Hospital and Health Care Facility
Content
AR 331
ARCHITECTURAL DESIGN 07
RSW PR-01:
HOSPITAL AND HEALTH CARE FACILITIES-PHILIPPINES
Date given: January 25, 2011
Due date: February 1, 2011
Date submitted: February 1, 2011
Student:
PION, REDEN S.
Instructor:
Arch. Robert Romero
Introduction
• “Health care presents a different problem in
every country for the way it is organized is a
response to geography, climate, historical
development, economic situation and social,
cultural and political conditions…
• Appreciation of these differences is
fundamental to understanding of the
situation which prevails in a country.”
D efi
n ition on H ealth
“Health is a state of complete physical, mental,
and social well-being and not merely the absence
of disease or infirmity”
W.H.O.
“Health, as we define it today, is a state of
complete physical, psychological, social and
spiritual well being.”
Islamic worldview
……………………Thus, provides the overview that health is not just the
absence of disease in physical sense but encompass the whole wellbeing of the person.
WHAT IS A HOSPITAL
A hospital, in the modern sense, is an institution for health
care providing patient treatment by specialized staff and equipment, and
often, but not always providing for longer-term patient stays. Its historical
meaning, until relatively recent times, was "a place of hospitality", for
example the Chelsea Royal Hospital, established in 1681 to house
veteran soldiers.
Today, hospitals are usually funded by the public sector, by health
organizations (for profit or non profit), health insurance companies
or charities, including by direct charitable donations. Historically,
however, hospitals were often founded and funded by religious orders or
charitable individuals and leaders. Conversely, modern-day hospitals are
largely staffed by professional physicians, surgeons, and nurses,
whereas in history, this work was usually performed by the founding
religious orders or by volunteers. Today, there are
various Catholic religious orders, such as the Alexians and the Bon
Secours Sisters which still focus on hospital ministry.
The basic form of a hospital is, ideally, based on its functions:
a. bed-related inpatient functions
b. outpatient-related functions
c. diagnostic and treatment functions
d. administrative functions
e. service functions (food, supply)
f. research and teaching functions
5 Ways Hospital Design Influences Patient Health
1. SENSE OF PLACE
2. PRIVATE ROOMS
3. NATURE + ARTWORK
4. NOISE
5. COLOR
BUILDING ATTRIBUTES
1. Efficiency and Cost-Effectiveness
2. Flexibility and Expandability
3. Therapeutic Environment
4. Cleanliness and Sanitation
5. Accessibility
6. Controlled Circulation
7. Aesthetics
8. Security and Safety
9. Sustainability
What is healthcare?
• “Essential health care based on practical,
scientifically sound and socially
acceptable methods and technologies
made universally accessible to
individuals and families in the
community through their full
participation and at a cost that the
community and country can afford to
maintain at every stage of their
development in the spirit of self-reliance
and self determination”
H ealth Pyram id
• Healthcare buildings encompass the
predefined healthcare strata of PRIMARY,
SECONDARY and TERTIARY level of care.
Tertiary
Secondary
Primary
The Levelof Care
• Primary care embraces all the general health
practices, educational, preventive and curative,
that are offered to the population at the point of
entry into the System.
• Secondary Care comprises the care provided by
more specialized services to which people are
rendered by the primary care services.
• Tertiary Care includes highly specialized
services not normally found at secondary level,
including super-specialties such plastic surgery,
neurosurgery and heart surgery.
Principle of Referralof Patients
• The principle of referral of patients from
a lower level of care to a higher level as
a method of sorting them according to
their need for specialist diagnosis or the
nature or the degree or their disabilities is
also universally recognised.
• Another is aim to work in both direction
for which the reverse is meant for
convalescence.
