Chapter 1: Modern Hospital Architecture
Learning Outcome
The main objective of this chapter is to:
Define engineering and treatment in hospital
Classify hospitals based on different criteria
List and explain main services in hospitals
Briefly explain Hospital Engineering Services
list and define Building Attributes
Introduction
Hospital
It is a health care institution providing patient diagnosis,
advice and treatment with specialized staff and equipment.
The treatment can be through chemicals, radiation,
physiotherapy, psychiatry, surgery etc.
It contains the more expensive and high-tech equipment.
What is Hospital engineering?
It is both an art and a science of efficiency planning,
managing, and maintaining the physical environment and
equipment for health care.
Treatment In Hospital
1.Outpatients: patients go to a hospital just for diagnosis,
treatment, or therapy and then leave without staying overnight.
2.Inpatients: patients are admitted and stay overnight or for
several days or weeks or months.
Hospitals usually are distinguished from other types of medical
facilities by their ability to admit and care for inpatients.
Hospital Classification
I. Based on financial status and ownership
1.Voluntary (not-for- profit).
2.Corporate (profit- making).
3.Government(Public).
Hospital Classification
II. Based on objective
1. General Hospitals
The best-known type of hospital.
Set up to deal with many kinds of disease and injury.
Has emergency department to deal with immediate and urgent
threats to health.
Have large numbers of beds for intensive.
Has specialized facilities for surgery, plastic surgery, childbirth,
etc.
Hospital Classification
2.Specialized
Types of specialized hospitals include: trauma centers,
rehabilitation hospitals, children's hospitals, seniors' (geriatric)
hospitals, and hospitals for dealing with specific medical needs
such as psychiatric problems.
3.Teaching
It combines assistance to patients with teaching to medical
students and nurses and often is linked to a medical school,
nursing school or university.
Hospital Classification
4.Clinics
The medical facility smaller than a hospital is
generally called a clinic.
Often it is run by a government agency for health
services or a private partnership of physicians (in
nations where private practice is allowed).
Clinics generally provide only outpatient
services.
Hospital Classification
III. According to level of care:
1. Secondary Hospitals: district and some specific hospitals
2. Tertiary Hospitals: central high specialized and
educational hospitals
IV. According to the size of hospital
1.Mini size hospitals <50 bed
2.Mid hospitals <50-250 bed
3.Big hospitals <250-500bed
4.Huge hospitals >500 bed
Elements and Division of Hospital
The main division of hospitals are:
1.Adminstration division
2.Outpatient division ,Includes:
a) Outpatient clinics
b) Pharmacy
c) Emergency receptions
3.Diagonostic Service division ,includes:
a) Laboratories
b) Radiology (diagnostic )
5.Therapuetic service divisions ,includes:
a) Physical therapy
b) Radiology (therapeutic)
Elements and Division of hospital
6.Internal medical treatment division, includes
a) Operation theaters
b) Intensive care unit
c) Maternity section
d) Central sterilization department
7.Inpatient division ,includes:
a) Patient ward
b) Nurses ward
c) Inpatient service
Cont’d
8.General service division
a) Kitchen
b) Laundry
c) Storages
d) Workshops
e) Mechanical services
f) Mortuary
g) Parking
Morphology and Design of Modern Hospitals
A functional design can promote skill, economy, conveniences,
and comforts.
A non-functional design can impede activities of all types, detract
from quality of care, and raise costs to intolerable levels.
Good hospital design integrates functional requirements with the
human needs of its varied users.
Hospitals are the most complex building types.
Cont.
Each hospital is comprised of a wide range of services and
functional units.
These include: Diagnostic, treatment and hospitality function
such as:
1. Clinical Laboratories, Imaging
2. Emergency rooms, Surgery
3. Food service
4. House keeping
5. Fundamental impatient care (bed related) function.
Cont.
Ideally, hospital design process incorporates direct
input from the owner and from key hospital staff
early in the process.
The designer also has to be an advocate for the
patients, visitors, support staff, volunteers, and
suppliers who do not generally have direct input into
the design.
Cont.
The basic form of a hospital is, ideally, based on its
functions:
a. Outpatient and inpatient related functions
b. Diagnostic and treatment functions
c. Administrative functions
d. Service functions (food, supply)
e. Research and teaching functions
Cont.
Physical relationships between these functions
determine the configuration of the hospital.
Relationships between the various required
functions described in the flow diagrams.
