Improving Public Healthcare in Santa Maria, Bulacan

P O LY T E C H N I C U N I V E R S I T Y O F T H E P H I L I P P I N E S 1
Chapter I
THE PROBLEM AND ITS SETTING
INTRODUCTION
Health is one of the vital keys for the success of any firm or organization.
According to Occupational Safety and Health Administration (OSHA), good health and
safety measures implemented in workplaces can cause workers to increase productivity,
boost morale, and reduce cost from losses cause by work related injuries and accidents.
It is a factor to be considered in many health and safety management plans in
businesses. Health mostly affects staffs, members or employees of a group. In
response, firms and businesses provides proper healthcare benefits by contracting
healthcare providers or institutions to give them the proper health maintenance.
A hospital is a health care institution providing patient treatment with specialized
medical team and nursing staff, and medical equipment (Wikipedia). They allow every
person to have access in any healthcare services they need for the purpose of improving
health or preventing disease. Hospitals are classified in different types in terms of many
aspects. One aspect is based on its objective type of hospitals and includes (1) General.
Meant to provide wide range of various types of healthcare, but with limited capacity; (2)
Specialty. Limited services within a particular condition (e.g. maternity or orthopedics
type of hospitals); and (3) A Teaching Cum Research Hospital. A type that is attached for
medical, nursing, dental or pharmacy education.
Other common classification of hospital is based on administration, ownership,
control or financial income which includes: (1) Governmental or Public. A hospital owned,
administered and controlled by the government, and a type that provides free care for
patients; (2) Non-governmental or Private; Owned or controlled by an individual or group
of physicians or citizens or by private organization; (3) Semi-Governmental Hospital.
Hospitals run both by the government and private entity, and (4) Voluntary Agency. Not
for profit hospitals by the Voluntary Organizations.
Hospitals are usually funded by the public sector, by health organizations (for
profit or nonprofit), by health insurance companies, or by charities, including direct
charitable donations. Historically, hospitals were often founded and funded by religious
orders, or by charitable individuals and leaders (University of Perpetual Help System
Molino Dalta, Bacoor Cavite). These institutions are also the center of innovations when
it comes to methods, treatments, and procedures of providing health services to every
people. Furthermore, hospitals are also profitable infrastructures. They become
landmark of the community that provide extra value to businesses and areas around its
vicinity.
According to Department of Health, there are approximately 1800 hospitals in the
Philippines. 70 are DOH funded hospitals, 1,071 are licensed private hospitals and the
721 are all public hospitals, (Philippines Health Service Delivery Profile, 2012).
Thirty percent (30%) of the Private Hospitals population uses the North American
Medical models as their core ideals and principle of providing healthcare system
(Transfer wise Content Team, 2017). This model of healthcare service is a uniform
health system that includes high cost service payment in exchange of good quality
healthcare. It is proven through patients’ testimonies and reviews that private hospitals
implementing the said model in their management and service has a higher medical
service standard than a public hospital. On the other hand, healthcare services in public
hospitals are much economical to most Filipinos. Subsidies from the government allows
ordinary people to access healthcare services for free which makes public hospitals
more in demand.
The World Health Organization (2012) described in their page that healthcare in
public hospitals in the Philippines is “fragmented”, means greatly affected by poor
attention given by government, resulting to significant problems that degrades public
hospitals healthcare quality.
The health system shortcomings, hospital deteriorations, inefficient healthcare
service, and hospital deficiencies are few of problems brought about by devolution cause
by lack of government attention. Possibly, those scenarios will led to the deterioration of
health providers like hospitals. In return, public hospital managers, and community
leaders are starting to make their move of giving solution to those problems, one of
which is the researching of suitable restorative techniques to reverse the effects of
devolution.
Modernization is the process of transforming and adapting the existing building or
facilities to meet the growing demands of modern community (Jaroslaw Bakowski,
Gdansk Technical University, Poland). Hospital buildings as a specialized environment is
one of the types of infrastructures that requires modernization improvement or frequent
upgrades to have the ability to cope up with the never-ending needs for healthcare of
people. As documented hospitals are one of the most complex building types. Its
complexity is reflected in the breadth and specificity of regulations, codes, and oversight
that govern hospital construction and operations. The functional units within the hospital
can have competing needs and priorities. Considerations like idealized scenarios and
strongly-held individual preferences must be balanced against mandatory requirements,
actual functional needs (internal traffic and relationship to other departments), and the
financial status of the organization, should be properly evaluated to have a complete and
successful construction, planning or designing of its development.
For 21st century, ways of developing, and improving different structures exist, and
includes: (1) Renovations, the process of restoring buildings to its optimum form. (2)
Expansions, enlarging in terms of capacity, area or limits; and (3) Multi-phase
constructions, methods of constructing either new, addition or renovation of buildings by
parts or with intervals. These trends are all combined to a single term “rehabilitation”,
used to describe most modernization projects of infrastructures that requires special
considerations and construction treatments.
In the case of existing, functioning hospitals (without the possibility of excluding
them from use, even temporarily) continuity of their work is one of the factors
determining the possibilities of functional transformation, and it is a very difficult
condition to meet.
It is unacceptable when during construction works a department of the
hospital simply ceases its functioning or works on a limited basis. This mainly relates to
diagnostic and treatment departments, without which the functioning of other parts
becomes impossible. Hence one of the characteristics of modernization is either to carry
them on the principle of relocating the department (or ward, with appropriate functional
links between departments) or splitting a task into several modernization stages
(allowing the department to be left at the original place) or most likely fall as a multi-
phase type of construction.
The necessity for development can be obviously observed to most public
hospitals. People are starting to demonstrate their disappointments to government
healthcare institutions. Thereby, the government makes progress to develop public

hospitals. Critics suggest that the government should start with the provinces where
population is high and where the community needs it the most.
BACKGROUND OF THE STUDY
Santa María (or Sta. Maria), officially known as the Municipality of Santa Maria
(Filipino: Bayan ng Santa Maria) is a first class highly urban municipality in the province
of Bulacan, Philippines. It is the most populous municipality in Central Luzon and the 6th
most populous in the Philippines. Santa Maria has a land area of 9,092 hectares with 24
barangays as its constituents. Currently, infrastructures that can be found in the
municipality are 10 bridges, 32 public elementary schools, 5 public secondary schools,
two tertiary institutions, a public wet and dry market, shopping mall, one government
owned hospital, 7 private hospitals, and plenty of supermarket and convenience stores.
The Rogaciano M. Mercado Memorial Hospital (RMMMH) is the only
government–run hospital in the town. It has a land area of 14, 256 sq. meters, and
provides healthcare services for the Santa Maria, Meycauyan, Marilao, Bocaue,
Balagtas, Pandi, Norzagaray, and San Jose del Monte.
The RMMMH is a general type of hospital that do not just heal mere physical
illness which attacks the human body, but a much deeper and holistic healing of the
entire human person by providing quality healthcare service and therapeutic
environment. The service areas that RMMMH include are all the wards including
medical and surgical for male and female, pediatrics, chest unit and the maternity
section. Other departments are out-patient department (OPD), laboratory department,
pharmacy department, central sterling and supply department (C.S.S.D), X-ray
department, operating departments, and administrative offices. The roles of these

