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(1)

HOSPITAL DESIGN: CASE STUDY

ARCHITECTURAL DESIGN 7

TH

SEMESTER

4

OUT-PATIENT DEPARMENT

REVATHI,PARVATHY

POOJA,SHRETIKA

(2)

INTRODUCTION

COLUMBIA ASIA

Columbia Asia offers OPD services for the following

departments

ENT surgeon

General surgeon

Obstetrics and gynaecology

Ophthalmologist

Orthopaedic surgeon

Paediatrics

Physician

Gastroenterologist

Dermatology

Allergist and immunology

Neurosurgery

Plastic surgeon

Vascular surgery

Psychiatrist

Endocrinology

Cardiology

Pulmonologist

Urology

With working hours of 8AM to 8PM on all

weekdays and Saturdays there are a total of 20

consultation rooms

OPD

OPD

Columbia Asia receives

800 patients on the weekdays

1200 patients on the weekends

(3)

LOCATION OF

DEPARTMENT

COLUMBIA ASIA

Radiology

and

diagnostics

Labs

Waiting

area

Waiting

area

OPD

OPD

Administration

Entry

Emergency

Pharmacy

Layout of OPD department

IPD

EMERGENCY

IPD

CAFÉ

ADMIN

EMERGENCY

OPD

Vertical arrangement seen from

the entrance of the hospital

Vertical arrangement as seen from

the right side of the hospital

The whole OPD is spread out on the

ground floor

The OPD can also be accessed from

the emergency department

The patients are confined to a

particular area of the hospital and

does not interact with the IPD

(4)

PATIENT ACTIVITY

MOVEMENT

COLUMBIA ASIA

New users

Old users

Administration

OPD

Waiting area

LABS

DIAGNOSTICS

New patients are the

users coming to the

hospital without a

appointment or a

medical record

Patients who have a

appointment and

medical records move

directly to the waiting

room

In the waiting area the

nurses station keeps the

movement of patients into

the consultation rooms

under control

Taking of appointments, asking for

information and payment occurs

here

The doctor can ask for further

investigations for which the patient

goes to the lab or the diagnostic

centre

(5)

PATIENT MOVEMENT

COLUMBIA ASIA

Radiology and

diagnostics

Labs

Waiting area

Waiting area

OPD

OPD

Administration

Entry

Emergency

Pharmacy

New patients without

appointments go to the

administration department to get

an appointment

Upon getting it they move to the

waiting area

From here they are called by the

nurse to the respective

consultation room

The doctor may advice them to do

further test which leads them to

the labs and diagnostic centres

(6)

PLACEMENT OF DEPARTMENTS

COLUMBIA ASIA

Radiology and

diagnostics

Labs

Waiting area

Waiting area

OPD

OPD

Administration

Entry

Emergency

Pharmacy

Administration department

• placed on the right side to the

entrance into the hospital

•Function-handles the

administration and appointment

making for the OPD

Advantage

•easy access for patients coming

through the main entrance

•Acts as a help desk as well as a

security (the desk is manned at all

hours)

Disadvantage

•Creates a bottle neck situation

for users going the OPD

(7)

ADMINISTRATION AREA

COLUMBIA ASIA

Admin area

Area of admin and

(8)

WAITING AREA

COLUMBIA ASIA

Radiology and

diagnostics

Labs

Waiting area

Waiting area

OPD

OPD

Administration

Entry

Emergency

Pharmacy

•Common waiting area for the

consultation rooms

•Two separate waiting clusters

connected by a single corridor

•Each waiting area was equipped with

its own nurses station which helped in

managing the consultations

Total number of seats-88 seats

Area per seat-0.65msq

Area for the waiting area-57.2msq

Measured area-354.606

Taking 800 patients

Area for seating -0.6 x 800

= 480msq

(9)

WAITING AREA

COLUMBIA ASIA

Advantages

•Patients consulting several doctors do not

have to travel to different waiting areas

•Common waiting area helps in segregating the different

users such as the IPD visitors, emergency visitors etc

•Placement of public facilities such as toilets and

drinking water becomes combines rather than dispersed

Waiting

area

(10)

PLACEMENT OF

AREA-WAITING AREA

COLUMBIA ASIA

Disadvantage

•Large number of people in a single area can

cause confusion and high amounts on noise

Seat arrangements

•A single nurses station

servers each of the waiting

areas

(11)
(12)

FACILITIES IN THE WAITING

AREA

COLUMBIA ASIA

Labs

Waiting

area

Waiting

area

OPD

Entry

-PLAY PEN

Age group- 3 to 6 years

Security – closed of on 3 sides and one side opening

directly into the main circulation passage

Designing for the children-soft flooring with different

colour patterns and also a TV displaying cartoons also

present

(13)

CONSULTATION ROOM

COLUMBIA ASIA

LAYOUT OF CONSULTATION ROOM

Furniture and fittings present

•Doctor’s table and workstation

•Chairs for the doctor, patient and attending

•Examination bed with a step

•A sink for the doctor to wash

•X-ray viewing box

•Cabinets for storage

Advantage-circulation space for the

doctor and patient to move to and from

the examination bed

(14)

CONSULTATION ROOM

COLUMBIA ASIA

1.2

1.2

1.2

Services required

•electrical and water supply

•data cable for computers

•smoke detectors for fire protection

•nurse call bell

(15)

SIGNAGES

COLUMBIA ASIA

Signs with consultation room

number along with name of doctor

given

Name of doctor on a temporary

removable board thereby allowing

flexibility in the use of the

consultation room.

Signage with names of doctors and theirs

specialisation placed at the entrance of

the OPD section of the floor

(16)

LIGHTING AND

VENTILATION

COLUMBIA ASIA

Lighting in waiting area– use of diffused lighting in the

seating area

Direct lighting in areas of circulation

Lighting in consultation

room-light directly above the

consultation table and the

examination bed

(17)

MATERIALS

COLUMBIA ASIA

Waiting

area-Seats places on carpeted area while

circulation space is tiled

Carpeted area becomes difficult to

clean and the tiled areas may

become slippery.

Consultation

room-Vinyl flooring

Easier to clean in an area

where cleanliness is a must.

(18)

FIRE EMERGENCY

COLUMBIA ASIA

Radiology and

diagnostics

Labs

Waiting area

Waiting area

Administration

Entry

Emergency

Pharmacy

During an emergency the evacuation route for the OPD

users go through the emergency room.

The path covers the OPD, waiting area, labs and diagnostic

areas

Maximum distance to be covered

for the emergency evacuation is

70.55m

(19)

WINDOWS AND

DOORS

COLUMBIA ASIA

Opaque blinds used in areas in rooms where

the light can effect the tests conducted on the

patient

Temporary blinds that can be

used when required

(20)

INTRODUCTION

VIKRAM HOSPITAL

Vikram’s Hospital offers OPD services

for the following department

ENT Dermatology

General Sciences Allergist and immunology Obstetrics gynaecology Neurosurgery Ophthalmology Cardiology Orthopaedic Pulmonologist Paediatrics Urology Physician Gastroenterology Nephrology

VIKRAMS HOSPITAL -200 bedded hospital.

