Hospital Design Principles - Revision history

VSadiki: /* Web sites */

2020-10-21T09:37:23Z

Web sites

← Older revision		Revision as of 11:37, 21 October 2020
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	*Carthey, J., Chow, V., Jung, Y.‐M. & Mills, S. 2009, Flexibility and Adaptability Report: An International Review for the NSW Context, Centre for Health Assets Australasia, UNSW, Sydney.		*Carthey, J., Chow, V., Jung, Y.‐M. & Mills, S. 2009, Flexibility and Adaptability Report: An International Review for the NSW Context, Centre for Health Assets Australasia, UNSW, Sydney.

	=Papers, articles=		==Papers, articles==
			

			

	=Web sites=		==Web sites==
	 HST.org.za, 2014 <u><nowiki>http://www.hst.org.za/publications/national-health-insurance-conferencereport-lessons-south-africa</nowiki> </u>		 HST.org.za, 2014 <u><nowiki>http://www.hst.org.za/publications/national-health-insurance-conferencereport-lessons-south-africa</nowiki> </u>

VSadiki at 09:35, 21 October 2020

2020-10-21T09:35:47Z

← Older revision		Revision as of 11:35, 21 October 2020
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	*Carthey, J., Chow, V., Jung, Y.‐M. & Mills, S. 2009, Flexibility and Adaptability Report: An International Review for the NSW Context, Centre for Health Assets Australasia, UNSW, Sydney.		*Carthey, J., Chow, V., Jung, Y.‐M. & Mills, S. 2009, Flexibility and Adaptability Report: An International Review for the NSW Context, Centre for Health Assets Australasia, UNSW, Sydney.

	==Papers, articles==		=Papers, articles=
			

			

	==Web sites==		=Web sites=
	 HST.org.za, 2014 <u><nowiki>http://www.hst.org.za/publications/national-health-insurance-conferencereport-lessons-south-africa</nowiki> </u>		 HST.org.za, 2014 <u><nowiki>http://www.hst.org.za/publications/national-health-insurance-conferencereport-lessons-south-africa</nowiki> </u>

VSadiki at 09:33, 21 October 2020

2020-10-21T09:33:55Z

← Older revision		Revision as of 11:33, 21 October 2020
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	==Web sites==		==Web sites==
	 HST.org.za, 2014 <nowiki>http://www.hst.org.za/publications/national-health-insurance-conferencereport-lessons-south-africa</nowiki>		 HST.org.za, 2014 <u><nowiki>http://www.hst.org.za/publications/national-health-insurance-conferencereport-lessons-south-africa</nowiki> </u>

VSadiki at 09:30, 21 October 2020

2020-10-21T09:30:35Z

← Older revision		Revision as of 11:30, 21 October 2020
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	Many of these documents are interrelated and in order to avoid duplication information is located primarily in the document related to the primary function. Cross reference is made to documents where topics common to more than one department or unit are covered in more detail. For example specific requirements for infection prevention and control (IPC) will be highlighted directly where applicable, such as in the surgery or out-patient services documents but as IPC is critical across all healthcare facilities, the subject covered more thoroughly and in more detail in the IPC document.		Many of these documents are interrelated and in order to avoid duplication information is located primarily in the document related to the primary function. Cross reference is made to documents where topics common to more than one department or unit are covered in more detail. For example specific requirements for infection prevention and control (IPC) will be highlighted directly where applicable, such as in the surgery or out-patient services documents but as IPC is critical across all healthcare facilities, the subject covered more thoroughly and in more detail in the IPC document.

	~~the tabke~~ below lists the full suite of documents and the key cross reference documents for the hospital design principles document.		The table below lists the full suite of documents and the key cross reference documents for the hospital design principles document.
	{\| class="wikitable"		{\| class="wikitable"
	\| colspan="2" \|'''A: CLINICAL'''		\| colspan="2" \|'''A: CLINICAL'''
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	The make-up of a particular facility depends on the defined service to be delivered as well as services provided from or shared with other related facilities (such as referred clinical services, breakdown and prepacking in the pharmacy for linked clinics or outsourcing laundry services). This must be defined in the project brief.		The make-up of a particular facility depends on the defined service to be delivered as well as services provided from or shared with other related facilities (such as referred clinical services, breakdown and prepacking in the pharmacy for linked clinics or outsourcing laundry services). This must be defined in the project brief.
	[[File:Health system performance framework.png\|thumb\|none]]		[[File:Health system performance framework.png\|thumb\|none\|360x360px\|Health system performance framework]]

