Smt.

Manoramabai Mundle college of

architecture



2014
Rini Mohabey
B.Arch X semester
2013-2014
GUIDE: Ar. Vajayanti yadav

CARDIOCARE HOSPITAL

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ACKNOWLEDGEMENT

I would like to acknowledge and extend my heartfelt gratitude to the principle Dr. Ujwala Chakradeo & my
guide -Ar.Vajayanti yadav for their support & helping me in this thesis. I would like to thanks to all the
teachers for their valuable suggestions.
Finally I would like to thank my family & friends & all those who directly or indirect helped me in completing
this thesis.
Rini Mohabey
B.Arch X semester
2013-2014


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CONTENT

ABSTRACT 4
AIM 5
OBJECTIVE 5
SCOPE & LIMITATIONS 5
METHODOLOGY 5
SPECIALTY HOSPITALS 6
REQUIREMENT 8

PROVISION FOR THE HANDICAPPED 10

CASE STUDY

SITE ANALYSIS

FLOOR PLANS

SECTIONS

ELEVATIONS

ELECTRIC LAYOUT













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ABSTRACT
A hospital is a health care institution providing patient treatment by specialized staff and equipment. There
are classified in general n specialized hospitals. We are here focusing on specialized hospital i.e. the
cardiac hospital.
Space is the boundless three-dimensional extent in which objects and events have relative position and
direction
So the THESES topic I opted is the cardiac hospital .
These days hospitals are designed with a completely different perception. Earlier a single hospital use to
cater all types of patients, BUT now as we see all patients have different requirement. For example
neurology patients suffering from nervous imbalance have completely different requirement from a patients
suffering from cancer, in terms of area requirement, type of treatments, space requirement etc. One among
them is a cardiac care centre; patients suffering from heart problems, they have entirely different
requirement as compared to others.
Architecture is a design process which involves planning, designing, various types of spaces that are
functionally efficient, and aesthetically pleasing. Through spaces we can communicate the quality of the
building and we can understand the function of the building. Spaces can be defined on functional as well as
aesthetic way. Any space so created should first fulfill the basic need for which it has been design & than it
should be aesthetically appealing.

















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AIM: CARDIC CARE HOSPITAL
GENERAL INTRODUCTION: These days hospitals are designed with a completely different perception.
Earlier a single hospital use to cater all types of patients, BUT now as we see all patients have different
requirement. For example neurology patients suffering from nervous imbalance have completely different
requirement from a patients suffering from cancer, in terms of area requirement, type of treatments, space
requirement etc. One among them is a cardiac care centre; patients suffering from heart problems, they
have entirely different requirement as compared to others.
OBJECTIVE: To design cardiac cares hospital which full fill all the necessary requirement of patients
and relatives accompanying them; following all the rules n regulations of it.
SCOPE & LIMITATIONS: the major challenge will be to designing such a centre following all the rules
and regulations would be an architectural challenge. And making it aesthetically pleasuring at the same
time.
METHODOLOGY:
Understanding the problem and psychology of patients suffering from heart problem.
Understanding their requirement and proposing an environment which would actually help them to
heal soon.
Also combining the form with all the rules and regulation of such centre.
Study of cardiac centre; space and area requirements.










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HOSPITAL

A hospital is a health care institution providing patient treatment with specialized staff and equipment.
Hospitals are usually funded by the public sector, by health organizations (for profit or nonprofit), health
insurance companies, or charities, including direct charitable donations. Historically, hospitals were often
founded and funded by religious orders or charitable individuals and leaders. Today, hospitals are largely
staffed by professional physicians, surgeons, and nurses, whereas in the past, this work was usually
performed by the founding religious orders or by volunteers.
CATEGORIES OF HOSPITALS: Hospitals are classified depending on the nature of the healthcare
facilities other on the type of ownership. with respect to. To healthcare facilities :



