AR 331

ARCHITECTURAL DESIGN 07

RSW PR-01:

HOSPITAL AND HEALTH CARE FACILITIES-PHILIPPINES

Dategiven:January 25, 2011

Duedate:February 1, 2011
Datesubmitted:February 1, 2011

Student:

PION, REDEN S.

Instructor:

Arch. Robert Romero

Introduction
Health care presents a different problem in
every country for the way it is organized is a
response to geography, climate, historical
development, economic situation and social,
cultural and political conditions
Appreciation of these differences is
fundamental to understanding of the
situation which prevails in a country.

D efi
n ition on H ealth
Health is a state of complete physical, mental,
and social well-being and not merely the absence
of disease or infirmity
W.H.O.

Health, as we define it today, is a state of

complete physical, psychological, social and
spiritual well being.
Islamic worldview

Thus, provides the overview that health is not just the

absence of disease in physical sense but encompass the whole wellbeing of the person.

WHAT IS A HOSPITAL
Ahospital,inthemodernsense,isaninstitutionforhealth
careprovidingpatienttreatmentbyspecializedstaffandequipment,and
often,butnotalwaysprovidingforlonger-termpatientstays.Itshistorical
meaning,untilrelativelyrecenttimes,was"aplaceofhospitality",for
exampletheChelseaRoyalHospital,establishedin1681tohouse
veteransoldiers.
Today,hospitalsareusuallyfundedbythepublicsector,byhealth
organizations(forprofitornonprofit),healthinsurancecompanies
orcharities,includingbydirectcharitabledonations.Historically,
however,hospitalswereoftenfoundedandfundedbyreligiousordersor
charitableindividualsandleaders.Conversely,modern-dayhospitalsare
largelystaffedbyprofessionalphysicians,surgeons,andnurses,
whereasinhistory,thisworkwasusuallyperformedbythefounding
religiousordersorbyvolunteers.Today,thereare
variousCatholicreligiousorders,suchastheAlexiansandtheBon
SecoursSisterswhichstillfocusonhospitalministry.

Thebasicformofahospitalis,ideally,basedonitsfunctions:
a.bed-relatedinpatientfunctions
b.outpatient-relatedfunctions
c.diagnosticandtreatmentfunctions
d.administrativefunctions
e.servicefunctions(food,supply)
f.researchandteachingfunctions
5WaysHospitalDesignInfluencesPatientHealth
1.SENSEOFPLACE
2.PRIVATEROOMS
3.NATURE+ARTWORK
4.NOISE
5.COLOR

BUILDING ATTRIBUTES
1.Efficiency and Cost-Effectiveness
2.Flexibility and Expandability
3.Therapeutic Environment
4.Cleanliness and Sanitation
5.Accessibility
6.Controlled Circulation
7.Aesthetics
8.Security and Safety
9.Sustainability

What is healthcare?
Essential health care based on practical,
scientifically sound and socially
acceptable methods and technologies
made universally accessible to
individuals and families in the
community through their full
participation and at a cost that the
community and country can afford to
maintain at every stage of their
development in the spirit of self-reliance
and self determination

H ealth Pyram id
Healthcare buildings encompass the
predefined healthcare strata of PRIMARY,
SECONDARY and TERTIARY level of care.
Tertiary
Secondary
Primary

The Levelof Care

Primary care embraces all the general health
practices, educational, preventive and curative,
that are offered to the population at the point of
entry into the System.
Secondary Care comprises the care provided by
more specialized services to which people are
rendered by the primary care services.
Tertiary Care includes highly specialized
services not normally found at secondary level,
including super-specialties such plastic surgery,
neurosurgery and heart surgery.

Principle of Referralof Patients

Theprincipleofreferral of patientsfrom
alowerlevelofcaretoahigherlevelas
amethodofsortingthemaccordingto
theirneedforspecialistdiagnosisorthe
natureorthedegreeortheirdisabilitiesis
alsouniversallyrecognised.
Anotherisaimtoworkinbothdirection
forwhichthereverseismeantfor
convalescence.

Not more than 1000 beds

Large
Large District
District
Hospital
Hospital

500-750 beds

Medium
Medium District
District
Hospital
Hospital

300-500 beds

Small
Small District
District
Hospital
Hospital

150-300 beds
26-150 beds Health Clinic
Health Clinic

With and without

Alternative Birthing Centre

Community
CommunityHealth
HealthClinic
Clinic
//Rural
RuralHealth
HealthClinic
Clinic

TERTIARY
CARE

State/General
State/General
Hospital
Hospital

SECONDARY
CARE

Normal referral

Just over 1000 beds

PRIMARY CARE

National
National Referral
Referral
Hospital
Hospital

Emergency referral

H ealth care R eferral S ystem

B asic H osp ital Form s an d

C on f i
g u ration s
Emergenc
y Entry

Outpatient entry
The
TheOutpatient
OutpatientZone
Zone

Diagnostic
Diagnostic&&
Treatment
Treatmentzones
zones

Visitors
Visitors
Visitors
Control
Control

visitors

Inpatient
Inpatientzones
zones

Medical
Medicaland
andNon
NonMedical
Medical
Support
Zones
Support Zones
Supplies and
Disposal

Naturally ventilated areas

are normally long and thin
while fully air conditioned
areas are thick and wide

In the tropics

W ard Layout
natural ventilation and natural lighting.

