Planin n Org of Hosp Unit and Ancillary Services

PLANNING & ORGANIZING HOSPITAL UNITS & ANCILLARY SERVICES

Aims of hospital planning To enlarge the existing hospital by introducing new facilities.

• .

To increase utilization of hospital facilities To increase population coverage Modernization of existing facilities To increase productivity of hospital

Hospital planning process

Feasibility study for the hospital Actual planning

The feasibility study

Need of the hospital in that location

Site conditions

Catchment of the area

Economy of the area where the hospital

Financial resources

Availability of manpower

Actual planning

Planning & Co-ordination with othe departments

HOSPITAL DESIGN

LAND REQUIREMENTS No. of beds 50 beds

Land in acres Storey of building 10 acres Single storey

500 beds

55-70 acres

3-5 storey

1000 beds

90-100 acres

6-9 storeys

• SPACE REQUIREMENTS: 780-1005 sq ft is required. • HOSPITAL SIZE: plan two separate hospitals of 400 beds, each with a scope of future expansion • BED PLANNING: 85% bed occupancy .

BED DISTRIBUTION : • Medical: 30-40% Surgical: 25-30% • Obstetrical: 15-18% • Pediatric: 10-12% • Miscellaneous: 10-15% (including eye and ENT)

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SERVICES RENDERED • main plan.pdf

OUTPATIENT DEPARTMENT

LOCATION • easily accessible to those who come for outside. • separate wing with OPD attached

• SPACE: 0.66-1 sq ft area per annual outpatient attendance should be provided for OPD

• SIZE: the size of OPD depends upon the volume of attendance, clinics provided and extent of facilities like blood bank, emergency department

FUNCTIONS OF THE OPD • Records • Public relations

Facilities in OPD • The general procedure and rules should be hung on walls. • The registration area should be easily recognizable. • The waiting lines should have enough furniture • Health education messages can be promoted through fliers, posters and mass media.

Staffing of OPD The medical staff Nursing staff Paramedical staff Receptionists and Medico social worker

EQUIPMENTS

Planning and organization

• General wards • Specific wards

Ward planning • • • • •

Size of ward: 100-120 sq ft/bed and Smaller rooms of 2-4 beds are preferable. Area per bed (within the ward) - 80 sq ft/bed Area per bed (in acute ward) -100 sq ft/bed Space between two beds is 3 1/2 - 4 ft.

Size of rooms

Single bed room -125 sq ft/bed • 6 bed room - 400 sq ft/bed • ICU - 120-150 sq ft/bed • Obstetrics and orthopedics - 120 sq ft/bed

EQUIPMENTS

Hospital Ancillary Service

CSSD

Planning and organizational consideration of CSSD: Bed size of the hospital

Location of CSSD

Up to 100 beds

In operation theatre

100-500 beds

CSSD centrally located in service area CSSD in service area and a separate unit for OT

Above 500 beds

Distribution of the space • • • • • • •

Clean area including sterilization- 40% Sterile storage area-15% Equipment storage-14% Fluids, needles & syringes- 14% Receiving & clean up area-12% Glove processing area-5 - 7% Additional 25% space located for future expansion

AREA REQUIREMENT

• up to 400 bedded hospitals -1.64 sq.m/bed • > 400 beds an area -1 sq.m/bed

Staffing pattern 200-300 bed hospital- 10-15 person Recommended : 1 CSSD worker per 30 beds plus one supervisor

Inventory management • • • •

Stock Issue of materials Distribution of sterile items Grocery system

ARTICLE Saudi Arabia: Monday, May 24 - 2010 at 10:45 King Faisal Specialist Hospital and Research Center Riyadh enhances their CSSD department

• E3 has successfully implemented Lawson's Surgical Instrument Management (SIM) . • It enables hospitals to track surgical instruments and trays throughout their life cycle from procurement to assembly, packaging, sterilization, storage, distribution and utilization

LAUNDRY SERVICES:

Planning and organization

No.of beds

Space

200-300 beds

3750 sq.ft.

300-500 beds

5670 sq.ft.

500-600 beds

6460 sq.ft.

>650 beds

8210 sq.ft.