SPECIALTY HOSPITALS:
Specialty hospitals, owned and operated by physicians with an expertise in a particular medical condition,
offer the opportunity to design a utopian care environment for optimal delivery of care. In fact, the concept
of specialty heart hospitals dates back to the mid-19th century in England, with the opening in 1857 of
Londons National Hospital for Diseases of the Heart and Paralysis.
A heart hospital is a hospital that specializes in the diagnosis and treatment of heart disease. It can be a
free-standing hospital or it can be a section of a large hospital that is designated as a heart hospital.
Whether it is free-standing or incorporated into a section If the larger hospital it specializes only in the
diagnosis and treatment of heart disease. The nurses and doctors that work in these areas receive special
training in the diagnosis and treatment of heart cardiac services function more effectively and efficiently
when they are integrated into a full-service hospital. Faced with the option of moving cardiac services to a
freestanding facility or integrating them into a full-service hospital, health systems and facilities typically
choose integration for a number of important reasons. These include continuity of care, cost-effective
integration of support services, shared support spaces, and more integration in the delivery of healthcare
services. At the same time, many cardiac specialists seek an environment that is exclusively designed to
meet their needs. A heart hospital within a hospital often offers the best of both worldsthe separate
identity physicians and hospitals oftenisease. Seek for a key service line, and the efficiencies of integrated
Clinical and administrative support services.






HOSPITAL
GENERAL SPECIALIZED DISTRICT TEACHING
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DESIGNING A HOSPITAL :
Modern hospital buildings are designed to minimize the effort of medical personnel and the possibility of
contamination while maximizing the efficiency of the whole system. Travel time for personnel within the
hospital and the transportation of patients between units is facilitated and minimized. The building also
should be built to accommodate heavy departments such as radiology and operating rooms while space for
special wiring, plumbing, and waste disposal must be allowed for in the design. However, the reality is that
many hospitals, even those considered 'modern', are the product of continual and often badly managed
growth over decades or even centuries, with utilitarian new sections added on as needs and finances
dictate. As a result, Dutch architectural historian Cor Wagenaar has called many hospitals:
"... built catastrophes, anonymous institutional complexes run by vast bureaucracies, and totally
unfit for the purpose they have been designed for ... They are hardly ever functional, and
instead of making patients feel at home, they produce stress and anxiety

Some newer hospitals now try to re-establish design that takes the patient's psychological needs into
account, such as providing more fresh air, better views and more pleasant color schemes. These ideas
harken back to the late eighteenth century, when the concept of providing fresh air and access to the
'healing powers of nature' were first employed by hospital architects in improving their buildings. The
research of British Medical Association is showing that good hospital design can reduce patient's recovery
time. Exposure to daylight is effective in reducing depression. Single sex accommodation help ensure that
patients are treated in privacy and with dignity. Exposure to nature and hospital gardens is also important
looking out windows improves patients' moods and reduces blood pressure and stress level. Eliminating
long corridors can reduce nurses' fatigue and stress. Another ongoing major development is the change
from a ward-based system (where patients are accommodated in communal rooms, separated by movable
partitions) to one in which they are accommodated in individual rooms. The ward-based system has been
described as very efficient, especially for the medical staff, but is considered to be more stressful for
patients and detrimental to their privacy. A major constraint on providing all patients with their own rooms is
however found in the higher cost of building and operating such a hospital; this causes some hospitals to
charge for private rooms.











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REQUIREMENTS:
AREA
1 hectare for every 25 beds is recommended.

SITE
Sites with high degree of sensitivity to outside noise should be avoided.
Sensitive areas like wards, consulting and treatment rooms and operation theatres to be placed away from
the outdoor sources of noise.
The importance of landscape elements such as open areas, horticulture increase the comfort conditions
inside the building and also in the surrounding environment.

REQUIREMENTS FOR PROPER HOSPITAL PLANNING. Hospital requirements are worked out
primarily through functional planning. for the purpose of hospital planning various components and
departments are taken into consideration . Each department is an independent entity and specific
peculiarities.

FLOOR HEIGHT
The height of all the rooms in the hospital should not be less than 3.00 m measured at any point
from the surface of the floor to the lowest point of the ceiling. The minimum head-room, such as,
under the button of beams. fans and lights shall be 2.50 m measured vertical under such beam, fan
or light.


DOOR OPENINGS:
Minimum dimensions of clear door openings of patients bedrooms 1500mm wide and 2100mm
high.
Clear door opening to room that may be accessed by stretchers, wheeled bed stretchers, wheel
chairs or handicapped persons should be 900mm.
Doors, except those to spaces such as ducts (which are not subject to constant patient or staff
occupancy), shall not swing into corridors in a manner that might obstruct traffic flow or reduce the
required corridor width.

