ARCHITECTURAL
DESIGN
MAJOR DESIGN PROBLEM:-
HOSPITAL DESIGN
CONTENT
1 ▪ INTRODUCTION
2 ▪ TYPE OF HOSPITAL
3 ▪ PLANNIG CONSIDERATION
4 ▪ CODES AND STANDARDS
Introduction
• Hospital is an institution that is built, staffed, and
equipped for the diagnosis of disease, for the
treatment, both medical and surgical, of the sick
and injured, and their housing during this process.
the modern hospital also often serves as center of
investigation and for teaching
• Hospitals are the most complex of building types.
Each hospital is comprised of a wide range of
services and functional units. These include
diagnostic and treatment functions, such as
clinical laboratories, imaging, emergency rooms,
and surgery; hospitality functions, such as food
service and housekeeping; and the fundamental
inpatient care or bed-related function.
• This diversity is reflected in the breadth and
specificity of regulations, codes, and oversight
that govern hospital construction and operations.
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1. Functionality
Functionality refers to whether the hospitals are general-purpose, teaching hospitals, acute care facilities, long-term
hospitals, community hospitals, research hospitals or if they provide trauma care for patients. It refers to how the
hospitals themselves function within the communities they serve.
2. Size
There are three primary classifications when it comes to size:
Small hospitals: Fewer than 100 beds
Medium hospitals: 100 to 499 beds
Large hospitals: 500 or more beds
3. Location
You can also classify hospitals by their locations. Rural hospitals aid smaller communities and often have limited access to
advanced equipment or specialized procedures and techniques.
3. Location
You can also classify hospitals by their locations. Rural hospitals aid smaller communities and often have limited access to
advanced equipment or specialized procedures and techniques.
, urban hospitals serve larger metropolitan areas and must often offer a wide degree of versatility when it comes to
treatment options and patient experience.
4. Ownership
Knowing who owns the hospital will also tell you a great deal about how the hospital will operate. Some hospitals are part
of larger networks that offer a streamlined approach to management. While some physicians feel this improves efficiency
and patient experience, some feel it removes the emphasis from the patient and makes treatment less personal.
5. Specializations
Specialized hospitals appeal to physicians who entered the medical field with plans to treat people with a specific
condition. Most physicians choose specializations due to personal reasons, an area of intense interest or a desire to
provide a comfortable life for themselves and their families.
Academic Medical Centers
Academic medical centers often serve specific medical schools or universities. Facilities like this offer a variety of services
to treat the general healthcare needs of their communities as well as specialized services while simultaneously offering
educational opportunities to students in the healthcare field.
• Idealized scenarios and strongly-held individual
PLANING CONSIDERATION preferences must be balanced against mandatory
requirements, actual functional needs (internal traffic
and relationship to other departments), and the
financial status of the organization.
• The transportation systems are influenced by the
building configuration, and the configuration is heavily
dependent on the transportation systems.
• The hospital configuration is also influenced by site
restraints and opportunities, climate, surrounding
facilities, budget, and available technology.
• Nursing units today tend to be more compact shapes
than the elongated rectangles of the past. Compact
rectangles, modified triangles, or even circles have been
used in an attempt to shorten the distance between the
nurse station and the patient's bed.
Glazed nursing station
CONNECTIVITY NURSING STATION TO PATIENTS ROOM
Efficiency And Cost-Effectiveness
• Promote staff efficiency by minimizing distance of
necessary travel between frequently used spaces
• Allow easy visual supervision of patients by limited
staff
• Include all needed spaces, but no redundant ones.
This requires careful pre-design programming.
• Consolidate outpatient functions for more
efficient operation—on first floor, if possible—
for direct access by outpatients
• Group or combine functional areas with similar
system requirements
• Make efficient use of space by locating support
spaces so that they may be shared by adjacent
functional areas, and by making prudent use of
multi-purpose spaces
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Flexibility And
Expandability
• Since medical needs and modes of
treatment will continue to change,
hospitals should Follow modular
Easily accessed area with concepts of space planning and layout
simple circulation • Be served by modular, easily accessed,
and easily modified mechanical and
electrical systems
• Be open-ended, with well planned
directions for future expansion; for
instance positioning "soft spaces" such
as administrative departments,
adjacent to "hard spaces" such as
clinical laboratories
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Therapeutic
Environment
• Hospital patients are often fearful and
confused and these feelings may impede
recovery. Every effort should be made to
make the hospital stay as unthreatening,
comfortable, and stress-free as possible.
