REPORT ONMULTI-SPECIALITY HOSPITAL

SUBMITTED BY:NIKITA GUPTAA51204011037B.ARCH6TH SEMESTERSUB: ARCHITECTURE DESIGN

Amity School of Architecture and Planning Amity University HaryanaABSTRACT

CONTENTSINTRODUCTION 1CHAPTER-11.1 INTRODUCTION OF HOSP ITAL 2 CHAPTER-22.1 CASE STUDY 2.1.1 CASE STUDY FORTIS HOSPITAL 32.1.2 CLIMATIC CONDITIONS 42.1.3 MATERIALS USED IN CONSTRUCTION 42.1.4 STRATERGIES WERE ADOPTED TO REDUCE 4-5THE BUILDING IMPACT ON THE NATURAL ENVIRONMENT2.1.5 FLOOR PLANS 62.1.6 REQUIREMENTS OF FORTIS HOSPITAL 6-72.1.7 DISABLED FACILITIES 92.1.8 BUILDING SERVICES 9-102.1.9 PNEUMATIC TUBE SYSTEM 10-112.1.10 STANDARDS AND NORMS 11-14INFERENCE 15REFERENCES

INTRODUCTIONOBJECTIVEThe objective of this report is to develop an understanding of the meaning of the multi-specialty hospital, its functioning and the requirements. APPLICATIONThe application of this report aims at giving a broad view of hospitals designs and construction. Also, a case study of a hospital would further help to understand the ideas behind its functioning and designing. METHODOLOGY ADOPTEDThe methodology adapted to the completion of this report is divided into following phases:Phase I Literature survey by collection of data from sources like various books available in the college library or on the internet and knowledge gathered from various websites. This phase also includes in practically visiting the hospital.Phase II Thereafter, the data so collected was sorted out accordingly and studied thoroughly so as to extrapolate the relevant information. The information was then compiled. Phase III After compiling the information the discussion and drawing of conclusion was made. Phase IV The last phase of this report comprised of compiling the study carried out so far.

1CHAPTER-11.1 INTRODUCTION A hospital is a health care institution providing patient treatment by specialized staff equipment [1]. In accord with the original meaning of the word hospital were originally places of hospitality. Hospitals are usually distinguished from other types of medical facilities by their ability to admit and care for inpatients.

The best known type of hospital is the one which is set up to deal with many kinds of disease and injury and normally has an emergency department to deal with immediate and urgent threats to health. The hospital buildings are designed to minimize the effort of medical personnel and possibility of contamination while maximizing the efficiency of the whole system. A multi-specialty hospital is a hospital which provides various facilities like cardiac, urology, diabetic etc. and what not under the same roof [2]. The main advantage of this hospital is that patient need to rush from one hospital to another for varied diseases, saving time, manpower and money.

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CHAPTER-22.1 CASE STUDY2.1.1 CASE STUDY OF FORTIS HOSPITAL [3]LOCATION: SECTOR- 44, GURGAON, HARYANA

32.1.2 CLIMATIC CONDITIONS DELHI[4] Monsoon influenced humid subtropical It has high variation between summer and winter temperature and precipitationSince, Haryana is near to Delhi, so the climatic conditions are similar to both the states. HARYANA[5] The climatic conditions are similar to other states of India lying in northern plains. Very hot in summer Cold in winter Rainfall is varied, since, the Aravalli hills region being the driest. FLORA AND FAUNA IN HARYANA[6] Thorny, dry, deciduous forests and thorny shrubs.2.1.3 MATERIALS USED IN CONSTRUCTION Steel Structure: It is used in the construction work so as to carry load according to the height of the structure. Glass: It is used for the lighting ventilation in the building. Brick Work Roof style: Near the reception area lounge, in the roof, skylights are used for natural lighting. 2.1.4 STRATERGIES WERE ADOPTED TO REDUCE THE BUILDING IMPACT ON THE NATURAL ENVIRONMENT [7] Sustainable site planning: Top soil from the site, which was not very fertile was stacked, preserved, made fertile with the addition of manure and re-laid on the landscape areas. Consolidation of all site services along the transportation corridors minimizes the site disturbances.4 Surface parking is provided with 100% grass pavers reduce the heat island effect on site. Sufficient plantation done at the site reduces the noise levels considerably and enhances exterior environmental quality. Reduction in water consumption (compared to GRIHA benchmark): Low flow plumbing fixtures used to minimize the building water consumption reduction by 63%. Drip Irrigation system adopted on the site along with native plant species to cut short the landscape water consumption by 50%. 100% Treated water from sewage treatment plant is reused for cooling towers and irrigation purposes. Reduction in energy consumption (compared to GRIHA benchmark) while maintaining occupant comfort: For achieving visual comfort Ingress of daylight in Patient areas &Waiting areas. Landscape in sync with the Architectural spaces to provide visual comfort. For achieving thermal comfort Use of AAC blocks, Double Glazing & Roof insulation. Renewable energy technologies installed on site: Solar Photovoltaic Panels for 25 KWp are installed at site. Solar Water Heaters for 8000 litres are also installed to meet the surplus hot water requirement after heat recovery system. Use of low energy materials: Autoclaved Aerated Concrete blocks are used for the construction of the hospital building. Cement with sufficient percentage of fly ash had been used for the construction. Low embodied energy construction materials and finishes have been used in the hospital interiors.

