PROGRAM STATEMENT

A secondary hospital is a hospital with 25 to 99 beds and

community and the structural stability of the main facility and lastly
the projected vision of the researchers to the secondary hospital.

equipped with the services capabilities needed to support licensed

physicians rendering services in the fields of Medicine, Pediatrics,
Obstetrics and Gynecology, General Surgery and other ancillary
services.

I.

HOSPITAL PLANNING CONSIDERATIONS

The planning and designing of hospitals is a systematic

process. There must be participation between the users and the

This chapter discusses: the functional aspect of the hospital

professionals. A need to identify the end-users of the hospital is

such as circulation of activities, movement of people, and how the

important. There are 4 main end-users namely: patients, medical

different areas are linked together. These relationships should be

staff, administration, service staff, and others (public information,

thoroughly understood in order to create a well-planned hospital.

visitors,

The technical aspect which tackles how the researchers

etc.).

These

users

need

to

have

the

adequate

infrastructure, equipment, utilities and systems, and services.

made use of the information, statistical data, and standard

The hospitals challenge is to create a patient-oriented

requirements in determining the number of beds, sizes of rooms,

system, thereby providing the best experience for the patients and

the number of personnel and other related topics.

also to the other users. There are five categories that enumerate

And lastly, the building features to be adopted, the projected

the users and patients experience.

building shape and site utilization, how the design concept will
evolve to build a structure that will create a sense of place in the

35

1. Space and suitability of space size, functionality,

adopting standards/minimum requirements
2. Privacy desired in bed, treatment, toileting, access to
social support
3. Comfort personal comfort, colours, views, shape of room,
etc.

1. Efficiency and cost-effectiveness distance of travel,

adjacencies of spaces, support spaces
2. Flexibility and expandability modular concepts, generic
room sizes, directions for future expansion
3. Therapeutic environment colors and textures, natural
light

4. Variety contact with outdoors, radio and television,

pictures
5. Communication access to the hospital at car parking,
reception, signage, etc.

4. Cleanliness and sanitation durable finishes

5. Accessibility minimum requirements, way finding process
6. Controlled circulation simple routes for outpatients and
visitors, cadavers route to be out of sight, soiled materials
7. Aesthetics increased natural light, proportions, artwork

BUILDING ATTRIBUTES
A thorough understanding of the main building is
important for the designer to come up with a well-planned
design.

8. Security and safety protection of hospital property,

patients, protection from violent patients
9. Sustainability utilities for conserving water and energy,
recycling, byproducts.

36

PROGRAM REQUIREMENTS
SITE DEVELOPMENT

Provide truck maneuvering area outside of the RROW

(within property or lot lines only).

1. Parking Requirements
A public hospital is classified under Group D (Division D-2)

2. Green Areas

of the National Building Code. As stated in the NBC (P. D.

These areas are comprised of the open spaces for future

1096), the Minimum Required Off-Street cum On-Site Parking

developments, gardens, natural buffer zones, and site protection.

Slot, Parking Area and Loading/Unloading Space Requirements

The intended structure will be a vertical development to preserve

by Allowed Use or Occupancy under this division shall be:

natural spaces and utilize the others for gardens. These gardens

provide significant effects in the healing of patients.

One (1) off-street cum on-site car parking slot for every
twenty five (25) beds;

One (1) off-RROW (off-street) passenger loading space that

can accommodate two (2) queued jeepney/shuttle slots;

Provide at least one (1) loading slot for articulated truck or

vehicle (12 meter long container van plus 6 meter length for
a long/hooded prime mover);

One loading slot for a standard truck for every 5000 sq.

3. Traffic Circulation
The external routes are comprised of the traffic lines outside of the
buildings. These are utilized by patients, staff, visitors, suppliers,
and other clients (e.g. those who collect garbage, remove the
deceased) whether they are on foot or on vehicle. The researchers
use four access points to separate the traffic:

meters of gross floor area; and

37

Service: for delivering supplies and collecting garbage

Service: for removal of the deceased

Emergency: for patients in ambulance and other vehicles

going to emergency department

Main: for all others

Zoning
The different sections of the hospital can be grouped

according to zone as follows:

Outer Zone areas that are immediately
accessible

to

the

public:

emergency

service,

outpatient service, and administrative service. They

INTERNAL SPACES (MAIN BUILDING)
1. Functional Relationships

shall be located near the entrance of the hospital.

