Professional Documents
Culture Documents
ARCHIT
ECTURA
(Space
L
planning
RESEA
DESIGN
2)
5RCH Level 2
Hospital
WORK
NO. 1
Submitted by:
Dumalaon, Micahelle Joy
Gando, Zedric C.
Tiglao, Reynell S.
Soliman Jr., Jesus
Ugale, Lara Mae
Submitted to:
Ar. Arlen M. Guieb
available
In
a
large
hospital, the form of the typical
nursing unit, since it may be repeated
many times, is a principal element of
the overall configuration. Nursing
units today tend to be more compact
shapes than the elongated rectangles of the past. Compact
rectangles, modified triangles, or even circles
have been used in an attempt to shorten the distance between the nurse
station and the patient's bed. The chosen solution is heavily dependent on
program issues such as organization of the nursing program, number of beds
to a nursing unit, and number of beds to a patient room. (The trend, recently
reinforced by HIPAA, is to all private rooms.)
BUILDING ATTRIBUTES
Regardless of their location, size, or budget, all hospitals should have certain
common attributes.
Efficiency and Cost-Effectiveness
An efficient hospital layout should:
Therapeutic Environment
Hospital patients are often fearful and confused and these feelings may
impede recovery. Every effort should be made to make the hospital stay as
unthreatening, comfortable, and stress-free as possible. The interior designer plays
a major role in this effort to create a therapeutic environment. 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 aging, loss of visual acuity, other
physical and mental disabilities, and abusiveness. Some important aspects of
creating a therapeutic interior are:
Using cheerful and varied colors and textures, keeping in mind that some
colors are inappropriate and can interfere with provider assessments of
patients' pallor and skin tones, disorient older or impaired patients, or agitate
patients and staff, particularly some psychiatric patients.
Providing views of the outdoors from every patient bed, and elsewhere
wherever possible; photo murals of nature scenes are helpful where outdoor
views are not available
Accessibility
All areas, both inside and out, should:
Comply with the minimum requirements of the Americans with Disability Act
(ADA) and, if federally funded or owned, the GSA's ABA Accessibility
Standards
Controlled Circulation
A hospital is a complex system of interrelated functions requiring constant
movement of people and goods. Much of this circulation should be controlled.
Outpatients visiting diagnostic and treatment areas should not travel through
inpatient functional areas nor encounter severely ill inpatients
Typical outpatient routes should be simple and clearly defined
Visitors should have a simple and direct route to each patient nursing unit
without penetrating other functional areas
Separate patients and visitors from industrial/logistical areas or floors
Outflow of trash, recyclables, and soiled materials should be separated from
movement of food and clean supplies, and both should be separated from
routes of patients and visitors
Transfer of cadavers to and from the morgue should be out of the sight of
patients and visitors
Dedicated service elevators for deliveries, food and building maintenance
services
Aesthetics
Aesthetics is closely related to creating a therapeutic environment (homelike,
attractive.) It is important in enhancing the hospital's public image and is thus an
important marketing tool. A better environment also contributes to better staff
morale and patient care. Aesthetic considerations include:
Sustainability
Hospitals are large public buildings that have a significant impact on the
environment and economy of the surrounding community. They are heavy users of
energy and water and produce large amounts of waste. Because hospitals place
such demands on community resources they are natural candidates for sustainable
design.
Abstract
Since the second half of the twentieth century to today, the architectural
design of the hospital building has undergone great changes. These are related to
the role that it plays within the city and the community, but also to the recovery of
values that are different from those of quantity and function, characterizing modern
hospitals in the first half of the twentieth century. These new values, really
recovering from the past and agreeing to a humane and humanistic vision of reality,
together with the recent technological discoveries and new ways of treatment and
care, influence the design choices in hospitals contemporaries.
The proposed research Architectural of hospital space: Changes and Design
Methods seek to define the characteristics and the architectonic qualities of the
contemporary hospital. It is care center and hub of scientific and medical knowledge
and it is also the important place for observations on the relationship between the
man and the built environment.