The hospital is built across 8 floors with the first three floors comprising of the Emergency, OPD and Diagnostic department. The rest of the floors comprise of the OT’s, ICU,IPD and the food court.

Vikram’s Hospital is a multispecialty hospital which caters to various departments

Cardiology, Gastroenterology, Gynecology, Nephrology etc.(about 15 departments)

The OPD foot fall is 230-250 patients per day

--3000 new patients per month --avg of 7000 patients per month

The hospital refers injured patients to the emergency even in the case of OPD patients.

Staff No. in OPD –(100-115 people.. Including doctors, secretaries,

nurses and other employees)

USERS

-

Patients & their accompanying families

-Children -Adults

Older People

Physically and Mentally Challenged People

-Doctors & Nurses -Administration Staff -Cleaning Staff

(21)

SITE PLAN AND ENTRANCE

LAYOUT

VIKRAM HOSPITAL

ENTRANCE

RECEPTION

-MAIN RECEPTION ACTIVITY-CREATION OF APPOINTMENTS

RECEPTION II

-SECONDARY RECEPTION ACTIVITY-MAINTAINING APPOINTMENTS OF EVERY DEPT. APPOINTMENT TAKEN CONSULTATION BY DOCTOR EXAMINATION ROOM DOCTOR PERFORMS PHYSICAL EXAMINATION DIAGNOSIS TESTS TAKEN BY PATIENTS/RESULTS SENT TO DOCTORS CASH COUNTER PAYMENT OF BILL EMERGENCY CRITICAL CONDITION OF OPD PATIENT TREATMENT ADMITTED TO IPD ICU

LABS

EMERGENCY

OPD

OPD

OPD

DIAGNOSTIC

CARDIOLOGY OTS

OTS AND IPD

ICU AND IPD

---FOOD COURT

-

Pathology lab on first floor a later development

OPD with diagnostic dept.-easy access for patients

No OPD on ground floor. Only lift and stair case access.

Emergency and Day Care

connected to OPD with IPD lifts for treatment of patients in

PROCEDURE ROOM

MINOR ACTIVITY PERFORMED BY DOCTOR & NURSES

(22)

SITE PLAN AND ENTRANCE

LAYOUT

VIKRAM HOSPITAL

ROUTE FOR EXTERNAL ACCESS-EXIT FOR VEHICLES

PARKING FOR AMBULANCES FOR EASY AID

ENTRANCE TO OPD EMERGENCY ENTRANCE VISITORS ENTRANCE SERVICES

No entrance from

front provided. A side

access provided for

OPD patients

SERVICE ENTRY

IPD

LIFTS

(23)

SITE AND ENTRANCE LAYOUT

VIKRAM HOSPITAL

Very less frontage space led to a side entry. The valet parking people help with parking services at the entrance.

Cars park their vehicles at the side or at some other place by hospital authorities The side entry was narrow, a walkway with

illustration describing the various departments were put up leading the visitors to the entrance. Other than that no Feature marks the entry to the hospital

The side entry is not pedestrian friendly. Patients tend to move to the sides giving their way to the vehicles.

The frontal part of the site is given away for two wheeler parking for staff and a few visitors. The front entry is sealed off as it is used by the pathology department which was a later

development

Hospital

Building

(24)

VERTICAL ZONING

VIKRAM HOSPITAL

sketch

OTHER OPD’S &

CONSULTATION ROOMS

WAITING AREA LOCATED IN THE CENTER

FACILITATING ALL OPD’S-EASIER ACCESS

CONSULTANCY ROOM AROUND THE WAITING AREA SPECIALISING IN CARDIO.

GENERAL WAITING AREA FACING MAIN ROAD WITH

CURTAIN WALL FOR MAX. NATURAL LIGHTING

LOBBY

VERTICAL

TRANSPORTATION AT CENTER FOR ACCESS TO EACH DEPT.

MORGUE LOCATED ON GROUND

FLOORWITH AN OUTDOOR ACCESS

OTHER OPD’S & CONSULTATION ROOMS PLACED ON THIS FLOOR RESEARCH LABS LOCATED ON GROUND FLOOR RADIOLOGY LOCATED IN THE END WHICH FACILITATES ALL OPD’S

SAMPLE

TE

STI

NG

DIA

GNOSIS

SECOND FLOOR

FIRST FLOOR

GROUND FLOOR

(25)

ADMINISTRATION

VIKRAM HOSPITAL

The entrance lobby contains the security desk and the help desk. The side wall bears the directory board which guides the patients to the other departments

SECURITY DESK ENTRANCE LOBBY

WAITING AREA,

RECEPTION & ACCESS TO OPD

WAITING AREA

Help Desk

Security desk placed near the entrance to guard & record staff entry

The lobby leads the patient/visit or to the lifts and staircase. Master health check up counter which further leads you to the opd

Signage's guiding patients to respective departments- sign ages important near main transportation since all people enter from this point

Main reception counter for OPD

Individual reception desks for each department for appointments, system records

Individual receptions works-No token System Each department with one reception desk reduces work load on main reception desk and conveys instructions to patients faster

-Main reception need not have been so huge-wastage of space-The executive lounge and a part of waiting space could have been used to make common waiting space or minor

(26)

WAITING AREA

VIKRAM HOSPITAL

WAITING AREAS –FIRST FLOO

R

Glass panels around the lounge for visual connectivity The ambience in the

waiting area is unlike other hospitals. It is designed like a lounge to give a sense of comfort to the visitors and patients

The main waiting area has a seating capacity of about 35-40 seats.

The waiting and processing time for each patient is about 1-1 1/2 hours.

The first floor receives about 10-12 patients per hour.

Area of the waiting area is about 50 m2

which is sufficient enough to accommodate the people.

7.2m

7.

7

m

2

The executive waiting area is about 28-30m2

According to

standard the waiting area is 0.65 m 2 per

person with 15% circulation.

(0.65*40=26m2)

+(0.15*26=3m2 )

Therefore the waiting area is more than enough provided for the first floor.

The lighting is recessed and the waiting area is provided with a speaker for light music to keep the ambience pleasant

Executive

lounge area

The waiting area is carpeted which is a lot of maintenance. It could have been separated with another type of flooring

Executive waiting area The executive area is for privileged people, VIPs as per decided by hospital authorities. It appears first before the main OPD waiting area.

The No. of patients for the

executive lounge are very less on a day to day basis-about 5-8

(27)

CLUSTER CONCEPT

VIKRAM HOSPITAL

CARDIOLOGY OPD OPD WAITING AREA DIABETOLOGY /INTERNAL MEDICINE CARDI OLOGY OPD CARDIOLOGY OPD

The hospital adopted a cluster concept where there would be clusters for each department and each cluster had 2-3 consultation rooms with one staff toilet. They also had one room in the cluster (if required by that department) for any tests or laser surgeries to be done.