Second Zone areas that receive workload

Hospital Services

from the outer zone: laboratory, pharmacy, and

The researchers recognize four main divisions of hospital

radiology. They shall be located near the outer zone.

namely: clinical, ancillary, domestic, and administrative. The

Inner Zone areas that provide nursing care

clinical services provide the diagnostic and curative services.

and management of patients: nursing service. They

The ancillary services provide the technical support to the

shall be located in private areas but accessible to

clinical services, while the domestic and administrative

guests.

services provide the direction and overall support to the

clinical and ancillary.

Deep Zone areas that require asepsis to

perform the prescribed services: surgical service,
delivery service, nursery, and intensive care. They

38

shall be segregated from the public areas but

accessible to the outer, second and inner zones.

2. Patient Movement
Patient movement in the hospital should not be restricted,

Service Zone areas that provide support to

whether they are on stretchers, their own beds, or wheel chairs.

hospital activities: dietary service, housekeeping

Spaces should be wide enough for free movement of patient.

service, maintenance and motor pool service, and

Similar conditions should also be considered in designing

mortuary. They shall be located in areas away from

corridor and door width. Circulation of patients is very important,

normal traffic.

hence, circulation routes for transferring patients from one

area/room should be available and free at all times. With

Flow of Activities

regards to vertical routes, the use of lifts or ramps are

The movement of services in every department and

preferable.

services of a hospital is a complex one. The Time Saver

Standards provided flow charts for selected hospital services

3. Staff Movement

and departments which will serve as a guide for the

There should be a clear route for staff movement from

researchers to understand better the movement of patients,

outside the hospital going inside the hospital. Several entry

personnel, and visitors.

points shall be plotted accordingly, parking area near that entry

point should be available. Staff working area (departments)
should be distributed harmoniously and in balance of hospital

39

wide facilities. There should not be any high concentration of

other mode of transporting materials using hospitals regular

staffs in one area and low concentration in other areas. All

route/corridor. Entry to facilities should be through alternative

facilities that need a considerable number of staff should be

doors, not doors for patients/staffs. Those doors should

equipped with staff amenities such as comfort rooms, changing

accommodate the dimension of trolleys.

rooms with lockers and conference/study room when necessary.

5. Disposal of Used Goods
4. Supplies Delivery

The effective management of health care waste considers

The hospital should adopt a centralized system for storage

the basic elements of waste minimization, segregation and

and delivery of medical supplies for better inventory control of

proper identification of the waste. Appropriate handling,

medical supplies. There should be different storage space for

treatment and disposal of waste by type reduce costs and do

flammable and dangerous materials. Separate storage might be

much to protect public health. Segregation at source should

necessary

as

always be the responsibility of the waste producer. Segregation

electrical/mechanical inventories. With regards to pharmacy

should take place as close as possible to where the waste is

supplies, central pharmacy department may store its supplies in

generated and should be maintained in storage areas and

the central pharmacy department. Satellite pharmacy should

during transport.

for

engineering

supplies

such

also be constructed in strategic places such as inpatient

Segregation is the process of separating different types of

department. Delivery of supplies would utilized trolleys and

waste at the point of generation and keeping them isolated from

40

each other. Appropriate resource recovery and recycling

inflate waste volume but too few containers may lead to non-

technique can be applied to each separate waste stream.

compliance. Minimizing or eliminating the number of hazardous

Moreover the amount of hazardous waste that need to be

waste containers in patient care areas (except sharp container,

treated will be minimized or reduced subsequently prolonging

which should be readily accessible,) may further reduce waste.

the operational life of the disposal facility and may gain benefit

Facility management should develop a segregation plan that

in terms of conservation of resources.

includes staff training.

Hazardous waste should be placed in clearly marked

Categories of Health Care Waste

containers that are appropriately labeled for the type and weight

a) General Waste Comparable to domestic waste, this

of the waste. Except for sharps and fluids, hazardous wastes

type of waste does not pose special handling problem

are generally put in plastic bags, plastic lined cardboard boxes,

or hazard to human health or the environment. It

or leaked proofed containers that meet specific performance

comes

standards.

housekeeping functions of health care establishments

mostly

from

the

administrative

and

To improve segregation efficiency and minimize incorrect

and may also include waste generated during

use of containers, proper placement and labeling of containers

maintenance of health care premises. General waste

must be carefully determined. General waste containers placed

should be dealt with by the municipal waste disposal

beside infectious waste containers could result in better

system.

segregation. Too many hazardous waste containers tend to

41

b) Infectious Waste This type of waste is suspected

towels, gowns, aprons, gloves and laboratory

to contain pathogens (bacteria, viruses, parasites, or

fungi) in sufficient concentration or quantity to cause
disease in susceptible hosts. This includes:

Cultures and stocks of infectious agents from

coats);

