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ARCHITECTURAL PROGRAM

for

McALLEN MEDICAL CENTER

McALLEN TEXAS

BY

REYNALDO VARGAS

THESIS

Submitted in Partial Fulfillment of the Requirements for the Degree of

Bachelor of Architecture

Texas Tech University Lubbock, Texas

December, 1975

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,5,-7- ACKNOWLEDGEMENTS

Professor William Stewart

Dr. Jack Thorpe, & Associates, who devoted part of their time to this project

Kandy May, the stenographer

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TABLE OF CONTENTS

I. GENERAL INTRODUCTION Page

A. Nature of project ^ -r B. Socio-economic Regional Study o C. Climatic Analysis ^3

II. MEDICAL OPERATIONAL SYSTEM

A. Progressive Patient Care Concept -^2 B. Some Aspects of Progressive Patient Care 34 C. Elements of Progressive Patient Care 35 D. Flow of Patients in Progressive Patient Care L^Q

E. Benefits of Progressive Patient Care Zf6

III. ECONOMIC ANALYSIS

A. Sources of Income of a Health System /g B. Cost of Providing Health Service * 50

C. Economics in Allocation Decision 51

IV. DEPARTMENTAL DESCRIPTIONS

A. Administration Division 55

B. Patient Quarters Division 57 C. Diagnostic-Therapeutic Division* 59 D. Ancillary Services Division gO

V. GROUPING OF ELEMENTS AND CIRCULATION A. Administration Division 62 B. Patient Quarters Division 63 C. Diagnostic-Therapeutic Division 65 D. Ancillary Services Division; 68

VI. DEPARTMENTAL SPACE ALLOCATIONS

A. Administration Division 70 B. Patient Quarters Division, 77 C. Diagnostic-Therapeutic Division 96 D. Ancillary Services Division 121

V I I . SITE ANALYSIS

A- Site Criteria Statements ; 1 i 4

B. Site Plan, li.6 C. Site Survey and Soil Investigat Jo n 14? D. City Ordinances and Standards 150

VIII. BUILDING CODE ANALYSIS

A. Introduction 169 B. Types of Construction 1 69 C. Height and Area Restrictions 170 D. Structural 171 E. Means of Egress, Passageways, and Vertical Openings ... 175 F. Fire Prevention 1 82 G. Elevators and Dumbwaiters 1 8if

IX. INTRODUCTION TO SOLAR ENERGY STUDY

A. Solar Energy 195 B. Air Conditioning 19? C. Solar Space Heating 199 D. Solar Heat Collectors 200 E. Storage 210 F. Controls 212

X, MAJOR EQUIPMENT SCHEDULES

XI. BIBLIOGRAPHY

GENERA L INTRO DUG TION

GENERAL INTRODUCTION

I A. NATURE OF PROJECT

B. SOCIO-ECONOMIC STUDY

C. CLIMATIC ANALYSIS

GENERAL INTRODUCTION

Whatever the stage of development of a society, adequate

health care is nowadays considered the right of every individual.

If it were desirable for no other reason, good health care plays

an important role in simulating economic development. When

suffering is reduced and the possibility of a longer and richer

life unfolds, people face their future with more optimism and

confidence. They become more capable of improving their conditio^i,

and their productivity rises.

Thus the planner of medical facilities must consider man's

innermost needs, the aspirations of peoples, social structures,

values and attitudes toward human life. But the substance of

physical planning is mostly technical. It deals with the strin­

gent functional requirements of medicine, a highly involved and

specialized complex of scientific disciplines. The hospital is

justly referred to these days as perhaps the most complex of con­

temporary social institutions. It is the traditional job of the

architect as master builder to bring out the orderly and meaningful

solution inherent in the problem. But modern life, its insti­

tutions and functions, inextricably intertwined, may not be re­

duced to simple forms. If we are to plan effectively to satisfy

man's needs we must face up to the complexity of the task, and

to do this we must base our efforts on two reciprocal concepts:

comprehensiveness and integration. (12)

COMPREHENSIVENESS, as applied to planning, means that plan­

ning should embrace all facets of a given problem. Specifically,

in medical facility planning, it means that institutions or health

care systems should complete, and contain all the elements

necessary to perform a medically effective job.

INTEGRATION means that the components of a hospital or a

health system are arranged to complement and support each other

so that they can work in unison. It means that the parts should

help the task to be accomplished and that their distribution should

be appropriate to the needs of the population to be served, with

no wasteful or neglected gaps.

NATURE OF PROJECT

On October 22, 1972, a group of McAllen's leading Physicians comprised of Dr. Williams Johnson, Dr. Carlos Trevino, Dr. Anthony McMasters, and Dr. Jack Thorpe met to discuss the possibilities and potentialities of locating a major medical center in McAllen, Texas.

At this meeting it was the general consensus of the group that such a facility would have numerous, positive effects, not only to the Southern portion of Texas, but also to the Northern portion of Mexico. A facility of this nature vould help foster diplomatic relations with the two countries and at the same time help improve the health^9nditions of the region.

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A year later, on September 29, 1973, a preliminary study

was conducted and it was learned that an area with a radius of

22 5 miles and approximately 1 million people was served with only

1300 hospital beds. Such a limited number of beds resulted in

recommending to the physicians an increase of 600 - 700 beds

of varied and specialized medical services not found available

to this region because of its isolated geographical location

relative to other specialized medical services.

On June 21, 1974, the following recommendations were made

to the physicians now organized as the board of directors.

Phase 1 A. 200 Bed General Hospital with future expansion

of 150 beds. Total 3 50 beds. B. Out-patient Department C. Doctor's Office Complex D. Nursing Teaching Facility

Phase 2 A. 160 bed Convalexcent Home B. 55 bed Veteran's Hospital C. Cancer Research Center D. Pharmaceutical Teaching Facility

Phase 3

A. 50 bed Tuberculosis Hospital B. Rehabilitation Center

This recommendation is to be distributed over a 10 year period

with provisions being taken into account for the general ancillary

services necessary for such a center to operate on. Adequate

7

provisions should also be made to accomodate other medical insti­

tutions which may be added due to the vast concentration of re­

sources which a Medical Center provides.

8

In November 1975, this preliminary proposal and feasibility

study had tentatively been approved by the legislature, progress

was being reade for a 3.5 million dollar federal loan, and work

was being preformed for an additional 1.5 million dollar federally

funded grant for solar energy research conducted as part of a

health facility.

As was stated before in the general introduction, the vast

and complex nature of a medical center of this scope, practically

makes it impossible to program in a one semester's period.

Therefore, it will be my intention to program phase 1 and develop

a predominating mood which may b e incorporated with the other

phases.

SOCIO-ECONOMIC REGIONAL STUDY

Although nationally known as the Lower Rio Grande Valley

of Texas, this fertile region is not a valley at all. For tne

most part it is a delta of rich alluvial soil deposited over

the years by the meandering Rio Grande, the international river

that forms the boundary line between the United States and Me­

xico. In typical delta formation, the slope is away from the

river, with drainage generally northeast. East to west, the

Valley extends about 140 miles upstream from the mouth of the

Rio Grande, and to the north, 35 to 50 miles. It includes the

counties of Cameron, Hidalgo, Starr and Willacy. Cameron, Hi­

dalgo, and Starr counties lie directly on the Rio Grande.

McAllen is located in the Lower Rio Grande Valley of Texas

in Hidalgo County, and is in the southermost settled area in the

United States, at the same latitude as Miami, Florida. The

Valley is an irrigated garden spot approximately 40 miles wide

and 140 miles long on the banks of the Rio Grande River. In

this setting of tropical trees, shrubbery, flowers and citrus

groves, you will find McAllen a beautiful clean city composed of

friendly and progressive citizens, U.S. Highway 281 is the main

highway entering into the Valley and McAllen is located just 3

miles w4st of it on U.S. 83. U.S. Highway 77 is another main route

into the Valley.

10

Basic industries of the Lower Rio Grande Valley are agri­

culture, manufacturing, petroleum and tourism. Fishing and in­

ternational trade are also important.

Because of the rich soil and mild climate, agriculture is

the leading contributor to the area's economy. Cotton is the

major crop although it has dropped some in importance in recent

years. Livestock, grain sorghum and vegetable production have

become increasingly important. Two or more vegetable crops are

raised annually. County agricultural agents report that total

cash farm income in 1972 was $230 million.

Some 690 Valley manufacturing and industrial firms produce

and process over 260 products. Widely diversified in their ac­

tivities, these industries include petro-chemicals, refineries,

clothing and furniture manufacturing, canneries, concrete and

plastic pipe plants, and many others.

The third largest industry is oil and gas. The 1972 dollar

value of petroleum products was $175 million. Natural gas ex­

tracted in 1972 totaled 220 billion cubic feet.

Seafood and seafood processing, with an annual cash volume

in excess of $40 million, has become one of the Valley's leading

industries. The 1973 shrimp catch totaled 14.5 million pounds

taken in by 3 50 trawlers operating out of the Port Brownsville

and Port Isabel shrimp basins.

11

Both Port Brownsville and Port Isabel are deep-water ports.

Port Brownsville, the largest, is located at the terminus of a

17-mile deep-water ship channel leading from the Gulf of Mexico.

In 1973 this port handled 4% million tons of cargo. Port Browns­

ville and Port Isabel are also Intracoastal Canal barge ports

as are Port Mansfield and Port of Harlingen.

Tourists find the Valley especially attractive because of

the excellent opportunities for hunting, fishing, swimming, and

other outdoor sports, and its proximity to the quaint charm of

Mexico. Most popular attraction of recent years is the new

Padre Island National Seashore area. Padre Island is a 110-

mile strip of land extending from Corpus Christi south to Port

Isabel. Accommodations on the south end of the island, reached

via a causeway from Port Isabel, range from luxury motels to fish­

ing camps. For swimming, fishing, or just lying in the sun. Padre

Island offers uncluttered, uncrowded and unending miles of sandy

beach and rolling surface.

The Lower Rio Grande Valley is a popular winter resort area

for people from the Midwest. Most impressive, is the unhurried,

easy-going relaxed atmosphere of the border towns. Perhaps the

"do it manana" philosophy has much to do with it. At any rate,

it is a refreshing change from the fast-paced hustle and bustle

of most cities.

Many tourists who have visited the area return to enjoy

their retirement here. Persons reaching retirement age are

12

attracted by the warm subtropical climate, the excellent recrea­

tional facilities and the low cost of living. Most larger cities

in the Valley have special retiree groups or "tourist clubs", and

settlements with recreational facilities specifically designed

for senior citizens.

The Lower Rio Grande Valley serves as an important gateway

to northern Mexico and its interior. Mexico is easily reached

over international bridges at Brownsville, Progresso, Hidalgo,

Roma-Los Saenz and Rio Grande City. The Lower Rio Grande Valley

of Texas represents only one-half of the actual urbanization

area. The population on the Texas side of the Rio Grande is matched

by an approximately equal number on the Mexico side. The estimated

1963 population of Matamoros was 100,000 people. In Matamoros

and Reynosa, across the river from Brownsville and McAllen, re­

spectively, the traveler can take a quiet stroll through the plaza,

up narrow streets, and into the market place, where he can purchase

everything from fine Mexican silver to trinkets from the Orient.

For the fanciers of fast-paced tourism, Reynosa and Matamoros do

offer a good smattering of neon-embellished night clubs, complete

with floor shows, exotic Latin American drinks and tasty food.

A paved highway extends 200 miles southward from the Brownsville-

Matamoros International Gateway to a junction with the Pan-American

Highway at Ciudad Victoria. Other paved highways connect Reynosa

and Roma with Monterrey-

CLIMATIC ANALYSIS

The Lower Rio Grande Valley has a subtropical, semi-arid

climate. Although the area borders the Gulf of Mexico on the

east, and is largely dominated by maritime tropical air from

this source region, it does not possess a truly marine clinate.

Average annual rainfall is considerably less than along the mid­

dle and upper Texas coast. Rapid temperature changes, accompany­

ing strong polar or occasional arctic air masses in winter, give

the climate a modified continental flavor during this particular

season.

Typical of subtropical regions, the climate is characterized

by short mild winters and long hot summers. There is no sharply

established delineation of the so-called four seasons. Shortened

spring and fall transitional periods often possess the character­

istics of either winter or summer. The persistent southeasterly

breeze from the Gulf is quite refreshing during the warmer months.

SUMMER. Climatically, summer begins with the month of May

and lasts through September. While the highest temperatures are

normally reached in July and August, both May and September are

"hot" months with only minor day-tc-day fluctuations.

WINTER. The winter season consists of the traditional period,

December through February, although little in the way of actually

cold weather is experienced before December 15. This season is

not marked by any prolonged periods of cold weather but rather

by short spans of 2 to 3 days. The winter season is one of nany TEXAS TECH UBRARY

1^

changes. The weather fluctuates between warm and cold, clear and

cloudy, wet and dry. Usually there is a frontal passage about

once a week, but with 5 to 6 intervening days of pleasant wea­

ther conditions for outdoor work and recreation. Occasional

short periods of cold temperatures and drizzle (generally 1 to 2

days each week) interfere some with outdoor activities.

SPRING AND FALL. The fall months of October and November,

and the spring months of March and April, are transitional,

offering some variety in the weather pattern as modified polar

air masses move in and out of the area. Daytime temperatures

and drizzle are mild but usually not hot and nights are cool-

These are the most pleasant months of the year. (36)

Temperature

The moisture-laden air from the Gulf of Mexico has a mo­

derating effect on Valley temperatures. In general, summer

maxima are hotter and winter minima cooler as the distance from

the Gulf increases. The average annual temperature is close to

74° F. (23.3* C.) at all stations; however, the range between

the average maximum and the average minimum increases westward.

o ^ \ • The average annual daily maximuip is 87.1 F. (30.6 C.) at Rio

Grande City compared to 80.4* F . (26.9^ C.) at Port Isabel. Ex­

cept in the western portion of the Valley, minimum temperatures

equal or exceed 50° F. (10.0° C.) on an average of more than 300

15

days per year. Daily maxima of 100° F. (37.8° C.) or above are

quite common in July and August in the Western portion. January

is the coldest month, with an average daily minimum of 54.8° F.

(12.7° C.) at Port Isabel and 46.2° F. (7.9° C. ) at Rio Grande

City. On an average, lowest daily minima occur from about the

last week in December through the third week in January. Average

winter maxima are in the low 70's. (35)

Precipitation

Average annual rainfall in the Lower Rio Grande Valley de­

creases from over 26 inches in a wide belt along the eastern part

to 18 inches in the southwestern part, with a minimum of a little

over 17 inches at Rio Grande City. From Raymondville in west

central Willacy County to Rio Grande City in south central

Starr County, the average annual rainfall decreases about one

inch every 7% miles. Most of the precipitation falls in the form

of thundershowers, with the result that amounts are unevelny dis­

tributed, both geographically and seasonally. Large variations

may occur over relatively small areas. Occasional tropical cy­

clones in the late summer produce heavy rains and cause the monthly

rainfall averages to show a September maximum . A secondary rain­

fall maximum, occurs in late May and early June as the result of

squall line thunderstorms. It is possible for a single thunder-

16

storm to account for the entire month's rainfall at a station.

The most persistent rains are associated generally with warm

fronts and stationary fronts during the winter, and with easterly

waves or tropical lows during the late summer and early fall.

November and March are usually the driest months, although the

entire period November through March could be termed the dry

season. The average number of days per year with .10 inch or

more of precipitation ranges from 37 and 3 5 at Port Isabel and

Brownsville, respectively, down to 28 days at Rio Grande City.(36)

Relative Humidity

The distribution of relative humidity is similar to rainfall-

Mean annual relative humidity averages about 75 to 80 percent in

Willacy and Cameron counties, 70 to 7 5 percent in Hidalgo and 65

to 70 percent in Starr County. Although monthly variations are

small, lowest mean monthly relative humidities occur in March and

April, and again in July and August. Highest mean monthly rela­

tive humidities occur in January and February, and again in May.

Daily values are usually highest during the early morning hours

just before sunrise and lowest during mid-afternoon. Although

the humidity is high in the coastal counties, cool sea breezes

during the summer are very refreshing.

17

Wind

The predominant low-level wind flow across the Lower

Rio Grande Valley is from a southeast to south-southeasterly

direction. Surface winds blow from these directions about 41 percent

of the time at Brownsville and about 38 percent of the time at

Harlingen (20). Surface winds from southwest through west-north­

west are the most effective in removing moisture from the area

and in producing clear skies. Winds blow from these directions

about 5 percent of the time. The southeast to south-southeasterly

flow off the Gulf of Mexico is prominent in winter as well as in

summer. Surface winds from this direction reach a minimum during

December, but the frequency does not drop below 26 percent at

Brownsville or 21 percent at Harlingen. Northwest to north-

northeasterly winds reach a peak frequency during November through

February with little variation from month to month, then decrease

in frequency in March. ( 36 )

Sunshine and Solar Radiation

The Lower Rio Grande Valley receives between 60 and 65

percent of the total possible sunshine annually. Although

the western portion receives more sunshine than the coastal

section, the difference is rather small. Total sunshine is least

in December and January and most abundant in July and August.

Average annual sunshine at Brownsville is 46 percent of the

18

total possible in December and January and 80 percent in July.

Sightly more sunshine is received during the fall than during

the spring.

Tables 18a and 18b list mean daily total radiation received

near the ground at Brownsville, Texas, measured in Langleys. The

Langley is a unit of energy equal to one gram-calorie per square

centimeter. Data are a combination of both direct and diffused

radiation received on a horizontal surface. In the absence of

clouds, energy is depleted from the direct solar beam through

absorption and scattering by air molecules, water vapor and dust.

A considerable portion of this scattered radiation also reaches

the ground. It has been estimated that in the area of the

United States, about 80 percent of the incident extraterrestrial

energy reaches the ground during cloudless days. Table 18c indicates

that, for Brownsville, approximately 70 percent reaches the ground

during cloudless days with only a small variation from month to

month. The variations in extraterrestrial energy introduced by

clouds is considerably with cloud types as indicated by data in

Table 18f. In general cirroform clouds permit much more radia­

tion readhing the ground through a stratus overcast is only about

14 percent of the total possible, on an average. The percentages

of extraterrestrial radiation reaching the ground through altostra-

tus and cirrus overcasts are 22 and 53 percent, respectively.

19

Measurements of solar radiation at Brownsville show lowest

average daily values for December, when the days are the shortest,

but with considerable variation from year to year. Likewise,

highest values appear in June and July near the period of

maximum duration of daylight. Maximum cloudiness occurs in winter

and the amount of solar radiation received at the ground during this

season is significantly reduced by the prevalence of "low type"

clouds. During the summer the period of minimum cloudiness cor­

responds closely to the period of maximum available daylight so

as to increase the amount of solar radiation received.(36)

Cloudiness and Fog

At Brownsville the average number of clear days per year

is 99; partly cloudy days, 139; and cloudy days, 127. In the

more western portion of the Valley, Starr County for example,

the number of clear days increases while the number of partly

cloudy days decreases- There is only a small decrease in the num­

ber of cloudy days.

Cloudiness (sunrise to sunset) readies a maximum during

the period December through April with only a slight vatiation

in average cloudiness from month to month. Minimum cloudiness

occurs in July and August. Low clouds, especially stratus, are

the predominant type. Cloudiness in the Lower Rio Grande Valley

exhibits the same diurnal characteristics typical of all South

20

Texas stations; that is, it reaches a maximum between the hours

of 7 a.m. and noon during November through April. This cloudi­

ness generally decreases to less than 50 percent during all other

periods of the day except during March April. Afternoon and night­

time cloudiness show a greater persistence during March and April.

Afternoon and nightime cloudiness show a greater these two months

than during any other months of the year.

The high frequency of morning cloudiness decreases from

April to June, but themost significant change occurs between

June and July. The amount of morning cloudiness does not increase

significantly again until about November. ( 36)

Freezes

Freezes (32° F. or lower) do not occur every year in the

Lower Rio Grande Valley. Because of the moderating influence

of the Gulf of Mexico, freezes are less frequent near the coast

and increase in frequency as the distance from the coast increases.

If we arbitrarily classify any freeze that occurs on or after

January 1 as a spring freeze, and any freeze that occurs on or

before December 31 as a fall freeze (this is convenient for

statistical computation), then spring freezes occur with greater

regularity than fall freezes since the coldest weather occurs

during January and February. At Brownsville a freeze occurs

in the spring only an average of about 2 out of every 5 years,

21

and a freeze occurs in the fall only about once in 5 years.

At Weslaco a spring freeze occurs about 2 out of every 3

years while a fall freeze occurs on an average of about 1 out

of every 2 years. At Rio Grande City, which is least influenced

by moist air from the Gulf, a freeze occurs in both spring and

fall about 3 out of every 4 years.(3 6)

Thunderstorms, Wind and Hailstorms, Tornadoes

Thunderstorms do not occur frequently in the Lower Rio

Grande Valley, The average number of days per year with

thunderstorms is only about 24. The peak season is during

August and September with an average of about four thunderstorms

each month. Thunderstorms are rare during the colder season

November through February. The great majority of thunder­

storms occur during the afternoon and early evening. Maximum

frequency occurs between 1 p.m. and 3 p.m. The least thunder­

storm activity occurs from about 10 p.m. to 3 a.m. and again

from 8 a.m» to 11 a.m.

Hailstorms are equally rare. Only two major hailstorms

are known to have occurred during the 5-year period of 1960-64.

Hailstones up to 1% inches in diameter fell from a thunderstorm

a few miles north of Raymondville in October 1960, and in May,

1963, hail caused extensive damage to a small area-of citrus

and crops north of Mission. In the latter storm, hailstones

22

averaged about three-quarter inch in diameter, with the

largest stones iH to 2 inches in diameter. The months

of April and May are the most favorable for the occurence

of hail, and average diameter of the hailstones is most

likely to be about one-quarter inch.

The frequency of tornadoes in the lower Rio Grande

Valley is among the lowest in the State. Only three have

occurred within the 5-year period 1960-64. These were small

storms that touched ground only briefly and caused relatively

minor damage.( 3 6)

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TABLE 1

STATION Jan Feb

TEMPERATURES 1931-1962

Mar Apr May Jun Jul Aug Sep Oct Nov

24

Dec Annual

Port I sabel Ejctrerae High Mean Daily Max Mean Daily Mean Daily Hin Qctreroe Low

Brownsville Eictreine High Mean Daily Max Mean Daily Mean Daily Hiii fictrerae Low

89 68.8 61.8 51.8

22

87 69.3 60.8 52.2

19

90 71.5 6ii.li 57.3

30

9U 72.8 6a.0 55 .1

22

92 7ii.3 67.8 61.2

32

99 76.2 67.8 59.3

32

9U 79.0 73.3 67.5

37

100 81.8 73.7 65.6

97 8U.0 78.5 73.0

56

100 86.5 75.8 71.1

53

99 86.3 82.5 76.7

62

101 90.0 82.5 75.0

eh

99 89.9 63.7 77.5

66

102 92.2 8ii.2 7 6 . 1

68

99 90.2 83.8 77.3

65

102 92.5 au.2 75.9

66

98 67.8 81.9 75.9

59

lOU 89.a 81.3 73.2

55

96 83.5 77.2 70.8

52

96

76,0 67.2

hh

9:i 76.U 69.6 62.7

36

9U 76.U 67.5 58.5

3U

89 71.U 61i.3 57.2

32

90 71.5 62.7 53.8

29

99 80.U 7U.1 67.7

22

IQU 81.9 73.6 65.3

19

Harlingen Extreme High 91 99 102 106 103 106 107 Mean Daily Max 71-5 75-5 79-5 85.6 90.5 9U.0 96.3 Mean Daily 61.1 6^.5 68.7 lh*9 79.9 83.6 85.2 Mean Daily Min 50.6 53.5 57.9 6U.2 69.3 73.2 3U.0 Extreme Low lU 21 29 37 50 61 68

106 96,9 85.li 73.8

63

106 92.5 81.9 71.2

52

100 87.6 76.2 6ii.8

U5

95 78.6 67.5 56.li

32

93 73-3 62.6 51.8

27

107 85.2 7U.3 63.1*

lii

Raymondville Extreme High 92 99 105 IO6- 106 lOU Mean Daily Max 70.5 7U.5 79.3 85.5 90.i4 9U.0 Mear Daily 60.0 63.U 68.2 7U.6 79-7 83.3 Mean Daily Min h9.h 52.3 57.1 63-7 69.O 72.5 Extreme Low lii 19 28 37 U8 59

106 96.2 8U.6 73.U

65

107 96.9 85.0 73.0

61

105 92.2 81.5 70.8

51

100 87.0 75.5 63.9 . 1*0

95 77.3 66.2 55.1

28

93 72.0 6l.li 50.8

26

107 8a.7 73.7 62.6

Hi

Wealaco 2E Extreme High Mean Da i ly Max Mean Da i ly Mean Da i ly Min Extreme Low

McAllen* Extreme High Mean Daily Max Mean Daily Mean Daily Kin Extreme Low

91 71.6 61.2 50.7 16

92 71.1 60.0 18.9 17

98 75.9 6U.9 53.9 19

99 75.9 6a.5 53.1

19

101 80.5 6 9 . a 58.3 31

102 80.7 69.1 5 7 . a 31

105 85.9 75.8 65.7 38

105 86.1 7a.9 63.7

ao

103 89.9 79.9 69.9

a?

106 90.6 80.1 69.6 50

102 92.6 63.1 73.3 61

l o a 93.6 63.5 73.3 61

105 9a.5 6a.5 7a.1 67

105 96.0 85.0 7a .0 65

105 95.2 8a.5 73.8 62

loa 96.5 85.2 73.8

6a

102 91.5 8i .a 71.2

ae

102 92.6 51.9 71.1 50

99 66.9 75.9 6a.8

ao

100 67.1 75.8 6a .a

a2

95 78.2 67.5 56.7 30

97 78.0 66.9 55.8 30

92 73.1 62.7 52.2 2a

95 73.2 61.9 50.5 26

105 8a.7 7a.2 63.7 16

106 65.1 7a.1 63.0 17

Mission Extreme High 9a 101 103 Mean Daily Max 70.2 7a.6 80.2 Mean Daily 59-3 63.2 68.a Mean Daily Min a8.a 51.7 56.5 Extreme Low 10 19 31

108 86.6 75.1 63.6 39

106 7I.I 60.2 67.3

a6

106 9a. t 83.9 73.1

S9

110 96.9 85.5 7a . i 67

108 97.8 85.8 73.8 63

106 93.3 82.2 71.0 51

100 87.7 75.8 63.9

ao

98 77.7 66.3 5a .9

29

9a 71.6 60.7 a9.8

25

110 85.2 73.9 62.5 18

McCook * Extreme High Mean Daily Max Mean Daily Mean Daily Min Extreme Low

Rio Grande City Extreme High Mean Daily Max Mean Daily Mean Daily Min Extrone Low

9a 71.7 59.8 a7.9 10

96 71.1 58.7 a6.2 10

99 76.9 6a.5 52.1 16

102 76.0 62.9 a9.7 15

105 82.2 69.6 57.0 30

108 52.1 6 8 . a 5 a . 7

26

106 88 .a 76.1 63.8

a2

112 69.6 75.8 62.0 32

108 92.5 80.8 69.1

a?

