HOSPITAL PLANNING

INTRODUCTION
Hospitals form an integral part of the health care delivery system and play an important role in providing curative services. Efficient management of hospital is essential, so that there is proper utilization of resources available within the constraints existing in the present health care delivery system and also to provide quality services to the community.

PLANNING A HOSPITAL
The hospital planning process concentrate more on the :designing of buildings and their architectural appearance. planning of organisation and equipment as well as accommodating them and generating spaces to meet policies.

PRINCIPLES OF HOSPITAL PLANNING

Protection from unwanted and uneasily disturbance to helps in speedy recovery. Control:The nursing station should be positioned strategically to enable proper monitoring of visitors entering and leaving the ward Circulation: all the departments of the hospital must be properly intgrate.

Separtion from disimilar activity

Characteristics of Hospital Organization

Every organization has a head. In every organization there should be a clear line of authority for every individual. In a hospital, there are dual lines of authority The Administrators are responsible for solving management problem and health care personnel are involved in patient care.

The hospital is in continuous operation which Cont. high requires operating costs and substantial personnel and scheduling problems. The diversity of personnel ranges from highly skilled and educated administrators and doctors to unskilled and uneducated employees like the staff involved in sanitary functions.

Cont.
Hospitals are characterized by having wide diversity of objectives and goals for different personnel, professional groups and subsystems. For example: The house keeping department works towards maintaining cleanliness and sanitation, the clinical team focus on patient care.

Cont.
The hospital organization is characterized by interdependence. For example: An orthopaedic surgeon cannot perform an orthopaedic surgery without the findings from the radiology department and the assistance of the nurses and technicians.

Types of hospital
1. General The best-known type of hospital is the general hospital, which is set up to deal with many kinds of disease and injury, and normally has an emergency department to deal with immediate and urgent threats to health.

2.District

A district hospital typically is the major health care facility in its region, with large numbers of beds for intensive care and long-term care; and specialized facilities for surgery, plastic surgery, childbirth bioassay laboratories, and so forth.

Specialized hospitals include:3.Specialized Trauma centres, rehabilitation hospitals, children's hospitals, seniors' (geriatric) hospitals, and hospitals for dealing with specific medical needs such as psychiatric problems.

4.Teaching
A teaching hospital combines assistance to patients with teaching to medical students and nurses and often is linked to a medical school, nursing school or university

A medical facility smaller than a hospital is generally 5.Clinics and often is run by a government called a clinic, agency for health services or a private partnership of physicians Clinics generally provide only outpatient services.

PLANNINGzone, which is the most community Outermost OF UNIT

oriented Primary health care support areas Out-Patient Department Emergency Department Administration Admitting Office Reception

Second zone Which receives workload from Diagnostic X-Ray Laboratories Pharmacy Middle zone between outer and inner zones Operating Department Intensive Care Unit Delivery area Nursery

Inner zone: Cont.. but with direct access for the public In the interior Wards And Nursing Units Service Zone, Disposed Around A Service Yard Dietary Services Laundry And Housekeeping Storage maintenance and engineering laboratory x-ray,Medical shop, carrying common drugs, vaccines, serum and surgical items

1. Outpatient department ORGANIZATION OF THE UNIT The design of the out-patient department of the hospital depends on the scheduling of consultations Consultation Rooms Examination Rooms Treatment Rooms, Staff and Supply Areas.

UNREFFERAL PATIENTS WALK IN

FOLLOW UP PATIENTS

SOURCE OF PATIENTS IN OPD

EMERGEN CY PATEINTS

REFFERRED PATIENTS

WORK FLOW OF OPD

Front office

Registration Waiting area

XRAY

LAB

INJ ROOM

DRESSING ROOM

Pharmac

IP WARDS

IP Admission

Emergency medical services

Emergency service dedicated to providing out-ofhospital acute medical care and/or transport to definitive care, to patients with illnesses and injuries which the patient, or the medical practitioner, believes constitutes a medical emergency.

