ACHARYA’S NRV SCHOOL OF ARCHITECTURE
SOLADEVANAHALLI, BENGALURU -560107
PROJECT TITLE
ARCHITECTURE DESIGN PROJECT (THESIS) – 2021-22
Submitted in partial fulfillment of the Requirements for the
“Bachelor of Architecture” Degree Course
Submitted by
USN
Guide
: Ananya Kulkarni
: 1AA17AT009
: Ar. Abhilasha
A project report submitted to
VISVESHWARAYA TECHNOLOGICAL UNIVERSITY
“Jnana Sangama”, Machhe, Belgaum – 590018
ವಿಶ್ವ ೇಶ್ವ ರಯ್ಯ ತಾಂತ್ರಿ ಕ ವಿಶ್ವ ವಿದ್ಯಯ ಲಯ್, ಬೆಳಗಾವಿ - ೫೯೦೦೧೮
CERTIFICATE
This is to certify that this thesis report titled Trauma Centre by Ananya Kulkarni of
IX SEMESTER B. Arch, USN No. 1AA17AT009, has been submitted in partial
fulfillment of the requirements for the award of under graduate degree Bachelor of
Architecture (B.Arch.) by Visveshwaraya Technological University VTU,
Belgaum during the year 2021- 22.
Guide
Principal
Examined by :
1)Internal Examiner
:
2)External examiner 1
:
3)External examiner 2
:
|Page
DECLARATION
This thesis title “Trauma centre”, submitted in partial fulfillment of the requirement
for the award of the under graduate of Bachelor of architecture is my original work to
the best of my knowledge.
The sources for the various information and the data used have been duly
acknowledged.
The work has not been submitted or provided to any other institution/ organization for
any diploma/degree or any other purpose.
I take full responsibility for the content in this report and in the event of any conflict
or dispute if any, hereby indemnify Acharya NRV School of Architecture and
Visveshwaraya Technological University, Belagavi and its official representatives
against any damages that any raise thereof.
Students Name : Ananya Kulkarni
USN No. : 1AA17AT009
Page | 3
ACKNOWLEDGEMENT
The satisfaction and euphoria that accompany the successful completion of my task
would be incomplete without mentioning the people, who made it possible, whose
consistent guidance and encouragement crowned our effort with success.
I have been fortunate to have Ar. Abhilasha, professor at Acharya NRV school of
architecture as my guide for the project. I would like to thank her for guidance and
constant support.
I am priviledged and honoured to thank Ar. Sanjyot Shah, principal of Acharya
NRV school of Architecture for constant support.
Page | 4
TABLE OF CONTENTS
CHAPTER NO. & TITLE
PAGE
1. INTRODUCTION
-
GENERAL
7
-
TRAUMA CENTRE V/S EMERGENCY
9
-
DISCIPLINE
13
-
AIM, OBJECTIVES, LIMITATIONS
14
-
ESSENTIAL SPACES
16
2. NET CASE STUDIES
2.1 NEW ZAYED MILITARY AND TRAUMA CENTRE
18
2.2 LEISHENSHAN HOSPITAL
27
2.3 UNIVERSITY PSYCHIATRIC CENTRE
33
3. BYE LAWS
37
4. SITE STUDY AND ANALYSIS
39
5. CONCEPT
42
6. REFERENCES/BIBLIOGRAPHY
43
Page | 5
Page | 6
1. INTRODUCTION:
In Southeast Asia, accidents and injuries are increasingly becoming the primary causes of
morbidity and mortality. Developing countries are becoming more vulnerable to disasters due
to increased urbanisation and technological use without corresponding increases in
precautionary measures and workplace protection.
India alone lost – 26.7 million
It is estimated that 11 people will be injured/ killed every minute by 2001.
Health care systems are insufficiently prepared to manage incidents of trauma, accidents and
mass casualties, as the essential infrastructure is lacking.
To reduce morbidity and mortality, reinforcing of primary/secondary/tertiary health care is
necessary.
It is urgent need to establish health care facilities as the large number of trauma cases is of
young adults and those in productive age group.
Trauma centre has to have minimum human resources and equipments to ensure minimum
level of preparedness for the effected patients.
The lack of specialised equipments and operators is the major weakness seen in the existing
trauma care systems.
A trauma centre is a section of a hospital dedicated to treating the most critical injuries, such
as gunshot wounds, serious vehicle accidents, and major burns. Trauma centres provide more
comprehensive care than emergency rooms, and the distinction between the two can be the
matter of life and death.
Trauma centres are reserved for patients who have suffered the most severe injuries.
Trauma centres require highly qualified doctors that specialise in the treatment of catastrophic
injuries, such as:
Page | 7
• Radiologists
• Trauma surgeons
• Registered nurses
• Cardiac surgeons
• Neurosurgeons
• Orthopaedic surgeons
They staff the center 24/7 and have access to resources such as an operating room,
resuscitation area, laboratory, and diagnostic testing equipment. They are always prepared to
treat patients.
