1. Hospital Planning

2. Hospital Planning Team Hospital planning starts with the formation of a planning team : A.Hospital Administration B.Reps from clinical branches C.Nursing advisor D.Electrical, civil engineers E.Local representative F.Architect/Engineer

3. Objective of Planning Team 1.Needs Assessment: Need of new facility so as to provide necessary services to people per their need. 2.Review Existing Facilities: Document the adequacy of existing facilities as it pertains to the need of the people. 3.Assess for new facility as per need

4. Components of Hospital Planning Hospital Planning Feasibility Study Strategic Planning Commissioning Shakedown period Project Planning Implementation

5. Feasibility Study Feasibility Data Collection Site Selection Environmental Study Water & Electricity Transport & Communication Prioritize Need Need Assessment Demographic Pattern

6. Data Collection Data Demographic Data Current Facility Utilization Disease Pattern Existing Facilities Metriological Data Geographic Data

7. A.Demographic Pattern: 1.Type of Residents: High, middle, low class 2.Affordability status 3.Extent of people to be covered 4.People’s beliefs, attitudes, culture, practices 5.Availability of temporary residences (hotels, etc.) B. Need Assessment: 1.Type of health care need (preventive, curative, rehab, specialty) 2.For which group (old, children, women, specified disease, etc) 3.Economic status 4.Utilization of current facilities 5.Housing and education for hospital staff

8. C.Site Selection: 1. Availability of sufficient land depending on the size of the hospital and supporting operations (cancer center, wellness center, lab, imaging, etc.) 2. 25 bed – 5 acres; 100 bed -- 15 acres, etc. D. Environmental Study: 1. Environment must have sunlight, trees; avoid nearby large buildings 2. Climate should be moderate 3. Avoid nearby industries that are loud or emit smoke, steam, etc. 4. Flow of fresh air 5. Located away from roads/highways with heavy traffic

9. E.Availability of Electricity: 1. Utility sub station close by 2. Availability of three-phase electrical supply with adequate load (1 kw/bed) 3. Dedicated electric supply line 4. Emergency generators F. Water & Sanitation 1. Availability of deep table subsoil water 2. Adequate water supply (400 liters/bed/per day) 3. Well maintained sewage system (300-400 liters/bed/per day) 4. Accessibility to sewage treatment plant 5. Accessibility to near-by disposal of bio-medical waste G.Transport and Communication 1. Easy access for emergency, patient, supply, and maintenance vechicles 2. Availability of heliport, or similar if required 3. Access to high speed telecommunication, data, and network services 4. Availability of dedicated radio communication between facility and emergency providers

10. Project Planning and Implementation Project Planning Proposal Outline & Basis Detailed Proposal Project Approval Resource Allocation Tendering & Awarding Contract Architect Brief Construction Planning Land Acquisition

11. A.Project Outline: 1. Why undertake the project? 2. Justify with statistics, legislation, etc. 3. Benefit to people 4. Minimum size of project. B.Detailed Project Proposal 1. Size and scope of project 2. Availability of land sufficient for size of project 3. Scope of services to be provided 4. Approximate capital required 5. Recurring costs C.Project Approval 1. Once project is defined and prepared it should be forwarded to approving authority, including estimate capital requirements D.Resource Allocation: 1. Once administrative approval is received, proposal is then forwarded to financing authority. 2. Finance committee sanctions expenditures

12. Land Acquisition Departmental Clearance* Registration & Transfer Land Acquisition Land Clearance & Non Encumbrance Change of zoning Activities Local Development Authority State Pollution Control Board Local Municipal Board Utility Board *

13. Construction Plan: 1.Overall design 2.Number of floors 3.Designation of area/floor by function 4.Design of functional areas 5.Design of support and ancillary services area 6.Design of Auxiliary areas (Lab, Imaging, Canteen, Parking) 7.Room for expansion Architecture Brief: 1.Design of specific functional areas 2.Interrelationship between dependent functional areas 3.Preparation of drawings and models 4.Design of electricity, HVAC systems, elevators 5.Design of water supply and fire suppression systems 6.Finalization after briefing with the planning team

14. Tendering and Award of Contract: 1.Requires finalized design 2.A global tender is issued in competitive bid system 3.Bid responses are evaluated by the planning team 4.Results / recommendations are presented to spending authority 5.Contract is awarded to contractor/builder 6.Finally, construction can begin

15. Strategic Planning While construction is in progress, simultaneous planning begins for staffing, equipment, machinery, furniture, décor, etc. Staffing Medical Doctors Nursing Staff Security Sanitation & Maintenance Admin Staff Food Service s Grounds Technical Staff

16. Equipment Procurement via normal formalities Material Planning Heavy Equipment Investigation Machines Stationaries & Reagents Linens Furniture & Fixtures Drugs and Disposables Transport Instruments

17. Commissioning Once construction has been completed: Installation of HVAC systems, fire suppression systems, elevators Installation of equipment and machinery Recruiting of staff The hospital is commissioned- Advertisements Publicity Finalize inauguration date

18. Shakedown Period After commissioning the hospital, some time is taken for the functional integration of different units, services, staff, and patients. 1.Machinery is tested 2.Equipment is tested 3.Alarms/emergency procedures are tested 4.Standard operating procedures are established and put into place. 5.Staff is recruited and trained 6.Ancillary services are put into place 7.Materials and consumables are procured The new hospital is then ready to function normally!