Final Report

400 BEDDED HOSPITAL AT BHEL, BHOPAL
HOSPITAL AT BHEL
BHOPAL
JUNE-2005
Under the guidance of

Ar.Mehboob Hasan
B.Arch.
Submitted by
Anjana Jain
Reg. No.
C.O.A.I.I.A

A THESIS REPORT
SUBMITTED TO
INDIAN INSTITUTE OF ARCHITECTS, MUMBAI
For the award of

Associate membership of
Indian Institute of Architects,
Mumbai
DECLARATION
I here by declare that thesis report titled Hospital at BHEL Bhopal prepared for the award
of associate membership of Indian Institute of Architects is a record of my own work, carried
out under the guidance of Prof. L.K. Jain.
I also declare that the matter in the thesis has not been submitted for the award of any other
degree or diploma.
Yours sincerely
Anjana Jain
(Final Yr. I.I.A., Mumbai)
ACKNOWLEDGEMENT
Hospitals are an abode to the patients combating with the diseases in want of life. While
presenting the thesis report on the Hospital at BHEL Bhopal, I was deeply conscious about
the pain and agony existing in this world. I know I cant do much but at least design an
edifice in which patients could come with healing hope.
In carrying out my project I was diverted by many storms (hindrances) but the blessings of
my father and invaluable endorsement, encouragement, inspiration and help of my guide,
family, and friends let me to come out of the hard time.
At the outset it is with reverence I express my sincerest gratitude towards my thesis guide Ar.
Mehboob Hasan for having so generously given his knowledge, time and expertise for
proceeding with the project. Without his precious guidance throughout the project my work
would have remained to a mediocre level.
The aid and abet of my friend Architect Sumit augmented my working spirits. I am therefore
grateful to him for his invaluable cooperation. I would also like to thank celebrated
professionals architects Mr. and Mrs. Sanjay Singh Jadon for their encouragement, and
inspiration.
I cant belittle the help, support and propping up spirit of all my family members by my
words of thanks. But I owe a great debt of gratitude to them for they were always with me in
my every walk of work. I would also like to thank all those who directly or indirectly helped
me through different quarters.
Very special thanks to the curators of Kasturba Hospital Bhopal, Bhopal memorial Hospital
Bhopal, and Apollo Hospital Delhi for their kind cooperation.
INDEX
DECLARATION
CERTIFICATE
ACKNOWLEDGEMENT
S.No
CHAPTER NAME
INTRODUCTION
1.1
PREAMBLE
1.2
NEED
SHEET No.
1.3 THE IMPORTANCE

1.4
2.
3.
RELEVANCE OF PROJECT IN PRESENT SCENARIO.
THE PROBLEM
2.1
BASIC ISSUES AND RELEVANCES
2.2
AIMS AND OBJECTIVES
2.3
GENERAL REQUIRMERNT OF BUILDING
2.4
METHODOLOGY
2.5
SCOPE
DATA INFORMATION

3.1
DATA INFORMATION
3.2
CASE STUDY
3.2.1 Kasturba hospital, Bhopal
3.2.2 Bhopal Memorial Hospital, Bhopal
3.2.3 Apollo Hospital, Delhi
4.
5.
6.
3.3
LITERATURE SURVEY
3.4
COLLECTION OF DATA
ANALYSIS
4.1
SITE
4.2
GENERAL
4.3
SITE CHARACTERISTIC
4.4
CLIMATOLOGY
PLANNING & DESIGN APPROACH

5.1
RATIONALE
5.2
THEME
5.3
PLANNING
5.4
DESIGN APPROACH
5.5
SERVICES
CONCLUSION
CHAPTER # 1
1.INTRODUCTION
1.1 PREAMBLE
Sun charges the nature health charges the life.
The sound health is the essence of human life. It is defined as a state of complete physical
mental and social well-being and not merely the absence of disease or infirmity.
Health is a social value. This is reflected in provision of service, which needs to consider
ethical, psychological issues as well as medical scientific and medical behavior issues.
Todays consciousness about health has made hospital an indispensable public institution
working for public welfare. Hospital is a complex social institution composed of varied
technical and non-technical elements requiring highly efficient engineering services and staff
with a wide variety of technologies to support the process of health care. It is a place for
delivery of ongoing scientific and human care, which provides hope rather than despair.
Technological enhancements of today have brought drastic revolution in medical services in
the areas such as surgery, clinical laboratories and radiological services. Hospital is
composed of many groups representing a wide variety of interests and diverse needs. It
utilizes the services of various medical, paramedical and support personnel to render all
needed healthcare to the patients in its custody and through outreach programs to all on its
medical charge. It employs a wide variety of modern technologies and engineering services
to support the process of healthcare. It handles the dynamics of life and death situations
during the process of rendering healthcare. Therefore planning of hospital is tailored to meet
the immediate and long-term objectives of the patients, to deliver efficient Medicare, visitors
as well as hospital staff. It specially addresses the issue of healing environment where
hospital infections have been minimized and the healing process is accelerated.
The visitors to a hospital comprise of relatives, friends and acquaintances of the patients and
staff who visit socially. Others are the business visitors who represent the visiting faculty,
officials from statutory and non-statutory departments and hospital
Thus there is a fusion of a wide spectrum of organizational skills, professional expertise and
diverse interests. This needs a coherent, organized structure where each one has adequate

freedom to practice his skill and at the same time, his work compliments the work of others
and leads into effective
1.2 NEED
With the advent of new technologies the outlook of common man too had changed
rigorously. Researches have made impossible things possible by the incredible steps taken in
the field of medicine and surgery.
Bhopal, the very heart of India, is a capital city, which is a fascinating amalgamation of
scenic beauty with historic and modern urban planning. The Heavy Electricals (1) Limited,
Bhopal was registered on 29th August 1956. Foundation stone was laid down on 15th
November 1958 and its production started on 1st July 1960. Later, it was merged with Bharat
Heavy Electricals Limited on 1st January 1974.
There are two major industries namely BHEL & railway coach factory besides the industrial
areas like Mandideep, Pilukhedi & Govindpura. These large & small-scale industries are
major source of employment in the city.
The professionals working in these industries are backed up with all the facilities in the close
vicinity of their residential area. The BHELtoo was aided with the medical facilities but with
the establishment of railway coach factory in vicinity it was decided to handover its major
general hospital to the railways. Thus need arose for the development of a general hospital in
order to serve the BHEL public. Though BHEL have 10 minor clinics spread all over its area
but for major medical facilities a hospital with high tech facilities became mandatory. This
necessity resulted in the project to be undertaken for the welfare of the public of BHEL a
world-class, innovative, competitive and profitable engineering enterprise providing total
business solutions.
1.3 IMPORTANCE
India, the worlds biggest democracy, has population of one billion and ranks fifteenth in the
world in terms of GNP, but, on a per capita basis, it ranks 102 nd. It has only 3.5 hospital beds
per 1000 population. With an estimated 2.5 million victims a year, India leads the old in the
incidence of heart disease. With the fast pace of urbanization and modern living, neuro cases
are also on the increase. Infectious diseases are receding, whereas non-infectious diseases are
assuming menacing proportions. The government is focusing on the provision of an essential

health package, leaving the provision of discretionary secondary and tertiary clinical services
to the private sector and non governmental organizations. But the primary care and the
diagnosis is of greater importance as after diagnosis only specialized treatment could be
started. Therefore the general hospitals with advanced technologies in the field of diagnosis
and treatment possess an outstanding value.
1.4 RELEVANCE OF PROJECT IN PRESENT SCENARIO:
In the last two decades there has been a perceptible and a sudden change in our
society from its slow and sluggish life style to a contented consumer oriented atmosphere.
This change has taken place in terms of health and the sensitivity of people towards their own
well-being. This change has been brought about by the exposure and awareness and the
change of attitude of people who are now inquisitive about everything which affects them.
The new goals and urges put severe stress and pressure on individuals living in such a
society. All this, in addition to the pollution, unregulated food habits, etc. has had a marked
influence on the general health conditions.
Also in the era where the consumer is of prime importance, people are more aware and play
an active role in keeping themselves fit, and shop for health care services with a critical eye.
Even the escalating cost is accepted as a matter of course. The health insurance schemes,
which have emerged as a good utility, also give people a choice of expensive treatment. With
people getting more health conscious, a need arises for new techniques to increase life
expectancy. The hospital will cater latest diagnostic and treatment facilities to the patients.
These facilities will be free of cost to the BHEL employees and will be available within
limits to the masses.
Hospitals being the most important health facility provider, a large number of studies have
been carried out on them. The design rules and the considerations to be kept in mind while
designing such institutions is very important.
CHAPTER # 2
SYSTEM APPROACH
2.1 BASIC ISSUES AND RELEVANCE
A large number of hospitals with varied bed strengths are planned both in public as well as
private sector. But the hospital building is said to be appealing only when it caters to the
needs of the patients as well as when it creates good working conditions to the doctors,
nurses and technicians. So while working on the project all the functional aspects of the
building have to be observed minutely for its efficient and easy processing. Proper
coordination of all the sections of the building by arranging them in appropriate places based
on their functional relationships is the perennial need along with creating friendly
environment for all visiting it. Thus while designing a hospital building segregation as well
as association of different units, healthy working atmosphere, well-defined landscape, with
proper orientation of building plays a vital role in offering best Medicare to patients and best
working conditions to the staff.
2.2 AIMS & OBJECTIVES
Aim -1
A central idea enlivens a building, hence the design of hospital is evolved out of
our vital idea its aim to meet medico social needs of various communities of different
economic status, obliged to adjust its various services / facilities of general nature and
teaching the present requirements of the society in India and create a healthy environment
combined with treatment, achieved through building form, materials and landscape.
Objective: The objectives are the means to achieve the ultimate that is central idea and are
inherent in the various aspect related to hospital The broad objectives of the 400-bedded
hospital are cited below:
To provide comprehensive health care, encompassing preventive, primitive, curative and
rehabilitative health care by evaluating the needs, services hospital policies, staffing patterns,
and other related factors.
To establish a well balanced organization for health care in an adequate and environmental
framework.
To built a hygienic environment for curing diseases and provide friendly/homely atmosphere.

To analyze and develop idea of planning along with study of various factums related to
several levels of function and functional procedure.
To design a structure exposing itself to improve building aesthetics along with Functional
Economy.
Last but not the least the hospital, as a measure for future expansion, in response to the
changing trend in hospital services, would also provide facilities/ services (clinical,
diagnostic, and therapeutic) of various other specialties in future depending upon the real
needs of the population.
2.3
GENERAL REQUIREMENTS OF PROJECT
SITE ANALYSIS
Location
Temperature
Site area
Humidity
Shape
Rainfall
Topography
Wind direction
Soil condition
Bioclimatic chart
Access
Air movement
Vegetation
Climatic analysis
Surroundings
Existing structures
North direction
CONCEPT & DESIGN APPROACH
Design process
Basic design consideration
Zoning / grouping
Circulation
Sequence
Scale
Disposition of buildings
Report
Model
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2.4
METHODOLOGY:
Discussion
With Professional Architects
With Seniors & Colleagues

Survey
Live
Hypothetical
Selection of topic
Literature Survey
Case Study
Analyzing of Literature & case study
Finalization of requirements
Design factors
Conceptual drawings
Prefinal drawings
Final drawings
Project report & Model
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2.5
SCOPE:
The planning and designing of a 400-bedded hospital is a complex task and needs a great
knowledge in the field. The extent of study possible on this subject is almost infinite.
However the project comprises of designing of hospital building to fulfill the abovementioned objectives and concentrate on the design of different spaces like out patient
department, in patient department, operation theatre and also on the organization of spaces.
The design should also concentrate on the different services offered to the users.
As an architectural dissertation, the scope of study would probe into different architectural
problems, their coordination with the design and their solutions regarding circulation pattern,
spatial requirements and acoustic, ambiance, visual effect, services, finishes etc. the emphasis
will be on the environment quality of the entire facility the understanding of which will lead
to a sensitive design approach and hence add a dimension to the dynamic relationship
between architecture, nature, health care provider and user and the overall health care
Hospital shall embody a variety of activities apart from providing treatment to the patients.
Three important aspects have to be achieved through architectural designing and planning of
hospital. They are: Magnetism
Built
natural
Movement
Vehicular
pedestrian
Management
specific
Segregated
flexible
integrated
Types of environment to be achieved: Corporal

Human & psychological
Discerning
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2.6
LIMITATIONS:
Study of various factors like government health policies and its supervisory role, financial
burden on the owner, medical implications and other bureaucratic intricacies have been
considered as an issue and the have not been dealt in much detail.
The technical detail of various services (electrical, air-conditioning, water supply, and
sanitation etc.) shall not be dealt with in detail though they shall be mentioned briefly where
and when required in terms of coordinated approach.
Norms, regulations, socio-economic structure all vary from place to place. This might lead to
an imbalance in the analysis of various case studies. To provide a general view of the present
situation, all the hospitals under case study are analyzed
and studied. Hence, the
information provided for the design would have certain variables and certain fixed
components and with the help of these a solution can be arrived at which can prove to be
useful for the design.
13
CHAPTER # 3
DATA INFORMATION
3.1
DATA INFORMATION
The hospitals are a fusion of some simple and some extremely complex components. A
hospital is not a place to dump the terminals but a place for delivery of ongoing scientific and
human care.
The points to be considered while designing: 1. Environment inside as well as outside the building.
2. Connectivity of different parts of building
3. Coordination between different units of hospital
4. Circulation within the building
5. Traffic management
6. Compact and efficient planning
7. Sufficient light and ventilation inside the building.
3.2 CASE STUDY
Hospitals being the most important health facility provider, a large number of studies have
been carried out on them. It is very important to keep the design rules and considerations in
mind while designing such institutions.
The case study of analogous projects gives an insight into behavior and response. It shows
how far the given project has been able to fulfill its basic objectives. The merits and demerits
give a basic guideline to project development and understanding. Therefore the following
projects have been taken for case study.
1
Kasturba hospital
Bhopal
Bhopal Memorial hospital
Bhopal
Peoples General Hospital
Bhopal
Case studies include the planning, landscaping, and all associated architectural facilities.
These all case studies mentioned above belong to same cuisine but constructed in different
manner.
14

AIM OF CASE STUDY:
1.
To study the role of hospitals and clinics in the health care industry.
2.
To evaluate the success and merits of hospitals and clinics in catering to the needs and
requirements of the ultimate consumer, the patients.
3.
To arrive at guidelines for the planning and designing also recommending methods to
make their environment more humane.
Appraisals of old design qualities are attempted with respect to a ll the relevant drawings, sketches,
photographs and informations of the study as collected on the following basis.

