DIFFERENT DEPARTMENTS OF HOSPITAL CAN BE GROUPED ACCORDING TO ZONES:
1 OUTERMOST ZONE, WHICH IS THE MOST COMMUNITY ORIENTED
▪ PRIMARY HEALTHCARE SUPPORT AREAS
▪ OUT-PATIENT DEPARTMENT
▪ EMERGENCY DEPARTMENT
▪ ADMINISTRATION
▪ ADMITTING OFFICE, RECEPTION
2 SECOND ZONE, WHICH RECIEVES WORKLOAD FROM OUTERMOST ZONE
▪ DIAGNOSTIC X-RAY
▪ LABORATORIES
▪ PHARMACY
3 MIDDLE ZONE, BETWEEN OUTER AND INNER ZONES
▪ OPERATING DEPARTMENT
▪ INTENSIVE CARE UNIT
▪ DELIVERY ROOM
▪ NURSERY
4 INNER/ NURSING ZONE, IN THE INTERIOR BUT WITH DIRECT ACCESS FOR PUBLIC WARDS AND NURSING UNITS
5. SERVICE ZONES, DISPOSED AROUND A SERVICE YARD
HOSPITALS
ON ADMINISTRATION: ▪ GOVERMENTAL OR PUBLIC
SEMI. GOVERNMENT HOSPITAL ▪ VOLUNTARY AGENCY HOSPITAL
HOSPITAL
BASIS ON SYSTEM OF MEDICINE: ▪ ALLOPATHIC HOSPITAL
AYURVEDIC HOSPITAL
HOMEOPATHIC HOSPITAL
UNANI HOSPITAL
AS PER WHO CLASSIFICATION: ▪ REGIONAL HOSPITAL
DISTRICT HOSPITAL ▪ RURAL HOSPITAL
TRIBAL HOSPITAL
FACTORS TO CONSIDER:
1. IT SHOULD BE WITHIN 15-30MINS TRAVELLING TIME. IN A DISTRICT WITH GOOD ROADDS AND ADEQUATE MEANS OF TRANSPORT, THIS WOULD MEAN A SERVICE ZONE WITH A RADIUS OF 25KMS.
2. IT SHOULD BE GROUPED WITH OTHER INSTITUTIONAL FACILITIES
3. IT SHOULD BE FREE FROM DANGERS OF FLOODING, IT MUST NOT BE SITED AT LOWEST POINT OF DISTRICT.
4. IT SHOULD BE IN AN AREA FREE OF POLLUTION INCLUDING AIR, NOISE, WATER AND LAND POLLUTION.
5. IT MUST BE SERVICED BY PUBLIC UTILITIES: WATER, SEWAGE AND STORM WATER DISPOSAL, ELECTRICITY, GAS AND TELEPHONE. IN AREAS WHERE SUCH UTILITIES ARE NOT AVAILABLE, SUBSTITUTES MUST BE FOUND.
ENTRIES IN HOSPITAL:
▪ GENERALLY THERE ARE 3 MAIN ENTRIES TO THE HOSPITAL THAT ARE THROUGH THE EMERGENCY ENTRANCE, IN-PATIENT (IPD) ENTRY AND OUTPATIENT (OPD) ENTRY
▪ BESIDES THESE HOSPITAL HAS SEPARATE SERVICE ENTRY AND SEPARATE ENTRY FOR ADMINISTRATION WING
▪ DIETARY SERVICES
▪ LAUNDRY AND HOUSEKEEPING
▪ STORAGE
▪ MAINTAINANCE AND ENGINEERING
▪ MORTUARY
▪ MOTOR POOL
ADMINISTRATION:
▪ THE ADMINISTRATIVE DEPARTMENT IS ORIENTED TO THE PUBLIC BUT IS AT THE SAME TIME PRIVATE AREAS FOR BUSSINESS, ACCOUNTING, AUDITING, CASHIERS, AND RECORDS, WHICH HAVE A FUNCTIONAL RELATIONSHIPS WITH THE PUBLIC, MUST BE LOCATED NEAR THE ENTRANCE OF HOSPITAL OFFICES FOR HOSPITAL MANAGEMENT, CAN BE LOCATED IN MORE PRIVATE AREAS