	~~Figure 1: Health system performance framework~~		Healthcare facilities provide the environment through which healthcare services are delivered over the full life cycle of the asset. Facilities, usually with a life span of up to 50 years, are the most fixed component and therefore also potentially the most constraining aspect of the health care delivery system. Quality assets can positively enable the service; equally poor facilities can negatively impact service delivery. The more effectively the service is planned, defined and resourced the more likely that individual projects can be developed to provide an effective foil for service delivery. The better and more experienced the team deployed to a new or upgrade project, the more likely the resultant facility will be both enabling and resilient over time.

	Healthcare facilities provide the environment through which healthcare services are delivered over the full life cycle of the asset. Facilities, usually with a life span of up to 50 years, are the most fixed component and therefore also potentially the most constraining aspect of the health care delivery system. Quality assets can positively enable the service; equally poor facilities can negatively impact service delivery. The more effectively the service is planned, defined and resourced the more likely that individual projects can be developed to provide an effective foil for service delivery. The better and more experienced the team deployed to a new or upgrade project, the more likely the resultant facility will be both enabling and resilient over time.

	The context for service delivery for the specific facility that the professional team is tasked on, will be developed from the provincial Service Transformation Plan into the project brief.		The context for service delivery for the specific facility that the professional team is tasked on, will be developed from the provincial Service Transformation Plan into the project brief.
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	==Infrastructure planning context==		==Infrastructure planning context==
	All healthcare facilities go through a life cycle starting with strategic service and project planning through to eventual decommissioning and disposal. This is illustrated in figure xx below.		All healthcare facilities go through a life cycle starting with strategic service and project planning through to eventual decommissioning and disposal. This is illustrated in figure below.
	[[File:Healthcare life cycle.png\|thumb\|none\|462x462px]]		[[File:Healthcare life cycle.png\|thumb\|none\|462x462px\|Healthcare facility life cycle]]

	===Strategic planning===		===Strategic planning===
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	The classification of health care facilities and levels of care has been gazetted by the national Department of Health<sup><sup>[1]</sup></sup>. This shows types of facilities and levels of care. Some specialist services can however be provided at		The classification of health care facilities and levels of care has been gazetted by the national Department of Health<sup><sup>[1]</sup></sup>. This shows types of facilities and levels of care. Some specialist services can however be provided at

	Levels of care however are often shared across facility types as illustrated in figure xx below.		Levels of care however are often shared across facility types as illustrated in figure below.
	[[File:Facility classification vs levels of care.png\|thumb\|none\|462x462px]]		[[File:Facility classification vs levels of care.png\|thumb\|none\|462x462px\|Facility classification vs levels of care]]

	==Document scope==		==Document scope==
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	At a high level systems require four actions: input, throughput, output with a feedback loop as illustrated in figure xx below:		At a high level systems require four actions: input, throughput, output with a feedback loop as illustrated in figure xx below:
	[[File:System framework hospital.png\|thumb\|none\|440x440px]]		[[File:System framework hospital.png\|thumb\|none\|440x440px\|''Systems framework<sup>8</sup>'']]

	''~~Figure 3:~~ Systems framework<sup>8</sup>'' ~~Hospital systems include clinical~~

	Hospital support systems include:		Hospital support systems include:
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	<sup>7</sup> Derived from the Latin ''salus'' for health and the Greek ''genesis'' for origin.		<sup>7</sup> Derived from the Latin ''salus'' for health and the Greek ''genesis'' for origin.

	*<sup>8</sup> Adapted from Sullivan & Decker, 1998. ''Effective Leadership & Management in Nursing''.		<sup>8</sup> Adapted from Sullivan & Decker, 1998. ''Effective Leadership & Management in Nursing''.