Not more than 1000 beds
Large
Large District
District
Hospital
Hospital
500-750 beds
Medium
Medium District
District
Hospital
Hospital
300-500 beds
Small
Small District
District
Hospital
Hospital
150-300 beds
26-150 beds Health Clinic
Health Clinic
With and without
Alternative Birthing Centre
Community
CommunityHealth
HealthClinic
Clinic
//Rural
RuralHealth
HealthClinic
Clinic
TERTIARY
CARE
State/General
State/General
Hospital
Hospital
SECONDARY
CARE
Normal referral
Just over 1000 beds
PRIMARY CARE
National
National Referral
Referral
Hospital
Hospital
Emergency referral
H ealth care R eferral S ystem
B asic H osp ital Form s an d
C on f i
g u ration s
Emergenc
y Entry
Outpatient entry
The
TheOutpatient
OutpatientZone
Zone
Diagnostic
Diagnostic&&
Treatment
Treatmentzones
zones
Visitors
Visitors
Visitors
Control
Control
visitors
Inpatient
Inpatientzones
zones
Medical
Medicaland
andNon
NonMedical
Medical
Support
Zones
Support Zones
Supplies and
Disposal
Naturally ventilated areas
are normally long and thin
while fully air conditioned
areas are thick and wide
In the tropics
W ard Layout
natural ventilation and natural lighting.
Clinic Layout
Patient
Waiting
Area
Linking to
Main
Entrance or
Hospital
Street
C/E
rooms
C/E
rooms
Treatment
Room
Stores
Dirty
Utility
Staff corridor
reception
C/E
rooms
Natural Day light
C/E
rooms
C/E
rooms
Clean
Utility
Procedure
Room
Linking to staff
areas
D evelopm ent of H ospital
Architecture Abroad
• UK, USA, EUROPE,JAPAN,
SOUTH AFRICA, BRAZIL…
British Experience
• In the early 50s-60s during the energy
crises, the British embarked on several
hospital development program starting
from
–
–
–
–
the Greenwich experience,
through the Harness system,
the Best Buy Mark I, then Best Buy Mark II,
through the varied Nucleus Hospital program
including the energy efficient Nucleus Hospital
of St. Mary on the Isle of Wright.
– Now ..one off designs through……Private
Finance Initiative (PFI)
G reenw ich hospital
floor
Interstitial
Service
floor
PLAN
PLAN
The construction methods would be revolutionary - all
lateral engineering services were to be contained in a 6foot gap between floor and ceiling of each pair of floors so
that repairs and maintenance works could be carried out
without disturbing ward or department routine. All wards
would have natural light but the service departments e.g.
x-ray, pathology and operating theatres would be in the
centre and artificially lit.
The whole hospital was to be ventilated mechanically and
none of the windows would open so that the air in the
wards would be as ‘pure’ as possible.
U SA Experience
• Being on private insurance based healthcare
system, architects in the United States had to
convince the facility management that good
healing design is profitable.
• Extensive campaign or crusades on both sides of
the Atlantic to market the will of healing
environment through provision of good view,
music therapy, good interior design, lots of
sunlight, fresh air and energy efficiency through
passive design strategies are done with many
researches being conducted to provide evidence
that environment do indeed improves the person
health outcomes.
European Experience
• In Europe, apart from access to daylight and
fresh air, strategies for passive design include
the choice of building materials for healthcare
buildings that has rigorous requirements.
– The material is specifically specified to be
environment friendly e.g.the choice of wall and
floor finishes should not be from material that can
burn nor emit toxic fumes.
• Building services system should promote the
recycle of waste water; retention of natural
water before gradual discharge; recycle heat
energy of air condition to radiators; use of
solar power with photo voltaic, wind energy
and others.
The Asian Experience
• There have been movement in the Asian
scene about going back to tradition and
local Asian values when designing
hospitals.
• The deep rooted wisdoms on the use of
Feng Shui (literally means wind, water) by
the Chinese and Vaastu Shastra by the
Indians had made significance come back in
this millennium.
• Both values, are basically based on the
planning of the environment that deals with
orientation and provision of good healthy
living.
W orldw ide experience sum m ary
More hospital planning layouts are going
away from deep planning and massive
concept to thinner blocks with
courtyards to provide
opportunity for all habitable rooms or spaces to
have a natural daylight and view to the outside;
– More patients’ spaces are accessible to the
gardens or sizeable courtyards whether it is on
the roof-tops or on the ground floors;
– More external cladding, although of high
tech material, provides the shades and light
at their openings through provision of
retractable blinds or hoods as and when
necessary.
