Professional Documents
Culture Documents
HEALTH FACILITY
BUILDING NEEDS
Contents
Introduction
EBD
Introduction
Introduction
Interdependence of departments
Controlled environments
76 beds
108 beds
268 beds
306 beds
500 beds
Expected
Workload
(attendances)
>800
500-800
300-500
150-300
100-150
<100
<50
I Malaysia Clinic
GENERAL HOSPITAL
Set-Up
Operational policies
Special needs
hospital
community
Emergency Dept.
Clinic GOPD, Specialist Clinic
Day Care
Dialysis (Haemo-dialysis & PD)
Wards
Double corridor
Single corridor
Single room
Imaging (XRay)
Pathology (Lab)
Forensic
(Mortuary)
Rehabilitation
(OT & PT)
Pharmacy
Inpatient
Out-patient Pharmacy
Medical Store
Central Sterile
Supply (CSSD)
Haemodynamic
Respiratory
Medical Record
ITD
Medical Social Services
Infant Nutrition (Milk
Kitchen)
Dietatics
Catering/Kitchen
Linen holding
Waste disposal
General
Clinical/Biohazard
Chemical
General
Maintenance/Cleaning &
Housekeeping
Engineering
Porter/Transport
Helipad
General Administration
Nursing Administration
Admission & Revenue Collection
Telephone Operator & PABX
Accessibility
Controlled circulation
Redundancy
Aesthetic
Security & Safety
Sustainability
Group functional
areas with similar
system requirements
Encourage sharing of
resources & avoid
duplication
Provide optimal
functional adjacencies
eg. ICU next to OT
Therapeutic Environment
Unthreatening,
comfortable and stress
free
Using familiar & culturally
relevant materials
Using cheerful and varied
colours & texture (note:
some colours are
inappropriate)
Therapeutic Environment
Adequate &
appropriately located
housekeeping spaces
Special materials,
finishes, and detail of
spaces for sterile
areas
Accessibility
Controlled Circulation
Controlled Circulation
Redundancy/Back-up Plan
Able to
service/maintain
systems without greatly
affecting service
Able to tolerate certain
degree of system
failure
Aesthetics
Protection of
hospital property &
assets
Protection of
patients & staff
Safe control of
violent or unstable
patients
Sustainability
Operational Costs
Maintenance Costs
Energy saving features
Basic Principle
Small vs Bigger Hospitals / Non Specialist vs Specialist
Hospitals
Small Hospital
(<150 beds)
Bigger Hospital
(>300 beds)
-May be separated
-May have satellite
pharmacy
Multidisciplinary Ward eg
Obst + Pediatric Ward;
Female Ward
Basic Principle
Doctors examine
patient on the right
side; hence it shall be
the basis for the
orientation of patient
bed, examination
couches and procedure
table within a room etc.
Dr Maarof Sudin
Planning & Development Division
Ministry of Health Malaysia
Introduction
Introduction
Impact of building on
people/occupants
Second to fresh air, I should be inclined to
rank light in importance for the sick. Direct
sunlight, not only light is necessary for speedy
recovery. I mention from experience, as quite
perceptible in promoting recovery, the being
able to see out of a window, instead of looking
against a dead wall
- Florence Nightingale on Light, 1860
No Environment is Neutral
The design of facilities,
organizations, work
processes, and
equipment impact one
another as well as patient
outcomes, safety and
staff satisfaction
Either positively or
negatively, the design will
exert its impact
Approach
Hospital
Outlook
New
Also include:
-psychological needs
-social needs
-spiritual needs
Pathogenic conception
-reduction of infection and disease
risk exposure
-prevent illness and physical harm
Institutional
Stressful
Healing Environment
Friendly
Quality Care
Traditional Hospitals
New Hospitals
High
demand
satisfaction
Growing stress,
healthcare staffs
to
increase
work
patient
demands
for
- Empirical Approach /
Engineering-style Approach
Measure first then fix
Saint Alphonsus
Centre for Advanced Healing
Identify evidence based design elements with
positive outcomes (in order of the strength of evidence):
-High HAI
-More medical error
-Increase patient transfers
-Privacy violation
-Lack family involvement
-Stress
-Reduced quality of care
-Reduced satisfaction
-Reduced staff productivity
-Faster recovery
-Lower HAI & medical error
-Better privacy
-Less noise
-Better communication
between staff and patient
-High satisfaction
-Isolation of patient
-During construction and renovation
(portable HEPA) to filter m. organism
eg. aspergillus from soil
Positive Distraction
-ARTS, music etc
-Increase satisfaction
-Positive escape & recuperation from stress
-Opportunity for patient-visitors interactions
Artwork - Example
Comforting/Healing
Stress Induced
- Acoustic environments
-Reduce noise
- Reduce stress
- Improve sleep
- Improve communication
- pain
- Less
-Decrease LOS
-Walks 6 miles/shift
Nowhere to Rest
Conclusion
Environmentally preventable hospital
Conclusion
Cost-effective, evidence based
environmental design
interventions should be included
in all hospital improvement
programs
Evidence-based environmental
design intervention should be
implemented together with other
process improvements for them
to be effective
THANK
YOU