GENERAL HOSPITAL OF

NIGER
CASESTUDY
LAMEYA MAHMOOD 56381
INTRODUCTION TO HOSPITAL

• WHAT IS A HOSPITAL?
• an institution providing medical
and surgical treatment and
nursing care for sick or injured
people.
INTRODUCTION TO HOSPITAL
TYPES OF
HOSPITAL
• ACCORDING TO SPECIALTY

1. GENERAL HOSPITAL: (a non-specialized

hospital, treating patients with all types of
medical condition)

2. SPECIALIZED HOSPITAL: any hospital devoted

3. TEACHING HOSPITAL: a hospital that is affiliated primarily to the specialized care and treatment
to a medical school, in which medical students of persons with chronic or long-term illness,
receive practical training injury, or infirmity.
INTRODUCTION TO HOSPITAL
BASED ON SIZE BASED ON CARE LEVEL BASED ON OWNERSHIP

SMALL : LESS
PRIMARY CARE GOVERNMNET DISTRICT
THAN 50 OR 50
HOSPITALS OR PUBLIC HOSPITAL
BEDS

MEDIUM: MORE SECONDARY

THAN 150 LESS CARE
HOSPITALS PRIVATE
THA 1000 BEDS

LARGE: MORE TERTIARY CARE

THAN 1000 BEDS
HOSPITALS

PRIMARY
CARE
 Hospital Divison In
Pakistan
Primary health Secondary Tertiary care
care model care
• BHU’S (Basic • THQ’S ( Tehsil • Teaching
health unit) Headquarter Hospitals
• RHC’S (Rural Hospitals)
health • DHQ’S
center) ( District
Headquarter
Hospitals)
Types Of Hospitals in Pakistan

Public hospitals
• 1200 public hospitals

Private hospitals
• 700 private hospitals

• 55 Basic Health Units

• 683 rural health centers
• 5802 dispensaries
• 731 maternity and child health centers
• 347 TB centers
Site selection
criteria for
hospitals Quite
place

Future
expansion
are

No loss of
amenity
No
contaminated
land
Functions of a hospital
• Health supervision and
prevention of disease.
• Health care and medical
research
• Rehabilitation.
• Education of health care
providers.
• Investigation diagnosis and care
of the sick and injured.
OVERVIEW
• hospitals are the most complex of
building types.
• Each hospital comprised a wide range
of services and functional units, these
includes:
• Diagnostic and treatment functions,
such as clinical laboratories, imaging,
emergency rooms, and surgery,
hospitality functions, such as food
service and house keeping, and the
fundamental in-patient care or bed-
related function.
• Hospital design discipline is extremely
important for building hospitals.
Essential points which should be
kept in mind while planning for
healthcare facilities are:
• 1. Environment: readily accessible to the community
and reasonably free from undue noise, smoke, dust, foul
odor, flood, and shall not be located adjacent to
railroads, children's playgrounds, airports, industrial
plants, disposal plants.

• 2. Occupancy: A building designed for other purpose

shall not be converted into a hospital. The location of a
hospital shall comply with all local zoning ordinances.

• 3. Safety: shall provide and maintain a safe

environment for patients, personnel and public. The
building shall be of such construction so that no hazards
to the life and safety of patients, personnel and public
exist. It shall be capable of withstanding weight and
elements to which they may be subjected.
• 4. Security: A hospital and other health facilities shall
ensure the security of person and property within the
facility.

• 5. Patient Movement: Spaces shall be wide enough

for free movement of patients, whether they are on
beds, stretchers, or wheelchairs. Circulation routes for
transferring patients from one area to another shall be
available and free at all times.

• 6. Lighting: All areas in a hospital and other health

facilities shall be provided with sufficient illumination to
promote comfort, healing and recovery of patients and
to enable personnel in the performance of work.

