1.

1 INTRODUCTION AND BACKGROUND INFORMATION:

Planning can be defi ned as ' The specifi cation of the means
necessary for the accomplishment of goals and objectives before
action towards these goals
hasbegun'W h a t a r e t h e v a r i o u s t h i n g s t h a t m u s t b e a d d r e s
s e d t o d u r i n g h e a l t h c a r e programming and design process?
1.Provide a functional design that ensures effi cient, safe and
appropriate workspaces.2.Accommodate technical requirements for
highly sophisticated equipment.3 . C re a t e c l e a r , s e g re g a t e d
p a t h s f o r m o v e m e n t o f p e o p l e a n d m a t e r i a l w i t h i n the
building.4.Create a humane environment for patients and
staff .5.Develop building systems that can accommodate rapid
change.6.Blend technical and functional requirements into a design
that brings delight to those who use the building and those who pass by it.
Architects and construction oriented professionals acting alone may
provide a building that operates effi ciently as a physical structure,
however, it is
equallyp o s s i b l e t h a t t h e y m a y e n t i r e l y m i s s t h e m a r k
i n t e r m s o f o p e r a t i o n a l functionality.And Functionality as a
prime determinant of operational effi ciency is a major factor in the
total life cycle cost of all hospital structures. There is also little doubt that
quality of care and treatment is also affected by the degree to which
designa c c o m m o d a t e s b o t h i n t e r a n d i n t r a - d e p a r t m e n t a l
f u n c t i o n s . H e n c e a n e w discipline called functional planning has
emerged over the past few years, which augurs well for the future of
hospital design. Individuals possessing
adequatet r a i n i n g a n d e x p e r i e n c e i n t h i s fi e l d h a v e m a d e a n d a
re m a k i n g s u b s t a n t i a l contributions to the planning and design
process. Usually such planners have backgrounds in hospital
management. They could also be architects who have specialized in
hospital architecture or trained personnel of consulting firms.
Responsibilities of a functional planner :
1.Physical evaluation of existing facilities (along with architect)
2.Functional evaluation of existing facilities.
3 . P re p a r a t i o n o f w o r k l o a d p r o j e c t i o n s .
4 . Fu n c t i o n a l p ro g r a m m i n g .
5.Space programming (along with architect).
6.Master site planning (along with architect).
A l t h o u g h f u n c t i o n a l p l a n n i n g o f h o s p i t a l s h a s n o t re a c h e d i t s
m a t u r i t y a n d indeed may never do so, concepts springing from its
practice are burgeoning yearly as intense study is made of alternative
operational and building systems. There are even more innovative changes

in operational methods and procedures on the horizon as demands for

greater employee productivity are considered.
All this will directly depend upon architectural design for
implementation and
fewc a n b e b r o u g h t i n t o b e i n g w i t h o u t d i r e c t i n p u t t o t h e
d e s i g n p r o c e s s b y functional planners.
D e t e rm i n a t i o n o f t h e s e r v i c e s t o b e p r o v i d e d i n q u a n t i t a t i v e t
e rm s re q u i re s consideration of the following:
Functions
Locations
Relationship
Utilization
Staffing pattern
Space requirements
Work flow
Before an architect can develop a hospital design that w
ill best serve itsfunctions he has to be provided a writte
n p r o g r a m m e e x p l a i n i n g t h e s e requirements. This is the
architects brief from the interpretation of which he prepares schematic
drawings and sketch plans.
AN ARCHITECTURAL BRIEF FOR A PROPOSED 100 BEDDED HOSPITAL
The brief would contain the permission required from various regulatory
bodies, spatial needs of various departments, manpower required, special
requirements of various departments, inter and intra departmental
relationships.
1.2 RATIONALE FOR THE STUDY:
T h e f u t u re w i l l s e e
a c o n t i n u e d d e m a n d f o r t h e c o n s t r u c t i o n o f h e a l t h c a re facilities
including completely new or replacement facilities and projects involving
major additions and modernization. The annual value of healthcare
construction p r o j e c t s w i l l s e e a n u p t re n d i n t h e i m m e d i a t e y e a r s
ahead owing to
v a r i o u s f a c t o r s l i ke o p e n i n g u p o f t h e i n s u r a n c e s e c t o r a n d p r i
v a t i z a t i o n i n i t i a t i v e s . Therefore planning and design will continue
to merit prime emphasis amongst other responsibilities of healthcare
offi cials. In the case of hospitals functional complexities far
outweigh physical complexities and demand an addition to the
planning and design team of persons who understand not only the work
processo f i n d i v i d u a l d e p a r t m e n t s b u t t h o s e o f t h e h o s p i t a l
o p e r a t i n g a s a s i n g l e functional system. Functional planning is