112 9a . 0 61.L 66,8

aa

106 95.7 Su.3 72.9 60

U2 97.0 8 5 . a 73.0 56

107 98.a 86.1 73.7 66

no 99.7 87.0 7a.3 59

107 96.9 86.1 73.3 63

115 100.3 67.1 73.6 60

107 9a.0 82.2 70.3

as

107 9a.5 82.5 70.5 52

100 68.1 75.6 63.1

ao

101 88.8 75.8 62.8

39

98 78.6 66.6 5a.6 29

99 78.5 65.6 52.6 27

96 73.8 61.8 a9.7 26

96 72 . a 60.0 a7.6 23

108 86.6 7a.5 62.3 10

115 67.1 7a.2 61.3 10

*Period of Record 19a2-1962

34

TABLE L8A. MEAN DAILY TCTTAL RADIATION* -

EROV,T:SVILLE (JULY 1952-JUNE 1963)

25

Mean

Mean

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov

Spring

a66.6 161.6

Summer

589.0 123.2

Fa l l

386.0 l a i . i

Winter

286.0 132.9

Dec

279.9 331.ij aoo.3 a63.5 5a6,2 595.6 622.1 555.7 a62.a a02.2 286.2 25l.a ^ 126.7 i a5 .5 150.8 157.1 iao .8 127.2 109.0 122.8 125.2 121.8 116,8 u a . 6

Year

a32 . i 178.2

* Lan. leys per Day <y* Standard Deviation

Note

Data in Tables I8a- l8f are taken fror. R. A, Atlas and P. N. Charles, Sunriary of Solar "--;:L^Lion j r r e r v a l i jns - Tabular 5u.ijr.aries, Document D2->0577-2, December 196h, 995 pp. .O'-.-ir.ent rz-?-.-:;*?-!, S-Jinary of ^ioiar radia t ion Observations, December 196a, describes the

basic jQta, defines s t a t i s t i c a j . r t ia i ior ic and procedures used in preparing the tabular cu-'-T-ar^es. Both docunents, Zi-yC577-l and -I may be ordered for t he cost of reproduction i'ro-i: Director , National V.eather Records Center, U. S. 'Weather Bureau, Aahevil le , North Ca: --Ima 2o601,

TABLE iSb, MEAN DAILY TOTAL RADIATION^ BY TRIPARTED MONTHS -

BRO^JSVILLE (JULY 1952-JUNE 1963)

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

1-10 Mean <r

11-20 Mean cr

2]!-M) Mean

26a.O 3ai.O 380.6 a60.9 517.3 6 ia .0 627.7 609.7 UiS.! a2a.3 296.6 262.9 122.6 133.1 136.2 167.7 166.7 96.1 12a.2 lOl.a ia7.3 130.6 123.2 l lO.a

%•), ^^ fii ^i g-i 215 S;S 1 5 i£5 S:; S £5

S:l S5 ^i S5 Si S:5 'Hi '&i " - ^i -:>' -'.;

* Langleys per Day (S' Standard Deviation

82

TABLE iSc. MEAN PERCENTAGE OF DAILY F.XTRA-TERRESTRIAL RADIATION vs . L'AILY t-XAN CLOJ:- COVLi - 2 6

BRO' 'SVILLE (JULY 1952-JUN" 1963)

Claud Ccr«r Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

0/10 t Mean 72.9 71.5 69.7 69.8 69.5 68.5 69.6 71.5 66.3 72.5 67.2 69.1 , ^ 3.6 3.1 8.3 2.7 2.6 2.1 5.1 3.3 2.5 a .3 12.^ 1C.6

0-3/10 Mean , _ . _ . _ , . . (T 5.2 3.7 5.5 3.8 a.6 5.3 a.a 5.3 5.3 5.6 9.6 7.6

70.a 70.a 68.7 68.a 68.0 67.1 68.5 67.7 66.1 68,7 66.6 68.8

a-7/10 Mean ^ . . , ^ - , , ^ — , . - ^ , . _ _ , , . (T 9,1 8,3 8.6 8.0 9-S 8.2 8.6 9.3 10.1 9.7 9.9 6.8

57.6 58.7 58.1 57.a 57.0 60.8 62.5 59.2 55.8 55.9 53.0 53-5

29.5 30.3 35.5 35.7 36.5 38.2 a6.a 39.a 35.a 33-2 30.9 28.8 8-10/10 Mean ^,-^ ^--, ^^.^ -,,-. , _ . _ , , ,^ , <r 15.6 15.2 15.1 ia.9 ia.2 15.6 15.5 13.2 13.7 13.9 la.a 15.1

10/10 Mean 22.3 21.3 25.7 2a.a 23.1 28.5 31.a 33.7 2a.a 23.9 20.2 21.0 <r 12.5 12.6 12.3 13.1 13.6 16.0 21.a 11.5 10.9 10.1 10.1 12.3

•1" Standard Deviation

83

TABLE I8d. hXAN HOURLY AIJD MEAN DAILY SOLAR RADIATION* -

BROWNSVILLE (JULY 1952-JUNE I963) Zl

Hour

05 06 07 08 09 10 11 12 13 la 15 16 17 18 19 20 IkUy

March Mean ^

0. 0.1 3.8

15.8 29.5 ao.3 50.0 55.8 56.0 52.a a3.7 31 .a 16.6

3.8 0 .1 0.

395.5

- 0 . 0,1 2.6 6.2

i a . 3 i 9 . a 22.1 23.0 22.7 2 i . a 18.0 12.9

7.a 2.2 0 .1

- 0 . 151.3

April Mean

0. o.a 7.3

2o.a 3a.3 a 7 . i 56.7 62.6 61.9 57.8 a9.o 36.7 21.2 7.0 O.a 0.

a55.a

<r

- 0 , o.a 3.8 9.6

15.2 19.3 22.2 23.6 23.a 21.6 18.2 13.8

9.0 3.5 0.5

- 0 . 161.3

May Mean

0, 1.7

12 .a 27.3 a2.6 5a.a 63.9 69.8 69.7 6a.6 57.7 aa .6 27.5 11.6 1.5 0.

5a7.8

<r

- 0 . 0.^ a.7

10.0 i a .7 18.8 20.2 20.6 20.9 16.9 15.7 12.1

8.8 a .3 1.0

- 0 . 136.8

June Mean

0. 2.9

15.8 31.6 a7.5 60.3 68.1 7a . i 72.0 68.3 52.1 a7.o 31.3 i a . 6

2.5 0,

590.8

c r

- 0 . 1.3 a.7 9.2

12.9 16.2 17.6 19.3 19.8 19.3 17.3 13 .a

9.1

a.a 1.2 - 0 .

133.6

July Mean

0. 2.5

16.2 33.5 50.0 63.3 71.9 76,1 76.1 71.5 62.8 as .9 32.3 l a . a

2.1 0.

616.9

<r

- 0 . 1.1 a .o 7.a

11.a 13.7 i6 .a 18.7 19.0 18.2 i a . 5 11.0

7.1 3.9 1,0

- 0 . 112.9

August Mean

0. 1,0

11.9 29.2 aa.7 58.a 65.6 69.2 69.3 66.3 57.7

aa.o 27.5 10.5 0.9 0.

552.9

(T

0. 0.7 a.o 6.a

i 2 . a 15.3 18.2 20.7 20.7 1?.0 16.6 12.8

6.a a.o 0.8

- 0 . i 2 a . i

84

"y^m

TABLE iSd. MEAN HOURLY AND MEAN DAILY SOLAR RADIATION* -

BROWNSVILLE (JULY 1952-JUNE I963)

28

^emr

« 06 D7 OS 09 10 11 12 13 lU v^ 16 17 18 19 20 Ikily

*

Septenber Mean

0 . 0.2 6.7

22.8 36.0 U9.B 57.5 61.3 61.7 57.7 U8.1 33.7 19.5 5.5 0.2 0.

1*59 .U

Langleya

(T

0 . 0.2 2.9 7.6

i 2 . a 16.5 20.1 2 i . a 21.U 19.5 17.2 13.2

7.6 2.6 0 .3

- 0 . 126.2

October

Mean

0 . 0 . 2.7

15.7 3 i . a as.2 53.9 57.9 57 .a 50.9 a2.5 28.9 la.o

2.1 0 . 0 .

399 .a

^ Standard Deviation

6'

- 0 . - 0 .

1.8

6.a 10.8 i a . 7 17.6 19.3 19 .a 18.9 15.1 10.9

5.6 1.2

- 0 . - 0 .

122.5

November Mean

0 . 0 . 0.7 8.6

21.0 32.2 ao.o a3.o a2,7 38.a 30.9 19.5

7.5 0.5 0 . 0 .

282.0

cT

- 0 . - 0 . 0.6 a.5 9.6

i a . 3 17.6 19.2 19.9 18.3 i a . 5 9.5 a.i 0.5

-G. - 0 .

118.0

December

Mean

0. 0 . 0.2 5.8

17.0 27.8 36,a ao.8 39.a 35.1 27.6 16.6

5.6 0.3 0. 0 .

250.3

cr

- 0 . - 0 . 0,2 3.5 9.0

13.9 17.7 i 9 . a 19.7 17.8 13.8

8.7 3.0 0,3

- 0 . - 0 .

115.5

January Mean

0 . 0 . O.a 7.3

19.1 31-2 39.2 a3.5 a3.3 36,7 30.0 19.1

6.9 0.5 0 . 0 .

276.2

cT

- 0 . - 0 , O.a a.2

10.2 15.3 19.1 20.9 20.7 18.9 15.0

9.8 3.8 0.6

- 0 . - 0 .

i28 .a

February Mean

0. 0 . 1.2

10.2 23.3 35.9 aa.5 a9.6 a9.6 a5 .3 36.2 2a.1 10.6

1.3 0. 0 .

328.1

<s

- 0 . - 0 . 1.0 6,0

12.2 17.6 21.2 22.8 23.1 21.0 17.5 11.7

5.7 1.5

- 0 . - 0 .

laa.a

TABLE 18 «i MEAN TRANSMISSIVITY AS A FUNCTION OF SOLAH ELEVATION AND CU)UD COVER

BROWNSVILLE (JULY 1952-JUNE 1963)

Cloud Corer

O-3A0 Mean

U-7A0 Mean

8-ioAo Mean

0/25

17.9 17.3

ao.8 17 .3

25 .1 15.8

26/36

66.2 8.2

57 .0 1 3 . 1

32.8 18.2

37/a5

7 i . a 6.9

61.7 12.5

36.0 19.2

Elevation Angle a6/53 5a/6o

72.5 6 .1

62.8 13.a

37.2 19.0

72.3 5.8

65.3 11.9

a i . 8 20.2

(De&) 61/66

71.9 6.2

63.2 13.6

a i . 6 19.8

67/72

72.9 5 .9

66.5 11 .8

a3 .2 2o.a

73/78

72.9 5.8

6a .5 13.a

aa.o 20.0

79/90

73.a 5.7

67.9 U . 7

a8.2 19.5

(T standard Deviation

note: Transndssivity is the ratio of the amount of radiation transmitted •through the at«.osi*.ere to the total radiation incident at the top of the ataospbere.

85

TABLE l 8 f . MEAN PERCENTAGE OF POSSIBLE RADIATION v s . OVERCAST CLOUD TYPES

BRO'.VNSVILLE (JULY 1952-JUNE I963) 29

Mean cr

Mean

ST

15.0 11.1

ST

la.o 8.1

3T

sc, CU, CB

23.a 12.5

SC CU, CB

21.8 12.5

SC CU, CB

Spring

AS AC

2o.a 2a.9 10.7 12.8

Fall

AS AC

19.9 25.6 10.0 11.0

Year

AS AC

CI

a6.o 16.6

CI

a5.2 lo.a

CI

OS

a5.7 16.3

CS

a6,5 13.0

CS

ST

6.0 2.8

ST

so, CU, CB

21.9 15 .a

SC CU, CB

Sunner

AS AC

21.7 19.5 6.a 12.8

Winter

AS AC

CI

0. -0.

CI

13.9 21.7 2a.a 28.1 57.1 9.a 12.3 10.7 13.9 i5.a

.< standard Deviation

Note: Readings of cirrostratus cirrus (CI), altocumulus (AC), a

CS

37.6 19 .a

CS

a2.7 18.0

CS), Lto-

stratus (AS), and stratus (ST) cloud Mean ia.2 22.1" 21.8 26.0 52.9 a3.5 types are used only when no other layers T 9.6 12.5 10.2 12.5 16.3 16.3 are reported. Also, readings of strato-

cumulus (SC), cumulus (CU), and cumulo­nimbus (CB) are used only when no other cloud types are reported.

86

, ^ ^ . ^ . ^ m » .- ... • ' — " •• * • " • ' ^ " i " " '•-'

TABLE 2 3 c . TOTAL HOUBS OF COLD AND WARM TEMPERATURES AT WESUCO 2B DURING THE WINTER SEASON

30

November 15 - February 15

1955-1956

1956-1957

1957-1958

1958-1959

1959-1960

1960-1961

1961-1962

1962-1963

1963-1964

1964^1965

Average

U5 and below

195

128

265

375

269

305

285

390

408

220

284

70 and above

383

645

411

363

450

364

496

447

321

528

U1

Source: Noman MazveU, Texas Agricultural Experiment S ta t ion , UeslacOy Texas

TABLE 2a. NUMBER OF DAYS WITH MINIMUM TEMPERATURES OF 32 F OR LOWER

FOR AT LEAST ONE STATION IN THE LCWER RIO GRANDE VALLEY

November through March Number of Days

195a

1955

1956

1957

1958

1959

1960

1961

1962

1963

Average

1955

1956

1957

1958

1959

I960

1961

1962

1963

196a

6

6

3

5

8

13

7

U

13

104

— '•—

11

MEDIGAL OPERATIONAL SYSTEM

31

II. MEDICAL OPERATIONAL SYSTEM

It is very important for the hospital designer to fully

understand the basic principle by which a patient receives care

and treatment in a hospital. Therefore, a brief description

of the "PROGRESSIVE PATIENT CARE CONCEPT" has been provided.

A. PROGRESSIVE PATIENT CARE CONCEPT

B. SOME ASPECTS OF PROGRESSIVE PATIENT CARE

C. ELEMENTS OF PROGRESSIVE PATIENT CARE

D. FLOW OF PATIENTS IN PROGRESSIVE PATIENT CARE SYSTEM

E. BENEFITS OF PROGRESSIVE PATIENT CARE

1 1 : l i :

• '

32

PROGRESSIVE PATIENT CARE CONCEPT

In the face of ever-increasing costs and demands for health

and hospital services in a modern industrial society \A ere

resources, such as medical personnel, are limited, the concept

of progressive patient care appears to open a new dimension

for better planning and management of health services. The

current trend of the hospital and health system appears to move

towards the progressive patient care pattern.

The concept of progressive patient care can be character­

ized by the following two prominent features: (1) the tailoring

of hospital services to meet the patient's need; and (2) the

right patient, in the right bed, with the right service, at

the right time (14). The primary objective of this growing

concept is to provide better treatment and care by organizing

health services around the individual patient's medical and

nursing needs. This can be best achieved by setting up special

units to v^ich patients will be assigned according to their

degree of illness and need for care-

In a health care delivery system, the nurses, the patients,

the physicians, and all others involved operate as interacting

components of the total system, rather than independent entities.

Although each component has a distinct role in the operation

of the system, because of high interdependency, the system has

developed a high degree of complexity for the coordination of

33

the activities of each individual component towards a common

objective (31).

In the conventional hospital, the patient is kept in a

private, semi-private, or ward room. All the necessary

emergency or regular services are rushed to him when required.

In contrast to this, the progressive patient care system allows

the movement of the patient from one service unit to another

depending upon the nature of service and the degree of care

necessary for his particular health condition. Therefore there

is considerable flow of patients among the various service units

within the total system.

3k

SOME ASPECTS OF PROGRESSIVE PATIENT CARE

Although progressive patient care with its present refine­

ment seems to be a radical change in hospital procedure, the

basic philosophy of this concept is not new. For centuries,

the Japanese have been classifying the patients according to

their needs. Even in England more than one hundred years ago.

Miss Florence Nightingale, in a sense, practiced progressive

patient care in the operation of open wards. It was her plan

to place the sickest persons at the head of the ward, nearest

the nurse's desk. (14)

Since the beginning of the twentieth century in the United

States, the concentration of the critically ill, the convales­

cent, and the self-care patients in separate wards has been

practiced in army hospitals, tuberculosis hospitals, psychiatric

institutions, and some private hospitals. Except for these

scattered examples, however, few attempts have been made to

follow an organizational plan of this type prior to the develop­

ment of the current progressive patient care concept. It is

believed that the concept of progressive patient care began

to take shape in several hospitals in the United States in the

early 19 50's although it was not given the name "progressive

patient care" until 1956. During this period, the Department

of Health, Education, and Welfare began to place special emphasis

on the need to study and develop methods of organizing health

facilities and services more closely related to the varied needs

35

of the patients. A Government Advisory Committee was appointed

in September, 19 56 to survey the problem areas and make recommen­

dations for use in new hospitals as well as in the existing

health systems. (32)

Elements of Progressive Patient Care

At least six elements can be incorporated in the progressive

patient care concept. (25) These are: (1) emergency care,

(2) surgical or operative care, (3) intensive care, (4) inter­

mediate care, (5) self-care, and (6) long-term care. In

addition two more elements, namely (7) home care, and (8) out­

patient care, have been suggested by Abdellah. (3)

Emergency Care

Emergency care is for the patients who are usually brought

to the hospital as a result of accidents or other unexpected

eventualities for receiving emergency treatments. Traditionally

this service unit has emphasized on emergency surgery because

of accidents, and emergency medical care for the cases such

as heart attack, stroke, fainting, snake bite, and burn injuries.

Patients are given necessary emergency treatment and subsequently

moved to other nursing units depending upon their needs for subse­

quent care.

Surgical Care

Surgical care is for the patients who need to have a surgical

operation performed on their body for an adjustment or cure to

36

prevailing functional disorders. Usually the diagnosis is made

through X-ray or laboratory tests about the functional dis­

orders, such as a broken bone; a severed, torn or cut muscle,

ligament, or tendon; an abnormal growth; a displaced or swollen

nerve; a displaced organ; and some other functional disabilities.

The diagnosis is usually made before the patient arrives at

the surgical unit.

Intensive Care

Intensive care is for the critically ill patients who are

usually unable to communicate their needs and require extensive

observation and nursing care. Surgical cases constitute a

major portion of the total load in intensive care. They

usually include patients with intestinal perforation, chole­

cystectomy, gastrectomy, hysterectomy, pneumonectomy, traumatic

wounds, and complicated surgical problems. Medical cases

constitute the remainder of the case load. They usually include

patients with gastointestinal bleeding, intracranial hemorrhage,

acute myocardial infraction, pulmonary embolism, neoropsychiatric

problems including attempted suicide, delirium tremens or other

acute mental disturbances. (4) These patients are kept under

close observation of specially trained nurses. All necessary

emergency lifesaving equipment, drugs and supplies are

immediately available at the intensive care unit.

31

Intermediate Care

Intermediate care is for those patients who require a

moderate anount of care- Some of these patients may be ambu­

latory for a short period of time. Usually, patients in this

unit include persons with uncomplicated appendectomies,

varicose vein litigations, hemorrhoidectomies, and medical

problems such as pneumonia, colitis, and hepatitis. Those

patients who are beginning to participate in taking care of

themselves are also included in this group. Emergency nursing

care and extensive observation are seldom required. The

level of nursing care becomes relatively stable with a per­

sistent high level of occupancy.

Self Care

Self care is for the ambulatory and physically self-

sufficient patients who need diagnostic or therapeutic ser­

vices, or who may be convalescing (i.e., gradually recovering after

illness). This unit usually handles three types of inpatient

ambulatory problems: therapeutic, postsurgical,convalescent,

and diagnostic. For example the diabetic patient receives

training in diet maintenance; the postcoronary patient regains

confidence in his ability to perform his normal social duty;

the diagnostic patient can stay in this unit during the period

of diagnosis. The patients are instructed in self care

38

within the limit of their illness. This unit is a new thera­

peutic tool which allows the physician to study the patient

in an environment very similar to that of average daily

Iving.

Long-term Care

Long-term care is for the patients who require skilled

as well as prolonged medical and nursing care. The patients

in this unit usually include cases, such as malignancy, severe

intractable cardiac decomposition, etc. They may need

occupational therapy, physical therapy, and rehabilitation

services. In addition, emphasis is primarily directed towards

teaching them to adjust to their illness and disability.

Home Care

Home care is for patients who can adequately be taken care

of in the home through the extension of certain hospital

services. In a hospital based home care program, equipment

and personnel are supplied by the hospital or by the community

health service agencies, such as the local health department,

or the Visiting Nurses Association. The hospital, however,

assumes the responsibility of coordinating the services,

whether they are offered by the hospital or by another agency.

39

Out-patient Care

Out-patient care is for the ambulatory patients who need

diagnostic, curative, preventive, and rehabilitative services,

This element is a generally accepted activity of the average

general hospitals.

^0

Flow of Patients in Progressive Patient Care Svst em

One of the important features of a progressive patient

care system is the flow of patients among the various cata-

gories of services. As soon as the condition of health of

the patient changes considerably, he is usually moved to

another service unit depending upon the degree and need for

care for his particular health condition. For example, a patient

in an intensive care unit may be transfered to an intermediate

care unit as soon a s his health condition improves significant­

ly. Although, there exists a very high controversy about who

should decide about the transfer of a patient from one service

unit to another, still now it is commonly accepted that the

patient's physician should be the right person to make this

decision. The possible movement and flow of patients in and

out of the various categories of services in a progressive patient

care system will be described in detail in the following paragraphs,

In Emergency Care Unit

Upon arrival at the emergency entrance, a patient is

taken into the preparation room, where he may be given his

initial examination. His relatives may be asked to wait in

the adjacent waiting room. By this time the emergency staff

has been assembled, and the physician in charge takes over.

The patient may need to be washed, bandaged, given blood.

41

given sedation to kill pain, given minor surgery or splints,

or prepared for further treatment in surgery, or diagnosis

in X-ray. After the diagnosis has determined what treatment

is needed, the patient may be transfered to such service units,

or to an observation bed, or he may be given treatment forth­

with and discharged. Average service time in an emergency

care unit is usually 4-5 hours. It is desirable to have this

service unit close to X-ray and surgical unit. But as the

emergency care unit becomes larger and more self-sufficient,

these proximities become less important. This service unit

should be easily accessible from the emergency ambulance

entrance.

In Surgical Unit

The patient who s to undergo surgery is usually admitted

to an intermediate care unit, a self-care unit or a long-

term care unit by appointment, or may be admitted through the

emergency care unit. The patient is usually given preliminary

laboratory tests, and examined by X-rays prior to the surgery.

On the day of operation, the patient may be given sedation and

taken to the operating room on a wheeled stretcher, possibly

on a recovery room bed, or occasionally on his own bed.

There, he is transfered to the operating table, shaved if

necessary, draped with linens, and made ready for anesthesia.

42

As soon as the patient is anesthetized, time becomes most

important and the operation begins at once. Upon completion

of the surgery, the patient is usually removed to an adjoining

recovery room to recover from the anesthetic. Thereafter, he

is usually transfered to his own bed. But if his condition

deteriorates, he must be removed to the intensive care unit

for further care. It is desirable to have this service unit

close to the intensive care unit; Some hospitals prefer to

have the surgical unit close to the emergency care unit> so

that the emergency surgery can also be performed in this

service unit.

In Intensive Care Unit

When the health condition of a patient in an emergency

care unit, a post operative recovery room, an intermediate

care unit, or a long-term care unit deteriorates, he is usually

transfered to an intensive care unit for a high level of

constant intensive care. Surgical cases constitute the major

portion of the total case load in this service unit. They

mostly come from the emergency care unit or the post operative

recovery room. Medical cases constitute the remainder of the

case load who are usually transfered from intermediate care

and long-term units. After receiving services in this

unit the patient is usually transfered to an intermediate care

43

unit or a long-term care unit for further care. He may even

expire during his stay in this service unit. The average

lenghth of stay of a patient in this service unit is usually

4-5 days. It is desirable to have this service unit close

to the surgical unit, and the emergency care unit.

In Intermediate Care Unit

Patients are usually admitted directly into an intermediate

care unit by appointment. They may also get transfered to

this service unit fran an intensive care unit, or a self-

care unit. The length of stay in an intermediate care

unit depends upon the nature and the degree of illness; and

it usually varies from 6-10 days. After receiving treatments

in this service unit a patient may go back home, or to a self-

care unit where he may be kept for some days for observation.

But if his health condition deteriorates he is usually trans­

fered to an intensive care unit. He may also need a surgical

operation in which case he must be transfered to an inten­

sive care unit. He may also need a surgical operation in which case

he must be transfered to the surgical unit. It is desirable to have

this service unit close to the self-care unit, where the patient

can be moved without much difficulty. Besides, the provision for

a number of interchangeable beds can be made for absorbing the fluc­

tuations in load in either of these service units.

44

In Self-Care Unit

Patients are usually admitted directly into this service

unit by appointment for diagnosis. X-ray, or laboratory tests,

prior to surgery or physical therapy. Patients are also

transfered to this service unit from an intermediate care

unit, a surgical unit, an emergency care unit, and a long-term

care unit. The average length of stay in this service is

usually 5-6 days. After receiving services in a self-care

unit most of the patients go back home. But those patients

who get admitted to this service unit prior to surgery, are

usually transfered to the surgical unit. They may also get

transfered to a long-term unit.

In Long-Term Care Unit

Patients are usually admitted directly into this service

unit by appointment. They may also get transfered to this

unit from a self-care unit after diagnosis of the illness,

or from an emergency care unit, a surgical unit, or an in­

termediate care unit, for further long-term care. The average

length of stay in this unit is usually 25-30 days. A large

number of patients go back home after receiving services in

a long-term care unit. Some of the patients may

get transfered to the surgical unit for a surgical operation,

or to the intensive care unit if their health condition

deteriorates suddenly so that intensive care becomes essential.

45

This unit is usually located at a remote part of the hospital,

because the flow of patients in and out of this unit is not

very frequent, and in most of the cases isolation is desirable.

In Home Care

In a home care program patients are usually kept at their

home. They are usually transfered to the hospital only when

their health condition deteriorates to such a level that such

transfer becomes necessary. After receiving service in a

hospital a patient may come back home and receive care through

a home care program until he recovers completely.

In Out-Patient Care Unit

Patients arriving at an out-patient care unit are ambu­

latory in nature, and need primarily diagnostic, preventive,

and curative services. After receiving services, they usually

go back home. Some of them may get admitted to the self-care,

long-term care, or the surgical unit of the hospital.

46

Benefits of Progressive Patient Care

Haldeman (32), and Abdellah (33) have reported that prog­

ressive patient care has numerous benefits. These benefits

extend primarily to the patient, the physicians, the nurses,

and to the hospitals.