	*Catering		*Catering
	*Laundry and linen		*Laundry and linen
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	Sound lifecycle based decisions – for both engineering systems and detailing and materials – can also significantly impact the facility maintenance and management costs through the lifecycle of the facility.		Sound lifecycle based decisions – for both engineering systems and detailing and materials – can also significantly impact the facility maintenance and management costs through the lifecycle of the facility.
	[[File:Cumulative total cost of service provision.png\|thumb\|none\|388x388px]]		[[File:Cumulative total cost of service provision.png\|thumb\|none\|388x388px\|Cumulative total cost of service provision ]]

	''~~'''Figure 4''':~~ Cumulative total cost of service provision highlighting the relationship between capital and operating costs over the life cycle of the asset as well as the critical importance of the initial decision making processes in the lead in to the project on the total cost of service delivery''		''Cumulative total cost of service provision highlighting the relationship between capital and operating costs over the life cycle of the asset as well as the critical importance of the initial decision making processes in the lead in to the project on the total cost of service delivery''

	==Lean design==		==Lean design==
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	As the hospital support or industrial zone will have heavy vehicle deliveries and is often a noisier area, it needs to be located away from other hospital clinical areas and be linked to a slip road off the main entrance. Direct deliveries are also made into a security cage linked directly to the pharmacy.		As the hospital support or industrial zone will have heavy vehicle deliveries and is often a noisier area, it needs to be located away from other hospital clinical areas and be linked to a slip road off the main entrance. Direct deliveries are also made into a security cage linked directly to the pharmacy.
	[[File:Typical district or regional hospital zoning and relationships diagram.png\|thumb\|none\|415x415px]]		[[File:Typical district or regional hospital zoning and relationships diagram.png\|thumb\|none\|415x415px\|Typical district/ regional hospital zoning and relationships diagram]]

	''~~Figure 5: Typical district/ regional hospital zoning and relationships diagram showing~~ primary links between departments and relative weighting of traffic volumes''		''Diagram above shows primary links between departments and relative weighting of traffic volumes''

	Space syntax/ SA ~~diag~~ of flow between departments Travel and circulation		Space syntax/ SA diagram of flow between departments Travel and circulation

	===Designing for expansion===		===Designing for expansion===
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	====Way finding orientation====		====Way finding orientation====
	'''Way-finding maps''' should be located at strategic points throughout the site and allow visitors to orientate themselves. The maps should be consistent with the signage and the typology needs to be clear and concise. Maps need to be located on all floors and be strategically placed at floor access nodes throughout the building. Figure 2 shows examples of such maps at Mitchells Plain Hospital.		'''Way-finding maps''' should be located at strategic points throughout the site and allow visitors to orientate themselves. The maps should be consistent with the signage and the typology needs to be clear and concise. Maps need to be located on all floors and be strategically placed at floor access nodes throughout the building. Figure below shows examples of such maps at Mitchells Plain Hospital.[[File:Way finding map at Mitchells Plain Hospital, Cape Town.png\|thumb\|none\|592x592px\|''Way finding map at Mitchells Plain Hospital, Cape Town'']]

	~~''Figure 6~~: Way finding map at Mitchells Plain Hospital, Cape Town''
	~~[[File:~~Way finding map at Mitchells Plain Hospital, Cape Town~~.png\|thumb\|none\|592x592px~~]]

	====Signage====		====Signage====
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	The use of pictograms in conjunction with written names is recommended. The health team at Western Cape Department of Transport and Public Works has developed a logical and clearly understood standardised set of pictograms for use in Western Cape Provincial healthcare facilities<sup><sup>[5]</sup></sup>		The use of pictograms in conjunction with written names is recommended. The health team at Western Cape Department of Transport and Public Works has developed a logical and clearly understood standardised set of pictograms for use in Western Cape Provincial healthcare facilities<sup><sup>[5]</sup></sup>

	Where possible signage should be done in an appropriate selection of the official languages of South Africa. In the Western Cape provincial policy is for signage to be in the 3 dominant languages, English, Afrikaans and isiXhosa. This three language option is more difficult to achieve in provinces where there are more than three dominant languages. Refer to local provincial policy.		Where possible signage should be done in an appropriate selection of the official languages of South Africa. In the Western Cape provincial policy is for signage to be in the 3 dominant languages, English, Afrikaans and isiXhosa. This three language option is more difficult to achieve in provinces where there are more than three dominant languages. Refer to local provincial policy.[[File:Example of mapping for hub and secondary destination points.png\|thumb\|none\|575x575px\|Signage from main entrance at Mitchells Plain Hospital showing directional arrows, colour pictograms, primary name and name translations and Example of mapping for hub and secondary destination points, respectively.]]