the responsibility of a trained

hospitala d m i n i s t r a t o r w h o s h o u l d b e c a p a b l e o f i n t e r p re t i n g c o
m p l e x re l a t i o n s h i p s , internal traffic flows (personnel and
supplies),Technological requirements and operational procedures to the
extent a product of beauty, reasonable cost and optimal utility will
result. A functional design
canpromote skill, economy, conveniences and comforts whereas a no
nfunctionaldesign can impede activities of all types, detract from the
quality of care and raise costs. A non-functional building is the
nemesis of any hospital striving to compete in the current climate
of competition and emphasis on productivity. Thus this stage consisting of
preparation of the architects brief is important as
thed e s i g n o f t h e h o s p i t a l w i l l b e c o m e c r y s t a l l i z e d d u r i n g t h i s
p h a s e . Ti m e a n d t r o u b l e s p e n t d u r i n g t h i s s t a g e w i l l b e w e l l
re p a i d a n d w i l l e n a b l e t h e w h o l e project to proceed smoothly with a
minimum of subsequent revision. In undertaking any complex activity it
is well to examine the experiences of others in similar situations if
such information can easily be found and properly interpreted

1.3 OBJECTIVE:
To p re p a re a n a rc h i t e c t u r a l b r i e f t h a t w o u l d h e l p t h e a rc h i t e c t
t o b u i l d a functional, economical and efficient hospital.
1.4 SPECIFIC OBJECTIVES:
1.To study/understand the issues involved in functional planning of a
hospital.2.To determine the recent trends and changes in the
healthcare facility needs and to evolve a document that can incorporate
these changes so as to enable the architects to build hospitals in tune with
modern requirements.3.To draw up a space plan for the proposed
hospital.4. To study certain departments in greater detail and to provide a
brief that maybe used as a basis for detailed programming later on.
1.5 METHODOLOGY
:

Both primary and secondary research was carried out with more emphasis on
the latter.

Primary research will involve in-depth interviews with hospital consultants

and architects experienced in building healthcare facilities.

Secondary research will involve descriptive studies of the functional planning

carried out while building hospitals in the recent past. This will also
involve literature review by going through different books and journals. Thus
the study design is both

exploratory and descriptive in nature.

1.6 LIMITATIONS OF THE STUDY:

Considering the time factor all the departments of the hospital were
not dealt with: only certain key departments were covered.

The study could provide only a preliminary brief for the architect. It would-be
the basis for the development of a more detailed brief.
1.7 TIME PERIOD AND PLACE:
The study was carried out at HOSMAC (India) Pvt. Limited, Mumbai from 24
th January till 17 th April 2003.
Chpt. 2 ABOUT THE ORGANIZATION:
H O S M AC I n d i a Pr i v a t e L i m i t e d i s a p i o n e e r i n g n a m e i n t h e
fi e l d o f H o s p i t a l P l a n n i n g & M a n a g e m e n t c o n s u l t a n c y i n I n d i a .
S i n c e i t s i n c e p t i o n i n 1 9 9 6 , H O S M AC h a s g ro w n r a p i d l y t o
b e c o m e a U n i q u e h u b o f s k i l l s e t s w h i c h c u t s across various
facets of a health care facility be it architecture, engineering,
management, or information technology. In a short span of 6 years, HOSMAC
has notched up an impressive string of more t h a n 8 0 p ro j e c t s i n I n d i a
a n d a b ro a d . H O S M AC p r o v i d e s t h e e n t i re r a n g e o f services that
any health care service provider, may require: undertaking market research,
feasibility studies, detailed architectural design, project coordination,equipment procurement, commissioning assistance, conduc
ting an operationalaudit for existing hospitals. To provide such
wide ranging services HOSMAC has a motivated team of highly
qualified and experienced professionals (doctors, MBAs, architects, engineers
and project managers). On a cumulative basis these professionals
have more than2 4 5 m a n y e a r s o f e x p e r i e n c e a n d h a v e re n d e re d
m o re t h a n 6 0 , 0 0 0 h o u r s o f management consulting services, designed
1.4 million sq feet of hospital space, and are coordinating hospital projects
worth more than 3.34 billion INR.Unlike other industries, the health care
industry is extremely complex in terms
of t h e w i d e s p e c t r u m o f s p e c i a l t i e s , t e c h n o l o g i e s , a n d t h
e s k i l l e d / u n s k i l l e d manpower. The smooth interplay of these
factors only will lead to a successful health care organization. The
alarming rise in cost for providing quality health care will drive
hospitals to cut costs rather than only enhancing revenue.
Some of HOSMACs servicesOSPITAL PLA
Market Research For Project Conceptualization
A comprehensive market research is undertaken to ascertain the
needs in
thel o c a l h e a l t h c a re m a r ke t . H O S M AC ' s fi e l d w o r ke r s a re s p e c i
fi c a l l y t r a i n e d t o conduct surveys and gather secondary data from

