Tuesday, June 12, 2007

Hospital Construction Tips,Tips rumah sakit, HOSPITAL CONSULTANT, best hospital, hospital , klinik, dokter terbaik, rumah sakit,

Hospital Construction Tips



+62 21 9285 8971 ( Subsidiari Corporate of SM Eng Singapore )

Whether you are an investor, project owner or a contractor who just entering Hospital building construction, these few tips among thousands others will be useful for you.

Hospital construction is not How to erect the building itself but thousands aspects must be studied carefully and well understood. Failing to understand the aspect will cause in Lay-outing and budget inefficiency and effectiveness and worse will cause in system malfunctioning.

Hospital is considered the second grade building in complexity and Risk factors after Nuclear Plan construction. If we talking about Nuclear plan, the risk is Nuclear leakage which will contaminate hundreds or thousands surrounding people, but if we talk about Hospital, we are talking about Nosocomial. Nosocomial is undetected bacterial spread by patient to healthy people who come into a Hospital which the spread is exponentially. That’s why many Hospital restrict children under 13 years old to enter a Hospital unless they are sick since their antibody / self immune still developing even the Hospital has done some sterilizing the vicinity through anti germ fogging, UV, etc.

Preparation for a construction :

· Market research ( Feasibility Study etc ) determining type of Hospital ( Cardiac, Children, General etc ), total beds etc
· Sketch design and lay-outing
· Gather the Hospital and medical equipment ( Brand and system to be used )
· Fetching the M/E information
· Study and select the IT or software system
· Collecting data ( SOP, employee RR )
· Preliminary drawing
· Maturing the design with choosing the right material
· Maturing and matching the Medical equipment, Hospital Equipment, M/E would be installed, IT software etc and matching with
the design

· Starting construction

Market research ( Feasibility Study etc ) determining type of Hospital ( Cardiac, Children, General etc ), total beds etc

Feasibility Study or FS is a must stage for any business. FS for a hospital include the statistic data of the surrounding people about their age, mortality rate, majority disease, living standard, etc which are very helpful to determine which type of Hospital and total beds as well.

Sketch design and lay-outing,

Operational and construction permits must have been in hand before this stage.
Sketch design and lay-outing ,study the efficient and effective human ( patients, medics and paramedics flow ) and equipment flow. Some expert will draw each room based on section and each section must connect other correlated department. When we are talking about accident and trauma, one thing always put in mind is quick handling. Quick and successful handling means preserving life. I.e Emergency section, Blood Bank, Surgery Room, ICU, Radiology, Lab must be adjacent each other. Other inspection for soil data etc must have been accomplished during this stage and let the

Gather the Hospital and medical equipment ( Brand and system to be used )

As you know that medical world change very rapidly and we must keep up with it. Cardiac CT Scan is different with regular CT Scan. Some developing country still used double slice CT Scan ( or even single slice )while some others use 64 slice CT Scan capable for cardiac scanning.( we heard some brand developed 256 slice CT. Amazing ) and different brand has its own characteristic in size, electric consumption, etc. Never forget to coat Plumbum ( Pb ) for Radiology section
Wall. If you would like to digitized your hospital, all equipment are equipped with DICOM capability for PACS ( Pictures Advance Comm System ) where negative film use is reduced or even eliminated and using secure Wi Fi throughout the hospital for patient input data to Doctors PDA and from PDA transferred to Hospital servers. As DICOM consume large bandwith, you also should installed Hi Speed cable data ( Category 6 cable ).

Fetching the M/E information

From UPS, Lift, Elevators, escalator, sincronized Generator back up etc to get max result and efficiency.

Study and select the IT or software system

Software is customized and make sure that IT software is capable and has experience in Hospital software before avoiding your Hospital as their Trial and error.

Collecting data ( SOP, employee RR )

Each department must have strong in Standard Opeartion Procedure to reduce Moratlity rate, which contribute in incredibility, profit lost, and legal issues.

Preliminary drawing

This is the second stage of design. Though this design data is clear enough but is not yet mature for construction.

Maturing the design with choosing the right material

This stage is close to construction

Maturing and matching the Medical equipment, Hospital Equipme
nt, M/E would be installed, IT software etc and matching with the design

Why do we put so many stage for design? You have come to this stage after all data from M/E have been collected. The design is almost completed and ready for construction. You still have to matching and readjust how the equipment fixed to be installed. This stage means all the equipment supplier meet together and do brainstorm. All wiring diagram discussed in this stage and takes times to complete. Make them speak about their equipment weak points ! Are you going to put a sprinkler on ceiling above your CT Scan and jeopardize your expensive equipment if the sprinkler spray water during malfunction or you put Fire Extinguisher in CT Scan room ? What kind of Fire Ext ? What a huge lost if you miss this small thing !! How to prevent the bacterial entering Sterile Surgery area ? Putting air tight door and fogging or UV is not enough. You must use positive air pressure differential. What kind of air condition and filter type? How to prevent laminary or turbulent flow of the Air condition inside the surgery room ? What is the flow procedure of sterile and after surgery instrument ? Many things must be discussed during this stage. Digging up the weak point of other suppliers will help.

