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T.C.

ZİRVE UNIVERSITY FACULTY OF ENGINEERING

FACILITY PLANNING REPORT

HOSPITAL DESIGN AND PLANNING

by

Bahadir Ezici & Büşra Özoğlu

Industrial Engineering Department

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TABLE OF CONTENT 1.INTRODUCTION...........................................................................................................32.FORECASTINGBEFOREIMPLEMENTATIONofHOSPITALCONSTRUCTION..............................................................................................................43.FACILITYPLANNIGTOHOSPITAL.........................................................................5

4.ELEMENTSANDDIVISIONSOFTHEHOSPITAL.................................................64.1.Themaindivisionofthehospitalsare:....................................................................64.1.1.Administrationdivision.............................................................................................74.1.2.Outpatients’division...................................................................................................94.1.2.1.ExternalOutpatientClinics...................................................................................94.1.2.2.Emergencyreception:..........................................................................................114.1.3.Diagnosticservicesdivision..................................................................................124.1.3.1.Laboratories:...........................................................................................................124.1.3.2.Radiologydivision:................................................................................................144.1.4.Therapeuticservicesdivision...............................................................................154.1.4.1.Physicaltherapydivision:...................................................................................154.1.5.Internalmedicaltreatmentdivision..................................................................164.1.5.1.Operationtheatre:.................................................................................................164.1.5.2.Intensivecareunit:...............................................................................................184.1.6.Inpatientdivision......................................................................................................194.1.7.Generalservicedivision.........................................................................................204.1.7.1.Dietarydivision:.....................................................................................................204.1.7.2.Housekeepingdivision:.......................................................................................214.1.7.3.GeneralStorages:...................................................................................................214.1.7.4.Mortuarydivision:.................................................................................................22

5.DETERMININGPARKINGLOTS............................................................................236.CONCLUSION..............................................................................................................24

7.REFERENCES..............................................................................................................25

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1.INTRODUCTION Designing a hospital is no easy feat. In a perfect world, there might be a simple, one-size-fits-all solution. However, there is no such thing, especially when it comes to hospitals. While the goal of any building is to meet the maximum number of goals while staying within a strict budget, hospitals seem to require a more strategic approach. This is primarily because the facility will be required to provide a wide range of services and functions. This list includes, but isn’t limited to:

• Inpatient services (medical, surgical, psychiatric, surgery, pharmacy)

• Outpatient services (emergency, clinics) • Diagnostic and treatment services (labs, surgery, imaging,

morgue) • Administrative services (reception, registration, record

keeping, HR, marketing, accounting) • Service functions (cafeteria, housekeeping, supplies) • Research and teaching services (pharmacy)

As you can tell, the vast complexity of hospital services is what makes the design process quite complicated. Many different needs must be met, while simultaneously maintaining daily efficiency. It is certainly a great deal to take on, but with the proper preparation and guidance, this daunting task can be simplified as much as possible.

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2.FORECASTINGBEFOREIMPLEMENTATIONofHOSPITALCONSTRUCTION

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3.FACILITYPLANNIGTOHOSPITALPlanning is the forecasting and organizing the activities required to achieve the desired goals.All successful hospitals,without exception,are built on a triad of good planning,good design & construction & good administration.To be successful,a hospital requires a great deal of preliminary study and planning .It must be designed to serve people and for promoters to build in the first place & sustain later. It must be staffed with competent and adequate number of efficient doctors,nurses & other professionals.A strong management is essential for the daily functioning of a facility & this must be included in the plans of a new hospitals

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4.ELEMENTSANDDIVISIONSOFTHEHOSPITAL

4.1.Themaindivisionofthehospitalsare: 1.Administration division. 2.Outpatients’ division, includes;

• Outpatient clinics. • Pharmacy. • Emergency reception.

3.Diagnostic services division, includes; • Laboratories. • Radiology (diagnostic).

4.Therapeutic services division, includes; • Physical Therapy. • Radiology (therapeutic).

