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

Availability of

manpower

Catchment of the area

Economy of the area where the hospital

Site conditions

Financial resources

Actual planning

Planning & Co-ordination with othe departments

HOSPITAL DESIGN

LAND REQUIREMENTS

No. of beds Land in acres Storey of building

50 beds 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)

JOURNAL

HOSPICON is a leading hospital consultancy firm with national and international experience

• Hospital Planning, • Designing and Consultancy• Doctor/Hospital Practice Management & Promotion

• Medical Tourism

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

WARD

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

Above 500 beds CSSD in service area and a separate unit for OT

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

ARTICLESaudi Arabia: Monday, May 24 - 2010 at 10:45King 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 layoutTwo distinct areas:• Dirty area:Reception of solid linenSorting of soiled linen into suitable quantities

for processing• Clean area:dryingfinishingdischarge 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

ArticleSunday 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 alMany 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. 186-4002. Currentnursing.com3. http://laico.org/v2020resource/files/

Hospital_planning.pdf4. 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.html7. http://www.guardian.co.uk/society/2007/aug/12/

health.freedomofinformation