Manual of Hospital Planning and Designing; For Medical Administrators, Architects and Planners 9789811684562, 9789811684555
This book is a one-stop resource on all the critical aspects of planning and designing hospitals, one of the most comple
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English Pages 580 Year 2022
Table of contents :
Part I Hospital Planning
1 Phases of Planning and Designing
1.1 Hospital Planning
1.2 Schematic Design
1.3 Construction Documents
1.4 Design and Development
1.5 MEP Planning
1.6 Construction
1.7 Equipment Planning
1.8 Man Power Planning
1.9 Finalizing the Standard Operating Procedures of Hospital
1.10 Commissioning
Further Reading
2 Inception of the Idea
3 Factors Assessing Feasibility of the Hospital
3.1 Demographics
3.2 Understanding the Type of Diseases
3.3 Community
3.4 Healthcare Systems and Hospitals Network
3.5 Innovations in Facility Planning and Management
3.6 The Requirement of the Specialty Facilities and/or Departments
3.7 Medical Tourism
3.8 Health Insurance and Empanelment
3.9 Catchment Area
Further Reading
4 Preparation of Detailed Project Report (DPR) and Techno-Commercial Feasibility Report (TCFR)
4.1 Information to Be Generally Provided in DPR
4.2 Documents DPR Shall Contain
4.3 General Contents in DPR
4.4 Evaluation of DPR
4.5 Sample Formats of DPR
Further Reading
5 Site Selection
5.1 Size of the Land Required for Hospital
5.2 Assessment of the Covered Area Required for Hospital
5.3 Total FAR Allowed
5.4 Set Back Area
5.5 Maximum Permissible Land Coverage
5.6 Maximum Permissible Height of the Building
5.7 Approach to the Site
5.8 Location of the Land
5.9 Availability of Transportation
5.10 Security
5.11 Availability of Utilities
5.12 Road Network in the Area
5.13 Environmental Pollution
5.14 Wind and Earthquake
5.15 Flood Protection
Further Reading
6 General Issues to Be Considered While Designing Hospital Building
6.1 Importance of Hospital Planning and Designing
6.2 Flexibility and Expandability
6.3 Design for the Patient Experience
6.4 Design for Employee Productivity
6.5 Accessibility to the Patient
6.6 Security and Safety of Men and Material
6.7 Sustainability of Resources
6.8 Efficiency and Cost-Effectiveness
6.9 Adaptation of Technological Advancements
6.10 Stress and Fear of Patients and Visitors
6.11 Quality Care of Patients
6.12 Therapeutic Environment
6.13 Cleanliness and Sanitation
6.14 Noise Reduction
6.15 Minimizing the Operative, Postoperative and Hospital-Acquired Infections
6.16 Automation Where Possible
6.17 Environmental Pollution Control
6.18 Internal Road
6.19 Parking
6.20 Wind, Earthquake-Resistant and Flood Protection
6.21 Nature Plus Artwork
6.22 Colours to Be Used
6.23 Choice of Building Materials
6.24 Flooring
Further Reading
7 Area Requirement and Planning
7.1 Functional Areas
7.2 Room/Space Requirement
7.3 Sizes of the Rooms
7.4 Zoning
7.5 Placement of Zones in the Building
Further Reading
Part II Schematic Design of Hospital
8 Schematic Design
8.1 What Is the Schematic Design?
Further Reading
9 Effects of COVID-19 on the Design of the Hospital
9.1 What Will Be the Design of Future Hospitals
9.2 Issues to Be Addressed While Planning and Designing a Hospital in Post-COVID-19 Era
9.3 Changes in the Design of Building, Location, Spaces and Sizes of the Rooms in the Healthcare Facility
9.3.1 Hybrid Design of Building
9.3.2 Improving Infection Prevention
9.4 Changes in the Layout, Facilities of Various Departments, Emergency Rooms, Operating Rooms, Intensive Care Area, Diagnostic Facilities, Waiting Lobbies, Staff Zones, the Administrative Zones etc.
9.4.1 Entrance Lobbies
9.4.2 Waiting Lobbies
9.4.3 Outpatient Department
9.4.4 Emergency Department
9.4.5 In-Patient Department
9.4.6 Operating Rooms
9.4.7 Diagnostic Laboratories
9.4.8 Radiology
9.4.9 Staff and Administrative Workplaces
9.5 Acceptance of the New and Improved Building Materials Which Seems to Be More Appropriate as Per the New Building Designs or Which Can Ease Out the Concept of the New and Better-Designed Building
9.5.1 Antimicrobial Finishes and Materials
9.5.2 Use of Antibacterial Materials
9.5.3 Use of Non-porous Materials
9.5.4 For the Furniture
9.5.5 Touch-free Controls
9.5.6 Automatic Doors and E-switchable Privacy Glass
9.5.7 Smart Facade Glazing
9.5.8 Prefabricated Materials
9.5.9 Paints
9.5.10 Flooring
9.5.11 Clean Rooms with HEPA Filters
9.5.12 Dehumidification
9.5.13 Contactless Office
9.5.14 Conference Rooms
9.5.15 Automation
9.5.16 Automatic Body Thermal Scanner
9.6 Temporary Conversion of Space in the Hospital into Treatment Units, Emergency Suits, ICUs and Isolation Units to Handle Surges in the Number of Patients due to Pandemics
9.6.1 Wall Finishes
9.6.2 Flooring
9.6.3 Electrical Points
9.6.4 Medical Gases
9.6.5 Bed and Hospital Furniture
9.6.6 Partitions
9.6.7 Washrooms
9.6.8 Air Conditioning
9.6.9 Nurse Call Systems
9.7 Modification and Adoption of Improved Working Systems and SOPs Which Are in Consensus with the New or Modified Design of Healthcare Facility
9.7.1 Health Worker’s Safety and Support
9.7.2 Entrance
9.7.3 Waiting Lobbies
9.7.4 Out Patient Department
9.7.5 Indoor and Isolation
9.7.6 Emergency Department
Further Reading
10 Site Plan
10.1 Contents of Site Plan
Further Reading
11 Detailed Engineering Drawings
11.1 Concept Drawings
11.2 Floor Plan Drawings
11.3 Cross Section Drawings
11.4 Elevation Drawings
11.5 Landscape Drawings
11.6 Finishing Drawing
11.7 Working Plan Drawings
11.8 Section Drawings
11.9 Structural Drawings
11.10 Column Layout Drawings
11.11 Plinth Beam Layout Drawings
11.12 Lintel Beam Layout Drawings
11.13 Roof Beam and Shuttering Layout Drawings
11.14 General Note
11.15 Excavation Drawings
11.16 Electrical Drawings
11.17 Plumbing Drawings
11.18 Firefighting and Detection Drawings
11.19 Shop Drawings
11.20 Furniture Layout Drawings
11.21 Furniture Design Drawings
11.22 Hospital Signage Drawings
11.23 As-Built Drawings
11.24 PERT Charts
Further Reading
Part III Construction Documents
12 Preparation of Construction Documents
12.1 Definition of Construction Documents
12.2 Contents of Construction Document
12.2.1 General Information About the Hospital Project
12.2.2 Construction Contract Agreement
12.2.3 Scope of Work
12.2.4 Construction Schedule
12.2.5 General Conditions
12.2.6 Special Conditions
12.2.7 Specifications
12.2.8 Bill of Quantities
12.2.9 Cost Estimate
12.2.10 Drawings
12.2.11 Other Documents
Further Reading
Part IV Design & Development
13 Designing Details of Individual Department or Spaces of the Hospital
14 Design of the Main Entrance Gate to the Hospital
Further Reading
15 Designing of the Entrance Lobby of the Hospital
15.1 Location of the Entrance Lobby
15.1.1 The Infrastructure of the Entrance Lobby
15.2 Services in the Lobby
15.3 Reception and Enquiry Counter
15.3.1 Furniture at the Reception
15.3.2 Electrical and Other Points at the Reception
15.4 Help Desk, Registration and Admission and Discharge Counters
15.4.1 Furniture at Help Desk, Registration, Admission and Discharge Counters
15.4.2 Electrical and Other Points at Help Desk, Registration and Admission and Discharge Counters
15.5 Cash Counter
15.5.1 Furniture at Cash Counter
15.5.2 Electrical and Other Points at Cash Counter
15.6 Cafeteria
15.6.1 Furniture in the Cafeteria
15.6.2 Electrical and Other Points in the Cafeteria
15.7 Pharmacy
15.8 Other Service Counters in the Entrance Lobby
15.9 Public Utility for Patient/Visitors
15.10 Prayer Room/Meditation Spaces
15.11 Self-Service Kiosks
15.12 Interiors of the Entrance Lobby
15.13 Entrance Gates to the Lobby
15.14 Signage and Wayfinding in the Lobby
15.15 Acrylic or Glass Partitions
15.16 General Issues Related to Entrance Lobby
15.17 Outside Entrance Lobby
15.17.1 Screening Areas
15.17.2 Hand Wash/Sanitizer Stations
15.17.3 Face Masks /Shoe Covers Dispensers
15.18 Reduction of People Landing in the Entrance Lobby
Further Reading
16 Emergency Services
16.1 Objectives of the Emergency Department
16.2 Location of Emergency Department
16.3 Signage of the Emergency Department
16.4 Size of the Emergency Department
16.5 Areas Required for Emergency Department
16.6 The Entrance of the Emergency Department
16.6.1 Main Gate
16.6.2 Entrance Door to the Emergency Department
16.6.3 Outside Entrance Lobby
16.6.4 Screening Areas
16.6.5 Handwash/Sanitizer Stations
16.6.6 Face Masks/Shoe Covers Dispensers
16.6.7 Decontamination Area
16.6.8 General Waiting
16.6.9 Ambulance Control
16.7 Reception
16.7.1 The Infrastructure of Reception
16.7.2 Furniture
16.7.3 Tools and Instruments
16.7.4 Electrical Points at Reception
16.7.5 Other Communication Points at Reception
16.8 Triage and Resuscitation
16.8.1 Location of Triage
16.8.2 Size of Triage
16.8.3 Issues Related to Infrastructure of Triage
16.8.4 Bed Layout in Triage
16.8.5 Isolation Room/Units/Area in Triage
16.8.6 Resuscitation Rooms in Triage
16.8.7 Furniture in Triage
16.8.8 Equipment in Triage
16.8.9 Tools and Instruments
16.8.10 Doors
16.8.11 Windows
16.8.12 Hand Washing
16.8.13 Central Piped Medical Gas Supply
16.8.14 Electrical Points in Triage
16.8.15 Other Communication Points in Triage
16.8.16 Curtain Partitions
16.8.17 Doctors Duty Rooms in Triage
16.9 Treatment/Procedure Room/Minor Operation Theatre
16.9.1 Location of Minor OT
16.9.2 Size of Minor OT
16.9.3 The Infrastructure of Minor OT
16.9.4 Issues Related to Infrastructure of Minor OT
16.9.5 Furniture in Minor OT
16.9.6 Equipment
16.9.7 Tools and Instruments
16.9.8 Doors
16.9.9 Windows
16.9.10 Handwashing
16.9.11 Central Piped Medical Gas Supply
16.9.12 Electrical Points in Minor OT
16.9.13 Other Communication Points in Minor OT
16.10 Procedure and Diagnostic Setup
16.10.1 Location of Investigation Rooms
16.11 Emergency Operation Theatre Complex
16.12 Day-Care Observation Ward
16.12.1 Location of Observation Ward
16.12.2 Size of Observation Ward
16.12.3 The Infrastructure of Observation Ward
16.12.4 Issues Related to Infrastructure of Observation Ward
16.12.5 Bed Layout in Observation Ward
16.12.6 Isolation Room in the Observation Ward
16.12.7 Furniture in Observation Ward
16.12.8 Equipment
16.12.9 Tools and Instruments
16.12.10 Doors
16.12.11 Windows
16.12.12 Handwashing
16.12.13 Central Piped Medical Gas Supply
16.12.14 Electrical Points in Observation Ward
16.12.15 Other Communication Points in Observation Ward
16.12.16 Curtain Partitions
16.13 Other Issues Relating to Emergency Department
16.14 Disaster Plan
16.14.1 Factors for Disaster Plan
Further Reading
17 Outpatient Department
17.1 Location of the OPD
17.2 Schemes of the Layout of the OPD
17.2.1 Single Corridor OPD
17.2.2 Double Corridor OPD
17.2.3 Clustered OPD Block
17.3 Infrastructure Requirements in the OPD
17.4 Reception and Enquiry Counter
17.4.1 Furniture at the Reception
17.4.2 Electrical and Other Points at the Reception
17.5 Registration Counter
17.5.1 Furniture at Registration Counter
17.5.2 Electrical and Other Points at Registration Counters
17.6 Waiting Lobby/Hall
17.7 Examination Rooms
17.7.1 Combined Multi-Disciplinary Consultation Room
17.7.2 Separate Consultation Room
17.8 Procedure/Treatment Rooms
17.9 Support Rooms
17.10 General Issue While Designing the OPD
17.11 Number of OPDs Required
17.12 Consultation Room
17.12.1 Size of the OPD Room
17.12.2 Doors
17.12.3 Windows
17.12.4 Hand Washing
17.12.5 Furniture
17.12.6 Instruments and Equipment
17.12.7 Electrical Points in Consultation Room
17.12.8 Other Communication Points in OPD
17.12.9 Curtain Partitions
17.13 Design of OPD
17.13.1 Use of Touch-free Medical Devices
17.13.2 OPD Consultation Rooms with Videoconferencing Solutions
17.13.3 Creating Virtual OPD
17.13.4 Sterilization and Pressure
17.13.5 Telemedicine Impact on the Facility
17.13.6 Mobile Health
17.14 Procedure /Treatment Room
17.14.1 Size of the Procedure/Treatment Room
17.14.2 Doors
17.14.3 Windows
17.14.4 Handwashing
17.14.5 Furniture
17.14.6 Instruments and Equipment
17.14.7 Electrical Points in Procedure/Treatment Room
17.14.8 Other Communication Points in Procedure/Treatment Room
Further Reading
18 Intensive Care Units
18.1 Types of ICUs
18.2 Number of Beds in a Single Unit of ICU
18.3 Location of Intensive Care Units
18.4 Infrastructure of ICU
18.5 Size of the ICU
18.6 Sizing Considerations
18.7 Patient Care Zone
18.7.1 Patient Unit
18.7.2 Isolation Room/Units/Area in ICU
18.7.3 Furniture in ICU
18.7.4 Equipment
18.7.5 Tools and Instruments
18.7.6 Doors
18.7.7 Windows
18.7.8 Nursing Station
18.7.9 Hand Hygiene
18.7.10 Toilets
18.7.11 Air Conditioning System of ICUs
18.7.12 Central Piped Medical Gas Supply
18.7.13 Electrical Points in ICU
18.7.14 Other Communication Points in ICU
18.7.15 Curtain Partitions
18.8 Procedure and Treatment Room
18.8.1 Location of Treatment/Procedure Room
18.8.2 Size of Treatment/Procedure Room
18.8.3 Issues Related to Infrastructure of Treatment/Procedure Room
18.8.4 Furniture in Treatment/Procedure Room
18.8.5 Equipment
18.8.6 Tools and Instruments
18.8.7 Doors
18.8.8 Windows
18.8.9 Handwashing
18.8.10 Central Piped Medical Gas Supply
18.8.11 Electrical Points in Treatment/Procedure Room
18.8.12 Other Communication Points in Treatment/Procedure Room
18.8.13 Other Issues on Patient Care Zone and Procedure/Treatment Room
18.8.14 Lighting in the ICU
18.8.15 Dialysis Equipment
18.8.16 Power Backup
18.9 Clinical Support Zone