The study of typological and theoretical contribution, the analysis of
representative examples of recent architecture, Italian and international, give
scientific basis - to the reflections that define the variant and invariants typological
characters, (1) to explain the meaning of the changes, specifying the architectural
quality, (2) to provide the guidelines for design.
Architectural value of the hospital building
Functional aspects of a hospital building often overshadow the others that
characterize its architecture. The reason for of this inattention in favor of the
fictional aspects concerns the difficulty to define the quality of the architecture is
and how this can be assessed. Once, the architectural quality was synonymous with
safety and functional efficiency. Now, it is searched in the aesthetic and cultural
values. Moreover, there isnt a scale of absolute values of quality depending on the
different "users" and aims. Specifically in hospital buildings, assessment tools and
related quality indicators are numerous. They are referred more to specific sanitary
functions than others. These appraise the hospital only as a building system and not
as architecture. As such, the hospital building has to consider the physical and
psychological needs of the person (the sick in particular). The hospital plays a
catalytic role within urban environment, carries out some positive correspondences
for the city and the citizens. It works to promote the recovery of the values of
belonging and integration with the socio-cultural context.
A Level 2 hospital shall have as minimum, all of Level l capacity, including,
but not limited to, the following:
1. An organized staff of qualified and. competent personnel with Chief of
Hospital/Medical Director and appropriate board certified Clinical Department
Heads;
2. Departmentalized and equipped with the service capabilities needed to support
board certified/eligible medical specialists and other licensed physicians rendering
services in the specialties of Medicine, Pediatrics, Obstetrics and Gynecology,
Surgery; their subspecialties and ancillary services;
3. Provision for general ICU for critically ill patients.
4. Provision for NICU (Neonatal Intensive Care Unit)
5. Provision for HRPU (High Risk Pregnancy Unit)
6. Provision for respiratory therapy services;
7. A DOH licensed tertiary clinical laboratory;
8. A DOH licensed level 2 imaging facility with mobile x-ray inside the institution and
with capability for contrast examinations.
3.2 A minimum of two (2) exits, remote from each other, shall be provided for
each floor of the
building.
3.3 Exits shall terminate directly at an open space to the outside of the
building.
4. Security: A hospital and other health facilities shall ensure the security of
person and property within the facility.
5. 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.
5.1 Corridors for access by patient and equipment shall have a minimum
width of 2.44 meters.
5.2 Corridors in areas not commonly used for bed, stretcher and equipment
transport may be reduced in width to 1.83 meters.
5.3 A ramp or elevator shall be provided for ancillary, clinical and nursing
areas located on the
upper floor.
5.4 A ramp shall be provided as access to the entrance of the hospital not on
the same level of the site.
6. 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.
7. Ventilation: Adequate ventilation shall be provided to ensure comfort of
patients, personnel and public.
8. 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.
9. 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.
10. 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.
19.4 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.
19.5 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.
20. Function: The different areas of a hospital shall be functionally related with
each other.
20.1 The emergency service shall be located in the ground floor to ensure
immediate access. A
separate entrance to the emergency room shall be
provided.
20.2 The administrative service, particularly admitting office and business
office, shall be located
near the main entrance of the hospital. Offices for hospital
management can be located in private areas.
20.3 The surgical service shall be located and arranged to prevent nonrelated traffic. The operating room shall be as remote as practicable from the
entrance to provide asepsis. The
dressing room shall be located to avoid
exposure to dirty areas after changing to surgical garments. The nurse station
shall be located to permit visual observation of patient movement.
20.4 The delivery service shall be located and arranged to prevent nonrelated traffic. The delivery room shall be as remote as practicable from the
entrance to provide asepsis. The
dressing room shall be located to avoid
exposure to dirty areas after changing to surgical garments. The nurse station
shall be located to permit visual observation of patient movement.
The nursery
shall be separate but immediately accessible from the delivery room.
20.5 The nursing service shall be segregated from public areas. The nurse
station shall be
located to permit visual observation of patients. Nurse stations
shall be provided in all inpatient
units of the hospital with a ratio of at least
one (1) nurse station for every thirty-five (35) beds.
Rooms and wards shall be
of sufficient size to allow for work flow and patient movement. Toilets shall
be
immediately accessible from rooms and wards.
