H

UNIVERSAL SYMBOL
FOR HOSPITALS DURING
TIMES OF PEACE
+ UNIVERSAL SYMBOL
FOR HOSPITALS DURING
TIMES OF CONFLICT
 • DEFINITION OF HOSPITAL
• TYPE OF HOSPITALS
• THE PRIMARY HEALTH CARE PROGRAMME
• THE DISTRICT HOSPITAL
• PLANNING A DISTRICT HOSPITAL
TOPICS • LOCATION & SITE SELECTION
• MASTER PHYSICAL DEVELOPMENT
• MASTERPLAN CONSIDERATIONS
• BUILDING SHAPE
• DEPARTMENTAL PLANNING
 • P. D. 1096 – National Building Code of the Philippines
and Its Implementing Rules and Regulations
• P. D. 1185 – Fire Code of the Philippines and Its Implementing Rules and
Regulations
• P. D. 856 – Code on Sanitation of the Philippines and Its Implementing Rules
and Regulations
• B. P. 344 – Accessibility Law and Its Implementing Rules and Regulations
• R. A. 1378 – National Plumbing Code of the Philippines and Its Implementing
Rules and Regulations
• R. A. 184 – Philippine Electrical Code
• Manual on Technical Guidelines for Hospitals and
Health Facilities Planning and Design. Department of
REFERERENCES •
Health, Manila. 1994
Signage Systems Manual for Hospitals and Offices. Department of Health,
Manila. 1994 Health Facilities Maintenance Manual. Department of Health,
Manila. 1995
• Manual on Hospital Waste Management. Department of Health, Manila. 1997
• District Hospitals: Guidelines for Development. World
Health Organization Regional Publications, Western
Pacific Series. 1992
• Guidelines for Construction and Equipment of Hospital and Medical Facilities.
American Institute of Architects, Committee on Architecture for Health. 1992
• De Chiara, Joseph. Time-Saver Standards for Building
Types. McGraw-Hill Book Company. 1980
 San Lazaro Hospital
- Oldest Hospital

Oldest Hospital in the country, extablished as a dispensary clinic in

Intramuros in 1557 by Spanish Frey Juan Clemente
 • A place where sick or injured people are
given care or treatment and where
children are often born
• A charitable institution for the needy, aged,
infirm or young
• An institution where the sick or injured are
HOSPITAL given medical or surgical care
• Etymology : Middle English, from Anglo-
French from Medieval Latin
“hospitale”(hospice), guest house from
neuter of Latin “hospitalis” of a guest, from
hospit-, hospes (14th Century)

Merriam-Webster DIctionary
 • Classified under Group D Institutional –
Government & Health Services
• A community to national level of
institutional use, or occupancy,
HOSPITAL characterized mainly as a low – rise,
medium – rise or high – rise building /
structure for medical, government service
administrative and related services.

Based on Rule VII.1 of the NBC, Schedule of Principal, Accessory &

Conditional Use / Occupancy of Building / Structure
 • ACCORDING TO OWNERSHIP
TYPES OF HOSPITALS •
•
ACCORDING TO SCOPE OF SERVICES
ACCORDING TO FUNCTIONAL CAPACITY

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 • GOVERNMENT
TYPES OF HOSPITALS • PRIVATE

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 • GOVERNMENT
• The hospital is created by law.
• A government health facility may be
TYPES OF HOSPITALS under the National Government, DOH,
Local Government Unit (LGU),
(by Ownership) Department of Justice (DOJ), State
Universities and Colleges (SUCs),
Government-owned and controlled
corporations (GOCC) and others

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 Philippine General
Hospital
-Government

Founded 1907, designed by [Link] E. Parsons based on the plans

by Daniel Burnham
 • PRIVATE
• Owned, established, and operated
TYPES OF HOSPITALS with funds from donation, principal,
investment, or other means by any
(by Ownership) individual, corporation, association, or
organization

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
Asian Hospital and
Medical Center
- Private

Founded in 2002, designed by Luis and Associates

 • GENERAL
• A hospital that provides services for all
kinds of illnesses, diseases, injuries or
deformities
• It provides medical and surgical care
TYPES OF HOSPITALS to the sick and injured, maternity,
newborn and child care
(by Scope of Services) • It shall be equipped with the service
capabilities needed to support board
certified/ eligible medical specialists
and other licensed physicians
rendering services in:

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 • GENERAL
• Not limited to the following:
• Clinical Services (Family
Medicine, Pediatrics, Internal
Medicine, Obstetrics and
TYPES OF HOSPITALS Gynecology, Surgery)
• Emergency Services
(by Scope of Services) • Outpatient Services
• Ancillary and Support Services
(Clinical Laboratory, Imaging
Facility, Pharmacy)

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 Chinese General
Hospital and Medical
Center
-General

Founded in 1891 by Cralos Palanca Tanchueco and with businessmen

Chan Guan and Mariano Velasco
 • SPECIALTY
• Specializes in a particular disease or
condition or in one type of patient
• A specialized hospital may be devoted
to the treatment of the following:
• Treatment of a particular type of
illness or for a particular
TYPES OF HOSPITALS condition requiring a range of
treatment
(by Scope of Services) • Treatment of patients suffering
from a particular diseases of a
particular organ or group of
organs
• Treatment of patients belonging
to a group such as children,
Based on DOH (2015) Administrative Order 2012-0012. Rules and
Regulations Governing the New Classification of Hospitals and Other
women, elderly or others
Health Facilities in the Philippines. Department of Health Philippines
Philippine Heart
Center of Asia
-Specialty

Designed by Arch. Jorge Ramos, inaugurated 1975

 • LEVEL 1 GENERAL HOSPITAL
TYPES OF HOSPITALS • LEVEL 2 GENERAL HOSPITAL
(by Functional •
•
LEVEL 3 GENERAL HOSPITAL
SPECIALTY HOSPITALS
Capacity) • TRAUMA HOSPITALS

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 • LEVEL 1 GENERAL HOSPITAL
• A staff of qualified, medical, allied medical and
administrative personnel headed by a physician duly
licensed by the PRC
• Bed space for its authorized bed capacity, in accordance
with DOH Guidelines in the Planning and Design of
Hospitals
• An operating room with standard equipment and

TYPES OF HOSPITALS •
provisions for sterilization of equipment and supplies in
accordance with:
DOH Reference Plan in the Planning and Design of an

(by Functional •
Operating Room or Theater
DOH Guidelines on Cleaning, Disinfection, and
Sterilization of Reusable Medical Devices in Hospital
Capacity) •
Facilities in the Philippines
A post-operative Recovery Room
• Maternity Facilities consisting of Ward(s), Room(s), a
Delivery Room, exclusively for maternity patients and
newborns

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 • LEVEL 1 GENERAL HOSPITAL (cont’d)
• Isolation facilities with proper procedures for the care
and control of infection and communicable diseases as
well as for the prevention of cross infection

TYPES OF HOSPITALS •
•
A separate dental section/ clinic
Provision for blood donation
• A DOH-licensed secondary clinical laboratory with the

(by Functional •
services of a consulting pathologist
A DOH licensed Level 1 imaging facility with the services
of a consulting radiologist
Capacity) • A DOH licensed pharmacy

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 • LEVEL 2 GENERAL HOSPITAL
• As minimum, all of Level 1 capacity, including but not
limited to:
• An organized staff of qualified and competent personnel
with Chief of Hospital/Medical Director and appropriate
board certified Clinical Department Heads
• Departmentalized and equipped with the service
capabilities needed to support board certified/ eligible
medical specialties and other licensed physicians
rendering services in the specialties of Medicine,
TYPES OF HOSPITALS Pediatrics, Obstetrics and Gynecology, Surgery, their
subspecialties, and other ancillary services

