04. OPD

4

OUT-PATIENT DEPARMENT

HOSPITAL DESIGN: CASE STUDY

REVATHI,PARVATHY

ARCHITECTURAL DESIGN 7TH SEMESTER FACULTY OF ARCHITECTURE MANIPAL UNIVERSITY JULY 2013

POOJA,SHRETIKA SURBHI,ELIZABETH RIYA,DIPAL

COLUMBIA ASIA

INTRODUCTION

Columbia Asia offers OPD services for the following departments ENT surgeon General surgeon Obstetrics and gynaecology Ophthalmologist Orthopaedic surgeon Paediatrics Physician With working hours of 8AM to 8PM on all Gastroenterologist weekdays and Saturdays there are a total of 20 Dermatology consultation rooms Allergist and immunology Neurosurgery Plastic surgeon Vascular surgery OPD Psychiatrist Endocrinology Cardiology Pulmonologist OPD Columbia Asia receives Urology 800 patients on the weekdays 1200 patients on the weekends

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

2

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

LOCATION OF DEPARTMENT

IPD CAFÉ

ADMIN

EMERGENCY

OPD Labs Radiology and diagnostics Pharmacy

Entry

Administration

Waiting area

Vertical arrangement seen from the entrance of the hospital

IPD

OPD

OPD Waiting area

Emergency

Layout of OPD department

EMERGENCY 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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

3

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

PATIENT ACTIVITY MOVEMENT

Old users

New users New patients are the users coming to the hospital without a appointment or a medical record

Waiting area

In the waiting area the nurses station keeps the movement of patients into the consultation rooms under control

Administration Taking of appointments, asking for information and payment occurs here

LABS

Patients who have a appointment and medical records move directly to the waiting room

OPD

DIAGNOSTICS

The doctor can ask for further investigations for which the patient goes to the lab or the diagnostic centre

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

4

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

PATIENT MOVEMENT OPD

Waiting area

Labs

Radiology and diagnostics Pharmacy

Entry

Administration

New patients without appointments go to the administration department to get an appointment Upon getting it they move to the waiting area

OPD Waiting area

Emergency

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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

5

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

PLACEMENT OF DEPARTMENTS OPD Labs

Waiting area

Radiology and diagnostics OPD Pharmacy

Entry

Administration

Waiting area

Emergency

COLUMBIA ASIA 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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

6

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

ADMINISTRATION AREA

Area of admin and billing71.065sq m

Admin area

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

7

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

WAITING AREA OPD Labs

Waiting area

Radiology and diagnostics Pharmacy

Entry

Administration

•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

OPD

Waiting area

Emergency

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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

8

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

WAITING AREA Advantages •Patients consulting several doctors do not have to travel to different waiting areas

Waiting area •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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

9

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

PLACEMENT OF AREAWAITING AREA Disadvantage •Large number of people in a single area can cause confusion and high amounts on noise •A single nurses station servers each of the waiting areas

Seat arrangements

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

10

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

WAITING AREA

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

11

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

FACILITIES IN THE WAITING AREA

COLUMBIA ASIA

OPD

Labs

Waiting area

Waiting area 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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

12

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

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

LAYOUT OF CONSULTATION ROOM Advantage-circulation space for the doctor and patient to move to and from the examination bed

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

13

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

CONSULTATION ROOM

Services required •electrical and water supply •data cable for computers •smoke detectors for fire protection •nurse call bell

1.2

1.2 1.2 Area of consultation room- 51.256463msq

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

14

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

SIGNAGES

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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

15

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

LIGHTING AND VENTILATION

Lighting in waiting area– use of diffused lighting in the seating area Direct lighting in areas of circulation

Lighting in consultation roomlight directly above the consultation table and the examination bed

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

16

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

MATERIALS

Consultation roomVinyl flooring Easier to clean in an area where cleanliness is a must. Waiting areaSeats places on carpeted area while circulation space is tiled Carpeted area becomes difficult to clean and the tiled areas may become slippery.

