CHAPTER I

Introduction

The term "district hospital" is used here to mean a hospital at the first referral level that

is responsible for a district of a defined geographical area containing a defined population and

governed by a politico-administrative organization such as a district health management team.

It is possible that this term "district hospital" may vary from country to country but will remain

distinct with its functions. In some countries, where the population is small, the role and

functions of district hospital may be enlarged to suit the needs of the population. (Who

Regional Publications, Western Pacific Series No.22,District Health Facilities)

Most of the people in the Philippines cannot easily achieve the proper health care

delivery. This situation exist particularly in the rural areas in the provinces that usually lacks in

health care facilities, poor service capabilities and even inadequate design of some hospital

especially to the primary level hospital. Thats why most approach of the people to primary

level hospital is that, it has poor services of healthcare that leads the people by passing the

primary levels hospital without the proper referral system which results for the overcrowding

of the patients in higher level of hospitals.

Today, the health care services in Iloilo city has improved in terms of medical staff

capability. The provincial government of Iloilo city has carried out a program to improve the

facilities of the provincial hospital and there are 11 district hospitals that scattered all over the

province. They have allocated additional budget to make the hospitals better able to handle the
needs of the people. The staffs of the hospitals were also given opportunities to enhance their

skills and knowledge.

Just before the end of 2005, the Sangguniang Panlalawigan approved an ordinance

adopting standard rates for all accommodation and services at hospitals. This is geared toward

improving the revenue generation component of hospitals.

Hospitals before have to earn money to be able to sustain their operations and to

provide better services to the people. Recent strategies adopted by the health sector are now

focused on the operation of health reforms namely: Public Health Reforms, and Local Health

Systems. As part of health reforms,The provincial government implemented health programs

and projects to address the top causes of morbidity and mortality in the province of Iloilo. Local

health system is another area that needs reform, to improve the delivery of services. At

present, there are 11 inter local health zones that were organized and operationalized namely:

(1st district)- Rep. Pedro G. Trono Memorial Hospital in Guimbal,(2nd district)- Aleosan District

Hospital in Alimodian,(3rd district)-Iloilo Provincial Hospital in Pototan, Ramon Tabiana

Memorial District Hospital in Cabatuan, Federico Roman Tirador Sr. Memorial District Hospital

in Janiuay, Dr. Ricardo Y. Ladrido Memorial Hospital in Lambunao, Dr. Ricardo S. Provido Sr.

Memorial District Hospital in Calinog, (4th district) Dumangas District Hospital, Don Valerio

Palmares Sr. Memorial District Hospital in Passi City, (5th district) Barotac Viejo District Hospital,

Sara District Hospital, Jesus M. Colmenares District Hospital in Balasan.

The Statement of the problem is to design a district hospital that will cater the needs of

the people in terms of healthcare not only in the Municipality of Lemery but also in the whole
5th district. The Municipality of Lemery needs a district hospital because it has mountainous

barangays and its about 25 kilometers far from Sara District Hospital. Sometimes, when the

patients of Lemery reach the Sara district hospital it is already very crowded that other patients

stays in the alleys of the hospital or sometimes they cannot be accommodated and referred to

the city hospital.

One way to improve concerns with regards to effective and efficient delivery of

healthcare services here in Iloilo city, is putting up a proposal that would be the solution for the

healthcare needs of the people in 5th district. The study has the following objectives: [1.]To

design a hospital department such as inpatient care for critically ill or injured persons and

outpatient for consultation and examination.[2.]To study how to organize spaces involving

hospital standard facilities and to design auxiliary facilities for convenience and easy access of

the users.[3.]To provide a pit-stop hospital with standard facilities for the public in nearby

barangays and municipalities primarily on secondary care.

This study is significant to the public for them to know the role of district hospital to the

community and to enhance their knowledge about proper health care delivery or referral

system. To the Local Government Unit, this can help them find out the importance of district

hospital in the community. It is also significant to all the architects, engineers and designers to

design and to build appropriate health care facilities with the integration of Bioclimatic

Architecture to balance the ecological, economics, and social circumstances and to promote a

healing environment inside and outside of the building. This study will be significance to the

Architecture students undergoing research as their source of reference and to enhance their
knowledge on how to develop a new strategies for the improvement of modern district

hospital.

The scope of this study covers the important Architectural Design data and information

relevant to the planning and space programming of a Primary level hospital. It comprised

relevant records from books and the internet about the District hospital and selected facilities

involved. Similarly, conducted surveys and interviews were used as a basis for processing the

design of the proposed facility. This included the architectural analysis, planning, and space

programming for the said healthcare facility. The study was limited to the planning of District

hospital.
 CHAPTER II

REVIEW OF RELATED LITERATURE

A district hospital typically is the major healthcare facility in its region, with large

numbers of beds for intensive care and long-term care. Public district hospitals fulfill vital roles

in the states healthcare system. Without them many people would be unable to receive

healthcare in their own communities. District hospitals are authorized not only to operate as

hospitals, but to deliver any kind of service to help people stay healthy physically, socially and

mentally. Because they are owned and governed by local citizens, district hospitals tailor their

services to meet the unique needs of their individual communities. It is the community based

mission that defines and distinguishes district hospitals from other healthcare entities.

The role of district hospitals in primary healthcare has been expanded beyond being

dominantly curative and rehabilitative to include promotional, preventive and educational roles

as part of a primary healthcare approach. Health systems in developing countries are often

organized in a hub and spoke arrangement, with a district hospital (the hub) having more

personnel with more advanced training than the peripheral clinics (the spokes). The peripheral

clinics are usually health centers and health posts located in communities and staffed by nurses

and other health workers who provide primary care services. Ideally, district hospitals provide

the first level of outpatient or inpatient care for patients who have been referred by their

primary care providers. District hospital also refer to people who need more specialized care to

regional or national level health facilities.(Canadian International Development and the Aga
Khan Foundation, 1981. The role of the hospitals in primary healthcare Karachi: Canadian

International Development Agency and the Aga Khan Foundation Canada).

HOSPITAL SECTOR IN THE PHILIPPINES

Delivery of healthcare services in the Philippines is provided both by public and private

provider. It is designed as a referral network, wherein barangay Health Stations (BHS), manned

by barangay Health Workers (BHWs), serve as the base 1, they report to City Health Offices

(CHOs) or Rural Health Units (RHUs)usually located in a city or a town Poblacion. CHOs/RHUs

are usually staffed by a physician, nurses, a sanitary inspector, trained midwives, affiliated

traditional birth attendants and BHWs. RHUs refer patients to primary hospitals, usually

composed of 25 beds. Large provinces usually have secondary hospitals usually composed of

provincial and city hospitals. Final referral hospitals are composed of medical centers, regional

hospitals, and specialty care hospitals. With the devolution of health services in 1992, the

referral network failed to work as envisioned. For instance, tertiary hospitals normally attend to

all the cases, even primary ones.