20.6 The dietary service shall be away from morgue with at least 25-meter
distance.
21. Space: Adequate area shall be provided for the people, activity, furniture,
equipment and utility.
Space
Administrative Service
Lobby
Waiting Area
Information and Reception Area
Toilet
Business Office
Medical Records
Office of the Chief of Hospital
Laundry and Linen Area
Maintenance and Housekeeping Area
Parking Area for Transport Vehicle
Supply Room
Waste Holding Room
Dietary
Dietitian Area
Supply Receiving Area
Cold and Dry Storage Area
Food Preparation Area
Cooking and Baking Area
Serving and Food Assembly Area
Washing Area
Garbage Disposal Area
Dining Area
Toilet
Cadaver Holding Room
Clinical Service
Emergency Room
Waiting Area
Toilet
Nurse Station
Examination
and
Treatment
Area
with
Lavatory/Sink
Observation Area
Equipment and Supply Storage Area
Wheeled Stretcher Area
Outpatient Department
Waiting Area
Toilet
Admitting and Records Area
Examination
and
Treatment
Area
with
Lavatory/Sink
Consultation Area
Surgical and Obstetrical Service
Major Operating Room
Delivery Room
Sub-sterilizing Area
Sterile Instrument, Supply and Storage Area
Scrub-up Area
0.65/person
5.02/staff
1.67
5.02/staff
5.02/staff
5.02/staff
5.02/staff
5.02/staff
9.29
5.02/staff
4.65
5.02/staff
4.65
4.65
4.65
4.65
4.65
4.65
1.67
1.40/person
1.67
7.43/bed
0.65/person
1.67
5.02/staff
7.43/bed
7.43/bed
4.65
1.08/stretcher
0.65/person
1.67
5.02/staff
7.43/bed
5.02/staff
33.45
33.45
4.65
4.65
4.65
Clean-up Area
Dressing Room
Toilet
Nurse Station
Wheeled Stretcher Area
Janitors Closet
Nursing Unit
Semi-Private Room with Toilet
Patient Room
Toilet
Isolation Room with Toilet
Nurse Station
Treatment
and
Medication
Area
with
Lavatory/Sink
Central Sterilizing and Supply Room
Receiving and Releasing Area
Work Area
Sterilizing Room
Sterile Supply Storage Area
Nursing Service
Office of the Chief Nurse
Ancillary Service
Primary Clinical Laboratory
Clinical Work Area with Lavatory/Sink
Pathologist Area
Toilet
Radiology
X Ray Room with Control Booth, Dressing Area
and Toilet
Dark Room
Film File and Storage Area
Radiologist Area
Pharmacy
4.65
2.32
1.67
5.02/staff
1.08/stretcher
3.90
7.43/bed
7.43/bed
1.67
9.29
5.02/staff
7.43/bed
5.02/staff
5.02/staff
4.65
4.65
5.02/staff
10.00
5.02/staff
1.67
14.00
4.65
4.65
5.02/staff
15.00
Notes:
1. 0.65/person Unit area per person occupying the space at one time.
2. 5.02/staff Work area per staff that includes space for one (1) desk and one (1)
chair, space for occasional visitor, and space for aisle
3. 1.40/person Unit area per person occupying the space at one time
4. 7.43/bed Clear floor area per bed that includes space for one (1) bed, space
for occasional visitor, and space for passage of equipment
5. 1.08/stretcher Clear floor area per stretcher that includes space for one (1)
stretcher
Level 2 Hospital
Model Organizational Structure for a Level 2 Hospital
(100 to 200 Bed Capacity)
Number
Positions
Bed Capacity
100
150
200
4
2
2
4
2
2
5
2
3
B. Medical Service
1. Office of the Chief of Medical Professional Staff
2. Outpatient Department
3. Emergency Medicine Department
4. Clinical Departments
5. Special Care Areas
6. Department of Pathology
a. Blood Bank
b. Anatomic and Clinical Laboratory
7. Department of Radiology
8. Dental
9. Health Information Management
a. Admitting/Information
10. Nutrition and Dietetics
11. Pharmacy
12. Medical Social Work
C.