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

17

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

FIRE EMERGENCY 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

Labs Waiting area Radiology and diagnostics Pharmacy

Entry

Administration

Waiting area

Emergency

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

18

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COLUMBIA ASIA

WINDOWS AND DOORS 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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

19

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

INTRODUCTION Vikram’s Hospital offers OPD services for the following department ENT General Sciences Obstetrics gynaecology Ophthalmology Orthopaedic Paediatrics Physician Gastroenterology

Dermatology Allergist and immunology Neurosurgery Cardiology Pulmonologist Urology Nephrology

USERS

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

-Patients & their accompanying families -Children -Adults Older People Physically and Mentally Challenged People

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)

-Doctors & Nurses -Administration Staff

-Cleaning Staff

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

20

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

SITE PLAN AND ENTRANCE LAYOUT

VIKRAM HOSPITAL FOOD COURT ----------------

ENTRANCE

ICU AND IPD RECEPTION -MAIN RECEPTION ACTIVITYCREATION OF APPOINTMENTS

RECEPTION II

OTS AND IPD

-SECONDARY RECEPTION ACTIVITYMAINTAINING APPOINTMENTS OF EVERY DEPT.

CARDIOLOGY OTS OPD

APPOINTMENT TAKEN

EMERGENCY

DIAGNOSTIC

CRITICAL CONDITION OF OPD PATIENT

EXAMINATION ROOM

CONSULTATION BY DOCTOR

EMERGENCY

CASH COUNTER

ICU

PAYMENT OF BILL

DOCTOR PERFORMS PHYSICAL EXAMINATION

PROCEDURE ROOM MINOR ACTIVITY PERFORMED BY DOCTOR & NURSES

TREATMENT ADMITTED TO IPD

DIAGNOSIS TESTS TAKEN BY PATIENTS/RESULTS SENT TO DOCTORS

OPD

OPD

LABS

-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 pain/trauma

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

21

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

SITE PLAN AND ENTRANCE LAYOUT ROUTE FOR EXTERNAL ACCESS-EXIT FOR VEHICLES SERVICE ENTRY SERVICES

ENTRANCE TO OPD

IPD LIFTS

EMERGENCY ENTRANCE

VISITORS ENTRANCE

No entrance from front provided. A side access provided for OPD patients

PARKING FOR AMBULANCES FOR EASY AID

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

22

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

SITE AND ENTRANCE LAYOUT

VIKRAM HOSPITAL

Hospital Building 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

5m 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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

23

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

VERTICAL ZONING OTHER OPD’S & CONSULTATION ROOMS

WAITING AREA LOCATED IN THE CENTER FACILITATING ALL OPD’SEASIER ACCESS

SAMPLE TESTING

DIAGNOSIS

CONSULTANCY ROOM AROUND THE WAITING AREA SPECIALISING IN CARDIO.

sketch

LOBBY

SECOND FLOOR FIRST FLOOR

GROUND FLOOR

GENERAL WAITING AREA FACING MAIN ROAD WITH CURTAIN WALL FOR MAX. NATURAL LIGHTING RESEARCH LABS LOCATED ON GROUND FLOOR

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

VERTICAL TRANSPORTATION AT CENTER FOR ACCESS TO EACH DEPT.

MORGUE LOCATED ON GROUND FLOORWITH AN OUTDOOR ACCESS

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

24

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

ADMINISTRATION

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

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 ENTRANCE LOBBY

Help Desk

SECURITY DESK

The lobby leads the patient/visit or to the WAITING AREA lifts and staircase.

WAITING AREA, RECEPTION & ACCESS TO OPD

Master health check up counter which further leads you to the opd

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

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 hugewastage of space-The executive lounge and a part of waiting space could have been used to make common waiting space or minor consultation rooms

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

25

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

WAITING AREA WAITING AREAS –FIRST FLOOR

7.7 m2

Executive lounge area

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

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 people. Wastage of place

7.2m

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.

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 executive waiting area is about 28-30m2

Glass panels around the lounge for visual connectivity The lighting is recessed and the waiting area is provided with a speaker for light music to keep the ambience pleasant

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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

26

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

CLUSTER CONCEPT CONSULTATION ROOMS

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.