Hospitals in the Philippines are relatively small. Sixty-five percent of all hospitals have 50

or fewer beds. On average, government hospitals are composed of 62 beds while private

hospitals have 38 beds. In the early 1970s, public hospital beds outnumbered private hospital

beds by a big margin. But this gap has been narrowing as the number of private hospital beds

has been catching up with the number of public hospital beds. In 2005, the gap was minimal at

342. Government bed capacity decreased particularly after the devolution of hospitals to local

governments. With the passage of the Local Government Code in 1991, the powers and
responsibilities of the central government were passed to local government units. The DOH

devolved its hospitals, provincial and district offices, and the staff of these offices to the

provinces. The municipalities were given the responsibility of providing basic health services

through Rural Health Units and barangay Health Stations while the cities were in charge of

health offices in the city. Out of 639 public hospitals, only 45 remained under the DOH as

national government facilities in 1992. (Solon, Orville, Gertler, Paul, and Alabastro, Stella(1998):

Insurance and Price Discrimination in the Market for Hospital Services in the Philippines.

Quezon City: University of the Philippines).

The country has an average ratio of 1,000 people per hospital bed. Based on the

licensing report on the number of beds according to category of health facilities, the

government owns most of the beds in infirmary facilities and in the first and third level referral

hospital while the private sector owns most of the beds in birthing homes, second level referral,

and acute, chronic and custodial psychiatric care facilities. While there have been efforts in the

past to integrate the dual hospital system into a cohesive one, much remains to be desired in

this respect. The interface between the public and private hospital system needs to be further

elucidated and the areas of engagement strengthened. (Bossert T, Beauvais J. Decentralization

of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of

decision space. Health Policy and Planning 2002;17: 14-31).

 CURRENT CATEGORIES OF HOSPITALS

(1) GOVERNMENT OR PRIVATE:

Government Hospital - operated and maintained partially or wholly by the national,

provincial, municipal or city government or other political subdivision, board or other

agency thereof.

Private Hospital privately owned, established and operated with funds raised or

contributed through donations, or by private capital or other means by private

individuals, association,corporation religious organizations, firm company, or joint stock

association.

(2) GENERAL OR SPECIAL:

General Hospital - provides services for all kinds of Illnesses, diseases, injuries or

deformities.

Special Hospital provides services for one particular kind of Illness/disease or medical

health care need.

LEVELS OF HOSPITAL

Primary-level hospital: District hospital, Rural hospital, Community hospital, General hospital

Provide the first level of outpatient or inpatient care for patients who have been

referred by their primary care providers. District hospitals also refer people who need more

specialized care to regional or national-level health facilities. Specialties offered are mainly

internal medicine, obstetrics and gynecology, pediatrics, and general surgery, or just general
practice; limited laboratory services available for general but not specialized pathological

analysis.

Secondary-level hospital: Regional hospital, Provincial hospital (or equivalent administrative

area such as county), General hospital.

Highly differentiated by function with 5 to 10 clinical specialties; size ranges from 200 to

800 beds; often referred to as a provincial hospital.

Tertiary-level hospital: National hospital, Central hospital, Academic or teaching university

hospital.

Are designed to cater to more serious diseases are also accommodating cases that can

be handled by lower level facilities. This leads to tertiary hospitals requiring more financial

resources to be able to attend to all its patients. Highly specialized staff and technical

equipment for example, cardiology, intensive care unit, and specialized imaging units; clinical

services highly differentiated by function; could have teaching activities; size ranges from 300

to 1500 beds.(Definitions from Mulligan and others 2003, 59.)

(4) TRAINING AND NON-TRAINING:

Teaching and Training Hospital departmentalized hospital with accredited Residency

Training Program in a specified specialty or discipline.(source: Hospital Licensure Act

Sec. 16 of R.A. 4226)

 PATIENT CARE AREAS

Patient care areas, classified as follows, shall be those areas designated by the governing body

of the health care facility in accordance with the type of patient care anticipated:

(1) General Care Areas are patient bedrooms, examining rooms, treatment rooms,

clinics, and similar areas in which it is intended that the patient shall come in contact

with ordinary appliances such as a nurse call system, electrical beds, examining

lamps, telephone, and entertainment devices. In such areas, it may also be intended

that patients be connected to electro medical devices (such as heating pads,

electrocardiographs, drainage pumps, monitors, otoscopes, ophthalmoscopes,

peripheral intravenous lines).

(2) Critical Care Areas are those special care units, intensive care units, coronary care

units, angiography laboratories, cardiac catheterization laboratories, delivery rooms,

operating rooms, and similar areas in which patients are intended to be subjected to

invasive procedures and connected to line operated, electro medical devices.

(3) Wet Location is a patient care area that is normally subject to wet conditions

including standing water on the floor or routine dousing or drenching of the work

area. Routine housekeeping procedures and incidental spillage of liquids do not

define a wet location.(source: Philippine Electrical Code. Article 7.11.6)

Zoning: The different areas of a hospital shall be grouped according to zones as follows:

Outer Zone - areas that are immediately accessible to the public: emergency service,

outpatient service, and administrative service. They shall be located near the entrance

of the hospital.

Second Zone - areas that receive workload from the outer zone: laboratory, pharmacy,

and radiology. They shall be located near the outer zone.

Inner Zone - areas that provide nursing care and management of patients: nursing

service. They shall be located in private areas but accessible to guest.

Deep Zone areas that require asepsis to perform the prescribed services: surgical

service, delivery service, nursery, and intensive care. They shall be segregated from the

public areas but accessible to the outer, second and inner zones.

Service Zone areas that provide support to hospital activities: dietary service,

housekeeping service, maintenance and motorpool service, and mortuary. They shall be

located in areas away from normal traffic.

York Hospital, Wigginton Road, York, YO31 8HE, North Yorkshire, England, United Kingdom

York Hospital is the Trusts largest hospital. It has over 700 beds and offers a range of

inpatient and outpatient services. It has an Accident and Emergency department and provides

acute medical and surgical services, including trauma, intensive care and cardiothoracic services

to the population and visitors to York and North Yorkshire. The York Hospital is situated on

Wigginton Road about 15 minutes walk from the centre of the city.

York Hospital is a National Health Service teaching hospital in York, England. The hospital serves

a population of 500,000 in North Yorkshire. York Hospital now has over 700 beds and offers a

range of inpatient and outpatient services.

The hospital has a day unit department for day operations and operating theatres for more

complex operations. Ambulance service for the hospital is provided by Yorkshire Ambulance

Service. On-site at York Hospital there is a range of services including an accident & emergency

department, adult critical care unit, coronary care unit, maternity unit and specialist

departments including dermatology, elderly medicine, ear, nose and throat, neurology,

ophthalmology, oral and maxillofacial surgery, orthopedics, pediatrics and restorative dentistry.
During 2010/2011:

64,207 referrals were sent to the hospital by general practitioners

76,432 inpatient spells

101,913 first outpatient appointments

233,753 patients had subsequent outpatient appointments

32,730 patients were operated on

https://www.yorkhospitals.nhs.uk/

York Hospital Floor Plans and Facilities

 Surgery Center Maternity Unit Maternity Ward

Hospital Ward Nurse Station Cancer Care Centre

Orthopedics at York Hospital David Lyon Art York Show Chapel

Emergency Entrance York Hospital Enhanced Recovery Restaurant

 Milton District Hospital, Halton Region, Ontario, Canada

Milton District Hospital (or MDH) is a community hospital built on 30 acres (12 ha) of land,

located in Milton, Ontario, Canada. It is founded on 1959.The hospital had 66 beds.

Milton District Hospital offers a wide range of primary care services. Its major areas of clinical

emphasis include emergency, obstetrics, general medicine, intensive care unit, surgery,

rehabilitation, and complex continuing care.

The emergency department is open 24 hours a day, seven days a week, together with the

outpatient department provides care to more than 37,000 patients annually. The hospital is

equipped with a helipad.

