overall study of hospital standards

1. LITERATURE STUDY
HOSPITAL
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2. What is a hospital ?
A hospital is an health care institution
which providing patient treatment with specialized
medical and nursing staff and medical equipment. The
hospital, the major social, institution for the delivery
of the health care in the modern world, offers
considerable advantages to both patient and society.
The hospital is also for center for the training of health
workers and biosocial research.
INTRODUCTION:
The word “HOSPITAL” ordinated from latine “HOSPICE”
In early Greek and Roman civilizations, The temples of the gods were used as hospitals.
The very first hospital was built by Romans between 1096 and 1291......it’s a large
single room like structure....Where sick or injured people were used to be kept.
HISTORY:
CLASSIFICATION OF HOSPITALS:
LITERATURE STUDY FOR HOSPITAL:1

3. FACTORS TO BE CONSIDERED IN LOCATING A HOSPITAL.
(1) It should be within 15-30 min travelling time. In a district with good
roads and adequate means of transport, this would mean a service
zone with a radius of about 25 km.
(2) It should be grouped with other institutional facilities, such as religious
(church), educational (school), tribal (cultural) and commercial
(market) centers.
(3) It should be free from dangers of flooding; it must not, therefore, be
sited at the lowest point of the district.
(4) It should be in an area free of pollution of any kind, including air,
noise, water and land pollution.
(5) It must be serviced by public utilities: water, sewage and storm-water
disposal, electricity, gas and telephone. In areas where such utilities
are not available, substitutes must be found, such as a deep well for
water, generators for electricity and radio communication for
telephone.
SIZE OF THE SITE
The site must be large enough for all the planned
functional requirements to be met and for any expansion
envisioned within the coming ten years Recommended standards
vary from 1.25 to 4 ha per 100 beds; the following minimum
requirements have been proposed:
25-bed-capacity - 2 ha
100-bed capacity - 4 ha
200-bed capacity - 7 ha
300-bed capacity - 10 ha
SITE ZONING
LITERATURE STUDY FOR HOSPITAL:2

4. • Generally there are three main entrances to the hospital that are through the
emergency entrance, second is the in-patient I.P.D entry and the third is the out-
patient entry i.e. O.P.D entry.
• Besides this the hospital has the separate service entry and the separate entry for the
administration wing.
• The main entry to the hospital is characterized by the ease in circulation, large
waiting area and the general public facilities such as atm, phone booths, coffee
stands and the reception area etc. . . . Nowadays the modern hospitals also have the
provision of the florist shop in the hospital building.
TYPES OF ENTRIES:
Quite Place
Future Expansion
area
Almost sq. area
No loss of amenity
No contaminated
land
Location
SELECTION OF SITE FOR HOSPITAL

5. OUT PATIENT DEPARTMENT:
Out Patient Department is defined as a part of the
Hospital, with allotted physical facilities and medical and other
staff . With regularly scheduled hours . To provide care for
patients who are not registered as Inpatients .
The location should be very close to the main
entrance of the hospital and close to the diagnostic services (labs
and x-ray) and close the pharmacy
REQUIREMENTS:
• Reception and Enquiry
• Waiting area
• Wheel chair and Trolley bay
• Registration counter and Medical
record room
• Injection room
• Dressing room
• Dispensary
• Laboratory
• Radiology
DIVISIONS IN HOSPITALS:
 Administration.
 O.P.D
 I.P.D.
 Emergency.
ADMINISTRATION DIVISION
REQUIREMENTS:
• Reception hall - 10 Sq.M
• Registration - 15 Sq.M
• Accounts Room - 20 Sq.M
• Staff Rooms - 15-20 Sq.M
• Manager room - 15 Sq.M
• Staff lounge - 30- 40 Sq.M
• Conference hall - 20-30 Sq.M
• Common Toilets - 5 Sq.
ADMINISTRATION
PUBLIC SEMI PUBLIC PRIVATE
2.reception
1.entrance 1.account room
2.consultancy
3.pharmacy
1.staff room
2.staff lounge
3.manager room
4.conference
ADMINISTRATION :
The administrative department is orientated to the public but is at the same time private. Areas for
business, accounting, auditing, cashiers and records, which have a functional relationship with the
public, must be located near the entrance of the hospital. Offices for hospital management, however,
can be located in more private areas.