There are 118 trauma centres in the whole of India. The deaths due to accidents reported is
increasing every year. Introducing trauma centres at the required areas is utmost important to
reduce the number of trauma deaths.
Patients with serious injuries require extensive care from a variety of experts, including
physiotherapists, occupational therapists, speech therapists, psychiatrists, vocational
therapists, and rehabilitation nurses, who will help the patient return to a state of normalcy.
POST TRAUMA STRESS DISORDER:
Without the support
of qualified psychiatrists,
psychologists, and Rehabilitation
professionals, some patients after a traumatic event have night terrors, flashbacks, insomnia,
irritability, and trouble moving on with their life.
Trauma surgeons, Orthopedic surgeons (both adult and pediatric), Neuro and Spine surgeons,
Plastic and General Surgeons make up the Trauma team. Anesthetists, cardiologists,
neurologists, physicians, and intensive care specialists support the surgical team.
Page | 8
The Evolution of Trauma Care:
The evolution of trauma care began in Europe in the 17th century, with soft tissue techniques
being used to treat injuries. Following the American independence war, American doctors
educated in England and Scotland accepted these European values. Blood transfusions were
proven to save lives throughout the first and second world wars. The need of immobilizing
fractured limbs and then medically stabilizing them with implants became widely known.
Since the Korean War, it was discovered that after a trauma, blood vessel fluid moves into
cells, causing blood volume to be depleted. The importance of transferring patients swiftly to
hospitals by air ambulances was recognized at that time.
TRAUMA CENTER vs EMERGENCY DEPARTMENT:
The distinction between an emergency room and a trauma centre is both legal and degreebased. – All hospitals are mandated by law to respond to all medical crises as soon as possible,
and hence must have emergency services. Emergency departments are designed to handle a
wide range of minor to major medical emergencies, but trauma centers have a narrower scope
of practice and rigorous staffing, specialist availability, and response time standards to care
for the seriously injured. An emergency room can be designated as a Trauma Care Facility
based on its ability to manage serious injuries. The emergency rooms of hospitals that are not
really classified trauma centers may not have coordinated multi-specialty teams ready to react
to trauma calls or access to the same degree of rapid, high-level surgical care as a recognized
trauma centre.
Page | 9
Trimodal distribution of trauma deaths:
Trauma-related death is thought to be distributed in a trimodal fashion. This concept describes
three distinct peaks correlating with immediate, early and late death from trauma.
The first peak represents immediate death within the first hour following trauma and accounts
for 45% of patients.
The second peak represents death within 1- 4 h after trauma. This peak contains 34% of all
deaths. In this period, there is a critical interval between injury and treatment.
The third peak represents approximately 20% of deaths occurring more than 1 week after
trauma.
The ability to evaluate the arrangement of trauma care, resources, and more targeted research
to improve quality of care of trauma patients requires knowledge on the time of death
distribution.
Clinicians use the Advance Trauma Life Support (ATLS) protocol in trauma settings. The
concept can be broken down into three sections:
1) Primary survey and resuscitation
2) Secondary survey and examination, and
3) Definitive care and transfer
The guideline is described in full in the next section, which places it in the context of the
environment, tasks, and goals:
Trauma Domain Description - Trauma Team Structure:
The core team typically includes the attending surgeon, residents, an anesthesiologist, and
nurses.
A respiratory therapist, chemist, and X-ray technician are among the team's supporters.
Members of the team's roles and duties are clearly defined. The trauma team leader is in
charge of the incident, making significant decisions and directing duties to other team
members.
Page | 10
A fellow physician might assist the trauma lead. The helping physician conducts a hands-on
examination and makes treatment recommendations. The main trauma nurse is in charge of
the patient's immediate care. The main trauma nurse may be assisted by a nurse recorder who
records occurrences in process sheets. The team's organization is frequently fluid.
Fellows and attending surgeons may alternate in the roles of team leader and assistant
physician. In selected hospitals, attending surgeons primarily serve as mentors to trainees who
serve as trauma leaders.
Walkthrough of a Trauma Scenario:
Regardless of the type of trauma, certain important stages (in quasi-sequential sequence) are
undertaken to evaluate the patient. At this section, we'll go over a common trauma case
scenario seen in a trauma centre (workflow depicted in Flowchart). This phase will focus on
workflow seen on site at a Level-1 Trauma Center and current literature on ATLS
recommendation adherence.
Trauma Preparation:
A trauma scenario usually starts with a severity or incident classification indicator announcing
the trauma arrival. In the Trauma unit, provider teams are assembled depend on the
seriousness of the trauma. The clinicians have a short window (varying from 2 to 10 minutes)
after the required staff members have assembled to do various activities in preparation for the
case at hand.
Members may, for example, share case information or scrub and dress in suitable protective
gear. When the patient is admitted, emergency hospital professionals move him to the trauma
bay and give him a quick rundown of his medical history. The trauma leader now assumes
command of the situation and begins the primary survey.
