PUNJAB INSTITUTE OF MEDICAL SCIENCE

IMPORTANT POINTS

MAIN DESIGN OF HOSPITAL SHOULD POSSES WITH FLEXIBILTY DESIGN, BUILDING STRUCTURE SHOULD BE SIMPLE TO EXTEND AT DIFFERENT POINTS & SHOULD BE ABLE TO COPE WITH INTERNAL DISPLACEMENT.

FLEXIBILTY- USAGE – CHANGING THE USE WITHOUT INNOVATION. DISPOSAL POSSIBILTY –waste treatment. INTERNAL FLEXIBILTY-POSSIBILITY OF

INTERCHANGING HOSPITAL FUNCTIONS INDEPENDENT OF SUPPORTING STRUCTURE.

EXTERNAL FLEXIBILTY- NURSING, DIAGNOSTIC& TREATMENT DEPARTMENTS CONCENTRATED IN ONE MAIN CORE.

PHARMACY ,LABS ,STOREROOMS& KITCHEN LOCATED IN SERVICE BUILDING AT A DISTANCE FROM MAIN CORE.

PLANNING ON BASIS OF PATIENT FLOWS:-

EACH PATIENT FLOW DIFFERS FROM OTHERS IN TERMS OF ATMOSPHERE ,ORGANIZATION ,PLANABILITY, POSITION OF PROFESSIONALS, RELATIONSHIP WITH REFERRERS & FOLLOW UP CARE & BUILDING ASPECT LIKE- ACUTE CARE , ELECTIVE CARE , URGENT CARE, CHRONIC CARE.

ACTIVITES RELATED TO PATIENTS CAN BE TRANSLATED INTO SPATIAL FACILITIES – THAT CAN BE DIVIDED INTO ‘ BLOCKS’.

(a) PATIENT RELATED FACILITIES ( PATIENTS PRESENT THEMSELVES)

Nursing- special care , general nursing, pediatric, nursing, maternity( delivery rooms), geriatrics & day nursing.

Diagnostics- outpatient appointment department , investigating, imaging , diagnostics, nuclear medicine, outpatient treatment , operative unit, emergency unit & physiotherapy.

Special- dialysis, rehabilitation, day treatment unit or radiology unit.

(b) PATIENTS RELATED FACILITIES( PATIENTS NOT PRESENT)- PHARMACY & LABS CENTRAL STERILISING SERVICES , CLINICAL CHEMISTRY, MICROBIOLOGY, PATHOLOGY ETC.

(c) GENERAL & TECHNICAL SUPPORT SERVICES – STAFF FACILTY ( KITCHEN , LINEN SERVICE, RESTAURANT & TECHNICAL SERVICES , FACILTY FOR MANAGEMENT & TRAINING.

THERE SHOULD BE 3 MAIN TYPES OF ENTRANCES MAIN ENTRY AND EXIT EMERGENCY ENTRY( PARKING BESIDE IT) OUTPATIENT ENTRANCE. THERE SHOULD BE BEDS IN LABOUR AREAS , OUTPATIENT

AREA( SHORT EXAMINATION & EMERGENCY AREAS, BEDS IN DIAGNOSTIC & THERAPEUTIC DEPARTMENTS & ANAESTHESIA RECOVERY BEDS & BEDS IN INFIRMARY.

PRIVATE- 1/ ROOM SEMIPRIVATE- 2-3/ ROOM GENERAL WARDS- ~20/ROOM

AVOID USING FATIGUING STEPS & ROUTES, SIMPLE DESIGN , KEEP TRAFFIC AWAY FROM PATIENTS.