Doctor’s movement is through the normal visitors' passage-no privacy for the doctor. Situations of visitors interrupting the

doctor’s activity may occur.

WAITING AREA CONSULTATION

ROOMS

No vision barrier created between the OPD patients and the doctors working at the consultation rooms.

Doctor’s movement across the floor

-Each cluster has its own reception

A set of 2- 4 doctors work in the cluster at a time

If the required dept needs a surgery or treatment room it is included inside the cluster itself

A TYPICAL CONSULTATION ROOM

Round

consultation room-removes the

psychological

barrier between the Doctor and Patient. The layout also gives provision for the patients' family to be a part of the discussion. Examination Bed Doctor’s Workstation(space for storage, computer ,stethoscope and other requirements

The door opens to the view of the round table which addresses the doctor giving a sense of belonging.

Each consultation room has one fire alarm and sprinkler.

Sprinkler diameter-5m

(sufficient for one consultation room)

(28)

1

ST

FLOOR PLAN

VIKRAM HOSPITAL

The consultation rooms are arranged around the waiting area with separate reception for each cluster.

-Easy approach to the patient and doctor

v

EXECUTIVE WAITING AREA DIAGNOSTIC DEPARTMENT

OPD

CARDIO TEST CENTER LIFTS

Fire Escape route

CONSULATION CLUSTERS OPD WAITING AREA DIAGNOSTIC DEPARTMENT FIRE ESCAPE CORRIDOR

Max run from the farthest point to fire exit is 24 meters

(29)

TOILETS

One set of toilet

VIKRAM HOSPITAL

facilities provided

near the diagnostic centre.

Only one toilet

provided near the OPD department. Common for all.

It doesn’t prove

comfortable for Indian public and insufficient according to standards Toilet services provided near the entrance of the diagnostic department.

The toilet facility at the diagnostic department suffices the requirement. But as it is placed away from the main waiting area. It is not known to a lot of people unless the visitors pass through the connecting passage.

All toilets are provided with a handle but not completely barrier free.

The door almost opens on to the WC which is not ethical for the physically challenged . Toilet dimensions – (1.5*2)m2 A screen is provided at the base of the door to help any patient in case of a situation

(30)

MATERIAL AND FINISHES

VIKRAM HOSPITAL

A carpet flooring

separates the waiting areas and corridors.

Too much maintenance

Granite flooring used in corridors and other places except waiting areas.

Polished granite would not be safe for patients with physical ailments

Grey color granite stone does not show up dirty spots well.

Granite also used to suit the color and theme of the hospital interiors

Vinyl flooring used on the sides and used for skirting as well.

The central part of the corridor was marked of by a running stretch of unpolished granite which would be patient friendly and easy for the movement of stretchers and wheelchair holding the patient

Matt finish walls-cream color walls used which gives a calm serene effect to the patients.

Mono color laminates used throughout the hospital gives an identity to the ambience

Crash guard used all along the corridor as a handle and to prevent the stretcher from barging into the wall.

(31)

OPD DEPARTMENTS

VIKRAM HOSPITAL

CARDIOLOGY AND DIABETOLOGY and

GYNAECOLOGY

Cardiology

The cardiology had altogether three clusters with a total of 12 consultation rooms and three reception desks.

The cardiology consultation room exactly look like the typical consultation room of the hospital

The doctors have been provided with a blood pressure equipment to check the health of the patient.

The test rooms for cardiology are located on the same floor as the clusters are located.

Total area of one cardiology cluster is –45.5m2

Rooms-(4*9)=36

Lobby and reception-7.2m2

Toilet-2.5m2 24m distance from the staircase

Diabetology

The dialectology cluster is same as the cardiology.

-No examination bed provided though given in the drawings. The department receives about 10 patients per day.

Total area of the diabetology cluster -45m2

No wash basin provided.

No provision for curtain-also because the consultation room doesn’t open out to the waiting area.

Gynecology

One consultation room

-No of patients per day-10 on avg.

-consulation room same size as typical room

Curtain provided as the rooms opens out to the corridor

(32)

2

ND

FLOOR

VIKRAM HOSPITAL

DIALYSIS

WAITING

AREA

UROLOGY

OPD

ONCOLOGY

&BARIATRIC

OPD

OTHOPEADIC &

PHYSIOTHERAPY

NEURO

OPD

DERMATOLOGY

ENT/PULMONOLGY/AU DIOMETRY

The second floor of the hospital contains the opd and renal dialysis department.

The opd departments consist of the –urology-nephrology- neurology- orthopedic-

ENT-WAITING

AREA

WAITING AREA

The max. run to the nearest

fire staircase is 24 metres on

the 2

nd

floor

FIRE ESCAPE

ROUTE

(33)

WAITING AREA

VIKRAM HOSPITAL

The waiting area comprises of 70-80 waiting capacity. The 2nd floor has a footfall of about 180 patients per

day.

The average waiting time for the opd patients varies a lot in each department.

-The seating capacity although suffices the requirement and is sufficient enough even for peak hours

.

The average waiting space is 0.65m2

The first waiting area is 49m2.

The other waiting area is about 35m2. Therefore

(0.65*90=58.5m2)+(0.15*58.5+ 0.15*35) =72m2.

(49+35=84m2)-suffices.

The ambience is same as the waiting area below Carpeted floor for waiting area-high maintenance.

Waiting areas.

The waiting floor above also has no partition

The Doctors move through the normal patient/visitor corridor.

The ambience is set as per the other floors. The space gives a psychological comfort to patients and improves their mood

(34)

UROLOGY DEPARTMENT

VIKRAM HOSPITAL

UROLOGY OPD

The no. Of consultation rooms are two

The no. Of patients the

department receives are 15-20 per day

Age group visiting 20 to 50 years -65% Above 60 years -35% WAITING AREA UROFLOWMETRY ROOM UR O D YNA MI CS CONSULTATIO N ROOM LITHOTRIPS Y ROOM

Furniture in the consultation room-•Informal seating

•Doctors work space •Xray viewing box •Hand washing sink Advantage of layout

•Combining of similar departments allows easier management

•Uro dynamics and uroflowmetry place in same cluster for easier access for patient and doctor

Advantage of location

-The lithotripsy room is located in the urology cluster thereby allowing easy access for the patients and doctors

-The patient is made to lie on a bed where an over head emitter emits radiation to break kidney stones

The lithotripter machine is adjusted in a room which is just little more than the size of the consultation room. There is hardly any space for the doctor to move around the lithotripter machine bed.

(35)

NEURO SCIENCES

VIKRAM HOSPITAL

TREATMENT LAB-EEG AND NERVE CONDUCTION

CON SULTATION

ROOMS

TREATMENT

LAB

The Neuro sciences department receives about 10-12 patients per day.

Special treatment for certain patients was done in the day care.

