Use photo murals of nature scenes

Repeat similar objects and patterns to establish continuity

Design a "way-finding" process by using signage, graphics and artwork to facilitate movement of Patients, visitors, and staff

FACTORS AFFECTING HEALING ENVIRONMENT DAY LIGHT "Light is so fundamental that it has come to symbolize life itself just as its opposite, darkness, symbolizes death". Light is known to affect hormonal and metabolic balance and entertainment of body rhythms. In fact, neuroscientists, believes: "Light is the most important environment input, after food, in controlling the body function". Daylight reduces pain and depression as well as improves patient and staff satisfaction. Research indicates that exposure to light â&#x20AC;&#x201C; daylight or bright, full spectrum artificial light â&#x20AC;&#x201C; is effective in reducing depression even for those hospitalized with severe depression. COLOUR Colour has the quality to control the healing environment-by making patents/visitors relax, and they improve the paramedical staff performance by reducing fatigue and enhancing concentration. The predominant colour used in healthcare buildings is either cream or off-white, due to their neutral ambience. However, now with the greater understanding of human psyche and the healing quality of various colours, they are being used in healthcare buildings for better visual expressions. Colours can be used to create variety and continuity, yet maintain a balance. It can also be exploited to assist in way finding.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

SMELL Unpleasant smell are known to increase heart rate and respiration and have opposite effect. Researchers have shown that olfactory messages reach the brain faster than aural signs. Research at Yale and Duke has demonstrated that sniffing specific floral and fruit fragrances slowed respiration, lowered blood pressure and heart rate, and relaxed muscles. Recent research conducted at Milan University has shown that essential oils are effective in treating anxiety and depression. NOISE noise is one of the most noxious of environment stressors: It produces a generalized stress reaction that can increase blood cholesterol levels, increase the need for pain medications by lowering al individual’s pain individual s threshold, and keep brain stimulated so that the patient cannot rest or sleep, which impedes healing. In words of Florence Nightingale-”unnecessary noise…is the most critical absence of care which can be inflicted on the sick or well’. Hospitals are attempting to both reduce the sources of and improve soundproofing with sound-absorbing ceilings and carpeting in order to reduce stress. Carpet alone can reduce ambient noise by up to 70%. ART AND MUSIC The art is an expression by humanity that carries the legacy of the culture and touches the heart. Art has the tendency to stir emotions in people and help overcome stress in the deepest need. In the hospital setting, music and art therapy can help to distract people from their pain, enable them to feel that life is worth fighting for. This state of mind positively Influences healing and enhances immunologic competency. "Music can also have an analgesic or painkilling effect when pleasure centres of the brain stimulate the pituitary gland to release endorphins. Soothing music has been known to lower the levels of catecholamine, such as adrenaline, and to lower blood pressure, heart rate, and the amount of free fatty acids in the blood, potentially reducing the risks of hypertension, stroke, and coronary heart disease. This is the reason why music has been used to help treat depression, to reach autistic children, and to relax agitated psychiatric patients. NATURE/LANDSCAPE A number of studies have presented strong evidence that even 3 to 5 minutes of contact with nature can significantly decrease stress, reduce anger and fear, and increase pleasant feelings. Indoor gardens, aquariums, and landscapes to bring nature into the environment. Current design standards encourage the use of large windows in patient areas that allow patients and their visitors to see outside and receive the benefits of natural light. Patients in rooms that receive more sunlight may be less depressed and have shorter stays. For those reasons, windows are now considered a therapeutic component of patient rooms. Several researches have shown that just the view of the park or natural elements can be restorative even in the acutely stressed patients. View of the vegetation or the greenery, reduces the hypertension and the blood pressure levels, inducing positive emotions like, happiness, joy etc. and reducing pain, fear, anger and tension. Green outdoor spaces not only provide for a beautiful setting for a hospital but also allow patients to engage in more physical activity, resulting in a healthier physical health too. When a patient is equally exposed to a heavy vegetated area and a concrete wall, he feels more relaxed and calmer at the view of the greens.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

INFERENCES: • After studying the various departments of the hospital it can be concluded that various departments of a hospital, though are individual units, yet they have complex inter-relation with each other and understanding these inter- relations is very important while designing a hospital. • The design of the healthcare environment can have a therapeutic effect on patients. Understanding the senses is the key to good design it allows designers to design with greater skill and enables them to create truly responsive healing environments.

DEVELOPING A HEALING ENVIRONMENT: Light • No glare lighting in patient Room. • Ability to control intensity of Light • Good reading light •Window should be low enough for patient to see outdoors while lying in bed •Patient room lighting should be full spectrum Colour • Careful use of color to create mood, lift spirit, and-make rooms cheerful • Use in bed linens, bedspreads, gowns, personal hygiene kits, accessories, food trays Views of nature •Views of nature from patient’s room •Indoor Landscaping. Texture • Introduce textural variety in wall surfaces, floors, ceilings, furniture, fabrics, and artwork

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Noise control • Sound of footsteps in corridor •Slamming doors, clanking latches • Loudspeaker paging system • Other patients' televisions and radios • Clanking of dishes on food carts Air quality • Need for fresh air, solarium, or roof garden • Avoidance of odiferous cleaning agents • Adequate number of air changes. Thermal comfort • Ability to control room temperature, humidity, and air circulation to suit personal needs.

Accommodation for families • Provide place for family members to make them feel welcome, rather than intrusive • Provide visitor lounges and access to vending machines, telephones and cafeteria

CHAPTER 3 :- CASE STUDIES LIVE CASE STUDY 3.1 Rockland hospital,Qutub institutional area, New Delhi 3.2 Fortis hospital, Gurgaon, haryana LITERATURE CASE STUDY 3.3 Bronson methodist hospital, kalamazoo, Michigan

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

3.1 CASE STUDY : ROCKLAND HOSPITAL,QUTUB INSTITUTIONAL AREA, NEW DELHI NAME OF PROJECT : ROCKLAND HOSPITAL

ARCHITECT : Ar. ANIL YADAV LOCATION : QUTUB INSTITUTIONAL AREA, NEW DELHI.