(by Functional •
•
Provision for general ICU for critically ill patients
Provision for NICU
• Provision for HRPU

Capacity) •
•
Provision for Respiratory Therapy Services
A DOH licensed tertiary clinical laboratory
• A DOH licensed level 2 imaging facility with mobile X-ray
inside the institution and with capability for contrast
examinations

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 • LEVEL 3 GENERAL HOSPITAL
• As minimum, all of Level 2, including but not limited to:
• Teaching and/or Training Hospital with accredited
residency training program for physicians in the four
major specialties namely: Medicine, Pediatrics, Obstetrics
and Gynecology, and Surgery
TYPES OF HOSPITALS •
•
Provision for physical medicine and rehabilitation unit
Provision for ambulatory surgical clinic

(by Functional •
•
Provision for dialysis facility
Provision for blood bank
• A DOH licensed level 3 imaging facility with
Capacity) interventional radiology

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 • SPECIALTY HOSPITAL
TYPES OF HOSPITALS • As described above

(by Functional
Capacity)

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
Philippine Orthopedic
Center
-Trauma

Designed by Francisco Mańosa and Partners, inaugurated 2004

 • TRAUMA HOSPITAL
• The trauma capability of hospitals shall be assessed in
accordance with the guidelines formulated by the
Philippine College of Surgeons

TYPES OF HOSPITALS • Trauma Capable Facility is a DOH licensed hospital

designated as a Trauma Center
• Trauma Receiving Facility is a DOH licensed hospital

(by Functional within the trauma service area which receives trauma
patients for transport to the point of care or a trauma
center

Capacity)

Based on DOH (2015) Administrative Order 2012-0012. Rules and

Regulations Governing the New Classification of Hospitals and Other
Health Facilities in the Philippines. Department of Health Philippines
 •
TYPES OF HOSPITALS •
PRIMARY
SECONDARY
(by Service Capability) • TERTIARY

Based on DOH Manual on the Technical Guidelines for Hospitals and

Health Facilities Planning and Design (DOH, 2001)
 • PRIMARY – equipped with the service
capabilities needed to support licensed
physician rendering service in:
TYPES OF HOSPITALS • Medicine
(by Service Capability) • Pediatrics
• Obstetrics, and
• Minor Surgery

Based on DOH Manual on the Technical Guidelines for Hospitals and

Health Facilities Planning and Design (DOH, 2001)
 • SECONDARY – equipped with the service
capabilities needed to support licensed
physician rendering services in the field of:
TYPES OF HOSPITALS • Medicine
• Pediatrics
(by Service Capability) • Obstetrics, and Gynecology
• General Surgery and
• Ancillary S

Based on DOH Manual on the Technical Guidelines for Hospitals and

Health Facilities Planning and Design (DOH, 2001)
 • TERTIARY – Fully departmentalized and
equipped with service capabilities needed
to support certified Medical Specialists and
other licensed physicians rendering
TYPES OF HOSPITALS services in the field of:
• Medicine
(by Service Capability) • Pediatrics
• Obstetrics and Gynecology
• Surgery and their
• Subspecialties and Ancillary Services

Based on DOH Manual on the Technical Guidelines for Hospitals and

Health Facilities Planning and Design (DOH, 2001)
 • TEACHING OR TRAINING
TYPES OF HOSPITALS • FRONTLINE HOSPITAL
• OUTPATIENT HOSPITAL
(by Operation)

Based on DOH Manual on the Technical Guidelines for Hospitals and

Health Facilities Planning and Design (DOH, 2001), the Whole Building
Design Guide (WBDG, 2011), and The Frontline Hospital by Philip Mein
(World Health Organization)
 The Medical City
-Teaching

Designed by Francisco Manosa and Partners, inaugurated 2004

 • TEACHING OR TRAINING
TYPES OF HOSPITALS • Departmentalized hospital with accredited
Residency Training Program in a specified
(by Operation) specialty or discipline

Based on DOH Manual on the Technical Guidelines for Hospitals and

Health Facilities Planning and Design (DOH, 2001)
 UST Hospital
-Teaching

Inaugurated 1945 in Espana, Manila, 2011 expnasion by Arch. John

Joseph Fernandez
 • FRONTLINE HOSPITAL
• The farthest outpost for organized
healthcare to which the sick were
expected to come
• The forefront of health care delivery
TYPES OF HOSPITALS • Typically rural hospitals
(by Operation) • Make-shift hospitals during times of
calamity
• Centre for outreach and primary
health care serving community health
needs within its catchment area

Based on The Frontline Hospital by Philip Mein (World Health

Organization)
 • OUTPATIENT HOSPITAL
• A type of hospital without overnight
patients, loosely called clinics
• Generally less expensive to build and
operate compared to a bedded
TYPES OF HOSPITALS hospital
• Can range from simply Physicians’
(by Operation) Offices providing primary health care
to large, independent “hospitals
without beds” to community-level
outpatient clinics that are satellites of
larger medical centers or systems

Based on the Whole Building Design Guide (WBDG, 2011)

American Outpatient
Clinic
-Outpatient

Americzan Hospital, Intramuros, Manila

 •
TYPES OF HOSPITALS •
SMALL : less than 100 beds
MEDIUM: 100 to 300(up to 500) beds
(by Bed Strength) • LARGE: more than 500 beds

Based on DOH Manual on the Technical Guidelines for Hospitals and

Health Facilities Planning and Design (DOH, 2001), the Whole Building
Design Guide (WBDG, 2011), and The Frontline Hospital by Philip Mein
(World Health Organization)
 Primary Health Care
Programme

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 • The term "district hospital" is used here to
mean a hospital at the first referral level
Definition of a that is responsible for a district of a
defined geographical area containing a
District Hospital defined population and governed by a
politico-administrative organization such
as a district health management team

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 • model clarifies the place of hospitals at the
first referral level as the component of
district health systems that immediately
supports the health activities of the
Role of a district or community, and especially
primary health care activities.
District Hospital • Such hospitals can provide wide-ranging
support for patient referral as well as
support for various technical,
administrative and educational/training
activities in the district.

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 Services of a
District Hospital

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 Services of a
District Hospital

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 Computations:

(1) Total number of admissions per year:

= district population x rate of admission per year (1
in every 20)
= 150000 x 1/20 = 7,500

(2) Bed-days per year:

= total number of admissions per year x average

Size of the Hospital length of stay in hospital (5 days)

= 7,500 x 5 = 37,500

(3) Total number of beds required when occupancy is 100%:

= bed-days per year /365 days
= 37500 + 365 = 102.74 , say 105 beds.

(4) Total number of beds required when occupancy is 80%:

= bed-days per year + (365 x 80% )
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO< = 37 500 + (365x80%) = 128.42, say 130 beds
1998)
 Computations:

(5) Total area of hospital:

= total number of beds x 40 square meters per bed
(depends on type can go as high as 130-200 for
Size of Hospital specialty tertiary)
= 105 beds x 40 = 4,200 square meters (for
100% occupancy)
= 130 beds x 40 = 5,200 square meters (for
80% occupancy)

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INVENTORY& DISTRIBUTION OF HEALTH
FACILITIES

Location of the
Hospital
One of the most effective ways of determining
the location of a new facility is to use a base
map of the district and vicinity, on which one
can enter, translate and compare data, facts
and information
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 SERVICE CATCHMENT AREA:
POLITICO-ADMINISTRATIVE BOUNDARIES

Politico-administrative boundaries are usually

the strongest determinant, as they set a
Location of the defined area and imply an established
organization which directs, manages and
Hospital operates the affairs of the population within its
jurisdiction

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 SERVICE CATCHMENT AREA:
GEOGRAPHICAL BOUNDARIES

Location of the
Hospital

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 SERVICE CATCHMENT AREA:
TIME BOUNDARIES

Location of the
Hospital

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 (1) It should be within 15-30 min travelling time. In a district with good
roads and adequate means of transport, this would mean a service
zone with a radius of about 25 km.