Term emergency medical services may refer solely to Cont the pre-hospital element of the care, or be part of an integrated system of care, including the main care provider, such as a hospital. Emergency medical services may also be locally known as: first aid squad, emergency squad, rescue squad, ambulance squad, ambulance service, ambulance corpsor life squad

Administration Block
The administrative department is orientated to the public but is at the same time private. Areas for business, accounting, auditing, cashiers and records, which have a functional relationship with the public must be located near the entrance of the hospital

Radiology and imaging department

The term "radiology department" usually refers to the department in which diagnostic imaging is provided. It is distinct from that in which radiotherapy and radiation oncologist are carried out.

Work flow in radiology department

X-ray room Dark room

Toilet Change room Waiting room Reception room Patient Traffic flow

Reading and interpretation

Doctors viewing

File correction and storage room X-ray film flow

Cont
The X-ray department should consist of three rooms: The X-Ray Room; The Dark-Room and Office And Storage Space.

Medical record room

Well-kept medical records form an integral and vital part of an efficient hospital system. Full-scale computerized data bank should be created in which all data relating to hospital patients are retained

Laboratory services
Modern medicine is increasingly dependent on laboratory services for the prevention, diagnosis and control of diseases. Pathology laboratories play a central role in the hospital and and each hospital must have an adequate laboratory service under the direction of a medically qualified pathologist.

LAB LAY OUTRECEPTION

/REGISTRATION TOILET MALE FE FEMALE

SAMPLE COLLECTION ROOM

SAMPLE STORGAE/REFIRI GRATION STORAGE

WAITING AREA

PATHOLOGIST ROOM/PATIENT REPORT

PATH LAB

 In designing the pharmacy, the following considerations Pharmacy mind: should be kept in (1) location: accessible to the out-patient department, convenient for dispensing, accessible to the central delivery yard. (2) Traffic within the department must be economical and flexible. (3) Its size is determined by its organization and operational policies. (4) Provision for security of dangerous drugs.

Work flow of pharmacy

Manufacturer dealer suplier

Main stores

Sub stores or pharmacy

wards

outpatients

 A blood bank is a cache or bank of blood, gathered Blood bank donation, stored and preserved for as a result of blood later use in blood transfusion. The term "blood bank" typically refers to a division of a hospital laboratory where the storage of blood product occurs and where proper testing is performed to reduce the risk of transfusion related events.

The design of operating theatres has become more Operating theatre and more complex. The latest technology in OT Bacteria-free environments in which surgery can be undertaken under almost completely aseptic conditions. Sophisticated provision of equipment.

Location of operating department

The preferred location is on the same floor as the surgical wards, which may be the ground floor. It should be connected to the surgical ward by the simplest Possible route, it should also: Adjoin The Central Sterile Supply Department

O.t layout c
Operating room1
autoclav e Operating room 2

stores
Nurses office

Female change room

Male change room

Reception room

Operating room3

Doctors lounge

Anesthetists room

Operating room4

Recovery room

The intensive care unit is for critically ill patients Intensive care unit who need constant medical attention and highly specialized equipment to control bleeding, to support breathing, to control toxaemia and to prevent shock.

LoCAtIon Cont
Be Easily Accessible From The Accident And Emergency Department Be Easily Accessible For The Delivery Suite Adjoin the intensive care unit.

Paediatrics unit
The nursery should be located adjacent to the delivery department to ensure protected transport of newborns .Areas must be provided for cribs for both well and ill babies and for support services that include formula and preparation rooms.

 The older population of any community is usually Geriatric in community-based facilities where services best cared for their special needs and requirements are provided for in sensitive and Rooming-in caring designs that allow them to lead independent and dignified lives for as long as possible

 These wards provide accommodation for patients Inpatient nursing wards who are dependent on others because of their illness. They have the following functions: to substitute for the home for regular eating, bathing, sleeping, etc; to allow examination, treatment and cure of patients. to prepare patients to return to domestic life.

