HOSPITAL

DESIGN
PROJECT
CARDIAC SPECIALITY HOSPITAL
INTRODUCTION TO HOSPITAL
Hospital, an institution that is built, staffed, and equipped for
the diagnosis of disease
INTRODUCTION TO HOSPITAL DESIGN
WHAT IS HOSPITAL?

Hospital, an institution that is built, staffed, and equipped for

the diagnosis of disease; for the treatment , both medical and surgical, of the
sick and the injured; and for their housing during this process.

“a hospital is a residential establishment which provides short-term or long-term

medical care consisting of observational, diagnostic, therapeutic and
rehabilitative services for persons suffering from a disease or injury. It may or
may not also provide ambulatory patients on an out-patient basis”.
FUNCTION OF THE DEPARTMENTS IN
HOSPITAL THE HOSPITAL
1. Emergency Department
 Patient care
2. Out Patient Department
 Diagnosis and treatment of
disease (OPD)

 Out patient services 3. In Patient Department ( IPD)

 Medical education and 4. Diagnostic Department

training 5. Intensive Care Unit ( ICU)
 Medical and nursing research 6. Operation Theater (OT)
 Prevention of disease and 7. Admin Block
promotion of health
8. Supporting Services Block/
Store/ Workshops
9. Residential Areas
10. Parking/ Landscaping
RELATIONSHIP DIAGRAM OF DEPARTMENTS
 CLASSIFICATION OF HOSPITAL
PRIMARY HOSPITALS:
• CONTAINS LESS THAN TERTIARY
100 BEDS HOSPITALS:
• PROVIDE MINIMAL • NATIONAL OR
HEALTH CARE,REHABILIT SECONDARY HOSPITALS: PROVINCIAL LEVEL
ATION SERVICES. HOSPITAL
• MORE THAN 100 , LESS THAN
• INCLUDE FAMILY PYSICI 500 • BED CAPACITY
ANS, PHYSIOTHERAPIST. EXCEEDING 500
• COMPLETE
• MEDICAL OFFICE, STAFF HEALTH SERVICE, MEDICAL • PROVIDE SPECIALIST
NURSE AND PHRMACY. EDUCATION HEALTH
SERVICE, MEDICAL
• INCLUDES
CARDIOLOGISTS, UROLOGI EDUCATION AND
STS AND OTHER SCIENTIFIC
RESEARCH
• ACUTE CARE, SHORT
PERIOD STAY • OFFER FACILITIES
• EXAMPLE: DISTRICT
HOSPITAL OR CUMMUNITY
HOSPITAL
 CLASSIFICATION OF HOSPITAL
BASED ON BASED ON LENGTH
OWNERSHIP: OF STAY:
• GOVERNMENT • LONG-TERM OR
HOSPITAL LONG STAY HOSPITAL
(PUBLIC HEALTH HOSPITAL) BASED ON (MORE THEN 30 DAYS)
• PRIVATE HOSPITAL SERVICES: • SHORT-TERM OR
• CORPORATION • GENERAL HOSPITAL SHORT STAY
(DISTRICT HOSPITAL)
HOSPITAL HOSPITAL
• SPECIAL HOSPITAL
(PROFITABLE , NON-PROFITABLE
(MEDICAL COLLEGE, CANCER,
(LESS THEN 30 DAYS)
OR PARTNERSHIP HOSPITAL) CHILDREN, CARDIC ETC)
• TEACHING AND
RESEARCH
HOSPITAL
(INSTITUTION, TRAINING CENTER)
ORGANIZATION OF HOSPITAL

Organization is defined as
“a dynamic process” in
which various management
activities bring and bind
people together, for
the Achievement Of
Common Goals And
Objectives.

Multiple layers of
accountability in order to
function.
Hospital employees know
their own responsibilities.
 ORGANIZATION OF HOSPITAL SERVICES

1.CLINICAL SERVICES
1. OPD
2. MANGAEMENT
3. EMERGENCY
4. SERVICES 2.DIAGNOSTIC
5. ICU SERVICES
6. SAFETY 1. Pathology
7. IPD 2. Radiology
8. OT 3. Blood Bank
9. NURSING UNIT 4. Pharmacy
3.UTILITIES SERVICES 4.ADMINISTRATION
10. WARDS 5. Laboratory
1. CSSD 1. Finance
2. Laundry 2. Engineering
3. Dietry Service 3. Management
4. Medical Record 4. Security
5. Mortury Service 5. Transport Services
SPECIALITY HOSPITAL
CARDIAC SPECIALITY HOSPITAL
 Rate of
Heart
LITERATURE REVIEW Diseases
(per 100,000
 heart attacks happen a year population)
 In the United States, someone has a heart attack World 485
every 40 seconds. Every year, about 805,000 people
in the United States have a heart attack. Pakistan 526
 Rate of heart attack in Pakistan:
 According to the most recent WHO data on the heart
attack ratio in Pakistan, 240,720 people died from
coronary heart disease in Pakistan in 2020,
accounting for 16.49 percent of all fatalities. Pakistan
is ranked #30 in the world with a death rate of 193.56
per 100,000 people.
 Heart patient with respect to age:
 Young adults between the ages of 30 and 40 are
developing hypertension (high blood pressure) which
can become the cause of heart attack. Smoking and
tobacco use is on the rise in Pakistan, and this is
leading to a high incidence of heart attacks among
younger citizens.
 LITERATURE REVIEW

Rates of Heart Diseases

Risk increases with age. CVDs are more common in individuals over
Age
50 years old.

CVDs are more common in men than in women. However, after

Sex
menopause, women's risk increases.

CVDs are more common in people with lower socio-economic status

Socio-economic status due to factors such as poor diet, lack of physical activity, and limited
access to healthcare.

CVDs are more common in developed countries due to factors such

as higher rates of obesity, diabetes, and tobacco use. However,
Geographical location CVDs are also prevalent in low- and middle-income countries, where
risk factors such as poor diet, physical inactivity, and tobacco use are
increasing
LITERATURE REVIEW
 Some well known cardiac hospital in Pakistan :
• Pervez elahi institute of cardiology – Wazirabad
• Punjab Institute of Cardiology (PIC) - Lahore
• Armed Forces Institute of Cardiology (AFIC) - Rawalpindi
• National Institute of Heart Diseases (NIHD) - Rawalpindi
• Shifa International Hospital - Islamabad
• Aga Khan University Hospital (AKUH) - Karachi
• Liaquat National Hospital - Karachi
• Institute of Cardiology - Peshawar
• Institute of Cardiovascular Diseases (ICVD) - Multan
• Punjab Cardiology Institute – Faisalabad
• National Institute of Cardiovascular Diseases (NICVD) - Karachi
CARDIAC SPECIALITY HOSPITAL

 A heart hospital is a hospital that

specializes on the diagnosis and
treatment of heart disease.
 It can be free standing hospital or
a section of a large hospital.
 Provide specialized treatment and
staffed with trained medical
cardiac care.
 In many hospitals, CCUs treat a
growing number of patients who,
in addition to cardiovascular
disease.
 The nurses and doctors work in
these areas.
ANATOMY OF HEART
ANATOMY OF HEART
ANATOMY OF HEART
 The heart is a muscular organ that pumps blood throughout the body. It has four
chambers: the right atrium, the right ventricle, the left atrium, and the left ventricle.
The chambers are separated by valves that regulate the flow of blood through the
heart. Here are the functions of each part of the heart:
1. Right atrium: The right atrium is the upper chamber of the heart that receives
deoxygenated blood from the body through the superior and inferior vena cava. The
blood then flows through the tricuspid valve into the right ventricle.
2. Right ventricle: The right ventricle is the lower chamber of the heart that pumps the
deoxygenated blood to the lungs through the pulmonary artery. The pulmonary valve
regulates the flow of blood between the right ventricle and the pulmonary artery.
3. Left atrium: The left atrium is the upper chamber of the heart that receives
oxygenated blood from the lungs through the pulmonary veins. The blood then flows
through the mitral valve into the left ventricle.
4. Left ventricle: The left ventricle is the lower chamber of the heart that pumps the
oxygenated blood to the body through the aorta. The aortic valve regulates the flow
of blood between the left ventricle and the aorta.
 Surgical/No
Disease n-surgical Description Symptoms Rate Age group Hospital space
Non- Headaches, dizziness, shortness of
Hypertension surgical High blood pressure breath 29% Adults Cardiology clinic
Non- Fluttering in chest, slow or fast
Arrhythmia surgical Irregular heartbeat heartbeat 6% Adults Cardiac care unit

Cardiac
Coronary artery Build-up of plaque in arteries Chest pain, shortness of breath, catheterization lab,
disease Surgical that supply blood to the heart fatigue 10% Adults cardiac surgery unit