Page | 11
Primary Survey and Resuscitation:
The leader assesses the patient's air passages, breathing, circulation, and neurological status
during the primary survey. Typically, this assessment is completed during the first two
minutes of the patient's arrival. Other members of the team execute resuscitative attempts
(orders from the leader) and patient exposure in simultaneously (primary nurse and assisting
physician).
After all life-threatening situations have been addressed, the team uses available testing to
evaluate patient trauma and administer necessary treatment.
Secondary Survey and Definitive Care:
The secondary survey, which includes a complete head-to-toe assessment of the patient, can
be done while awaiting the results of diagnostic tests. Following that, the trauma leader
develops a therapy plan. If necessary, physicians may confer with the supervisor (attending
surgeon) or a specialised speciality (for example, orthopaedic or plastic surgery consult).
Following that, the team can provide definitive care (treatment of conditions that were not
addressed at the end of the first survey) and conduct tertiary surveys. When the patient is ready
to go home from the trauma centre, they may be discharged or transported to a room for
observation and additional care via a consult.
Page | 12
DISCIPLINE:
Social architecture:
Architecture has a tremendous impact on its occupants, not only on a societal level as well as
on a more intimate level. Buildings have an ever-changing and long-lasting impact on the
communities in which they are located. Spaces and buildings must adapt to meet the
requirements of coming generations as the world population expands. When a physical
environment is sensitively organized and configured, it can enhance productivity
Socially responsible architecture is the conscious design of an environment which encourages
social behaviour of the people leading towards the same goal or a set of goals. Peoplegathering social condensers – areas where designed space and cultural progress collide.
It's a human-centered architectural approach that combines the concepts of "for the people –
by the people."
The state of public and social areas has had a significant impact on social interaction.
Designing a system that utilizes inherent social behaviour to recognize and reward a different
approach is more likely to result in change.
Contextually, social architecture can be considered in rural and urban.
Architects' social responsibility stems in part from their belief that design can improve
locations, have an impact on society, and even play a role in civilising a place by creating a
community more habitable. Social and environmental obligation are inextricably linked. The
built environment emits more pollutants than the transportation sector. As a result, architects
must incorporate energy-efficient systems that result in reduced energy usage, as well as
sustainable or renewable building materials, to minimise emissions and counteract the effects
of climate change and enhance the state of the globe. Getting more bang for your buck when
it comes to solving challenges.
Page | 13
Aim:
To reduce the percentage/ number of deaths and other damages (post trauma disorders) caused
due to high-risk injuries and to give more importance to the mental health.
Goal:
To increase in number of trauma hospitals and to provide the best facility to the high risk
injured patients (physical/mental). Due to growth in number of vehicular populations, the
number of fatalities has been steadily increasing.
The spotlight on mental health is slowly increasing and and to provide the proper space for
treatment and curing of post traumatic disorders.
Due to lack of facilities in India for the trauma accidents, trauma impact on mental health,
designing a building which can treat both mental and physical traumas can save many lives.
Report says:
Death due to mental trauma:
According to the World Health Organization, India's mental health burden is 2443 disabilityadjusted life years (DALYs) per 100 000 people, with a suicide rate of 211 per 100 000 people.
Death due to physical health:
As per the report of 2001 The National Crime Records Bureau (NCRB), 2,710,019 accidental
deaths, 108,506 suicidal deaths and 44,394 violence related deaths were reported in India.
Objectives/ target:
•
To provide all the equipments, ambulance with emergency kit, with experts like, Trauma
surgeons, Neurosurgeons, Orthopedic surgeons, Cardiac surgeons, Radiologists, Registered
nurses.
•
Providing immediate stabilization to the injured within the golden hour is crucial for this
method. The time between the injury and initial stabilization is the most critical period for
Page | 14
the patient's survival.
•
To provide facilities, expert staffs and a design which helps to recover from the post
traumatic disorder.
Strategies:
•
To provide the design which will make the movement of patients easier and saves time, as
the time is the most important factor for the trauma patients.
•
To have a design for patients based on the severity of the injuries.
•
Provide emergency hybrid rooms to stabilize the patients.
•
Design and provide facilities which soothes the mind to support the mental trauma patients.
•
Crowd free entrance to the hospital for the ambulance to transfer the patients to the required
rooms for the treatments.
Scope:
Achievable criteria for trauma care services that might be made accessible to practically
everyone who has been injured.
Limitations:
•
The distance from the accident and the centre can be more leading to damages to the
patients. The medical staff - availability of the experts.
•
Transfer of blood from blood banks might take time.
•
The results revealed that the most common barriers are fear of stigmatization, lack of
awareness of mental health services, sociocultural scarcity, scarcity of financial support,
lack of geographical accessibility, that limit the patients to utilize mental health services.
