Hospital, an institution that is built, staffed, and equipped for the diagnosis of disease; for the

treatment, both medical and surgical, of the sick and the injured; and for their housing during this
process. The modern hospital also often serves as a centre for investigation and for teaching.

HISTORY
The history of hospitals dates back to antiquity, with the earliest documented institutions aiming
to provide cures found in ancient Egyptian temples. In ancient Greece, temples dedicated to the
healer-god Asclepius served as early healthcare centers. The Romans, however, did not have
dedicated public hospitals. The concept of public hospitals emerged during the Christian period,
with the founding of the first Christian hospital in the eastern Byzantine Empire towards the end
of the 4th century. These hospitals became widespread in Byzantine society and later developed
throughout Byzantine, medieval European, and Islamic societies from the 5th to the 15th century.
European exploration brought hospitals to colonies in North America, Africa, and Asia. Notably,
St Bartholomew’s hospital in London, founded in 1123, is considered one of the oldest
functioning hospitals today. The evolution of hospitals continued through the 20th century,
marked by advancements in medical technology, the integration of new treatments like X-rays,
and the transformation of hospitals into modern centers of science and technology.

Definition of terms:

A hospital and other health facilities shall be planned and designed to observe appropriate
architectural practices, to meet prescribed functional programs, and to conform to applicable
codes as part of normal professional practice.

Essential points which should be kept in mind while planning for healthcare facilities are :

1. Environment: A hospital and other health facilities shall be so located that it is readily
accessible to the community and reasonably free from undue noise, smoke, dust, foul
odor, flood, and shall not be located adjacent to railroads, freight yards, children’s
playgrounds, airports, industrial plants, disposal plants.

2. Occupancy: A building designed for other purpose shall not be converted into a
hospital. The location of a hospital shall comply with all local zoning ordinances.
 3. Safety: A hospital and other health facilities shall provide and maintain a safe
environment for patients, personnel and public. The building shall be of such construction
so that no hazards to the life and safety of patients, personnel and public exist. It shall be
capable of withstanding weight and elements to which they may be subjected.

Exits shall be restricted to the following types: door leading directly outside the building,
interior stair, ramp, and exterior stair.
A minimum of two (2) exits, remote from each other, shall be provided for each floor of the
building.
Exits shall terminate directly at an open space to the outside of the building.
4. Security: A hospital and other health facilities shall ensure the security of person and
property within the facility.

5. Patient Movement: Spaces shall be wide enough for free movement of patients,
whether they are on beds, stretchers, or wheelchairs. Circulation routes for transferring
patients from one area to another shall be available and free at all times.

Corridors for access by patient and equipment shall have a minimum width of 2.44 meters.
Corridors in areas not commonly used for bed, stretcher and equipment transport may be reduced
in width to 1.83 meters.
A ramp or elevator shall be provided for ancillary, clinical and nursing areas located on the upper
floor.
A ramp shall be provided as access to the entrance of the hospital not on the same level of the
site.
6. Lighting: All areas in a hospital and other health facilities shall be provided with
sufficient illumination to promote comfort, healing and recovery of patients and to enable
personnel in the performance of work.

7. Ventilation: Adequate ventilation shall be provided to ensure comfort of patients,

personnel and public.
8. Auditory and Visual Privacy: A hospital and other health facilities shall observe
acceptable sound level and adequate visual seclusion to achieve the acoustical and
privacy requirements in designated areas allowing the unhampered conduct of activities.

9. Water Supply: A hospital and other health facilities shall use an approved public water
supply system whenever available. The water supply shall be potable, safe for drinking
and adequate, and shall be brought into the building free of cross connections.

10. Waste Disposal: Liquid waste shall be discharged into an approved public sewerage
system whenever available, and solid waste shall be collected, treated and disposed of in
accordance with applicable codes, laws or ordinances.

11. Sanitation: Utilities for the maintenance of sanitary system, including approved water
supply and sewerage system, shall be provided through the buildings and premises to
ensure a clean and healthy environment.

12. Housekeeping: A hospital and other health facilities shall provide and maintain a healthy
and aesthetic environment for patients, personnel and public.

13. Maintenance: There shall be an effective building maintenance program in place. The
buildings and equipment shall be kept in a state of good repair. Proper maintenance shall
be provided to prevent untimely breakdown of buildings and equipment.

14. Material Specification: Floors, walls and ceilings shall be of sturdy materials that shall
allow durability, ease of cleaning and fire resistance.
 15. Segregation: Wards shall observe segregation of sexes. Separate toilet shall be
maintained for patients and personnel, male and female, with a ratio of one (1) toilet for
every eight (8) patients or personnel.

16. Fire Protection: There shall be measures for detecting fire such as fire alarms in walls,
peepholes in doors or smoke detectors in ceilings. There shall be devices for quenching
fire such as fire extinguishers or fire hoses that are easily visible and accessible in
strategic areas.

17. Signage. There shall be an effective graphic system composed of a number of individual
visual aids and devices arranged to provide information, orientation, direction,
identification, prohibition, warning and official notice considered essential to the
optimum operation of a hospital and other health facilities.