Patients in Milton will benefit from:

A new patient care building to offer priority clinical services, including critical care,

maternal newborn, diagnostic imaging, emergency, surgery and inpatient beds

Increasing inpatient beds from 63 to 129, including more single-patient rooms for

improved infection prevention and increased patient privacy

 The addition of the hospital's first Magnetic Resonance Imaging (MRI) machine

A Special Care Nursery with capacity for eight bassinettes in the Maternal Newborn

Unit.

Construction at Milton District Hospital is now underway and is expected to be complete

in the spring of 2017.

https://en.wikipedia.org/wiki/Milton_District_Hospital
 Top view of Milton District Hospital

Facilities of Milton District Hospital

Emergency department Diagnostic Imaging Medical/Surgical Inpatient Units

Intensive Care Unit Maternal Newborn Surgical Services

 KhooTeckPuat Hospital, Yishun, Singapore

KhooTeckPuat Hospital is a 590-bed hospital located at Yishun in Singapore. The hospital

was officially opened by Minister Mentor Lee Kuan Yew on 15 November 2010, but began

seeing outpatients and day surgery patients on 28 March 2010. Spanning over 3.5 hectares (8.6

acres) in the Yishun Central Area overlooking the scenic Yishun Pond. The hospital offers an

extensive range of medical services and healthcare options for residents living in the north

The facility's inpatient wards and acute care and emergency department began operation on 28

June 2010.

Key facilities

550 beds

19 wards consisting: 8 private wards (including one deluxe suite), 10 subsidized wards

and 1 classless isolation ward

2 intensive care units

90 consultation rooms

8 operating rooms

6 day surgery operation rooms

 4 endoscopy suites

Other amenities such as family-friendly restrooms, handicapped-friendly restrooms,

retail mall, food court and caf

Design

The Khoo Teck Puat Hospital is designed to be patient-friendly. The 10-bedded "C"-class wards

is divided into two sections, each with its own toilet and shower facilities. There is only one

drop-off point for the hospital and the distance from it to the emergency department is only 20

metres, while the distance to the specialist clinics is between 20 and 40 metres. There are no

protruding sinks or cupboards in the wards so patients are less likely to hurt themselves.

The hospital also incorporates environmentally friendly features. The building uses 30% less

energy than other newer hospitals such as Tan Tock Seng Hospital, Changi General Hospital and

Kandang Kerbau Women's and Children's Hospital, a savings of more than S$1 million a year on

utilities costs.

"Fins" along the building's walls are designed to channel the prevailing north-east winds into

the building. Wind tunnel tests conducted at the National University of Singapore found that

the "fins" would enhance the air flow by 20 to 30%. Sunshades over the windows protect

patients from the direct glare of sunlight. The shades also re-direct light towards the ceiling to

enhance the brightness of the wards and save on the use of energy. Large fans in public areas

are powered by solar panels on the roof. The air-conditioning system draws supply air from its

internal courtyards, where the air is cooler, hence reducing the cooling loads.
http://www.rmjm.com/portfolio/khoo-teck-puat-hospital-singapore/

Khoo Teck Puat hospital Site Plan

Aerial Perspective
 Emergency Department Hospital Ward Private Room

Ward 45 Ward 46 Ward 47

(Pediatric Intensive Care Unit/ High Dependency)

Built-in operating theatre Food court Waiting Area for consultation

 South Jakarta Hospital,Indonesia

Aims to be environmentally friendly and energy efficient, while serving as a new icon or

healthcare services. It contains the necessary facilities of a full-functioning standard hospital

such as a 24-hour Emergency Room, a clinical laboratory, diagnostic unit, operating theatre, a

polyclinic providing a wide range of health care services, physiotherapy, radiology, and wards

with a capacity of 432 inpatient beds, etc. Effective and efficient connectivity, between and

within units, and smooth flow between patients, employees and visitors, are some of the

aspects taken into consideration while designing the building layout.

There are three aspects of the architecture that responded to the site:

1. Orientation - the optimization of greenery and land on the west of the site;

north-south orientation of the building.

2. Form massing - the complex is designed to leverage the relationship between

indoors and outdoors.

3. Site circulation - the pedestrian and vehicular traffic is kept separated with the

pedestrian paths positioned closer to the trees on the west and the ER pathway and

main entrance located on the other side. The corridor on the west side is an important

element of the building, as it connects the building with the main road to ease access for
 visitors who use public transportation. It also helps expand the drop-off area, as well as

decrease the vehicles queuing at the car park.

The extensive greenery presents a positive healing environmentit provides a calm,

serene setting for patientsand acts as a barrier against noise and air pollution. Responding to

the tropical climate setting, the architecture creates shadow and shading to lower ambient

temperature and urban heat island effect, which in turn will help reduce energy needed for

artificial cooling.

The hospital's podium program is arranged to operate separately but it is still linked to

the main scheme. This concept, likened to individual cells inside the human body functioning

together, helps connect the spaces between the indoor and outdoor while facilitating the

process for phasing development and any future expansion without jeopardizing the forest land

on the west side. The design layout also seeks to organize the spaces inside to ensure optimal

usage, allowing smooth flow of movement without compromising the quality of the view.

South Jakarta Hospital

 Intensive Care Unit Surgical Inpatient Unit

Private Room Nursing Unit

http://tropical-architecture.blogspot.com/2012/12/RUMAH-SAKIT-jakarta-selatan.html
Mid Coast Hospital,Brunswick, Maine, Mid Coast, Maine, United States

Mid Coast Hospital is a full-service community hospital located in the heart of Maines Midcoast

region. The 93-bed facility is an independent, not-for-profit hospital governed by a community

Board of Directors.MID COAST HOSPITAL was formed after a merger between Bath Memorial

Hospital and Regional Memorial Hospital. The hospital opened its modern campus in 2001 and
then expanded in 2009 with a new Emergency Department and additional Medical/Surgical

inpatient beds.

MID COAST HOSPITAL is part of MID COASTPARKVIEW HEALTH, a dynamic healthcare system

dedicated to improving the health of the community. MID COASTPARKVIEW HEALTH was

created in 2015 when Parkview Adventist Medical Center joined with Mid Coast Health Services

to realign healthcare services in the region.

The active medical staff includes more than 180 physicians and advanced practice providers in

more than 30 primary care and specialty areas. This includes outstanding private physician

practices as well as a large multi-specialty physician practice that is part of the hospital, Mid

Coast Medical Group.

MID COAST MEDICAL GROUP is made up of Internal Medicine practices in Bath and Topsham,

Family Practice groups in Brunswick and Topsham, a Pediatric Maine Care clinic, and a Walk-In

Clinic Downtown at Brunswick Station. The Mid Coast campus includes Breast & Surgical

Oncology, Cardiology, Diabetes & Endocrinology, Ear, Nose & Throat, Gastroenterology,

Nephrology, Neurology, Ophthalmology, Orthopedics, Pulmonary, Critical Care & Sleep

Medicine, Rheumatology, Surgical Care, Urology, Women's Health Care (an OB/GYN and

Certified Nurse Midwifery practice), and Wound & Ostomy Care. The Parkview Medical Center

campus includes General Surgery and Hematology & Oncology practices.

MID COAST HOSPITAL has a 24-hour Emergency Department, Intensive Care, Surgical Services,

Medical/Surgical/Pediatrics, Pharmacy, Maternity Care, and Behavioral Health services.