departments are complementary and depict what they call team-work in patient
management, the patient always being at the center.
The Hospital since its establishment has demonstrated a very keen interest in the
staff recruitment and development of highly skilled and very dependable medical and
paramedical personnel. Presently, their work force stands at 216 of which 130 are
medical staffs and 86 are administrative and utility personnel.
Many of its beneficiaries are satisfied with its performance and services given to
public. Its value is undeniably great due to the fact that it is one of the main factors of
development of life style and health in Santa Maria, and cities and municipalities nearby.
Due to many factors, RMMMH can also be subjected to unknown inefficiencies that can
deteriorate its great image. For that, the researchers will conduct the following rationale.
Rationale. This study intends to investigate and assess the whole RMMMH to be
able to accurately determine its condition, possible problems, and needs. The findings of
said investigations and assessment will be the basis for the plan and design of a
proposed development for Rogaciano M. Mercado Memorial Hospital.
Location. The current RMMMH is held at 15 C De Jesus Street, Brgy. Poblacion,
Santa Maria, Bulacan.

Figure 1. Location of Rogaciano M. Mercado Memorial Hospital
OBJECTIVES OF THE STUDY
This study aims to provide and produce a proposed development for Sta. Maria’s
Rogaciano M. Mercado Memorial Hospital (RMMMH), thus an assessment and
investigation of its different aspects should be exploited first to make an accurate basis
for its development.
Specifically, this study aims to do the following:
1. To determine the current situations and conditions of RMMMH.
2. To determine the problems of RMMMH.
3. To determine the possible alternatives.
4. To determine the best alternative/s.
5. To implement the best alternative/s.

a. Plans and Specifications
b. Project Outline
c. Recommendations
d. Project Estimate
i. Bill of Labor and Materials
THEORETICAL FRAMEWORK
The researchers will follow and use the following theories and methodology to
accomplish objectives of this study.
Customer Service Theory. Adam Smith (1776) states that “if a manager or
owner of a firm (e.g. hospital) wants his business to succeed, then he must meet the
customer’s needs. By doing so, meeting the customer’s needs would also mean meeting
the deficiencies of the firm itself, including staffs, facilities, and even the management.”
Furthermore, Smith includes features or elements that should be with the solution for
those deficiencies including: (1) Reliability: Whatever services the firm offers, it should
be able to perform those services in a reliable manner. (2) Flexibility: A firm needs to be
able to respond, not only to changing the industry and overall market conditions but also
to the changing needs of the customer. It is only by being responsive to the customer
that a firm can be flexible enough to stay afloat in any kind of economic atmosphere. (3)
Aesthetics: There are many tangible aspects that the firm should take care of, so that it
can attract the customer. One of those is that the firm should always create a welcoming
ambience, which many believe is on the decline in our social relationships.
Professor Jaroslaw Bakowski, faculty of Gdansk Technical University, Poland
presents in his published paper entitled “Modernization of Historic Healthcare
Buildings” four (4) conditions to be determined to successfully reconstruct, expand or
modernize an old healthcare building, specifically a hospital. The four (4) conditions to
be determined includes, (1) Factors influencing changes in the hospital, presenting
different structural part (e.g. Structural system, Installation equipment, Fire protection
and other safety-related issues) current status of the existing structure, that when
analyzed properly often leads to a successful reconstruction or remodeling of the internal
or whole structure that is required. (2) The size of the hospital building – consolidation
and steady growth is related to the connected functioning of each facility inside the main
building. (3) A function relocating within the hospital building includes the idea of
staging the construction or making it in a multi-phase to prevent some functions from
ceasing its work. (4) Problems connected to reconstruction and expansion of
hospitals, these indicate a set of several characteristics that determines the architecture
of the three [3] extra objects: [1] size of the building, [2] repeatability of architectural
composition, [3] compactness.

These principles are not sufficient to drive a significant hospital development
planning process; thus, they can serve as a quick reference for project planners and
researchers as they present concrete procedure through the many analysis and
conceptual iterations required to provide a way of successfully developing a historical
healthcare building.
CONCEPTUAL FRAMEWORK
INPUT PROCESS OUTPUT

 Preliminary Data  Evaluation of
Preliminary Data
 Budget: Provincial
Government of
PROPOSED
Bulacan
DEVELOPMENT OF
 Architectural and
 Plan of Building and ROGACIANO M.
Structural design MERCADO
Facilities of Present
RMMMH MEMORIAL
HOSPITAL IN SANTA
 Construction MARIA, BULACAN
 Land Title Owned by Estimates
the municipality of
Sta. Maria
FEEDBACK
Figure 2. Conceptual Framework
SCOPE AND LIMITATIONS OF THIS STUDY
This study will only focus and is limited on investigating and assessing the
Rogaciano M. Mercado Memorial Hospital (RMMMH). It covers the RMMMH present
conditions, historical background, systems, and integrity as a hospital. The researchers
will investigate and assess those aspects to identify the problem/s provided with proofs
or evidence, and the best solution/s to address the problem/s found. The aim of that
work will yield to the provision of proposed plan, design, and recommendations for the
development of RMMMH in Sta. Maria, Bulacan. In designing and planning, the
researchers will refer to different codes and standards implemented in the Philippines. In
addition, this study will also include creating a complete architectural, structural,
plumbing and electrical plan. A clear and base-in-standard computations accompanied
by systematic procedures will also be utilized. Furthermore, the use of engineering
software will also be provided.
SIGNIFICANCE OF THE STUDY
This study aims to investigate and assess the Rogaciano M. Mercado
Memorial Hospital to provide a basis for its development. The researcher’s
purpose is to help the RMMMH improve and sustain its main function of giving a
quality healthcare for its patients. Specifically, the result of this study will benefit
the following sectors:
To the Government, to increase the chance of giving more prosperous
development to the Sta. Maria’s Rogaciano M. Mercado Memorial Hospital (RMMMH).
This can also embellish their image to the public because of the progression that can be
done to their one and only government-run hospital.
To the Patients, the findings of the study will yield to the development of public
healthcare given by the local government of the municipality of Sta. Maria.
To the Citizens of Sta. Maria, Bulacan, the findings of this study will redound to
the credits of the people in the municipality itself. This can respond to the outgrowing
concerns of many citizens in the municipality about RMMMH. Furthermore, if RMMMH is
developed, the citizens will have a good quality healthcare, a strong economy, job and
opportunities and an ensured lifestyle.
To the Civil Engineers, to provide assistance to those who need information
about the current situation and problems of one of the public hospitals in the Philippines,
and some possible solutions to public hospital’s problems. It can also be used as their
guidelines if it will be materialized in the near future.
To the Researchers, to enable them to access information that can be useful
during discussions or talk concerning subjects about construction, or other related topics
and lessons that may include structural enhancement techniques. Also, it can provide
new ideas and knowledge for strategically inclined projects and can show a different
stand point for the use in their future endeavors.
DEFINITION OF TERMS
Assessment – process of evaluating or making judgement about the facts, information,
or conclude scenario presented.
Construction - process of constructing a building or infrastructure.
Department of Health (DOH) - department in Philippines that is responsible for
ensuring access to basic public health services to all Filipinos through the provision of
quality health care and regulation of providers of health goods and services.
Engineering - the application of knowledge in the form of science, mathematics, and
empirical evidence, to the innovation, design, construction, operation and maintenance
of structures, machines, materials, devices, systems, processes, and organizations.
Eschewing - the renovation and redecoration of something, especially a building.
Euro code - a means to prove compliance with the requirements for mechanical
strength and stability and safety in case of fire established by European Union law. A
basis for construction and engineering contract specifications.
Expansion - Refers to process of becoming larger or more extensive.