Cardiac
Valvular heart Damage or defect in one of the Adults and catheterization lab,
disease Surgical heart's valves Chest pain, fatigue, dizziness 3% older adults cardiac surgery unit

Non- Heart cannot pump enough Shortness of breath, fatigue, swelling in Heart failure clinic,
Heart failure surgical blood to meet the body's needs legs and ankles 9% Older adults heart transplant unit

Congenital Structural defects present from Cyanosis, shortness of breath, poor Infants and Pediatric cardiac
heart disease Surgical birth weight gain 1% children care unit
Vascular lab,
Peripheral artery Non- Build-up of plaque in arteries Leg pain or cramping, poor wound Adults and interventional
disease surgical outside the heart, usually in legs healing 18% older adults radiology suite

Sudden weakness or numbness in

Non- Interruption of blood supply to face, arms, or legs, trouble speaking or
Stroke surgical the brain understanding speech 8% Older adultsStroke unit

Cardiac
Ballooning of the aorta, the Deep, constant pain in abdomen or Adults and catheterization lab,
Aortic aneurysm Surgical largest artery in the body back 1% older adults cardiac surgery unit
CARDIAC
DEPARTMENTS
 CARDIAC DEPARTMENTS
 The Cardiac Department Consist Of These Major
Units:
1. Emergency Unit
2. Out Patient Service Unit (OPD)
3. Inpatient Department (IPD)
4. Cardiac Diagnostic Unit
5. Cardiac Angiography Suite
6. Coronary Care Unit (CCU)
7. Cardiac Operation Theater (OT)
8. Cardiac High Dependency Unit (HDU)
9. Ancillary Department
10.Administration And Services
 EMERGENCY UNIT
• Emergency ward or casualty EMERGENCY UNIT SPACES:
department, is a medical
treatment facility specializing in 1. Triage area
emergency medicine, the acute 2. Examination rooms
care of patients who present 3. Cardiac monitoring area
without prior appointment; either
by their own means or by that of 4. Resuscitation Room
an ambulance. 5. Treatment rooms
• CARDIC EMERGENCY AND CARDIC 6. Observation areas
CARE UNIT (CCU) 7. Reception
• Patients with cardiac emergencies 8. Staff room
are assessed, treated and 9. Toilets
disposed of in Cardiac emergency
unit and Cardiac care unit.
• Heart emergencies include:
1. a heart attack.
2. a sudden cardiac arrest or
SCA (sometimes called out-of-
hospital cardiac arrest - or OCHA)
3. an angina attack or unstable
angina.
 Triage

EMERGENCY UNIT SPACES

area

1. Triage area (where patients are initially assessed to determine the Examination
rooms
severity of their condition and prioritize treatment.)
2. Examination rooms (detailed evaluation of patients, physical
examinations, order diagnostic tests, and initiate appropriate Cardiac
treatment.) monitoring
area
3. Cardiac monitoring area (This area is equipped with monitoring
equipment such as electrocardiography (ECG) machines, which
allow continuous monitoring of patients' heart rhythms.)
Resuscitation
4. Resuscitation Room (Also known as a "code room”) handles Room
cardiac arrests and other life-threatening emergencies. equipment,
including defibrillators and medications.)
5. Treatment rooms (administering medications, starting intravenous Treatment
rooms
(IV) lines, and providing initial treatment for cardiac emergencies.)
6. Observation areas (After initial stabilization, some patients may be
placed in an observation area where they can be closely monitored
Observation
to ensure their condition remains stable or improves.) areas
Out Patient Service Unit (OPD)
 Out Patient Department (OPD) is the
busiest department among all
cardiac hospitals in the country.
 OPD is a part of the hospital with
allotted physical facilities and
medical and other staff, with regularly
scheduled hours, to provide care for
patients who are not registered as
inpatients.
 A hospital department where
patients receive diagnosis and/ or
treatment but do not stay overnight.

OPD SPACES INCLUDE:

- Consultant rooms - Doctor’s Lounge
- Patient examination room - Report delivery
- Procedure room - Appointment & OPD cash counter
- Sample collection room - OPD Pharmacy
- Electrocardiography (ECG) room - Patient waiting
Out Patient Service Unit Spaces
 Reception and Waiting Area:
initial point of contact for patients check-in, provide the
necessary paperwork and wait for their appointments. It
may include seating areas, registration desks, and
administrative staff.
 Examination Rooms:
designed for outpatient consultations, patients meet with
cardiologists, nurses, and other healthcare professionals to
discuss their cardiac condition, Examination Rooms:

undergo physical examinations, review test results, and

receive treatment recommendations.
 Diagnostic Testing Areas:
diagnostic tests which may include electrocardiography
(ECG), echocardiography, stress tests, Holter monitoring,
and other cardiac imaging procedures. Diagnostic Testing Areas:
 Out Patient Service Unit Spaces
 Procedure Rooms:
cardiac interventions can be performed without the need
for hospital admission. Examples include cardiac
catheterizations, pacemaker implantations, and certain
electrophysiological studies.
Procedure Rooms:
 Consultation Rooms:
used for in-depth discussions between patients and
healthcare providers. They provide a private and
comfortable space for patients to ask questions, discuss
treatment options, and receive education regarding their
cardiac condition.
 Education and Rehabilitation Spaces: Consultation Rooms:
educational programs and rehabilitation services for
cardiac patients. These spaces could include classrooms or
group meeting areas where patients can learn about
heart-healthy lifestyles, receive counseling, participate in
exercise programs, and engage in cardiac rehabilitation.
Education and Rehabilitation Spaces:
 IN PATIENT DEPARTMENT
 Indoor Patients Department (IPD) refers to the
areas of the hospital where patients areIN PATIENT UNIT SPACES:
accommodated after being admitted, based1. Patient Rooms
on the doctor's/specialist's assessment, from the2. Nursing Stations
Out-Patient Department, Emergency Services,3. Telemetry Monitoring Area
and Ambulatory Care. 4. Procedure Rooms
5. Consultation Rooms
6. Patient Lounge or Dayroom
7. Nutrition Services
8. Support Services
 IN PATIENT DEPARTMENT
 Patient Rooms
cardiac patients are admitted for care and recovery. Patient Rooms
These rooms are equipped with beds, vital sign monitors,
cardiac monitoring systems, and other necessary
medical equipment.
 Nursing Stations
where nurses and other healthcare professionals monitor
and coordinate patient care.
 Telemetry Monitoring Area Nursing Stations
where patients' cardiac rhythms are continuously
monitored. These areas typically have a central
monitoring system displaying real-time information from
multiple patients, allowing healthcare providers to closely
observe any changes or abnormalities in cardiac
function.
Telemetry Monitoring Area
 Operation theatre/ procedure room
equipped with specialized equipment and instruments
necessary for procedures such as central line placement,
bedside echocardiography, or minor cardiac
interventions.
procedure room
IN PATIENT DEPARTMENT
 Consultation Rooms
 Patient Lounge or Dayroom
Some inpatient departments may have a patient Consultation Rooms
lounge or dayroom where patients can relax,
socialize, or engage in recreational activities.
These spaces offer a break from the patient rooms
and provide opportunities for interaction with
other patients or visitors.
 Nutrition Services Patient Lounge or Dayroom
This area may include a nutrition station or
kitchenette where specialized diets or nutritional
interventions can be prepared and provided to
patients.
 Support Services
support services available, such as social work, Nutrition Services
chaplaincy, or patient advocacy. These services
offer emotional support, counseling, spiritual
guidance, and assistance with navigating
healthcare resources and support systems.

Support Services
CARDIAC DIAGNOSTIC UNIT
 The diagnostic unit supports general
diagnostic services such as orthopedic 1. CARDIAC DIGNOSTIC UNIT
diagnostics, TB screening and a wide SPACES:
range of lab tests. The patients enter the 2. Reception and waiting area
mobile diagnostic unit in the waiting 3. Consultation Rooms
area/small office that gives access to the 4. CARDIOGRAPHY/ RADIOLOGY
X-ray room and the lab area. 5. Electrocardiography (ECG) Room
6. Echocardiography Room
7. Nuclear Cardiography
8. Stress Testing Area
9. Holter Monitoring Room
10. Cardiac Catheterization Lab
11. Cardiac CT
12. Cardiac MRI
13. Waiting Areas
14. Reporting and Review Areas
15. Electrophysiology (EP) laboratory
16. Operating Room
17. Recovery Room
18. Cardiac Rehabilitation Room
 CARDIOGRAPHY
 Cardiography is the process of recording the electrical activity of the heart.

Type of Cardiography Use

Electrocardiography (ECG) To assess heart rhythm or detect heart attacks.
To diagnose and monitor heart conditions such as valvular heart disease, congenital heart disease, and
Echocardiography
cardiomyopathy.
To diagnose and monitor heart conditions such as coronary artery disease, heart failure, and congenital
Cardiac MRI
heart disease.

