Wilson Churchill has once remarked “First we
shape our buildings, thereafter they shape us”.
This is certainly true for hospital buildings.
"A functional design can promote skill,
economy, conveniences, and comforts; a nonfunctional design can impede activities of all
types, detract from quality of care, and raise
costs to intolerable levels."
Presented by
DR. ANU GUPTA
KALPANA VERMA
IIHMR JAIPUR
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.Green Architecture
10.Energy Savings
11.Water and Waste Management
12.Materials
EFFICIENCY AND COST-EFFECTIVENESS
An efficient hospital layout should:
 Promote staff efficiency by minimizing distance of necessary
travel between frequently used spaces
 Allow easy visual supervision of patients by limited staff
 Provide an efficient logistics system, which might include
 elevators,
 pneumatic tubes, box conveyors,
 manual or automated carts,
 gravity or pneumatic chutes
for efficient handling of food and clean supplies and
removal of waste, recyclables, and soiled material
 Make efficient use of space by locating support spaces so that
they may be shared by adjacent functional areas
 Consolidate outpatient functions for more efficient
operation—on first floor, for direct access by outpatients
 Group functional areas with similar system requirements
 Follow modular concepts of space planning
 Use generic room sizes and plans , than highly specific ones
 Provide optimal functional adjacencies, such as
 locating
the surgical intensive care unit adjacent to the
operating suite.
 These adjacencies should be based on the hospital's
intended operations ,from the standpoint of
patients, staff, and supplies.
 Be served by modular, easily accessed, and modified
mechanical and electrical systems
 Be open-ended, with well planned directions for
future expansion
THERAPEUTIC ENVIRONMENT
 Using familiar and culturally relevant materials consistent
with sanitation and other functional needs
 Using cheerful and varied colors and textures, keeping in
mind that some colors can interfere with provider
assessments of patients' pallor and skin tones, disorient older
or impaired patients, or agitate patients and staff, particularly
some psychiatric patients .
 Admitting ample natural light
 Providing views of the outdoors from every
patient bed,
 photo murals of nature scenes are helpful where
outdoor views are not available
 Designing a "way-finding" process into every
project. Building elements, color, texture, and
pattern should all give cues, as well as artwork
and signage.
CLEANLINESS AND SANITATION
 durable finishes for each functional space
 Careful detailing of such features as doorframes, casework,
and finish transitions to avoid dirt-catching and hard-toclean crevices and joint
 Special materials, finishes, and details for spaces which are
to be kept sterile, such as integral cove base. The new
antimicrobial surfaces might be considered for
appropriate locations.
ACCESSIBILITY
All areas, both inside and out, should:
 be easy to use by patients with handicaps
 grades are flat enough to allow easy movement
 sidewalks and corridors are wide enough for two wheelchairs
to pass easily
 entrance areas are designed to accommodate patients with
slower adaptation rates to dark and light; marking glass walls
and doors to make their presence obvious
CONTROLLED CIRCULATION
 Outpatients visiting diagnostic and treatment areas ,
not travel through inpatient functional areas nor
encounter severely ill inpatients
 Visitors have a simple and direct route to each patient
nursing unit without penetrating other functional areas
 Outflow of trash, recyclables, and soiled materials
separated from movement of food and clean supplies,
and both separated from routes of patients and visitors
 Transfer of cadavers to and from the morgue , be out of
the sight of patients and visitors
 Dedicated service elevators for deliveries, food and
building maintenance services
AESTHETICS
 Increased use of natural light, natural materials, and
textures
• Use of artwork
• Attention to proportions, color, scale, and detail
• Bright, open, generously-scaled public spaces
SECURITY AND SAFETY
 Protection of hospital property and assets, including drugs
 Protection of patients and staff
 Safe control of violent or unstable patients
 Vulnerability to damage from terrorism
GREEN ARCHITECTURE
 Minimize the use of carpets and other such materials that
have the potential to absorb and release indoor pollutants.
 Use high-reflectant roofing.
 Use high-performance windows (double-glazed, argon, etc.).
 Use rapidly renewable building materials, such as bamboo
flooring, wool carpet, strawboard, linoleum, sunflower seed
board, wheatgrass cabinetry, hemp fabrics, etc
 Install and maintain a temperature/humidity monitoring
system to automatically adjust to building conditions and
link system to building automation system.
 Evaluate safe strategies to recycle wastewater/gray water for
other purposes on the site.
 Use low-flow taps, nozzles, and toilets.
 Avoid ozone-depleting chemicals in mechanical equipment
and insulation (zero tolerance for CFC-based refrigerant).
 Avoid materials that will offgass pollutants, such as solvent-
based finishes and adhesives, carpeting, and particleboards
that release formaldehyde
 Audit existing building systems using refrigerant and fire
suppression chemicals and remove HCFCs and halons.