Page | 15
ESSENTIAL AREAS IN A TRAUMA CARE FACILITY:
Patient access:
• Ambulance entrance
• Walking entrance
Patient care areas:
• Triage & Reception area
• Resuscitation area
• Treatment area
• Ambulatory care area
• Waiting Area
• Observation Ward
• Isolation rooms
Clinical Support Services:
• Lab Services
• Radiology
• Blood Bank
• Pharmacy
• Communications
• CSSD
• Services
• Manifold
Page | 16
Facilities for patient’s relatives:
• Waiting Area
• Communication Room
• Toilets
• Refreshment Area
Staff facilities:
• Staff changing rooms
• Staff shower and toilets
• Staff dining area
Office accommodation:
• Administrative support
• Staff offices
Page | 17
2. NET CASE STUDY:
2.1: NEW ZAYED MILITARY AND TRAUMA CENTRE HOSPITAL:
Site Plan:
•
Road ways are shown within the complex with driveways to the following:
•
Loading Dock
•
Main Hospital Entrance Secondary Entrance from Parking Structures
•
Emergency and Trauma Centre Walk-in Entrance
•
Emergency and Trauma Centre Ambulance Entrance Dedicated Psychiatric
•
Medicine Entrance
•
Physical Therapy and Rehab Medicine dedicated entrance
•
Outpatient Clinic Building Entrance VIP dedicated entrance
•
The Site Plan also shows Pedestrian Foot Passages
A connecting bridge from the Parking Structures to level 1and possible to level 2 of the
Diagnostic and Treatment
Centre, thus creating a secondary, secured and convenient entrance to the Hospital directly
from the Parking.
In addition to the available parking structures that will hold up-to 400 cars, there are
additional surface parking stalls adjacent the following critical services for the convenient
and easy access:
•
Emergency Department.
•
Physical Therapy and Rehab Medicine.
•
Psychiatric Medicine
•
Outpatient Building
•
VIP
Page | 18
While there is one Helipad located on the roof of the Diagnostic & Treatment Building, there
are two additional helipads located behind the Central Plant Building, with a short and direct
pathway to the Emergency Ambulance Entrance, to keep the dust and wind that will be
generated from the helicopters away from visitors and employees.
All the inpatient rooms overlook water features that are surrounded by greenery and special
landscaping.
Page | 19
Building Organizations:
Private/Public Realms
The Hospital complex is comprised of separate and yet connected buildings (Three PillarsInpatient, Diagnostic & Treatment, Outpatient) thus allowing ease of movement between the
buildings and consolidated support services to address the needs of the entire complex
Public areas are separated from Service areas.
Inpatient areas are separated from Outpatient areas
Separate Inpatient and Outpatient Access to Diagnostic & Treatment Services
The Diagnostic and Treatment in centrally located to support the inpatient and outpatient.
Inpatient flow is separated from Outpatient Flow.
in addition, direct and secured path for Critical Patient flow is provided.
Stacking Plan :
The proposed Stacking Plan promotes Quality and Efficiency through :
Minimized Patient Movement
Decreased Staffing and Equipment by eliminating unnecessary Space by consolidating similar
services
Reduced project Construction Cost and Time, accordingly.
The proposed plans can still achieve the above planning benefits even if the circular curve
massing becomes straight lines. Curve massing will minimize the institutional aspects of
linear building that usually consist of visible long corridors and doors that constitute
conventional institutional environment. (With the curved corridor, one will not see the end of
the long corridor and constantly appearing doors.)
Page | 20
Nursing Unit Design :
The key attribute of our Stacking Plans is curved triangular nursing units where the visibilities
from the Nurse Station to the Patients rooms are greater to meet the increasing higher acuity
patient populations needs.
Patient rooms are not looking directly to each others windows.
VIP rooms can be located with greater privacy at either the extreme ends of each triangular
unit or the outer centre curves.
Two Nursing Units are connected for the Swing Bed capabilities for operational efficiencies
and for shared Support Space opportunities to optimize staffing and space efficiencies.
Therapeutic Garden Courtyard (or Atrium) is proposed between two Patient Units for view to
the outdoors and landscapes.
Of special note, two ICU/CCU and one Acute Care are proposed on the similar Floor Plate to
provide future conversion capabilities, to allow accommodation of higher acuity patients as
need arises in the future, with minimum remodel.
[ Multi-story high Atrium Lobby
Energy efficient Atrium is located between the Front Entrance and the Diagnostic and
Treatment Building which opens from the roof to the ground floor thus creating a modern
ambience.
Courtyard as Place of Respite
Courtyard is located on 3rd Floor to provide secured, respite space for patients, staff, and
family members.
Most of the general support departments are located in the basement level of the Diagnostic
and Treatment (D&T) Building and the Inpatient Building. ]
Page | 21
B Level :
A connecting corridor connects the D&T building with the Outpatient Building thus achieving
optimal consolidation, integration and collaboration of the general support services.
A special hazard storage/vendor pick-up area is dedicated for storage and treatment of medical
waste.
The loading dock is large enough to support all services in the complex.