Holter Monitoring To detect arrhythmias or other heart conditions that may not be captured during a standard ECG.

Event Monitoring To diagnose arrhythmias or other heart conditions that may be related to specific symptoms.

Stress/Exercise ECG To evaluate for signs of coronary artery disease and assess exercise tolerance.

Transesophageal To produce more detailed images of the heart using a specialized probe passed through the esophagus
Echocardiography to diagnose and monitor heart conditions such as valvular heart disease and congenital heart disease.

Magnetic Resonance To produce detailed images of the heart and blood vessels using a powerful magnetic field and radio
Angiography waves to diagnose and monitor heart conditions such as coronary artery disease and heart failure.

To produce detailed images of the heart and blood vessels using X-rays and a contrast dye to diagnose
Cardiac CT
and monitor heart conditions such as coronary artery disease and heart failure.
DIAGNOSTIC UNIT
ELECTRO CARDIOGRAPHY (ECG)
Electrocardiography
(ECG)
A non-invasive diagnostic tool used to record the
electrical activity of the heart. An ECG can help
Use
diagnose heart conditions such as arrhythmias, heart
attacks, and other abnormalities.

The patient lies down while electrodes are attached

to their chest, arms, and legs. The electrodes are
Procedure connected to an ECG machine, which records the
electrical activity of the heart. The procedure is
painless and takes about 5-10 minutes to complete.

The ECG tracing is analyzed by a healthcare

provider to identify any abnormalities or irregularities
Interpretation in the heart's electrical activity. The results are often
compared to a standard ECG tracing to help
diagnose specific heart conditions
 ELECTRO CARDIGRAPHY (ECG)
Condition Use of ECG
Helps identify the type of arrhythmia
Arrhythmias
and its severity.

Helps diagnose atrial fibrillation and

Atrial fibrillation
monitor its treatment.

Can help diagnose a heart attack and

Heart attack
determine its severity.

Can help detect coronary artery

Coronary artery disease
disease and monitor its progression.

Can help diagnose heart failure and

Heart failure
monitor its treatment. MACHINE
Can help identify structural
Structural abnormalities abnormalities in the heart, such as
hypertrophy or congenital defects.

Can help identify the cause of syncope,

Syncope (fainting) including arrhythmias or other heart-
related conditions ECG REPORT
ECG ROOM
 It's a common and painless test used to quickly detect heart problems and
monitor your heart's health. Electrocardiograms — also called ECGs or EKGs
— are often done in a doctor's office, a clinic or a hospital room.
 ECHOCARDIOGRAPHY ROOM (ECHO)
Echocardiography

A non-invasive diagnostic tool used to produce images of the heart and its
Use structures. An echocardiogram can help diagnose heart conditions such as
valvular heart disease, congenital heart disease, and cardiomyopathy.

A transducer is placed on the chest to produce high-frequency sound waves

that create images of the heart and its structures. The procedure is painless and
Procedure takes about 30-60 minutes to complete. In some cases, a specialized probe is
passed through the esophagus to produce more detailed images
(transesophageal echocardiography).

The echocardiogram is analyzed by a healthcare provider to identify any

abnormalities or irregularities in the heart's structure or function. The results are
Interpretation
often compared to previous echocardiograms to monitor changes in the heart
over time
ECHOCARDIOGRAPHY ROOM (ECHO)

MACHINE

TRANSDUCER
At the core of each echo machine is
this piezoelectric crystal transducer.
When varying voltages applied to the
crystals, it vibrate and transmits
ultrasound. REPORT
 NUCLEAR CARDIOGRAPHY
 Nuclear cardiology is a branch of cardiology
that uses non-invasive imaging techniques to
diagnose and manage cardiovascular disease.
It involves the use of small amounts of
radioactive materials called radiotracers, which
are injected into the patient's bloodstream and
then tracked as they travel through the heart
and blood vessels.
 There are several types of nuclear cardiology
tests, including:
• Myocardial perfusion imaging (MPI), which
evaluates blood flow to the heart muscle
• Positron emission tomography (PET), which can
provide information about heart function and
metabolism
• Single photon emission computed tomography
(SPECT), which is commonly used to diagnose
coronary artery disease
 STRESS TESTING
Stress Test Definition Procedure Use

The patient walks on a treadmill or

pedals a stationary bicycle while
To diagnose coronary artery
A test that evaluates the heart's connected to an ECG machine
disease, assess exercise tolerance,
Exercise Stress Test response to physical activity and that records the heart's electrical
and evaluate the effectiveness of
stress. activity. The intensity of the
treatments for heart conditions.
exercise is gradually increased to
evaluate the heart's response.

The patient is given medication

such as adenosine, dipyridamole,
or dobutamine to increase blood To diagnose coronary artery
A test that evaluates the heart's
flow to the heart and simulate the disease, assess exercise tolerance,
Pharmacological Stress Test response to medication that
effects of exercise. The patient is and evaluate the effectiveness of
simulates the effects of exercise.
connected to an ECG machine treatments for heart conditions.
that records the heart's electrical
activity.

The patient walks on a treadmill or

pedals a stationary bicycle while
connected to equipment that
To diagnose and monitor heart
measures oxygen consumption,
A test that evaluates the heart and lung conditions, assess
carbon dioxide production, and
Cardiopulmonary Stress Test and lungs' response to physical exercise tolerance, and evaluate
other indicators of
activity and stress. the effectiveness of treatments for
cardiopulmonary function. The
heart and lung conditions
intensity of the exercise is
gradually increased to evaluate
the heart and lungs' response.
STRESS TESTS ETT (Exercise Tolerance Testing)
Category Description
To evaluate the heart's response to
Purpose physical activity

Patient exercises on a treadmill or

stationary bike while being monitored
for changes in heart rate, blood
Procedure pressure, and other vital signs

Suspected coronary artery disease,

Indications arrhythmias, heart valve problems

Acute myocardial infarction,

unstable angina, uncontrolled heart
Contraindications failure, severe hypertension

Cardiac arrhythmias, myocardial

Risks infarction, chest pain, hypotension
Patient should avoid eating, drinking,
or smoking for at least 2 hours prior to
Preparation the test
Duration Typically takes 10-15 minutes
 CARDIAC MRI
 Cardiac MRI (magnetic resonance imaging) is
a non-invasive diagnostic test that uses
powerful magnets and radio waves to produce
detailed images of the heart's structure and
function.
 It provides a comprehensive evaluation of the
heart, including the size, shape, and function of
its chambers and valves, as well as the flow of
blood through the heart and blood vessels.
 PROCEDURE: During a cardiac MRI, the patient
lies inside a large, tube-like machine that
creates a strong magnetic field. The magnetic
field causes the atoms in the patient's body to
emit signals that are detected by a computer
and used to create detailed images of the
heart.
 USE: It is used to diagnose and evaluate a
variety of heart conditions, including coronary
artery disease, heart valve disease, and
congenital heart defects. It can also be used
to monitor the effectiveness of treatments for
these conditions.
The magnetic resonance
imaging (MRI) scanner
CARDIAC MRI LAYOUT
 CARDIAC CT
 Cardiac CT, or Cardiac Computed
Tomography, is a non-invasive imaging test
that uses X-rays and advanced computer
technology to produce detailed images of
the heart and surrounding blood vessels.
 USE: It can be used to diagnose and
evaluate various heart conditions, including
coronary artery disease, heart valve
problems, and congenital heart defects.
 PROCEDURE: During a Cardiac CT, the
patient lies on a table that slides into a
large, donut-shaped machine. The
machine takes multiple X-ray images of the
heart and blood vessels from different
angles. A computer then combines these
images to create detailed, 3D images of
the heart and surrounding structures.
DIFFERENCE B/W CARDIAC MRI AND CARDIAC CT
Cardiac MRI Cardiac CT

Uses strong magnetic fields and radio waves to Uses X-rays and advanced computer technology to
produce detailed images of the heart and surrounding produce detailed images of the heart and surrounding
blood vessels blood vessels

Does not expose the patient to ionizing radiation Involves exposure to ionizing radiation

Can be used to evaluate heart function and blood

Can be used to diagnose and evaluate various heart
flow, as well as diagnose and evaluate various heart
conditions, including coronary artery disease, heart
conditions, including heart disease, heart failure, and
valve problems, and congenital heart defects
congenital heart defects

May require the use of a contrast agent to produce May require the use of a contrast agent to produce
clearer images of the heart and blood vessels clearer images of the heart and blood vessels

Typically takes longer to complete (30-60 minutes) Typically takes less time to complete (10-15 minutes)

May not be suitable for patients with certain medical May not be suitable for patients with severe kidney
devices, such as pacemakers or cochlear implants disease or allergies to contrast agents