Any other instruments or materials that have been

in contact with infected persons.

c) Pathological Waste - This type of waste contains

laboratory work;

tissues, organs, body parts, human fetus, blood and

Waste from surgery and autopsies on patients with

body fluids. Within this category, recognizable human

infectious disease (e.g. tissues, materials or

body parts are also called anatomical waste. This

equipment that have been in contact with blood or

category should be considered as a subcategory of

other body fluids);

infectious waste, even though it may also include

Waste from infected patients in isolation wards

healthy body parts

(e.g. excreta, dressings from infected or surgical

d) Sharps include needles, syringes, scalpels, saw,

wounds, clothes heavily soiled with in human

blades, broken glass, infusion sets, knives, nails, and

blood or other body fluids);

any other items that can cause a cut or puncture

Waste that has been in contact with infected

wounds. Whether or not they are infected, such items

patients undergoing hemodialysis (e.g. dialysis

are usually considered as highly hazardous health

equipment such as tubing and filters, disposable

care waste

42

e) Pharmaceutical Waste includes expired, unused,

waste from health care may be hazardous or non-

spilt, and contaminated pharmaceutical products,

hazardous

drugs or vaccines, and sera that are no longer

Chemical waste is considered hazardous if it has at

required and need to be disposed of appropriately.

least one of the following properties

This category also includes discarded items used in

Toxic

handling of pharmaceuticals such as bottles or boxes

Corrosive

with residues, gloves, masks, connecting tubing and

Flammable

drug vials.

Reactive (explosive, water-reactive, shock-

f) Genotoxic Waste May include certain cytostatic

drugs, vomit, urine or feces from patients treated with

sensitive)

Genotoxic (e.g. cytostatic drugs)

cytostatic drugs, chemicals and radioactive materials.

Non-hazardous chemical waste consists of chemicals

This type of waste is highly hazardous and may have

with none of the above properties such as sugars,

mutagenic, teratogenic, or carcinogenic properties

amino acids, and certain organic and inorganic salts.

g) Chemical Waste Consists of discarded solid, liquid

h) Waste with high content of heavy metals

and gaseous chemicals, for example from diagnostic

represent a subcategory of hazardous chemical

and

cleaning,

waste, and are usually highly toxic. Mercury wastes

housekeeping, and disinfecting procedures. Chemical

are typically generated by spillage from broken clinical

experimental

work

and

from

43

equipment (thermometers, blood pressure gauges,

handled with care; containers may explode if

etc). Whenever possible, spilled drops of mercury

incinerated or accidentally punctured.

should be recovered. Residues from dentistry have

j) Radioactive Waste includes disused sealed

high mercury content. Cadmium waste comes mainly

radiation sources, liquid and gaseous materials

from discarded batteries. Certain reinforced wood

contaminated with radioactivity, excreta of patients

panels containing lead is still being used in radiation

who

proofing of X-ray and diagnostic departments. A

therapeutic applications, paper cups, straws, needles

number of drugs contain arsenic but these are treated

and syringes, test tubes, and tap water washings of

here as pharmaceutical waste.

paraphernalia.

underwent

radionuclide

diagnostic

and

i) Pressurized Containers many types of gas are

used in health care and are often stored in

Color Coding Scheme for Health Care Waste

pressurized cylinders, cartridges, and aerosol cans.

The most appropriate way of identifying the categories of

Many of these, once empty or of no further use

health care waste is by sorting the waste into color-coded

(although they may still contain residues), are

plastic bags or containers. Recommended color-coding scheme

reusable, but certain types notably aerosol cans, must

for health care waste is shown in the table below:

be disposed of. Whether inert or potentially harmful;

gases in pressurized containers should always be

44

area, room or building of a size appropriate to the quantities of

waste produced and the frequency of collection. In cases where
the health care facility lacks the space, daily collection and
disposal should be enforced.
Cytotoxic waste should be stored separately from other
waste in a designated secured location. Radioactive waste
Waste Storage
All health care waste should be collected and stored in
waste storage until transported to a designated off-site
treatment facility. This area shall be marked with warning sign:
CAUTION: BIOHAZARDOUS WASTE STORAGE AREA
UNAUTHORIZED PERSONS KEEP OUT.
Storage areas for health care waste should be located within
the establishment or research facility. However, these areas
should be located away from patient rooms, laboratories,
hospital function/operation rooms or any public access areas.
The waste in bags or containers should be stored in a separate

should be stored separately in containers that prevent

dispersion, and if necessary behind lead shielding. Waste that
is to be stored during radioactive decay should be labeled with
the type or radionuclide, the date, and details of required
storage conditions. Storage facility for radioactive waste must
bear the sign Radioactive Waste placed conspicuously.
Methods of treatment and disposal of radioactive waste shall
conform to the requirements and guidelines of the PNRI.
During storage for decay, radioactive waste should be
separated according to the length of time needed for storage,
for example, short-term storage (half-lives less than 30 days)

