Hospital business plan new

"Developing an infrastructure master plan is essential to guide increasing healthcare capacity and making sure that the sector meets the rising demand for quality services and facilities"

1. Hospital Business Plan

2. *Must meet the needs of the
patient it is going to serve
adequately.
*It must be in a size and
proportions which the owners
or promoters will be able to
build and operate.

3. Sound Architectural Plan
Economic Viability
Effective Community Orientation
Quality Patient Care

4. •Protection from unwanted and unnecessary disturbances
in order to help speedy recovery
•Separation of dissimilar activities
•Control the nurses station should be positioned
strategically to enable proper monitoring of visitors
entering and leaving the ward, infants and children
should be protected from theft and infection etc.
•Circulation all the departments of a hospital must be
properly integrated.
•Separate all departments, yet keep them all together;
separate types of traffic, yet save steps for everybody;
that is all there is to hospital planning.

5. *Needs of the Community
Ease of accessibility
Range of services offered
Availability of specialists
Availability of technology
*Study of Existing Hospital(if any)
*Requirements of Staff and Services

6. *Private
*Partnership
*Public Charitable Trust
*Cooperative Society
• Primary
• Secondary
• Tertiary

7. Bed: Population = A X S X 100
365 X PO
A= number of inpatient admissions/1000 population/year
S= average length of stay
PO= percentage occupancy

8. Funds required for Rental, 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.

9. Built in Equipment These include counters and cabinets
in laboratory, Pharmacy and other
parts of the hospital, elevators,
incinerators, coolers, fixed sterilizing
equipment etc.These are usually
included in the construction contract
and the planning of these equipments
is the architect's responsibility.
Depreciable Equipment This includes equipment that has a
life of five years or more and is not
purchased through construction
contracts. These are large pieces of
furniture which have a relatively
fixed location and are capable of
being moved e.g., diagnostic and
therapeutic equipment, laboratory
instruments, office furniture etc.

10. Non Depreciable Equipment These are small items with a low
unit cost and life span of less than
five years. These are generally
under the control of the store room
and are bought through other than
construction contracts. They
include kitchen utencils,surgical
instruments,linen,waste baskets
etc.

11. Admission Human resource
Administration Stores
General engineering Purchasing
Laundry Maintenance
Clinical services Waste disposal plant
Pharmacy Fire and safety
Nursing services Disaster plan
House keeping information
Records Dietary services
Public relations Clinical engineering
Employee facilities Sanitation

12. In Patient Department
Patient Room- These may be
private/semi private rooms or multi-bed
general wards. They should be designed
to be safe and aesthetically pleasing so as
to assist in quick recovery of patient.
They must contain space for equipments,
staffs and various need of the patient.
Nurses Control Station- should be
located and designed in such a way that
the nurses can observe the patient room.
The Work Area- related to handling
materials necessary for patient care,
maintaining communication and records
etc.

13. *Economical
*High quality patient care
*Comfort to the patient
*Efficient operation of the unit
*Meeting the needs of the visitors

14. *Examination and treatment room with wash basin etc.
*Cupboard for clean linen.
*Basket for soiled linen with sink, waste receptacles.
*Equipment storage room for walkers, IV stands etc
*Space for storing stretchers and wheel chairs
*Lockers for staff personal belongings
*Staff toilet
*Small laboratory

15. Preferably on the ground level with a
separate entrance and adequate parking
facilities.
It should be close to admitting area , MRD,
emergency, radiology ,lab services and
pharmacy.
Attention should be paid to circulation,
which results in the smooth flow of various
traffic lines Traversing the department.
Properly signed

16. *Should be located on the ground floor with easy
access for patients and ambulances
*Separate entrance for the department
*Well marked with proper lighting and signs should
be easily visible and accessible from the street.
*Should be close to the admitting department,
medical records and cashier’s booth, radiology
department, lab services, blood bank, elevators
and wards.

17. Should preferably be located on the
ground floor with convenient access
from the operation theatre suit and
emergency department and easy
accessibility for wards.
It consists patient area, staff area,
support area.
Four basic requirements-
Direct observation of the patient by nursing and
medical staff
Surveillance of physiological monitoring
Provision and efficient use of routine and emergency
diagnostic procedures and interventions.
Recording and maintenance of patient information.

18. *Monitoring Equipment
*Cardiovascular Therapy
*Respiratory Therapy
*Dialysis Equipment
*Radiological Equipment
*Laboratory Equipment
*Others

19. *The obstetrical unit should
ideally be located close to the
labor and delivery room as also
to the nursery to avoid the
exposing the bodies to
infection.
*A room for patient education
and group discussions is
essential with cheerful
decoration is desirable.

20. An area of 30sq.ft/ infant with
a space of at least three feet
around is recommended
All partition should be made of
clear glass to permit
observation.
Furnishing in the full term
nursery include a bed side
cabinet, incubator, utility
table, wash basin, waste
receptacles, outlets for oxygen
and suction, facilities for
examination etc.

