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.
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
nition 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 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 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
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.
H ealthcare R eferral S ystem 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 Clinic Health 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 beds 26-150 beds With and without
Alternative Birthing Centre
S E C O N D A R Y C A R E T E R T IA R Y C A R E P R IM A R Y C A R E N o rm a l re fe rr a l E m e rg e n c y re fe rr a l
B asic H ospital Form s and
C onf i
gurations
Diagnostic & Treatment zones Diagnostic & Treatment zonesThe Outpatient Zone
The Outpatient Zone
Medical and Non Medical Support Zones
Medical and Non Medical Support Zones Supplies and Disposal Visitors E m er g en c y E n tr y Visitors Control Visitors Control Inpatient zones Inpatient zones
Naturally ventilated areas are normally long and thin while fully air conditioned areas are thick and wide
Outpatient entry
visitors
W ard Layout
Clinic Layout
Patient 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
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
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.
PLAN PLAN floor Interstitial Service floor
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
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
– 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
W hat is G overnm ent
H ealthcare 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
Facility P lanning N orm s
• State Hospital at every State • Regional Hospital
• Hospital for every district
• Network of facilities for sub-specialties
Community Clinic
For 2,000 to 4,000 population.
Rural Health Clinic
For 15-20,000 population
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
Site Planning
i) 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
