SERVICES IN HOSPITAL

To study the various services

provided in hospital

To understand the significance

& requirement of various
services.

To study different hospital

buildings and their services.

Literature study of services

provided in hospitals from NBC
and research papers.

Case studies and comparative

analysis of services in multiple
hospitals.

Role of an architect

An Architect plan, design, monitor and inspect systems to make buildings

comfortable, functional, efficient and safe.

Increasingly architects are also central to the design and assessment of sustainable
systems, assessing the life cycle of buildings and their component services to
minimise the resources consumed and the impact on the environment during
fabrication, construction, operation and dismantling.

Architects play a central role in contributing to the design of a building, not only in
terms of overall strategies and standards to be achieved, but also in facade
treatment, the weights, sizes and location of major plant and equipment, the
position of vertical service risers, routes for the distribution of horizontal services,
drainage, energy sources, sustainability and so on.

This means that building services design must be integrated into the overall
building design from a very early stage, particularly on complex building projects
such as hospitals.

AIR CONDITIONING SYSTEM

Hospitals have a very heavy bio-particulate matter load in the air, especially
in patient areas. This is responsible for hospital infections. To prevent this
iatrogenic process and related hazards and also to provide a comfortable
working and healing environment in certain key areas like the OTs,
Gynaecology and Maternity Suites, Radiology and some labs. Etc. air
handling systems are installed

There is a need for conditioning air in particular areas of the hospital to

achieve a certain level of temperature, humidity, filtration and circulation

Operating rooms, labour delivery suites, ICUs nurseries, morgue and

autopsy room are some of the areas which require air conditioning.
Sophisticated medical equipment are sensitive to temperature and humidity
which affect its readings and performance. It should thus be housed in air
conditioned rooms.

Central air conditioning system is now preferred for reason of flexibility,

application and maintenance.

Electric System

Hospital activity now days is based on various types of supporting equipment like infusion
pumps, telemetry, tele-therapy units, physiological monitoring equipment etc.

These equipment need adequate electric supply either stabilized or otherwise and some
of the equipment need uninterrupted power supply either for the protection of the
patients or for the protection of data collected by the equipment though does not require
uninterrupted power supply but shall need almost consistent supply of electric current to
function smoothly as in case of general Illumination, Blood Bank, Refrigerator, etc.

Hence there is a requirement of separate electric substation and if not electric substation,
then generators, converters and transformers become necessary.

The main board where the medium voltage(6.6 kV) supply enters the energy meter and
then the main switch, it is near the entrance of the building.

In case of large building, supply is taken from Main board to different sub distribution
board

WATER SUPPLY

At low pressure where water supply in most of the areas is unpredictable, under ground
storage tanks, a pump house, over head tanks, with certain stand by storage, capacity
becomes essential.

Sanitary System
Hospital should have sufficient numbers of toilets, wash rooms, etc., as per national
building code.
In addition the recommendation for the following functional requirements should be
made:
Provision
Provision
Provision
Provision

for
for
for
for

wash basin/sink.
potable water.
soft water.
hot water.

Generally speaking the toilet facilities should be separated in to the following groups:
Male and female.
Public (include visitors), patient and staff.
Doctors and other staff.

The ablution facilities in terms of wash basin, sinks (for instruments) and sluice basin in
appropriate areas should be adequate to cater for expansion.

Provision should be made for supporting rails, grab bars etc., for handicapped in all
toilets in wards and in at least one toilet in all public areas which should be suitably
marked. Provision should be made for bidet in all toilets in Obst. ward; private wards;
I.C.U.s and in all staff duty rooms meant for female staff.

Medical Gas Supply

Medical gas comprise of oxygen and nitrous oxide. Necessary pipeline network should
be laid in departments and wards to connect them to the manifold room (where gas
cylinder of bulk supply will be mounted on wall).

A compressor should also be provided in a separate room adjoining to the manifold

room to provide suction along with medical gas supply pipe.

All these three pipes should be of different colours confirming to a laid down standard
and mounted on wall or ceiling surface

FIRE FIGHTING

The fire detection and fire fighting requirements have been adequately dealt
with by various codes and N.B.C.