WAITING AREA

No vision barrier created between the OPD patients and DIABETOLOGY the doctors working at the consultation rooms. /INTERNAL MEDICINE CARDIOLOGY OPD OPD WAITING AREA CARDIOLOGY OPD

CARDI OLOGY OPD

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

Doctor’s movement across the floor

A TYPICAL CONSULTATION ROOM

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

-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

Each consultation room has one fire alarm and sprinkler. Sprinkler diameter-5m (sufficient for one consultation room)

Doctor’s Workstation(space for storage, computer ,stethoscope and other requirements

Examination Bed

Room height 2.75 m

Round consultation roomremoves the psychological barrier between the Doctor and Patient. The layout also gives provision for the patients' family to be a part of the discussion.

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

27

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

1ST FLOOR PLAN The consultation rooms are arranged around the waiting area with separate reception for each cluster. -Easy approach to the patient and doctor

Fire Escape route

DIAGNOSTIC DEPARTMENT DIAGNOSTIC DEPARTMENT

CARDIO TEST CENTER

LIFTS

FIRE ESCAPE CORRIDOR EXECUTIVE WAITING AREA

OPD WAITING AREA

OPD CONSULATION CLUSTERS

v

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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

28

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

TOILETS

Toilet services provided near the entrance of the diagnostic department.

Only one toilet provided near the OPD department. Common for all. It doesn’t prove comfortable for Indian public and insufficient according to

VIKRAM HOSPITAL

One set of toilet facilities provided near the diagnostic centre.

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. The door almost opens on to the WC which is not ethical for the physically challenged .

Toilet dimensions – (1.5*2)m2

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

standards

A screen is provided at the base of the door to help any patient in case of a situation

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

29

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MATERIAL AND FINISHES

VIKRAM HOSPITAL

A carpet flooring separates the waiting areas and corridors. Too much maintenance

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

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

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

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

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

30

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

OPD DEPARTMENTS CARDIOLOGY AND DIABETOLOGY and GYNAECOLOGY Cardiology

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.

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 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

24m distance from the staircase

One consultation room -No of patients per day-10 on avg.

Total area of one cardiology cluster is –45.5m2 Rooms-(4*9)=36 Lobby and reception-7.2m2 Toilet-2.5m2

-consulation room same size as typical room Curtain provided as the rooms opens out to the corridor

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

31

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

2ND FLOOR

The second floor of the hospital contains the opd and renal dialysis department. The opd departments consist of the –urology-nephrology- neurology- orthopedic- ENT-

UROLOGY OPD

OTHOPEADIC & PHYSIOTHERAPY DIALYSIS ENT/PULMONOLGY/AU DIOMETRY WAITING AREA

WAITING AREA

ONCOLOGY &BARIATRIC OPD

WAITING AREA

FIRE ESCAPE ROUTE

NEURO OPD DERMATOLOGY

The max. run to the nearest fire staircase is 24 metres on the 2nd floor

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

32

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

WAITING AREA

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 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

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

Waiting areas.

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

33

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

The no. Of consultation rooms are two The no. Of patients the department receives are 15-20 per day

VIKRAM HOSPITAL URO DYNAMICS

UROLOGY DEPARTMENT UROLOGY OPD

Age group visiting 20 to 50 years -65% Above 60 years -35%

UROFLOWMETRY ROOM

LITHOTRIPS Y ROOM WAITING AREA

CONSULTATIO N ROOM 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

Furniture in the consultation room•Informal seating •Doctors work space •Xray viewing box •Hand washing sink

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.

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

34

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

NEURO SCIENCES 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

CON SULTATION ROOMS

The Nerve Conduction and EEG machine Most of the patients are children but no provision for their comfort has been done

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

TREATMENT LAB-EEG AND NERVE CONDUCTION

TREATMENT LAB

The dark room for other type of EEG readings

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

35

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VIKRAM HOSPITAL

ENT & AUDIOMETRY ROOM 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.

Nephrology room

ENT room

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

The hospital only gives minor services in the above departments.

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

36

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

VERTICAL ZONING

INTRODUCTION

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 Fortis has arranged • renal care, gastroenterology their OPDs as a • mother and child care. vertical complex considering ease of It is a 250 bed hospital. patient access in Commenced in 1999 mind.