• Using familiar and culturally relevant
materials wherever consistent with
sanitation and other functional needs
• Using cheerful and varied colors and
textures, keeping in mind that some colors
are inappropriate and can interfere with
provider assessments of patients' pallor and
skin tones, disorient older or impaired
patients, or agitate patients and staff,
particularly some psychiatric patients.
• Admitting ample natural light wherever
feasible and using color-corrected lighting
in interior spaces which closely
approximates natural daylight
• Providing views of the outdoors from
every patient bed, and elsewhere
wherever possible; photo murals of
nature scenes are helpful where
outdoor views are not available
• 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. A patient's sense
of competence is encouraged by
making spaces easy to find, identify,
and use without asking for help.
Building elements, color, texture, and
pattern should all give cues, as well as
artwork and signage.
CONNECTIVITY BETWEEN SPACES IN A HOSPITAL
BUBBLE DIAGRAM SHOWING CONNECTIVITY
BETWEEN SPACES
Cleanliness And Sanitation Controlled Circulation
• Hospitals must be easy to • A hospital is a complex
clean and maintain. This is system of interrelated
facilitated by: functions requiring constant
movement of people and
• Appropriate, durable finishes goods. Much of this
for each functional space circulation should be
• Careful detailing of such controlled.
features as doorframes, • Outpatients visiting
casework, and finish diagnostic and treatment
transitions to avoid dirt- areas should not travel
catching and hard-to-clean through ill inpatients
crevices and joints
• Typical outpatient routes
• Adequate and appropriately should be simple and clearly
located housekeeping spaces defined
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SECURITY AND SUSTAINABILTITY
SAFTEY
• In addition to the general • Hospitals are large public
safety concerns of all buildings, buildings that have a
hospitals have several
particular security concerns: significant impact on the
environment and economy of
the surrounding community.
• Protection of hospital property
and assets, including drugs They are heavy users of
energy and water and
• Protection of patients,
including incapacitated produce large amounts of
patients, and staff waste. Because hospitals
• Safe control of violent or place such demands on
unstable patients community resources they
• Vulnerability to damage from are natural candidates for
terrorism because of proximity sustainable design
to high-vulnerability targets, or
because they may be highly
visible public buildings with an
important role in the public
health system.
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STANDARDS AND CODES
• Vertical arrangement in a hospital should be design so that functional area-
care, treatment, supply, disposal, access and bedridden, patients, services
yard, underground garage, stores, administration, medical services, can be
connected, and accessed most efficiently, an affective arrangement would
be as follows.
• TOP FLOOR:- Helipad, air-conditioning plant room, nursing school and
laboratories.
• 2nd/3rd FLOOR:- Wards
• IST FLOOR:- surgical areas, central sterilization, intensive care, maternity,
children hospital
• GROUND FLOOR:- Entrance, radiology, medical services, ambulance,
entrance for bedridden patients, emergency, ward, information,
administration, cafeteria.
• BASEMENT:- Stores, physiotherapy, kitchen, heating and ventilation plant
room, radio therapy, linear accelerator
• SUB BASEMENT:- Underground, garage, electric supply
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DIMENSIONS CO-
ORDINATION
• Construction grid must provide a precise
guide as well as allowing, for
differentiation of area for the main
function, support function, vehicular
traffic.
• the varies operations centers can be
planned most appropriately with column
grid spacing, of 7.20m or 7.80m
• smaller construction grids are problematic
because large rooms as operation theater
which must be free from columns, are
more difficult to accommodate
• Source:- newfert, Architects data, third eddition
CORRIDORS
• Corridor should be designed for the maximum
expected circulation flow,
• generally, access corridor should be 1.50 m
wide.
• Corridor in which patients will be transported
should have size 2.25m wide
• The suspended ceiling at least 2.40m clear Hight
• Windows for lighting and ventilation should not
be further than 25m apart.
• the effective width of the corridor must not be
constricted by projections, columns, or other
building elements.
DOORS
• When designing doors the hygienic requirement should be
considered. The surface coating must withstand the long-
term action of cleaning agents and disinfectants,
• And they must be designed to prevent the transmission of
sound odors and draughts.