The Materials Management Department is sized large enough to handle the needs of the
institution but it shall still rely on replenishment from an external large warehouse,
incorporating just-in-time efficient operational protocol.
The inpatient pharmacy will dispense medication through the 'dumb waiter' to D&T
departments above for vertical transport and via pneumatic tube system throughout the
Medical Centre. An Automated Pharmacy and Supplies Dispensing System are proposed in
the medical equipment and IT budget.
CSSD is proposed to be located on the Basement with dedicated '2 smart elevators' (separate
clean and soiled) for vertical transport of case carts to Endoscopy and Surgery Departments.
Kitchen is proposed to be located on the Basement with dedicated 2 ‘dumb waiters' for vertical
transport of dietary carts to Patient Nursing Units
IT department is strategically located to support all buildings. The IT department will employ
the latest technologies in Hospital Information System (HIS), Clinical Information System
(CIS), Wireless communication, Financial System, and integration of medical equipment with
the HIS/CIS Systems
Medical Records is strategically located for future conversion of portion of the department
space to other patient support services when all EMR and space need is reduced
Page | 22
Ground Floor :
The Emergency Department shall have dedicated 24 hour Radiology consist of a CT and Xray equipment’s for faster and more efficient point of care of emergency patients.
Emergency Department shall access vertically connected to Radiology Department floor
above for secluded and efficient patient
The Outpatient Psychiatry department is next to the Inpatient Psychiatry department and has
a dedicated entrance. In addition, a therapeutic garden shall be located in the inpatient
psychiatry department to allow for better healing and greater patient family interaction.
Additional outdoor area (or covered air-conditioned area) can be extended to inpatient
psychiatry area to allow for activities and exercise.
Rehabilitation is located on the ground floor in order to serve both the inpatients and the
outpatients. This affords easy and safe flow of patients in and out of the department.
Also, as a positive program attribute, a semi outdoor exercise area in proposed in addition to
surface parking access directly adjacent to the dedicated entrance on the back.
The Amenities including Health Education Resources and Food Retails are proposed on
Ground Floor for convenient access to outpatients and visitors.
Page | 23
First Floor :
There is a connecting corridor that also connects the D&T building with the Outpatient
Building for convenient access The Amenities are located on this Floor to service large
population that uses this Diagnostic Services Floor.
The Radiology is consolidated on the first floor in order have more efficient operations. Its
location creates less congestion, pleasant healing environment and avoids having patients on
stretchers and heavy foot traffic that is traditionally present of the ground floor.
The Radiology Department is located above the emergency department (vertical adjacency)
for easy access by a dedicated elevator to some of the most sophisticated equipment.
Floors will be reinforced for heavy equipments transports; and exterior window /wall access
panel will be constructed to accommodate initial installation and future replacement of MRI
equipment and other heavy equipment.
The Endoscopy and Non-Invasive Cardiology, and Invasive Cardiology Departments are
horizontally adjacent to the Radiology Department to provide patient and physician
convenience which is a high efficiency factor. This is now a popular concept to consolidate
several diagnostic services that share a common support and nursing staff for specialized
procedures.
In addition, when necessary, this co-location of Radiology and Cardiology will allow
convergence of Imaging and Cardiology horizontally to promote interdisciplinary care for
patient-centered protocol and specialty collaboration for integrated care.
The Imaging / Radiology support services and offices are located on the same floor and next
to the Imaging Department in order to achieve better staff productivity There are four ICU/
CCU units on the first floor each with private rooms and all are intended to achieve swing
capability, flexibility and consolidation of support areas between units. Triangular nursing
units are proposed for the most visibilities from Nurse Station to the Patients rooms.
Page | 24
Second Floor :
The Operating Theatres are located on the second floor with easy access (vertical) to the ICU
/ CCU units below.
Anaesthesia & Pain Management is next to the theatres to achieve greater staff efficiency.
The Laboratory is located next to the operating theatres as stat lab since most of the lab work
will be outsourced.
Page | 25
Third Floor and Above
Executive
Administration,
Nursing
Administration,
Financing,
and
Quality
Control/Utilization Review/Risk Management Services are proposed to be located on this top
floor of the D&T Block that provides both required privacy as well as public access to provide
high patient relations services. The proposed location has direct adjacency to Education.
All of the Acute Care areas will be located from the third floor and above.
Page | 26
2.3 : LEISHENSHAN HOSPITAL :
INTRODUCTION :
In January of 2020, Wuhan City Disease Prevention Headquarters agreed to construct
Leishenshan hospital within half a month. The former 2019 Military World Games (MWGs)
athlete restaurant has been converted into Wuhan's second hospital devoted to treating patients
diagnosed with the coronavirus disease 2019. One thousand six hundred beds were freshly
constructed.
•
Leishenshan hospital was designed by Zhongnan Architectural Design Institute
•
Organized by Wuhan Real Estate Group
•
Constructed by China Construction Third Engineering Bureau as a general contractor.
