SUSTAINABLE HEALTHCARE FACILTY DESIGN By; ANYANGO P. AMOKO Ministry of Medical Services, Kenya 8-10/6/2010 EARC2010-KAMPALA

INTRODUCTION A health care facility can simply be defined as a built-in environment where health services are provided This include;- Medical clinic Nursing Home Dispensary Health centre All levels of Hospital 8-10/6/2010 EARC2010-KAMPALA

"You never get a second chance to make a good first impression." INTRODUCTION "You never get a second chance to make a good first impression." 8-10/6/2010 EARC2010-KAMPALA

INTRODUCTION 8-10/6/2010 EARC2010-KAMPALA

INTRODUCTION Applied to health care facilities. The state healthcare facility conveys a message to Patients Visitors, Volunteers, Vendors, and Staff. 8-10/6/2010 EARC2010-KAMPALA

HEALTHCARE FACILITY The clues starts;- The facility also communicates a torrent of clues about the organization and the medical care being provided there. The clues starts;- At the approach to the facility, The drop-off area The parking lots 8-10/6/2010 EARC2010-KAMPALA

Garden or landscaping and HEALTHCARE FACILITY Garden or landscaping and The street signs Health service delivery environment 8-10/6/2010 EARC2010-KAMPALA

HEALTHCARE FACILITY The State of infrastructure therefore impacts on accessibility to safe affordable and sustainable health services Unless it is properly planned, designed, constructed and maintained. No amount quality healthcare can be given to the population 8-10/6/2010 EARC2010-KAMPALA

HEALTH FACIITY FUNCTION UNITS Health care facilities are comprised of wide range of services and functional units. 8-10/6/2010 EARC2010-KAMPALA

SOME OF THE FUNCTIONAL UNITS INCLUDE DIAGNOSTIC AND TREATMENT FUNCTIONS SUCH AS IMAGING FACILITIES LABORATORIES CASUALTY OPERATING THEATRES DISPENSING FUNCTIONS SUCH AS PHARMACIES STERILIZATION 8-10/6/2010 EARC2010-KAMPALA

FUNCTION UNITS HOSPITALITY FUNCTIONS SUCH AS FOOD SERVICE HOUSE KEEPING ADMINISTRATIVE FUNCTIONS SUCH AS STRATEGY FORMULATION AND IMPLEMENTATION ACCOUNTING AND FINANCE TRAINING FUNCTIONS SUCH AS RESEARCH AND TEACHING ETC 8-10/6/2010 EARC2010-KAMPALA

WHY PLANNING OF HF Each of these wide-ranging and constantly evolving functions of a hospital, including highly complicated mechanical, electrical, and telecommunications systems, requires specialized planning knowledge and expertise. This is so because these functional units can have competing needs and priorities and aesthetic tastes must be balanced against mandatory requirements, functional needs and financial setbacks. 8-10/6/2010 EARC2010-KAMPALA

Physical relationships between these functions determine the configuration of the hospital and certain relationships between the various functions are required. Planning should facilitate flow of human traffic, services, movement of materials and waste since the physical configuration of a hospital and its transportation and logistic systems are inextricably intertwined. Hospital planning is also influenced by site restraints and opportunities, climate, surrounding facilities, budget, and available technology. 8-10/6/2010 EARC2010-KAMPALA

Efficiency and cost effectiveness Some of the salient design attributes include: Efficiency and cost effectiveness Promote staff movement efficiency . Allow easy visual supervision of patients by limited staff Include all needed spaces without redundancy. Provide an efficient logistics system. Make efficient use of space by locating support spaces so that they may be shared by adjacent functional areas. E.g. Positioning sterilization room to cover outside requisition and within. Consolidate outpatient functions for more efficiency Group or combine functional areas with similar system requirements Provide optimal functional adjacencies., such as locating the surgical intensive care unit adjacent to the operating theatre. 8-10/6/2010 EARC2010-KAMPALA

Flexibility and expandability. Since medical needs will continue to change, hospitals should: Follow modular concepts of space planning and layout Use generic room sizes and plans as much as possible. Be served by modular, easily accessed, and easily modified mechanical and electrical systems Be open-ended, with well planned directions for future expansion. 8-10/6/2010 EARC2010-KAMPALA

Therapeutic Environment The characteristics of the patient profile will determine the degree to which the interior design should address Aging, Children Loss of visual acuity, Other physical and mental disabilities, and abusiveness 8-10/6/2010 EARC2010-KAMPALA

Using cheerful and varied colors and textures, Admitting ample natural light wherever feasible. Creating a healing environment by providing views of the outdoors from every patient bed. Designing a "way-finding" process into every project. Patients, visitors, and staff all need to know where they are, what their destination is, and how to get there and return. 8-10/6/2010 EARC2010-KAMPALA

Cleanliness And Sanitation Hospitals must be easy to clean and maintain. This is facilitated by: Appropriate, durable finishes for each functional space Careful detailing of construction features. Adequate and appropriately located housekeeping spaces Special materials, finishes, and details for spaces which are to be kept sterile. Incorporating operational and maintenance practices that stress indoor environmental quality. 8-10/6/2010 EARC2010-KAMPALA

Accessibility All areas, both inside and out, should: Comply with the minimum requirements for invalids circulation. Be designed so as to be easy to use by the many patients with temporary or permanent handicaps. E.g. use of ramps lifts and hoists Ensuring grades are flat enough to allow easy movement and sidewalks and corridors are wide enough for wheelchairs to pass easily. A minimum corridor width of 2400mm is recommended. Ensuring entrance areas are designed to accommodate patients with slower adaptation rates to dark and light; marking glass walls and doors to make their presence obvious 8-10/6/2010 EARC2010-KAMPALA

Controlled Circulation Outpatients should not travel through inpatient functional units. Typical outpatient routes should be simple and clearly defined. Visitors should have a simple and direct route to each patient nursing unit. Separate patients and visitors from industrial/logistical areas or floors Outflow of trash, recyclables, and soiled materials should be separated from movement of food and clean supplies, and both should be separated from routes of patients and visitors Transfer of bodies to and from the morgue should be out of the sight of patients and visitors 8-10/6/2010 EARC2010-KAMPALA

Aesthetics Aesthetic considerations include: Aesthetics is important in enhancing the hospital's public image and is thus an important marketing tool. A better environment also contributes to better staff morale and patient care. Aesthetic considerations include: Increased use of natural light, natural materials, and textures Use of artwork Attention to proportions, color, scale, and detail Bright, open, generously-scaled public spaces Homelike and intimate scale in patient rooms. Compatibility of exterior design with its physical surroundings 8-10/6/2010 EARC2010-KAMPALA

SECURITY AND SAFETY In addition to the general safety concerns of all buildings, hospitals have several particular security concerns: Protection of hospital property and assets, including drugs Protection of patients, staff and visitors. Safe control of violent or unstable patients 8-10/6/2010 EARC2010-KAMPALA

"A functional design can promote skill, economy, conveniences, and comforts; a non-functional design can impede activities of all types, detract from quality of care, and raise costs to intolerable levels." ... Hardy and Lammers …..END…... 8-10/6/2010 EARC2010-KAMPALA

Thank you Questions and comments. 8-10/6/2010 EARC2010-KAMPALA