• Door should be meet the same standards of noise
insulation as the walls surrounding them.
• Double – skinned door leaf constructed must meet a
recommended minimum sound reduction requirement of
25db. The clear Hight of doors depend their type and
functions.
• NORMAL DOORS :- 2.10 - 2.20M
• VEHICLE ENTRANCE, OVER SIZED DOORS:- 2.50M
• TRANSPORT ENTRANCE :- 2.70 – 2.80M
• MINIMUM HIGHT OF APPROACH ROAD:- 3.50
STAIRS
• The stairs must be deigned in such a way that if necessary they can accommodate all of the vertical circulation.
• The relevant national safety and buildings regulations will apply.
• Stairs must have handrails on both side without projecting tips
• The effective width of staircase and landing in essential staircase must be minimum of 1.50m and should not exceed
2.50m
• doors must not constricted the use full width of landings and, in accordance with hospital regulation
• Doors to staircase must open in the direction of escape
RAMPS
1. PROBLEM IDENTIFICATION
Inaccessible building entrances due to difference between indoor and outdoor levels.
Inaccessible routes due to differences in level.
Lack of or improper design of ramps.
Very steep and/or long ramps with no resting landings.
2. PLANNING PRINCIPLE
To provide ramps wherever stairs obstruct the free passage of pedestrians, mainly wheelchair users and people with mobility
problems.
DESIGN CONSIDERATIONS
3.1 General
*An exterior location is preferred for ramps. Indoor ramps are not
recommended because they take up a great deal of space.
*Ideally, the entrance to a ramp should be immediately adjacent to the stairs.
3.2 Ramp configuration (1)
*Ramps can have one of the following configurations:
(a) Straight run (fig. 1);
(b) 90 turn (fig. 2);
(c) Switch back or 180 turn (fig. 3).
3.3 Width
*Width varies according to use, configuration and slope.
*The minimum width should be 0.90 m.
3.4 Landings
*Ramps should be provided with landings for resting,
maneuvering and avoiding excessive speed.
*Landings should be provided every 10.00 m, at every
change of direction and at the top and bottom of every
ramp.
*The landing should have a minimum length of 1.20 m
and a minimum width equal to that of the ramp
3.5 Handrail
*A protective handrail at least 0.40 m high must be
placed along the full length of ramps.
*For ramps more than 3.00 m wide, an intermediate
handrail could be installed (fig. 5).
*The distance between handrails when both sides are
used for gripping should be between 0.90 m and 1.40 m
(fig. 5).
3.6 Surface
*The ramp surface should be hard and non-slip.
*Carpets should be avoided.
3.7 Tactile marking
*A colored textural indication at the top and bottom of the ramp should be placed to alert sightless
people as to the location of the ramp.
*The marking strip width should not be less than 0.60 m.
3.8 Drainage n Adequate drainage should be provided to avoid accumulation of water.
3.9 Obstacles
*The same clearance considerations that apply to pathways apply to ramps (see Obstructions).
3.10 Mechanical Ramps
*Mechanical ramps can be used in large public buildings but are not recommended for use by
persons with physical impairments.
*If the ramp is to be used by a wheelchair-confined person, the slope should not exceed 1:12.
*The maximum width should be 1.00 m to avoid slipping.
4. EXISTING CONSTRUCTIONS
If the topography or structure of the existing building is restrictive, minor
variations of gradient are allowed as a function of the ramp length:
*A non-slip surface finish should be added to slippery ramps.
LIFTS
• lifts transports people, medicines, laundry, meals and
hospital beds between floors, and for hygiene and aesthetic
reason separate lifts must be provided for some of these
• In building in which care, examination or treatment areas
are accommodated on upper floors, at least two lifts suitable
for transporting beds must be provided.
• The elevator car must be of a size that allows adequate room
for a bed and accompanying people,
• the internal surfaces must be smooth, washable, and easy to
disinfect, the floor must be non slip, lift shaft must be fire
resistant.
• One multipurpose lift should be provided per 100 beds, with
a minimum of two for a hospital, in addition there will be a
minimum two smaller hospital
• In addition there should be a minimum of two smaller lifts
for portable equipment, staff and visitors
• Clear dimension of lift car :- 0.90 x 1.20m, Clear dimension
of lift shaft :- 1.25 x 1.50m
• In the past, operations centers tends to planed centrally
located examination and treatment unit for used by various
specialist, departments. For better utilization of space,
equipment, and staff and better service functions under the
management specialist and hygienic consideration.