(2) It should be grouped with other institutional

facilities, such as religious (church), educational (school), tribal
(cultural) and commercial (market) centres.

Factors to consider in (3) It should be free

from dangers of flooding; it must
not, therefore, be sited at the lowest point of the
locating a District district.

(4) It should be in an area free of pollution of any kind,

Hospital including air,
noise, water and land pollution.

(5) It must be serviced by public utilities: water, sewage and

storm-water disposal, electricity, gas and telephone. In areas where
such utilities are not available, substitutes must be found, such as a
deep well for water, generators for electricity and radio
From the World Health Organization Western Pacific Series District communication for
Health Facilities Guidelines for Development & Operations (WHO< telephone.
1998)
 Site Selection
CRITERIA SIZE OF THE SITE
The site must be large enough for all the
planned functional requirements to be met
and for any expansion envisioned within the
coming ten years (Fig. 5). Recommended
standards vary from 1.25 to 4 ha per 100
From the World Health Organization Western Pacific Series District
beds; the following minimum requirements
Health Facilities Guidelines for Development & Operations (WHO< have been proposed:
1998)
 Site Selection TOPOGRAPHY
CRITERIA A flat terrain is the easiest and least expensive
to build on. A rolling or sloping terrain is more
difficult and more expensive to build on, but
the solutions can be interesting and
innovative; by using the natural slope of the
ground, the drainage and sewage disposal
systems can be designed so as to result in
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO< lower construction and maintenance costs
1998)
 DRAINAGE

Site Selection The terrain must allow for easy movement of water away from the
site. A high point in the community is ideal. If this is not available and
the site is at a low point or in a depression, the following must be
CRITERIA checked:
• how the surrounding natural terrain and
waterways can be used to move water away from
the site;
• whether the type of soil allows rapid absorption and
disposal of water;
• the use of other technical means of ensuring
From the World Health Organization Western Pacific Series District drainage such as the building on a podium or on
Health Facilities Guidelines for Development & Operations (WHO< stilts, or digging temporary reservoirs
1998)
 SOIL CONDITIONS
Site Selection • Waterlogged areas, swamps and former rice fields
should be avoided
CRITERIA • Check the bearing capacity of the soil. As foundation
requirements vary greatly with the form of construction and the
building materials used, the subsurface soil and water conditions
must be determined
• Scrap unstable top layers, if necessary, and fill
with well compacted, suitable materials, like
clean coarse sand
• Seek engineering advice before finalizing the depth and size of the
From the World Health Organization Western Pacific Series District foundations, which should be designed to suit the site conditions
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 UTILITIES
• Electrical, water and communication lines
should be available. If not, generators, deep
Site Selection wells and water pumps must be provided
and radio communication lines established
CRITERIA • Health care facilities are quite ineffective if
all-weather roads, water supplies and a
reliable electrical supply are not available at
the site.

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 Site Selection
CRITERIA NATURAL FEATURES
• Building design should respond as much as
possible to the site, so that the structure is in context with
the environment:
• a waterway that bisects a site also generally bisects the building
form; this might call for an innovative design solution
• The presence of a large pond on a site diminishes its area and
coverage and might call for a multi-storey solution on a site
• Solutions can be numerous, involving creativity and innovation, but
From the World Health Organization Western Pacific Series District they should be based on two overriding considerations: (i) that the
Health Facilities Guidelines for Development & Operations (WHO< design respects and follows the laws of nature; and (ii) that the
1998) limitations imposed by the natural features do not detract from the
functional performance or cost-effectiveness of the facility.
 Site Selection LIMITATIONS

CRITERIA • Direct access from the road?

Is it a contiguous piece with proper ownership title?
• Does the site have existing structures?
• Can they be incorporated into the design of the new
structure and the existing parts converted into functional
spaces in the new hospital?
• If the existing structures are too old to become part of the
new hospital, could they be converted to a motor pool,
laundry, store or workshop? Are these buildings suitably
From the World Health Organization Western Pacific Series District located on the site?
Health Facilities Guidelines for Development & Operations (WHO<
• Are they so old and dilapidated that they must be
1998)
demolished? If so, are any of the parts, members or
 • DOCUMENTS
• The Title
• The Survey Plan
• The Topographic Survey
• The Slope Map
• THE SITE SURVEY
• Definitions of property line
• Dimensions and locations of any buildings, structures,
easements, rights-of-way or encroachments on the site;
• All existing utility services, including their size and

Master Physical characteristics;

• Official data on which elevations are based and permanent
values established on or adjacent to the site;

Development • Information regarding the disposal of sanitary

wastes and storm-water and suitability of subsoil
BASIC DOCS & INFO for disposal of rainwater arid sewage;
• All trees and types of vegetation within the plot; and
• Elevations on a horizontal grid system of not more than 6-m
interval, indicating changes of slope, to form a basis for a
contour map of 50-cm intervals.
• LEGAL DOCUMENTS
• Zoning Restrictions
From the World Health Organization Western Pacific Series District • BuIlding Code
Health Facilities Guidelines for Development & Operations (WHO<
1998) • Fire Code
• Other Codes
 • OPERATIONAL FUNCTIONS
• Aims and objectives of the services to be provided
• Patients and types
• Types of illnesses to be treated
• (Activities involved
• Minor operational functions
• (Other functions contemplated (e.g., teaching,
research)
• People involved (e.g., patients, staff, researchers,
students, outside faculty members)

Master Physical • SCALE

• Workload (e.g., daily number of in-patients treated, of in-
patient meals served, of X-rays taken)
Development • Manpower and staffing needed to meet the workload
• ORGANIZATIONAL POLICY

OPERATIONAL POLICY • Patient Movement

• Staff and Staffing Movement
• Supply Delivery
• Disposal of Used Goods
• Laundry Services
• Food Services
• Domestic Services
• Engineering
From the World Health Organization Western Pacific Series District
• Fire Safety
Health Facilities Guidelines for Development & Operations (WHO<
1998) • Communications and Call Systems
• ADMINISTRATION
 DESIGN CONTROL PARAMETERS (DCP):
• Occupancy: Group D Institutional Division 2
• Allowable Building Height Limit (BHL) = 15
meters (or 5 floors, at 3.0 meters F2F)
• Maximum Alllowable Building Footprint
(AMBF) for a regular lot
• W/ Sprinklers: 60% of TLA
Master Physical • W/O Sprinklers: 50% of TLA
• Parking Requirements:
Development • Public: 1 for every 25 beds
• Private: 1 for every 12 beds
SITE UTILIZATION • 1 Truck Loading Dock for every 5,000
SQM of GFA
• Maximum Allowable Floor-Area-Ratio: 2.50
• Maximum Allowable PSO:
• W/O Firewalls: 50% of TLA
Based on Rule VII and VIII of the IRR of the National Building Code • W/ Firewalls: 60% of TLA
 ORIENTATION

Master Physical
Development • It has been found that orientating buildings
along an east-west axis, giving the longer
SITE UTILIZATION sides of the building northern and southern
exposures, is the most desirable.
• In areas where the major climatic problem is
humidity rather than heat, buildings should
be sited at a slight angle, either towards the
From the World Health Organization Western Pacific Series District east or the west, depending on the direction
Health Facilities Guidelines for Development & Operations (WHO<
1998) of the prevailing wind.
 ORIENTATION

• Illumination and ventilation are major problems in

hospitals, and these are further aggravated by modern
trends to construct "deep" buildings using steel and
reinforced concrete.
• Good ventilation in tropical climates ideally requires long,
narrow buildings; but this is not always feasible, and a
Master Physical compromise must be found by separating activities and
orientating buildings or wings of buildings.
Development • Incorrect orientation of buildings strongly affects the
consumption of energy in the finished hospital.