Rockland Hospital

CAPACITY : 150 Beds. SITE AREA : 3360sqm (approx.)

Foundation for Applied Research in cancer

F.A.R.: 1.8 Ground Coverage: 45%

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

ZONING: â&#x20AC;¢BASEMENT

GROUND FLOOR

FIRST FLOOR

SECOND FLOOR THIRD FLOOR FOURTH FLOOR

OPD SERVICES RADIOLOGY LABORATORY OPD PHARMACY OFFICE RECEPTION CUM WAITING AREA PHYSIOTHERAPY DAY CARE UNIT OPERATION THEATRE OPERATION THEATRE ICU POST OPERATIVE WARDS PATIENTS ROOM PATIENTS ROOM PATIENTS ROOM

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

N SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

SECOND AND THIRD FLOOR

N SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

3.2 : LIVE CASE STUDY :- FORTIS HOSPITAL , GURGAON Fortis Memorial Research Institute Location : sector 44, Gurgaon Site area : 43,303 sq. m. Built – up area : 65,961 sq.m. FAR: 1.52 Principal Architect : Ar. Rajinder kumar, Rajinder Kumar Associates, New Delhi Fortis Memorial Research Institute, Gurgaon (FMRI) is a flagship hospital of the Fortis Healthcare Limited. FMRI is a multi super-speciality, hospital. FMRI is a set on an 11 –acre campus. It has 430 functional beds, with a further planned increase in beds to 1000. FMRI is accessible easily by road, It can also be reached using Delhi Metro, as the hospital is located opposite to the HUDA city metro

DEPARTMENTS:Minimal Access, Bariatric & GI Surgery Plastic Surgery Ophthalmology Pulmonology Plastic Surgery Dental Sciences Internal Medicine Cosmetic & Plastic Surgery Invasive Cardiology Paediatrics Minimal Assess Surgery (Gynae) C-DOC Neonatology IVF Liver Transplant, GI & Hepato Pancreato The main aim of Biliary Surgery hospital is Mental Health & Behavioural Science creating a Radiation Oncology environment not Radiology to give feeling of Rheumatology a boring hospital. ENT Gastroenterology & Hepatobiliary SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI Sciences

NO. OF BEDS- 430 TUMMY LUCK

General care beds: 250 ICU beds : 100 OPD chamber- 80

A multi-cuisine food court

CRECHE

FACILITIES-

A day care and an activity centre for children.

MEDITORIUM An auditorium for knowledge sharing programme

R & R LOUGE Rest options with recliners, private cubicles, shower, and locker facilities for attendants.

HEALTH4U Preventive programme with lifestyle Interventions including tailor-made health screenings.

FORTIPLEX Movie lounge

TERI GRIHA RATING ▪ Air- conditioned area : 26,254 sq.m ▪ Non- Air- conditioned area : 44,612 sq.m ▪ Energy consumption reduction : 33% reduction in energy consumption compared to TERI GRIHA benchmark ▪ EPI : 154 KWh/ sq.m/year ▪ Renewable energy installed on site : Rated capacity of solar PV installed on site is 25 KWp ▪ TERI GRIHA provisional rating : 4 stars

Air-conditioned area

Non-Air-conditioned area

The following strategies were adopted to reduce the building impact on the natural environment : ▪ Sustainable site planning ▪ Top soil from the site, which was not very fertile was stacked, preserved, made fertile with the addition of manure and re- laid on the landscape areas. ▪ Consolidation of all site services along the transportation corridors minimizes the site disturbances. ▪ Surface parking is provided with 100% grass pavers reduce the heat island effect on site. ▪ Sufficient plantation done at the site reduces the noise levels considerably and enhances exterior environmental quantity. ▪ Reducti on in water consumption (compared to GRIHA benchmark) : ▪ Low flow plumbing fixtures used to minimize the building water consumption reduction by 63%. ▪ Drip Irrigation system adopted on the site along with native plant species to cut short the landscape water consumption by 50%. ▪ 100% Treated water from sewage treatment plant is reused for cooling towers and irrigation purposes. ▪ Reduction in energy consumption (compared to GRIHA benchmark) while maintaining occupant comfort : ▪ For achieving visual comfort ▪ Ingress of daylight in patient areas & Waiting areas. ▪ Landscape in sync with the Architectural spaces to provide visual comfort. ▪ For achieving thermal comfort ▪ Use of AAC blocks, Double Glazing & Roof insulation. ▪ Renewable energy technologies installed on site : ▪ Solar Photovoltaic Panels for 25 K Wp are installed at site. ▪ Solar Water heaters for 8000 litres are also installed to meet the surplus hot water requirement after heat recovery system.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

▪ Use of low energy materials : ▪ Autoclaved Aerated Concrete blocks are used for the construction of building. ▪ Cement with sufficient percentage of fly ash had been used for the construction. ▪ Low embodied energy construction materials and finishes have been used in the hospital interiors.

VERTICAL DISTRIBUTION OF SPACES Typical Floor Third Floor (patient beds 67) Service floor Second floor (surgical floor 10 OT. ICU BEDS 92) First floor (maternity ICU 62 beds, wards, ICU relatives

Upper ground (maternity, atrium lobby)

Lower ground (diagnostics, OPD, ER) Basement (parking, plant rooms)

DISTRIBUTION OF SPACES FLOOR-WISE PLOT BOUNDARY

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

SITE PLAN-

Emergency parking (36 cars) Main OPD drop off

Ramp up and down for parking Service entry drop off

Emergency parking (36 cars)

FORTIS HOSPITAL

OPD Entry/ex it

Site area : 43,303 sq.m Built-up area : 65,961 sq.m FAR : 1.52 Surface parking : 143 cars