CORRIDORS:
Corridor widths in which there is frequent bed stretcher and trolley movement, e,g inpatients units,
OTs, ICUs, - 2100 to 2400mm.
Corridor widths where infrequent trolley or bed movement is expected 1800mm
Corridor width where no patient transportation is required and where corridor rooms are no longer
than 12meters (such as offices) 1200mm.
Major inter departmental arterial corridors and public corridors 2100mm.










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CEILING HEIGHTS:
The minimum ceiling height in occupied areas shall be 2400mm, but consideration should be given
to the size (Aesthetic consideration) and use of the room. 2700mm is Considered a more
appropriate ceiling height in work areas.

The minimum ceiling height in corridors, passages, recesses, etc. shall also be 2400mm. In portions
of remodeled existing facilities, the corridor ceiling height may
be reduced to 2250mm, but only over limited areas, e.g., where a mechanical duct passes over a corridor,
a reduced ceiling height for no greater corridor length than 3000mm is acceptable.

In areas where access is restricted, e.g., drinking fountain recess etc., a minimum ceiling height of
2250mm is acceptable.



RAMPS:
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Most common provision made for wheelchairs is a ramp. However, ramps are mostly difficult to use,
both in mounting and in descending. They should be no steeper than 8 per cent (preferably 6 per
cent) and unbroken lengths of ramp no longer than 10 m. For a rise of only 650 mm, therefore, a
good ramp would take up a considerable area. The use of a chair lift or of ordinary lifts is therefore
often preferable to a ramp, although these suffer from the need for adequate maintenance, and
problems arise when they break down.



















PROVISION FOR THE HANDICAPPED:

CORRIDORS
Should be at least 7 ft wide to allow enough room both for two-way traffic of persons using crutches
or wheelchairs.
Handrails of a bright color or material in bold contrast to the walls should be provided on corridor
walls. Such handrails are especially helpful to people with poor vision end to blind persons.
Provision for blind people needs to be made in the design of signs, raised letters being preferable to
Braille, particularly in lifts.

WIDTH AND DESIGN OF CORRIDORS AND DOORWAYS :
The width of a corridor should not be less than 900 mm for a self-propelled wheelchair, or 1.8 m if
two wheelchairs are likely to want to pass each other, no columns, radiators, drinking fountains,
telephone booths, pipes, or other projections should protrude into public corridors.

TURNING SPACE
Most wheelchairs require a space 1.4 m square to turn around. Crutch users often find ramps more
of a problem than steps. Ideally, all wheelchair ramps should be adjacent to supplementary steps.



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AMBULANCE:

CANOP
Y HT.:
3.2M
VAN
HT:
2.7M
LENGT
H: 5.5M
BREAD
TH:
2.6M
TURNIN
G DIA. :
14.17M





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TURNING THROUGH 90 DEGREES :DIMENSIONS FOR DIFFERENT VEHICLES

Length=5885mm
Width= 2000mm
Height=2540mm
Round clearance=190mm
Turning circle=6.5m









EXTERNAL DIMENSIONS OF A CAR












ANTHROPOMETRIC DATA:






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LIFT DIMENSIONS:

Lifts transport people ,medicines, laundry, meals and hospital beds between two floor in buildings in
which care, examination or treatment areas are accommodated on upper floor at least two lifts
suitable for transporting beds must be provided. One multipurpose lift should be provided for 100
beds, with a minimum of two for smaller hospitals. In addition there should be a minimum of two
smaller lift for portable equipments, staff and visitor Clear dimensions of the lift car: 0.90X1.20 m
Clear dimensions of the shaft: 1.25x1.50 m

Passenger lifts should be within a reasonable walking distance from the furthest part of the floor
areas served (70 m maximum)
The location of goods and service lifts will depend on their function, but they should not open into
passenger lift lobbies or public areas.
Bed lifts shall be necessarily provided in the emergency areas.












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HOSPITAL DEPARTMENTS & ITS CIRCULATION:

OUT PATIENT DEPARTMENT (OPD) :

The OPD should be ideally located on the ground floor with separate entrance and adequate
parking facilities.
Reception area and waiting space should be immediately apparent and welcoming.
Attention should be paid to circulation transversing department.
There should be easy access to labs , pharmacy , and pathology lab.
Treatment rooms for minor procedures and cast work be easily accessible from main waiting spaces
and consultation rooms.