1
Location of project.
General information about ownership, architectural influences area etc.
Basic concept.
Site planning site environment, approach, access, and circulation.
Various activities space along with area analysis and functional analysis,
interrelationship between various activity spaces.
Structural system materials and finishes.
Building services including all mechanical, electrical, fire fighting, sanitary, air
conditioning and water supply.
Relevant specialties as interiors, landscape, parking.
Any other relevant information about the project.
15
3.2Case studies:
3.2.1 Kasturba hospital, Bhopal
Project
- Kasturba hospital, Bhopal
Ownership - BHEL Bhopal

Location
- Habibganj BHEL Township Bhopal
Design team - Engineering Dept. of BHEL

Total site area - 56 Acres
INTRODUCTION: -
16

The Kasturba hospital is 400-bedded general Hospital. It is one of the leading hospitals of
Bhopal serving the BHEL employees at the macro level and other at micro level..
The planning:The building of the Kasturba hospital is based on linear planning. The main building of the
hospital is divided into four parallel wings, connected with the help of corridors. The
building has a separate wing for the private wards on the eastern side of the main building,
and doctors hostel on the western side. The whole complex rises up to G+1 level. The
campus is having its principle entrance from west.
The following are the various wings described floor wise: The ground floor plan covers 800 sq.mts, of floor area. It is having two main entrances one
for emergency ward; situated to the extreme left on the site and nearest to the principle
entrance, and the other for O.P.D (i.e. out patient department). To the right of the O.P.D, there
is pathology department; which again has a separate entrance.
The emergency, O.P.D, and the pathology department, all together form the front wing of the
hospital.
17
The second wing of the hospital comprises of the intensive care unit (I.C.U) and the
operation theatres (O.T) connected with the emergency and the front wing, through corridors,
the intensive care unit being near to the emergency unit and connected to the operation
theatres to the right. A corridor further extends towards right to reach the private wards at the
extreme east of the sight. The corridor from the centre of the intensive care unit and the
operation theatres extends northward to lead towards the third wing.
The third wing comprises of the stores and the electric sub station. The corridor further
extends northward to reach the fourth wing, which comprises of the surgical ward and eye
ward towards east and the childrens ward toward the west.
The following gives the individual description of various wards on the ground floor.
1)
Emergency ward : the emergency ward ,which is nearest to the main entrance of
the hospital, is having a registration counter , a central waiting area, various
18

examination rooms, and casualty wards. The central waiting area facilitates the
patients with direct and easy access to all the examination rooms and the casualty
wards.
2)
Out patient department: the O.P.D is linear in planning and is segregated in two
different parts, from its entrance foyer. To the left are various consultancy rooms,
physiotherapy room, rehabilitation room, and X-Ray room .and to the right are the
private wards.
3)
Pathology laboratory: the pathology lab is situated adjacent to the private wards
of the O.P.D. and is to the extreme right of the building. The block has a
rectangular linear plan and is furnished with various laboratories.
The second wing consist of the Intensive Care Unit (I.C.U) and the Operation Theatres
(O.T) which are well connected to the emergency ward and the O.P.D. to the right of the
O.T. and just adjacent to it, there is an A.C. plant room, a gas manifold and a store.
The third wing mainly consists of electric sub-station, and various medical stores and
general stores. The planning of this block is based on linear rectangular planning.
Fourth wing: Then comes the fourth wing, which includes childrens ward, surgical ward
and eye ward. The planning is again linear with wards for children and surgical wards on
either side.
The hospital also consists of the private wards on the extreme east and the kitchen and the
existing doctors hostel on towards the west.
Various wards on the first floor are:
The first floor consist of the administrative block, neurology department, male surgical
department, orthopedic department, maternity ward , delivery suits, and cardiology
department .
19

Administrative block:
Above the emergency ward, is the administrative block. The planning of this block is
similar to that of the emergency ward. It is connected to the rest of the hospital through
neurology ward and the emergency ward.
The first floor of the front wing consists of the neurology ward, male surgical ward, and
the orthopedic department. The planning of this block is similar to that on the ground
level, with neurology ward over the Out Patient Department and the orthopedic partly
overlapping the pathology, and the male surgical lies in between them.
In the second wing over the Intensive Care Unit, is the maternity ward and over the
Operation Theatres are the delivery suites. A long corridor extends from between them;
northward, to reach the fourth wing which is the cardiology department. It is again
segregated into two parts just as that on ground level, with a central waiting space. To the
left is the male medical and to the right is the female medical.
BUILDING SERVICES
The hospital building demands for the major services in all the fields and is thus served with
certain services at macro and some other at micro level.
FIRE FIGHTING
The cylindrical units of firefighting are provided in the corridors as well as within the
departments to meet the hazards of fire fighting at the mini level. To meet the uncontrolled
conditions if any happens the BHEL has its own fire station with instant services in such
circumstances
AIR CONDITIONING
The hospital does not possess any centralized air conditioning facilities , but in the required
departments the individual window ACs are provided to meet there needs in the departments
as Operation theatres, intensive care units, labor delivery suits and other diagnostic areas.
20

ELECTRICAL SERVICES
The major supply is from the BHEL unit and for emergency services generators are provided
which provides emergency supply to the operation theatre, labor delivery suits and other
diagnostic areas. The operation theatre is provided with uninterrupted power supply too in
case of instant failure of electricity.
SANITARY SERVICES
The BHEL has main sewer lines laid all around thus sewage is disposed off through the
sewer lines. But here there is no provision for water treatment plant so as to reuse the water
from the laundry, kitchen and other parts of the hospital.
INFERENCES:1)
Disperse planning has been done which incorporates the use of prolonged
corridors and both patients and doctors need to move a very long distance which
is both time taking as well as exhaustive.
2)
Various departments have been segregated from each other and hence unwanted
traffic could be avoided to a certain extent.
3)
Private wards have been planned too far which seems to be a drawback in the
planning.
4)
Service blocks like kitchen and laundry have been isolated from the rest of the
building.
Electric sub-stations and have been placed in between the third and fourth wing so as to
facilitate the accessibility.
21
Case study 2
3.2.2: - Bhopal Memorial Hospital
Project: Bhopal Memorial Hospital.

Location: - Raisen by pass road (Karoand).
Total Area: - 87 areas,
Design team: - Sanjiv Sood.
Consultants: - Hospital Services consultancy corporation (Structural, Electrical, HVAC,
Plumbing, Civil)
Built up Area: - Hospital 3200sq.m;
Housing & others 27000sq. m.;
Development Stages Phase I 1998, Phase II 1999.
INTRODUCTION
The bedded super specialty hospital Bhopal Memorial Hospital and Research center is
establish to heal up the wounds of the unfortunate
Gas victims of 1984.Along with the hospital, mini units (outreach health centers) have been
setup in affected wards where out door treatment free of cost for gas victims. There
departments and subjects there to for the people of Bhopal and the public at large. The
Mission of Bhopal Memorial Hospital and Research is to provide the patients with the
22

medical treatment of a highly specialized nature in defined areas it also promotes medical
research and continuous education programs.
The out reach centers and the hospital are completely computerizes and interconnected by the
most modernized system.
LOCATION: The 400 bedded multispeciality hospital complex in situated on an 87-acre site, which is
gently sloping upwards from the highway. The hospital complex is sited on raisen bypass
road. The hospital is easily accessible to visitors by air, rail or road. The airport is
Approximately 6.5 k.m The Bhopal railway station is approx. 7.5 k.m. and the bus stand
Approx. 7K.m. from the hospital.
SITE LAYOUT: -
The site has irregular shape and is sloping.

The site accommodates the hospital, the housing complex, Doctors hostel, Nurses hostel, and
Clubhouse, Service Buildings and research center.
23

DESIGN PHILOSOPHY:
The hospital is in the center with a ring road around it. The complex has a central
encompassing space. The court is flanked by double height-canopied spaces denoting the
entrance, and the whole hospital with all its public elements, is visually accessible to visitors.
This makes travel through the hospital a comfortable proposition with the destination being
known.
The site accommodates the hospital, the housing complex, doctors hostels, nurses hostel,
clubhouse, service buildings and a research center.
Space is allocated for the future expansion needs of the institute. A cricket field has also been
proposed.
The major components of the hospital are wards, outpatient department, the treatment block,
services and eye wing. The form of the complex is based on a compact integrated, contiguous
form, which is not high-rise and is a judicious combination of low and high-rise building
components. Only the ward blocks rise up to take advantage of ramps and lifts.
The wards are grouped together and face southwest to take advantage of the climate. They
form a c shaped green court, which becomes the focus between the housing, the hospital and
the research center.
GROUND FLOOR PLAN
24
Planning is a combination of compact and linear forms. A special eye block is specially
provided for the gas victims. Treatment block is provided in between so as to facilitate both
O.P.D & I.P.D patients.
FIRST FLOOR PLAN

The form that involves is a juxtaposition and integration of the functional needs, the
servicing requirements and the human considerations for a building complex of this nature. It
aspires to be a vibrant and playful whole with the interaction of the voids and the colors of
the materials used.
25
THIRD FLOOR PLAN
BUILDING SERVICES
The services are the chief component of the hospital building .The special care and attention
is thus given in planning and designing of the services in the Bhopal Memorial Hospital.
FIRE FIGHTING
The hospital is served with all the possible fire-fighting measures to protect the building from
the hazards of fire The cylindrical units of firefighting are provided in the corridors as well as
within the departments. In the basement sprinkler system is provided. Fire-fighting staircase,
smoke detectors, CBD all helps to overcome the calamity.
AIR CONDITIONING
The hospital has centralized air conditioning facilities in the Operation theatres, intensive
care units, treatment block and other diagnostic areas. The other parts of the building are
served with air blowers provided on the roof of the building serving through the ducts.
ELECTRICAL SERVICES
The major supply is from the two feeders .The emergency supply is to the operation theatre,
intensive care units and other diagnostic and supporting service areas. The operation theatre
is provided with uninterrupted power supply too in case of instant failure of electricity.
SANITARY SERVICES
26

The Bhopal Memorial Hospital has main sewer lines laid all around thus sewage is disposed
off through the sewer lines. The water from the laundry, kitchen and other parts of the
hospital is reused for AC plant, plantation and used in the flushing cisterns in the toilets after
being treated in the water treatment plants.
MECHANICAL SERVICES
The circulation within the departments and the whole building is canalized by the provision
of vertical transportation units at the required locations in the form of lifts and staircases so
as to avoid traffic congestion at the peak hours.
Case study- 3
3.2.3 Peoples General Hospital:
Project: Peoples general hospital.
Location: Sehore raisen bypass road, Bhanpur, Bhopal.
Total area: 56 acres.
Design Team: Engineering Department of BHEL.
Year of completion: completed in different phases and addition and alterations are continuous
even today.
27

Built up area:
SITE PLAN
The O.T complex is independent of general traffic and movement of rest of the hospital.
Sufficient no. of sterile, semi-sterile and scrubs are provided near the OT. NICU with
necessary holding the lobby is provided with all ultra modern machines. Labour complex is
well located as at have access through separate lift and staircase near to entrance.
PATHOLOGY:
Pathology is the concerned analysis of deceased tissue or fluids and other elements in the
body. It is mainly diagnostic in function and comprise of activities like biochemistry,
microbiology, hematology, etc.
It is well located at place, which is easily accessible.
FIRST FLOOR
First floor comprises of I.C.U and O.T complex, labor room and IT isolation and supportive
services. The I.C.U has been provided with the necessary infrastructure for independent
functioning. I.C.U had a rectangular plan with beds placed along the sides and nursing station
in the center to observe each patient closely. The per bed area for one I.C.U bed is
sq. m.
which are separated by curtains. All necessary services are readily available at the bedside. A
separate recovery room is missing.
28
SECOND FLOOR:
Second floor comprises of pediatrics wards and obstetrics, gynecology wards, blood bank
area and other areas like demonstration rooms, duty rooms, treatment rooms, and nurse
stations.
Blood Bank Area is in close proximity to pathology department and OT. Maintenance of
current blood groupings, collection, storage, examination, issue and supply of blood for
transfusion to the patients are the major functions of this area.
Refreshment room and toilets are provided for donors to rest and take light refreshment
before returning but one major drawback is that it not near to the emergency and accident
department.
Separate pediatric ward units are provided. But provision should be made that 25% of the
patients are in isolation cubicles in single and two bedded rooms which are absent.
The obstetrics department is well planned for all type of delivery rooms. Maternity ward is in
the form of general ward .in planning a ward, the aim is to minimize the work of the nursing
staff and provide basic amenities to the patients within the unit. The distance to be traveled
by the nurse is kept minimum by locating the nurse station centrally.
Separate ward units are provided for male and female patients for each medical discipline.
Treatment room: major dressing and complicated treatments are carried out to avoid the risk
of cross infection.
Ward pantry: for collection and distribution of meals and preparation of beverages. Ward
pantries are provided near both the departments.
THIRD FLOOR:
General medical wards:
General wards are divided according to speciality as well as genderwise. Proper light and
ventilation for each bed is provided along with provision of separate inbuilt cupboards for
each bed. Nurses station is located centrally, so as to monitor each patient effectively.
29

Complete segregation from OPD block, leads to reduction of traffic and noise. Sufficient
waiting spaces are provided adjacent to the treatment rooms.
FOURTH FLOOR:
General surgery wards:
The wards are divided according to the speciality and genderwise. Separate treatment rooms,
demonstration rooms and doctors room and pantry is also provided for male and female
wards. Provision of adequate light and ventilation has been made into the wards. Here also
centrally located nurse stations are provided with insufficient light and ventilation. The
number of bath and toilets are not sufficient. Only two units of each are provided for such a
large number of beds. The floor is continued by the two lifts, one for service and the other for
patients and doctors.
BUILDING SERVICES
The peoples general hospital is a part of a large complex comprising of many major building
blocks. Therefore services become an important element to be dealt with in detail with
respect to the individual block too.
FIRE FIGHTING
The fire extinguishers are provided in the corridors as well as within the departments to meet
the hazards of fire fighting at the mini level. In the basement to meet the uncontrolled
conditions if any provision was made for sprinkler system.
AIR CONDITIONING
Unlike Bhopal Memorial Hospital the hospital does not possess any centralized air
conditioning facilities, but in the required departments the individual window ACs are
provided to meet there needs in the departments as Operation theatres, intensive care units,
labor delivery suits and other diagnostic areas.
ELECTRICAL SERVICES
The emergency services are met with generators provided which provides emergency supply
to the operation theatre, labor delivery suits and other diagnostic areas. The operation theatre
is provided with uninterrupted power supply too in case of instant failure of electricity.
30

