HOSPITAL PLANNING

INTRODUCTION
Hospitals form an integral part of the health care
delivery system and play an important role in
providing curative services.
Efficient management of hospital is essential, so
that there is proper utilization of resources
available within the constraints existing in the
present health care delivery system and also to
provide quality services to the community.
PLANNING A HOSPITAL
The hospital planning process concentrate more on
the :-
designing of buildings and their architectural
appearance.
planning of organisation and equipment as well as
accommodating them and generating spaces to meet
policies.
PRINCIPLES OF HOSPITAL PLANNING
Protection from unwanted and uneasily disturbance
to helps in speedy recovery.
Control:The nursing station should be positioned
strategically to enable proper monitoring of visitors
entering and leaving the ward
Circulation: all the departments of the hospital must
be properly intgrate.
Separtion from disimilar activity
 Characteristics of Hospital
Organization
Every organization has a head.
In every organization there should be a clear line of
authority for every individual.
In a hospital, there are dual lines of authority
The Administrators are responsible for solving
management problem and health care personnel are
involved in patient care.
The hospital is in continuous operation which
Cont.
requires high operating costs and
substantial personnel and scheduling problems.
The diversity of personnel ranges from highly skilled
and educated administrators and doctors to unskilled
and uneducated employees like the staff involved in
sanitary functions.
Cont.
Hospitals are characterized by having wide diversity
of objectives and goals for different personnel,
professional groups and subsystems.
For example: The house keeping department works
towards maintaining cleanliness and sanitation, the
clinical team focus on patient care.
Cont.
The hospital organization is characterized by
interdependence.
For example: An orthopaedic surgeon cannot
perform an orthopaedic surgery without the findings
from the radiology department and the assistance of
the nurses and technicians.
Types of hospital
1. General
The best-known type of hospital is the general
hospital, which is set up to deal with many kinds of
disease and injury, and normally has an emergency
department to deal with immediate and urgent threats
to health.
 2.District

A district hospital typically is the major health care

facility in its region, with large numbers of beds for
intensive care and long-term care; and specialized
facilities for surgery, plastic surgery, childbirth
bioassay laboratories, and so forth.
Specialized hospitals include:-
3.Specialized
Trauma centres, rehabilitation hospitals, children's
hospitals, seniors' (geriatric) hospitals, and hospitals for
dealing with specific medical needs such as psychiatric
problems.
4.Teaching
A teaching hospital combines assistance to patients
with teaching to medical students and nurses and
often is linked to a medical school, nursing school or
university
A medical facility smaller than a hospital is generally
5.Clinics
called a clinic, and often is run by a government
agency for health services or a private partnership of
physicians
Clinics generally provide only outpatient services.
PLANNING OF which
Outermost zone, UNITis the most community
oriented
Primary health care support areas
Out-Patient Department
Emergency Department
Administration Admitting Office
Reception
Second zone
Which receives workload from
Diagnostic X-Ray
Laboratories
Pharmacy
Middle zone between outer and inner zones
Operating Department
Intensive Care Unit
Delivery area
Nursery
Inner zone:
Cont..
In the interior but with direct access for the public
Wards And Nursing Units
Service Zone, Disposed Around A Service Yard
Dietary Services
Laundry And Housekeeping
Storage maintenance and engineering
laboratory
x-ray,Medical shop, carrying common drugs,
vaccines, serum and surgical items
ORGANIZATION OF THE UNIT
1. Outpatient department
The design of the out-patient department of the
hospital depends on the scheduling of consultations
Consultation Rooms
Examination Rooms
Treatment Rooms,
Staff and Supply Areas.
 UNREFFERAL
PATIENTS
WALK IN

