LIBRARY STUDY HOSPITAL

SUBMITTED TO: SUBMITTED BY:

Ar. ARUN LAKHANPAL SONALI 18BAR1107
Ar. GARIMA GHANDHI PAVAN 18BAR1065
BERISHA 18BAR 1104
 AIM: To improve people’s worlds – is the first thing our
healthcare team would think about when we begin to
Hospital, an institution that is built, staffed, and
design is; To achieve our mission, we focus on how we
equipped for the diagnosis of disease; for the can:
treatment, both medical and surgical, of the sick • Reduce stress for patients, family, and staff
and the injured; and for their housing during this • Encourage those who are grieving
process. The modern hospital also often serves as • Provide a safe environment for patients, family, and
a Centre for investigation and for teaching. staff
• Promote efficient and timely care
Classification of Hospital • Provide a healing environment

A healthcare building includes a

large number of functions and
activities across a range of
healthcare provision services
and non-healthcare support
services such as laundries,
kitchens, supplies and disposal
services and estates
maintenance facilities.
 Design Agendas
AEDET (‘achieving excellence design
evaluation toolkit’, now known as ‘AEDET
Evolution’) evaluates a design by posing a series
of clear, non-technical statements which
encompass the three areas of Impact, Build
Quality and Functionality.
Each area is assessed across a range of specific
criteria:
• ‘Impact’
○ Character and innovation
○ Form and materials
○ Staff and patient environment
○ Urban and social regeneration
• Build quality’
○ Performance
○ Engineering
○ Construction
• ‘Functionality’
○ Use
○ Access
○ Space
General Specialties
General Medicine
General Surgery
Obstetric & Gynecology Services
Family Planning services
Pediatrics including Neonatology and Immunization
Emergency (Accident & other emergency)
Critical care/Intensive Care (ICU)
Anesthesia
Ophthalmology
Otorhinolaryngology (ENT)
Orthopedics
Radiology including Imaging
Psychiatry
Geriatric Services (10 bedded ward)
Health promotion and Counseling Services
Dental care
DOT center
Integrated Counseling and Testing Centre; STI Clinic; ART
Centre
Blood Bank
Disability Certification Services1
Services under Other National Health Programmes TSS
DISTRICT HOSPITAL DESIGN
Diagnostic and other Para clinical Ancillary and support services Administrative services
services regarding • Following ancillary services shall be • Finance
• Laboratory services including ensured: • Medical records (Provision should be
Pathology and Microbiology • Medico-legal/post mortem2 made for computerized medical records)
• Designated Microscopy center • Ambulance services • Procurement
• X-Ray, Sonography • Dietary services • Personnel
• ECG • Laundry services • Housekeeping and Sanitation
• Endoscopy • Security services • Education and training
• Blood Bank and Transfusion • Waste management including • Inventory Management
Services Biomedical Waste • Hospital Information System
• Physiotherapy • Ware housing/central store • Grievances redressal Services
• Dental Technology (Dental • Maintenance and repair
Hygiene) • Electric Supply (power generation and
• Drugs and Pharmacy stabilization)
• Water supply (plumbing)
• Heating, ventilation and air-
conditioning
Transport
Communication
Medical Social Work
Nursing Services
CSSD - Sterilization and Disinfection
Horticulture (Landscaping)
Refrigeration
Hospital Infection Control
Referral Services
Standard Anthropometrics
ADMINISTRATION DIVISION

ADMINISTRATIVE BLOCK ATTACHED TO

MAIN HOSPITAL ALONG WITH PROVISION
OF MS OFFICE AND OTHER STAFF WILL
BE PROVIDED

PARTS AND COMPONENTS OF

ADMINISTRATIVE BLOCK ARE: -

•RECEPTION HALL
• WAITING AREA
• REGISTRATION
• TREASURY AND ACCOUNTS
• STAFF OFFICES
• GENERAL MANAGER OFFICE
• STAFF LOUNGE - NURSING HEAD
OFFICE
• WCs.
Administrative Block