SITE UTILIZATION • In areas where there are heavy rains accompanied by

wind, all openings should be protected against wind-
driven rain.
• In hot, humid areas, the external surface should reflect as
much solar radiation as possible, and the walls and roof
should, as far as possible, be made of lightweight material
with low thermal capacity.
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 SLOPE STUDY

Master Physical
Development • On sites with steep slopes, the best areas
SITE UTILIZATION for building must be found.
• As a rule, slopes of 0-10% are desirable and
easy to build on ;
• slopes greater than these require either
massive cuts or massive fill or a
From the World Health Organization Western Pacific Series District
combination of the two.
Health Facilities Guidelines for Development & Operations (WHO,
1998)
 LANDSCAPING & HORTICULTURE

Master Physical
Development • The physical features of the land should govern the
building shape

SITE UTILIZATION • Create microclimates by landscaping, paving,

planting trees and shrubs creating sunny and shady
areas
• Dense vegetation controls hot and dusty winds,
while increasing humidity lowering the heat index
• Trees and bushes can deflect or divert wind
From the World Health Organization Western Pacific Series District • Waterways and water channels reduce
Health Facilities Guidelines for Development & Operations (WHO, temperature, large grassy areas reduce glare
1998)
 EXTERNAL ROUTES

Master Physical • Various type of traffic should be grouped for entry

Development according to their nature, typically:
• emergency: for patients in ambulances and other vehicles

CIRCULATION for the emergency department;

• service: for delivering supplies and collecting rubbish;
• service: for removal of dead; and
• main: for all others.
• Hospital administrators prefer fewer points of
access, a solution is to have:
• A maximum of one or two main entrances from the main
access road
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO, • Break this into several branches in a hierarchy of roads
1998) within the site
 INTERNAL ROUTES

• CORRIDOR SIZE IN RELATION TO TRAFFIC INTENSITY:

• Studies have shown that traffic problems are caused by:
• Inadequate pace of circulation, e.g., when there are more
users than were provided for;
• different paces of circulation, e.g., when a slow-moving
trolley bed with a sedated
• patient and equipment obstructs the normal flow of traffic
in a busy corridor;
Master Physical • and two-way traffic, e.g., when a food trolley and a bed
trolley cross at a corridor intersection.
• A study of traffic in hospital corridors showed however, that a
Development corridor 2- 3 m wide can accommodate daily
traffic. A corridor 3 m wide in a major hospital
CIRCULATION can accommodate a walking traffic load of 4000
people per direction per hour, or 8000 people in
both directions per hour, assuming a free-flowing
walking speed in hospitals of 4 km/h. The same
corridor can accommodate 20-60 journeys per
hour of wheeled traffic, including supplies, bed
From the World Health Organization Western Pacific Series District and food trolleys.
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INTERNAL ROUTES

Master Physical
Development
CIRCULATION

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INTERNAL ROUTES

Master Physical
Development
CIRCULATION

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INTERNAL ROUTES

Master Physical
Development
CIRCULATION

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 • GENERAL CAUSES OF GROWTH
• Growth of the community. A community may urbanize or may
change drastically as the result of an event or a catalyzing situation
that requires the equivalent growth of health care services.
• Accumulated needs and requirements. Necessary expansion may

Master Physical not be undertaken immediately because of lack of resources; needs

are deferred and accumulate to the bursting point.
• Physical effects on the building with time. Buildings deteriorate

Development and become obsolete and even irrelevant over the years.
• Changing standards and codes. Regulations for health and safety
• change to meet advances in construction techniques and materials.
GROWTH & CHANGE A building may be declared unsafe and unfit for human use if it is
not updated, upgraded and properly maintained.
• Changing methods in medicine. Development of new equipment,
miniaturization, computerization and other new technologies in the
medical field translate into new requirements for architectural
design to provide better and more modern clinical services.

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 Master Physical
Development
GROWTH & CHANGE

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 Master Physical
Development
GROWTH & CHANGE

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 Master Physical
Development
GROWTH & CHANGE

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INCREMENTS OF GROWTH

Master Physical
Development
GROWTH & CHANGE It is most advisable to expand not in spurts with needs but by
deliberate increments, thus:
• by number of beds, but in terms of ward units with
their complementary manpower and supporting services
(Fig. 33a);
• by functional units, in the case of a new hospital
department (Fig. 33b );

From the World Health Organization Western Pacific Series District • by specialist rooms and their supporting units and
Health Facilities Guidelines for Development & Operations (WHO< services (Fig. 33c).
1998)
 ENERGY CONSERVATION
GENERALLY ADDRESSED BY TWO APPROACHES:
• PRACTICAL LOW-KEY TECHNOLOGY
• APPLICATION OF SUSTAINABLE
BUILDING DESIGN APPROACHES THAT
RELY ON THE VERNACULAR LANGUAGE
PREVALENT IN THE LOCALE
• THE USE OF THE NATURAL FETAURES OF
Master Physical THE SITE TO MINIMIZE ENERGY
CONSUMPTION AND OPERATIONAL
Development CARBON FOOTPRINT OF THE FACILITY
• USE OF LOCALLY-AVAILABLE MATERIALS
FOR CONSTRUCTION
• SOPHISTICATED HIGH-LEVEL TECHNOLOGY
• RELIANCD ON HIGH-TECH SOLUTIONS
TO MINIMIZE ENERGY CONSUMPTION
From the World Health Organization Western Pacific Series District AND TO AUTOMIZE CERTAIN ASPECTS
Health Facilities Guidelines for Development & Operations (WHO< OF OPERATION
1998)
 ENERGY CONSERVATION

Master Physical UTILIZING SOLAR ENERGY

• USE OF SOLAR-HEATING DEVICES TO PROVIDE
Development FOR THE HOT WATER REQUIREMENTS OF CERTAIN
DEPARTMENTS SUCH AS LAUNDRY, KITHCEN AND THE NURSING
WARDS
• MAXIMIZING SOLAR ENERGY FOR LIGHTING
• PROVISION OF SPECIAL INLETS WITH
TRANSLUCENT COVERS AT VARIOUS PLACES IN THE ROOF
TO PROVIDE GLARE-FREE LIGHT DURING THE DAY FOR AREAS SUCH
AS CORRIDORS, WAITING HALLS AND ATRIA
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 ENERGY CONSERVATION

BUILDING DESIGN
• MAXIMIZE USE OF OPEN, OPERABLE WINDOWS
BOTH FOR LIGHTING AND VENTILATION
• AIRCONDITIIONING IS ONLY NECESSARY IN
CERTAIN AREAS SUCH AS THE OPERATING
Master Physical THEATERES, ICU’S AND X-RAY FACILITIES
• HIGH-ENERGY BUILDINGS REQUIRE MORE SOPHISTICATED