18.9.1 Rigorous Monitoring
18.9.2 Radiology
18.9.3 Laboratory
18.9.4 Medication Rooms
18.9.5 Pneumatic Tube Systems
18.9.6 Clean Utility
18.9.7 Dirty Utility/Sluice Room
18.9.8 Equipment Park/Store
18.9.9 Emergency Eyewash Station
18.10 Unit Support Zone
18.10.1 Change Room: Male/Female in ICU
18.10.2 Doctors Duty Rooms in ICU
18.10.3 Nurses Night Duty Rooms in ICU
18.10.4 Night Duty Room for On-Call Junior Doctors
18.10.5 Ward Pantry
18.10.6 Staff Lounge
18.11 Family Support Zone
18.11.1 Family Lounge
18.11.2 Consultation Rooms
18.11.3 Meditation Spaces
18.11.4 Family Cafeteria
18.11.5 Family Sleep Rooms
18.11.6 Family Laundry
18.12 Specialized Intensive Care Units
18.12.1 Intensive Coronary Care Unit
18.12.2 Respiratory Care ICU
18.12.3 Neurosurgical Intensive Care Unit
18.12.4 Burn Unit
18.12.5 Geriatric ICU
18.12.6 Neonatal Intensive Care Unit
18.13 Common Design Considerations
18.13.1 Signage and Way Finding
18.13.2 Security and Access Control
18.13.3 Patient Safety Technology
18.13.4 Communications
18.13.5 Storage
18.13.6 Relationships with Other Departments
18.13.7 Central Nursing Station
18.13.8 Patient Records
18.13.9 X-ray Viewing Area
18.13.10 Reception Area
18.13.11 Corridors in ICU Complex
18.13.12 Administrative Offices
Further Reading
19 Operation Theatre Suite
19.1 Location of Operating Theatre (O.T.) Complex
19.2 Zones in O.T. Complex
19.2.1 Unsterile Zone
19.2.2 Protective Zone
19.2.3 Clean Zone
19.2.4 Sterile Zone
19.3 Infrastructure of O.T. Complex
19.4 Unsterile Zone
19.4.1 Administrative Area
19.4.2 Operation Theatre In-charge or Manager
19.4.3 Room for Head of Anaesthesia
19.4.4 Surgeons Room for Office Work
19.4.5 Trolley Bay
19.4.6 Frozen Section Biopsy Laboratory
19.4.7 Shoe Change Area
19.4.8 Entry Door for Changing Room
19.4.9 Waiting Area for Attendants
19.4.10 Public Utility for Attendants
19.4.11 Linen Pre-wash Room
19.4.12 Instrument Wash Room
19.5 Protective Zone
19.5.1 Changing Rooms
19.5.2 Entry Gate of Pre-operative Ward
19.5.3 Unsterile Store for Equipment Storage
19.5.4 Store for Medicines, Consumables and Disposables
19.5.5 Pantry
19.6 Clean Zone
19.6.1 Pre-operative Room
19.6.2 Preparation Room
19.6.3 Surgeons Rest Room
19.6.4 Restroom for Staff: Males and Females
19.6.5 Exit Doors of all Change Rooms
19.6.6 Pre-anaesthetic Check-up Room (PAC)
19.6.7 Dirty Utility
19.6.8 Post-operative Recovery Ward
19.7 Sterile Zone
19.7.1 Clean Supply Room
19.7.2 Instrument Trolley Lay Up
19.7.3 Scrub Station
19.7.4 Sterilization Room
19.7.5 Operating Theatres/Rooms
19.7.6 Number of OR
19.7.7 Location and Layout of the ORs
19.7.8 Types of Operating Rooms
19.8 Simple Room OR
19.9 Pre-fabricated Modular OR
19.9.1 Size of the OR
19.9.2 Walls of the OR
19.9.3 Ceiling of the OR
19.9.4 Corners of OR
19.9.5 Door of the OR
19.9.6 Window in OR
19.9.7 Control Panel
19.9.8 View Box
19.9.9 Writing Board
19.9.10 Pressure Relief Damper (PRD)
19.9.11 Peripheral Lights
19.9.12 Plenum
19.9.13 Plenum Lights
19.9.14 Pass-through Windows/Hatch Boxes
19.9.15 Electrical Points
19.9.16 Anaesthetist Pendant
19.9.17 Surgeon Pendant
19.9.18 Flooring
19.9.19 Painting
19.9.20 Air Conditioning and Environment of ORs
19.9.21 Supply Air Ducts
19.9.22 Return Air
19.9.23 Special Air Requirements for OR
19.9.24 Other Communication Points in OR
19.9.25 Equipment in OR
19.9.26 Furniture OR
19.10 Septic Operation Theatre
19.11 Endoscopy Suite
19.11.1 Endoscopy Room
19.11.2 Endoscope Washroom
19.11.3 Store
19.11.4 Change Room
19.11.5 Recovery Room
19.11.6 Consultation Room
19.12 Semi-modular OR
19.13 Modular OR
19.14 Hybrid OR
Further Reading
20 Delivery Room/Labour Room
20.1 Location of LDR Complex
20.2 Zones in LDR Complex
20.2.1 Unsterile Zone
20.2.2 Protective Zone
20.2.3 Delivery Zone
20.3 Infrastructure of LDR Complex
20.4 Unsterile Zone
20.4.1 Administrative Area
20.4.2 Labour Room In-Charge
20.4.3 Gynaecologist Room for Office Work
20.4.4 Trolley Bay
20.4.5 Shoe Change Area
20.4.6 Entry Door for Changing Room
20.4.7 Waiting Area for Attendants
20.4.8 Public Utility for Attendants
20.4.9 Linen Pre-wash Room
20.4.10 Instrument Wash Room
20.5 Protective Zone
20.5.1 Changing Rooms
20.5.2 Store for Equipment, Medicines, Consumables and Disposables
20.5.3 Pre-labour Room/Ward
20.5.4 Eclampsia Room
20.5.5 Examination/Preparation Room
20.5.6 Surgeons Rest Room
20.5.7 Dirty Utility
20.5.8 Post-labour Recovery Ward
20.5.9 Doctors Night Duty Rooms
20.6 Delivery Zone
20.6.1 Clean Supply Room
20.6.2 Instrument Trolley Layup
20.6.3 Scrub Station
20.6.4 Sterilization Room
20.6.5 Delivery Rooms
20.6.6 Location and Layout of the Delivery Rooms
20.6.7 Types of Delivery Rooms
20.6.8 Equipment in Delivery Rooms
20.6.9 Furniture Delivery Rooms
20.6.10 Other Issues Relating to the Delivery Room
20.6.11 Septic Delivery Room
20.7 Baby Resuscitation Area
20.8 Other Important Issues to be Considered While Designing LDR
20.8.1 Labour Table Specifications
20.8.2 Shifting Baby to NICU
20.8.3 Access to the Operating Room
Further Reading
21 Intermediate Care Area (Patient Rooms)
21.1 Improve Patient and Staff Safety
21.2 Increase Patient and Staff Satisfaction
21.3 Provide Amenities and Comfort for the Family
21.3.1 Family Lounge
21.3.2 Consultation Rooms
21.3.3 Meditation Spaces
21.3.4 Family Cafeteria
21.3.5 Family Sleep Rooms
21.3.6 Family Laundry
21.4 Increase Staff Efficiency
21.5 Patient Room Furnishings
21.5.1 Room Decor
21.5.2 Lighting in the Patient Room
21.5.3 Ceiling Finishes
21.6 Types of Patient Rooms in the Hospital
21.6.1 Single Bed Occupancy
21.6.2 Sharing Rooms
21.6.3 General Wards
21.6.4 Isolation Ward/Rooms
21.7 Infrastructure Details of the Indoor Patient Units
21.8 Location of the Indoor Patient Areas
21.9 Zoning of the Isolation Areas
21.10 Single Patient Room (Private Room)
21.10.1 Room Layout
21.10.2 Size of the Room
21.10.3 Walls
21.10.4 Doors
21.10.5 Windows
21.10.6 Toilets
21.10.7 Bed Layout in Patient Room
21.10.8 Furniture and Instruments in Patient Room
21.10.9 Air Conditioning System of Patient Rooms
21.10.10 Central Piped Medical Gas Supply
21.10.11 Electrical Points in Patient Room
21.10.12 Other Communication Points in Patient Room
21.10.13 Curtain Partitions
21.10.14 IV Track
21.10.15 Psychiatric Patient Rooms
21.11 Deluxe Single Patient Room (Deluxe Room)
21.12 Family Suite with Single Patient Room (Suite Room)
21.12.1 Patient Room of the Suite
21.12.2 Family Room of the Suite
21.13 Sharing Patient Room (Semi-private Room)
21.13.1 Room Layout
21.13.2 Size of the Semi-private Sharing Room
21.13.3 Design of the Semi-private Sharing Room
21.13.4 Toilets
21.13.5 Bed Layout in Patient Room
21.13.6 Furniture and Instruments in Patient Room
21.13.7 Air Conditioning System of Patient Rooms
21.13.8 Central Piped Medical Gas Supply
21.13.9 Electrical Points in Patient Room
21.13.10 Other Communication Points in Patient Room
21.13.11 Curtain Partitions
21.13.12 IV Track
21.13.13 Lighting in the Patient Room
21.14 General Ward (Multiple Beds Room)
21.14.1 Location of the Multiple Bed Wards
21.14.2 Room Layout
21.14.3 Number of Beds in the Multiple Bed Ward
21.14.4 Size of the Multiple Bed Ward
21.14.5 Design of the Multiple Bed Ward
21.14.6 Toilets
21.14.7 Bed Layout in Ward
21.14.8 Furniture and Instruments
21.14.9 Air Conditioning System
21.14.10 Central Piped Medical Gas Supply
21.14.11 Electrical Points in Ward
21.14.12 Other Communication Points in Ward
21.14.13 Curtain Partitions
21.14.14 IV Track
21.14.15 Lighting in the Patient Room
21.15 Isolation Rooms/Wards
21.15.1 Isolation in ICU
21.15.2 Single Bed Isolation Rooms
21.15.3 Air and Pressure Monitoring System for Isolation Rooms
21.15.4 Pressurization of the Isolation Rooms
21.15.5 Air Conditioning of the Isolation Wards/Units
21.16 Supporting Room/Units for Indoor Patient Service
21.17 Nursing Station
21.17.1 Hand Hygiene
21.17.2 Alcohol Gel/Sanitizer Dispensers
21.18 Nurses Duty Rooms
21.19 Doctors Duty Rooms
21.20 Procedure and Treatment Room
21.20.1 Location of Treatment/Procedure Room
21.20.2 Size of Treatment/Procedure Room
21.20.3 Issues Related to Infrastructure of Treatment/Procedure Room
21.20.4 Furniture in Treatment/Procedure Room
21.20.5 Doors
21.20.6 Windows
21.20.7 Handwashing
21.20.8 Central Piped Medical Gas Supply
21.20.9 Electrical Points in Treatment/Procedure Room
21.20.10 Other Communication Points in Treatment/Procedure Room
21.21 Clean Utility
21.22 Dirty Utility/Sluice Room
21.23 Store for Medicines, Consumables and Disposables
21.24 Medication Areas
21.25 Equipment Park/Store
21.26 Trolley Park Area
21.27 Ward Pantry
Further Reading
22 Radiology
22.1 Diagnostic vs Therapeutic Radiology
22.2 Location of the Radiology Department
22.3 Infrastructure on Centralized Radiology Department
22.4 Main Equipment in the Department of Radiology
22.5 Utility Area
22.5.1 Reception and Enquiry
22.5.2 Registration and Cash Counter
22.5.3 Waiting Lobby
22.5.4 Reporting Room
22.5.5 Stores for Unused Consumables and Films
22.5.6 Stores for Used Films and General Items
22.5.7 Report Delivery Counter
22.6 X-Ray Zone
22.6.1 Radiography Rooms
22.6.2 Room for Mobile X-Ray System
22.6.3 Change Rooms
22.6.4 Patient Preparation Room
22.6.5 Computerized Radiography (CR) Room
22.6.6 Sub-waiting for Radiography
22.7 Ultrasound Zone
22.7.1 Ultrasound Room
22.7.2 Change Rooms
22.7.3 Toilets
22.7.4 Sub-waiting for Ultrasound
22.8 CT Scan Zone
22.8.1 CT Scan Machine Room
22.8.2 CT Control Room
22.8.3 UPS Room
22.8.4 CT Panel Room
22.8.5 Change Rooms
22.8.6 Sub-waiting for CT Scan
22.9 MRI Zone
22.9.1 MRI Machine Room
22.9.2 MRI Control Room
22.9.3 UPS Room
22.9.4 MRI Panel Room
22.9.5 Chiller
22.9.6 Change Rooms
22.9.7 Sub-waiting for MRI
22.10 Mammography Zone
22.10.1 Mammography Rooms
22.10.2 Change Rooms
22.10.3 Computerized Radiography (CR) Room
22.10.4 Sub-waiting for Mammography
22.11 DEXA Scan Zone
22.11.1 DEXA Scan Machine Room
22.11.2 Sub-waiting for DEXA Scan
22.12 PET CT/MRI Zone
22.12.1 Location of the Zone in Hospital
22.12.2 PET CT Scan Machine Room
22.12.3 PET MRI Machine Room
22.12.4 SPECT CT Machine Room
22.12.5 Operating Console Rooms
22.12.6 Low-Risk Areas or Cold Areas
22.12.7 High-Risk Areas or Radiation Exposure Hot Areas
22.12.8 Toilet
22.12.9 Control and Scanning Room
22.12.10 Post-examination Waiting Room
22.12.11 Waste Disposal Room
Further Reading
23 Clinical Laboratories
23.1 Infrastructure of Clinical Lab
23.2 Size of the Lab
23.3 Layout
23.4 Spaces
23.5 Location and Arrangement of Areas
23.6 Open Lab Designs
23.7 Biosafety
23.8 Molecular Testing
23.9 Laboratories
23.9.1 Working Slabs
23.9.2 Sinks
23.9.3 Equipment Park/Store
23.9.4 Emergency Eyewash Station
23.9.5 Clean Utility
23.9.6 Biohazard/Trash/Recycle Room
23.10 Pneumatic Tube Systems (PTS)
23.11 Clear Floor Space
23.12 Electrical Points in Laboratories
23.13 Other Communication Points in Laboratories
23.14 Air Conditioning System of Laboratories
23.15 Furniture in the Laboratories
23.16 Main Equipment in the Clinical Laboratories
23.17 Support Services
23.17.1 Autoclave
23.17.2 Bulk Storage Room
23.17.3 Cold Storage Room
23.17.4 RO Water Closet
23.17.5 Gas Storage Closet
23.17.6 Record/File/Copy Room
23.17.7 Flammable Storage
23.17.8 Specimen Storage/Recycle
23.17.9 Block and Slide Storage
23.17.10 Penta Head/Deca Head Microscope Room
23.18 Utility Area
23.18.1 Doctors Room
23.18.2 Laboratory Manager
23.18.3 Technicians Room
23.19 Outpatient Phlebotomy
23.19.1 OPD Phlebotomy Room
23.19.2 Fine Needle Aspiration Room
23.19.3 Toilets
23.19.4 Waiting Area
23.20 Employee Support
23.20.1 Staff Lounge
23.20.2 Lockers
23.20.3 Shower with Water Closet
Further Reading
24 Blood Bank
24.1 Location of the Blood Bank in Hospital
24.2 Controlling Authority
24.3 Functions of Blood Bank
24.3.1 Receiving
24.3.2 Storage
24.3.3 Testing
24.3.4 Distribution
24.4 Infrastructure of the Blood Bank
24.5 Area of Blood Bank
24.6 Equipment in the Blood Bank
24.7 Receiving Area
24.7.1 Entrance
24.7.2 Reception
24.7.3 Registration
24.7.4 Waiting
24.7.5 Medical Examination
24.7.6 Bleeding Room
24.7.7 Refreshment/Recovery/Rest Room
24.7.8 Apheresis Room
24.8 Testing Area
24.8.1 Working Slabs
24.8.2 Sinks
24.8.3 Electrical Points in Laboratories
24.8.4 Other Communication Points in Laboratories
24.8.5 Air Conditioning System of Laboratories
24.8.6 Furniture in the Laboratories
24.9 Storage and Processing Area
24.9.1 Blood Component Room
24.10 Distribution Area
24.10.1 Pneumatic Tube Systems
24.11 Utility Area
24.11.1 Change Room
24.11.2 Doctors Rest Rooms
24.11.3 Store
24.11.4 Record Room
24.11.5 Medical Officer Room
24.11.6 Sterilization Room Cum Washing Room
24.11.7 Waste Management and Disposal
Further Reading
25 Other Investigations and Procedures
25.1 Coronary Catheterization (Cath Lab)
25.1.1 Location of the Cath Lab
25.1.2 Number of Cath Lab Procedure Rooms
25.1.3 Cath Lab Console Room
25.1.4 UPS Room
25.1.5 Cath Lab Panel Room
25.1.6 Change Rooms for Patients
25.1.7 Change Rooms for Staff
25.1.8 Waiting for Cath Lab
25.1.9 Stores for Unused Consumable
25.1.10 Stores for Records and CDs
25.1.11 Consultation Rooms
25.2 Thallium Scan
25.3 Audiometry
25.3.1 Location of the Audiometry Room
25.3.2 Room Designing
25.4 Bronchoscopy
25.5 Capsule Endoscopy, Cholangioscopy, Colonoscopy, Duodenoscopy, Endoscopic Ultrasound, Upper Gastrointestinal Endoscopy etc.