Administrative services
• Finance
• Medical records (Provision should be
made for computerized medical
records)
• Procurement
• Personnel
• Housekeeping and Sanitation
• Education and training
• Inventory Management
• Hospital Information System
• Grievances redressal Services

TSS
DISTRICT HOSPITAL DESIGN
 OUT PATIENT DEPARTMENT

• Separate entrance
• Easily accessible
• Should have approach from main road
• Adjacent to supportive facilities, x-ray and laboratory
• Amenable for Expansion
IPD
Wards

SIZE OF BEDROOM:
SINGLE ROOM: 117 TO 172SFT
DOUBLE ROOM: 157 TO 210SFT
FOUR-BED ROOM: 308 TO 401SFT

TYPES OF WARD DESIGN

• LINEAR WARD
• RACE TRACK WARD
• COURTYARD WARD

Types of Layout for wards

 EMERGENCY /CASUALTY DEPRTMENT

Emergency should have

• mobile X-ray/ laboratory, side labs/plaster
room/and minor OT facilities.
• Separate emergency beds may be provided.
• Duty rooms for Doctors/nurses/ paramedical
staff and medico legal cases.
• Sufficient separate waiting areas and public
amenities for patients and relatives and located
in such a way which does not disturb
functioning of emergency services.
• Emergency block to have ECG, Pulse Oxymeter,
Cardiac Monitor with Defibrillator, Multipara
meter Monitor, Ventilator also.
• Stretcher, wheelchair and trolley shall be
available at the entrance of the emergency at
designated area.
 This diagram shows the typical layout for an ED. You can
see the ambulance drop off, the public access walk-in and
vehicle drop off, the various sub-departments within the
ED, as well as access points and the relationships between
each area.
These rooms are larger to accommodate the several staff
members and equipment that are usually necessary to
treat serious or critical conditions.

designcollaborative.com/design-blog/hospital-planning-emergency-departments/
OPERATION THEATRE
Types of OT complexes
There are three main categories of operating theatre:

• The single theatre suite with OT, scrub-up and gowning,

anesthesia room, trolley preparation, utility and exit bay
plus staff change and limited ancillary accommodation.
• The twin theatre suite with facilities similar to 1, but
with duplicated ancillary accommodation immediate to
each OT, sometimes sharing a small post anesthesia
recovery area.
• OT complexes of three or more OTs. With ancillary
accommodation including post anesthesia recovery,
reception, porter’s desk, sterile store and staff change.

Bubble diagram of general

flow in operation theatre
https://hhbc.in/operation-theatre-planning-design/
 SUB
STERILIZING