Servic e Yard -8800

Total no. of entry/exit in the building-

-2750

Serviceentry/ex it

+1500

Oxyge n plant Materni ty entry/ex it

S E

Maternity ward drop off

Maternity ward Parking (71 cars) Emergenc y drop off

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

▪ ▪ ▪ ▪ ▪

OPD entry- at lower ground floor to the OPD Main entry- at upper ground floor Emergency entry- at lower ground floor Service entry- at upper ground floor Oncology OPD entry- at upper ground floor

Total no. of entry/exit in the site▪ ▪ ▪ ▪

OPD entry- at lower ground floor Maternity entry- at upper ground floor Emergency entry- at lower ground floor Service entry- at upper ground floor

Emergenc y entry/exit Oncolog y drop off

BASEMENT PLAN

LINAC (Radiation therapy) used for treatment of oncology has 1 to 1.5 meters thick wall

LINAC (Radiation therapy)

D.G.Room

Total parking in the basement▪ 280 cars parking ▪ 51 two wheeler parking

S E

Admin area Service yard Mechanical therapy Radiation therapy Lifts and services

BASEMENT IS USED FOR▪ The basement is used for engineering services plant room like HVAC, LT panel room, DG room, Pump rooms etc. ▪ And it is also used for radiation therapy used in oncology treatment. ▪ And for parking and HR department and staff areas.

HVAC Plant Room

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Water Supply And Fire Fighting Pump

LT Panel Room

LOWER GROUND FLOOR IS USED FOR

LOWER GROND FLOOR S E

▪ ▪ ▪ ▪ ▪ ▪ ▪

OPD Oncology OPD Laundry CSSD Radiology Emergency Physiotherapy department

Total area of lower ground floor – 7864.890 SQ.M.

Laundry Radiology

Laundry

CSSD

Lower G.F.

OPD OPD entry

Emergency Entry

Swimming pool Physiotherapy Gym Physiotherapy

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Oncology

UPPER GROUND FLOOR FLOOR

UPPER GROUND FLOOR IS USED FOR-

Kitchen

Food Court

▪ ▪ ▪ ▪ ▪ ▪ ▪

Maternity ward SPA kitchen Food court Finance department Shop arcade Health check-up area

Total area of lower ground floor – 7864.890 SQ.M. Food Court

Finance deptt.

S E

Waiting

Health checkups

Waiting

Shops SPA Maternity Ward

SPA Food court Finance Deptt. Maternity ward Kitchen Shops Health check-up

SPA

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Shops

SECTIONS -

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

3.3 LITERATURE CASE STUDY :BRONSON METHODIST HOSPITAL DESIGN TEAM : SHEPLEY BULFINCH RICHARDSON & ABBOTT LOCATION : KALAMAZOO, MICHIGAN CAPACITY : 405 BEDS. SITE AREA : 17.2 Acre (approx.) F.A.R : 1.25 GROUND COVERAGE : 25%

THIS NEW, 750,000 SQUARE-FOOT, FULL-SERVICE MEDICAL CAMPUS COMBINES MEDICAL OFFICES, AMBULATORY CARE, AN INPATIENT HOSPITAL, AND PARKING INTO A COHESIVE PATIENT EXPERIENCE THAT REFINES THE "MEDICAL MALL" PLANNING CONCEPT. MEDICAL SPECIALTIES ARE ARRANGED HORIZONTALLY WITHIN A SERIES OF LINKED BUILDINGS TO PERMIT EASY TRANSITION FROM ARRIVAL TO MEDICAL BUILDINGS, OFFICE, TO AMBULATORY, TO INPATIENT CARE. EACH LEVEL IS DEVOTED TO A PARTICULAR SPECIALTY. THE GARDEN LEVEL PROVIDES SERVICE FUNCTIONS INCLUDING A HEALING GARDEN THAT SERVES AS THE "HEART" OF THE COMPLEX AND A FOCAL POINT FOR A SERIES OF LINKED MULTI-STORY ATRIA THAT EXTEND FROM THE GARAGE TO THE INPATIENT PAVILION. LEVEL ONE HOUSES DIAGNOSTIC IMAGING AND EMERGENCY, ORTHOPEDIC BEDS AND A TRAUMA/BURN ICU UNIT; LEVEL TWO IS SURGICAL SERVICES; LEVEL THREE IS WOMEN’S AND CHILDREN’S SERVICES; AND LEVEL FOUR CONTAINS CARDIOLOGY AND ONCOLOGY SERVICES.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

SITE PLAN SITED AT THE EDGE OF A MID-SIZED DOWNTOWN COMMERCIAL DISTRICT AND A RESIDENTIAL NEIGHBOURHOOD, THE SOLUTION REQUIRED CONSIDERABLE SENSITIVITY TO SCALE IN RESPONDING TO THE MODEST ENVIRONS. THE FACILITY TAKES A HOLISTIC APPROACH TO HEALING, FEATURING INDOOR GARDENS, A NATURAL COLOUR PALETTE, ART, INTUITIVE WAY FINDING, CONSIDERABLE NATURAL LIGHT, AND PATIENT ACCESS TO MEDICAL INFORMATION. A CONTINUOUS RIBBON OF BEDROOMS THAT RANGES FROM ACUTE AT ONE END TO INTENSIVE CARE AT THE OTHER, WITH A STRING OF ROOMS IN THE MIDDLE THAT ARE CHANGEABLE IN USE DEPENDING ON PATIENT POPULATION, MAKES THIS A VERY FLEXIBLE FACILITY. THE PROJECT HAS ACTED AS A CATALYST FOR FURTHER REDEVELOPMENT IN THE

INTERIOR VIEWS OF HOSPITAL

COMMUNITY, SPURRING THE CITY OF KALAMAZOO TO REGENERATE ITS DOWNTOWN CORE WITH HOUSING AND RETAIL.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

LAYOUTS OF HOSPITAL :

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

LAYOUTS :

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

SUSTAINABLE FEATURES:

INTERIOR VIEWS OF HOSPITAL

EXTERIOR VIEWS OF HOSPITAL SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