SANITARY SERVICES
The sewer lines laid all around thus sewage is disposed off through the sewer lines. But here
there is no provision for water treatment plant so as to reuse the water from the laundry,
kitchen and other parts of the hospital.
INFERENCES:Unhygienic kitchen, laundry and CSSD.
No proper connectivity between the two departments on same floor.
Absence of adequate light and ventilation in eye and ENT wards and centrally placed
demonstration rooms and nurse stations.
Insufficient A.C services in treatment blocks.
Insufficient space categorization for various activities.
Monotonous planning is incorporated on each floor.
Less number of lifts for the patients.
COMPARISION OF CASE STUDIES:ACTIVITY
CASE
CASE
CASE
BEST
STUDY-1
STUDY-2
STUDY-3
LOCATION
KASTURBA
BHOPAL
(PEOPLE'S
Administrative
At
MEMORIAL
At
GENERAL)
At
area
first floor of
Basement(below Ground(near
Ground(near
OPD
height)
to entrance)
to entrance)
&Emergency
G.F.(Adjacent
G.F.(Adjacent
At Basement
At
to main
to main
Ground(near
entrance)
entrance)
to entrance
G.F.(in between G.F.(adjoining
and tretment)
G.F.(in
I.P.D.& O.P.D.
the reception)
between
G.F.(near OPD)
G.F.(near the
I.P.D.& O.P.D
Near OPD and
O.P.D.
Diagnostic
G.F.(near
services/pathology OPD but far

Casualty
from IPD)
G.F.(near
At
31

OPD but far
entrance)
from
treatment
block.
treatment
O.T.
block)
G.F (Near
Scattered all
ICU,IPD
around.
G.F & F.F
Convenient to
IPD,
&OPD)
Emergency
and near to
Radiology
ICU & CSSD.

convenient to
G.F
OPD,IPD
Pharmacy
G.F
&Emergency
convenient to
I.P.D.
G.F & F.F
IPD&OPD
At upper
floors with
diagnostic
services easily
approachable
and near
supportive
Nurses
Near to every
centrally
In Between
services.
centrally
Station
Wards
ward.
6.5 sq.m/bed+
located
7 sq.m/bed+
every ward.
5 sq.m/bed+
located
7 sq.m/bed+
nursing
nursing station
nursing station
nursing
station
30 sq.m
Near the
23.5 sq.m
Near the main
station
12.5 sq.m
12-16 sq.m
Near the main Convenience
main gate
gate
gate
Single rooms
Parking
space for all.

Segregated
parking for
Services
inconvenient
convenient to
inconvenient
all.
Convenient to
32
Dietary
Laundry
Mortuary
Staircase/Lift
A.C.
Climatologically
OPD,IPD
OPD,IPD
rear of the
&Emergency
adjacent to
&Emergency
Convenient to
main block
each other
OPD
near I.P.D.
Away from
Near
Out side
To be in
main
O.P.D.&O.T. in
campus.
campus.
building
the supporting
block
Extreme
suitably
services bloc
Extreme
suitably located
Extreme
suitably
Extreme
at places
located and
and sufficient in
located but less
convenient for
sufficient in
number
in number
easy
number
AC (In OT,
AC (In OT,
Split and
movement
Central AC
ICU,
ICU, Pathology) window.
with 100%
As per climate.
fresh air.
As per climate.
Pathology)
Cross
As per climate.
ventilation,
grill at
waiting.
33
3.3
LITERATURE SURVEY
SOME IMPORTANT PRINCIPLES OF PLANNING HOSPITAL FACILITIES AND

SERVICES ARE STATED BELOW.
PLANNING THE HOSPITAL
To be successful, a hospital requires a great deal of preliminary study and planning .it must
be designed to meet the needs of the people it is going to serve and be of a size, which the
promoters can afford to build and operate. It must be staffed with competent and adequate
number of doctors, nurses and other professionals to render efficient service. If mediocre
hospitals abound in our country or if some of them are unable to provide adequate and
efficient service to the community, the principal reason is most likely the lack of proper
planning, the other being paucity of funds.
HIGH QUALITY PATIENT CARE
This can be achieved by the following:
Appointing competent and adequate number medical, nursing, and other professional staff
and providing necessary facilities, equipments and support services:
Establishing an organizational structure in which clearly defined responsibility and authority
are assigned to each job, particularly in-patient care. There should be proper accounting:
Medical staff working as a team and interacting with each other health care professionals:
Instituting a mechanism or procedure for continuous review of patient care provided by
physicians, nurses and other professionals.
Providing continuing medical and other educational programs to all professionals to enable
them keep abreast with the latest medical and technological knowledge aimed at improving
patient care:
Establishing and enforcing standards in patient care:
INTRODUCTION TO HOSPITAL DESIGN
Functions of a hospital: To provide comprehensive health care.
To reach out to the family and its home environment through its outpatients services.
34

To train health workers.
To involve itself in biosocial research.
SITE AND LOCATION
The most important client of the hospital is the patient; therefore maximum efforts should
be made for the convenience of the patient. Ease in access for the patient is absolutely
essential and for this the site must be well connected by good roads and public
transportation.
The site should be large enough for expansion in future.
Other factors which are related to infrastructure like availability of public services,
supply of water, electricity, main sewerage etc should be studied before choosing the
site.
It should be established that the site is free from pollution, insect vectors of disease, noise
etc.
GENERAL PLANNING PRINCIPLES

Planning is a scheme drawn up beforehand to accomplish a goal i
The increasing demand for medical and health care services has brought out the need for
careful planning of health services. Planning has assumed an even more significant role for
effective use of the management of resources and services offered.
The important principles, which apply to planning of all hospitals, and the general features
that should be borne in mind while planning, are illustrated here.
The two general principles that is important to planning are--(1) Planning should not be hurried, and
(2) The details should be complete.
The third principle that is even more important to remember is that hospital planning starts
with circulation. In the words of Emerson Goble separate all department, yet keep
them all close together; separate types of traffic, yet save steps for everybody; that is all
there is to hospital planning. For the architect who is uninitiated to all there to the modern
hospital planning, the most important rule to remember is circulation. The numerous
departments of the hospital should be properly integrated so that the different types of traffic
traversing the building are separate as much as possible, traffic routes are kept short and
35

important functions are protected from prying eyes or intrusion. The skill with which the
architect handles circulation will determine the efficiency of the hospital during its life.
RULES FOR PLANNING: 1.
Protection of the patient: - Too much traffic will disturb the patient, affect the
efficiency in patient care and increase the risk of infections, particularly in the case of
surgical patients for whom aseptic conditions is essential.
2.
Shortest traffic routes: -They assist in maintaining aseptic conditions and save steps for
everybody nurses, doctors, patients, and other hospital personnel. A hospital is the place
where everything should be done fast. Patients lives often depend on it. Time wasted on
unwanted steps costs money besides making people suffer from fatigue at the end every
working day.
3.
Separation of dissimilar activities: -Separation of clean and dirty operations, quiet and
noisy activities, different types of patients, different types of traffic both inside and outside
the building, etc
4.
Control: -A certain amount of control is inherent when dissimilar activities are
separated; but that is not enough. The nurses station should be so situated as to assist the
nurses to exercise control over patients, corridors and over the visitors entering and leaving
the unit. Infants must be protected from being stolen and against germs brought in by visitors
and hospital personnel. Patients in the ICU must be guarded against infection. Operating
rooms similarly protected.
The Building Plan with consideration for future planning:
The most desirable way to provide for expansion in a hospital building without
eliminating established values is to plan each department with a corridor leading to an
outside wall so that it can be extended when necessary.
Care should be taken to avoid blocking any such corridors with stairs or other fixed
elements. Where such planning is impractical as, for instance, in small departments, soft
space, that is space with minimal mechanical services should be planned adjacent to hard
spaces. The soft space can be reallocated relatively and will thus permit the required
expansion.
36
Main circulation and utility distribution system in a hospital are similar to those of a
small city with the added complication that they should be conceived in three dimensions.
Generally, maintaining a rectilinear pattern will provide the greatest amount of flexibility.
Also, if they are consolidated, they will provide the greatest amount of free usable space.
Room sizes are seldom so critical that a variation of 10% to 20% will make much
difference in their usefulness. If a module can be developed that is acceptable for a large
variety of occupancies and mechanical services, changes in use will require minimum
alteration.
Careful consideration should be given to sun control and materials used. Orientation of
all or most sections of the hospital to allow maximum light to all parts of the building and
maximum exposure to breeze is an important factor.
The development of air conditioning and high levels of artificial illumination has had a
significant effect on planning. Dependence on natural light and air impose limits on the
width of the building.
FACTORS AFFECTING INTERNAL PLANNING
Separation of patients on basis of:
(i)
Privacy Separation (as far as is reasonable) of in and out patient area.
(ii)
Degree of illness Separate rooms, wards units for the critically ill patients and the
normal care or the general ward patients.
(iii) Sex Separation of sexes will be achieved by room assignment; this applies to all
nursing units, except the postoperative recovery unit and I.C.U.
Functional separation
(i)
Curative and Preventive Services.
(ii)
As far as possible separate traffic flow of in and out patients.
(iii) Separate circulation of staff and public wherever necessary.

(iv) Separate transport of clean and soiled material.
Preferably separate access to consulting rooms for physicians and the publications
GENERAL FEATURES
Some general features which should be incorporated while planning and building a general
hospital discussed here.
37

1.
Orientation of all or most sections of the hospital to allow maximum light to all parts
of the building and maximum exposure to breeze is an important factor.
2.
Windows should be screened, as far as possible, to keep out mosquitoes and flies,
which seem to be ubiquitous in our hospitals.
3.
Detailed and careful planning of traffic and entrance is necessary.
4.
These include traffic of patients, staff and employees, visitors, service deliveries,
garbage and waste removal.
5.
As a rule there should be only one entrance for the general public. One of the difficult
problems of the hospital administration is the control of visitors. Thefts are not
uncommon in our hospitals, particularly through unsupervised passages. Each
additional entry point increases this problem. There will, of course, be additional
entrances for emergency, for delivery of goods, and in some hospitals a separate
entrance for staff. Added numbers of entrances increase costs of design, access roads
and walks.
6.
By and large, patients and visitors will use main entrance which may also be used by
staff expect in larger hospitals where a separate entrance may be designated for them.
The outpatient department is better served if it has a separate entrance.
7.
The service entrance should be adjacent to the kitchen and storage areas, and
wherever possible, to a service elevator. A platform and scales are provided in that
area. Garbage and other solid wastes are removed from this point, so also in many
hospitals; dead bodies. Access to the morgue from patient areas and for removal of
dead bodies to the outside should be protected from patients and visitors view for
psychological reasons. In some hospitals, this outside entry is combined with the
emergency entrance for better control.
8.
Outside may be routed from the registration and medical records to the waiting area
and from there to laboratory, x- ray, pharmacy, special therapeutic areas other
services. They should not be routed to pass though inpatient areas.
9.
Inpatients may be routed from the admitting office and medical social workers
office, if necessary, to laboratory, x ray and other departments and then to rooms on
the patient floors according to established admitting procedure.
38

10.
Visitors route should be controlled carefully. They should not be allowed to wander
undirected through patient areas. They are best routed past information or main
office. Where a system of passes is used, colors coded visitors passes may be issued
to a particular ward or floor for which the pass is applicable.
11.
Staff should pass from the entrance to locker rooms, and then to the place where they
punch time cards or sign their attendance before entering their respective work areas.
12.
Corridors of seven to eight feet width with a finished ceiling height of 7 to 8 feet are
most widely accepted pattern. They should be as straight as possible. Where ramps
are used the gradient should not exceed 1:10.
13.
Walls must be smooth so as not to collect dust and dirt. They must be added with tiles
or polished stone up to a height of five feet as a protection against soiling and damage
by wheelchairs and stretchers. Angles and sharp corners should be avoided and in
some places provided with protective metal or rubber guards to prevent stretchers,
wheelchairs and carts from damaging the corners of the walls. A 5 to 7 inch skirting is
useful against damage caused by casters. Walls finished in light colors are most
attractive.
14.
Stairways may not be normally used in handling traffic when there are elevators.
Nevertheless, they must be planned with care, as they are essential in case of fire.
There should be at least two stairways leading from the top floor to a ground level
exit. They should be located in separate areas of the building. The stairway entrance
should be closed with self-closing doors to eliminate noise as well as to meet fire
regulations. The stairway should also be provided with lighted exit signs. A minimum
width of three feet eight inches is necessary for handling stretchers in an emergency,
for ex, for evacuation of patients in case of fire. The stairways should also have wide
landings for the same purpose. Continuous railings on both sides at a height of
approximately three feet are required for safety of patients.
15.
Elevators should be located where there is maximum concentration of traffic.

