Departmental Planning in Hospitals

By Abdulla Israr & Simran Rani

Departmental Planning in Hospitals

Introduction

·       Hospitals are complex organizations that integrate multiple specialized departments to provide comprehensive healthcare.

·       Proper departmental planning ensures that patient care is efficient, safe, and accessible while optimizing workflow for healthcare professionals.

·       Each department must be designed keeping in mind space allocation, patient flow, staff requirements, equipment needs, infection control, accessibility, safety, and future expansion.

·       Integration between clinical and non-clinical units is also essential for seamless operations.

Outpatient Department (OPD)

  • Purpose: First point of contact for patients; handles preventive, promotive, and curative care without admission.
  • Planning Considerations:
    • Location: Near hospital entrance for easy access.
    • Layout: Registration, waiting area, consultation rooms, minor procedure rooms, pharmacy, billing counters.
    • Segregation: Separate areas for general, specialty, and super-specialty clinics.
    • Patient Flow: Minimize waiting and crowding with electronic queue systems.
    • Amenities: Toilets, drinking water, patient guidance counters.
    • Infection Control: Ventilation, handwashing stations, and separate area for infectious cases.

Inpatient Department (IPD)

  • Purpose: Provides care for patients requiring admission, observation, and continuous treatment.
  • Planning Considerations:
    • Bed strength based on hospital size (e.g., 1.5–2.5 beds per 1,000 population in general hospitals).
    • Ward design: Adequate spacing (7.4–9.4 sq. m per bed).
    • Types: General wards, semi-private, and private rooms.
    • Support Facilities: Nursing stations, treatment rooms, utility rooms, waiting lounges.
    • Patient Safety: Fire exits, handrails, call bell system.
    • Accessibility: Special provisions for elderly and disabled.

Emergency and Trauma Care

  • Purpose: Handles critically ill or injured patients requiring immediate intervention.
  • Planning Considerations:
    • Location: Easily accessible near hospital entrance with direct ambulance access.
    • Zoning: Triage area, resuscitation bays, observation units, minor OT, diagnostic support.
    • Infrastructure: Crash carts, ventilators, defibrillators, trauma kits.
    • Connectivity: Proximity to radiology, ICU, operation theatres, and blood bank.
    • Design: Separate entry/exit to avoid congestion.

Operation Theatres (OTs)

  • Purpose: Facilities for surgical procedures under sterile conditions.
  • Planning Considerations:
    • Location: Near ICU and surgical wards.
    • Zoning: Sterile, clean, protective, and disposal zones.
    • Infrastructure: Modular OTs with laminar airflow, HEPA filters, anesthesia rooms, scrub stations, recovery areas.
    • Sterilization: Central Sterile Supply Department (CSSD) integration.
    • Safety: Gas pipeline, backup power, fire safety, infection control.

Pediatrics, Maternity, Antenatal and Geriatric Units

  • Pediatrics: Child-friendly design, isolation rooms for infectious diseases, play areas, neonatal ICU.
  • Maternity: Antenatal OPD, labor rooms, delivery suites, postnatal wards, breastfeeding corners.
  • Antenatal: Regular check-up clinics, ultrasound and diagnostic support, counseling areas.
  • Geriatric: Elderly-friendly design (ramps, handrails, wide corridors), physiotherapy support, long-term care facilities.

Physiotherapy and Rehabilitation

  • Purpose: Restores mobility and function through therapy.
  • Planning Considerations:
    • Space for exercises, hydrotherapy, electrotherapy.
    • Separate cubicles for privacy.
    • Accessibility: Located near orthopedic, neurology, and rehabilitation wards.
    • Staff: Physiotherapists, occupational therapists, speech therapists.

Dental and Surgical Departments

  • Dental: OPD, minor OT, X-ray unit, sterilization area, dental labs.
  • Surgical: General surgery OPD, pre-op evaluation units, recovery wards, integration with OT and ICU.
  • Special design for infection control and anesthesia recovery.

Intensive Care Unit (ICU)

  • Purpose: Manages critically ill patients needing life support.
  • Planning Considerations:
    • Location: Close to OT and emergency.
    • Bed spacing: 15–20 sq. m per bed.
    • Facilities: Ventilators, dialysis, monitoring systems.
    • Design: Isolation rooms, nursing stations with visibility, separate entry for staff and patients.
    • Air quality: Negative/positive pressure rooms for infection control.

Laboratory and Diagnostic Services

  • Purpose: Supports diagnosis and treatment decisions.
  • Planning Considerations:
    • Includes pathology, microbiology, biochemistry, radiology, imaging (CT, MRI, USG).
    • Location: Easily accessible from OPD, IPD, and emergency.
    • Safety: Biosafety standards, radioactive waste disposal.
    • Patient Flow: Sample collection areas separate from reporting areas.
    • Connectivity: Digital reporting through hospital information systems.

Medical Record Department (MRD)

  • Purpose: Stores and manages patient records.
  • Planning Considerations:
    • Functions: Registration, coding, indexing, filing, retrieval, and statistics.
    • Physical Records: Secure fire-proof storage with shelves.
    • Digital Records: Electronic Medical Records (EMR) systems with backup.
    • Confidentiality: Controlled access.
    • Proximity: Near administration and OPD for easy coordination.

Housekeeping and Non-Medical Services

  • Purpose: Maintain hygiene, safety, and comfort.
  • Planning Considerations:
    • Laundry services, dietary/kitchen services, waste management, sanitation, pest control.
    • Separate storage for clean and soiled items.
    • Integration with infection control protocols.
    • Adequate manpower and supervision.

Mortuary and Support Facilities

  • Purpose: Temporary preservation of deceased patients and medico-legal work.
  • Planning Considerations:
    • Location: Isolated from main patient areas with separate access.
    • Facilities: Cold storage, autopsy room, waiting and counseling area for relatives.
    • Safety: Biohazard disposal, ventilation, privacy.

Public Health Services and Community Clinics

  • Purpose: Extends preventive and promotive healthcare to the community.
  • Planning Considerations:
    • Services: Immunization, health education, outreach clinics, screening camps.
    • Integration: With national health programs (TB, HIV, maternal and child health).
    • Community Clinics: Satellite units or mobile health vans for rural coverage.
    • Role: Bridges hospital care with primary healthcare system.

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