Outpatient services include Day Surgery, Laboratory, Diagnostic Imaging, Cardiac

Catheterization, Interventional Radiology, Cardiac and Pulmonary Rehabilitation, Physical,

Occupational, and Speech Therapy, and Walk-In Care. Outpatient services at the Parkview

campus include Day Surgery, Rehabilitation, Laboratory, and Diagnostic Imaging.

In addition, the hospital offers advanced care through such integrated, interdisciplinary centers

as The Heart Center, Primary Stroke Center, Center for Cancer Care, Digestive Health Center,

Center for Joint Replacement, Sleep Disorders Center, Addiction Resource Center, Womens

Imaging Center, and Center for Community Health and Wellness.

 Mid Coast Hospital Facilities

Patient Care Room Patient Care Room Reception

Desk

Nurse Station Emergency room Cafeteria

 Talisay District Hospital, San Isidro, City of Talisay, Cebu, 6045 Philippines

Talisay District Hospital (TDH) launched the Department of Health (DOH) Universal High

Impact Five with simultaneous nationwide live broadcast.Hi-5 is a unique directive involving all

DOH hospitals to support the regional offices in their aspiration in achieving Universal Health

Care, a crucial segment of the countrys 2015 Eight Millennium Development Goals. Hi-5

focuses on maternal health, infant health, child health, HIV/AIDS and the service delivery

network. The featured Philippine Health Atlas highlights the crucial Hi-5 responsibility zones,

primarily remote locations in every region that both have the greatest need and the least

access to proper health care. This Hi-5 launching also introduced the Alagang Pinoy brand, a

theme dedicated to improving customer satisfaction and high standard patient-centered care in

DOH hospitals.
 The new 4 storey Building 2 shall house the state of the art departmentalized clinical

services (Operating Rooms, Recovery Rooms, Labor and Delivery Rooms, etc.) and

departmentalized Philhealth wards and Rooms.

The infrastructure development of TDH shall prepare the upgrading of TDH to a 250 BED Level 3

general and specialty hospital to become the Trauma, Rehabilitation, and Sports Medicine in

the Visayas as envisioned in the DOH Philippine Hospital Development Plan for the hospital.

This project is realized through the efforts of Talisay District Hospital and the full support of the

national government through the Department of Health.

Facilities of Talisay District Hospital

http://tdh.doh.gov.ph/
 BACKGROUND OF THE STUDY

Lemery was a corrupt word derived from the Spanish word Lamenaria, the luminescent

lamp. It is referred to a very tall tress, a Palo Maria, a variety of Lawaan spacie, which grows at

the outskirts of the now poblacion. To the settlers it was called the labogkahoyand was the

landmark of the dull lamp when seen from a far. How Lamenaria metamorphosed into

Lemery is claimed to have arisen from the natives proactivity to adopt a simplified, shortened

version for a multisyllabic foreign word. Thus,Lamenaria was shortened Lamiri and finally

was called Lemery.

The area which represent the Municipality of Lemery, was once been a part of the

Municipality of Sara. It became an Independent Municipality in 1984, virtue of republic act 197,

sponsor then representative of the 5th congressional district of Iloilo, the honorable Juan V.

Borra. A fifth class municipality, Lemery is relatively depressed agricultural town in the northern

part of the Province of Iloilo, Its link to the northern coastal traffic is a sand and gravel that

extends to the opposite direction to the Municipality of San Rafael, then to Passi and central

traffic.
 Lemerys economic growth depends mainly on each agricultural sector. It posses a vast and

rich area best suited for agricultural. Industrialization post a good potential considering that it

has biggest bulk deposits of white clay, for ceramics industry, as well as traces of copper, iron,

gold, and other metallic minerals. Lemery has a total of 31 barangays and has 15,296 registered

voters as of 2010. Lemery has a total land area of 11,990 hectares as of 2007 and it is was a 4th

class Municipality and partially Urban. According to the 2010 census, It has a population of

27,441 people. Lemery is in the Iloilo province and within Region VI in the Western Visayas Area

in the eastern side of the island of Panay.

Profile and Analysis of the Existing Situation

The devolved Municipal Health Office has the following Vision: A healthy Community

immediate access to affordable, sustainable and quality health services. Mission: Effective

and efficient delivery of basic health services in partnership with the Local Government Units,

Government organization, NGO and the community.

 The Municipality of Lemery has 4 BHS, located at Brgy. Nagsulang, Gerongan, Milan,

Bankal, and 1 Main Health Center in Poblacion South East Zone.

In the year 2015 Pneumonia rank no. 1 in leading causes of Mortality. For the top

leading causes of morbidity Pneumonia ranked no. 1.

10 LEADING CAUSES OF MORTALITY YEAR 2015

SARA (SDH) BAROTAC VIEJO (BVDH) BALASAN (JMCDH)
1. PNEUMONIA 55 35 66
2. SEPSIS 27
3. CEREBRO VASCULAR ACCIDENT (CVA) 13 25
4. HYPERTENSIVE CARDIO VASCULAR DISEASE (HCVD) 8
5. MYOCARDIAL INFARCTION (MI) 12 9 6
6. OULMONARY TUBERCULOSIS (PTB) 6 1
7. CANCER (CA) 8 11 2
8. PREMATURITY 7 4
9. ACUTE/CHRONIC RENAL FAILURE 9 5
10. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
TOTAL 103 76 130

10 LEADING CAUSES OF MORBIDITY YEAR 2015

SARA (SDH) BAROTAC VIEJO (BVDH) BALASAN (JMCDH)
1. PNEUMONIA 490 565 2243
2. ACUTE GASTROENTERITIS (AGE) 703 465 1490
3. URINARY TRACT INFECTION (UTI) 391 158 365
4. GASTRITIS 145 557
5. HYPERTENSIVE CARDIOVASCULAR DISEASE (HCVD) 274 155 37
6. HYPERTENSION 310 244
7. OBSTETRIC CASES
8. PULMONARY TUBERCULOSIS (PTB) 99 120
9. NEWBORN (NB)
10. CEREBRO VASCULAR ACCIDENT (CVA) 155 161
TOTAL 2267 1763 5097
10 LEADING CAUSES OF REFERRALS YEAR 2015
SARA (SDH) BAROTAC VIEJO (BVDH) BALASAN (JMCDH)
1. PNEUMONIA 23 93
2. CEREBRO VASCULAR ACCIDENT 36 14 29
3. INTRA UTERINE PREGNANCY 11 13
4. OBSTETRICS (OB)
5. APPENDICITIS (AP) 16 8 3
6. DENGUE HEMMORRHAGIC 17 3 19
7. ACUTE GASTROENTERITIS (AGE) 11 23
8. HYPERTENSIVE CARDIO-VASCULAR DISEASE (HCVD) 14
9. FRACTURE 24
10. HYPERTENSION 21 14
TOTAL 148 77 167

TOTAL ADMISSION YEAR 2015

SARA (SDH) BAROTAC VIEJO (BVDH) BALASAN (JMCDH)

7361 2710 8947

 Sara District Hospital is a 50 bed hospital. It has a total of 500 patients per day. It is

located at the Brgy. Anoring ,Sara, Iloilo City. It has an Accident and Emergency department.