various governmental and nong

o
v
e
r
n
m
e
c
i
e
s
.
The survey could include

households
medical professionals
diagnostic centres
nursing homes
hospitals.
r e l e v a n t d a t a f r o m c e n s u s r e p o r t , d e m o g r
a p h i c s u r v e y s , government/media publications, and
v a r i o u s o t h e r s o u r c e s i s a l s o searchedSuch a market study is
essential:

t o p r i m a r i l y k n o w t h e d e fi c i e n c i e s i n t h e h e a l t h c a re m a r ke t , t
h e re b y assisting us arriving at a proper facility & bed mix.

to helps us finalizing the project size

f o r e x i s t i n g h o s p i t a l s t o u n d e r t a ke b e n c h m a r k i n g i n a re a s l i ke
t a r i ff r a t i o n a l i z a t i o n , c o m p e n s a t i o n p o l i c i e s , u t i l i z a t i o n re v i e w
s f o r v a r i o u s services etc.
Feasibility Reports
Having decided on the facility mix, the next value added service
provided
byH O S M AC i n c l u d e s a v e r y d e t a i l e d a n d c o m p re h e n s i v e f e a s i b i
l i t y s t u d y o f t h e project. This has been our major strength and we
have to credit more than 30such studies. We are proud to mention here
that many of our reports have been

LITERATURE REVIEW:
Since Henri Fayol's pioneering treatise on management in 1916,
planning has involved two considerations, i) Assessing the future and ii)
making provisions for it. According to Robert M. Fuller "Planning is of
course decision Making because it involves selecting from among
established alternatives" Certainly the adoption of a systematic planning

process is imperative in any hospital facility. Failure to a d o p t a n d t o

a d h e re t o a s p e c i fi c m e t h o d o l o g y a l m o s t i n v a r i a b l y re s u l t s i n
a deterioration of the quality of planning. Architectural design represents the
mostd e fi n i t i v e a c t o f p l a n n i n g a n y b u i l d i n g p r o j e c t . A l t h o u g h r
e p re s e n t i n g a n e w d i s c i p l i n e , f u n c t i o n a l p l a n n i n g a l re a d y h a s a
c h i e v e d re c o g n i t i o n t h ro u g h i t s contribution to operational
functionality and has become a key factor in hospital design. Future research
in this area of planning and design process may further enhance productivity
in the healthcare field. In terms of broad categories of activities the process
of hospital project planning can be a multistep process. The steps are as
follows:1.Perception of need for a building program.2.Strategic
Planning and feasibility assessments.3.Organizing for planning,
design and construction.4.Determining the planning, design and
construction approach.5.Scheduling planning, design and
construction.6 . O p e n i n g t h e c o m p l e t e d p r o j e c t . The role of the
Functional planner is most important in steps 3 and 4.
Selection of the professional planning team
A complete team should possess capabilities in

Financial Feasibility Consulting.

Functional Planning.

Architectural and Engineering services

Construction Management.
Selection Timing:
The Functional Planner, the architect and the construction manager
can all m a ke v a l u a b l e c o n t r i b u t i o n s i n t h e e a r l y s t a g e s
o f a p ro j e c t a n d s h o u l d b e contracted at approximately the
same time. Because the functional planner has the most intense
involvement in the very fi rst stages, he might be brought in first, but
the other two must closely follow. The possibility to influence a project and
its cost is reduced during the course of its development after the client has
decided to establish the requirements of the user and started to investigate
the problems. The largest reduction of possibilities
t o i n fl u e n c e t h e d e s i g n
o c c u r s a t p o i n t 1 , w h i c h m a r k s t h e c l i e n t s d e c i s i o n concerning
implementation. The figure is based on a study by Stig Nordquist.
Responsibilities of a Functional Planner :
1.Physical evaluation of existing facilities (along with architect)
2.Functional evaluation of existing facilities.