45

and long-term storage (half-lives from 30 to 65 days). Low level

radioactive waste should be stored for a minimum of ten times

the half-life of the longest-lived radionuclides in the container

insects and birds.

and until radioactivity decays to background levels as

confirmed by radiation survey.

should

be

good

lighting

and

adequate

The storage area should not be situated in the

proximity of fresh food stores or food preparation

The storage area should have an impermeable, hardstanding floor with good drainage; it should be easy to

There

ventialtion.

Requirements for Storage Facilities

The storage area should be inaccessible to animals,

areas.

A supply of cleaning equipment, protective clothing,

clean and disinfect.

and waste bags or containers should be located

There should be water supply for cleaning purposes.

conveniently close to the storage area.

The storage area should allow easy access for staff in

Floors, walls and ceilings of the storage must be kept

charge of handling the waste.

clean in accordance to established procedures, which

It should be possible to lock the storage area to

at a minimum should include daily cleaning of floors.

prevent access of unauthorized persons.

Biodegradable general and hazardous waste should

Easy access for waste collection vehicle is essential.

not be stored longer than 2 days to minimize microbial

There should be protection from sun, rain, strong

growth, putrefaction, and odors. If the waste must be

winds, floods, etc.

stored longer than 2 days, application of treatment

46

like chemical disinfection or refrigiration at 4 degrees

Celsius or lower is recommended.

Primary treatment consists of temporarily holding the

sewage in a quiescent basin where heavy solids can

SEWAGE TREATMENT PLANT

settle to the bottom while oil, grease and lighter solids

Sewage treatment is the process of removing

float to the surface. The settled and floating materials are

contaminants from wastewater, including household sewage

removed and the remaining liquid may be discharged or

and runoff (effluents). It includes physical, chemical, and

subjected to secondary treatment.

biological processes to remove physical, chemical and

Secondary

treatment removes

dissolved

and

biological contaminants. Its objective is to produce an

suspended biological matter. Secondary treatment is

environmentally safe fluid waste stream (or treated effluent)

typically performed by indigenous, water-borne micro-

and a solid waste (or treated sludge) suitable for disposal or

organisms in a managed habitat. Secondary treatment

reuse (usually farm fertilizer).

may require a separation process to remove the micro-

Sewage collection and treatment is typically subject to

organisms from the treated water prior to discharge or

local, state and federal regulations and standards. Industrial

sources of sewage often require specialized treatment
processes.
Sewage treatment generally involves three stages,
called primary, secondary and tertiary treatment.

tertiary treatment.

Tertiary treatment is sometimes defined as anything

more than primary and secondary treatment in order to
allow rejection into a highly sensitive or fragile
ecosystem (estuaries, low-flow rivers, coral reefs).

47

Treated water is sometimes disinfected chemically or

centralized stores and supplies system advocated elsewhere,

physically (for example, by lagoons and microfiltration)

the various units and departments of the hospital do not

prior to discharge into a stream, river, bay, lagoon or

themselves maintain stocks of linen. This stock is the

wetland, or it can be used for the irrigation of a golf

responsibility of the central linen or stores department while

course, green way or park. If it is sufficiently clean, it can

subsequently collects the used materials, removes trolley and

also be used for ground water recharge or agricultural

replaces all the items used.

purposed.
7. Food Service
6. Laundry Service

The total number of staff in a modern hospital is roughly

Laundry service needs to be centralized with the advantage

equal to the number of beds, so the number of meals served to

in terms of economy of building and operation. The first principle

staff would be at least equal to that served to patients. It is best

to observe in the laundry arrangement is that dirty and clean

to centralize catering service. The standard of hygiene in the

linen should be kept entirely separate, both in the laundry or

hospital kitchen must be maintained at very high level. Each

linen room and at the points of use. The design, equipment and

ward receives two trolleys from the central kitchen, one

management of the laundry itself are matters to be highly

containing the food, and the other containing clean plates and

considered. The clean linen will go to a clean section of the

eating utensils. Central washing is likewise recommended. The

linen room for sorting and return to the point of use. Under the

removal of washing up from the ward also reduces noise and

48

nuisance to patients, and the number of persons who have to

work in the wards.