The age group comprised more of children

People suffering from Epilepsy and Fits are treated here. 2- consulation rooms

2-treatment rooms

Most of the patients are children but no provision for their comfort has been done

The Nerve Conduction and EEG machine

All the reports are studies through computer devices and treatment inferences are prepared in the Treatment lab itself

The dark room for other type of EEG readings

(36)

ENT & AUDIOMETRY ROOM

VIKRAM HOSPITAL

The ENT dept receives about 30 patients per day. The dept receives all age groups ,but specifically infants and babies which comprise 20

patients of the total

The Nephrology room receives about 15patient per day. It has a typical layout with an addition of a wash basin.

This department is located right in front of the reception desk.

ENT

room

Audiometry

room

Nephrology

room

No examination bed has been provided.

A patient seat and a ENT workstation occupies the space.

Instead of the round table a seats for the patients' family has been

provided

ENT

work

station

Surgical

chair

The surgical chair, ent

workstation, working cabinet and the doctors' chair was concentrated on one side crowding up the area

The Nephrology room and Audiometry room had a similar layout as of a typical room layout. No labs concerning these departments were attached to the respective departments above. The hospital only gives minor services in the above departments.

(37)

FORTIS

Fortis Healthcare Limited is an established chain of super speciality hospitals .

They include multi-specialty hospitals and super-specialty centers Provide tertiary and quaternary healthcare to patients in areas like : • cardiac care,

• orthopedics

• neurosciences & oncology • renal care, gastroenterology • mother and child care.

It is a 250 bed hospital. Commenced in 1999

VERTICAL ZONING

CARDIOLOGY OPD PEDIATRIC – DENTAL -GYNACOLOGY ORTHOPEDIC-NEUROLOGY – OPD PHARMACY UROLOGY-NEPHROLOGY

LEVEL 3

LEVEL 2

LEVEL 1

LEVEL -1

GENERAL OBSERVED FEATURES

• Fortis planners have grouped OPDs considering the physical condition of patients in mind.

• Every doctor has a room to himself. • Doctors take shifts on a daily basis. • 2-3 departments are clubbed on a level

• Every OPD has a common lobby and reception.

• Most consultation rooms are centrally air conditioned. • OPD’s have their own diagnostic services.

• Examination space is combined with the consultation rooms.

Fortis has arranged their OPDs as a vertical complex considering ease of patient access in mind.

Lack of natural ventilation is observed

INTRODUCTION

(38)

USERS

FORTIS

Patients - (childern /adults/senior citizens)  300/day

Patient escort - mother/friends ..etc Visitors - (children/students/adults) Staff : 1. Medical 2.Admin 3.Service Other services : laundry

raw food materials - loading unloading

ACTIVITIES

ENTRANCE LOBBY

• To the left is the reception & billing section. • On the right side wall is an information board

with the names of all the departments and their concerned specialists.

• The lobby provides no seating spaces for the users, which was seen as a necessity. (CON)

• An OPD pharmacy is present in the same space. • The lobby then directs patients towards the health

check and Out Patient Department.

• Other major activities are :

• Vertical circulation • Lab test procedures • Physical health checks • Dietary activities

• Patient care – stretchers, wheelchairs • Waiting areas

• Visual surveillance

• Food and dining  cafeteria

• Examination and Recovery spaces

LOCATION OF THE OPD COMPLEX

ENTRANC E FOYER OPD LEVEL 2 LEVEL 1 LEVEL 3 OPD The OPD location starts

at ground floor and can be easily located and accessed.

Access to OPD can be from main entrance or through the 2 fire exits, one to the left and other far in-front of the OPD.

(39)

FORTIS

CONNECTIVITY

The OPD complex is located next to the elevators and one of the 3 fire exit stairs.

One can get direct access to the BONE & JOINT – BRAIN & SPINE department through the entrance lobby – in less than

2 MINS

The hospital has no provision of ramps

.

(CON

)

- They substitute ramps with more number of

elevators.

- Can cause difficulty during emergency / fire

Spaces are vast and grouped commonly for

departments.

(40)

FORTIS

ORTHOPEDIC-NEUROLOGY

DEPARTMENT

LOCATION : Ground floor.

USER : patients with joint/bone pain or spine/nerve

condition.

 patient has difficulty in moving from place to place.

ACTIVITY : Registering

waiting

consulting/examination

OBSERVATIONS

• Combined waiting lobby with reception. • 35 – 40 waiting seats

• Isolated consultation chambers doubly loaded on a 1.5m corridor .

• EEG room & ECG room  3 x 2.5 sq.m.

• 9 orthopedic and 5 neurology consultation rooms observed.

• According to the staff these rooms may be temporarily used by doctors on daily shifts.  nameplate outside also changeable.

• Restrooms : 1 Male & 1 Female

Consultation rooms are

designed flexibly and

not department specific

except dental

Narrow corridors

leading to

consultation

rooms. No visual

connectivity for

patients

(41)

FORTIS

COMPONENTS OF A ROOM

• DOCTORS DESK + CHAIR • PATIENTS CHAIRS

• EXAMINATION BED + STEPS • SIDE SHELF • X RAY VIEWER • TABLE LAMP • COMPUTER SYSTEM • CABINET • BOOK SHELF

DOORS AND WINDOWS

Main door is double opening type.  for stretchers need be

The consultation room doors are: 80cm wide

2.1m in height.

Off white in color  to compliment the soothing peach walls Doors open into the room.

Windows are rarely seen in the rooms  lack of peripheral spaces

or inner courtyards (open to sky)

2-3 rooms have natural ventilation.

PROPORTION OF SPACES

• Consultation room = 3.5 x 2.5 = 8.75  A • Waiting + reception + circulation = 41.5 sq. m.

 4.5A

• ECG/EEG = 5.2 sq. m.  0.6A

• Entire department = 206.91 sq. m.  24A

CPWD

• No ramps present in the hospital.  eats up space

• OPD has level surface.

• Corridors not ideally designed for wheelchairs

( required 1.5m  present 1.2 m) • No special railings seen.

(42)

FORTIS

MATERIAL & FINISHES

• Flooring : Vinyl sheets 

Anti Static & Anti Bacterial

for hospital

• Walls : peach color, smooth finish

• Skirting is COVED with the floor.  ease of cleaning corners • Paintings hung on the walls in intervals.

• Thick glass name plates used for doctors chambers.

SERVICES

Lighting : due to lack of natural light A/C : Lack of natural ventilation Plumbing : For wash basins

LIGHT & VENTILLATION

• Recessed lighting used .

• Natural ventilation & light hardly seen. • Centrally Air conditioned throughout.

STRUCTURAL GRID

Columns are 6 m apart

(43)

PEDIATRIC- DENTAL - GYNACOLOGY DEPARTMENT

FORTIS

LOCATION : Level 2

USERS : children & parents, women, dental patients ACTIVITIES :

waiting

taking care of babies

consulting with the doctors

PEDIATRIC DEPARTMENT

• 5 Pediatric rooms

• Glass for doors and walls used (waiting area  consult. Room)

This department leads

patients first into the

pediatric & gynecology

spaces and then moves

onto dental at the back.

Creates

chaos

as all 3

departments share same

common waiting space

No play area  disadvantage.