6. INPATIENT DEPARTMENT:
• Waiting area - 10 sq.m
• Doctor’s room - 12 Sq.m
• Wards - 8 Sq.m / bed
• ICU - 25-35 Sq.m
• common toilets - 5 Sq.m
• Nursing room - 12 Sq.m
• Treatment rooms - 20 Sq.m
• Storage - 20 Sq.m
• Mobile Pharmacy - 5 Sq.m
• Emergency Exit - 2m width
• Inpatient department are for those patients who need treatment
under health care personal’s supervision.
• Patients are admitted in inpatient ward for short and long term
depending upon severity of their disease.
INPATIENT REQUIREMENTS:
Sudden illness or injury required immediate physicians attention to prevent the danger and delay in
treatment to save the precious part or life with minimum disability or death .
Which function 24x7 , 365 days
EMERGENCY DEPARTMENT :
EMERGENCY RECEPTION
parts and components of the division:-
1.entrance +waiting area
2.registration
3.staff room
4mini -surgery
5.rest room
6.medical utilities
7.mini sterilization room
the location should be very close to the exit door of the emergency
and very close to the radiology and close to the pharmacy,
laboratories and central sterilization and direct access to the stairs
and elevators

7. The different departments of the hospital can be grouped according to zone,
as follows:
(1) Outermost zone, which is the most community oriented
• primary health care support areas
• out-patient department
• emergency department
• administration
• admitting office, reception
(2) Second zone, which receives workload from (1)
• diagnostic X-ray
• laboratories
• pharmacy
(3) Middle zone between outer and inner zones
• operating department
• intensive care unit
• delivery room
• nursery
(4) Inner zone, in the interior but with direct access for the public
• wards and nursing units
(5) Service zone, disposed around a service yard ~
• dietary services
• laundry and housekeeping
• storage
• maintenance and engineering
• mortuary
• motor pool
DIVISIONS IN HOSPITALS (ZONING):
Types of departments
1. Accident and emergency (A&E)
2. Anaesthetics
3. Breast screening
4. Cardiology
5. Chaplaincy
6. Critical care
7. Diagnostic imaging
8. Discharge lounge
9. Ear nose and throat (ENT)
10. Elderly services department
11. Gastroenterology
12. Gynaecology
13. Haematology
14. Maternity departments
15. Microbiology
16. Neonatal unit
17. Nephrology
18. Neurology
19. Nutrition and dietetics
20. Obstetrics and gynaecology units
21. Occupational therapy
22. Oncology
23. Ophthalmology
24. Orthopaedics
25. Pain management clinics
26. Pharmacy
27. Physiotherapy
28. Radiotherapy
29. Renal unit
30. Rheumatology
31. Sexual health (genitourinary
medicine)
32. Urology

8. CARDIOLOGY:
• The department which deals with heart and its
function.
• Specialized doctors who cures or treats people about
their heart care were cardiologist .
• REQUIREMENTS
- Doctors personal chamber
-Semi personal chamber
- Consultancy
- Observation room
- Consultation room
-Treatment room
normal treatment treatment critical
GYNAECOLOGY
.These departments investigate and treat problems of the female urinary tract
and reproductive organs, such as end metritis, infertility and incontinence.
. They also provide a range of care for cervical smear screening and post-
menopausal bleeding checks.
REQUIREMENTS:
a specialist ward
day surgery unit
emergency gynaecology
assessment unit
outpatient clinics.
vitals room
consultancy room
examination rooms
Incubator room
delivery room
FLOW DIAGRAM

9. •DOCTOR WHO DEALS - PEDIATRICIAN
Department of medical sciences which deals which
Medicare of children and adolescents.
Age of patients : 0-14
Treatment : general treatment of children , includes
care all health imbalances .
REQUIREMENTS
Waiting
consultancy
treatment room
counseling
Equipment room
Environment as general indoor decoration with bright colors
per child indoor - min 25 sqm
per child outdoor - min 75sqm
outdoor play area and indoor should be maintain
PEDIATRICS:
ORTHOPAEDICS:
•Branch of medical sciences which deals with
musculoskeletal system, joints and ligaments.
Users of the Space
Doctors chamber
treatment room
observation room
some other common areas like :
waiting, reception, operation theater , labor
room, wards, laboratory ,sterilization, radiology and
diagnostics.
GENERAL SERVICE
Dietary :
• Storage room
• Kitchen
• Preparing and supply area
• Cleaning
Housekeeping :
• Office
• Dirty linen
• Storage
• Laundry
FLOW DIAGRAM

10. REQUIREMENTS:
• Reception/Registration
• Pharmacy
• Examination/Consultation
• Nursing station
• Clinical laboratory
• Imaging
• Patient area
• Nursing station
• Operating theatre
• Labor room
• General administration
• Medical-cum-general store
• Manifold
• Central sterilization and supply dept,
• Laundry
• Kitchen
NOTE — The work flow analysis gives only the broader services to be
provided. Actual layout may be decided by hospital administration
depending upon the local needs.
TYPICAL WORKFIOW ANALYSIS,15O-BEDDEDHOSPITAL
• Sub-station
• Workshop
• Mortuary
• Incinerator
• Entrance
• Parking
• Library/Conf
• Intensive Care
• Shopping arcade
• Casualty
• Blood bank
• Physiotherapy
• Fire-protection
• Residential accommodation
• Park
 Main entrance:
- Only one main entrance,
- Secondary entrances have to be pointed out apart (hygiene measures).
 Entrance hall:
- Conceived as a waiting room for visitors (principle of open doors),
- Like a hotel hall,
- Its size depends of number of beds,
- Different ways (for patients, visitors, staff) separated from the entrance hall,
-Reception (12 m2): with a reception desk to supervise entrances and circulation ways.
 Entrances for laying patients:
- For admission, a closed hall and an entrance slope are required; they have to be
separated from the entrance hall but visible from the reception,
- Shorts connections with emergencies separated from main circulation ways are
required.
 Sterilization room:
- A direct connection with the operating room is required,
- Two different sides are required: a non-sterilized side with non sterilized
implements and a sterilized one,
- Fit up with a sink, working and storage areas.
 Laboratories
They are designed for blood samples and analysis of those samples.
 They consist of:
- Locals for rinse, disinfecting, preparation of sterilized implements,
- A storage room,
- A cold room,
- A meeting room,
- A waiting room,
- An administration office.
 For microbiology: independent unit or access through a tambour.
• All rooms ought to be lit with natural light.
• Rooms with microscopes have to be orientated northern.
• Width of doors: 1m minimum.
 Mortuary
• shall provide facilities for keeping of dead bodies and conducting autopsy.
• It should be so located that the dead bodies can be transported unnoticed by the general public
and patients.
• Relatives and mourners should have direct access to the mortuary.
• The mortuary shall have facilities for walk in cooler, post mortem area, etc.