Development EQUIPMENT AND MAINTENANCE

• MECHANICAL AND ELECTRICAL BUILDING SERVICE EQUIPMENT
REUIRE MORE REGULAR AND PREVENTIVE MAINTENANCE
• RELIANCE ON HIGH-ENERGY MECHNANICAL SERVICES NECESSITATE
THE DUPLICATION OF SOME ITEMS OF EQUIPMENT AND THE
PROVISION OF EMERGENCY (STAND-BY) POWER

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 GENERAL CONSIDERATIONS

The master plan consists of two elements:

• determination of circulation routes and
MASTERPLANNING corridor systems; and
• location of elements on the site in relation
to one another

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 GENERAL CONSIDERATIONS

• grouping main functions, like wards, medical

services, admissions and central supplies;
• ·establishing appropriate access routes for
easy orientation of patients and visitors, with
special emphasis on disabled people; and
MASTERPLANNING • providing scope for future expansion, to cope
with an increased number of beds,
supplementary functions and medical
specialization, by ensuring maximum
interaction between hospital units and
support services

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 PRINCIPLES & GUIDELINES

• ZONES
• OUTER ZONE – accessible to the public, emergency
service, outpatient service, administrative service
• SECOND ZONE- receive from the outer zone,
laboratory, pharmacy, radiology (ancillary and support
services), located near outer zone
• INNER ZONE- nursing care and management of
MASTERPLANNING patients, private areas accessible to guests
• DEEEP ZONE- areas requiring asepsis, surgical service,
nursery, ICU segregated from the public areas but accessible
to the first three zones
• SERVICE ZONE- provides support to hospital activities,
dietary service, housekeeeping, maintenance, motorpool,
and mortuary, located away from normal traffic

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 PRINCIPLES & GUIDELINES

MASTERPLANNING • (1) Departments that are most closely linked to the community
should be closest to the main entrance: out-patient department,
emergency, administration (especially business sections), family
planning clinic and other primary health care support.
• (2) Departments that receive their workload from those described
above should be next closest to the entrance: X-ray, laboratories,
dispensary.
• (3) In-patient departments should be in the interior zones, or
wards.
• (4) Operating theatres, the delivery department and the nursery
should have (1) and (2) on one side and (3) on the other, e.g., to
From the World Health Organization Western Pacific Series District provide easy access from the emergency and accident departments
Health Facilities Guidelines for Development & Operations (WHO< to X-ray and operating theatres. The delivery department and
1998) nursery must be separated from the operating theatre.
 PRINCIPLES & GUIDELINES

MASTERPLANNING • (5) Housekeeping and domestic service areas should be grouped

around a service yard: laundry, kitchen, housekeeping,
maintenance, storage and motor pool.
• (6) Staff facilities should be located on the periphery near roads
and public transport: staff dormitories, quarters or housing.
• (7) Teaching facilities, if any, should be close to both staff facilities
and teaching areas and to roads and public transport: student areas,
educational and training components of primary health care.
• (8) The mortuary should be in a special service yard, with a
From the World Health Organization Western Pacific Series District discreet entrance; it should be away from the out-patient
Health Facilities Guidelines for Development & Operations (WHO< department, ward block and nursery.
1998)
 PRINCIPLES & GUIDELINES

• A district hospital should reflect the local

architecture
• The hospital should not be alien to its
surroundings or stand out as an exception
but should fit in with local life, expressing its
spirit and character.
• The hospital building should not be a huge,
BUILDING SHAPE unfriendly, structure but should be a human,
welcoming part of the community.
• Layouts suitable for tropical climatic
conditions include: an open-plan layout for
"hot-humid" areas; a compact layout for
"hot-dry" areas; and a compact layout for
"upland" regions
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 BASIC SHAPES

BUILDING SHAPE

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 BASIC SHAPES

BUILDING SHAPE

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 BASIC SHAPES

BUILDING SHAPE

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 BASIC SHAPES

BUILDING SHAPE

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 THE HOSPITAL NUCLEUS

DEPARTMENTAL THE NUCLEUS

PLANNING & DESIGN • THE OUTPATIENT/ MATERNAL &
CHILDHEALTH DEPARTMENT
• MEDICAL SERVICE (DIAGNOSTICS) – X-
RAY, LABORATORY, PHARMACY
• INPATIENT DEPARTMENT
• SURGICAL DEPARTMENT (A MAJOR
From the World Health Organization Western Pacific Series District THEATRE, A MINOR THEATHRE, AND A
Health Facilities Guidelines for Development & Operations (WHO< DELIVERY SUITE)
1998)
• ADMINISTRATIVE OFFICES
 THE HOSPITAL EXPANDED NUCLEUS

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 PERIPHERAL FACILITIES

DEPARTMENTAL • PERIPHERAL FACILITIES

PLANNING & DESIGN • KITCHEN & LAUNDRY SERVING THE
INPATIENT DEPARTMENT
• CENTRAL STORE FOR SUPPLIES WITH
POSSIBLY A GARAGE FOR A SERVICE
MOBILE UNIT
• STAFF HOUSING FOR SENIOR & JUNIOR
From the World Health Organization Western Pacific Series District
STAFF
Health Facilities Guidelines for Development & Operations (WHO< • SHELTERS FOR RELATIVES, CAN BE
1998)
ALLOCATED FOR A SELF-CARE FACILITY
 PERIPHERAL FACILITIES
• FACTORS TO CONSIDER WHEN PLACING
PERIPHERAL FACILITIES AROUND THE
NUCLEUS:
• Building must have an obvious
connection at least some part of the
nucleus
• A function likely to cause air pollution
DEPARTMENTAL (smoke, smell) must be placed at the
leeward side of the nucleus
PLANNING & DESIGN • Most buildings particularly the garage
and store will require vehicular access
• Staff housing should be placed at the
most attractive part of the side to for
peace and quiet and away from the
wards
• All peripheral facilities shall never be
From the World Health Organization Western Pacific Series District placed in such a way that will restrict
Health Facilities Guidelines for Development & Operations (WHO<
1998) the future expansion of the nucleus
 THE PAVILLION –TYPE (DISPERSED)

DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS

• Typically found in rural hospitals where there

is no shortage of land space
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO< • Facilities are scattered and buildings have
1998)
been added gradually over the years
 THE PAVILLION –TYPE (DISPERSED)
Philippine General Hospital - Manila

DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Most flexible in terms of construction and
planning
From the World Health Organization Western Pacific Series District • Most exposed to the elements in terms of
Health Facilities Guidelines for Development & Operations (WHO<
1998)
circulation
 THE BLOCK-TYPE (LINEAR)

DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Usually taking the form of a number of
block each housing a specific function,
oriented along a circulation spine
• Combines many of the advantages of the
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO< pavilllion-type with a more efficient
1998) circulation system
 THE BLOCK-TYPE (LINEAR)
Cardinal Santos Medical Center – San Juan

DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Inhibits opportunity for cross-ventilation
• May lead to wind-tunelling and dust
• Not suitable for sloping sites
• Most econonomical because of modularity,
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO< with expansion easier to execute
1998)
 THE GRIDIRON-TYPE (RECTILINEAR)

DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Consists of separate rectangular blocks
positioned in a such a way to a
chequerboard of block and open spaces
with circulation along the lines of the grid
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO< • Most attractive of the types suitable to a
1998) large range of climate types
 THE GRIDIRON-TYPE (RECTILINEAR)
US Naval Hospital – Subic Bay