	~~''Figure 7~~: Signage from main entrance at Mitchells Plain Hospital showing directional arrows, colour pictograms, primary name and name translations''
	~~[[File:~~Example of mapping for hub and secondary destination points.~~png\|thumb\|none\|575x575px~~]]

	~~''Figure 8: Example of mapping for hub and secondary destination points''~~

	~~Further detailed guidelines and information on wayfinding and signage is also contained in Part D of the IUSS GNS document '''''Inclusive environments'''''.~~

			Further detailed guidelines and information on wayfinding and signage is also contained in Part D of the <u>IUSS GNS document '''''Inclusive environments'''''.</u>
	===Inclusive environments===		===Inclusive environments===

VSadiki at 08:25, 21 October 2020

2020-10-21T08:25:25Z

VSadiki at 08:23, 21 October 2020

2020-10-21T08:23:00Z

← Older revision		Revision as of 10:23, 21 October 2020
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	The make-up of a particular facility depends on the defined service to be delivered as well as services provided from or shared with other related facilities (such as referred clinical services, breakdown and prepacking in the pharmacy for linked clinics or outsourcing laundry services). This must be defined in the project brief.		The make-up of a particular facility depends on the defined service to be delivered as well as services provided from or shared with other related facilities (such as referred clinical services, breakdown and prepacking in the pharmacy for linked clinics or outsourcing laundry services). This must be defined in the project brief.
			[[File:Health system performance framework.png\|thumb\|none]]

	Figure 1: Health system performance framework		Figure 1: Health system performance framework

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	==Infrastructure planning context==		==Infrastructure planning context==
	All healthcare facilities go through a life cycle starting with strategic service and project planning through to eventual decommissioning and disposal. This is illustrated in figure xx below.		All healthcare facilities go through a life cycle starting with strategic service and project planning through to eventual decommissioning and disposal. This is illustrated in figure xx below.
			[[File:Healthcare life cycle.png\|thumb\|none]]

	===Strategic planning===		===Strategic planning===
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	Levels of care however are often shared across facility types as illustrated in figure xx below.		Levels of care however are often shared across facility types as illustrated in figure xx below.
			[[File:Facility classification vs levels of care.png\|thumb\|none]]

	==Document scope==		==Document scope==
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	At a high level systems require four actions: input, throughput, output with a feedback loop as illustrated in figure xx below:		At a high level systems require four actions: input, throughput, output with a feedback loop as illustrated in figure xx below:
			[[File:System framework hospital.png\|thumb\|none]]

	''Figure 3: Systems framework<sup>8</sup>'' Hospital systems include clinical		''Figure 3: Systems framework<sup>8</sup>'' Hospital systems include clinical
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	Sound lifecycle based decisions – for both engineering systems and detailing and materials – can also significantly impact the facility maintenance and management costs through the lifecycle of the facility.		Sound lifecycle based decisions – for both engineering systems and detailing and materials – can also significantly impact the facility maintenance and management costs through the lifecycle of the facility.
			[[File:Cumulative total cost of service provision.png\|thumb\|none]]

	'''''Figure 4''': Cumulative total cost of service provision highlighting the relationship between capital and operating costs over the life cycle of the asset as well as the critical importance of the initial decision making processes in the lead in to the project on the total cost of service delivery''		'''''Figure 4''': Cumulative total cost of service provision highlighting the relationship between capital and operating costs over the life cycle of the asset as well as the critical importance of the initial decision making processes in the lead in to the project on the total cost of service delivery''
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	As the hospital support or industrial zone will have heavy vehicle deliveries and is often a noisier area, it needs to be located away from other hospital clinical areas and be linked to a slip road off the main entrance. Direct deliveries are also made into a security cage linked directly to the pharmacy.		As the hospital support or industrial zone will have heavy vehicle deliveries and is often a noisier area, it needs to be located away from other hospital clinical areas and be linked to a slip road off the main entrance. Direct deliveries are also made into a security cage linked directly to the pharmacy.
			[[File:Typical district or regional hospital zoning and relationships diagram.png\|thumb\|none]]