9. Security
The number of entrances and exits are often the concern of
the security unit of the administrative office the hospital. The

8. Domestic Service

circulation routes in a hospital consist of external and internal

Centralized domestic service is preferable for the hospital.

routes. External routes are discussed in the previous sections.

The most obvious advantage is better control of linen and

Internal traffic streams link departments. Some important

cleaning equipment, domestic service staff/housekeepers.

guidelines are as follows:

Housekeeping and domestic service areas should be grouped

Corridor size in relation to traffic intensity

around a service

yard, laundry, kitchen, housekeeping,

Corridor size in relation to maneuverability

maintenance, storage and motor pool. Workshops are needed

Vertical circulation

for the maintenance staff to look after the building and

equipment for storage space. It is practicable to site the

10. Engineering Service

mortuary so that it is easily accessible in the department of

About a third of the cost of hospital building goes into the

pathology, so that specimens removed at autopsy could be

mechanical engineering services, heating and ventilation,

readily conveyed for examination to the laboratories of morbid

electricity, lifts and communications. These services for the

anatomy and histology.

circulation and nervous systems, without which, the hospital

cannot function. The mechanical services must be planned so

49

that easy access can be obtained to all equipment for repairs

and maintenance without the disruption of the daily functions of
the hospital.

II.

SPACE PROGRAMMING
The space requirements provided below are based on the

Manual on Technical Guidelines for Hospitals and Health Facilities

Planning and Design.
The researcher provided a tabulation showing the users and
number of personnel who will use the spaces, the space
requirements, the minimum areas, and lastly the derived or actual

Table 3. Space Requirements

areas for the overall building and facility.

50

Table 3. Space Requirements

Table 3. Space Requirements

51

Table 3. Space Requirements

Table 3. Space Requirements

52

Table 3. Space Requirements

Table 3. Space Requirements

53

Table 3. Space Requirements

54

ORGANIZATIONAL CHART

55

NURSING PERSONNEL REQUIREMENTS

ER/ICU/RR

Staffing

70:30

Table 4. Nursing Care Hours for patients in the various units of the hospital

Staffing is the process of determining and providing

acceptable number and mix of nursing personnel to produce a
desired level of care to meet the patients demand.

Patient Care Classification System

The patient care classification system is a method of
grouping patients according to the amount and complexity of their

The Hospital Nursing Service Administration Manual of the

Department of Health has recommended the following nursing care
hours for patients in the various nursing units of the hospital.
Prof. to Non-Prof.
Cases/Patients

6.0

nursing care requirements and the nursing time and skill they
require (Helberg, J., Nursing Management p. 989).
Patient care classifications have been developed primarily
for medical, surgical, pediatrics, and obstetrical patients in acute

NCH/Patient/Day
Ratio

care facilities.

General Medicine

3.5

60:40

Medical

3.4

60:40

Surgical

3.4

60:40

Level I Self Care or Minimal Care Patient can take a

Obstetrics

3.0

60:40

bath on his own, feed himself, feed and perform his activities of

Pediatrics

4.6

70:30

daily living. Falling under this category are patients about to be

Pathologic Nursery

2.8

55:45

discharged, those in non-emergency, those newly admitted, do not

Classification Categories

56

exhibit unusual symptoms, and requires little treatment/observation

observation at least every 30 minutes for impending haemorrhage,

and/or instruction.

with hypo or hypertension and/or cardiac arrhythmia.

Level II Moderate Care or Intermediate Care Patients

Level IV Highly Specialized Critical Care Patients

under this level need some assistance in bathing, feeding, or

under this level need maximum nursing care. Patients need

ambulating for short periods of time. Extreme symptoms of their

continuous treatment and observation; with many medications, IV

illness must have subsided or have not yet appeared. Patients may

piggy backs; vital signs every 15-30 minutes; hourly output. There

have slight emotional needs, with vital signs ordered up to three

are significant changes in doctors orders and care hours per

times per shift, intravenous fluids or blood transfusion; are semi-

patient per day may range from 6-9 or more.

conscious and exhibiting some psychosocial or social problems;

NCH

Ratio of Prof. to

Needed/Patient/Day

Non-Prof.

