Each major department, clinical area, supportive units and administrative units have to be distributed over the site in appropriate zones to group them in such a manner that they are related to each other in contiguity and proximity.
The departments which come in close contact with the public should be isolated from the main inpatient areas and allotted areas closer to the main entrance to the site. Such departments are the outpatient department and accident and emergency or casualty department.
The supportive service departments, viz. the X-ray and laboratory services are extensively used by outpatients and need to be located as near the outpatient department as possible, at the same time integrated with the main inpatient wards.
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Therefore, these departments need to be located in such a way that they are approachable by separate entrances by outpatients as well as through inpatient areas, but preferably closer to the outpatient department.
Beyond this, from the main entrance should be the main inpatient zone which will consist of ICU, wards, operation theatres and delivery suite.
This zone will be as far away and therefore isolated, from the hubbub of activity that takes place in areas proximate to the main entrance to hospital site.
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The other supportive and clinicoadministrative departments in the hospital consist of the hospital stores, kitchen and dietary department, pharmacy, central sterile supply department (CSSD), engineering services, workshop and laundry.
Central services, especially the heavy duty service departments are better located on the ground floor—they include laundry, CSSD hospital stores, pharmacy, kitchen and cafeteria. These departments should be preferably grouped around a service core area.
Not each and every one of such departments described below will form part of every hospital. Smaller hospitals will have only the most essential services areas; whileas a large hospital may incorporate all of them.
Hospital Stores:
If the volume of stores is only a few days’ consumption requirement and remains small, the various items of stores- rations and vegetables, linen, drugs and dressings and laboratory supplies can be kept in the respective storage areas in the kitchen, laundry, pharmacy and laboratory respectively.
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When the bulk of these goods are high, it is necessary to design a central place as hospital store. This will depend upon the hospital’s philosophy on materials management.
The central store should be approachable by supply vehicles and should therefore have separate service entrance. The risk of fire and explosion in a medical supplies storehouse, storage of acids, inflammable materials and oxygen and other gas cylinders will require special attention while earmarking for such stores.
CSSD:
Central sterile supply department (CSSD) mostly serves the operation theatres, but its other users include the emergency and casualty department, the wards and maternity suite and should be so sited as to be central to all these.
Hospital Kitchen:
It will have to be located taking into consideration the prevailing wind direction so that smoke and kitchen odours are not constantly wafted to patient care areas.
The best site for a kitchen is at the ground level. However, kitchens on first, second and higher floors are in existence, with stores located on ground floor and connected to the kitchen with lift.
Hospital Workshop:
A large quantum of various types of mechanical and electrical equipment is installed in a hospital and requires repair and preventive maintenance.
Even if the major installation, plant and equipment may have maintenance and repair contracts with outside agencies for maintenance, some equipment will from time to time require repairs by the hospitals in- house maintenance staff. No large hospital can function satisfactorily without a workshop.
Laundry:
Mechanical laundries are becoming popular with larger hospitals. Used linen from wards, operation theatres and delivery suites may be infected, and therefore needs careful handling at an area remote from all other clinical and supportive services departments.
If the indigenous dhobi ghat type of laundry arrangement are planned, then space for bhatties, dhobi-stores, drying sheds and ironing rooms have to be catered for it an appropriate area, preferably at a remote corner of the site with plentiful supply of water.