Study Analysis Final draft of case study

Case study

1. Hospital Research Architectural Design Studio V ARCH410 Fall Semester 2019-2020 Supervised by: Dr. Waleed Jaffar Done by: Abdullah Zuhra

2. What is a Hospital? It’s an institution that provide medical and surgical treatment and nursing care for sick or injured people.

3. Classifications of Hospitals According to the size of the hospital: Mini sized hospital < 50 bed Mid sized hospital 50 – 250 bed Big hospitals 250 – 500 bed Huge hospitals > 500 bed

4. Classifications of Hospitals According to the size of the medical specialist: Specialist Hospital; pediatric hospital, eye hospital, cardiac hospital…etc. General Hospital; all medical specialist are provided.

5. Classifications of Hospitals According to the owners of the hospital: Private Hospitals. Public Hospitals; university hospitals, …etc.

6. Hospital Elements & Divisions Administration division. Outpatients’ division: Outpatient clinics. Pharmacy. Emergency reception. Diagnostic services division: Laboratories. Radiology (diagnostic). Therapeutic services division: Physical Therapy. Radiology (therapeutic).

7. Hospital Elements & Divisions Internal medical treatment division: Operation Theaters. Intensive Care unit. Maternity Section. Central Sterilization Department. Inpatient division: Patient wards. Nurses wards. Inpatient services. General service division: Kitchen. Laundry. Storages. Workshops. Mechanical services. Mortuary. Security. Parking. Landscaping.

8. Administration division. Parts and components of the division: Reception hall Waiting area Registration Treasury and accounts Staff offices General manager office Staff lounge Nursing head office WCs Administration External clinics Other services Entrance Internal Service 10

9. Administration division. Location: Very close to the main entrance of the hospital. Entrance area, registration, accounts should face the entrance, while the manger office should be back for privacy. Area of the department: 50 bed hospital area = 214 m² 100 bed hospital area = 363 m² 200 bed hospital area = 567 m²

10. Area of the department: 50 bed hospital area = 214 m² 12

11. Area of the department: 100 bed hospital area = 363 m² 13

12. Area of the department: 200 bed hospital area = 567 m²

13. Outpatients’ division External outpatients’ clinics Parts and components of the division: Consultation room Examination room Treatment room Waiting area – 20 seats/clinic (1.25 m²/seat) Staff room WCs Examination Entrance Shaft Psychiatrist Register Waiting WC Consultant Treatment Pharmacy To the x-ray, labs and physical therapy 15

14. Outpatients’ division External outpatients’ clinics Location: Very close to the main entrance of the hospital. Close to the diagnostic services (labs and x-ray). Close to the pharmacy. Area of the department: 50 bed hospital area = 215 m² 100 bed hospital area = 350 m² 200 bed hospital area = 540 m²

15. External outpatients’ clinics Clinic Department Number of Clinics according to the Size of the Hospital 100 Bed 200 Bed 300 Bed 400 Bed 500 Bed Internal Clinics 2 3 4 5 5 Surgery Clinics 2 2 3 4 5 Gynecology Clinics 1 1 2 2 3 Pediatric Clinics - 1 1 2 2 Psychological and Neurological Clinics - - 1 1 3 Ophthalmology Clinics 1 1 1 1 1 Ear, Nose and Throat Clinics - - 1 1 2 Orthopedic Clinics - - 1 12 2 Urology Clinics - - 1 12 2 Dental Clinics - - 1 1 1 Total No. of Clinics 6 8 16 20 26 No. of Beds in the Clinics 6 – 8 8 – 12 16 – 21 20 – 27 26 – 33 17

16. Area of the department: 50 bed hospital area = 215 m²

17. Area of the department: 100 bed hospital area = 350 m²

18. Area of the department: 200 bed hospital area = 540 m²

19. Outpatients’ division

20. Outpatients’ division Emergency Reception Parts and components of the division: Entrance & Waiting area Registration Staff room Mini-surgery Test room Medical utilities Mini sterilization room Main Entrance X-ray Emergency Pharmacy Utilities Operation Maternity Internal Exit Entry