▪ THE ADMINISTRATION DEPARTMENT OF HOSPITAL SHALL ESSENTIALLY LOOK AFTER ORGANIZED GROUP OF PEOPLE, PATIENTS AND RESOURCES IN TO ACCOMPLISH THE TASK OF PROVIDING BEST PATIENT CARE, IT SHALL HAVE TWO MAIN SECTIONS,
▪ GENERAL RECORDS
▪ MEDICAL RECORDS
▪ CONTROL: FOR OBSERVATION AND CONTROL OF ACCESS TO THE TREATMENT AREA, PUBLIC WAITING AREA, AND PEDESTRIAN AND AMBULANCE ENTRANCE AREA SHOULD BE EQUIPPED WITH A COMMUNICATION SYSTEM INCLUDING INTERCOMMUNICATION
▪ WAITING PATIENTS AND THEIR RELATIVES SHOULD BE BETTER SHIELDED FROM WHAT IS GOING ON IN THE TREATMENT AREA
▪ SPACE FOR STRETCHERS AND WHEELCHAIRS ADJACENT TO THE ENTRANCE BUT OUT OF THE STREAM OF TRAFFIC
▪ STRETCHERS SHOULD BE PROVIDED WITH WHEEL LOCKS
▪ WAITING AREA SHOULD BE SEPARATED FROM THE WORKING OR TREATMENT AREA AND SHOULD BE PROVIDED WITH TOILET FACILITIES, WATER COOLERS, OR DRINKING FOUNTAINS, PUBLIC TELEPHONES, STD AND ISD CALL FACILITIES AND VENDING MACHINES IF POSSIBLE
▪ OFFICE FOR THE NIGHT ADMINNISTRATOR/NIGHT SUPERVISOR – CAN BE OFF SITE BUT NOT TOO FAR AWAY
OUT PATIENT DEPARTMENT (OPD)
OPD IS DEFINED AS A PART OF THE HOSPITAL, WITH ALLOTED PHYSICAL FACILITIES AND MEDICAL, AND OTHER STAFFS TO PROVIDE CARE FOR PATIENTS WHO ARE NOT REGISTERED AS IPD PATIENTS THE LOCATION SHOULD BE VERY CLOSE TO THE DIAGNOSTIC SERVICES (X-RAYS, LABS) AND CLOSE TO PHARMACY
FACILITIES:
▪ THE EXAMINATION ROOM IT SHOULD BE CLOSE TO NURSE STATION AND THE CONSULTATION ROOM
▪ THE CONSULTATION ROOM: IT IS MOSTLY USED WHEN LENGTHY CONVERSATION IS INVOLVED BETWEEN DOCTOR AND THE PATIENT
▪ CLINICAL DEPARTMENT: IT INCLUDES CLINICS WHICH CAN USE STANDARD ACCOMODATION, GENERAL MEDICINE, SURGERY, ETC
▪ OPD FOR SURGICAL DEPARTMENT: SHOULD BE LOCATED ON GROUND FLOOR AND NEAR THE EMERGENCY WITH DIRECT ACCESS TO IT
▪ MINOR SURGERY ROOM: MAY BE USED AS A CAST ROOM, ECG ROOM, MINOR
OPERATIONS IT SHOULD HAVE A SEPARATE ENTRANCE
▪ SUPPORT SERVICES: INCLUDES CLINICS WHICH CAN USE STANDARD ACCOMODATION, GENERAL MEDICINE, SURGERY , ETC DESIGN
▪ 60% OF AREA SHOULD BE FOR WAITING AND CORRIDORS WAITING AREA AT THE SCALE OF 1 SQ FT/PER AVERAGE DAILY PATIENT WITH MINIMUM 400 SQ FT OF AREA IS TO BE PROVIDED SUB WAITING AREAS MAY BE SHARED WITH VARIOUS CONSULTATION ROOMS
▪ CONSULTATION ROOM 150 SQ FT
▪ ATTACHED EXAMINATION ROOM: 80 SQ FT
AREAS/ZONES IN OPD:
▪ PUBLIC AREAS (ENTRANCE ZONE)
▪ CLINICAL AREA (AMBULATORY AND DIAGNOSTIC ZONE)
▪ ADMINISTRATION AREA
▪ CIRCULATION AREA
PATIENT AMENITIES:
▪ POTABLE DRINKING WATER.