FORTIS

CARDIOLOGY OPD

LEVEL 3

PEDIATRIC – DENTAL GYNACOLOGY

LEVEL 2

ORTHOPEDIC-NEUROLOGY – OPD PHARMACY

LEVEL 1

UROLOGY-NEPHROLOGY

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. Lack of natural ventilation is observed

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

37

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

USERS

• Other major activities are :

Patients - (childern /adults/senior citizens)  300/day Patient escort - mother/friends ..etc Visitors - (children/students/adults) The OPD location starts at ground floor and can be easily located and accessed.

Staff : 1. Medical 2.Admin 3.Service Other services : laundry raw food materials - loading unloading

• • • • • • • • •

FORTIS

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 OPD

ACTIVITIES

OPD ENTRANC E FOYER

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.

LEVEL 1

LEVEL 2

LEVEL 3

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.

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

38

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

CONNECTIVITY

FORTIS

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. Many restricted areas à staff/patient only

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

39

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

FORTIS

OBSERVATIONS

ORTHOPEDIC-NEUROLOGY DEPARTMENT

• Combined waiting lobby with reception. • 35 – 40 waiting seats LOCATION : Ground floor. • Isolated consultation chambers doubly loaded on a 1.5m USER : patients with joint/bone pain or spine/nerve corridor . condition. • EEG room & ECG room  3 x 2.5 sq.m.  patient has difficulty in moving from place to • 9 orthopedic and 5 neurology consultation rooms place. observed. Narrow corridors • According to the staff these rooms may be temporarily ACTIVITY : Registering waiting leading to used by doctors on daily shifts.  nameplate outside also consulting/examination changeable. consultation rooms. No visual • Restrooms : 1 Male & 1 Female

connectivity for patients

Consultation rooms are designed flexibly and not department specific except dental

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

40

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

COMPONENTS OF A ROOM

FORTIS

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.

DOCTORS DESK + CHAIR PATIENTS CHAIRS EXAMINATION BED + STEPS SIDE SHELF X RAY VIEWER TABLE LAMP COMPUTER SYSTEM CABINET BOOK SHELF

Windows are rarely seen in the rooms  lack of peripheral spaces or inner courtyards (open to sky) 2-3 rooms have natural ventilation.

CPWD

PROPORTION OF SPACES • Consultation room = 3.5 x 2.5 = 8.75  A

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

• Waiting + reception + circulation = 41.5 sq. m.  4.5A

• OPD has level surface.

• ECG/EEG = 5.2 sq. m.  0.6A

• Corridors not ideally designed for wheelchairs ( required 1.5m  present 1.2 m)

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

• No special railings seen.

5 x 14 = 70  required waiting area in sq m

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

41

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MATERIAL & FINISHES

FORTIS

SERVICES

• Flooring : Vinyl sheets  Anti Static & Anti Bacterial

Lighting : due to lack of natural light

for hospital • Walls : peach color, smooth finish

A/C : Lack of natural ventilation

• Skirting is COVED with the floor.  ease of cleaning corners

Plumbing : For wash basins

• Paintings hung on the walls in intervals.

LIGHT & VENTILLATION

• Thick glass name plates used for doctors chambers. • Recessed lighting used . • Natural ventilation & light hardly seen. • Centrally Air conditioned throughout.

STRUCTURAL GRID Columns are 6 m apart

Waiting area seating

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

42

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

FORTIS

PEDIATRIC- DENTAL - GYNACOLOGY DEPARTMENT LOCATION : Level 2 USERS : children & parents, women, dental patients ACTIVITIES : waiting taking care of babies consulting with the doctors

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 PEDIATRIC DEPARTMENT • 5 Pediatric rooms • Glass for doors and walls used (waiting area  consult. Room)

No play area  disadvantage. Feeding room – translucent glass

5 x 5 = 25  pediatrics 3 x 7= 21  dental 6 x 7 = 42  gynecology Total waiting area reqd = 88 sq m

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

43

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

GYNACOLOGY DEPARTMENT

FORTIS

DENTAL DEPARTMENT

Gynecology department to the left. Combined consultation – examination rooms.

3 consultation rooms + examination rooms Equipment : dental chair x-ray viewer doctors desk patients waiting chairs wash space storage units

Ped-Gyno-Dental grouping with no separate waiting or recovery for dental patients

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

44

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

FORTIS

CARDIOLOGY DEPARTMENT 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.