General Hospital Relationship
Administration
Inpatient
Diagnostic
& Outpatient
Treatment
Service
Research
&
Teaching
Major Clinical Relationships
Reception &
registration
Admit
Records
Inpatient Diagnostic
Wards &treatment Outpatient
•Medical •Laboratories Outpatient
•Surgical •Morgue
clinics
•Psychiatric •Surgery
•X-ray dpt
•P.M.S Emergency
Pharmacy
Discharge Post hospital Discharge
care
Hospital Engineering Services
The engineering service broadly categorized under:
Electrical
Civil Engineering Services
Services Services
Biomedical
Others Services Services
Hospital Engineering Services
1. Civil Services 2. Electrical Services
Buildings and Electric Supply
Infrastructures Load assessment and
Water Supply distributions
Hospital roads, Garden Alternative Energy
and parks generations
Drainage System Short circuit protection and
Natural Light fire protections
Land procurement and Air conditioning and
development Refrigeration
Ventilations and Electric filling and
Horticulture installations
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Hospital Engineering Services
3. Biomedical Services 4. Others Services
Includes all Equipment Laundry, Kitchen
used in hospital Communications System
Radiology ,X-ray, MRI, Workshop
CT-scan, Ultrasound Sanitary Services
Operation theaters, Hospital Security
ICU,NNU
Transportations
Central Gas pipeline
Pathology ,
microbiology, Blood
bank and related
laboratory Services
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Building Attributes
1.Efficiency and Cost- 7.Aesthetics
Effectiveness 8.Security and Safety
2.Flexibility and Expandability 9.Green Architecture
3.Therapeutic Environment 10.Energy Savings
4.Cleanliness and Sanitation 11.Water and Waste
5.Accessibility Management
6.Controlled Circulation 12.Materials
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1.Efficiency and Cost-Effectiveness
Promote staff movement efficiency .
Allow easy visual supervision of patients by limited
staff
Include all needed spaces without redundancy.
Provide an efficient logistics system.
Group or combine functional areas with similar
system requirements
Provide optimal functional adjacencies., such as
locating the surgical intensive care unit adjacent to
the operating theatre
2.Flexibility and Expandability
Follow modular concepts of space planning and
layout
Use standard room sizes and plans as much as
possible.
Be served by modular, easily accessed, and easily
modified mechanical and electrical systems
Be open-ended, with well planned directions for
future expansion.
3.Therapeutic Environment
Using familiar and culturally relevant materials consistent with
sanitation and other functional needs.
Using cheerful and varied colors and textures,
Designing a "way-finding" process into every project. Patients,
visitors, and staff all need to know where they are, what their
destination is, and how to get there and return.
Admitting sufficient natural light.
Providing views of the outdoors from every patient bed, and
elsewhere.
4. Cleanliness and Sanitation
Hospitals must be easy to clean and maintain. This is facilitated by:
Appropriate, durable finishes for each functional space.
Careful detailing of such features as doorframes and finish
transitions to avoid dirt-catching and hard-to-clean cracks and
joints.
Adequate and appropriately located housekeeping spaces.
Special materials, finishes, and details for spaces which are to be
kept sterile.
5.Accessibility
All areas, both inside and out, should:
Be easy to use by patients with handicaps.
Ensuring grades are flat enough to allow easy
movement.
Sidewalks and corridors are wide enough for two
wheelchairs to pass easily.
Marking glass walls and doors to make their presence
obvious.
6. Controlled Circulation
Outpatients visiting, diagnostic and treatment areas should not travel
through inpatient functional areas nor encounter severely ill inpatients.
Typical outpatient routes should be simple and clearly defined.
Visitors should have a simple and direct route to each patient nursing
unit without penetrating other functional areas.
Separate patients and visitors from industrial/logistical areas or floors.
Dedicated service elevators for deliveries, food and building
maintenance services
7. Aesthetics
Increased use of natural light, natural materials, and
textures.
Use of artwork.
Attention to proportions, color, scale, and detail.
Bright, open, generously-scaled public spaces.
Homelike and intimate scale in patient rooms, day
rooms, consultation rooms, and offices.
Compatibility of exterior design with its physical
surroundings.
8.Security and Safety
Protection of hospital property and assets, including
drugs.
Protection of patients and staff.
Safe control of violent or unstable patients.
Vulnerability to damage from terrorism
9. Green Architecture
Green architecture promotes good environment and health. It has
also been found to aid in early recovery and shorter hospital stays.
Minimize the use of carpets and other such materials that have the
potential to absorb and release indoor pollutants.
Use high reflecting roofing
Evaluate safe strategies to recycle waste water for other purposes on
the site..
Avoid ozone-depleting chemicals in mechanical equipment and
insulation.(read about Montreal Protocol)
Preventing the Entry of Pollutants from Outside the Building
10.Energy Savings
Maximum use of natural light, solar energy and green
power can lead to plenty of energy being saved.
Solar energy can also be used to produce thermal energy
which can further be used to produce electrical energy.
Construction of the building aligned at an angle to the sun.
The major orientation of the building to face north and south
maximizes use of natural light.
Note: solar north-south is different from magnetic north-
south. The short axis of your home should orient toward solar
north-south.
11. Water and Waste Management
Rainwater harvesting and storm-water management, to
conserve water efficiently.
This method requires rain water to run across terraces
through clean pipes to storage tanks where they are purified
and then used.
Sewage water is recycled for further use.
Minimize wastewater by using ultra-low flush toilets,
low-flow showerheads, and other water conserving
fixtures
Waste can be effectively disposed through
vermicomposting or simple composting
Compost and vermicompost
12.Materials
PVC, and arsenic-free material.
Digitalized devices, instead of mercury counterparts.
When disposing acids they should be diluted in alkaline.
High Density Poly Ethylene (HDPE) products, for plumbing
and roofing purposes.
Concrete, the waste building material be mixed with industrial
by-products like Fly ash, cinder, stone dust, is an acceptable
substitute
Biodegradable materials as they are cheap and can be easily
disposed
Examples
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