▪ FUNCTIONAL AND CLEAN TOILETS WITH RUNNING WATER AND FLUSH
▪ FANS/COOLERS
▪ SEATING ARRANGEMENT AS PER LOAD OF PATIENT FUNCTIONAL ZONES:
▪ PUBLIC ZONE- MAIN ENTRANCE, FOYER, BAYS FOR TROLLEYS AND WHEELCHAIRS, PUBLIC CONVENIENCES, REGISTRATION AREA, CASH COUNTER, HEALTH EDUCATION FACILITIES
▪ JOINT USE ZONE- CONSULTATION AND EXAMINATION ROOMS COMBINED, CONSULTATION EXAMINATION ROOMS, SHARED EXAMINATION ROOMS, COMMON POOL OF SHARED ROOMS DESIRABLE SERVICES
▪ AIR-COOLING
▪ PATIENT CALLING SYSTEM WITH ELECTRONIC DISPLAY
▪ SPECIMEN COLLECTION CENTRE
▪ TELEVISION IN WAITING AREA
▪ COMPUTERIZED REGISTRATION
▪ PUBLIC TELEPHONE BOOTH
▪ PROVISION OF OPD MANAGER
EMERGENCY DEPARTMENT
▪ EMERGENCY- A SERIOUS, UNEXPECTED, AND OFTEN DANGEROUS SITUATION
REQUIRING IMMEDIATE ACTION
▪ AREA- THE TOTAL INTERNAL AREA OF EMERGENCY DEPARTMENT, SHOULD BE AT LEAST 145 SQ M
EMERGENCY DEPARTMENT
▪ SUDDEN ILLNESS OR INJURY REQUIRED IMMEDIATE PHYSICIAN ATTENTION TO PREVENT THE DANGER AND DELAY IN TREATMENT TO SAVE THE PRECIOUS
DEFINED AS THE PRIOTIZATION OF PATIENT CARE BASED ON SEVERITY OF INJURY, PROGNOSIS AND AVAILABILITY OF RESOURCES
▪ A TRIAGE AREA IS DESIGNED FOR THE INITIAL CLINICAL ASSESSMENT
▪ AREA SHOULD INCLUDE A SERVICE PANEL, EXAMINATION LIGHT, WALL MOUNTED SPHYGMOMANOMETER, EMERGENCY CALL FACILITIES
▪ 2 4M OF CLEAR SPACE BETWEEN BEDS
▪ EACH TREATMENT AREA REQUIRES SPACE OF 15SQ M, DOORS MIN 1 3M
LITRATURE STUDY IPD, TYPES OF DEPARTMENTS, FIRE SAFETY
INPATIENT DEPARTMENT (IPD):
▪ INPATIENT MEANS THAT THE PROCEDURE REQUIRE THE PATIENT TO BE ADMITTED TO THE HOSPITAL, PRIMARILY SO THAT HE OR SHE CAN BE CLOSELY MONITORED DURING THE PROCEDURE AND AFTERWARDS, DURING RECOVERY
▪ IPD FORMS 33-50% OF THE STRUCTURE OF HOSPITAL MOST OF THE EQUIPMENT AND STAFFS ARE IN THIS DEPARTMENT WITH MAX AMOUNT OF PATIENT CARE, TRAINING, MEDICAL TEACHING AND RESEARCH CONCENTRATED IN THIS DEPARTMENT
GENERAL IPD BEDS SHALL BE CATEGORIZED AS FOLLOWING:
▪ MALE MEDICAL WARD
▪ MALE SURGICAL WARD
▪ FEMALE MEDICAL WARD
▪ FEMALE SURGICAL WARD
▪ MATERNITY WARD
▪ PAEDIATRIC WARD
▪ NURSERY ISOLATION WARD
AS PER NEED AND INFRASTRUCTURE HOSPITAL HAVE FOLLOWING WARDS:
▪ EMERGENCY WARD/TRAUMA WARD
▪ BURN WARD
▪ ORTHOPAEDIC WARD
▪ POST OPERATIVE WARD
▪ OPHTHALMOLOGY WARD
▪ MALARIA WARD
▪ INFECTIOUS DISEASE WARD
▪ PRIVATE WARD: DEPENDING UPON THE REQUIREMENT OF THE HOSPITAL AND CATCHMENT AREA, APPROPRIATE BEDS MAY BE ALLOWED FOR PRIVATE FACILITY
10% OF THE TOTAL BED STRENGTH IS RECOMMENDED AS PRIVATE WARDS BEDS
▪ LOCATION: LOCATION OF THE WARD SHOULD BE SUCH TO ENSURE QUIETNESS AND TO CONTROL NUMBER OF VISITORS
▪ THERE SHALL BE AT LEAST 2 5M BETWEEN CENTRES OF TWO BEDS TO PREVENT CROSS INFECTION AND ALLOW BEDSIDE NURSING CARE
▪ EVERY BED SHALL BE PROVIDED WITH IV STAND, BED SIDE LOCKER AND STOOL FOR ATTENDANT SCREEN SHALL BE AVAILABLE FOR PRIVACY