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

Department has its own diagnostic spaces, sample rooms treatment rooms

Lighting & Ventilation No windows  Centralised A/C Artificial lighting  recessed

Proportion of spaces • Consultation room = 6.5 sq. m. A

A

• Waiting Area = 78.3 sq. m.  12A

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

45

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

FORTIS

OPTHALMOLOGY DEPARTMENT

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

KEY PLAN – LEVEL 1

OPD PHARMACY LOCATION : Ground floor, entrance lobby USERS : OPD patients, pharmaceutical staff ACTIVITIES : storage of medicines attending to patient prescriptions payment & bill

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

Approximate dimension : 4.5 m x 5m

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

46

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

FORTIS

SIGNAGES

ROOM INFORMATION LEVEL/ FLOOR DIRECTORY

BUILDING DIRECTORY

Signages are informative but may not be legible to the less literate. Less number of pictoral signages. OVERALL DIRECTORY - LEVELS

DOOR DETAILS

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

47

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MANIPAL HOSPITAL

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

GENERAL OBSERVED FEATURES Provide tertiary and quaternary healthcare to patients in areas like : • dentistry, neurology dermatology • diabetes and endocrinology • paediatrics • • . • • It is a 800 bed hospital. •

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. Examination space is combined with the consultation rooms.

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 health check up centre

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

48

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

Location :

MANIPAL HOSPITAL

Drop off area Main road parking

Secondary road

The hospital is connected directly to the main road. Drop off area

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

49

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

ZONING – GROUND FLOOR •

• •

TOILETS

R

T

s

L

MAIN LOBBY

PHAR MACY

R

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.

10th floor 9th floor 8th floor 7th floor 6th floor 5th floor 4th floor 3rd floor 2nd floor 1st floor Ground floor Ground floor Basement -1 Basement -2

DENTISTRY

LIFTS &S T

MANIPAL HOSPITAL

D&E Drop off area Public spaces (Toilets, Lobby, Lifts and Staircases) Administration/ Reception(R) Fire escape staircases Pharmacy Diabetes and Endocrinology OPD

DROP OFF LANE

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

50

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

FIRST FLOOR LAYOUT •

TOILETS

•

LIFTS &S T

T s

MANIPAL HOSPITAL

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.

PHAR MACY

L

First floor

Ground floor

s

R

MAIN LOBBY

R

LIFTS &S

s

Entrance

Ground floor to first floor circulation layout

Drop off lane Ophthalmology OPD Neurology and Neuro sciences OPD General medicine OPD Circulation Drop off area Public spaces (Toilets, Lobby, Lifts and Staircases)

T

T

s

L

Administration/ Reception(R) Fire escape staircases Pharmacy Diabetes and Endocrinology OPD Dermatology OPD

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

51

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

DENTAL

MANIPAL HOSPITAL dentistry DENTAL MACHINE PHARMACY

DENTAL CHAIR

PHARMACY

MAIN ENTRY SPACE FOR WHEEL CHAIR

LOCATION _GROUND FLOOR

ROOM

AREA

STAFF ROOM EMERGENCY ROOM CLEANSING+XRA Y ROOM CONSULTATION SPACE CONSULTATION ROOM E RAY VIEWERS ROOM Total

4SQM 5SQM

2.5 M 1.5m

2M

10.5+5SQM 8SQM

WAITING AREA,18 SEATS

Consultation space

6.25SQM

MANA GERS ROOM

EMERG ENCY ROOM

X RAY VIEWE R

3SQM

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

LIGHT AND VENTILATION GLASS WINDOW FOR MORE LIGHT INTO THE ROOM

HOSPITAL DESIGN: CASE STUDY

52

120sqm

4. OUT-PATIENT DEPARTMENT REVATHI, PARVATHY

RAMP LEADING INTO THE DEPT

ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MANIPAL HOSPITAL

SPECIAL FEATURES SPECIAL ROOM

WHEEL CHAIRS FOR THE OLDERLY

STORAGE SPACES

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

53

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MANIPAL HOSPITAL

EQUIPMENTS

X ray and cleansing room equipments

CONSULTATION AREA EQUIPMENTS

Dental machine of size 1.5m *1m

X RAY CONE SUCTION TUBES in the Kept in the x-ray room CLEANERS ROOM

Suction machine Spit on

MAIN ENTRY

ULTRASONIC CLEANER MACHINE IN CLEANING AND X RAY ROOM

A SMALL FRIDGE INSTALLED NEXT TO THE CONSULTATION AREA

Waste bins

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

54

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MANIPAL HOSPITAL

DIABETES AND ENDOCRINOLOGY

PLAN OF THE DEPARTMENT PHARMACY

MAIN LOBBY

1. 2. 3.