DEPARTMENTAL
PLANNING & DESIGN
SCHEMATICS
• Main disadvantage is it is an inflexible
growth and change only by the addition of
more blocks/ grids
• The circulation routes tend to be extensive,
From the World Health Organization Western Pacific Series District circling upon itself in most cases
Health Facilities Guidelines for Development & Operations (WHO<
1998)
• Present construction difficulties with blocks
requiring single-spans acrosss buildings
 ZONES
Outermost zone, which is the most community-oriented
• primary health care support areas
• out-patient department
• emergency department
• Administration
• admitting office, reception
Second zone, which receives workload from (1)
• diagnostic X-ray
• laboratories
• Pharmacy

DEPARTMENTAL Middle zone between outer and inner zones

• operating department
• intensive care unit
PLANNING & DESIGN • Delivery
• nursery
Inner zone, in the interior but with direct access for the public
• wards and nursing units
Service zone, disposed around a service yard ~
• dietary services
• laundry and housekeeping
• Storage
From the World Health Organization Western Pacific Series District • maintenance and engineering
Health Facilities Guidelines for Development & Operations (WHO< • Mortuary
1998) • motor pool
 PRIMARY HEALTHCARE SUPPORT AREAS:
EDUCATION & TRAINING SUPPORT AREAS

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 PRIMARY HEALTHCARE SUPPORT AREAS:
TECHNICAL SUPPORT AREAS

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 OUTPATIENT DEPARTMENT

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 EMERGENCY DEPARTMENT

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 ADMINISTRATIVE BLOCK

• The administrative department is

orientated to the public but is at the same
time private.
• Areas for business, accounting, auditing,
DEPARTMENTAL cashiers and records, which have a
functional relationship with the public,
PLANNING & DESIGN must be located near the entrance of the
hospital.
• Offices for hospital management, however,
can be located in more private areas.

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 MEDICAL RECORDS ROOM
• If possible a full-scale computerized data
bank should be created, including a
standardization of a database
• This should be in an area that ensures the
records remain confidential
• Should be immediately adjacent to the
Admitting Section for ease od filing of new
DEPARTMENTAL patients, and retrieval of records of
returning patients
PLANNING & DESIGN • To balance the proportion of the space, the
patients records are usually fragmented –
active records are kept at the Medical
Records Room in the Public Zone, while
inactive and dead records are kept in
Medical Record Storage somewhere in the
inner areas of the hospital accessible to the
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO< central MIS
1998)
 RADIOLOGY AND IMAGING DEPARTMENT

• Diagnostic imaging (or diagnostic radiology) is provided by

• X-ray units,
• ultrasound and
• radionuclide (radioisotope) scanners.
• (1) Diagnostic imaging, both X-rays and ultrasound, should be
available to both in-patients and out-patients. The equipment
needs electrical power. There are many advantages to locating X-
DEPARTMENTAL ray and ultrasound equipment in the same department. In small
hospitals with a daily workload of 5-10 patients, the two can be in
the same room. As the workload increases, separate rooms
PLANNING & DESIGN •
should be made available.
(2) Ultrasound does not require any special building construction.
The room should contain a patient couch, firm but comfortable, a
chair and at least 1 SQM for the equipment. The lighting must be
dim - bright light makes it difficult to examine a patient properly-
but the room must not be very dark. Handwashing facilities
should be located either in the room or close by. There must be a
toilet close to the ultrasound room.

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 RADIOLOGY AND IMAGING DEPARTMENT

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 RADIOLOGY AND IMAGING DEPARTMENT

CONSIDERATIONS:
• The diagnostic imaging area should be on the Ground
Floor of the hospital, with easy covered access to
wheelchairs, patient trolleys and beds
• Location should be close to the emergency section of the
outpatient if possible, but easy access to ALL patients
should be the first consideration
DEPARTMENTAL • One x-ray room and one dark room can handle 40-50
patients per day; because of equipment costs it is better
PLANNING & DESIGN to increase staff and lengthen working days than adding
additional rooms and equipment
• A 150-bed hospital usually can manage with one x-ray
room
• One dark room is sufficient for two x-ray rooms
• If the hospital increases in size, it is preferred to x-ray
rooms in the same area

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 RADIOLOGY AND IMAGING DEPARTMENT

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 RADIOLOGY AND IMAGING DEPARTMENT

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 LABORATORY SERVICES

DEPARTMENTAL A comprehensive laboratory should have the following

sections:
• morbid anatomy
PLANNING & DESIGN • Haematology
• Clinical pathology
• Microbiology
• Laboratory services come under great pressure to
• expand, as the workload tends to double every 5-8
years. Their growth will be even faster as the out-patient
department is strengthened to integrate provisions for
From the World Health Organization Western Pacific Series District primary health care. The plan for laboratory work
Health Facilities Guidelines for Development & Operations (WHO< benches must therefore be flexible, perhaps comprising
1998) modules Fig. 53. Plan for laboratory (Fig. 53).
 LABORATORY SERVICES

RULES OF THUMB
• Allocate 6 SQM of floor area for each laboratory staff,
administrative or technical
• This does not include corridors, stairs, toilets, stores or
wall space, for which an additional 30-50% of space
should be provided, depending on the size and type of
equipment.

DEPARTMENTAL • Must be planned on a modular system that allows for

flexible use, and ease of expansion
• External walls of the laboratory should be of permanent,
PLANNING & DESIGN durable construction, but the partition walls should be
considered to be temporary so that they can be taken
out or replaced easily as the activities expand.
• The ceilings should be made of materials that are easily
cleaned and disinfected so as to reduce airborne
contamination.
• They should be 2.55-2.80 m in height to allow for wall-
mounted distillation racks and other equipment.
From the World Health Organization Western Pacific Series District
• The floors should be made of materials that are resistant
Health Facilities Guidelines for Development & Operations (WHO<
1998) to acids, alkali and salts and can be easily cleaned and
disinfected.
 LABORATORY SERVICES

COLOR-CODING OF UTILITIES
• Doors should be located in places where entry and exit

DEPARTMENTAL is easy and does not interfere with the laboratory

benches or equipment.
• Laboratory doors should be no less than 1 m wide to
PLANNING & DESIGN allow easy access of equipment. In some areas, double
doors, 1.2 m wide, should be provided for passage of
large equipment, such as deep-freezes.
• All doors should open towards the corridor.
• The basic utilities that are to be provided in the
laboratory are water supply, sanitary drains and drain
vents, electricity, compressed air, distilled water, carbon
dioxide, steam and gas. Others may be necessary
From the World Health Organization Western Pacific Series District depending on the types of tests to be performed.
Health Facilities Guidelines for Development & Operations (WHO< • Should have external access to a small, remotely
1998)
located store for dangerous goods.
 PHARMACY
• The pharmacist is responsible for the purchase, storage
and dispensing of all drugs and of bulk pharmaceutical
preparations, disinfectants and sterile solutions.
(1) The pharmacy must be located so that it is:
• accessible to the out-patient department,
• convenient for dispensing, and
• accessible to the central delivery yard.
(2) Traffic within the department must be economical and
flexible.
DEPARTMENTAL (3) Its size is determined by its organization and operational
policies.