▪ DEDICATED TOILETS WITH RUNNING WATER FACILITY AND FLUSH SHALL BE PROVIDE FOR EACH WARD
▪ DIRTY UTILITY ROOM WITH SLUICING FACILITY AND JANITORS ROOMS SHALL BE PROVIDED WITH IN WARD ALL WARDS SHALL BE PROVIDED WITH POSITIVE VENTILATION (EXCEPT ISOLATION WARD) AND FANS
▪ ICU BEDS- 5-10% OF TOTAL BEDS
▪ FLOOR SPACE FOR EACH ICU BEDS- 25-30SQ.M/BED
▪ FLOOR SPACE FOR PAEDIATRIC ICU BEDS- 10-12 SQ M/BED
▪
▪
TYPES OF DEAPRTMENTS:
▪ GENERAL MEDICINE
▪ GENERAL SURGERY
▪ OBSTETRICS AND GYNAECOLOGY
▪ PAEDIATRIC MEDICINE
▪ ORTHOPAEDICS
▪ CARDIOLOGY ▪ UROLOGY
▪ NEPHROLOGY
▪ ANESTHESIOLOGY
▪ OPTHALMOLOGY
▪ PSYCHIATRY
▪ DERMATOLOGY & VENEROLOGY
▪ DENTISTRY
▪ GASTROLOGY
▪ CARDIO SURGERY
▪ PHYSIOTHERAPY
▪ ENT(OTORHINOLARYNGOLOGY)
▪ EMERGENCY (MEDICAL, TRAUMA SERVICE)
▪ RADIO DIAGNOSIS
HOSPITAL CAN BE DIVIDED INTO TWO MAIN SECTIONS:▪ MEDICAL SECTION ▪ NON MEDICAL SECTION MEDICAL SECTION IT CONSIST OF ▪ PATIENT CARE DIVISION
DEPARTMENT
RECORDS PURCHASE ACCOUNTS
ENGINEERING SEVICES
WATER SUPLLY
FIGHTING MEDICAL GAS
SEWERAGE DISPOSAL ELECTRIC SUBSTATION ANCILLARY SERVICES
FIRE PROTECTION IN HOSPITALS
HOSPITALS SHALL PROVISION FOR TWO LEVELS OF SAFETY WITHIN THEIR PREMISES:
COMPARATIVE SAFETY WHICH IS PROTECTION AGAINST HEAT AND SMOKE WITHIN THE HOSPITAL PREMISES, WHERE REMOVAL OF THE OCCUPANTS OUTSIDE THE PREMISES IS NOT FEASIBLE AND/OR POSSIBLE
COMPARATIVE SAFETY MAY BE ACHIEVED THROUGH:
a. COMPARTMENTATION
b. FIRE RESISTANT WALL INTEGRATED IN THE FLOORING
c. FIRE RESISTANT DOOR OF APPROVED RATING
d. PRESSURIZED LOBBY, CORRIDOR, STAIRCASE
e. PRESSURIZED SHAFT (ALL VERTICAL OPENINGS)
f. REFUGE AREA
g. INDEPENDENT VENTILATION SYSTEM
h. FIRE DAMPERS
i. AUTOMATIC SPRINKLER SYSTEM
j. AUTOMATIC DETECTION SYSTEM
k. MANUAL CALL POINT
l. FIRST AID
m. FIRE FIGHTING APPLIANCES
n. FIRE ALARM SYSTEM
o. ALTERNATE POWER SUPPLY
p. PUBLIC ADDRESS SYSTEM
q. SIGNAGE
r. FIRE EXIT DRILLS AND ORDERS
ULTIMATE SAFETY: WHICH IS THE COMPLETE REMOVAL OF THE OCCUPANTS FROM THE AFFECTED AREA TO AN ASSEMBLY POINT OUTSIDE THE HOSPITAL BUILDING ULTIMATE
SAFETY MAY BE ACHIEVED THROUGH: COMPARTMENTATION FIRE RESISTANT DOOR OF,APPROVED RATING ,PROTECTED LOBBY, CORRIDOR, STAIRCASE AND SHAFT ,PUBLIC
ADDRESS SYSTEM ,SIGNAGE ,FIRE DRILLS AND ORDERS
STRUCTURAL ELEMENTS OF FIRE SAFETY
OPEN SPACES
i. HOSPITALS SHALL MAKE PROVISIONS FOR SUFFICIENT OPEN SPACE IN AND AROUND THE HOSPITAL BUILDING TO FACILITATE THE FREE MOVEMENT OF PATIENTS AND EMERGENCY/FIRE VEHICLES
ii. THESE OPEN SPACES SHALL BE KEPT FREE OF OBSTRUCTIONS AND SHALL BE MOTORABLE
iii. ADEQUATE PASSAGE WAY & CLEARANCE FOR FIRE FIGHTING VEHICLES TO ENTER THE HOSPITAL PREMISES SHALL BE PROVIDED
iv. THE WIDTH OF SUCH ENTRANCES SHALL BE NOT BE LESS THAN 4 5 MTRS WITH CLEAR HEAD ROOM NOT LESS THAN 5 MTRS.