• Atriums with gardens and natural daylighting are
a common feature. Due to their four seasons and
differential natural day-lighting intensity
throughout the year, ventilation systems need to
be boosted with mechanical means to provide the
space with the required thermal comfort level.
H ealthcare Facility
• “….means any premises in which one
or more members of the public
receive healthcare services..”
W h at is G overn m en t
H ealth care Facility
• …” GHF Means any facility used or
intended to be used for the provision
of healthcare services established,
maintained, operated or provide by
the Government but excludes
privatized or corporatized
Government healthcare facilities;”
Facility P lan n in g N orm s
Rural Health Clinic
Community Clinic
For 2,000 to 4,000 population.
Health Centre
•
•
•
•
For 15-20,000 population
State Hospital at every State
Regional Hospital
Hospital for every district
Network of facilities for sub-specialties
General Guide
• Base on the principles of total planning &
development, the general guide to
planning healthcare facilities are as
follows:
Site planning
Minimum area or acreage
Component of healthcare
facilities
Support facilities
i)
Site Planning
Healthcare facilities should be provided
complete according to its hierarchy:
a) Hospital-includes general
hospital, district hospital, with
or without specialists.
These are provided at state
and district level.
b) Health Clinics are provided
at local level, and
c) Rural Health Clinic is provided
at the rural areas.
Site Planning
ii) The planning on the type of healthcare
facilities must be according to the region and
the catchment area as shown in the Table A;
iii) The location of healthcare facilities should be
suitable and appropriate in terms of its
accessibility, quality of the environment, and
safe for the community;
iv) The healthcare site should be access by the
network of roads and near to the public
transportation system;
Site planning
v) The location of a hospital need not
necessarily be in the town centre to
avoid traffic congestion; but accessible
vi) The location of hospital is not suitable
at noisy and polluted areas;
vii) The site planning of healthcare
facilities must be in accordance to the
proposed and development strategy in
the local plan as well as approved by
the state authority.
Layout Plan and D esign
i)
The design of healthcare facilities
should be a functional design to serve
as the health centres for all
communities; the building should
reflect friendliness;
ii) The design should take note the
function and adjacency of the various
work area or departments base on
the workflow of patients and medical
procedures so as not to obstruct;
ARCHITECTURAL DESIGN 07
RSW PR-01:
HOSPITAL AND HEALTH CARE FACILITIES-PHILIPPINES
Date given: January 25, 2011
Due date: February 1, 2011
Date submitted: February 1, 2011
Student:
PION, REDEN S.
Instructor:
Arch. Robert Romero
Introduction
• “Health care presents a different problem in
every country for the way it is organized is a
response to geography, climate, historical
development, economic situation and social,
cultural and political conditions…
• Appreciation of these differences is
fundamental to understanding of the
situation which prevails in a country.”
D efi
n ition on H ealth
“Health is a state of complete physical, mental,
and social well-being and not merely the absence
of disease or infirmity”
W.H.O.
“Health, as we define it today, is a state of
complete physical, psychological, social and
spiritual well being.”
Islamic worldview
……………………Thus, provides the overview that health is not just the
absence of disease in physical sense but encompass the whole wellbeing of the person.
WHAT IS A HOSPITAL
A hospital, in the modern sense, is an institution for health
care providing patient treatment by specialized staff and equipment, and
often, but not always providing for longer-term patient stays. Its historical
meaning, until relatively recent times, was "a place of hospitality", for
example the Chelsea Royal Hospital, established in 1681 to house
veteran soldiers.
Today, hospitals are usually funded by the public sector, by health
organizations (for profit or non profit), health insurance companies
or charities, including by direct charitable donations. Historically,
however, hospitals were often founded and funded by religious orders or
charitable individuals and leaders. Conversely, modern-day hospitals are
largely staffed by professional physicians, surgeons, and nurses,
whereas in history, this work was usually performed by the founding
religious orders or by volunteers. Today, there are
various Catholic religious orders, such as the Alexians and the Bon
Secours Sisters which still focus on hospital ministry.