In normal conditions, a hospital of this scale can only be constructed in 3 to 5 years, and
Leishenshan hospital had to be placed into service in 2 weeks.
At the building's peak construction time, more than 1500 pieces of machinery and equipment
were built for more than 10,000 employees.
The year's construction tasks were compressed into more than ten days. Therefore, modular
composite buildings' use, industrialized, and prefabricated construction methods are
inevitable for project construction.
The design and construction methods of prefabricated modular box buildings are different. It
uses a room as the basic unit and is relatively independent in structure.
The dimensional error between other systems will not affect the completion and overall use
of building construction.
the use of prefabricated modular box buildings can meet the demand to the greatest extent
and fully reflect the advantages of prefabricated buildings of “light, good, fast, energy-saving,
energy-saving and environmental protection.”
Page | 27
Architectural planning and design :
Wuhan Leishenshan hospital is located north of Qiangjun Road, 2019 MWGs village, Jiangxia
District,
SITE SELECTION CRITERIA :
There is already a 300mm thick concrete hardened ground, which can be used as a basic castin layer for the isolation medical area, significantly reducing the workload of site leveling and
speeding up Leishenshan hospital's construction
The site is flat and has a hardened floor, which is very suitable for constructing temporary
buildings.
Simultaneously, the roads around the site are open, the traffic is perfect, and it is far away
from the central urban area. The surrounding area is not yet developed and mature, with closed
control and isolation conditions. The distance between the overall building and the
surrounding roads and other buildings shall meet the infectious disease hospital's requirements
Air conditioning exhaust and sewage are discharged after disinfection, and rainwater is
released to the sewage pipe network after collection and disinfection.
According to landfill standards, a layer of High-density polyethylene (HDPE) anti-seepage
membrane was laid in the hospital area. The membrane is a kind of flexible waterproof
material with a high anti-seepage coefficient, excellent heat resistance, and cold resistance.
The hospital area is equipped with a sewage treatment station, the disinfection tank, the
integrated regulating tank, the biochemical tank, the efficient sedimentation tank, and other
environmental protection facilities.
The construction of Leishenshan hospital mainly uses containers for modular assembly to
form various functional modules of the hospital and uses BIM technology to assist in
automated construction.
Page | 28
Structure design :
Superstructure design :
The container adopts a steel structure skeleton and color steel composite board wall as a
whole. The mainframe beams and columns are made of cold-formed steel welding.
The structure has strong integrity, high bearing capacity, wind resistance, earthquake
resistance, safety, and durability through the welding connection.
The box roof is equipped with a waterproof and thermal insulation system, and drainage
systems are hidden in the four corners.
The box is the basic unit and can be used alone or combined horizontally and vertically to
form a spacious use space and stacked vertically.
According to the production conditions of the manufacturer at the time, Leishenshan Hospital
adopted two box-type room units with dimensions of 3 m × 6 m × 2.9 m and
2 m × 6 m × 2.9 m.
The height of the medical technology area in the isolated medical area is 4.3 m.
All modules are prefabricated in the factory, transported to the roads around the site,
assembled outside the area, and hoisted.
Small pipelines inside the ward modules are reserved and embedded simultaneously. Some
unique function rooms, such as pharmacies, use boxes as the basic unit, forming a spacious
use space through different horizontal and vertical directions.
Page | 29
Three zones and two channels :
The three zones refer to clean, semi-contaminated and contaminated areas, and the two
channels refer to the patient channel and the medical care channel.
The isolated medical area is a new temporary building, including 30 isolation wards and two
intensive care units. There is a sanitary passing unit, ward nursing unit, medical technology
unit, and reception area, excluding outpatient and emergency departments.
The plan is a “fishbone” layout, and each “fishbone” is an independent medical unit. The ward
is divided into north and south areas, each with 15 wards, and the ward spacing is 12 m.
Multiple H-shaped modules arrange the wards. Among them, the office area and medical staff
passage are placed along the central axis. Each central module is responsible for four.
Medical staff enters the ward through the “sanitary passage unit” from the central axis's core
through disinfection, dressing, and inspection
The medical and nursing living area has two floors
The main structure of the light steel movable board house is a lightweight steel frame, and
Page | 30
there are cross cables between the frames to ensure the rigidity and stability of the structure;
the floor supporting system adopts a light steel truss with a wooden floor on it; the roof and
wall enclosure adopt sandwich color steel plate.
Hushenshan and Leishenshan hospital's key bodies are designed with light steel frameworks,
if Hushenshan hospital uses a container house as a building module unit, while Leishenshan
hospital as a building module unit is a steel frame.
Fig 6 – shows the assembled Leishenshan hospital's steel frame module.
Page | 31
CONCLUSIONS :
It benefits from the efficient coordination ability of design and construction organization and
the more sophisticated light steel structure assembly modular building industry system.
Use BIM technology to realize site layout planning and design efficient-efficient design
solutions. So as to provide technical support for rapid construction.