May be more expensive than Cardiac CT May be less expensive than Cardiac MR
HOLTER MONITORING
 In medicine, a Holter monitor (often
simply Holter) is a type of ambulatory
electrocardiography device, a portable
device for cardiac monitoring (the
monitoring of the electrical activity of
the cardiovascular system) for at least
24 to 72 hours (often for two weeks at a
time).
 Holter monitoring is used to help
diagnose a variety of heart-related
conditions, including:
• Irregular heart rhythms
• Chest pain or discomfort
• Shortness of breath
• Fainting or lightheadedness
• Palpitations or skipped beats
 ELECTROPHYSIOLOGY LABORATORY (EP)
Topic Information

A subspecialty of cardiology focused on

Definition
the electrical activity of the heart

Arrhythmias, including atrial fibrillation

Disorders
(AFib), supraventricular tachycardia
evaluated and
(SVT), ventricular tachycardia (VT), and
treated
bradycardia

Use of special catheters to record

Diagnostic tests
electrical activity of the heart

Medication, lifestyle modifications,

Treatments ablation, pacemaker implantation,
defibrillator implantation

Electrophysiologists, who are cardiologists

Specialists with specialized training in
electrophysiology
 CARDIAC CATHERIZATION LAB
Term Definition
Cardiac A specialized medical facility that uses imaging
catheterization equipment to examine the heart and its blood
lab vessels
Cardiac catheterization labs are used to diagnose
and treat various heart conditions, such as
Use
coronary artery disease, heart valve disorders, and
congenital heart defects

imaging machines, such as X-ray machines or

fluoroscopy machines, as well as catheters, guide
Equipment
wires, and other specialized tools for performing
procedures such as angioplasty or stenting.

1. procedure room, where the patient is positioned

on a table,
2. a control room, where the healthcare providers
monitor the procedure and control the imaging
Spaces
equipment.
3. pre- and post-procedure areas for preparing the
patient and monitoring their recovery after the
procedure
CATH LAB RELATIONSHIP DIAGRAM
CARDIAC CATHERIZATION/ ANGIOGRAPHY SUITE
 Angiography uses X-rays to view your body's
blood vessels. The X-rays provided by an CARDIO ANGIOGRAPHY SUITE
angiography are called angiograms. Our SPACES:
Angiography suites provide specialized 1. Procedure Room
minimally invasive surgeries using needles 2. Control Room
and X-rays to guide the Doctor. 3. Patient Preparation Area
4. Recovery Area
5. Equipment and Supply Storage
6. Hand scrub unit
7. Changing Room Male/Female
8. Catheter store room / Medical
Store
9. Clean & Dirty Utility room
10. Electrical control systems
11. Doctor’s room
12. Family waiting area
 Cardiac Catheterization/Angiogram
 Angiogram:
• An angiogram is a scan that shows blood
flow through arteries, veins, or the heart,
using X-rays, computed tomography
angiography (CTA) or magnetic resonance
angiography (MRA).
 Angiogram and how is it performed?
• To complete a coronary angiogram, a
catheter is inserted in an artery in your groin
or arm and threaded through your blood
vessels to your heart. Your doctor uses the
angiogram to check for blocked or
narrowed blood vessels in your heart.
 Purpose of an angiography?
• Angiography is an X-ray examination of your
veins, arteries and heart chambers that looks
at blood flow. Angiography may be used to
identify the sites where the arteries have
become narrowed or blocked and can also
reveal any blood clots.
 TYPES OF ANGIOPLASTY
 Balloon Angioplasty is a procedure wherein a
balloon-tipped catheter is threaded to the site of
the arterial blockage through a small incision in
the groin or arm. This balloon is then expanded to
widen the narrowed artery.
 Stent Angioplasty stent is mounted on a balloon-
tipped catheter, threaded through an artery, and
positioned at the blockage. The balloon is then
inflated, opening the stent. Then, the catheter
and deflated balloon are removed, leaving the
stent in place permanently.
 Rotoblation During rotoblation, a special catheter,
with an acorn-shaped diamond-coated tip, is
guided to the point of narrowing in the coronary
artery. The tip spins around at a high rate of speed
and grinds away the plaque that has built up on
your artery walls and narrowed your artery. The
microscopic particles are washed safely away in
your blood stream and filtered out by your liver
and spleen.
PACEMAKER ANGIOGRAPHY
 A pacemaker is a small device that is powered by a
battery. It helps the heart beat in a regular rhythm.
Pacemakers are needed for those who have a slow and
irregular heart rhythm. A pacemaker is about the size of
a small matchbox.
 The pacemaker "can" or container has two parts inside:
• A pulse generator, which includes the battery and
several electronic circuits.
• Wires, called leads, which are attached to the heart wall.
Depending on the type of pacemaker you need, there
may be one or two leads.
 The pacemaker is implanted under the skin and fatty
tissue near the collarbone. If only one lead is needed, it is
placed in the lower-right chamber (the right ventricle). If
two leads are needed, the other lead is placed in the
upper-right chamber (the right atrium). The leads are
then attached to the pacemaker (pulse generator).
 Once the pacemaker is implanted, the leads carry
signals back from the heart. The pulse generator "reads"
these signals. When the heart rate is too slow, it sends an
impulse to the heart to help beat in a regular rhythm.
 ANGIOGRAPHY MACHINE
LAYOUT

Allura 3d Coronary Angiography Machine

Cardiac Angiography Suite Spaces
 Preparation room
 Distraction-free space for medication preparation by the
nursing staff. ‘Security’: The entrance door will be an
electrically controlled and semitransparent sliding door,
allowing for the observation of the ward during the
preparation process.
 Hand scrub unit
 important procedure required to reduce the risk of
contamination by microorganisms during operative
procedures.
 Equipment room
 Operating rooms are designed for surgeons and surgical staff
to perform surgical procedures that require time, patience,
focus, and safety. Various pieces of equipment are required
for use in the operating room.
 Control room
 A control room operator is a professional who works in the
control room of a power plant to monitor the operations of the
plant as well as ensures that everything is properly working
 Cardiac Angiography Suite Spaces
 Procedure Room:
Equipment needed for conventional angiography
• Set of catheters and guide wires
• Auto injector
• Image intensifying screen
• Sliding table
• Remote computerized equipment
• Biplane C-arm digital imaging
• Generator
 Post holding room:
 Pre-operative Holding Area. This allows the staff to
complete any tests that cannot be performed until
the day of surgery
 Changing Room Male/Female
 The intent of the change room requirement for both
of the standards is the prevention of contamination
of an employee's street clothes and the subsequent
spread of hazardous substances to offsite areas such
as an employee's home
 Cardiac Angiography Suite Spaces
 Catheter store room / Medical Store
 Clean & Dirty Utility room.
 Any item that will eventually come into contact
with a patient must be stored correctly, to
prevent it from becoming a health risk.
 . Generally, these will be containers which have
been used to collect and hold human waste.
 Electrical control systems
 Electrical systems control nearly every aspect of
a modern hospital, and a knowledgeable facility
manager recognizes the interconnectedness of
electrical systems and their energy sources
 Doctor’s room
 Family waiting area.
 friend or family member of a patient who is
staying at Strong Memorial Hospital for more than
one day you will be directed to one of the Family
Waiting Rooms
LABORATORY AND BLOOD BANK
 OPERATION THEATER OPERATION THEATER SPACES
1. Doctor’s waiting room
2. Patient Preparation room
 In the Operation Theater Suite, bypass
3. Modular Operation Theater (OT)
surgeries are performed (doctors call 4. Sterilized Instrument Store (for OT)
them CABGs, for Coronary Arterial Bypass 5. Anesthesia Room
Grafts), and these theaters are designed 6. Hand scrub unit
adjacent to cardiac catheterization 7. Post Operative Unit, Instrument
laboratories. room, Clean Utility room and
Doctor’s room
• The theaters should be provided with HEPA 8. Medicine Room
(High Energy Particulate Arrestors) filters and 9. OT Staff room
dedicated air-conditioning conforming to 10. Common Dirty utility room
applicable standards of sterility. 11. Family waiting area