Physical layout Two distinct areas: • Dirty area:  Reception of solid linen  Sorting of soiled linen into suitable quantities for processing • Clean area:  drying  finishing  discharge  a barrier wall between the clean and dirty area

Decor • Laundry manager’s office • Supply storage room • Sufficient space for the storage of one week • Utility services • The steam supply system • The power supply -220 or 440 volts in three phases • Lighting • Fire extinguishers

News….. FEB2006, NY • Mother sues hospital after her dead newborn found in ………………………… HOSPITAL LAUNDRY

KITCHEN SERVICES

• 200 beds or less: 20 sq ft per bed • 200-400 beds: 16 sq ft per bed or 18 sq ft per bed • 500 beds & above: 15 sq ft per bed

Functional areas in department • • • • • • • • • •

Recipient area Preparation area Cooking area Service area Washing area Disposal area Storage area Dry provisions Fresh provisions Office store keeper

• items to be stored at room temperature • Items require cool temperature (8-100c is maintained). • Deep fridge where temperature • Day store:

Functions of the Dietary store • • • •

Storage of food items Purchase of food products Equipment planning Financial control

Article Sunday 12 August 2007,Denis Campbell,UK

Scandal of filthy hospital kitchens • 46 %- were found to have poor cleanliness in their kitchens, or canteens or cafes used by staff, patients and visitors. • Nine of the 377 were private hospitals,. 68 did not meet the legal minimum standard for food storage and 66 were storing food at the wrong temperature, which can stimulate the growth of bacteria

LABORATORY SERVICES

Internal design and fitments • Work benches: 75-90 cm • Lighting: fluorescent fixtures that give uniform illumination and minimize heat. • Storage • Partitions • Air conditioning: • Working surface/ flooring: Flexible vinyl flooring

• • • • • • • • • • •

Area/space Laboratory space -200 sq. ft Primary space Secondary space. Circulation space. sample collection Bar-coding system for samples Specimen toilet Pathologist office Glass washing and sterilizing unit Report issue. Utility services

Staffing Staff requirement of laboratory technicians can be worked out empirically on the basis of generally accepted norm which is about 30 tests per day per technician.

Equipment: • • • • • • • • • • • •

Auto analyzers Cell counter: Centrifuge Refrigerators Pressure sterilizers Pipette washers Analytical balance Semi auto analyzer ELISA reader Blood gas analyzer PCR instrument Flow cytometer

EMERGENCY SERVICES

Design

• 1000 sq.ft is required for daily patient load of 100 patients. • equipped room of about 10 m2 near the entrance hall with attached • Work area. • Visitor‘s toilet • Nurse‘s station • Examination and treatment area: • Stretcher, trolley, wheelchair store

Rooms in the emergency department

• • • •

Fracture room: Plaster room: Care of burns: Isolation room

Equipments • • • •

Stretchers On-the wall oxygen unit On-the wall suction unit BP apparatus, otoscope, stethoscope, opthalmoscope etc. • Spot lights • Utility table • Airways and resuscitation bags

Staffing pattern: • 24x7emergency physicians, especially trained in emergency medicine • A well staffed emergency department • For registration and records, usually 3 clerks work in day and afternoon shift, and 1 during night. • Round the clock Security • Public relations and social worker

JOURNAL david ki reoche et al Many Hospital Emergency Department Visits Could be Treated Elsewhere .USA Many studies have found the cost of treating of nonemergent conditions in the emergency department is significantly higher than in other settings, which can increase patients' out-of-pocket costs and add avoidable spending to the nation's health care bill. • A new RAND Corporation study says about 17 percent of all visits to hospital emergency departments across the United States could be treated at retail medical clinics or urgent care centers, potentially saving $4.4 billion annually in health care costs.

Reference

1. N anoop. Textbook of nursing management. 186-400 2. Currentnursing.com 3. http://laico.org/v2020resource/files/Hospital_pl anning.pdf 4. http://www.online-medical dictionary.org/Hospital+Ancillary+Service.asp?q =Hospital+Ancillary+Service 5. http://www.hospiconsultant.com/ 6. http://www.ameinfo.com/233387.html 7. http://www.guardian.co.uk/society/2007/aug/1 2/health.freedomofinformation