v. THE WIDTH OF THE ACCESS ROAD SHALL BE A MINIMUM OF 6 MTRS
vi. A TURNING RADIUS OF 9 MTRS SHALL BE PROVIDED FOR FIRE TENDER MOVEMENT
vii. THE OPEN SPACE AROUND THE BUILDING SHALL NOT BE USED FOR PARKING AND/OR ANY OTHER PURPOSE
viii. THE SET BACK AREA SHALL BE A MINIMUM 4.5 MTRS
ix. THE WIDTH OF THE MAIN STREET ON WHICH THE HOSPITAL BUILDING ABUTS SHALL NOT BE LESS THAN 12 MTRS & WHEN ONE END OF THAT STREET SHALL JOIN ANOTHER STREET, THE STREET SHALL NOT BE LESS THAN 12 MTR WIDE
x. THE ROADS SHALL NOT BE TERMINATED IN DEAD ENDS
MEANS OF ESCAPE/EGRESS
A MEANS OF ESCAPE/EGRESS IS A CONTINUOUS AND UNOBSTRUCTED WAY TO EXIT FROM ANY POINT IN A BUILDING OR STRUCTURE TO A PUBLIC WAY THREE SEPARATE AND DISTINCT PARTS OF AN ESCAPE/EGRESS ARE:
a. THE EXIT ACCESS
b. THE EXIT
c. THE EXIT DISCHARGE
i. THE EXITS IN HEALTHCARE FACILITIES SHOULD BE LIMITED TO DOORS LEADING DIRECTLY OUTSIDE THE BUILDING, INTERNAL STAIRCASES AND SMOKE PROOF ENCLOSURES, RAMPS, HORIZONTAL EXITS, EXTERNAL EXITS AND EXIT PASSAGE
INTERNAL STAIRCASES
i. SHALL BE CONSTRUCTED AS SELF-CONTAINED UNITS ALONG AN EXTERNAL WALL OF THE BUILDING CONSTITUTING AT LEAST ONE OF ITS SIDES AND SHALL BE COMPLETELY CLOSED
ii. A STAIRCASE SHALL NOT BE ARRANGED AROUND A LIFT SHAFT
iii. WIDTH OF THE TREAD SHALL NOT BE LESS THAN 300 MM, THE HEIGHT OF THE RISER SHALL NOT BE LESS THAN 150 MM AND THE NUMBER OF STAIRS PER FLIGHT SHALL NOT EXCEED 15
iv. NO ELECTRICAL SHAFT AND PANEL, AC DUCTS OR GAS PIPELINES, ETC SHALL PASS THROUGH OR OPEN ONTO THE STAIRCASES
BASEMENTS
i. EACH BASEMENT SHALL BE SEPARATELY VENTILATED
ii. EACH VENT SHALL HAVE A CROSS-SECTIONAL AREA (AGGREGATE) NOT LESS THAN 2 5% OF THE FLOOR AREA SPREAD EVENLY ROUND THE PERIMETER OF THE BASEMENT
iii. A SYSTEM OF AIR INLETS AND SMOKE OUTLETS SHALL BE PROVIDED & CLEARLY MARKED AS “AIR INLET” & “SMOKE OUTLET”
iv. THE BASEMENT SHALL NOT BE PERMITTED BELOW THE WARD BLOCK OF A HOSPITAL CLEAR HEADROOM OF MINIMUM 2 4 MTRS SHALL BE PROVIDED FOR THE ENTIRE BASEMENT
v. A MINIMUM CEILING HEIGHT OF ANY BASEMENT SHALL BE 0 9 MTRS AND MAXIMUM 1 2 MTRS ABOVE THE AVERAGE SURROUNDING GROUND LEVEL
vi. THE ACCESS TO THE BASEMENT SHALL BE SEPARATE FROM THE MAIN AND ALTERNATIVE STAIRCASE PROVIDING ACCESS AND EXIT FROM HIGHER FLOORS WHERE THE STAIRCASE CONTINUES, IN THE CASE OF BUILDINGS SERVED BY MORE THAN ONE STAIRCASE, THE SAME SHALL BE OF ENCLOSED TYPE SERVING AS A FIRE SEPARATION BETWEEN THE BASEMENT AND HIGHER FLOORS
vii. OPEN RAMPS SHALL BE PERMITTED IF THEY ARE CONSTRUCTED WITHIN THE BUILDING LINE AND SURFACE DRAINAGE DOES NOT ENTER THE BASEMENT
viii. MECHANICAL EXTRACTORS SHALL HAVE AN ALTERNATE SOURCE OF ELECTRICITY SUPPLY
ix. VENTILATION DUCTS SHALL BE INTEGRATED WITH THE STRUCTURE OF THE BUILDING AND SHALL BE MADE OUT OF BRICK MASONRY OR REINFORCED CEMENT CONCRETE AS FAR AS POSSIBLE WHEREVER THIS DUCT INTERSECTS THE TRANSFORMER AREA OR AN ELECTRICAL SWITCH BOARD, FIRE DAMPERS SHALL BE PROVIDED