	''Figure 5: Typical district/ regional hospital zoning and relationships diagram showing primary links between departments and relative weighting of traffic volumes''		''Figure 5: Typical district/ regional hospital zoning and relationships diagram showing primary links between departments and relative weighting of traffic volumes''
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	''Figure 6: Way finding map at Mitchells Plain Hospital, Cape Town''		''Figure 6: Way finding map at Mitchells Plain Hospital, Cape Town''
			[[File:Way finding map at Mitchells Plain Hospital, Cape Town.png\|thumb\|none]]

	====Signage====		====Signage====
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	''Figure 7: Signage from main entrance at Mitchells Plain Hospital showing directional arrows, colour pictograms, primary name and name translations''		''Figure 7: Signage from main entrance at Mitchells Plain Hospital showing directional arrows, colour pictograms, primary name and name translations''
			[[File:Example of mapping for hub and secondary destination points.png\|thumb\|none]]

	''Figure 8: Example of mapping for hub and secondary destination points''		''Figure 8: Example of mapping for hub and secondary destination points''

VSadiki at 08:08, 21 October 2020

2020-10-21T08:08:39Z

← Older revision		Revision as of 10:08, 21 October 2020
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	Many of these documents are interrelated and in order to avoid duplication information is located primarily in the document related to the primary function. Cross reference is made to documents where topics common to more than one department or unit are covered in more detail. For example specific requirements for infection prevention and control (IPC) will be highlighted directly where applicable, such as in the surgery or out-patient services documents but as IPC is critical across all healthcare facilities, the subject covered more thoroughly and in more detail in the IPC document.		Many of these documents are interrelated and in order to avoid duplication information is located primarily in the document related to the primary function. Cross reference is made to documents where topics common to more than one department or unit are covered in more detail. For example specific requirements for infection prevention and control (IPC) will be highlighted directly where applicable, such as in the surgery or out-patient services documents but as IPC is critical across all healthcare facilities, the subject covered more thoroughly and in more detail in the IPC document.

	~~Table 1~~ below lists the full suite of documents and the key cross reference documents for the hospital design principles document.		the tabke below lists the full suite of documents and the key cross reference documents for the hospital design principles document.
	{\| class="wikitable"		{\| class="wikitable"
	\| colspan="2" \|'''A: CLINICAL'''		\| colspan="2" \|'''A: CLINICAL'''
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	\|		\|
	\|}		\|}
	~~Table 1:~~ IUSS guidelines and interdependencies		IUSS guidelines and interdependencies table

	This document outlines the policy and service context for a hospital project as well as providing detailed requirements and context for planning and design decisions that need to be considered during the development process. The document is divided into 3 main sections:		This document outlines the policy and service context for a hospital project as well as providing detailed requirements and context for planning and design decisions that need to be considered during the development process. The document is divided into 3 main sections:
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	The primary function of a health care system is to deliver services that will contribute towards the health and wellbeing of the community served. Facilities are part of the healthcare service system and require a set of allocated resources – including people, buildings, equipment drugs and supplies to operate effectively. The ability of the system to operate depends equally on the quality and effectiveness of the stewardship and oversight and on available and allocated funding.		The primary function of a health care system is to deliver services that will contribute towards the health and wellbeing of the community served. Facilities are part of the healthcare service system and require a set of allocated resources – including people, buildings, equipment drugs and supplies to operate effectively. The ability of the system to operate depends equally on the quality and effectiveness of the stewardship and oversight and on available and allocated funding.

	The make-up of a particular facility depends on the defined service to be delivered as well as services provided from or shared with other related facilities (such as referred clinical services, breakdown and prepacking in the pharmacy for linked clinics or outsourcing laundry services). This must be defined in the project brief.		The make-up of a particular facility depends on the defined service to be delivered as well as services provided from or shared with other related facilities (such as referred clinical services, breakdown and prepacking in the pharmacy for linked clinics or outsourcing laundry services). This must be defined in the project brief.