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DESIGN CONSIDERATION FOR OPD
The storage areas for wheel chairs and stretchers should be neatly alcove and easily accessible
from main traffic line.
Elevators should be accessible to the lobby and especially important for cardiac and obestric
patients who require immediate care.
To improve the atmosphere, patients should be dispersed to sub waiting areas.
There should be proper link between the emergency services and outpatient department.
There should be provision of public telephones , toilets , water , cafeteria












RADIOLOGY:

The department receives inpatients, outpatient, and casualties. Its function is to photograph,
process the film and provide facilities for its interpretation and storage.
X RAY rooms are equipped with photograph machinery of considerable sophistication .the x-ray
rooms need dark rooms nearby for the processing of the films and a room for viewing.
The location of the department should be convenient for trolley access from the wards and close to
the outpatients department unless the accident and emergency department has its own x-ray
facilities, it is essential that there should be easy access to the x-ray department.
The radiology department comprises of mri room, ultrasound room, changing room, sub waiting
area, xray general , radiography room , control room , change room , film store , reporting room.










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Structural shielding from radiation can be achieved by using
lead inserts or with thick concrete walls . The thickness of walls
constructed in concrete only should be 3.00 m for treatment and
examination rooms in the primary radiation area and 1.5m for rooms in the secondary radiation area ,
according to the type of equipment. The huge weight of the equipment and the required structural radiation
protection measures make it necessary for radiotherapy departments to be located in basement or ground
floor.













WARDS:

AREAS
General ward 3978sqft
Semiprivate + deluxe 8437sqft
Private+deluxe 8437sqft
Clear space around the bed
Total area wards 45378 sqft. 43% of the total floor
Clear space around the bed
Bed spaces + clinical support + two en- suites + circulation added In between.













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GENERAL

WARD:

LINEAR WARD
20-30 beds supported by nurse working room at end, sluices and wc at other.














COURTYARD PLAN
Reduces internal working room.
Success depends on amount of daylight and degree of privacy .












DEEP WARD OR RACE TRACK
it neglects spaces where spaces can be neglected.
Background noise reduced but as result audio-privacy for consultations is not so good.
Walls laced on outside wall, naturally lit and ventilated
Nurses workstation being centrally located needs artificial light and ventilation













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OPERATION THEATER( OT) :

OT is that specialized facility of the hospital where life saving or life improving procedures are carried out
on the human body by invasive methods under strict aseptic conditions in a controlled environment by
specially trained personnel to promote healing and cure with maximum safety, comfort and economy.















LOCATION:
The OTs can be grouped together in a centralized form to have an entire OT complex or they can
be decentralized. However,

professional supervision and greater efficiency.
There will be 3 OTs- 2 General and 1 Specialty OT. They will be located on the 3rd floor.
The location will be such that they will be away from major traffic areas and also not on the top floor.
This will avoid overheating.
They will be located close to the ICUs for the easy transport of patients.
They will also be located close to vertical transport and above the CSSD.
There will be 2 dumbwaiters- one for clean linen and one for soiled linen.

















An operating room for general surgery will have an area of 450 sq ft.
The operation suite will consist of an operating room a scrub room a waste disposal room an exit room.
Each stretcher station should be of 80 sq. feet (7.43 sqm) and should have a
Clearance of 4 feet (1.22m) on the sides of the stretcher and foot of the stretcher.



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POST ANESTHETIC CARE UNITS :
omedication station
hand washing station
nurse station
storage space for stretchers
supplies and equipment


Additionally 80 sq feet (7.43 sqm) for each patient Bed clearance of 5 feet (1.5 m) between beds and 4 feet
should be (1.22m) between patient bed sides and adjacent walls.


































INTENSIVE CARE UNIT:

The intensive care includes monitoring and treatment as well as care of patients.

ARRANGEMENT-
The intensive care department must be a separate area and only accessible through lobbies.
Each intensive care unit be a separate fire compartment.
Apart from the patient and staff lobbies visitors should only access the unit through a visitors lobby (
waiting room).
The central point of an intensive care unit must be an open nurses workstation from which it is
possible to oversee every room.
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The recovery room of the operating department is often located in icu so the patients can
economically be cared for by the same staff.
The number of patients per unit should be between six and ten in order to avoid overloading.
One nurses duty station a sterilize work station , one material room and one equipment room per
unit should be included in plan.














ICU INTERDEPARTMENTAL RELATIONSHIP


EIGHT-BED INTENSIVE CARE SUBGROUP: GLAZED INDIVIDUAL ROOMS

PHARMACY :

A dispensary is needed, close to the out-patient department and with a comfortable waiting area.
If the main hospital pharmacy cannot be so located, pneumatic tubes from it to the dispensary and
some other user areas may be justified. Pharmacy store - Area = 520 sqft.
Pharmacy outlet- Area = 260 sqft.
Area required for pharmacy per bed bed is 7.8 sqft.













