The Application of Sustainable Development System

At Dr.Kariadi-Hospital in Semarang


Eddy Hermanto
a
, Sukawi
b



a
Department of Architecture Faculty of Engineering Diponegoro University,Tembalang Semarang 50275
Telp: 024 76480837 Fax: 024 76480836 E-mail:eddyhermanto@ymail.com

b
Department of Architecture Faculty of Engineering Diponegoro University,Tembalang Semarang 50275

Telp: 024 76480837 Fax: 024 76480836 E-mail:zukawi@gmail.com




ABSTRACT

This paper reports the implementation of synergies between the design-construction partnering with health services to
achieve sustainable development as system in Semarang General Hospital Dr.Kariadi. The design-construction partnering
could achieve substantial sustainable development system in the area of the existing building and the construction of the
General Hospital Dr.Kariadi. Substance benefits through the application of sustainable design in the field during construction
with or without high technology. Development activities and the activities of health services running at the same time has
achieved success, such as there is no accident for both project activities and for health service activities, without disputes and
litigation.

Key words: Sustainable Development, System, Technology, Partnering.



1. INTRODUCTION

The design concept is based on Organic Architecture of Frank Lloyd Wright to form formations such as the Space
between buildings, Continues spaces, and Corridors (8). The existence of a small river not intervened so that the function of
the drainage water is still running smoothly without sedimentation. So the alignment formed the natural surroundings and so as
to create the sides: an open space that can be used as a field hospital in an emergency, natural lighting, under natural condition,
water recharge, circulation of traffic in the plot, multiple service areas.The concept was meant from the beginning attention to
the safety of pedestrians, speed of ambulance service, speed of other services, and possibly physical development stages.The
construction of the building from the side view system known as the order of the input-process-output-outcome-impact-
benefit. In the system approaches the boundary of the system is framed which is also meant the legal aspects in the matters of
development (2, 7). Sustainable development is closely related to green: system, concept and strategy if there is a simultaneous
development with very small negative impact (Low Impact Development/LID) while obtaining greater benefits known as
sustainable development based on the sustainable design (4-6).

Based on the system, there are two elements (sustainable, cost effectiveness) as foundation for further studies stand to
be applied to the construction of General Hospital Dr.Kariadi. Physical development through the design of the hospital based
on the master plan, so the site plan that has been in the master plan does not change the basic framework. Once the decision is
made to build, start thinking of the principles of project management, design management and construction management
consists of: knowledge and skills of construction, architectural, mechanical-electrical, and environmental design (7, 9). It
connotes the Critical Success Factors (CSF) for the construction project, namely: Time, Quality, Cost, Meet the expectations
of the owner, and small construction issues. From the Quality through performance specification of building products in the
end as the term is known that the performance of buildings demonstrate the performance and leverage in the role of visual
physical health function operated in the long term (3-6).
It is therefore very important and critical for any land development in an area, particularly in the project objectives
and goals of health care activities at the same time.

The objectives of the study are to determine design of the developed area; and to develop a model of system to
achieve building performance.

2. METHODOLOGY

STUDY AREA

The study would be carried out in the developed area of Garuda II, Medical Rehabilitation, Education and Training,
and Installation Inpatient Class 3-General Hospital Dr.Kariadi located on Dr.Soetomo, Semarang (Fig. 1).




Fig. 1: Location of Study Area



This study is an observational study in the field of general hospital Dr.Kariadi during the construction of four
buildings and health care at the same time.

Dr.Kariadi hospital area is about 210,000 m2 and the building floor area is about 190,000 M2. This condition gives
a signal that has not occurred since the construction optimization building regulations stipulate Floor Area Ratio is 5 to
downtown Semarang. So there is still a potential for a large area to be built in the future. Dr.Kariadi gates as access requires
rethinking with regard to speed of access, safety and convenience by taking into account: the density of traffic circulation
around the land, increasing the number of visitors, access to the ambulance, queuing theory.