3 . P re p a r a t i o n o f w o r k l o a d p r o j e c t i o n s .
4 . Fu n c t i o n a l P r o g r a m m i n g .
5.Space programming (along with architect)
6.Master site planning (along with architect
1.
Physical evaluation of existing facilities:
This is a study to determine the degree of physical obsolescence of
existingfacilities and to identify major code violations and physical
problems and toproject future usability.2.
Functional evaluation of existing facilities:
This is a study to defi ne functional problems that detract from
operationalefficiency, quality of patient care, and convenience of building
inhabitants
toe v a l u a t e t r a ffi c fl o w s a n d p h y s i c a l r e l a t i o n s h i p s , t o d e t
e r m i n e s p a c e i n s u ffi c i e n c i e s i n t e r m s o f c u r r e n t r e q u i r e m
e n t s t o s t u d y t h e n e e d f o r modernization, alterations and
expansion, according to strategic plan findingsand to note possible
alternative future uses of the structure as a whole as wellas of various
departmental areas.3.
Preparation of workload projections:
The functional planner can determine and formulate concepts of operation
forthe proposed project according to previous study findings. These concepts
willbe incorporated in the functional program. These projections form
the basisfor functional programming, revenue projections and staffing
estimates.4.
Functional programming:
Using approved recommendations and findings of the strategic plan,
findingsof physical and functional evaluations and workload projections, the
functiona
planner formulates recommendations for operational concepts, the
detailedroom composition of the project, required phasing,
alterations, internal andexternal traffic flows, interdepartmental
relationships and operating systems.5.
Space programming:
Based on the functional program, as amended and approved by the hospital
aroom by room listing is made of all areas in the proposed project. Net
squaref o o t a g e i s a s s i g n e d t o e a c h s p a c e , a n d t o t a l s a c c u
m u l a t e d f o r e v e r y department or functional entity. using the net

figures, appropriate calculationsare then made to set gross totals for each
department or functional entity aswell as the total for the entire project.
Some pointers to successful hospital planning
Good planning is critical to the hospitals success:
If a hospital has to be successful it must be built on the bedrock of
three
soundp r i n c i p l e n a m e l y g o o d p l a n n i n g , g o o d d e s i g n a n d c o
n s t r u c t i o n a n d g o o d management. The absence of the fi rst two of
the equally important but closelyrelated triad, good planning and
good design and construction means failure to design the facilities for
the optimum utilization of staff and services. This in turnresults in a mediocre
hospital that fails to realize its economic goals.
Efficient, Functional and economical hospital:
The real test of any hospital is the quality of healthcare it provides. If the
hospitalhas to pass this test- a truly rugged test-planning and design
must result in afunctional, efficient and economical hospital. It should be
remembered that evenminor defects in designing could make the operation
of a hospital inefficient. Thecorollary of this is that an inefficient hospital
costs significantly more to operate,staff and maintain, not to mention
the fact that the patients within it get less health services for the money
they pay.It should be borne in mind that economy of operation and
maintenance over thel i f e o f t h e b u i l d i n g a s w e l l a s t h e q u a l i t y
c a re t o p a t i e n t s d e p e n d s i n a l a r g e m e a s u re o n t h e
p ro p e r p l a n n i n g a n d d e s i g n i n g o f t h e h o s p i t a l a n d i s m o re
important than the economy of construction. The initial cost of building a
hospitalis insignificant when compared to the cost of running and
maintaining it over theyears- by one reckoning eighteen to twenty
times over a period of say twentyyears. Another study says that the
running cost of a hospital over 4 to 5 years f ro m t h e d a t e o f
completion is about the same as the capital cost. and if
t h e f a c i l i t i e s a re n o t p l a n n e d a n d d e s i g n e d p ro p e r l y t h i s i n t a n
g i b l e c o s t c a n b e e n o r m o u s . t h e e ffi c i e n c y w i t h w h i c h t h e p h y s
i c i a n s a n d t h e i r a s s i s t a n t s c a n function has been greatly
handicapped by obsolete design. Patient comfort
andp r o v i s i o n f o r e x p a n s i o n h a v e o ft e n b e e n o v e r l o o ke d . G ro w i
n g e ffi c i e n c y a n d i n n o v a t i v e i d e a s h a v e re v o l u t i o n i z e d h o s p i t a l
b u i l d i n g c o n s t r u c t i o n t o m e e t among other things, the special
needs of patients. It is believed that a
pleasante n v i ro n m e n t t h a t m a ke s f o r a n e n t h u s i a s t i c a n d m o re
p ro d u c t i v e s t a ff a l s o benefits the patients albeit indirectly.Promoters and
hospital planners often overlook to include in the facilities designw h a t
h e l p s t o p re s e r v e t h e p a t i e n t s ' d i g n i t y a n d s t a t u s a s a h u m a n
b e i n g o r details that would make the hospital more livable. Many
patients complain