All the neonates, all patients in I.C.U., all patients in acute care units, all
patients in intermediate care units and all patients in the pediatric nursing
units should be considered incapable of reacting either to a fire or to the
water jet of the sprinkler, therefore provision of appropriate fire detection and
alarm systems in all such areas with adequate fire fighting should be given.

There are three main types of sprinkler system:

Wet pipe
Alternate wet and dry pipe
Dry pipe

TELECOMMUNICATION

Communication is very vital for decision making. Good communication is quick and
timely communication. Various means of communication are:
External tel. Line.
Internal tel. Line
Nurses call system with provision for calling additional help.

Public address system for alarms and emergency communication.

able to carry audio and video signals for entertainment, health
C
emergency communication.

education and

omputerized hospital information system for real time transfer of data

C
from
functional departments as well as to provide support to critical care
decision making for
medical facility.
losed circuit T.V. monitoring system for providing deterrent values as well
C
monitoring of hospital traffic.

as close

SOLID WASTE MANAGEMENT

System available for internal disposal of solid waste

INCINERATORS

PYROLYSIS

ELECTRIC INCINERATOR

TRANSPORTATION

Movement inside hospital is through

Elevators

Lifts

Dumbwaiters

Stairways

Ramps

CASE STUDY- BHOTA HOSPITAL

RADHA SOAMI HOSPITAL, Bhota is one of the most reputed hospitals in

the north India.

It is known for both its architecture and service style.

It is a combination of built mass and landscape treatment.

The ultimate way of merging of nature with the mankind service is really
praiseworthy. It is situated in the divine serenity of Himachal Pradesh,
which is called the DEV BHUMI.

This hospital serves 500 patients daily and is meant for mainly the poor
people who have less money to spend on health.

It is a charitable hospital that works on fundsand serves a radius of

about15 km only.

About

Foundation stone was laid in 1990.

Construction work started in 1990

Finished in 2003.

In the same year this hospital was fully opened for service.

Architect - Ar. Ranjeet Singh from M Design India Pvt Ltd, Delhi.

Structure design - Er. R K Bhola from Civtech consultant.

Medical gases

The storage of medical gases is done out side the hospital, and are supplied to
hospital with help of medical gas pipes.

the

Air conditioning:

In this hospital split air conditioner and window units has been used.

This is not completely air conditioned hospital but certain areas like OTs, ICUs, blood banks
have been air conditioned.

Total no. of air conditioners and their distribution:

Type
Split A.C.

no.
08 units

capacity
5 of 2t &
3 of 1.5t

Window A.C.

05 units

2 of 1t &
3 of 1.5t

Fire Protection

Fire extinguishers have been provided at different places in the hospitals

Electricity:

Electrical supply has been taken from the H.P.S.E.B.

And a separate electrical sub station has been established in the campus having
capacity of 500KV.

In case of any main electricity failure, two generators have been provided each
having capacity of 125KV.

Incinerator

A 15 kg capacity incinerator has been installed in the

hospital campus only having chimney

Solid waste management

There is a very well managed system for the disposal of the wastes. Wastes have
been categorized into three categories as following:1.Biomedical
2.Residential
3.Glass and plastics

To collect all these waste materials, different containers having colour coding can
be found in the whole of the hospital premises. Colour coding is as following:Colour of container
Yellow
Red
Green

Type of waste

Biomedical
Residential

Glass & plastics

Drainage system

Formerly two drains were situated. Being at the center of the site, they were
intersecting and creating hindrance

A tunnel of RCC was proposed on that site. The tunnel was of 375m long ,10 m
below the ground level.

And the size was of 1.5mX 1.8m . This tunnel was carrying the waste water of
residence of village.

This total arrangement was done on the basis of cut-n-fill arrangement where one
slope is cut and leveled at the other side.

Another tunnel is moving along the hospital road.

There are two bore wells in the site, One of which caters the residence and other
was for satsang.

The capacity of the bore wells was 1.5 lakh lrs per day and was of 250 ft down.

Inferences

Fire fighting system was inadequate. They were present only in the
kitchen& community centre.

Even smoke detectors and alarm system were not installed.

There was no covered parking for the visitors.

Absence of colour codes

The construction & maintenance of the drainage system is also worth

mentioning.

The re-harvesting of the rain-water for future use is a very good technique
employed out there.

There is the presence of cleanliness & good hygienic conditions inside as

well as outside the hospital.

Thank you