• 7. Ventilation: Adequate ventilation shall be provided

to ensure comfort of patients, personnel and public.
• 11. Material Specification: Floors, walls and
ceilings shall be of sturdy materials that shall
allow durability, ease of cleaning and fire
resistance.
• 12. Segregation: Wards shall observe
segregation of genders. Separate toilet shall
be maintained for patients and personnel,
male and female, with a ratio of one (1) toilet
for every eight (8) patients or personnel.
• 13. Signage: for information, orientation,
direction, identification, prohibition, warning
and official notice considered essential to the
optimum operation of a hospital and other
health facilities.
• 14. Function: The different areas of a hospital
shall be functionally related with each other.
• 8. Auditory and Visual Privacy: A hospital and
other health facilities shall observe
acceptable sound level and adequate visual
seclusion to achieve the acoustical and
privacy requirements in designated areas
allowing the unhampered conduct of
activities.
• 9. Waste Disposal: Liquid waste shall be
discharged into an approved public sewerage
system whenever available, and solid waste
shall be collected, treated and disposed of in
accordance with applicable codes, laws or
ordinances.
• 10. Housekeeping: A hospital and other
health facilities shall provide and maintain a
healthy and aesthetic environment for
patients, personnel and public.
Function
1. The emergency service shall be located in the ground floor to ensure immediate access. A
separate entrance to the emergency room shall be provided.
2. The administrative service, particularly admitting office and business office, shall be located
near the main entrance of the hospital. Offices for hospital management can be located in
private areas.
3. The surgical service shall be located and arranged to prevent non-related traffic. The
operating room shall be as remote as practicable from the entrance to provide asepsis. The
dressing room shall be located to avoid exposure to dirty areas after changing to surgical
garments. The nurse station shall be located to permit visual observation of patient
movement.
4. The delivery service shall be located and arranged to prevent non-related traffic. The
delivery room shall be as remote as practicable from the entrance to provide asepsis. The
dressing room shall be located to avoid exposure to dirty areas after changing to surgical
garments. The nurse station shall be located to permit visual observation of patient
movement. The nursery shall be separate but immediately accessible from the delivery
room.
5. The nursing service shall be segregated from public areas. The nurse station shall be located
to permit visual observation of patients. Nurse stations shall be provided in all inpatient
units of the hospital with a ratio of at least one (1) nurse station for every thirty-five (35)
beds. Rooms and wards shall be of sufficient size to allow for work flow and patient
Zoning
The different areas of a hospital shall be grouped according to zones as follows:
• Outer Zone – areas that are immediately accessible to the public: emergency service,
outpatient service, and administrative service. They shall be located near the entrance of the
hospital.
• Second Zone – areas that receive workload from the outer zone: laboratory, pharmacy, and
radiology. They shall be located near the outer zone.
• Inner Zone – areas that provide nursing care and management of patients: nursing service.
They shall be located in private areas but accessible to guests.
• Deep Zone – areas that require asepsis to perform the prescribed services: surgical service,
delivery service, nursery, and intensive care. They shall be segregated from the public areas
but accessible to the outer, second and inner zones.
• Service Zone – areas that provide support to hospital activities: dietary service, housekeeping
service, maintenance etc. They shall be located in areas away from normal traffic.
Departments In
Hospitals
• Emergency • Ophthalmology
• Cardiology • Obstetrics and
• Dentistry gynecology
• Neurology • Gastroenterology
• Oncology • Pulmonology
• Orthopedics • Dermatology
• Urology • ENT
• Nephrology
• Pediatric
• Psychiatry
DEPARTMENTS IN HOSPITALS
• EMERGENCY DEPARTMENT
• The primary role is to deal with serious causalities and accidents.

considerations Should be located on the ground floor level, with separate access for patients
and ambulances
Should be well marked with proper lighting and signs
Raised platform for ambulance discharge and ramps for wheel chair and
pedestrians access

Close to administration, medical records, cashiers booth, laboratory services, and blood
bank
Proximity to elevators is also important in order to proceed to surgery without loss of
time
DEPARTMENTS IN HOSPITALS
• OUT PATIENT DEPARTMENT (OPD)
• It is designed for the treatment of
outpatients, people with health problems
who visit the hospital for diagnosis or
treatment, but do not at this time require a
bed or to be admitted for overnight care.
• Access requirements: pedestrian and
ambulance access.
• Location: main reception and waiting, usually
ground floor but maybe on the other levels
OPD (Out Patient Department)
• It consist of the following:

