Thesis Report On Hospital Design

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Thesis Report On Hospital Design

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Hence, this contribution is a model for hospital design, where design derives as a response to the defined variables, requirements and preferences. AB - This PhD project presents a design model that generates and evaluates hospital designs with respect to long-term performances and functionalities. Malene Kirstine Holst. Abstract This PhD project presents a design model that generates and evaluates hospital designs with respect to long-term performances and functionalities.

Access to Document Aalborg Universitetsforlag. And yet, these would be the team members that define the requirements. That was the design team. Now come a slew of cooks to prepare the broth, the recipe for which has been collectively given by the 28 consultant cooks! Enumerated below are the agencies who would be collectively involved in the construction of the hospital: 1. Excavation contractor: 2. Civil contractor 3. Plumbing 4. Fire-fighting 5. Electrical 6. HVAC 7. Elevator 8. MGPS 9. Pneumatic Tubes Nurse Call IBMS Casework, millwork False Ceiling Painting Wall coverings Doors Windows Loose furniture Artworks Landscape Signage Steel storage Medical furniture Display screens Equipment — medical, non-medical It kind of gives us a handle on which we can hang our hats before rolling up our sleeves, loosening our ties and getting down to some serious work.

Healthcare designers can derive their planning grids in one of the two following ways: 1. In the example given below you can see how the planning grid modules in red of 3. This room centerline of 3. In some of our Gulf projects we have even used 4. Expanding on this with the addition of the access corridor and stringing the rooms out in a line, as in the plan below, we see how the planning grid starts taking form. Looking more closely at this plan we can see something important has been determined, namely, the positions of the columns that will support the building.

We can thus see how the structural grid in blue , the network of lines defining the location of columns, has been derived from the planning grid. The structural grid need not necessarily be the same as the planning grid, but is usually derived from it. This is just one example of how the planning grid could take almost any conceivable shape depending on what the designer wants to do with it. Having said that, we can still see how this twisted planning grid still serves its purpose of imposing order on a blank chaos, giving the designer a framework within which to design, even the rest of the hospital.

Well, consider this. The positions of the structural columns determined by this planning grid, twisted or otherwise, will continue downwards through the rest of the hospital, through the lower floors the podium mentioned above till their respective foundations, where they will transfer their load to the ground below. Hence the lower floors the podium , which will contain the Operation Theater Suite, the Radiology and Imaging Sciences Department, the Main Kitchen and the Mechanical Areas in the basement, to name just a few, will all need to be designed within the constraints of these column positions. Even if the podium extends beyond the footprint of the tower above, it is almost certain that the positions of the additional columns required would be derived from the structural grid used for the tower, which has been derived from the planning grid determined by inpatient facility design.

Not really. Actually we design in a kind of collapsing spiral with a time dimension. What I mean by this is illustrated in the sketch below. The design process can be conceptualized as a process that begins at a point in time and space and endeavors to find for its particular problem definition and in its particular circumstances real world time and money constraints an of course, illusory ideal solution.

What is this talk of ideal solutions? Design blasphemy! Let me give you an example. Let us assume the design search is on for a healthcare facility, and the above diagram represents the way you would search for it before you have read this guide. Can we see how you have started your search closer to the solution you are looking for and take less time to zero in on it? If we can see this by means of these two diagrams then they are surely representative of some aspects of the design process. I invite you to invent your own diagrams to illustrate other aspects and share them with us.

Providing space for the parents to stay overnight with the child is very desirable in such dedicated pediatric hospitals, and you can see how the planning grid is 8. This is enabled despite providing a duct along the full face of the toilet along the corridor, that eases maintenance and repair considerably. However, it should be kept in mind that this large toilet only works with a single occupancy room, as shown. Another example below shows how the provision of a handicapped access toilet within the same planning grid can significantly reduce the area available for the inpatient room. This example also demonstrates how the inpatient room works within a grid of 7.