TECHNIQUES USED IN BRONSON METHODIST HOSPITAL FOR A GREEN HOSPITAL AND CREATING A HEALING ENVIRONMENT: •THE HOSPITAL JUST TORE DOWN A 10-STORY BUILDING, AND 75 PERCENT OF IT WAS RECYCLED. BRONSON HAS A TOTAL RECYCLING RATE OF 44 %. •BY CHANGING TO LIGHT-EMITTING DIODE (LED) FLATSCREEN COMPUTER MONITORS AND FLUORESCENT LAMPS AND BY INSTALLING FREQUENCY DRIVES, WHICH ACT LIKE THERMOSTATS SO THAT AIR HANDLERS ONLY RUN WHEN NEEDED, THE HOSPITAL MADE SIGNIFICANT REDUCTIONS IN POWER USAGE. A NEW CHILLIER PLANT, WHICH COOLS WATER AS NEEDED FOR AIR CONDITIONING, SERVES THE ENTIRE HOSPITAL CAMPUS AND IS SO EFFICIENT THAT IT PROVIDES FREE COOLING IN THE WINTER MONTHS. •A CENTRAL SKY LIT ATRIUM SPACE IS THE "HEART" OF THE COMPLEX AND INCLUDES RETAIL, PHARMACY, CHAPEL, FOOD COURT, LIBRARY, AND EDUCATIONAL SPACES. THESE AMENITIES CREATE A LIVELY AND ACCESSIBLE FACILITY THAT IS ORIENTED TOWARD FAMILY AND COMMUNITY USE. •THE MAIN ENTRANCE AT JOHN STREET GREETS VISITORS WITH A LIGHT-FILLED CORRIDOR THAT LEADS DIRECTLY TO THE MAIN LOBBY OF THE HOSPITAL. •THE GARDEN ATRIUM IN THE CENTER OF THE BUILDING INCORPORATES LIGHT, WATER AND GREENERY TO CONNECT PATIENTS AND VISITORS WITH THE HEALING POWERS OF NATURE. •THE GREENERY ON THE OUTSIDE ALSO CREATES A SERENE ENVIRONMENT WHICH FACILITATES QUICK HEALING. 44

CHAPTER 4 : ACTIVITY PROGRAM ANALYSIS 4.1 AREA PROGRAM 4.2 QUALITATIVE ANALYSIS

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

4.1 : AREA PROGRAMMING Area program i a b c d e f g ii a b c iii a b c iv a b c d e f v a b c d vi a b c d vii a b c d e viii a b c d e f

1 OUT-PATIENT DEPARTMENT (OPD) General Entrance hall with enquiry counter, cash counter and Record Area Officer- in - charge Nurse-in-charge Sanitory Inspector Room OPD Record Room Canteen Janitor Closet Medical Clinic Consultation and examination room Treatment Room Waiting Surgical Clinic Consultation and examination Treatment and dressing/minor surgery Waiting Area Orthopedic Clinic Consultation and Examination Room Plaster and Splint Storage Room Fracture and treatment Plaster cutting room Recovery Room Waiting ENT Clinic Consultation and Examination Treatment Audiometric Room Waiting Eye Clinic Consultation and Examination Room Minor Surgery and treatment room Dark Room Waiting Dental Clinic Consultation and Examination Room Dental Hygienist Room Recovery Dental Workshop Waiting Obstectric and Gynaecological Clinic Reception and registration Consultation and Examination Treatment Clinical Laboratory Toilet cum Changing Waiting

ROOM NO.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

AREA(SQ.M)

TOTAL AREA(SQ.M)

1 1 1 1 1 1 1

150 17.5 17.5 14 35 30 12

4 2 1

17.5 14 50

70 28 50

4 1 1

17.5 17.5 50

70 17.5 50

3 1 1 1 1 1

17.5 14 17.5 17.5 14 50

52.5 14 17.5 17.5 14 50

3 1 1 1

45.5 14 14 50

136.5 14 14 50

4 1 1 1

45.5 17.5 17.5 50

182 17.5 17.5 50

3 1 1 1 1

21 17.5 14 17.5 50

63 17.5 14 17.5 50

2 4 1 1 1 1

17.5 21 17.5 17.5 14 50

35 84 17.5 17.5 14 50

f a b c d e f x a

xi a b

xii a b c d e f

a b c d e f g h i

Paediatric Clinic Consultation and Examination Dressing, treatment and Dispensing Therapy Room Immunisation Room Recreation and Playroom Waiting Skin and STD Clinic Consultation and Examination Treatment Room Skin laboratory Waiting Psychiatric Clinic Consultation and Examination ECT Room Recovery Room Psychologist Room Social Worker Room Waiting Supporting facilities Central Injection Room Specimen Collection Room Clinical Laboratory Social Worker Room Store Room Waiting Total Circulation Area NET TOTAL OPD

4 1 1 1 1 1

21 17.5 17.5 17.5 30 50

84 17.5 17.5 17.5 30 50

2 2 1 1

17.5 17.5 21 40

35 35 21 40

1 1 1 1 1 1

17.5 21 21 17.5 17.5 40

17.5 21

2 1 1 1 1 1

17.5 17.5 17.5 14 35 40

35 17.5 17.5 14 35 40 2208.5 883.4

17.5 17.5 40

40% 3091.9

2 Pharmacy Dispensing Area with issue counter Preperation and compounding area Bottle Washing area Queing Area Pre-Packaging Area Stores Total

Room No.

3 Blood Bank Reception and Waiting Bleeding Area Donor's Rest Room With Kitchenette Doctor's Room with toilet Blood transfusion Office Room with Toilet Lavatory Janitor's Closet Stores Laboratory Area Technician's Room with Toilet Routine Serology Component Lab Special test Lab Sterlization and Washing Component Storage and Frozen Bank Issuing Counter Total Circulation Area NET TOTAL BLOOD BANK

Room No.

Area(sq.m.) 1 1 1 1 1 1

Total Area (sq.m.)

35 17.5 17.5 50 14 20

35 17.5 17.5 50 14 20 154

Area(sq.m.)

Total Area (sq.m.)

