1. Process of Planning, Designing and Financing a Hospital
Daniel Kelly, CEO

2. Overview
Hospitals differ from other building types in the complexity of functional relationships that must exist between the various parts of the hospital.
Apart from providing the right environment for patients and care providers, it should also be sensitive to the needs of visitors.
It is thus imperative to examine the emerging issues, analyze the challenges, appreciate the emerging trends and study the various strategic options available for planning, designing and constructing a hospital.

3. EMERGING ISSUES Epidemiological and demographic changes
Enhanced expectations of patients
Emphasis on ambulatory/ day care
Regulatory standards
Ever changing function of a hospital
Advancement in medical sciences
Trend toward outsourcing

4. Schema of Building a Hospital

5. STRATEGIC ESSENTIALS Issues that must be considered: Regionalization
Needs assessment
Design for flexibility and expandability
Fulfill the demand functions
Emphasis on patient focused hospital
Focus on energy conservation

6. IMPACTING FACTORS Community Profile Socio – economic Health Age
Local regulations
Source of finance
Climatic zones

7. STEPS IN PLANNING Need Assessment Feasibility Report Architects Brief
Request for Proposal
Appointment of Consultant
Detailed Project Report

8. STEPS IN PLANNING-cont.
Award of Work
Construction of Building
Equipment Purchase
Stage of Commissioning
Occupancy

9. Feasibility Study

10. PLANNING A HOSPITAL
Planning is the forecasting and organizing the activities required to achieve the desired goals.
All successful hospitals, without exception, are built on a triad of good planning, good design & construction & good administration.
To be successful, a hospital requires a great deal of preliminary study and planning.
It must be designed to serve people and for promoters to build in the first place & sustain later.

11. Planning Team Make-up Hospital administrator
Specialists from various clinical branches
Nursing Personnel
Civil and electrical engineers
Representative of local board
Senior architect

12. HOSPITAL DESIGN
The main guideline while designing the hospital is ‘FORM FOLLOWS FUNCTION’.
All architectural and aesthetic design should be secondary in nature
The design of the department should be according to the function of the department

13. REQUEST FOR PROPOSAL Background of the project Architects brief
Best practices in medical architecture
Limitations
Methodology and time frame
Contract conditions
Local regulations

14. ARCHITECTS BRIEF
It is written document which explains the operational policies, types of services provided, inter relationships and interdependency of each facility. It includes:
Site information
Functional content
Workload
Staffing
Equipment

15. ARCHITECTS BRIEF cont…
Polices and procedure
Schedule of accommodation
Zoning
Financial aspects

16. Bed planning-
Bed: Population=A S PO A= number of inpatient admissions/1000 population/year S= average length of stay PO= percentage occupancy

17. Planning of finances-
Funds required for constructing, furnishing and equipping the hospital.
Operating funds- salaries, loans and interest, other maintenance expenses.
Arranging financial assistance-patient fees, bed charges, and other modes of revenue generation process.

18. Project costing-
The most common method of estimating hospital construction costs has been the “ per bed” method.
With a transition toward outpatient procedures the current methodology is the cost per square foot.
Break up of project cost-
Acquisition of site
Site survey, investigation
Landscaping
Construction contact-building with fixed equipment
Supervision and inspection
Equipping the hospital-diagnostic and therapeutic equipment
Movable equipment, furniture etc.
Architect's fee
Consultant’s fee
Site engineer’s fee

19. Phasing -
The necessity to bring facilities into use as quickly as possible for operational reasons.
The necessity to split a major project into a smaller units as a contractual consideration
The necessity of having certain departments ready before others
Limitation on availability of capital funds

20. Commissioning- Formation of commissioning team Activities-
Hospital consultant
Hospital administrator
Clinical Department Managers
Senior nurses
Supplies officer
Others
Activities-
Bring the hospital building, plant and equipment to a state of the operational readiness
Development operational system
Testing of equipment
Coordinate training of staff
Ensure good communication

21. Conclusion- Technology requirement must be met
Clinical needs must be considered
Safety is a major factor
Standards and Guidelines are essential
Importance of the role of Hospital Staff in construction and design.

22. THANK YOU
A hospital is a living organism, made up of many different parts, having different functions, but all these must be in due proportion and relation to each other and to the environment to produce desired result. – Dr. S. Billings