25.6 Neurology
25.7 Polysomnography (Sleep Lab)
25.7.1 Location of the Sleep Lab
25.7.2 Room Designing
25.8 Ophthalmology
25.9 ESW Lithotripter of Urology
25.10 Dialysis
25.10.1 Location of the Dialysis Room
25.10.2 Dialysis Procedure Room
25.10.3 Washroom for Dialyzers
25.10.4 Store
25.10.5 Change Rooms for Patients
25.10.6 Change Rooms for Staff
25.10.7 Waiting for Dialysis
Further Reading
26 Radiation Therapy
26.1 Location of Radiotherapy Unit
26.2 Infrastructure of the Radiotherapy Department
26.3 Utility Areas
26.3.1 Entrance to the department
26.3.2 Outside Entrance
26.3.3 Reception and Enquiry Counter
26.3.4 Registration Counter
26.3.5 General Waiting
26.3.6 Store
26.3.7 Consultation Room
26.4 Treatment and Planning Area
26.4.1 Mould Room
26.4.2 Mould Workshop
26.4.3 Medical Physics
26.4.4 CT Simulators
26.5 Radiation Therapy Treatment Area
26.5.1 External Beam Radiation Therapy
26.5.2 Internal Beam Radiation Therapy
26.6 Radiotherapy Ward
26.7 Trolley Bay
26.8 Change Rooms
26.9 Store
26.10 Signage and Wayfinding
26.11 Sub-waiting Lobbies
26.12 Clean Utility
26.13 Dirty Utility/Sluice Room
26.14 Handwashing
26.15 Administration/Offices
26.16 Other Issues on Infrastructure of the Radiation Therapy Unit
26.16.1 Acoustics
26.16.2 Doors
26.16.3 Finishes
26.16.4 Other Communication Points in the Radiation Department
26.17 Heating Ventilation and Air conditioning
26.18 Central Piped Medical Gas Supply
26.19 Electrical Points in the Radiation Therapy Department
26.20 Power Backup
Further Reading
27 Rehabilitation and Allied Health Therapies
27.1 Location of Physiotherapy Department
27.2 Layout of the Physiotherapy Department
27.3 Entrance/Entrance Lobby
27.4 Reception
27.5 Waiting Areas
27.6 Examination Room with Exam. Cubicles
27.7 Patient Therapy Areas
27.7.1 Physiotherapy
27.7.2 Occupational Therapy
27.8 Administrative Area
27.9 In-Charge Rehabilitation Department
27.10 Secretarial Staff
27.11 Store
27.12 Trolley Bay
27.13 Clean Utility
27.14 Dirty Utility/Sluice Room
27.15 Change Rooms
27.16 Other Issues About the Infrastructure of the Rehabilitation Department
Further Reading
28 Pharmacy Unit
28.1 Location for the Pharmacy
28.2 Size of the Pharmacy
28.3 Infrastructure of Pharmacy
28.4 Pharmacy for Outpatients
28.4.1 Entrance
28.4.2 Drug Receiving Area
28.4.3 Disbursing Hall
28.4.4 Bulk Storage
28.4.5 Cold Store
28.4.6 Expiry Drug Room
28.4.7 Costly Drug Room
28.4.8 Drug Sorting Room
28.4.9 Narcotics and Controlled Drug Store
28.5 Pharmacy for Inpatients
28.6 Pneumatic Tube Systems
28.7 Pharmacist Offices
28.8 Automation in the Pharmacy
Further Reading
29 CSSD
29.1 Methods of Sterilization Processes
29.2 Infrastructure of CSSD
29.3 Location
29.4 Area Required for CSSD Department
29.5 Material Flows
29.6 Functional Zones of CSSD
29.7 Receiving Zone (Unclean Area)
29.8 Decontaminating, Washing and Disinfecting Zone
29.9 Packaging Area
29.9.1 Location
29.9.2 Role of the Packing Room
29.9.3 Packing Room
29.10 Sterilization Area
29.10.1 Location and Relationships
29.10.2 Main Activities of the Sterilization Process
29.10.3 Size of the Sterilization Room
29.10.4 Methods and Types of Sterilizers
29.10.5 Steam Sterilizers
29.10.6 Ethylene Oxide Gas Sterilizer (ETO)
29.10.7 Dry Heat Sterilizer
29.10.8 Hydrogen Peroxide Plasma Sterilizer
29.10.9 Requirements for the Infrastructure of Steam Sterilizer
29.10.10 Requirements for the Infrastructure of ETO Sterilizer
29.11 Clean Storage Area
29.11.1 Location of the Clean Storage Room
29.11.2 Designing of the Storage Shelves
29.12 Delivery Counter
29.13 Support Areas
29.13.1 Staff Changing Rooms
29.13.2 Administrative Area
29.14 Finishing Details of the CSSD
29.14.1 Walls
29.14.2 Ceilings
29.14.3 Floors
29.14.4 Doors
29.14.5 Sound/Noise
29.14.6 Natural Light
29.14.7 Electrical Points
29.14.8 Lighting
29.14.9 Air Conditioning
Further Reading
30 Piped Medical Gas Supply System (MGPS)
30.1 Oxygen (O2)
30.2 Nitrous Oxide (N2O)
30.3 Compressed Medical Air 4 Bar
30.4 Compressed Medical Air 7 Bar
30.5 Carbon Dioxide (CO2)
30.6 Nitrogen (N2)
30.7 Medical Vacuum
30.8 System Components
30.9 Sources
30.9.1 Bulky Systems
30.9.2 Manifold Systems
30.9.3 Central Plants
30.9.4 Generators
30.10 Piping Networks
30.10.1 Pipeline Installation
30.10.2 Valves
30.10.3 Warning and Alarm Systems
30.10.4 Gas Outlets
30.10.5 Secondary Equipment
30.11 Designing the MGPS System
30.11.1 Analysis of the Area of the Hospital
30.12 Infrastructure for MGPS
30.13 Manifold Room
30.13.1 Purging of the System
30.13.2 Location of the Manifold
30.13.3 Size of the Manifold Room
30.13.4 Fixing the Manifold Systems in the Hall/Room
30.14 Compressed Medical Air
30.14.1 Compressor Air Plant
30.14.2 Air Filtration
30.14.3 Medical Air 400 kPa
30.14.4 Surgical Air 700 kPa
30.15 Vacuum
30.15.1 Vacuum Plant
30.15.2 Filtration System
30.16 Issues While Designing the Plant Room and the Manifold Room
30.17 Medical Gases Outlet Terminals
30.18 Bulk Liquid Oxygen Gas System
30.18.1 Liquid Oxygen Vessel
Further Reading
31 Hospital Kitchen
31.1 Infrastructure of Hospital Kitchen
31.2 Location of Hospital Kitchen
31.3 Size of the Kitchen
31.4 Entry
31.5 Change Rooms cum Wash Areas
31.6 Receipt Area for Supplies
31.7 Storage Area
31.7.1 Bulk Storage
31.7.2 Fruit and Vegetable Store
31.7.3 Refrigeration, Cool Rooms, Freezers
31.7.4 Storage Areas for Dry Ration/Goods
31.8 Preparation Areas
31.9 Cooking Areas
31.10 Reheating Areas
31.11 Packing/Plating
31.12 Meal Trolley/Cart Parking
31.13 Food Distribution
31.14 Trolley Return/Stripping
31.15 Trolley/Cart Wash
31.16 Dishwashing
31.17 Pot Washing
31.18 Waste Disposal
31.19 Gas Storage Closet
31.20 Staff and Support Areas
31.21 General Issues About Infrastructure Requirements
31.22 Fixtures, Fittings and Equipment
Further Reading
32 Laundry
32.1 Facilities and Space Requirements
32.2 Location of the Laundry
32.3 Size of the Unit
32.4 Dirty and Soiled Linen Generation
32.5 Dirty and Soiled Linen Interim Storage
32.6 Central Storage Area
32.7 Dirty Receipt
32.8 Sorting and Weighing
32.9 Washing Area
32.9.1 Loading and Washing
32.9.2 Extractors
32.9.3 Tumble Drying
32.9.4 Ironing
32.10 Inspection and Repairing
32.11 Packaging and Storage
32.12 Dispatch Room
32.13 Trolley Washing
32.14 Store
32.15 Staff and Support Areas
32.16 Other Issues Relating to the Infrastructure of Laundry
32.16.1 Infection Control
32.16.2 Airflow
32.16.3 Floors
32.16.4 Walls
32.16.5 Natural Lighting
32.16.6 Mechanical Ventilation
32.16.7 Hot-Air Extraction
32.16.8 Compressors
32.16.9 Steam
32.16.10 Water Supply, Heating and Water Treatment Equipment
32.16.11 Fire Prevention and Detection
32.16.12 Communications
Further Reading
33 Medical Record Department (MRD)
33.1 Electronic Medical Records (EMR)
33.2 Location of MRD
33.3 Layout
33.4 Entry and Reception
33.5 Medical Record Receipt Room
33.6 Compilation Desk
33.7 Indexing and Coding
33.8 Statistical Analysis
33.9 Computer Lab
33.10 Medical Record Storage Room
33.11 Dictation Room/Cubicles
33.12 Transcription Room
33.13 Photocopying/Printing Room
33.14 Scanning Room
33.15 Binding Room
33.16 Waste Holding Room
33.17 Store
33.18 Administrative Area
33.19 Other Issues About the Infrastructure of MRD
Further Reading
34 Mortuary
34.1 Location of the Mortuary
34.2 Infrastructure of Mortuary
34.3 Mortuary
34.3.1 Entrance Lobby
34.3.2 Body Wash
34.3.3 Body Holding Area
34.3.4 Waiting/Viewing Area
34.3.5 Storage
34.3.6 Administration Area
34.3.7 Exit Lobby
34.4 Autopsy Area
34.4.1 Pre Autopsy Room
34.4.2 Autopsy Room (Indoor)
34.4.3 Autopsy Room (Outdoor)
34.4.4 Post Autopsy Room
34.4.5 Autopsy Surgeon’s Room
34.4.6 Instrument Wash Room
34.4.7 Viscera Preparation Room
34.4.8 Viscera Stores
34.4.9 Surgeon Change Room
34.5 Other Infrastructural Issues Relating to the Mortuary/Autopsy Room
Further Reading
35 Administration Area
35.1 Levels of Administrative Staff
35.2 Infrastructure of the Administrative Area
35.3 Location of the Administrative Area
35.4 Reception
35.5 Infrastructure of Reception
35.6 Waiting Lobby
35.7 Offices of the Senior Management
35.7.1 Electrical Points
35.7.2 Other Communication Points in the Room
35.7.3 Lighting in the Offices
35.7.4 Doors
35.7.5 Windows
35.7.6 Flooring
35.7.7 Air-Conditioning
35.7.8 Room Décor
35.7.9 Furniture in the Executive Offices
35.7.10 Acoustics
35.7.11 Privacy
35.8 Offices of the Senior Executive Level Management
35.8.1 Electrical Points
35.8.2 Other Communication Points in the Room
35.8.3 Lighting in the Offices
35.8.4 Doors
35.8.5 Windows
35.8.6 Flooring
35.8.7 Air-Conditioning
35.8.8 Furniture in the Executive Offices
35.8.9 Acoustics
35.9 Offices of the Executive Level Management
35.9.1 Electrical Points
35.9.2 Other Communication Points in the Room
35.9.3 Lighting in the Offices
35.9.4 Doors
35.9.5 Windows
35.9.6 Flooring
35.9.7 Air-Conditioning
35.9.8 Furniture in the Executive Offices
35.10 Offices of the Junior Level Management
35.10.1 Electrical Points
35.10.2 Other Communication Points
35.10.3 Lighting in the Offices
35.10.4 Doors
35.10.5 Windows
35.10.6 Flooring
35.10.7 Air-Conditioning
35.11 Support Room/Facilities
35.11.1 Senior Management’s PA Room
35.11.2 Secretarial Staff
35.11.3 Kitchen
35.11.4 Dining Area
35.11.5 Staff Toilets
35.11.6 Store
35.11.7 Notice Boards
35.12 Meeting Rooms
35.12.1 Electrical Points
35.12.2 Other Communication Points in the Room
35.12.3 Lighting
35.12.4 Doors
35.12.5 Windows
35.12.6 Flooring
35.12.7 Air-Conditioning
35.12.8 Room Decor
35.12.9 Furniture in the Meeting Room
35.12.10 Acoustics
35.12.11 Privacy
Further Reading
36 Stores in the Hospital
36.1 Functions of Stores
36.2 Types of Hospital Stores
36.3 Planning of Hospital Stores
36.4 Location of the Stores
36.5 Infrastructure of Stores
36.5.1 Store
36.5.2 Storekeeper Room
36.5.3 Store Secretarial Staff
36.5.4 Kitchen
36.5.5 Staff Toilets
36.5.6 Special Store Room
36.5.7 Cold Room
36.5.8 Issue Counter
36.5.9 Receiving Area
36.6 Other Infrastructure Issues
36.6.1 Electrical Points