MAIN ENTRY

RECEPTION WAITING AREAS

D AND E

RECEPTION UTILITY ROOM

LOCATION : Ground floor PHARMACY : Common pharmacy located at the ground floor. TOILETS : Common toilets outside the OPD for both doctors and patients

EXAMINA TION ROOM

CR

CONSULTATION ROOM NO. OF CONSULTATION ROOMS = 4 •No of doctors = 4 consultants and 3 juniors •AREA = 4.5x5sq.m

CHECK UP AREA

CONSULTATION ROOM

WAITING AREA

CONSULTATION ROOM

•SHARING/SINGLE = single 8. NO OF PATIENTS / DAY= 70-100 MAX

TV REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

55

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MANIPAL HOSPITAL

ENTERTAINMENT PRACTICES

EQUIPMENTS USED IN CHECK UP AREA

WAITING AREAS_2 SEPERATE

GLUCOMETER

AMBIENCE

CEILING CEC TREATEMENT

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

56

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MANIPAL HOSPITAL

DERMATOLOGY

TV CONSULTANT ROOM

CONSULTANT ROOM

DUTY DOCTORS ROOM

PROCED URE ROOM

STORE STORE ROOM ROOM

LIBRARY

GENERAL MEDICINE dermatology

,

MICROSC OPE MICROSCOPE ROOMROOM

CONSULTANT ROOM

NEOROLOGY

FIRST FLOOR

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

PROCEDURE ROOM

DERMATOLOGY

LOCATION_FIRST FLOOR USERS =100 PER DAY ACTIVITIES 1.CONSULTATION 2.waiting in the waiting area which is next to the reception 2 SETS OF 3.PATIENTS COMING WAITING IN FOR HAIR REMOVAL AREAS

GENERAL MEDICINE

RECEPTION

NEOROLOGY

AESTH ETIC LASER ROOM

OPTHAMOLOGY

WAITING AREA

LIFTS

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

3.5 M

HOSPITAL DESIGN: CASE STUDY

MAIN ENTRY 57

4. OUT-PATIENT DEPARTMENT REVATHI, PARVATHY

CIRCULATION

ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

PROPORTION ROOM S

AREAS

1. PHOTOTHERA _6SQM(6%) PY ,AESTHETIC 2. STORE ROOM 16SQM(14%) 3. CONSULTANT 9SQM(24%) 4. 5.

6. 7. 8.

ROOM ,3 DUTY DOCTOR ROOM PROCEDURE ROOM ,2 MICROSCOPE ROOM LAB CIRCULATION AND WAITING SPACE,REC

1. TOTAL

MANIPAL HOSPITAL

EQUIPMENTS KEPT IN STORE ROOM 1.CO2 LASER 2.ALMA LASER 3.ENDIAC 3.DPN 4.SUCTION MACHINE 5.SHR_SUPERFICIAL HAIR REMOVAL 6.MICRO DURBO OPERATOR

EQUIPMENTS USED IN THE STORE ROOM

9SQM(8.27%) 6.25SQM(11.46 %)

ALMA LASER USED FOR HAIR REMOVAL

9SQM(8.27%) 5SQM(5%) 30SQM(22.9%) ENDIAC USED FOR TATTOO REMOVAL

109SQM

CO2 LASER

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

58

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MANIPAL HOSPITAL

OPHTHALMOLOGY

Reception

First floor

Entry Lifts

ophthalmology s

1. 2. 3.

L

4.