SOURCE
FOLLOW OF EMERGEN
UP CY
PATIENTS
PATIENTS PATEINTS
IN OPD

REFFERRED
PATIENTS
 Front office
WORK
FLOW OF
OPD
Registration

Waiting
area

1 2 3 4 5

X- INJ DRESSING Pharmac

LAB
RAY ROOM ROOM y

IP WARDS IP Admission
Emergency medical services
Emergency service dedicated to providing out-of-
hospital acute medical care and/or transport to
definitive care, to patients with illnesses and injuries
which the patient, or the medical practitioner,
believes constitutes a medical emergency.
Term emergency medical services may refer solely to
Cont
the pre-hospital element of the care, or be part of an
integrated system of care, including the main care
provider, such as a hospital.
Emergency medical services may also be locally
known as: first aid squad, emergency squad,
rescue squad, ambulance squad, ambulance
service, ambulance corpsor life squad
Administration Block
The administrative department is orientated to the
public but is at the same time private. Areas for
business, accounting, auditing, cashiers and records,
which have a functional relationship with the public
must be located near the entrance of the hospital
Radiology and imaging
department
The term "radiology department" usually refers to the
department in which diagnostic imaging is provided.
It is distinct from that in which radiotherapy and
radiation oncologist are carried out.
Work flow in radiology
department
X-ray room Dark room

Toilet
Reading and
interpretation
Change
room

Waiting Doctors viewing

room

Reception
room File correction and
storage room

Patient Traffic
flow X-ray film flow
Cont
The X-ray department should consist of three rooms:
The X-Ray Room;
The Dark-Room and
Office And Storage Space.
Medical record room
Well-kept medical records form an integral and vital
part of an efficient hospital system.
Full-scale computerized data bank should be created
in which all data relating to hospital patients are
retained
Laboratory services
Modern medicine is increasingly dependent on
laboratory services for the prevention, diagnosis and
control of diseases.
Pathology laboratories play a central role in the
hospital and and each hospital must have an adequate
laboratory service under the direction of a medically
qualified pathologist.
LAB LAY OUTRECEPTION
/REGISTRATION
TOILET
MALE
FE
FEMALE
WAITING AREA PATHOLOGIST
SAMPLE ROOM/PATIENT
COLLECTION REPORT
ROOM

SAMPLE
STORGAE/REFIRI
GRATION PATH LAB
STORAGE
 In designing the pharmacy, the following considerations
Pharmacy
should be kept in mind:
(1) location: accessible to the out-patient department,
convenient for dispensing, accessible to the central
delivery yard.
(2) Traffic within the department must be economical
and flexible.
(3) Its size is determined by its organization and
operational policies.
(4) Provision for security of dangerous drugs.
Work flow of pharmacy
Manufacturer
dealer suplier

Main stores

Sub stores or pharmacy

wards outpatients
 A blood bank is a cache or bank of blood, gathered
Blood
as a resultbank
of blood donation, stored and preserved for
later use in blood transfusion. The term "blood bank"
typically refers to a division of a hospital laboratory
where the storage of blood product occurs and where
proper testing is performed to reduce the risk of
transfusion related events.
The design of operating theatres has become more
Operating
and more complex. theatre
The latest technology in OT
Bacteria-free environments in which surgery can be
undertaken under almost completely aseptic
conditions.
Sophisticated provision of equipment.
Location of operating
department
The preferred location is on the same floor as the
surgical wards, which may be the ground floor. It
should be connected to the surgical ward by the
simplest
Possible route, it should also:
Adjoin The Central Sterile Supply Department
O.t
c layout stores Female change
Operating room1 room
autoclav
e
Nurses
Male change
office
room
Operating room 2
Reception
room

Operating room3 Anesthetists

Doctors lounge room

Operating room4 Recovery room

 The intensive care unit is for critically ill patients
Intensive care
who need constant unitattention and highly
medical
specialized equipment
to control bleeding,
to support breathing,
to control toxaemia and to prevent shock.
LoCAtIon Cont
Be Easily Accessible From The Accident And
Emergency Department
Be Easily Accessible For The Delivery Suite
Adjoin the intensive care unit.
Paediatrics unit