The SDH is now under renovation because of the typhoon Yolanda. The patients of Lemery,

Ajuy, San Dionesio and Concepcion also referred to the Sara district Hospital, because Sara

District Hospital is the only nearest hospital in the said Municipalities. When the patients of

Lemery reach to the Sara District Hospital it is already very crowded or sometimes they cannot

be accommodated and referred to the city hospital.

Sara District Hospital has a total of 89 active staff which is:

5 24hrs rotating doctors,

1 OPD doctor & 1 OPD nurse

1 hospital director

15 nurse1 & 2 nurse2

1 midwife

1 sanitary inspector

2 surgeons

10 institutional workers

7 nursing aid & 5 staff in record section

5 cashier,5 staff in philhealth,

1 dietician,1 nutritionist3 medical technologist,1 radiologist,1 chiefnurse,5 staff in

canteen

10 volunteer nurses,4 security guard,1 dentist,1 obegyne

 Sara District Hospital Facilities

Staff Dormitory Outpatient Department Emergency Room

Pharmacy Laboratory Ward

Hallway Private Room Supply Room Dietary

Canteen Parking Dressing Room

Xray Dark Room Comfort Room Ward

Morgue Garbage Disposal Surgical Ward OBR

 The Municipality of Lemery has a Rural health Unit that support the needs of the people in

terms of health services. Lemery Rural Health Unit composed of 5 midwives,5 casual midwives,

1RSI,1 Municipal health officer,1 contractual public health nurse,10 DOH nurse deployment

program (NDP),3 Rural health midwife program (RHMPP),1 medical technologist,1 driver,1 IT

encoder.1 contractual midwife,1 DOH PHA public health aid. The Municipality of Lemery needs

a district hospital because it has mountainous barangays and its about 25 kilometers far from

Sara District Hospital. Sometimes, when they reach the hospital it is already very crowded that

other patients stays in the alleys of the hospital or sometimes they cannot be accommodated

and referred to the city hospital. There are also issues and problems on the hospital

management such as the following: inadequate budget, lack of medical and surgical supplies,

lack of hospital equipment and unfinished infrastructure.

The Existing Floor Plan of Lemery Rural Health Unit

 The existing facade of Lemery Rural Health Unit

Newborn Screening Area Lavatory at the Newborn

Screening Area

Files & Records of all Patients Treatment Counselling Room Exit way to the TB Dots Room
Inside of the Conference Room Entrance & Exit Hallway outside of the
Conference Room

Inside of the RHU Waiting Area of TB Patients Admitting Section

Vaccine room & Comfort Room Lavatory inside at the Vaccine Room
 CHAPTER III
METHODOLOGY

The Descriptive and Interview Method are the methods that had been applied by

researcher to this study in order to attain the set of objectives and to complete the needs of

this study. Through Internet, checking the library to find the relevant data which is related to

this study and reading some finished architecture thesis as a sort of reference, going to the

related agencies to know the feasibility of the problem. By obtaining data from the Department

of Health (DOH) and conducted some interviews from the officer in charge and asked for the

guidelines and considerations in planning a Primary Level Hospital, and also to the Municipal

Health Office to analyze the health status within the locality, and proceeding to the Municipal

Assesors Office to choose an appropriate site for the problem and lastly from the Municipal

Planning and Development Office to ask for the copy of the Comprehensive Land Use Plan in

order for the researcher to analyze present scenario of the chosen site.

The Observation Method is also used as an instrument in this study to sustain the needs

of the problem. By observing the present scenario and even the past scenario and through the

data that has been gathered in the MHO (Municipal Health Office) the researcher has been able

to analyze the certain needs of the Municipality by understanding the health status including

the population growth rate, crude birth rate, crude death rate, causes of morbidity, mortality

and the nutritional status.

 Conceptual Framework

A Proposed 100 Bed Lemery Hospital

Secondary Data Collection Primary Data

Collection

Site Investigation Conduct Survey &

Conduct research in library Government Agencies Analysis Interview

Conduct research in Picture Conceptualization

Existing library/internet Survey
Situation

Data Collection
Municipal Planning Schematic Evolution of
and Development Analysis Concepts
Municipality of
Lemery Office of Lemery

Municipal Assessor's Office

Bureau of Lands /Registry of Deeds

 CHAPTER IV
PRESENTATION OF ANALYSIS AND RESULTS

This chapter includes findings of the study as presented such as: Site Analysis which

involves the selection of suitable or potential sites, analysis and the evaluation of the said

proposed sites for the probable use and development of the area, Design Considerations that

include specific and important considerations suitable to Primary Level Hospital, Site and Space

Programming comprises the details on schematic diagrams and behavioral patterns, space

integration and space requirements relevant to the standards specific for the users, Diagrams

and schematics include concept evolution, bubble diagrams and site development plan

diagrams.

SURVEY RESULTS AND DATA EVALUATION

During the investigative process of this study, the researchers conducted surveys,

interviews, and statistical analyses in order to find solutions and ways in solving the problem

regarding the proposed District Hospital. 3 sets of survey questionnaires was prepared and sent

out to be filled by randomly chosen people within the existing health facilities and in the 5th

district. The questionnaires namely SET A is intended for the patients, Watchers and Guardian

respondents and Set B for the community of 5th district, Set C for the Medical and Non-medical

Staff respondents.

RESPONDENTS OF THE CONDUCTED SURVEY AND INTERVIEWS

A total of one hundred twenty (120) people were taken in as respondents of the

conducted survey and interview. This was composed of different people with varying views,

opinions and with different way in life so that the researcher might be able to know how these
groups of people perceives and apprehend the situation of the existing facility, 50 respondents

were from the Set A group within the existing health facilities, 50 respondents were from the

Set B group within the 3 District hospitals in the 5th district and 20 respondents were from the

Set C group within the existing health facilities.

Set A group

According to the survey 96% of the people agrees that the site is located at the

Barangay Poblacion South East Zone, Lemery ,Iloilo City.

According to the survey 90% of the people said that they are not contented with the

facility present in the health center in the municipality.

 According to the survey 82% of the people said that the assessment of their present

health status in the municipality is poor.

According to the survey 97% of the people agrees that they want a district hospital in
Lemery and 3% of the people disagree.

67% of the people says that they visit the Hospital or RHU twice a year,15% once a

month,10% twice a month and 8% once a week.

According to the survey 55% says that they want an Indoor Lanscape,25%

landscape,10% Cafeteria and 10% Lobby.

Set B group
 According to the survey 75% of the people said that the facility which the government

provide is poor.

According to the survey they visited the RHU/Hospital 35% twice a year, 30% twice a

month, 20% once a week and 15% once a month.

According to the survey 65% of the people said that they are not satisfied with the

services provided by their municipality when it comes to health services.

According to the survey 95% of the people Agrees to have a district hospital in Lemery.

Set C group
 According to the survey 98% of the people said that they want a district hospital in

Lemery.

According to the survey 60% of the people said that the facilities that the government
provided in terms of health is poor.

According to the survey the people said that the important services in district hospital is

Emergency Room.

According to the survey people said that in 30 days there are 3,200 patients visited the

RHU.
 According to the survey 50% of the people said that the top diseases that usually occurs

in Lemery/5th district are ARI (Acute Respiratory Infection), 30%Dengue,

15%Tuberculosisand 5% is Diabetes.

According to the survey 55% of the people said that they want an indoor Landscape in

the proposed district hospital.

1000 1000-1200 1200-1500 1500-2000

According to the Staffs of Sara District Hospital The top leading causes of motality
is Pneumonia and in 1 month there are 2,000 and above patients that admit to
the Hospital.