LOCATION : 1st floor NO. OF ENTRANCES : One PHARMACY : Common OPD pharmacy located at the ground floor and a has an eye care shop at the entrance. 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 • WALKING PATIENTS = 15-20 mins maximum

Optic shop Lifts and staircase

Common corridor Consultation and examination room Fire escape staircase Waiting area and circulation zone

Equipments used

Dr’s desk

Desk Chair

3*2.5 sq.m

Examination chair

2.25s q.m

Entry Dr’s circulation Patients’ circulation

Examination chair

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

59

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

Ophthalmology

Proportion of spaces Consultation room= Corridor space= Examination rooms=

• 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

Diagnostic room

Field room

cr

MANIPAL HOSPITAL

cr • VENTILATION CENTRAL A/C SYSTEM FEW ROOMS HAVE BEEN PROVIDED WITH AN ADDITIONAL SPLIT A/C

sr

cr 3.0m

cr

R L

cr

cr

cea cr • •

3.0m

• • •

Consultation room layout

Cr- Consultation room Sr- staff room Cea- collie eye anomaly R- refraction room L- Laser room

Lifts and staircase Common corridor Consultation & staff 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. 1. Dr’s desk 2. Chairs 3. Computer 4. X ray machine 5. Storage desks

Fire escape staircase Waiting area and circulation zone

33 seats

REVATHI, PARVATHY

POOJA, SHRETIKA

SURBHI, ELIZABETH

RIYA, DIPAL

HOSPITAL DESIGN: CASE STUDY

60

4. OUT-PATIENT DEPARTMENT ARCHITECTURAL DESIGN

7TH SEMESTER

FACULTY OF ACHITECTURE

2013

MANIPAL HOSPITAL

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

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MANIPAL HOSPITAL

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

.

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INTRODUCTION The main block of narayana hospital is specialized in cardiology opd’s. The multispecialty hospital of narayana has other opd’s like

NARAYANA HRUDAYALAYA

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

ACTIVITY PHARMACY

PATIENT

VISITORS

WAITING

STAFF

CHECK OUT CONSULTATION

CHILD ADULT

ADMIN DOCTORS MAINTENANCE

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LOCATION Doctors enter from the main Entry. They have been allotted specific parking space—this will include at the side and at the rear.

Way to multi specialty hospital

parking

The cardiology opd is accessed from the main drop off area .

ENTRY

DROP OFF

MAIN ENTRY REVATHI, PARVATHY

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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 floorGENERAL

First floorEXCECUTIVE

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ENTRANCE

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

KEY PLAN

DROP OFF SECURITY KIOSK MAIN ENTRY 6m

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GROUND FLOOR OPD

The ground floor contains opd for cradiology,pediatric and dental. It is approached by 3 double door entries CARDIOLOGY MAIN RECEPTION AND WAITING

DENTAL PEDIATRIC

Verandah seating Reception Travel desk provided for patient convenience

Reception

cash

cash

• Toilets –at 1 level down • 5 w/c • 3 wash basin • 1 storage Common waiting – 21x3(2

IDOL IN THE FRONT -AESTHETICALLY PLEASING Key plan Pre-operative cell

ENTRY

sets)- 126 seats AREA=0.5X0.8X126=50.4sqm

Column size-300x600mm Grid-8.5x4.6

PLAN

LEGEND PATIENT CIRCULATION

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CONNECTIVITY

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GROUND FLOOR • •

•

THE OPD ACTIVITY IS RESTRICTED TO THE FRONT THE IPD AND OTHER DPARTMENTS START AFTER THE BRIDGE

OPEN PLAN AND GOOD CONNECTION TO OUTSIDE

•

• PROPER BUFFER SPACES BETWEEN MAIN ENTRY WAITING AND SUBWAITING

• •

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

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CARDIOLOGY OPD 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

9 : 18 =CONSULTATION ROOM :SEATING

Consultation rooms3mx3.9m

Key plan

4. OUT-PATIENT DEPARTMENT REVATHI, PARVATHY

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Grid -4.4X4.5 approx.