PLANNING & DESIGN (4) Provision for security of dangerous drugs must be
ensured.
(5) Provision for control of fire must be ensured, as many
inflammable substances are stored there. Bulk quantities
should not be held in the pharmacy but should be drawn
from a remotely located store for dangerous goods.
(6) Finishes must be impervious to acid and alkali and easy
to clean.
From the World Health Organization Western Pacific Series District (7) The corridors must allow easy turning of wheeled
Health Facilities Guidelines for Development & Operations (WHO< vehicles.
1998)
 BLOOD BANK
• Blood should be supplied from a blood transfusion
centre (national or regional) after appropriate testing.
• If this is not possible, the blood-bank system may be
based on blood obtained from previously screened local
donors.
• A third approach in which donors are recruited locally
when the need arises ("the working blood bank") is the
least desirable alternative.
• The promotion of donor recruitment is a community
task to be organized through the district health council.
DEPARTMENTAL
STERILIZATION
PLANNING & DESIGN • While major hospitals regard a central sterile -supply
department as essential, it may be easy to organize a
separate sterilization unit in a small hospital.
• However, it is essential to ensure that all instruments,
dressings, and equipment that come into contact with
patients' tissues are sterile.
• It is also necessary to ensure that, after use,
From the World Health Organization Western Pacific Series District contaminated utensils are rendered safe for handling.
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 OPERATING THEATRE

DEPARTMENTAL
PLANNING & DESIGN • The essential physical requirements for meeting these
conditions are:
• a place in which to work that is comfortable and
unobstructed by the movement of other staff,
• with a table is strong enough to hold the patient
and easy to clean;
• basic services of water, light and medical gases;
and
From the World Health Organization Western Pacific Series District • two sets of basic instruments, comprising about
Health Facilities Guidelines for Development & Operations (WHO< 50 pieces each.
1998)
 OPERATING THEATRE

• As a general rule, one operating theatre is required for

every 50 general inpatient beds and for every 25
DEPARTMENTAL surgical beds.
• The preferred location is on the same floor as the
PLANNING & DESIGN surgical wards, which may be the ground floor. It should
be connected to the surgical ward by the simplest
possible route, It should also:
• adjoin the central sterile supply department;
• be easily accessible from the accident and
emergency department;
• be easily accessible for the delivery suite;
• adjoin the intensive care unit;
From the World Health Organization Western Pacific Series District • be located in a cul-de-sac, so that entry and exit
Health Facilities Guidelines for Development & Operations (WHO<
1998)
can be controlled; there should be no through-
traffic
 OPERATING THEATRE

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 OPERATING THEATRE
ROOM PLANNING REQUIREMENTS
(a) Reception and office - In a two- or three-theatre suite,
the reception and the theatre sister's office can be
merged.
(b) Transfer area- This area should be large enough to allow
for the transfer of a patient from a bed to a trolley. A line
should be clearly marked in red on the floor, beyond which
no person from outside the operating department should be
permitted to set foot without obtaining authority and
putting on protective clothing.
DEPARTMENTAL (c) Holding bay - This space is required when the corridor
system is used and should be located to allow supervision of

PLANNING & DESIGN patients waiting to go into the theatre. One bed per two
theatres should be foreseen.
(d) Staff changing rooms - Access to staff changing rooms
should be made from the entry side of the transfer area. At
both the transfer area and the theatre side of the changing
rooms, space must be provided for the storage, putting on
and removal of theatre shoes.
(e) Operating theatres - Each theatre should be no less than
6 x 6 m (36 m2) in area and should have access from the 1
From the World Health Organization Western Pacific Series District
anaesthetic room, scrub-up room and supply room.
Health Facilities Guidelines for Development & Operations (WHO<
1998) Separate exit doors should be provided.
 ROOM PLANNING REQUIREMENTS cont’d
OPERATING THEATRE
(f) Scrub-up room - Scrub-up facilities may be shared by
two theatres. A minimum of three scrub-up places is
required for one theatre, but five places are adequate for
two theatres. A clear area within the scrub-up room, at
least 2.1 x 2.1 m, must be provided for gowning and for
trolley or shelf space for gowns and masks.
(g) Sub-clean-up - In suites of four or more operating
theatres, a small utility area is required for each pair of
operating theatres, for the disposal of liquid wastes, for

DEPARTMENTAL rinsing dropped instruments and to hold rubbish, linen &

tissue temporarily until they are removed to the main clean-
up room.
PLANNING & DESIGN (h) Sub-sterilizing - An area for sterilizing dropped
instruments should be provided to serve two theatres.
(i) Trolley parking - Parking space outside the theatre and
clear of all doorways is required for patient trolleys & beds.
(j) Recovery room - The recovery room should be located
on the hospital corridor near the entrance to the operating
department. The number of patients to be held, until they
come out of anaesthesia, depends on the theatre
From the World Health Organization Western Pacific Series District throughput; two beds per theatre is usually satisfactory. In
Health Facilities Guidelines for Development & Operations (WHO< hospitals where there is an intensive care unit, additional
1998) room and facilities will be needed.
 INTENSIVE CARE UNIT

DEPARTMENTAL
PLANNING & DESIGN
• The number of beds in this unit should correspond to
approximately 1-2% of the total beds in the hospital. In
the Western Pacific Region, where district hospitals
provide on average 50-100 beds, this would mean only
one or two beds.
• This number would not warrant the provision of an
intensive care unit. Such a unit should contain no fewer
From the World Health Organization Western Pacific Series District than six beds in order to justify the highly sophisticated
Health Facilities Guidelines for Development & Operations (WHO< equipment and highly specialized manpower involved.
1998)
 OBSTETRICS & GYNECOLOGY UNIT

• Delivery department is very similar to the operating

department in its functional requirements and layout.
• In many hospitals, the two departments are fused into
one, with shared staff and support areas, due to a
dearth of doctors, especially in rural areas, where the
chief of the hospital is also the public health officer, the
DEPARTMENTAL •
surgeon and the obstetrician-gynaecologist.
The integration of these two departments, however,

PLANNING & DESIGN violates the basic requirements for aseptic conditions in
the operating department, as these are not always
required in the delivery department.
• The two departments should thus at least be
segregated. Proximity to the operating department is
desirable, however, as transfer of delivery patients may
be necessary.

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 PEDIATRICS

DEPARTMENTAL • The nursery should be located adjacent to the delivery

department to ensure protected transport of newborns.

PLANNING & DESIGN • Areas must be provided for cribs for both well and ill
babies and for support services that include formula and
preparation rooms.
• The number of cribs varies depending on the maternal
and child health trends in the country.
• "Rooming-in" (Fig.62) is virtually replacing the well-baby
area in space requirements for the nursery; instead, the
dimensions of maternity wards are changing to
accommodate babies' cribs and other materials.
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO< • A small night nursery for well babies may still be
1998) required.
 GERIATRIC SERVICES
• The older population of any community is usually best
cared for in community-based facilities where their
special needs and requirements are provided for in
sensitive and Fig. 62. Rooming-in caring designs that
allow them to lead independent and dignified lives for
as long as possible. However, because older persons are
also prone to conditions that cannot be attended to
except in the environment of a hospital, a geriatrics
ward may be provided within a general hospital if
economics would so warrant. If this is not possible, older
DEPARTMENTAL people may also be nursed in the regular medical or
surgical wards, depending on their illness.