The toilet duct gets impacted by this shrinking of the grid, and while this sort of duct can work, it is not the ideal configuration for a maintenance-friendly hospital. Getting back to the business of planning grids in healthcare facility design, below we have the second way in which we can determine these planning grids. In semi-urban or rural situations, where the land available is very likely to be larger with respect to the built-up area desired, determining the planning grid is another ballgame, one with much greater flexibility in the rules.

When there is a lot of land available, it gives the architect more elbowroom, and his hand is likely to move with more hopefully graceful abandon. This freedom enables many different types of building layout and form. At the point of separation, the designer throws up a whole lot of different ways in which he could define an ordering principle that he would use to design the hospital. Different parts of the hospital may have different planning grids derived from the functional planning requirements of the hospital departments they house. Of course, certain spaces in the hospital may be designed without using any geometrical planning grid at all. In practice, however, you will find such spaces are few among the totality of spaces that comprise the hospital, and are usually those in which the activities have little to do with the field of medical technology or do not house patients who are ill.

These areas are usually ancillary facilities such as auditoriums, entrance lobbies or spaces in which patients are recuperating after treatment. Healthcare facilities often present a complex and challenging proposition to designers engaged in other types of architectural design projects. To impose arbitrary constraints is meaningless, though it will also make life easier for you. That is just avoiding the issue and moving the job along when it may well have stalled in the studio. It is better to collect all the design sketches, crumple them up and throw them away, send the staff home early, go home and put your feet up, listen to the music that turns you on till midnight, then crash out and get up in the morning to the beauty and awesome potential of the sun rising on a new day.

It will be a beautiful day, you just have to live your life to its fullest, and the healthcare design solutions will flow. But finding good planning grids might help that flow along just a little bit. This configuration enables good observation to and from the room. It can be used to minimize the room width, if so desired, for a still workable stretcher movement within the room. The toilet gets the advantage of natural light and ventilation, an advantage not to be sneezed at! Another advantage is that the toilet duct can be accessed externally. A major disadvantage is that it reduces the window area in the bedroom.

We get all the previous advantages and disadvantages as well, with one additional disadvantage, that it increases the floor area of the room, if the same feeling of spaciousness is to be provided. The disadvantage is that we get one internal bathroom per two bedrooms, without natural light and ventilation. This toilet needs forced ventilation. Another major disadvantage is that this configuration increases the length of corridor needed to service each room, width remaining constant, thus increasing the area of the entire hospital, maybe even in the podium floors in some circumstances.

This configuration has the disadvantage of reducing observation to and from the room. It has the advantage of maximizing the window area in the bedroom, and the toilet duct can be maintained from the corridor. This is, however, the only configuration that minimizes the approach passage area while maximizing the window area in the room. It is thus widely used, more so in the hospitality industry. The toilet needs continuous forced ventilation. Depending on which of the above types or your own type of room-toilet configuration you use, you will generate different planning grids, and each type of configuration will necessitate or limit your options of building form, especially on the lower floors.

Especially in the UK, where the Nightingale ward horizontally planned pavilion hospital never really died out. The usage of the Nucleus planning templates in the UK bears this out. An in-built problem of vertical planned healthcare facilities and more so of an inpatient tower block, is that it can only expand vertically, not laterally. The substantial portion of the floor template taken up by the vertical circulation core and vertical service runs is not just wasteful and costly, it makes the template rigid and difficult to massage and limits its flexibility.

The expansion of a vertically planned hospital usually takes the form of a collection of small buildings at the bottom of the tower, making for more and more difficult service runs and circulation paths. Vertical planned hospitals are less likely to have a workable master plan for expansion, especially for the lower floors. Vertical hospitals will usually need more costly environment controls; they have large facades which are exposed to direct sunlight so they are less energy efficient, and have more difficulties of evacuation in case of fire than have horizontally planned ones, in which evacuation is through successive fire zones moving away from the location of the fire. It is mooted that vertically organized hospitals can be built on smaller sites.

