Efficiency and Cost - Effectiveness

An efficient hospital layout should :

Promote staff efficiency by minimizing distance of necessary travel between frequently used spaces

Allow easy visual supervision of patients by limited staff

Include all needed spaces, but no redundant ones. This requires careful pre-design programming.

Provide an efficient logistics system, which might

include elevators, pneumatic tubes, box conveyors,

manual or automated cart, and gravity or pneumatic chutes, for the efficient handling of food and clean supplies and the removal of waste, recyclables and soiled material

Cleanliness and Sanitation

Hospital must be easy to clean and maintain. This is facilitated by :

Appropriate durable finishes for each functional space

Careful detailing of such features as door frames, casework and finish transitions to avoid dirt - catching and hard to clean crevices and joints

Adequate and appropriately located housekeeping spaces

Special materials, finishes and details for spaces which are to be kept sterile such as integral cove base. The new antimicrobial surfaces might be considered for appropriate locations

Incorporating O&M Practices that stress indoor environmental quality (IEQ)

Accessibility

All areas both outside and inside should :

Comply with the minimum requirements of any disability acts of government, local authorities, and any governing codes in the area.

To be designed so as to be easy to use by the many patients with temporary or permanent handicaps

Ensuring grades are flat enough to allow easy movement and sidewalks and corridors are wide enough for two wheelchairs to pass easily

Ensuring entrance areas are designed to accommodate patients with slower adaptation rates to dark and light; marking glass walls and doors to make their presence obvious.

Controlled Circulation

A hospital is a complex system of interrelated functions requiring constant movement of people and goods. Much of this circulation should be controlled.

Outpatients visiting diagnostic and treatment areas should not travel through inpatient functional areas nor encounter severely ill inpatients

Typical outpatient routes should be simple and clearly defined

Visitors should have a simple and direct route to each patient nursing unit without penetrating other functional areas

Patients and visitors should be separated from industrial/logistical areas or floors

Outflow of trash, recyclables and soiled materials should be separated from movement of food and clean supplies and both should be separated from routes of patients and visitors

Dedicated service elevators for deliveries, food and building maintenance services

Security and Safety

In addition to the general safety concerns of all buildings, hospitals have several particular security concerns :

Protection of hospital property and assets including drugs.

Protection of patients including incapacitated patients and staff.

Safe control of violent or unstable patients.

Vulnerability to damage from terrorism because of proximity to high-vulnerability targets or because they may be highly visible public buildings with an important role in the public health system.

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