Benefits to the Patient

The patient receives the specialized attention and care

for his needs at the right time. He is helped in making his

adjustments, first to the hospital atmosphere and later to

his return to his home and community. Some hospitals strive

to offer emergency services within seconds; continuous nursing

Whenever necessary; complete high quality care irrespective

of the economic status of the patient; total (physical, teaching,

emotional, and rehabilitative) services and nursing care when ne­

cessary, all in a planned progressive way towards complete

recovery of the patient. Important consideration is given in

preparing the patient to adjust from hospital to the home or

community. The transfer of the patient to the self-care unit

prior to discharge helps the patient in adjusting gradually

from complete dependency to self-sufficiency.

Benefits to the Physician

The physician receives greater assurance that his patient

is receiving high quality nursing care, and that the special

drugs, medication, and equipment necessary for diagnosis and

treatment are readily available. There can be better planning

in the allocation of beds and of trained personnel. The nurses

on duty can contact the physician immediately in emergencies

and carry out orders and procedures as required. Emergency

orders can be carried out more efficiently without upsetting

the entire routine, as the personnel are geared mentally and

physically to such emergency situations.

Benefits to the Nurse

The nurse makes effective use of her special capabilities,

and the nursing department faces fewer problems in providing

coverage for critically ill patients in widely seperated areas.

This system permits the assignment of nurses to the area where

their individual skill can best meet the needs of the

patient. Nurses have more time to spend with patients, and

are able to help patients and their families in solving their

health problems.

In a conventional nursing system, patients are usually

separated by type of service, age and sex. The patient usually

remains in the same unit during the various stages of illness.

This decreases the possibility of his receiving intensive

care when he really needs it. At the same time, when he makes

seme progress and needs instruction, emotion support, and

48

rehabilitation, the demands of other critically ill patients

receive priority. Consequently, the patient is often left

with the feeling of being neglected, which may retard his

progress towards full recovery.

By organizing the service and skill based on the need of

patients, this system can help to make comprehensive specialized

nursing care available to patients during different stages of

illness. As the nursing supervisors, head nurses, and team

leaders work closely together in planning the whole patient

care program, the coordination of patient care emerges as a

major responsibility of the nursing team. Moreover, the nurse

utilizes her competence more effectively and thereby obtains

more job satisfaction.

Benefits to the Hospital

The hospital can improve the quality of patient care as a

result of effective and efficient use of personnel, beds,

physical facilities, equipment, supplies, and funds. Better

utilization of hospital facilities reduces the capital outlay for

installation and maintenance of such a system, and subsequently

may reduce the medical expenses to the patients.

''.'.fir

EGONOMIG ANALYSIS

ECONOMIC ANALYSIS

A. SOURCES OF INCOME OF A HEALTH SYSTEM

B. COST OF PROVIDING HEALTH SERVICE

C. ECONOMICS IN ALLOCATION DECISION

49

Sources of Income of a Health System

Hay (6) has described the various possible sources of

income of a health institution. The management of a hospital

may plan on receiving income from one, some, or all of the

following sources: (1) grants or subsidies from public and

private agencies, (2) contributions, donations, legacies, and

bequests, (3) donated services, (4) revenue from the pharmacy,

the nursing school, or other services on the hospital premises,

and (5) charges for services rendered to patients. Revenue

from fund-raising drives, legacies, and bequests is very

difficult to anticipate on a scientific basis. Similarly,

grants from government agencies, community chests, and founda­

tions also depend upon v^ether the request for such graits will be

honoured or not. Donated services from religious groups may

not always be available. There is a high degree of uncertainty

involved in the availability of an income from these sources.

It is not advisable to depend heavily on such uncertain incomes

for the purpose of designing a health system for a community.

Therefore, the only dependable source of income will be the

charges for services rendered to patients.

It should be noted that the management of a hospital does

not have complete control on the charges for the various cate­

gories of services offered. The various health insurance companies,

such as Blue Cross, Blue Shield, and the Welfare Department of the

50

government, are contract purchasers of hospital services.

These agencies usually put enormous pressure on the

hospital authority to reduce the charges. Also the charges

for various categories of services depend on the market si­

tuation, which means that it is to the interest of the indi­

vidual hospitals to make sure that their own charge fixation

policies are in accord with those of other hospitals.

Cost of Providing Health Service

The total cost of providing health service in a hospital

or a health system includes not only the cost of the day-to­

day operations, such as nursing, dietary, laundry. X-ray,

laboratory, pharmacy, etc., but also the capital for buildings,

equipment, and facilities, payment of interest and principal

of indebtedness are also items of cost resulting from the

securing of funds by borrowing.

A cost budgeting and cost analysis is necessary for the

determination of the unit cost of operation for each category

of service offered in the hospital or the health system. The

cost budgering should consider all possible costs pertaining

to the physical construction, operation and maintenance over

a predetermined useful life of the system. Similarly, the

cost analysis should apportion all the budgeted costs among

the revenue sharing units for the determination of the unit

cost of operation for each category of service of the proposed

system. Hay (6) has discussed in detail some of the standard

51

procedures of cost budgeting for hospitals and health systems.

The American Hospital Association has described the

various cost finding and allocation methods usually used for

the cost analysis in hospitals.

Economics in Allocation Decision

With the increasing rise in cost and demand of health

services, there has been a growing demand for better plan­

ning for utilization of the available resources and improvement

of the economics of the operation of a health system. This

trend has been continuously forcing a change in management

philosophy of a health system from one of a charitable organ­

ization to one of a nonprofit-seeking business. Currently,

most of the hospitals usually try to recover as much as

possible of the total cost of operation from the fees charged

to the patients for the offered services. Then, additional

funds in the form of donations and/or government appropriations

are sought for compensating the incurred loss. There are also

some hospitals which plan to operate on a break-even point

without depending on private or public donations or govern­

ment appropriations. At the same time, there are very few

examples where a hospital can be found to operate as a profit-

seeking enterprise. Still, it depends entirely upon the

management of the health system to select the policy decision

L ^ .^ t-k. ^

52

regarding the operation of the proposed health system and the

allocation of beds.

I?f P>1 R TMEN TA L DESGRIP TIONS

53

Departmental Descriptions

A brief description of each department within the hospital's major divisions is essential for the designer to be fully aware of its internal function. a>fa

Administration Division

A. Admitting Department B. Business Department C. Public Relations Department D. Volunteer Services Department E. Medical Redords Department F. Medical Library Department

II. Patient Quarters Division

A, Nursing Service Departments

1. Medical and Surgical 2. Pediatrics 3. Orthopedics 4. Obstetrics 5. Tuberculosis

6. Psychiatric

B. Physiatric Department

III. Diagnostic-Therapeutic Division

A. Clinical Laboratories Department B. Radiology Department C. Electrocardiography Department D. Electroencephalography Department E. Anesthesiology Department F. Social Service Department G. Outpatient Department H. Dental Department

IV. Ancillary Services Division

A. Central Supply Department B. Dietary Department

54

C. Pharmacy Department D. Housekeeping Department E. Laundry Department F. Maintenance Department

55

Administration Division

A. Admitting Department

Purpose: Admit patients to hospital in accordance with policies and regulations established by govern­ing board and executive office, in such a way as to promote good relationships with patients, relatives, and medical staff,

B. Business Department

Purpose: Manage the hospital's business activities and keep administration informed of financial con­dition of institution.

C. Public Relations Department

Purpose: Interpret policies and objectives of hospital to the public, foster attitudes and respect in the hospital on the part of the community, and interpret the public's opinion of the hospital to hospital authorities.

D. Volunteer Services Department

Purpose: Supplement activities of regular hospital staff in order to release technical personnel from routine duties; and perform amenities which will contribute to pleasant environment and comfort to patient, thereby helping to foster favorable public relations. (13)

E. Medical Records Department

Purpose: Provide a central file of medical records com­piled during treatment of a patient, that will be used as a permanent record in event of future illness, as an aid in clinical and statistical research, as an administrative tool for planning and evaluating the hospital program, and as a legal protection for the patient, hospital, and physician.

56

F. Medical Library Department

Purpose: Make accessible to staff members, medical lit­erature on standard procedures and recent de­velopments in medicine, surgery, and the various specialties. (13)

57

Patient Quarters Division

A. Nursing Service Department

Purpose: Furnish nursing care, as a part of professional treatment, for the recovery and physical well-being of the patient. (13)

1. Medical and Surgical: Nursing care is provided in medical and surgical units in accordance with physicians' instructions. The patient with pneu­monia or a cardiac condition requires a much different type of nursing from that given the patient with anemia, diabetes, or nephrites. Surgical patients also require special pre­operative and postoperative care,

2. Pediatrics: This service embraces care of children under 14 years of age.

3. Orthopedics: Nurses in this unit must have a thorough knowledge of operative procedures in all types of bone, joint, muscle, tendon, and other corrective surgery, as well as techniques for care of patients after surgery.

4. Obstetrics: Prenatal work, observation and com­fort of patients in labor, delivery room assis­tance, and care of mother after delivery, as well as nursing care of the newborn, are important responsibilities of this unit.

5. Tuberculosis: Tuberculosis is usually a long-term illness requiring special facilities. Nursing care must reflect understanding of effects on patients of long-term illnesses, and specific knowledge of prevention of infection among personnel.

6. Psychiatric: While most mental patients are treated in specialized hospitals, the general hospital also has recognized its responsibility and provided facilities for the mentally retarded.

58

B. Physiatric Department

Purpose: Assist in recovery and rehabilitation of mental, orthopedic, traumatic, and other patients, through physical means such as mechanical devices, con­structive recreational programs, and handicrafts. (13)

59

Diagnos t ic -Therapeut ic Division

A. C l i n i c a l Labora tor ies Department

Purpose: Perform laboratory tests necessary for diagnosis and treatment of hospital patients, and engage in research essential to medical advancement.(13)

B. Radiology Department

Purpose: Provide an adjunct diagnostic and therapeutic radiology service in examination, care, and treatment of hospital patients.

C. Electrocardiography Department

Purpose: Assist in diagnosis of heart disease and aid in medical research of heart conditions.

D. Electroencephalography Department

Purpose: Assist in diagnosis and treatment of mental ill­ness and aid in medical research.

E. Anesthesiology Department

Purpose: Provide for administration of all anesthetics used in the hospital, and contribute to treat­ment of patients and advancement of knowledge of use of drugs and anesthetics,

F. Social Service Department

Purpose: Assist in meeting the problems of patients whose medical needs may be aggravated by social factors and who, therefore, may require social treatment based on their medical conditions and courses of treatment.

G. Outpatient Department

Purpose: Provide facilities for medical diagnosis and treatment of ambulatory patients, contribute to preventive health care in community, and serve in a training capacity for interns and residents-

60

Ancillary Services Division

A. Central Supply Department

Purpose: Centralize the storage, issuance, and preparation of nursing supplies and equipment used in care and treatment of patients in order to save time, money, and equipment, and provide a more effective supply service. (13)

B. Dietary Department

Purpose: Prepare and serve special general diets, educate patients in good nutritional habits, and train dietitians, student nurses, and other hospital personnel in diet therapy.

C. Pharmacy Department

Purpose: Supply all prescriptions and manufacture stock drugs and solutions to both in-patient and out­patient services.

D- Housekeeping Department

Purpose: Keep the hospital clean, healthful, and in sanitary condition in order to provide an en­vironment important to welfare and care of patients -

E. Laundry Department

Purpose: Collect and launder hospital linens and uniforms in order to provide adequate supplies of clean, sanitary linens to all using departments. (13)

F. Maintenance Department

Purpose: Provide services of light, heat, repair, and maintenance necessary for care of hospital facilities; and to create a pleasant and comfort­able physical environment for patients, employees, medical staff, and general public.

•B!!

^i'

GROUPING OF ELEMENTS & CIRCULATION

61

Grouping of Elements and Circulation

In order for todayfe modern hospital to function properly,

the following grouping of departments into divisions have to be

taken into consideration. How these divisions relate to each

other and how their organization influences avenues of circula­

tion for proper movement of persons, supplies, and services is

an essential step for proper hospital design.

1. Administration Division: Business, Medical, and Miscellaneous, etc,

2. Patient Quarters Division and their immediate services.

3- Diagnostic-Therapeutic Division

4. Ancillary Services Division: processing, supply, disposal, housekeeping, maintenance, etc.(12)

62

Administration Division

There are two major arms of Administration: Medical, and

Ancillary. The first is concerned with the Medical-Professional

aspects of hospital activity. The second has to do with Busi­

ness, and Operation of the institution. It is desirable that

both anns of administration adjoin each other, so there is no

wall between medical and non-medical. (12)

63

Patients Quarters Division

Today with "Progressive Patient Care", patient quarters can

be classified as recovery beds, intensive care beds, intermediate

care beds, maternity beds, pediatric beds, self-care beds, and

long-term beds. (12 )

A. Recovery beds should be adjacent to the operating suite,

because these areas are or should be under the super­

vision of the Anesthetist.

B. Intensive care beds should be adjacent to recovery beds,

because acutely ill patients require the same kind of

expert nursing as recovery patients, and much can be

gained in patient welfare and in operating economy if

these two services are intimately conjoined.

C. Intermediate care beds comprise the bulk of the short-

term beds, and these, as nursing units, should be beside

the Disgnostic-Therapeutic Division, or be spread over

the ground adjoining it.

D. Maternity beds, when part of the general hospital,

should be sufficiently separated from the rest of the

hospital, to avoid contamination, but still be a part of

the hospital, with reasonably ready access to the Diag-

64

nostic-Therapeutic Division and Ancillary Services Division-

The beds of the mothers should conjoin the delivery suite,

again in the interest of Asepsis,

E. Pediatrics beds may be part of an intermediate care nursing

unit.

F, Self-care and long-term care beds can be in separate nursing

units on the ground floor, or adjoining the intermediate

care nursing units - so connected that patients from inter­

mediate care can go or be taken to the long-term quarters

with ease and, conversely, so that long-term patients can

be readily taken to the Diagnostic-Therapeutic Division

or back to the short-term nursing units when occassion

demands .

65

Diagnostic-Therapeutic Division

When possible, all services comprising the Diagnostic-

Therapeutic Division should be assembled in a logical sequence

into one entity. The components of this division usually are:

(12)

Clinical Laboratories, radiation services, surgery and

recovery beds, physical medicine, social service, outpatient

service, doctor's offices, and blood bank.

A. Laboratories serve both inpatients and outpatients and

it is therefore preferable that this department be so

situated that it is accessible to both. It is even more

important that those in laboratories be easily accessible

to those in radiation services and in surgery.

B. Radiation services also serve both inpatients and out­

patients, but in this case it is the patient himself

who comes to this service. In modern medicine, there

are situations in which the work of the departments

of laboratories and radiation intermingle, when there

is need for frequent consultation between the two and

consequently it is desireable that the departments be

contiguous.

66

C- Surgery: Except for some minor surgery, the great bulk

of surgery is done on inpatients. Because of the

necessity of consultation between surgeons, laboratory

scientists, roentgenologists, the surgery suite should

be contiguous to laboratories and roentgentology.

Consultation is often done while a patient is on the opera­

ting table.

D. Physical medicine, which is an important factor in the

rehabilitation process, should be, if possible, in the

diagnostic-therapeutic division so that it will be

simple for surgeons or other specialists to help plan

physical therapy regimens and to drop in to see how

patients are progressing. Physical medicine serves

both inpatients and outpatients. Since outpatients

who report to physical medicine may, in various ways

be disabled, the trip from the entrance of the hospital

to the physical medicine component should be as short

and as convenient as possible.

E. Social service is in a sense both diagnostic and thera­

peutic and therefore belongs in this division - situated

conveniently to the admitting office and to the out­

patient service.

67-

F, Emergency service, outpatient service and doctors' offices

Emergency patients may need immediate laboratory tests.

X-rays and even surgical intervention. This is the main

reason for placing emergency in the diagnostic-thera­

peutic division. Following emergency treatment, a patient

may need intensive care; this is why the intensive care

unit should be placed convenient to emergency in this

division.

68

Ancillary Services Division

The ancillary services division should be placed for con­

tiguity and ready access to the diagnostic-therapeutic division

and the patients quarters. The elements comprising the ancillary

services are generally: supplies, purchasing offices, and dis­

tribution center; sterilization facilities, laundry, pharmacy,

kitchen, mortuary and autopsy, housekeeping offices, mailing

and printing, locker rooms for non-professional personnel; and

power plant, incinerator, other mechanical facilities, and

maintenance shops. (12)

A. Supplies, purchasing, distribution, sterilization,

laundry, pharmacy. Supply services should be grouped

around the distribution center which adjoin means of

conveyance. The reverse process should be considered:

returning supplies for reprocessing, for incineration,

or other ways of disposal; also the discreet transportation

of corpses to autopsy and necropsy and their departure

from the hospital.

B. The kitchen is a source of supply, i.e., food, it

should therefore be contiguous to the source of supplies.

C. Housekeeping should be placed so that it lies in the

path transversed by employees.

•"J

-^^*-»«y,,

DEPARTMENTAL SPACE ALLOCATIONS

ADMINISTRATION DIVISION

DEPARTMENTAL SPACE ALLOCATION,

A C T I V I T I E S AND RELATIONSHIPS

69

DEPARTMENTAL SPACE ALLOCATION

A. ADMINISTRATION DIVISION

1. Adqninistration Department

B. PATIENT QUARTERS DIVISION

1. Nursing Unit

2. Obstetrical Suite

3. Newborn Nursery Department

C. DIAGNOSTIC THERAPEUTIC DIVISION

1. General Laboratory

2. Radiology Suite

3. X-Ray Therapy Suite

4. Surgical Suite

5. Physical Therapy Suite

6. Emergency Department

D. ANCILLARY SERVICES DIVISION

1. Central Storage Department

2. Dietary Department

3. Central Sterliziing and Supply Room

4. Housekeeping Department

5. Employee's Facilities

6. Pharmacy Departijnent

7. Pathology Department

8. Engineering Service and Equipment Areas

NOTE: The following sq. ft. figures for each department are essential minimums.

70

ADMINISTRATION

The administration offices are grouped in the area adjoining

the main lobby and main entrance. Certain subgroupings should be

considered so that each unit within a subgroup will be conveniently

located with reference to others. (29)

1. Main Lobby and Waiting Room

The main lobby and waiting room should be convenient to the

stairs, corridors and elevators, leading to the patient areas,

but access to these facilities by the public is controlled by

the information desk.

The lobby should have direct access to the business office

through the cashier's window and access tothe administrator's

office under the control of the information desk.

Separate toilets for men and women should be convenient to

the lobby and waiting room and, preferably, so located that visitors

do not have to go beyond the area controlled by the information

desk to reach them.

2. Information and Switchboard

The information is located so as to govern public entry

to the hospital proper and to the administrative offices. It is

highly desirable to separate telephone and paging service. The

desk should be furnished with the standard information desk

71

equipment, including the doctors" in and out register, the patients"

index and the room register,

3. Admitting Office

The admitting office should provide privacy, be in a quiet

location convenient to the main lobby, and adjacent to the social

service office.

No examination facilities are required in conjunction with

the admitting office. Convenient communication with the business

and administration offices and the emergency room and easy access

to the medical record room are required. A small space for a

miniature X-ray machine should be provided in conjunction with

the admitting office.

4. Business Office

This provides the general office space for the clerical staff

and equipment, a vault for business records and a safe for patient's

valuables. The business office should be arranged with a cashier's

window opening from an alcove off the main lobby, but with no

direct entry from that area.

5. Administrator's Office

The administrator's office should be accessible to all other

offices but located so as to allow privacy.

72

6. Director of Nurses' Office

The director of nurses is provided with office space convenient

to the administrator's office and to stairs and elevators. The

office should be quiet and protected from the public. Separate

areas should be provided for assistants and secretaries.

7.Medical Social Service Office

The medical social service office should be convenient to

the admitting office and reasonably accessible to the business

and administrative offices and medical record room. When there

is more than one social worker, provision for privacy in inter­

viewing should be provided. The social service office should

be readily accessible fresco the outpatient waiting room.

8, Medical Record Room

The medical record room should have convenient access to

the inactive record storage room. Space should be available for

staff members to use while completing their medical records and

for reviewing microfilmed records. A pneumatic tube system is

necessary to convey records to and from the nurses' stations,

admitting room, outpatient department and emergency room.

73

9. Library and Conference Room

A separate library and conference room should adjoin the

medical records room, thus serving the double purpose of

furnishing a control for the library books and space for staff

members to consult records without removing them from the con­

trol of the medical record librarian.

10. Staff Lounge and Locker Room

Adequate space must be provided for the comfort of the

visiting staff. These facilities include a sitting room and

private cloakroom, a bulletin board, lockers, telephones, paging

outlet, clock, and lavatories.

11. Gift Shop

It is highly desirable to have a space next to the lobby set

aside for furnishing minor items for visitors, patients, and employees

74

Administration Department

Description Quantity

Main Lobby & Waiting Room 1

Public Toilets (m & f) 1

Public Telephone Booths

Admitting Office

Social Service Office

Information Center

Administrator's Office

Secretary

Business Offices

Personnel Toilets

1

1

2

1

Staff Lounge & Conference Room 1

Medical Library 1

Director of Nurses' Office 1

Janitor's Closet 1

Medical Records Unit

Active Record Storage Area 1

Assistant Administrator's Office 1

Record Review and Dictating Area 1

Work Area 1

Inactive Record Storage Area 1

Area Sg. Ft,

900

450

40

175

290

100

300

240

800

4 50

650

200

225

50

100

200

125

200

100

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Main Lobby & Waiting Room

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Secretary

Business Offices

Personnel Toilets

Staff Lounge & Conference Room

Medical Library

Director of Nurses' Office

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PATIENT QUARTERS DIVISION

DEPARTMENTAL SPACE ALLOCATION,

A C T I V I T I E S AND RELATIONSHIPS

77

NURSING FACILITIES

1. Patient Areas

Each nursing unit will contain patient accomodations and those

auxiliary nursing facilities required for proper operation. The

auxiliary facilities required in each nursing unit include the nurses

station, a solarium, toilets, bath, bedpan rooms, a utility room,

flower room, a linen closet, and a supply closet.

In addition to the facilities needed for each nursing unit,

certain other facilities will be required on each floor to serve

the nursing units on that floor. These will include a visitor's

room, a floor pantry, a stretcher closet, attendant's toilet

facilities, a janitor's closet, a treatment room and conference room.

Those areas designated for the nursing units, however, must

be so located within each nursing unit as to require maximum

travel of not more than 80 ft. to serve patients, and those

designated for floors must be centrally located on each floor.(29)

2. One-Bed Room

One-bed rooms should be furnished with a lavatory with knee

or elbow controlled valves and gooseneck spout. Each toilet

should have a lavatory and a silent water closet equipped with

a device for emptying, flushing and cleaning the patient's in­

dividual bedpan. Some bedrooms may be provided with baths to

meet the local demand for more complete accomodations. For

78

safety it is not advisable to place showers over tubs.

Whenever possible, one-bed rooms should be of such size as

to accomodate two beds in emergencies. Two clothes lockers should

be installed so they will be available for two patients.

3. Two-bed Room

Two-bed rooms should be provided with cubicle curtains but

otherwise should be similar to the one-bed rooms. The entrance

door should be so situated that a person using it will not be

struck by the opening door if the door is hung on that side.

4, Isolation Unit

Each isolation room should have a lavatory with knee action

control, a hook strip for gowns near the corridor door and an

individual toilet with bedpan flushing attachment and shower or

bath. It is advisable to locate these rooms either at the end

of a corridor or off a subcorridor. Placing of one-bed rcxDms

on the opposing side of the corridor will permit additional

isolation beds if needed.

5- Psychiatric Room

The typical isolation rooms which are included in each

nursing unit can be made satisfactory for this purpose by the

installation of certain safety features.

79

Maximum safety and security should be provided. Care should

be taken to avoid projections of structure, sharp corners, exposed

piping, etc. and no design should be acceptable which could en­

courage attempts at hiding, escape or suicide.

6. Treatment Room

Treatment rooms are necessary on each patient floor. They

should be acoustically treated and equipped with supply cupboard,

bulletin board, instrument cabinet, nurse's call, and scrub sink.

Space is provided for an examination table with a small portable

sterilizer.

7. Nurses' Stati on

This unit, centrally located, should provide optimum space

for desk and administrative activities inherent in patient care,

such as charting, receiving physicians' orders, direction of

visitors, nurses' call system, telephone and intercommunicating

systems, centralization or personnel assignments and control of

assignments and control of supplies.

A separate medicine room will provide for the least disturbance

and distraction, to the nurse while preparing medications, A

separate locked compartment is essential for narcotics,

8. Consultation Room

A small room in each floor is required where staff members

80

can retire for consultation, teaching and conferences with physicians,

patients or patients' families. Such a room would require space

for a desk, chairs, bookcase, locker, and lavatory.

9. Utility Room

The utility room should be centrally located in each nursing

unit. This room requires ample cupboard and counter space,

sterilizer, utensil cabinet, and clinical sink.

Space will be provided for a crushed-ice box for nonbeverage

use. The utility room should be provided with a separate area

for the preparation of treatment trays and another for the cleaning

of nursing supplies and equipment.

10. Solarium

A solarium at the end of each patient's wing is highly desirable.

The solarium is a therapeutic adjunct for the convalescent patient.

11. Pediatric Unit

When the number of child patients carried does not warrant

a separate pediatric unit, children will be cared for in one

or two-bed rooms designed for them. This arrangement will be si­

milar to that in one and two-bed rooms with provisions for cu­

bicles as required.

Bed A l l o c a t i o n

81

1^

Recovery Beds

A. Surgical B. Maternity

Intensive Care Beds

Singles

3 0

Doubles

0 6

Wards

0 0

Total

3 6

A. I.C.U. B. Cardiac

3 3

0 4

0 0

3 7

Intermediate Care Beds

A. Surgical B. Pediatrics C. Psychosis D. Neurosis E. Ortho-

9 4 2 4 3

26 8 8 8 8

0 8 1 3 3

35 20 11 15 14

Maternity Beds

A. Obstetrics

B. Gynecology

Long Term - Self Care

A. Extended Care B. MedicaJ

2 2

13 9

0 6

26 24

2 0

0 2

4 8

39 35

Tota l 57 124 19 200

( 1 5 )

82

Nursina Unit

Description

One Bedroom Plan

Two Bedroom Plan

Ward Plan

Toilet and Shower

Treatment Rooms

Solariums

Visitors

Nurse's Station

Toilets. Baths, B edpans

Utility Room

Sub Utility Room

Floor Pantries

Stretcher Alcove

Flower Room

Closf^ts

Quantity

57

124

19

100

4

6

4

8

8

8

8

8

8

8

8

Area Sg. Ft,

100

160

100

30

760

500

100

1460

1200

190

60

125

960

50

20

83

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Two Bedroom Plan

Ward Plan

Toilet and Shower

Treatment Rooms

Solariums

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Toilets, Baths, Bedpans

Utility Room

Sub Utility Room

Floor Pantries

Stretcher Alcove

Flower Room

Closets

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85

OBSTETRICAL FACILITIES

Maternity service facilities should be planned in a "dead

end" area, and so located that future building expansion will

not make them a traffic thoroughfare. (29)

The accomodations will be generally the same for obstetrical

patients as for other types of patients with adecpaate provisions

for toilets, showers and lavatories.