This only holds true for centrally located urban hospitals. The podium of these hospitals will spread in most cases to have a footprint which is the same as those of compact horizontal hospitals. The inflexibility of such vertical hospitals is becoming more evident when across the world hospitals are becoming centers of mostly acute care and the ratio of inpatient wards to total built up area of the hospital is diminishing. An argument could be sustained that modern hospitals, with their complex functional design requirements and unpredictable final form, are more suitable for the alternative much more organic school of modern architecture, as seen in the work of Frank Lloyd Wright, Aalvar Aalto and Hans Scharoun, than for the purist geometrical designs of Mies van der Rohe and his followers.

But in India we are still fascinated by the phallocentric attractions of the glass and metal clad tower, no matter how unsuitable this building form and materials are in the prevailing circumstances. The amount of design time spent in placing and orienting a building on the site with respect to the open spaces and the path of the sun is time well spent. It may be the single most important decision you will make regarding the hospital with respect to its response to its environment and consequent energy savings. With the building tentatively located on site, you have to then determine the approximate shape of the building before designing interior spaces. Buildings shaped without consideration for the sun-path require more energy to heat and cool. Huge amounts of energy are consumed in heating and cooling buildings worldwide.

This design approach is made necessary and timely in an age of rapacious energy consumption. Today, more than ever before we need to design our buildings in a way that is strongly related to site, climate, local building materials and the sun. Inherent in this design approach is a special relationship to nature that offers the potential for an inexhaustible supply of energy. A lot of vernacular architecture has always shown a strong relationship to daily and seasonal climatic and solar variations. In the buildings of today this approach shows itself in the materials we build with, such as plastics and synthetics.

Especially in healthcare facility design, there is a dependence on the air-conditioning of indoor spaces rather than the usage of climatic and other natural processes to maintain the comfort conditions. In a way, we have become prisoners of complicated air-conditioning systems, since windows must be permanently closed and airtight in order for these systems to work.

A minor power or equipment failure can make these buildings uninhabitable. Scant attention is given to the unique types of local climatic conditions and building materials. One can now see essentially the same types of recently built retail, commercial and institutional buildings across the country. But we are wandering; let us get back on track. It implies purpose, and purpose implies design. We are going to talk about the importance of the design of circulation in a healthcare facility. Hospitals, like the small cities they are likened to, contain main circulation routes often described as hospital streets. The way in which the different parts of the hospital are assembled, as a coherent whole but with the parts differentiated, make for analogies with urban design; the way in which traffic moves, and the routes that are taken by mechanical and electrical services are fundamental generators of the plan.

In a vertically stacked hospital, which could also be called a functionally stratified hospital, almost always the inpatient areas are placed on the upper floors, to allow for a more pleasant, naturally lit environment. The planning grid is determined by the layout of these inpatient floors. Another important planning feature, the vertical circulation core, is also to some extent located within the building by the layout of the inpatient floors. The pattern of circulation conceptualized for the hospital under design will be considerably impacted by the location s of the vertical circulation core s.

It is something like all roads leading to Rome s. The vertical circulation core is the focus of all the major circulation paths of the hospital. An attempt can be made through design to minimize vertical transportation by placing for example all surgical beds, operating theatres and the intensive care unit on the same floor. It is important that patients, visitors and staff be able to orient themselves while moving through the hospital by providing windows in corridors to enable them to look out and to allow natural light in, important in alleviating the tedium of long corridors.

If the site enables them, courtyards are also an excellent means to this end. As such there is no easily available prescription for the way the circulation pattern for a healthcare facility should be. By this I mean it should be designed with purpose, and should not be leftover space or squeezed into the gaps between other areas. Geometry can be a recourse, but it should work with other planning imperatives, and junctions should be uniquely treated to avoid confusion over which corner of the hexagon for example you have reached.

Try to make walking from one place to another interesting, modulate those corridors, color them differently, and hang artwork along the way. Niches, outside views, courtyards, all these will help. In combination with well-designed signage and maybe super- graphics, people should be able to find their way to their destination with ease. Color-coding for floors or departments is sometimes used.