Health - Defined by the World Health Organization (WHO), is "a state of complete
physical, mental and social well-being and not merely the absence of disease or
infirmity.
Healthcare - the maintenance or improvement of health via the prevention, diagnosis,
and treatment of disease, illness, injury, and other physical and mental impairments in
human beings. It includes work done in providing primary care, secondary care, and
tertiary care, as well as in public health.
Hospital - A health care institution providing patient treatment with specialized medical
and nursing staff and medical equipment.
In-patient - A patient who stays in a hospital while under treatment.
Investigation – process of gathering information, proofs, evidence about something to
be able to conclude or explain.
Medical Staff - Refers to physicians and dentists who are approved and given privileges
to provide health care to patients in a hospital or other health care facility. Medical staff
personnel may work full time or part time and may be employed by the facility or granted
admitting privileges to practice.
Modernization - refers to a model of a progressive transition from a 'pre-modern' or
'traditional' to a 'modern' society.
Multi-phase - procedure consisting of or involving more than one phase, stages or
aspects.
Occupational Safety and Health Administration (OSHA) - an institution responsible
for worker safety and health protection.
Out-patient - a patient who receives medical treatment without being admitted to a
hospital.
Public Hospital - a public hospital or government hospital is a hospital which is owned
by a government and receives government funding. In some countries, this type of
hospital provides medical care free of charge, the cost of which is covered by
government reimbursement
Rationale - explanation of controlling principles of opinion, belief, practice, or
phenomena.
Refurbishment - renovation and redecoration of something, especially a building.
Rehabilitation - process of making possible a compatible use for a property through
repair, alterations, and additions while preserving those portions or features which
convey its historical, cultural, or architectural values.
Remodeling - generally work to change the appearance, structure, or function of a
room. In other words, a remodel works to improve upon or transform the existing design
and layout of a room. Remodeling refers to “changing” or “transforming” a building or
home.
Renovation - restore to a good state of repair.
RMMMH - Rogaciano M. Mercado Memorial Hospital, the only public hospital in Sta.
Maria, Bulacan.
Senescence - condition or process of deterioration with age.
WHO - World Health Organization, a specialized agency of the United Nations that is
concerned with international public health.

Chapter II
REVIEW OF RELATED STUDIES AND LITERATURES
This chapter includes the review of related literature and studies both local and
foreign. It contains articles that are related to hospital development which contributes
information to the research.

MODERNIZATION OF HISTORIC HEALTHCARE BUILDINGS, Jaroslaw Bakowski,
Gdansk Technical University, Poland, (2017).
The practice of transforming and adapting the existing healthcare facilities to
meet the growing demands of modern medicine applies not only to buildings of historical
value but also for those structure whose greatly in need for development. Of course, one
can set a time point from which healthcare facilities specifically hospitals, erected mostly
with industrialized technologies, undergo upgrades for better or worse effect. Existing
healthcare buildings or facilities, including historic ones, or built fairly long, to be
refurbished and adapted to meet the growing demands of modern medicine.
Modernizing now is a must; the enactment of the Local Government Code which
devolved certain public services like health has led to such deterioration precisely for
lack of appropriate funding and able management. As a result, health care delivery
especially in hard to reach areas has suffered. “The problems brought about by
devolution led to the deterioration of health services particularly in far-flung areas where
services are needed most. Of the 41,000 villages in the Philippines, only one fourth have
health units. The villages lacked staff, equipment, and medicines (Martina C, 22 Jan
2017).
Freedom in building a new space facing constraints arising only from the
functional and technological requirements is conducive to creating new, even innovative
solutions. Expansion of the hospital, especially historic, brings more challenges: first of
all, the principle decision on the extent of change and intervention must be taken. It
translates to determine whether its architecture presents such characteristics for which a
decision on respecting them is obvious. The main criterion is always the assessment
and reference to real cultural and historical values of the building.
Different essential principles such as the four (4) main considerations to be
determine to successfully reconstruct, expand or modernize an old healthcare building,
specifically hospital is given in this study by Professor Jaroslaw Bakowski, of Gdansk
Technical University, Poland. The four (4) considerations to be determined are, (1)
Factors influencing changes in the hospital, presenting different structural part (e.g.
Structural system, Installation equipment, Fire protection and other safety-related issues)
current status of the existing structure, that when analyze properly often lead to a
successful reconstruction or remodeling of the internal or whole structure that is
required. (2) The size of the hospital building – consolidation and steady growth is
related to the connected functioning of each facility inside the main building. (3) A
function relocating within the hospital building includes the idea of staging the
construction or making it in a multi-phase to prevent some functions from ceasing its
work. (4) Problems connected to reconstruction and expansion of hospitals, these
indicate a set of several characteristics that determine the architecture of the three [3]
extra objects: [1] A size of the building, [2] A repeatability of architectural composition, [3]
A compactness.
Theoretically, using these considerations will produce a successful development
plan of any hospitals.

HOSPITAL DEVELOPMENT: A STRUCTURAL, ARCHITECHTURAL, AND
MANAGEMENT ASSESSMENT, University of Perpetual Help System Dalta Master’s
study, (2015)
This study presents significant amount of information’s about hospital
development, specifically in the aspects of structural and architectural development.
According to this study, a hospitals should have certain common attributes, (1)
An efficient hospital layout, (2) medical needs and (3) modes of treatment will continue
to change, (4) hospitals must be easy to clean and maintain, (5) area access inside and
out, (6) a complex system of interrelated functions requiring constant movement of
people and goods, (7) general safety concerns of all buildings, (8) significant impact on
the environment and economy of the surrounding. These hospital attributes become one
of the major considerations in planning the appropriate design of common hospitals.
Figure 3. Hospital Attributes
Architectural and Structural reference is also presented in this study.