5 x 5 = 25  pediatrics 3 x 7= 21  dental

6 x 7 = 42  gynecology

Total waiting area reqd = 88 sq m

Feeding

room –

translucent

glass

(44)

FORTIS

GYNACOLOGY DEPARTMENT

DENTAL DEPARTMENT

3 consultation rooms + examination rooms Equipment :

dental chair x-ray viewer doctors desk

patients waiting chairs wash space storage units

Gynecology

department to the

left.

Combined

consultation –

examination rooms.

Ped-Gyno-Dental

grouping with no

separate waiting

or recovery for

dental patients

(45)

CARDIOLOGY DEPARTMENT

FORTIS

LOCATION : 3rd level

USER : heart patients, cardiac staff, visitors ACTIVITIES:

waiting consulting watching tv

This department has its own spaces for: ECG

TMT (tread mill test)

PFT (pulmonary function test) ECHO tests

60 waiting spaces observed.

LOCATION PLAN

Proportion of spaces

• Consultation room = 6.5 sq. m.  A • Waiting Area = 78.3 sq. m.  12A

A

Other Features

Rooms arranged in a peripheral layout Corridors are not more than 1.8m Provision of minor test services (x-ray)

Lighting & Ventilation

No windows  Centralised A/C Artificial lighting  recessed

Department has its

own diagnostic spaces,

sample rooms

(46)

FORTIS

OPD PHARMACY

OPTHALMOLOGY DEPARTMENT

KEY PLAN – LEVEL 1

LOCATION : Ground floor, entrance lobby

USERS : OPD patients, pharmaceutical staff

ACTIVITIES :

storage of medicines attending to patient prescriptions

payment & bill

Approximate dimension : 4.5 m x 5m

LOCATION : Ground floor, in the Health Check Division

USERS : Eye Patients, doctors,

receptionist, accompanying persons ACTIVITIES:

Waiting in lobby

consulting with doctor undergoing visual tests waiting after medication

2.5 x 6 sq. m. Minimum 2.5m between patient and reader board 20 waiting spaces 1 Sonography room

(47)

SIGNAGES

FORTIS

LEVEL/ FLOOR DIRECTORY

ROOM INFORMATION

OVERALL DIRECTORY - LEVELS

BUILDING DIRECTORY

DOOR DETAILS

Signages are informative

but may not be legible to

the less literate.

Less number of pictoral

signages.

(48)

INTRODUCTION

MANIPAL HOSPITAL

MANIPAL Hospital is an established chain of super speciality hospitals . They include multi-specialty hospitals and super-specialty centres

Provide tertiary and quaternary healthcare to patients in areas like : dentistry,

neurology dermatology

diabetes and endocrinology paediatrics

.

It is a 800 bed hospital

.

USERS

Patients - (children /adults/senior citizens)  300/day Patient escort - mother/friends ..etc

Visitors - (children/students/adults)

Staff : 1. Medical 2.Admin 3.Service Other services :

laundry

raw food materials - loading unloading

the floor beneath the wards is for services alone social work centre

Xerox centre

GENERAL OBSERVED FEATURES

• Manipal planners have spread out the OPDs in 4 floors 2 basements and 1st floor and ground floor considering the

physical condition of patients in mind. • Every doctor has a room to himself. • Doctors take shifts on a daily basis. • No departments are clubbed on a level

• Every OPD has a common lobby and reception.

• Most consultation rooms are centrally air conditioned. • OPD’s have their own diagnostic services.

(49)

Location :

MANIPAL HOSPITAL

The hospital is

connected directly

to the main road.

Secondary road

Main road

Drop off area

Drop off area

(50)

DROP OFF LANE

MAIN

LOBBY

TOILETS

LIFTS

&S

D&E

PHAR MACY DENTISTRY

R

Drop off area

Public spaces (Toilets, Lobby, Lifts and Staircases) Administration/ Reception(R)

Fire escape staircases Pharmacy

Diabetes and Endocrinology OPD

R

L

ZONING – GROUND FLOOR

Patients and staff members

enter from the main lobby after they are dropped at the drop off lane.

• Patients enter into the main lobby and are directed to the reception.

• Main lobby has directive and textual signages that aid people to identify the location of

different departments. Ground floor

T

T

s

Ground floor 1st floor 2ndfloor 3rdfloor 4thfloor 56thfloor thfloor 7thfloor 8thfloor 9thfloor 10thfloor Basement -1 Basement -2

MANIPAL HOSPITAL

(51)

FIRST FLOOR LAYOUT

MAIN

LOBBY

T

TOILETS

LIFTS

&S

s

s

PHAR MACY

R

R

L

T

Ground floor to first

floor circulation layout

T

LIFTS

&S

T

L

s

s

Ophthalmology OPD

Neurology and Neuro sciences OPD General medicine OPD

Circulation

Drop off lane Entrance

Administration/ Reception(R) Fire escape staircases

Pharmacy

Diabetes and Endocrinology OPD Drop off area

Public spaces (Toilets, Lobby, Lifts and Staircases) • The users from the entrance lobby

use lifts or staircase to reach the first floor.

• The departments in the first floor are accessed through a common corridor.

First floor

Dermatology OPD

Ground floor

(52)

DENTAL

MANIPAL HOSPITAL

PHARMACY

2.5

M

2M

X RAY VIEWE R

MAIN

ENTRY

WAITING AREA,18 SEATS DENTAL MACHINE DENTAL CHAIR MANA GERS ROOM EMERG ENCY ROOM

SPACE FOR WHEEL CHAIR

GLASS WINDOW FOR MORE

dentistry

LOCATION _GROUND FLOOR

PHARMACY

ROOM

AREA

STAFF ROOM EMERGENCY ROOM CLEANSING+XRA Y ROOM CONSULTATION SPACE CONSULTATION ROOM E RAY VIEWERS ROOM Total 4SQM 5SQM 10.5+5SQM 8SQM 6.25SQM 3SQM

120sqm LIGHT AND VENTILATION

1.5m

Consultation space RAMP LEADING INTO THE DEPT

(53)

SPECIAL FEATURES

MANIPAL HOSPITAL

WHEEL CHAIRS FOR THE OLDERLY

STORAGE SPACES

SPECIAL

(54)

EQUIPMENTS

MANIPAL HOSPITAL

MAIN ENTRY

X RAY CONE

Kept in the x-ray room

X ray and

cleansing

room

equipments

SUCTION TUBES in the CLEANERS ROOM Dental machine of size 1.5m *1m

Spit on

Suction machine

ULTRASONIC CLEANER MACHINE IN CLEANING AND X RAY ROOM

Waste

bins

A SMALL FRIDGE INSTALLED NEXT TO THE CONSULTATION AREA

CONSULTATION

AREA

EQUIPMENTS

(55)

DIABETES AND ENDOCRINOLOGY

1. LOCATION : Ground floor

2. PHARMACY : Common pharmacy

located at the ground floor.