There may be a lot of stuff parked along the sides, despite instructions to OT staff to the contrary. Patients on stretchers get to look at the ceilings. Hospital ceilings are boring. See the complexity of the circulation paths in the hospital plan given as example above. Some of the hospitals currently existing in India have been provided with ramps in addition to the usual elevators and stairs. Power cuts are realities that have to be considered.

But consider putting some two of the elevators on a generator, if this helps in avoiding the ramp, which is wasteful of space and difficult to use, as the gradient is often excessive. With an acceptable gradient, the length becomes excessive, considering that the lower floors of hospitals are considerably higher than those of the usual non-hospital building. However, ramps may be mandatory like in teaching hospitals, and required by code in many cities and towns across India.

When planning for the area occupied by this circulation space corridors in the architectural space plan, it can be provided for as a percentage of the department area usable, built-up area. This percentage will vary depending on the department and may also vary if the architect has any special feature in mind for that department which is not explicitly provided for in the room-by-room area statement such as semi-covered, landscaped waiting. In the Inpatient unit there may be singly loaded or doubly loaded corridors.

On the Inpatient floors or even in the Outpatient Department, these corridors can be modulated by recessing pairs of doors that occur at regular intervals, and using an accent color in the niche so created. This helps relieve the boredom of walking through long, uninteresting corridors. Very frequently the major circulation paths through the hospital are laid out even before the tentative space allocation for the hospital departments is done.

Thus, the importance of conceptualizing these paths in a way that they contribute to the concept and functional layout of the hospital is not to be underestimated, the exercise should not be done casually. Frequently you will find that in the areas below the footprint of the inpatient tower in the podium, you end up using the same corridors that you used in the inpatient floors. At least I find myself doing this quite often. There must be a good reason for this, I hope there is! It beats me if I can think of it though. Maybe you can think of one. Taking the easy way out? The funda is: Defining major circulation paths through the proposed and future buildings is a design decision that will considerably impact the form, layout and thus the eventual functioning of the healthcare facility being designed.

Do it thoughtfully and with conceptual clarity. However, for the benefit of my healthcare professional readers I will give a brief description of what they are. The space program that we spoke of earlier contains a list of rooms comprising a department, the area per room, the number of such rooms and the total area of that kind of room. After adding a percentage area for circulation within the department we get the total area of the department. This is the figure we use to prepare the block plan. When we prepared the stack plan we allocated areas for each department and put them on the various floors of our tentatively conceptualized hospital.

A block plan is an extension of the stack plan only this time the word plan is used in an architectural sense and we draw out a tentative template for each floor and locate within this template the major circulation routes and vertical circulation cores and other vertical elements like staircases and proposed vertical service runs. Then we mark out the area for each department on this template in different colors. This is done keeping in mind functional adjacencies for departments and the nature of the proportions of the space required for future good planning.

Now this is something you will get the hang of only through experience. The preparation of this block plan is important as it forms the content of what is usually the presentation of the first architectural plan to the client, and when you get a sign-off on this you can proceed to the next step, schematic design, or room by room planning of your hospital, which will be the subject of the next handbook in this series. This reads a lot easier than it is to do, how would you go about doing this in a meaningful manner?

The block plan after all implies that some decision has been taken on the massing of the building. The way I go about it is to first of all lay out the planning grid for the proposed hospital on the site. This will usually mean you cannot afford more than three or at the most four floors of inpatient facility at 3. You might think 3. There are many different types of inpatient unit configurations, and to describe all of them would be beyond the scope of this first volume of these Hospital Design Guides. They will be covered in detail in the second volume. Earlier we discussed various different types of hospital built form. This will substantially influence the type of inpatient floor you choose for your particular site.

While designing your inpatient floor you will also have to make decisions on the location and configuration of the vertical core various kinds of elevators and the staircases. You may have dedicated patient elevators for only inpatient movement bed or stretcher elevators , visitor elevators and service elevators for movement of supplies and food service to the inpatient wards. It is a good idea to size all these elevators as bed elevators so that they can be used as such at a crunch. Also, while designing the inpatient floor you will have to locate nursing stations and nursing support facilities clean utility, dirty utility and floor pantry. Such support services may also be shared between two nurse stations, in which case they have to be sized accordingly.