21. *Equal space should be provided for beds.
*If patients are allowed to stay with the parents,
provision must be made for toilets, sleeping and
storage of personal belongings
*Separate provision for examination and treatment
of infants.
*Each pediatric unit have isolation room with other
necessities like washing facilities and sterile gowns
and masks.
*Single room for critically ill and uncontrollable
patients
*Recreation or play room
*Storage space for toys, linen, recreational materials
*Walls between patient room and the corridor
should have glass panels for viewing
*Lighting decoration and equipment must create a
cheerful atmosphere.

22. Consultation area containing staff
offices for individual and family care
sessions.
Conference therapy area for group
therapy session.
Inpatient area for hospitalizing patients
Activities area for occupational
recreational therapy.
The number of beds should be between
20-24 I order to permit proper
observation and treatment and private
rooms are preferred.
One room for the management of
violent patients are desirable.
There should be no object which can be
used to hurt one self.

23. Should be easily accessible to the OPD,
casualty and the inpatient wards.
Preferably be sited on the ground floor.
Adequate reception and registration area
Convenient patient flow with minimization
of criss cross traffic.
Adequate waiting area
Separate entrance for accident and
emergency cases in busy hospital
Provision of room for technical functioning
Flexibility, expandability and upgradability
need to be kept in mind while sitting the
department.

24. Out patient should have ready access to the hospital pharmacy to
collect prescription.
Staff of wards and department can access it without having to travel
a long distance thorough other crowded areas.
Collection of indents and dispensing of prescription for inpatients can
be carried out in a central dispensing area which is accessible to
hospital staff when they come to consult the pharmacist or to obtain
stocks for ward use.
Suppliers have an access to it from out side
Space required for-
Dispensing counter
Cash counter
Drugs storage including dressings
Cool and cold storage
Administrative office
Circulation space
Space for compounding and bulk preparation

25. Hospital Store It should be located centrally to the hospital
Approachable by supply vehicles and should
have separate service entrance
Risk of fire and explosion in a medical supplies
storehouse, storage of acids, inflammable
materials and oxygen and other gas cylinders
will require special attention
CSSD CSSD mostly serves the operation theatre,
emergency, casualty department, wards,
maternity suit and should be so cited as to be
central to all this
Hospital Dietary Service Should be located taking into consideration
the prevailing wind direction so that smoke and
kitchen odours are not constantly wafted to
patient care area
Should be sited at ground level and connected
to store with lift

26. Hospital Work Shop / BME department A large quantum of various types of
mechanical and electrical equipment is
installed in a hospital and requires repair
and preventive maintenance.
Laundry Used linen from wards, operation
theatres and delivery suites maybe
infected, and therefore needs careful
handling at an area remote from all other
clinical and supportive services areas
Space for washing, storing, drying
shades and ironing rooms have to be
catered for at an appropriate area with
plentiful supply of water
MRD Should be located immediate to the
admission and registration area.
Enough space for keeping/storing of
patient files
Adequate safety .

27. Area Sq .ft / bed
Nursing unit 250-280
Nursery 12-18
Delivery suite 15-20
Operation theatre 30-50
Physical medicine 12-18
Radiology 25-35
Laboratory 25-35
Pharmacy 4-6
CSSD 8-25
Dietary 25-35
Medical record 8-15

28. Area Sq .ft / bed
House keeping 4-5
Laundry 12-18
Mechanical installation 50-75
Maintenance work shop 4-6
Stores 25-35
Public areas 8-10
Staff facilities 10-15
Administration 40-50
Total 567-751
Circulation 115-751
Total net area 682-891

29. *The most common method of estimating hospital
construction costs has been the “ per bed”
method, i.e., if the total cost of a 100 bedded
hospital has been Dhs-1500000 to Dhs 2000000
*Break up of project cost-
Acquisition of Building rental plan
Site survey, investigation
Buying equipment
Supervision and inspection
Equipping the hospital-diagnostic and
therapeutic equipment
Movable equipment, furniture etc.

30. *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

31. Formation of commissioning team
Hospital consultant
Hospital administrator
Chief of clinical services
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 equipments
Coordinate training of staff
Ensure good communication

32. Stage A
Functional content:
Outline brief:
Project team
Assessment of functional content
Submission of owners( Govt,private
organization etc.)for approval
Site appraisal, gross floor areas
Building space. Draft master plan
Estimation of cost and phasing
Appraisal of work by owners
Stage B
Operational policies:
Developmental plan:
Operational policies
Departmental and inter related
activities
Departmental and hospital policies
Development control plan
Budget cost
Continuous informal discussion
with owners

33. Stage C
Schedules of accommodation, sketches,
Final cost estimate:
Schedules of accommodation
Sketch drawing
Equipment schedules component
estimates
Cost revenue and staffing estimates
Final cost approval
Stage D
Detail design working drawings, tender
action:
Working drawings
Engineering details
Bills of quantities
Calling tenders
Stage E
Contract and construction: Assessments of tenders
Award of contract
Construction
Engineering commissioning
Stage F
Commissioning: Staff assembly and training
Equipment and supplies assembly
Testing of installation

34. *Technology requirement must be met
*Clinical needs must be considered
*Safety is a major factor (DHA RULES)
*Standards and Guidelines are essential
*Importance of the role of Hospital Staff in
construction and design.

35. THANK YOU
Tom Jose