52.1.5 FLOOR PLANS [8] (Enclosed Floor Plans) UPPER GROUND FLOOR AREA DETAIL = 146.465 X 102.185 (-) LESS AREALESS AREA= 7101.636 SQM=14966.526(-) 7101.636=7864.890 SQM

FIRST FLOOR AREA DETAIL=146.465 X 102.185 (-) LESS AREALESS AREA= 8138.336= 14966.526 (-) 8138.336= 6828.190 SQM

SECOND FLOOR AREA DETAIL =146.465 X 102.185 (-) LESS AREALESS AREA= 8123.227=14966.526 (-) 8123.227= 6843.2919 SQMSite area: 43,303 m2Built-up area: 65,961 m2Air-conditioned area: 26,254 m2Non-Air-conditioned area: 44,612 m2Energy consumption reduction: 33% reduction in energy consumption compared toTERI GRIHA benchmark2.1.6 REQUIREMENTS OF FORTIS HOSPITAL PARKING RADIATION THERAPY

6 STEM CELL PAEDIATRICS PHYSIOTHERAPY NUCLEAR MEDICINE/ ONCOLOGY OPEN LAB/ RADIOLOGY & IMAGING OPD EMERGENCY AND TRAUMABOULEVARD RETAIL THERAPY TUMMY LUCK/ FORTIPLEX HEALTH 4 U ADMISSIONS/ DISCHARGESLOBBY GYNAECOLOGY/ OBSTETRICS FORTIS BLOOM/ BREAST CLINIC PHARMACY/ SPA PRIVATE BIRTHING SUITES DELIVERY ROOMS/ NURSERY/ NICU COSMETOLOGY/ PLASTIC SURGERY HDU AND NIGHTINGALE WARDS LAB OR BLOOD BANK EYE AND DENTAL CHEMO DAY CARE/ DIALYSIS R & R LOUNGE/ MEDITORIUM OPERATING ROOMS AND BRAIN SUITES ICUs / TRANSPLANT ICUs CATHLABS/ ENDOSCOPY SUITES EXECUTIVE ROOMS SIGNATURE FLOOR/ THE BOARD ROOM7

INFORMATION DESK REST OPTIONS FOR ATTENDANTS

FORTIPLEX: A MOVIE LOUNGE PEVONIA

LOUNGE AREA FORTIS HOSPITAL, GURGAON

82.1.7 DISABLED FACILITIES No guiding tiles were there for blind. Railings were not there in corridors for disabled to walk with support. No signs were there to be followed for the deaf/ disabled. In toilets a handle was not provided for support to the patients but a button was provided that sounded like a siren. For each patient a personal person was provided to guide them to the destination and to take care of them. 2.1.8 BUILDING SERVICES [9] Structural Bays The structural bay is the basic unit of which all other modules are comprised. The dimensions of the structural bay are influenced by the functional layout, service zone clearances, and the type of structural system selected. Service Zones A service zone includes a full height service bay (with independent mechanical, electrical, and telecommunications rooms) and an independent service distribution network that includes an interstitial space above the functional zone. Functional Zones The functional zone is the occupied floor area within a service module. Space modules are subdivisions of the functional zone. Fire Compartmentation A fire compartment is a unit of area enclosed by a two-hour rated fire-resistant construction on all sides, from which there are at least two different exits. Plumbing Utilities 9Plumbing supply and return risers being grouped together at one end of the service bay. The horizontal sanitary waste pipes drain toward the service bays and connect to two or more waste stacks located in the service bay. The storm drain follows the same concept as the sanitary waste. ZONING OF PLUMBING SYSTEMS The hot water heaters are centrally located in one or more equipment rooms at or below grade. The medical air, oxygen, and medical vacuum systems are usually located at the medical centers central utility building or basement mechanical room. In Fortis hospital, for fire safety, a fire hose was placed at the end of every corridor which was according to the length of the corridor. Sprinklers were placed in corridors and in every room. A.C. ducts were provided in every room. The hospital had good lighting ventilation. No other ventilation was provided.2.1.9 PNEUMATIC TUBE SYSTEM [10]Pneumatic tubes (or capsule pipelines; also known as Pneumatic Tube Transport or PTT) are systems that propel cylindrical containers through a network of tubes by compressed air or by partial vacuum. They are used for transporting solid objects, as opposed to conventional pipelines, which transport fluids. Pneumatic tube networks gained acceptance in the late 19th and early 20th centuries for offices that needed to transport small, urgent packages (such as mail or money) over relatively short distances (within a building, or, at most within a city). Some installations grew to great complexity, but were mostly superseded. In some settings, such as hospitals, they remain widespread and have been further extended and developed in recent decades. A small number of pneumatic transportation systems were also built for larger cargo, to compete with more standard train and subway systems. However, these never gained popularity.