FROZEN OPERATION ROOM

SECTION
LAB CLEAN UP

SUPERVISOR
ANESTHESIA
ROOM SCRUB UP
INSTRUMENTAL
STORAGE

NURSES
DOCTORS LOCKER
LOCKER CENTRAL
PATIENTS
STERILIZING
SUPPLIES
DOCTORS NURSES
GUIDELINES FOR AIR CONDITIONING IN OPERATION Idle OT should have following characteristics
THEATERS • Operative room for routine work (18ft * 20 ft.)
• The AHU of each OT should be dedicated one and
For this purpose operation theaters have been divided
should not be linked to air conditioning of any other
into groups:
area for all OT constructed.
1.Super specialty OT: Super specialty OT means
•  Window & split A/c should not be used in any type
operation theatres for Neurosciences, Orthopedics
of OT because they are pure re circulating units and
(Joint Replacement), Cardio thoracic and Transplant
have convenient pockets for microbial growth which
Surgery (Renal, Liver etc.).
cannot be sealed.
2.General OT: This includes operation theatres for
• Super specialty departments like neurosurgery &
Ophthalmology, District hospital OTs, FRU OT and all
cardiac surgery require bigger area i.e. about 500ft
other basic surgical disciplines.
to 600ft, as these theaters need to have more
The minimum size of the filtration area should extend equipment's
one feet (i.e. 304.8 mm) on each side of the OT table to • Effecting air conditioning should maintain the
cover the entire OT table and surgical team. temperature as per requirement
• Efficient & sincere paramedical & non-medical staff
Positive Pressure: There is a requirement to maintain to carry out necessary instructions promptly.
positive pressure differential between OT and adjoining • Walls: Smooth wall which is impermeable to
areas to prevent outside air entry into OT. Positive moisture having finish of epoxy resin or vinyl sheets
pressure will be maintained in OT at all times type of painting.
(operational & non-operational hours)Laminar flow • Doors: Main door to the OT complex has to be of
boxes/diffusers should be installed in the OT for adequate width (1.2 to 1.5 m). The doors of each OT
supplying majority air and also majority return air should be spring loaded flap type, but sliding doors
should be picked up 75-150 mm above floor level. are preferred as no air currents are generated. All
The minimum positive pressure recommended is 2.5 fittings in OT should be flush type and made of
Pascal (0.01 inches of water). steel.
• Flooring: The surface / flooring must be slip
Temp & RH for Super-specialty OT: It should be resistant, strong & impervious with minimum joints
maintained 21 C +/- 3 C (except for Ortho for Joints (e.g. mosaic with copper plates for antistatic effect)
replacement as 18 C +/-2 C) with corresponding or joint less conductive tiles/ terrazzo, linoleum etc.,
relative humidity between 20 to 60% though the ideal The recommended minimum conductivity is 1m
RH is considered to be 55%. ohm and maximum 10m Ohms.
district-hospital.pdf
https://hhbc.in/operation-theatre-planning-design/
https://passionatengineer.blogspot.com/2020/12/operation-theater-design-guidlines-for.html
INTERNAL MEDICAL TREATMENT DIVISION
PARTS AND COMPONENTS OF AREA OF THE DEPARTMENT:
THE DIVISION:
•Entrance. •50 bed hospital area = 185 m2
•Storage. •100 bed hospital area = 360 m2
•Preparation room. •200 bed hospital area = 550 m2.
•Access area.
•Staff clothes room + WCs.
•Operation theatre.
•Clean up room.
•Sub sterilizing room.
•Supervision room.
•Staff lockers.

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.
GUIDELINES FOR AIR CONDITIONING IN OPERATION Idle OT should have following characteristics
THEATERS • Operative room for routine work (18ft * 20 ft.)
• The AHU of each OT should be dedicated one and
For this purpose operation theaters have been divided
should not be linked to air conditioning of any other
into groups:
area for all OT constructed.
1.Super specialty OT: Super specialty OT means
•  Window & split A/c should not be used in any type
operation theatres for Neurosciences, Orthopedics
of OT because they are pure re circulating units and
(Joint Replacement), Cardio thoracic and Transplant
have convenient pockets for microbial growth which
Surgery (Renal, Liver etc.).
cannot be sealed.
2.General OT: This includes operation theatres for
• Super specialty departments like neurosurgery &
Ophthalmology, District hospital OTs, FRU OT and all
cardiac surgery require
PHARMACYbigger area i.e. about 500ft
other basic surgical disciplines.
to 600ft, as these theaters need to have more
The minimum size of the filtration area should extend equipment's
one feet (i.e. 304.8 mm) on each side of the OT table to • Effecting air conditioning should maintain the
cover the entire OT table and surgical team. temperature as per requirement
• Efficient & sincere paramedical & non-medical staff
Positive Pressure: There is a requirement to maintain to carry out necessary instructions promptly.
positive pressure differential between OT and adjoining • Walls: Smooth wall which is impermeable to
areas to prevent outside air entry into OT. Positive moisture having finish of epoxy resin or vinyl sheets
pressure will be maintained in OT at all times type of painting.
(operational & non-operational hours)Laminar flow • Doors: Main door to the OT complex has to be of
boxes/diffusers should be installed in the OT for adequate width (1.2 to 1.5 m). The doors of each OT
supplying majority air and also majority return air should be spring loaded flap type, but sliding doors
should be picked up 75-150 mm above floor level. are preferred as no air currents are generated. All
The minimum positive pressure recommended is 2.5 fittings in OT should be flush type and made of
Pascal (0.01 inches of water). steel.
• Flooring: The surface / flooring must be slip
Temp & RH for Super-specialty OT: It should be resistant, strong & impervious with minimum joints
maintained 21 C +/- 3 C (except for Ortho for Joints (e.g. mosaic with copper plates for antistatic effect)
replacement as 18 C +/-2 C) with corresponding or joint less conductive tiles/ terrazzo, linoleum etc.,
relative humidity between 20 to 60% though the ideal The recommended minimum conductivity is 1m
RH is considered to be 55%. ohm and maximum 10m Ohms.
https://hhbc.in/operation-theatre-planning-design/
https://passionatengineer.blogspot.com/2020/12/operation-theater-design-guidlines-for.html
RADIOLOGY
THE TERM RADIODIAGONICS NOW INCORPORATES WITH
RADIO DIAGNOSIS—
• X RAY
• SONOGRAPHY
• CT SCAN
• MAGNETIC RESONANCE IMAGING (MRI)
• DIGITAL SUBTRACTION ANGIOGRAPHY (DSA)
• RADIOTHERAPY
• NUCLEAR MEDICINE
• INTERVENTIONAL RADIOLOGY