1 1 1 1 1 1 1 1

40 45 45 17.5 25 14 9 30

1 1 1 1 1 1 1

21 17 17 17 17 14 10.5

21 17 17 17 17 14 10.5 339 101.7

30% 440.7

4 Accident and Emergency Department

a b c d e f g h i j k l m n o p q r s t u v w x y z

a b c d e

f g h i j k l m n o p q r

Room No.

Drive in Ambulane (reception, public phone, trolley bay, waiting areas, police post, etc.) Triage Officer on Duty Doctor's Duty Room with Toilet Medico Legal Specimen and Record Room Brought in Dead Room Retiring Room for ambulance drivers ECG Room Fracture treatment room with plaster preperation Treatment Room Instrument Sterlisation Scrub Up Dirty Wash Resuscitation Room(3 Beds) Doctor's Lounge X-ray Room Consultation Room Injection Room Blood Storage Area Drug Dispensing Facility Stores Sluice Room and Janitor Closet Nurses Station with toilet Observation Room Emergency Ward(20 Beds) Pantry Total Circulation Area NET TOTAL Accident and Emergency Department 6 Diagnostics Reception and Specimen Collection Patients waiting area toilet Radio Diagnostic Unit Reception registration with waiting area and toilet X-Ray Room, with waiting area, changing area, and toilet 100mA units 200 mA Units Film Developing and processing area Film Drying Room Contrast Studies and Preperartion Room Stores X-ray Record Room Radiologists office with Toilet Technicians room with toilet Nurses Room with toilets Fiml Viewing room Office Trolley Bay Switch Room Janitor's Closet

Area(sq.m.)

1 1 1 1 1 1 1 1

250 50 21 21 10.5 10.5 17.5 14

1 1 1 1 1 2 1 1 2 1 1 1 1 1 1 4 1 1

ii a b

Total Area (sq.m.)

250 50 21 21 10.5 10.5 17.5 14

17.5 40 10.5 10.5 10.5 50 30 35 14 14 10.5 10.5 30 14 35 35 300 17.5

17.5 40 10.5 10.5 10.5 100 30 35 28 14 10.5 10.5 30 14 35 140 300 17.5 1248 436.8

35% 1684.8 Room No.

Area(sq.m.)

Total Area (sq.m.)

1 1 1

50 50 30

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

21 42 14 14 14 21 21 24 24 24 21 21 10.5 17.5 10

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

c d e f g h

a b c d e f g h i j k l m n

i a b c d e f g h i j k l ii a b c d f g h i iii a b c d e f g h iv a b c d

Radio Therapy Unit Contact Therapy Superficial Therapy Intermediary therapy with dressing cubicles and control desk Physicist Room with laboratory CT Scan Reception and waiting with toilet total area Circulation Area NET TOTAL Diagnostic Department

7 Laboratories Pathology Lab with toilet Office and record Technicians room with toilet Stores Biochemistry Microbiology with incubator Media Room Clinical pathology and heamotology Histology and cytology Washing and sterlisingArea Routine Lab Sereology laboratory Janitor's Closet Specimen Disposal and Sluice Room Total Circulation Area NET TOTAL Laboratories 8 Operation Theatre Department Zone A OT Reception Bay Relatives Waiting Office-in-charge of OT with toilet Doctor's change room Nurses Change Room Technician change room Class IV staff change room Sterile storage area Instrument and linen room Trolley Bay Gas Cylinder Storage Switch Room Zone B Fracture-cum casualty theatre Pre-operative room with toilet recovery room( 6 beds) nurses duty room Theatre pack preperationroom Frozen section X-ray room with dark pantry Zone C Operation Theatre(Major) Operation Theatre (Minor) Intrument Sterilization Scrub Up Anaesthesist Room Conference Room Doctor's work room Nurses work room Zone D Dirty Utility Janitor's Closet Total Circulation Area NET TOTAL Operation Theatre

1 1

21 24

1 1 1 1

21 36 42 50

21 36 42 50 673 235.55

35% 908.55

Room No.

Area(sq.m.) 4 1 1 4 1 1 1 1 1 1 1 1 1 1

Total Area (sq.m.) 42 30 24 17.5 36 32 21 42 80 40 36 42 17.5 10

168 30 24 70 36 32 21 42 80 40 36 42 17.5 10 648.5 226.975

35% 875.475 Area(sq.m.)

Room No.

Total Area (sq.m.)

1 1 1 1 1 1 1 1 1 1 1 1

30 40 21 24 25 24 25 25 36 21 21 17

1 1 1 1 1 1 1 1

30 56 60 21 24 24 21 17

6 1 3 3 1 1 1 1

35 35 21 17.5 36 56 24 36

210 35 63 52.5 36 56 24 36

3 1

14 12

42 12 1128.5 394.975

35% 1523.475

b c d e f g h i j k l m n o p q

a b c d e f g h i j k l m n o p q r s t

9 In Patient Department 9 In Patient Department Wards Room (4 beds) Wards Room (2 beds) Wards Room (1 bed) Common Toilets Nursing Station with work area and toilet Doctor's Duty Room Record Room Procedure Room Treatment Room Ward pantry Ward Store Trolley Bay Sluice Room Janitor's Closet Day Space Patient's relatives waiting area with toilet Total Circulation Area Net total In Patient Department

Room No.

10 Delivery Suite Unit Reception and Admission with waiting area Examination and preperation room Doctor's change room Nurse change room class IV Change room Technician change room Sterile storage Instrument and linen store trolley bay switch room recovery room Anaesthesia Room Labour room Delivery room Operating Delivery room Instrument sterilization scrub up children birth room dirty room janitor's closet Total Circulation Area Net total Delivery Suite Unit 910

Room No.