SPACE REQUIREMENTS AREA GROSS SQ-

FT/BED ADMINISTRATION 30-35 EMERGENCY 10-15 OUTPATIENT 10-15 SOCIAL SERVICE 1 ADMITTING & DISCHARGE 2 CLINICAL LAB/ PATHOLOGY 25-30 DELIVERY SUITE 12-15 DIAGNOSTIC/ RADIOLOGY 30-40 DIETARY & FOOD SERVICES 25-30 EMPLOYEE FACILITY 5-8

AREA GROSS SQ-FT/BED

EDUCATION / AUDITORIUM 5-10 SPEECH & LEARNING THERAPY 1 HOUSE KEEPING 4-5 MATERIALS MANAGEMENT 4-5 CENTRAL STORE 25-35 PURCHASING 2 LAUNDRY 10-

15 MEDICAL RESEARCH 5-8 MEDICAL STAFF FACILITY 2-3 MAINTENANCE 50-

60 NUCLEAR MEDICINE

4-5

NURSERY 4-5 PERSONNEL 3-4 PHARMACY 4-6 PUBLIC SPACE 10-15 PULMONARY FUEL 1-2 RADIATION THERAPY 8-10 PHYSICAL THERAPY 10-12 OCCUPATIONAL THERAPY 3-5 SURGERY 35-50 CIRCULATION 100-150 NURSING UNITS 250-300

GUIDING PRINCIPLES IN PLANNINGHOSPITAL FACILITY & SERVICES

HIGH QUALITY PATIENT CARE. EFFECTIVE COMMUNICATION ORIENTATION ECONOMIC VIABILITY SOUND ARCHITECTURAL PLANS. FACTORS AFFECTING BED DISTRIBUTION EXISTENCE OF SPECIALITY HOSPITALS IN NEIGHBOURHOOD

OR SPECIALIST DOCTORS ON STAFF OF HOSPITAL. HOSPITAL GIVING ½ SERVICES ( CARDIOVASCULAR

SURGERY ) ETC AS SPECIALLY CENTERPIECES. OLD THUMB RULE 30-40% BEDS FOR SURGICAL & MEDICAL PATIENT. 10-15% BEDS FOR OBSTETRICS 7-10% BEDS FOR PAEDIATRICS 9-15% FOR EYES, EAR , NOSE & THROAT.

HOSPITAL DESIGN MUST PROVIDE INTERCHANGEABILITY OF PATIENTS ROOM & AREA FOR CLINICAL DEPARTMENTS WITH FLUCTUATING CENSUS.

HOSPITAL SITE ACCESSIBILITY TO TRANSPORTATION & COMMUNICATION LINES. PARKING FACILITIES. AVAILABILITY OF PUBLIC UTILITIES. PROPER ELEVATION FOR GOOD DRAINAGE & GENERAL SANITARY

MEASURES. FREEDOM FROM NOISE, SMOKE, VAPOURS & OTHER ANNOYANCES. FUTURE EXPANSION. DRAINAGE AND SEWERAGE FACILITY, POTABLE WATER AVAILABILITY. POPULATION CONCENTRATION.

DETERMINING SIZE OF HOSPITAL ADEQUATE FOR VARIOUS SERVICES , ADMINISTRATIVE & FUNCTIONAL NEEDS OF DEPARTMENTS & PATIENT CARE & TREATMENT.

RECOGNISING THE IMPORTANCE OF ESTABLISHING TRAFFIC PATTERNS FOR MOVEMENT OF PHYSICIANS , HOSPITAL PERSONNEL , PATIENT VISITORS & EFFICIENT TRANSPORTATION OF FOOD ,LINEN , DRUGS& OTHER SUPPLIES.

DESIGN THAT AVOID DUPLICATION OF SERVICES BUT AT THE SAME TIME PROVIDE FLEXIBILTY & INTERCHANGEABLE OF PATIENT ROOMS FOR CLINICAL DEPARTMENTS WITH FLUCTUATING CENSUS.

PAYING ATTENTION TO SPECIAL SERVICES LIKE OUTPATIENT INTENSIVE CARE , OBSTETRICS, OPERATING ROOMS, MEDICAL & SURGICAL , SPECIALITIES & TO SUCH CONCEPTS AS INFECTION CONTROL , DISASTER PLANNING.