Site Analysis/Description

The municipality of Lemery is composed of 31 barangays. Its total area is approximately

13,998 hectares. It is located in the North - Central part of the Province of Iloilo, Island of Panay.

The municipality is bounded from the North by the Municipalities of Cuartero and Maayon,

both of the province of Capiz, in the south by the municipality of Barotac Viejo, Iloilo in the east

by the municipalities of Sara and Ajuy, Province of Iloilo, In the west by the Municipality of San

Rafael, Iloilo and the Municipality of Dumarao Capiz. The exact location of Lemery is at

coordinates ranging from 111825 latitude and 1225222 to 1225742 longitude. From the
City of Iloilo, Lemery is 107 kilometers via Sara and 85 kilometers via Passi sand gravel road

links.

Total No. of Barangays 31

Urban 2

Rural 29

Classification 5th

Site Description

Infrastructure and Utilities Sector

Transportation

Lemery has a total road length of 120.329 Kilometers with an average width of 5.00

Meters. But the most notable and prevalent problem is the fact that most of the road portion

are totally worn-out. This, however, result to inconvenience of vehicles traversing in the

barangay road of Lemery. In the remote barangays worse road condition is also the reason of

the inconvenience and difficulty of transportation services especially during rainy season hence

residents experienced difficulties.

 To address these problems, the municipal government included the rehabilitation and

maintenance, road concreting and construction of bridges and overflow in the flooded area

during rainy season.

Communication

Just recently, ISLACOM Inc. a cellphone company constructed their cell site in the

municipality. This ushered new trend in communication service in the municipality which

formerly depended solely on postal service. However, few problems are also identified in this

area by the municipal government of Lemery. Due to the anticipated increase in the population

in the future there is a need to employ additional personnel, provide vehicles to transport

letters and messages to the barangays and request PLDT to open telephone lines and services

in the municipality.
Power

The electric line of Iloilo Electric Cooperative III (ILECO III) cover the town of Lemery. In

1981 only one barangay was served by electricity among 31 barangays.

Water

At present, only four (4) barangay out of 31 barangays has Level II Water System, The

rest get their water source from deep well and dug well. The Poblacion has no waterworks

system to provide safe/potable drinking water.

Existing Land Use Area (Has.)

Built up Area 64.5480

Agricultural 10,197.3010
Timber Land 2,671.9600
Socialized Housing 0.000
Agro Industrial 1.0100
Special Use
Cemetery 1.5109
Buffer Strip 552.0000
Dumpsite/Landfill 0.000
Infrastructure 141.6700
Water Bodies 368.0000
Total 13,998.0
Topography

Lemery is mountainous in the Northwestern and South-Eastern part and hilly on the

NorthEast and Southwest. Wedge between this elevated sections are fertile plains extending to

the North. This portion of level land is concentrated on agricultural activity and planted with

palay, corn, legumes and rootcrops. The existing land used area of the site is agricultural land.

Soil Types

There are three types of soil in Lemery namely, Sara Sandy Loam, Barotac Loam and San

Rafael loam.The proposed site is belong to the Sara

Loam.
 Soil Classification

Soil Type Area (Has.) % to total land area

San Rafael Loam 11,218.376 80.18
Barotac Viejo Loam 1,523.5016 10.38
Sara Sandy Loam 1,256.1224 8.99
Total 13,998 100%
Source: Department of Agriculture (DA)
Climate

The climate situation of Lemery like the rest of Iloilo Provinces belongs to type 3

whereby season is not very pronounced relatively dry from November to April and wet the rest

of the year.
Site Vicinity

The site is located at the Brgy. Poblacion South East Zone, Lemery, Iloilo City. It is about 23,578

sq.m wide. It is 120 meters far from the Proper.

Lot Plan
 BEARINGS AND DISTANCES
AREA IN SQ.
METERS
MON. TO CORNER LINE 1-2 LINE 2-3 LINE 3-4 LINE 4-5
N3539'E N3622'E S4129'E S3114'E S4311'E
128.19 218.97 35.2 2.85 48.91
S3954E S4532'E S5019'W S4622'W
26.49 29.68 80.04 22.77
S5643'E S5726'W N8016'W N7220'W
23.38 42.08 66.76 7.02
N8415'W N5233'W
23,578
41.75 22.98

SITE PICTURES
Access Road

Road Going to the Municipality of Sara

 Road Going to the Municipality of San Rafael

Existing Poor Drainage

SWOT ANALYSIS

STRENGTH WEAKNESS OPPORTUNITIES THREATS

THE WHOLE THERE IS NO PROPER HEALTH FLOOD
VICINITY OF EXISTING CARE TO THE
THE SITE IS TREES AND COMMUNITY
LOCATED WATER JOB
ALONG THE ELEMENTS OPPORTUNITIES
MAIN ROAD
 THE VIEWS OF THE SITE IS A WIDE OPEN NOISE AND
ENVIRONMEN FOOT LOWER SPACE OF THE SMOKE FROM
T ALLOW TO THE NATL NEIGHBOURING THE ROAD
PATIENTS TO ROAD SITES ALLOWS MAYBE A
RECOVER AMIHAN AND FACTOR OF
EASILY HABAGAT POLLUTION
WINDS TO TO THE
ENTER THE SITE HEALTHCARE
FOR AN AMPLE FACILITY
VENTILATION
AND GOOD AIR
CIRCULATION
WHICH GIVES
COMFORT TO
THE PATIENTS

THERE IS VIEWS OF THE

POOR ENVIRONMENT NATURAL
DRAINAGE ALLOW CALAMITIES
SYSTEM PATIENTS TO
PRESENT IN RECOVER EASILY
THE SITE

EASY PUBLIC
TRANSPORTATI-
ON TO THE SITE

THE SITE HAS A

WIDE AREA AND
FLAT SURFACE
WHICH ALLOWS
THE PATIENTS A
SAFE AND
CONDUCIVE
ENVIRONMENT
FOR RECOVERY
PROCESS
 EXISTING ELEMENTS

CLIMATIC AND ENVIRONMENT ANALYSIS

ZONING & CIRCULATION

SITE PROGRAMMING
Schematic flow of Emergency Department

Schematic flow of Radiology

Schematic Flow of Dietary

Schematic flow of Nursing Unit

 Schematic Flow of Outpatient Department

Schematic flow of Surgical and Delivery Service Complex

Design Consideration
A hospital and other health facilities shall be planned and designed to observed appropriate

architectural practices, to meet prescribed functional programs, and to conform to applicable

codes as part of normal professional practice. References shall be made to the following:

P.D. 1096-National Building Code of the Philippines and its implementing Rules and

Regulations

P.D. 1185-Fire Code of the Philippines and its Implementing Rules and Regulations

P.D. 856-Code on Sanitation of the Philippines and its Implementing Rules and

Regulations

B.P. 344-Accessibility Law and its Implementing Rules and Regulations

R.A. 1378-National Plumbing Code of the Philippines and its Implementing Rules and

Regulations

R.A. 184-Philippine Electrical Code

Manual on Technical Guidelines for Hospitals and Health Facilities Planning and Design.