Elevators door should not open to the main lobby, but preferably to an alcove or a
side corridor where patients are accommodated. Two elevators are minimum for any
multi-storied building, but hospitals with more than 250-300 beds require three or
39

more. They are best utilized in a bank not at separate locations. Where possible,
separate passenger and service elevators are recommended.
16.
Hospital type elevator car size should be preferably 5x 71/2 feet and the door at least
4 wide to allow handling of beds stretchers together with attendants. As a rule,
hospital is too slow. There is no reason why they should not be fast as those in hotels
and commercial buildings, and why with advances in the field of engineering, they
should not be made to run smoother. Elevators should preferably have dual controls.
This will obviate the need for an operator during the hours when traffic is light. All
safety devices including self-leveling feature, telephone, alarm and ventilation are
necessary.
17.
Fire escapes are hardly used. They are, however, mandatorily required. To be of any
value, personnel should know how to operate them. By and large, personnel our
hospitals are ignorant of how to operate fire escapes and how to handle firefighting
equipment like extinguishers and hoses. The fire escapes should also be sufficiently
wide at the turns to allow a stretcher to be carried conveniently. There should be
appropriate lighted signs to indicate their location.
THE DESIGN ASPECT: Hospital
provides
preventive
curative
restorative
rehabilitative
promotive
comprehensive health care to the community. Thus each and every department of hospital
must be designed with great care.
The hospital basically consists of: 1. Outpatient services
2. Administrative services
3. Diagnostics
4. Critical Care
5. Nursing Zones / IPD
6. Supportive Services
7. Building Engineering services
8. Research & Training facilities.
The support services include:
Management Personnel / Material / Finance / Estate / Maintenance.
40
Building engineering systems Lighting /HVAC/Medical gas supply/Water supply /

Sewage disposal.
Bio-medical engineering Related to Hospital Equipments.
Workshops
Security
Dietary
Waste Management
OUTPATIENT SERVICES
Outpatient care is a major service encompassing a wide range of treatment, diagnostic tests
and minor surgeries. Caring for sick is the primary function of the outpatient department;
thereby it renders an essential community service. Hospitals must therefore pay much care
and attention to proper planning, designing, organization and functioning of the outpatient
department.
LOCATION
The outpatient department should be conveniently located adjacent or in close proximity to
vital Adjunct services such as registration and medical records, admitting, emergency and
social services. It should also be easily accessible and rapid services should be available from
the laboratories, radiology, and pharmacy and physical therapy departments since the patients
use practically all of the diagnostic and therapeutic departments during every visit. Attention
should be paid to circulation, which should result in a smooth flow of the various traffic lines
traversing the department
In larger hospitals, if the laboratory is located at a distance or on another floor, it is
recommended that the laboratory substation be located in the outpatient clinics area. The
outpatient department should be on the ground level preferably with a separate entrance and
adequate parking facilities.
DESIGN
Special attention should be given to the design of the following areas of the outpatient
department; adequate parking facilities, entrance located at ground level and designed to
handle wheelchairs and stretchers.
41
The two main functions of the O.P.D are to provide: -
Diagnostic and treatment facility.
Follow- up services
COMMON ELEMENTS OF OUTPATIENT FACILITIES

AND SPACE REQUIREMENTS
Entrance and parking
An approach road with a wide footpath from the public transport should lead to the
entrance.
Enough parking spaces should be provided at the entrance for ambulance, doctors, and
patients vehicles.
Entrance should be located on the ground floor and designed to handle wheelchairs and
stretchers.
Entrance lobby
The entrance should be provided with ramps for barrier free movement, and the patient
should face the reception desk as he enters.
The entrance lobby must be connected to public utility spaces.
Circulation area, which is an integral part of the net area of the main lobby, should be
provided generously.
Reception and registration areas
Reception area to be located near the entrance with adequate waiting area.
Methods should be devised by which new patients are segregated from the old patients.
Old patients should be sent directly to their clinical department, while new patients will
have to wait for registration and other formalities. This can be achieved by using
information technology and new techniques available.
Direct access to horizontal and vertical circulation.
Signage system and graphics should be used to guide the patients for easy finding.
42
FIGURE 01 A Two Station Reception
PLATE-01 O.P.D Entrance
Areas
Enough waiting space should be provided adjacent to the registration.
The actual requirement for the waiting space could be assessed on the basis of workload
tendencies or as ascertained by survey. The fact that one or two relatives or attendants
usually accompany all patients should be taken into account while planning. Use of
available demographic data should be carried out.
It is general and convenient to provide benches for waiting as these reduce the number of
furniture pieces and make it convenient to keep the waiting space in order. Stone benches
should be preferred as they help in easy maintenance.
Circulation spaces
Corridors should be minimum 2.1 meters wide.
Stairs should be minimum 1.25 meter wide to permit carrying stretchers.
Hand rails on both sides of the stairs and continuous from top to bottom are highly
desirable.
Railing should be minimum 0.9 meter high for safety.
Treads with grooves should be provided to make the surface of the steps non slippery or
non slippery tiles should be used on the surface.
Ramp slopes should not exceed 1:10, width is 2.5m, width at landing at the U-turn is
3.0m, concrete railings are at a height of 0.9m, and top of the railing having a diameter of
75mmii.
The flooring should have grooves in perpendicular direction to the slope to avoid
skidding. The floor should be of tiles, stone slabs, or vinyl.
When ramps are located in the periphery of the building they should be sheltered from
the weather.
Public toilets
Lavatory blocks should be located conveniently.
43
The number of fittings should be calculated on the following scale and on the optimum
number of persons expected to be present at any one time.
- Water closet with ablution taps. 1 for every 100 males or part thereof.
2 for every 100 females or part thereof.
1 for every 100 persons or part thereof.
1 for every 50 males or part thereof.
4.2 - Consultation rooms
For consultation room a floor area of 15 sq.m (160 sq.ft.) is considered essential to fit: -
1. Examination table
2. Work table
3. Sink
4. Doctors desk
5. Wall mounted cabinet
6. X-Ray viewer
Consultation room for specialist (E.N.T., Eye, and Medicine)
To save on space a unit specialist consultation complex can be provided.
Specialist room unit would consist of a consultation room and a dark room. Consultation
room shall be similar in design and arrangement to the consultation room described before.
The dark room should have an area of 8sq.m (85sq.ft.) and should be accessible directly
from the consultation room.
A distance of 6.5m (21-4) is required for the conventional method of eye testing, the
patient being at a distance of 6m (19-8) from the eye test chart. To provide this the dark
room can be made use ofiii. However if the area of the room is small and the required
room depth is not possible, use of mirror helps in maintaining desired distance for the eye
test chart.
1. Examination table
2. Eye testing chart
3. Wash basin
4. Instrument cabinet
5. Doctors table
6. Shelves
44

7. Sterilization and slab
FIGURE 02 Specialists Consultation
PLATE-02
Specialists
Consultation Room
EMERGENCY AND CASUALTY DEPARTMENT

Emergency is a life and death situation involving an injury or acute illness threatening life,
limb or sight, a situation which warrants immediate treatment. Emergency services are
required normally in case of accidents or when immediate medical care is required. It is
required to render a comprehensive range of services right from the elementary first aid to
sophisticated management of surgical and medical emergencies and full scale trauma care.
LOCATION
The emergency department should be located on the ground floor with easy access for
patients and ambulances. There should be a separate entrance to the department, which is
away from the main hospital, and the outpatient entrance; it should be well marked with
proper lighting and signs, and should be easily visible and accessible from the street. Since
the emergency department becomes the main entrance for the hospital during the night, it
must relate to the public and vehicular transportation.
The department should be close to the admission, medical records and cashiers booth where
possible, admitting functions, cashiering, and registration of new patients and creation of
their medical records could be done in the department. A good percentage of emergency
patients require x-ray. The portable x-ray unit is not satisfactory. So close proximity to the
45

radiology unit is essential to facilitate the movement of accident cases and to save every
minute, which is precious. The laboratory services including the blood bank should also be
accessible to emergency since a sizable numbers of patient need these services. In the
location of the emergency department proximity to elevators is also important in order to
proceed to surgery without loss of time.
DESIGN
The entrance to the emergency should be sheltered to protect ambulance patients from the
weather while unloading. There should be paved access to permit discharge of patients
comfortably from ambulances and cars. Adequate parking space for ambulances and cars of
patients and medical staff should be provided. The ambulance entrance should be large
enough to admit one or more ambulances negotiating with stretchers. If there is a raised
platform for ambulance discharge, ramps should be provided for wheel care and pedestrian
access.
With injured patients, accident victims and their distraught relatives around, emotions
frequently run high in the emergency department. So traffic within the department is critical.
The design should facilitate good public relations. Unsatisfactory arrangements, congestions,
delays and inefficient operation due to faulty design will present a poor image of the hospital
in the eyes of the emergency patients and their relatives. The design should also facilitate
quick access to lay patients by staff and supplies. The department is equipped with facilities
like examination, minor O.T., X-ray, plaster etc.
PHYSICAL FACILITIES AND SPACE REQUIREMENTS
Facilities in the emergency department are broadly categorized into:
Administrative and public areas
Reception control
Space for stretchers and wheelchairs adjacent to the entrance
Public waiting area with toilet, water coolers, and other public facilities.
Space/ room for security staff, police, ambulance driver and attendant.
Office for night administrator/ night supervisor-an be off site but not too far away;
and
Coffee snack bar in the vicinity.
46

Clinical facilities
Trauma room (s) for trauma procedure or emergency surgery with all the supportive
facilities
Examination treatment room(s)
Storage for equipments
Separate soiled and clean utility room
Janitors closet
Rooms for duty/ on-call duty doctors, separate for male and female, with sleeping
accommodation and toilet facilities;
Dressing and Minor Operations

Minor surgical operations such as dressing etc. and minor operations will be carried out here.
The equipment required in this room would include:
1. Instrument cabinet
2. Instrument trolley
3. Operation table
4. Dressing trolley
5. Dressing table
6. Sterilizer
7.
Glass
shelves
FIGURE
03 Dressing and minor operation theatre

8.
Sink
(Source- Report on Urban Health Centre Buildings)
A total floor area of 19sq.m should be provided for treatment and minor
operations and the area allotted for minor operations should not be less than 11sq.m.
CLINICAL LABORATORIES
OVERVIEW
The primary function of the clinical laboratories is to perform laboratory taste, which will
provide information to clinicians in arriving at correct diagnoses and in the treatment and
prevention of diseases. Some of the laboratory tests are specialized tests. others are routine
ones such as urine analysis and blood cell counts. In addition to the usual tests, obstetrical
patients may require Rh factor and blood grouping. For surgical patients, they may include
47

examination of organs and tissues removed during operations. The laboratory plays an
important role in the hospitals infection control and surveillance programme.
Location:
The laboratory should be conveniently located on the ground floor to serve the outpatient,
emergency and admitting departments.
It should also be close to or easily accessible to surgery, intensive care, radiology and
obstetrics.
As the laboratory would cater to the needs of both out patients and in-patients, it should
be placed centrally and preferably away from the general traffic line.
The autopsy area as well as the morgue should be a little away from the emergency and
inpatient areas and the removal of dead bodies to the outside should be through nonpublic corridors for psychological reasons.
Design: While designing, the laboratory, the use of modules is recommend for work stations and for
piping layout for essential utility services.
For workstations 10 feet by 20 feet with work benches 12 feet long and 30 inches high
free space should be left at the back of the work benches for air circulation.
The height of the bench should be 0.8m if work is to be carried out sitting and 0.9m if
work is to be done standing.iv
Ample shelving for keeping specimens and cupboard space for equipment is necessary.
Glare free and even distribution of light on the bench is essential.
The materials used on the floors and the walls shall have minimum joints to avoid
bacterial growth in the joints.
The most important factor that will vary the laboratory programme from one hospital to
another is the type of disease the specialty most commonly treated. For example, in a
general hospital, there will be a large amount of clinical pathology work. In tuberculosis
hospital there is more sputum work and bacteriology will therefore be emphasized. A
contagious disease hospital will require more work in chemistry and bacteriology. If the
48

hospital has a predominance of kidney or bone cases, the biochemistry department will be
the larger. If there is emphasis on heart diseases, the biochemistry and clinical pathology
facilities will probably be increased.
Haematology, urine analysis, biochemistry and autoanalysers as well as clerical and

secretarial work are located in open areas where as bacteriology, serology, pathology,
histology, sterilization, blood bank, and offices in the closed.
FACILITIES AND SPACE REQUIREMENTS:
Administrative areas i/n offices for pathologist, secretarial and clerical work area, space
for filling and records.
Sterilizing area.
Storage for surgical operations
Glass washing area- dirty area which should be separated and closed.
space for autopsy and morgue
appropriate storage for chemicals and flammable liquids.
Work counters with space for all the necessary equipments, counter sinks and specimen
collection area for blood urine and faeces
Radiology unit
Good medical and surgical care depends, to a great extent on the availability of prompt,
thorough and skillful diagnostic services. A well planned diagnostic Radiology department
ensures an efficient flow of service prompt scheduling and minimum of movement and
distance to the patients and staff. Components of radiology are X-Ray, Fluoroscopy,
Mammography, ultrasound, computerized axial tomography (CAT scan), and Magnetic
Resonance Imaging (MRI).
LOCATION
The diagnostic radiology department should be located on the ground floor, conveniently
accessible to inpatients, outpatients and emergency patients. It is also desirable to locate the
department close to the elevators and near other diagnostic and treatment facilities.
DESIGN
49

This department must be designed in consultation with the experts familiar with the
mandatory regulations of the Atomic Energy Regulatory Board (AERB)and the Division of
Radiological Protection, Bhabha Atomic Research Centre (BARC)
Flexibility in design is of vital importance and it is necessary to provide for an increase in

the volume of work load and for the expansion of the X-Ray services.
The rooms should be designed around a central core

A control- monitoring generator room to be
located between two diagnostic or
fluoroscopic rooms.
X-rays have cumulative effect on the human body, which could be dangerous. Providing
lead lining in between the screen and the wall can prevent this.
The optimum size of the X-ray room is about 4.2metres X 5.5metres and the ceiling
height a minimum of 3metres.v
PHYSICAL FACILITIES AND SPACE REQUIREMENTS
Reception-control and registration area
Patients waiting room
Secretary and file clerks area
Radiologists office, conveniently located near the X-Ray rooms, .
Doctors viewing room near radiologists office
Rooms for routine diagnostic X-Ray and fluoroscopic procedures, CAT scan, MRI,
with all the supportive facilities.
The darkroom should be located between two x-ray rooms
Film processing area
dressing rooms
patients toilets, staff toilets and lockers
Operation Theatre
LOCATION
The best location for the operation theatre is the one which permits a convenient and
uncomplicated flow of patients, staff and clean supplies traffic. It receives patients from the
floors through non public corridors, elevators and ramps. In regard to services, ideal
50

adjacencies would be emergency, radiology, clinical laboratories, intensive care units, CSSD,
and delivery suite, particularly if it does not have a room for Caesarean section.
The location of the department should be decided on the following factors
1. Quiet environment;
2. Freedom from noise and other disturbances;
3. Freedom from contamination and possible cross infection;
4. Maximum protection from solar radiation; and
5. Convenient relationship with surgical ward, ICU, radiology, pathology, blood bank and
CSSD.
DESIGN:
Operation theatre is the most important department in a hospital. Planning of an operation

theatre is based on a series of considerations like:
size
usage
environmental control
lighting(surgical and general illumination)
equipment
Services like suction, nitrous oxide, compressed air etc.
Provision to X-ray, plaster etc.
Within the surgical suite zoning shall be done depending on the types of activities and
circulation involved and the degree of sterility to be maintained. These zones are:(a) Outer or protective zone (b) Intermediate or clean zone (c) Inner or sterile zone
(d) Disposal or dirty zone
(a) Outer or protective zoneIt is the administrative element and the basic control area where the staff enters and the
patients are received. It contains mostly theatre supply, changing rooms, pre-anesthetic
examination room and waiting area.
(b) Intermediate or clean zone
51