40 15 10 10 8 8 8 4 7 7 7 7 7 7 7 7 7

Area(sq.m.) Total Area (sq.m.) 60 60 36 36 36 40 36 24 21 24 36 36 21 24 10 36 60

2400 900 360 360 288 320 288 96 147 168 252 252 147 168 70 252 420 6888 2755.2 9643.2

40%

1 1 1 1 1 1 1 1 1 1 1 1 2 2 1 1 2 1 1 1

Area(sq.m.) Total Area (sq.m.) 100 30 21 21 21 21 24 27 17 17 21 24 56 36 36 14 10 30 12 10

40%

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

100 30 21 21 21 21 24 27 17 17 21 24 112 72 36 14 20 30 12 10 650 260

b c d e f

a b c d e f g h i j k l m

i a b c d e f g h i j k

Neonatal Intensive Care Unit(NICU) Room No. Area(sq.m.) Total Area (sq.m.) Nursery Premature 1 36 36 Septic 1 48 48 Normal 1 48 48 Nurses Station with toilet 1 48 48 Doctor's Duty Room with toilet 1 21 21 Formula cum breast feeding room 1 21 21 Store 1 17 17 Sluice Room 1 12 12 Total 251 Circulation Area 35% 87.85 Net total Neonatal Intensive Care Unit area 338.85 12 Intensive Care Unit(ICU) Patients relatives waiting area Wards(7 beds) nurse station with toilet Nure Change Room doctor's room with toilet Equipment Room Conference Room Stores Pantry Switch Room Trolley Bay Sluice Room Janitors Closet Total Circulation Area NET TOTAL ICU 820.8

Room No.

13 Services C.S.S.D. Reception and Receiving Counter Administration office Inspection Area Wash and Disinfector Sterlisation Area Packing Area Storage Area Issue Counter Staff Changing Room Trolley Bay Janitor's Closet Total Circulation Net C.S.S.D. 352.3

Room No.

1 2 2 1 1 1 1 2 1 1 1 1 1

Area(sq.m.) Total Area (sq.m.) 50 120 36 24 21 24 48 24 21 21 17 12 10

35%

50 240 72 24 21 24 48 48 21 21 17 12 10 608 212.8

Area(sq.m.) Total Area (sq.m.) 1 1 1 1 2 1 1 1 1 1 1 30%

30 17 30 45 21 21 35 12 17 12 10

30 17 30 45 42 21 35 12 17 12 10 271 81.3

ii a b c d

e f g h i j k l m n o p

iii a b c d e f g h i j

iv v vi vii

Central Kitchen Veg Cooking Counter Non-Veg Cooking Counter Diet Kitchen Stores Dry Store Blast Chillers Cold Store- Vegetable Cold Store- Meat Milk/Milk Product Store Day-to-day Store Equipment Store Janitor Store Office- Manager Deitician Room Record Keeper Room Workers Rest Room Change Room Pot Washing Dishwashing Pantry Trolley Parking Loading Deck Disposal Room Toilets Total Circulation NET KITCHEN AREA

Room No.

Laundry Reception and Sorting Sluicing and Disinfection Mending Washing Machines, Drirs, hydroextractors, Pressing Machines etc. Mattress Sterlization Clean Linen Storage and Distribution Office Changing Room Trolley Storage Stores Total Circulation NET TOTAL LAUNDRY

Room No.

Area(sq.m.)

Total Area (sq.m.)

1 1 1

40 40 30

1 1 1 1 1 1 1 1 3 1 1 1 1 1 1 1 1 1 1 1

25 15 15 15 15 15 20 12 12 12 16 25 12 30 21 18 12 30 12 20

25 15 15 15 15 15 20 12 36 12 16 25 12 30 21 18 12 30 12 20 486 170.1 656.1

35%

Area(sq.m.)

NURSHING COLLEGE(60 studentintake) 19 Teaching block i Lecture hall ii a nurshing foundation lab b CHN c Nutrition d OBG and paediatrics labs e pre clinical labs f computer labs iii multipurpose hall iv common room v staff room vi principle room vii vice principle room viii hod office ix faculty room x library xi toilet circulation

100

1 1 1 1 1 1 1 1 1 1 1 1 1 1

140 80 80 80 80 140 280 100 90 27 17.5 17.5 150 225 90 30%

400 0 140 80 80 80 80 140 280 100 90 27 17.5 17.5 150 225 90 1997 599.1 2596.1

Total Area (sq.m.)

1 1 1

30 21 10

1 1 1 1 1 1 1

100 30 30 17 15 16 21

100 30 30 17 15 16 21 290 101.5 391.5

35%

Morturary Central Pharmacy ( Hospital Stores Department) Bio Medical Waist treatment facility Medical Gas TOTAL SERVICE AREA

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

200 100 100 75 1874.9

a b c

d e f g

h i j k l m n o p

a b c d e f g h

14 Administration Reception Waiting Lobby CMO Office Office forSingle Person ( Fordirectors - administration, nursing, finance , medical procurement)

Room No.

Office for2person Share d Office Workstation Stores Office Single Person ( formanager - HRD, quality assurance, public rel ations, IT, accounts)

Interview Room Meeting Room Auditorium Staff Room Lunch Room and Pantry Toilets for staff Staff Cafeteria Doctor's Cafeteria Total Circulation NET ADMINISTRATION BLOCK 15 Support Facilities Reception for Guest Rooms House Keeping Storage Guest Rooms Restaurant CafÃ© Prayer Room Meditation Retreat Total circulation Support Facilities

a b

a b c d e

6 4 20 2

21 21 6 16

126 84 120 32

6 1 1 1 1 1 2 1 1

16 21 40 50 25 30 15 40 40

96 21 40 50 25 30 30 40 40 826 247.8

Room No.