36.6.2 Other Communication Points in the Room
36.6.3 Lighting in the Stores
36.6.4 Doors
36.6.5 Windows
36.6.6 Flooring
36.6.7 Air-Conditioning
36.6.8 Furniture in the Stores
36.6.9 Notice Boards
Further Reading
37 Engineering and Maintenance Unit
37.1 Worksshops
37.2 Biomedical Workshop
37.3 Electrical Workshop
37.4 HVAC Workshop
37.5 MGPS Workshop
37.6 Low Voltage Workshop
37.7 Building Maintenance
37.8 Mechanical Workshop
37.9 Firefighting Workshop
37.10 Automobile Workshop
37.11 Location of the Workshops
37.12 Infrastructure of Workshops
37.12.1 Workshop
37.12.2 Workshop In-charge Room
37.12.3 Workshop Engineers
37.12.4 Staff Toilets
37.12.5 Receiving/Issue Counter
37.13 Other Infrastructure Issues
37.13.1 Electrical Points
37.13.2 Other Communication Points in the Room
37.13.3 Lighting in the Workshops
37.13.4 Doors
37.13.5 Windows
37.13.6 Flooring
37.13.7 Air-Conditioning
37.13.8 Furniture in the Workshop
37.13.9 Notice Boards
Further Reading
Part V MEP Planning & Designing
38 HVAC (Air-Conditioning) System
38.1 Central Water Chilled Plant
38.1.1 Chillers
38.1.2 Cooling Towers
38.1.3 Air Handling Systems
38.1.4 Variable Air Volume (VAV) Ventilation
38.1.5 Diffusers, Registers and Grills
38.1.6 Ductwork
38.1.7 Air Intake and Exhaust
38.1.8 Filtration
38.2 Installation of Central Chilled Water Plant
38.2.1 Chillers
38.2.2 Cooling Towers
38.2.3 Air Handling System
38.3 DX (Direct Expansion) Chilling
38.3.1 The Plant Room
38.3.2 Air Handling Unit Room
38.3.3 Air-Conditioned Room
38.3.4 Benefits of DX Air-Conditioning Systems
38.3.5 Disadvantages of DX system
38.4 Split Air-Conditioning
38.5 HVAC—Room Side Design
38.5.1 Operating Rooms
38.5.2 Intensive Care Units
38.5.3 Patient Rooms
38.5.4 Isolation Rooms
38.5.5 Recovery (Post-Anaesthesia Care Unit)
38.5.6 Emergency
38.5.7 Burn Units
38.5.8 Procedure Rooms
38.5.9 Endoscopy Rooms
38.5.10 Imaging Rooms
38.5.11 Central Laboratories
38.5.12 Pharmacy
38.5.13 Mortuary and Autopsy
38.5.14 Central Sterile Supply Department (CSSD)
38.5.15 Server Room
38.6 Effects of COVID-19 on the Design of Air-Conditioning
Further Reading
39 Electrical Services
39.1 Primary Power Supply (PPS)
39.2 Secondary Power Supply (SPS)
39.3 Tertiary Power Supply (TPS)
39.4 Electrical Load Calculation
39.5 HT Distribution System
39.6 LT Power Distribution
39.7 Redundancy Due to Power Failure
39.8 Emergency Power Generation System
39.9 Uninterrupted Power Supply System (UPS)
39.10 Switching Arrangement
39.11 Emergency Lighting
39.12 Earthing System
39.13 System of Wiring and Cabling
39.14 Switches/Sockets and Boxes
39.15 Lightning Protection
39.16 Power Quality
39.17 Power Factor Correction
39.18 Street Lighting System
39.19 Lighting Management System
39.19.1 Occupancy Sensor
39.20 Illumination Levels
Further Reading
40 ELV, ICT and IBMS Services
40.1 Data System
40.2 Nurse Call System
40.2.1 Desktop Console
40.2.2 Room Lights
40.2.3 Patient Call with Handset
40.2.4 Patient Call—in Toilets
40.2.5 Staff Assist Call
40.2.6 Emergency Call
40.2.7 Wireless Handset
40.2.8 Wireless Console
40.2.9 Audio-Video Nurse Call System
40.3 Electronic Security and Video Surveillance System
40.3.1 Closed Circuit Television System (CCTV)
40.4 Access Control System
40.4.1 No-Touch Access
40.5 Telecommunication System
40.6 Patient Entertainment and Information Systems
40.7 Queue Management System
40.8 Public Address System
40.9 Integrated Building Management Systems (IBMS)
Further Reading
41 Information Technology and Computerization
41.1 Health Information System (HIS)
41.2 Modules of Hospital Information Software
41.2.1 Information Desk Module
41.2.2 Patient Registration Module
41.2.3 Outpatient Management Module
41.2.4 In-Patient Management Module
41.2.5 Admission, Transfer, Discharge (ADT) Module
41.2.6 Consulting Appointment Management Module
41.2.7 Bed Management Module
41.2.8 Ward Management Module
41.2.9 Nursing Management Module
41.2.10 Operating Room Module
41.2.11 Laboratory Module
41.2.12 Blood Bank Module
41.2.13 Radiology Module
41.2.14 Picture Archiving and Communication System (PACS) Module
41.2.15 Casualty and Emergency Management System
41.2.16 Pharmacy Information System
41.2.17 Order Management System Module
41.2.18 The Birth/Death Registration Module
41.2.19 Electronic Medical Records Module
41.2.20 Billing and Finance Module
41.2.21 Insurance and Medi-Claim Module
41.2.22 Human Resources Module
41.2.23 Materials Management System (Stock, Purchasing and Fixed Asset Module)
41.2.24 Dietary Module/Catering Module
41.2.25 Statistics and Reporting Module (MIS)
41.2.26 Hospital Analytics
41.2.27 Interface Module
Further Reading
42 Water Supply and Drainage System
42.1 Water Supply System
42.1.1 Source of Water Supply
42.2 Water Storage
42.3 Water Storage Tank Locations
42.4 Systems of Water Treatment
42.4.1 Pasteurization
42.4.2 Chemical Treatment
42.4.3 Chlorine Water Treatment
42.4.4 Water Softener Plants
42.4.5 Silver–Copper Ionization
42.4.6 Reverse Osmosis Treatment
42.4.7 Ultraviolet Treatment
42.4.8 Ozone Water Treatment
42.4.9 Distilled Water
42.5 Drinking Water
42.6 Water Booster Pumps
42.7 Hot Water System
42.7.1 Electrical Hot Water Generation
42.7.2 Hot Water Generation from Boiler/Steam by Burning Fuel
42.7.3 Solar Hot Water Generation
42.7.4 Stand-Alone Hot Water Geysers
42.8 Sanitary Fittings
42.9 Irrigation Water Supply
42.10 WC Flushing Systems
42.11 Steam System
42.12 Water Drainage System
42.13 Drainage Strategy
42.14 Types of Drainage Systems
42.14.1 Wastewater Drainage
42.14.2 Soil Water Drainage
42.14.3 Storm Water Drainage
42.14.4 Chemical Drainage
42.14.5 Radiation Drainage
42.15 Methods of Drainage
42.15.1 Vent Pipes
42.15.2 Floor Drains
42.15.3 Soil Water Drainage
42.15.4 Rainwater Drainage System
42.15.5 Infectious Contaminated Drainage
42.15.6 Radiation Drainage
42.15.7 Kitchen Grease Drainage
Further Reading
43 Vertical Transportation System
43.1 Lift Categories
43.1.1 General Passenger Lifts
43.1.2 Bed Lifts
43.1.3 Service/Goods Lift
43.2 Design Considerations
43.3 Engineering Guidelines
Further Reading
44 Pneumatic Tube Systems (PTS)
44.1 Pneumatic Tube System Components
44.1.1 Blower and Air Reverse Valve
44.1.2 Carrier
44.1.3 Control Centre
44.1.4 Database
44.1.5 Inter-Zone Connection
44.1.6 Station
44.1.7 Diverter
44.1.8 Tubing
44.1.9 Zone
44.1.10 Slow Speed Device
Further Reading
45 Signage System
45.1 Categories Using Wayfinding
45.1.1 Patients and Visitors
45.1.2 Staff
45.1.3 Users with Special Needs
45.1.4 Sensory Impairment
45.1.5 Language and Illiteracy
45.2 Principles for Designing Wayfinding System
45.3 Types of Sign Boards
45.3.1 Classified by Function
45.3.2 Signs Classified by Physical Characteristics
45.3.3 Other Factors of Classification of Sign Boards
Further Reading
46 Biomedical Waste Management
46.1 Classification of Hospital Waste
46.1.1 Biomedical Waste
46.1.2 General Waste
46.1.3 Other Wastes
46.2 Steps Involved in Biomedical Waste Management
46.3 Biomedical Waste Segregation
46.4 Biomedical Waste Collection
46.4.1 Time of Collection
46.4.2 Packing of Biomedical Waste and Labelling
46.4.3 Interim Storage
46.5 Transportation of Biomedical Waste in Hospital
46.5.1 Transportation Trolleys
46.5.2 Route of Transportation
46.5.3 Central Waste Collection Room for Biomedical Waste
46.6 Record Keeping
46.7 Updating Information on the Website
46.8 Management of General Waste
46.9 Management of Other Wastes
46.9.1 Used Batteries
46.9.2 Management of Radioactive Wastes
46.9.3 Management of E-Wastes
46.10 Effluent Treatment Plant (ETP/STP)
46.10.1 Preliminary Stage
46.10.2 Primary Stage
46.10.3 Secondary Stage
46.10.4 Tertiary Stage
Further Reading
47 Fire Safety
47.1 Planning for Fire Safety in Hospitals
47.2 Structural Elements for Fire Safety
47.2.1 Compartmentalization
47.2.2 Open Spaces
47.2.3 Basements
47.2.4 General Exit Requirements
47.2.5 Corridors and Passageways
47.2.6 Staircases
47.2.7 Ramps
47.2.8 Electrical and Emergency Power
47.2.9 Air-Conditioning, Ventilation and Smoke Control
47.2.10 Fire Barrier
47.2.11 Glazing
47.2.12 Surface Interior Finishes
47.2.13 Fire Command Centre (FCC)
47.3 Fire Detection and Alarm
47.4 Fire Extinguishers/Fixed Firefighting Installations
47.4.1 Static Water Storage Tanks
47.4.2 Fire-Fighting Pump House
47.4.3 Automatic Sprinkler Installation
Further Reading
48 Green Hospitals
48.1 What Is Green Hospital?
48.2 Benefits of Green Buildings Hospitals
48.3 Barriers to Create Green Hospitals
48.3.1 System Redundancy
48.3.2 Infection Control
48.3.3 Regulatory Compliance
48.3.4 Intense Energy and Water Consumption
48.3.5 Ventilation Rates
48.3.6 Accreditation and Licensing Demands
48.3.7 Higher Volume of Hospital Waste
48.3.8 Chemical Use
48.3.9 Frequent Upgradations and Renovations
48.4 Elements of a Green Hospital
48.4.1 Energy Conservation
48.4.2 Alternative Means of Energy Generation
48.4.3 Water Conservation
48.4.4 Indoor Environmental Quality and HVAC Optimization
48.4.5 Chemical Management
48.4.6 Solid Waste Management
48.4.7 Environmental Services
48.4.8 Food Services
48.4.9 Environmentally Preferable Purchasing
48.4.10 Sustainable Construction Materials
48.4.11 Pharmaceutical Minimization, Management and Disposal
48.4.12 Reducing Transportation Cost
48.4.13 Greenery
Further Reading
Part VI Equipment Planning
49 Equipment Planning
49.1 Choosing the Desired Equipment
49.1.1 Quality of the Equipment
49.2 Points to Be Considered While Purchasing the Medical Equipment
49.2.1 Warranty
49.2.2 Maintenance Contracts
49.2.3 Availability of the Service Engineers and the Workshops
49.2.4 Period of Spare Part Availability
49.2.5 Cost of Consumables
49.2.6 Life Expectancy of the Equipment
49.2.7 Plan for Space and Development
49.2.8 Vendors Evaluation
49.2.9 Checking Regulations
49.2.10 Inspection and Testing Before Transfer of Ownership
49.3 Equipment Used in the Hospital
49.4 General Items Used in Intensive Care Units, Wards, Pre & Post-Operative Units, Post Labor Wards, Triages Area and OPD’s Etc.