Figure 4. Architectural Reference Data

Trends for Hospital as a Specialized Environment

Hospital is the place intended not only for patients. Patient expectation in health
care continues to increase and this is something that needs to be managed adequately
in order to improve outcomes and decrease liability. Understanding patients’
expectations can enhance their satisfaction level. In the environment of the Emergency
Department, with the acutely ill, serious and time-dependent issues as well as high level
of stress, managing patient expectations can indeed be challenging (Fatimah Lateef,
2011). Obviously, it is a strong simplification – the patient is its main and the most
sensitive user and the whole activity of the hospital is based on solving his or her health
problems. Still, the hospital is additionally a place of work for professionals of different
specialties, a troublesome production plant, and a significant part of the infrastructure of
the city taking an advantage of its resources and aggravating it with dangerous waste.
Basic requirements for hospitals always focused one thing – the fastest and the
most effective healing of the patient. Currently, according to George J Mann, Joseph G
Sprague, and Ronald L Skaggs, these are the trends that the hospital should observed,
adapt and consider in planning and design of hospitals: (1) New channels for
continuous care, the widely acknowledged focus on disease prevention and wellness
continues to be tremendously important. Non-communicable ailments such as heart
disease, stroke and chronic respiratory diseases are becoming more prevalent, and
chronic diseases continue to account for many healthcare costs. In response to this,
forward-thinking healthcare providers are expanding their services beyond the physical
walls of hospitals and clinics. With strong informational and educational components,
these services include virtual consultations, remote monitoring of vital signs, access to
online medical records and targeted community health screening events, those can be
shortly explained as modern applications of technologies to enhance health services. (2)

Crafting better-performing facilities through research, more than ever, healthcare
designers are responsible for crafting environments that provide quantifiable
improvements in organizational effectiveness and patient outcomes and satisfaction. A
cornerstone of this practice is evidence-based design, characterized by the use and
generation of scientific evidence in order to support decision-making for more
predictable outcomes. This framework is used to systematically analyze the outcomes of
particular types of designs for areas such as patient rooms, nurse stations and surgical
suites. An evidence-based healthcare design should result in demonstrated
improvements in the organization’s clinical outcomes, economic performance,
productivity, and/or customer satisfaction. (3) Patient safety, one of the greatest issues
in healthcare design and operation is patient safety, and a great amount of evidence
demonstrates that planning and design decisions have a direct impact on this. Evidence-
based design strategies to reduce safety concerns such as patient falls may include
providing handrails, designing flush flooring transitions and requiring direct, unobstructed
pathways to frequently-used areas such as bathrooms. (4) Sustainability, a hospital
building is one of the highest consumers of energy, and sustainable design is essential
in reducing the consumption of natural resources and reducing a facility’s life cycle
costs. It is vital that the principles of lean design, lean operations and standardized
design be applied to minimize waste of all types.
On the other hand, two main trends for constructing the hospital can be
observed: (1) one implying filling the hospital with possible resources, technical
equipment and apparatus to the maximum extent and providing sufficient space for
medical procedures (technologization trend) or (2) one concerning creation of favorable

conditions for staying, using non-physical therapies or providing the friendly environment
(a humanization trend).
The design of appropriate health and health facilities for large populations
requires above all a broad understanding and consideration of the overall culture,
specific health issues and available health trends before appropriate facilities can be
successfully planned, programmed, designed, built, operated and maintained.
Essential of Parking Structure of Hospital
Today, hospitals and health systems face unprecedented challenges in reducing
costs while improving quality, efficiency, sustainability, and staff and patient satisfaction.
Yet, they also have another challenge – and opportunity – that is frequently overlooked:
parking structures. While it can seem like there is never enough convenient parking –
especially on high-density, landlocked urban hospital campuses – recent innovations in
design and technology can alleviate parking shortages with attractive, sustainable,
affordable solutions that improve the user experience (Mark Toothacre, 2018). Parking is
one of the main factors considered in modernizing. Changes in capacity or having
aesthetic amenities of facilities will increase the number of the hospital’s beneficiaries
and without adding enough space for that increase will cause another big problem
(Ayrshire and Arran).
Patients, families, physicians and staff all want to get in and out of their
healthcare facilities as quickly as possible and expect convenient, safe parking. Most
hospital executives and planners understand that a good parking facility is essential to
any campus, and offers another way to differentiate themselves from other providers.
Consequently, more hospitals are eschewing the simple, drab asphalt parking lots and
dreary concrete parking structures of the past and developing facilities that combine
function with design. The trend for a developer today is to go beyond the traditional way,
“Hospitals today want parking structures that are customer-centric, so they’re building in
amenities that will enhance users’ experiences as well as improve safety and security,
(Wadell, 2018).
Among the newest amenities are carpool van and alternative energy parking
stalls, charging stations for electric cars, valet parking, shuttle services, and pay-on-foot
systems and charge card readers at exit lanes that replace slower, less flexible kiosk pay
systems. But the ultimate convenience for busy, time-pressed patients and staff are
automated parking display systems that indicate parking availability on a floor-by-floor
and stall-by-stall basis. Many hospitals also offer convenient pedestrian bridges and
well-planned stairways and elevators. Surveys by Hospital Consumer Assessment of
Healthcare Providers and Systems (HCAHPS) find that patients who are offered extra
amenities from their hospital are more likely to rate the hospital favourably and to
recommend the facility to their friends and family (Mark Toothacre, 2018).
The Impact of Facility Design on Patient Safety
Recent attention in health care has been on the actual architectural design of a
hospital facility, including its technology and equipment, and its effect on patient safety.
To address the problems of errors in health care and serious safety issues, fundamental
changes of health care processes, culture, and the physical environment are necessary
and need to be aligned, so that the caregivers and the resources that support them are
set up for enabling safe care. The facility design of the hospital, with its equipment and
technology, has not historically considered the impact on the quality and safety of
patients, yet billions of money are and will be invested annually in health care facilities.
This provides a unique opportunity to use current and emerging evidence to improve the
physical environment in which nurses and other caregivers work, and thus improve both
nurse and patient outcomes.
A plan or drawing produced to show the look and function or workings of a
building, garment, or other object before it is built or made. The Design in plans can
have different connotations in different fields of application, but there are two basic
meanings of design: as a verb and as a noun. Design is the intentional creation of a plan
or specification for the construction of an object or system or for the implementation of
an activity or process (Wikipedia). According to Henriksen and colleagues, the design of
a facility/structure with its fixed and moveable components can have a significant impact
on human performance, especially on the health and safety of employees, patients, and
families.
Cognitive psychologists have identified the physical environment as having a
significant impact on safety and human performance. Understanding “the
interrelationships between humans, the tools they use, and the environment in which
they live and work” is basis to any study of the design a health care facility and its effect
on the performance of the nurses and other caregivers who interface with the facility and
its fixed (e.g., oxygen and suctioning ports on the wall of a patient room) and moveable
(e.g., a patient bed) equipment and technology.
Humans do not always behave clumsily and humans do not always do errors, but
they are most likely to do so when they work in a badly conceived and designed health
care setting.
Organizational or system factors that can potentially create the conditions
conducive for errors are called latent conditions. According to Reason, latent conditions
are the inevitable “resident pathogens” that “may lie dormant within the system for a long
time, only becoming evident when they combine with other factors to breach the
system’s defences. Latent conditions can be identified and remedied before an adverse
event occurs”. Examples of latent conditions are: (1) poorly designed facilities, including
the location of technology and equipment; (2) confusing procedures; (3) training gaps;
(4) staff shortages or improper staffing patterns; and (4) poor safety culture. A specific
example of a latent condition effecting patient safety would be the impact of low lighting
levels in the medication dispensing areas that are associated with some medication
errors but not others. These and other conditions occur at what Reason describes as the
“blunt end,” where administrators, the work environment, and resources determine the
processes of care delivery. Latent conditions are present in all organizations and can be
unintentionally created by those who are responsible for designing systems. Thus,
ensuring adequate staffing, creating ways to prevent the hazards of latent conditions,
providing enforcing policies, and allocating efficiently the utilities and structural amenities
will enough solutions to atleast minimize the risk (Rockville, 2008).