3. TOILETS : Common toilets outside the

OPD for both doctors and patients

MANIPAL HOSPITAL

D AND

E

MAIN ENTRY

UTILITY ROOM WAITING AREA

PHARMACY

MAIN LOBBY

CONSULTATION ROOM RECEPTION CHECK UP AREA CONSULTATION ROOM EXAMINA TION ROOM CR

WAITING

AREAS

RECEPTION

NO. OF CONSULTATION ROOMS = 4

•No of doctors = 4 consultants and 3 juniors

•AREA = 4.5x5sq.m

•SHARING/SINGLE = single

8. NO OF PATIENTS / DAY= 70-100 MAX

CONSULTATION ROOM

PLAN OF THE

DEPARTMENT

(56)

MANIPAL HOSPITAL

WAITING

AREAS_2

SEPERATE

GLUCOMETER

CEC

ENTERTAINMENT

PRACTICES

AMBIENCE

CEILING

TREATEMENT

EQUIPMENTS

USED IN CHECK

UP AREA

(57)

DERMATOLOGY

CONSULTANT ROOM CONSULTANT ROOM MICROSC OPE ROOM STORE ROOM PROCEDURE ROOM DUTY DOCTORS ROOM AESTH ETIC LASER ROOM PROCED URE ROOM CONSULTANT ROOM LIBRARY MICROSCOPE ROOM STORE ROOM 2 SETS OF WAITING AREAS

TV

Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects'

,

dermatology

LOCATION_FIRST FLOOR

FIRST FLOOR

GENERAL

MEDICINE

NEOROLOGY

USERS =100 PER DAY ACTIVITIES

1.CONSULTATION 2.waiting in the waiting area which is next to the reception 3.PATIENTS COMING IN FOR HAIR REMOVAL

WAITING AREA

RECEPTION

MANIPAL HOSPITAL

DERMATOLOGY GENERAL MEDICINE NEOROLOGY OPTHAMOLOGY LIFTS CIRCULATION

(58)

PROPORTION

MANIPAL HOSPITAL

EQUIPMENTS USED IN THE STORE ROOM

CO2 LASER

ENDIAC USED FOR

TATTOO REMOVAL

ROOM S

AREAS

1. PHOTOTHERA

PY ,AESTHETIC

2. STORE ROOM

3. CONSULTANT

ROOM ,3

4. DUTY DOCTOR

ROOM

5. PROCEDURE

ROOM ,2

6. MICROSCOPE

ROOM

7. LAB

8. CIRCULATION

AND WAITING

SPACE,REC

1. TOTAL

_6SQM(6%)

16SQM(14%)

9SQM(24%)

9SQM(8.27%)

6.25SQM(11.46

%)

9SQM(8.27%)

5SQM(5%)

30SQM(22.9%)

109SQM

ALMA LASER USED

FOR HAIR

REMOVAL

EQUIPMENTS

KEPT IN STORE

ROOM

1.CO2 LASER 2.ALMA LASER 3.ENDIAC 3.DPN 4.SUCTION MACHINE 5.SHR_SUPERFICIAL HAIR REMOVAL

(59)

OPHTHALMOLOGY

Lifts

s L

First floor

ophthalmology

Lifts and staircase Common corridor

Consultation and examination room Fire escape staircase

Waiting area and circulation zone 1. LOCATION : 1stfloor

2. NO. OF ENTRANCES : One 3. PHARMACY : Common OPD

pharmacy located at the ground floor and a has an eye care shop at the entrance.

4. TOILETS : Common toilets outside the OPD for both doctors and patients

5. RECEPTION

:-• COMMON/SEPARATE = separate

• NO. OF COUNTERS = one counter and one nurse station • TOKEN SYSTEM (YES/NO)= No

6. WAITING SPACES = capacity of 33 seats 7. NO. OF CONSULTATION ROOMS = 6

• No of doctors = 9 • AREA = 3x3 sq.m

• SHARING/SINGLE = single

• The consultants worked in shifts and the rooms were occupied by the doctor according to the shift timings. 8. NO OF PATIENTS/DAY = 90-100max

9. WAITING HOURS = 15-30 mins

• PATIENTS WITH APPOINTMENT = No waiting time

Examination chair

Dr’s desk

Reception

Entry

Entry

3*2.5 sq.m

2.25s q.m Dr’s circulation Patients’

Desk

Chair

Examination

chair

Equipments used Optic shop

MANIPAL HOSPITAL

(60)

Ophthalmology

Diagnostic room Field room

cr

cr

cr

cr

cea cr

cr

L

R

cr

sr

Cr- Consultation room Sr- staff room

Cea- collie eye anomaly R- refraction room L- Laser room

• Main entrance double door 1.5m wide

• Consultation room door- 1.0-1.2m wide

• Rooms were lit by artificial lights and had AC outlets.

• The floors were covered with vinyl sheets that are easy to maintain. • Walls were painted with calm

peach or white colours to avoid any kind of anxiety.

Consultation room layout

3.

0m

Lifts and staircase Common corridor

Fire escape staircase Waiting area and circulation zone

1. Dr’s desk 2. Chairs 3. Computer 4. X ray machine

3.0m

Consultation & staff room

33 seats

LIGHTING

MOSTLY ARTIFICIAL LIGHTING

APPROX. 1 LIGHT FIXTURE ABOVE EACH BED/CHAIR (1.5M- 2M APART)

WINDOWS PROVIDED IN ROOMS HAVING AN EXTERIOR FACE – SLIDING/FIXED

VENTILATION

CENTRAL A/C SYSTEM

FEW ROOMS HAVE BEEN PROVIDED WITH AN ADDITIONAL SPLIT A/C Proportion of spaces

Consultation room= Corridor space= Examination rooms=

(61)

Pros and cons

PROS

 THE OPD DEPARTMENTS WERE IN THE GROUNDFLOOR ,FIRST FLOOR AND THE 2 BASEMENTS WHICH WAS HIGHLY CONVENIENT FOR THE PATIENTS.

 THE OPD PHARMACY WAS PLACED IN THE GROUND FLOOR WHICH WAS EASILY ACCESSIBLE TO THE PATIENTS USING THE OPD DEPARTMENTS.

 THERE WERE CANTEENS AND BOOKSTORES INSIDE THE HOSPITAL PREMISES FOR ALL KIND OF USERS.  PROPER USAGE OF DIRECTIONAL SIGNAGES MADE THE USER FLOW CONVENIENT AND NON CONJUSTED.

 EVERY DEPARMENT HAD ITS OWN SPACE AND PRIVACY ,NONE OF THE 2 OPD DEPARTMENTS WERE TOGETHER.  THERE WERE SEPARATE WAITING AREAS FOR EACH DEPARTMENT AND HENCE REDUCED ANY KIND OF

CONFUSION OR CONGESTION.

 THEY EMPLOYED THE USE OF TOKEN SYSTEM TO AVOID CONFUSION DURING HEAVY CROWDING.G

(62)

Pros and cons

CONS

 THE TOILETS PROVIDED WERE USED COMMONLY BY STAFF AS WELL AS THE PATIENTS .

 THERE IS NO IMMEDIATE CONNECTION BETWEEN THE INPATIENT DEPARTMENT AND THE

OUTPATIENT DEPARTMENT.