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PLAN

Waiting 2 sets of 9 chairs each on both sides Total-162seats ARA=0.5X0.8X162=64.8sqm

ARCHITECTURAL DESIGN

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CARDIOLOGY OPD Number of consultation room=18

OPEN PLAN USE OF COURTYARD— NATURAL LIGHT AND VENTILATION

main entry

Key plan

EACH CONSULTATION ROOM HAS A WINDOW

PROPER BUFFER SPACES BETWEEN MAIN ENTRY WAITING AND SUBWAITING

CONCEPTUAL PLAN REVATHI, PARVATHY

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CARDIOLOGY TYPICAL CONSULTATION ROOM

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

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

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

Curtain rails

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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 Roomsconsultation rooms-7 Feeding room Number of patients per day– 50-70

RECEPTION

Key plan Play area Aesthetically pleasing

Consultation rooms

Consultation room

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PEDIATRIC OPD

WAITING-XRAY

Duct—for the toilets in the wards above

Key plan

TYPICAL CONSULTATI ON ROOMPEDIATRIC

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SIGNAGES GROUND FLOOR FIRST FLOOR Fire exit Info desk at the entry

Directional signage

Consultation room(cardiology)Doctors name Room no

Consultation room(cardiology)Doctors name Room no

List of departments and labs in the main entry waiting

Registration and cash

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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) Key plan

•TMT ROOM •ECG ROOM •SPECIMEN COLLECTION •XRAY ROOM,ELECTRO ROOM

•12 DOCTORS •10 CONSULTATION ROOMS

•REGISTERATION AND CASH FOR GENERAL AND CORPORATE •INTERNATION DIVISION

•STAFF TOILETS

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FIRST FLOOR The executive opd is visited by scheme patients . It is for fast consultation

each consultation room has a window

TO IPD -ACCESIBLE TO DOCTORS AND STAFF

18:10=GENERAL OPD :EXECUTIVE OPD NO OF PATIENTS=60-70

TOTAL NO OF SEATS=79+35+4+13=131

13 seats SPECIMEN COLLECTION

7

35 GENERAL WAITING Area =35X0.5X0.8=14sqm

Coffee kiosk •

•

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 PLAN

12x3 seats +9x3 +9+7=79 seats Area =0.8X0.5X79=31.6

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•

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

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BASEMENT • • • •

Converted to office

•

•

•

Medical • records room

•

•

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

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

Key plan

• not sufficient restroom compared to waiting ratio • Stair width-0.9 m

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FIRE ESCAPE PLAN

RAMP

21.2 m approx

45 m approx

STAIR

23 m approx

STAIR

51 m approx

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NARAYANA HRUDAYALAYA-MULTI SPECIALITY

INTRODUCTION 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.

Emergency Entry

Patient’s Entry Service Entry

Hospital Entry from Main Road

Hospital Entry from Main Road Front elevation of the MultiSpeciality hospital

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

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USERS/ACTIVITIES

Activity Movement for Doctors

Activity Movement for Nurses •

Number of doctors – 130

•

Number of nurse – 1,200

•

Number of patients each day – 1500+ Activity Movement for Patients

Activity Movement for Admin.

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NARAYANA HRUDAYALAYAMULTI SPECIALITY

LOCATION

LEGEND 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

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NARAYANA HRUDAYALAYAMULTI SPECIALITY

LAYOUT OF DEPT.

• • • •

•

Connectivity with other Every department has 3-4 consultation rooms Dept. 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)

•

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 Radiology

Laboratory

•

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

Consultation

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NARAYANA HRUDAYALAYA-MULTI SPECIALITY

CIRCULATION

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COMPONENT OF A ROOM

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 A diagram of a general consultation room with dimensions.

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.

Desk&Chair

19.0%

Bed

41.22% 15.11%

12%

12.67%

• Distance between to columns = 1. 10m 2. 8m 3. 5m

• Various Sizes of columns = Equipments 1. 1.2mX1.2m Open Space 2. 0.8mX0.3m 3. 0.6mX0.3m Store

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NARAYANA HRUDAYALAYA

MATERIAL AND FINISH •

BARRIER FREE ARCHITECTURE

Corridor –

•

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

• •

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

Ramps going through the vertical height of the entire building. Separate Toilets for physically disabled. Handrails on the walls along corridors and ramps.

3. Floor – White Marble. •

Consultation Rooms –

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

Provision of hand rails in corridor

2. Walls – Painted with light colours.

Provision of wheel chairs

3. Desks and chairs – wooden. Dado work on walls Aluminum cased Windows White Marble Floor

Provision of hand rails along ramp Provision of ramps

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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.

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

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

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

Large windows for maximum lighting in staircases.

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FIRE ESCAPE ROUTES

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COMPARATIVE ANALYSIS 10. OPD.xlsx

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