• Disadvantage of central organized surgical department are
high organized coast,
• Increase risk of infection because large no. of people brought
together.
• A further disadvantage is the combination of septic and
SERGICAL
aseptic operation in one center
• Current large hospitals have separate large units for septic DEPARTMENT
and aseptic operations as a rule
• When deciding the location of surgical department, service
Centralization:- advantages and
relationship must be checked, these include reception, the disadvantages
emergency service, causality surgery obstetrics endoscopy
and specialist clinics.
FUNCTIONS AND
LAYOUT
• The patient demarcations lobbies for two operating theatres are used to bed to bed transfer, preparation, of
operating tables and ward beds, and theatre stores
• an appropriate size is around [Link] and fittings should include wash basins and an electric conveyor for bed to
bed transfer
• IDEAL FLOOR PLAN of an external surgical area with a direct link to the main building.
• A requirement when planning a new building is that it must expandable on at least one side.
• Use:-In the surgical department, treatment is given to the patients whose conditions have been diagnosed but
cannot be cured solely with the medicines
• It should be closed to the intensive care department, The recovery room and the central sterilization area
because there is intensive interaction between these departments and easy access must be assured
• To maintain hygienic precautions require the surgical unite to be isolated from the rest of the hospital
operations.
• This is achieved be a demarcations system using lobbies
• Surgical department are must located centrally in the core area of the hospital where they are easy to reach
• the reception area for emergency cases causality must be as close as possible to the surgical area since such
patients often need to be moved into surgery immediately
FUNCTIONS AND LAYOUT
• ORGANIZATION OF THE SURGERY
DEPARTMENT
• Operating theater 40 – 48 sq.m
• Entry room 15 – 20 sq.m
• Exit room 15 – 20 sq.m
• Wash room 12 – 15 sq.m
• Equipment room 10 – 15 sq.m
• in new projects, it is permissible for two
operating theaters to share the same exit
room.
• Essential to surgical departments are a staff
lobby, patients lobby, clean work corridor,
anesthetic workroom,
• Waste lobby, supply lobby standing area for
two operating trolleys and nearby, the
recovery room.
• A number of necessary supply and workrooms adjoin the
operating theatre directly
• The operating theater should be designed to be as square as
possible to allow working whatever direction the operating
table is turned in.
• A suitable size must be 6.50 x 6.50 m with a clear height of
3.00m
• Height allowance for roughly 0.70m for air conditioning and
other service.
• Operating theaters should be fitted out as uniformly as
MAIN SERGICAL
possible, in order to maximum flexibility, and center on a
transportable operating table system which is mounted on ROOMS
fixed base in the middle of the room.
• Natural lighting in the operating theater id psychologically
adventurous, cannot be provided because of the layout,
where it is, there must be the means of shut out the light
completely.
• Floor and falls must be smooth and washable and disinfect.
ANESTHTIC ROOM
• The anesthetic room should be completely 3.80 x 3.80m in size
• Should have electric sliding door into the operating theatre (clear width of 1.40m)
• These doors must have windows to give a visual link with the operating theatre
• The room should be equipped with the refrigerator, draining sink, rinsing line, cupboard for
cannulas, connection for anaesthesia equipment and emergency power
ANESTHTIC DISCHARGE ROOM
• This is setout identically to the anesthetic room
• The door to working corridor should be designed as a swing door with a clear width of 1.25m.
WASHROOMS
• Division into clean and non clean washroom is ideal, but from a hygenic point of view a single large
room is adequate
• The minimum width of the room should be 1.80 m
• For each operating theater there should be three non-splash wash basins with foot control,
• The doors into the operating theater must have an inspection window and, they are electric, be
opened by foot control
• Swing doors can be used if coast saving is priority
STERILE GOODS ROOM
• The size of the room is more flexible but there must be sufficient shelf and cupboard space and it
must be accessed directly from the operating theater.