 THE OPD DEPARTMENTS WERE ARRANGED NOT IN A ORDERLY MANNER .IT WAS SPREAD OUT

THROUGHOUT THE BASEMENT ,GROUND FLOOR AND FIRST FLOOR .THE PAEDIATRIC

DEPARTMENT WAS MIXED UP WITH A ADMINISTRATIVE SECTION.

 THE ROOMS WERE GETTING CLUSTERED AS A RESULT OF EXPANSION OF SERVICES PROVIDED BY

THE HOSPITAL

.

(63)

INTRODUCTION

NARAYANA

HRUDAYALAYA

The main block of narayana hospital is specialized in cardiology opd’s.

The multispecialty hospital of narayana has other opd’s like dermatology,opthamology,orthopaedic etc

.

Narayana hrudayalaya initially started as a multispecialty clinic. Later ,as the number o cardio patients started increasing they decided to expand the department and make it the foundation .

The main wing of the hospital contains only out-patient departments related to cardiology.

USERS

PATIENT

VISITORS

STAFF

ADMIN

DOCTORS

MAINTENANCE

ADULT

CHILD

ACTIVITY

WAITING

CONSULTATION

PHARMACY

CHECK OUT

(64)

DROP OFF ENTRY

pa

rki

ng

Way to multi

specialty

hospital

MAIN

LOCATION

The cardiology opd is accessed from the

main drop off area .

Doctors enter from the main

Entry.

They have been allotted specific

parking space—this will include

at the side and at the rear.

(65)

LOCATION

The cardiology OPD department is in two floors.

the general opd is accessed from the main entry ie at the drop off point.

There are 3 double door entry’s.

The executive cardiology OPD is accessed from the waiting area of the general opd.

The executive opd is accessible from 2 lifts and a staircase around it OPD Ground floor-GENERAL First floor-EXCECUTIVE

(66)

ENTRANCE

6m

Pharmacy--General -Opd patients -A part of future development

The pharmacy being outside is difficult as

visitors and patient have to comeback to the doctor sometimes

RAMP-2

RAMPS OF

1m WIDTH

MAIN

ENTRY

DROP OFF

KEY PLAN

SECURITY

KIOSK

(67)

GROUND FLOOR

The ground floor contains opd for cradiology,pediatric and dental.

It is approached by 3 double door entries

CARDIOLOGY PEDIATRIC DENTAL

OPD

Key plan Verandah seating Common waiting – 21x3(2 sets)- 126 seats AREA=0.5X0.8X126=50.4sqm Travel desk provided for

patient convenience

• Toilets –at 1 level down • 5 w/c • 3 wash basin • 1 storage PATIENT CIRCULATION Column size-300x600mm Grid-8.5x4.6 Pre-operative cell Reception Reception cash cash MAIN RECEPTION AND WAITING IDOL IN THE FRONT -AESTHETICALLY PLEASING

PLAN

LEGEND ENTRY

(68)
(69)

GROUND FLOOR

• THE OPD ACTIVITY IS RESTRICTED TO THE FRONT

• THE IPD AND OTHER DPARTMENTS START AFTER THE BRIDGE

• PROPER BUFFER

SPACES

BETWEEN MAIN

ENTRY WAITING

AND

SUBWAITING

• EACH CONSULTATION ROOM HAS A WINDOW-NATURAL LIGHT • USE OF COURTYARDS • BARRIER FREE

OPEN PLAN AND GOOD

CONNECTION TO OUTSIDE

(70)

CARDIOLOGY OPD

Key plan CARDIOLOGY DEPARTMENT(HOSPITAL)--11 cardiologists

7 critical care 10 anesthesiologists ONLY THE CARDIOLOGISTS AND CARDIAC SURGEONS HAVE CONSULTATION ROOMS IN THE OPD DEPARTMENT

Working hours –9am-5pm

Each doctor has a private secretary seated outside

NO OF PATIENTS PER DAY=50-60

Waiting

2 sets of 9 chairs each on

both sides

Total-162seats

ARA=0.5X0.8X162=64.8sqm

Consultation

rooms-3mx3.9m

Grid -4.4X4.5

PLAN

(71)

CARDIOLOGY OPD

Key plan Number of consultation room=18

PROPER BUFFER SPACES BETWEEN MAIN ENTRY WAITING AND SUBWAITING

main

entry

OPEN PLAN

USE OF COURTYARD— NATURAL LIGHT AND VENTILATION

EACH CONSULTATION ROOM HAS A

(72)

CARDIOLOGY

TYPICAL CONSULTATION ROOM

Services-sink-plumbing, A/C , switches. Luminaire over consultation bed and doctors desk

Centralized A/C for the entire OPD through ventilation ducts through false ceiling. Curtain rails X ray viewer

Windows facing outside with venetian curtains for controlled lighting in consultation rooms.

Typical consultation room consists of Consultation desk Consultation bed 3 chairs 1 sofa X-ray viewer Computer

Each doctor had a private secretary seated outside that controls the flow of patients

Window dimensions-2x1.5m Venetion blinds

(73)

PEDIATRIC OPD

Total of 7 doctors

The pediatric department has a small play area for the children

The pediatric department is specialized in cardiology It has a total of 25 seats-0.8x0.5x25=10sqm

Rooms-consultation rooms-7 Feeding room

Number of patients per day– 50-70

Key plan Play area Aesthetically pleasing

RECEPTION

Consultation room

Consultation rooms

(74)

PEDIATRIC OPD

Key plan TYPICAL CONSULTATI ON ROOM-PEDIATRIC

Duct—for the

toilets in the

wards above

WAITING-XRAY

(75)

SIGNAGES

List of departments and labs in

the main entry waiting

Directional signage

Info desk at the entry

Consultation

room(cardiology)-Doctors name

Room no

GROUND FLOOR

FIRST FLOOR

Fire exit

Consultation

room(cardiology)-Doctors name

Room no

Registration and

cash

(76)

FIRST FLOOR

The first floor consists of executive opd’s

It is accessed by 2 lifts and a stair around them The executive opd is for the private patients It is approached by a glass partition.

Lift lobby-coffee kiosk Chairs-12

Round tables of 1.5m diameter RESTROOMS

2 w/c,1 handicapped toilet,3 wash basin,1 dustbin

EXCECUTIVE

OPD

(CARDIOLOGY)

•12 DOCTORS •10 CONSULTATION ROOMS •TMT ROOM •ECG ROOM •SPECIMEN COLLECTION

•XRAY ROOM,ELECTRO ROOM

•STAFF TOILETS •REGISTERATION AND CASH

FOR GENERAL AND CORPORATE

•INTERNATION DIVISION

(77)

FIRST FLOOR

TO IPD

-ACCESIBLE TO DOCTORS AND STAFF

The executive opd is visited by

scheme patients .