In considering the nursery and delivery room suite in their

relationship to each other, they should be as far removed as the

limits of the obstetrical department will permit, inasmuch as

visitors to the view windows of the nursery would be a potential

danger if pemitted near the delivery area.

1. Delivery Rooms

Delivery rooms should be provided in similar design as

operating rooms. In addition to space for regular room equip­

ment, delivery rooms should have space for a heated bassinet and

oxygen resuscitation apparatus-

2. Labor Rooms

Labor Rooms are of the general type as ordinary patient's

rooms, except that they are sound proofed and will require

portable lighting equipment. Provisions of toilet facilities

for use by patients in early stages of labor may be desirable.

86

3. Scrub-up Alcove

Scrub-up facilities will be similar to those of the operating

suite.

4. Substerilizing Room

Sterilizing facilities must be furnished in the delivery suite,

even though this section will be supplied from the central supply

room. The area suggested is intended for the obstetrics suite,

adjacent to the delivery rooms. Provision should be made in the

sterlizing room for water sterilizer, small high speed, pressure

instrument sterilizer, and work counter with sink.

5. C lean-up Room

The clean-up room should be similar to that of the operating

suite except that a bedpan flushing attachment has been added to

the service sink.

6. Treatment Room

A treatment room within the maternity section, but not in the

delivery suite, is essential for postpartum examination, removal

of sutures and similar procedures.

87

7. Supervisor's Office

A small office is needed for the obstetrical supervisor

similar to that in the operating suite.

8. Doctors' Locker Room

The doctors' lounge should follow the general design of

the lounge in the operating suite.

9. Nurses' Locker Room

The nurses' locker room in the obstetrics suite is similar

to that in the operating suite.

88

Obstetrical Suite

Description Quantity Area Sq. Ft,

Delivery Room 2 610

Labor Room 3 600

Recovery Room 3 (2 beds each) 120

Isolation Room 1 100

Scrub-up Alcove 1 60

Substerilizing 1 115

Clean-up Room 1 130

Doctors' Lounge 1 28 5

Nurses' Lockers 1 1^0

Nurses• Station 1 ^^

Non-sterile Storage 1 ^^

Sterile Storage 1 ^^

Stretcher Storage 1 ^^

Janitor's Closet 1 ^^

Toilet & Shower 1 - 5 ^

89

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91

NURSERY FACILITIES

The nursery area is located in the maternity section but

outside the delivery suite. It should be readily available to

visitors who wish to observe the infants through the nursery

windows, with a minimum of traffic through corridors in patients'

areas. (29)

1. Premature Nursery

It is suggested that nurseries for premature infants be

limited to a maximum of four premature infants in any one nursery.

Individually heated bassinets or incubators with temperature and

humidity control should be furnished and oxygen outlets installed,

2. Worlf Space, Nurses' Station and Examination Room

The examination area requires a table for the examination

of infants, a hook strip for gowns, a waste receptacle, and a

lavatory.

The nurses' station area should be designed as a control

station, with the nurse's desk so located that she can control

the entrances from the corridor to the anteroom and from the

anteroom to the nurseries.

The nurseries should be visible from the nurses' station

through observation windows in the walls-

92

3. Suspect Nurseries

The suspect nurseries are provided for the observation and

care of newborn infants who develop symptoms suggestive of com­

municable disease. Infants with definitely diagnosed communicable

disease are cared for elsewhere in an isolation unit.

4. Forumula Room

Location of the formula room should be in the maternity

and dietary section. Two separate areas should be provided,

one for the receiving and washing of soiled bottles and the

other for the preparation of formulas and filling and sterili­

zing of bottles.

Newborn Nursery Department

93

Description Quantity

Nursery (12 bassinets.) 2

Formula Room 1

Work Space & Examination 1

Suspect Nursery (2 bassinets) 1

Suspect Anteroom (6 bassinets) 1

Bottle Washing

Preparation

1

1

Area Sg, Ft.

765

100

160

2 50

45

25

25

T

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DIAGNOSTIC-THERAPEUTIC DIVISION

DEPARTMENTAL SPACE ALLOCATION,

A C T I V I T I E S AND RELATIONSHIPS

96

GENERAL LABORATORY

The laboratory should be so located as to be accessible to

members of the medical staff and to outpatients who may be sent

to the laboratory for specific procedures. (29)

A small waiting room as well as a small room for taking

specimens should be provided for patients coming to the labora­

tory. Spaces should be provided for pathology, serology, bacteriology,

chemistry, hematology, urinalysis, and blood bank.

Ample work bench facilities of standard manufactured units

with the proper bench top material should be carefully selected

according to the type of laboratory procedure performed.

1. Basal Metabolism, Electrocardiography

One room in a quiet location will usually serve this dual

purpose. Except for test equipment, it will be similar to a

one-bed room. Since these tests and observations are usually

done by, or under the supervision of, the laboratory technician

or director, reasonably convenient access to the laboratory is

prefered.

General Laboratory

97

Description Quantity Area Sg. Ft,

General Laboratory 1

Bacteriology and Serology 1

Washing and Sterlizing Room 1

Basal Metabolism, Electro- 1 cardiograph and specimen room

Storage Room

Office

Wa i t i ng Room

1

1

1

745

200

100

2 50

50

175

100

98

1

1

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fv

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OJ

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1

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rv

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rv

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1

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Property

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2.

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3

General Laboratory

Bacteriology and Serology

Washing and Sterilizing Room

Basal Metabolism, Electrocar­diograph & Specimen'Room

Storage Room

Office

Waiting Room > tD P 01

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RADIOLOGY SUITE

The department of radiology should be so located as to be

conveniently accessible to the inpatient areas, as close as

possible to the emergency room and to the outpatient department.

Corridor traffic should be kept to a minimum. (29)

This department should include a separate radiographic room,

fluoroscopic room, therapy room, viewing room, office, and waiting

room.

1. Darkroom

The darkroom should be lightproof, mechanically ventilated

and equipped with developing tank, unexposed film storage, work

counter, sink, film dryer, built-in film illuminators, and a ref­

rigerated water supply and thermostatic mixing valves.

2. Radioisotope Facilities

The minimum, basic, adequate facility for use of radio

isotopes in the hospital consists of two rooms: a radiochemistry

laboratory and a patient uptake-measuring room. It will provide

for a patient load of about 60 patients per month with a maximum

of 10 patients in one day.

The radiochemistry laboratory should include the following

features, equipment located on the side walls; separate work tops

for patient dose and clinical specimen preparation; high level

radiation area and isotope storage; separation from patient

101

uptake-measurement room to minimize disturbance of radiation

measurements by radioisotopes stored in laboratory.

Contaminated dry wastes may be collected in a waste container

and stored in the hood base behind lead bricks until disposed of.

Wall and base cabinets are desirable to provide storage space for

equipment and supplies. Sufficient space is needed for a

patient's stretcher and the medical treatment team for special

injections.

Radiology Suite

102

Description Quantity Area Sg. Ft

Radiology and Fluoroscopy 1 Room

Toilet 2

Control Enclosure 2

Film Processing Room 1

Office & Viewing 1

Waiting Room 1

Dressing Room 4

Film Filing Room 1

Storage 1

Holding Area for Stretcher 1 Patients

200

30

70

200

200

125

16

40

40

50

Mobile X-Ray Machine Room 50

103

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1

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Radiology & Fluoroscopy Room

Toilet

Control Enclosure

Film Processing Room

Office & Viewing

Waiting Room

Film Filing Room

Storage

Holding Area for Stretcher Patients

Mobile X-Ray Machine Room

fD P 01

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X-Ray Therapy Suite

104

Description

Waiting Room

Office

Linen Closet

Rest Room

Dressing Room

Deep Therapy

Control Corridor

Superficial Therapy

Examination & Radium Treatment Room

Quantity

1

1

1

2

6

1

1

1

1

Area Sg. Ft

125

175

25

30

16

42 5

150

425

175

Doctor"s Office 175

105

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106

SURGICAL FACILITIES

It is important that the operating suite be completely

isolated from the reat of the hospital and so located that there

will be no traffic through it. (29) (11)

1. Operating Rooms

Operating rooms require sufficient space for the operating

table, instrument and dressing tables, anesthetist's table,

anesthesia apparatus, basin stands, stools and foot stools, sponge

rack, drum stand and container for soiled dressings. Open or

closed shelving for 24 hour supply ot sutures, solutions, trays

and other material necessary for use during operating procedures

may be built in or movable. Equipment includes overhead, portable

and emergency lights; emergency nurses' call; suction and oxygen

outlets, and a double x-ray illuminator.

2, Cystoscopic Room

This room may be provided for in the operating suite area

where continuous surgical supervision can be given. While i^

is prefered to have a cystocospy table with the x-ray tube

directly on it, mooile x-ray equipment may be used. A connecting

toilet should be provided.

107

3. Fracture Room (Ortnopedic)

A special fracture room may be located in the operating

suite. Fixed equipment includes a stainless steel work counter

for use by the surgeon in preparing plaster applications.

Explosion proof light fixtures are required as anesthetic gases

will be used.

4. Substerilizing Rooms

Direct access from each operating room and the corridor is

desirable. The facilities include a small high pressure, high

speed instrument sterilizer, hot and cold sterile water supply,

solution warmer, instrument sinj:, counter space and clock.

5. Scrub-up Facilities

A minimum of three sinks to be used for scrub-up should

be supplied for each pair or operating rooms. The sinks should

have gooseneck spout or other high outlet, hot and cold water

supply controlled by knee valves. Glass view windows between

the scrub-up sink area and operating rooms are advantageous.

Clean-up Room

One clean-up room for the surgical area is sufficient.

It should be located close to the operating rooms and furnished

^ith a rim-flushing service sink, work counter, and a double

108

compartment sink with drainboards.

7. Anesthesia Equipment Room

A special fireproof room is necessary for the storage of

ether, anes the t ic gases and anesthesia equipment. This room

should be convenient to the operating rooms but snould open to

a corridor.

8. Surgical Supervisor 's Office

The surgical supervisor's office should be so located as to

control the department and should have a glass partition on the

corridor side. A bulletin board, intercommunicating telephone,

clock and nurses' call indicator will be supplied in this office.

9. Doctors' Locker Room

The doctors' locker room snould be situated at the entrance

of the surgical suite, preferably a walk-through room serving

as a doctors' entrance to the suite. Adjoining should be the

shower, toilet and lavatory facilities.

10. Nurses" Locker Room

The nurses' locker room also should be situated at the

entrance of the surgical suite, and designed to serve as the nurses'

109

entrance. It should have lockers and shower, toilet and lavatory

facilities.

110

CENTRAL STERILIZING AND SUPPLY ROOM

Space in the sterilizing room is divided into three distinct

areas, which may or may not be physically divided: (1) work areas

for receiving and cleaning unsteril material and for assembling

packs; (2) sterilizing area for sterilizing supplies; (3) sterile

supply area for storage and issuing sterile supplies and (4) un-

sterile storage. (29)

Surgical Suite

11

Description

Major Operat ing Room

Sub S t e r i l i z i n g Room

Scrub-up Alcove

Minor Operat ing Room

Cystopic Room

Recovery Room

Central S t e r i l i z i n g & Supply

Unster i l Supply Room

Instruments

Clean-up Room

Storage Closet

Stretcher Alcove

J a n i t o r ' s Close t

Surgical Supervisor

Surgical Corr idor

Recorder

Doctor "s Lockers T,L, & S

Nurse's Lockers T,L, & S

Fracture Room

Plas te r Close t

Spl int Close t

Darkroom (X-Ray)

^ e s t h e s i ? » S-hrvT-Arro

Quanti ty

4

2

2

1

1

3

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

Area Sg. Ft.

1325

230

185

265

230

120

900

160

150

140

60

50

20

100

180

45

3 50

250

220

35

85

30

150

112

s 50 (D (D p

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M a j o r O p e r a t i n g Room

S u b S t e r i l i z i n g Room

S c r u b - u p A l c o v e

M i n o r O p e r a t i n g Room

C y s t o p i c Room

R e c o v e r y Room

C e n t r a l S t e r i l i z i n g & S u p p l y

U n s t e r i l S u p p l y Room

I n s t r u m e n t s

C l e a n - u p Room

S t o r a g e C l o s e t

S t r e t c h e r A l c o v e

J a n i t o r ' s C l o s e t

S u r g i c a l S u p e r v i s o r

S u r g i c a l C o r r i d o r

R e c o r d e r

D o c t o r s • L o c k e r s

N u r s e s ' L o c k e r s

F r a c t u r e Room

A n e s t h e s i a S t o r a g e

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n/,

PHYSICAL THERAPY SUITE

The principal divisions of the department are for electro­

therapy, hydrotherapy, and exercise. The first is by far the most

extensive in the hospital and in the small unit may constitute prac­

tically the entire activity. Treatment tables, short-wave diathermy,

infrared and ultraviolet equipment are essential. (29)

The hydrotherapy room should be separated from the electro­

therapy area. Whirlpool bath equipment is essential, along with

mobile or Hubbard tanks, and equipment for hot and cold applica­

tions and contrast baths.

The exercise or gymnasium area should include such commercial

equipment as posture mirror, gym mat, pulleys, etc. Parallel

bars, stall bars, practice steps, shoulder wheels, and ladders

are also used.

A physical therapy office, waiting-room space, and patient

toilet facilities are necessary-

f I

Physical Therapy Suite

15

Description Quantity Area Scr- Ft,

Waiting Room

Office

Exercise Room

Rest Room

Corridor

Examination Room

Therapy Booths

Hydrotherapy

Linen and Storage Closet

Stretcher Alcove

Occupational Therapy

1

1

1

1

1

1

4

1

1

1

1

125

200

400

30

85

100

80

200

30

50

500

116

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W a i t i n g Room

O f f i c e

E x e r c i s e ^ o m

R e s t Room

C o r r i d o r

E x a m i n a t i o n Room

T h e r a p y B o o t h s

H y d r o t h e r a p y

L i n e n a n d S t o r a g e C l o s e t

S t r e t c h e r A l c o v e

O c c u p a t i o n a l T h e r a p y

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117

EMERGENCY DEPARTMENT

The emergency department should be so located that patients

arriving by ambulance may have direct access to the emergency room.

It should not be directly connected to the operating suite nor

should the emergency room be counted as an operating room. The

emergency entrance should have a convenient loading platform or

a ramp and a marquee to protect patients being taken from cars or

ambulances. (29)

1. Emergency Room

The emergency room will be planned as a minor operating

room along with scrub-up facilities. It should have a special

medicine closet, poison cabinet, nurses call, and space for

resuscitation equipment.

2. Observation Beds

It is recommended that a few beds in this area for patients

in shock, for moribund patients and possibly for accident patients

suspected of having communicable disease.

3. Office and Waiting Room

An office and a waiting room is essential for the emergency

department convenient to emergency entrance.

118

Emergency Department

Description

Vestibule & Office

Stretcher Alcove

Toilet

Emergency Operating Room

Supply Storage & Closet

Utility Room

Bath

Observation Bedroom

Quantity

1

1

1

1

1

1

1

2

Area Sg. Ft

280

50

50

280

45

45

59

205

119

Attractiveness

nj

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PJ

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Resistcuice to chemicals

'

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Ease of cleaning

Resistance

to water

1

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VJ

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-Floors & Walls

Ray protection

Halls Onlv

Durability

Resistance to impact

Absence

of reflection

-

1

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Conductivity

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Resistance to wear

Resistance

to indentation

-

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^

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Floor Onlv

1 —

Property

Desireable

1

Very Desireable

2

Most Desireable

3

Vestibule & Office

Stretcher Alcove

Toilet

Emergency Operating Room

Supply Storage & Closet

Utility Room

Bath

Observation Bedroom

Areas of

Use

k k k k

120

o

<

EH

p

ANCILLARY SERVICES DIVISION

DEPARTMENTAL SPACE ALLOCATION,

A C T I V I T I E S AND RELATIONSHIPS

1 1

CENTRAL STORAGE DEPARTMENT

The central storage area includes space for bulky pharmace

stores, facilities for the storage of special beds, large

orthopedic equipment, extra equipment and for all supplies and

replacements to be issued for use throughout the institution. (29)

In planning a central storeroom, the pharmacy storeroom, furniture

room and anesthetic storeroom should be independent of the main sto­

rage area, although immediately adjacent to it.

The pharmacy stores are usually handled by the pharmacist

rather than by the general storekeeper. When this room is kept

separate, pharmacy stores are available without allowing access

to the other storage areas.

The furniture room must be available at any hour as a bed

or a fresh mattress may be needed in an emergency when the store­

keeper is off duty.

The stores office should connect with the main storage area

so that the storekeeper can have ready access to it.

Central Storage Department

122

Description

Vestibule

Anesthesia Storage

Issue Sc Receiving

General Storage

Bulk Storage

Furniture Room

Pharmacy Storage Room

Record Storage Room

Quantity

1

1

1

1

1

1

1

1

Area Sg. Ft

50

200

300

1000

1000

1000

450

400

123

Resistance to water

Resistance to chemicals

Attractiveness

PJ

1

1

1

v

'

1

1

1

i

1

-

-

'

'

1

1

1

1

Ease of cleaning

-

-

ro

PO

p j

PJ

ro

ro Floors & Walls

Resistance to impact

Absence of reflection

Ray protection

1

1

1

1

.

1

1

1

--

-

vj^

^

^

VJJ

v^

^

Durability

-

-

V>i

v j

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Walls Onlv

Nonslip characteristics

Conductivity

1

^

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r\j

Resistance to indentation

-^

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Resistance to wear

-

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Property

Desireable

1

Very Desireable

2. Most

Desireable

3

Vest ibule

Anesthesia Storage

Issue & Receiving

General Storage

Bulk Storage

Furn i tu re Room

Pharmacy Storage Room

Record Storage Room

1

Area s of Use

2k

DIETARY DEPARTMENT

The main components of the dietary department are food

refrigeration and storage, preparation, cooking, servicing, special

diets, dishwashing, dining, and formula preparation. These

must be laid out with consideration for traffic lines within the

kitchen and with related units properly grouped. (29)

A good traffic flow requires that the refrigerators and day

storagestorage area be located close to the delivery entrance of the

kitchen so that the food progresses through various stages to the

serving area. From the refrigerators the food is taken to the

preparation area where it is cleaned, peeled and cut and then to

the cooking areas frcxn which it moves to the serving areas.

1. Receiving

The delivery entrance should be located at a point where

truck unloading will not disturb patients-

2. Day Storage

The day storage area takes care of small food items and part

cases of food not requiring refrigeration. The most convenient

place to locate the day storage is near the receiving area, and

adjacent to the meat, vegetable and salad preparation.

125

All storerooms must be constructed so that rats, mice and

insects cannot enter and hide. The bottom metal shelf must be

at least 18 inches above the floor to permit inspection of all

parts of the floor, and the top and ends should provide space for

cleaning and inspection.

3. Meat, Vegetable and Salad Preparation

The meat, vegetable and salad preparation should be in

convenient relationship to their respective refrigerators and

cooking areas.

4. Cooking and Baking and Special Diets

The main cooking section consists of ranges, fryers,

broilers, ovens, steam kettles and steamers. This equipment is

best placed in a centralized location convenient to the serving

area.

5. Pot Washing

The pot washing area should be located off the main traffic

lines but near the range from which most of its work comes.

Since this is a noisy area, it should be enclosed in a separate

room.

6. Dietician's Office

The kitchen area is the prefered location for the dietician's

126

office so that it may allow him close supervision of the work

performed in the kitchen.

7. Dishwashing

The dishwashing area should be located near the entrance

of the kitchen area where the noise will not be audible to

patients' areas and dining room areas,

8. Dining area

The dining area should be adjacent to the kitchen if either

cafeteria or table service is to be installed.

1^7

Dietary Department

Description Quantity

Food Preparation Center 1

Dietician's Office 1

Formula Room 1

Dishwashing Room 1

Refrigerated Walk-in Storage

Meat 1

Dairy Products

Fruit & Vegetables

Potwashing Facilities

Receiving Area

Janitor's Closet

Toilet Room

Day Storage

Cart Cleaning Facilities

Cart Storage Area

Waste Disposal Facilities

Dining Facilities Staff (2 sittings, 50 persons)

Dining Facilities Employees (2 sittings, 30 persons)

1

1

1

1

1

1

1

1

1

Area Sg. Ft,

2600

200

275

275

75

45

100

200

65

40

60

150

200

125

100

1200

600

128

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Food Preparation Center

Dietician's Office

Formula Room

Dishwashing Room

Refrigerated Walk-in Storage

Potwashing Facilities

Receiving Area

Janitor's Closet

Toilet Room

Day Storage

Cart Cleaning Facilities

Cart Storage Area

Waste Disposal Facilities

Dining Facilities Staff

Dining Facilities Employees

ro p

0)

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129

130

HOUSEKEEPING DEPARTMENT

1. Housekeeper's Office and Stores

The housekeeper's office may be located adjacent to the

central linen room.

2. Central Linen Room

In this room space and equipment is needed for mending and

sewing, as well as for marking new linens. Space for linen trucks

and their loading will be required. The central linen room

should be located adjacent to the "clean" end of the laundry.

3. Soiled Linen Room

Sorting bins in the soiled linen room assist in sorting and

in the preparation of loads of proper size for the washers. The

bins may be of the fixed type, or movable, but the capacity of

each bin should be the same as that of the washer compartments.

(29)

131

Housekeeping Department

Description Quantity Area Sg. Ft.

Central Linen Room 1 500

Housekeeper's Office 1 150

Soiled Linen Room 1 260

Clean Linen & Mending Room 1 400

Linen Cart Storage 1 200

Lavatories 1 26 5

Laundry Processing Room 1 900

Janitor's Closet 1 30

Storage for Laundry Supplies 1 100

Central Storage Department

Description Quantity Area Sg. Ft.

Record goom 1 400

Central Stores 1 4000

132

Resistance to chemicals

Attract ivenes

8

1

'^

'

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—

1

1

1

1

1

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1

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Resistance

to water

-

1

pj

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Ray protection

Absence of reflection

1

1

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1

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Resistance to impact

—

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Walls Onlv

Durability

-^

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Resistance to wear

Resistance to indentation

Nonslip characteristics

Conductivity

1

1

1

1

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Property

Deaireable

1

Very

Deaireable

2 Moat

Deaireable

3

Central Linen Room

Housekeeper's Office

Soiled Linen Room

Clean Linen & Mending ^om

Linen Cart Storage

Lavatories

Laundry Processing Room

Janitor's Closet

Storage for Laundry Supplies

Record Room

Central Stores

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33

EMPLOYEE'S FACILITIES

Employee lockers and rest rooms should be conveniently ad­

jacent to the employee entrance. It is considered good practice

to permit neither professional nor non-professional employees

to go through the building in street clothes.(29)

1. Nurses' Locker Room

This area is equipped with individual lockers, a built-in

counter for a dressing table of sufficient length to accommodate

several persons and with mirrors above; adjacent should be showers,

toilet and lavatories.

2. Locker Room for Male Employees

This area is similar to that of the nurses' locker room

however separate entrances are required.

3. Locker Room for Female Employees

This area is similar to that of the nurses' locker room.

Employee's Facilities

134

Description Quantity Area Sg. Ft.

Nurses' Locker Room 4-T, 96-L, 5-S

Female Help's Locker Room 4-T, 50-L, 4-S

Male Help's Locker Room 3-T, 1-U, 50-L, 4-S

1000

600

4 50

Pathology Department

Description Quantity Area Sg. Ft.

Morgue & Autopsy Room

Shower Room

Refrigeration Unit

1

1

2

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PHARMACY DEPARTMENT

The hospital pharmacy should be located near the center of

the activities called upon most frequently, easily accessible

to the elevators and outpatient department.

1. Compounding and Dispensing Laboratory

Adequate storage space is essential in the pharmacy. Cabinets,

drawers and shelves are required for storage of chemicals and

pharmaceuticals.

2. Parental Solution Laboratory

This space should be a separate, enclosed, and dust-free

room for the preparation of sterile solutions.

The arrangement of the parental solution laboratory should

provide for a sequence of operations: (a) washing the flasks,

(b) rinsing in sterile water, (c) filling, (d) sterilizing,

(e) sealing and labeling.

3. Active Store Room

The active store room holds the reserve stock of the many

items which are represented in smaller size units in the compounding

and dispensing laboratory. This conserves the drug cabinet

storage space in the latter and facilitates dispensing.

1 'O

Pharmacy Department

Description Quantity Area Sg. Ft

Compounding & Dispensing 1 500 Laboratory

Active Storage Room 1 200

Parenteral Solution Laboratory 1 200

Manufacturing Laboratory 1 120

Alcohol Vault 1 30

Office 1 100

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OUTPATIENT DEPARTMENT

AREA REQUIREMENTS

NOTE: ISSER APPENDIX A

DOCTOR'S OFFICES

AREA REQUIREMENTS

-: R'FI^r-: APPENDIX Ai

NURSING SCHOOL FACILITIES

PROGRAM

NOTE: REF! :! APFE'IDIX A

O - r •

SITE ANALYSIS

1 3

SITE ANALYSIS

A. SITE CRITERIA STATEMENTS

B. SITE PLAN

C. SITE SURVEY AND SOIL INVESTIGATION

D. CITY ORDINANCES AND STANDARDS

I I

14^

S I T E ANALYSIS

1. Accessibility

The accessibility of the site for ambulant and nonambulant

patients, visitors, staff members and personnel, and for the

delivery of supplies, must be considered. The modern nospital

designed to handle acute cases should be reasonably accesible to

the center of community activity, but located in an uncongested

district so that unnecessary noise and parking and traffic problems

can be avoided. (29) (30)

Inexpensive transportation facilities for ambulant patients

should be available within reasonable distance, especially if an

outpatient service is to be maintained.

2. Public Utilities

The hospital should be situated near adequate sewerage,

water, electrical, telephone and gas facilities.

Whenever possible the hospital should be served with water

from an approved public supply system. The site should be readily

available to a portion of the distribution system having mains

of adequate size to furnish the quantity of water that will be

required, (30)

Sewer levels should be low enough for adequate drainage of

all outlets on tfe lowest floor of the building.

1 5

3. Nuisances

The site chosen for the hospital should be free from undue

noise, such as that emanating from railroads, freight yards, main

traffic arteries, schools and childrens playgrounds. It should

be remote from industrial or topographic conditions which would

encourage the breeding of flies, mosquitoes or other insects-

The site should not be exposed to smoke, foul odors or dust, or

so located that prevailing winds from a nearby industrial develop­

ment will bring smoke or objectionable odors to the hospital.

Proximity to a cemetery is undesirable for a hospital site.