x. NO CUT OUTS TO UPPER FLOORS SHALL BE PERMITTED IN THE BASEMENT AN OPENABLE WINDOW ON THE EXTERNAL WALL SHALL BE FITTED WITH LOCKS THAT CAN BE EASILY OPENED PROTECTED STAIRCASES
i. THE STAIRCASES SHALL BE ENCLOSED BY WALLS HAVING 02 HRS FIRE RESISTANCE
ii. THE EXTERNAL EXIT DOORS AT GROUND FLOOR SHALL OPEN DIRECTLY ONTO OPEN SPACES OR A LOBBY AND FIRE & SMOKE CHECK DOORS SHALL BE PROVIDED
iii. PROTECTED STAIRCASES SHALL BE PRESSURIZED. UNDER NO CIRCUMSTANCES SHALL THEY BE CONNECTED TO A CORRIDOR, LOBBY AND STAIRCASE WHICH IS UNPRESSURIZED
iv. PRESSURIZATION SYSTEMS SHALL BE INCORPORATED IN PROTECTED STAIRCASES WHERE THE FLOOR AREA IS MORE THAN 500 SQ MTR v. THE PRESSURIZATION SYSTEM SHALL BE INTERCONNECTED WITH THE AUTOMATIC/MANUAL FIRE ALARM SYSTEM FOR ACTUATION
EXTERNAL STAIRCASES
i. SERVING AS A REQUIRED MEANS OF EGRESS SHALL BE OF PERMANENT FIXED CONSTRUCTION
ii. SHALL BE PROTECTED BY A RAILING OR GUARD, HEIGHT SHALL NOT BE LESS THAN 1200 MM
iii. SHALL BE SEPARATED FROM THE INTERIOR OF THE BUILDING BY WALLS THAT ARE FIRE RESISTANT AND HAVE FIXED OR SELF CLOSING OPENING PROTECTIVES’, AS REQUIRED FOR ENCLOSED STAIRS EXTERNAL STAIRCASES SHALL EXTEND VERTICALLY FROM THE GROUND TO A POINT 3 METERS ABOVE THE TOPMOST LANDING OF THE STAIRWAY OR THE ROOF LINE WHICHEVER IS LOWER, AND ATLEAST 3 METERS HORIZONTALLY
iv. EXTERNAL STAIRCASES SHALL BE SO ARRANGED TO AVOID ANY DISCOMFORT/OBSTRUCTION FOR PERSONS WITH A FEAR OF HEIGHTS, FROM USING THEM
v. SHALL BE CONTINUOUS FROM THE GROUND FLOOR TO THE TERRACE LEVEL
vi. THE ENTRANCE TO THE EXTERNAL STAIRCASES SHALL BE SEPARATE AND REMOTE FROM INTERNAL STAIRCASES
vii. EXTERNAL STAIRCASES SHALL HAVE A STRAIGHT FLIGHT WITH A WIDTH NOT LESS THAN
viii.
LITRATURE STUDY PLANNING AND DESIGN PARAMETERS
ENVIRONMENT LOCATION: A HOSPITAL SHALL BE SO LOCATED THAT IT IS READILY
ACCESSIBLE TO THE COMMUNITY AND REASONABLY FREE FROM UNDUE NOISE, SMOKE, DUST, FOUL,ODOR, FLOOD, AND SHALL NOT BE LOCATED ADJACENT TO RAILROADS, FREIGHT YARDS, CHILDREN'S PLAYGROUNDS, AIRPORTS, INDUSTRIAL PLANTS, DISPOSAL PLANTS
ORIENTATION: THE MOST SUITABLE ORIENTATION FOR TREATMENT AND OPERATING ROOM IS BETWEEN NORTH-WEST AND NORTH-EAST FOR NURSING WARD FACADES,SOUTH TO SOUTH IS FAVOURABLE:PLEASANT MORNING SUN,MINIMAL HEAT BUILD UP,LITTLE REQUIREMENT FOR SUN SHADIN,MILD IN THE EVENINGS EAST AND WEST FACING ROOMS HAVE COMPARATIVELY DEEPER SUN PENETRATION,THOUGH LESS WINTER SUN THE ORIENTATION OF WARDS IN HOSPITALS WITH SHORT STAY IS NOT SO IMPORTANT SOME SPECIALIST DISCIPLINES MIGHT REQUIRE ROOMS ON THE NORTH SIDE SO THAT PATIENTS ARE NOT SO SUBJECTED TO DIRECT SUNLIGHT
OCCUPANCY: A BUILDING DESIGNED FOR OTHER PURPOSE SHALL NOT BE CONVERTED INTO A HOSPITAL THE LOCATION OF A HOSPITAL SHALL COMPLY WITH ALL LOCAL ZONING ORDINANCES
SAFETY: A HOSPITAL SHALL PROVIDE AND MAINTAIN A SAFE ENVIRONMENT FOR PATIENTS, PERSONNEL AND PUBLIC THE BUILDING SHALL BE OF SUCH CONSTRUCTION
SO THAT NO HAZARDS TO THE LIFE AND SAFETY OF PATIENTS, PERSONNEL AND PUBLIC
EXIST IT SHALL BE CAPABLE OF WITHSTANDING WEIGHT AND ELEMENTS TO WHICH THEY MAY BE SUBJECTED.