5.Internal medical treatment division, includes; • Operation Theatres. • Intensive Care unit.

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• Maternity section. • Central Sterilization Department.

6.Inpatient division, includes; • Patient wards. • Nurses wards. • Inpatient services.

7.General service division, includes; • Kitchen. • Laundry. • Storages. • Workshops. • Mechanical services. • Mortuary. • Security. • Parking. • Landscaping.

4.1.1.AdministrationdivisionParts and components of the division:

• Reception hall. • Waiting area. • Registration. • Treasury and Accounts. • Staff offices. • General manager office. • Staff lounge. • Nursing head office. • WCs.

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Location:

• Very close to main entrance of the hospital. • Entrance area, registration, accounts should face the

entrance, while the manager office should be back for privacy.

50 bed hospital , total area = 214 m2

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4.1.2.Outpatients’division

4.1.2.1.ExternalOutpatientClinics

v Parts and components of the division: • Consultation room. • Examination room. • Treatment room. • Waiting area. • Staff room. • WCs.

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Location:

• Very close to the main entrance of the hospital. • Close to the diagnostic services (labs and x-ray). • Close the pharmacy.

50 bed hospital , total area = 215 m2

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4.1.2.2.Emergencyreception:

v Parts and components of the division: • Entrance + waiting area. • Registration. • Staff room. • Mini-surgery. • Test room. • Medical utilities. • Mini sterilization room.

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Location:

• Very close to the exit door of the emergency. • Very close to the radiology. • Close to the pharmacy, laboratories, and central sterilization. • Direct access to the stairs and elevators

4.1.3.Diagnosticservicesdivision

4.1.3.1.Laboratories:

v Parts and components of the division: • Work area. • Waiting area. • Sample room.

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• Cleaning room. • Staff offices.

The most important labs in the hospital are:

• Chemical lab. • Bacteriology lab. • Histology lab. • Pathology lab. • Serology lab. • Hematology lab. • Microbiology lab.

Location:

• Very close to the emergency department and external clinics.

• Easily accessible from internal division. • Easily accessible from maternity and surgery

departments. • Accessibility from central storages.

• 50 bed hospital area = 25 m2

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4.1.3.2.Radiologydivision:

v Parts and components of the division: • X-ray rooms. • Control room. • Waiting area. • Staff office. • Utility room. • Dark room. • Film view. • Store. v Location: • Very close to the emergency department and external

clinics. • Easily accessible from internal division. • Ground floor is preferred.

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Location:

• Very close to the emergency department and external clinics.

• Easily accessible from internal division. • Ground floor is preferred. • 50-100 bed hospital area = 65-104 m2

4.1.4.Therapeuticservicesdivision

4.1.4.1.Physicaltherapydivision:v Parts and components of the division: • Waiting area. • Office. • Hydrotherapy. • Exercise room. • WCs.

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v Location: • Close to the main entrance of the hospital. • Easy accessible from external clinics. • Easy accessible from internal division. • Must be in the ground floor.

4.1.5.Internalmedicaltreatmentdivision

4.1.5.1.Operationtheatre:

v Parts and components of the division: • Entrance. • Storage. • Preparation room. • Access area. • Staff clothes room + WCs. • Operation theatre. • Cleanup room. • Sub sterilizing room. • Supervision room. • Staff lockers.

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v Location: • Very close to the intensive care division and should

be touchable both of them. • Very close to the central sterilization division of the

hospital. • Close to the inpatient wards. • Can be easily accessible from the emergency division. • 50 bed hospital area = 185 m2 • Examples for operation department

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4.1.5.2.Intensivecareunit:

v Parts and components of the division: v I.C.U space

Location:

• Very close to the recovery room in the operation theatre.

• Can be easily accessible from the emergency division by elevator.

• Must be designed 1-2 % of • hospital beds.