Healthcare in the Philippines, Allianz Care, (2019)
Overall, the healthcare system in the Philippines is of a high standard. Filipino
medical staff are expertly trained, but the facilities may not be as impressive as those
found in high-end US or European hospitals. The quality of the Philippines’ state-
subsidised public healthcare, although good, varies widely between rural and urban
areas. Private healthcare in the Philippines provides much more consistent care and
facilities tend to be better equipped than public ones. English is also spoken throughout
the Philippines, meaning that there should be few language barriers preventing expats
from accessing healthcare (Allianz Care, 2019).
Doctors and nursing staff in public hospitals are highly proficient, however public
healthcare in the Philippines faces some limitations. Despite having achieved universal
healthcare, the Philippines still struggles with unequal access to medical care. As such,
the standard of public healthcare in the Philippines generally varies from excellent in
urban centres to poor in rural areas. Public healthcare also faces strain both from
treating the large number of Filipinos who rely on public healthcare and from the trend of
Filipino medical staff migrating to Western countries. This has resulted in understaffing in
some hospitals and patients may experience delays in treatment.
Public healthcare in the Philippines is administered by Philhealth, a government
owned corporation. Philhealth subsidises a variety of treatments including inpatient care
and non-emergency surgeries, although it does not cover all medical treatments and
costs.
Enrolling with Philhealth is mandatory for expats who are employed in the
Philippines. Philhealth contributions are derived from employers, employee salaries and
the state. Expats can voluntarily enrol with Philhealth if they have residency status.
Private healthcare services are well-established and growing in the Philippines.
Although doctors in private hospitals are as good as doctors practising in the public
sector, private facilities are much better equipped and treatment is typically faster.
Private services are considered to be expensive by locals, but are relatively cheap by
most expat standards. The relative affordability of private healthcare can be seen in the
increasing popularity of the Philippines as a medical tourism destination.
There are numerous pharmacies in the Philippines and many 24-hour
pharmacies can be found in major cities and attached to most hospitals. Pharmacies are
staffed by accredited pharmacists who maintain the state’s strict guidelines on the sale
of prescription drugs.
Although most medicine is available in the Philippines, some prescription
medicine may not be available in the country, so expats should ensure that they either
bring the necessary medication with them, or that alternatives can be prescribed in the
Philippines.
911 is the general national emergency number in the Philippines.
The quality of ambulance services differs significantly and this problem is
compounded by the lack of strict policies governing how emergency services operate.
This may result in slow response times and poor pre-hospital treatment. The public
emergency system also directs most serious emergencies to designated public facilities
which may delay emergency care.
Private ambulances generally have highly proficient staff and better equipment
while also promising faster response times. Private ambulance services are often
secured through monthly subscriptions, or their services are included as part of a
medical insurance package. Many private hospitals also have their own ambulance
services.
Impact of Aging Structures
In an era of an exceedingly specialized workforce and sophisticated equipment’s,
the small struggling hospitals has no place. These kinds of infrastructures, which in any
case most residents bypass for their acute care given and offered, are the ones that is
being deteriorated caused by lack of attention given for their developments. A scholar
would say that these structures need to be redesigned and reconfigured to befit in the
current age so that they can survive and play an important role within the healthcare
hierarchy (Garthwaite and Pam, 2017).
Public buildings such as town halls and parliament buildings could be expected
to last for 100 to 200 years. Whereas private structures such as offices and dwellings
perhaps may be used for up to 50 to 60 years. BS 7543 of 1992, defines the ‘normal’ life
of a building as 60 years. But the new Euro codes, (e.g. BS EN 1992-1-1 of 2008),
assume this period to be a lower one of 50 years. Socio-economic considerations
impinge on the above durations. Some of which tend to reduce the lifespan of buildings,
while others increase them. The changing needs of various owners, and indeed the
changing face of the city or area in which the building is located may cause a building to
be obsolete even before it ceases to be serviceable. In the context of the above
proneness to change, most investors or builders may not want to invest in a building with
an excessive service life. On the other hand, owners sometimes try to use an existing
building over and above its service life, because demolition and reconstruction may force
them to comply with new planning regulations. Once a building exceeds a certain
lifespan, the owner, or even other interested parties, may wish to prolong its life further, if
it is considered a national heritage. The different materials of construction that are used
in a building will give rise to different rates of deterioration. In general, steel and
reinforced concrete will tend to deteriorate faster than masonry; and timber in internal
environments.
Heat and moisture are environmental factors that tend to accelerate
deterioration. Likewise, if steel embedded concrete and structural steel are subjected to
a chloride environment, inclusive of proximity to the coast, this situation will significantly
enhance corrosion (W.P.S. Dias, 2013).
Buildings change during their life-cycle. From construction handover they
become operational space. Eventually they become less effective as technology,
processes, or fashions change, until functional obsolescence is reached. The process of
refurbishment or adaptation may provide to prolong further the period/s of its operation.
Finally, senescence and decay ensue, followed by demolition and in some cases,
redevelopment is needed (Mansfield, 2008).
Hospital Renovation Challenges, Widmer, (2018)

Any renovation comes with its own set of challenges, but renovating a hospital is
a bit more complex than adding a new kitchen island. However, with the right
preparation, it is certainly possible to prepare for the most common challenges faced by
hospital administration as well as the construction personnel that are involved in the
project. With 62% of healthcare facilities projecting that they will increase the instance of
hospital renovation in the next 2 years, it is essential that these challenges be addressed
(Hepacart, 2016).
Today, most of hospitals are experiencing the four (4) most common challenges
occurring during renovations: [1] Choosing the Right Team (Challenge). A renovation
project is only as good as the team that takes it on, but it is not always easy to find a
team that fits both the budget and the expertise requirement of the project. Solution: (1)
Find a Balance. The team that guarantees they will work the fastest may not be the
team with the best design experience. The team that will come on board for the lowest
price is may not be the team that can meet your deadlines. Picking the right players is
the key to building any successful team. Simple as it seems, the process is not just
about selecting the best available for each role. It is about getting the right blend to form
the team best suited to undertake the particular job in hand. The best way to find the
right team is to determine your must haves (perhaps the hospital renovation absolutely
needs to be complete by a certain date or definitely needs to look a certain way) and find
a team that can offer those while still balancing their ability to meet your projects and
other goals. [2] Creep of Schedule and/or Scope (Challenge). Construction projects
can often be faced with the challenge of creep. That is when the project begins to push
past the schedule and/or scope limits of the original plan. Solution: (2) Plan for the
Long Term. A hospital renovation should never be considered in a vacuum. Rather, it