Buildings were built in 2011-2012 consisted of Garuda II building (8 floors, 12.000 M2) with a capacity of 400
beds, Education and Training Building (3 floors, 4000 M2), Rehabilitation Medic Building (7 floors, 5600 M2), Installation
Inpatient Class III Building (7 floors, 14.000 M2) with capacity of 400 beds. Thus, in 2012 RSUP Dr.Kariadi has more than
1200 beds totally. This situation requires the addition of labours : doctors, nurses, and other support even now has a total
workforce of 3600 people, divided into 3 shifts within 24 hours working time per day in addition to a review of the order was
carried out to better health care. Increasing the quality and intensity of health care services required as a principle of
competitive advantages and maintain brand name in order to survive.
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In the present, parking capacity that uses the principle of on-street and off -street parking is full even less because
every day there are 1800 cars and 2340 motorcycles taking place of parking-lot. These are demanding that the building will be
constructed and parking area is already set in two places connected by the outer ring road in the general hospital area. Utilities
built on green environment concept consisting of: there is space between buildings (for water recharge, emergency etc),
network infrastructures: roads; pipes of clean water, sewage/domestic waste water, fire piping using the principle of ring
system; rainwater network flowed directly to the river; medium voltage power supplied by the state power company (PLN)
and applied the centralized system, decentralization of low voltage of general hospital, Waste Water Treatment Plan (WWTP)
is a decentralized network design and divided into 4 zones, and decentralized network for medical gas.

Approach the orientation system for architects and engineers in the design and application development, especially
building complex that includes the substance of sub-systems: architectural, structural, mechanical, electrical, and environment.
In the development process of buildings required role of the development and technology management in the construction
industry. There is flexibility for the construction industry technology options, technology tools and technology in both medical
devices types and in the amounts, namely: conventional, rational and industry. Implementation of building can be done by
methods: cast in situ, cast in place and precast or prefab depending on circumstances. These are supported by the existence of
space between buildings and the outer ring road of Dr.Kariadi hospital.












































3. RESULTS AND DISCUSSION
Main characteristic of general hospital Dr.Kariadi orientation is expressed in the design on the sides of the LID
through considerations of: Planning (Master plan, Feasibility Study); System (open/closed; hard/soft; approach); Green
Concepts and Grand Strategy (Strength Weakness Opportunity Thread/SWOT, Public Private Partnership/PPP, Private
Fig. 2: System Approach

INPUT PROCESS OUTPUT OUTCOME IMPACT
DEVELOPMENT STAGES -
APPLICATION
Cost Effectiveness
efficient effective Sustainable
SYSTEM OF DESIGN-CONSTRUCTION on
STRATEGIC and PROJECT PARTNERING:
1. Sub system : ARCHITECTURE
2. Sub system : CIVIEL-STRUCTURE
3. Sub system : MECH-ELECTRICAL
4. Sub system : ENVIRONMENT
BENEFIT
OWNER, USERS,
ARCHITECTS, ENGINEERS &
Health Equipment Vendors
Boundary of System Legal Aspects

LOW IMPACT DEVELOPMENT (LID)
- Development Management
- Technology of Construction Industry
- Technology of Health Equipment
- Technology of Utilities
REQUIREMENTS
EXTERNAL FORCES
CONSTRAINTS (flight approach
area, building conservation,
resources)
Dr.KARIADI HOSPITAL:
Planning (Master plan, FS)
SYSTEM (open/closed;
hard/soft; approach)
Green CONCEPTS & Grand
Strategy (SWOT, PPP, PFI,
BOT, DB,DBB)
Development Possibility
Analysis (approach area,
conservation)
Comprehensive Planning
(basic need, building code)
Threshold Analysis
(optimization)
Total Design (Building as
System, sustainable)
Development Stages in
harmony (series/parallel)

JOINT COMMISSION
INTERNATIONAL (JCI)
UU; PP;
PERPRES;
PERMENK
ES


Problem Solving & Decision Making
Forecasting
Ministry of Healths
Policy & Strategy

Finance Initiative/PFI, Build Operate Transfer/BOT, Design Build/DB, Design Bid Build/DBB); Development Possibility
Analysis (approach area, building conservation); Comprehensive Planning (according to: basic need; building code: Floor
Area Ratio/FAR, Building Coverage/BC, Building Height/BH); Threshold Analysis (Highlight on Optimization); Total Design
(Building as System, and Sustainable).