PLANNING & DESIGN • As such, a geriatric ward, if provided in a hospital,

should be designed for longer than usual confinement.
Therefore, spaces should be home-like, cheerful, and
non-institutional. Apart from the regular institutional
spaces, social spaces such as day rooms must be
provided so that the older person can be encouraged to
walk about in the process of recovery from the illness.
Family spaces must be provided so that the older
person may be aided in regaining both his physiological
From the World Health Organization Western Pacific Series District and psychological well-being leading to return to the
Health Facilities Guidelines for Development & Operations (WHO< community.
1998)
 INPATIENT NURSING WARDS

• These wards provide accommodation for patients who

are dependent on others because of their illness. They
have the following functions:
• to substitute for the home for regular eating,
bathing, sleeping, etc;
• to allow examination, treatment and cure of
DEPARTMENTAL patients; and
• to prepare patients to return to domestic life.

PLANNING & DESIGN • The wards in a hospital are usually classified according
to specialties: medicine, paediatrics, obstetrics-
gynaecology and surgery, which are the basic services
offered by a district hospital. There are no radical
differences between the requirements of medical and
surgical wards and only minor differences between
those of the other specialties.

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INPATIENT NURSING WARD FORMS

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INPATIENT NURSING WARD FORMS

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INPATIENT NURSING WARD FORMS

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 GENERAL SERVICES DEPARTMENT

DEPARTMENTAL
PLANNING & DESIGN

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 GENERAL SERVICES DEPARTMENT
DIETARY SERVICES
• Located near the kitchen or anywhere on the
Ground Floor
• Directly accessible from the service court
• Direct delivery to refrigerated section
• Locate the dietitian in the kitchen or next to it
• Kitchen must be located such that heat and odors
are directed away areas of high population
• FOOD DISTRIBUTION
DEPARTMENTAL • Centralized Tray Service - food is prepared
in a main kitchen , loaded into conveyor

PLANNING & DESIGN carts and transported to the wards

• Bulk Service- food brought to wards in
heated carts, trays are prepared in sub-
kitchens in each ward
• MAIN COMPONENTS
• Food refrigeration and storage
• Cooking
• Serving
From the World Health Organization Western Pacific Series District • Special diets
Health Facilities Guidelines for Development & Operations (WHO<
1998)
• Dishwashing, and
• Dining (1.5 SQM per seated person)
 GENERAL SERVICES DEPARTMENT

HOUSEKEEEPING
• Housekeeepers’ Office should be located on the lowest
floor, adjacent to the linen room
• Central Linen Room supplies the whole hospital, must
have shelves and spaces for sewing, mending, and
DEPARTMENTAL marking new linen, locate at the “clean end” of the
laundry room

PLANNING & DESIGN • Soiled linen area for sorting and checking all soiled
laundry, must be located at the “dirty end” of the
laundry area with sorting bins
• Laundry can be in-house or contracted to an outside
service, if in-house proper washing and drying
equipment must be installed, if contracted-out provide
area for receiving clean and dispatching dirty linen for
sorting
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 GENERAL SERVICES DEPARTMENT

STORAGE, STOCK-KEEPING & DISTRIBUTION

• As hospitals are regular consumers of a large variety of
goods, adequate space must be provided for their
storage, inventory and distribution. Many different types
of storage facilities will be required, e.g., for some live
virus vaccines at -20 °C, for large equipment and
furniture, for crude disinfectants, for medical gases, for
dangerous drugs, for radioactive agents, which need

DEPARTMENTAL different space provisions. Designers must obtain all the

relevant information to meet the requirements.
• A standard for central storage space is 2 SQM per bed,
PLANNING & DESIGN in smaller hospitals this value is usually increased
• COMPONENTS
• Pharmacy Storeroom
• Furniture Room
• Anaesthesia Storeroom
• Records Room, and
• Central Storeroom
From the World Health Organization Western Pacific Series District For smooth, rapid flow of materials both to and from the
Health Facilities Guidelines for Development & Operations (WHO< central store, sufficient space and ramps should be provided
1998) for handling, unpacking, loading, unloading and inspection.
 GENERAL SERVICES DEPARTMENT

MAINTENENNACE & ENGINEERING AREA

(a) Boiler room - This must be located in accordance with
local fire ordinances. The boiler plant must be " designed by
a qualified engineer to ensure the safety of patients and
staff.

DEPARTMENTAL (b) Fuel storage - The space will vary according to the fuel
used. The designer must know for how many days stock
must be kept.
PLANNING & DESIGN (c) Groundkeeper's toolroom - Space must be provided for
working and for the storage of equipment and tools for the
staff in charge of landscaping and general upkeep of the
garden and grounds.
(d) Garage - The garage is best located in a shed or building
separated from the hospital itself. If the hospital is to
maintain 24-hour ambulance service, additional facilities
must be provided for drivers' sleeping quarters.
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 GENERAL SERVICES DEPARTMENT

MAINTENENNACE & ENGINEERING AREA cont’d

(e) Maintenance workshop - A carefully planned and
organized maintenance program for general repair of
medical and nonmedical equipment is necessary for
ensuring reliable hospital service. A mechanical workshop
with an electric shop, well equipped with tools, equipment
DEPARTMENTAL and supplies, is conducive to preventive maintenance and is
most important in emergencies. Failure of lights or essential
PLANNING & DESIGN equipment in an operating theatre, such as respirators, can
have serious consequences. Adequate space for equipment
like lathes, welding materials and wood- and metal-working
machines should be provided, and there should be storage
space for damaged material, such as stretchers, beds,
wheelchairs, portable machines and food trolleys As most
repair work is done outside of normal working hours, space
should be provided for workers, maintenance staff,
supervisory personnel and biomedical engineers..
From the World Health Organization Western Pacific Series District
Health Facilities Guidelines for Development & Operations (WHO<
1998)
 GENERAL SERVICES DEPARTMENT

MORTUARY
The mortuary has the following functions:
• to hold dead bodies until burial can be arranged;
• to provide a place where a pathologist can
investigate causes of death and make scientific
DEPARTMENTAL investigations
• to allow viewing and identification of bodies by

PLANNING & DESIGN relatives and other people

• Should be located near the pathology department or
laboratory
• Easily accessible from wards and the emergency and
operating departments
• Separate access available for staff, relatives and
undertakers

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 GENERAL SERVICES DEPARTMENT

MORTUARY
• The following areas are needed:
• covered access
• body store

DEPARTMENTAL • staff changing room with lockers and toilets

• soiled garments holding area

PLANNING & DESIGN • post-mortem facilities

• viewing room
• visitors' waiting room
• cleaning materials storage room
• cleaner's room
• prayer and religious rites room

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 SITE SELECTION

RECOMMENDED
PLANNING & DESIGN
CONSIDERATIONS

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 BUILDING FOEM

RECOMMENDED
PLANNING & DESIGN
CONSIDERATIONS

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 BUILDING FORM

RECOMMENDED
PLANNING & DESIGN
CONSIDERATIONS

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 ADAPTABILITY & CONVERTABILITY

RECOMMENDED
PLANNING & DESIGN
CONSIDERATIONS

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INCREMENTS OF GROWTH

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 INCREMENTS OF GROWTH

From the World Health Organization Western Pacific Series District

Health Facilities Guidelines for Development & Operations (WHO<
1998)
 NOTES FROM THE DOH GUIDELINES

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 NOTES FROM THE DOH GUIDELINES

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 NOTES FROM THE DOH GUIDELINES

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 NOTES FROM THE DOH GUIDELINES

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 NOTES FROM THE DOH GUIDELINES

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 NOTES FROM THE DOH GUIDELINES

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 NOTES FROM THE DOH GUIDELINES

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 NOTES FROM THE DOH GUIDELINES

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)
 NOTES FROM THE DOH GUIDELINES

From the Manual on Technical Guidelines for Hospitals and Health

Facilities Planning and Design (DOH, 2001)