The nursery should be located adjacent to the

delivery department to ensure protected transport of
newborns .Areas must be provided for cribs for both
well and ill babies and for support services that
include formula and preparation rooms.
 The older population of any community is usually
Geriatric services
best cared for in community-based facilities where
their special needs and requirements are provided for
in sensitive and Rooming-in caring designs that
allow them to lead independent and dignified lives
for as long as possible
Inpatient nursing
These wards provide wards
accommodation for patients
who are dependent on
others because of their illness. They have the
following functions:
to substitute for the home for regular eating, bathing,
sleeping, etc;
to allow examination, treatment and cure of patients.
to prepare patients to return to domestic
life.
Dietary services
Apart from parenteral feeding (not considered here),
hospitals should provide dietary services for those in
special need of them (i.e., infants and other patients
unable to eat normal meals). These services should be
provided whether or not the local custom is for the
family to provide regular meals for the patient.
CONT..
The department should contain the following
facilities:
Prepared diets and service, meals and/or disposable
items are used: food preparation centre, food serving
facilities, for both patients and staff, dishwashing
facilities (or room),pot-washing facilities
Refrigerated storage-3-day supply, day storage-3-day
supply, cart-cleaning facilities, cart storage area waste
disposal facilities, dining facilities.
Central sterile supply
(C.S.S.D.) is a integral department in the hospital ,the
department
purpose of CSSD is to supply all departments of a
hospital theatres, wards, out-patient and casualty
departments with complete, sterile equipment ready
and available for immediate use in the treatment of
patients.
 The basic equipment consists of
Cont
steam pressure
sterilizers and hot-air ovens, which provide a uniform
standard of sterility of supplies throughout the
hospital.
decentralized boiling-water sterilizers, used for
instruments, bowls, syringes, etc.,
 Work flow of
RECEIPT CSSD

Accounting
Sorting

Gloves Instruments
E Needles And
Syringes

Packing

Awaiting Sterilization

Autoclaves Dry ovens

Check for sterility Sterile storage

ISSUE
CSSD LAY OUT
RECEIVIN CHANGE
SORTING G ROOM OFFICE ISSUES
ROOM

WASHING
AUTOCLAVES
STERILE
STORGAE
Laundry service

Laundry service is responsible for providing an

adequate, clean and constant supply of linen to all
users.
The basic tasks include: sorting,washing,extracting,
drying, ironing, folding, mending and delivery. A
reliable laundry service is of utmost importance to the
hospital.
 WORK FLOW OF LAUNDRY
Reception

Soiled linen infected linen

Storage Central
Staff uniform ward disinfection
area
department articles

barrier wall with double door storage

Marking and
classification classification
washing

Washing and extracting

Distributio
Assemblin n
Pressing drying calendaring g ,packing
The housekeeper's office
Housekeeping facilities
should be on the lowest
floor, adjacent to the central linen room.
The central linen room supplies linen for the whole
hospital. It must have shelves and spaces for sewing,
mending and marking new linen. If laundry is to be
handled in the hospital, the central linen room must
be adjacent to the "clean" end of the laundry room
 Hyun-Bo Seo,Young-Seon Choi2011 reported in an exploratory
RESEARCH
study comparesABSTRACT ON HOPITAL
nurses trips to procure medicationsUNIT
in a smaller
intensive care unit (ICU) and those in a larger ICU designed for
patient-centered care. The smaller unit observed has global
visibility to most of patient rooms, and the larger unit has local
visibility from distributed substations to patient rooms. The
comparison showed that nurses did not walk longer and spend
more time getting medication in the larger unit. They did
interact less and made fewer extra stops than the smaller unit.
Unlike some studies, nurses did not walk further in a larger unit.
This study suggests that visibility, the presence of substations,
and location of medications can reduce walking. This needs
verification in further research.
RESEARCH ABSTRACT ON Hospital capacity
Bernd Rechel,Stephen
planning: from measuring stocksin
Wright reported toa study of
modelling
innovative flows
hospital projects in Europe stated that
hospital capacity planning should not be based on
beds, but rather on the ability to deliver processes.
using approaches that are based on manufacturing
theory such as lean thinking that focuses on the
value that different processes add for the primary
customer, i.e. the patient. it is beneficial to look at the
hospital, not from the perspective of beds or
specialties
 Reddy S.S .hospital administration and
References
planning volume 3 page no.184-190
Joshi hospital administration and planning
.volume 2 page no.670-677
Basvanthapa BT. Nursing
Administration.volume 3 page no.543
http://www.wikipedia.comHospital ,types, and
services
http://ctb.ku.edu CSSD,laboratory,
hosekeeping,lay out.