Rubia, Jan E.

BS ARCH 31-E1
Definition of a Hospital (by DOH)
Hospital a place devoted primarily to the maintenance and operation of health
facilities for the diagnosis, treatment and care of individuals suffering from illness,
disease, injury, or deformity or in need of obstetrical or other surgical, medical and
nursing care. It shall be construed as any institution, building, or place where there
are installed beds, cribs, or bassinets for 24-hour use or longer for patients in the
treatment of diseases.
A hospital is a health care institution providing patient treatment with specialized
staff and equipment. The best-known type of hospital is the general hospital, which
has an emergency department. A district hospital typically is the major health care
facility in its region, with large numbers of beds for intensive care and long-term
care. Specialised hospitals include trauma centres, rehabilitation hospitals,children's
hospitals, seniors' (geriatric) hospitals, and hospitals for dealing with specific
medical needs such as psychiatric problems (seepsychiatric hospital) and certain
disease categories. Specialised hospitals can help reduce health care
costs compared to general hospitals. A teaching hospital combines assistance to
people with teaching to medical students and nurses. The medical facility smaller
than a hospital is generally called a clinic. Hospitals have a range of departments
(e.g., surgery, and urgent care) and specialist units such as cardiology. Some
hospitals have outpatient departments and some have chronic treatment units.
Common support units include a pharmacy, pathology, and radiology.
Hospitals are usually funded by the public sector, by health organisations (for
profit or nonprofit), by health insurance companies, or bycharities, including direct
charitable donations. Historically, hospitals were often founded and funded
by religious orders or charitable individuals and leaders.[1] Today, hospitals are
largely staffed by professional physicians, surgeons, and nurses, whereas in the
past, this work was usually performed by the founding religious orders or
by volunteers. However, there are various Catholic religious orders, such as
the Alexians and the Bon Secours Sisters that still focus on hospital ministry today,
as well as several other Christian denominations, including the Methodists and
Lutherans, which run hospitals.[2] In accordance with the original meaning of the
word, hospitals were originally "places of hospitality", and this meaning is still

preserved in the names of some institutions such as the Royal Hospital Chelsea,
established in 1681 as a retirement and nursing home for veteran soldiers.

CONCEPT: RETHINKING HOSPITAL ARCHITECTURE

A hundred years ago, we tended to die of infectious diseases like pneumonia, that, if
they took hold, would take us away quite quickly. We tended to die at home, in our
own beds, looked after by family, although that was the default option because a lot
of people lacked access to medical care.
And then in the 20th century a lot of things changed. We developed new medicines
like penicillin so we could treat those infectious diseases. New medical technologies
like x-ray machines were invented. And because they were so big and
expensive, we needed large, centralized buildings to keep them in, and they
became our modern hospitals.
After the Second World War, a lot of countries set up universal healthcare
systems so that everyone who needed treatment could get it. The result was that
lifespans extended from about 45 at the start of the century to almost double that
today. The 20th century was this time of huge optimism about what science could
offer, but with all of the focus on life, death was forgotten, even as our approach to
death changed dramatically.
We now tend to die of cancer and heart disease, and what that means is that many
of us will have a long period of chronic illness at the end of our lives. During that
period, we'll likely spend a lot of time in hospitals and hospices and care homes.
Now, we've all been in a modern hospital. You know those fluorescent lights and the
endless corridors and those rows of uncomfortable chairs. Hospital architecture has
earned its bad reputation. But the surprising thing is, it wasn't always like this.
This is L'Ospedale degli Innocenti, built in 1419 by Brunelleschi, who was one of the
most famous and influential architects of his time. And when I look at this building
and then think about hospitals today, what amazes me is this building's
ambition. It's just a really great building. It has these courtyards in the middle so
that all of the rooms have daylight and fresh air, and the rooms are big and they
have high ceilings, so they just feel more comfortable to be in. And it's also
beautiful. Somehow, we've forgotten that that's even possible for a hospital.
Now, if we want better buildings for dying, then we have to talk about it, but
because we find the subject of death uncomfortable, we don't talk about it, and we

don't question how we as a society approach death. One of the things that surprised
me most in my research, though, is how changeable attitudes actually are. This is
the first crematorium in the U.K., which was built in Woking in the 1870s. And when
this was first built, there were protests in the local village. Cremation wasn't socially
acceptable, and 99.8 percent of people got buried. And yet, only a hundred years
later, three quarters of us get cremated. People are actually really open to changing
things if they're given the chance to talk about them.
Spaces tend to include noise and acoustics. A room like this has acoustics, this one
very good acoustics .Many rooms are not so good. Let me give you some examples
from a couple of areas which I think we all care about: health and
education. (Hospital noises) When I was visiting my terminally ill father in a hospital,
I was asking myself, how does anybody get well in a place that sounds like
this? Hospital sound is getting worse all the time. Noise levels in hospitals have
doubled in the last few years, and it affects not just the patients but also the people
working there. I think we would like for dispensing errors to be zero, wouldn't we?
And yet, as noise levels go up, so do the errors in dispensing made by the staff in
hospitals. Most of all, though, it affects the patients, and that could be you, it could
be me. Sleep is absolutely crucial for recovery. It's when we regenerate, when we
rebuild ourselves, and with threatening noise like this going on, your body, even if
you are able to sleep, your body is telling you, "I'm under threat. This is
dangerous." And the quality of sleep is degraded, and so is our recovery. There are
just huge benefits to come from designing for the ears in our health care. This is an
area I intend to take on this year.

