Location & Layout Of Hospital

SUBMITTED BY :ASOGWA INNOCENT KINGSLEY

ML-508 PEOPLE’S FRIENDSHIP

UNIVERSITY OF RUSSIA

SUBMITTED TO :Dr. KICHA .D.

DOES COMMUNITY NEED A HOSPITAL ?

There are two methods to estimate the need for hospital in a population: Analytical method : Taking feedback and analysis of data collected through survey e.g. distributing questionnaire. Estimation method

PlanningPlanning (also called forethought/forecasting) is the process of thinking about and organizing the activities required to achieve a desired goal.

For

Planning involves six Questions1.What are we expect to do?2.Why it should be done ?3.Where will it be done ?4.When are we expect to do it?5.Who are those going to do it ?6.How will it be done ?

Excellent firms don’t believe in excellence – only in constant improvement and constant change – Tom Peters

Community interest over individual interest

Preventive services over curative services

Services catering to the weaker sections of the community

Rural over Urban

Regionalized Planning

Factors in hospital planning

Data required in Planning the Hospital

Demographic Details Population StrengthSex & Age RationSocial StatusEducational level

Geographic Data Morbidity & Mortality Status Need & Demand Details of existing Facilities Financial Feasibility

Hospital must meet two basic fundamental needs:

Must meet the needs of the patient that it is going to serve adequately.

It must be in a size and proportions which the owners or promoters will be able to build and operate

Basic Objectives which are to be Met by the Hospital

Sound architectural planEconomic viabilityEffective community orientationQuality of patient care

PRINCIPLES OF HOSPITAL PLANNING-Protection from unwanted and unnecessary disturbances in order to help speedy recoverySeparation of dissimilar activitiesControl – the nurses station should be positioned strategically to enable proper monitoring of visitors entering and leaving the ward, infants and children should be protected from theft and infection etc.Circulation- all the departments of a hospital must be properly integrated.(“separate all departments, yet keep them all together; separate types of traffic, yet save steps for everybody; that is all there is to hospital planning “– Emerson Goble)

Selection of site-Needs of the community

Ease of accessibility

Range of services offered

Availability of specialists

Availability of technology

Study of existing hospital(if any)

Requirements of staff and services

Bed planning-Bed: Population = A x S x 100 365 x PO

A= number of inpatient admissions/1000 population/yearS= average length of stayPO= percentage occupancy

Planning of finances-Funds required for constructing, furnishing and equipping the hospital.

Operating funds- salaries, loans and interest, other maintenance expenses.

Arranging financial assistance-patient fees, bed charges, and other modes of revenue generation process.

Hospital project staging-Stage AFunctional content:Outline brief:

Project teamAssessment of functional contentSubmission of owners( Govt,private organization etc.)for approvalSite appraisal, gross floor areasBuilding space. Draft master planEstimation of cost and phasingAppraisal of work by owners

Stage BOperational policies:Developmental plan:

Operational policiesDepartmental and inter related activitiesDepartmental and hospital policiesDevelopment control planBudget costContinuous informal discussion with owners

Stage CSchedules of accommodation, sketches,Final cost estimate:

Schedules of accommodationSketch drawingEquipment schedules component estimatesCost revenue and staffing estimatesFinal cost approval

Stage DDetail design working drawings, tender action:

Working drawingsEngineering detailsBills of quantitiesCalling tenders

Stage EContract and construction: Assessments of tenders

Award of contractConstructionEngineering commissioning

Stage FCommissioning: Staff assembly and training

Equipment and supplies assemblyTesting of installation

Equipment planning-Built in equipment These include counters and cabinets in

laboratory, Pharmacy and other parts of the hospital , elevators , incinerators , coolers , fixed sterilizing equipment etc. These are usually included in the construction contract and the planning of these equipments is the architect's responsibility.

Depreciable equipment This includes equipment that has a life of five years or more and is not purchased through construction contracts. These are large pieces of furniture which have a relatively fixed location and are capable of being moved e.g., diagnostic and therapeutic equipment, laboratory instruments, office furniture etc.

Non depreciable equipment These are small items with a low unit cost and life span of less than five years. These are generally under the control of the store room and are bought through other than construction contracts. They include kitchen utencils,surgical instruments,linen,waste baskets etc.

Operation programAdmission Human resource

Administration Stores

General engineering Purchasing

Laundry Maintenance

Clinical services Waste disposal plant

Pharmacy Fire and safety

Nursing services Disaster plan

House keeping information

Records Dietary services

Public relations Clinical engineering

Employee facilities Sanitation

Intensive critical care unit (ICCU)-

Should preferably be located on the ground floor with convenient access from the operation theatre suit and emergency department and easy accessibility for wards.It consists patient area, staff area, support area.Four basic requirements-

Direct observation of the patient by nursing and medical staffSurveillance of physiological monitoringProvision and efficient use of routine and emergency diagnostic

procedures and interventions.Recording and maintenance of patient information

Design and Layout of ICCU Design should take into consideration the integration and smooth functioning of three areas

1. The Patient Area2. The Staff Area3. The Support Area

Total area ranges from 350 to 500 sq. feet per bed which includes

1. Circulation Area2. Nursing Station3. Sanitary and Ancillary Accommodation

Ancillary & Support ServicesIt should be centrally air conditioned.Overall lighting Requirement in ICCU is for subdued illumination for the patient bed with capacity for increasing it in case of need.Main light at the bed head should be fitted with dimmer switch.A high intensity emergency light or spot focusing light should also be provided.Emergency buzzer switch connected to central buzzer and location panel at central nursing station.Multiple electrical gadgets required.Stand by generator is also required.

Diagnostic SupportShould have round the clock access to Laboratory servicesRadiologyImagingPhysiotherapy.

Equipment maintenanceVisitor Lounge

Quality Quantity & Temperature

Space requirements of some basic departments-

Area Sq .ft / bed

Nursing unit 250-280

Nursery 12-18

Delivery suite 15-20

Operation theatre 30-50

Physical medicine 12-18

Radiology 25-35

Laboratory 25-35

Pharmacy 4-6

CSSD 8-25

Dietary 25-35

Medical record 8-15

Area Sq .ft / bed

House keeping 4-5

Laundry 12-18

Mechanical installation 50-75

Maintenance work shop 4-6

Stores 25-35

Public areas 8-10

Staff facilities 10-15

Administration 40-50

Total 567-751

Circulation 115-751

Total net area 682-891

Hospital Noise Control

Hospital administrators and staff have an ongoing concern with controlling unwanted noise in their facilities. Patient comfort, employee satisfaction and environmental concerns are always at the forefront in the continuous design and maintenance of a wide array of systems that keep a medical facility running efficiently.

Hospital Equipment & Furniture Choice

QuantityPriceSourceQuality

Conclusion-Technology requirement must be metClinical needs must be consideredSafety is a major factorStandards and Guidelines are essentialImportance of the role of Hospital Staff

in construction and design.

A hospital is a living organism, made up of many different parts , having different functions, but all these must be in due proportion and relation to each other and to the environment to produce the desired result - Dr S Billings

THANK YOU