▪ EXITS SHALL BE RESTRICTED TO THE FOLLOWING TYPES DOOR LEADING DIRECTLY OUTSIDE THE BUILDING, INTERIOR STAIR, RAMP, AND EXTERIOR STAIR
▪ A MINIMUM OF TWO EXITS, REMOTE FROM EACH OTHER, SHALL BE PROVIDED FOR EACH FLOOR OF THE BUILDING
▪ EXITS SHALL TERMINATE DIRECTLY AT AN OPEN SPACE TO THE OUTSIDE OF THE BUILDING
SECURITY: A HOSPITAL SHALL ENSURE THE SECURITY OF PERSON AND PROPERTY WITHIN THE FACILITY
PATIENT MOVEMENT: SPACES SHALL BE WIDE ENOUGH FOR FREE MOVEMENT OF PATIENTS, WHETHER THEY ARE ON BEDS, STRETCHERS, OR WHEELCHAIRS
▪ CIRCULATION ROUTES FOR TRANSFERRING PATIENTS FROM ONE AREA TO ANOTHER SHALL BE AVAILABLE AND FREE AT ALL TIMES
▪ CORRIDORS FOR ACCESS BY PATIENT AND EQUIPMENT SHALL HAVE A MINIMUM WIDTH OF 2 44 METERS
▪ CORRIDORS IN AREAS NOT COMMONLY USED FOR BED, STRETCHER AND EQUIPMENT TRANSPORT MAY BE REDUCED IN WIDTH TO 1 83 METERS
▪ A RAMP OR ELEVATOR SHALL BE PROVIDED FOR ANCILLARY, CLINICAL AND NURSING AREAS LOCATED ON THE UPPER FLOOR.
▪ A RAMP SHALL BE PROVIDED AS ACCESS TO THE ENTRANCE OF THE HOSPITAL NOT ON THE SAME LEVEL OF THE SITE
▪ MIN RATIO OF RAMP WILL BE 1:10
▪ DOORS:WHEN DESIGNING DOORS THE HYGIENE REQUIREMENTS SHOULD BE CONSIDERED THE SURFACE COATING MUST WITHSTAND THE LONG TERM ACTION OF CLEANSING AGENTS AND DISINFECTANTS AND THEY MUST BE DESIGNED TO PREVENT THE TRANSMISSION OF SOUND,ODOURS AND DRAUGHTS
▪ CLEAR HEIGHTS OF THE DOOR ARE AS FOLLOWING:
NORMAL DOORS: 2 1-2 2 M
VEHICLE ENTRY 2 5 M
TRANSPORT ENTRANCE 2 7-2 8 M
MINIMUM HEIGHT ON APPROACH ROAD 3 50 M MINIMUM WIDHT OF DOOR INPATIENT BEDROOM 1 2 M ACCESSED BY STRETCHER OR WHEELCHAIRS 1 M CORRIDOR DOORS 1 2 M
▪ STAIRS:FOR SAFETY REASONS STAIRS MUST BE DESIGNED IN SUCH A WAY THAT IF NECESSARY THEY CAN ACCOMMODATE ALL OF VERTICAL CIRCULATION
▪ STAIRS MUST HAVE HANDRAILS ON BOTH SIDES WITHOUT PROJECTING PIPES
MINIMUM WIDTH 1 5 M
MAXIMUM WIDTH 2 5 M
MINIMUM RISER 150 MM
MAXIMUM RISER 170 MM
MINIMUM TREAD 280 MM
MAXIMUM TREAD 300 MM
WHILE DESIGNING STAIRS IT IS FAVAOURABLE TO PROVIDE TREAD OF 300 MM AND RISER OF 150 MM
▪ LIGHTING ALL AREAS IN A HOSPITAL AND OTHER HEALTH FACILITIES SHALL BE PROVIDED WITH SUFFICIENT ILLUMINATION TO PROMOTE COMFORT, HEALING AND RECOVERY OF PATIENTS AND TO ENABLE PERSONNEL IN THE PERFORMANCE OF WORK
▪ VENTILATION: ADEQUATE VENTILATION SHALL BE PROVIDED TO ENSURE COMFORT OF PATIENTS,PERSONNEL AND PUBLIC
▪ AUDITORY AND VISUAL PRIVACY: A HOSPITAL AND OTHER HEALTH FACILITIES SHALL OBSERVE ACCEPTABLE SOUND LEVEL AND ADEQUATE VISUAL SECLUSION TO ACHIEVE THE ACOUSTICAL AND PRIVACY REQUIREMENTS IN DESIGNATED AREAS ALLOWING THE UNHAMPERED CONDUCT OF ACTIVITIES
▪ WATER SUPPLY: A HOSPITAL AND OTHER HEALTH FACILITIES SHALL USE AN APPROVED PUBLIC WATER SUPPLY SYSTEM WHENEVER AVAILABLE THE WATER SUPPLY SHALL BE POTABLE, SAFE FOR DRINKING AND ADEQUATE, AND SHALL BE BROUGHT INTO THE BUILDING FREE OF CROSS CONNECTIONS.