It is for fast consultation

• THE CHAIRS FOR COFFEEE KIOSK OUTSIDE IS LESS COMPARED TO THE NO OF WAITING SPACES INSIDE • LIFT LOBBY IS SMALL

COMPARE TO THE DENSITY OF PEOPLE 35 GENERAL WAITING Area =35X0.5X0.8=14sqm 13 seats SPECIMEN COLLECTION each consultation

room has a window

12x3 seats +9x3 +9+7=79 seats

Area =0.8X0.5X79=31.6

Coffee kiosk

7 18:10=GENERAL OPD :EXECUTIVE OPD

NO OF PATIENTS=60-70

TOTAL NO OF

(78)

• ENTRY TO IPD FOR DOCTORS AND STAFF • RAMPED APPROACH

• DOUBLE DOORS

• ALSO FIRE EXIT. GRANITE FLOORING

• WOODEN PANELLEND CEILING SIGNANGES AHU GROUND FLOOR-2 FIRST FLOOR -1 COVE LIGHTING

(79)

BASEMENT

• The restrooms for the main entrance and for opd patients is 1 level down

• This is accessed by stairs near the lift for the executive opd

• The stairs are almost 0.9m which is narrow for the amount of people.

• The basement also has a store room and a cloakroom converted office which also use the same stairs for access.

• The buffer space at the end of the stairs is really crowded • Women toilet • 5 w/c,3washbasin,1 storage • Gents toilet • 6 toilets Key plan • Converted to office • Medical records room

• the restroom area is crowded as it is near the office and medical records of ipd and the stairs are very narrow due to the addition of the stairs leading to the executive opd

(80)

FIRE ESCAPE PLAN

21.2 m approx

51 m approx

45 m approx

23

m a

pp

ro

x

RAMP

STAIR

STAIR

(81)

INTRODUCTION

NARAYANA

HRUDAYALAYA-MULTI

SPECIALITY

Narayana Hrudayalaya, headquartered in the city of Bengaluru, India, is one of India's largest multi-specialty hospital chains. The Bangalore cardiac unit of Narayana Hrudayalaya is one of the world's largest pediatric heart hospitals. Narayana Hrudayalaya also receives patients from outside India, and it has created a record of

performing nearly 15,000 surgeries on patients from 25 foreign countries. It has 5,000 beds (as of 2012) and it is building large hospitals across India totaling 30,000 beds, to enable it to gain large economies of scale and bargain down the cost of supplies to the hospitals.

Apart from cardiology, the hospital also offers treatments in the area of Neurosurgery, Pediatrics, Neurology,

Gastroenterology, General Surgery, Dental, Nephrology, Urology, Transplants, Nuclear Medicine, Medical Imaging and Radiology. It also houses a Blood bank and

Laboratory. With the help of ISRO, Narayana Hrudayalaya has pioneered some of the aspects of Telemedicine.

Front elevation of the Multi-Speciality hospital

The Main Lobby of the Hospital with the Main Reception and the seating

Emergency Entry

Patient’s Entry

Service Entry

Hospital Entry from Main Road

Hospital Entry from Main Road

(82)

USERS/ACTIVITIES

Activity Movement for Patients

Activity Movement for Doctors

Activity Movement for Nurses

• Number of doctors – 130 • Number of nurse – 1,200

• Number of patients each day – 1500+

(83)

WAITING LOBBY

VERTICAL TRANSPORT

1. OPD for General Medicine, etc.

2. OPD for dental, urology, prosthetics, etc.

3. OPD for Neurology, Gastrology.

4. OPD for Oncology,

Pediatrics, Chemotherapy. I.C.U. EMERGENCY A.H.U. Room ADMINISTRATION CASH COUNTER PHARMACY TOILET CHEMOTHERAPY

LEGEND

LOCATION

NARAYANA

(84)

LAYOUT OF DEPT.

• Every department has 3-4 consultation rooms depending on the number of doctors and patients. • Some departments have a Minor OT attached to it. • A number of 6-7 nurses are appointed for each

department.

• Oncology – 3consultation rooms 1 minor OT

Endoscopy room

• Pediatric – 4 consultation rooms 1 triage (emergency)

Connectivity with other

Dept.

• 4 main hospital buildings connected to 1 lab

building.

• Each floor of the OPD is connected through a series of Ramps and staircases. Central Registration Out-Patient Registration Consultation Investigation Laboratory Radiology Consultation

• Flow of patients from within an OPD – from central registration to consultation.

NARAYANA

(85)

CIRCULATION

NARAYANA

HRUDAYALAYA-MULTI

SPECIALITY

(86)

COMPONENT OF A ROOM

Each Room Contains :

• A desk with computers, doctor’s accessories, etc.

• One chair for doctors, 2 more for patients and associates.

• A bed with curtains hanging from ceiling.

• A washbasin.

• Cupboards on wall for storage.

A diagram of a general consultation room with dimensions.

Doors And Windows

Each Room Contains :

• Most of the consultation rooms contain 1 main door for both doctor and patients entry.

• Some consultation rooms have two separate entry doors.

• Most consultation rooms contain one large window with either venetian curtain with transparent glass or normal curtains with

trasclucent glass.

Proportion of spaces

Desk&Chair Bed Store Equipments Open Space 41.22% 19.0% 15.11% 12.67% 12% • Distance between to columns = 1. 10m 2. 8m 3. 5m

• Various Sizes of columns =

1. 1.2mX1.2m 2. 0.8mX0.3m 3. 0.6mX0.3m

(87)

MATERIAL AND FINISH

• Corridor –

1. Walls – White washed, Dadoeing, Crash Guard with hand rails.

2. Ceiling – White washed with false ceiling, lighting and ventilation ducts.

3. Floor – White Marble. • Consultation Rooms –

1. Doors & Window – Wooden doors and aluminum cased windows with translucent glass panels, for viewing.

2. Walls – Painted with light colours. 3. Desks and chairs – wooden.

Dado work on walls White Marble Floor Aluminum cased Windows

BARRIER FREE ARCHITECTURE

• Ramps going through the vertical height of the entire building.

• Separate Toilets for physically disabled. • Handrails on the walls along corridors

and ramps. Provision of hand rails in corridor Provision of wheel chairs Provision of hand rails along ramp Provision of ramps

NARAYANA HRUDAYALAYA

(88)

LIGHT/VENTILATION

• Glass curtain wall through the entire height of the building in the lobby.

• Lobby lighting through artificial ceiling lighting. • Natural lighting some waiting spaces and

consultation rooms.

• Consultation rooms – ceiling lights, translucent panels on doors and walls in some.

• Central A/C for all consultation rooms, examination rooms, waiting spaces, etc.

Glass curtain wall for natural lighting in waiting spaces with a dynamic view of the outside Seating Area

Centralized A/C for the entire OPD through ventilation ducts through false ceiling.

1 AHU room in each floor.

Ceiling Lights Along corridors and in Consultation Rooms Windows facing outside with venetian curtains for controlled lighting in consultation rooms.

Large windows for maximum lighting in staircases.

NARAYANA HRUDAYALAYA-MULTI

SPECIALITY

(89)
(90)

COMPARATIVE

ANALYSIS

References

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