AR 331ARCHITECTURAL DESIGN 07

 RSW PR-01:

HOSPITAL AND HEALTH CARE FACILITIES-PHILIPPINES   

Date given: January 25, 2011Due 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.”

Definition on Health

“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 well-being 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 functionsb. outpatient-related functionsc. diagnostic and treatment functionsd. administrative functionse. service functions (food, supply)f. research and teaching functions

5 Ways Hospital Design Influences Patient Health

1. SENSE OF PLACE2. PRIVATE ROOMS3. NATURE + ARTWORK4. NOISE5. COLOR

BUILDING ATTRIBUTES

1. Efficiency and Cost-Effectiveness2. Flexibility and Expandability3. Therapeutic Environment4. Cleanliness and Sanitation5. Accessibility6. Controlled Circulation7. Aesthetics8. Security and Safety9. 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”

Health Pyramid• Healthcare buildings encompass the

predefined healthcare strata of PRIMARY, SECONDARY and TERTIARY level of care.

Tertiary

Secondary

Primary

The Level of 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 Referral of 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.

Healthcare Referral System

State/General Hospital

State/General Hospital

National Referral Hospital

National Referral Hospital

Large District Hospital

Large District Hospital

Medium District Hospital

Medium District Hospital

Small District Hospital

Small District Hospital

Health ClinicHealth Clinic

Community Health Clinic/ Rural Health Clinic

Community Health Clinic/ Rural Health Clinic

Just over 1000 beds

Not more than 1000 beds

500-750 beds

300-500 beds

150-300 beds26-150 beds

With and withoutAlternative Birthing Centre

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Basic Hospital Forms and Configurations

Diagnostic & Treatment zones

Diagnostic & Treatment zones

The Outpatient ZoneThe Outpatient Zone

Medical and Non Medical Support Zones

Medical and Non Medical Support Zones

Supplies and Disposal

Visitors

Em

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Visitors Control

Visitors Control

Inpatient zonesInpatient zones

Naturally ventilated areas are normally long and thin while fully air conditioned areas are thick and wide

                   

  Outpatient entry

visitors

In the tropics

Ward Layout

Clinic LayoutPatient Waiting Area

C/E rooms

C/E rooms

Dirty Utility

Treatment Room Stores

C/E rooms

C/E rooms

Procedure Room

C/E rooms

Clean Utility 

Staff corridor Linking to staff areas

Linking to Main Entrance or Hospital Street

 

Natural Day light

reception

natural ventilation and natural lighting.  

Development of Hospital 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)

Greenwich hospital

The construction methods would be revolutionary - all lateral engineering services were to be contained in a 6-

foot 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.

PLANPLAN

floor

InterstitialService floor

USA 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.

Worldwide experience summary

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.

Healthcare Facility • “….means any premises in which one

or more members of the public receive healthcare services..”

What is Government Healthcare 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 Planning Norms

• State Hospital at every State• Regional Hospital• Hospital for every district• Network of facilities for sub-specialties

Community ClinicFor 2,000 to 4,000 population.

Rural Health Clinic

For 15-20,000 population

Health Centre

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

Site Planningi) 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 Planningii) 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 Design

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;