18. Parking. A hospital and other health facilities shall provide a minimum of one (1)
parking space for every twenty-five (25) beds.

19. Zoning: The different areas of a hospital shall be grouped according to zones as follows:

Outer Zone – areas that are immediately accessible to the public: emergency service, outpatient
service, and administrative service. They shall be located near the entrance of the hospital.
Second Zone – areas that receive workload from the outer zone: laboratory, pharmacy, and
radiology. They shall be located near the outer zone.
Inner Zone – areas that provide nursing care and management of patients: nursing service. They
shall be located in private areas but accessible to guests.
Deep Zone – areas that require asepsis to perform the prescribed services: surgical service,
delivery service, nursery, and intensive care. They shall be segregated from the public areas but
accessible to the outer, second and inner zones.
Service Zone – areas that provide support to hospital activities: dietary service, housekeeping
service, maintenance and motor pool service, and mortuary. They shall be located in areas away
from normal traffic.
20. Function: The different areas of a hospital shall be functionally related with each other.

The emergency service shall be located in the ground floor to ensure immediate access. A
separate entrance to the emergency room shall be provided.
The administrative service, particularly admitting office and business office, shall be located
near the main entrance of the hospital. Offices for hospital management can be located in private
areas.
The surgical service shall be located and arranged to prevent non-related traffic. The operating
room shall be as remote as practicable from the entrance to provide asepsis. The dressing room
shall be located to avoid exposure to dirty areas after changing to surgical garments. The nurse
station shall be located to permit visual observation of patient movement.
The delivery service shall be located and arranged to prevent non-related traffic. The delivery
room shall be as remote as practicable from the entrance to provide asepsis. The dressing room
shall be located to avoid exposure to dirty areas after changing to surgical garments. The nurse
station shall be located to permit visual observation of patient movement. The nursery shall be
separate but immediately accessible from the delivery room.
The nursing service shall be segregated from public areas. The nurse station shall be located to
permit visual observation of patients. Nurse stations shall be provided in all inpatient units of the
hospital with a ratio of at least one (1) nurse station for every thirty-five (35) beds. Rooms and
wards shall be of sufficient size to allow for work flow and patient movement. Toilets shall be
immediately accessible from rooms and wards.
The dietary service shall be away from morgue with at least 25-meter distance.
21. Space: Adequate area shall be provided for the people, activity, furniture, equipment and
utility.

All these consideration should be part of the drawing board when hospital planning is initiated.
We at Hosconnn Consulting Services ensures all the points are considered while we plan for your
establishment.
Hospitals are the most complex of building types. Each hospital is comprised of a wide range of
services and functional units. These include diagnostic and treatment functions, such as
clinical laboratories, imaging, emergency rooms, and surgery; hospitality functions, such as food
service and housekeeping; and the fundamental inpatient care or bed-related function. This
diversity is reflected in the breadth and specificity of regulations, codes, and oversight that
govern hospital construction and operations. Each of the wide-ranging and constantly evolving
functions of a hospital, including highly complicated mechanical, electrical, and
telecommunications systems, requires specialized knowledge and expertise. No one person can
reasonably have complete knowledge, which is why specialized consultants play an important
role in hospital planning and design. The functional units within the hospital can have competing
needs and priorities. Idealized scenarios and strongly-held individual preferences must be
balanced against mandatory requirements, actual functional needs (internal traffic and
relationship to other departments), and the financial status of the organization.

In addition to the wide range of services that must be accommodated, hospitals must serve and
support many different users and stakeholders. Ideally, the design process incorporates direct
input from the owner and from key hospital staff early on in the process. The designer also has to
be an advocate for the patients, visitors, support staff, volunteers, and suppliers who do not
generally have direct input into the design. Good hospital design integrates functional
requirements with the human needs of its varied users.

The basic form of a hospital is, ideally, based on its functions:

Bed-related inpatient functions

Outpatient-related functions
Diagnostic and treatment functions
Administrative functions
Service functions (food, supply)
Research and teaching functions
Physical relationships between these functions determine the configuration of the hospital.
Certain relationships between the various functions are required—as in the following flow
diagrams.

These flow diagrams show the movement and communication of people, materials, and waste.
Thus the physical configuration of a hospital and its transportation and logistic systems are
inextricably intertwined. The transportation systems are influenced by the building configuration,
and the configuration is heavily dependent on the transportation systems. The hospital
configuration is also influenced by site restraints and opportunities, climate, surrounding
facilities, budget, and available technology. New alternatives are generated by new medical
needs and new technology.

In a large hospital, the form of the typical nursing unit, since it may be repeated many times, is a
principal element of the overall configuration. Nursing units today tend to be more compact
shapes than the elongated rectangles of the past. Compact rectangles, modified triangles, or even
circles have been used in an attempt to shorten the distance between the nurse station and the
patient’s bed. The chosen solution is heavily dependent on program issues such as organization
of the nursing program, number of beds to a nursing unit, and number of beds to a patient room.
(The trend, recently reinforced by HIPAA, is to all private rooms.)