It is an area in which degree of sterilization changes. It includes casualty theatres, recovery
room, plaster room, and pre-operative rooms. It also includes work and storage areas where
material is delivered.
(c) Inner or sterile zone
The actual operating room, the scrub-up areas, and the patient holding areas are a major part
of this zone. A high degree of cleanliness and aseptic conditions are maintained here.
A consideration must be given for a transportation of patient to the surgical suite, how is he
checked and where does he wait if the room for which he is scheduled is not ready.
(d) Disposal or dirty zone
The soiled instruments and dressings are transacted through this area for washing and
resterilization or disposal. It includes the sluice rooms and disposal corridors.
52

PLATE 04- Scrub-up sinks
The relationship between out patient and the operation theatre is to be taken care of
though outpatient survey is generally limited to minor surgical procedures requiring local
anesthesia. Patients are admitted for surgery and discharged the same day.
PLATE 05- operation theatre
Operating room must have a minimum clear area of 360sq.ft (180X200) excluding
fixed cabinets and built-in shelvesvi. Air distribution in operation theatre to maintain a
sterile and aseptic atmosphere is not a function of only one item but of several i.e.-
a) Operating procedures and techniques.

a) Cleanliness of air supply.
b) Method of air distribution and air change rate.
c) Cleanliness of operation theatre.
53
If patients have to be carted a great distance post operatively it becomes a hazard and
recovery rooms have to be provided.
PLATE 06- recovery
operating department where the patient may remain until, in the judgment of the surgeon,
it is safe to move him to a nursing unit.
54

PLATE 07- X-ray view box in O.T
FACILITIES AND SPACE REQUIREMENTS
Pre-operative holding and preparation room
Control station. Should be so located as to permit visual observation of all traffic into and
within the department.
OR supervisors office.
Operation rooms as required
Scrub facilities, Induction area, recovery rooms
Medication storage with refrigeration facilities
Clean work room / clean supply room.
Sterilizing facilities. High speed autoclaves/flash sterilizers located to serve all ORs
Anaesthesia work room for cleaning, testing and storing Anaesthesia equipment with
work counter and sink.
Family waiting rooms outside the operating rooms complex
Changing rooms for all categories of staff with lockers, toilets and washing facilities.
Staff lounge and toilet facilities
Storage area for x-ray unit and other equipments.
Dictation and report preparation area accessible from the lounge area
DEPARTMENT OF OBSTETRIC
The clinical section of the obstetrical department should be located in a convenient but
segregated area. Within the clinical facilities, the labour and delivery suites should be as
remote as practicable but easily accessible from entrance to the department so as to avoid
non-related and unnecessary traffic through the suites, and to provide privacy to the patients.
The facility should be close to the nursery, obstetrical nursing unit and to the vertical
transport so that it is easy for patients to access. The department should be in close proximity
to the operating room of its own. The different units within the clinical section of the
department should be located, in such a manner that they facilitate movement of the patients
between them and observation of patients by the unit personnel.
DESIGN
55

The delivery suite is very much like the operating rooms, and the same general
considerations of location and control hold here. In designing the labour and delivery suite,
attention must be focused on four major functional areas where much of the activities take
place. These are preparation room, labour room, recovery room and support services area.
PREPARATION ROOM
Many of the patients are admitted in labour room. They have to be prepared for labour and
delivery. The patient receives a cleansing bath, is shaved and then given an enema before
being send to the labour room. Although this preparation can be done in the patients room,
particularly in the case of private room patients, it is preferable to have a special room for
this purpose. The preparation room should be located outside although adjacent to the labour
and delivery suite. The room must have facilities for carrying out the procedures in
connection with the preparation, such as an examining table, shower bath, wash basin,
equipment for giving an enema and preparation tray. A locker to keep the patients clothes is
desirable.
If the hospital has an adequate number of single labour rooms, they eliminate the need for a
patient preparation room and an observation room for suspected infectious patients.
LABOUR ROOM
This is the room in which the patient remains during the first stage of labour, i.e. from the
time the pains commence until she is ready to be moved to the delivery room.
Labour rooms must be designed in such a way that they can serve as emergency delivery
rooms. To that end they must be of adequate size, preferably, 18 feet by 18 feet. Single rooms
are recommended. The labour rooms should be close to the delivery rooms.
Doors should be four feet wide to permit passage of the bed or stretcher with attendants. The
bed must be furnished with oxygen, suction and compressed air outlet, nurse call system, and
lighting controls. Piped-in-music is desirable, as also lockable locker for patients personal
belongings.
DELIVERY ROOM (S)
Facilities provided in delivery rooms are essentially the same as for the surgical suite, such as
scrub-up area with windows for view into the delivery room, lighting and operating lights,
oxygen, suction and air, a clock, with a second timer, built-in protection against explosion
hazards, equipment and supplies.
56

A delivery room should accommodate only one patient at a time. It is difficult to maintain
aseptic conditions in a room where more than one patient is being delivered.
DEPARTMENT OF PHSIOTHERAPY
The physical therapy department provides a specialized rehabilitative service. I is
necessitated as a result of surgery, trauma, stroke and other functional impairment. The
department is relatively smazll in most hospitals. The size of the department depends on the
factors as the amount orthopaedic surgery done in and various other rehabilitative services
offered by the hospital.
LOCATION
It should be centrally located to accommodate all categories of patients. It should be close to
the elevators with easy access to both the inpatients and outpatients. It should be located on
the ground floor as most of its seekers are physically handicapped to various degrees.
DESIGN
The size of the of the department depends on the number of patients using the facilities
Facilities and space requirements
Office and clerical area with storage facility for files
Reception and control station
Offices for physiatrist and chief physical therapist
Space for all the necessary equipments
Individual treatment cubicles with screens for privacy
IN PATIENT DEPARTMENT
LOCATION
Nursing units have a close relationship with the operating rooms, pharmacy, central stores,
laboratory and the dietary. In maintaining this relationship, they are highly dependant on
vertical transportation and an efficient communication system. The location of these facilities
must be considered from the point of view of their relationship to the nursing units.
DESIGN
NURSING UNITS OR WARDS
The nursing unit is the part of the hospital where patient is housed and bedded when he is not
fit to go home. It includes all services and ancillary rooms to care for the patient. The size of
the nursing unit depends upon a number of factors:
57
quality of nursing
condition of patients
type of rooms
type of hospital
Generally an average nursing unit has 30 to 35 beds, smaller accommodation give greater
flexibility in care of patient by age, sex, and condition. In case of accident and trauma cases
the nursing unit size should be still lower, i.e. 20 to 25 beds in intermediate care wards, 15 to
20 in acute care wards and 5 to 10 in I.C.U. wards.
Single rooms are provided for the patients of the following categories:
Those who have chances of infection.
Those who will disturb others.
Those who are likely to be disturbed by others.
Those who require intensive care.
FACILITIES AND SPACE REUIREMENT:

As evident the factors involved in a nursing unit are as follows:
Patient room.
Nurses station.
Patient service areas- toilets and day room.
Nurses room and facilities.
Ward store, pantry
Treatment room
Solarium where beds are sun dried.
The in patient department provides accommodation for:

-
Maternity cases
Patients undergoing treatment and kept under observation
Patients undergoing and recovering from surgery
58
FIGURE 04 Plan of one-bed patient room
Patient rooms
Patient rooms and the wards can be designed as per requirements of the hospital and the
beds can be distributed accordingly.
It is recommended that the minimum size of a one-bed room should not be less than
125sq.ft, with a width of 126
It is advisable to keep all one-bed rooms sufficiently large to accommodate two beds if
emergencies so require.
The two-bed room should be a minimum of 160sq.ft in size and provided with cubicle
curtains for visual privacy.
The four-bed room should have a minimum floor area of 320sq.ft.
There should be no less than 40 of space between the beds, and sufficient space to
allow the nurse to pass between the bed and the wall.
Each patient bed must be supplied with a built-in wardrobe and an outlet on the wall for a
nurse call signal. The movable furniture in each private room includes a bed, a lounge
chair, a visitors chair, and a bedside locker.
PLATE-03 two-bed patient room
FIGURE 05 Plan of two-bed patient room
59
Windows are important for the psychological well being of the patients. The height of the
window sill should not exceed 30 to allow the patient the outside view.
Doors of the patient room should open outwards into the corridor.
The patient room toilet should be provided with a grab bar, an emergency call button
within easy reach, and a flush valve for bedpan cleaning. Door of the toilet should open
outside towards the patient room.
Nurses station
The nurses station provides space for the duty nurse to carry out the administrative
duties of the ward and to look after the needs of the patients. It should thus be placed
centrally so that the nurse has to travel a minimum distance to attend to the patients in
different rooms.
The instruments required in this room would include a desk and a chair, nurses call
system panel, cabinets for medicines, small refrigerator for drugs, lavatory basin and
instrument trolley.
A linen and equipment store with sufficient shelves should be directly attached to the
duty room. The area of store should be worked out at 0.9sq.m per bed subject to a
minimum of 9sq.m.
An area of 11sq.m should be provided for this room. An alcove for storage of wheel
chair and stretcher is also desirable.
A combination of 6-bed bays and 4-bed bays 3-bed bays or double bedrooms and single
bedrooms can be tried but keeping one factor in mind, i.e. proximity of nurses to the
patients. This not only helps in achieving efficient and better patient care but it also cuts
down the total distance traveled by the nurses during the day.
So the important considerations are: Walking distance:
Keep walking distance as short as possible for nurses and ambulant patient. Maximum
distance from bed to toilet (W.C.) is 12 m., and from nurses working room to furthest bed
approx.20 m.
Observation:
60

Continuous observation of patient by staff is essential part of nursing care. Good design aim
minimum 50% beds to be visible from nurses station.
Daylight and Glare
Beds should be parallel to windows unless external or between glass blinds or similar devices
fitted.
Organization of wall outlet
A check list for a well equipped bed in a single room will include some 24 different facilities.
In order to minimize the scatter effect at normal eye-level, the committee suggests that half
of these facilities could be consolidated in a low wall outlet through a single flexible cable to
bedside table, where many items would be within reach of the patient. Only two items then
occur on the wall at eye-level oxygen outlet and over-bed light. Following check list gives an
indication of the thinking of some of the committee on this point.
Portable bedside panel (patients control)
Nurse call switch, pilot switch, monitor light.
General room illumination switch, dimmer control.
Reading light switch.
Room thermostat remote control
Jack for pillow speaker (ceiling speaker in private rooms).
Provision for T.V. and telephone instrument.
4.8 Supporting Services

When most people think of hospitals, they usually think in terms of doctors and nurses
because of their high visibility, the kind of services they render and the close contact and
relationship they have with the patients and their relatives. But those who are familiar with
the day to day operations of hospitals realize that no hospital can operate without the less
glamorous and not-so-conspicuous services such as laundry, kitchen etc. that go by the name
of supportive services.
Central Sterile Supply Department
In any medical institution there is a large amount of material that needs to be

cleaned and sterilized before it can be re-used. The support services department receives
61

dirty articles within the hospital for re-use. It also receives clean and new material from
the manufacturers and suppliers.
Clean and dirty materials require separate delivery points. Thus the department
should be easily accessible from the road and should be well linked with the different
departments.
PLATE-08 Sterilization equipment
Accommodation is required for storing new materials and sterile equipment, a clean up
room, an office, and a trolley loading bay.
The department should be centrally located in relation to the departments that use its
services the most.
STORES:
The proper functioning of the continuous supplies to various departments is possible only if a
large area of the hospital is allocated for bulk stores the stores are of various categories.
Equipment stores
Rubber goods store
Injectible stores
Medicine stores
Furniture stores
62

The constant supply to the various departments is given through these stores according, a
single access into the stores should be the basic criteria for planning in order to avoid any
sort of goods through the stores.
Laundry
This unit provides facilities for cleaning, washing, drying and disinfecting the dirty
linen and sorting of linen. This could be done mechanically or manually.
The laundry may ideally be located on the ground floor in the rear setback of the
building where a large open area can be used for drying.
An assessment on the plant and machinery required for a laundry could be made
keeping in mind the Indian Standards according to which the thumb rule is five kg. Per
bed per day.
PLATE-09- laundry (source-author)
Kitchen
Well cooked food is an important part of the patient care. Food has to be supplied
to the patients and may be to the staff also.
Kitchen should be centrally located and should be delivered by means of insulated

trolleys.
Kitchen could be designed on the top floor (airy, no smell-penetration, short routes
for transportation) but it is preferable on the ground floor since it would be near to the
stores, easy to expand and would require less vertical movement.
Key spaces
63

Central kitchen, receiving and storage, preparation, cooking, dishwashing, scullery, waste
trash and garbage disposal. Dinning (for staff, visitors and ambulant patient) service line,
table seating, and local distribution areas, for kitchens or pantries
Housekeeping
Housekeeping services, also called environmental services, are of paramount

importance in providing a safe, clean, pleasant, orderly, and functional environment for
both the patients and the hospital staff. A clean and hygienic environment has a
tremendous psychological impact on the patients and visitors, which immediately sets for
them the overall impression for the nursing home.
The housekeeping performs the following functions:-
Daily cleaning of consultation rooms, patient rooms, toilets etc.
Trash and garbage disposal
Extermination of bugs and pets
Preventing the spread of infection
Along with these the housekeeping department also has certain incidental responsibilities, as
follows:-
Saving electricity by turning off lights, fans etc. when not in use.
Ensuring an economical use of supplies.
Developing goodwill by a courteous, helpful, and caring attitude towards patients and
relatives.
The following facilities and spaces are required for housekeeping

-
Office for housekeeper
Clerical work area
Storage room for housekeeping equipment and supply

Housekeeping (janitors) closets on all floors throughout the hospital.
SERVICES
Electrical supply
The electrical system should be designed such that it will operate economically and
provide for easy maintenance rather than the least possible installation cost.
64
Emergency generators should be provided for power supply to operation theatres,