Dietary services
Apart from parenteral feeding (not considered here), hospitals should provide dietary services for those in special need of them (i.e., infants and other patients unable to eat normal meals). These services should be provided whether or not the local custom is for the family to provide regular meals for the patient.

CONT.. The department

should contain the following

facilities: Prepared diets and service, meals and/or disposable items are used: food preparation centre, food serving facilities, for both patients and staff, dishwashing facilities (or room),pot-washing facilities Refrigerated storage-3-day supply, day storage-3-day supply, cart-cleaning facilities, cart storage area waste disposal facilities, dining facilities.

Central sterile supply (C.S.S.D.) is a integral department in the hospital ,the department is to supply all departments of a purpose of CSSD
hospital theatres, wards, out-patient and casualty departments with complete, sterile equipment ready and available for immediate use in the treatment of patients.

 The basic equipment consists of Cont steam pressure sterilizers and hot-air ovens, which provide a uniform standard of sterility of supplies throughout the hospital. decentralized boiling-water sterilizers, used for instruments, bowls, syringes, etc.,

RECEIPT

Work flow of CSSD

Accounting Sorting

Gloves

Instruments E

Needles And Syringes

Packing Awaiting Sterilization

Autoclaves Check for sterility

Dry ovens Sterile storage

ISSUE

CSSD LAY OUT

SORTING
RECEIVIN G ROOM

CHANGE ROOM

OFFICE

ISSUES

WASHING AUTOCLAVES
STERILE STORGAE

Laundry service
Laundry service is responsible for providing an adequate, clean and constant supply of linen to all users. The basic tasks include: sorting,washing,extracting, drying, ironing, folding, mending and delivery. A reliable laundry service is of utmost importance to the hospital.

WORK FLOW OF LAUNDRY

Reception

Soiled linen
Storage Staff uniform ward department articles
Marking and classification

infected linen
Central disinfection area

barrier wall with double door

classification

storage washing

Washing and extracting Pressing drying calendaring

Assemblin g ,packing Distributio n

The housekeeper's office should be on Housekeeping facilities

the lowest

floor, adjacent to the central linen room. The central linen room supplies linen for the whole hospital. It must have shelves and spaces for sewing, mending and marking new linen. If laundry is to be handled in the hospital, the central linen room must be adjacent to the "clean" end of the laundry room

 Hyun-Bo Seo,Young-Seon Choi2011 reported in an exploratory RESEARCH ABSTRACT procure medicationsUNITsmaller study compares nurses trips to ON HOPITAL in a intensive care unit (ICU) and those in a larger ICU designed for patient-centered care. The smaller unit observed has global visibility to most of patient rooms, and the larger unit has local visibility from distributed substations to patient rooms. The comparison showed that nurses did not walk longer and spend more time getting medication in the larger unit. They did interact less and made fewer extra stops than the smaller unit. Unlike some studies, nurses did not walk further in a larger unit. This study suggests that visibility, the presence of substations, and location of medications can reduce walking. This needs verification in further research.

RESEARCH ABSTRACT ON Hospital capacity Bernd Rechel,Stephen Wright stocks to planning: from measuring reported in a study of innovative hospital modelling flows projects in Europe stated that hospital capacity planning should not be based on beds, but rather on the ability to deliver processes. using approaches that are based on manufacturing theory such as lean thinking that focuses on the value that different processes add for the primary customer, i.e. the patient. it is beneficial to look at the hospital, not from the perspective of beds or specialties

 Reddy S.S .hospital administration and References 3 page no.184-190 planning volume Joshi hospital administration and planning .volume 2 page no.670-677 Basvanthapa BT. Nursing Administration.volume 3 page no.543 http://www.wikipedia.comHospital ,types, and services http://ctb.ku.edu CSSD,laboratory, hosekeeping,lay out.