Modular construction can increase construction speed by more than 50% while reducing costs.
It can increase productivity because different construction tasks can be completed at the same
time.
In the experience accumulation and post epidemic reflection of the Leishenshan hospital, it
provides experience for emergency construction under the background of frequent natural
disasters and infectious diseases.
Using BIM technology to assist in the whole process of design and construction, presimulating the design plan and construction plan, and using structural assembly modular
construction technology, the large-scale construction was successfully completed in a
relatively short period of time.
In hospitals' construction, digital models enable companies to monitor the entire construction
process, using large amounts of high-tech technology such as big data, artificial intelligence,
drones, and 5G. It provides customers with a comprehensive construction model. The isolation
area is located in the first parking lot or green belt area. There is a hardened floor in the original
parking lot area, and the isolation area foundation
Page | 32
2.3 : UNIVERSITY PSYCHIATRIC CENTRE :
LOCATION : Belgium
ARCHITECTS : Stephane Beel architects
The psychiatry building is part of AWG Architects’ master-plan for the further development
of the UZ Gasthuisberg campus. It is structured around an internal patio. The exentrically
position of the patio allows the creation of different sections for large therapy rooms and for
smaller spaces such as patients’ rooms.
The master-plan sets out measures to create an urban context, which include creating density
and differentiation in the public space, and building a diverse range of streets and squares.
This will enable the open ‘green’ zones around the site to be safeguarded.
The entire site is surrounded by a new ring-road, and a number of ‘main streets’ run through
the site to create structure. The psychiatry building, designed by Stéphane Beel Architects, is
located on the edge of this master-plan zone, in between the ring-road, the green zone and one
of the main streets. The master-plan allows for a building volume of five storeys.
The patio has been developed as a ‘therapeutic landscape’. This ‘landscape’ is connected to
every floor, so that patients can reach their therapy areas by passing through it. At the same
time, it is a place for relaxation and informal contact between patients, visitors and healthcare
Page | 33
professionals. On the third floor, this ‘therapeutic landscape’ culminates in a spacious terrace,
which connects to the sports hall. From here, patients have a view out over the green zone
and Leuven city centre.
The central patio is covered with a sliding greenhouse roof, which creates a tempered outdoor
climate. This increases its potential uses, as well as having a positive effect on energy
consumption.
On the ground floor, adjacent to the main street, are the public functions: the reception area,
consultation rooms, training and administration rooms. On the first, second and third floors
are the hospitalisation units, together with their respective therapy areas. For structural
reasons, the double-height sports hall is located on the top floor.
Page | 34
Much thought has gone into choosing the right materials and decoration. Perforated glazed
bricks and acoustically absorbent floors and ceilings have been used to create an acoustically
pleasant environment. More specifically, the rubber tiles chosen for the patio floor meet both
acoustic and other requirements (safety, look and feel, etc.).
Look and feel studies were carried out for the entire interior decoration. A lively colour palette
was created to complement the champagne-coloured masonry and it is by no means sterile.
Although this is a hospital, the idea is to create an environment that feels both homely and
safe. Based on detailed research, a standard room was designed with a colourful sliding
partition to conjure up a homely atmosphere.
The advisory role played by Stéphane Beel Architects in the choice of the free-standing
furniture ensured that the look and feel was implemented to maximum effect, and has resulted
in a harmonious whole.
Three oval green islands have been placed in the patio, which serve to bring it down to a more
Page | 35
human scale.
The inner patio is surrounded by perforated brick-work. This material is absorbing and helps
to avoid loud noises in the patio. In the whole building there was a lot of attention to acoustics.
A crucial item to create a relaxing and tempering atmosphere.
This psychiatric patient center for adults and elderly people consists of 90 hospitalisation beds
(day and night), an ambulant center with day hospital for 25 additional patients, with the
related consultation, therapy and conversation spaces, and with the administration. Part of the
patient rooms are equipped with medical gas fittings. The building has 5 layers, enclosing a
central winter garden, as an additional protected living space for the patients. An integrated
design approach enabled for VK's sustainable and technical solutions to be integrated
seamlessly.
A motorised glazed roof covering the winter garden during the winter months creates a
thermal buffer between the indoors and the outdoors. During summer, temperature rises in the
winter garden can be regulated, with a maximum rise of 3°C on top of the outdoor temperature,
by completely opening the roof and through automated solar protection.
A well thought-out thermal insulation of the building envelope results in a building with
excellent airtightness, while dynamic outdoor solar protection strongly reduces the cooling
charges inside the building. The central air groups are equipped with a heat exchanger.
Heating and cooling are delivered by the central energy plant of the Gasthuisberg-site.
Energy consumption for electricity is further reduced by energy efficient lighting.
Page | 36
BYE LAWS :
The Nursing Home shall be situated in a place having clean surroundings and shall not be
adjacent to an open sewer, drain or public lavatory or to a factory omitting smoke or obnoxious
odour.