21. Outpatients’ division External outpatients’ clinics Location: Very close to the exit door of the emergency. Close to the radiology. Close to the pharmacy, laboratories and central sterilization. Direct access to the stairs and elevators. Area of the department: 100 bed hospital area = 100 m² 200 bed hospital area = 215 m²

22. Area of the department: 100 bed hospital area = 100 m²

23. Area of the department: 200 bed hospital area = 215 m²

24. Diagnostic services division

25. Diagnostic services division

26. Diagnostic services division Laboratories Parts and components of the division: Work area Waiting area Sample room Cleaning room Staff office The most important labs in the hospital are: Chemical lab Bacteriology lab Histology lab Pathology lab Serology lab Hematology lab Microbiology lab Labs Blood Bank Emergency clinics Central storages Internal department Operations & Maternity

27. Diagnostic services division Laboratories Location: Very close to the emergency department and external clinics. Easily accessible from internal division. Easily accessible from maternity and surgery departments. Accessibility from central storages. Area of the department: 50 bed hospital area = 25 m² 100 bed hospital area = 60 m² 200 bed hospital area = 103 m² Or area can be counted by the number of the beds, 0.7 – 0.8 m²/ bed.

28. Area of the department: 50 bed hospital area = 25 m²

29. Area of the department: 100 bed hospital area = 60 m²

30. Area of the department: 200 bed hospital area = 103 m²

31. Diagnostic services division

32. Diagnostic services division Radiology Parts and components of the division: X-ray rooms Control room Waiting area Staff office Utility room Dark room Film view Store Radiology Emergency Utility store Clinics Surgery Maternity Clinics

33. Diagnostic services division Radiology Location: Very close to the emergency department and external clinics. Easily accessible from internal division. Ground floor is preferred. Area of the department: 50 – 100 bed hospital area = 65 – 104 m² 100 – 200 bed hospital area = 220 – 240 m²

34. Area of the department: 100 bed hospital area = 155 m² 37

35. Area of the department: 200 bed hospital area = 175 m²

36. Therapeutic services division

37. Therapeutic services division Physical therapy division Parts and components of the division: Waiting area Office Hydrotherapy Exercise room WCs Physical Therapy Clinics Internal Entrance

38. Therapeutic services division Physical therapy division Location: Very close to the main entrance of the hospital. Easily accessible from external clinics. Easily accessible from internal division. Must be in the ground floor. Area of the department: 50 – 100 bed hospital area = 65 – 104 m² 100 – 200 bed hospital area = 155 – 225 m²

39. Area of the department: 200 bed hospital area = 155 m²

40. Internal medical treatment division

41. Internal medical treatment division Operation Theatre Parts and components of the division: Entrance Storage Preparation room Access area Staff clothes room & WCs Operation theatre Cleanup room Sub sterilizing room Supervision room Staff lockers Operation department Intensive care Internal surgery Reception Central sterilization Radiology Labs & blood bank

42. Internal medical treatment division Operation Theatre Location: Very close to the intensive care division. Very close to the central sterilization division of the hospital. Close to the inpatient wards. Easily accessible from the emergency division. Area of the department: 50 bed hospital area = 185 m² 100 bed hospital area = 360 m² 200 bed hospital area = 550 m²

43. Area of the department: 50 bed hospital area = 185 m²

44. Area of the department: 100 bed hospital area = 360 m²

45. Area of the department: 200 bed hospital area = 550 m²

46. Internal medical treatment division

47. Internal medical treatment division Intensive Care Unit Parts and components of the division: I.C.U space Intensive Care Division I.C.U Internal division Central sterilization Labs & blood bank I.C.U

48. Internal medical treatment division Intensive Care Unit Location: Very close to the recovery room in the operation theatre. Easily accessible from the emergency division. Area of the department: Must be designed 1 – 2 % of hospital beds Operating division I.C.U From: Wards Emergency Admitting office Recovery

49. Internal medical treatment division

50. Internal medical treatment division Maternity Section Parts and components of the division: Open room 20 – 20 m² Operation 26 m² WCs Utilities 8 m² Office 15 m² Unclean room 8 m² Cleanup room 5 m² Storage 10 m² Waiting area 10 m² Corridors w = 2.2 m

51. Internal medical treatment division Maternity Section

52. Internal medical treatment division Maternity Section

53. Internal medical treatment division

54. Internal medical treatment division Central Sterilization Division Parts and components of the division: Work space Receiving area Washing area Supplies storage C.S.D Surgery department Internal Emergency Laundry Central storages Maternity Clinics In various floors In the same floor

55. Internal medical treatment division Central Sterilization Division Location: Very close to the operation theater and maternity division. Can be easily accessible from the emergency division, laundry and central storage. Area of the department: 100 bed hospital area = 65 m² 200 bed hospital area = 110 m² Or 0.6 – 0.9 m²/bed, 0.6 m² for large hospitals or 0.9 m² for small hospitals.