• The theaters are usually also contiguous to

the Surgical ICCU (Intensive Cardiac Care
Unit), on the same floor if the particular
design circumstances allow it.
 CARDIAC OPERATION THEATER
• A well-equipped cardiac operation theatre
consisting of surgical instruments, ventilators,
piped gases, OT lamp need to be prepped OPERATION THEATER TEAM
for a smooth functioning operation. Operation theater management
have following teams:
• The operation theatre must feature proper Surgical team:
light intensity in the specified setting, Your cardiac surgeon or
aerodynamic shape of domes for proper surgeons and a surgical
supply of air, low heat generation by filtration assistant will perform your CABG
of infrared rays. procedure.
Anesthesiology team:
Your anesthesiologist will give
and monitor your
anesthesia, medicines, and vital
signs during the surgery.
Nursing team:
Specially trained nurses will assist
the surgical team.
Relationship diagram of operation
theater
Relationship diagram of operation
theater
OPERATION THEATER LAYOUT
 OPERATION THEATER LAYOUT
 It should be spacious
enough to allow free
movement of personnel,
trolleys, stretchers, wheel
chairs, monitoring
devices, portable x-ray
machines .
 OT should be divided into
four zones named
protective, clean, aseptic
and disposal zones.
Proper ventilation, air
circulation, temperature,
maintenance of sterile
environment in operation • The doors of each OT should be spring loaded flap type,
but sliding doors are preferred as no air currents are
theatres plays key role in
generated.
prevention of such • All fittings in OT should be flush type and made of steel.
infections. • The surface / flooring must be slip resistant, strong with
minimum joint
 FLOOR/WALLS/CEILING/ LIGHTING OF OPERATION
THEATER • The general room illumination the OT is
 FLOOR provided by
• fluorescent lamps (surface ceiling
• Non slippery, antistatic, non reflection,
mounted) to produce
non porous, water, stain and fire-resistant
• even illumination of at least 500 Lux at
• seamless working height, with
• minimal glare are preferred.
 CEILING
• This contrast should be maintained in
• Same quality as floor corridors and scrub
• Usually stainless steel • areas, as well as in the room itself, so
that the surgeon
• Diffuser for laminar air flow • becomes accustomed to the light
• Mounting for lights before entering the sterile field.
• Color and hue of the lights also should
 WALLS be consistent.
• Same quality as the floor
• Seamless
• Usually stainless steel
 Facilities of operation theater
 Electric generator - OT department should have
electric generator to ensure uninterrupted electricity
supply in case of electricity failure.
 O2 supply & suction system - OT should have
piped in O2 supply through central O2 supply system
from a central source. There should also be central
suctioning through piped in suction arrangement.
 Music system - Operation theatre can also have a
soft music system. Music creates a pleasant
environment for patients & staff. Music also provide
diversion of the patient's mind. Music can provide
relaxation to pts who undergo surgery under local,
regional or spinal anesthesia. It also provide a
soothing atmosphere & decreases tension & fatigue
of the OT staff.
 Computer terminal - The modern OT construction
also provide a surface area for the computer terminal
in each OT. These computers are being used to
record & maintain patient information
Ventilation , temperature
and humidity
 The OT Require Efficient ventilation
that will control temperature and
humidity in OT and dilute the
contamination by microorganisms
and anesthetic agents.
 The ventilation in OT should follow
the principles that the direction of SRUB STATION
airflow should take place from the • For sterile hand wash
sterile to the clean zone & form • Types: Stainless/ Granite/Marble/ Cement
the clean zone to the less clean • Gradient of basin forward and downwards
areas. • Gradient towards outlet
 There should be no open window • Hot water mixing: automatic or manual
in the OT and sliding doors of the • Non splashing taps; possible to change
OT should be open from the OT direction
towards the sub sterile zone. • Elbow/ Foot or Infra-Red operated taps
 There should be no interchange • Soap dispenser: Manual/automatic
air movement between one OT • to be planned for at least for 2-3 persons in
and another. each OT.
Operation theater equipment's
 CORONARY ARTERY BYPASS SURGERY
 Heart bypass surgery creates a new route, called a bypass, for blood and
oxygen to go around a blockage to reach your heart. The coronary arteries
supply blood to the heart muscle. The right coronary artery supplies both the left
and the right heart; the left coronary artery supplies the left heart.
 OPEN HEART SURGERY
 Open-heart surgery is a general term for surgical procedures
performed to treat heart problems by directly accessing the
heart through an opening the chest. During open-heart
surgery, the surgeon will cut through the breastbone
(sternotomy) and spread the ribs to access the heart.
 Condition commonly treated with open heart surgery
include
• Heart valve surgery
• Atrial septal defect
• Cardiac transplant
• Coarctation of the aorta
• Congenital heart defect corrective surgery
• Heart bypass surgery (coronary artery bypass graft - CABG)
• Mitral valve surgery
• Tetralogy of Fallot
• Ventricular septal defect (VSD)
Types of open heart surgery
 Types of open heart surgery procedure includes
 On pump surgery
On-pump surgery uses a heart-lung machine (cardiopulmonary bypass). This
machine temporarily takes over the heart’s job of pumping oxygen-rich blood
to the organs and tissues. This is the traditional type of open heart surgery. It
allows surgeon to operate on a heart that is not beating and has no blood
travelling through it.
 Beating heart or off pump surgery
Beating heart or off-pump surgery does not use a heart-lung machine and
surgeon operates on an actively beating heart. However, surgeon will slow
heart rate with medication or a device. This type of open heart surgery is
limited to a few specific procedures
 Robot-assisted surgery
Robot-assisted surgery allows surgeon to use a special computer to control
robotic arms that perform the surgery. The surgeon sees a three-dimensional
view of the surgery on the computer. This type of surgery is very precise.
However, it also is limited to a few specific procedures.
 Coronary Care Unit (CCU)
 A coronary care unit (CCU) provides high
dependency care to those with serious heart issues. CORONARY CARE UNIT SPACES:
It is a mixed ward (men and women). Cardiology 1. Changing room
(means heart medicine) doctors, nurses, and other 2. Doctors room
healthcare professionals have extensive training to 3. Nurse station
work in a CCU. 4. Patient Observation Bed
5. Medicine store room
6. Equipment store room
-Clean utility room
-Dirty utility room
7. Counseling room
8. Kitchen/Pantry
9. Isolation Patient Room
10. Staff / Patient Toilet
Family waiting area
CCU spaces
 Change room
 Doctor’s room
 Nurse station
 A central nurses’ station gives nurses a
place to take a break while still being in
the unit and aware of what’s going on.
 Patient Observation Bed
 An observation bed is where the
patient is placed to be observed by
providers and nurses.
 Medicine store room
 Equipment store room
• Clean utility room
• Dirty utility room
CCU spaces
 Counseling room
 The Medical Counseling room deals
with various concerns of patients
related to details of their medical
treatment, hospitalization and
hospital visits,
 Kitchen/Pantry
 Isolation Patient Room
 An isolation room is a specially
constructed area in a hospital
designed for housing patients with
an infectious disease in order to
prevent the spread of the disease
in the hospital
 Staff / Patient Toilet
 Family waiting area
RELATIONSHIP DIAGRAM OF CCU
 Cardiac High Dependency Unit
 A cardiac high dependency unit CARDIAC HIGH DEPENDENCY
(HDU) is a specialized area within a UNIT SPACES:
hospital that provides intensive care 1. Patients beds
for patients with serious heart 2. Nursing stations
conditions. 3. Treatment room
 These units typically have more 4. Staff areas
advanced equipment and specialized 5. Equipment storage
staff compared to a regular hospital
ward, and can provide a higher level
of care for patients who require close
monitoring and intervention.
 CARDIAC HIGH DEPENDENCY UNIT
1. Patient beds: each bed will be equipped with
advanced monitoring equipment to track the
patient's vital signs, as well as a call system to alert
staff if the patient requires assistance.
2. Nursing stations: The cardiac HDU will have one or
more nursing stations where staff can monitor patients
and access their medical records. These stations will
typically be equipped with computers, phones, and
other necessary equipment.
3. Treatment rooms: The HDU may have one or more
treatment rooms where patients can receive
specialized cardiac procedures or interventions.
These rooms will be equipped with advanced
equipment and technology to ensure that the
procedures are safe and effective.
4. Staff areas: The HDU will have areas where staff can
take breaks, store their belongings, and attend to
administrative tasks. These areas may include locker
rooms, break rooms, and offices.
5. Equipment storage: The HDU will have designated
areas for storing specialized equipment, such as
ventilators, defibrillators, and other advanced
medical devices
LAYOUT OF Cardiac High Dependency Unit
 EQUIPMENTS USE IN ICU, CCU AND HDU
Equipment Usage
Used to monitor the heart's electrical activity and detect abnormalities or
Electrocardiogram (ECG) machine
changes in rhythm.
Used to monitor patients with heart conditions or those at risk of developing them,
Continuous cardiac monitoring
such as those with a history of heart disease or undergoing cardiac procedures.

Used for critically ill patients with cardiovascular instability, shock, or other
Hemodynamic monitoring devices
conditions affecting blood flow and heart function.

Used in emergency situations to restore normal heart rhythm in patients with

Defibrillator
cardiac arrhythmias or cardiac arrest.

Used when a patient is unable to breathe on their own or requires additional

Ventilator respiratory support due to respiratory failure, acute respiratory distress syndrome
(ARDS), or other lung conditions.
Used to deliver medications, fluids, and other treatments directly into the
Intravenous (IV) infusion pumps
bloodstream.
Used to monitor a patient's blood pressure and other hemodynamic parameters
Arterial line monitoring
continuously.
Used to monitor the patient's oxygen saturation levels and detect changes in
Pulse oximeter
respiratory function.
Temporary pacemaker Used for patients with abnormal heart rhythms or bradycardia (slow heart rate).

