Maintenance, Management & Planning of Hospital Facilities

Arch. Allen R. Buenaventura, MCM

1

Maintenance, Management & Planning of Hospital Facilities


2Objectives


• Discuss the process of Planning and Design of a health facility

• Discuss the methods of maintenance for a health facility


3

The Needs Assessment Team

Client

Planner

Administrator

Nurse

Functional

Financial

Physical

End -Users

Planners



4

The Briefing Team

Architect

Client

Planner

Administrator

Nurse

Other Medical Specialist

Health Officer

Functional

Financial

Physical

Structural Engineer

ElectricalEngineer

SanitaryEngineer

MechanicalEngineer

End -Users

Planners

Architects / Engineers



5

Factors Affecting Site Selection


Size

Drainage

Utilities

Limitation Soil Condition

Natural Features

Topography


Recommended Hospital Site


• Not at the edge of a slope

• Not close to a seismic fault

• Not near the foot of a mountain

• Not near bodies of water

• Not on a reclaimed site

• Not in flood prone areas

• Not within typhoon zone

• Not near active volcano


7


Written expression of the clients needs

Description of the services to be delivered in the hospital and their requirements

Prepared by the user of the hospital in the persons of the hospital administrator.

Architects Brief


8


Functional Content – size and content of departments

Philosophy of Service- type of patients, type of service, type of department

Workload- number of hours of work

Planning Principles- guided by the operational policy and procedures of the hospital

Contents of the Architects Brief


9

The Design Team

Architect

Client

Planner

Administrator

Functional

Financial

Physical

Structural Engineer

ElectricalEngineer

SanitaryEngineer

MechanicalEngineer

End -Users

Planners

Architects / Engineers



10


Phases and Outputs of the Architect’s Regular Services

and Percentage Completion Per Phase

(with architect as supervisor)

the physical form of the hospital20%Construction Phase

bidding and contract document (5sets)

detailed technical specifications

probable construction cost

working drawings50%Contract Document Phase

probable construction cost

outline specifications

Plans, evaluation other drawings, 20%Design Development Phase

Probable Project Construction Cost

Schematic Phase

Consultation with owner10%Schematic Design Phase

Output/s% CompletionPhase/s


11The Construction Team

Architect

Client

Builder

Administrator

Structural Engineer

ElectricalEngineer

SanitaryEngineer

MechanicalEngineer

Structural Engineer

ElectricalEngineer

SanitaryEngineer

MechanicalEngineer

End -Users

Architect

Engineers

Builder



12The Standard Hospital Plan Zoning


Outer Zone● Emergency Service●Outpatient Service

●Administrative Service

Second Zone

Laboratory ServicePharmacy Radiology

Inner Zone● Nursing Service

Deep Zone● Surgical Services●Delivery Services

●Nursery●Intensive Care

Service Zone ● Dietary Service●Housekeeping ●Maintenance

●Mortuary

Twilight Zone● Mortuary







14

Emergency Services


• Satellite Business Office• Accessible to Diagnostic and Treatment Department• Accessible Administration, Business Office, and Medical Records• Operational Accessibility to Outpatient Department• Operational Accessibility to Morgue

Outpatient Services

• One entry point for Out Patients• Close Proximity with the Main Lobby, Pharmacy, Laboratory, Diagnostic Imaging Services and Physical Therapy• Connected with Medical Records and Pharmacy


15Administrative Services


Hospital Lobby

• Information Desk

• Security Desk

• Directional Signs

• Well Ventilated

• Adequately Lighted

• Accounting

• Admitting Section

• Cashier

• Billing


16

The Standard Hospital Plan Zoning


Second Zone



17Laboratory Services


Haematology - Blood Bank Unit Urinalysis UnitBiochemistry UnitHistology UnitSerology – Bacteriology Unit

Ancillary Service Area

Glass Washing and Sterilizing unitLocker and Toilet FacilitiesOptional Services

Administrative Area

Waiting RoomCubicleSpecimen toiletBasal Metabolism Electrocardiography RoomPathologist’s Office

Laboratories


18


4.3.2 Biosafety Level 2 (BSL-2) practices, safety equipment, and facility design and construction are appropriate for work done with moderate-risk agents that are present in the community and associated with human disease of varying severity. With good microbiological techniques, these agents can be used safely in activities conducted on the open bench, provided splashes or aerosol productions are unlikely.


19



20



21


Pharmacy

WardPharmacy

EROut-Patient

STAFFSERVICESOut Patients


22


Pharmacy

Safety of Flammable Liquids

Wall – WashableFloor – impervious surfaceCountertops , work surfaces – stainless steelDoor- large enough for trolleys and carts, with glass panels






Second Zone






●Mortuary






25



26Nursing Wards


NURSING FACILITIES SPACE ACCOMMODATION

• One-Bed Room - Furnished with lavatory, toilet and bath, side table, locker. When possible, it should be of

such size to accommodate two beds in emergencies.