• One room of roughly [Link] required per operating theater
EQUIPMENT ROOM
• Although directly operating to the operating theater is preferable. It is not always feasible, where
direct access cannot be provided
• The equipment room must be located as close as possible to the theater in order to reduce waiting
time
• Room size approximately [Link] should be allowed
SUBSTERILISATION ROOM
• This room may or may not connected directly to the operating theater’s sterile area. It contain an non – clean
area for non- sterile material and a clean area for prepared sterile terms.
• It must be contains a sink, storage surface, work surface, and steam sterilizer
• Linking a substerillisation room to several operating theaters causes hygiene problem and so should be
avoided.
• Not that surgical instruments area prepared in the central sterilizing unit which lies out side the surgical area
PLASTER ROOM
• For hygienic reason this is not located in the surgical zone but in the outpatient area.
• In emergencies the patients must be channeled through lobbies in order to get the operating theater
AUXILARY FUNCTION
• The room for auxiliary functions do not need
to be in immediate area of the operating
theater
• Separation be a corridor which is not
intended for patient use is available
NURSES LOUNGE
• The dimensions of the room depend on the size of
the surgical department.
• It should be assumed that there are eight members
of the staff per surgical team (doctors, theater
nurses, anesthesia nurses).
• In the case of surgical units with more than two
operating theaters, it is appropriate to separate
smokers to non smokers
• The lounge must offer sufficient seating, cupboard
and sink
NURSE WORKSTATION
• This should be located centrally and have large glass screens to allow the working corridor to be viewed
• In addition to the desk they must have cupboards and walls on which organizational schedule planner can be mounted
DICTATION ROOM
• No larger than [Link]. in size,
• Such room are where the doctors prepare reports following an operation, they are not absolutely
necessary
PHARMACY
• A [Link] can supply a combination of anesthetics and surgical medication and other materials
particularly if a space – saving rotating shelving system is installed.
CLEANING ROOM
• A size of [Link] is sufficient for cleaning rooms.
• They should be closed to the operating theater since cleaning and disinfection are carried out after
each operation
STANDING AREA FOR CLEAN BEDS
• Close to the patients demarcation lobby there should be sufficient space to stand beds which have
been cleaned and prepared
• Requirement is for one additional clean bed for each operating table.
Wcs
• Toilet should be located in the lobbies not in the surgical areas for hygienic reasons
• LAYOUT OF THE ROOMS:-
• Medical rooms and washrooms should be accessed from
the main station corridor which must be easily supervised
from the glazed nurses work station to prevent
unauthorized entry.
• SIZE OF THE PATIENT ROOM:-
• The patient beds must be accessible from the sides of and
it sets the size of the room
• The smallest size of the one bed room is [Link].
• For two- and three – bed room a minimum size of [Link]
• Width of the room should be 3.20m
• Next to each bed there must be night table
• Toward the window there should be 900 x 900mm table
CARE AREA
• NON – CLEAN WORK ROOM
• Size of the work room should be [Link]. approximately
• The room will contain a sink and sluice, preferably in
stainless steel, and fully tied walls are recommended
• NURSES WORK STATION
• NURSES WORK STATION SHOULD BE PLACED CENTARLY
• SIZE APPROXIMATELY 25-30 SQ.M.
ONE BED
ROOM
TWO BED ROOM
FOUR BED ROOM
REST ROOM/ KITCHENETTE
• Roughly [Link]. in size
• Used for staff break-time
• STATION DOCTORS
• Room size of the room should be 16-20sq. For
examine patients
• There should be a shelve and
• examination chair table setup
• CLEAN WORK ROOM
• It should have an area about 10 SQ.M
• EQUIPPED WITH FIXED SHELVING ( 600 MM DEEP)
• OR FEXIBLE STORAGE SYSTEM
• PATIENT’S BATHROOM
• Bathroom should be fixed with a tub which is accessible from three sides to ease the lifting shelving
• Shower can be a option for wheelchair users provide enough space is allowed (1400 x 1400mm)
• PLANT ROOM
• Each station must have a plant room approximately 8 SQ.M
• Should be equipped with a fuse board
PATIENTS LAUNGE
• Approximately 22-25sq.m in size, allocated for
general meeting place for patients
• The design should emulate a domestic
environment
• INTERNAL MEDICINE TREATMENT AREA
• It brings all the examination techniques
together
• The basic facilities comprises examination
room [Link],
• administration office- [Link].
• Between the senior physician room(15-
[Link]) and chief physician’s room (20- 25
sq.m)
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