The rooms in the nursing home shall be well ventilated and lighted and shall be kept in clean
and hygienic conditions. Arrangement shall be made for cooling them in summer and heating
them in winter.
The wall of the labour room and operation theatre upto a height of four feet from the floor
shall be of such construction as to render it waterproof. The flooring shall be such as not to
permit retention or accumulation of dust. There shall be no chinks or crevices in the walls or
floors.
An operation theatre shall be provided with, minimum floor space of 180 sq.ft
The floor space in the nursing home shall be 120 sq. ft. for single bed and additional 80 sq. ft.
for every additional bed in single room. Adequate arrangements shall be made for isolating
septic and infectious cases.
A duty room shall be provided for the " Nursing staff " on duty.
Adequate space for storage of medicines, food articles, equipments etc shall be provided
•
Corridor width – min. 2m
•
Ramp width – min. 2.4m
Page | 37
Page | 38
3. SITE ANALYSIS AND STUDY :
LOCATION : WHITE FIELD, BANGALORE
ACRES : 7.25
LAND USE MAP :
-
SITE
REASONS FOR SELECTING THE SITE :
Strength :
•
It is in the area where IT sector is mainly seen.
•
Its near main road (within 500 mtrs).
•
Easy accessible.
•
Surrounded by residences which will create a calm environment to the patients.
•
Selected site falls under the area left for development according to the landuse map.
Weakness :
•
Residence surrounding the site might disturb them due to ambulance movements.
Opportunities :
•
Catalyst for developing the area and surroundings further more
•
Provide better facilities and treatment to the patients.
Page | 39
CLIMATE :
•
The hot season lasts for 2.5 months, from March 4 to May 21, with an average daily
high temperature above 90°F. The hottest month of the year in Bengaluru is April,
with an average high of 92°F and low of 72°F.
•
The cool season lasts for 3.3 months, from September 29 to January 6, with an
average daily high temperature below 82°F. The coldest month of the year in
Bengaluru is December, with an average low of 62°F and high of 80°F.
•
The rainy period of the year lasts for 8.9 months, from March 20 to December 18, with
a sliding 31-day rainfall of at least 0.5 inches. The month with the most rain in
Bengaluru is September, with an average rainfall of 5.2 inches.
•
The rainless period of the year lasts for 3.1 months, from December 18 to March 20.
The month with the least rain in Bengaluru is January, with an average rainfall of 0.1
inches.
Page | 40
•
The windier part of the year lasts for 3.0 months, from June 1 to September 2, with
average wind speeds of more than 10.5 miles per hour. The windiest month of the year
in Bengaluru is July, with an average hourly wind speed of 14.0 miles per hour.
•
The calmer time of year lasts for 9.0 months, from September 2 to June 1.
The calmest month of the year in Bengaluru is October, with an average hourly wind
speed of 6.8 miles per hour.
•
The length of the day in Bengaluru does not vary substantially over the course of the
year, staying within 53 minutes of 12 hours throughout. In 2022, the shortest day
is December 22, with 11 hours, 22 minutes of daylight; the longest day is June 21,
with 12 hours, 53 minutes of daylight.
Page | 41
CONCEPT :
LIGHT AND SHADOWS / SHADOW ARCHITECTURE/ TREASURY OF SHADOWS :
According to Louis Kahn, light and shadows are giver of all presence.
•
He states : “A plan of building should be read like a harmony of spaces intended to be
dark should have just enough light from some mysterious opening to tell us how dark
it really is. Each space must be defined by its structure and character of its natural
light”.
•
Even a room which must be dark needs atleast a crack of light to know how dark it is.
Page | 42
BIBLIOGRAPHY :
Louis Khan :
https://antonialoweinteriors.com/louis-kahn-an-architect-of-light-the-power-of-light-andshadow
Byelaws : (condensed)
https://mohua.gov.in/upload/uploadfiles/files/Chap-4.pdf
Net case studies :
2.1 https://www.architectmagazine.com/project-gallery/zayed-militaryospital#:~:text=Project%20Description&text=LEO%20A%20DALY%2C%20design%20a
rchitect,located%20in%20downtown%20Abu%20Dhabi.
2.2 https://www.sciencedirect.com/science/article/pii/S0926580521000066
2.3 https://www.archdaily.com/804323/university-psychiatric-centre-stephane-beelarchitect#:~:text=The%20psychiatry%20building%2C%20designed%20by,building%20vo
lume%20of%20five%20storeys.&text=The%20patio%20has%20been%20developed%20a
s%20a%20'therapeutic%20landscape'.
Introduction :
https://morth.nic.in/sites/default/files/RA_Uploading.pdf
https://www.nhp.gov.in/world-trauma-day-2019_pg
https://share.upmc.com/2016/05/er-vs-trauma-center-levels/
https://dghs.gov.in/WriteReadData/userfiles/file/Operational_Guidelines_Trauma.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897990/
Page | 43