4. Orientation and exposure

The site should be chosen with consideration for proper

orientation of tY^ building so that every patient room will receive

sunlight at least during part of the day and proper advantage

can be taken of prevailing winds in the interest of natural venti­

lation. (29)

5. Dimensions

The dimensions of the site will be affected by the type of

plan adopted. Sufficient space must be available to accomodate

the various traffic lanes approaching the institution and ample

parking spaces must be provided. About 15 to 2 parking spaces

1 6

per bed is recommended for medical staff, hospital personnel, and

visitors" parking. (15)

6. Topography

Ideally the building is best located on relatively high

ground in order to take advantage of natural drainage. The

elevation should not be so great, however, as to be a handicap

to ambulant patients who approach on foot. The contours should

be such that it will permit the patient entrances to be located

close to the ground level.

The outlook from the site should be as unrestricted and

pleasing as possible. The nature of the adjacent areas should

be considered.

147

Site Survey and Soil Investigation

1. The owner should provide for a survey and soil investigation

of the site and furnish a plot of the site- The purpose of

this survey and soil investigation is to obtain all information

necessary for the design of the building foundations and

mechanical service connections and development of the site.

It is suggested that this matter be deffered until the architect

has been selected in order that he may cooperate with the

engineer who obtains the data. (33)

2. If any existing structures or improvements on the site are

to be removed by the owners or others, the buildings or

improvements should be designated on the pfe t,

3. Any discrepancies between the survey and the recorded legal

description should be reconciled or explained.

4. The plat should indicate:

The courses and distances of property lines.

Dimensions and location of any buildings, structures, easements, rights-of-way or encroachments on the site.

Details of party walls, or walls and foundations adjacent to the lot lines.

The position, dimensions and elevations of all cellars, excavations, wells, back-filled areas, etc., and the elev­ation of any water herein.

148

All trees which may be affected by the building operations.

Detailed information relative to established curb and building lines and alley, street, sidewalk and curb grades at or adjacent to the site and the materials of which they are constructed.

All utility services and the size, characteristics, etc., of these services.

The location of all piping, mains, sewers, poles, wires, hydrants, manholes, etc., upon, over or under the site or adjacent to the site if within the limits of the survey.

Complete information as to the disposal of sanitary, storm, water and subsoil drainage and suitability of subsoil for rainwater or sanitary disposal purposes if fry wells are used.

Official datum upon which elevations are based and a bench mark established on or adjacent to the site.

Elevations on a grid system of not more than 20-foot intervals to indicate changes in slope, etc., over that portion of the site to be developed.

Elevations of contours, bottoms, excavations, etc.

Contemplated date and description of any proposed improve­ments to approaches or utilities adjacent to the site.

5. The plat should bear a certification by the city engineer or other qualified official , that the true street lines and the officially established grades of curbs, sidewalks and sewers are correctly given.

6. Adequate investigation should be made to determine the sub­

soil conditions. The investigations should include a sufficient

number of test pits or test borings as will determine, in the

judgment of the architect, the true conditions.

149

7. Samples of strata of soil or rock taken in each pit or boring

should be retained in suitable containers. Each sample con­

tainer should be identified as to the boring and elevations

at which taken and the labels initialed by the engineer making

the soil investigation.

8. The following information should be noted on the plat:

Thickness, consistency, character, and estimated safe bearing value of the various strata encountered in each pit or boring.

Amount and elevation of ground water encountered in each pit or boring, its possible variation with the seasons and effect on the subsoil.

The elevation of rock, if known, and the probability of encountering quicksand.

Average depth of frost effect below surface of ground.

High and low levels of nearby bodies of water affecting the ground water level.

The probability of freshets overrunning the site.

Whether the soil contains alkali in sufficient quantities to affect concrete foundations.

S I T E PLAN

y

150

CITY ORDTNANCR.q

AND STAJN^DARDS J

Adopted from City of Lubbock

ORDINANCE NO. 4371 151

AN ORDINANCE AMENDUX; SECTIONS 2 8 - 1 , 28-4^ 2 8 - 1 0 , 2 8 - 1 5 , ARTICLE I AND SECTIONS •8 -17 , 2 8 - 2 2 , 2 8 - 4 2 , 2 8 - 4 3 , 2 8 - 5 0 , 2 8 - 5 0 a , 2 8 - 5 2 , 2 8 - 5 5 , 2 8 - 5 8 , 28-60 AND 23-63 OF ARTICLE I I AND SECTION 28-66 OF ARTICLE I I I OF CHAPTER 28 CODE OF ORDINANCES, CITY 7F LUBBOCK; TO PROVIDE FOR THE ADOFTIGN OF OFFICIAL MAPS; A METHOD 7CR DETERMINING rrREET NUMBERS; PROHIBITING THE OBSTRUCTION AND PIANTI?X3 IN PARKWAYS AND PROVXnr^. 'OR EXCEPTIONS THERETO; MAKING TT THE DUTY OF THE OCCUPANT OF PREMISES TO KEEP AD-fACEWr SIDEWALKS, PARKWAYS AND ALLEYWAYS CLEAN; REQUIRING COMPLIANCE WITH ARTICLE t l AS PREREQUISITE TO THE ISSUANCE OF A BUILDING PERMIT; REQUIRING A BOOT), CERTAIN CNSURANCE AND AN AGREEMENT FOR INDEMNITY FOR WCRK ON PUBLIC RIGHT OF WAY; PROVIDING ?0R AND AUTHORIZING AN APPEAL TO THE BOARD OF EXAMINERS AND APPEALS UNDER CERTAPJ :ONDTriONS; ADOPTING CERTAIN DESIGN AND LAYOUT PUNS FOR CONSTRUCTION OF SIDEWALKS, )RIVEWAYS, CURBS AND GUTTERS IN THE CITY OF LUBBOCK; PROVIDING FOR LOCATION CF SIDEWALKS AND MAKING CERTAIN EXCEPTIONS THERETO; DESCRIBING THE REQUTREME TTS FCR SIDEWALK WIDTHS; PRESCRIBING FOR THE SETTING OF LINES AND GRADES FOR SIDEWALKS AS fELL AS THE MATERULS TO BE USED IN THE CONSTRUCTION (T SUCH SIDE-H^ALKS; DIRECTING rHE FINISHING AND MARKING OF SIDEWALKS; DIRECTING THE PLACEMENT OF INNER CURBS JHERE SIDEWALK IS ADJACENT TO AN OFF-STREET PARKING AREA; PROVIDING FCR THE PAVING OP DRIVEWAYS INTO PRIVATE PROPERTY OR FOR ALLEYS AND PROVIDING FOR THE REPLACEMENT OP PAVEMENT WTTUIN A PUBLIC STREET THAT IS CUT FOR UnLITY INSTALLATION; REPEALING SECTION 28-24 OF ARTICLE I I AND SECTION 28-61 OF ARTICLE I I I OF SAID CHAPTER 2 8 ; PROVIDING FOR A PENALTY AND A SAVINGS CLAUSE; DIRECTIIIG THE PUBLICATION OF THE DESCRIPTIVE CAPTION AND THE PENALTY CLAUSE IN LIEU OF PUBLICATION OF THE CRDTNANCE ( S PROVIDED BY LAW.

BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:

SECTION 1 . THAT A r t i c l e s I , I I , I I I of Chap te r 28 e n t i t l e d S t r e e t s and S lda -walks of t h e Code of O r d i n a n c e s of t h e C i t y of Lubbock be and t h e same i s hereby amended a s f o l l o w s :

S e c . 2 8 - 1 . O f f i c i a l Maps.

" t h e o f f i c i a l map of t h e C i t y of Lubbock s h a l l be p r e p a r e d by t h e C i t y E n - i n e e r on the I n d i v i d u a l s h e e t s r e p r e s e n t i n g 2 ,560 a c r e s of a r e a p e r s h e e t t o s c a l e or 1 . 3 0 0 ' and on which s h a l l be shown and d e s i g n a t e d t h e v a r i o u s s t r e e t s , - v e n u e s ^nc bou.e v a r d a , t e r r a c e s and p u b l i c p a r k s and a l l e y s t o g e t h e r w i t h t h e l o t s and a u d i t ion or s u b d i v i s i o n nuiDbers and names , a s w e l l a s t h e s t r e e t n u n i e r for each b l c c x . The Cit: . E n g i n e e r I s h e r e b y a u t h o r i z e d and d i r e c t e d t o r e v i s e t h e o f f i c i a l map when any p i a . of any s u b d i v i s i o n a d d i t i o n o r o t h e r a r e a has been approved by t h e P l a n n i n g Conn^ission of t h e C i t y of Lubbock and h a s been r e c o r d e d in t h e County C l e r k ' s o f f i c e of Lubbo..< County , T e x a s , o r when o t h e r w i s e d i r e c t e d by o r d i n a n c e .

S e c . 2 8 - 4 . S t r e e t number method.

•The Bu l ld ln i ? I n s p e c t o r s h a l l de t e rmine t h e o f f i c i a l s t r e e t numbers by d e s i g ­n a t i n g o^e J u ^ r J l ^ ^ e r . o r each p l a t t e d l o t a l o n g t h e s t r e e t - - - ^ J - ^ ^ W excep t where t h e p r o p e r t y I s p l a t t e d i n t o l o t s c r t r a c t s w i t h a f ^ ° " " g « / J " " , ^ ^ „ \ ' ^ " s t r e e t , avenue or b o u l e v a r d i n e x c e s s of 75 f e e t ^l>«>^^° « " ' \ « ^ f ' ' ' J ^ ^ ^ ^ ^ J ' ^ ^ ^ , ^ i n s p e c t o r s h a l l a l l o c a t e one n u n ^ r l c a l a d d r e s s f o r each 50 f ee t of f " " ^ ^ g « ° ^ ^ ^ ° ^ p o r i i o n t h e r e o f . Where duplex h o u s e s , a p a r t m e n t s or b u s i n e s s b u i l d i n g s a r e e r e c t e d

- 1 -

152

e n t i r e l y on any one lot wnlch i s e n t i t l e d to receive only one number as provided herein and defined in Section .8^3 , each apartment, business or other unit shal l be designated with the numoer to which the lot i s e n t i t l e d followed by an alpha­betical suf f ix for each such additional unit beginning v l t h the l e t t e r *W\

Sec. 28-10. Obstruction and planting in Paric^avs - Cerera i

"No obstruction or planting of any kind shall be maintained, constructed, placed, planted or grown in the area of the public parkway Iving between the curb or grade l ine of any public s treet and the abutting sidewalk or private property l ine other than grass, plants or shrubs thac w i l l not exceed 13 inches in height above the top of the curb l e v e l , and which are kept t r i m e d or pruned In such manner as t o keep such plants and shrubbery from encroaching over or obstructing the adjacent public sidewalk or street area.

Provided, however, the owner of any abutting property may use the public parkway contrary t o the above provision by application for a "Street Parkway Use Permit" executed by the City Secretary who i s hereby authorized to issue such a permit which sha l l provide that the oermittee by acceptance of such permit agrees and obl igates himself or ass igns to maintain any t r e e , shrub or plant placed in such area In such manner as to keep same from becoming a motor vehicle or pedestrian t r a f f i c hazard and further i f in the event said parkway shall at any time be needed for any puollc purpose or for any u t i l i t y llr.e or po les , s treet s igns , t r a f f i c s igns and/or other devices placed in such area under lawful author­i ty of the City Council the permittee shal l wtienever i t shal l be deemed necessary in the public Interest as may be determined by the City Council remove any t r e e , plant or shrub s i tuated within such area at no expense to City.

Sec. 28-15. Duty to keep stdewalkp parkway and alleyway clean.

"it sha l l be the duty of the owner, tenant or l e s see to keep the abutting or adjacent sidewalk, parkway^ and alleyway clean and free of a l l weeds^ trash rubbish, f i l t h and debris which may Incumber such sidewalk, parkway and a l l e y ­way and t o place such material in trash receptacles aa required by t h i s Code and fa i lure t o comply with the requirement of t h i s paragraph shal l be and Is hereby declared to const i tute a nuisance subject to abatement as provided for in Section 15-29 t o 15-34, of t h i s Code,

Sec. 28-17. Compliance with ar t i c l e prerequlsi^g to IssuaT^ce of building permit.

'Vhenever appl icat ion i s made to the Building Inspector by any person^ firm or corporation for a building permit to naks any construction, addition or structural a l t era t ion on a building or other structure, or to pave a parking lot where a permit Is required by t h i s Code or any other ordinance of the City on property adjacent t o or abutting on a public s t r e e t , where the ex i s t ing sidewalks, driveways e i ther private or conroerclal, curbs, street curbs and gutters abutting such property do not conform to the basic standards, s p e c i f i c a t i o n s , layout, de­t a i l s and designs provided for and established by t h i s a r t i c l e , or in the event »*hen a l l sidewalks, driveways e i ther private or connnercial, curbs, s treet curbs and gut ters , required to be constructed have rot been construcced, no permit shal l be Issued by the Building Inspector unti l applicant for such p-rmit shal l agree In writ ing t o construct, reconstruct or repair, the curb, gutter^ si-iewalk or

- 2 -

iip5

driveway in accordance with t h i s a r t i c l e as a part of and a condition to the Issuance cf such building permit. No construction, addit ion or a l t e ra t ion to such buildings or ether improvements placed or constructed on the adjacent private property shal l be approved by the Building Inspector , un t i l such times as a l l the sldewalkso driveways, curbs, s t reet curbs and gutters have been construct­ed or reconstructed and comply with tha provisions of t h i s a r t i c l e .

Sec. 28-22. Bond retjuired for work on Public Right-of-Wav,

"The person, firm or corporation to whom a bui lding permit i s issued co do construct ion, a l t e r a t i o n , repair or other work on private property which i s adjacent to a sidewalk, curb, gutter and/or driveway or other work within public right-of-way which i s required to be constructed, reconstructed, removed or repaired as a condition to the issuance of a permit, shal l provide the Building Inspector with evidence that the General Contractors Bond required and as pro­vided in the Building Code of the City includes coverage on a l l work required to be done on public right-of-way as well as private property pr ior to issuance of the bui lding permit for any such construction.

"(1) When construction, removal or repair of sidewalks, curbs, gutters and driveways or other work within the public right-of-way i s to be done separate to construction on the adjacent private property, the applicant for permit under Sec. 28-20, shal l provide the Building Inspector at the time of making application for permit, a good and sufficient performance bond issued by a surety company authorlr^ed to do business as such In the s t a t e . In the penal sum equal to the t o t a l estiicated cost of the proposed sidewalk, curb, gutter , s t reet or a l ley a l t e ra t ion or im­provement. In favor of the City of Lubbock, conditionad that such construction shall be completed In accordance with the City 's standards and specif icat ions. Such bond shall be approved by the City Attorney pr ior to tha issuance of permit hereunder. In l ieu of such performance bond, the applicant may deposit in cash with the Building Inspector a sum equivalent to the estimated cost of the improve­ments or a l t e r a t i on to secure the completion of such construction m accordance with the C i ty ' s standards and specif icat ions. Said money to be returned to applicant upon proof of completion and acceptance. Provided, however, in the event such construction as herein contemplated is not completed in accordance with the Ci ty ' s standards and specif icat ions,said money deposited in l ieu of bond shall be forfeited In favor of the City of Lubbock.

"(2) Where the application for building permit Includes work on public right-of-way, the Building Inspector shall require tha t there be filed with each application for permit hereunder a cer t i f ica te of insurance for public l i a b i l i t y and property damage issued by a solvent insurance company or companies authorized to do business in the State of Texas, evidencing that the City of Lubbock is ^ adequately protected from any l i a b i l i t y or damages r e su l t ing by vir tue of applicant s construction pursuant to such permit. The public l i a b i l i t y and property damage insurance required herein shall have a minimum limit of Five Thousand Dollars ($5,000.00) property damage for each accident and Twenty-five Thousand Dollars ($25,000.00) aggregated property damage and Twenty-Five Thousand Dollars (525,oOO 00) bodily Injury or death of one person and Fifty Thousartd Dollars ($50,000.00) bodily Injury or death for more than one person.

"(3) In addition to the performance bond and insurance required in Sub­sections (1) and ( 2 ) , the Building Inspector shall be furnished an agreement,

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evidenced by execution of the application and acce;t^.nce of the permit Issued hereunder, that applicant will indemnify and hold h=*rml-s3 the Citv, its officers, agents, servants and employees from ^ay and ail claims, damagss, suits, attorneys' fees, cause of action and Judgrrents which may result in any mar.rer from the construction or laying of any such improvements upon any public street or alley In the City.

"(4) The Building Inspector shall require agreement by the applicant, •vidancad by execution of application and acceptance of permit hereunder, that applicant shall, during the period of such construction and prior to the acceptance of such improvetnents by the City, maintain such public street or alley in a safe condition and Issue all necessary instructions and take all precautions as may be reasonably required to maintain such public streets or alleys in a safe condition for all public use.

Sec. 28-42. Appeal to Board of Examiners and Appeals - Authorized.

•Vhen in the event the application of the provisions of this article is cal­culated to do manifest injury to any property or the improvements thereon or to be constructed thereon or the lawful use thereof, which is due to che peculiar physical condition of the property or the improvements, the Board of Examiners and Appeals as established by Chapter 5 of the Building Code, is hereby authorized and vested with jurisdiction to review such conditions, upcn written appeal made by the owner of such property which shall set forth the reasons the application of this article will do a manifest injury to such property, the improvements thereon or lawful use thereof.

Sec. 28-48. Design^ layout and Plans.

••rha desigHt layout and plans for construction, reconstruction, alteration or replacement of all sidewalks, curbs, driveways either private or commercial, and street curbs and gutters shall conform to ani be constructed according to the design, layout, plans, details shown and provided by the City of Lubbock Standard Plans and Specifications for Construction of Sidewalks, Driveways, Curbs, and Cutters in the City of Lubbock, which have been or may hereafter from time to time, be adopted or amended by ordinance.

Sec. 28-50. Sidewalk Location.

"All sidewalks shall be constructed in that area between the curb or grade Una of the public street and the abutting property line with the inner-edge of tha sidewalk being contiguous and parallel wich the property line.

"Sidewalks shall be constructed along all streets ar.d avenues abutting tha property being developed or Improved and shall extend to the curb Una on each comer lot simultaneous with any construction or development on the property except:

"(a) On any one side of a residential street into which lots front when more than 60% of the frontage between street intersections has been developed without sidewalks at the time a permit is requested.

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••(b) TJhen a Specific Use Zone Permit is hereafter granted which specifically oes noL provide for a sidewalk.

"(c) Where, in a single family residentlally zoned area the minimum lot Tontage on the side of the street In question between street intersection, as latted and as developed, is 150 feet and the minimum lot area is 30,000 square feet,

"(d) In manufacturing or industrial zoning districts, where the abutting itreet is not designated as Highway or is not designated by the Master Thoroughfare Ian as a Major Street, and is outside the area bounded by 4th Street, Avenue A, 9th Street, and Avenue Q.

"(e) When the area to be Improved is on a street where there are no existing :oncrete sidewalks on the same side of the street within the block and is to be Lsed as off-street parking lot the entire surface of which is to be paved, including he area extending to the curb under the terms of a Street Use License that provides 'or construction of bumper rails or guards as specified in Sec. 28-60 of this Code o be placed along and on the property line. Provided, however, this exception ihall not apply when the parking lot area is within the area bounded by 4th Street, ivenue A, 19th Street and Avenue Q, or when the parking area is to be used In connection with an adjacent commercial operation or a building is constructed on :he same lot.

"(f) When an addition or Improvement Is made to an existing residential itructure and the area of such addition does not exceed 200 square feet, not in-:luding unenclosed porches or carports.

"At locations where sidewalks are not required by this Code or where side-lalks do not exist it shall be the duty and responsibility of the property owner to oaintain the parkway area in such a condition so as to permit safe use by pedestrians, to sidewalk shall be removed except for repair or replacement and then it shall be repaired or replaced in accordance with this Code.

Sec. 28-50a. Sidewalk Widths.

"Sidewalks shall be a minimum of four feet wide in residential and indus­trial areas and a minimum of six feet wide In commercial areas except commercial Breas when the sidewalk constructed at the required width would leave 24 Inches or less of space between the back of the curb and the outer edge of the sidewalk In which case the sidewalk width shall be increased sufficiently to extend to the back of the curb.

Sec. 28-52. Lines and grades.

"It shall be unlawful for any person, firm or corporation to excavate com­mence construction or place any mterlal for any work described in this article in a public street or public place, until a permit for such work has been obtained from the Building Inspector, as provided herein or until stakes or lines and grades for such work have been given by the City unless the curb adjacent to the property is existing, and then the contractor shall follow the grade of the f ^^^^"^ curb . Contractors or other persons in charge of such work will be required to P^°^;-^^oth line and grade stakes after the same have been set and any errors In lines or grades

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caused by stakes having been ra ised, lowered or otherwise charged or los^ wi l l be charged against the ;:or/cractcr or other person in dtarge of e.ch work, ^ni he wil l be required to correct such mistak-s at h is own cost and expense.

•The aligameat of the sidewalk sh . l l para l le l the acjacer.t property l i r e unless the Building Inspector gr^r.ts permission for the sidiv^lK to para l le l ^r. ex is t ing s t r ee t curb. The property owner shall have his property line established before Issuance of a permit by the Building Ir.spector,

"The grade of the sidewalk shall para l le l the grade of the top of the s t reet curb when the curb ex i s t s at the time of the sidevilk construction or shall conform to grades establ ished by the City when there is no curb exis t ing , A minimum fee of $2.50 shal l be charged by the City to set two grade acikes for the elevation of the sidewalk and an addi t ional one dollar shall be charged for each addit ional grade stake required or requested by the contractor. The contraccor shall preserve the grade stakes set by the City un t i l the final inspection by the City,

"The elevation of the sidewalk at the edge nearest the s t ree t shall be at leas t as high as but not more than two Inches above the top of the adjacent curb and the elevation of the sidewalk may r i s e as much as one-quarter of an Inch per foot of width.

•*rhe elevation of tha sidewalk at a prl'r^te drlvev&y shall continue the grade of the sidewalk on e i ther side of the driveway except:

"(a) When the distance from the edge of the sidewalk to the back of curb is four feet or less in which case not more than two feet of the sidewalk widch may be sloped and used as a part of the driveway t ransi t ion between the gutter and the property l i n e .

"(b) When the sidewalk i s constructed adjacent to the back of the curb in which case not more than five feet of the sidewalk width may be sloped for the driveway t r ans i t i on approach.

"(c) When in the opinion of the Building Inspector on-site or private property drainage cannot be provided with the sidewalk placed =it curb grade in such event the longitudinal gr^tie of the sidewalk on ei ther sice of tha driveway may be sloped down at the ra te of one inch per foot of length not to exceed four inches but the concrete sidewalk shall be continuous across the driveway.

Sec, 28-55, Material to be used.

"Sidewalks, driveways, inner curbs or s treet curbs shall be constructed of concrete composed of Portland cement, fine aggregate and coarse aggregate, except as herein specified. Except that other comparable material may be used when approved by the Building Inspector. The concrete shall contain not less than five sacks of cement per cubic yard and not more than eight gallons of wicer net per sack of cement when coarse aggregate is used. The amount of ccarsa aggregate shall not exceed eighty-five one hur.credths cubic feet per cubic foot of ce.r.-r.t (dry, loose volume). The minimum compressive strength at 28 days shall be 2,500 pounds per square inch.

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Sac. 28*58. ' F in i sh ing and maiklng.

•Tlia f ln iah on the surface of the cor.crete sl iewalk sha l l be monolithic with eh« alab and sha l l ba such that i t does not present a hazardous condition. The •arklng of tha top of the sidewalk slab must be docs with a s p e c i a l l y devised • srk ing t o o l at four*foot i n t e r v a l s . The narKlng muse cut at l e a s t one-half way through tha s lab and sha l l be done af ter tha slab hss set s u f f i c i e n t l y so that the coacroca w i l l not f l o v . The exposed edges of a l l concrete sha l l be neatly finished with a spac ia l edging t o o l . Tha contractor shal l employ adequate measures to proeact a l l work from tha act ion of tha sun, cold and wind u n t i l the same has thoroughly hardanad and s a t .

Sac. 28*60. Inner Curbs where sidewalk Is adjacer.t t o o f f - s t r e e t parking area,

"Vhara aidawalka are adjacent t o an o f f - s tree t parking area a concrete inner curb or an iron pipe buapar r a i l sha l l be bui l t to separate the parking area from tha sidawalk* Any such concrete curb or iron pipe bumper r a i l sha l l be at. least 4 Inchas high. I f * concrete inner curb i s constructed i t must be at least 4 Inches la width and axtand a Biniiaum of 6 inchas below the driving surface. Iron pipe uaad for a bumper r a i l sha l l have a minimum of 3 inches in outside diameter. The sidawalk may be used as t h i s inner curb provided such sidewalk extends a minimum of 4 inchaa abova tha driving surface.

Sac. 28-63, Privaways into private property or a l l e y s .

"All driveways Into private property shal l be paved from the s treet curb Una t o tha proparty l i n e . They shal l be constructed according t o the standards contained harain and the ir design shal l be as shown on the standard de ta i l s for construction of s idewalks, drlv«ways, curbs and gutters , referred to in Sec. 28-48, for access t o a l l proparty other than s ingle family residences sha l l be approved aa t o daaign by the City Traff ic Engineer under the terms and conditions of t h i s A r t i c l e .

"Wo drivMay access t o ' ^ - 1 " , "R-2", 1 l -3" or other r e s i d e n t l a l l y zoned proparty sha l l ba permitted from a street which ia designated as a Major Street by tha Maater Thorou^fare Plan except when the Pla:L:r.ing Commission shal l have approved tha plat with l o t s fronting on such s t ree t s or when the plat was f i l e d of record prior t o January 2 2 , 1953, with l o t s fronting on the Major Street .

Sac. 28"66. Rsplaceaent of pavetoent.

"All pavad aurfacas of City s t ree t s cut for u t i l i t y i n s t a l l a t i o n shal l be rapUcad by tha City at the expense of the u t i l i t y who caused the s tree t cut. The u t i l i t y may place the concrete base as required herein with i t s own or contractor Ubor but only under the direct ion and supervision of the Street Superintendent of tha City of Lubbock. Tha City w i l l b i l l the contractor or u t i l i t y for the actual coat of mater ia l s , equipment, labor and supervision required to repair the paving. In l iau of tha City doing tha work the u t i l i t y may ^"^« '^^ ^ '' ^^^^ ^ \ !!5*o^^ Mnc paraons of Ita s e l ec t i on provided tha u t i l i t y provides the City with a bond assuring that tha aurface replaced w i l l ba adequately repaired by the u t i l i t y for a period of thraa years ."

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SECTION 2 . Section 28-24 of Art ic le H , chapter 28 and Section 28-61 of irt ic la I I I of said Chapter 28 are hereby repealed.

SECTION 3 . If any s ec t ion , subsection, sentence, clause^ phrase or portion jf t h i s ordinance i s for any reason held invalid or unconstitutional by any court 3f competent j u r i s d i c t i o n , such portion shal l be deemed a separate, d i s t inc t and Indapendcnt provis ion and such holding shal l not affect the v a l i d i t y of the raaaining portions thereof .