 Identify opportunities to incorporate recycled materials into
the building, such as beams and posts, flooring, paneling,
bricks, doors, frames, cabinetry, furniture, trim, etc
 Specify materials free from toxic chemicals and that do not
release toxic byproducts throughout their life cycle, and
avoid those toxins that are carcinogenic or bioaccumulative.
Key materials to avoid include mercury (switching
equipment), arsenic (pressure-treated wood), urea
formaldehyde (engineered wood), PVC (floors, wall
coverings, furniture, roof membranes, plumbing pipe,
electrical wire), and asbestos.
 Place air intakes away from vehicles and other such sources of
pollution to prevent indoor air contamination.
ENERGY SAVINGS
 Maximum use of natural light, solar energy and green power
can lead to plenty of energy being saved.
 Solar energy can also be used to produce thermal energy
which can further be used to produce electrical energy.
 construction of the building aligned at an angle to the sun .
 The major orientation of the building to face north and south
maximises use of natural light.
 Shades on the south side block unwanted direct sunlight
while reflecting light onto the ceiling of the interior.
 This in turn will lead to proper lighting, heating-cooling and
ventilation process of a hospital..
• Courtyards increase access to air movement and daylight.
Windows must be located in such a manner so as to ensure
ventilation, and increase access to natural light, which will
reduce heat.
• Green power like bio-gases, bio fuel and renewable sources of
energy should be used.
WATER AND WASTE MANAGEMENT
 Rainwater harvesting and storm-water management , to
conserve water efficiently. This method requires rain water to
run across terraces through clean pipes to storage tanks
where they are purified and then used.
 Sewage water is recycled for further use.
 Minimise wastewater by using ultra-low flush toilets, low-
flow showerheads, and other water conserving fixtures
 Waste can be effectively disposed through vermicomposting
or simple composting,.
 During construction, waste materials and debris can be
further re-used to built inland roads, pavements and gardens.
 .In the same manner, paramedical waste should be reused,
recycled and then disposed
MATERIALS
Hospitals should use
 PVC, VOC and arsenic-free material
 Digitalised devices , instead of mercury
counterparts.
 When disposing acids they should be diluted in
alkaline
 High Density Poly Ethylene (HDPE) products ,
for plumbing and roofing purposes.
 Concrete, the de-facto building material be
mixed with industrial by-products like Flyash,
cinder, stone dust, is an acceptable substitute.
• Powdered well-burnt brick , for water proofing roofs and in
outdoor pathways.
•
Biodegradable materials, especially for syringes, as they are
cheap and can be easily disposed.
• In a country like India, minimum glass should be put in the
east and west side since the maximum amount of heating
and cooling happens there leading to abnormal heating of
the building.
EXAMPLES
Thank you
COST ANALYSIS AFTER IMPLEMENTATION OF GREEN
ARCHITECTURE
 Green architecture promotes good environment and health.
It has also been found to aid in early recovery and shorter
hospital stays. Since the average stay of patients is reduced,
hospitals can expect an influx of patients, thus increasing
profits
 An upfront investment of two per cent in green building
design, on an average, results in lifecycle savings of 20 per
cent of the construction costs — more than ten times the
initial investment. The US Environmental Protection Agency
(USEPA) estimates that —a $4 investment (per square foot)
in green buildings nets a $58 benefit (per square feet) over 20
years
 Jehangir Hospital saved Rs 46.25 lakh with an investment of
mere Rs 27.95 lakh. The hospital through its innovative
strategies reduced electrical energy consumption by 12.66%,
water energy consumption by 53.9%, specific energy
consumption for air conditioning by 17.9% and lighting by
5.99%..
• Banner Health in Phoenix, saved nearly $1.5 million in 12
months from reprocessing operating room supplies such as
compression sleeves, open but unused devices, pulse
oximeters and more
 According to the survey, hospitals with a high dependence on
artificial lighting spent more than 3 times as compared to
hospitals depending on natural lighting systems. Hospitals
which have higher level of technology spend four times more
than those with basic technology infrastructure.
 Indian hospitals have also documented evidences on energy
conservation, reducing electricity utilization by 27 per cent
and saving up to Rs 40 lakh rupees per annum.
 The medical centres including the six All India Institute of
Medical Sciences (AIIMS) facilities coming up in the country
will implement ‘Green Architecture’ and ‘Green Engineering’
as an option to save the rising electricity consumption.
 Some of the other hospitals which are now taking on the
Green Design route are Breach Candy, Jaslok and Hinduja in
Mumbai; Batra Hospital in New Delhi., Kovai Medical Centre
and Hospital, Coimbatore, Fortis and Apollo