Examination room Types of clinics

• Should be close to the nurses station and the • Surgical, orthopedic, medical, pediatric, skin,
consultation room ophthalmic, ENT, dental, chest, psychiatric,
cardiology clinic, urology clinic

Consultation room
OPD
• Is mostly used when lengthy conversations is • For the surgical department on the ground floor
involved between the doctor and patient or near the emergency departments

Clinical department of OPD Minor surgery room

• Use standard accommodation, general medicine, • Maybe used as a cast room, ECG room, minor
and surgery operations. It should have separate entrance
Relationship of OPD with other
spaces
Inpatient Department
• Inpatient department is the unit of a hospital where patients
are admitted for their medical care and attention.

Isolation units • An area contains a bed, beside locker, and separate toilet facilities

Wards • For particular specialties, should be located close to their respective department,
self contained centers

• Shall comprise 24 to 36 beds, isolation rooms should be present for 15 percent of

Wards units the patients

Aim
• To minimize the works of the nursing staff and provide basic amenities to the
patients within the unit

Orientation • adequate lighting enter into wards at day time

RADIOLOGY
DEPARTMENT

• should be always on
ground level
• Includes x ray rooms
• Sonography
• Mammography
• CT scan room
FLOW CHART OF X RAY DEPARTMENT
Radiotherapy
• Conditions diagnosed in radiography
department are treated:
• Eg: Tumors
• The section of radiotherapy comes under
the department of oncology
• For hygiene reasons the patient waiting
area, examination, localization, preparation
and radiation rooms must be well
ventilated.
• It comprises waiting area, doctor’s room,
switch room, film developing room, stores
and cleaner room
Physiotherapy
• It comes under rehabilitation
department
• Should be accessed through
main reception area
• Additional rooms: changing
room, WCs, restrooms, linen
stores, waiting areas, cleaners
room and service room
• A gymnasium to be included in
it.
 OT - Operation Theatre

Adequate glare, free

Independent general natural light is required
Independent from noise
traffic movement from which has psychological
and disturbances
rest of the hospital effect hence north light
is desirable

Correct and convenient

Free from relation with ICU, CSSD,
contamination Radiology and
pathology lab

Temperature range
should be between 23
to 24 degree Celsius
 Operation For each OT there should be three non
splash washbasins with foot controls
theatre
washroom
Must be directly
Sterile accessed
Electric sliding doors, Anesthetics
goods
refrigerator, draining room
room
sink, rinsing line
attachments

Should be as
Plaster Equipment close as possible
For hygiene reasons this is not located room room to the OT
in surgical zone but in the outpatient
area. In emergencies the patient must Sub-
be channeled through lobbies in order sterilization It contains non clean area for non sterile items
to get to the OT room and clean area for prepared sterile items.
Should be equipped with a sink, storage
surface, work surface, and steam sterilizer
INTENSIVE CARE UNIT (ICU)
• The task of intensive care is to prevent life threatening
disruption of the vital bodily functions. The services of ICU
includes monitoring and treatment as well as care of patient

Arrangements Must be a separate area and only accessed by lobbies

6 to 10 units

Arrangement Open, close or combined arrangement

of bed spaces
Beds must be in clear view of central nurse station

Auxiliary Small OT, Laboratory spaces, Kitchenette, sub sterilization, cleaning room, lounge for relatives
Duty doctors room, consulting room, documentation room.
functions
4 types : medical (coronary care), Surgical ( including trauma and cardiovascular), neonatal and
pediatric, medical-surgical including thoracic cases as well
Admitting Department
• responsible for the flow of patients and the
processing of admissions, discharges, transfers
and also most procedures to be carried put in
the event of a patients death
• Maintain bed index showing current
occupancy status.
• Prepare admission and discharge lists.
• Should be situated on the same level as the
hospital main entrance.
• Be readily identifiable
• Waiting area to be large enough to
accommodate patients and their relatives
• Wheelchair and stretcher alcove, space for
computer and office equipment
Some Other Departments
• CSSD DEPARTMENT
(CENTRAL STERILIZATION
AND SUPPLY
DEPARTMENT)
• MEDICAL DEPARTMENT
• FOOD DEPARTMENT