should be a part of a long-term plan for the facility. When you can look at the renovation
in terms of a bigger picture, it is easier to organize the renovation from the outset and
ensure that the project does not go beyond scope. Schedule creep can be more
challenging, but one way to mitigate that possibility is to consider a design-build delivery
system from the outset. When a single hospital contractor is able to both design and
build the renovation, there is a better chance of staying on schedule.
Related Projects:
1. Bulacan Medical Center (BMC)
Location: Malolos, Bulacan
Bulacan Medical Center (BMC) is a Level 3- DOH Accredited tertiary, teaching
and training hospital located at the center of Malolos City, Bulacan. It was initially built
merely as a 25-bed capacity as Bulacan Provincial Hospital whose main objective is to
deliver quality health care for Bulakeños. With the passage of the Republic Act No. 7169
on 1991, otherwise known as the Local Government Code, devolution of health services
was mandated, hence the transfer of the jurisdiction of the Bulacan Provincial Hospital to
the Local Government Unit. Since then, full support from the Provincial Government of
Bulacan was extended to the hospital. From a mere 25-bed capacity it has a grown into
a 300-bed capacity hospital.
Continuous expansions and renovations were initiated by different leaderships.
Long term medical manpower development program resulted to the accreditation of the
four major departments, Medical, OB-Gyne, Pediatrics and Surgery. Each Department
has clinical ward minimum of 50 beds each to address the needs of their respective
patients.
There are also special areas: Operating Room, Recovery Room, Medical and
Neurological Intensive Care Units (ICU), Neonatal ICU (NICU), Pediatric ICU (PICU),
Labor Room (LR) and Delivery Room (DR), available wherein patients can be provided
of the necessary medical treatment, equipment and facilities.
Significance. Modern facilities with brand new equipment were provided
continuously by the Provincial Government handling the hospital. New treatments and
services can now be done in the BMC due to its technologizations and modernizations.
Furthermore, Bulacan Medical Centre made an impact in the province of Bulacan by
being the sole tertiary state-owned hospital in the province.
Figure 5. Bulacan Medical Center

2. Philippine General Hospital (PGH)
Location: Metro Manila
The Philippine General Hospital (PGH) is a tertiary state-owned hospital
administered and operated by the University of the Philippines Manila, the University of
the Philippines System's Health Sciences Centre. It is the largest government hospital
administered by the university, and is designated as the National University Hospital.
It is the biggest hospital in the country with a 1,500-bed capacity. It is a mixed-use
hospital, with 1,000 beds for indigent patients and 500 beds for private patients, and
offers some of the lowest rates for patients and is generally known as the hospital for
indigent patients.
PGH Manila occupies 10 hectares in UP Manila, having only 120,000sqm of hospital
service area for its 1,500 patients. Its basic design is 2 floor pavilions spread out in 6
hectares, augmented by the 7 floor Central Block, and the 3-storey Outpatient building
within it. PGH Diliman is vertically designed needing less land area. This makes
construction and maintenance more efficient.
Significance. Planning the structure of PGH Diliman necessitates knowledge of the
surrounding hospitals. Considerations of hospitals near the place it is held is analysed to
perfectly develop its current state and its master plan for future developments and
maintenance. PGH developer’s dedication of making an impact in the community by
creating a high-class public hospital is inspiring from the intent up to the infrastructure as
its product.
Figure 6. Philippine General Hospital (PGH)

3. Santa Ana Hospital (Manila)
Location: Santa Ana, Manila
Santa Ana Hospital was built by the City of Manila with the help of Lucio Tan's
Tan Yan Kee Foundation. The said hospital, according to city engineer Armand Andres,
sits on an 8,000-square-meter lot with a floor area of at least 5,000 square meters and
has a 500-bed capacity. The opening of the said hospital, constructed by the Freyssinet
(F.F. Cruz) Filipino Corp., marks the fruition of Lim’s vision since he became mayor in
1992, of building one city hospital giving free medical services for the poor residents for
each of Manila’s six districts.
The hospital building was completed in April 2010, opening on April 28. Santa
Ana is ten stories high, is fully modernized and has a capacity of 500 inpatient beds.
Significance. Santa Ana multi-story and fully modernized building will provide the
people within its vicinity great prosperity in terms of high-quality healthcare and a known
landmark of their community.

Figure 7. Santa Ana Hospital (Manila)
4. Ospital ng Maynila
Location: Metro Manila
The Ospital ng Maynila Medical Center (Hospital of Manila; abbreviation: OMMC)
is a 300-bed non-profit tertiary, general and training hospital in Malate, Manila,
Philippines. It is the laboratory hospital of health science students (students of medicine,
nursing and physical therapy) enrolled at the “Pamantasan ng Lungsod ng Maynila”, one
of the Philippines' universities.
As hospital operated and maintained through taxes paid by Manila residents,
OMMC has for its primary concern the admission and treatment of patients who are
bona fide residents of the city. Furthermore, it is responsible for the provision of an
integrated community health program and research activities.
Significance. Its population prepared multi-story building and specialized facilities
is one of the main assets of “Ospital ng Maynila”. It allows this public hospital to maintain
its good services without any problem of shortage in capacity.

Figure 8. Ospital ng Manila
5. Christiana Hospital, 2010
Project
Location: Newark, DE
The Christiana Hospital, a 906-bed,
1.3-million-square-foot, modern facility in
Newark, Delaware, is providing a non-profit health care services to all of the U.S. state of
Delaware and portions of seven counties bordering the state in Pennsylvania, Maryland
and New Jersey. The system includes two hospitals in Delaware, Wilmington Hospital
and Christiana Hospital, as well as the Eugene du Pont Preventive Medicine &
Rehabilitation Center, the Helen F. Graham Cancer Center, the Center for Heart &
Vascular Health, Visiting Nurse Association and a wide range of outpatient and satellite
services.
A Christiana Hospital project in 2010 is a 299,000 square foot addition to the
Christiana Medical Campus. An expansion, designed by architects at Wilmot/Sanz, will
develop the hospital’s clinical capabilities along with adding a new medical education
center capable of providing this teaching hospital with the latest techniques and learning
tools. Structurally the building has been designed essentially into two separate
buildings. These two buildings consist of a three-story education wing using steel
construction and an eight story clinical tower that takes advantage of reinforced concrete
construction.
Significance. The Christiana Hospital is built in the middle of Newark city, Delaware.
Its expansion structure is built above its existing medical school. The construction is well
managed that allows it to minimized losses and incapability’s of some departments due
to construction.
Figure 9. Christiana Hospital, 2010
6. La Paz Medical Center In Bata Equatorial Guinea

 120 beds hospital including:
 4 Operating theatres, 12 beds ICU
 2 labor and delivery rooms
 8 beds new born nursery
 Two 38 bed wards
 Surgical and internal radiology institute including CT, X-Ray,
Fluoroscopy, Mammography and Ultrasound