There are various pros and cons which are beyond the scope of this first guide. We advocate that the OT floor be a minimum of 4. This is necessary to ease design and construction of service runs. To Eliminate environmental stressors, such as noise, that negatively affect patient outcomes and staff performance. To Reduce stress and promote healing by making hospitals more pleasant, comfortable and supportive for patients and staff alike. To create a health care environment personalized to each patient that focuses on health and wellness, provides and wellness. To Provides convenience and case of access and incorporate the latest technologies. To Community Hospital will be the hospital Choice for the services we provide To the Visitors should have a simple and direct route to each patient nursing unit without penetrating other functional areas.

This requires careful pre-design programming. To Provide an efficient logistics system, which might include elevators, pneumatic tubes, box conveyors, manual or automated carts, and gravity or pneumatic chutes, for the efficient handling of food and clean supplies and the removal of waste, recyclables, and soiled material To Group or combine functional areas with similar system requirements To Provide optimal functional adjacencies, such as locating the surgical intensive care unit adjacent to the operating suite. These adjacencies should be based on a detailed functional program which describes the hospital's intended operations from the standpoint of patients, staff, and supplies.

Providing an end to end solutions for hospital in a various scales and types. Our services include: planning and building of mobile and fixed hospitals, establishment of infrastructure and support systems, design of operational concept, training, quality control physical and budget and schedule monitoring. This means the latest diagnostic scanners, new theatre equipment and even robots deployed in our pharmacy and laboratories to make drug dispensing and testing faster and safer. For example, there are dedicated patient and visitor lifts, with other lifts available for staff and the moving of goods. The new hospital allows us to support new ways of working that benefit both patients and staff. This helps our emergency services, in particular, to provide care precisely when and where it is required.

Despite its size, the hospital is designed to operate on a human scale, putting our patients at ease. The scope of this research covers the general hospital. Each hospital is comprised of a wide range of services and functional units. This diversity is reflected in the breadth and specificity of regulations, codes, and oversight that govern hospital construction and operations.

Comprised of a wide range of services and functional units. The functional units within the hospital can have competing needs and priorities. Idealized scenarios and strongly-held individual preferences must be balanced against mandatory requirements, actual functional needs internal traffic and relationship to other departments , and the financial status of the organization. This analysis meant to propose a well designed computer base management information system that will take care of the existing problems of the current system. Another card Doctor prescription will be given. The Doctor will then direct the patients to the O. D pharmacy to collect the drugs. The treatment card will be filled at the O. D filling section and filed according to their registration numbers.

The medical record officer will know the total number of patients discharge, the number of days stayed and this diagnosis will then be coded according to the number of the disease falls into. This process helps understand the need of the community that will be served by the hospital in the given location. For doing this, one needs to undertake a detailed market survey by collecting data from various sources.

It was important to MGH to uphold their reputation of offering the latest in medical technology and environmentally friendly design. The new building would allow MGH to continue to provide advanced, patientcentered care. They needed to create a space that would best service their high acuity patients, retain the culture of a therapeutic environment with eco-friendly construction and design and include comfortable furnishings for family members.

The nursing side would need toincorporate an extensive amount of services to best care for their high acuity patients, while the respiratory side of the patient bed needed to house the ventilator. Therefore, it was essential for one of the service modules to be designed as a shorter column so that the ventilator could be rolled and kept underneath the service unit.

There was a need to install a product that would help to reduce the stay of the patient and create an environment where the staff and clinicians would be able to do their best work. Environmental conservation studies have shown that a natural environment can help to promote healing for sick patients. It has expanded, collated and enhanced services in cancer, neurology, neurosurgery, radiation oncology and emergency care. Improvement of hospital work environments might be a relatively low cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.

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