I.C.U, Delivery rooms, lifts, pumps, essential kitchen equipment, ventilation systems,
water supply systems and partial lighting of all other areas.
H.V.A.C. Systems
For H.V.A.C. system, all the departments in the hospitals can be divided into groups
according to their environmental control requirements. The different groups are as
follows
Group A: Operation theatres and delivery suites need to be provided with 100% fresh air
since outdoor air is free of pathogens.
Air supply to operating rooms and delivery rooms should be from the ceiling outlets near the
centre of the work areas. This will effectively control air movement. Exhaust or return air
should be from near the floor area. If however, fresh air intake is too close to the exhaust
outlets, the fresh air can become contaminated. Basically, the idea is to bathe the patient in a
current of fresh air so that the clean air provides a protective curtain about the
operative field. Great care should be exercised in the design to ensure that turbulence and
other factors of air movement do not cause particulates to fall in the wound site.vii
PLATE-10 I.C.U
Group
B:
rooms,
provided
I.C.U.,
Recovery
laboratories etc. are

with
sufficient amounts
of fresh air.
65

-
Group C: Wards, physiotherapy, nursing stations, O.P.D., clean utilities and kitchen
provided with evaporate cooling systems.
Group D: Laundry, electrical room, pump room, and toilets are provided with exhaust
fans for exhausting foul air.
Water supply and sanitary systems
The primary source of water supply to hospitals is generally the public utility supply
system. Invariably water is in short supply. To meet the high and ever growing demand
for water, the following alternative sources of water supply may be considered:
Bore wells
Tanker supply
Recycled water. The treated wastewater from wash basins, showers, laundry etc. can be
used in W.C. flushing, landscaping etc.
Rainwater harvesting is a good alternative to raise the underground water table of the
area.
To ensure a continuous supply of water, adequate storage capacity of underground sumps
and overhead tanks should be provided.
In designing the hospital water supply, the major elements that merit attention are as
follows:
Continuous and reliable supply of water
Quality of water
Proper distribution network
Ease of maintenance and operation
Drainage system
The drainage system of the hospital should be effective, simple, economical, and
serviceable. It should be designed keeping in view the kind of septic and toxic waste
envisaged which in turn needs to be effectively disposed off.
Provision should be made to terminate the collected sewage in the municipal sewer
line via. An inspection chamber or manhole.
For sewage disposal, it is preferable to use PVC pipes, as they are easy to install and
repair, and also allow for smooth flow of sewage.
Waste disposal
66
Bio-medical waste means any waste, which is generated during the diagnosis,
treatment of immunization of human beings or in research activities pertaining thereto in
the production of testing of biological.
Bio-medical waste should be segregated into containers/bags at the point of the

generation and these should be labeled in accordance with the categories as stated in the
standards given by the government of India.
Separate puncture proof containers should be provided for syringes, needles and other
sharp objects to prevent accidental injury to those handling them. As far as possible,
pathogenic waste, including waste from patients in isolation and waste in specimens from
the laboratory, should be sterilized at or near the point of production and prior to removal
from the place.
In the absence of proper waste disposal services, the infectious agents may spread
through discarded items. Chemical disinfecting is necessary prior to final disposal of such
items.
General waste that is non-infectious can be discarded at municipal waste disposal sites.
Chemical and pharmaceutical waste after proper detoxification could be disposed off in
sanitary landfills or sanitary services
3.4 COLLECTION OF DATA
67

S.No. Facility
Case
Case
Study- Study-2
1.
a.
ADMINISTRATIVE UNIT
Medical Supdt. Room with
Case
No. of
Area in
Study-3
rooms
Sq. m.
30
25
28
31.50
toilet
b.
c.
d.
e.
f.
Dy./Asst. M.S. Room with toi.

P. S. to M.S./ Dy. M.S.
Admn. Officer
Waiting room
Library-cum-Conference room
21
12
20
15
32
20
15
20
18
35
18
13
21
25
35
1
1
1
1
1
21.00
14.00
21.00
21.00
35.00
g.
Nursing officers room with
58
32
50
30
45
28
1
1
56.00
31.50
h.
i.
j.
k.
l.
m.
n.
toilet
Accounts officer
Cashier
Purchase Officer
Clerical Staff
Security Officer
Lav. For male & female staff
Stationery/ Records
15
12
13
12
13
15
12
13
15
5.25 sq. m. per staff member
12
13
15
9
9
11
50
50
48
1
1
1
14.00
14.00
14.00
1
2
1
14.00
10.5
49.00
346.5
40
45
40
42.00
b.
years )
Medical Records Officer with
120
20
125
18
122
15
1
1
126.00
17.50
c.
d.
toilet
Staff Office with toilet
Medical Record Processing
20
30
18
27
15
26
1
1
17.50
28.00
e.
Area
Doctors Record Completion
16
15
14
14.00
f.
g.
room
Room for various automations
Printed Stationary Store
15
12
14
11
13
9
1
1
14.00
10.50
2.
a.
MEDICAL RECORDS DEPT.

Medical Records store
1) Active (up to 2 years )
2) Inactive (Between 2 to 10
68

h.
General Store
12
11
10.50
252.00
3
a.
b.
c.
d.
e.
CSSD
Bulk storage
Officer-in-charge with toilet
Technicians room with toilet
Receipt counter
Deassembling and
20
20
20
20
20
15
18
15
18
15
18
15
18
15
18
3
1
1
1
3
17.50
17.50
17.50
17.50
17.50
f.
g.
Decontamination
Washing and cleaning
Assembly and Set packing
20
25
15
30
18
18
3
1
17.50
28.00
h.
room
Gloves preparation room and
20
15
18
17.50
i.
j.
k.
l.
m.
n.
o.
Gauze cutting area

Autoclave area
Hot air-oven room
Sterile store
Issue counter
Class IV room
Trolley bay
Switch room
25
12
30
20
12
12
12
28
11
34
15
11
11
11
30
10
38
18
10
10
10
1
1
1
1
1
1
1
28.00
10.50
35.00
17.50
10.50
10.50
10.50
273.00
4.
a.
b.
c.
DIETARY UNIT
Reception area
Cooking area
Therapeutic diet preparation
40
80
20
45
92
15
40
86
18
1
1
1
42
84
17.5
d.
and cooking area

1) Dietitian with toilet
20
15
18
17.5
2) Stewards and Staff with
20
15
18
17.5
toilet
Trolley loading
Walk in cold storage
Dry ration storage
Washing area
16
12
12
14
11
11
12
10
10
1
1
1
14
10.5
10.5
1)Pots
16
12
13
14
2) Trolleys
15
17
18
17.5
i.
j.
3) Dishes
Garbage collection area
Switch room
15
12
12
17
11
11
18
10
10
1
1
1
17.5
10.5
10.5
283.50
5.
LAUNDRY UNIT
e.
f.
g.
h.
69

a.
Dirty clothes receiving and
40
45
40
42
b.
sorting
Sluice and autoclaving
25
28
30
28
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
machine
Washing area
Hydro extractor area
Drying tumbler area
Tailor desk
Steam pressing
Manual press area
Clean clothes storage area
Issue area
Boiler room
Trolley bay
Store
Laundry supervisor office with
50
50
50
12
25
28
30
25
18
12
20
18
60
60
45
15
30
30
34
31
20
12
22
20
45
45
60
14
28
36
38
27
22
18
21
17
1
1
1
1
1
1
1
1
1
1
1
1
56
56
56
14
28
28
35
28
21
14
21
17.5
o.
p.
toilet
Laundry staff room with toilet
Switch room
20
6
22
9
21
8
1
1
21
7.0
472.50
6.
OUT-PATIENT DEPARTMENT
General
a.
Ent. hall with enquiry counter ,
160
155
152
154
b.
c.
d.
e.
f.
g.
h.
i.
cash counter and record area

Office-in-charge with toilet
Nurse-in-charge with toilet
Sanitary inspector room
Key room (security)
OPD medical record room
Canteen
Lavatories ( male and female )
Janitor closet
20
20
15
15
68
50
52
12
15
15
12
12
72
52
50
11
18
18
15
15
70
48
47
10
1
1
1
1
1
1
1
1
17.5
17.5
14
14
70
49
49
10.5
395.5
a.
Medical clinic
Consultation and examination
20
15
18
17.5
b.
c.
a.
b.
Room
Cardio graphic examination
Waiting
SURGICAL CLINIC
Treatment and dressing/minor
20
60
15
62
18
60
1
1
17.5
63
20
28
15
30
18
36
4
1
17.5
28
70

c.
a.
b.
c.
d.
e.
f.
a.
surgery
Waiting * (Category D and E )
ORTHOPAEDIC CLINIC
Plaster and splint storage room
Fracture and treatment
Plaster cutting room
Recovery room
Waiting
EYE CLINIC
Consultation /exam./
b.
d.
e.
a.
60
62
61
63
20
20
20
20
20
52
15
15
15
15
15
50
18
18
18
18
18
47
2
1
1
1
1
1
17.5
17.5
17.5
17.5
17.5
49
28
30
36
28.00
refraction
Minor surgery & treatment
20
15
18
Dark room
28
30
36
waiting
ENT CLINIC (to be shared in common with eye clinic)
28
30
36
1
1
1
17.5
17.50
28.00
28.00
1
1
1
1
17.50
1.50
17.50
28.00
2
2
1
1
1
17.50
17.50
21.00
28.00
28.00
1
2
1
1
1
17.50
17.50
17.50
17.50
10.50
b.
c.
d.
a.
b.
c.
d.
e.
a.
b.
c.
d.
e.
Treatment
2
1
2
Audiometric room
20
15
18
Waiting
28
30
36
DENTAL CLINIC
20
15
18
Dental hygienist room
20
15
18
recovery
20
22
21
Dental workshop
28
30
36
Waiting
28
30
36
OBSTETRIC AND GYNAECOLOGICAL CLINIC
Reception and registration
20
15
18
20
15
18
Treatment
20
15
18
Clinical laboratory
20
15
18
Toilet-cum-changing (attach. to 12
11
10
f.
a.
b.
c.
treatment
Waiting
30
FAMILY PLANNING CLINIC
Consultation and examination 20
Treatment
20
Health educator & social
20
d.
e.
worker
recovery
Waiting
20
28
34
38
35.00
15
15
15
18
18
18
2
2
1
17.50
17.50
17.50
22
30
21
36
1
1
21.00
28.00
71
a.
b.
PAEDIATRIC CLINIC
Treatment, dressing &
20
c.
d.
e.
f.
a.
dispensing
Therapy room
Immunization room
Recreation & playroom
Waiting
SKIN & STD CLINIC
b.
c.
d.
e.
f.
a.
b.
c.
d.
e.
g.
a.
7)
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
8)
a.
b.
c..
d.
e.
f.
Treatment,
20
Biopsy room
12
Superficial therapy
20
Skin laboratory
28
Waiting
28
PHYCHIATRIC CLINIC
ECT room
20
recovery room
20
Psychologist room
20
Social worker room
20
Waiting
28
SUPPORTING FACILITIES
Central injection room
20
THE BLOOD BANK
Reception and waiting
20
Bleeding area
20
Donors rest room
20
Lab and blood storage area
28
Office
12
Stores
12
Bottle washing
15
Doctors room with toilet
20
Social worker (attached toi.)
20
Lavatory
12
Janitors closet
4
THE EMERGENCY DEPARTMENT
Stores
15
Sluice room & Janitor closet 12
Nurses station with toilet
20
Observation room (4 beds)
30
Emergency ward
21
pantry
12
15
15
18
18
2
2
17.50
17.50
12
20
15
30
11
15
12
34
10
18
15
38
1
1
1
1
10.50
17.50
14.00
35.00
20
15
18
17.50
15
11
15
30
30
18
10
18
36
36
3
1
1
1
1
17.50
10.50
17.50
28.00
28.00
15
15
15
15
15
30
18
18
18
18
18
36
2
1
1
1
1
1
17.50
17.50
17.50
17.50
17.50
28.00
15
18
17.50
22
15
15
30
11
11
12
15
15
11
3.5
21
18
18
36
10
10
15
18
18
10
3.8
1
1
1
1
1
2
1
1
1
1
1
21.00
17.50
17.50
28.00
10.50
10.50
14.00
17.50
17.50
10.50
3.50
12
11
15
34
24
11
15
10
18
38
20
10
2
1
1
1
1
1
14.00
10.50
17.50
35.00
20.00
10.50
72

8)
a.
THE PATHOLOGY DEPARTMENT

Reception & specimen
30
34
38
35.00
b.
c.
d.
e.
f.
g.
h.
i.
j.
collection/distribution
Patients waiting (with toilet)
Pathologist lab. (with toilet)
Office and record
Technicians rm.(with toilet)
Stores
Biochemistry
Microbiology with incubator
Media room
Photometry & other
30
20
15
15
12
30
30
15
34
34
15
12
12
11
34
34
12
35
38
18
15
15
10
38
38
15
36
1
4
1
1
4
1
1
1
1
35.00
17.50
14.00
14.00
10.50
35.00
35.00
14.00
35.00
k.
l.
m.
n.
o.
electronic equip. room

Histology & cytology
Washing & sterilizing
Serology & lab.
Janitors closet
Specimen disposal and sluice
20
15
15
3.5
12
22
12
12
4
11
21
15
15
3.8
10
1
1
1
1
1
21.00
14.00
14.00
3.50
10.50
9)
a.
room
THE RADIOLOGY DEPARTMENT
Reception, registration with
40
45
40
42.00
b.
c.
waiting & toilet

Radiography & fluoroscopy
Film developing and
12
12
11
11
10
10
1
2
10.50
10.50
d.
e.
processing
Contrast studies& preparation 12
Stores
12
11
11
10
10
10.50
10.50
1
1
1
1
1
1
1
1
1
1
10.50
28.00
1
1
1
14.0
14.0
14.0
1) film
f.
g.
h.
i.
j.
k.
l.
m.
n.
10
A
B
C
2) chemical
X-ray record room
Radiologists office with toi.
Technician rm. With toilet
Nurses rm. With toilets
Film viewing
Office
Trolley bay
Switch room
Janitors closet
RADIO THERAPY UNIT
Contact therapy(45kv)
Superficial therapy(100kv)
Intermediary therapy with
28
30
36
12
15
12
20
11
12
11
15
10
15
10
18
15
15
12
12
15
15
10.5
14.00
10.50
17.50
3.50
73

dressing cubicles and control
D
E
desk 3.5 sq.m

Deep therapy
Cobalt therapy with dressing
30
68
34
72
38
70
1
1
35.0
70.0
90
92
88
91.0
28
30
36
28.0
facility.
Physicist room with
40
45
40
42.0
I
J
laboratory & toilet.

Mould room
Simulator room with control
20
30
22
34
21
38
1
1
21.0
35.0
sq.m
Treatment planning system
20
15
18
17.5
(TPS) room
C T scanner room with
20
15
18
17.5
M
N
computer 10.5 sq.m

Transformer room
Dressing room/preparation
6
10
6.8
11
8
10.5
1
1
07.0
10.5
O
P
room with dark room facility.

Record room
Reception and waiting with
40
54
45
58
40
56
1
1
42.0
56.0
11.
toilet.
PROVISIONS OF
40
45
40
42
cubicles 3.5sq.m and control

F
room.
Megavoltage therapy
(12mev) with dressing
cubicles 3.5 sq.m &control
room 7 sq.m.
Radiotherapist room with
examination room and toilet
room 7sq.m. &waiting 14
VARIOUS FLOOR AREA

IN PHYSIOTHERAPY
A
DEPARTMENT
Reception and waiting with
toilet.
Physical and electrical
74

therapy.
a) diathermy
12
11
10
10.5
07.0
b) ultraviolet
c) infrared
d) radiant heat
e) Selective combined
treatment.
10.5
f) Traction
g) Wax bath
1
Hydrotherapy comprising of
30
34
10.5
38
10.5
35.0
91.0
42
21
a tank, shower, and dressing

D
E
F
cubicles.
Gymnasium
Occupational therapy
Physiotherapist office
G
12
including toilet of 3.5 sq.m

Store
Provision of various floor
40
20
45
22
40
21
1
1
1
28
30
36
28
A
B
C
areas in O.T department

Zone A
OT reception bay
Relatives waiting room
Officer in charge of OT with
12
30
20
11
34
15
10
38
18
1
1
1
10.5
35.0
17.5
D
E
F
G
H
I
J
K
toilet
Doctors change room
Nurses change room
Technicians change room
Class IV staff change room
Sterile storage area
Instrument and linen room
Trolley bay
Gas cylinder storage
15
15
20
20
30
30
15
12
12
12
15
15
34
34
12
11
15
15
18
18
38
38
15
10
2
2
1
1
1
1
1
1
14.0
14.0
17.5
17.5
35.0
35.0
14.0
10.5
75

L
A
Switch room (keep light)

Zone B
Fracture cum casualty
15
12
15
14.0
theatres
a) instrument sterilization
b) scrub up
c)dirty wash up
76
CHAPTER # 4
ANALYSIS
4.1
BHOPAL AT A GLANCE
4.2
SITE
4.3
SITE CHARACTERISTIC
4.4
CLIMATOLOGY
4.1 BHOPAL AT A GLANCE:

Name of City
State & District
Latitude
Longitude
Altitude
Av. Max. Temperature
Av. Min. Temperature
Relative Humidity
Av. Rainfall
Predominant Wind
Direction
Planning Area
Population Bhopal U.A.
(2001)
Primary Functions
Major Industries
BHOPAL
Madhya Pradesh, Bhopal
77.35N
23.25E
550-600 MSL
40C
3C
57%
1328.7 mm
W/NW/NE
60,106 ha.
14.54 Lakhs
Administrative-Commercial
BHEL, Govindpura Industrial Area,
Mandideep Growth Center, Rly.
Coach Factory
77

CLIMATE
Madhya Pradesh in general may be treated as tropical region, which has a fairly
heavy rainfall during the wet season, succeeded by a dry season.
However the climate of Bhopal is relatively moderate and dry except in the monsoon
season, indicating a seasonal rhythm of weather. The year may be divided into four major
seasons. The period from March to mid June is summer while heavy showers along with
South West monsoon till the end of September constitutes the rainy season. October and
November constitute the post monsoon season from December to the end of February is the
cold and dry winter season. Major part of Bhopal lies on the east edge of Malwa plateau and
at northern foot hills of vindhayachal is not very much marked and the climate in general is
pleasant. During the months of April to June the days are hot but nights are moderately cool
with blowing of slow breeze what is commonly known as shab-e-malwa. The weather
during the rainy season is fresh and pleasant but between each fall of the rain the weather is
unpleasant. Winter season is generally bright and cloudless. There are light showers during
early winters.
Topography & Climate

Bhopal is situated on 2316 north latitude & 7725 east longitudes. The city is situated
on sandstone ridge at 503 m above M.S.L. The high and low topography of the city has
been very advantageous in providing beautiful & panoramic views and settings. The city
stands on the edge of two main lakes, the upper lake or Bara talab having as area of
48.27 sq.km. And the lower lake or the Chota talab occupying an area of 3.218 sq.km.
These two lakes divide the city into two main parts. There are few smaller lakes in the
city. And thus the city is rightly called as the City of Lakes. Major part of Bhopal lies on
the Malwa plateau sloping towards North except the southern valley. The topography of
the Malwa plateau presents undulating surface depressed with areas rich with Black
78

cotton soil. Bhopal stands on red sand stone strata on the Malwa Plateau with various
hillocks in and around the city. The top portion of various hillock and the slopes have
mostly hard red soil mixed with boulders. Black cotton soil is however, observed in
various depths from 1 to 2.5 meters on the north-eastern and south-eastern side of the city.
Sub-surface within planning area is not rich in minerals. The sheet rock of red stone is
available in parts. The depth of bed rock varies according to slopes. Vegetation around
the city is in the nature of mixed forest. The soil being shallow the growth is stunted and
not true to the original growth of the species Madhya Pradesh in general may be treated
as tropical region which has fairly heavy rainfall during the wet season succeeded by a
dry season.. However the climate of Bhopal is relatively moderate & dry except in the
monsoon season.
The year may be divided into four major seasons. The duration from beginning of March
to the mid of June constitute the summer followed by the rainy season till end of
September. October & November constitute the post monsoon season while December to
February is the cold and dry winter.
Major part of Bhopal region lies in the east edge of Malwa plateau and at northern
foothills of Vindhyachal ranges. Here the extremes of temperature are no marked and the
climate in general is pleasant. During the months of April to June the days are hot while
the nights are moderately cool with gentle breeze what is commonly known as Shab-eMalwa.
Westerly and south-westerly winds are more predominant. Average velocity of wind
varies from 4 Km. To 9 Km. Per hour. However, numerous hill and valleys situated in and
around the city produce considerable variations in direction and speed of the wind. Micro
climate in this area, therefore, plays a very important role in orientation and design of
buildings. The weather during the rainy season is fresh & pleasant, but between each fall
of rain it becomes sultry & unpleasant. Winter season is generally bright & cloudless
There are light showers during early winters. She The average rainfall is about 920 mm
per year of which 92% is concentrated in the monsoon months of June to September. The
average number of rainy days is approximately 40. Winds are generally light except in
late summer and early monsoon season. Winds are predominant from the west and
79

south-west during the monsoon. The presence of the lakes and hillocks create numerous
and varying micro-climates.
The temperature varies from 3C to 36C in winters whereas from 16C to 45C in
summers. The relative humidity varies from 10% to 92%. During the months of
southwest monsoon the relative humidity remains above 70% while during the summer it
remains as low as 20%. Occasionally the depressions and storms originating in Bay of
Bengal and moving in westerly and northwesterly directions reach upto Bhopal and cause
depressed heavy rains and gusty winds.
There are 14 water bodies in and around Bhopal includes the two large lakes Upper and
Lower lake in the south-east and Sirpur tank in the south-west.
Natural drainage of the urban area is through three main streams; on the northeast, the
Halali River and for the south-east the Kaliyasote River. Both drain into the Betwa River.
The old city with waste from a few industries drains into the Halali. Most of this water is
pumped up for irrigation before it joins the Betwa. The south-west of the city is drained
by the small streams joining the Kolar River, which in turns eventually discharges into
the Narmada River.
Rainfall:
Average annual rainfall in Bhopal is about 920mm of which 92% takes place in the months
of June to September.
Temperature:
The temperature in summer varies from 9.9deg.C to 45 deg. C with middle of May to middle
of June being the hottest period, the temperature in winter season vary from 3.1 deg. C to
35.5deg .C.
Relative humidity:
The relative humidity generally varies between 10% to 90%. During the months of southwest
monsoon the relative humidity generally remains above 70%. Remaining part of the year is
dry and during summer afternoons the relative humidity is low as 20% or even less.
Winds
80

Winds are generally light except in late summer and early monsoons. During from
southwest the wind blow from southwest to northwest. In the post monsoon, winds are
generally light and blow direction northeast is northwest.
Westerly and northwesterly winters are predominant in summer.
The summers loo is a common phenomenon monsoon winds are predominant from
the west or southwest from Arabian Sea.
Special weather phenomenon
Depression originating in the head of the Bay of Bengal during monsoon often moving in
westerly to north westerly direction often reaches Bhopal. Its neighborhoods causing
dispersed heavy rains and gusty winds. Occasionally post monsoon storms and depressions
also affect the area in the same way. Thunder storms also occur of June and July.
Landscape and vegetation
The city is very famous thus is popularly known as lake city. Two major lakes along with a
series of small lakes and hilly tracts covered with luxuriant vegetation offer beautiful settings
in the city. Commonly habitable species are solai, gangal, jamun eucalyptus, Gulab, Palm,
Mango, Bamboo, Kehad, Kadam, Ashoka Gulmohar, Raibans, koha etc.
SITE ANALYSIS:
Location:
Site is located at kalibaadi temple road in BHEL area of Bhopal.
81
THE SITE
Access:
Site is accessible from a 24m wide main road (kalibaadi temple road)
82

Distance from habibganj railway station-8 km
Distance from main railway station-11km
Distance from airport-22km
Distance from proposed new ISBT-7km
Distance from BHEL factory-2km
Surroundings:
St Saviors school and kalibadi temple are the landmarks nearby and open land
Existing structures: No
Site area: total area of site is 13 acres out of which hospital building is accommodated in 10
acres of land. The remaining part of land is used for the other elementary buildings
Shape : Rectangular
Topography: Plain site with slight slope towards east.
Wind direction: Predominantly from west and south west.
Soil condition: Top layer upto 1m is yellow alluvial soil below which hard strata is available.
Vegetation: only shrubs and bushes.
83
CHAPTER 5
PLANNING & DESIGN APPROACH
CONCEPT & DESIGN PRINCIPLES:
CONCEPT:
The sound health is the essence of human life. It is defined as a state of complete physical
mental and social well-being and not merely the absence of disease or infirmity.
Hospital is a complex social institution composed of varied technical and non-technical
elements requiring highly efficient engineering services and staff with a wide variety of
technologies to support the process of health care.
The main concept of design is that Planning is done considering Hospital as amalgam of
simple and complex components being an embodiment of life is conceived as a living
entity where Form Follows Function. There is an amalgam of medical technologies
with material, spiritual and emotional activities within the building.
Hospital is composed of many groups representing a wide variety of interests and
diverse needs. It utilizes the services of various medical, paramedical and support
personnel to render all needed healthcare to the patients in its custody and through
outreach programs to all on its medical charge. In addition to the foreground prima-facie
activities a wide background activities are present which are hidden. These activities use
modern technologies and engineering services to support the process of healthcare. For
example to undergo an operation in OT there are no. of teams involved such as
A preparation team,
A team involved in doing the operation,
A team for post operative care.
84

A team taking care of accounting and administration.etc.
All these superficial and hidden activities are given equal importance while planning the
hospital. The form is generated following the functional requirements of the hospital and
satisfying all the needs of the patients and staff members.
To create a space means to express the sense of being. It is necessary to reflect human needs
in our Architecture. Creation of ideal environment therefore was the key underlying factor
while designing the hospital.
DESIGN PROCESS:
Form:
Form is a stable form in space. The formal and symmetrical form with boldness in it.
Compact planning is done for quick mobilization of services from one part to another.
Design is a functionally graceful structure to serve the users well and satisfy there
physical and psychological needs.
Open spaces:
Inspite of compactness in planning sufficient open spaces are provided within the
building for good light and ventilation in core areas.
Integration:
An attempt is made for integrated approach in design. Integration of functional,
psychological, climatic and aesthetic aspects to create a harmonies effect. Each space is
given a different identity by means of form, color and landscape to avoid repetation that
would create a monotonous environment. An interest is created in soft and hard landscape
through judicious selection of landscape furniture and good viewpoints.
Structure:
An R.C.C Framed structure in which a regular grid of 7.5m is followed in such as way
that the module can be repeated and there is a scope of future expansion also.
Zoning:
The hospital is divided into 6 zones:
a) Administrative zone.
b) Nursing units
c) Out patient department
85

d) Treatment block
e) Supporting services
f) Utility
Orientation: Good natural light ventilation is given prime consideration. Orientation is such that to ensure
glass free natural light which will reduce radiation of heat.
Circulation:
The three type of traffic flow i.e. patients, staff & supplies are properly channelized. Patients
are brought from the ward without crossing the transfer area, which is great source of
infection.
Staff enters from a separate route & through a set of change rooms.
1)
Too much traffic will disturb the patients, affect the efficiency in patient care and
increase the risk of infection, particularly in the case of surgical patients for whom aseptic
condition is essential.
2)
The second rule is to plan for the shortest possible routes. They assist in
maintaining aseptic conditions and save steps for everybody nurses,doctors, patients and
other hospital personnels. A hospital is a place where everything should be done fast.
Patients lives often depend on it.
3)
The third rule is the separation of dissimilar activities. Examples, - separation of

clean and dirty operations , quiet and noisy activities , different types of patients , different
types of traffic both inside and outside the building,etc.
Control is the fourth rule to follow. A certain amount of control is inherent when dissimilar
activities are separated, but that is not enough. The flow of students should be made limited
to some particular parts of hospital, which are essential for teaching purposes, by this it may
be possible that some of the facilities has to be duplicated. (Duplication of requirement may
be done on the cost of infrastructure.)
86

BASIC DESIGN CONSIDERATION:
To provide comprehensive health care is the major concern while planning the
hospital.
Ease in access for the patient is kept in consideration and hence the site is well
connected by good roads and public transportation.
The site is large enough for expansion in future.
Care has been taken to avoid blocking of any corridors with stairs or other
fixed elements.
Pattern has been maintained so as to provide the greatest amount of

flexibility. Also, they are consolidated, they are provided with the greatest
amount of free usable space.
Orientation of all or most sections of the hospital is so as to allow maximum

light to all parts of the building and maximum exposure to breeze is an
important factor.
Proper coordination of all the sections of the building by arranging them in
appropriate places based on their functional relationships is the perennial need
along with creating friendly environment for all visiting it.
Awareness of circulation, traffic segregation, specific flow, material handling,
and control, grouping and home environment is the main synthesis of design.
Best Medicare to the patients and best working conditions for the staff is the
major aim of design.
The most important client of the hospital is the patient; therefore maximum
efforts should be made for the convenience of the patient. Ease in access for
the patient is absolutely essential and for this the site must be well connected
by good roads and public transportation.
The site should be large enough for expansion in future.
Separation of patients on basis of:
Privacy Separation of in and out patient area.
Degree of illness Separate rooms, wards units for the critically ill patients
and the normal care or the general ward patients.
87

Functional separation
Curative and Preventive Services.
Traffic flow of in and out patients has been separated.
Separate circulation of staff and public.
Separate transport of clean and soiled material.
Separate access to consulting rooms for physicians and the publications
RADIOLOGY DEPARTMENT:
Film development and processing room: it is provided in between a pair of radiology
rooms so that new and exposed x-ray films may be easily passed through the castle pan with
2mm lead backing installed in wall between room is cut off from direct light / air lock.
Loading bank / processing tank, washing tank, sink, acid and alkali proof flooring.
Adequate space for accommodating the therapy apparatus and free movement of couch, etc.
Control desk and dressing cubicles for the patients.
The viewing system such as closed circuit T.V, leads glass viewing window is provided near
the control desk for viewing the patients undergoing radiotherapy.
The structure is such as to prevent the escape of radiations. Walls have radiation protection of
2mm lead lining up to a height of 2 m. for superficial and intermediate therapy rooms
300mm thick brick walls and 150mm thick R.C.C. roof is provided.
PHYSIOTHERAPY DEPARTMENT:
Availability of natural light, fresh air and adequate ventilation are given prime importance.
Accommodations are provided in the form of booths for complete privacy.
OPERATION THEATRES:
Zoning:
High degree of asepsis is ensured to provide appropriate environmemt for staff and patients.
Passing of patients and equipments through long corridors and unprotected areas are avoided.
1)
Protective zone: - Theatre supply, changing rooms, pre anesthetic examination

rooms, and waiting rooms.
2)
Clean zone: - casualty theaters, recovery wards, plaster rooms, theatre pack
preparation and pre operative wards.
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3)
Aseptic / sterile zone: O.Ts, anesthetics and sterilizing room. In these areas
highest degrees of antibacterial precautions is required.
4)
Disposal / dirty zone: - sluice room and disposal corridors are incorporated under
this zone.
The flow of traffic from one zone to another is arranged through proper nursing. All
soiled material both disposal and non-disposable are moved without crossing the sterile
and clean zone.
Optimum comfort level in O.Ts
Wards are placed to ensure sufficient nursing care, segregating patients according to
their categories, locating them according to the needs of treatment in respective medical
discipline and checking cross infection.
Quietness & freedom from unwanted visitors.
General wards units are of repelative nature & piled up vertically one above other, which
result in efficiency, easy circulation & service economy.
OUTPATIENT SERVICES
The outpatient department is conveniently located adjacent or in close proximity to vital
Adjunct services such as registration and medical records, admitting, emergency and social
services. It is easily accessible and rapid services are available from the laboratories,
radiology, and pharmacy and physical therapy departments since the patients use practically
all of the diagnostic and therapeutic departments during every visit. Attention is paid to
circulation, which results in a smooth flow of the various traffic lines traversing the
department
The emergency department is located on the ground floor with easy access for patients and
ambulances. There is a separate entrance to the department, which is away from the main
hospital, and the outpatient entrance; it is well marked with proper lighting and signs, and is
easily visible and accessible from the street.
89
The laboratories are conveniently located on the ground floor to serve the outpatient,
They are close to or easily accessible to surgery, intensive care, radiology and obstetrics.
As the laboratory would cater to the needs of both out patients and in-patients, they are
placed centrally and away from the general traffic line.
The autopsy area as well as the morgue are away from the emergency and inpatient areas
and the removal of dead bodies to the outside is through non-public corridors for
psychological reasons.
INPATIENT DEPARTMENT
The patients admitted in the hospital are those who need to be observed by the concerned
disease doctor. Therefore while planning the inpatient department the special care and
attention has been given in maintaining the peaceful, calm and soothing life-giving
atmosphere within the department. To maintain this atmosphere the access of general public
is restricted by providing the outpatient and the treatment block consisting of the pathology
laboratory, radiology, blood bank and all the other diagnostic facilities in vicinity of both the
departments diagonally so as to avoid unnecessary movement of the outpatients and the
others within the in patient department to maintain privacy at least to some extents the
general wards are laid in the cubicles of six beds with a low heighted partition within the
cubicles.
ISOLATION ROOMS
The patients in the isolation rooms are those suffering from the communicable diseases. They
therefore require segregation from other patients as well the working staff so as to restrict the
diseases from being communicated. The interdepartmental and a unit of isolation wards
outside the main building block is thus planned to save others being getting infected.
OUTPATIENT SERVICES
The outpatient department is conveniently located adjacent or in close proximity to vital
Adjunct services such as registration and medical records, admitting, emergency and social
services. It is easily accessible and rapid services are available from the laboratories,
radiology, and pharmacy and physical therapy departments since the patients use practically
90

all of the diagnostic and therapeutic departments during every visit. Attention is paid to
circulation, which results in a smooth flow of the various traffic lines traversing the
department
The emergency department is located on the ground floor with easy access for patients and
ambulances. There is a separate entrance to the department, which is away from the main
hospital, and the outpatient entrance; it is well marked with proper lighting and signs, and is
easily visible and accessible from the street.
The laboratories are conveniently located on the ground floor to serve the outpatient,
They are close to or easily accessible to surgery, intensive care, radiology and obstetrics.
As the laboratory would cater to the needs of both out patients and in-patients, they are
placed centrally and away from the general traffic line.
The autopsy area as well as the morgue are away from the emergency and inpatient areas
and the removal of dead bodies to the outside is through non-public corridors for
psychological reasons.
RADIOLOGY:
Film development and processing room:
It is provided in between a pair of radiology rooms so that new and exposed x-ray films may
be easily passed through the castle pan with 2mm lead backing installed in wall between
room is cut off from direct light / air lock.
Loading bank / processing tank, washing tank, sink, acid and alkali proof flooring.
Adequate space for accommodating the therapy apparatus and free movement of couch, etc.
Control desk and dressing cubicles for the patients.
The main feature of this hospital is proper organization of functional spaces which is O.P.D ,
I.P.D,diagonostic therapeutic services etc . the emergency department is on far left facing
towards the main entrance. Adjacent to emergency towards right is the out patient
department. Thereafter in continuation towards right are general wards and further on is
operation theatre complex (surgery department). Provision of community facilities like social
workers ,pharmacy stores ,free of cost dietry services,etc, are made available.
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On the northern side of the site college block is made , besides the college block stood the
hostels for students as well as residents and nurses. The teaching hospital is on southern part
of the site facing towards east. In between the college block and hospital block stood
auditorium. Provision for recreational facilities for students (viz playgrounds ,etc.) has also
been made . college block and hospital block are connected by a 10m road.
Most of the department mainly OPD and IPD are planned on a module concept. Proper
arrangements are made for vertical circulation. Two set of ramps are provided.
SERVICES:
KITCHEN:
Hospital kitchen is alone responsible for spreading diseases if hygienic conditions are not
maintained. Location is such that any noise or cooking odors generating from the
department does not cause any inconvenience to other departments, and also the location
involves shortest possible time in delivering food to the wards.
LAUNDRY:
The laundry is placed at such a location that the disposed and used linen as well as the
washed and sterile linen from the related departments could easily be transferred from
one department to the other. The laundry is located in the services zone of the building
away from the general public flow within the departments. It is also situated near its
supporting department for maintaining the utmost sterile conditions, the central
sterilization department.
CENTRAL STERILIZATION AND SUPPLY DEPARTMENT
The sterile surroundings are the first and the foremost requirement of the hospital. It is
the key to the successful planning of the hospitals. Thus this part has been given a great
heed and the central sterilization and supply department is being planned to maintain the
sterile and hygienic surroundings throughout the hospital complex. The major
requirement of the CSSD is for the treatment block and to the inpatient block it is
therefore sited on the ground floor of the treatment block in vicinity of the inpatient block
as well as the laundry in order to maintain the sterility of the linen as well. The unsterile
accessories are disposed to the CSSD through the disposal stairways and the sterile
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accessories are in turn supplied to the departments concerned through the sterile
stairways and the lift and the corridor vertically as well as horizontally.
WATER SUPPLY: The major supplier of the water to the hospital at BHEL will be the
Municipal Supply Line. The hospital will have its own individual units of supply too, as
the hospitals are the major consumers of the life-giving element, water. The water
requirement per bed in the hospital is approximately 450 litres per bed per day.
Total No. of beds = 400
Quantity of water consumed by 400 beds per day = 400 x 450 = 180000 litres
SANITATION:
To maintain the cleanliness in the surroundings and also within the building the better
discharge of sanitary services is the prior requirement of the hospital complex. The
vertical and the horizontal flow of sewage will be thus kept a check by the provision of
all the elementary sanitary services by the provision of the required traps and the
inspection chambers within the building as well as the building complex. The sewage will
be disposed off site through available the main sewer line. The water from the bathing
rooms and the kitchen will be diverted from being disposed off site through the main
sewers and sent to the water treatment plant. This treated water will be then recirculated
in the flushing cisterns, in the gardens and in the AC plant in the chilling unit.
FIRE FIGHTING
The tragedies are unavoidable but safety measures to them are in the human hands. Thus
incase of any such circumstances of fire many safety measures will be adopted to protect
the public within the building and also the building from it. For the purpose of firefighting the whole building will be divided into zones for easy detection of the part of the
building under the tragic grip of it. The fire-fighting staircase is provided to detect the fire
in the different zones of the building the some detectors will be provided in the building.
Along with it cylindrical units will be provided at the entrance of each department. CBD
units too will be provided. The sprinkler system will be used in the basement for fire
fighting.
AIR CONDITIONING:
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Air conditioning and environmental control in hospital is essential to ensure the comforts
of patients, sterile and comfortable conditions in operation theatres, maintenance of
essential sophisticated instrument and equipments and to help is the speedy recovery and
treatment of ill patients.
The following department/wards are considered essential and recommend for airconditioned:
a) Blood laboratory in blood bank of out patient department.
b) Operation theatre complex in emergency and casualty department
c) Certain laboratories in pathology department.
d) Radiography and radiotherapy rooms in radiology department.
e) Fracture cum casualty theatre, recovery, frozen section of clear zone and all rooms in
sterile zone of operation theatre department.
f) Certain number of beds in ward unit of particular specialties.
g) All rooms in sterile zone of delivery suits.
h) Intensive care units, and
i) Autopsy room in mortuary.
Centralized air conditioning is provided in O.T. ICU, Pathology, treatment block and
nursing block.
Individual fan coil units are provided in private wards.
A.C calculations:
Total area to be air conditioned: 1695+1740= 3435 sq.m
Thumb rule: For conditioning 13.8 sq.m area 1 ton A.C is required.
For conditioning 3435 sq.m area tonnage required is 250Tons.
REFRIGERATION
Hospitals shall be provided water cooler and refrigerators in wards and department,
freezers in pathology, cold storage plants for pathology, mortuary, medical stores and
delivery department. All these, power consuming units shall be provided with voltage
stabilizers.
94

ILLUMINATION:
General General lighting of all hospital areas except stores and lavoratory block shall
be fluorescent.
Shadow less light Shadow less light (Mountable type) shall be provided in operation
theatres and operating delivery rooms where as in others areas, where operation of minor
nature are carried out shadow less lamps (portable type) shall be provided.
Call bells Call bell switches should be provided in wards and departments to serve as
alternative source of light in case of power failure.
Emergency and lighting Emergency portable light units should also be provided in the
wards and departments to serve as alter native source of light in case of power failure.Sex
Separation of sexes will be achieved by room assignment, this applies to all nursing
units, except the post operative recovery unit and I.C.U
FUTURE EXPANSION: Collaboration within and between departments is encouraged, by making possible common
use of space and equipment. Individual clinical departments may, to some extent, be
fragmented to accommodate those clinicians who will have their offices in the hospital
patients care facilities and spend most of their time there.
CONCLUSION:
Efforts have been made to achieve a design solution which is based on the design and
planning principles of hospital design. But as standards are to be modified according to local
conditions rather than applying them directly. Planning is done by taking into consideration
the practical aspects and needs of the hospital users.
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400 BEDDED HOSPITAL AT BHEL, BHOPAL

Under the guidance of

400 BEDDED HOSPITAL AT BHEL, BHOPAL

For the award of

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

1.3 THE IMPORTANCE

RELEVANCE OF PROJECT IN PRESENT SCENARIO.

BASIC ISSUES AND RELEVANCES

AIMS AND OBJECTIVES

GENERAL REQUIRMERNT OF BUILDING

400 BEDDED HOSPITAL AT BHEL, BHOPAL

PLANNING & DESIGN APPROACH

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

GENERAL REQUIREMENTS OF PROJECT

400 BEDDED HOSPITAL AT BHEL, BHOPAL

With Professional Architects

With Seniors & Colleagues

400 BEDDED HOSPITAL AT BHEL, BHOPAL

Types of environment to be achieved: Corporal

400 BEDDED HOSPITAL AT BHEL, BHOPAL

and studied. Hence, the

400 BEDDED HOSPITAL AT BHEL, BHOPAL

Bhopal Memorial hospital

Peoples General Hospital

400 BEDDED HOSPITAL AT BHEL, BHOPAL

photographs and informations of the study as collected on the following basis.

General information about ownership, architectural influences area etc.

Site planning site environment, approach, access, and circulation.

Structural system materials and finishes.

Relevant specialties as interiors, landscape, parking.

Any other relevant information about the project.

400 BEDDED HOSPITAL AT BHEL, BHOPAL

- Kasturba hospital, Bhopal

Ownership - BHEL Bhopal

- Habibganj BHEL Township Bhopal

Design team - Engineering Dept. of BHEL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

Project: Bhopal Memorial Hospital.

400 BEDDED HOSPITAL AT BHEL, BHOPAL

The site has irregular shape and is sloping.

400 BEDDED HOSPITAL AT BHEL, BHOPAL

GROUND FLOOR PLAN

400 BEDDED HOSPITAL AT BHEL, BHOPAL

FIRST FLOOR PLAN

400 BEDDED HOSPITAL AT BHEL, BHOPAL

THIRD FLOOR PLAN

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

400 BEDDED HOSPITAL AT BHEL, BHOPAL

G.F.(in between G.F.(adjoining

services/pathology OPD but far

400 BEDDED HOSPITAL AT BHEL, BHOPAL