SECTION 4 . Any person, firm or corporation v io la t ing any of the provisions of t h i s ordinance shal l be deemed gui l ty of a misdemeanor and upon conviction there­of shal l be fined not exceeding the sum of $200.00. Each day such v io la t ion Is coaBittad, or permitted to continue, shal l const i tute a separate offense and shall be punishable as such hereunder.

SECTION 5. The City Secretary i s hereby authorized and directed to cause :ha publication of the descr ipt ive caption hereof together with the penalty provision for v i o l a t i o n thereof in l i e u of publication as provided by Art ic le 1176b-l, Vernon's lanotated Civ i l Statutes of Texas.

SECTION 6. This order shal l take ef fect 10 days from and af ter the las t lata of publ icat ion as herein provided,

A N D I T I S SO ( DERED.

tessed by tha City Council on f i r s t reading t h i s 4th day of June, 1964.

?assed by tha City Council on second reading t h i s 30th day of June, 1964.

YlTklj/. ^Jrh^AAA^ MAX TIDMORE, Mayor

ATTEST:

lavanla Lowe, City Secretary-Treasurer

) '.

' ' 1 1 > 1 1 • ' '

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SECTION 12 159

"AM" APARTMENT-MEDICAL DISTRICT

PURPOSE

The purpose of this d i s t r ic t is to provide for quality medical and related development through p roper planning and design. The regulations a re inten­ded to produce an a t t rac t ive environnnent which will insure the compatibility between nnedical and other uses ; encourage and protect future developnnent; provide modern facilities for the public; provide proper acces so ry uses ; and p romote , s tabi l ize , and enhance the City as a medical center . When proposed development in this d i s t r ic t is adjacent to any residentlally zoned proper ty , the proposed development shall be designed to provide for maximum compa­tibility with the adjacent development. Architectural design, landscaping, screening , and parking a r e a s shall be properly provided to insure maximum protect ion of the adjacent uses .

GENERAL PROVISIONS

12. 2-1 When proposed development in this dis t r ic t is adjacent to " R - 1 " or " R - 2 " zoned proper ty , on either side or to the rear» even if separated by an alley, a six (6) foot solid screening fence of wood or masonry construction or an equivalent landscaping sc reen shall be installed and permanently maintained on the development lot along the adjacent property line.

12. 2-2 Accessory uses shall be located and designed to provide for com­patibili ty with the p r imary use and shall be for the convenience of the occupants and their clientele.

PERMITTED USES

12. 3-1 Apartments as specified in the "A-2" Section, including efficiency uni ts .

12.3-2 Blood Bank.

12.3-3 Convalescent, nursing, orphan, materni ty, or ger ia t r ics homes.

12.3-4 Day N u r s e r i e s .

12. 3 .5 Hospital , clinic or medical office, except ve ter inary facili t ies.

12. 3-6 Medical , dental, and optical laboratories providing service for individuals of the medical profession and their clientele.

43

12.3-7

12.3-8

12.3-9

Adminis t ra t ive offices for the medical profession including independent management, legal, accounting and bookkeeping '^ ^''^ serv ice for doctors , hospitals , c l imes , and medical personnel .

P h a r m a c y , not exceeding two thousand (2,000) square feet of g ross floor a r ea , limited to retail sale of d rugs , medicines and /o r medical supplies only.

Schools, pr ivate or public, directly related to the medical p r o ­fession.

12, 3-10 Acces so ry uses as follows, provided such uses a r e not visible o r identifiable from outside the building in which they are located, have no exter ior signs, have no entrance except from a lobby or other comnnon area, within the building and are for the use and convenience of the occupants and/or the clientele.

12. 3-10-1 Barber Shop.

12. 3-10-2 Beauty Shop.

12. 3-10-3 Flower Shop.

12. 3-10-4 Gift Shop.

12. 3-10-5 Newsstand.

12. 3-10-6 Res taurants .

CONDITIONAL USES

The following uses may be permit ted when approved by the Zoning Board of Adjustment in the manner specified in Section 25.

12. 4-1 Ba rbe r Shop.

12. 4-2 Beauty Shop.

12.4-3 Establ ishments which sell , fit, or repair devices for the c o r r e c ­tion or prevention of physical deformities.

12. 4-4 Flower Shop.

12.4-5

12.4-6

Gift Shop.

Newsstand.

44

12. 4-7 Ambulance service and other medically related facilities of a p r ima r i l y service type nature not provided for as permit ted 161 uses in this Dis t r ic t .

SPECIFIC USE

To provide l imited flexibility for modern urban design, additional uses in this Dis t r ic t a r e provided in the "Specific Use" section of this Ordinance.

YARD REQUIREMENTS

^2.6-1 Fron t Yard. The minimum front yard shall be twenty-five (25) feet, except that when the entire front yard is landscaped and permanent ly maintained, the required front yard may be fifteen-(15) feet. This section shall not be construed so as to permi t obstruct ions of any nature on corner lots within the visibility triangle as defined in Section 27 .2 -6 -9 -2 .

12.6-2 Rea r Yard. The minimum rea r yard shall be five (5) feet. When proposed development is adjacent to any "R-1" or "R-2" Dis t r ic t , even if separated by an alley, the rea r yard shall be a minimun:i of one (1) foot for each one (1) foot of total height.

12. 6-3 Side Yard. There shall be a minimum side yard of ten (10) feet on each side of any one (1) or two (2) s tory s t ruc ture , and twenty (20) feet on each side of any s tructure with more than two (2) s t o r i e s . When proposed developnnent is adjacent to any " R - 1 " or " R - 2 " Dis t r ic t , the nriinimum side yard shall be one (1) foot for each one (1) foot of total height.

7 LOT WIDTH. The minimum lot width shall be fifty (50) feet, except as provided for apartnnents in the "A-2" regulations.

8 LOT AREA. The minimum lot a rea shall be six thousand (6,000) square feet except as provided for apartments in the "A-2" regulations.

9 LOT COVERAGE. The combined area of all buildings shall not exceed forty (40) percent , except that permitted accessory uses in apartment developments may cover an additional ten (10) percent of the development lot a r ea .

10 FLOOR AREA RATIO. Apartments shall meet the requirements of the "A-2" Dis t r ic t .

11 HEIGHT LIMIT. Buildings shall not exceed three (3) s tor ies and shall not exceed forty (40) feet. Provided, however, that buildings may be erected to aheight of seventy-five (75) feet whenthe front, side and rea r yards a re increased one (1) additional foot for each foot such buildings exceed fort>' (40) feet.

45

O F F - S T R E E T PARKING 162

12.12-1 Off-Street Parking - Required.

12 .12-1-1

12 .12 -1 -2

12 .12 -1 -3

1 2 . 1 2 - 1 - 4

12 .12 -1 -5

12 .12 -1 -6

12 .12 -1 -7

12 .12 -1 -8

12 .12-1-9

Apartments - one (1) space for each efficiency unit, one and one-half (1 1/2) spaces for each one bedroom unit, two (2) spaces for each unit with two bedrooms, two and one-half (2 1/2) spaces for each unit with three (3) o r more bedrooms, plus one (1) additional space for each four (4) units in the development.

Hospital - two (2) spaces for each bed.

Clinic and Offices one (1) space for each one hundred and fifty (150) square feet of gross floor a r e a .

Convalescent, nursing, materni ty , or ger ia t r i cs homes . Three (3) parking spaces for each five (5) beds .

Orphan home one (1) space for each five (5) beds .

Medical, dental, or optical laborator ies - one (1) space for each one hundred and fifty (150) square feet of gross floor a r e a .

Schools - one (1) space for each one hundred and fifty (150) square feet of gross floor a r e a .

Day Nurser ies - one (1) space for each three hundred (300) square feet of gross floor a r ea plus an off-s t r ee t drive, having separa te ingress and eg res s , capable of the temporary storage of three (3) or more vehicles.

Blood Bank - one (1) space for each two hundred (200) square feet of gross floor a r ea .

12 .12-1-10 Conditional uses - the number of required, spaces shall be set up by the Zoning Board of Adjustment, based on the requirements for that use or s imi lar type uses in this or other d is t r ic t s .

12.12-2 Off-Street Parking - Provisions

12.12-2-1 AH parking spaces required herein shall be located on the same lot with the building or use served, except that where an inc rease in the number of spaces is required by a change or enlargement of a permit ted

46

use or building, the required additional spaces may be located a distance not to exceed three hundred (300) feet from the proper ty l ine.

12.12-2-2 P lans of proposed off-street parking a reas shall be submitted to the City Traffic Engineer to be checked for compliance under the t e r m s of this d i s t r ic t and the City's driveway regulations.

163

\ LANDSCAPING REQUIREMENTS

12.13-1 Apar tments :

12.13-1-1 Fifteen (15) percent of the total development lot a r e a shall be landscaped and permanently nnaintained. One-fourth (1/4) of the required landscaping shall be located in the required front yard.

12.13-1-2 The parkway area shall be landscaped and permanent ly maintained. This area shall be in addition to the required landscaping.

12.13-2 All Other Uses:

12.13-2-1 Ten (10) percent of the total developnnent lot a rea shall be landscaped and permanently maintained. All of the required landscaping shall be located between the building lines and adjacent s t ree t s .

12,13-2-2 The parkway area shall be landscaped and permanent ly maintained. This area shall be in addition to the required landscaping.

47

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VEWAY STANDARDS !• It

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COMSIXATIOH

RpqinrNTlAL DRIVEVt'AYS

CITY OF LUBBOCK

TKAFFIC EN"'=? DEPT.

R<vis«<l •^pr.;, 1974

165

PLATE NO. 4

VISIBILITY TRIANGLE Ord.** 5309

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BUILDING CODE ANALYSIS

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168

BUILDING CODE ANALYSIS

A . INTRODUCTION

Bo TYPES OF CONSTRUCTION

C . HEIGHT AND AREA RESTRICTIONS

D . STRUCTURAL

E . MEANS OF EGRESS, PASSAGEWAYS AND VERTICAL OPENINGS

F . F I R E PREVENTION

G. ELEVATORS AND DUMBWAITERS

H . H £ A i r , : , COOLING, AND VENTILATION SYSTEMS

169

General Construction Requirements

A. Introduction

1. These standards constitute minimum requirements of con­

striction. They are considered necessary to insure

properly planned and well constructed hospitals, which

can be maintained and efficiently operated to furnish

adequate service. (33)

2- No attempt has been made in establishing these standards

to comply with all the various state and local codes

and regulations which, of course, must be observed. THE

STANDARDS HERE SET FORTH MUST BE FOLLOWED WHERE THEY

EXCEED ANY OTHER STATE AND LOCAL CODES AND REGULATIONS.

B. Types of Construction

1. Type 1 - NONCOMBUSTIBLE: THE STRUCTURAL ELEMENTS SHALL

BE OF STEEL, IRON, CONCRETE OR MASONRY. WALLS AND

PERMANENT PARTITIONS SHALL BE OF NONCOMBUSTIBLE ONE-

HOUR FIRE RESISTIVE CONSTRUCTION. SEE ALSO CHART BELOW.

2. Type 2 - NONCOMBUSTIBLE: THE STRUCTURAL ELEMENTS SHALL

BE OF STEEL, IRON, CONCRETE OR MASONRY. WALLS AND

PERMANENT PARTITIONS SHALL BE OF NONCONBUSTIBLE ONE-

HOUR FIRE RESISTIVE CONSTRUCTION. SEE ALSO CHART BELOW.

170

3. Type 3 - NONCONBUSTIBLE (1-HOUR): THE STRUCTURAL ELEMENTS

SHALL BE NONCONBUSTIBLE MATERIAL. (Interior partition

of one story structures may contain combustible material,

but must have a 1-hour fire resistive rating.) SEE ALSO

CHART BELOW. (34)

MINIMUM FIRE RESISTIVE VALUES, BY CONSTRUCTION TYPE

Exterior bearing Type 1 Type 2 Type 3 Type 4 Walls 4-hr. 2-hr. 1-hr. 1-hr.

Structural Frame 3-hr. 2-hr. 1-hr. 1-hr.

Partitions

Vertical Shafts

Floors and Roofs

Boiler Rooms

Combustible Storage

C. Height and Area Restrictions

1. Type 1 - No limit.

2. Type 2 - LIMIT THREE STORIES, no area limit.

3. Type 3 - SINGLE STORY AREA LIMIT, 7,000 SQUARE FEET: TWO STORY AREA LIMIT 4,000 SQUARE FEET PER STORY. OVER TWO STORIES NOT PERMITTED.

4. Type 4 - SINGLE STORY AREA LIMIT 5,000 SQUARE FEET. NO MULTISTORY BUILDING PERMITTED.

1-hr.

2 -hr .

2 -hr .

2-hr .

2 -h r .

1-hr.

2-hr .

2-hr .

2-hr .

2-hr .

1-hr.

2 -hr .

1-hr.

2 -hr .

2 -hr .

1-hr

1-hr

1-hr

2-hr

2-hr

(35)

171

For the purpose of this section, each portion of a building

separated by one or more continuous 4-hour fire resistive

walls extending from the foundation through the roof at all

points may be considered a separate building.

The above restrictions may be waived to the extent indicated

below:

Separation from existing structures or adjoining property

lines along 3 sides (75% of perimeter) of the building

will make possible a 2.5% increase in area for each foot

of separation in excess of 20 feet. Maximum increase, 100%.

Separation from existing structures or adjoining property

lines along all sides (100% of perimeter) of the building

will make possible a 5% increase in area for each foot of

separation in excess of 20 feet. Maximum increase, 100%.

D. Structural

1. CODES - IN ADDITION TO COMPLIANCE WITH THESE STANDARDS,

ALL OTHER APPLICABLE LOCAL AND STATE BUILDING CODES AND

REGULATIONS MUST BE OBSERVED, IN AREAS WHICH ARE NOT

SUBJECT TO LOCAL BUILDING CODES, THE RECOMMENDATIONS OF

THE FOLLOWING NATIONAL CODES SHALL APPLY INSOFAR AS SUCH

RECOMMENDATIONS ARE NOT IN CONFLICT WITH THESE STANDARDS.

Southern Building Code; Building Officials Conference of America, 1525 East 53rd Street, Chicago, Illinois 60615

72

2. Design Data

GENERAL - THE BUILDINGS AND ALL PARTS THEREOF SHALL BE

OF SUFFICIENT STRENGTH TO SUPPORT ALL DEAD, LIVE AND

LATERAL LOADS WITHOUT EXCEEDING THE WORKING STRESSES

PERMITTED FOR THE MATERIALS OF THEIR CONSTRUCTION IN

THE APPLICABLE CODE.

SPECIAL - SPECIAL PROVISIONS SHALL BE MADE FOR MACHINE

OR APPARATUS LOADS WHICH COULD CAUSE A GREATER STRESS

THAN THAT PRODUCED BY THE SPECIFIED MINIMUM LIVE LOAD,

WITH DUE CONSIDERATION OFVIBRATION OR IMPACT RESULTING

FROM OPERATION OF SUCH EQUIPMENT (e.g., some portable

x-ray machines weigh as much as 1,000 pounds). CONSI­

DERATION SHALL BE GIVEN TO STRUCTURAL MEMBERS AND CON­

NECTIONS OF STRUCTURES WHICH MAY BE SUBJECT TO HURRICANES,

TORNADOES AND EARTHQUAKES. SUITABLE ALLOWANCE SHALL BE

MADE FOR FUTURE PARTITION CflANGES.

FOUNDATIONS - FOUNDATIONS SHALL REST ON NATURAL SOLID

GROUND AND SHALL BE CARRIED TO A DEPTH OF NOT LESS THAN

ONE FOOT BELOW THE ESTIMATED FROST LINE OR SHALL REST ON

LEVEL ROCK OR LOADBEARING PILES WHEN SOLID GROUND IS NOT

ENCOUNTERED. FOOTINGS, PIERS, AND FOUNDATION WALLS SHALL BE

ADEQUATELY PROTECTED AGAINST DETERIORATION FROM THE ACTION

OF GROUND WATER.

173

LIVE LOADS - THE FOLLOWING UNIT LIVE LOADS SHALL BE TAKEN AS

THE MINIMUM UNIFORMLY DISTRIBUTED LIVE LOADS FOR THE OCCUPAN­

CIES LISTED:

HOSPITAL WARDS, BEDROOMS, AND ALL ADJOINING SERVICE ROOMS

COMPRISE A TYPICAL NURSING UNIT (EXCEPT SOLARIA AND

CORRIDORS) - 40 P.S.F. SOLARIA, CORRIDORS IN NURSING UNITS

AND ALL CORRIDORS ABOVE THE FIRST FLOOR, OPERATING SUITE,

EXAMINATION AND TREATMENT ROOMS, LABORATORIES, TOILETS AND

LOCKER ROOMS - 60 P.S.F.

CORRIDORS ON FIRST FLOOR, WAITING ROOMS AND SIMILAR PUBLIC

AREAS, OFFICES, CONFERENCE ROOM, LIBRARY, KITCHEN AND

RADIOGRAPHIC ROOM - 80 P.S.F.

STAIRWAYS, LAUNDRY, LARGE ROOMS USED FOR DINING, RECREATION

OR ASSEMBLY PURPOSES, VDRK SHOPS - 100 P.S.F.

RECORDS FILE ROOM, STORAGE, SUPPLY - 125 P.S.F-

MECHANICAL EQUIPMENT ROOM (UNLESS ACTUAL EQUIPMENT LOADS

ARE ACCURATELY DETERMINED) - 150 P.S.F.

ROOFS (EXCEPT USE INCREASED VALUE WHERE SNOW AND ICE MAY

OCCUR) - 20 P.S.F.

WIND - AS REQUIRED BY LOCAL CONDITIONS, BUT NOT LESS THAN

15 P.S.F.

17^

3. Veiling Heights:

BOILER ROOM:

NOT LESS THAN 12'-0" except that a lesser height may be

used for these small buildings which may use a domestic type

packaged hearing unit. When a boiler is set in a depressed

pit area, the height shall be measured from the pit bottom.

LAUNDRY:

NOT LESS THAN ll"-0" (a higher ceiling is desirable).

KITCHEN:

NOT LESS THAN lO'-O" (a higher ceiling is desirable).

OPERATING ROOMS, DELIVERY ROOMS, CYSTOPIC ROOMS, EMERGENCY ROOMS

AND SIMILAR ROOMS HAVING CEILING-MOUNTED LIGHT FIXTURES:

NOT LESS THAN 9'-6" (a higher clearance may be necessary for

some surgical lights).

CORRIDORS AND PASSAGEWAYS:

NOT LESS THAN 7'-6" (a higher ceiling is desirable).

ALL OTHER ROOMS EXCEPT THOSE CONTAINING SPECIAL EQUIPMENT WHICH

MAY REQUIRE A GREATER HEIGHT (X-RAY, ETC.):

not less than 8'-0" except that ceiling heights for corridors,

storage rooms, patients' room toilets and other minor auxil­

iary rooms may be lower.

INSULATION IN CEILINGS: CEILINGS OF KITCHENS AND LAUNDRIES SHALL

BE INSULATED WHERE THE FLOOR DIRECTLY ABOVE TflEM IS TO BE USED

FOR HOSPITAL PURPOSES-

175

E. Means of Egress, Passageways and Vertical Openings

1. Means of Egress {3k)

ALL EXIT FACILITIES SHALL FOLLOW THESE STANDARDS, AND WHERE

THERE IS NO CONFLICT, THE RECOMMENDATIONS OF THE BUILDING

EXITS CODE OF THE NATIONAL FIRE PROTECTION ASSOCIATION.

NUMBER, LOCATION, AND TYPE OF EXITS - EACH FLOOR OR STORY

OF EVERY BUILDING SHALL HAVE AT LEAST TWO SEPARATE AND INDE­

PENDENT MEANS OF EGRESS LEADING TO THE OUTSIDE, OR TO A

CORRIDOR WHICH HAS TWO SEPARATE AND INDEPENDENT MEANS OF

EGRESS LEADING TO THE OUTSIDE.

ALL EXIT DOORS SHALL BE BETWEEN FLOORS OF EQUAL ELEVATION

EXTENDING AT LEAST THE WIDTH OF THE DOOR IN EITHER DIRECTION.

MEANS OF EGRESS IN ADDITION TO THE MINIMUM OF TWO REQUIRED

FROM EACH FLOOR SHALL BE REQUIRED WHEN THE MAXIMUM POSSIBLE

OCCUPANCY EXCEEDS 100 PATIENTS PER FLOOR. THERE SHALL BE

AT LEAST ONE ADDITIONAL MEANS OF EGRESS FOR EACH ADDITIONAL

100 PATIENTS PER FLOOR. EXITS SHALL BE OF SUCH NUMBER AND

SO ARRANGED THAT IT WILL NOT BE NECESSARY TO TRAVEL MORE THAN

100 FEET FROM THE DOOR OF A PATIENT OCCUPIED ROOM TO REACH

THE NEAREST APPROVED MEANS OF EGRESS FROM THAT FLOOR.

ALL PATIENT OCCUPIED ROOMS SHALL BE LOCATED BETWEEN APPROVED

MEANS OF EGRESS, EXCEPT ONE ROOM ON EACH END OF A CORRIDOR

THAT MAY PIAVE NOT MORE THAN TWO PATIENTS IN EACH ROOM, OR

ONE ROOM AT THE END OF ANY CORRIDOR THAT MAY HAVE NOT MORE

176

THAN FOUR PATIENTS. DOORS FROM ROOMS PROVIDED FOR BY THIS

PARAGRAPH SHALL BE NOT MORE THAN 30 FEET FROM AN APPROVED

EXIT, STAIRWAY, FIRE ESCAPE, OR EGRESS DIRECTLY TO THE OUT_

SIDE AT GRADE.

WARD ROOMS AND OTHER PATIENT ROOMS LOCATED IN AREAS BETWEEN

EXITS SHALL BE OF SUCH DIMENSIONS THAT NO PART OF TflE ROOM

WILL BE IN EXCESS OF 30 FEET TO THE ROOM EXIT DOOR UNLESS AN

APPROVED SECONDARY MEANS OF EGRESS IS PROVIDED FOR SUCH WARD.

NO ARCHITECTURAL TREATMENT, MIRRORS, FALSE WINDOWS, DOORS, OR

OTHER DECORATIONS SPIALL BE USED SO AS TO GIVE THE APPEARANCE

OF DOORS OR EXITS WHERE NO DOORS OR EXITS EXIST, OR SO PLACED

AS TO DECREASE THE WIDTH OR IMPAIR THE USE OF THE EXIT.

NOTHING SHALL BE PLACED OR HUNG IN FRONT OF EXIT SIGNS WHICH

WILL OBSTRUCT OR PREVENT A CLEAR VIEW OF THE EXIT SIGNS.

PASSAGEWAYS TO ANY MEANS OF EGRESS SHALL NOT BE USED FOR

HOUSING OR PATIENTS.

ELEVATORS SHALL NOT BE APPROVED AS REQUIRED MEANS OF EGRESS,

BUT WHERE REQUIRED, THE MINIMUM PLATFORM SIZE SHALL BE 64"X96"

AND THE MINIMUM DOOR WIDTH SHALL BE 46".

WINDOWS SHALL NOT BE APPROVED MEANS OF EGRESS; HOWEVER, FOR

THE PURPOSES OF SMOKE CLEARING AND OF EMERGENCY ACCESS TO

FRESH AIR, ALL PATIENT BEDROOMS SHALL POSSESS A WINDOW. THE

177

WINDOW SILLS OF ONE-STORY BUILDINGS CONSTRUCTED OF OTHER

THAN NONCOMBUSTIBLE MATERIALS SHALL BE NOT MORE THAN SIX FEET

ABOVE THE ADJACENT GROUND LEVEL.

ALL CORRIDORS SHALL LEAD DIRECTLY TO THE OUTSIDE OR TO A RE­

QUIRED STAIRWAY HAVING DIRECT ACCESS TO THE OUTSIDE THROUGH

APPROVED EXIT DOORS AT GRADE WHICH WILL GIVE ACCESS TO PUBLIC

STREET. ONLY ONE REQUIRED STAIRWAY MAY TERMINATE IN AND HAVE

EGRESS DIRECTLY ACROSS THE MAIN FLOOR ENTRANCE LOBBY, WHICH

HAS AMPLE APPROVED MEANS OF EGRESS TO THE OUTSIDE GIVING

ACCESS TO A PUBLIC STREET.

CORRIDORS AND PASSAGEWAYS CONSIDERED AS APPROVED MEANS OF

EGRESS SHALL BE AT LEAST 90" IN HEIGHT.

CORRIDOR BARRIER DOORS, OTHER THAN APPROVED SMOKE BARRIER

DOORS, SHALL BE EQUAL TO 1 HR. RATED DOUBLE ACTION DOORS ONLY

AND SHALL NOT BE SECURED BY ANY DEVICE OTHER THAN BY A TYPE

THAT WILL PERMIT OPENING THE DOOR IN THE DIRECTION OF TRAVEL

FROM EITHER SIDE WITH A NORMAL PUSH OR PRESSURE. ALL DOUBLE

ACTION DOORS SHALL INCORPORATE VISION PANELS, MEETING RE_

QUIREMENTS FOR GLASS IN PARTITIONS, AS SPECIFIED BELOW.

ALL ROOMS SHALL BE SEPARATED FROM CORRIDORS WITH PARTITION

CONSTRUCTION WHICH WILL AFFORD AT LEAST A 1 HOUR FIRE RESIS_

TIVE RATING. ANY GLASS IN SUCH PARTITIONS (INCLUDING DOORS)

178

SHALL BE k INCH WIRED GLASS IN STEEL FRAMING, NOT EXCEEDING

1,296 SQUARE INCHES PER OPENING WITH NO LINEAR DIMENSION EX_

CEEDING 54 inches.

2 . Doors and doorways (3k-)

ALL DOORWAYS WHICH ARE A PART OF A MEANS OF EGRESS SHALL BE

AT FLOOR LEVEL EXCEPT WHERE PROPER APPROVED RAMPS ARE PRO­

VIDED.

ALL DOORS, INCLUDING SCREEN AND STORM DOORS, FORMING A PART

OF AN APPROVED MEANS OF EGRESS TRAVEL. This section shall

not be construed to require doors from patient occupied rooms

to open into corridors EXCEPT THAT SUCH DOORS SHALL NOT BE

HUNG SO AS TO OBSTRUCT EGRESS PASSAGE. THERE SHALL BE NO

OBSTRUCTION AT ANY TIME TO THE OPENING AND CLOSING OF EGRESS

DOORS OR DOORS FROM PATIENT OCCUPIED ROOMS INTO CORRIDORS.

ALL DOORWAYS FROM PATIENT BEDROOMS AND DOORS FORMING A PART

OF AN APPROVED MEANS OF EGRESS SHALL BE AT LEAST 80" IN

HEIGHT AND OF SUCH GREATER HEIGHT AS WILL ALLOW FOR FREE

PASSAGE OF BEDS AND ATTACHED EQUIPMENT WHERE REQUIRED,

DOOR STOPS ALONG FACINGS SHALL BE TERMINATED 4"-6" FROM THE

FLOOR, IN ORDER TO PROVIDE AN EASILY-CLEANABLE JOINT AT THE

BASE OF THE FACING.