Clinic Layout
Patient
Waiting
Area

Linking to
Main
Entrance or
Hospital
Street

C/E
rooms

C/E
rooms

Treatment
Room

Stores

Dirty
Utility

Staff corridor
reception

C/E
rooms

Natural Day light

C/E
rooms

C/E
rooms

Clean
Utility

Procedure
Room

Linking to staff
areas

D evelopm ent of H ospital

Architecture Abroad
UK, USA, EUROPE,JAPAN,
SOUTH AFRICA, BRAZIL

British Experience

In the early 50s-60s during the energy

crises, the British embarked on several
hospital development program starting
from

the Greenwich experience,

through the Harness system,
the Best Buy Mark I, then Best Buy Mark II,
through the varied Nucleus Hospital program
including the energy efficient Nucleus Hospital
of St. Mary on the Isle of Wright.

Now ..one off designs throughPrivate

Finance Initiative (PFI)

G reenw ich hospital

floor

Interstitial
Service
floor

PLAN
PLAN
The construction methods would be revolutionary - all
lateral engineering services were to be contained in a 6foot gap between floor and ceiling of each pair of floors so
that repairs and maintenance works could be carried out
without disturbing ward or department routine. All wards
would have natural light but the service departments e.g.
x-ray, pathology and operating theatres would be in the
centre and artificially lit.
The whole hospital was to be ventilated mechanically and
none of the windows would open so that the air in the
wards would be as pure as possible.

U SA Experience
Being on private insurance based healthcare
system, architects in the United States had to
convince the facility management that good
healing design is profitable.
Extensive campaign or crusades on both sides of
the Atlantic to market the will of healing
environment through provision of good view,
music therapy, good interior design, lots of
sunlight, fresh air and energy efficiency through
passive design strategies are done with many
researches being conducted to provide evidence
that environment do indeed improves the person
health outcomes.

European Experience

In Europe, apart from access to daylight and

fresh air, strategies for passive design include
the choice of building materials for healthcare
buildings that has rigorous requirements.
The material is specifically specified to be
environment friendly e.g.the choice of wall and
floor finishes should not be from material that can
burn nor emit toxic fumes.

Building services system should promote the

recycle of waste water; retention of natural
water before gradual discharge; recycle heat
energy of air condition to radiators; use of
solar power with photo voltaic, wind energy
and others.

The Asian Experience

There have been movement in the Asian
scene about going back to tradition and
local Asian values when designing
hospitals.
The deep rooted wisdoms on the use of
Feng Shui (literally means wind, water) by
the Chinese and Vaastu Shastra by the
Indians had made significance come back in
this millennium.
Both values, are basically based on the
planning of the environment that deals with
orientation and provision of good healthy
living.

W orldw ide experience sum m ary

More hospital planning layouts are going
away from deep planning and massive
concept to thinner blocks with
courtyards to provide

opportunity for all habitable rooms or spaces to

have a natural daylight and view to the outside;

 More patients spaces are accessible to the

gardens or sizeable courtyards whether it is on
the roof-tops or on the ground floors;

 More external cladding, although of high

tech material, provides the shades and light
at their openings through provision of
retractable blinds or hoods as and when
necessary.

 Atriums with gardens and natural daylighting are

a common feature. Due to their four seasons and
differential natural day-lighting intensity
throughout the year, ventilation systems need to
be boosted with mechanical means to provide the
space with the required thermal comfort level.

H ealthcare Facility
.means any premises in which one
or more members of the public
receive healthcare services..

W h at is G overn m en t
H ealth care Facility
GHF Means any facility used or
intended to be used for the provision
of healthcare services established,
maintained, operated or provide by
the Government but excludes
privatized or corporatized
Government healthcare facilities;

Facility P lan n in g N orm s

Rural Health Clinic

Community Clinic

For 2,000 to 4,000 population.

Health Centre

For 15-20,000 population

State Hospital at every State
Regional Hospital
Hospital for every district
Network of facilities for sub-specialties

General Guide
Base on the principles of total planning &
development, the general guide to
planning healthcare facilities are as
follows:

Site planning

Minimum area or acreage

Component of healthcare
facilities

Support facilities

i)

Site Planning

Healthcarefacilitiesshouldbeprovided
completeaccordingtoitshierarchy:
a)Hospital-includesgeneral
hospital,districthospital,with
orwithoutspecialists.
Theseareprovidedatstate
anddistrictlevel.
b)Health Clinicsareprovided
atlocallevel,and
c)Rural Health Clinicisprovided
attheruralareas.

Site Planning
ii)Theplanningonthetypeofhealthcare
facilitiesmustbeaccordingtotheregionand
thecatchmentareaasshownintheTableA;
iii)Thelocationofhealthcarefacilitiesshouldbe
suitableandappropriateintermsofits
accessibility,qualityoftheenvironment,and
safeforthecommunity;
iv)Thehealthcaresiteshouldbeaccessbythe
networkofroadsandneartothepublic
transportationsystem;

Site planning
v) Thelocationofahospitalneednot
necessarilybeinthetowncentreto
avoidtrafficcongestion;butaccessible
vi)Thelocationofhospitalisnotsuitable
atnoisyandpollutedareas;
vii)Thesiteplanningofhealthcare
facilitiesmustbeinaccordancetothe
proposedanddevelopmentstrategyin
thelocalplanaswellasapprovedby
thestateauthority.

Layout Plan and D esign

i)

Thedesignofhealthcarefacilities
shouldbeafunctionaldesigntoserve
asthehealthcentresforall
communities;thebuildingshould
reflectfriendliness;
ii) Thedesignshouldtakenotethe
functionandadjacencyofthevarious
workareaordepartmentsbaseon
theworkflowofpatientsandmedical
proceduressoasnottoobstruct;