• LOCATION-
-THE DEPARTMENT SHOULD BE EASILY ACCESSIBLE TO THE OPD, CASUALTY AND THE
INPATIENT WARDS.
-THE LOCATION OF THE DEPARTMENT WILL BE ON THE GROUND FLOOR.
-IT SHOULD HAVE SOME SCOPE FOR EXPANSION AT A LATER DATE.
-THIS SERVICE REQUIRES A DIRECT ACCESS FROM THE EMERGENCIES FOR LYING
PATIENTS. IT MUST BE SITUATED ON THE GROUND FLOOR OR AT THE FIRST GROUND
(BECAUSE OF WEIGHT OF APPARATUS).
Ernst_Neufert_ARCHITECTS_DATA.pdf
367433564-200-Bed-Peshmarga-General-Hospital-Thesis-Project-by-Munir-Khoshawi.pdf
Laboratories and blood bank
THEY ARE DESIGNED FOR BLOOD
SAMPLES AND ANALYSIS OF THOSE
SAMPLES.

THEY CONSIST OF: - LOCALS FOR RINSE,

DISINFECTING, PREPARATION OF
STERILIZED IMPLEMENTS,

A STORAGE ROOM,
-A COLD ROOM,
- A MEETING ROOM,
- A WAITING ROOM,
- AN ADMINISTRATION OFFICE

• ALL ROOMS OUGHT TO BE LIT WITH NATURAL

LIGHT.
• ROOMS WITH MICROSCOPES HAVE TO BE
ORIENTATED NORTHERN.
• WIDTH OF DOORS: 1M MINIMUM
Laboratory floor Plan
THERAPEUTIC SERVICES DIVISION
LOCATION

• Close to the x-ray

therapy department.

PHYSICAL THERAPY.
PARTS AND COMPONENT
OF THE DIVISION:

• Waiting area
• Office
• Hydrotherapy
• Exercise room
• WCs
OBSTETRICAL AND GYNACOLOGY DEPARTMENT • Open room.
•Operation.
•WCs.
•Utilities.
DELIVERY ROOMS •Office.
•Unclean room.
SUPERVISOR •Cleanup room.
•Storage.
•Waiting area.
SUB STERILIZING •Corridors

DOCTORS NURSES LABOUR CLEAN UP

LOCKER LOCKER ROOM

SUPPLIES JANITOR
CL. STRETCHERS
DOCTORS NURSES PATIENTS

Labor rooms should provide maximum comfort

and relaxation for the patient and should have
facilities for examination, preparation, and
observation . Unless an admitting and
preparation unit outside the labor-delivery unit is
LOCATION available, the patient may be admitted directly to
Very close to the newborn nursery and maternity unit the labor room
 The formula preparation room shall include the following:

(a) Cleanup area for washing and sterilizing sup- plies. This area shall
include a hand-washing station, facilities for bottle washing, a work
counter, and sterilization equipment.