Department of Health, Manila.1994

Signage Systems Manual for Hospitals and Offices. Department of Health, Manila.1994

Health Facilities Maintenance Manual. Department of Health, Manila.1995

Manual on Hospital Waste Management. Department of Health, Manila.1997

District Hospitals: Guidelines for Development. World Health Organization Regional

Publications, Western Pacific Series. 1992

Guidelines for Construction and Equipment of Hospital and Medical Facilities. American

Institutes of Architects, Committee on Architecture for Health.1992

 De Chiara, Joseph. Time-Saver Standards for Building Types. Mcgraw-Hill Book

Company.1980

1. Environment: A hospital and other health facilities shall be so located that it is readily

accessible to the community and reasonably free from undue noise, smoke, dust, foul

odor, and flood it shall not be located adjacent to railroads, freight yards, childrens

playgrounds, airports, industrial plants, disposal plants.s

2. Occupancy: A building designed for other purpose shall not be converted into a hospital.

The location of a hospital shall comply with all local zoning ordinances.

3. Safety: A hospital and other health facilities shall provide and maintain a safe

environment for a patients, personnel and public. The building shall be of such

construction so that no hazards to the life and safety of patients, personnel and public

exist. It shall be capable of withstanding weight and elements to which they may be

subjected.

3.1 Exits shall be restricted to the following types: door leading directly outside the

building, interior stair, ramp, and exterior stair.

3.2 A minimum of two (2) exits, remote from each other, shall be provided for each

floor of the building.

3.3 Exits shall terminate directly at an open space to the outside of the building.

4. Security: A hospital and other health facilities shall ensure the security of person and

property within the facility.

5. Patient Movement: Spaces shall be wide enough for free movement of patients,

whether they are on beds, stretchers, or wheelchairs. Circulation routes for transferring

patients from one area to another shall be available and free at all times.

5.1 Corridors for access by patient and equipment shall have a minimum width of

2.44 meters.

5.2 Corridors in areas not commonly used for bed, stretcher and equipment

transport may be reduced in width to 1.83 meters.

5.3 A ramp or elevator shall be provided for ancillary, clinical and nursing areas

located on the upper floor.

5.4 A ramp shall be provided as access to the entrance of the hospital not on the

same level of the site.

6. Lighting: All areas in a hospital and other health facilities shall be provided with

sufficient illumination to promote comfort, healing and recovery of patients and to

enable personnel in the performance of work.

7. Ventilation: Adequate ventilation shall be provided to ensure comfort of patients,

personnel and public.

8. Auditory and Visual Privacy: A hospital and other health facilities shall observe

acceptable sound level and adequate visual seclusion to achieve the acoustical and

privacy requirements in designated areas allowing the unhampered conduct of

activities.
9. Water Supply: A hospital and other health facilities shall use an approved public water

supply system whenever available. The water supply shall be potable, safe for drinking

and adequate, and shall be brought into the building free of cross connections.

10. Waste Disposal: Liquid waste shall be discharged into an approved public sewerage

system whenever available, and solid waste shall be collected, treated and disposed of

in accordance with applicable codes, laws or ordinances.

11. Sanitation: Utilities for the maintenance of sanitary system, including approved water

supply and sewerage system, shall be provided through the buildings and premises to

ensure a clean and healthy environment.

12. Housekeeping: A hospital and other health facilities shall provide and maintain a healthy

and aesthetic environment for patients, personnel and public.

13. Maintenance: There shall be an effective building maintenance program in place. The

buildings and equipment shall be kept in a state of good repair. Proper maintenance

shall be provided to prevent untimely breakdown of buildings and equipment.

14. Material Specification: Floors, walls and ceilings shall be of sturdy materials that shall

allow durability, ease of cleaning and fire resistance.

15. Segregation: Wards shall observe segregation 0f sexes. Separate toilet shall be

maintained for patients and personnel, male and female, with a ratio of one (1) for

every eight (8) patients or personnel.

16. Fire protection: There shall be measures for detecting fire such as fire alarms in walls,

peepholes in doors or smoke detectors in ceilings. There shall be devices for quenching
 fire such as fire extinguishers or fire hoses that are easily visible and accessible in

strategic areas.

17. Signage. There shall be an effective graphic system composed of a number of individual

visual aids and devices arranged to provide information, orientation, direction,

identification, prohibition, warning and official notice considered essential to the

optimum operation of a hospital and other health facilities.

18. Parking. A hospital and other health facilities shall provide a minimum of one (1) parking

space for every twenty-five (25) beds.

19. Zoning: The different areas of a hospital shall be grouped according to zones as follows:

19.1 Outer Zone areas that are immediately accessible to the public: emergency

service, outpatient service, and administrative service. They shall be located near

the entrance of the hospital

19.2 Second Zone areas that receive workload from the outer zone: laboratory,

Pharmacy, and radiology. They shall be located near the outer zone.

19.3 Inner zone areas that provide nursing care and management of patients:

nursing service. They shall be located in private areas but accessible to guest.

19.4 Deep zone areas that require asepsis to perform the prescribed services:

surgical service, delivery service, nursery and intensive care. They shall be

segregated from the public areas but accessible to the outer, second and inner

zones.
 19.5 Service zone areas that provide support to hospital activities: dietary service,

housekeeping service, maintenance and motorpool service and mortuary. They

shall be located in areas away from normal traffic.

20. Function: The different areas of a hospital shall be functionally related with each other.

20.1 The emergency service shall be located in the ground floor to ensure immediate

access. A separate entrance to the emergency room shall be provided.

20.2 The administrative service, particularly admitting office and business office, shall

be located near the main entrance of the hospital. Offices for hospital

management can be located in private areas.

20.3 The surgical service shall be located and arranged to prevent non related traffic.

The operating room shall be as remote as practicable from the entrance to

provide asepsis. The dressing room shall be located to avoid exposure to dirty

areas after changing to surgical garments. The nurse station shall be located to

permit visual observation of patient movement.

20.4 The delivery service shall be located and arranged to prevent non-related traffic.

The delivery room shall be as remote as practicable from the entrance to provide

asepsis. The dressing room shall be located to avoid exposure to dirty areas

after changing to surgical garments. The nurse station shall be located to permit

visual observation of patient movement. The nursery shall be spate but

immediately accessible from the delivery room.

20.5 The nursing service shall be segregated from public areas. The nurse station shall

be located to permit visual observation of patients. Nurse stations shall be

 provided in all inpatient units of the hospital with a ratio of at least one (1) nurse

station for every thirty five (35) beds. Rooms and wards shall be of sufficient size

to allow for work flow and patient movement. Toilets shall be immediately

accessible from rooms and wards.

20.6 The Dietary service shall be away from morgue with at least 25 meter distance.

21. Space: Adequate area shall be provided for the people, activity, furniture, equipment

and utility.