thath o s p i t a l s a s i n s t i t u t i o n s re d u c e p r i v a c y , i n d i v i d u a l i t y a n d
m o re i m p o r t a n t l y human dignity. Many of these details and facilities can
be incorporated with littleor no extra cost.While planning and
designing a hospital the patients needs and expectationsshould be
kept uppermost in mind and any design should aim at his satisfactionand
comfort.Today's healthcare facility is by its very nature a complicated entity
and
planninga n d d e s i g n i n g s u c h a f a c i l i t y t o s e r v e t h e i n c re a s i n g l y
c o m p l e x n e e d s o f i t s patients, staff and management team is difficult
and complicated. The problem iscompounded by rapid changes and
advances that are taking place in the fields of technology and medicine and
the constant need to modernize, renovate, replaceand expand healthcare
facilities.
Process of planning:
A common understanding should be established between the architect and
theengineers on one hand and the promoters, doctors, administrators and
planners.
o n t h e o t h e r. A w i d e v a r i e t y o f p r o f e s s i o n a l s n e e d t o b e
i n t e g r a t e d i n t o a planning team that is responsible for the
implementation of this complex
process.I n i t i a l p l a n n i n g e n c o m p a s s e s t h e g e n e r a l p h y s i c a l f a c i l i
t i e s t h a t a re b e i n g considered, the space requirements, cost constraints,
time schedules, standardsthat must be included.In the next step details of
the operational plan for each department should
bec o n s i d e r e d - l o c a t i o n o f e a c h d e p a r t m e n t , r e q u i r e m
e n t o f fl o o r s p a c e , intradepartmental and interdepartmental rel
ationships, circulation, traffi c fl owand requirements in relation
to equipment, personnel and patients.
Operational and Functional planning first:
Before any plans can be drawn by the architect an under
s t a n d i n g o f t h e requirements of the hospital in terms of services it is
going to provide, number
of b e d s , d e p a r t m e n t a l f u n c t i o n s , d e p a r t m e n t a l n e e d s , m a j o r e
q u i p m e n t , s p a c e requirements, required personnel, relationships and
adjacencies must be agreedupon. All this must form a written document. This
is called operational planning-a written programme needed for
any architectural project.Operational planning establishes a deptby dept description of needed space byoutlining for example, the no.
and type of surgeries, X ray rooms,
outpatients e r v i c e s , l a b o r a t o r y s e r v i c e s e t c . t h e e xe rc i s e t h u s d
e t e rm i n e s c u r re n t a n d p ro j e c t e d n e e d s w i t h i n t h e f a c i l i t y. A c o
n s u l t a n t o r a n a d m i n i s t r a t o r w h o i s knowledgeable and has
experience in the operation of the hospital is by far the best person to
develop this document. Normally there is either no briefing of thearchitect or