Used for patients with severe heart failure or other conditions that impair the
Intra-aortic balloon pump (IABP)
heart's ability to pump blood effectively.
 DIFFERENCE BETWEEN CCU, ICU AND HDU
Criteria ICU CCU HDU

High acuity patients, often with Moderate acuity patients who

Highest acuity patients, requiring
severe cardiac conditions or those require close monitoring and
Patient Acuity constant and complex monitoring
who have undergone cardiac interventions, but not to the extent
and interventions.
procedures. of ICU or CCU patients.

Highly trained medical Specialized nursing staff, including

Specialized cardiac care
professionals, including critical registered nurses, who have
professionals, including
Staffing care physicians, critical care advanced training and
cardiologists, cardiac care nurses,
nurses, respiratory therapists, and experience in caring for critically ill
and other specialists.
other specialists. patients.

Advanced monitoring and life

support equipment, including
Cardiac monitoring equipment, Basic monitoring equipment,
mechanical ventilators,
including ECG machines, including cardiac monitors, pulse
Equipment hemodynamic monitoring
defibrillators, and temporary oximeters, and blood pressure
devices, and extracorporeal
pacemakers. monitors.
membrane oxygenation (ECMO)
machines.

Stays are shorter than ICU and

Typically shorter stays, usually a CCU but longer than general
Longer stays, often several days or
few days, depending on the wards, usually a few days,
Patient stays weeks, depending on the
patient's condition and treatment depending on the patient's
patient's condition.
plan. condition and response to
treatment.

Most expensive due to the high Less expensive than ICU and CCU
Expensive due to the specialized
level of staffing and equipment due to the lower level of staffing
Cost staffing and equipment needed
required to provide advanced and equipment needed for
for cardiac care.
critical care. moderate acuity patients.
SETUP IN ICU,
CCU AND
HDU
ANCILLARY SERVICES
 REHABILITATION GYM
 Rehabilitation gym for heart patients is a specialized facility that offers a
supervised exercise program and other services to help patients recover from a
heart attack, heart surgery, or other heart-related conditions.
 The gym is typically staffed by medical professionals, such as exercise
physiologists, physical therapists, and nurses, who have expertise in cardiac
rehabilitation.
 The goal of a rehabilitation gym for heart patients is to help patients regain their
strength, endurance, and overall health after a heart-related event or surgery.
 The exercise program is tailored to each patient's individual needs and is
designed to help them gradually increase their physical activity level in a safe
and controlled manner.
 In addition to exercise, rehabilitation gyms for heart patients may also offer
education and counseling services to help patients understand their condition,
manage their symptoms, and make lifestyle changes that can improve their
heart health.
 Services may include nutritional counseling, stress management, smoking
cessation, and medication management.
REHABILITATION GYM
 CSSD (CENTRAL STERILE SUPPLY DEPARTMENT)
 Central Sterile Supply Department (CSSD) Objective and Functions
comprises that service within a hospital which 1.To provide sterilized material.
receives stores; processes, distributes and controls 2.Contributing to a reduction in the
professional supplies and equipment, both sterile incidence of hospital infection.
and non-sterile to and from all departments of the 3.To avoid duplication of costly
hospital for the care and safety of patients. equipment.
 CSSD an independent department with facilities to 4.To maintain record of
receive, clean, pack, disinfect, sterilizes, store and effectiveness of cleaning,
distribute instruments and supplies as per well- disinfection and sterilization
delineated protocols process.
5.to monitor and enforce controls
necessary to prevent cross
infection.
6.To maintain an inventory of
supplies and equipment.
7.To stay updated regarding
developments in the field.
8.To provide a safe environment for
the patients and staff
 CSSD
1. Designing of a CSSD
• Size and location of CSSD varies
• 7 to 10 square feet per bed is recommended
• It should be located as close as possible to Operation theatres,
Accidents and Emergency department and wards
• The CSSD layout should be designed for a unidirectional flow
1. CSSD should have four zones for a smooth work flow:
a. The unclean and washing area
b. The assembly and packing area
c. The sterilization area
d. The sterile area
1. PLANNING of CSSD - The materials/ items from contaminated and
sterile areas should not get mixed. - There should be physical barrier
between clean and dirty areas. - The floor should be smooth,
impervious, non skid and robust. - Relative humidity should be
maintained at 45±5 %
 CSSD
1. - The clean area should be maintained at STAFF IN CSSD
positive pressures.
CSSD is usually manned by
- The minimum ventilation rate should be 6-10 air following staffs:
changes / hour.
- CSSD in charge/ manager:
- The work area should be made of marble / supervises activities of cssd.
granite / stainless steel.
- CSSD technicians: operate the
- The sterilization must be planned for autoclaving autoclave and eto machines.
by steam as well as by gas.
- CSSD assistants: perform the
1. Location • The CSSD should be close to the cleaning and packing, gauge
casualty, Operation Theatre and wards which
cutting and cotton ball making.
are the largest consumer of the sterilized
material. - Clerk or storekeeper: to
manage the inventory and
• In multistoried buildings, CSSD may be planned in
the lower floor right under the Operation Theatre, sterile stores.
where vertical movement will be the quickest - Housekeeping staff
possible movement of the material.
CSSD LAYOUT
 LAUNDRY
Element Description
To process and clean linens, uniforms, and other textiles used in the
Purpose
hospital
The laundry department receives soiled linens and textiles from
Working various hospital departments. The process involves the following
steps:
Soiled linens are sorted based on type and level of contamination.
Sorting This ensures appropriate treatment and prevents cross-
contamination.
Linens are laundered using specialized washers and detergents. The
Washing washing process may include pre-washing, main washing, and
rinsing cycles.

Clean linens are dried using dryers or hanging methods to remove

Drying moisture and ensure hygiene. Proper temperature and drying time
are maintained.

Once dry, linens are folded or ironed to achieve a neat and

Folding/Ironing
organized appearance. This aids in efficient storage and distribution.

Clean and folded linens are stored in designated areas, ready for
Storage
distribution to various hospital departments as per their requirements.

The laundry department ensures the cleanliness, hygiene, and

Quality Control proper functioning of equipment through regular maintenance and
quality checks.