Space Area in Square Meters

Administrative Service
Lobby
Waiting Area 0.65/person
Information and Reception Area 5.02/staff
Toilet 1.67
Business office 5.02/staff
Medical Records 5.02/staff
Office of the Chief of Hospital 5.02/staff
Laundry and Linen Area 5.02/staff
Maintenance and Linen Area 5.02/staff
Parking Area for Transport Vehicle 9.29
Supply Room 5.02/staff
Waste Holding Room 4.65
Dietary
Dietitian Area 5.02/staff
Supply Receiving Area 4.65
Cold and Dry Storage Area 4.65
Food Preparation Area 4.65
Cooking and Baking Area 4.65
Serving and Food Assembly Area 4.65
Washing Area 4.65
Garbage Disposal area 1.67
Dining Area 1.40/person
Toilet 1.67
Cadaver Holding Room 7.43/bed
Clinical Service
Emergency Room
Waiting Area 0.65/person
Toilet 1.67
Nurse Station 5.02/staff
Examination and Treatment Area with Lavatory/Sink 7.43/bed
Observation Area 7.43/bed
Equipment and Supply Storage Area 4.65
Wheeled Stretcher Area 1.08/stretcher
Outpatient Department
Waiting Area 0.65/person
Toilet 1.67
Admitting and Records Area 5.02/staff
Examination and Treatment Area with Lavatory/Sink 7.43/bed
Consultation Area 5.02/staff
Surgical and Obstetrical Service
Major Operating Room 33.45
Delivery Room 33.45
Sub-Sterilizing Area 4.65
Sterile Instrument, Supply and Storage Area 4.65
Scrub-Up area 4.65
Clean-Up Area 4.65
Dressing Room 2.32
Toilet 1.67
Nurse Station 5.02/staff
Wheeled Stretcher Area 1.08/stretcher
Janitor's Closet 3.9
Nursing Unit
Semi Private Room with Toilet 7.43/bed
Patient Room 7.43/bed
Toilet 1.67
Isolation Room with Toilet 9.29
Nurse Station 7.43/bed
Treatment and Medication Area with Lavatory/Sink
Central Sterilizing and Supply Room
Receiving and Releasing Area 5.02/staff
Work Area 5.02/staff
Sterilizing Room 4.65
Sterile Supply Storage Area 4.65
Nursing Service
Office of the Chief Nurse 5.02/staff
 Ancillary Service
Primary Clinical Laboratory
Clinical Work Area with Lavatory/Sink 10
Pathologist Area 5.02/staff
Toilet 1.67
Radiology
X-Ray Room With Control Booth, Dressing Area and
Toilet 14
Dark Room 4.65
Film File Storage Area 4.65
Radiologist Area 5.02/staff
Pharmacy 15

Notes:

1. 0.65/person Unit area per person occupying the space at one time

2. 5.02/staff Work area per staff that includes space for one (1) desk and one (1) chair,

space for occasional visitor, and space for aisle.

3. 1.40/person Unit area per person occupying the space at one time

4. 7.43/bed Clear floor area per bed that includes space for one (1) bed, space for

occasional visitor, and space for passage of equipment.

5. 1.08/stretcher Clear floor area per stretcher that includes space for one (1) stretcher
 Architectural Theories: Bioclimatic and Biophilic Architecture
Bioclimatic architecture is defined as an architecture which has a connection with

nature, it is about a building that takes into account the climate and environmental conditions

to favor thermal comfort inside. This architecture seeks perfect cohesion between design and

natural elements (such as the sun, wind, rain and vegetation), leading us to an optimization of

resources.

The main principles of Bioclimatic architecture are:

The consideration of the weather, hydrograph and ecosystems of the environment in

which buildings are built for maximum performance with the least impact.

The efficacy and moderation in the use of construction materials, giving priority to low

energy content compared to high energy.

The reduction of energy consumption for heating, cooling, lighting and equipment,

covering the remainder of the claim with renewable energy sources.

The minimization of the building overall energy balance, covering the design,

construction, use and end of its life.

The fulfillment of requirements of hydrothermal comfort, safety, lighting and occupancy

of buildings.
 Green 45 Thessaloniki, Domotechniki S.A.

Green45 is designed according to contemporary principles of ecological-bioclimatic

architecture and expresses a new approach of building design in city centers. The design

emphasizes particularly on the study and use of climatic conditions of the surrounding area and

orientation of the plot, use of solar energy and optimization of microclimate. It focuses on

energy saving techniques and use of harmless for human and environment renewable

materials.

The building is divided into two volumes with large glass surfaces, in order to enhance

the natural lighting and ventilation in all interior spaces. Moreover, splitting the building

volume ensures a different understanding of the relationship between private and public areas.

The strong presence of plants at terraces, facades and roofs create great conditions of thermal

and visual comfort, help in the reduction of emissions and increase humidity and natural

ventilation. This green scenery is achieved by metal frames surrounding the two volumes,

which hold suspended pots with trees, climbing plants and creepers.
 The construction is being made of environmentally friendly materials that are

recyclable, require little energy for their production and are relatively durable. The choice of

materials and the light coloring of the surfaces will further improve the insulation and lighting

of interiors at the lower floors through reflection. The design provided external shading of the

glass surfaces from the direct insulation, with the use of movable wooden panels supported on

metal frames, thermal insulation of the building envelope, the installation of ceiling fans and

natural cross-ventilation. Enhanced thermal insulation of the building envelope combined with

the presence of a considerable internal building mass, due to heavy construction of reinforced

concrete and masonry from probation block elements, contribute to mitigating the extent of

internal temperature differences during the days 24 hours, resulting in the desired thermal

comfort inside the building.

http://domotechniki.gr/en/?portfolio_page=green-45
 Example of Bioclimatic Architecture

Lyons Part-Dieu shopping center

Lyons Part-Dieu shopping center focuses on improving the buildings relationship with

the surrounding urban fabric by introducing a more porous facade and welcoming green space.

New landscaped walkways and visible green space extend the public realm from the street level

to the complex, which will offer its landscaped roofs as publicly accessible parks. The shopping

mall Thessaloniki DOMOTECHNIKI S.A.l will also be restructured to improve access to

surrounding facilities, such as the library and the Part-Dieu train station.

The mall facade will also receive a major facelift. The formerly beige concrete panels will

be painted with a dirt-repelling white coating. Panels will be carefully removed in certain areas

of the building and reused to clad the new extensions; a glazed facade will replace the areas

where paneling is removed to evoke the appearance that the panels are evaporating. The

glazed areas also promote a sense of permeability and transparency, and allow natural light to

pour into the building.

 The terraces turn the vast roofs of the shopping center into open, green space in which

the public can meet and relax; a quality that is currently missing in this area, said MVRDV co-

founder Winy Maas. By rearranging the programed, we create an urban platform that is

somewhere between tranquil park and vibrant market square, recreating an atmosphere

inspired by the Lyon river side. Restaurants, cafes, and bars will be accessible from the

terraces and rooftop gardens.

http://inhabitat.com/french-architects-unveil-exciting-inside-out-design-for-a-bio-climatic-office-building/

Biophilic Architecture
Biophilic Design is an innovative way of designing the places where we live, work, and learn. We

need nature in a deep and fundamental fashion, but we have often designed our cities and

suburbs in ways that both degrade the environment and alienate us from nature. The recent

trend in green architecture has decreased the environmental impact of the built environment,

but it has accomplished little in the way of reconnecting us to the natural world, Together, we

will encounter buildings that connect people and nature - hospitals where patients heal faster.
 Example of Biophilic Architecture

It is is designed to be patient-friendly. The building uses 30% less energy. "Fins" along the

building's walls are designed to channel the prevailing north-east winds into the building.

Sunshades over the windows protect patients from the direct glare of sunlight. The shades also

re-direct light towards the ceiling to enhance the brightness of the wards and save on the use of

energy. Large fans in public areas are powered by solar panels on the roof.

DESIGN CONCEPT
 University of San Agustin

College of Engineering and Architecture

Department of Architecture

A Proposed Lemery District Hospital

Submitted by:

Pauline Joy B. Aquino

&

Anbon Q. Santillana

Arch 5B

Submitted to:

AR. Antoine Geoffrey Coo

2016