11. • These should include major surgical and medical cases, head injuries, severe haemorrhage, acute
coronary occlusion kidney and respiratory catastrophe, poisoning, etc..
• The number of patients requiring intensive care may be about 2to 5 percent of total medical and
surgical patients in a hospital.
• The unit shall not have less than 4 beds nor more than 12 beds.
 INTENSIVE CARE UNIT
Location
• This unit should be located close to operation theatre department and other essential
departments, such as, X-ray and pathology so that the staff and ancillaries could be shared. Easy
and convenient access from emergency and accident department is also essential.
OPERATION THEATER
zones
 Protective zone
 Clean zone
 Aseptic zone
 Disposal zone
Operation theater is also known as operating room . It is a facility in a hospital where surgical
operations are carried out in a sterile environment .
Location
 Low rise building limited to two or three stores high are preferred because of maximum
advantages of natural light and ventilation
 OT should be separated from general traffic and air movement of root of hospital
 OT surgical ward , intensive care ,accident and emergency department ,radiological, department
should be closely related and access is also required unit and laboratory facilities
 OT is planed on first on first floor ,connecting to surgical and other ward on same floor
Size of operation theatre
6.5x6.5x35 glass windows can be planned one side only of the room (Inside)

12. Following facilities/area may also be considered while planning hospital.
(Desirable)
(i) Operation Theatre a. One OT for every 50 general in-patient beds
b. One OT for every 25 surgical beds.
(ii) ICU beds = 5 to 10 % of total beds
(iii) Floor space for each ICU bed = 25 to 30 sq m (this includes support services)
(iv) Floor space for Pediatric
ICU beds = 10 to 12 sq m per bed
(v) Floor space for High
Dependency = 20 to 24 sq m per bed
Unit (HDU)
(vi) Floor space Hospital beds = 15 to 18 sq m per bed
(General)
(vii) Beds space = 7 sq m per bed.
(viii) Minimum distance between = 2.5 m (minimum)
centers of two beds
(ix) Clearance at foot end of each bed = 1.2 m (minimum)
(x) Minimum area for apertures = 20% of the floor area
(windows/ Ventilators opening in (if on same wall)
fresh air) = 15% of the floor area
(if on opposite walls)
 Pharmacy (Dispensary)
The pharmacy should be located in an area conveniently accessible from all clinics. The
size should be adequate to contain 5 percent of the total clinical visits to the OPD in one
session. For every 200 OPD patients daily there should be one dispensing counter.
Pharmacy should have component of medical store facility for indoor patients and
separate pharmacy with accessibility for OPD patients.
Hospital shall have standard operating procedure for stocking, preventing stock out of
essential drugs, receiving, inspecting, handing over, storage and retrieval of drugs,
checking quality of drugs, inventory management (ABC & VED), storage of narcotic drugs,
checking pilferage, date of expiry, pest and rodent control etc.
Norms for Fitments

13. REQUIREMENTS/ AREAS
ADMINISTRATIVE SERVICE
Area in Sq.m
.Waiting Area - 0.65/person
.Information and
Reception Area - 5.02/staff
.Toilet - 1.67
.Business Office - 5.02/staff
.Medical Records - 5.02/staff
Space
.Office of the
Chief of Hospital - 5.02/staff
.Laundry and
Linen Area - 5.02/staff
.Maintenance and
Housekeeping Area - 5.02/staff
.Parking Area for
.Transport Vehicle - 9.29
.Supply Room - 5.02/staff
.Waste Holding Room - 4.65
Space: Adequate area shall be provided for the people, activity, furniture, equipment
and utility.
DIETRY
Space Area in Sq.m
.Dietitian Area - 5.02/staff
.Supply Receiving
Area - 4.65
.Cold and Dry
Storage Area - 4.65
.Food Preparation
Area - 4.65
.Cooking and
Baking Area - 4.65
.Serving and Food
Assembly Area - 4.65
.Washing Area - 4.65
.Garbage Disposal
Area - 1.67
.Dining Area - 1.40/person
.Toilet - 1.67
.Cadaver Holding
Room - 7.43/bed
. Surgical and Obstetrical Service
.Major Operating Room - 33.45
.Delivery Room - 33.45
.Sub-sterilizing Area - 4.65
.Sterile Instrument,
Supply and Storage Area - 4.65
.Scrub-up Area - 4.65
.Clean-up Area - 4.65
.Dressing Room - 2.32
.Toilet - 1.67
.Nurse Station - 5.02/staff
.Wheeled Stretcher
Area - 1.08/stretcher
.janitor’s Closet - 3.90
Area in Sq.mSpace
Space Area in Sq.m
 .Semi-Private Room
with Toilet - 7.43/bed
 Patient Room - 7.43/bed
 Toilet - 1.67
 Isolation Room
with Toilet - 9.29
 Nurse Station - 5.02/staff
 Treatment and
Medication Area with
Lavatory/Sink - 7.43/bed
 Office of the
 Chief Nurse - 5.02/staff
NURSING UNIT
Ancillary Service
 Clinical Work Area
with Lavatory/Sink - 10.00
 Pathologist Area - 5.02/staff
 Toilet - 1.67
Area in Sq.mSpace
1. 0.65/person – Unit area per person occupying the space at one time
2. 5.02/staff – Work area per staff that includes space for one (1) desk and one
(1) chair,
space for occasional visitor, and space for aisle
3. 1.40/person – Unit area per person occupying the space at one time
4. 7.43/bed – Clear floor area per bed that includes space for one (1) bed, space
for occasional visitor, and space for passage of equipment
5. 1.08/stretcher – Clear floor area per stretcher that includes space for one (1)
stretcher
NOTE

14. No of beds = 150
Area for one bed = 92.5 sq.m
(include all requirements like waiting space , entrance hall
Registration counter etc.)
Total floor area of hospital = 92.5x150 = 13875 sq.m
Take 3 floors
Provide 40% of total SITE area as
built-up area = 5550 sq.m
Other 2 floors will carry 60% of total floor area.
That is 1st & 2nd floor 30% = 4162.5 sq.m
According to Amaravathi by laws we have to take
25 % of plot area as built-up area.
As we know the 25% of plot area = 5550 sq.m
Then 100% of plot area should be = 5550 × 4 = 22200 sq.m, 2.22 ha
Area statement for 150 bed hospital based on IS And
Amaravati Bylaws
SUMMARY OF AREA REQUIREMENT PER BED
Particulars Area Per Bed (Sq.m)
Entrance area - 4.20
Ambulatory - 9.31
Diagnostic services - 5.95
Intermediate care area - 15.75
Intensive care area - 1.96
Critical care area - 4.69
Therapeutic services - 8.75
Hospital services - 7.00
Engineering services - 3.92
Administrative/Ancillary services 4.48
Total - - 66.01
Add 40 percent for circulation - 26.40
space including corridors - 92.41
Water closets (male) - 1 - 8 beds
(female) - 1 - 6 beds
Urinals (male) - 1 - 12 beds
Wash basins - 1
Baths - 1
Bed pan washing sink - 1
Cleaner’s sinks and sink - 1
slab for cleaning room - 1
Min wash room in single or double bedded - 3.5sq.m
Common toilets - 5.2sq.m
Accident and emergency (A&E)
. This department (sometimes called Casualty) is
where you're likely to be taken if you've called an
ambulance in an emergency.
. It's also where you should come if you've had an
accident, but can make your own way to hospital.
. These departments operate 24 hours a day, every
day and are staffed and equipped to deal with all
emergencies.
Patients are assessed and seen in order of need,
usually with a separate minor injuries area
supported by nurses.

15. Civil engineering Electrical engineeringMechanical engineering
SERVICES
water
Plumbing
Drainage
Sanitation
Air conditioning
Refrigeration
Illumination
Electrical supply
Gas supply
communication
Fire protection
Waste Disposal System
Barrier free,
Circulation
Ventilation
furniture
Color thery
Miscellaneous
services

16. FIRE SAFETY
BUILDING MATERIALS
• Must be non combustible or non-flammable.
• Have adequate fire resistance ratings.
• Should not emit toxic gases or smoke during fire.
• Remove or protect flammable materials (fire retardant paints, fire
insulating materials.)
• Fire retardant doors and windows, ceiling tiles and wall finishes.
• Fire doors and frames between each fire-proof compartments.
NUMBER OF FLOORS :
• The aim of the design of new facilities is to reduce the vertical height
and the number of floors of the building (favour horizontal evacuation
rather then the vertical evacuation).
• ICU and ED should be located on the floor or first floor with access
ramps.
• High traffic units should be located on the lower floors. Eg- diagnostic
units
EGRESS :
• Minimum two independent egress routes and exists for every location
on every floors.
• Width of corridor leading to exist should be unobstructed with width
at least 2.4m.
• Evacuation maps to be posted at hospital’s main access with clearly
exists and egress routes.
FIRE
EXTINGUISHER
HOSE REEL PIPE
FIRE PROTECTION SYSTEM
FIRE ALARM SYSTEM :
• Manual activated alarm initiating devices (eg break glass)
installed at area with high presence of staff.
• Smoke and heat detectors in low traffic areas away form
staffs or personals.
FIRE SUPPRESSION;
• Fire extinguishers.
• Water sprinkler systems
• Mist sprinkler systems
• Water hose reels
• Smoke extractors
• Minimum height of floor = 2.4 m - 3.6m
• Ramp ratio should be = 1:12 to 1:20
• Minimum width of exit = 2m
• Minimum exit door height = 2.1m
• Staircase minimum width = 1.5m
• Distance between exits = 30m
• No of persons can go through 2m width door
= door width/Capacity factor
= 2000 ÷ 15 = 133 persons
FIRE SAFETY MEASURES • Fire hydrant may be installed between 30-60m.
• Underground water tank capacity should be 50,000 lt
g+2,
• 1,00,000 lt for hospitals more than 15m, but less than
24m height with plot area more than 100m2.
• 1,50,000 lt for hospitals more than 24m, but less than
30m height.

17. ARTIFICAL LIGHTING :
 Luminosity of 1000lux in Operating Rooms
 Luminosity of 500 lux in Annex
 Ceiling Fixtures for general illumination.
 All rooms are given with a wall fixture over head of bed.
 No wall light gives adequate illumination for examining the patient.
 Control Light in multi – Bedrooms so that it will not shine in the eyes of the p
 All rooms have night lights.
LIGHTING
S.No. AREAS
ILLUMINATION(lux)
1 Reception & waiting 150
area.
2 Wards
General 100
Beds 150
3 Operating theatres
General 300
Tables 50,000 – 1,25,000
4 Laboratories 300
5 Radiology department 100
6 Stairs and corridors 50-150
7 Dispensaries 300
RECOMMENDED VALUES OF ILLUMINATION IN HOSPITALS
 LIGHTING : DAY LIGHTING ARTIFICAL LIGHTING
VIEW OUT
• Window areas 20%-30% of the external wall are likely to give a satisfactory view.
• reduces feelings of isolation and claustrophobiaIt.
• provides contact with the outside world may help patients recover more quickly.
LIGHT FROM THE SKY
• Gives excellent colour rendering.
• Making many clinical tasks easier
• This short-term variation in daylight gives variety and interest.
• A lack of windows gives a constant environment, which is potentially boring and depressing
Good lighting is necessary for all buildings and has three primary aims.
The first aim - work and other activities carried out.
The second aim - safety of the people using the building.
The third aim - to create, in conjunction with the structure and decoration,
a pleasing environment conducive to interest of the occupants and a
sense of their well-being.
plane at the following positions:
at a distance of 3 m to 3.75 m from the window along the central line
perpendicular to the window.
DAY LIGHTING
8 Reading ( casual-critical) 200-500

18. WASTE DISPOSAL
good waste disposal system should be planned for –
1. Good appearance
2. Safety
3. Pest control
4. Odor control
5. Public health safety
FIVE BASIC COMPONENTS :
• Handling waste at the point of production
• Transportation within the facilities.
• Internal storage.
• Internal processing/ treatment.
• Transportation to point of final disposal.
• Solid waste should be sterilized at for near the point of
production.
• Source preferable in disposable plastic bags in containers .
• Pathologic waste should be sterilized at or near the point of
production prior to removal from the place.
• hospital waste are the waste produced in the course of health care
activities during treating diagnosing and immunizing human beings.
• 75 to 90% non hazardous or general waste.
• 10 to 15% hazardous.
Biomedical waste –
Category no. 1 – human anatomical waste such as human tissue, organs, body
parts.
Category 2 – animal waste
Category 3 – microbiology & biotechnology waste such as waste from lab
cultures, stocks or specimens
Category no. 4 – waste sharps such as needles, syringe, blades, glass etc.
Category no. 5 – discarded medicines
Category no. 6 – items contaminated with blood and body fluids including cotton,
dressing, beddings
Biomedical waste must be segregated, disposed and transported through color
coded plastic containers and send to the near biomedical disposal unit.
WASTE CATEGORIES EXAMPLES
1)General waste Office papers , wrapper , kitchen waste ,
general sweeping etc.
2)Pathological waste Body parts , blood , body fluids etc.
3)Sharps Needles , sepals , knives , blades etc.
4)Infectious waste Laboratory culture , tissues , bandage etc.
5)Chemical waste Laboratory reagent , disinfectants , film
developer etc.
6)Radioactive waste Unused liquid from radio therapy or lab
research , contaminated glass waste etc.
7)Pharmaceutical waste Expired outdated drugs
8)Pressurized container Gas cylinder , aerosol cans etc.
9)Genotoxic waste Waste containing cytotoxic drugs

19. SIGNAGE
There shall be an effective graphic system composed of a number of individual visual aids and
devices arranged to provide information, orientation, direction, identification, prohibition, warning
and official notice considered essential to the optimum operation of a hospital and other health
facilities.

20. GAS SUPPLY
• Gas supply is provided from the central medical gas distribution which is
to supply a medical gas (O2, N2O, N2) to each ward and OTs through
piping.
• The system has a through going color coordination according to the kind
of gas.
• An audio visual monitoring system capable of checking the situation.
Types of medical gases
 Oxygen
 Medical air
 Surgical air
 Nitrous oxide
 Helium / oxygen mixer
 Carbon dioxide
 Piped vacuum or suction

23. LAUNDRY
The main objective of a laundry service is to provide an adequate quantity
of the right quality linen for the patients, Ots, OPD and for the medical
and para-medical personal engaged in providing health care
FUNCTION -
 RECEPTION
 SORTING
 SLUICING
 WASHING
 HYDROEXTRACTION
 DRYING
 CALENDERING
 PACKING, STORAGE AND DISTRIBUTION OF CLEAN
 34% should be as circulation area in laundry room

24. HVAC
PROCESS
 The outdoor air enters the system where low efficiency or coarse filters remove the large
particles and micro organisms.
 Conditioning to the appropriate temperature and humidity levels, passes through the
another filters for further cleaning.
 Delivered to the each required zone.
 After conditioned air is distributed, it is returned back to the air handling unit through a
duct.
 A portion of the return air is exhausted outside.
COMPONENETS OF HVAC SYSTEM-
• Outside air inlet and intake filters.
• Humidity modification mechanism.
• Heating and cooling equipment.
• Fans.
• Ductwork
• Air exhaust.
• Diffuser or grills for proper distribution of air.
• Controls and switches.
• Electricity supply system with DG set backup.
PURPOSE
 It provides clean, comfortable and controlled environment to patients and staff.
 It minimizes the risk of transmissions of airborne pathogens.
• It controls the air balance in terms of the risk of air quality and air movement.
• It facilitates restriction of air quality and air movement through and between the various
departments.
• It provides different types of temperature and humidity to various area.
• It facilitates ventilation and filtration to dilute and remove contamination, e.g.. Airborne
micro-organism, hazardous chemicals and odour..
FIRE DAMPERS
 Ducts offers an easy propagatory passage to fire hence fire
dampers should be inserted in the air ducts.
 Fire dampers are actuated to close the passage by fire detectors.
AIR FILTRATION
 Coarse filters (90%efficiency) and micro fine filters
(99.9%efficiency) to prevent large particles, insects and other
particles from entering AHU.
 High efficiency particulate air filters (HEPA filters) which filters up
to 0.3 microns with 99.97% efficiency
 Ducts are made up of G.I., Aluminum. And concealed to avoid noise.

25. AIR CONDITIONING PLANT
 Components are condensing unit and air handling unit.
 Cool air produced in the refrigeration unit is transferred directly
to the circulating air or to circulating water.
 cooling of circulatory air occurs in the AHU.
 It has air filters, cooling coils, and air blowers.
 Capacity of ACU is expressed in tonnes of refrigeration (TR),
which is heat extraction capacity of the plant.
There is a need for conditioning air in particular areas of the hospital to achieve certain
levels of temperature, humidity, filtration and circulation.
Operating rooms, labour –delivery suits, ICUs, nurseries, are some of the areas that
require air-conditioning.
As medical equipment is sensitive to temperature and humidity that affect its readings
and performance. It should , therefore, be housed in air-conditioned rooms.
There are basic differences between hospital air-conditioning and air-conditioning in
other types of buildings. One major difference is that hospital air-conditioning is more
attuned to patient and patient treatment rather than comfort.
EXAMPLE:
A cardiac patient and patient who have had brain surgery need an environment in
which they can lose heat by radiation and evaporation. They need cooled and
dehumidified air.
AIR CONDITIONING ROOMS AND AREA
 Operation theatres and procedures
 Recovery areas
 ICU, CCU,NICU
 Laboratories
 Imaging areas
 High dependency units in departments
 Day care facilities
 Dialysis rooms / facility
 Delivery suits / labour rooms
 Therapeutic facilities, endoscopy, radiotherapy facility,
path labs, treatments rooms.
 Blood transfusion service BTS
 Stores- walk in coolers, cold room
 Mortuary services
 General wads isolation rooms (optional)
 Private wards

26. Outdoor Patient and Other Departments
Block)
9 Water closets
1 for every 40 persons or part thereof (male)
2 for every 50
persons or part thereof (females)
10 Ablution taps
1 for each water-closet plus I water tap with
draining
11 Urinals
Arrangements in the vicinity of water-closet
and urinals
12 Wash basins Lavatory block
WATER SUPPLY AND SANITATION ; Sl. Fitments Requirements In patient wards or nursing units
No
.
1 Water- closets 1 for every 8 beds or part thereof (male)
1 for every 6 beds or part thereof (female)
2 Ablution taps 1 for each water-closet plus 1 water tap with draining
arrangements in the vicinity of water –closet
3 Urinals 1 for every 12 beds or part thereof (male only)
4 Wash Basins 1 for every 12 beds or part thereof
5 Baths 1 bath with shower for every 12 beds or part thereof
6
Bed pan
washing sinks 1 for each ward
7
Cleaner’s sinks
and sink/slab for 1 for each ward
cleaning
mackintosh
8 Kitchen sinks 1 for each ward in ward pantry
Water supply:
 Water is one of the critical utilities in a hospital.
• Hospitals require copious supply of water.
• Hospitals should, as far as possible, rely on the public water supply system for the necessary quantity and
quality of their water supply. This may be supplemented by their own water supply. Some hospitals have
private wells or bore wells that they can to augment their water supply.
• Water supply distribution network, and
• Sewage disposal
The design should allow flexibility to recycle waste water, if need be, for reuse as A.C cooling tower make-up
water or for gardening and toilet flushing.
Sources of water supply
The primary source of water supply to hospitals is generally the public utility supply system. Invariably, water is
in short supply in most cities. To meet the ever-growing demand for water, the following alternative sources of
water supply may be considered
• Bore wells
• Tanker supply
• Recycled water. The treated waste water from basin, shower, laundry, etc. can be used in W.C. flushing,
landscaping, etc.
to ensure a continuous supply of water, adequate storage capacity of underground sumps and overhead
tanks should be provided.
Water requirement of hospital
• The minimum requirement of water supply for any hospital shall be in accordance with the national
building code (NBC):
a. Number of beds not exceeding 100 = 340L per head per day
b. Number of beds exceeding 100 = 450L per head per day
c. Nurses/medical staff quarters = 135L per head per day
d. Minimum hot water requirement = 45L per head per day
• Design elements
in designing the hospital water supply, the major elements that merit attention are:

27. Planning
• In large hospitals, the service floor concept may be concept may be considered for running all sanitary and
water supply lines horizontally below the toilets and terminate them in a common vertical duct.
hot water system
• Hot water supply is one of the prime requirements in any hospital. It is required in patient bathrooms,
kitchen, laboratory, laundry, etc. if the hospital is located in a cold climatic area, it is essential to provide hot
water in all the toilets and washbasins. Hot water is supplied through the central distribution system and is
usually generated using oil-fired hot water generators. The temperature of water ranges between 55 C – 60
C and stored in an insulated, closed pressure hot water mixing tank.
drainage system
the drainage system of the hospital should be simple, effective , economical and serviceable. It should be
designed keeping in view the kind od septic and toxic waste that needs to be effectively disposed of. It is
advisable to adopt a double stack system in which separate stacks are provided to collect waste and soil from
the toilets and other areas. Pipelines should run with sufficient slopes so that sewage could be conveyed to
inspection chambers by gravity.
For sewage disposal, it is preferable to use PVC pipes as they are easy to install and repair, and also allow
for smooth flow of sewage.
Sewage treatment plant
the objective of the sewage treatment plant is to stabilize the decomposable organic matter present in
sewage to produce effluents and sludge. These can then be disposed of in the environment without causing
Any health hazards or nuisance. The treated sewage water can also be reused for various purposes like
gardening, landscaping , flushing of WCs A.C cooling towers, etc.

28. A.C. PLANT (Air conditioning)
Complete air conditioning provides following conditions for
both summer and winter:
•Air movement and circulation
•Air filtration, cleaning and purification
•Temperature control
•Restricted movement of air in between various departments
to avoid cross contamination.
•Ramps and stairs are not considered for air conditioning.
•Soft water plant shall be provided for supplying soft and
filtered water.
•Ducts are made up of G.I., Aluminum. And concealed to avoid
avoid noise.
MECHANICAL ENGINEERING SERVICES
Refrigeration unit.
• Direct expansion, one AHU chilled water system –multiple
AHU.
Under certain circumstances, even a 10 second interruption of power supply in hospitals may prove life-
threatning. In the operating rooms where an open heart surgery or kidney transplant is in progress, or on the
ICUs, such interruptions may be fatal.
Voltage sensitive medical equipment, computers and perphaps a small percentage of lighting are connected to
UPS that typically has a battery back-up of 30 minutes. Advanced models of some medical equipment have a
built-in battery back-up that provides uninterrupted power supply to keep the equipment operational for
some time.
ELECTRICAL LOAD ESTIMATES FOR A 200 BED STATE-OF-THE-ART HOSPITAL:
HVAC 1200kw
General lighting 320kw
General lights and power 350kw
X-rays 300kw
Surgical suits 150kw
Servers, PCs 100kw
Elevators 125kw
Laundry & kitchen 250kw
Water supply & treatment plants 180kw
miscellaneous 100kw
FROM THE FIGURE WE GET THE
ERAGE AMOUNT OF ELECTRICITY UTILIZEZ BY
DIFFERENT EQUIPMENTS
o HVAC: 30-65%
o Lighting: 30-40%
o Water pumping: 10-12%
o Others: 5-15%