The laundry process follows strict protocols to minimize the risk of

Infection Control
cross-contamination and transmission of infectious agents
PHARMACY
Department of hospital which deals with
procurement, storage, compounding,
FUNCTIONS OF PHARMACY
dispensing, manufacturing, testing, packaging 1. Provide specifications for the
and distribution of drugs. purchase of drugs, chemicals,
It is also concerned with education and research biological etc.
in pharmaceutical services. 2. Proper storing of drugs.
Hospital Pharmacy is controlled by a 3. Manufacturing and
professionally competent and a qualified distribution of medicaments
pharmacist. such as transfusion fluids,
parenteral products, tablets,
capsules, ointments, and
stock mixtures.
4. Dispensing and sterilizing
parenteral preparations
which are manufactured in
hospital.
5. Dispensing of drugs as per the
prescriptions of the medical
staff of the hospital.
 DIETRY MANAGEMENT
• Dietary management in hospitals is a crucial aspect of patient care, focusing on
providing appropriate and nutritionally balanced meals to meet the specific needs of
patients. It involves assessing individual dietary requirements, planning and preparing
meals, and monitoring the nutritional intake of patients.
MATERIAL MANAGEMENT
• Material management in hospitals
involves the efficient and effective
handling, procurement, storage,
distribution, and utilization of various
materials, supplies, and equipment
required for patient care and hospital
operations. It encompasses several
processes to ensure adequate inventory
levels, cost control, and timely availability
of materials.
 MORTUARY
 Mortuary is an important integral part of every
hospital as it deals with the preservation of the MORTUARY SPACES
dead body so that the forensic clinicians & 1. Parking area and Covered
pathologists may investigate the cause of death Portico
and make scientific investigations. 2. Reception & Waiting area
 Bodies may be viewed and identified by relatives 3. Trolley area
and friends (unidentified body), and bodies may 4. Storage Chamber
be kept until burial can be arranged. 5. Post mortem Room
6. Office room for record
keeping & Processing
7. Doctors room
8. Store room
9. Room for technicians &
attendants
10. Changing room
11. Toilets
MORTUARY LAYOUT
 MORTUARY
1. Parking with covered portico : Spacious parking area with a covered area of
about 18m2 for vehicles should be provided at entrance to the body store as
a protection in wet weather and screen from adjoining area with a exit to
subsidiary road or parking area.
2. Reception : A reception of the mortuary is the place where the bodies are
viewed and documents checked. It should have easy associability and
approachable .
3. Trolley area (3m2): A trolly bay is required to keep the trolley for
transportation of dead body. It should be nearby the reception.
4. Waiting area: A waiting room of 12-15m2 is recommended for the access to
visitors and relatives. It should be pleasantly furnished with provision of WC
and drinking water. In western countries viewing room(20m2) is adjoined to
waiting area to enable bodies to be viewed by relatives. It is treated in such
way that it can be used by all regions and denominations.
5. Storage chamber : (3m2)
2 storage chamber- 50-100 bedded hospital
3 storage chamber -200 bedded hospital excluding any provision for special
circumstances like disaster, with some allowance for epidemics and the
possibility of major accident (Putsep) Space needed Infront of cold chamber for
withdrawal of trays.
It should have assess to post-mortem room
1. Temperature for storage chamber :
Negative temperature storage : (-15/-25DC) for unclaimed
body/cause of death not identified . At this temperature, body
is completely frozen and decomposition is stopped. linen is
adhered firmly on tray.
Positive temperature storage : (+2/+4) , it does not prevent
decomposition which continues at slow rate . For bodies which
are to be disposed quickly and with no medicolegal
disputes(preservation).
1. Post mortem room : The post mortem room is suggested to
be treated like an operational theater in all technicality. The
major difference between mortuary and OT is that in
operation theater, utmost care is needed to prevent outside
infection entering inside, and in mortuary care is needed to
ensure that inside infection does not spread out.
2. The room should have 2 or more postmortem table.
Up to 400 bedded hospital – 2 tables
Additional 200 bedded- another 1 table More than 4 autopsy
table is not preferred.
A two tabled room need about 40m2 area.
About 15m2 area is needed for each extra table
The table are of porcelain, fireclay or stainless steel. Stainless
steel is favored with
1. Features of autopsy table : 7 ft long and 3.6 ft
wide
Have horizontal false top supporting body
Have a incline trope-top for drainage
Have either centered or foot drain.
Recent addition is arrangement of air inlets around
the sites of it through which air surrounding the body
is sucked away thus eliminating all smells.
1. A cool spot light should be available for use ,
e.g. for removing the brain.
A wall mount Xray view box is needed.
Telephone should be arranged with due
consideration of contamination.
Small sterilizer should be available
Shelf should be provided for formalin, saline and
other solution.
Hose point should be available.
1. Occasionally a so called foul room is provided
with temperature of 10 degree C for autopsy
procedure for decomposed body
1. Stores : Clean store for clean gown, aprons, gloves, gumboots and towel ; Instrument and equipment
store for equipment's, jars and solutions; linen store for drapes, shroud, towel etc.
Consultant/Doctors room
Changing room
Sluice Room : for washing and disinfecting the instruments
Doctor’s office : For report writing
Attendants room
1. Floors : Floor should be RCC, hard and durable & easily washable, non slippery. Should be of tiles or
standard terrazzo to which 3% copper may be added to act as insect inhibitor.
Walls : Washable ; with dadding and preferably of ceramic tiles.
1. Window : If possible natural day light should be used which provides adequate lightening. Window
should be in north side. Doors : Should be wide enough for passage of portable x-ray, Preferably it
should be a sliding door.
2. Adequate supply of heat and cold water
Safe drinking water facility
Wash basin with soap separately for the staffs and visitors
Fire fighting system
Sterilizer should be available
Proper heating and ventilation
Proper Drainage system
a) Cold Chamber
CHEMICALS USED IN CLEANING
Autopsy Table a)Bleaching powder for cleaning
Table ,Chair, Stools,File cabinets,Lockers mortuary table floors, etc.
b)2% Glutaraldehyde for cleaning
Computer with printers instruments.
c)Formative for sending specimens
Sterilizer
needing his to pathology.
Instrument cabinet d)Rectified and Methylated spirit
as preservative
Portable Xray machine e)Common salt
f)Sodium fluoride
Spectrophotometer
g)Potassium oxalate
Fume chamber h)EDTA vials and tubes
i)Sterilized glass tubes (plain).
a) Weighing Machine j)Sterilized glass tubes with swabs
Chromatography machine k)Liquid paraffin xiii)Sealing wax
etc.
Essential instruments : • Scissors • Forceps • Scalpels l)Big size envelops, plain papers
• Brian knives and saw ( preferably electric saw) • etc. (only 2/3rd of the specimen
Occasionally a pair of bone forecep container is Filled with solution)

Embalming machine if facility available

ADMINISTRATION
DEPARTMENT
 ADMINISTRATION DEPARTMENT
 Reception & waiting
 General admin office
 Statistics office
 Director office
 Director of finance
 Account office
 Inspection office
 Clerical staff
 Data entry room
 Medical records
 Medical maintenance &engineering
 Conference room
 Staff room
 It office
 Photocopying & printing
 Kitchenette & dinning
 Human resources management
ADMINISTRATION BLOCK LAYOUT
 MEDICAL RECORDS
 This department deals with the recording
and maintaining all the records/files of
inpatients and outpatients.
 these records furthur serve as purpose for
future use
MEDICAL MAINTENANCE &ENGINEERING

 This department make sure that

hospital is in operatable condition
 It makes plans and carries out
various project for hospital.
 This department make sure that all
electrical facilities are in perfect
condition, carries out repair and
replacement work for air-
conditioning units, plumbing, steel
works and general maintenance of
the hospital.
 IT AND COMMUNICATION

 All hospitals uses computers to track of

patient records.
 This dept. Provide technical support as
when needed keep systems updated
and provide support when systems
crashes.
 Its aim is to provide effective online
services for patients
 HUMAN RESOURCES MANAGEMENT

 This dept. Is given the objective of

recruiting efficient human recourses
for the hospital
 It create policies and procedures that
the staff have to follow in the hospital
and ensure employee satisfaction
 It is responsible for the providing
compensation for services rendered
by the employees.
 FINANCE
 This dept. Looks after the
financial aspects of the
hospital.
 They make budgets, financial
plans for future and allocate
resources for hospital
upgradation.
 They also provide wage
statements for the staff and
oversee purchases of medical
supplies and pharmaceuticals
for hospital.
SUPPORTIVE SERVICES
 STAIRCASES
 Riser height shall be
from 6 to 7.5 inches
(15.24 to 19.05 cm),
 stair width a minimum
of 22 inches (55.88
cm) between vertical
barriers,
 tread depth a
minimum of 12±2
inches (30.48±5.08 • Design wide staircases with handrails
cm),
for easy traffic flow.
 tread nosing shall be • Use slip-resistant materials for stair
straight leading treads.
edges. Stair landings • Ensure good visibility and lighting along
shall be at least 20
the stairs.
inches (50.8 cm) in
depth. • Provide clear signage and way finding
indicators.
• Incorporate safety features for
emergency egress.
 Hospital Elevators, Hospital Lifts,
 Hospital elevators may be preferred as to their
variable carrying capacities from 1600 kg to 2000 kg
and their various speeds from 0,40 m/s up to 30m/s.
 Dimensions of hospital elevator should be in standards
that at least one stretcher and one companion may
go into.
 Hospital lift cabins should suit with hygienic rules in
terms of health and precautions should be taken
place toward antibacterial prevention.
 The interior decoration of hospital elevators, also
known as patient elevators, is designed as stainless
and the lighting is kept at level that does not disturb
the patient.
 Hospital elevator cabin buttons are on the lower
position than the other kinds of elevators and their
doors are wider than the other kinds. Precautions for
any situation of electricity cut should be taken.
 Hospital lifts may be preferred as semi-auto, full auto
or hydraulic.
 ELEVATORS
CIVIL DIMENSION
LOAD CAR INSIDE LIFT SHAFT
TYPE OF MACHINE
Sr. No. ENTRANCE
PERSONS KG DOOR A B C D ROOM

1 13 884 Automatic 1000 2000 1900 2500 900

FOR MACHINE
2 15 1020 Automatic 1000 2400 1900 3000 900 ROOM
EXTENSIONS
PLEASE
3 20 1360 Automatic 1300 2400 2200 3000 1000 CONSULT IEC
LIFTS
4 26 1768 Automatic 1600 2400 2500 3000 1200

PitDepth : 1600 mm

OHRH : 5200 mm
 RAMPS IN HOSPITALS
 The ramp must have a 1:12 slope
ratio. This means that there must be
a one-inch rise in the ramp for every
corresponding 12 inches of the ramp
 The 36” (91.4 cm) clear width must
be maintained between all
including handrails.
• Design ramps with a gentle slope
and compliant dimensions for
accessibility.
• Incorporate landing platforms for rest
and smooth transitions.
• Install handrails at an appropriate
height for support.
• Use slip-resistant materials and
provide adequate lighting.
• Include signage to indicate the
presence and location of ramps.
Fire Protection System in Hospitals

Each Health Facility must have the following:

 All Health Facilities will have heat and smoke detectors;
 All Health Facilities should have a ‘Break Glass Alarm’ within its environment
and an internal alarm system;
 Most Health Facilities have fire and/or smoke rated doors;
 All Health Facilities will have a selection of fire fighting equipment
 canvas hose reels (for use of Fire Department)
 fire extinguishers;
 fire blankets
 fire hose reels
 All Health Facilities will have a maintenance system of all its equipment on a
annual basis
Potential Fire Hazards in hospitals
• Surgical equipment
• Hospital kitchens
• Overused sockets
• Cables
• Smoking

The Four Principles of Fire Safety

• Life Safety
• Notification
• Extinguish
• Relocate/Evacuate
Fixed Systems:

Fire Hose Cabinets

SPRINKLERS

Fire Pump System Stand pipe/ fireman’s connection

Difference between Fire Exit Door And
Fire Door
 Assembly Points
A fire assembly point is a location where staff and visitors
can gather in the event of a fire to ensure everyone is in
a designated safe area. Fire assembly point signs help
you make sure that people will know where to gather
following an emergency evacuation.
 BUILDING PLANNING
 The design of the building structure should be so planned that it allows
pressurized exclusion of smoke in case of fire or any smoke leak
 . Must have enough doors and windows for proper ventilation.
 Adequate emergency rescue aids and suitable refuge area should be
incorporated in the design.
 Ideally, a heavy-duty elevator especially for use of fire fighting personnel
only and used in case of emergency only should be incorporated.
 The building should be so designed that it can resist damages due to
earthquakes to a fair extent. Safe and easy means of access should be
provided to and in every place of work /in patient area.
 This should enable access to all including the disabled to move easily.
 In case of an emergency, safe and rapid exit should be provided for all
occupants.
 Each building must have separate fire exit, staircase with proper
signage.
LAYOUT PLANNING

 Following points must be kept in mind during building planning.

• There is sufficient open space around the building
• Sufficient open space between two buildings so as to minimize fire
spread possibilities from or to neighboring structures.
• Also there should be enough space for movement and parking of fire
fighting vehicles, ambulances, etc. in the premises and wide road
approach to the building.
• Considering the size & number of occupancy, lobbies, staircases, ramps,
etc. should be sufficiently wide to ensure easy movement of traffic and
quick evacuation during emergencies.
GAS SUPPLY
 Medical gas piping is needed for oxygen, nitrous oxide, medical air,
nitrogen, carbon dioxide, vacuum and anesthesia waste exhaust Scope
of work The details of the Product and System is mentioned below & the
Design, Supply, Installation, Testing and Commissioning of Central
Medical Gas Pipeline System with all accessories and basic systems,
should exactly conform to the hospital building and meet all the
requirements of the hospital needs:-
• The Bed Head Panels should be (Vertical and Horizontal) with Medi-Rail
System.
• There should be rigid / swivel / single arm / double arm pendants for the OT
& ICU.
• There should be an area Alarm Panel / Master
Alarm Panel for all medical gases.
• The Medi-rail system should be provided with
all mounting accessories.
• There should be a provision of a nurse call
system.
 Electricity
These two systems are:
1. Emergency system.
This is limited to
circuits essential to
life safety and
critical patient
care.
2. Equipment system. In healthcare applications, people's bodies are often in
This supplies major direct contact with energized equipment thus provides
electrical extensive grounding and bonding requirements-even for
equipment something as ordinary as a an electrical socket.
necessary for 1. Maximize the physical and electromagnetic protection
of wiring by requiring metal wiring methods.
patient care and
2. Minimize electrical hazards by minimizing the voltage
basic hospital potential between patients and medical equipment.
operation. 3. Minimize the negative effects of power interruptions with
specific requirements for essential electrical systems.
WASTE MANAGEMENT
This unit deals with multidisciplinary team
which includes collecting, transport,
processing, disposal, managing and
monitoring of waste material generated
from hospital.
 Infectious and pathological waste.
 Sharp waste
 Pharmaceutical waste
 General waste
 LOCATION
Near to housekeeping
Isolated from hospital
WHO classification of Hospital waste
 General waste: no risk to human health e.g. office paper, wrapper , kitchen
waste etc.
 Pathological waste: human tissues and fluid e.g. blood , body parts fluid etc.
 Sharps: Sharpe waste e.g. needles , scales, knives, eraser etc.
 Infectious waste: which may transmit bacteria, viral or parasitical diseases to
human being e.g. laboratory culture , tissue bandage etc.
 Chemical waste: e.g. laboratory reagent, disinfectants , film developer
 Radioactive waste: e.g., use liquid from radiotherapy or lab research,
contaminated glassware etc.
Classification of hospital waste
Sources of hospital waste
Hospital waste
management
system
Hospital waste disposal

 For disposal of hospital waste, following techniques are used:

 Incineration.
 Steam Autoclave Disinfection.
 Microwave Disinfection.
 Mechanical / Chemical Disinfection.
HVAC SYSTEM IN HOSPITAL
 HVAC stands for Heating,
Ventilation, and Air Conditioning.
HVAC refers to the different systems
used for moving air between indoor
and outdoor areas, along with
heating and cooling both
residential and commercial
buildings.
Types
 Heating and cooling split systems.
 Hybrid split system.
 Duct-free (Mini-split)
 Packaged heating and air
conditioning system.
 HVAC IN HOSPITAL
• HVAC systems provide comfort and
quality air for patients,
• staff, and visitors in hospitals. Comfort is
generally
• determined by temperature, humidity,
and air speed.
• These are the minimum standards used
by engineers
• to design hospitals.
• They also can be sub-classified into all-
air HVAC systems, air-water systems, all-
water systems, water-source heat
pumps, and heating and cooling panel
systems. The local HVAC systems are
mostly placed inside or adjacent to the
living spaces and serve one single zone.
They consist of local heating systems,
local air-conditioning systems, local
ventilation systems, and split systems.
 BENEFITS OF HVAC
 Performance, including infection control, comfort, patient outcome
 Safety, including fire prevention and control and minimizing falls and injuries
for employees, visitors, and patients
 Reliability and minimizing lost revenue
 Minimizing maintenance costs
 Minimizing energy costs
 Adaptability
Health Care Facilities Needing Well-
Functioning HVAC

 Aside from hospitals, a high-quality HVAC system is necessary for other

types of medical and care facilities as well, like:
 Inpatient and outpatient clinics
 Hospice facilities
 Nursing homes and assisted living facilities
 Doctors offices
 Medical billing centers
 Research facilities
HOSPITAL ENERGY FLOW
CASE STUDY
 INTERNATIONAL CASE STUDY
Hisham A. Alsager Cardiological Hospital
Hisham A. Alsager Cardiological Hospital

INTRODUCTION
 Architects: AGi Architects
 Area: 15000 m²
 Year: 2015
 City: Shuwaikh Medical
 Country: Kuwait
 CONCEPT
Hisham A. Alsager Cardiac Center is
a reflection on hospitals public
image. Usually hospitals have
negative connotations; therefore
we make a proposal that will lead to
a new and positive feeling.
The exterior façade is the most
relevant element and the first
connection with the patient. As a
cultural building we propose a
sculptural shape where two red
“gestures” invite to enter the
building in a good mood.
 INTERIOR
 The interior is organized like
a small city with different
scales and hierarchies.

 The main streets are the

corridors where patients can
be assisted in the different
receptions.

 The main waiting areas are

like a Square with direct
view to the main courtyards.
With double and triple free
height we have a big
outside feeling.
 LIVING ROOM
 The consults units are like apartments. The patients are
received in a “living room” and addressed by a
doctor in a private room. Each of those modules has
only two consults to guarantee the maximum privacy
and confidence with the doctors. All modules have a
small courtyard to provide light, natural ventilation
and privacy.
 REHABILITATION FACILITIES
 Rehabilitation facilities including a swimming pool, gym and running
track, are positioned along the building's north facade, together with
research and administration services.
 The main body of the building
is a monolithic geometric form
that rises up at one end,
accentuating the centre's
connection with the adjacent
ocean.
 This volume is clad with stone
panels to ensure adequate
protection from the harsh
climate.
GROUNFD FLOOR PLAN
FIRST FLOOR PLAN
SECOND FLOOR PLAN
 CONCLUSIONS
 Views of the courtyards and sea to give a sense of relief and openness to the
patients.
 Paths are clearly defined.
 The rehabilitation area is very well planned with natural light and views.
 The material used on the exterior very well corresponds with the environment
and prevent the harsh weather of Kuwait.
 Clinics grouped in three levels at the south part of the building.
 Two exam rooms with its waiting area.
 Consult office with their own waiting area.
 Each “cell” is organized between courtyards, providing all rooms with natural
light, ventilation, and privacy for each one. Courtyards provide the space
with natural light to experience the spacious architecture, in contrast with
smaller rooms.
 Inside this cluster, the main physical activity spaces are double height in
order to show up in the façade and “oxygenate” the experience.
THANK YOU