179

BASE OF THE FACING.

DOOR WIDTHS SHALL NOT BE LESS THAN 44 INCHES IN WIDTH. IN

ADDITION, DOOR WIDTHS SHALL BE AT LEAST 44 INCHES AT ALL:

TREATMENT ROOMS

OPERATIONG ROOMS

RECOVERY ROOMS

THERAPY AND DIAGNOSTIC X-RAY ROOMS

DELIVERY ROOMS

LABOR ROOMS

PHYSICAL THERAPY ROOMS

EMERGENCY ROOMS

REVOLVING DOORS SHALL NOT BE APPROVED AS PART OF A MEANS OF

EGRESS. WHERE REVOLVING DOORS ARE INSTALLED, A DOOR, OR

DOORS, COMPLYING WITH THESE STANDARDS SHALL BE INSTALLED

WITHIN 15 FEET OF EACH REVOLVING DOOR.

FIRE RESISTANT SMOKE BARRIERS WITH SINGLE ACTION DOORS SHALL

BE PROVIDED ACROSS CORRIDORS OVER 150 FEET IN LENGTH AND

BARRIERS SHALL BE NOT MORE THAN 150 FEET APART IN BUILDING

OF FIRE RESISTANT CONSTRUCTION, AND NOT MORE THAN 7 5 FEET

APART IN BUILDING OF NON-FIRE RESISTANT CONSTRUCTION.

BARRIERS SHALL BE LOCATED TO PROVIDE AN AREA OF REFUGE ON

EITHER SIDE THAT IS SERVICED WITH AN APPROVED MEANS OF EGRESS

WHERE THE CEILING OR FALSE CEILING IS LESS THAN ONE-HOUR

180

FIRE RESISTANT CONSTRUCTION, THE BARRIER SHALL CONTINUE TO

THE FLOOR OR ROOF ABOVE THE FULL WIDTH OF SUCH OPEN AREA.

SUCH SMOKE BARRIER DOORS SHALL BE NOT LESS FIRE RESISTANT

THAN CLASS "C" LABELED FIRE DOORS; AND WHERE DOUBLE DOORS

WITHOUT MULLIONS ARE USED, SYNCHRONIZING HARDWARE AND ASTRA­

GALS SHALL BE INSTALLED.

3. Stairways and other vertical openings (3U)

ALL STAIRWAYS FORMING AN APPROVED MEANS OF EGRESS SHALL HAVE

SUITABLE HANDRAILS ON EACH SIDE.

ALL STAIRWAYS FORMING AN APPROVED MEANS OF EGRESS SHALL BE

AT LEAST 44 INCHES WIDE IN THE CLEAR. HANDRAILS ATTACHED

TO WALLS MAY PROJECT INTO THE REQUIRED WIDTH OF A STAIRWAY

NOR MORE THAN 3H INCHES AT EACH SIDE.

ALL STAIRWAYS FORMING AN APPROVED MEANS OF EGRESS SHALL HAVE

TREADS NO LESS THAN 10 INCHES WIDE, EXCLUSIVE OF THE NOSING,

AND THE RISERS SHALL NOT EXCEED 7 INCHES IN HEIGHT. TREADS

AND RISERS SHALL BE OF UNIFORM WIDTH AND HEIGHT IN EACH INDI­

VIDUAL STAIRWAY, AND TREADS SHALL BE OF NON-SKID MATERIAL.

NO STAIRWAY FORMING A MEANS OF EGRESS CONSISTING OF TWO OR

MORE STEPS WHICH, IN CHANGING DIRECTION, DOES SO BY BENEFIT

OF THE VARIANCE IN THE WIDTH ALONG EACH TREAD, SHALL BE

APPROVEDo THIS SECTION SHALL NOT BE CONSTRUED TO PROHIBIT

181

A STAIRWAY WITH TREADS OF UNIFORM WIDTH THROUGHOUT WHICH

CHANGES IN DIRECTION BY BENEFIT OF INTERMEDIATE LANDINGS OR

PLATFORMS .

THE MAXIMUM VERTICAL DISTANCE BETWEEN PLATFORMS OR LANDINGS

IN ANY FLIGHT OF STAIRS SHALL NOT EXCEED 10 FEET.

THE TEXAS STATE FIRE ESCAPE LAW SHALL APPLY IN ALL CASES NOT

SPECIFICALLY COVERED HEREIN, EXCEPT THAT CHUTE TYPE FIRE

ESCAPES, BOTH STRAIGHT AND SPIRAL, ARE PROHIBITED.

AN ESCALATOR OR MOVING WALK MAY BE ACCEPTED AS A COMPONENT

IN A MEANS OF EGRESS WHEN IT CONFORMS TO THE GENERAL RE­

QUIREMENTS FOR MEANS OF EGRESS AND TO THE SPECIAL REQUIRE­

MENTS IN THIS SECTION. AS SUCH THE ESCALATOR IS DESIGNATED AS AN

EXIT ESCALATOR AND THE MOVING WALK AS A MOVING WALK EXIT.

A SIGN INDICATING THE DIRECTION OF THE NEAREST APPROVED EXIT

SHALL BE PLACED AT THE POINT OF ENTRANCE TO ANY ESCALATOR

OR MOVING WALK THAT DOES NOT CONFORM TO OR SERVE AS A MEANS

OF EGRESS.

AN EXIT ESCALATOR SHALL COMPLY WITH THE APPLICABLE RE«

QUIREMENTS FOR EXIT STAIRS EXCEPT AS MODIFIED IN THIS SECTION.

NO ESCALATOR CAPABLE OF BEING OPERATED IN THE DIRECTION

CONTRARY TO NORMAL TRAVEL SHALL BE USED IN A MEANS OF EGRESS.

182

AN EXIT ESCALATOR SHALL BE OF THE HORIZONTAL TREAD TYPE AND

SHALL BE OF NONCOMBUSTIBLE CONSTRUCTION THROUGHOUT EXCEPT

FOR THE STEP THEAD SURFACES, HANDRAILS AND STEP WHEELS.

TREADS AND RISERS SHALL BE DIMENSIONED IN ACCORDANCE WITH

THESE STANDARDS FOR STATIONARY STAIRS.

NO SINGLE EXIT ESCALATOR SHALL HAVE AN UNINTERUPTED VERTICAL

TRAVEL OF MORE THAN 1 STORY.

NO MOVING WALK CAPABLE OF BEING OPERATED IN THE DIRECTION

CONTRARY TO NORMAL EXIT TRAVEL SHALL BE USED IN A MEANS OF

EGRESS.

F. Fire prevention

l.Standpipe (3k)

IN ALL BUILDINGS EXCEEDING TWO STORIES IN HEIGHT ABOVE THE

HEIGHEST GRADE ENTRANCE, AN APPROVED STANDPIPE SHALL BE

PROVIDED AND EQUIPPED WITH HOSE SUFFICIENT IN LENGTH TO REACH

ALL PARTS OF EACH FLOOR.

THERE SHALL BE AT LEAST ONE OUTLET ON EACH FLOOR, INCLUDING

THE BASEMENT. FIRE DEPARTMENT CONNECTIONS SHALL BE PROVIDED

ON THE OUTSIDE OF THE BUILDING TO PERMIT A SUPPLY OF WATER

TO THE STANDPIPE SYSTEM. STANDPIPE OUTLETS WITHIN THE

BUILDING SHALL BE PROVIDED WITH A CONNECTION SUITABLE FOR

^83

USE BY THE LOCAL FIRE DEPARTMENT. RISERS FOR THE STANDPIPE

AND THE SIZE OF THE CONNECTIONS SHALL BE DETERMINED BY THE

INSPECTING AUTHORITY BASED UPON THE CONDITIONS INVOLVED.

ifi. Fire Alarm System (31 .)

ALL BUILDINGS SHALL BE EQUIPPED WITH AN APPROVED FIRE ALARM

SYSTEM WHICH SHALL CONSIST OF AT LEAST ONE OF THE FOLLOWING

(INSTALLED IN COMPLIANCE WITH NFPA 72 and 101, OR LOCAL CODES)

An electrically operated, closed circuit, self-supervised, local system with suitable signalling devices of such charac­ter and so located as to communicate the alarm of the fire to the personnel of each floor of the building, and to a manned, centrally located 24-hour duty station within the building or institution so that immediate notification can be given to the fire department. Such a system shall also have approved, actuating stations suitably located on each floor and basement so that it will not be necessary to travel more than 100 feet from any room to reach a station on the same floor.

^ inter-communication public address system, providing it can be operated from stations suitably located on each floor and basement and be heard in all parts of the building in­cluding a manned, centrally located 24-hour duty station within the building or institution, so that immediate notification can be given to the fire department. Oper­ating stations shall be so located that it will not be necessary to travel more than 100 feet from any room to reach a station that is on the same floor.

A TELEPHONE OR OTHER SUITABLE MEANS OF COMMUNICATION AND

ALARM OF FIRE TO THE FIRE DEPARTMENT SHALL BE PROVIDED. PAY

STATIONS WILL NOT BE AN APPROVED MEANS OF SENDING AN ALARM

OF FIRE.

18/f

3 . Sprinkler System (3 ^ )

ROOMS WHERE COMBUSTIBLE MATERIALS ARE STORED AND MAINTENANCE

SHOPS SHALL BE PROTECTED BY AN APPROVED AUTOMATIC SPRINKLER

SYSTEM AND SHALL BE A FIRE RESISTANT EOOM EQUIPPED WITH FIRE

DOOR AND FRAME ASSEMBLY.

SPRINKLERS, AUTOMATICALLY ACTUATED BY A TEMPERATURE RISE,

SHALL BE INSTALLED IN AT LEAST THE FOLLOWING LOCATIONS:

LAUNDRY CHUTES

LAUNDRY

SOILED LINEN ROOMS

BULK STORAGE AREAS

TRASH CHUTES

CARPENTER AND PAINT SHOPS

ACCESSIBLE ATTICS

BASEMENT CORRIDORS

ALL COMBUSTIBLE BUILDINGS OR BUILDING SECTIONS

IN ADDITION, AN AUTOMATIC FIRE OETECTION SYSTEM SHALL BE

INSTALLED IN BULK STORAGE AREAS.

*. Elevators and I\imbwaiters

1. Codes

ELEVATORS AND DUMBWAITERS SHALL COMPLY WITH ALL LOCAL AND

••••

185

STATE CODES, AMERICAN STANDARD SAFETY CODE FOR ELEVATORS,

DUMBWAITERS, AND ESCALATORS (A17 .1-1960 ) # THE NATIONAL

BOARD OF FIRE UNDERWRITERS, AND THE NATIONAL ELECTRICAL CODE.

2. Number of ^levators

ANY HOSPITAL WITH PATIENTS ON ONE OR MORE FLOORS ABOVE THE

FIRST OR WHERE THE OPERATING OR DELIVERY ROOMS ARE ABOVE THE

FIRST FLOOR SHALL HAVE AT LEAST ONE ELECTRICALLY OPERATED

HOSPITAL-TYPE ELEVATOR WITH CAR INSIDE DIMENSIONS OF AT

LEAST 64" WIDE BY 96" DEEP. AND DOOR CLEAR OPENING OF NOT LESS

TtiAN 46". HOSPITALS WITH A BED CAPACITY OF FROM 201 TO 3 50

ABOVE THE FIRST FLOOR SHALL HAVE NOT LESS THAN THREE SUCH

ELEVATORS.

3. Controls

ELEVATORS SHALL HAVE EITHER GENERATOR FIELD CONTROL OR MULTI-

VOLTAGE CONTROL WHERE SPEED IS GREATER THAN 150 FEET PER

MINUTE. ELEVATORS WITH SPEEDS OF MORE THAN 3 50 FEET PER

MINUTE SHALL BE THE GEARLESS TYPE. ELEVATORS SHALL HAVE

LEVELING (AUTOMATIC) OF THE TWO-WAY TYPE (AUTOMATIC MAIN­

TAINING) WITH ACCURACY WITHIN PLUS OF MINUS l^ INCH.

4- Operation

ELEVATORS FOR WHICH OPERATORS WILL NOT BE REGULARLY EMPLOYED

186

SHALL BE EQUIPPED FOR AUTOMATIC OPERATION AND SHALL HAVE CAR

SWITCH TO PERMIT OPERATION BY AN ATTENDANT DURING SPECIAL

OCCASIONS, OR TO BYPASS REGISTERED CALLS IN EMERGENCIES.

5. Dumbwaiters

ALL DUMBWAITERS SHALL BE ELECTRICALLY OPERATED. When travel

does not exceed 50 feet, the minimum speed should be 50 feet

per minute; FOR TRAVEL OF MORE THAN 50 FEET, THE MINIMUM

SPEED SHALL BE 100 FEET PER MINUTE.

H. Heating, Cooling, and Ventilation Systems

1. Codes

THE HEATING SYSTEM, STEAM SYSTEM, BOILERS, VENTILATION

SYSTEM, AND AIR CONDITIONING SYSTEM SHALL BE FURNISHED

AND INSTALLED TO MEET ALL REQUIREMENTS OF THE LOCAL AND

STATE CODES AND REGULATIONS, THE REGULATIONS OF THE

NATIONAL BOARD OF FIRE UNDERWRITERS, THE CURRENT EDITION

OF THE NATIONAL FIRE PROTECTION ASSOCIATION'S PAMPHLET

NO. 90-A ENTITLED, "AIR CONDITIONING AND VENTILATION

SYSTEMS." AND THE MINIMUM GENERAL STANDARDS AS SET FORTH

IN THIS SECTION.

2. General

The building shall be heated by a hot water, STEAM, OR

EQUAL TYPE HEATING SYSTEM.

187

THE USE OF FIREPLACES FOR ANY BURNING PURPOSE IN HOSPITAL,

BUILDINGS SHALL NOT BE PERMITTED

HEATING PLANTS SHALL BE ENCLOSED BY WALLS, FLOOR, AND

CEILING HAVING AT LEAST 2 HOUR'S RESISTANCE TO FIRE WITH

AT LEAST ONE WALL BEING AN OUTSIDE WALL. DOORWAYS AND

OTHER OPENINGS THROUGH REQUIRED HEATING PLANT ENCLOSURES

SPIALL BE PROTECTED BY ONE-HOUR FIRE DOORS AND FRAMES

INSTALLED SO AS TO BE REASONABLY SMOKE TIGHT, AND BE

EQUIPPED WITH SELF-CLOSING DEVICES.

HEATING PLANT ROOMS SHALL NOT BE LOCATED BENEATH ANY

PORTION OF A BUILDING. THIS REGULATION SHALL NOT BE CON­

STRUED TO REQUIRE THE REMOVAL OF AN EXISTING HEATING PLANT

FROM BENEATH AN EXISTING HOSPITAL OR INSTITUTION BUILDING

UNLESS IT SHALL BE SO REQUIRED IN THE INTEREST OF PUBLIC

SAFETY. IN THE EVENT IT BECOMES NECESSARY TO EXPAND THE

CAPACITY OF A HEATING PLANT TO HEAT A HOSPITAL OR IN­

STITUTION BUILDING, SUCH EXPANSION SHALL NOT BE PERMITTED

UNDER ANY PORTION OF THE EXISTING BUILDING.

FURNACE ROOMS OR HEATING PLANT ENCLOSURES SHALL BE PRO­

VIDED WITH APPROVED AIR VENTS CONNECTED DIRECTLY TO THE

OUTSIDE, SUFFICIENT IN SIZE TO SUPPLY THE REQUIRED VOLUME

OF AIR TO SUPPORT PROPER COMBUSTION. ADEQUATE VENTILATION

SHALL BE PROVIDED DIRECTLY TO THE OUTSIDE FROM THE CEILING

188

OF THE HEATING PLANT ENCLOSURE TO ELIMINATE EXCESSIVE

TEMPERATURE AT ALL T I M E S .

ALL HOT WATER HEATERS AND STEAM PLANTS SHALL BE LOCATED

IN THE HEATING PLANT ROOM OR IN A ROOM OF COMPARABLE

CONSTRUCTION.

THE USE OF UNVENTED OPEN FLAME HEATERS I S SPECIFICALLY

PROHIBITED. PORTABLE HEATING UNITS SHALL NOT BE PERMITTED.

WITHIN THE BUILDING, THERE SHALL BE NO CONTACT BETWEEN

AIR FOR COMBUSTION CHAMBERS (EXCEPT STERILIZERS) SHALL

HAVE THEIR OWN TOTAL AIR SUPPLY FROM THE OUTSIDE ATMOS­

PHERE.

ALL DIRECT-FIRED HEATING UNITS SHALL BE DESIGNED SO AS

TO DISCHARGE THE PRODUCTS OF COMBUSTION INTO VERTICAL

FLUE OR CHIMNEY LEADING TO THE OUTER AIR ABOVE THE HIGH

POINT OF THE ROOF. DIRECT-FIRED HEATING UNITS SHALL NOT

BE PERMITTED IN ANY OPERATING ROOMS, OR IN ANY OTHER

ROOM WHERE COMBUSTIBLE VAPORS MAY BE PRESENT.

GAS OR ELECTRIC METERS SHALL NOT BE PERMITTED WITHIN 5

FEET OF THE HEATING PLANT, AND SHALL BE LOCATED IN A ROOM

SEPARATED FROM OTHER OCCUPANCIES AND EXPOSURES BY AT LEAST

A ONE-HOUR RATED ENCLOSURE WHICH I S VENTED TO THE OUTSIDE.

^ ^ b

189

3* Steam System and Heating Plant Equipment and Accessories

A SYSTEM OF STEAM AND RETURN MAINS AND APPURTENANCES SHALL

BE PROVIDED TO SUPPLY ALL EQUIPMENT WHICH REQUIRES STEAM

HEAT.

BOILERS SHALL HAVE THE NECESSARY CAPACITY WHEN OPERATING

AT NORMAL RATING TO SUPPLY THE HEATING SYSTEM, HOT WATER,

AND STEAM OPERATED EQUIPMENT, SUCH AS STERILIZERS, LAUNDRY

AND KITCHEN EQUIPMENT. Spare boiler capacity should also

be provided in a separate unit to replace any boiler

which might break down.

BOILER WHICH SUPPLY HIGH PRESSURE STEAM TO STERILIZERS,

KITCHENS, LAUNDRY, ETC., SHALL MEET THE REQUIREMENTS OF

THE CITY AND CODES FOR 12 5 POUNDS WORKING PRESSURE. It

is desirable to operate boilers, supplying steam for

laundries, at not less than 105 pounds pressure while

boilers for sterilizers and kitchen may operate at 50

pounds pressure.

It shall be POSSIBLE TO MAINTAIN A TEMPERATURE OF 70°

FARENHEIGHT IN EACH ROOM AND OCCUPIED SPACE EXCEPT THAT

IN OPERATING AND DELIVERY ROOMS AND NURSERIES SHALL BE

750 FAHRENHEIT. IN SPACES WHERE RADIANT HEAT IS USED, THE

1 >

MINIMUM TEMPERATURES SPECIFIED MAY BE REDUCED TO MAINTAIN

AN EQUIVALENT COMFORT LEVEL. RADIATORS AND CONVECTORS,

IF USED, SHALL BE PROVIDED WITH HAND CONTROL VALVE EXCEPT

WHERE INDIVIDUAL ROOM AUTOMATIC CONTROL IS PROVIDED.

'•^^m-''

SOLAR ENERGY STUDY

191

INTRODUCTION TO SOLAR ENERGY STUDY

This country is experiencing an energy shortage and many

people are looking for alternative energy sources. The use of

radiant energy is one of these alternatives, hence, solar heat­

ing is becoming another method of dealing with the space con­

ditioning necessity of environmental control. {kO)

Today, there is growing public interest and pressure for

solutions to the energy problem and solar energy is one of the

viable solutions being investigated. The sun sends to the earth

enormous amounts of energy, most of which are not being used.

It is ecologically sensible to harness and use solar energy,

whenever feasible, rather than to use limited coal, oil, and gas.

The use of solar energy is one of the solutions to curtail the

declining reserves of fossil fuels.

It is important for an architect to know about the appli­

cations of solar energy for space heating and water heating, how

to apply its use, and how best to advise a client with

regard to its use. Sdar radiation can be collected in the form

of heat. Just ^ the sun varms a black object, it can warm water

or air that will be used to heat a house or water for domestic

use. Heat can be stored economically for use at a later time as

long as the storage time period is not too long- There are many

different methods of collecting and storing solar energy. The

amount of solar energy required may dictate the size of the collec-

]02

tor or the storage unit. The type and size of storage system may

depend on the medium used to transport the energy or the maximuun

number of days without sunshine. The possibilities for collect­

ing, storing, and using the amounts of energy necessary to meet

heating requirements are many. This study was undertaken to

examine solar energy from an architectural point of view hoping

to inform others on the best ways to deal with it in design.

193

SOLAR ENERGY

Solar radiation reaches the outskirts of the earth's at­

mosphere with an intensity of 1.94 calories per square centi­

meter per minute which is equal to 430 BTU (British Thermal

UnitsX per square foot per hour or 132 5 watts per square meter.

This fugure is called the solar constant and is based on the

earth's distance from the sun. This radiant energy varies

somewhat because of the changing distance from the earth to

the sun during the year and because of solar disturbances. (37)

It has been computed that in the year 1970 mankind con­

sumed an anount of energy equal only to the amount of solar

energy that strikes the earth's outer atmosphere in fifteen

minutes. In its downward passage through the earth's atmos­

phere, part of the radiation is scattered and part absorbed by

the constituents of the atmosphere. This depletion is sub­

stantial, even on cloudless days, and with heavy clouds it may

be nearly complete. The solar radiation received on the earth"s

surface consists of direct solar radiation and diffuse or sky

radiation. The sky radiation arises from the fact that the part

scattered or absorbed by the atmosphere may in turn be partial­

ly re-radiated downward to the earth's surface. Hence, the in­

tensity of radiation received on the earth's surface will change

not only diurnally, monthly, and annually; but will also depend

IQ/ -J'{

on the latitude and altitude of the site on the earth's hemisphere,

More specifically the amount of radiation received from the sun

depends on the following = the position of the sun according to

the time of day, the position of the sun according to the season,

clouds and other obstructions, the direction of the slope of the

measuring station, the angle of the slope of the station, the

altitude of the station and the physical surroundings of the

station. (39)

Insolation refers to the total of direct and diffuse solar

radiation incident on a unit area and is measured on a horizontal

plane by weather stations throughout the world in langleys per

minute. O^e langley is equal to one calorie of radiant energy,

per square centimeter or 221 Btu per square foot per hour. The

intensity of solar radiation on the earth's surface varies from

zero to 1.6 calories per square centiipeter per minute depending

on location, time, and atjnospheric conditions as stated above,

langleys per day can be converted to ^tu per square foot per

day when multiplied by 3.69. Weather information and maps

depicting solar radiation in langleys are given in Appendix A

and B respectively; but local climatological data should always

be attained prior to attempting analysis of solar conditions.

Solar energy is clean, "free", and abundant but has not

been used extensively in the past for various reasons. Though

this fuel is "free", the radiant energy reaching the earth is quite

dilute and therefore must be collected over a large area for use

HHIA^a^

195

in an extensive solar heating system. Also, the equip­

ment for collecting solar energy is expensive. -Mother reason

that solar energy has not been used extensively is that it is

variable. On cloudy days not much solar energy gets through to

the earth's surface and at night there is none. This necessi­

tates the storage of the energy for use at a later time.

The basic conversion processes for solar energy can be

divided roughly into three general groups, the thermal process,

the electrical processes, and the chemical processes. The most

pronising of the three is the thermal process, by which solar

energy is converted directly into heat. Thermal energy can be

found as low temperature heat, somewhat below that of boiling

water, obtained with flat plate collectors and useful for space

conditioning and water heating, low temperatures pumps and dis­

tilling devices. Temperatures up to one thousand degrees Centi­

grade (C.) are reached easily with concentrating collectors, and

are often transmitted to such devices as steam generators, cook­

ers, and low temperature furnaces. Ultra-high temperatures,

ranging from 1000*^ C. to the temperature of the sun, are achiev­

ed in specially designed furnaces with parabolic concentrators

and are presently used for industrial and research purposes.

The solar to electrical process deals with the direct conversion

of solar energy to electrical energy using various photovoltaic

materials. These have been very useful in the space program

but arestill very expensive.

196

The solar to chemical processes, includes chemical, bio­

chemical, and biological conversions, and these have produced various

means of using and converting solar energy.

The two possibilities to the United States "energy crisis",

as our impending shortages have been termed, seem to lie in the

future possibilities of nuclear fussion reactors and solar energy

power plants as proposed by the ^einels. Fussion reactors

haven't been developed yet but are to produce one hundred times

the output of present day nuclear fussion reactors that are

drawing so much criticism. (38)

197

AIR CONDITIONING

Since the 1930's the cooling process of "air conditioning"

has been predominantly an electrical one. Electrically powered

refrigerant compressors have been the principal means of

operating the refrigeration cycle. (37)

In areas of abundant sunshine, there is need for refrigera­

tion for air conditioning and food preservation. The use

of solar radiation itself in the absorption refrigerating cycle has

therefore much promise. The refrigerating cycle requires thermal

energy at a high-temperature level and this can be assured through

the utilization of solar concentrators or flat-plate collectors

with two or three glass layers.

Of the different types of absorption refrigerating systems,

the continuous operated unit requires many mechanical components.

On the other hand, the intermittent absorption unit has no mech­

anical parts, is cheap and easy to construct, and is most suit­

able for use in non-industrialized areas.

To accomplish solar refrigeration by one method, a steel

vessel is filled with ammonia and water and heated with focused

sunlight. The ammonia is driven out of the solution and con­

densed in a water-cooled container under pressure. The two

steel containers connected with a pipe to give a closed system

are then taken into the house and a small container of liquid

198

ammonia is placed in a small insulated box. The water solu­

tion cools down and the ammonia is reabsorbed in the water.

The evaporation of the liquid ammonia cools the refrigeration

box. A two-hour exposure to focused sunlight was found suffi­

cient to keep the box cooled to 0° C. for twenty-four hours.

For cooling by solar absorption and desorption, ammonia solu­

tions of non-volatile salts are even better than solutions of

cunmonia and water. (UO)

199

SOLAR SPACE HEATING

Solar space heating systems consist of a heat collector

or absorber, a storage unit, a method of utilizing the heat,

and the controls. The collector is able to absorb a portion

of the incoming direct or diffuse energy and transfer it to the

storage unit or to the place it will be utilized. A solar

heated building might have a collector plate located on the roof,

a storage tank in the basement, and utilize either hot air or

hot water controlled by a thermostat for heating the building in

the winter months. (UO)

200

SOLAR HEAT COLLECTORS

The general principle ot all flat-plate collectors is

essentially the same—a black surface faces the sun and absorbs

its radiant energy. Heat transfer fluid, usually air or water,

flows over the black surface ot through property arranged chan­

nels and transports tne absorbed energy out of the collector.