• Two-Bed Room - Similar to one-bed rooms but provided with cubicle curtains for privacy when needed.

• Four to Six-Bed Room - Similar to above. Furnished with common toilet and bath facilities.

• Isolation Unit - One-bed room designed for use by known infections or communicable disease patients

under observation that will require separate utility room facilities equipped with sink and

utensil sterilizer. Advisable at end of corridor or off a sub corridor.


27


WARDS

BULK STO.

KITCHEN

STAFF DINE

STORAGE

CSSD

SURGERYRADIOLOGY

PHARMACY PHYS

THER

LABORATORY

OPD

&

ER

PATIENTS

SERVICES

FOOD

STAFF

VISITORS

WARDS INTERDEPARTMENTAL RELATIONSHIP


28

Nurses Station


NURSES’ STATIONPHYSICAL REQUIREMENTS

• SHOULD BE OPEN TO THE CORRIDOR, PREFERABLY IN THE CENTER OF NURSING UNIT WHERE VISITOR ENTRY CAN BE CONTROLLED.

• EQUIPPED WITH NURSES’ CALL ANNUNCIATOR, MEDICINE CABINET WITH SEPARATE LOCKED SECTION, SMALL INSTRUMENT STERILIZER, AN ACID-RESISTANT SINK BELOW THE MEDICINE CABINET WITH KNEE OR ELBOW CONTROL, CLOCK, BULLETIN BOARD, TOILET, INTERCOM.




30


Obstetrical-Gynaecological Ward






Second Zone






●Mortuary




Deep Zone● Surgical Services● Intensive Care

●Delivery Services ●Nursery


33Surgical Services


Operating Department

• Outer Zone - Conference, classroom, locker spaces, outpatient reception

• Intermediate Zone – Work and Storage areas, recovery suite.

• Inner Zone – Operating room


34


Intensive Care Unit

Most unstable patients

Requiring technical/ and or artificial life support

Continuous invasive monitoring

1:2 ratio nursing ratio


35


Intensive Care Unit

• Ideally same floor as OR• Easy access to Emergency, OR and Wards• 6 to 8 beds / unit• Single patient ICU • Natural daylight but no glare• Controlled Humidity• 16-27 degrees C• Lobby Airlocks• Hot and cold water• 8 Power Outlet per bed• HEPA Filter Recommended


36


Delivery Department


37


Delivery Department


38


Nursery Department






Second Zone






●Mortuary





●Mortuary


41


Dietary Department

• Food receiving area• Food Preparation area• Cooking Area• Food Service Area• Dish washing• Refrigerated storage• Day storage • Cart cleaning facilities• cart storage area• waste disposal area• dining facilities

Dietary Service


42


Housekeeping Department• floor supply closet• floor equipment storage space• floor service closets with sinks• linen supply rooms and closets• office • locker• sewing room and sewing machine • proper shelving


43


Laundry Department

• soiled linen room• clean linen room• laundry cart storage room• laundry processing room• janitors closet • storage space


44


Storage• pharmacy• furniture• anesthesia • records section • central store room ( 2 square meter/ bed)

Pharmacy / chemical storage


45


Mortuary


46


Engineering


47



48The Commissioning Team

Client

Administrator

Nurse


Health Officer



49

The Needs Assessment Team



50

Architect

Client

Builder Planner

Administrator

Nurse


Health Officer

Functional

Financial

Physical

Structural Engineer

ElectricalEngineer

SanitaryEngineer

MechanicalEngineer

Structural Engineer

ElectricalEngineer

SanitaryEngineer

MechanicalEngineer

The Planning Team



51


Health Facility Maintenance

Preventive Maintenance – Consist of planned, scheduled and cyclic tasks of parts replacement, condition, monitoring, and general gathering of data in order to:

a. Prevent untimely breakdown of building elements and equipments.b. Maintain desired operating performance levelsc. Generate structured and coherent data needed for planning

and decision making

Corrective Maintenance – involves minor repair of building elements and minor servicing of equipment to correctconfirmed abnormalities or deteriorating conditions

Major Repair/Rehabilitation – involves major repair/rehabilitationof building elements and major servicing or overhauling of equipment and utility systems requiring substantial replacements and restructuring of such building elements and system.


52


Problems in Health Facility Maintenance


53


Preventive Maintenance Program

Building Inspection Schedule


54



Building Inspection Schedule


55




56


Corrective Maintenance Program

Job Order Request Form


57


Major Repair/ Rehabilitation


58


Annual building inspection must be conducted by Engineers and Architects.

As built plan must be kept on record.

Building permit and Occupancy Permit issued by building official.

Health Facility Maintenance