 Dialysis unit
 Gastroenterology institute
Significance. Has great exterior architectural design. Usage of green engineering
to provide illumination in the building with natural sunlight by using more glass panels.
Figure 10. La Paz Medical Center In Bata Equatorial Guinea
7. University of Texas M.D., Anderson Cancer Center
Location: Houston
Summary: The M.D. Anderson Cancer Center is one of the nation's highest-rated
hospitals for cancer care, which is the main reason why this world-class facility was in
desperate need of more patient beds. “We're beyond 100% occupancy,” says Susan
Lipka, the hospitals associate VP for capital planning and management services.
Fortunately, the existing 12-story Alkek Hospital Tower, completed in 1998, had
been designed by Dallas A/E firm HKS to accommodate a 10-story vertical expansion. In
2007 the hospital opted to put a massive 500,000-sf addition atop the tower, thereby
adding 208 new patient rooms (each 40 sf larger than those in the existing hospital) and
providing shell space for another 200 or so patient rooms.
Significance. A Building Team consisting of HKS, structural engineer Walter P
Moore, and contractor McCarthy Building Companies was hired under a design-build
contract to complete the $220 million project. There was just one hitch. The hospital
decided that if a 10-story addition was good, a 12-story one would be even better. That
meant adding two extra floors, at 45,000 sf each, while the existing facility was not only
occupied, but operating at more than 100% capacity.
Figure 11. University of Texas M.D., Anderson Cancer Center

Chapter III
RESEARCH METHODOLOGY
RESEARCH DESIGN
To justify and make an accurate outcome in proposing a development for
Rogaciano M. Mercado Memorial Hospital (RMMMH), it is important to properly identify
the suitable approach to be used in conducting the research.
A Quantitative approach is used to emphasize objective measurements and the
statistical, mathematical, or numerical analysis of data collected. The data’s will come
from questionnaires, and surveys, or by manipulating pre-existing statistical data using
computational techniques. This approach focuses on numerical data and generalizing it
across groups of people or to explain a particular phenomenon. Furthermore, the use of
different analyses, testing’s, and processing of the data’s as input to come up with a
conclusion are also under this type of approach.
Descriptive method is used to gather information, process and analyze data, and
to provide the output required. Interviews, observations calculations, analysis, and
surveys will also be used to gather information from professionals, RMMMH patients,
and RMMMH staffs. Documentation are provided for stronger factual basis.
RESEARCH PROCEDURE
An accurate step by step process should be implemented to be able to present a
well-managed proposal – hence, the researcher would be utilizing a research procedure
with three main phase.

The first phase is consist of three (3) parts. Part 1 is the assessment of structure
and facilities. The use of Non-Destructive Testing’s (NDT), such as Rebound Hammer
test, Ground Penetrating Radar test and FEMA Scoring will be used to find out the
condition of RMMMH building and facilities. Part 2 is about knowing the perception and
ideas of RMMMH beneficiaries. Survey method will be the method to be used to gather
the ideas and thoughts of its patients and staffs, while personal interviewing method will
be utilized to know the perception of implementing agencies and related offices
regarding the RMMMH. Part 3 is about assessing the historical background of RMMMH.
Analysis of the RMMMH operational statistics and previous developments will be the
scope of this part. Furthermore, the preliminary data’s to be gathered in the stated three
(3) parts will be subjected to further investigations about its effects and relationship
towards RMMMH’s performance as a healthcare provider.
Finishing first phase will yield to having data’s comparable to the standards and
interpretations, and will bring the researcher’s identification of RMMMH problem/s.
The Second phase is now about addressing the problem/s that is found in the
First phase. Researching and interviewing of professionals will be the methods to be
used to identify the possible alternatives for each problem/s. Determining which among
the alternatives is the best will be known after subjecting each of the alternatives in
Strengths, Weaknesses, Opportunities and Threats (SWOT) and Cost analysis.
The last phase would be the implementation of the best alternative in the form of
a proposed development for RMMMH which includes Plans and Specifications, a Project
Outline, Project Estimate, and Recommendations.

FLOW CHART
Fig. 12. Flow Chart - Gives an overview of the process used to accomplish research
objectives
POPULATION OF THE STUDY
Respondents are those persons who have been invited to participate in a
particular study and have actually taken part in the study (L.M. Given, 2008).
To determine the number of respondents, the researchers will use the Slovin’s
formula with a percentage of accuracy of 95% to calculate the sample size:
N
n=
(1+ N e2 )
Where:
n= number of sample
N= total population
e= error tolerance
The population of the study consisted of three (3) groups of respondents. These
groups is where the researchers will gather the data’s to be analyzed.
The first group was the involved professionals (e.g. Bulacan Provincial Engineer,
Sta. Maria MPDO head) from different firms, sectors, and departments related with the
subject of this study.
The second group was the 216 RMMMH Staff consisting of (130) RMMMH
Medical staffs (e.g. doctors, nurses), and (86) RMMMH Administrative personnel’s (e.g.
cook, utilities, admin officers) base on the 2019 number of personnel records of the
hospital.
And lastly, the patients of the Rogaciano M. Mercado Memorial Hospital
composed by Out-patients, and In-patients both found within the hospital’s vicinity.
The 50 percent of the factual basis for this research will come from one of the
three groups of respondents which is the professionals and persons involved and the
other half will come from the perceptions of other type of respondents.
SAMPLING TECHNIQUE
According to Walter A. Shewhart and Samuel S. Wilks, “In stratified sampling, the
population is partitioned into regions or strata, and a sample is selected by some design
within each stratum. The design is called stratified random sampling if the design within
each stratum is simple random sampling”. The researchers will used this sampling
technique in conducting the survey wherein hospital staff, and patients of RMMMH will
be the respondents of this method. In addition, involve persons and professionals will not
be administered to this sampling due to the fact that they’re number can be directly
administered to interviews and survey.
RESEARCH INSTRUMENT
To be able to supply necessary information for strengthening of the foundation of
this study, different instruments will be used such as formal consultation to professionals
and persons involved in the said project, survey questionnaires, different hospital
planning and development guidelines, engineering software, and safety standard and
procedures requirements. Furthermore, Non-Destructive testing techniques will also be
used to determine structural information, which are essential to accomplishing this
research aims and objectives.
Interview. It can be defined as a qualitative research technique which involves
“conducting intensive individual interviews with a small number of respondents to

explore their perspectives on a particular idea, program or situation.”(C. Boyce & P.
Neale, 2006). The format of the interview would be semi-structured wherein we, the
researchers, would prepare a set of questions to be answered by interviewees at the
same time, we can also ask additional questions to make the idea more profound.
Questionnaire. It is a written set of questions that are given to people in order to
collect facts or opinions about something. Different sets of questionnaires will be
developed for different groups of respondents.
Different Hospital planning and development guidelines. It is an utmost
precedence to develop the structural a design for the development of Rogaciano M.
Mercado Memorial General Hospital (RMMMH) in accordance to the policy made for the
provisions of hospitals and other health facilities by the governing authority.
Engineering Software. In this project, advance engineering software will be used
for the entire conception of the structural plan. Software like STAAD will be a tool for the
computation of shear, moment and reactions due to the load present on the building.
This will help the researchers design the beams, columns, slab and trusses efficiently
and effectively. It is also used to determine whether the designed structural element/s
is/are suitable for the structure and help the researchers to redesign and meet the
required standards if there is a failure. Meanwhile, software like AutoCAD and SketchUp
will also be used for architectural and conceptual design. (K.G. Baccol, F.D.F. Cuison,
C.J.C. Del Rosario, A.D. Ricardo, & M.P.S. Samaniego, 2018)
Safety standard and procedures requirements. The structural and management
enhancement design for Rogaciano M. Mercado Memorial Hospital (RMMMH) will be
liaising with the governing authority to ensure the compliance of every standard. While
fulfilling the said design, the following codes and standards would be obeyed:
A. For Design Clearances