49.5 Department of Cardiology and CTVS
49.6 Department of Gastric Sciences
49.7 Nephrology and Dialysis
49.8 Neurosurgery
49.9 Neurology
49.10 Plastic Surgery
49.11 Pulmonology
49.12 Radiation Oncology
49.13 Urology
49.14 Robotic Surgery
49.15 Orthopaedic
49.16 Dermatology
49.17 ENT
49.18 Gynaecology
49.19 Ophthalmology
49.20 Operating Rooms
49.21 Dental
49.22 In Vitro Fertilization Clinic
49.23 NICU
49.24 Pain Clinic
49.25 Labor Room
49.26 Radiology
49.27 Biochemistry
49.28 Microbiology
49.29 Pathology
49.30 Blood Bank
49.31 CSSD
49.32 Misc. Small Instruments
49.33 Misc. Disposable Items
49.34 Linen
49.35 Consumables
49.36 Back Up Services
49.37 Patient Furniture
Further Reading
Glossary
Part I Hospital Planning
1 Phases of Planning and Designing
1.1 Hospital Planning
1.2 Schematic Design
1.3 Construction Documents
1.4 Design and Development
1.5 MEP Planning
1.6 Construction
1.7 Equipment Planning
1.8 Man Power Planning
1.9 Finalizing the Standard Operating Procedures of Hospital
1.10 Commissioning
Further Reading
2 Inception of the Idea
3 Factors Assessing Feasibility of the Hospital
3.1 Demographics
3.2 Understanding the Type of Diseases
3.3 Community
3.4 Healthcare Systems and Hospitals Network
3.5 Innovations in Facility Planning and Management
3.6 The Requirement of the Specialty Facilities and/or Departments
3.7 Medical Tourism
3.8 Health Insurance and Empanelment
3.9 Catchment Area
Further Reading
4 Preparation of Detailed Project Report (DPR) and Techno-Commercial Feasibility Report (TCFR)
4.1 Information to Be Generally Provided in DPR
4.2 Documents DPR Shall Contain
4.3 General Contents in DPR
4.4 Evaluation of DPR
4.5 Sample Formats of DPR
Further Reading
5 Site Selection
5.1 Size of the Land Required for Hospital
5.2 Assessment of the Covered Area Required for Hospital
5.3 Total FAR Allowed
5.4 Set Back Area
5.5 Maximum Permissible Land Coverage
5.6 Maximum Permissible Height of the Building
5.7 Approach to the Site
5.8 Location of the Land
5.9 Availability of Transportation
5.10 Security
5.11 Availability of Utilities
5.12 Road Network in the Area
5.13 Environmental Pollution
5.14 Wind and Earthquake
5.15 Flood Protection
Further Reading
6 General Issues to Be Considered While Designing Hospital Building
6.1 Importance of Hospital Planning and Designing
6.2 Flexibility and Expandability
6.3 Design for the Patient Experience
6.4 Design for Employee Productivity
6.5 Accessibility to the Patient
6.6 Security and Safety of Men and Material
6.7 Sustainability of Resources
6.8 Efficiency and Cost-Effectiveness
6.9 Adaptation of Technological Advancements
6.10 Stress and Fear of Patients and Visitors
6.11 Quality Care of Patients
6.12 Therapeutic Environment
6.13 Cleanliness and Sanitation
6.14 Noise Reduction
6.15 Minimizing the Operative, Postoperative and Hospital-Acquired Infections
6.16 Automation Where Possible
6.17 Environmental Pollution Control
6.18 Internal Road
6.19 Parking
6.20 Wind, Earthquake-Resistant and Flood Protection
6.21 Nature Plus Artwork
6.22 Colours to Be Used
6.23 Choice of Building Materials
6.24 Flooring
Further Reading
7 Area Requirement and Planning
7.1 Functional Areas
7.2 Room/Space Requirement
7.3 Sizes of the Rooms
7.4 Zoning
7.5 Placement of Zones in the Building
Further Reading
Part II Schematic Design of Hospital
8 Schematic Design
8.1 What Is the Schematic Design?
Further Reading
9 Effects of COVID-19 on the Design of the Hospital
9.1 What Will Be the Design of Future Hospitals
9.2 Issues to Be Addressed While Planning and Designing a Hospital in Post-COVID-19 Era
9.3 Changes in the Design of Building, Location, Spaces and Sizes of the Rooms in the Healthcare Facility
9.3.1 Hybrid Design of Building
9.3.2 Improving Infection Prevention
9.4 Changes in the Layout, Facilities of Various Departments, Emergency Rooms, Operating Rooms, Intensive Care Area, Diagnostic Facilities, Waiting Lobbies, Staff Zones, the Administrative Zones etc.
9.4.1 Entrance Lobbies
9.4.2 Waiting Lobbies
9.4.3 Outpatient Department
9.4.4 Emergency Department
9.4.5 In-Patient Department
9.4.6 Operating Rooms
9.4.7 Diagnostic Laboratories
9.4.8 Radiology
9.4.9 Staff and Administrative Workplaces
9.5 Acceptance of the New and Improved Building Materials Which Seems to Be More Appropriate as Per the New Building Designs or Which Can Ease Out the Concept of the New and Better-Designed Building
9.5.1 Antimicrobial Finishes and Materials
9.5.2 Use of Antibacterial Materials
9.5.3 Use of Non-porous Materials
9.5.4 For the Furniture
9.5.5 Touch-free Controls
9.5.6 Automatic Doors and E-switchable Privacy Glass
9.5.7 Smart Facade Glazing
9.5.8 Prefabricated Materials
9.5.9 Paints
9.5.10 Flooring
9.5.11 Clean Rooms with HEPA Filters
9.5.12 Dehumidification
9.5.13 Contactless Office
9.5.14 Conference Rooms
9.5.15 Automation
9.5.16 Automatic Body Thermal Scanner
9.6 Temporary Conversion of Space in the Hospital into Treatment Units, Emergency Suits, ICUs and Isolation Units to Handle Surges in the Number of Patients due to Pandemics
9.6.1 Wall Finishes
9.6.2 Flooring
9.6.3 Electrical Points
9.6.4 Medical Gases
9.6.5 Bed and Hospital Furniture
9.6.6 Partitions
9.6.7 Washrooms
9.6.8 Air Conditioning
9.6.9 Nurse Call Systems
9.7 Modification and Adoption of Improved Working Systems and SOPs Which Are in Consensus with the New or Modified Design of Healthcare Facility
9.7.1 Health Worker’s Safety and Support
9.7.2 Entrance
9.7.3 Waiting Lobbies
9.7.4 Out Patient Department
9.7.5 Indoor and Isolation
9.7.6 Emergency Department
Further Reading
10 Site Plan
10.1 Contents of Site Plan
Further Reading
11 Detailed Engineering Drawings
11.1 Concept Drawings
11.2 Floor Plan Drawings
11.3 Cross Section Drawings
11.4 Elevation Drawings
11.5 Landscape Drawings
11.6 Finishing Drawing
11.7 Working Plan Drawings
11.8 Section Drawings
11.9 Structural Drawings
11.10 Column Layout Drawings
11.11 Plinth Beam Layout Drawings
11.12 Lintel Beam Layout Drawings
11.13 Roof Beam and Shuttering Layout Drawings
11.14 General Note
11.15 Excavation Drawings
11.16 Electrical Drawings
11.17 Plumbing Drawings
11.18 Firefighting and Detection Drawings
11.19 Shop Drawings
11.20 Furniture Layout Drawings
11.21 Furniture Design Drawings
11.22 Hospital Signage Drawings
11.23 As-Built Drawings
11.24 PERT Charts
Further Reading
Part III Construction Documents
12 Preparation of Construction Documents
12.1 Definition of Construction Documents
12.2 Contents of Construction Document
12.2.1 General Information About the Hospital Project
12.2.2 Construction Contract Agreement
12.2.3 Scope of Work
12.2.4 Construction Schedule
12.2.5 General Conditions
12.2.6 Special Conditions
12.2.7 Specifications
12.2.8 Bill of Quantities
12.2.9 Cost Estimate
12.2.10 Drawings
12.2.11 Other Documents
Further Reading
Part IV Design & Development
13 Designing Details of Individual Department or Spaces of the Hospital
14 Design of the Main Entrance Gate to the Hospital
Further Reading
15 Designing of the Entrance Lobby of the Hospital
15.1 Location of the Entrance Lobby
15.1.1 The Infrastructure of the Entrance Lobby
15.2 Services in the Lobby
15.3 Reception and Enquiry Counter
15.3.1 Furniture at the Reception
15.3.2 Electrical and Other Points at the Reception
15.4 Help Desk, Registration and Admission and Discharge Counters
15.4.1 Furniture at Help Desk, Registration, Admission and Discharge Counters
15.4.2 Electrical and Other Points at Help Desk, Registration and Admission and Discharge Counters
15.5 Cash Counter
15.5.1 Furniture at Cash Counter
15.5.2 Electrical and Other Points at Cash Counter
15.6 Cafeteria
15.6.1 Furniture in the Cafeteria
15.6.2 Electrical and Other Points in the Cafeteria
15.7 Pharmacy
15.8 Other Service Counters in the Entrance Lobby
15.9 Public Utility for Patient/Visitors
15.10 Prayer Room/Meditation Spaces
15.11 Self-Service Kiosks
15.12 Interiors of the Entrance Lobby
15.13 Entrance Gates to the Lobby
15.14 Signage and Wayfinding in the Lobby
15.15 Acrylic or Glass Partitions
15.16 General Issues Related to Entrance Lobby
15.17 Outside Entrance Lobby
15.17.1 Screening Areas
15.17.2 Hand Wash/Sanitizer Stations
15.17.3 Face Masks /Shoe Covers Dispensers
15.18 Reduction of People Landing in the Entrance Lobby
Further Reading
16 Emergency Services
16.1 Objectives of the Emergency Department
16.2 Location of Emergency Department
16.3 Signage of the Emergency Department
16.4 Size of the Emergency Department
16.5 Areas Required for Emergency Department
16.6 The Entrance of the Emergency Department
16.6.1 Main Gate
16.6.2 Entrance Door to the Emergency Department
16.6.3 Outside Entrance Lobby
16.6.4 Screening Areas
16.6.5 Handwash/Sanitizer Stations
16.6.6 Face Masks/Shoe Covers Dispensers
16.6.7 Decontamination Area
16.6.8 General Waiting
16.6.9 Ambulance Control
16.7 Reception
16.7.1 The Infrastructure of Reception
16.7.2 Furniture
16.7.3 Tools and Instruments
16.7.4 Electrical Points at Reception
16.7.5 Other Communication Points at Reception
16.8 Triage and Resuscitation
16.8.1 Location of Triage
16.8.2 Size of Triage
16.8.3 Issues Related to Infrastructure of Triage
16.8.4 Bed Layout in Triage
16.8.5 Isolation Room/Units/Area in Triage
16.8.6 Resuscitation Rooms in Triage
16.8.7 Furniture in Triage
16.8.8 Equipment in Triage
16.8.9 Tools and Instruments
16.8.10 Doors
16.8.11 Windows
16.8.12 Hand Washing
16.8.13 Central Piped Medical Gas Supply
16.8.14 Electrical Points in Triage
16.8.15 Other Communication Points in Triage
16.8.16 Curtain Partitions
16.8.17 Doctors Duty Rooms in Triage
16.9 Treatment/Procedure Room/Minor Operation Theatre
16.9.1 Location of Minor OT
16.9.2 Size of Minor OT
16.9.3 The Infrastructure of Minor OT
16.9.4 Issues Related to Infrastructure of Minor OT
16.9.5 Furniture in Minor OT
16.9.6 Equipment
16.9.7 Tools and Instruments
16.9.8 Doors
16.9.9 Windows
16.9.10 Handwashing
16.9.11 Central Piped Medical Gas Supply
16.9.12 Electrical Points in Minor OT
16.9.13 Other Communication Points in Minor OT
16.10 Procedure and Diagnostic Setup
16.10.1 Location of Investigation Rooms
16.11 Emergency Operation Theatre Complex
16.12 Day-Care Observation Ward
16.12.1 Location of Observation Ward
16.12.2 Size of Observation Ward
16.12.3 The Infrastructure of Observation Ward
16.12.4 Issues Related to Infrastructure of Observation Ward
16.12.5 Bed Layout in Observation Ward
16.12.6 Isolation Room in the Observation Ward
16.12.7 Furniture in Observation Ward
16.12.8 Equipment
16.12.9 Tools and Instruments
16.12.10 Doors
16.12.11 Windows
16.12.12 Handwashing
16.12.13 Central Piped Medical Gas Supply
16.12.14 Electrical Points in Observation Ward
16.12.15 Other Communication Points in Observation Ward
16.12.16 Curtain Partitions
16.13 Other Issues Relating to Emergency Department
16.14 Disaster Plan
16.14.1 Factors for Disaster Plan
Further Reading
17 Outpatient Department
17.1 Location of the OPD
17.2 Schemes of the Layout of the OPD
17.2.1 Single Corridor OPD
17.2.2 Double Corridor OPD
17.2.3 Clustered OPD Block
17.3 Infrastructure Requirements in the OPD
17.4 Reception and Enquiry Counter
17.4.1 Furniture at the Reception
17.4.2 Electrical and Other Points at the Reception
17.5 Registration Counter
17.5.1 Furniture at Registration Counter
17.5.2 Electrical and Other Points at Registration Counters
17.6 Waiting Lobby/Hall
17.7 Examination Rooms
17.7.1 Combined Multi-Disciplinary Consultation Room
17.7.2 Separate Consultation Room
17.8 Procedure/Treatment Rooms
17.9 Support Rooms
17.10 General Issue While Designing the OPD
17.11 Number of OPDs Required
17.12 Consultation Room
17.12.1 Size of the OPD Room
17.12.2 Doors
17.12.3 Windows
17.12.4 Hand Washing
17.12.5 Furniture
17.12.6 Instruments and Equipment
17.12.7 Electrical Points in Consultation Room
17.12.8 Other Communication Points in OPD
17.12.9 Curtain Partitions
17.13 Design of OPD
17.13.1 Use of Touch-free Medical Devices
17.13.2 OPD Consultation Rooms with Videoconferencing Solutions
17.13.3 Creating Virtual OPD
17.13.4 Sterilization and Pressure
17.13.5 Telemedicine Impact on the Facility
17.13.6 Mobile Health
17.14 Procedure /Treatment Room
17.14.1 Size of the Procedure/Treatment Room
17.14.2 Doors
17.14.3 Windows
17.14.4 Handwashing
17.14.5 Furniture
17.14.6 Instruments and Equipment
17.14.7 Electrical Points in Procedure/Treatment Room
17.14.8 Other Communication Points in Procedure/Treatment Room
Further Reading
18 Intensive Care Units
18.1 Types of ICUs
18.2 Number of Beds in a Single Unit of ICU
18.3 Location of Intensive Care Units
18.4 Infrastructure of ICU
18.5 Size of the ICU
18.6 Sizing Considerations
18.7 Patient Care Zone
18.7.1 Patient Unit
18.7.2 Isolation Room/Units/Area in ICU
18.7.3 Furniture in ICU
18.7.4 Equipment
18.7.5 Tools and Instruments
18.7.6 Doors
18.7.7 Windows
18.7.8 Nursing Station
18.7.9 Hand Hygiene
18.7.10 Toilets
18.7.11 Air Conditioning System of ICUs
18.7.12 Central Piped Medical Gas Supply
18.7.13 Electrical Points in ICU
18.7.14 Other Communication Points in ICU
18.7.15 Curtain Partitions
18.8 Procedure and Treatment Room
18.8.1 Location of Treatment/Procedure Room
18.8.2 Size of Treatment/Procedure Room
18.8.3 Issues Related to Infrastructure of Treatment/Procedure Room
18.8.4 Furniture in Treatment/Procedure Room
18.8.5 Equipment
18.8.6 Tools and Instruments
18.8.7 Doors
18.8.8 Windows
18.8.9 Handwashing
18.8.10 Central Piped Medical Gas Supply
18.8.11 Electrical Points in Treatment/Procedure Room
18.8.12 Other Communication Points in Treatment/Procedure Room
18.8.13 Other Issues on Patient Care Zone and Procedure/Treatment Room
18.8.14 Lighting in the ICU
18.8.15 Dialysis Equipment
18.8.16 Power Backup
18.9 Clinical Support Zone
18.9.1 Rigorous Monitoring
18.9.2 Radiology
18.9.3 Laboratory
18.9.4 Medication Rooms
18.9.5 Pneumatic Tube Systems
18.9.6 Clean Utility
18.9.7 Dirty Utility/Sluice Room
18.9.8 Equipment Park/Store
18.9.9 Emergency Eyewash Station
18.10 Unit Support Zone
18.10.1 Change Room: Male/Female in ICU
18.10.2 Doctors Duty Rooms in ICU
18.10.3 Nurses Night Duty Rooms in ICU
18.10.4 Night Duty Room for On-Call Junior Doctors
18.10.5 Ward Pantry
18.10.6 Staff Lounge
18.11 Family Support Zone
18.11.1 Family Lounge
18.11.2 Consultation Rooms
18.11.3 Meditation Spaces
18.11.4 Family Cafeteria
18.11.5 Family Sleep Rooms
18.11.6 Family Laundry
18.12 Specialized Intensive Care Units
18.12.1 Intensive Coronary Care Unit
18.12.2 Respiratory Care ICU
18.12.3 Neurosurgical Intensive Care Unit
18.12.4 Burn Unit
18.12.5 Geriatric ICU
18.12.6 Neonatal Intensive Care Unit
18.13 Common Design Considerations
18.13.1 Signage and Way Finding
18.13.2 Security and Access Control
18.13.3 Patient Safety Technology
18.13.4 Communications
18.13.5 Storage
18.13.6 Relationships with Other Departments
18.13.7 Central Nursing Station
18.13.8 Patient Records
18.13.9 X-ray Viewing Area
18.13.10 Reception Area
18.13.11 Corridors in ICU Complex
18.13.12 Administrative Offices
Further Reading
19 Operation Theatre Suite
19.1 Location of Operating Theatre (O.T.) Complex
19.2 Zones in O.T. Complex
19.2.1 Unsterile Zone
19.2.2 Protective Zone
19.2.3 Clean Zone
19.2.4 Sterile Zone
19.3 Infrastructure of O.T. Complex
19.4 Unsterile Zone
19.4.1 Administrative Area
19.4.2 Operation Theatre In-charge or Manager
19.4.3 Room for Head of Anaesthesia
19.4.4 Surgeons Room for Office Work
19.4.5 Trolley Bay
19.4.6 Frozen Section Biopsy Laboratory
19.4.7 Shoe Change Area
19.4.8 Entry Door for Changing Room
19.4.9 Waiting Area for Attendants
19.4.10 Public Utility for Attendants
19.4.11 Linen Pre-wash Room
19.4.12 Instrument Wash Room
19.5 Protective Zone
19.5.1 Changing Rooms
19.5.2 Entry Gate of Pre-operative Ward
19.5.3 Unsterile Store for Equipment Storage
19.5.4 Store for Medicines, Consumables and Disposables
19.5.5 Pantry
19.6 Clean Zone
19.6.1 Pre-operative Room
19.6.2 Preparation Room
19.6.3 Surgeons Rest Room
19.6.4 Restroom for Staff: Males and Females
19.6.5 Exit Doors of all Change Rooms
19.6.6 Pre-anaesthetic Check-up Room (PAC)
19.6.7 Dirty Utility
19.6.8 Post-operative Recovery Ward
19.7 Sterile Zone
19.7.1 Clean Supply Room
19.7.2 Instrument Trolley Lay Up
19.7.3 Scrub Station
19.7.4 Sterilization Room
19.7.5 Operating Theatres/Rooms
19.7.6 Number of OR
19.7.7 Location and Layout of the ORs
19.7.8 Types of Operating Rooms
19.8 Simple Room OR
19.9 Pre-fabricated Modular OR
19.9.1 Size of the OR
19.9.2 Walls of the OR
19.9.3 Ceiling of the OR
19.9.4 Corners of OR
19.9.5 Door of the OR
19.9.6 Window in OR
19.9.7 Control Panel
19.9.8 View Box
19.9.9 Writing Board
19.9.10 Pressure Relief Damper (PRD)
19.9.11 Peripheral Lights
19.9.12 Plenum
19.9.13 Plenum Lights
19.9.14 Pass-through Windows/Hatch Boxes
19.9.15 Electrical Points
19.9.16 Anaesthetist Pendant
19.9.17 Surgeon Pendant
19.9.18 Flooring
19.9.19 Painting
19.9.20 Air Conditioning and Environment of ORs
19.9.21 Supply Air Ducts
19.9.22 Return Air
19.9.23 Special Air Requirements for OR
19.9.24 Other Communication Points in OR
19.9.25 Equipment in OR
19.9.26 Furniture OR
19.10 Septic Operation Theatre
19.11 Endoscopy Suite
19.11.1 Endoscopy Room
19.11.2 Endoscope Washroom
19.11.3 Store
19.11.4 Change Room
19.11.5 Recovery Room
19.11.6 Consultation Room
19.12 Semi-modular OR
19.13 Modular OR
19.14 Hybrid OR
Further Reading
20 Delivery Room/Labour Room
20.1 Location of LDR Complex
20.2 Zones in LDR Complex
20.2.1 Unsterile Zone
20.2.2 Protective Zone
20.2.3 Delivery Zone
20.3 Infrastructure of LDR Complex
20.4 Unsterile Zone
20.4.1 Administrative Area
20.4.2 Labour Room In-Charge
20.4.3 Gynaecologist Room for Office Work
20.4.4 Trolley Bay
20.4.5 Shoe Change Area
20.4.6 Entry Door for Changing Room
20.4.7 Waiting Area for Attendants
20.4.8 Public Utility for Attendants
20.4.9 Linen Pre-wash Room
20.4.10 Instrument Wash Room
20.5 Protective Zone
20.5.1 Changing Rooms
20.5.2 Store for Equipment, Medicines, Consumables and Disposables
20.5.3 Pre-labour Room/Ward
20.5.4 Eclampsia Room
20.5.5 Examination/Preparation Room
20.5.6 Surgeons Rest Room
20.5.7 Dirty Utility
20.5.8 Post-labour Recovery Ward
20.5.9 Doctors Night Duty Rooms
20.6 Delivery Zone
20.6.1 Clean Supply Room
20.6.2 Instrument Trolley Layup
20.6.3 Scrub Station
20.6.4 Sterilization Room
20.6.5 Delivery Rooms
20.6.6 Location and Layout of the Delivery Rooms
20.6.7 Types of Delivery Rooms
20.6.8 Equipment in Delivery Rooms
20.6.9 Furniture Delivery Rooms
20.6.10 Other Issues Relating to the Delivery Room
20.6.11 Septic Delivery Room
20.7 Baby Resuscitation Area
20.8 Other Important Issues to be Considered While Designing LDR
20.8.1 Labour Table Specifications
20.8.2 Shifting Baby to NICU
20.8.3 Access to the Operating Room
Further Reading
21 Intermediate Care Area (Patient Rooms)
21.1 Improve Patient and Staff Safety
21.2 Increase Patient and Staff Satisfaction
21.3 Provide Amenities and Comfort for the Family
21.3.1 Family Lounge
21.3.2 Consultation Rooms
21.3.3 Meditation Spaces
21.3.4 Family Cafeteria
21.3.5 Family Sleep Rooms
21.3.6 Family Laundry
21.4 Increase Staff Efficiency
21.5 Patient Room Furnishings
21.5.1 Room Decor
21.5.2 Lighting in the Patient Room
21.5.3 Ceiling Finishes
21.6 Types of Patient Rooms in the Hospital
21.6.1 Single Bed Occupancy
21.6.2 Sharing Rooms
21.6.3 General Wards
21.6.4 Isolation Ward/Rooms
21.7 Infrastructure Details of the Indoor Patient Units
21.8 Location of the Indoor Patient Areas
21.9 Zoning of the Isolation Areas
21.10 Single Patient Room (Private Room)
21.10.1 Room Layout
21.10.2 Size of the Room
21.10.3 Walls
21.10.4 Doors
21.10.5 Windows
21.10.6 Toilets
21.10.7 Bed Layout in Patient Room
21.10.8 Furniture and Instruments in Patient Room
21.10.9 Air Conditioning System of Patient Rooms
21.10.10 Central Piped Medical Gas Supply
21.10.11 Electrical Points in Patient Room
21.10.12 Other Communication Points in Patient Room
21.10.13 Curtain Partitions
21.10.14 IV Track
21.10.15 Psychiatric Patient Rooms
21.11 Deluxe Single Patient Room (Deluxe Room)
21.12 Family Suite with Single Patient Room (Suite Room)
21.12.1 Patient Room of the Suite
21.12.2 Family Room of the Suite
21.13 Sharing Patient Room (Semi-private Room)
21.13.1 Room Layout
21.13.2 Size of the Semi-private Sharing Room
21.13.3 Design of the Semi-private Sharing Room
21.13.4 Toilets
21.13.5 Bed Layout in Patient Room
21.13.6 Furniture and Instruments in Patient Room
21.13.7 Air Conditioning System of Patient Rooms
21.13.8 Central Piped Medical Gas Supply
21.13.9 Electrical Points in Patient Room
21.13.10 Other Communication Points in Patient Room
21.13.11 Curtain Partitions
21.13.12 IV Track
21.13.13 Lighting in the Patient Room
21.14 General Ward (Multiple Beds Room)
21.14.1 Location of the Multiple Bed Wards
21.14.2 Room Layout
21.14.3 Number of Beds in the Multiple Bed Ward
21.14.4 Size of the Multiple Bed Ward
21.14.5 Design of the Multiple Bed Ward
21.14.6 Toilets
21.14.7 Bed Layout in Ward
21.14.8 Furniture and Instruments
21.14.9 Air Conditioning System
21.14.10 Central Piped Medical Gas Supply
21.14.11 Electrical Points in Ward
21.14.12 Other Communication Points in Ward
21.14.13 Curtain Partitions
21.14.14 IV Track
21.14.15 Lighting in the Patient Room
21.15 Isolation Rooms/Wards
21.15.1 Isolation in ICU
21.15.2 Single Bed Isolation Rooms
21.15.3 Air and Pressure Monitoring System for Isolation Rooms
21.15.4 Pressurization of the Isolation Rooms
21.15.5 Air Conditioning of the Isolation Wards/Units
21.16 Supporting Room/Units for Indoor Patient Service
21.17 Nursing Station
21.17.1 Hand Hygiene
21.17.2 Alcohol Gel/Sanitizer Dispensers
21.18 Nurses Duty Rooms
21.19 Doctors Duty Rooms
21.20 Procedure and Treatment Room
21.20.1 Location of Treatment/Procedure Room
21.20.2 Size of Treatment/Procedure Room
21.20.3 Issues Related to Infrastructure of Treatment/Procedure Room
21.20.4 Furniture in Treatment/Procedure Room
21.20.5 Doors
21.20.6 Windows
21.20.7 Handwashing
21.20.8 Central Piped Medical Gas Supply
21.20.9 Electrical Points in Treatment/Procedure Room
21.20.10 Other Communication Points in Treatment/Procedure Room
21.21 Clean Utility
21.22 Dirty Utility/Sluice Room
21.23 Store for Medicines, Consumables and Disposables
21.24 Medication Areas
21.25 Equipment Park/Store
21.26 Trolley Park Area
21.27 Ward Pantry
Further Reading
22 Radiology
22.1 Diagnostic vs Therapeutic Radiology
22.2 Location of the Radiology Department
22.3 Infrastructure on Centralized Radiology Department
22.4 Main Equipment in the Department of Radiology
22.5 Utility Area
22.5.1 Reception and Enquiry
22.5.2 Registration and Cash Counter
22.5.3 Waiting Lobby
22.5.4 Reporting Room
22.5.5 Stores for Unused Consumables and Films
22.5.6 Stores for Used Films and General Items
22.5.7 Report Delivery Counter
22.6 X-Ray Zone
22.6.1 Radiography Rooms
22.6.2 Room for Mobile X-Ray System
22.6.3 Change Rooms
22.6.4 Patient Preparation Room
22.6.5 Computerized Radiography (CR) Room
22.6.6 Sub-waiting for Radiography
22.7 Ultrasound Zone
22.7.1 Ultrasound Room
22.7.2 Change Rooms
22.7.3 Toilets
22.7.4 Sub-waiting for Ultrasound
22.8 CT Scan Zone
22.8.1 CT Scan Machine Room
22.8.2 CT Control Room
22.8.3 UPS Room
22.8.4 CT Panel Room
22.8.5 Change Rooms
22.8.6 Sub-waiting for CT Scan
22.9 MRI Zone
22.9.1 MRI Machine Room
22.9.2 MRI Control Room
22.9.3 UPS Room
22.9.4 MRI Panel Room
22.9.5 Chiller
22.9.6 Change Rooms
22.9.7 Sub-waiting for MRI
22.10 Mammography Zone
22.10.1 Mammography Rooms
22.10.2 Change Rooms
22.10.3 Computerized Radiography (CR) Room
22.10.4 Sub-waiting for Mammography
22.11 DEXA Scan Zone
22.11.1 DEXA Scan Machine Room
22.11.2 Sub-waiting for DEXA Scan
22.12 PET CT/MRI Zone
22.12.1 Location of the Zone in Hospital
22.12.2 PET CT Scan Machine Room
22.12.3 PET MRI Machine Room
22.12.4 SPECT CT Machine Room
22.12.5 Operating Console Rooms
22.12.6 Low-Risk Areas or Cold Areas
22.12.7 High-Risk Areas or Radiation Exposure Hot Areas
22.12.8 Toilet
22.12.9 Control and Scanning Room
22.12.10 Post-examination Waiting Room
22.12.11 Waste Disposal Room
Further Reading
23 Clinical Laboratories
23.1 Infrastructure of Clinical Lab
23.2 Size of the Lab
23.3 Layout
23.4 Spaces
23.5 Location and Arrangement of Areas
23.6 Open Lab Designs
23.7 Biosafety
23.8 Molecular Testing
23.9 Laboratories
23.9.1 Working Slabs
23.9.2 Sinks
23.9.3 Equipment Park/Store
23.9.4 Emergency Eyewash Station
23.9.5 Clean Utility
23.9.6 Biohazard/Trash/Recycle Room
23.10 Pneumatic Tube Systems (PTS)
23.11 Clear Floor Space
23.12 Electrical Points in Laboratories
23.13 Other Communication Points in Laboratories
23.14 Air Conditioning System of Laboratories
23.15 Furniture in the Laboratories
23.16 Main Equipment in the Clinical Laboratories
23.17 Support Services
23.17.1 Autoclave
23.17.2 Bulk Storage Room
23.17.3 Cold Storage Room
23.17.4 RO Water Closet
23.17.5 Gas Storage Closet
23.17.6 Record/File/Copy Room
23.17.7 Flammable Storage
23.17.8 Specimen Storage/Recycle
23.17.9 Block and Slide Storage
23.17.10 Penta Head/Deca Head Microscope Room
23.18 Utility Area
23.18.1 Doctors Room
23.18.2 Laboratory Manager
23.18.3 Technicians Room
23.19 Outpatient Phlebotomy
23.19.1 OPD Phlebotomy Room
23.19.2 Fine Needle Aspiration Room
23.19.3 Toilets
23.19.4 Waiting Area
23.20 Employee Support
23.20.1 Staff Lounge
23.20.2 Lockers
23.20.3 Shower with Water Closet
Further Reading
24 Blood Bank
24.1 Location of the Blood Bank in Hospital
24.2 Controlling Authority
24.3 Functions of Blood Bank
24.3.1 Receiving
24.3.2 Storage
24.3.3 Testing
24.3.4 Distribution
24.4 Infrastructure of the Blood Bank
24.5 Area of Blood Bank
24.6 Equipment in the Blood Bank
24.7 Receiving Area
24.7.1 Entrance
24.7.2 Reception
24.7.3 Registration
24.7.4 Waiting
24.7.5 Medical Examination
24.7.6 Bleeding Room
24.7.7 Refreshment/Recovery/Rest Room
24.7.8 Apheresis Room
24.8 Testing Area
24.8.1 Working Slabs
24.8.2 Sinks
24.8.3 Electrical Points in Laboratories
24.8.4 Other Communication Points in Laboratories
24.8.5 Air Conditioning System of Laboratories
24.8.6 Furniture in the Laboratories
24.9 Storage and Processing Area
24.9.1 Blood Component Room
24.10 Distribution Area
24.10.1 Pneumatic Tube Systems
24.11 Utility Area
24.11.1 Change Room
24.11.2 Doctors Rest Rooms
24.11.3 Store
24.11.4 Record Room
24.11.5 Medical Officer Room
24.11.6 Sterilization Room Cum Washing Room
24.11.7 Waste Management and Disposal
Further Reading
25 Other Investigations and Procedures
25.1 Coronary Catheterization (Cath Lab)
25.1.1 Location of the Cath Lab
25.1.2 Number of Cath Lab Procedure Rooms
25.1.3 Cath Lab Console Room
25.1.4 UPS Room
25.1.5 Cath Lab Panel Room
25.1.6 Change Rooms for Patients
25.1.7 Change Rooms for Staff
25.1.8 Waiting for Cath Lab
25.1.9 Stores for Unused Consumable
25.1.10 Stores for Records and CDs
25.1.11 Consultation Rooms
25.2 Thallium Scan
25.3 Audiometry
25.3.1 Location of the Audiometry Room
25.3.2 Room Designing
25.4 Bronchoscopy
25.5 Capsule Endoscopy, Cholangioscopy, Colonoscopy, Duodenoscopy, Endoscopic Ultrasound, Upper Gastrointestinal Endoscopy etc.
25.6 Neurology
25.7 Polysomnography (Sleep Lab)
25.7.1 Location of the Sleep Lab
25.7.2 Room Designing
25.8 Ophthalmology
25.9 ESW Lithotripter of Urology
25.10 Dialysis
25.10.1 Location of the Dialysis Room
25.10.2 Dialysis Procedure Room
25.10.3 Washroom for Dialyzers
25.10.4 Store
25.10.5 Change Rooms for Patients
25.10.6 Change Rooms for Staff
25.10.7 Waiting for Dialysis
Further Reading
26 Radiation Therapy
26.1 Location of Radiotherapy Unit
26.2 Infrastructure of the Radiotherapy Department
26.3 Utility Areas
26.3.1 Entrance to the department
26.3.2 Outside Entrance
26.3.3 Reception and Enquiry Counter
26.3.4 Registration Counter
26.3.5 General Waiting
26.3.6 Store
26.3.7 Consultation Room
26.4 Treatment and Planning Area
26.4.1 Mould Room
26.4.2 Mould Workshop
26.4.3 Medical Physics
26.4.4 CT Simulators
26.5 Radiation Therapy Treatment Area
26.5.1 External Beam Radiation Therapy
26.5.2 Internal Beam Radiation Therapy
26.6 Radiotherapy Ward
26.7 Trolley Bay
26.8 Change Rooms
26.9 Store
26.10 Signage and Wayfinding
26.11 Sub-waiting Lobbies
26.12 Clean Utility
26.13 Dirty Utility/Sluice Room
26.14 Handwashing
26.15 Administration/Offices
26.16 Other Issues on Infrastructure of the Radiation Therapy Unit
26.16.1 Acoustics
26.16.2 Doors
26.16.3 Finishes
26.16.4 Other Communication Points in the Radiation Department
26.17 Heating Ventilation and Air conditioning
26.18 Central Piped Medical Gas Supply
26.19 Electrical Points in the Radiation Therapy Department
26.20 Power Backup
Further Reading
27 Rehabilitation and Allied Health Therapies
27.1 Location of Physiotherapy Department
27.2 Layout of the Physiotherapy Department
27.3 Entrance/Entrance Lobby
27.4 Reception
27.5 Waiting Areas
27.6 Examination Room with Exam. Cubicles
27.7 Patient Therapy Areas
27.7.1 Physiotherapy
27.7.2 Occupational Therapy
27.8 Administrative Area
27.9 In-Charge Rehabilitation Department
27.10 Secretarial Staff
27.11 Store
27.12 Trolley Bay
27.13 Clean Utility
27.14 Dirty Utility/Sluice Room
27.15 Change Rooms
27.16 Other Issues About the Infrastructure of the Rehabilitation Department
Further Reading
28 Pharmacy Unit
28.1 Location for the Pharmacy
28.2 Size of the Pharmacy
28.3 Infrastructure of Pharmacy
28.4 Pharmacy for Outpatients
28.4.1 Entrance
28.4.2 Drug Receiving Area
28.4.3 Disbursing Hall
28.4.4 Bulk Storage
28.4.5 Cold Store
28.4.6 Expiry Drug Room
28.4.7 Costly Drug Room
28.4.8 Drug Sorting Room
28.4.9 Narcotics and Controlled Drug Store
28.5 Pharmacy for Inpatients
28.6 Pneumatic Tube Systems
28.7 Pharmacist Offices
28.8 Automation in the Pharmacy
Further Reading
29 CSSD
29.1 Methods of Sterilization Processes
29.2 Infrastructure of CSSD
29.3 Location
29.4 Area Required for CSSD Department
29.5 Material Flows
29.6 Functional Zones of CSSD
29.7 Receiving Zone (Unclean Area)
29.8 Decontaminating, Washing and Disinfecting Zone
29.9 Packaging Area
29.9.1 Location
29.9.2 Role of the Packing Room
29.9.3 Packing Room
29.10 Sterilization Area
29.10.1 Location and Relationships
29.10.2 Main Activities of the Sterilization Process
29.10.3 Size of the Sterilization Room
29.10.4 Methods and Types of Sterilizers
29.10.5 Steam Sterilizers
29.10.6 Ethylene Oxide Gas Sterilizer (ETO)
29.10.7 Dry Heat Sterilizer
29.10.8 Hydrogen Peroxide Plasma Sterilizer
29.10.9 Requirements for the Infrastructure of Steam Sterilizer
29.10.10 Requirements for the Infrastructure of ETO Sterilizer
29.11 Clean Storage Area
29.11.1 Location of the Clean Storage Room
29.11.2 Designing of the Storage Shelves
29.12 Delivery Counter
29.13 Support Areas
29.13.1 Staff Changing Rooms
29.13.2 Administrative Area
29.14 Finishing Details of the CSSD
29.14.1 Walls
29.14.2 Ceilings
29.14.3 Floors
29.14.4 Doors
29.14.5 Sound/Noise
29.14.6 Natural Light
29.14.7 Electrical Points
29.14.8 Lighting
29.14.9 Air Conditioning
Further Reading
30 Piped Medical Gas Supply System (MGPS)
30.1 Oxygen (O2)
30.2 Nitrous Oxide (N2O)
30.3 Compressed Medical Air 4 Bar
30.4 Compressed Medical Air 7 Bar
30.5 Carbon Dioxide (CO2)
30.6 Nitrogen (N2)
30.7 Medical Vacuum
30.8 System Components
30.9 Sources
30.9.1 Bulky Systems
30.9.2 Manifold Systems
30.9.3 Central Plants
30.9.4 Generators
30.10 Piping Networks
30.10.1 Pipeline Installation
30.10.2 Valves
30.10.3 Warning and Alarm Systems
30.10.4 Gas Outlets
30.10.5 Secondary Equipment
30.11 Designing the MGPS System
30.11.1 Analysis of the Area of the Hospital
30.12 Infrastructure for MGPS
30.13 Manifold Room
30.13.1 Purging of the System
30.13.2 Location of the Manifold
30.13.3 Size of the Manifold Room
30.13.4 Fixing the Manifold Systems in the Hall/Room
30.14 Compressed Medical Air
30.14.1 Compressor Air Plant
30.14.2 Air Filtration
30.14.3 Medical Air 400 kPa
30.14.4 Surgical Air 700 kPa
30.15 Vacuum
30.15.1 Vacuum Plant
30.15.2 Filtration System
30.16 Issues While Designing the Plant Room and the Manifold Room
30.17 Medical Gases Outlet Terminals
30.18 Bulk Liquid Oxygen Gas System
30.18.1 Liquid Oxygen Vessel
Further Reading
31 Hospital Kitchen
31.1 Infrastructure of Hospital Kitchen
31.2 Location of Hospital Kitchen
31.3 Size of the Kitchen
31.4 Entry
31.5 Change Rooms cum Wash Areas
31.6 Receipt Area for Supplies
31.7 Storage Area
31.7.1 Bulk Storage
31.7.2 Fruit and Vegetable Store
31.7.3 Refrigeration, Cool Rooms, Freezers
31.7.4 Storage Areas for Dry Ration/Goods
31.8 Preparation Areas
31.9 Cooking Areas
31.10 Reheating Areas
31.11 Packing/Plating
31.12 Meal Trolley/Cart Parking
31.13 Food Distribution
31.14 Trolley Return/Stripping
31.15 Trolley/Cart Wash
31.16 Dishwashing
31.17 Pot Washing
31.18 Waste Disposal
31.19 Gas Storage Closet
31.20 Staff and Support Areas
31.21 General Issues About Infrastructure Requirements
31.22 Fixtures, Fittings and Equipment
Further Reading
32 Laundry
32.1 Facilities and Space Requirements
32.2 Location of the Laundry
32.3 Size of the Unit
32.4 Dirty and Soiled Linen Generation
32.5 Dirty and Soiled Linen Interim Storage
32.6 Central Storage Area
32.7 Dirty Receipt
32.8 Sorting and Weighing
32.9 Washing Area
32.9.1 Loading and Washing
32.9.2 Extractors
32.9.3 Tumble Drying
32.9.4 Ironing
32.10 Inspection and Repairing
32.11 Packaging and Storage
32.12 Dispatch Room
32.13 Trolley Washing
32.14 Store
32.15 Staff and Support Areas
32.16 Other Issues Relating to the Infrastructure of Laundry
32.16.1 Infection Control
32.16.2 Airflow
32.16.3 Floors
32.16.4 Walls
32.16.5 Natural Lighting
32.16.6 Mechanical Ventilation
32.16.7 Hot-Air Extraction
32.16.8 Compressors
32.16.9 Steam
32.16.10 Water Supply, Heating and Water Treatment Equipment
32.16.11 Fire Prevention and Detection
32.16.12 Communications
Further Reading
33 Medical Record Department (MRD)
33.1 Electronic Medical Records (EMR)
33.2 Location of MRD
33.3 Layout
33.4 Entry and Reception
33.5 Medical Record Receipt Room
33.6 Compilation Desk
33.7 Indexing and Coding
33.8 Statistical Analysis
33.9 Computer Lab
33.10 Medical Record Storage Room
33.11 Dictation Room/Cubicles
33.12 Transcription Room
33.13 Photocopying/Printing Room
33.14 Scanning Room
33.15 Binding Room
33.16 Waste Holding Room
33.17 Store
33.18 Administrative Area
33.19 Other Issues About the Infrastructure of MRD
Further Reading
34 Mortuary
34.1 Location of the Mortuary
34.2 Infrastructure of Mortuary
34.3 Mortuary
34.3.1 Entrance Lobby
34.3.2 Body Wash
34.3.3 Body Holding Area
34.3.4 Waiting/Viewing Area
34.3.5 Storage
34.3.6 Administration Area
34.3.7 Exit Lobby
34.4 Autopsy Area
34.4.1 Pre Autopsy Room
34.4.2 Autopsy Room (Indoor)
34.4.3 Autopsy Room (Outdoor)
34.4.4 Post Autopsy Room
34.4.5 Autopsy Surgeon’s Room
34.4.6 Instrument Wash Room
34.4.7 Viscera Preparation Room
34.4.8 Viscera Stores
34.4.9 Surgeon Change Room
34.5 Other Infrastructural Issues Relating to the Mortuary/Autopsy Room
Further Reading
35 Administration Area
35.1 Levels of Administrative Staff
35.2 Infrastructure of the Administrative Area
35.3 Location of the Administrative Area
35.4 Reception
35.5 Infrastructure of Reception
35.6 Waiting Lobby
35.7 Offices of the Senior Management
35.7.1 Electrical Points
35.7.2 Other Communication Points in the Room
35.7.3 Lighting in the Offices
35.7.4 Doors
35.7.5 Windows
35.7.6 Flooring
35.7.7 Air-Conditioning
35.7.8 Room Décor
35.7.9 Furniture in the Executive Offices
35.7.10 Acoustics
35.7.11 Privacy
35.8 Offices of the Senior Executive Level Management
35.8.1 Electrical Points
35.8.2 Other Communication Points in the Room
35.8.3 Lighting in the Offices
35.8.4 Doors
35.8.5 Windows
35.8.6 Flooring
35.8.7 Air-Conditioning
35.8.8 Furniture in the Executive Offices
35.8.9 Acoustics
35.9 Offices of the Executive Level Management
35.9.1 Electrical Points
35.9.2 Other Communication Points in the Room
35.9.3 Lighting in the Offices
35.9.4 Doors
35.9.5 Windows
35.9.6 Flooring
35.9.7 Air-Conditioning
35.9.8 Furniture in the Executive Offices
35.10 Offices of the Junior Level Management
35.10.1 Electrical Points
35.10.2 Other Communication Points
35.10.3 Lighting in the Offices
35.10.4 Doors
35.10.5 Windows
35.10.6 Flooring
35.10.7 Air-Conditioning
35.11 Support Room/Facilities
35.11.1 Senior Management’s PA Room
35.11.2 Secretarial Staff
35.11.3 Kitchen
35.11.4 Dining Area
35.11.5 Staff Toilets
35.11.6 Store
35.11.7 Notice Boards
35.12 Meeting Rooms
35.12.1 Electrical Points
35.12.2 Other Communication Points in the Room
35.12.3 Lighting
35.12.4 Doors
35.12.5 Windows
35.12.6 Flooring
35.12.7 Air-Conditioning
35.12.8 Room Decor
35.12.9 Furniture in the Meeting Room
35.12.10 Acoustics
35.12.11 Privacy
Further Reading
36 Stores in the Hospital
36.1 Functions of Stores
36.2 Types of Hospital Stores
36.3 Planning of Hospital Stores
36.4 Location of the Stores
36.5 Infrastructure of Stores
36.5.1 Store
36.5.2 Storekeeper Room
36.5.3 Store Secretarial Staff
36.5.4 Kitchen
36.5.5 Staff Toilets
36.5.6 Special Store Room
36.5.7 Cold Room
36.5.8 Issue Counter
36.5.9 Receiving Area
36.6 Other Infrastructure Issues
36.6.1 Electrical Points
36.6.2 Other Communication Points in the Room
36.6.3 Lighting in the Stores
36.6.4 Doors
36.6.5 Windows
36.6.6 Flooring
36.6.7 Air-Conditioning
36.6.8 Furniture in the Stores
36.6.9 Notice Boards
Further Reading
37 Engineering and Maintenance Unit
37.1 Worksshops
37.2 Biomedical Workshop
37.3 Electrical Workshop
37.4 HVAC Workshop
37.5 MGPS Workshop
37.6 Low Voltage Workshop
37.7 Building Maintenance
37.8 Mechanical Workshop
37.9 Firefighting Workshop
37.10 Automobile Workshop
37.11 Location of the Workshops
37.12 Infrastructure of Workshops
37.12.1 Workshop
37.12.2 Workshop In-charge Room
37.12.3 Workshop Engineers
37.12.4 Staff Toilets
37.12.5 Receiving/Issue Counter
37.13 Other Infrastructure Issues
37.13.1 Electrical Points
37.13.2 Other Communication Points in the Room
37.13.3 Lighting in the Workshops
37.13.4 Doors
37.13.5 Windows
37.13.6 Flooring
37.13.7 Air-Conditioning
37.13.8 Furniture in the Workshop
37.13.9 Notice Boards
Further Reading
Part V MEP Planning & Designing
38 HVAC (Air-Conditioning) System
38.1 Central Water Chilled Plant
38.1.1 Chillers
38.1.2 Cooling Towers
38.1.3 Air Handling Systems
38.1.4 Variable Air Volume (VAV) Ventilation
38.1.5 Diffusers, Registers and Grills
38.1.6 Ductwork
38.1.7 Air Intake and Exhaust
38.1.8 Filtration
38.2 Installation of Central Chilled Water Plant
38.2.1 Chillers
38.2.2 Cooling Towers
38.2.3 Air Handling System
38.3 DX (Direct Expansion) Chilling
38.3.1 The Plant Room
38.3.2 Air Handling Unit Room
38.3.3 Air-Conditioned Room
38.3.4 Benefits of DX Air-Conditioning Systems
38.3.5 Disadvantages of DX system
38.4 Split Air-Conditioning
38.5 HVAC—Room Side Design
38.5.1 Operating Rooms
38.5.2 Intensive Care Units
38.5.3 Patient Rooms
38.5.4 Isolation Rooms
38.5.5 Recovery (Post-Anaesthesia Care Unit)
38.5.6 Emergency
38.5.7 Burn Units
38.5.8 Procedure Rooms
38.5.9 Endoscopy Rooms
38.5.10 Imaging Rooms
38.5.11 Central Laboratories
38.5.12 Pharmacy
38.5.13 Mortuary and Autopsy
38.5.14 Central Sterile Supply Department (CSSD)
38.5.15 Server Room
38.6 Effects of COVID-19 on the Design of Air-Conditioning
Further Reading
39 Electrical Services
39.1 Primary Power Supply (PPS)
39.2 Secondary Power Supply (SPS)
39.3 Tertiary Power Supply (TPS)
39.4 Electrical Load Calculation
39.5 HT Distribution System
39.6 LT Power Distribution
39.7 Redundancy Due to Power Failure
39.8 Emergency Power Generation System
39.9 Uninterrupted Power Supply System (UPS)
39.10 Switching Arrangement
39.11 Emergency Lighting
39.12 Earthing System
39.13 System of Wiring and Cabling
39.14 Switches/Sockets and Boxes
39.15 Lightning Protection
39.16 Power Quality
39.17 Power Factor Correction
39.18 Street Lighting System
39.19 Lighting Management System
39.19.1 Occupancy Sensor
39.20 Illumination Levels
Further Reading
40 ELV, ICT and IBMS Services
40.1 Data System
40.2 Nurse Call System
40.2.1 Desktop Console
40.2.2 Room Lights
40.2.3 Patient Call with Handset
40.2.4 Patient Call—in Toilets
40.2.5 Staff Assist Call
40.2.6 Emergency Call
40.2.7 Wireless Handset
40.2.8 Wireless Console
40.2.9 Audio-Video Nurse Call System
40.3 Electronic Security and Video Surveillance System
40.3.1 Closed Circuit Television System (CCTV)
40.4 Access Control System
40.4.1 No-Touch Access
40.5 Telecommunication System
40.6 Patient Entertainment and Information Systems
40.7 Queue Management System
40.8 Public Address System
40.9 Integrated Building Management Systems (IBMS)
Further Reading
41 Information Technology and Computerization
41.1 Health Information System (HIS)
41.2 Modules of Hospital Information Software
41.2.1 Information Desk Module
41.2.2 Patient Registration Module
41.2.3 Outpatient Management Module
41.2.4 In-Patient Management Module
41.2.5 Admission, Transfer, Discharge (ADT) Module
41.2.6 Consulting Appointment Management Module
41.2.7 Bed Management Module
41.2.8 Ward Management Module
41.2.9 Nursing Management Module
41.2.10 Operating Room Module
41.2.11 Laboratory Module
41.2.12 Blood Bank Module
41.2.13 Radiology Module
41.2.14 Picture Archiving and Communication System (PACS) Module
41.2.15 Casualty and Emergency Management System
41.2.16 Pharmacy Information System
41.2.17 Order Management System Module
41.2.18 The Birth/Death Registration Module
41.2.19 Electronic Medical Records Module
41.2.20 Billing and Finance Module
41.2.21 Insurance and Medi-Claim Module
41.2.22 Human Resources Module
41.2.23 Materials Management System (Stock, Purchasing and Fixed Asset Module)
41.2.24 Dietary Module/Catering Module
41.2.25 Statistics and Reporting Module (MIS)
41.2.26 Hospital Analytics
41.2.27 Interface Module
Further Reading
42 Water Supply and Drainage System
42.1 Water Supply System
42.1.1 Source of Water Supply
42.2 Water Storage
42.3 Water Storage Tank Locations
42.4 Systems of Water Treatment
42.4.1 Pasteurization
42.4.2 Chemical Treatment
42.4.3 Chlorine Water Treatment
42.4.4 Water Softener Plants
42.4.5 Silver–Copper Ionization
42.4.6 Reverse Osmosis Treatment
42.4.7 Ultraviolet Treatment
42.4.8 Ozone Water Treatment
42.4.9 Distilled Water
42.5 Drinking Water
42.6 Water Booster Pumps
42.7 Hot Water System
42.7.1 Electrical Hot Water Generation
42.7.2 Hot Water Generation from Boiler/Steam by Burning Fuel
42.7.3 Solar Hot Water Generation
42.7.4 Stand-Alone Hot Water Geysers
42.8 Sanitary Fittings
42.9 Irrigation Water Supply
42.10 WC Flushing Systems
42.11 Steam System
42.12 Water Drainage System
42.13 Drainage Strategy
42.14 Types of Drainage Systems
42.14.1 Wastewater Drainage
42.14.2 Soil Water Drainage
42.14.3 Storm Water Drainage
42.14.4 Chemical Drainage
42.14.5 Radiation Drainage
42.15 Methods of Drainage
42.15.1 Vent Pipes
42.15.2 Floor Drains
42.15.3 Soil Water Drainage
42.15.4 Rainwater Drainage System
42.15.5 Infectious Contaminated Drainage
42.15.6 Radiation Drainage
42.15.7 Kitchen Grease Drainage
Further Reading
43 Vertical Transportation System
43.1 Lift Categories
43.1.1 General Passenger Lifts
43.1.2 Bed Lifts
43.1.3 Service/Goods Lift
43.2 Design Considerations
43.3 Engineering Guidelines
Further Reading
44 Pneumatic Tube Systems (PTS)
44.1 Pneumatic Tube System Components
44.1.1 Blower and Air Reverse Valve
44.1.2 Carrier
44.1.3 Control Centre
44.1.4 Database
44.1.5 Inter-Zone Connection
44.1.6 Station
44.1.7 Diverter
44.1.8 Tubing
44.1.9 Zone
44.1.10 Slow Speed Device
Further Reading
45 Signage System
45.1 Categories Using Wayfinding
45.1.1 Patients and Visitors
45.1.2 Staff
45.1.3 Users with Special Needs
45.1.4 Sensory Impairment
45.1.5 Language and Illiteracy
45.2 Principles for Designing Wayfinding System
45.3 Types of Sign Boards
45.3.1 Classified by Function
45.3.2 Signs Classified by Physical Characteristics
45.3.3 Other Factors of Classification of Sign Boards
Further Reading
46 Biomedical Waste Management
46.1 Classification of Hospital Waste
46.1.1 Biomedical Waste
46.1.2 General Waste
46.1.3 Other Wastes
46.2 Steps Involved in Biomedical Waste Management
46.3 Biomedical Waste Segregation
46.4 Biomedical Waste Collection
46.4.1 Time of Collection
46.4.2 Packing of Biomedical Waste and Labelling
46.4.3 Interim Storage
46.5 Transportation of Biomedical Waste in Hospital
46.5.1 Transportation Trolleys
46.5.2 Route of Transportation
46.5.3 Central Waste Collection Room for Biomedical Waste
46.6 Record Keeping
46.7 Updating Information on the Website
46.8 Management of General Waste
46.9 Management of Other Wastes
46.9.1 Used Batteries
46.9.2 Management of Radioactive Wastes
46.9.3 Management of E-Wastes
46.10 Effluent Treatment Plant (ETP/STP)
46.10.1 Preliminary Stage
46.10.2 Primary Stage
46.10.3 Secondary Stage
46.10.4 Tertiary Stage
Further Reading
47 Fire Safety
47.1 Planning for Fire Safety in Hospitals
47.2 Structural Elements for Fire Safety
47.2.1 Compartmentalization
47.2.2 Open Spaces
47.2.3 Basements
47.2.4 General Exit Requirements
47.2.5 Corridors and Passageways
47.2.6 Staircases
47.2.7 Ramps
47.2.8 Electrical and Emergency Power
47.2.9 Air-Conditioning, Ventilation and Smoke Control
47.2.10 Fire Barrier
47.2.11 Glazing
47.2.12 Surface Interior Finishes
47.2.13 Fire Command Centre (FCC)
47.3 Fire Detection and Alarm
47.4 Fire Extinguishers/Fixed Firefighting Installations
47.4.1 Static Water Storage Tanks
47.4.2 Fire-Fighting Pump House
47.4.3 Automatic Sprinkler Installation
Further Reading
48 Green Hospitals
48.1 What Is Green Hospital?
48.2 Benefits of Green Buildings Hospitals
48.3 Barriers to Create Green Hospitals
48.3.1 System Redundancy
48.3.2 Infection Control
48.3.3 Regulatory Compliance
48.3.4 Intense Energy and Water Consumption
48.3.5 Ventilation Rates
48.3.6 Accreditation and Licensing Demands
48.3.7 Higher Volume of Hospital Waste
48.3.8 Chemical Use
48.3.9 Frequent Upgradations and Renovations
48.4 Elements of a Green Hospital
48.4.1 Energy Conservation
48.4.2 Alternative Means of Energy Generation
48.4.3 Water Conservation
48.4.4 Indoor Environmental Quality and HVAC Optimization
48.4.5 Chemical Management
48.4.6 Solid Waste Management
48.4.7 Environmental Services
48.4.8 Food Services
48.4.9 Environmentally Preferable Purchasing
48.4.10 Sustainable Construction Materials
48.4.11 Pharmaceutical Minimization, Management and Disposal
48.4.12 Reducing Transportation Cost
48.4.13 Greenery
Further Reading
Part VI Equipment Planning
49 Equipment Planning
49.1 Choosing the Desired Equipment
49.1.1 Quality of the Equipment
49.2 Points to Be Considered While Purchasing the Medical Equipment
49.2.1 Warranty
49.2.2 Maintenance Contracts
49.2.3 Availability of the Service Engineers and the Workshops
49.2.4 Period of Spare Part Availability
49.2.5 Cost of Consumables
49.2.6 Life Expectancy of the Equipment
49.2.7 Plan for Space and Development
49.2.8 Vendors Evaluation
49.2.9 Checking Regulations
49.2.10 Inspection and Testing Before Transfer of Ownership
49.3 Equipment Used in the Hospital
49.4 General Items Used in Intensive Care Units, Wards, Pre & Post-Operative Units, Post Labor Wards, Triages Area and OPD’s Etc.
49.5 Department of Cardiology and CTVS
49.6 Department of Gastric Sciences
49.7 Nephrology and Dialysis
49.8 Neurosurgery
49.9 Neurology
49.10 Plastic Surgery
49.11 Pulmonology
49.12 Radiation Oncology
49.13 Urology
49.14 Robotic Surgery
49.15 Orthopaedic
49.16 Dermatology
49.17 ENT
49.18 Gynaecology
49.19 Ophthalmology
49.20 Operating Rooms
49.21 Dental
49.22 In Vitro Fertilization Clinic
49.23 NICU
49.24 Pain Clinic
49.25 Labor Room
49.26 Radiology
49.27 Biochemistry
49.28 Microbiology
49.29 Pathology
49.30 Blood Bank
49.31 CSSD
49.32 Misc. Small Instruments
49.33 Misc. Disposable Items
49.34 Linen
49.35 Consumables
49.36 Back Up Services
49.37 Patient Furniture
Further Reading
Glossary
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