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4.1.6.InpatientdivisionParts and components of the division:

• Inpatient wards. 11.5m2/bed – 8m2/bed. • WCs. • Nursing station. Not less than 12m2 for 30 patients. • Treatment rooms. 10-15m2 for 60 patients. • Day rooms. 0.7m2/bed and not less than 15m2 • Nurses’ lounge. Not less than 12m2 • Storage. 8-12m2 • Kitchen. 12m2 • Doctor room. 15m2

The most suitable beds in the hospital is 20-40 patient / unit.

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DETERMINING THE NUMBER OF BED

• Bed planning: Population = A x S x 100 365 x PO

• A = number of patients admissions/1000 populations/year

• S = average length of stay • PO = percentage occupancy

4.1.7.Generalservicedivision

4.1.7.1.Dietarydivision:v Spaces of the division:

• Storage room. • Kitchen. • Preparing and supply area. • Cleaning.

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4.1.7.2.Housekeepingdivision:v Spaces of the division: • Office. • Dirty linen. • Clean linen. • Storage. • Laundry. • Mechanical room. v Location: • In the ground floor. • Close to central storages. • 50 bed hospital area = 150 m2

4.1.7.3.GeneralStorages:v Spaces of the division: • Medicine storage. • Furniture storage. • Food storage. • Utilities storage. • Achieve.

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• General storage

v Location: • In the ground floor. • Close to housekeeping and dietary division. • Direct access to the service entrance.

4.1.7.4.Mortuarydivision:v Location: • In the ground floor or basement floor. • Exit from emergency entrance or service entrance. • 50 bed hospital area 25 m2

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5.DETERMININGPARKINGLOTS - 1 car parking

space per 3 to 12 beds.

- In addition, 2 to 5 spaces should be allocated for disabled visitor parking.

- Additionally for hospitals with Accident and Emergency (A+E) departments, 8 parking spaces (9m x 3m) for ambulances and for hospitals without A+E departments, 3 parking spaces (9m x 3m) for ambulances.

- In determining the number of car parking spaces to be provided within the range permitted, it should be noted that hospitals with A+E departments require more parking spaces than other hospitals. Spaces are normally intended for operational needs, but some spaces are recommended for visitors especially at hospitals which provide emergency services. Adequacy of public transport facilities, the availability of public parking in the vicinity, and the location of the hospitals should be taken into account in assessing the overall parking requirement and the need for visitor parking.

- If visitor parking is provided, a number of the most conveniently located spaces should be reserved for emergency cases.

- Disabled visitor parking spaces should be located at the most convenient places for disabled drivers visiting the out-patients departments and A+E departments.

- 1 lay-by for taxis and private cars to be provided under cover for every:

(i) 80 beds, or part thereof, in hospitals with A+E departments.

(ii) 160 beds, or part thereof, in hospitals without A+E departments.

- 1 lay-by (8m x 3m) for PLBs or maxicabs for every:

(i) 200 beds, or part thereof, in hospitals with A+E departments.

(ii) 400 beds, or part thereof, in hospitals without A+E departments.

- Provision should be adequate to serve the special requirements of handicapped persons.

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6.CONCLUSION In hospitals that embrace the concepts of patientcentered care and support the development of their workforce, no one should be neglected. The application of digital technologies is already extending the reach of hospital care into the community and into the home. The hospital of the future may one day be defined by its intellectual property, rather than its physical facility. That said, the physical design of the hospital has significant implications for the ability of the hospital to meet its goals for care that is safe, patient-centered, clinically effective and collaboratively delivered. It also represents the physical manifestation of the hospital’s commitment to environmental health and sustainability. A hospital is a living organism, made up of many different parts , having different functions, but all theses must be in due proportion and relation to each other and to the environment to produce the desired result

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7.REFERENCES1.http://psqh.com/sepoct06/mrisuites.html 2.http://www.academia.edu/1199803/Final_Design_Project_Report 3.http://library.nhsggc.org.uk/mediaAssets/Community%20Engagment/Design%20Report%20Final.pdf 4.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464867/