(b) Separate room for preparing infant formula. This room shall
contain warming facilities, refrigerator, work counter,
formula sterilizer, storage facilities, and a hand-washing
station.

(c) Refrigerated storage and warming facilities for infant formula

accessible for use by nurs- ery personnel at all times.

• Location of the SNCU Should be located near the

Labour Room, Labour Ward and Obstetrics
Operation Theatre.
• Should not be located on the top floor.
• Should be accessible from the main entrance.
TSS
Neonatal care unit
 INTENSIVE CARE UNIT

LOCATION:

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

•Can be easily accessible from the emergency division
by elevator.
 CONSULTATION ROOM
In the combined C/E room, the doctor will both
consult with the patient and examine the
patient on a couch; while the patient is
dressing, the doctor may move to an adjoining
C/E room to deal with another patient and the
rooms should therefore have interconnecting
doors.
In the another arrangement, the patient moves
to the separate room, undresses and waits for
the doctor.

Consultation and examination room

The-Metric-Handbook-Architecture-must-have.pdf
DENTAL TREATMENT ROOM ,ENT AND OPTHOMOLOGY
 MORTUARY

Autopsy room Dead body storage space

Ernst_Neufert_ARCHITECTS_DATA.pdf
Ernst_Neufert_ARCHITECTS_DATA.pdf
TSS
LAUNDRY SERVICES
 KITCHEN

Food preparation area

Ernst_Neufert_ARCHITECTS_DATA.pdf
 CSSD

Ernst_Neufert_ARCHITECTS_DATA.pdf
 WASTE MANAGEMENT
Transportation of Waste Within The Hospitals:
• Within the hospital, waste routed must be designated to avoid the passage
of waste through patient care areas as far as possible.
• Separate time schedules are prepared for transportation of Bio-medical waste
and general waste. It will reduce chances of their mix up.
• Dedicated wheeled containers, trolleys or carts with proper label (as per
Schedule IV of Rule 6) should be used to transport the waste from the site of
storage to the site of treatment.
• Trolleys or carts should be thoroughly cleansed and disinfected in the event
of any spillage

district-hospital.pdf
Parking and Access
 All weather motor able road.
 Proper lighting should be there 24x7
 No open sewage.
 Separate area of the parking space should be
designated for ambulance, staff and visitors use.
 The parking for the doctors should be near the OPD
and emergency.
 Minimum road width should be 6m.
Corridors and Clearance
Corridors – Corridors shall be at least 3 m Wide to accommodate the daily traffic.
Ramps and Stairs  Maximum number of risers between landings for a flight =
12–14.
Ramps  Recommended riser height = 150–170 mm.
• shall have a slope of 1:15 to 1:18.  Risers should not be of the open type, as they are a trip
• An exterior location is preferred for ramps. hazard (especially for semi-ambulant people with leg braces
Indoor ramps are not recommended because and prostheses), disorientating, and may transmit
they take up a great deal of space. distracting sounds.
• Ideally, the entrance to a ramp should be  Nosings should contrast visually with the stairs, extend the
immediately adjacent to the stairs. full width of the step, and reach a depth of 50–60 mm on
• Ramp configuration both tread and riser to allow visually-impaired people to
(a) Straight run (fig. 1); detect the edge of each step.
(b) 90 turn (fig. 2);  Although rounded nosings may cause slipping, sharp
(c) Switch back or 180 turn (fig. 3) projecting nosing's and abrupt angles should be avoided.
 A tread should not overlap the one below. Where there is
an overlap, the nosing should not project by more than 25
mm.
 Minimum clear landing depth = 1200mm.

