Maintenance, Management & Planning of Hospital Facilities

1

Maintenance, Management & Planning of Hospital Facilities
Arch. Allen R. Buenaventura, MCM

Objectives 2

• Discuss the process of Planning and Design of a health facility

• Discuss the methods of maintenance for a health facility


3

End
-Users
Administrato Nurs
r e

Clien Functiona
t l
Planne
r
Financia
l
Planners
Physica
l

The Needs Assessment Team


Other 4
Medical
End Specialis
The Briefing Team -Users t
Administrato Nurs
r e
Health
Officer

Clien Functiona
t l
Planne
r
Architect Financia
l

Physica
l Planners
Mechanica Structural
l Engineer
Engineer Sanitary
Electrical
Architects / Engineers
Enginee Engineer
r

Maintenance, Management & Planning of Hospital
Facilities

5

Limitation Soil
Condition

Drainage

Natural
Features

Utilities

Topography
Size

Factors Affecting Site Selection
Arch. Allen R. Buenaventura, MCM Facilities

Recommended Hospital Site
• Not at the edge of a slope

• Not close to a seismic fault

• Not near the foot of a mountain

• Not near bodies of water

• Not on a reclaimed site

• Not in flood prone areas

• Not within typhoon zone

• Not near active volcano


7

Architects Brief

Written expression of the clients needs

Description of the services to be delivered in the hospital
and their requirements

Prepared by the user of the hospital in the persons of the
hospital administrator.


8

Contents of the Architects Brief

Functional Content – size and content of departments

Philosophy of Service- type of patients, type of service, type
of department

Workload- number of hours of work

Planning Principles- guided by the operational policy and
procedures of the hospital


9

End
The Design Team -Users
Administrato
r

Clien Functiona
t l
Planne
r
Architect Financia
l

Physica
l Planners
l Engineer
Engineer Sanitary
Architects / Engineers Electrical
Enginee Engineer
r


Phases and Outputs of the Architect’s Regular 10
Services
and Percentage Completion Per Phase
Phase/s % Completion Output/s

Schematic Design Phase 10% Consultation with owner
Schematic Phase
Probable Project Construction Cost
Design Development 20% Plans, evaluation other drawings,
Phase
outline specifications
probable construction cost
Contract Document Phase 50% working drawings
probable construction cost
detailed technical specifications
bidding and contract document
(5sets)

Construction Phase 20% the physical form of the hospital
(with architect as supervisor)


The Construction Team 11

Administrato End
r
-Users
Structural
Builder Engineer

Electrical Clien
Engineer t
Builder
Sanitary Architec
Enginee t
r
Architect
Mechanica
l
Engineer
l Engineer
Engineer Sanitary
Electrical
Enginee Engineer Engineers
r


12
The Standard Hospital Plan Zoning

Outer Zone Second Zone
● Emergency Service Inner Zone
●Outpatient Service Laboratory Service ● Nursing Service
Pharmacy
●Administrative Service
Radiology

Deep Zone Service Zone
● Surgical Services Twilight Zone
● Dietary Service ● Mortuary
●Delivery Services ●Housekeeping
●Nursery ●Maintenance
●Intensive Care ●Mortuary


13

Outer Zone
● Emergency Service
●Outpatient Service


14

Emergency Services
• Satellite Business Office
• Accessible to Diagnostic and Treatment Department
• Accessible Administration, Business Office, and Medical Records
• Operational Accessibility to Outpatient Department
• Operational Accessibility to Morgue

Outpatient Services
• One entry point for Out Patients
• Close Proximity with the Main Lobby, Pharmacy, Laboratory,
Diagnostic Imaging Services and Physical Therapy
• Connected with Medical Records and Pharmacy


Administrative Services 15

Hospital Lobby

• Information Desk • Accounting

• Security Desk • Admitting Section

• Directional Signs • Cashier

• Well Ventilated • Billing

• Adequately Lighted


16


Second Zone

Laboratory Service
Pharmacy
Radiology


Laboratory Services
17

Laboratories
Haematology - Blood Bank Unit
Urinalysis Unit
Biochemistry Unit
Histology Unit
Serology – Bacteriology Unit
Administrative Area
Waiting Room
Cubicle
Specimen toilet
Basal Metabolism Electrocardiography Room
Pathologist’s Office
Ancillary Service Area
Glass Washing and Sterilizing unit
Locker and Toilet Facilities
Optional Services


4.3.2 Biosafety Level 2 (BSL-2) practices, safety equipment, and facility design
18
and construction are appropriate for work done with moderate-risk agents
that are present in the community and associated with human disease of
varying severity. With good microbiological techniques, these agents can
be used safely in activities conducted on the open bench, provided
splashes or aerosol productions are unlikely.

Facilities

19


20


Pharmacy 21

STAFF
SERVICES
Out Patients Pharmacy
Ward

Out-Patient ER


22

Pharmacy

Safety of Flammable Liquids

Wall – Washable
Floor – impervious surface
Countertops , work surfaces – stainless steel
Door- large enough for trolleys and carts, with glass panels

Facilities

23

Pharmacy
Radiology

● Surgical Services ● Dietary Service

Facilities

24

Inner Zone
● Nursing Service


25


26
Nursing Wards
NURSING FACILITIES SPACE ACCOMMODATION

• One-Bed Room - Furnished with lavatory, toilet and bath, side
table, locker. When possible, it should be of
such size to accommodate two beds in emergencies.