Based on owners, users and experts of Dr.Kariadi hospital held frequent communication about the development of
an appropriate scope of future requirements combined with the policy of the Ministry of Health and international rules JCI to
produce a design that supports a minimum standard of health care and Standard Operating Procedures (SOP). Discussion was
also made in relation to the future problem solving and decision making and forecasting. The role of the function of these
activities will lead to the need for facilities that are closely linked: Development management; Technology of construction
industry; Technology of utilities and Technology of health equipment.

The substance of the above are to be considered in sustainable design through a BATNA (Best Alternative to a
Negotiated Agreement) and BATNEEC (Best Alternative Technology Non Entailing Economic Cost) that goes to the side of
sustainable development through sustainable construction. The substance of the design conducted design review and value
engineering prior to the construction site. The view point above descriptions is included aspects of Whole Life Costing
(WLC), which has been measured so that management role can be expected.

Within the scope of the hospital operation, on the one hand Dr.Kariadi process Eco Management Audit System
(EMAS) in the system of WWTP. Processing Installation internally to maintain systems that have been built while externally
conducted by the Environment Agency of Middle Java Province (BLH-Prop) with weekly-monthly evaluation reports and
field investigations per semester. On the other hand, based on the policy of the Ministry of Health in accordance era of
globalization in the Millennium Development Goals (MDGs), Dr.Kariadi follow the rules that apply in the JCI in terms of
standard of health care through completion of facilities and infrastructure that meet the technical requirements and applicable
law. In this case means that the use of partnering for construction projects of complex building that are in stages: planning,
design, procurement, construction. At the stage of human bionomic also used partnering on operations and maintenance.
Sustainable design considering implementation method either series or parallel.























GREEN:
Management &
Procurement
EMAS (Eco
Management
Audit System)
CONCEPTS of
Sustainable
Development
PROJECT
MANAGEMENT

Fig.3: Application of Sustainable Development
MILLENIUM DEVELOPMENT GOALS (MDGs)

PROVISIONAL to
FINAL HAND OVER

CONSTRUCTION -
MANAGEMENT

DECISION
to BUILD

DESIGN -
MANAGEMENT

GREEN: Site plan, Design,
Buildings, Architecture,
Structure, Health Equip,
Activities, Circulation, En-
virment, Building Utilities
CONSTRUCTABILITY
GREEN: Construction,
Health & Safety,
Mutualistic Symbiosis,
Dispute & Litigation,
Impacts.
Performance Specification
SUSTAINABLE DEVELOPMENT CONSIDERATIONS:
BATNA (Best Alternative To a Negotiated Agreement)
BATNEEC (Best Alternative Technology Non Entailing
Economic Cost)
WLC (Whole Life Costing)
HUMAN BIONOMIC

Feedback

EMAS (Eco
Management
Audit System)
DEMOLITION

Low Impact Development (LID)
Basic Principles of
Architectural Design:
Function
Technology
Aesthetic
Planning Design Procure
-ment
Construction
EXISTING of
Dr.Kariadi
Hospital
PERFORMANCE
of Dr.Kariadi
Hospital

4. CONCLUSION
The study, however, indicate that design-construction partnering can achieve substantial sustainable development
through sustainable design. Based on the above description, it can be concluded about the basics are as follows:

a) Sustainable design has a central role towards sustainable development in the system of construction projects.
b) Design-construction partnering consists of: owner, consultant, contractor, and supported by top management.
c) Sustainable design should be supported by: development possibility analysis, total design, comprehensive/overall
planning resulting LID threshold.



ACKNOWLEDGMENT

The Authors would like to thank to the Department of Architecture, Engineering Faculty, Diponegoro University; and
the General Hospital Dr.Kariadi, Semarang.



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