There is essentially only one layer of absorptive surface facing

the sun and the heat transfer area is therefore rather low.

If the convective heat transfer coefficient between the plate

and the fluid is also low, as is the case with air, a relative­

ly high plate surface temperature vrould be necessitated for a

given heat load per unit area of collector. Under such conditions

the various collector heat losses are high and its overall ef­

ficiency is low. This results in a large surface area for a given

heat output, relatively large friction losses, and an increased

capital and operating cost of the solar heating system. (37)

The collector is the key to any solar appliance as it ab­

sorbs the solar radiation and transfers the accumulated energy

to the transfer medium. The net rate of useful heat collection

is such a system per unit area of collector is the difference

between the amount ot solar energy absorbed inside the collector

and the outward heat loss rate. The absorbed energy depends on (1)

the insolation rate on the collector and the angle or incidence,

(2) the absorptivity of the surface for solar radiation, (3) the

201

transmittance properties of the transparent cover, and (4) losses

due to dust on the cover and shading of the side walls on the ab­

sorbing plate. In actual tests the effect ot dirtiness on col­

lector performance was surprisingly small. The reduction in

transmission was not greater than 3%. The thermal losses from

the collector depend on (1) the temperature of the absorbing

plate, (2) the emissivity of the plate, (3) the number ot trans­

parent covering sheets, (4) the environmental conditions such as

air temperature and wind speed, and (5) the rear and edge insu­

lation. The temperature of the absorbing plate also depends on

(1) the fluid flow rate through the collector, (2) the tempera­

ture at which the heat removal fluid enters the collector, (3)

the heat transfer coefficient between the heat removal fluid and

the flat absorbing plate, (4) tne conductance of the bond between

the tubes carrying the fluid and the absorbing plate, and (5) the

fin efficiency of the flat plate as determined by the plate

material, plate thickness, and distance between the fluid carry­

ing tubes. (38)

A solar heat collector intercepts solar radiation, converting

it to thermal energy, and transfers this heat to a working fluid.

The collector is a collector plus heat exchanger. Flat plate

collectors use diffuse or scattered radiation as well as direct

sunlight and are usually stationary. The flat-plate collector

is one of the simplest means of collecting solar energy for use

202

in systems that require thermal energy at comparatively low tempera­

tures . It usually consists of a flat metallic plate painted black

on the surface facing the sun, insulated on the reverse to reduce

heat loss and in the front with transparent glass sheets. In

the northern hemisphere, the collector is orten set facing

South and tilted toward the equator at an angle depending on

the latitude and the time of the year when maximum effect is

desired. There are many types of flat-plate collectors. One

type uses overlapped glass plates. Another uses copper tubes

soldered to a blackened metallic plate. A third type uses

single sheets of corrugated metal. Others use metallic sheets

with built-in fluid circulating channels. There are numerous

possibilities and many combinations of them. (39)

Formerly metallic collectors were invariably coated with a

flat black paint, but today selective surfaces are being used

wnich have a high absorptance for solar radiation and a low

emittance for long-wave radiation. Processes are now in use in

the United States and in Japan for producing sheets of copper

or aluminum in wnich tubes are formed by inflating narrow open­

ings within two malleable sheets. Discontinuities are created

within two malleable sheets. Discontinuities are created

within the sheets and then after the sheets are rolled, the

tubes are created by applying pressure a

203

Heat transfer is often affected by water flowing through

pipes soldered to the blackened copper absorber plate. The

copper pipes fixed to tne absorber are usually four to six

inches apart and effect on absorber efficiency depends on a

number of factors such as material and thickness of the absorber

plate, the number of glass plates, the distance between pipes,

and the limited contact area between pipes and plate. As the

rate of fl.ow through the collectors varies, so does the temp­

erature and the efficiency. As flow rate increases (generally

from four to twenty-one gallons per hour) temperature change

decreases and efficiency increases. A double exposure flat-

plate collector can be made by replacing the back insulation with

glass panels and utilizing an aluminum reflector to reflect incident

solar energy onto the reverse side of the collector.

Since the transfer of the maximum amount or heat to the

working fluid is desirei^, it is obvious that the heat losses to

the environment must be minimized and the heat transfer co­

efficients of tne heat exchanger process must be maximized.

Flat-plate collectors, unlike concentrating collectors, can take

advantage of the diffuse component of scattered solar radiation

as well as the direct component. The energy absorbed per unit

collector area for either one of these components is simply the

product of the absorptance coefficient for solar radiation, the

effective transmittance of the cover plates, and the solar irra-

20k

diance falling on the collector surface. The heat loss to the

environment is made up from a conduction loss from the back of the

absorber plate through the insulating material and the upward

radiation, conduction, and convection loss through the cover

plates. Since it is easy and economical to provide good insu­

lation of the rear surfaces, this heat loss is usually negli­

gible compared to the upward heat loss. (I4.I)

A conventional blackened absorber has a high emissivity and

easily loses heat by radiation. To reduce these radiation losses,

selective surfaces can be used. A selective surface is one

wnose emissivity is a function of wavelength. If a surface has

a high absorptance for solar radiation and has a low emissivity

at longer wavelengths where reradiation takes place, then it

will operate at higher temperatures than conventional blackened ab­

sorbers.(I4.0)

When solar radiation falls on a sheet of glass, part is re­

flected, part is transmitted, and the rest is absorbed. The

familiar warming of the interior of a greenhouse by the sun has

been the subject of sane disagreement as to its exact nature and

evaluation but it is generally agreed that the glass has the pro­

perty of transmitting light and other short-wave radiations and

that it is opaque to the long-wave radiation of the infra-red

part of the spectrum and of the longer waves of radiation.

205

From this, it follows that the short-wave energy which comprises

the bulk of the solar energy can pass through tne glass cover of

a greenhouse (or collector) and heat up whatever material may be

on the inside and is capable of absorbing the energy. Any long­

wave radiation that is reradiated from the inside will be trapped

by the cover. The collector glass is quite transparent to

the short-wave radiation that ccanes from the sun. When the black

copper sheet absorbs these rays and converts them into heat, it

radiates longer infra-red rays which do not pass easily through

the glass. Thus heat is trapped by the collector. Not all of

tne solar radiation is transmitted through the glass, part is re­

flected and part is absorbed. There is also some heat loss frem

tne collector plate to the outside. In all, the amount of use­

able heat picked up by the blackened copper sheet is usually

about one-third of that striking the outer glass surface. (I4.2)

Two glass sheets over the collector will produce higher

temperatures than a single glass sheet. This is explained by

the fact that upward heat loss from the absorber surface is the

sum of the convective loss and the radiation loss. Addition of

a glass layer reduces the convection loss considerably to offset

tne transmissivity and absorption coefficient of solar radiation

by its interposition.

The best year-round performance is obtained with the absorber

facing due south, when it is inclined with the horizongal approx-

206

imately 10° to 15° more than thellocal geographic latitude.

If the collector is within a 60° angle of incidence solar

radiation, very little effect difference in absorption is found.

The heat transfer in a solar collector takes place by

simultaneous radiation, convection, and conduction. The net

rate of useful heat energy collected per unit area is the

difference between the amount of solar energy absorbed and the

heat loss because of the collector being ho1;ter than the sur­

roundings. The efficiency of a solar absorber depends primar­

ily on the rate of solar radiation entering the exposed cover

and on the rate or heat loss from the same receiver surface.

Basic to the design of any solar energy utilization system

in which flat-plate collectors are used is the long term average

performance of these collectors. The long term average per­

formance, instead of the instantaneous rate ot energy collection,

is needed since the latter is extremely variable due to differ­

ences in cloudiness. As sufficient heat storage is usually

provided, the average energy collection is also the useful ener­

gy collection. The performance of a collector of any angle of

tilt at any locality can be predicted when the following two

parameters are known: the monthly average daily total radiation

on a horizontal surface and the monthly average daytime ambient

temperature. (UO)

207

Flat-plate solar collectors have advantages over concen=

trating types for several reasons: (l) they can be easily

manufactured in large sizes witnout the need of precision

methods, (2) they collect diffuse radiation as well as direct

beam radiation, (3) their orientation is not critical, (4) tne

collector can be used as part ot tne roof as for house heating

and air conditioning applications, and (5) less maintenance is

required.

Focusing or concentrating type collectors use direct sun­

light or a certain area and reflect it to a concentrated spot

to obtain very high temperatures that even approach the tem­

perature of the sun. The focusing of the parabolic or the

parabolic-cyclindrical mirrors type collectors has the advan­

tage of reducing heat losses. However, it is nearly useless

except in direct sunlight while the flat-plate collector will

continue some operation on cloudy days. \k^}

SOLAR ENERGY FOR HEATING i COOLING BUILDINGS

208

P\J,S' : OR GLASS - . r ASSCRB. ' .C S U ^ ' A C : .uVERS \ '

.\ ' / 0 \

COLLECTOR

UNIT

HE-IT STCRACt

"I"~!

HEATING

A L J X I L : A R Y HEADER

\| J COOU\G

I /

NASA -tQ 'P " J -15338 (1) l l - 5 - - ' 3

Fi :5ure 1

BASIC DESIGN CONCEPT ROOF TOP CONCENTRATOR

COLLECTOR

WINTER C O L L E C T O K

209

SUMVE9

F'.^--xe 13 H ji-T'^p Conce . t r . - Baa . ; r^esu-n C r ' - ' e p '

210

STORAGE

The second component in a solar heating system is the stor­

age unit. The intermittent availability of solar radiation

requires storage of the energy for use wnen it is nor available.

As sunlight is available for only part of the day, it is neces­

sary for many purposes to provide storage facilities. The stor­

age of power is more expensive than the storage of heat but it

can be accomplished through the use of storage batteries or by

pumping water to a higher reservoir and allowing it to flow back

later through a water wheel that drives a dynamo. Solar heat

may be stored by raising the temperature of such inert substances

as water or rock or in such reversible chemical reactions as the

dehydration of salt hydrates or the vaporization of water = See

Figure 4. Water has the highest heat capacity of any ordinary

material. Its specific heat of one (l,0) is the basis for com­

paring all other materials. A volume of water raised through

5 C, will return the five kilocalories which it absorbed, when

it is cooled to its original temperature.(l -O)

^ck bins have SOTie advantage for storing heat that is re­

moved from a stream of warm air. The heat capacity of the rocks

is about one-fifth that of water but the density is greater. A

blower is necessary for controlling tne flow of the air. Below

and above their melting points, the chemical compounds are ca­

pable of storing their specific heat, which is very nearly the

21 1

same specific heat of water, when compared on an equal volume

basis. The advantages of heat of fusion type materials is heat

storage within a narrow temperature range, higher collector

efficiency due to low storage tempeiature, and additional heat

as specific heat. It is estimated that five to nine times more

solar heat can be stored as heat of fusion than can be in water

or other specific heat storage material, compared on an equal

voluipe basis. The problems ot heat storage using chemically

inert material include packaging the chemical, tne cost, the

heat transfer temperature, and the thermal insulation required

to contain the heat. Physical changes and chemical reactions

involve much greater heat effects so heat storage vessels for

reacting chemicals can be smaller in size. The salt hydrates

are among the simplest types of chemical used for heat storage.

As the temperature changes sodium sulfate from a liquid to a

solid or jell at 90* F- the heat ot reaction is about fifty

calories per gram.

212

CONTROLS

Several methods of control can be used for the pumps and

fans necessary to circulate the water or air within a particu­

lar system. Here are three of the many possibilities of a

pumped system. The first, known as a differential controller,

monitors the water temperature in the bottom of the storage

tank and in the absorber or collector near the outlet. The

pump is switched on whenever the absorber temperature exceeds

the bottom tank temperature by some fixed amount, and is

switched off whenever the absorber outlet drops below the tem­

perature of the tank bottom. This controller adds energy to the

system wnenever it is available. The second control metnod

utilizes a thermostat near the absorber outlet and switches the

pump on or off as the temperature rises above or falls below

some predetermined level. This is known as a set temperature

controller. The third method uses a radiation sensor. The pump

is switched on or off according to whether incoming radiation is

greater or smaller than some predetermined minimum. Fans used

on air systems may be operated by thermostats, as above, to move

the hot air from collector to storage and storage to utilization

or from collector to utilization. Air systems necessitate the

use of filters to clean the dust from the air and leakproof

ducts to direct it. {kO)

From a tecnnical standpoint, the major cost is in tne heat col-

215

lector and the expense of enough heat storage capacity to get

through a number of cloudy days. Most advocates of solar heat­

ing now accept auxiliary heating by fuel as a necessity where

long successions of cloudy days or extremely cold spells are

likely. The inclusion of auxiliary heat has a definite basis

in a minimum-cost heating system. Provision for auxiliary

heat has a profound influence on the rest of the design as

concern over the difficulty of storing solar heat for a period

of several sunless days disappears. A decision on the type of

fuel to be used in an auxiliary heater might be dictated by

what is available in a particular area. Possibilities include

heat pumps, oil furnaces, gas heaters, electric heaters, and

wood burning stoves. The auxiliary system will probably use

the same ducts or piping as the solar system. The optimum

placement of the auxiliary heater will depend on the particular

system. It might be used on the heat transfer medium in storage

or just before utilization and could be the auxiliary for the

hot water heater too.

&.

r.*v'-

Si

MAJOR EQUIPMENT SCNEDUL

214

If

REFERENCE:

Refer to personal library for equipment schedules.

BIBLIOGRAPHY

1. Bell, George H.,"Hospital and Medical School Design", E. & S. Livingstone and London, July 1961.

2. Butler, Charles, F.A.I.A. and Erdman, Addison, A.I.A., F.W. Dodge Corporation, New York, 1946. "Hn< pii- i Planning"

3. Deasy, C.M.^ "Design for Human Affairs", Halstead Press Division, New York, 1974.

4. Griffith, John R., Weeks, Lewis E. Ph.D., and Sullivan, James H., "The MpPhpr.snn Fxpftrimpnt", The Bureau of Hospital Administration, The University of Michigan, ^ n Arbor, 1967.

5. Harding, le Riche, W. M.D., M.P.H., Balcom Carolee E., R.N., B.S., and Belle, Gerald van, M.A., "The Control of Infections in Hospitals". University of Toronto Press, Toronto, 1967.

6. Hay, Leon E., Ph.D., C.P.A., "Budgeting and Cost Analysis for Hospital Management", University Publications, Bloomington, Indiana, 1958.

7. Hung, William Dudley Jr., A.I.A., "Hospitals, Clinics, and Health Centers^. F.W. Dodge Corporation, 1960.

8. Koren, Herman R.P.S., M.P-H., H.S.D., "Environmental Health and Safetv". Pergamon Press Inc., New York, 1974.

9. Llewelyn, R. Davies, Macaulay, H.M.C., "Hospital Planning and Administration", World Health Organization, Geneva, 1966.

10. Rosenfield, Isadore FAIA, "Hospital Architecture Integrated Components", Van Nostrand Reinhold Company, New York, 1971.

11- Smith, Warwick, "Planning the Surgical Suite". F.W. Dodge Corporation, New York, 1960.

12. Rosenfield, Isadore FAIA, "Hospital Architecture and Beyond" Van Nostrand Reinhold Company, New York, 1969.

13. United States Department of Labor, "Job Descriptions and Organizational Analysis for Hospitals and Related Health Services", United States Government Printing Office, Washington, 1952.

14. Weeks, Lewis E., & Griffith, John R., "Progressive Patient ^^r^". The University of Michigan, Ann Arbor, 1964.

15. Wheeler, E. Todd, F.A.I.A., "Hospital Design and Funntion". McGraw-Hill Book Company", New York, 1964.

16. Wheeler, E, Todd, F.A.I.A.,"Hospital Modernization and Expansion", McGraw Hill Book Ccanpany", New York, 1971.

17. United States Department of Health, Education, and Welfare, "A Study of Hospital Central Medical and Surgical Supply Services". Public Health Service, United States Government Printing Office, 1966.

l^. United States Department of Health, Education, and Welfare, "Hospital Dietary Services", United States Government Printing Office, 1966,

19. Uniued States Department of Health, Education, and Welfare, "Design Features Affecting Asepsis in the Hospital", United States Government Printing Office, 1966.

20. United States Department of Health, Education, and Welfare, "Planning Nurseries for Newborn in the General Hospital", United States Government Printing Office, 1966.

21. United States Department of Health, Education, and Welfare, "Planning the Labor Delivery Unit in the General Hospital", United States Government Printing Office, 1966.

22. United States Department of Health, Education, and Welfare, "Public Health Service Regulations - Part 53", United States Government Printing Office, 1966.

23. United States Department of Health, Education, and Welfare, "The Hospital Electroencephalographic Suite", United States Government Printing Office, 1966.

24. United States Department of Health, Education, and Welfare, "Planning the Physical Therapy Department", United States Government Printing Office, 1966.

2 5. United States Department of Health, Education, and Welfare,

"Elements of Proaressjvfi Patient Care". United States Government

Printing Office, 1966.

26. United States Department of Health, Education, and Welfare, '^ "General standards of Construction and Equipment of ^^^f^^j-Hospitals". United States Government Printing Office, 1966.

27. United States Department of Health, Education, and Welfare, "Radioisotope Facilities in the General Hospital", Unit ed States Government Printing Office, 1966.

28. United States Department of Health, Education, and Welfare, "A Facility Designed for Coronary Care", United States Govern­ment Printing Office, 1966.

29. United States Department of Health, Education, and Welfare, "Design and Construction of General Hospitals", United States Government Printing Office, 1966.

30. United States Departr^ent of Health, Education, and Welfare, "General Standards of Construction for Medical Facilities", United States Government Printing Office, 1966.

31. Abeellah, F- H. "Progressive Patient Care: A Challenge for Nursing", Military Medicine, May, 1960.

32. Haldeman, J.C. El. PPC Public Health Service, Pub. No. 930-C-l, U.S.P.O.H.E. & W., Washington, D.C.

33. Croatman, W., "Progressive Patient Care: What It Means For You", Medical Economics, Inc., March, 3-962 .

34. Texas State Department of Health, Hospital Licensure Division. "Hospital Licensing Standard", Austin, Texas; 1969.

3 5. Southern Building Code; Building Officials Conference of America, Chicago, Illinois, 1972.

36. Orton, Robert, Texas State Climatologist. "Climatic Guide -The Lower Rio Grande v^ll^y of Texas". Texas A & M Univer­sity: College Station, Texas, 1967.

37. Solar Energy Society. ".qmar Energy:' I-XIII. New York: Pergamon

Press, 1957-1972.

38. Hammond, Allen L. "Solar Energy: A Feasible Source of Power?" Science. CVXXII (May 14, 1971), p. 660.

39. Pauly, David. "America's Energy Crisis". Newsweek, LXXXI (January 22, 1973), pp. 52-60.

40. Thorpe, Jack R. "Solar Space and Water Heating for Domestic Use". University of New Mexico, Albequerque, 1973.

41. committee on Science and Technology, U.S. House of Represen^^ tatives. Solar Heating and Cooling Demonstration Act of 1974.

41. (cont'd) May 1975.

42. Committee on Science and Astronautics, U.S. House of Representatives. Solar Heating and Cooling Demonstra­tion Act. November 1973, H.R. 10952 et al.

i

i

APPENDIX A

R U : -.TICrAL BASIS CF TH G:T

Five particular rcb cir.c played a

dec:, . .

\ inent part in r..; hospital

1. FATi::;:: a/.? : - I-Iovr to c.isare that the s:^Sotj and well-

belli, of the patient is not subr.ersed lii the complex

requirements of the medical „p, iT.ti-: al system.

2. nriTIGlITY - ::-A: tc relate closely, the Dia,;iiOSti.; -

Therapeutic Division, both trith the /. rsi:v" units

and the Paramedical Departments.

3. ADAI'T,\ri'ITY "ou to make provisions for meeting future

Jii. -rna! chanf;eG an-:' exter .al growth *n some . ajor depart-

me:its.

-'• CIRa'lATICN AIJ) TVJ'.TyiQ _ '.lev. U provide for movement of

patients, ct--'.'T and suprO'es, and for control of

externa^ a' 'val and departure c.' traffic.

5. SUPriT OP.GANIZATICr Hou to pla.: tAc production departments

for ease of ranai:rer.cnt and hc.f tc simp: ify distributl'u of

cuppl.'es.

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actuates smoke ser;Sl__ devices.

Color is used extensively throughout the hospital to establish

locaticus and for i '.entification on each patient floor. Each

nursir;,: floor is Izeyed ::ith identl-ying clors i:i flc^orlnr,, walls

and fur_.iG:.ings. Textured vinyl wall '~vf::livrs arc used in pul] ic

halls and in patient rooms.

Nursing flcis are des'.'?" to hold J2 beds each with each

f .oor divided into 2 l6 bed sections. A nursinr team of one R.l.

and one or two nursin;; assistants staff each sectic. . Instead cf a

nurses' station, each floor is equi ped irith an ad-Inistrative control

center where a nonprofessional staff ner-ler operates v.n e^abcrate

comi^unlcacion system and also serves as a rece "tli/i st.

Witacut a nurses* staticri as a focal "ci;.t, /iurses circulate

through patient roo"s during their entire shifts.

Call lie;hts in the corridors alert nurses tc patient needs,

but even when they are in patient rooms, nurses can be reached

by pocket pagers which they carry at all tir.cs.

This systei-. allows nurses to spend far more tine ,:ita patients

that in c: .\M:li mal arrajTcments and reduces the number of nurses

needed to rrovide con" arallo care.

2. CCI.TIGl'lTY

The architectural problems arise - rinarily in the relationship

of the clinical departments to the rrrc'ni-: .'.its. "'he main

-r'l. i'c] is that the needs of pat*o..i care should be the primary

•"a-l r in deteri^'n: n* hoi: t],e nursing in.its are grouped.

(!) raterj.lty an- per"': rtri cs department must relote to the

delivery s,7:ts an.' nursery department,

(2} Sur, ira"' patients must relate to the s..r,,ioo"i suite,

intensive care unit, radiology and reccvt r;,- departments.

(3) Lon, :-term patlc./L-s must relate to the , eneral services

offered by the I Istgnostic-Therapeut:'- Livision.

(A) For ease of i.cjlzontal i,;oveiiei.t for both patient and

professir :;al s c ' f, each departr.ent vri__.:- the Dia,uost:c-

Therapeutin Divlsi::j is on the same leve^ as its receptive

nursing uiIt war.

(B) Because of the high laboratory mec ' cal services, all

sub-laboratory spaces have been rt. uped.

(c) Outpatient Department, Doctors* arivate offices, and the

adml-.o'ons department are located on the first level to

provi>. c convenience to the v;alk-lii patient, and to y

eli. inate excessive vertical circulation. pf

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r a j o r grLU^; a reas of the hospi ta l i a^Llod in order of be'

i nc rease .

(A) r u r s l n g Uni ts bed : icrements

(h) Eiagnost lc-Therapeut ic Divis i - ; ,

1. T abora to r l e s

2. Kcu-'ology Department

3 . Sur.' i ca l Department

k. Tlaternlty Departneiit

(c) Anci l la ry l i v i s i o n

1. Food Prepara t ion

2. General s torage f a c i ^ ' t i e s

Adap tab i l i ty should be in ter ; ^ of the a l . ' l i t y tc make ? 1:1 ted

in t e rna l adjustmenlc to chan^^lu'; needs and to provide for some f'uture

growth ex t e rna ] ly .

Cuch adap ta l ' V ty "s achelved by the ,:TOUT : ng of ">'1^ f i j c l i o n s

and aVouin for changes re"'a'--'ve to the t^:eneral cata^^ory of ;ror^' for

which the un i t -.ras designed. No r e. cvacic p a r t i t i o n s were taken into

cons idera t ion for a p a r t i a l sr iuL'oa of a d a p t a l i l i t y ber-n-. -o of the

h"ph sound proofing requirements c h a r a c t e r i s t i c of these departments.

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5 . SUPPLY CRlA!a[ZATION

The i n t e r n a l d i s t r i b u t i o n system vi i ' l be by e l e c t r o n i c a l l y

con t ro l l ed c a r t s , Ih.ls system i s based on the close "rojpinr of

the supply •OT-ara ./ " located a t the center of the ccnple::. These

departr.ients include Central S t e r i l e S a r ^ l i e s , Pharmacy, li: tchen svrT^ly,

and Centr-^i! S t o r e s . This system has i t s g rea t e s t poten.tia] when ir . ter :atcc

:nt^ the future expansion of the ledi-^a"' Center.

e t h e r bene f i t s of the automated supply system include; ( l )

corc-lcte control of a^ l p a / o n t suppl ies and - ^-'^- -nt u n t i l they are

i:sGd. (2) Daily iaventory of a l l suppVcs used in pa t ien t care , inc""-d-. ._

ing constant cont ro l to prevent the use of outdated s t e r i l e c ^ i e s ,

and (3) reduct ion in the nuir.ber of s taff members required to move the

suppl ies and equipment.

11. J rr/IROPHJITTAl CONTROL

dnvironmental control is needed in three distinct '.rcyc;

(A) For psycholo,pical and physical comfort of patients, staff

and visitors.

(B) For safety of patients and staff in relation to cross

infection and other hazards.

(c) For scientific worl preformed in the lal oratory under

carefully controlled environmental '•'-ndltions.

A portion of tlils h-soital'?^ desire, is achej.ved ly prove i.

a sense of openess with a variety of external veers alonr: all major

circulatirn nodes. The total effect is an atmosphere designed to

the patient as well as the professional staff member.

MlCIIAelCAT SYST'ilMS

Total heat Recovery System

The central feature of the heat recovery system is elece^" ally

driven rec?procatinr "C;.e-r"03sion water chilling eqeei pne .it. When

cliilled water is bei le used for air cooling, the heat removed f-om

the liilding plus the heat generated by the compressor is transferred

to a second water sysbor. which vrarms those se-T'ti is of tijc hospital

requiring additional heat and also raises the temperature of vjater

intended for ^ne - hot water usage. When air cooling is not req\ .i-cd,

the chillers are operated with a e alse cooliiv; load and the compressor

heat Is channeled as "n warmer weather. Av;xilia?:y heaters are located

in hot water storage tank tc bring temperatures up to desired levels

before vrater is piped, i.ito the hospital.

The major advantages of eliminating combustion heat sources

(1) removal of the ooilor room and its iniierent problems, and (2)

the ability to design spaces rithout mailing accomodations for ducts,

vents and flues.

Since a hospital is on of the most comrlicated architectural

instit-ti'i.s to desi .., one of my earliest decisions was to elirlnate

the incorporaticn of a solar -energy systei,: into the desi, n.

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III. STRUCTURAL TEC}n:iQuns

Precast concrete construction techniques were used through­

out the hos ital base and nursing tower.

UCSPITAl B/\G_

The main emphasis for the structural system was the use of

repetitive bays irith modular ccnstnaction since repellLive bays are

more econrmical than esln. a variety cf structural systems. Combined

modular construction with open-ended planning also provided a vrorkable

solution for nondisruptive future expansion.

IX'RSIhG TOILER

A precast concrete module system was used for the nvrsin,-: tower.

This system allows for the mass production of each tvro bed room.

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