▪ WASTE DISPOSAL: LIQUID WASTE SHALL BE DISCHARGED INTO AN APPROVED PUBLIC SEWERAGE SYSTEM WHENEVER AVAILABLE, AND SOLID WASTE SHALL BE COLLECTED, TREATED AND DISPOSED OF IN ACCORDANCE WITH APPLICABLE CODES, LAWS OR ORDINANCES
▪ SANITATION UTILITIES FOR THE MAINTENANCE OF SANITARY SYSTEM, INCLUDING APPROVED WATER SUPPLY AND SEWERAGE SYSTEM, SHALL BE PROVIDED THROUGH THE BUILDINGS AND PREMISES TO ENSURE A CLEAN AND HEALTHY ENVIRONMENT
▪ HOUSEKEEPING: A HOSPITAL SHALL PROVIDE AND MAINTAIN A HEALTHY AND AESTHETIC ENVIRONMENT FOR PATIENTS, PERSONNEL AND PUBLIC
▪ MAINTENANCE: THERE SHALL BE AN EFFECTIVE BUILDING MAINTENANCE PROGRAM IN PLACE THE BUILDINGS AND EQUIPMENT SHALL BE KEPT IN A STATE OF GOOD REPAIR PROPER MAINTENANCE SHALL BE PROVIDED TO PREVENT UNTIMELY BREAKDOWN OF BUILDINGS AND EQUIPMENT
▪ MATERIAL SPECIFICATION FLOORS, WALLS AND CEILINGS SHALL BE OF STURDY MATERIALS THAT SHALL ALLOW DURABILITY, EASE OF CLEANING AND FIRE RESISTANCE
▪ SEGREGATION: WARDS SHALL OBSERVE SEGREGATION OF SEXES SEPARATE TOILET
SHALL BE MAINTAINED FOR PATIENTS AND PERSONNEL, MALE AND FEMALE, WITH A RATIO OF ONE (1) TOILET FORNEVERY EIGHT (8) PATIENTS OR PERSONNEL
▪ FIRE PROTECTION: THERE SHALL BE MEASURES FOR DETECTING FIRE SUCH AS FIRE ALARMS IN WALLS,PEEPHOLES IN DOORS OR SMOKE DETECTORS IN CEILINGS
THERE SHALL BE DEVICES FOR QUENCHING FIRE SUCH AS FIRE EXTINGUISHERS OR FIRE HOSES THAT ARE EASILY VISIBLE AND ACCESSIBLE IN STRATEGIC AREAS
LITRATURE STUDY FUNCTIONAL RELATIONSHIP
▪ AREAS THAT ARE IMMEDIATELY ACCESSIBLE TO THE PUBLIC: EMERGENCY SERVICE, OUTPATIENT SERVICE, AND ADMINISTRATIVE SERVICE
▪ THEY SHALL BE LOCATED NEAR THE ENTRANCE OF THE HOSPITAL SECOND ZONE
▪ AREAS THAT RECEIVE WORKLOAD FROM THE OUTER ZONE LABORATORY, PHARMACY, AND RADIOLOGY
▪ THEY SHALL BE LOCATED NEAR THE OUTER ZONE INNER ZONE
▪ AREAS THAT PROVIDE NURSING CARE AND MANAGEMENT OF PATIENTS: NURSING SERVICE.
▪ THEY SHALL BE LOCATED IN PRIVATE AREAS BUT ACCESSIBLE TO GUESTS DEEP ZONE
▪ AREAS THAT REQUIRE ASEPSIS TO PERFORM THE PRESCRIBED SERVICES: SURGICAL SERVICE, DELIVERY SERVICE, NURSERY, AND INTENSIVE CARE
▪ THEY SHALL BE SEGREGATED FROM THE PUBLIC AREAS BUT ACCESSIBLE TO THE OUTER, SECOND AND INNER ZONES SERVICE ZONE
▪ AREAS THAT PROVIDE SUPPORT TO HOSPITAL ACTIVITIES: DIETARY SERVICE, HOUSEKEEPING SERVICE, MAINTENANCE AND MOTOR POOL SERVICE, AND MORTUARY
▪ THEY SHALL BE LOCATED IN AREAS AWAY FROM NORMAL TRAFFIC