56. Area of the department: 100 bed hospital area = 65 m²

57. Area of the department: 200 bed hospital area = 110 m²

58. Inpatient division

59. Inpatient division Parts and components of the division: Inpatient wards 11.5 m²/ bed – 8 m²/ bed WCs Nursing station – not less than 12 m² for 60 patients Treatment room 10 – 15 m² for 60 patients Day room 0.7 m²/ bed Nurses’ lounge – not less than 12 m² Storage 8 – 12 m² Kitchen 12 m² Doctors’ room 15 m² The most suitable number of beds in a hospital are 20 – 40 beds/ unit Nightingale ward – it’s a type of hospital ward, which contains one large room without subdivision for patient occupancy. It contains about 24 – 34 beds usually arranged along the sides of the ward.

60. Inpatient division Inpatient Wards are divided according to: Medical specialty (surgery, internal pathology … etc ) – This is because similar diseases share the need for services and equipment that may differ from others, in addition to that it is better for the patient psychologically. Patients’ sex (females - males) – to achieve privacy for the patients. The amount of care a patient needs.

61. Area of the department: Multiple beds

62. Area of the department: 4 Bed Ward 2 Bed Ward Single Bed Ward

63. Area of bed:

64. General Service division

65. General Service division Service Entry Internal Storage Dietary Division Food Dietary Division Parts and components of the division: Storage room Kitchen Preparing and Supply area Cleaning

66. General Service division Dietary Division Location: In the ground floor. Direct opening to the service entrance. Area of the department: Rosen field 100 bed hospital area = 195 m² 200 bed hospital area = 355 m²

67. Area of the department: 100 bed hospital area = 195 m²

68. Area of the department: 200 bed hospital area = 355 m²

69. General Service division

70. General Service division Housekeeping Division Parts and components of the division: Office Dirty linen Clean linen Storage Laundry Mechanical room

71. General Service division Housekeeping Division Location: In the ground floor. Close to the central storages. Area of the department: Rosen field 50 bed hospital area = 150 m² 100 bed hospital area = 180 m² 200 bed hospital area = 270 m²

72. Area of the department: 50 bed hospital area = 150 m²

73. Area of the department: 100 bed hospital area = 180 m²

74. Area of the department: 200 bed hospital area = 270 m²

75. General Service division

76. General Service division General Storages Parts and components of the division: Medicine storage Furniture storage Food storage Utilities storage Archive General storages General Storage Pharmacy Laundry All Hospital Divisions Service Entrance Kitchen

77. General Service division General Storages Location: In the ground floor. Close to the housekeeping and dietary divisions. Direct access to the service entrance. Area of the department: 100 bed hospital area = 260 m² 200 bed hospital area = 520 m² Generally the area of the storages is 2 – 2.6 m²/bed

78. Area of the department: 100 bed hospital area = 260 m²

79. General Service division

80. General Service division Mortuary Division Parts and components of the division: Space to store the bodies (body refrigerators) Space to examine the dead body (forensic chamber) Space to display the dead bodies (for the relatives to see the dead body) Learning room (to display the dead bodies with rare conditions to educate the students)

81. General Service division Mortuary Division Location: In the ground floor or basement floor. Exit from emergency entrance or service entrance. Area of the department: 50 bed hospital area = 25 m² 100 bed hospital area = 45 m² 200 bed hospital area = 70 m²

82. Area of the department: 50 bed hospital area = 25 m²

83. Area of the department: 100 bed hospital area = 45 m²

84. Area of the department: 200 bed hospital area = 70 m² 87

85. General Service division

86. General Service division Maintenance workshops Parts and components of the division: Mechanical workshop Electrical workshop Storage room Changing room WCs Manger room

87. General Service division Maintenance workshops Location: In the ground floor or basement floor. Direct connection with the service entrance. Area of the department: 50 bed hospital area = 65 m² 100 bed hospital area = 90 m²

88. Area of the department: 50 bed hospital area = 65 m²

89. Area of the department: 100 bed hospital area = 90 m²

90. Entrances and Circulation of a Hospital

91. Entrances and Circulation of a Hospital Entrances: Patient visitors entrance. External clinics entrance. Emergency entrance. Service entrance. Mortuary entrance.