Area(sq.m.) 1 1 1 20 1 1 1 4

Total Are a(sq.m.) 60 15 15 30 200 50 50 20

60 15 15 600 200 50 50 80 1070 374.5 1444.5

25501.05

Units

17 hoste l for training Doctor Nurse Total Circulation ne t hoste l are a

Units

18 gue st resident dharamshala room reception/waiting mess office TOTAL Circulation ne t gue st re side nt

Units

TOTAL BUILT-UP AREA

16 40 36

30%

16 Staff Residence Type 1( 4BHK) Type 2( 3BHK) Type 3( 2BHK) Type 4( 1BHK) Community Hall (Multipurpose) Convinience Shopping IndoorSports Facilities Day Care Centre TOTAL Circulation Total Re side ntialAre a

ne t re side nt built-up are a

Total Are a(sq.m.) 16 40 36

1073.8

NET HOSPTAL BUILT UP

a b c d e f g h

Area(sq.m.) 1 1 1

Area 5 50 100 30 1 1 1 1

Total Area 120 50 60 40 300 30 200 100

600 2500 6000 1200 300 30 200 100 10930 2732.5

25% 13662.5 Area 20 50

Total Area 15 15

300 750 1050 262.5

25% 1312.5 Area 150 1 1 1

25%

Total Area 25 25 250 21

3750 25 250 21 4046 1011.5

5057.5 20032.5

48129.65

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

4.2 : QUANTITATIVE ANALYSIS

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Chapter â&#x20AC;&#x201C; 5 5.1 Site Information 5.2 climate analysis 5.3 Precinct Study 5.4 Neighbourhood Study 5.5 Site Study

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

5.1 SITE INFORMATION:• • • • • • • • • • • • •

SITE AREA – 20 ACRE & 80937 SQ.M SITE LOCATION – Guru Nanak Nagar, near Satya Park, Delhi Latitude - 28°38'39.27"N Longitude - 77° 8'57.89"E Site is surround by ploughing field. Prime location Having 40 m wide road from front side Current land use is in farming Site is levelled at road level Ownership – Pusa Shape and area – site is in form of a paralogram having 20 acres of area Soil and topography – fertile alluvial soil with the site having irregular ditches. Vegetation – scanty with shurbs

INDIA SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

LINKAGES AND APPORACH TO THE SITE :-

• SITE IS 4.9 KM AWAY FROM SHADIPUR METRO STATION

• SITE IS 2.5 KM AWAY FROM INDERPURI • BUS STAND

SITE TRAFFIC ANALYSIS :• SITE HAVING FROM SECONDARY ROAD 30 M WIDE THAT HAVING LESS TRAFFIC • SITE IS AWAY FROM PRIMARY ROAD THAT HAVING MORE TRAFFIC THAN SECONDARY ROAD

• SITE IS 13 KM AWAY IGI AIRPORT

• SITE IS 4.6 KM AWAY FROM KIRTI • NAGAR RAILWAY STATION

Road use patterns in Delhi. India are very different from those in cities in highly industrialized countries. In Delhi roads are also shared by unmotorized vehicles in large numbers. This study is an attempt to understand fatal crash patterns in Delhi in 1980 using police data. The results indicate that fatality patterns in Delhi are very different from those in highly industrialized countries. Pedestrians, two-wheeler riders and bus commuters comprise 80% of fatalities and motor-vehicle occupants a small minority. It appears that priorities for safety countermeasures in Delhi would have to be significantly different from those in more industrialized high-income countries. Some short-term and long-term measures are suggested in the paper.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

5.2 Climate analysis

SUN ORIENTATION Since The Design Will Be As Per The Sub Tropical Hot And Humid Climate So • topographical location with maximum air velocity and shade. •orientation to minimize sun radiation impact. •orientation to maximize natural ventilation by winds. • scattered pattern of buildings . • settlements should be placed preferably on southern or northern slopes, ideally facing away from the equator. • the warm-humid climate zones are generally located near the equator. as a consequence, east and west slopes receive more radiation compared to north and south slopes .

SOLAR RADIATION:▪Hours of sunshine range between 5.6 hours per day in July and 9.5 hours per day in November. On balance there are 2856 sunshine hours annually and approximately 7.8 sunlight hours for each day WIND ROSE DIAGRAM:-

WIND ANALYSIS :-

• The diagram for New Delhi shows how many days within one month can be expected to reach certain wind speeds. Monsoons create steady strong winds on the Tibetan Plateau from December to April, but calm winds from June to October. Wind speed units can be changed in the preferences (top right).

RELATIVE HUMIDITY:▪The month with the driest weather is November when on balance 1 mm (0.0 in) of rain, sleet, hail or snow falls across 1 days. The month with the wettest weather is July when on balance 211 mm (8.3 in) of rain, sleet, hail or snow falls across 14 days. ▪Mean relative humidity for an average year is recorded as 49.2% and on a monthly basis it ranges from 25% in April & May to 73% in August

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

SITE SURROUNDINGS :-

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

S.W.O.T. ANALYSIS The super specialty hospital will be a great asset to the people of ranjeet nagar, where the condition of existing healthcare

facilities and awareness among local people is very poor. The hospital will not only serve the people of ranjeet nagar, but will also enhance the living standards in the region and will open the gates for investors, contributing to the development of city. Strengths: This project would be the great opportunity of its kind, not only to the site and precinct but to the city as whole. Site having drain passes from the back side , so we can easily used that drain for waste water and sewage disposal. Weakness: The site not lies near the junction of national highway and internal streets which causes less traffic highly active 24hr. Therefore working out the entrance over to the site as well as developing efficient vehicular movement system in the site would require strict strategies. Opportunities: The site has potential to be a major health as well as sate-of-the-art educational destination in the state. Threats: The strategic location of the site along the major roads makes it a very important task to a proper vehicular movement

pattern which does not conflict with the existing networks. SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

CHAPTER 6 CONCEPT AND DESIGN STRATEGY

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

DESIGN STRATEGY AND CONCEPT

Maximum functionality with minimum staff

▪ PROVIDING A COMFORTABLE, ECONOMICAL AND USER FRIENDLY HEALING ENVIRONMENT TO PATIENT OF THE DISTRICT.

Efficient hospital

▪ PATIENT ORIENTED DESIGN STRATEGY. Ease of working

Energy conservation

HOSPITAL, LIKE HOME. USER FRIENDLY ▪

The courtyard topology is the traditional architecture typology of Bihar.

▪

This typology will create community type public space.