	Figure 1: Health system performance framework		Figure 1: Health system performance framework
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	Suitability		Suitability

	Site selection		Site selection <br />
	<br />

	====Site selection criteria====		====Site selection criteria====

VSadiki at 07:48, 21 October 2020

2020-10-21T07:48:27Z

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VSadiki at 14:22, 19 October 2020

2020-10-19T14:22:21Z

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VSadiki at 13:55, 19 October 2020

2020-10-19T13:55:28Z

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← Older revision		Revision as of 10:25, 21 October 2020
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	==Infrastructure planning context==		==Infrastructure planning context==
	All healthcare facilities go through a life cycle starting with strategic service and project planning through to eventual decommissioning and disposal. This is illustrated in figure xx below.		All healthcare facilities go through a life cycle starting with strategic service and project planning through to eventual decommissioning and disposal. This is illustrated in figure xx below.
	[[File:Healthcare life cycle.png\|thumb\|none]]		[[File:Healthcare life cycle.png\|thumb\|none\|462x462px]]

	===Strategic planning===		===Strategic planning===
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	Levels of care however are often shared across facility types as illustrated in figure xx below.		Levels of care however are often shared across facility types as illustrated in figure xx below.
	[[File:Facility classification vs levels of care.png\|thumb\|none]]		[[File:Facility classification vs levels of care.png\|thumb\|none\|462x462px]]

	==Document scope==		==Document scope==
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	At a high level systems require four actions: input, throughput, output with a feedback loop as illustrated in figure xx below:		At a high level systems require four actions: input, throughput, output with a feedback loop as illustrated in figure xx below:
	[[File:System framework hospital.png\|thumb\|none]]		[[File:System framework hospital.png\|thumb\|none\|440x440px]]

	''Figure 3: Systems framework<sup>8</sup>'' Hospital systems include clinical		''Figure 3: Systems framework<sup>8</sup>'' Hospital systems include clinical
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	Sound lifecycle based decisions – for both engineering systems and detailing and materials – can also significantly impact the facility maintenance and management costs through the lifecycle of the facility.		Sound lifecycle based decisions – for both engineering systems and detailing and materials – can also significantly impact the facility maintenance and management costs through the lifecycle of the facility.
	[[File:Cumulative total cost of service provision.png\|thumb\|none]]		[[File:Cumulative total cost of service provision.png\|thumb\|none\|388x388px]]

	'''''Figure 4''': Cumulative total cost of service provision highlighting the relationship between capital and operating costs over the life cycle of the asset as well as the critical importance of the initial decision making processes in the lead in to the project on the total cost of service delivery''		'''''Figure 4''': Cumulative total cost of service provision highlighting the relationship between capital and operating costs over the life cycle of the asset as well as the critical importance of the initial decision making processes in the lead in to the project on the total cost of service delivery''
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	As the hospital support or industrial zone will have heavy vehicle deliveries and is often a noisier area, it needs to be located away from other hospital clinical areas and be linked to a slip road off the main entrance. Direct deliveries are also made into a security cage linked directly to the pharmacy.		As the hospital support or industrial zone will have heavy vehicle deliveries and is often a noisier area, it needs to be located away from other hospital clinical areas and be linked to a slip road off the main entrance. Direct deliveries are also made into a security cage linked directly to the pharmacy.
	[[File:Typical district or regional hospital zoning and relationships diagram.png\|thumb\|none]]		[[File:Typical district or regional hospital zoning and relationships diagram.png\|thumb\|none\|415x415px]]

	''Figure 5: Typical district/ regional hospital zoning and relationships diagram showing primary links between departments and relative weighting of traffic volumes''		''Figure 5: Typical district/ regional hospital zoning and relationships diagram showing primary links between departments and relative weighting of traffic volumes''
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	''Figure 6: Way finding map at Mitchells Plain Hospital, Cape Town''		''Figure 6: Way finding map at Mitchells Plain Hospital, Cape Town''
	[[File:Way finding map at Mitchells Plain Hospital, Cape Town.png\|thumb\|none]]		[[File:Way finding map at Mitchells Plain Hospital, Cape Town.png\|thumb\|none\|592x592px]]

	====Signage====		====Signage====
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	''Figure 7: Signage from main entrance at Mitchells Plain Hospital showing directional arrows, colour pictograms, primary name and name translations''		''Figure 7: Signage from main entrance at Mitchells Plain Hospital showing directional arrows, colour pictograms, primary name and name translations''
	[[File:Example of mapping for hub and secondary destination points.png\|thumb\|none]]		[[File:Example of mapping for hub and secondary destination points.png\|thumb\|none\|575x575px]]

	''Figure 8: Example of mapping for hub and secondary destination points''		''Figure 8: Example of mapping for hub and secondary destination points''