the brief given to him is inadequate. The promoters must clearly tellthe
architect the requirements of the hospital and not the other way round.
Thea r c h i t e c t s h o u l d n o t d i c t a t e t o t h e m n o r s h o u l d h e c o
n j e c t u r e w h a t t h e re q u i re m e n t s a re o r w h a t h e s h o u l d
d e s i g n . M o re o ft e n t h a n n o t t h e re i s n o written brief or
operational program and to know what is needed the architect has to
fend for himself. Sometimes he is asked to prepare his building
scheduleswith the help of doctors, at other times he is asked to
observe other hospitalsand take guidelines from them. Both these are
unsatisfactory methods.
Key to Functional planning:
The proper sequence is the development of operational planning that
definesthe major requirements and needs fi rst. The operational plan
is then developedinto a functional plan. Planning of the hospital on a
functional basis-that listsevery room and suggests net sizes for major
functional rooms and the total sizeo f t h e d e p a r t m e n t . T h e ke y t o
f u n c t i o n a l p l a n n i n g i s n o t j u s t a r o o m l i s t b u t understanding that
travel and adjacencies will affect operational cost for the lifeof the facility
says David R. Porter the renowned hospital architect.
Mistakes in planning may prove costly:
I n s t a n c e s a re a p l e n t y o f h o s p i t a l s t h a t w e re n o t p l a n n e d w i t h
t h e s e c r i t i c a l factors in mind-within fi ve to ten years they found
that the cost of constructionhad been equalled or surpassed by operating
expenses.Functional grouping of high traffic areas such as X-ray,
laboratories, surgical anddelivery suites, physical therapy and clinics on two
floors is desirable. It permitsconcentration of hospital activities in a
manageable unit. When future expansionor changes becomes necessary,
they can be accomplished without disturbing thenursing areas.
Operational Plan and Functional Plan must precede Architectural
Plans:
P l a n n i n g a n d B u i l d i n g a h o s p i t a l t o s e r v e t h e i n c re a s i n g l y c o m
p l e x n e e d s o f modern healthcare is an intricate job. The architect
though competent in hisprofession may not be competent in the technical
aspects of hospital architectureand may lack knowledge of some of the
specialized clinical and administrative areas and matters. This document
called the operational plan and functional plandeveloped from it form the
basis and are necessary prerequisites for the architectto prepare the
architectural plans.
Hospitals must be planned for the future:
A fundamental rule that promoters should remember is that the hospital
shouldbe planned for at least 10 to 15 years ahead or else experts
say plans will be

obsolete when they come to the drawing board. With the rapid development
andadvances in technological, medical and administrative sciences
and innovativetechniques and therapies, space requirements of every
department has increasedmarkedly. New departments come to be
needed, and more space is required tosome specialties. In addition
to space needs, technology is imposing a host of physical demands on
our hospitals. Well planned systems must be built into themto keep pace
with the changes. Said one design expert ' We have got to
design` S m a r t ` h o s p i t a l s t h a t re s p o n d t o p re s e n t n e e d s w h i l e a
n t i c i p a t i n g f u t u re change.Within the building all departments must be
planned in such a way that they canstand individually. This can be done
by freely locating each department
withs p a c e a ro u n d f o r e x p a n s i o n . Fu r t h e r c a re s h o u l d b e t a ke n
t h a t e x p e n s i v e permanent fi xtures and fi xed equipment such as
plants and elevators are notlocated at the free ends of the
departments as they would permanently blockexpansion plans.
Future expansion is rendered easy with free ended buildings with
extendable corridors.
Space Program:
The space plan is made on the basis of personal intervie
w s w i t h h o s p i t a l admin istrators experienced in build ing hospi
t a l s a n d a l s o w i t h t h e h e l p literature review and would help the
architect in finalizing his plans. Hospitals
area d i ffi c u l t p l a n n i n g s u b j e c t a s e x p l a i n e d e a r l i e r. T h e m a x i m
Design followsf u n c t i o n m u s t b e k e p t i n m i n d w h i l e a l l
o c a t i n g s p a c e d e t a i l s . T h e a r e a specifications may be taken as
indicative as suitable alterations would have to bemade by the architect to
conform to the grid matrix.The total space area including the parking space,
HVAC and water is 1,05,319 sqft w h i c h w o r k s o u t t o b e 1 0 5 3 . 1 9 s q
f t . T h i s i s i n c o n c u rr e n c e w i t h m o d e r n standards of constructing
hospitals which provide for an area of 800-1200 sq ft per bed.Ground
Floor:Key Departments like OPD, Emergency, Radiology, Laboratory would be
situatedon the ground floor. The Radiology dept. would be situated near the
Emergencydept.(According to a study nearly 40% of cases coming to
Emergency require Xrays)The administration department would be
located on the
1st
fl oor along with theBlood bank and General and Paediatric wards.T h e
L a b o u r ro o m , O b s t e t r i c w a rd a n d N I C U w o u l d b e l o c a t e d o n
t h e 2 nd
flooralong with the semi-private ward.The CSSD would also be located on the
2nd

floor just below the operation theatrewith provision for dumb waiters
between the CSSD and the OT.The OTs will not be located on the top floor to
avoid the excess heating nor willthey be located near the major traffic
areas.The ICUs and private wards will also be located on the 3rd
floor.The residential area will be located on the 4 th
fl oor just above the ICUs and theOTs. So a doctor can easily attend to
the patient when called.30% of the area is kept for circulation.