1.
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2. Library Study HOSPITALS
NATIONAL INSTITUTE OF TECHNOLOGY, HAMIRPUR
Library Study HOSPITALS

3. Functional Planning Norms by Medical Council of India
Hospital
A hospital is an institution for  providing health care treatment to the patients  with specialized staff and equipments.
A general hospital is divided into operational areas of administration, examination, treatment, supply, disposal, residential areas, and support areas for service operation. 1
CATEGORY A : (25-50 BEDS) 2
CATEGORY B : ( BEDS)
Functional Planning Norms by Medical Council of India 3
CATEGORY C : ( BEDS) 4
CATEGORY D : ( BEDS) 5
CATEGORY E : ( BEDS)

4. Selection of Site for Hospital
Quite Place
Treatment rooms
Almost sq. area
Aligned along North-West and North-East direction
Location
Nursing Wards
Future Expansion area
Aligned along South to South-West direction
No loss of amenity
Special rooms
Aligned along North direction
No contaminated land

5. Connectivity b/w Areas

6. Space Requirements Spaces Areas PA = Productive area
Supply/disposal sqm. PA/planned bed-care area
Nursing area sqm. PA/planned bed
Intensive therapy sqm. PA/bed
Surgical area sqm. PA/surgical unit
Rehabilitation sqm. PA/treatment place
Physiotherapy sqm. PA/treatment place
X-ray sqm. PA/diagnosis room
Radiotherapy sqm. PA/equipment
Recovery area sqm. PA/recovery bed
NMR diagnosis sq. PA/diagnosis room
Clinical physiology sqm. PA/diagnosis room
Clinical neurophysiology sqm. PA/diagnosis room
Central reception sqm. PA/examination/treatment room
Delivery area sqm. PA/delivery room
Dialysis sqm. PA/dialysis bed
Specialist departments sqm. PA/examination/treatment room
PA = Productive area

7. Corridors, Doors, Stairs and Lifts
Dimensions of Bed Lift
Corridors
Doors
Stairs
Lifts
Access corridors – 1.5 m wide
Patient’s corridors – 2.25m wide
Normal door – 2.2m
Vehicle entrance – 2.5m
Transport entrance – 2.8m
Width – m
Step height – 170mm
Tread depth – 280mm
Lift car – m
Shaft – m

8. Circulation

9. External Traffic Control

10. Out Patient Department (OPD)
The Examination Room should be close to the nurses station and the consultation room.
Consultation Room is mostly used when lengthy conversation is involved between the doctor and the patient.
Clinical Department of OPD includes clinics which can use standard accommodation, general medicine, surgery, etc.
The OPD has facilities for screening, counseling, clinical examination, treatment and referral.
It consists of the following:
Types of clinics: surgical, orthopedic, medical, pediatric,skin, ophthalmic, ENT, dental, chest, psychiatric, cardiology clinic.
OPD for the surgical department should be located on the ground floor and near the emergency with direct access to it.
Minor Surgery Room may be used as a cast room, ECG room, minor operations. It should have a separate entrance.
Support services includes clinics which can use standard accommodation, general medicine, surgery, etc.

11. In Patient Department (IPD)
Isolation unit- An area of 14m2 for such rooms to contain a bed, beside locker, etc and separate toilet facilities.
Wards for the particular specialties, should be located closer to their respective department, self contained centers.
Ward unit shall comprise beds. Isolation rooms should be present for 15% of the patients in a hospital.
Inpatient- means that the procedure requires the patient to be admitted to the hospital so that he can be closely monitored during the procedure and afterwards for recovery.
Aim is to minimize the works of the nursing staff and provide basic amenities to the patients with in the unit.
Orientation of rooms should face south-east or south for the adequate day lighting in the wards
Size- Width of the doors > 1.2 m, dado to a height of 1.2 m. Effective corridor width of 2.40 m up to 3.10 m.
Size- Area of 7 m2 per bed is recommended, arranged with a minimum distance of 2.25 m between centers of two beds.

12. Emergency
Renders services right from the elementary first aid to sophisticated management of surgical and medical emergencies and full scale trauma care. 1
Should be located on the ground floor with separate access for the patients and ambulances, away from the outpatient entrance 2
Should be well marked with proper lighting and signs and should be easily visible and accessible from the street 3
Raised platform for ambulance discharge, ramps provided for wheelchair and pedestrian access 4
Close to admission, medical records, cashier’s booth, laboratory services, and the blood bank 5
Proximity to elevators is also important in order to proceed to surgery without loss of time.

13. Radiology
Radiology includes the specialist areas which use ionizing radiation for diagnostic and therapeutic purposes. This includes X-Ray diagnosis, radiotherapy and nuclear medicine. 1
Should always be close to the ambulance entrance and because of the great weight of the equipment should be on ground floor. 2
A connecting corridor which can be used simultaneously as a store, dictating room and switch room for staff is desirable. 3
Sonography, mammography and jaw X-ray require about sqm. Whereas standard X-ray and admission rooms need to be sqm. 4
The access route for the patients should be through 2 changing cubical. 5
WC’s should be installed in the X-ray room used for stomach/intestinal inspection.

14. Flow Chart of X-Ray Department
X-Ray Room
Dark Room
Toilet
Reading & Interpretation
(Radiologist)
ICU OT
Changing
Room
Doctor’s Viewing
Waiting
File Collection&
Storage
Reception
Control

15. Radiotherapy
In radiotherapy, conditions diagnosed in the radiography department (e.g. tumors) are treated. 1
It comprises of reception, waiting area, doctor’s room (18 sqm.), switch room (15 sqm.), localization room (20-25 sqm.), service room (20 sqm.), film developing room (10 sqm.), stores and cleaner’s room. 2
Each treatment room requires a changing cubicle for patients. 3
If the department includes a linear accelerator, a workshop (15 sqm.) and at least one physics laboratory (15-18 sqm.) 4
The clear height of the radiation rooms must be 4.3m. 5
For hygiene reasons the patient waiting area , examination, localization, preparation and radiation rooms must be well ventilated.

16. Physiotherapy
This department contains a wet area consisting of an exercise pool (4X6m), a four cell bath, a butterfly bath, inhalation rooms, a massage bath, hand and foot baths as well as necessary subsidiary rooms. Slip resistant tiles to be used. 1
Should be accessed through the main reception area. 2
Additional rooms – changing rooms, WCs, rest rooms, linen stores, waiting areas, cleaner’s room and service room. 3
A gymnasium to be included in it. 4
Because of the high internal temperatures (28-30 degree) construction physics problems should be anticipated. 5
Should be arranged on basement floor where natural lighting can be admitted through roof lights and light shafts.

17. Flow Chart of Surgical Unit
Wards
Post-operative Recovery
ICU
Theatre Sterile Supply Unit
Frozen Section Laboratory OT
Clean-up
Scrub-up
Anesthesia room
Central Sterilization & Supply Unit
Doctor’s Changing room
Nurse’s Changing room
Other Hospital Areas
Patients
Nurses
Doctors

18. Operation Theatre OT Freedom from noise and disturbances.
Freedom from contamination and possible cross infection.
Independent of general traffic movement from rest of the hospital.
Correct & convenient relationship with ICU, CSSD, Radiology & Pathology Lab.
Adequate glare free natural light is required which has psychological impact. Hence north light is desirable.
Most present day operations use artificial light, but good light and ventilation are of added advantage. OT
Freedom from noise and disturbances.
Temperature range should be between 23 to 24 deg C.

19. Operation Theatre Attach-ments Washroom Sterile goods room
Min. width – 1.8m. For each OT there should be 3 non-splash wash basins with foot controls.
Size of room – 3.8x3.8m. Electric sliding door of clear width 1.4m. Room should be equipped with a refrigerator, draining sink, rinsing line, cupboards, connections for anesthesia equipments and emergency power.
Washroom
Size of roughly 10 sqm. Must be directly accessed by the OT.
Sterile goods room
Anesthetics room
Attach-ments
Plaster room
Equipment room
For hygiene reasons this is not located in the surgical zone but in the outpatient area. In emergencies the patient must be channeled through lobbies in order to get to the OT.
Sub-sterilisation room
Size of approximately 20 sqm. Should be as close as possible to the OT.
It contains a non-clean area for non-sterile material and a clean area for prepared sterile items. Should be equipped with a sink, storage surface, work surface and steam sterilizer.

20. Ward Facilities Nursing station Workroom for nursing staff
Room for the staff nurse
Cloakroom
Sanitary
Room for the Head nurse
Sluice room
Storage for the stretcher
Examination & Treatment room
Laboratory
Ward store
Linen room
Pantry

21. Intensive Care Unit (ICU)
Description of ICU
The task of intensive care is to prevent life-threatning disruption of the vital bodily functions. The services of ICU include monitoring and treatment as well as care of the patient.
Must be a separate area and only accessed through lobbies.
For economical care of OT patients, recovery room is located in ICU.
Number of patients/unit should be 6 to 10
The beds may be placed in an open, closed or combined arrangement.
Beds in clear view of central nurses’ station.
It should have an OT for minor interventions (25-30 sqm.), Laboratory spaces, Kitchenette, Substerilisation (20 sqm.), clean material room, non-clean workroom, cleaning room, lounge for relatives, Duty doctor’s room, Documentation room, Consulting room and Sanitary facilities.
Arrangement of Bed Spaces
Auxiliary Functions
Arrangement

22. ICU n CCU

23. One-bed room with service panel Section of 3-bed room set
Patient’s Room
One-bed room with service panel
Section of the room
Section of 3-bed room set
Patient’s cupboard
Side view

24. Nursing Services
Nursing station is given in a ward in such a way that nurse keeps an eye on all patients. Nurse work room is used to sterilise the instruments along with storage of necessary instruments and machinery. 1
Double corridor nursing floor provides closer relationship between beds, nursing stations and other service areas. 2
Clean utility is designed to accommodate carts for storing linens, utensils and other supplies . 3
Elevators are located outside the nursing unit to cut down noise. 4
Nursing services can be integrated into the same module which includes the typical patient room. 5
Greater flexibility in segregation of patients for various medical reasons.

25. detail of nursing station and utility
Nursing Services
Flow chart
ward type
depth
width
1 bedroom
3.4m
3.15m
2 bedroom
3.3m
3.5m
3 bedroom 7m
4 bedroom
5.3m
6.4m
6 bedroom
8 bedroom
5.55m
2x6.4m
detail of nursing station and utility
Sizes of Nursing rooms

26. Admitting Department
Functions of the admitting department revolve around admitting, transfer and discharge of patients. This department coordinates patient’s arrival, registration, medical records and initial tests. 1
Maintain bed index showing current occupancy status. Prepare admission and discharge lists and midnight census. 2
It should be situated on the same level as hospital’s main entrance, be readily identifiable, and provided with a sign(easily seen). 3
Admitting patients’ waiting area, large enough to accommodate patients and relatives accompanying. 4
Clerical work area for maintaining hospital occupancy directories, records, forms,, notices, etc. 5
Wheelchair and stretcher alcove. Space for computers and office equipment.

27. Admitting Department Flowchart

28. Medical Department
The medical records department maintains records and documents relating to patient care. 1
Maintaining proper facilities and services for accurate and timely production, processing,checking,filing and retrieval of medical records. 2
It should be close to or on the corridor leading to doctors’ lounge so that they can stop by and complete their records and study. 3
It should be so designed with the best possible means of transportation of medical records thorough all stages of their use. 4
Reception-cum-registration area, space for copier. Work area for record processing, assembling, numbering, indexing, etc. 5
Storage area for medical carts. Staff facilities.

29. Medical Flowchart Flowchart of medical records on discharge of patient
Flowchart of medical records on admission of patient

30. Central Sterilisation and Supply Department (CSSD)
Despite of the advancement, hospital acquired infection remains the hospital’s single most serious concern that negated some of its otherwise good work. 1
This method basically involves cleaning, disinfecting and sterilizing before use all instruments, materials and equipment utilized in patient care. . 2
Is performed by heating them with pressurized steam of by gas sterilization. 3
Carrying out the process of decontamination or disinfection prior to sterilizing 4
Packing all materials for sterilizing,Sterilizing,Labelling and dating materials,Storing and controlling inventory,Issuing and distributing . 5
Accessiblity to elevators, dumbwaiters and stairs is of utmost importance. .

31. Food Service Department
Good food is important in the treatment of the patient and is a part of his total care. The food service department in today’s modern hospitals ranks one of the major departments. 1
Provide best possible food at a cost consistent with the policy of the hospital.. 2
The department should be close to the materials management department. 3
In general the important factor to be borne in mind is the logical workflow. 4
Plan and implement patient therapy, education and counselling.  . 5
A ground floor location is preferable, and is also convenient to deliver supplies. .

32. Food Service Flowchart

33. Delhi Bye-Laws For 500-200 bedded hospital
The Medical Facilities In Delhi are provided by various agencies operating at various hospitals, dispensaries, clinics and nursing homes. These agencies includes Delhi government, Central Government, Local bodies, Statuary Bodies, Voluntary Organizations and Private Sectors. A six Tier system of health facilities has been proposed in MPD-2001 as given below: S.
No.
Category
Population
Covered
Capacity
Area Of
Hospital
Residential
Area
Total Area 1
Gen. Hospital
2.5 lakh
500 Beds
4 Ha.
2 Ha.
6 Ha. 2
Intermediate
Hospitals (A)
1 lakh
200 Beds
2.7 Ha.
1 Ha.
3.7 Ha. 3
Hospitals (B)
80 Beds
0.6 Ha.
0.4 Ha. 4
Polyclinics
0.2 – 0.3 Ha. - 5
Nursing Home
Child Welfare
and Maternity
25-30 Beds 6
Dispensary
0.15 lakh
0.08 – 0.12 Ha.
For bedded hospital
Maximum Ground Coverage : 35%
Maximum Far : 200
Maximum Height: 33M

34. Case Study: Bhagwan Mahavir Hospital
INTRODUCTION:
Bhagwan Mahavir Hospital is located in Madhuban Chowk near Pitampura Metro Station, Delhi. It is a two side open site. There is 60m wide road in front and 5m wide road on the side.
As the name suggests Bhagwan Mahavir Hospital is dedicated to Bhagwan Mahavir and it runs under Maha Sati Devi Jain Educational Trust. The Hospital was inaugurated by the President Of India Giani Zail Singh on the 23 October It is a 40 Bedded Hospital.
CLIMATE:
Delhi is in the group of composite climate
Maximum Temperature : 41̊C
Minimum Temperature : 7 ̊C
Rainfall : 1.73M
In comparison, Delhi has high rainfall and less air movement, which in turn gives rise to high humidity round the year.

35. Case Study: Bhagwan Mahavir Hospital
FACILITIES AVAILABLE:
Ground Floor:
OPD Chambers
Laboratory
Ultrasound
ICU
Reception
Chemist
X-Ray
AREA STATEMENT :
Total Site Area: 3000 SQ.M.
Total Covered Area : 990 SQ.M.
F.A.R. = 100
First Floor:
Operation Theatre
Staff Room
Wards
Store
Nursery room
The total area of site is 3000SQ.M. . The front set back is 10M., rear set back is 5M., side set back is 3M. and the other side is 18M. left for future extension.
SITE PLAN
Tecnia
Institute
Saroj Hospital
R.S. Institute
Of Advanced
Studies

36. Case Study: Bhagwan Mahavir Hospital

37. Case Study: Bhagwan Mahavir Hospital

38. Case Study: Bhagwan Mahavir Hospital

39. National Institute of Technology, Hamirpur
Akanksha (08604)
Akanksha Rastogi (06005)
Ridima Sharma (08623)
Ruchika Yadav (08624)
Thank You !