1.50

55:45

3.0

60:40

4.5

65:35

Levels of Care
periodic treatments, and/or observations and/or instructions.
Level III Total, Complete or Intensive Care Patients

Level I Self Care or

under this category are completely dependent upon the nursing

Minimal Care

personnel. They are provided complete bath, are fed, may or may

Level II - Moderate

not be unconscious, with marked emotional needs, with vital signs

or Intermediate Care

more than three times per shift, may be on continuous oxygen

Level III Total or

therapy, and with chest or abdominal tubes. They require close

Intensive Care

57

Level IV Highly

Tertiary
6.0

70:30

Specialized or

30

45

15

10

10

25

45

20

Hospital
7.0 or higher

80:20

Critical Care

Special

Table 5. Categories or levels of care of patients, nursing care hours

needed per patient per day and ratio of professionals to nonprofessionals

Tertiary
Hospital

Table 6. Percentage of patients at various levels of care per type of

hospital

Percentage of Nursing Care Hours

The percentage of nursing care hours at each level of care

Computing for the Number of Nursing Personnel Needed

also depends on the setting in which care is being given.
When computing for the number of nursing personnel in the
Percentage of Patients in Various Levels of Care

various nursing units of the hospitals, one should ensure that there

Highly
Type of

Minimal

Moderate

Intensive

Hospital

Care

Care

Care

Special
Care
Primary
70

25

Hospital

absences, and time for staff development programs.

Staffing Formula
To compute for the staff needed in the In-Patient unit of the
hospital having 25 patients, the following steps are considered:

Secondary
65
Hospital

is sufficient staff to cover all shifts, off-duties, holidays, leaves,

30

1. Categorize the patients according to levels of care needed.

25 x 0.65 = 16.25 or 17 patients need minimal care

58

25 x 0.30 = 7.5 or 8 patients need moderate care

25 x 0.05 = 1.25 or 2 patients need intensive care

5. Find the total number of nursing personnel needed.

Total NCH/year

2. Find the number of nursing care hours (NCH) needed by

patients at each level of care per day.

Working hrs. /year

21,535

1, 704

Answer = 12.6 or 13

17 x 1.5 (NCH at Level I) = 25.5

26 NCH/day

Relief x Total Nursing Personnel = 13 X 0.15 = 1.95 or 2

8 x 3 (NCH at Level II) =

24 NCH/day

Total Nursing Personnel needed = 13 + 2 = 15

2 x 4.5 (NCH at Level III) =

Total

9 NCH/day
59 NCH/day

6. Categorize to professional and non-professional personnel.

Ratio of professionals to non-professionals in a secondary

3. Find the total NCH needed by 25 patients per year.

59 x 365 (days/year) = 21,535 NCH/year

hospital is 60:40.
15 x 0.60 = 9 professional nurses
15 x 0.40 = 6 nursing attendants

4. Find the actual working hours rendered by each nursing

personnel per year.

7. Distribute by shifts.

8 (hrs. /day) x 213 (working days/year) = 1, 704 working

9 nurses x 0.45 = 4.05 or 4 nurses on AM shift

hours/year

9 nurses x 0.37 = 3.33 or 3 nurses on PM shift

59

9 nurses x 0.18 = 1.62 o 2 nurses on night shift

Ratio/

Actual

Required Number

Number

Personnel
a. Total = 9 nurses
6 nursing attendants x 0.45 = 2.7 or 3 NA on AM shift

Administrative Service

6 nursing attendants x 0.37 = 2.22 or 2 NA on PM shift

Chief of Hospital

6 nursing attendants x 0.18 = 1.08 or 1 NA on night shift

Administrative Officer

Clerk (Pool)

1:50 beds

Bookkeeper

Billing Officer

Cashier

1:75 beds

b. Total = 6 Nursing Attendants

STAFFING PATTERN
The researcher provided tabulation for the identification of
the minimum number of personnel. The ratio and the fixed numbers

Medical Records

in the tabulation are indicated in the standard requirements for the

Officer

Licensing of a Level 1 Hospital. Actual numbers may vary

Medical Records Clerk

depending on the hospital administration.

Supply Officer

Storekeeper

1:50 beds

a.m. shift = 1:75 beds

Laundry Worker
Utility Worker

60

Security Guard

p.m. shift = 1:75 beds

every additional 50 beds

night shift = 1

= additional 2

1/shift

Maintenance
1/shift

Nutritionist/Dietician
Cook

Dental Aide

Personnel
Driver

Dentist

Nursing Service
1/shift

Chief Nurse

50 beds & below = 1

1:100 beds

51 100 beds = 2
Supervising Nurse

1
101 150 beds = 3

Food Service
1

Supervisor

151 beds & above = 4

Food Service Worker

1:50 beds

Head Nurse

1:15 staff nurses

Medical Social Worker

Staff Nurse

1:12 beds at any time

Clinical Service

* for every three (3) nurses, there must be one (1)

1

Chief of Clinics
Physician

50 beds & below = 6

reliever
Nursing
1:24 beds at any time

Attendant/Midwife
Table 7. Number of required personnel

61


FIRE PROTECTION

Safe

from

flooding,

landslide,

erosion

and

other

environmental hazards.