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Pneumatic tube system2.1.10 STANDARDS AND NORMS[11] OCCUPANT LOAD

Sl. No. Type of Occupancy Occupant Load per 100 sq m. of Plinth or Covered Area

1 Residential 8.0

2 Educational 25.0

3 Institutional 6.60

4 Assembly (a) with fixed or loose seats and dance floor (b) without seating facilities including dining rooms

166.6 66.6

5 Mercantile (a) street floor and sales basement (b) upper sale floor

33.3 16.6

6 Business and industrial 10.0

7 Storage 3.3

8 Hazardous 10.0

11 Main Building The plinth or any part of a building or outhouse shall be so located with respect to average road level from site so that adequate drainage of the site is assured but at a not height less than 45 cm. Basement The construction of the basement shall be allowed by Authority in accordance with the land use and other provisions specified under the Master Plan/Zonal Plan. The basement shall have the following requirement: i) Every basement shall be in every part at least 2.5 m. in height from the floor to underside of the roof slab or ceiling and with maximum height not more than 4.5 m. ii) Adequate ventilation shall be provided for the basement. Any deficiency may be met by providing adequate mechanical ventilation in the form blowers, exhaust fans (one exhaust fan for 50 sq m. basement area), air-conditioning system, etc. Arrangement of Exits a) Exits shall be so located so that the travel distance on the floor shall not exceed 22.50 m. for residential, educational, institutional and hazardous occupancies and 30.0 m. for assembly, business, mercantile, industrial and storage occupancies. Whenever more than one exit is required for a floor of a building they shall be placed as remote from each other as possible. All the exits shall be accessible from the entire floor area at all floor levels. b) The travel distance to an exit from the remote point shall not exceed half the distance as stated above except in the case of institutional occupancy in which case it shall not exceed 6.0 m. Staircase Requirement There shall be minimum of two staircases and one of them shall be enclosed stairway and the other shall be on the external walls of building and shall open directly to the exterior, interior open space or to any open place of safety. Single staircase may be accepted for educational, business or group housing society where floor area does not exceed 300 sq m. and height of the

12building does not exceed 24 m. and other requirements of occupant load travel distance and width of staircase shall meet the requirement. The single staircase in such case shall be on the outer wall of the building. Minimum Width Provisions for Stairways The following minimum width provisions shall be made for each stairway a) i) Residential low rise building 0.9 m. ii) Other residential building e.g. flats, hostels, group housing, guest houses, etc 1.25 m. b) Assembly buildings like Auditorium, theatres and cinemas 2.0 m. c) All other buildings including hotels 1.5 m. d) Institutional building like hospitals 2.0 m. e) Educational building like School, Colleges. 1.5 m. Minimum Width Provisions for Passageway/Corridors The following minimum width provisions shall be made for each passage way/corridor. a) Residential buildings, dwelling unit type 1.0 m. b) Residential buildings, e.g., hostels, etc. 1.25 m. c) Assembly buildings like auditorium theatres and cinemas 2.0 m. d) All other buildings including hotels 1.5 m. e) Hospital, Nursing Homes, etc. 2.4 m. Provision of exterior Open Spaces around the Building a) The set backs of the respective building shall be as per Master Plan, detailed Layout Plan, general Development Plan. b) For buildings identified in Building Bye-Laws no. 2.l0.5 and 7.1 the provision of exterior open spaces around the buildings shall be as given in Table 4.4.

Provision of Exterior Open Spaces Around the BuildingsSl. No.Height of the Building Upto (m.) Exterior open spaces to be left out on all sides in m. (front rear and sides in each plot)

1 10 As per prescribed set backs

2 15 5

3 18 6

4 21 7

5 24 8

6 27 9

7 30 10

8 35 11

9 40 12

10 45 13

11 50 14

12 55 and above 16

LIGHTING AND VENTILATION OF ROOMS All habitable rooms shall have for the admission of light and air, one or more apertures, such as window, glazed door and fan lights, opening directly to the external air or into a open verandah not more than 2.40 mt. in width. In case light and ventilation to habitable space area are through an internal courtyard, the minimum dimensions of such courtyard shall not be less than 3.0 m. x 3.0 m. for buildings upto 12.50 m. in height. Ventilation Shaft For ventilating the spaces for water closets and bathrooms, if not opening on the front side, rear and interior open spaces, shall open on the ventilation shaft, the size, of which shall not be less than the values given below:Size of Ventilation Shaft Height of Building in m. Size of ventilation shaft in sq m. Minimum size of shaft in m.

9.0 1.5 1.0

12.5 3.0 1.2

15 and above 4.0 1.5

14INFERENCE

15REFERENCES[1] http://wikipedia.org[2] http://wikipedia.org[3] http://google.co.in[4] http://wikipedia.org[5] http://wikipedia.org[6] http://wikipedia.org[7] http://google.co.in[8] Fortis hospital Gurgaon[9] http://google.co.in[10] http://wikipedia.org[11] guidelines-hospital.pdf