 P. D. 1185 – Fire Code of the Philippines and Its Implementing Rules and
Regulations
 P. D. 856 – Code on Sanitation of the Philippines and Its Implementing
Rules and Regulations

 P. 344 – Accessibility Law and Its Implementing Rules and Regulations
 R. A. 1378 – National Plumbing Code of the Philippines and Its
Implementing Rules and Regulations

 R. A. 184 – Philippine Electrical Code
 Manual on Technical Guidelines for Hospitals and Health Facilities
Planning and Design. Department of Health, Manila. 1994

 Signage Systems Manual for Hospitals and Offices. Department of
Health, Manila. 1994

 Health Facilities Maintenance Manual. Department of Health, Manila.
1995
 Manual on Hospital Waste Management. Department of Health, Manila.
1997
 District Hospitals: Guidelines for Development. World Health Organization
Regional Publications, Western Pacific Series. 1992

 Guidelines for Construction and Equipment of Hospital and Medical
Facilities. American Institute of Architects, Committee on Architecture for
Health. 1992
 De Chiara, Joseph. Time-Saver Standards for Building Types. McGraw-
Hill Book Company. 1980

B. For Structural Design
 National Structural Code of the Philippines
Non-destructive testing techniques. Non-destructive testing (NDT) is widely used
for quality control in the fabrication of process plant, infrastructures, and equipment. It is
a set of techniques used to evaluate the structural integrity of structures and detect any
flaws that can compromise their safety or functionality. Some of these testing techniques
can be the Rebound Hammer test– this test can be used to evaluate the quality of
concrete near the surface. While test results do not directly correlate to strength of
concrete, a site-specific calibration on concrete cores can be used to predict the
concrete strength on-site. These test is important to the determination of current
structural condition of RMMMH buildings and facilities.
DATA PROCESSING AND STATISTICAL TREATMENT
The data gathered will be collated manually and categorized following the order
of the objectives presented in Chapter 1. Statistical programs like Microsoft Excel will be
used to process the information. Data will be presented, analyzed and interpreted using
the following statistical tools:
1. Frequency and Percentage
The distribution of personal related variables given by the selected
respondents will be determined through this.
f
P= × 100 Where: P = percentage
n
f = frequency
n = total number of respondents
2. Arithmetic Mean
It is the sum of all the numbers in a group and divided by the number of
items in the group of numbers. Formula:
~
x=
∑x
n
Where x̌ is the arithmetic mean.
∑x is the summation of the variables, and
n is the number of all variables
3. Weighted Mean
This is the average wherein every quantity to be averaged has a
corresponding weight. These weights represent the significance of each quantity
to the average. Statistically, the weighted mean is calculated using the following.
Formula:
ΣfW
WM= Where: w = weight of each item
N
f = item frequency
WM = weighted mean
N = number of respondents
4. Likert Scale
To interpret the data using the weighted mean, the scores were converted
and have given description as follows:
RANGE QUALITATIVE DESCRIPTION

1.00-1.79 Outstanding
1.80-2.59 Very satisfied
2.60-3.39 Satisfied
3.40-4.19 Dissatisfied
4.20-5.00 Very dissatisfied

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P O LY T E C H N I C U N I V E R S I T Y O F T H E P H I L I P P I N E S 1

THE PROBLEM AND ITS SETTING

safety measures implemented in workplaces can cause workers to increase productivity,

It is a factor to be considered in many health and safety management plans in

businesses. Health mostly affects staffs, members or employees of a group. In

response, firms and businesses provides proper healthcare benefits by contracting

healthcare providers or institutions to give them the proper health maintenance.

A hospital is a health care institution providing patient treatment with specialized

Specialty. Limited services within a particular condition (e.g. maternity or orthopedics

medical, nursing, dental or pharmacy education.

Other common classification of hospital is based on administration, ownership,

patients; (2) Non-governmental or Private; Owned or controlled by an individual or group

of physicians or citizens or by private organization; (3) Semi-Governmental Hospital.

for profit hospitals by the Voluntary Organizations.

profit or nonprofit), by health insurance companies, or by charities, including direct

orders, or by charitable individuals and leaders (University of Perpetual Help System

it comes to methods, treatments, and procedures of providing health services to every

people. Furthermore, hospitals are also profitable infrastructures. They become

According to Department of Health, there are approximately 1800 hospitals in the

public hospitals in the Philippines is “fragmented”, means greatly affected by poor

attention given by government, resulting to significant problems that degrades public

hospitals healthcare quality.

The health system shortcomings, hospital deteriorations, inefficient healthcare

which is the researching of suitable restorative techniques to reverse the effects of

Modernization is the process of transforming and adapting the existing building or

facilities to meet the growing demands of modern community (Jaroslaw Bakowski,

Gdansk Technical University, Poland). Hospital buildings as a specialized environment is

one of the types of infrastructures that requires modernization improvement or frequent

strongly-held individual preferences must be balanced against mandatory requirements,

successful construction, planning or designing of its development.

Expansions, enlarging in terms of capacity, area or limits; and (3) Multi-phase

constructions, methods of constructing either new, addition or renovation of buildings by

used to describe most modernization projects of infrastructures that requires special

considerations and construction treatments.

In the case of existing, functioning hospitals (without the possibility of excluding

determining the possibilities of functional transformation, and it is a very difficult

It is unacceptable when during construction works a department of the

becomes impossible. Hence one of the characteristics of modernization is either to carry

links between departments) or splitting a task into several modernization stages

phase type of construction.

The necessity for development can be obviously observed to most public

hospitals. People are starting to demonstrate their disappointments to government

healthcare institutions. Thereby, the government makes progress to develop public

population is high and where the community needs it the most.

BACKGROUND OF THE STUDY

barangays as its constituents. Currently, infrastructures that can be found in the

municipality are 10 bridges, 32 public elementary schools, 5 public secondary schools,

The Rogaciano M. Mercado Memorial Hospital (RMMMH) is the only

Balagtas, Pandi, Norzagaray, and San Jose del Monte.

entire human person by providing quality healthcare service and therapeutic

section. Other departments are out-patient department (OPD), laboratory department,

pharmacy department, central sterling and supply department (C.S.S.D), X-ray

department, operating departments, and administrative offices. The roles of these

management, the patient always being at the center.

medical staffs and 86 are administrative and utility personnel.

proposed development for Rogaciano M. Mercado Memorial Hospital.

Location. The current RMMMH is held at 15 C De Jesus Street, Brgy. Poblacion,

Santa Maria, Bulacan.

Figure 1. Location of Rogaciano M. Mercado Memorial Hospital

OBJECTIVES OF THE STUDY

Rogaciano M. Mercado Memorial Hospital (RMMMH), thus an assessment and

for its development.

Specifically, this study aims to do the following: