Hospital

Architecture,
Planning and
Maintenance

Abdulwakil Daudi
 Modules in Hospital
Module 1: Introduction to Hospital and Hospital Administrator
 Definition and classification of hospitals.
 Changing role of hospitals in healthcare.
 Functions and objectives of a hospital.
 Role, responsibilities and objectives of a hospital administrator.
 Relationship between hospital and community.
Module 2: Hospital Planning and Architecture
 Principles of hospital planning and regionalization.
 Hospital planning process and site selection.
 Role of the hospital architect and architectural considerations.
 Equipping a hospital: Interiors, graphics, and safety planning.
 Electrical safety and injury prevention in hospital design.
Module 3: Technical Analysis of Hospital Infrastructure
 Assessment of hospital service demands and utilization.
 Bed planning, land requirements, and project costs.
 Space allocation and hospital layout planning.
 Hospital documentation and project report preparation.
Module 4: Hospital Design and Compliance Standards
 Hospital zoning: Entrance, ambulatory, diagnostic, critical, and service zones.
 Administrative and communication facilities in hospitals.
 Biomedical equipment standards and compliance.
 Voluntary and mandatory hospital regulations.
 Mechanical, electrical, and waste management standards.
 Hospital Planning and Information System (under a course in MBA healthcare)
 Module 4:
Hospital Design and
Compliance Standards
Hospital Designing and Zoning
 Specific Learning Objectives

By the end of this module, students should

be able:
1.Explain the concept of hospital design
2.Identify the different requirement of a hospital
building
3.List the utilities provided in a hospital
4.List the biomedical equipment to be installed
in a hospital
5.Elaborate various zones of a hospital along
with their functions and significance.
 Concept Hospital Design and Zoning

• A hospital setup consist of functional units/departments which

provides a wide range of services, which are interdependent.
• These include: Outpatient department (OPD), Inpatient
department (IPD) and Service departments.
• Each department of has several sections that perform
independent and quality services but with excellent
coordination with various other sections.
• Hospital design is a complex process that involves integrating
architecture, technology, and creativity to create a functional,
efficient, and patient-centric healthcare environment.
• A well-designed hospital should provide comfort, safety, and
convenience to patients, staff, and visitors.
 Functional Necessity for Hospital Design

1. Featured Care: The hospital should provide high-quality

clinical services and ensure patient satisfaction.
2. Patient Comfort: Wards and other patient areas should
offer a safe, comfortable, and private environment.
3. Staff Satisfaction: Happy and satisfied staff are more likely
to provide better patient care.
4. Convenience for Visitors: Clear signage, waiting areas,
cafeterias, and other amenities should be provided for
visitors.
5. Budget and Services: The hospital should offer necessary
services at an affordable cost.
 Design Hospital Requirements
• To fulfil all these objectives, a hospital design
should take care of the following:
1. Building requirement: The building must be
laid out and constructed to prioritize patient
and staff well-being (safety and comfort) while
also allowing for smooth workflows and
resource management (efficiency)
2. Utilities: These are the essential services that
make the hospital function. Utilities are the
lifelines of the building, providing things like
electricity, water, medical gases, and
communication systems.
3. Biomedical equipment: This encompasses
all the specialized tools and machines used for
patient care. Biomedical equipment is crucial
for diagnosis, treatment, and monitoring.
1.Environment: The hospital should be located in
Building Requirements
an accessible area, free from noise, pollution, and
other disturbances.
2.Safety and Security: The building should have
wide exits, emergency exits, fire safety systems,
and 24/7 security.
3.Patient Movement: Corridors should be wide
enough (minimum 2.5 meters) for easy
movement of patients on stretchers or
wheelchairs.
4.Lighting and Ventilation: Proper lighting and
ventilation are essential for creating a healing
environment.
5.Water Supply and Sanitation: Adequate water
supply and proper sanitation systems are crucial.
6.Maintenance: Regular maintenance and repair
7.Parking:
Cont: Building Requirements
Adequate parking space should be
provided for staff, patients, and visitors.
8.Zoning: The hospital should be divided into
different zones based on functionality and
services.
9.Flexibility: Therefore, the building should
have a flexible design to allow minimal
modifications as the system may require due
to evolving needs and procedures.
10.Expandability: Hospital should be an
open-ended system with proper plan and
directions for future expansion.
11.Positioning: All the specialties available in
the hospital must be positioned accurately to
prevent any inconvenience.
• Cont:
Emergency Department:
Examples ofLocated on
Positioning
the ground floor with a separate
entrance for quick access.
• Registration and Admission
Area: Positioned near the main entrance to
streamline the admission process.
• Operation Theatres (OT): Placed in a quiet,
sterile area close to the ICU to minimize
infection risks and ensure quick patient transfer.
• Intensive Care Unit (ICU): Located near
the emergency department and OTs for rapid
transfer of critically ill patients.
• Diagnostic and Imaging
Departments: Centrally located for easy
access by both outpatients and inpatients,
reducing waiting times.
• Pharmacy: Positioned at multiple points (near
Cont:
OPD and Examples
wards) for quickof Positioning
access to medications.
• Outpatient Department (OPD): Located near
the main entrance but separate from inpatient
areas
• Inpatient Wards: Situated in quiet zones away
from high-traffic areas to provide a peaceful
recovery environment.
• Support Services (CSSD, Kitchen,
Laundry): Placed in service zones (e.g.,
basement) to avoid interference with patient care
areas.
• Administrative Offices: Positioned in
a centralized area separate from clinical zones
for efficient management.
• Parking Areas: Located near the main
Designing Utilities in Hospitals
• Utilities are essential for the smooth functioning
of hospitals, ensuring that all departments and
services operate efficiently.
• They are broadly categorized into major
utilities and minor utilities.
Designing Utilities in Hospitals
• Utilities are essential for the smooth
functioning of hospitals, ensuring that all
departments and services operate efficiently.
• They are broadly categorized into major
utilities and minor utilities.
 Designing
• Life Major
Maintenance Utilities
Systems: In hospital
design, the placement and capacity of gas
pipelines, oxygen storage, and backup
generators must be meticulously planned
to ensure accessibility.
• Infection Control Systems: Incorporate
dedicated spaces for sterilization, airflow
management systems to prevent cross-
contamination, and hygienic water
treatment facilities.
• Atmosphere Control Systems: The
HVAC (Heating, Ventilation, and Air
Conditioning), requiring careful
consideration of air filtration, temperature
zoning, and humidity control.
Designing Major Utilities
• Equipment Control Systems:
Designing efficient electrical distribution,
pneumatic tube systems, and elevator
layouts is essential for efficient
operations and the safe movements.
• Communication Systems: Integrate
robust communication infrastructure,
including patient call systems, fire
alarms, and telephone networks, to
enhance communication.
Designing Minor Utilities
• Medical Supplies: Storage for
medical supplies must be strategically
placed for quick access and
replenishment in patient care areas.
• Diagnostic Kits: Designated spaces
for diagnostic kits should ensure
organized storage and easy access for
accurate and timely testing.
• Surgical Instruments: Surgical suite
design needs dedicated, sterile
storage for instruments, facilitating
efficient surgical procedures.
 Designing Minor Utilities
• Patient Care Items: Patient rooms
and nursing stations must incorporate
storage solutions for readily available
patient care items.
• Disposable Items: Waste
management systems, including
strategically placed disposal bins, are
crucial to maintain hygiene and prevent
contamination.
• Mobility Aids: Corridors and storage
areas must be designed to
accommodate the movement and
storage of mobility aids.
Biomedical Equipment in Hospitals
1. Diagnostic Equipment:
• These machines, like X-ray, CT, MRI, and ultrasound,
are crucial for identifying diseases.
• Design prioritizes shielded rooms, reliable power, and
data connectivity.
• Mammography and laboratory equipment like blood
analyzers also fall under this category, supporting
accurate and timely diagnoses.
2. Treatment Equipment:
• Ventilators, defibrillators, anesthesia, and dialysis
machines provide therapeutic care.
• Design focuses on critical care placement, integration
with medical gases, and easy maintenance access.
• Infusion pumps and ECG machines are also essential,
ensuring effective treatment and patient safety.
Biomedical Equipment in Hospitals
3. Monitoring Equipment:
• Patient monitors, cardiac monitors, fetal Dopplers, and
pulse oximeters track patient vitals.
• Design emphasizes network integration and ergonomic
interfaces for efficient data management.
• Neonatal monitors in NICUs are crucial for observing
premature or ill newborns.
4. Research and Specialized Equipment:
• EEG and EMG machines, pacemakers, laminar flow
systems, and incubators support advanced treatments
and research.
• Design requires specialized environments and
infrastructure.
• These tools facilitate cutting-edge medical
advancements while maintaining strict safety and
hygiene standards.
Hospital Equipment
 Hospital Zoning
• Hospital zoning refers to the systematic
division of hospital space into specialized
functional areas, ensuring that each
department operates efficiently and
effectively.
• It plays a crucial role in enhancing patient
care, minimizing cross-infection risks, and
improving accessibility.
• Given the limited healthcare infrastructure in
Somaliland, proper hospital zoning is essential
to maximize the efficient use of available
resources.
1.Gropupin
Outer Zone: Areas that are immediately accessible to
Zones in Hospital
the public: emergency service, outpatient service, and
administrative service. They shall be located near the
entrance of the hospital.
2. Second Zone: Areas that receive workload from the
outer zone: laboratory, pharmacy, and radiology. They
shall be located near the outer zone
3. Inner Zone: Areas that provide nursing care and
management of patients: nursing service. They shall be
located in private areas but accessible to guests.
4. Deep Zone: Areas that require asepsis to perform the
prescribed services: surgical service, delivery service,
nursery, and intensive care. Segregated from the
public areas but accessible to the outer, second and
inner zones.
5. Service Zone: Areas that provide support to hospital
activities: dietary service, housekeeping service,
maintenance and motor pool service, and mortuary.
 Main Zones in Hospital
• Hospital zoning refers to the systematic
division of hospital space into specialized
functional areas, ensuring that each
department operates efficiently and
effectively.
• It plays a crucial role in enhancing patient
care, minimizing cross-infection risks, and
improving accessibility.
• Given the limited healthcare infrastructure in
Somaliland, proper hospital zoning is essential
to maximize the efficient patient flow, infection
control, and resource optimization
1. Entrance Zone
Main Zones in Hospital
• This is the first point of contact for patients and
visitors. It is designed to facilitate patient
registration, provide initial triage, and ensure
security.
• It comprises of: Reception area, waiting lounges,
security checkpoints, triage units.
• Design Considerations:
Ensuring accessibility for disabled and elderly
patients.
Providing clear bilingual signage in Somali and
English.
Implementing infection control measures such as
handwashing stations and sanitation points to
address high infectious disease rates like
tuberculosis and cholera.
Adequate ventilation and seating capacity to
 Main Zones in Hospital
2. Ambulatory Zone
• This area serves patients requiring outpatient medical
services, including consultations, diagnostics, and
pharmacy services.
• The components include: Outpatient clinics,
consultation rooms, diagnostic laboratories,
pharmacies.
• Design Considerations:
Located near the entrance for ease of access.
Separate waiting areas for male and female
patients, where culturally appropriate.
Efficient patient flow system to prevent bottlenecks
and minimize waiting times.
Availability of essential medications and diagnostic
services to provide comprehensive outpatient care.
 Main Zones in Hospital
3. Diagnostic Zone
• This area houses diagnostic and imaging services
essential for accurate disease diagnosis and
treatment planning.
• This includes: Radiology (X-ray, ultrasound),
pathology labs, sample collection units.
• Design Considerations:
• Proper shielding and soundproofing for radiation-
emitting equipment.
• Close proximity to emergency and critical care
units to facilitate quick diagnostics for urgent
cases.
• Contingency plans for power outages, including
backup generators for critical diagnostic
equipment.
 Main Zones
4. Critical Zone
in Hospital
• This area handles emergency and critical care
services, requiring immediate medical attention and
intensive monitoring.
• The components include: Emergency department,
intensive care unit (ICU), operating theaters, recovery
rooms.
• Design Considerations:
High-level infection control measures to mitigate
risks of cross-contamination.
Rapid ambulance access, considering the poor
road infrastructure in some regions.
Adequate staffing with trained personnel for
handling trauma and critically ill patients.
Reliable backup power supply and emergency
medical equipment to ensure uninterrupted care.
 Main Zones
5. Service Zone
in Hospital
• This area supports hospital operations, ensuring the
smooth delivery of non-clinical services essential for
hospital functionality.
• This includes: Laundry facilities, kitchens, waste
management units, supply storage.
• Design Considerations:
Physical separation from patient care areas to
maintain hygiene and reduce contamination
risks.
Proper waste disposal mechanisms to manage
medical and general waste effectively.
Efficient logistics and inventory management to
prevent supply shortages.
 Main Zones in Hospital
6. Intermediate Zone:
• Includes wards and operation theaters (OT).
• Wards: Designed for patient care, with beds,
nursing stations, and bathrooms.
• Operation Theaters (OT): Equipped with high-
tech equipment and maintained in a sterile
environment. OTs are divided into zones (clean,
sterile, protective, and disposal zones).
 Administrative and Communication Zone

• Efficient hospital administration is critical for

managing healthcare services, ensuring
operational efficiency, and maintaining
regulatory compliance.
• Given the resource constraints in Somaliland and
Somalia, hospitals need streamlined
administrative structures to function effectively.
Administrative Zone/Facilities
1. Administrative Offices: These offices oversee
hospital management, human resources,
finance, and overall operations.
2. Medical Records Department: Maintains
patient records, ensuring accurate
documentation of medical histories and
treatment plans.
3. Conference Rooms: Multi-functional spaces
used for hospital meetings, medical training,
and community health education programs.
4. Staff Facilities: Providing essential amenities
for healthcare workers, including rest areas and
locker rooms.
Communication Systems Zones
• Effective communication is a cornerstone of hospital
operations, ensuring coordination between departments and
facilitating emergency response efforts.
1. Internal Communication : Enhancing coordination among
hospital staff and departments.. This includes: Basic
intercom systems, mobile phones, and radio
communication.
2. External Communication: Connecting hospitals with
government agencies, NGOs, and referral hospitals. They
include: Mobile phone networks, internet-based
communication, and satellite phones for remote areas.
3. Emergency Communication: Rapid response systems for
handling mass casualties, disease outbreaks, and natural
disasters. These include: Alarm systems, Community-based
networks using radio broadcasts and SMS alerts,
Coordination with local ambulance services and first
responders.
• Orthopedic specialty hospital: https
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