PATHOLOGY :
The four main laboratory disciplines in hospitals are
histology
microbiology
haematology
biochemistry.
The whole department will generally have a shared receiving area for specimens and records.






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MORTUARY :
It is desirable, but not essential, for the mortuary to be near the pathology department, as the
histologist is responsible for post-mortems.
The main elements are the body store, post-mortem rooms, and facilities for visitors.
The access route into the mortuary for bodies from the hospital should be separate from that taken
by visitors, although mortuary trolleys are discreet enough that separate lifts and circulation routes
through the hospital are not needed.
Particular care is needed for the furnishing and outlook of the visitors waiting and visiting areas; a
toilet and kitchenette unit is required.
Access by hearses should be out of sight from windows of wards and other patients areas.














LAUNDRY:

In India a common thing is lack of emphasis given to support services like kitchen, laundry, CSSD, back-up
electricity and so on.
AREA = 1918 sqft.
The area required for laundry per bed is 19.18 sqft.

The dirty utility opens into the dirty corridor from where the things are removed via the dumbwaiter to the
CSSD or the Laundry.
Figures for the amount of dirty dry washing defer from 0.8 kg to 3.0 kg. The following sequence of work is
preferred

KITCHEN:

The compartment has no direct link with the patient. It gives secondary services to the patient, but without
this department the whole hospital is paralyzed.
Food has to be supplied both to the patients and staff, and in modern hospitals the nos.of staff may be
roughly equal to the nos. Of beds. One central kitchen usually supplies all the food because it simplifies
service, the staff dining rooms are generally sited adjacent to the kitchen.


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CSSD:
A hospital consumes a large quantity of new material that need sterilization before use. it also processes
other material that has to be clean and sterilized before it can be used. this sterilization used to be carried
out where and when the material was wanted, for instance in the ward or the operating suite. nowadays
item can be supplied by manufacturers in sterilized packs appropriate for particular purposes and an
increasing no. of them are disposable. However, the hospital still needs to sterilize most items and also to
control the supply of properly sterilized material to wherever it is needed. the purpose of cssd is to
concentrate the skill and the responsibility for the supply of material and to reduce the risk of error. The
department also enables nursing staff to do their work with patients more effectively. Where there are
several hospitals in fairly close proximity one department may provide this service for them all.

ADMINISTRATION:


The extent of offices provided in the hospital depends on whether they are also the headquarters of
the Trust.
Main functions include Trust Board and Secretariat, finance, personnel, supplies, and senior nursing
and other professional staff.
Ancillary spaces include computer facilities, stationery and other stores.
The post room and telephone exchange are often associated with the main entrance.
Other administrative functions do not need priority locations, and may be on an upper floor. Clinical
Directorates offices are generally near their clinical areas.
Offices for consultants (shared if not full-time) may be centralized or near clinical areas.









NURSING UNIT:

Nursing unit or the nurse work station should be situated in the central position and require a size of about
25-30 sq.mts. The nursing unit comprises of :-
Bed control (within patient s reach, with nurse controller cut off feature) CEILING
Nurses call micro-speakers.
radio speakers (for private room only) HIGH ON WALL( 60 inches or higher)
over bed light fixtures(direct and in-direct)
oxygen outlet . LOW ON WALL( approx malty 24 inches0
Double duplex receptacle (bed, oxygen-tent ,portable x-ray heating pad etc.)
remote recording instrument receptacles(temprature,pulse,respiratory)
This nursing unit layout permits a close relationship between the patient bedrooms and the nursing
station and other service areas.
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It permit greater flexibility in segregation of patients for various medicals reasons.
In the nursing unit the cleaning utility is designed to accommodate carts for storing linens, utensils
and other supplies which would be brought from a central supply and sterilizing unit.
Much of the staff activity and particularly conversation can be carried on within the service unit
complex.


















































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BIBLIOGRAPHY


BOOKS:

Planning & designing a general hospital by kunders.
Modern trend in planning & designing of hospital by shakti kumar gupta , sunil kant,
R.chandardhekar.
Resource Handbook for Barrier Free Built Environment
Bureau of Indian standards ( IS 12433(part2) )