29. Design Elements
• Nature and Magnitude of load.
• Source of Power .
• Voltage Levels.
• Most Economical Size of substance.
• Short Circuit Protection.
• Grounding.
• Overcurrent Protection.
• Lighting Protection.
• Isolation of transformers for operation
operation room complex.
• Emergency Generators.
• Uninterruptible Power Supply (UPS)
Electric load estimate for 100 beds
• HVAC - 1200kv
• General Lighting - 320kv
• General Lights and P.P - 350kv
• MRI,CAT Scan and X-ray - 300kv
• Angiography & Gamma Camera - 175kv
• Pathology and Microbiology labs - 150kv
• CSSR - 200kv
• Surgical Suites (4-5) - 150kv
• Servers ,PC’s - 100kv
• Elevators - 125kv
• Laundry and Kitchen - 250kv
• Water Supply & Treatment Plants - 180kv
• Miscellaneous - 100kv
ELECTRICAL ENGINEERING SERVICES :-

30. COLOUR THEORY :
A positive and comforting aura is a must for any hospital. And a cheerful colour scheme
works wonders in creating that positivism.
The colour choice is related to psychological, visual, aesthetic, and technical aspects of
human made environments.
• According to the field , the colour represented for hospital or medicine is ‘GREEN’
• Mostly white and green colour is used in hospital .
• White – it is peaceful colour which associates with purity, innocence and virginity .
it mean safety and cleanliness.it makes patient feel assured and implies sterility
and it is the reason most nurses and doctor wear white uniforms. It is mostly
used for walls.
• green – means the colour of life ,freshness , safety, environment. The colour effect our
nature and environment.
- the brain interprets colours relative to each other, so the contrast between red
and green makes it easier to look out for blood oozing out during a surgery.
also continuously looking at red desensitises the cones in the eye , so looking
green scrubs during the surgery preserves the sensitivity of the eye to red.
It increases adrenaline and elevates blood pressure so avoid using it
when patient suffering from hypertension and also elevate
depression.
It is best color for hospitals and particularly for childrens rooms.it
radiates warmthand is associated with joy and happiness.
It is particularly recommended for patients with skin problems .it can
inspire creativity in people who feel sluggish or lethargic
It is for balanced healing properties . It is a restful colour that
symbolises growth and renewal & encourages comfort and
equilibrium and is particularly beneficial for the heart , lungs and
circulatory system.
It helps lower pressure and can reduce rapid heart rate. And relaxing
for mind and body .it is associated with organs like eyes , ears and
nose and involved with the senses of smell ,sight and sound
It is a protective and compassionate colour that heals and soothes .
The light-hearted colour can stimulate happiness . Too much of bright
pink might stimulate energy and incite passionate behaviour .

31. Osmania general hospital

32. LOCATION: Osmania general hospital,
Afzalgunj,Hyderabad,Telangana,500012.
SITE AREA: 26.5 acres
BUILT UP AREA: 11 blocks have own built-up area
ARCHITECT: British architect Vincent Jerome Esch
Nawab Khan Bahadur Mirza Akbar Baig
OSMANIA HOSPITALS:
YEAR OF CONSTRUCTION: 1912
NO. OF BEDS: 1168
 It is a general hospital. It has a 1000 functional beds,
with a further planned for increase in beds of 500.
GENERAL INFORMATION
CASE STUDY
INDI
A
TELANGANA
INTRODUCTION
Osmania General Hospital (OGH) is one of the oldest hospitals
in India located at Afzal Gunj, Hyderabad. It is run by
the Government of Telangana, and is one of the largest in the state.
The hospital building, a heritage structure is in dire need of repairs
and renovation. Total beds 1168 split into 363 super-specialty beds,
160 emergency beds and 685 general beds. It has 250 physicians and
surgeons and more than 530 nursing staff on its roll.
MIR OSMAN ALI KHAN is the founder
of OGH and he was the last Nijam of
Hyderabad. The present building was
Completed in the year 1912.
HISTORY
ARCHITECTURAL STYLE: Indo-Saracenic

33. APPROACH ROADS:
Bare facts:
1.The 150-year-old hospital is established on a 26.5 acre land on
the banks of Musi river.
2.Close to 2,000 students pursue medical and paramedical courses.
3.OGH receives eight lakh outpatients and 52,000 in-patients annually.
Present scenario:
1. There are 11 major blocks housing the hospital.
2. Eight blocks have been deemed unfit for usage.
3. The IP block has been declared a heritage building.
4. The infrastructure is crumbling by the day
SUN PATH SOIL CONDITION
Black alluvial soil
sun path diagram at 11:00sun path shows 11:00 am march month
CLIMATIC CONDITION
 Graph shows the maximum and minimum
temperatures Recorded in Hyderabad
region
RAINFALL
MONTHS

34. DEPARTMENTS
• Cardiology
• Dentistry
• Diabetology
• ENT (Otolaryngology)
• General Medicine
• Nephrology
• Neurology
• Ophthalmology
• Orthopedics
• Urology
• Cardio vascular
• Radiology