Nursing 122
180
Service
1. Office of the Chief Nurse
2. Clinical Nursing Units
3. Operating Room
4. Delivery Room
5. Special Care Areas
a. Post Anesthesia Care Unit
b. Intensive Care Unit
c. Neonatal Intensive Care Unit (NICU)
d. Pulmonary/Respiratory Unit
6. Central Supply and Sterilization
122
2
9
19
26
4
2
6
13
8
3
5
5
9
7
4
227
161
2
11
26
35
6
2
8
18
11
3
7
6
13
8
5
192
2
12
31
48
6
2
9
20
11
4
9
7
15
10
6
4
55
14
11
4
83
21
17
4
108
26
21
7
6
14
5
10
9
21
7
11
10
27
9
11
Organizational Unit
of
44
59
2
2
2
4
5
6
4
5
5
5
6
7
8
13
15
3
5
5
3
3
3
5
6
7
5
7
9
To be contracted
292
404
493
Organizational Chart
Level 2 Hospital
100, 150 and 200 Bed Capacity
Basic Structure
Office of the Medical Center
Chief
Integrated Hospital
Operations
And Management Program
(IHOMP Unit)
Medical Service
Medical Service
69
Medical Service
Medical Service
Outpatient Department
Emergency Medicine
Department
Clinical Departments
Outpatient
Outpatient
Anatomic and
Clinical
Laboratory
Blood Bank
Admitting/Info
Nutrition and
Pharmacy
Department of
Medical Social
Dental
Nursing Service
Office of the Medical Center
Chief
Nursing Service
Clinical Service
Operating Room
Delivery Room
Budget
Cash Operators
Accounting
Human Resource
Management
Procurement
Materials
Management
Housekeeping,
Linen and Laundry
1.1.10.10 Toilet
1.1.11 Cadaver Holding Room
1.2 Clinical Service
1.2.1 Emergency Room
1.2.1.1 Waiting Area
1.2.1.2 Toilet
1.2.1.3 Nurse Station
1.2.1.4 Examination and Treatment Area with Lavatory/Sink
1.2.1.5 Observation Area
1.2.1.6 Equipment and Supply Storage Area
1.2.1.7 Wheeled Stretcher Area
1.2.2 Outpatient Department
1.2.2.1 Waiting Area
1.2.2.2 Toilet
1.2.2.3 Admitting and Records Area
1.2.2.4 Examination and Treatment Area with Lavatory/Sink
1.2.2.5 Consultation Area
1.2.3 Surgical and Obstetrical Service
1.2.3.1 Major Operating Room
1.2.3.2 Delivery Room
1.2.3.3 Sub-sterilizing Area/Work Area
1.2.3.4 Sterile Instrument, Supply and Storage Area
1.2.3.5 Scrub-up Area
1.2.3.6 Clean-up Area
1.2.3.7 Dressing Room
1.2.3.8 Toilet
1.4.3 Pharmacy
2. PLANNING AND DESIGN
2.1 Floor plans properly identified and completely labeled
2.2 Conforms to applicable codes as part of normal professional
service:
2.2.1 Exits restricted to the following types: door leading directly
outside the building, interior stair, ramp, and exterior stair
2.2.2 Minimum of two (2) exits, remote from each other, for each floor
of the building
2.2.3 Corridors and ramps for ingress and egress at least 2.44 meters
in clear and unobstructed width
2.2.4 Exits terminate directly at an open space to the outside of the
building
2.2.5 Minimum of one (1) toilet on each floor accessible to the
disabled
2.3 Meets prescribed functional programs:
2.3.1 Main entrance of the hospital directly accessible from public road
2.3.2 Ramp or elevator for clinical, nursing and ancillary services
located on the upper floor
2.3.3 Administrative Service
2.3.3.1 Business office located near the main entrance of the
hospital
2.3.4 Emergency Room
2.3.4.1 Located in the ground floor to ensure easy access for
patients
2.3.4.2 Separate entrance to the emergency
2.3.4.3 Ramp for wheelchair access
2.3.4.4 Easily accessible to the clinical and ancillary services
(laboratory, radiology, pharmacy, operating room)