Fire Safety Principles must be observed which are:

Possibilities for sewage disposal.

Fire Avoidance reduction of the possibility of accidental

Soil must have a good value as foundation materials.

ignition of materials or separation of heat source from

inflammable materials.

HOSPITAL SAFETY INDICATORS

Fire Control firefighting equipment such as fire hose and

A hospital should not only focus on the aesthetic side. It

fire extinguishers must be easily visible and accessible for

should also be structurally sound to avoid further harm to the

immediate use.

occupants and to withstand natural forces. The following selected

structural indicators can serve as a checklist to identify strengths

ENVIRONMENTAL DESIGN REQUIREMENTS

Vegetation serves also the landscaping using deciduous

trees to control sun and shapes.

and vulnerabilities in the planning for a new construction of hospital

and other related health facilities.

Buildings must be located in highly suitable sites and away

Building Materials open interior and higher ceiling

from areas that will diminish its accessibility and threaten its

encourage ventilation and cooler temperature.

operations in times of emergencies.

Orientation the orientation of a building is the relationship

to its environments.

The design of the hospital structural system must strictly

conform to the requirements of the National Structural Code

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of the Philippines (NSCP, 2001); especially for wind and

Double swing main doors, ER / OR / DR / ICU

earthquake design.

Nursery / Radiology/ patients rooms, Dietary, kitchen,

The shape and form of the hospital building must be simple

laundry, linen and other support areas

and regular.
Non-structural Indicators should also be given emphasis on the

Swing-out toilets and exit doors

Smoke partition doors located along hallways and

planning aspect of the hospital. The non-structural elements are

corridors should be double swing, per groups of

those without forming part of the resistance systems, but those

rooms/section, for compartmentation.

enabling the facility to operate. Nearly 80% of the hospital cost is

made up of the non-structural elements (WHO, 2008).

With manual door closer - Operating Room (OR),

Intensive Care Unit (ICU), Recovery Room (OR),
Delivery Room (DR), Labor Room (LR), Isolation Rooms

The following specifications should be properly observed:

1. Safety of Ceilings:

(IR) and other sterile areas.

A door designed to be kept normally closed as a means

Ceilings made of wood are coated/treated with fire

of egress, such as a door to a stair or horizontal exit,

retardant paints and termite- controlled.

provided with a reliable self closing mechanism, and

2. Safety of Doors and Entrances:

shall not at any time be secured in the open position. A

door designed to be kept normally closed shall bear a
sign as follows: FIRE EXIT, KEEP DOOR CLOSED

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3. Safety of Windows and Shutters

Smoke detectors must be spaced not further apart than

Windows have wind and sun protection devices (e.g. sun

nine meters on center and more than four and six-tenths

baffles).

(4.6) from any wall

Window grilles to secure the safety of the patient,

provided with fire exit opening.

This chapter also consist program development which includes

All glass panels or windows are made of tempered glass

three

or with appropriate thickness or provided with protective

Development

films.

Technology; to be attained.

developmental
and

programs

Technology

namely
and

Program

Site,

Building

for

Building

4. Safety of Walls. Divisions, and Partitions

Exterior walls meet the fire resistance rating of 2 hours.

Interior walls made of fire-resistive materials and from

floor to floor.

5. Fire Suppression Systems

a)

SITE

Site Preservation
The agricultural land surrounding the site is not be abolished

nor destroyed for it could be helpful in the balance of ecology and

Alarm system is a combination of automatic and manual

maintaining green environment. It shall only be preserved and

system.

restored.

Heat and Smoke Detection installed in all areas.

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a)

b)

The proposal would be taking up the typical protection

Site Improvement
Putting up a better ambiance in the site such as

scheme for institutions like this which is walls and fences that

landscaping

ensure security and peace all over the site. Also, perimeter fences

for

aesthetic

purposes

and

natural

temperature.

shall be built along the parcel of lot where the building rises and the

To lessen hazards, walkways, parking spaces and areas

same goes with plants and vines; the use of gates would also be

and pedestrian lanes shall be incorporated within the site;

very helpful.

the same must go for persons with disabilities.

c)

Lightings must be improved inside the building, outside

Preserved vegetation within the site can be used as natural

the institution and within the premises of the hospitals.

d)

barricades.

Recreational facilities shall be made to terminate

boredom among patients.

e)

a)

BUILDING DEVELOPMENT

For accessible and feasible movements, there must be

The hospitals architectural characteristics shall be redeveloped

the development of emergency walkways like ramps,

to a relaxed atmosphere while reducing the sensory stimulating

steps,

elements inside it; design a building character considering

exit,

ambulance.