Fire Exit:
•There must be a fire exit in the building. If there is a stair and
no other fire exit than the stair should be considered as a fire
exit
•Width of fire stair should be minimum 1.4m
•If ramp is used as fire escape the slope should not exceed 1:12
•There must be a fire exit control room of 10 sq.m
 Lifts and Escalator

 Minimum internal dimensions for 8 = 1100

mm (wide) × 1400 mm (deep)
 General traffic lifts minimum internal
dimensions = 1600 mm (wide) × 1400 mm
(deep).
 Handrails should be provided on both the
side and rear walls of lift cars.
 larger general traffic lifts= 2000 mm (wide) ×
1400 mm (deep).
 The recommended minimum lift size for
patient trolley/stretcher movement is 1400
mm × 2400 mm.
 Minimum lift size for the movement of
patients on beds = 1800 mm × 2700 mm
 Area and Space norms of the hospital (based on CPWD) Signage.
1.Land Area (Desirable) Minimum Land area requirement • Directional signage's for Emergency, all the Departments
are as follows: and utilities shall be displayed appropriately, so that
• Upto 100 beds = 0.25 to 0.5 hectare they can be accessed easily.
• Upto 101 to 200 beds = 0.5 hectare to 1 hectare • Florescent Fire Exit plan shall be displayed at each floor.
• 500 beds above = 6.5 hectare (4.5 hectare for hospital • Safety, Hazard and caution signs displayed prominently
and 2 hectare for residential) . at relevant places.
Size of hospital as per number of Beds • Hospital lay out with location and name of the facility
a. General Hospital - 80 to 85 sqm per bed to calculate total shall be displayed at the entrance.
plinth area.
b. Teaching Hospital - 100 to 110 sqm per bed to calculate
total plinth area.
2.Following facilities/area may also be considered
while planning hospital.
(Desirable)
(i) Operation Theatre
a. One OT for every 50 general in-patient beds. The Roof height should not be less than approximately 3.6m
b. One OT for every 25 surgical beds. measured at any point from floor to roof.
(ii) ICU beds = 5 to 10 % of total beds.
(iii) Floor space for each ICU bed = 25 to 30 sq m (this includes
support services).
(iv) Floor space for Pediatric ICU beds = 10 to 12 sq m per bed.
(v) Floor space for High Dependency Unit (HDU) = 20 to 24 sq m Entrance Area
per bed. • Emergency: for patients in ambulances and other vehicles for
(vi) Floor space Hospital beds (General) = 15 to 18 sq m per bed emergency department.
(vii) Beds space = 7 sq m per bed. • Service: for delivering supplies and collecting waste.
(viii) Minimum distance between centres of two beds = 2.5 m Service: for removal of dead.
(minimum). • Main: for all others.
(ix) Clearance at foot end of each bed = 1.2 m (minimum).
(x) Minimum area for apertures (windows/Ventilators opening in
fresh air) = 20% of the floor area (if on same wall)= 15% of the
floor area (if on opposite walls).
district-hospital.pdf
 Location of OT
OT is centralized block in which all the
operating rooms are situated. This
arrangement has following advantages:
1.Avoids duplication of expensive
equipment
2.Avoids need to duplicate routine facilities
like changing room, scrub room, surgeon’s
room etc.
3.Supervision becomes easy
4.It is easier to ensure uniformity &
consistency in the procedures
5.Idle theatre time can be reduced
Location of OT should consider following
points:
6.Easy approachability, whether it is
horizontal traffic or vertical traffic in high
rise building.
7.Proximity of central sterile supply
department. If that is not possible, it
should at least have Proper regional sterile
v) Environmental friendly features The Hospital should be, as far as possible,
supply section.
environment friendly and energy efficient. Rain-Water harvesting, solar energy
8.Proximity to intensive care areas.
use and use of energy-efficient bulbs/ equipment should be encouraged.
9.Proximity to interventional laboratories
Provision should be made for horticulture services including herbal garden. A
of super specialty departments
room to store garden implements, seeds etc. will be made available

district-hospital.pdf
Design considerations
to be kept in mind
while designing a
hospital.

Metric Handbook_ Planning and Design Data.pdf

The-Metric-Handbook-Architecture-must-have.pdf