The basic form of a hospital is, ideally, based on its functions:
a. bed-related inpatient functions
b. outpatient-related functions
c. diagnostic and treatment functions
d. administrative functions
e. service functions (food, supply)
f. research and teaching functions
5 Ways Hospital Design Influences Patient Health
1. SENSE OF PLACE
2. PRIVATE ROOMS
3. NATURE + ARTWORK
4. NOISE
5. COLOR
BUILDING ATTRIBUTES
1. Efficiency and Cost-Effectiveness
2. Flexibility and Expandability
3. Therapeutic Environment
4. Cleanliness and Sanitation
5. Accessibility
6. Controlled Circulation
7. Aesthetics
8. Security and Safety
9. Sustainability
What is healthcare?
• “Essential health care based on practical,
scientifically sound and socially
acceptable methods and technologies
made universally accessible to
individuals and families in the
community through their full
participation and at a cost that the
community and country can afford to
maintain at every stage of their
development in the spirit of self-reliance
and self determination”
H ealth Pyram id
• Healthcare buildings encompass the
predefined healthcare strata of PRIMARY,
SECONDARY and TERTIARY level of care.
Tertiary
Secondary
Primary
The Levelof Care
• Primary care embraces all the general health
practices, educational, preventive and curative,
that are offered to the population at the point of
entry into the System.
• Secondary Care comprises the care provided by
more specialized services to which people are
rendered by the primary care services.
• Tertiary Care includes highly specialized
services not normally found at secondary level,
including super-specialties such plastic surgery,
neurosurgery and heart surgery.
Principle of Referralof Patients
• The principle of referral of patients from
a lower level of care to a higher level as
a method of sorting them according to
their need for specialist diagnosis or the
nature or the degree or their disabilities is
also universally recognised.
• Another is aim to work in both direction
for which the reverse is meant for
convalescence.
Not more than 1000 beds
Large
Large District
District
Hospital
Hospital
500-750 beds
Medium
Medium District
District
Hospital
Hospital
300-500 beds
Small
Small District
District
Hospital
Hospital
150-300 beds
26-150 beds Health Clinic
Health Clinic
With and without
Alternative Birthing Centre
Community
CommunityHealth
HealthClinic
Clinic
//Rural
RuralHealth
HealthClinic
Clinic
TERTIARY
CARE
State/General
State/General
Hospital
Hospital
SECONDARY
CARE
Normal referral
Just over 1000 beds
PRIMARY CARE
National
National Referral
Referral
Hospital
Hospital
Emergency referral
H ealth care R eferral S ystem
B asic H osp ital Form s an d
C on f i
g u ration s
Emergenc
y Entry
Outpatient entry
The
TheOutpatient
OutpatientZone
Zone
Diagnostic
Diagnostic&&
Treatment
Treatmentzones
zones
Visitors
Visitors
Visitors
Control
Control
visitors
Inpatient
Inpatientzones
zones
Medical
Medicaland
andNon
NonMedical
Medical
Support
Zones
Support Zones
Supplies and
Disposal
Naturally ventilated areas
are normally long and thin
while fully air conditioned
areas are thick and wide
In the tropics
W ard Layout
natural ventilation and natural lighting.
Clinic Layout
Patient
Waiting
Area
Linking to
Main
Entrance or
Hospital
Street
C/E
rooms
C/E
rooms
Treatment
Room
Stores
Dirty
Utility
Staff corridor
reception
C/E
rooms
Natural Day light
C/E
rooms
C/E
rooms
Clean
Utility
Procedure
Room
Linking to staff
areas
D evelopm ent of H ospital
Architecture Abroad
• UK, USA, EUROPE,JAPAN,
SOUTH AFRICA, BRAZIL…
British Experience
• In the early 50s-60s during the energy
crises, the British embarked on several
hospital development program starting
from
–
–
–
–
the Greenwich experience,
through the Harness system,
the Best Buy Mark I, then Best Buy Mark II,
through the varied Nucleus Hospital program
including the energy efficient Nucleus Hospital
of St. Mary on the Isle of Wright.
– Now ..one off designs through……Private
Finance Initiative (PFI)
G reenw ich hospital
floor
Interstitial
Service
floor
PLAN
PLAN
The construction methods would be revolutionary - all
lateral engineering services were to be contained in a 6foot gap between floor and ceiling of each pair of floors so
that repairs and maintenance works could be carried out
without disturbing ward or department routine. All wards
would have natural light but the service departments e.g.
x-ray, pathology and operating theatres would be in the
centre and artificially lit.