▪

It is the best way for natural lighting and ventilation which will

SUSTAINABLE DESIGN APPROACH ▪

Natural lighting and ventilation

▪

Passive cooling techniques

▪

Bring green inside the building for healing environment

reduce mechanical loading of the building.

▪

Creating different types of open spaces which will provide more

▪

options of recreational and healing spaces. ▪

The planning of building will be north – south oriented and work as a eastern wind catcher which will provide cool air in summer

Well connection between the departments

▪

Orientation of the building

season.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

Zoning • Hospital is easily accessible residence

from because main entry and exit from the road which connect highway and city road.

• Nursing college are access

from slip road on highway side.

• Nurses hostel and staff residence are accessible from slip road and pedestrian entry from tertiary road.

• Green buffer zone has been given between

hospital and residential area.

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

STAKE DIAGRAM

HOSPITAL ZONING

Flr

5 4

3 2

O.T

IPD

OPD

ICU

NICU

BLOOD BANK

IPD

OPD

DILIVERY SUITE

LABOR ATORY

IPD

OPD

EMERG ENCY

DIAGN OSTICS

KITC HEN

IPD

PARKIN G

-1

O.T

IPD

STAFF ROOM

MORT URY

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

REGIST RATION

OFFICE

STORE

CHAPTER 7

DESIGN DEVELOPMENT

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

STEP 1 :- PLACMENT DONE ON THE BASIS OF MAXIMUM USE

STEP 2 :- PLANING CHANGES TO MAKE STREETS PROPER FUNCTIONAL.

STEP 3 :- FINAL LAYOUT OF DESIGN DEVELOPMENTS FULFILLING ALL REQUIREMENTS

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

CHAPTER 7

FINAL THESIS PORTFOLIO

SUPER SPECIALITY HOSPITAL, KIRTI NAGAR, DELHI

S I T E

T H E S I S

P L A N

SITE AREA – 20 ACRE (80937 SQ.M) GROUND COVERAGE – 40 % (32374 SQ.M, GIVEN) GROUND COVERAGE – 40 % (10,500 SQ.M. ACHIEVED) FAR - 100% & 1 BUILTUP - 80937 M.SQ. (GIVEN) - 40, 500 M.SQ. (ACHIEVED) ECS - 1.5/100 M SQ. AREA TOTAL CAR PARKING - 700 VEHICLES SET BACKS - 15 M FRONT, 9 M REAR, 9 M BACK

GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

SUPER SPECIALITY HOSPITAL (200 BEDED)

REMARKS

2 0 1 7 SCALE :- 1:500

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

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E N T R Y

G R O U N D F L O O R P L A N

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GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

SUPER SPECIALITY HOSPITAL (200 BEDED)

REMARKS

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GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

SHEET NO. :-

LANDSCAPE DETAILS MATERIALS

T H E S I S 2 0 1 7

` ``

GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

SUPER SPECIALITY HOSPITAL (200 BEDED)

REMARKS

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

SHEET NO. :-

BASEMENT PLAN

T H E S I S

2 0 1 7 `

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SUPER SPECIALITY HOSPITAL (200 BEDED)

REMARK S

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

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ADMINISTRATION BLOCK

GROUND FLOOR PLAN

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TERRACE PLAN

2 0 1 7

FRONT ELEVATION

ROOF PLAN

SECTION AAâ&#x20AC;&#x2122; GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

3D VIEW

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REMARK S

SCALE :- 1:250

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

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EMERGENCY BLOCK

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SECTION DDâ&#x20AC;&#x2122;

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ROOF PLAN GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

SUPER SPECIALITY HOSPITAL (200 BEDED)

REMARK S

SCALE :- 1:300

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

SHEET NO. :-

OPD BLOCK

T H E S I S

FIRST FLOOR PLAN

GROUND FLOOR PLAN

SECOND FLOOR PLAN

TERRACE PLAN

2 0 1 7

SECTION BBâ&#x20AC;&#x2122;

3D VIEW GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

FRONT ELEVATION

SUPER SPECIALITY HOSPITAL (200 BEDED)

REMARK S

SCALE :- 1:300

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

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IPD, LABORATORIES, ICU, LAUNDRY BLOCK

T H E S I S

2 0 1 7

, LAUNDRY, DIAGNOSTICS SERVICES, CSSD) GROUND FLOOR PLAN (PHARMACY, KITCHEN)

SCALE :- 1:500

GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

SUPER SPECIALITY HOSPITAL (200 BEDED)

REMARK S

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

SHEET NO. :-

IPD, LABORATORIES, ICU, LAUNDRY BLOCK

T H E S I S

FRONT ELEVATION

2 0 1 7

3D VIEW

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GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

SUPER SPECIALITY HOSPITAL (200 BEDED)

REMARK S

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

SHEET NO. :-

NURSING COLLEGE

T H E S I S

2 0 1 7 `

GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

FRONT ELEVATION

3D VIEW

SECTION FFâ&#x20AC;&#x2122;

SUPER SPECIALITY HOSPITAL (200 BEDED)

SCALE :- 1:250

REMARK S

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

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NURSING HOSTEL

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2 0 1 7 `

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SECTION EEâ&#x20AC;&#x2122;

GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

3D VIEW

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SCALE :- 1:200

REMARK S

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

SHEET NO. :-

MORTURARY, SERVICE YARD, RESTAURANT, DUMP YARD

T H E S I S

2 0 1 7 `

3D VIEW GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

RESTAURANT 3D

SUPER SPECIALITY HOSPITAL (200 BEDED)

SCALE :- 1:100

REMARK S

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

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3D VIEWS

IPD ENTRANCE VIEW BIRD EYE VIEW

T H E S I S

2 0 1 7

FRONT VIEW

RESTAURANT 3D

BACKSIDE VIEW

FRONT FOYER VIEW GANGA INSTITUTE OF ARCHITECTURE AND TOWN PLANNING KABLANA, HARYANA

SUPER SPECIALITY HOSPITAL (200 BEDED)

REMARK S

GAURAV GUPTA B.ARCH, 4TH YEAR, 8TH SEMESTER

SHEET NO. :-