Landscape

Site Protection

entrance

and

separate

roadways

for

maintenance, strength, functionality and appropriation and green

architectural concepts that connive with the sites climate and
surrounding.

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a)

Controlling Microclimate
Ventilation - The building shall incorporate the use of natural

ventilation

to reduce

ones

shall

undergo

aerobic

composting,

while

incineration shall be applied for non-degradable.

electric consummation through green

environment, proper arrangement of windows and openings.

b)

degradable

All exterior storage; trash collection dumpsters, trash pads,

disposal areas shall be located and oriented.

Saving Energy
Illumination - Also to be included in the design concept ofb)

PROGRAM FOR BUILDING TECHNOLOGY

redevelopment s the use of wide windows to allow natural lighting

a)

with renewable source as the sun, not only it could save energy but

The buildings foundation shall be in accordance with the soil

it will improve environment comfort.

c)

Waste Management
The municipality is now implementing zero plastic use all

Foundation

and building type. Spread footing though will be applied since the
site has fine sandy clay loam, for a strong and safe architectural
building.

over its barangays so the site must follow the ordinance in

b)

accordance with the building redevelopment; years also passed

The site is prone to earthquake, strong winds and flashfloods;

that this town implemented proper waste segregation system.

Pharmaceutical wastes such as expired medicines shall be
disposed either by pulverization and disposing by burying method

Columns and Beams

with these natural forces, the building frame shall have long spans
which will rigidly form the building to resists these occurrences
c)

Acoustic

or into sink. Incombustibles will be buried after incineration. The

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Acoustical tiles, sound insulators, natural buffers and acoustical

materials and treatments shall be provided to control intensity and
excessive sounds, improve hearing conditions, comfort and

proper and efficient collection, storage and disposal of solid wastes

generated shall be also provided.
g)

convenience.
d)

Electric Supply

Fire Alarm
Use of materials for prevention of fires such as liquids and

asbestos shall be provided. Fire Alarms, smoke detectors, sprinkler

Power supply of the hospital and around the site shall be on the

systems, house boxes and fire extinguishers shall be installed

SORECO which also provides electricity for the Province. Also, the

inside and outside the building. Fire exits and fire prevention shall

use of solar panels will be utilized to maximize energy efficiency.

be easy and accessible at any time and place. Also, fire safety

e)

Water Supply

Potable, safe and adequate drinking, irrigation and cleaning

waters shall be provided by the local water supply system, Bulan
Water District.
f)

Utilities
For hygiene purposes, septic tanks shall be built to receive

the discharge of wastes which shall reduce organic and bacterial

content. The use of solid waste facilities is important as well as the

plans shall be installed in every wall.

h)

Walls and Partition

Interior To use the materials appropriate for the function of

each area in terms of stability and flexibility.
Exterior to adopt the appropriate materials for walls that will
protect the interior of the structure from different elements as well
as present an attractive exterior appearance.
Alternatives: plasterboards, concrete, plywood

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Materials shall be adapted in the basis of availability, ease of

i)

application, maintenance and aesthetic quality.

It should facilitate efficient sun control and ventilation to

To provide roofing materials based on quality, wind

resistance and appearance criteria.

minimize use of air-conditioner.

Paints will be used to cover unsightly surfaces, for aesthetics,
and to prevent moisture absorption, to act as vapor barrier and to

A number of rooting materials are available: shingles of all

kind, wooden shakes, clay roofing tile, cement roofing tile, slate,
sheet metal, asphalt roofing, glass and plastics.

provide a washable are of infection control.

Smooth form or plain groove finish shall be applied depending
upon the nature of the building, painted with light color schemes for
a relax atmosphere. (Interior surfaces)

Roofing

Plastic is the most appropriate material for curve roofing.

Reflective roofing or coatings help send the heat back into the sky
than into the building.
j)

Ceiling System

Finishes must be applied to material that are properly cured and

Ceiling function not just an attractive overhead surface but

dried. Concrete and other surfaces should be tested with a

also as a primary sound absorption surface containing lightning

moisture meter before being painted. To avoid subsequent

fixtures, concealing utility services and an outlet for heated and air

deterioration, avoid using epoxy paints unless proper application

conditioned air.

techniques are guaranteed to be nearly perfect. Colorless sealers

are usually more effective but must be applied over well-cured,

Use of acoustic ceiling panels and tiles that are noncombustible and light weight to be observed.

thoroughly dry concrete that has not been previously painted.

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