92. Entrances and Circulation of a Hospital Entrances: Things to be considered: Existence of a ramp for the disabled individuals. The main entrance must be for cars and pedestrians. The service entrance must be connected to a servicing yard to unload the kitchen, laundry and other needs. The morgue entrance should be out of the sight of visitors and patients and could be opened to the storage area.

93. Entrances and Circulation of a Hospital

94. Entrances and Circulation of a Hospital Circulation: Corridors Must be lit and evacuated. Must have fire insulating system and sound insulation. Stairs Types: Main stairs: for visitors and staff Width ≥ 1.5 m Trade = 30 cm Raiser = 15 cm Escape stairs: opens to the exterior of the building

95. Entrances and Circulation of a Hospital Circulation: Elevators Types according to size (ascending) Patient beds’ Visitors elevators Service elevators

96. Dimensions: Corridors

97. Circulation:

98. Systems used in a Hospital CCTV - Closed-Circuit Television Preventing theft – It prevents staff or visitors from stealing things that are kept in storerooms. Monitor patients – It simplifies check-in system for patients. Ambulances – From the footage of parking lot, it can track which vehicle has been assigned to whom. Employee check-ins – It shows who checked-in or checked-out at the specific time. Patient discharge – It detects if any patient gets discharged without the permission of the doctor.

99. Systems used in a Hospital Medical Gases and Vacuum Systems System components Sources Piping networks Valves Warning and alarm systems Outlets and inlets Secondary equipment

100. Systems used in a Hospital Medical Gases and Vacuum Systems Commonly used medical gases: Oxygen (O2) Nitrous oxide (N2O) Medical air 400 KPa or 4 bar (MA 4) Medical air 700 KPa or 7 bar (MA 7) Carbon dioxide (CO2) Nitrogen (N2) Medical vacuum

101. Systems used in a Hospital Plumbing Systems The plumbing systems of hospitals are unique and comprise equipment which that have distinct maintenance requirements and for the hospital to function efficiently. Sterilizer systems Pathology Laboratory systems

102. Systems used in a Hospital Sterilizer systems Many important areas such as the OTs, nurse stations, procedure rooms, gastrointestinal areas, etc. are equipped with sterilizers that are installed for washing and rinsing probes at temperatures of around 71oC-82oC It must be equipped with valves for mixing, controlling the temperature and to prevent backflow.

103. Systems used in a Hospital Pathology Laboratory systems Pathology labs are different from regular labs, as they use chemicals which produce a lot of foam. So, to prevent this foam, the plumbing system must be equipped with drain covers and anti-foaming systems. Pathology labs use unique chemicals and due to the foam, the water requirements for pathology labs is different, which also requires different filtration systems.

104. Systems used in a Hospital Fire Detecting System the following areas shall be protected: all patient access areas fire hazard rooms and areas rooms or departments below patient access areas from which fire can spread vertically to affect patient access areas stairways, lobbies and corridors used as means of escape when not in frequent use patient hotels commercial enterprise Atria mechanical and electrical services plant rooms (other than water tank rooms) toilets intended for use by the public.

105. Systems used in a Hospital HVAC - Heating, Ventilation and Air Conditioning HEPA filtration systems Re-circulating air ceiling systems for operating rooms Special ventilation using filter fan units, fiber filters, and quiet air-mixing systems Wall heating/cooling units that are built in to the walls Static cooling systems that provide cooling without moving air Adjustable multiplex air jet outlet systems that target air flow exactly to desired locations in a room

106. Systems used in a Hospital HVAC - Heating, Ventilation and Air Conditioning

107. Systems used in a Hospital Electrical System Non-essential (or normal) electrical system. Essential electrical system.