The whole hospital was to be ventilated mechanically and
none of the windows would open so that the air in the
wards would be as ‘pure’ as possible.
U SA Experience
• Being on private insurance based healthcare
system, architects in the United States had to
convince the facility management that good
healing design is profitable.
• Extensive campaign or crusades on both sides of
the Atlantic to market the will of healing
environment through provision of good view,
music therapy, good interior design, lots of
sunlight, fresh air and energy efficiency through
passive design strategies are done with many
researches being conducted to provide evidence
that environment do indeed improves the person
health outcomes.
European Experience
• In Europe, apart from access to daylight and
fresh air, strategies for passive design include
the choice of building materials for healthcare
buildings that has rigorous requirements.
– The material is specifically specified to be
environment friendly e.g.the choice of wall and
floor finishes should not be from material that can
burn nor emit toxic fumes.
• Building services system should promote the
recycle of waste water; retention of natural
water before gradual discharge; recycle heat
energy of air condition to radiators; use of
solar power with photo voltaic, wind energy
and others.
The Asian Experience
• There have been movement in the Asian
scene about going back to tradition and
local Asian values when designing
hospitals.
• The deep rooted wisdoms on the use of
Feng Shui (literally means wind, water) by
the Chinese and Vaastu Shastra by the
Indians had made significance come back in
this millennium.
• Both values, are basically based on the
planning of the environment that deals with
orientation and provision of good healthy
living.
W orldw ide experience sum m ary
More hospital planning layouts are going
away from deep planning and massive
concept to thinner blocks with
courtyards to provide
opportunity for all habitable rooms or spaces to
have a natural daylight and view to the outside;
– More patients’ spaces are accessible to the
gardens or sizeable courtyards whether it is on
the roof-tops or on the ground floors;
– More external cladding, although of high
tech material, provides the shades and light
at their openings through provision of
retractable blinds or hoods as and when
necessary.
• Atriums with gardens and natural daylighting are
a common feature. Due to their four seasons and
differential natural day-lighting intensity
throughout the year, ventilation systems need to
be boosted with mechanical means to provide the
space with the required thermal comfort level.
H ealthcare Facility
• “….means any premises in which one
or more members of the public
receive healthcare services..”
W h at is G overn m en t
H ealth care Facility
• …” GHF Means any facility used or
intended to be used for the provision
of healthcare services established,
maintained, operated or provide by
the Government but excludes
privatized or corporatized
Government healthcare facilities;”
Facility P lan n in g N orm s
Rural Health Clinic
Community Clinic
For 2,000 to 4,000 population.
Health Centre
•
•
•
•
For 15-20,000 population
State Hospital at every State
Regional Hospital
Hospital for every district
Network of facilities for sub-specialties
General Guide
• Base on the principles of total planning &
development, the general guide to
planning healthcare facilities are as
follows:
Site planning
Minimum area or acreage
Component of healthcare
facilities
Support facilities
i)
Site Planning
Healthcare facilities should be provided
complete according to its hierarchy:
a) Hospital-includes general
hospital, district hospital, with
or without specialists.
These are provided at state
and district level.
b) Health Clinics are provided
at local level, and
c) Rural Health Clinic is provided
at the rural areas.
Site Planning
ii) The planning on the type of healthcare
facilities must be according to the region and
the catchment area as shown in the Table A;
iii) The location of healthcare facilities should be
suitable and appropriate in terms of its
accessibility, quality of the environment, and
safe for the community;
iv) The healthcare site should be access by the
network of roads and near to the public
transportation system;
Site planning
v) The location of a hospital need not
necessarily be in the town centre to
avoid traffic congestion; but accessible
vi) The location of hospital is not suitable
at noisy and polluted areas;
vii) The site planning of healthcare
facilities must be in accordance to the
proposed and development strategy in
the local plan as well as approved by
the state authority.
Layout Plan and D esign
i)
The design of healthcare facilities
should be a functional design to serve
as the health centres for all
communities; the building should
reflect friendliness;
ii) The design should take note the
function and adjacency of the various
work area or departments base on
the workflow of patients and medical
procedures so as not to obstruct;