TOP 10 HEALTH AGENDAS OF THE PHILIPPINES

1. Improve hospitals and health facilities. This is the most basic problem we
need to address. If we lack the facilities, the machines, and the medicines, how can
we treat our people? To improve this, we not only need to increase the budget of
these hospitals; we should also look for capable and visionary hospital directors who
will know what to do with the additional money given to the hospital. The hospital
director should know how to manage the hospital efficiently, raise funds, and go
into public-private partnerships to quickly upgrade the hospitals capabilities.
He/she should know how to work inside the government bureaucracy and be savvy
in the political issues in his or her area.
2. Employ more health workers (doctors, nurses, and midwives). We have a
surplus of around 200,000 nurses in the country. And yet, we lack the funds to
employ the needed health workers in our health facilities. For example, the RN
Heals project only asks volunteer nurses to help the government in exchange for
an allowance. There are pending legislations to increase the budget of health
workers. Moreover, we should ensure their safety in their areas of work. Both

hospital improvement and employing the necessary health workers go hand in

hand.
3. Increase PhilHealth enrollment and improve PhilHealth benefits. This is
the flagship program of the Aquino Health Agenda (AHA), which is also called
Universal Health Care (Kalusugan Pangkalahatan). The key strategy is to enroll the
poorest 10 million families into PhilHealth. This is roughly 50 million Filipinos, half
the population, which are earning roughly less than P6,000 a month per family.
Indeed, the ugly truth is that half of our people live in poverty. If we can get the
necessary funds to enroll these poor Filipinos, then they will at least be partially
covered in their hospital expenses. But aside from giving out PhilHealth cards
(which is the easy part), the more difficult issues are 1) increasing the publics
awareness on how to use the card and 2) giving substantial health benefits for
indigent patients. To know the real state of PhilHealth coverage in the country, one
can ask around any government hospital and ask how many of their charity patients
are using PhilHealth. And this percentage (still low) will show us how far we are from
giving adequate care to our people.
4. Reduce maternal and infant deaths. The Philippines has a high rate of
mothers and infants dying. Experts say that the government will find it difficult to
attain the Millennium Development Goal for reducing maternal mortality. The
current rate is 152 mothers dying per 100,000 live births, and the target is to
reduce this number down to 50 mothers dying per 100,000 live births by 2015,
which is unlikely to be achieved.
Lifestyle Feature ( Article MRec ), pagematch: 1, sectionmatch:
To decrease maternal deaths, the strategies are to: 1) increase the number of
mothers undergoing pre-natal checkups to screen for high-risk pregnancies, 2)
increase hospital deliveries, 3) encourage mothers to space their pregnancies by
three to five years. To reduce infant deaths, the strategies are to 1) increase the
number of breastfeeding mothers, 2) increase vaccination coverage, 3) give the
proper nutrition to the mother and child.
5. Reduce non-communicable diseases. These so-called lifestyle diseases are
the top causes of mortality in the Philippines, and these include heart disease,
stroke, diabetes, high blood pressure, high cholesterol, obesity, and kidney
diseases. To address these medical conditions, the DOH needs to reduce the very
high smoking prevalence in the country (56 percent of Filipino males smoke),
increase intake of fruits and vegetables (three out of five Filipinos do not eat enough
fruits and vegetables), increase physical activity, and widen the access to cheap
medicines.
6. Reduce and prevent cancer cases. Cancer is the third leading cause of death
in the country. In my research, the top 4 preventable cancers are cancers of the
lung, liver, breast, and cervix. Smoking cessation (lung cancer), hepatitis B

vaccination (liver cancer) and early screening and treatments (breast and cervical
cancer) can dramatically reduce these cancer cases and deaths.
7. Lower the cost of medicines. The DOH is mandated to promote generic
medicines and to monitor the cost of essential medicines.
8. Control dengue outbreaks. Dengue is basically tied up with environmental
sanitation. Continue with the health information campaign on dengue prevention.
Ensure adequate hospital facilities, personnel, and equipment for dengue patients.
Facilitate the production of the dengue vaccine.
9. Reduce diarrhea outbreaks (gastroenteritis, typhoid and cholera). Like
dengue, these diseases are related to environmental sanitation. Ensure clean and
safe water supply. If this isnt possible, then we can teach the public to 1) prepare
safe drinking water, 2) wash their hands after using the toilet, and 3) dispose of
waste products safely.
10. Control the growing HIV-AIDS epidemic. Should HIV positive cases suddenly
increase in the Philippines as projected, then that will put a tremendous strain on
the health sector. This is because HIV patients can live a long time and will require
expensive maintenance medicines. How then can the government sustain such an
expense? A strong health information campaign on HIV transmission and safe sex
will help.
There are other important health issues like malnutrition, measles outbreaks,
potential flu epidemics, road accidents, air pollution, firecracker injuries, rabies,
dental health, mental health, newborn care, eye care, ear care, and many others.
Each deserves our attention and support.
However, we can start by focusing our efforts on these 10 health issues above. By
doing so, we can surely create a substantial impact on improving the health of
many Filipinos.