• Two-Bed Room - Similar to one-bed rooms but provided with
cubicle curtains for privacy when needed.

• Four to Six-Bed Room - Similar to above. Furnished with common toilet and
bath facilities.

• Isolation Unit - One-bed room designed for use by known
infections or communicable disease patients
under observation that will require separate
utility room facilities equipped with sink and utensil
sterilizer. Advisable at end of corridor or off a sub corridor.


WARDS INTERDEPARTMENTAL RELATIONSHIP 27

BULK STO. OPD
&
KITCHEN SURGERY
ER RADIOLOGY
STAFF DINE

WARDS
CSSD
PHARMACY PHYS LABORATORY
THER
STORAGE
PATIENTS STAFF

SERVICES VISITORS

FOOD


28

Nurses Station

NURSES’ STATION
PHYSICAL REQUIREMENTS

• SHOULD BE OPEN TO THE CORRIDOR,
PREFERABLY IN THE CENTER OF NURSING UNIT
WHERE VISITOR ENTRY CAN BE CONTROLLED.

• EQUIPPED WITH NURSES’ CALL ANNUNCIATOR,
MEDICINE CABINET WITH SEPARATE LOCKED
SECTION, SMALL INSTRUMENT STERILIZER, AN
ACID-RESISTANT SINK BELOW THE MEDICINE
CABINET WITH KNEE OR ELBOW CONTROL,
CLOCK, BULLETIN BOARD, TOILET, INTERCOM.


Facilities

Obstetrical-Gynaecological Ward
30


31

Pharmacy
Radiology



32

Deep Zone
● Surgical Services
● Intensive Care
●Delivery Services
●Nursery


Surgical Services 33

Operating Department

• Outer Zone - Conference, classroom, locker
spaces, outpatient reception
• Intermediate Zone – Work and Storage areas,
recovery suite.
• Inner Zone – Operating room


34

Intensive Care Unit

Most unstable patients

Requiring technical/ and or artificial life support

Continuous invasive monitoring

1:2 ratio nursing ratio


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Intensive Care Unit

• Ideally same floor as OR
• Easy access to Emergency, OR and Wards
• 6 to 8 beds / unit
• Single patient ICU
• Natural daylight but no glare
• Controlled Humidity
• 16-27 degrees C
• Lobby Airlocks
• Hot and cold water
• 8 Power Outlet per bed
• HEPA Filter Recommended


Delivery Department
36


Delivery Department
37


Nursery Department
38


39

Pharmacy
Radiology



The Standard Hospital Plan Zoning 40

Service Zone
● Dietary Service
●Housekeeping
●Maintenance
●Mortuary


Dietary Service 41
• Food receiving area
• Food Preparation area
• Cooking Area
• Food Service Area
• Dish washing
• Refrigerated storage
• Day storage
• Cart cleaning facilities
• cart storage area
• waste disposal area
• dining facilities

Dietary
Department


Housekeeping Department
• floor supply closet 42
• floor equipment storage
space
• floor service closets with
sinks
• linen supply rooms and
closets
• office
• locker
• sewing room and sewing
machine
• proper shelving


Laundry Department 43

• soiled linen room
• clean linen room
• laundry cart storage room
• laundry processing room
• janitors closet
• storage space


Storage 44
• pharmacy
• furniture
• anesthesia
• records section
• central store room
( 2 square meter/ bed)

Pharmacy / chemical storage

Facilities

Mortuary
45


Engineering 46


47


48
The Commissioning Team

Other
Medical
Specialis
t
Administrato Nurs
r e
Health
Officer

Clien
t


49

The Needs Assessment Team


Other 50
Medical
Specialis
t
Administrato Nurs
r e
Health
Structural Officer
Engineer

Electrical Clien Functiona
Engineer t l
Builder Planne
r
Sanitary Architect
Enginee Financia
r l

Mechanica
Physica
l
l
Engineer
l Engineer
Engineer Sanitary
Electrical
Enginee Engineer
r
The Planning Team


Health Facility Maintenance 51

Preventive Maintenance – Consist of planned, scheduled
and cyclic tasks of parts replacement, condition,
monitoring, and general gathering of data in order to:

e. Prevent untimely breakdown of building elements and equipments.
f. Maintain desired operating performance levels
g. Generate structured and coherent data needed for planning
and decision making

Corrective Maintenance – involves minor repair of building
elements and minor servicing of equipment to correct
confirmed abnormalities or deteriorating conditions
Major Repair/Rehabilitation – involves major repair/rehabilitation
of building elements and major servicing or overhauling of
equipment and utility systems requiring substantial
replacements and restructuring of such building elements
and system.


Problems in Health Facility Maintenance 52


53

Building
Inspection
Schedule

Preventive
Maintenance
Program
Facilities

54

Building
Inspection
Schedule

Preventive
Maintenance
Program


Preventive Maintenance Program 55


Corrective Maintenance Program
56

Job Order Request Form

Facilities

57
Major Repair/ Rehabilitation


Health Facility Maintenance 58

Annual building inspection must be conducted by Engineers and Architects.

As built plan must be kept on record.

Building permit and Occupancy Permit issued by building official.


Maintenance, Management & Planning of Hospital Facilities

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