Things or Jobs that may rise or Required in Hospital Industry :

- Ambulatory Care / Outpatient
- Anesthesia Information Management
- Application Service Providers (ASP)
- Behavioral Health
- Budgeting
- Cardiology
- Claims Administration / Processing
- Claims Auditing / Analysis
- Clinical Data Repositories (CDR)
- Clinical Information Systems (CIS)
- Clinical Outcomes / Protocols
- Coding Products / Services
- Community Health Information Networks (CHIN)
- Computer Training
- Computerized Patient Records (CPR)
- Consultants
- Credentialing / JCAHO
- Customer Relationship Management
- Decision Support
- Dictation / Transcription / Voice Recognition
- Dietary / Food Service
- Disaster Recovery
- Document Imaging / Optical Disk Storage
- E-commerce
- E-procurement
- Education (Patient)
- Education (Staff / Medical)
- Education Tracking
- Electronic Data Interchange (EDI) / Electronic Billing
- Emergency Department
- Employee Health
- Enterprisewide Systems
- Financial Systems
- HIPAA Products and Services
- Hand-held Devices
- Hardware
- Help Desk
- Home Health
- Hospital Information Systems (HIS)
- Human Resources
- Immunization Tracking
- Integration / Interface Engines
- Internet / Intranet Technologies
- Labor and Delivery / Fetal Monitoring
- Laboratory Information Systems (LIS)
- Long-term Care
- Managed Care

- Market Research
- Master Person Index (MPI)
- Materials Management / Supply Ordering
- Medical Device Interfaces
- Medical Records
- Network Monitoring
- Network Security
- Networking / LAN / WAN
- Occupational Health
- Office Automation
- Outsourcing
- PACS / Image Management
- Patient Identification Cards
- Pharmacy / Drug Management
- Physician Practice Management
- Point-of-service / Data Collection
- Project Management
- Quality Assurance (QA) / Risk Management / Infection Control
- Radiology Information Systems (RIS)
- Recruiters / Employment Search Firms
- Scheduling
- Staff Scheduling
- Surgery / OR Management
- Systems Integration
- Telecommunications Products / Services
- Telemedicine / Teleradiology / Telepathology
- Time and Attendance
- Wireless Communications
- Workflow Systems
- Admissions / Discharge / Transfer (ADT)

What will a hospital could give for services ?


- Alzheimers/Neurogenerative Diseases
- Anesthesia (Department of)
- Arthritis Center
- Asthma Center
- Bone and Joint Disease
- Bone Marrow Transplantation Center
- Breast and Gynecologic Cancer

- Women's Physician Group
- Primary Care Associates of Norwood
- Sports Medicine and Rehabilitation Center
- Internal Medicine Associates

- Community Health Center
- Cancer
- Cancer - Clinical Services
- Cancer - Treatment Centers
- Cardiac Center
- Cardiac Surgery
- Center for Cardiovascular Disease in Women
- Center for Excellence in Nursing Practice
- Cerebrovascular Surgery
- Clinical Laboratory Division (Department of Pathology)
- Colo-rectal Surgery
- Cutaneous Cancer
- Dash Diet Home Page
- Dermatology (Department of)
- Dermatology
- Diabetes
- Dialysis
- Emergency Medicine (Department of)
- Endocrine Cancer
- Endocrinology, Diabetes and Hypertension
- Executive Health Program
- Endoscopy

- Fibroid Center
- Gastroenterology, Hepatology and Endoscopy
- Gastrointestinal Cancer
- General and Gastrointestinal Surgery
- General Gynecology
- General Medical Service
- General Obstetrics and Gynecology
- Genetics
- Genitourinary Cancer
- Gynecologic Oncology
- Head and Neck Cancer
- Hematologic Oncology
- Hematology
- Hematology - Benign
- Hospitalist Program
- Infectious Disease
- Infusion
- Internists Associated
- Longwood Skull Base Program
- Lown Cardiovascular Group
- Magnetic Resonance Imaging (MRI)
- Maternal Fetal Medicine
- Medicine (Department of)
- Menopause
- Metabolic Support Service
- Midwifery Practice
- Neurologic Cancer
- Neurology (Department of)
- Neurosurgery (Department of)
- Neurophysiology
- Newborn Medicine (Department of)
- Nuclear Medicine (Division of)
- Nursing
- Nutrition
- Obstetrics and Gynecology (Department of)
- Obstetric Anesthesia
- Occupational Medicine
- Oncology
- Oral Surgery
- Orthopaedics
- Oral Medicine, Oral and Maxillofacial Surgery and Dentistry
- Orthopaedic Surgery (Department of)
- Otolaryngology
- Pain Management Center

- Palliative Care
- Pathology
- Pharmacy
- Physiotherapy
- Plastic Surgery
- Podiatry
- Psychiatry
- Partners Center for Human Genetics
- Partners Neurology
- Partners Online Specialty Consultations
- Pathology (Department of)
- Patient Care Services
- Pediatric/Adolescent Gynecology
- Pharmacoepidemiology
- Pharmacy
- Plastic Surgery
- Pregnancy and Childbirth
- Primary Care
- Private Primary Care Practices
- Program for Diabetes in Pregnancy
- Psychiatry (Department of)
- Pulmonary and Critical Care Medicine
- Pulmonary Rehabilitation Program
- Radiation Oncology
- Radiology (Department of)
- Renal
- Respiratory/Chest Medicine
- Renal Transplantation
- Reproductive Medicine
- Rheumatology, Immunology and Allergy
- Sarcoma
- Skeletal Health and Osteoporosis Program
- Sleep Disorders
- Southern Jamaica Plain Health Center
- Spine Surgery
- Surgery (Department of)
- Surgical Oncology
- Telemedicine
- Thoracic Cancer
- Thoracic Surgery
- Transplant Services
- Trauma and Burn Center
- Toxicology
- Urology
- Vascular Surgery
- Women's Health
- Weight Management
- Women's Musculoskeletal Center


. CONTRACT INFORMATION: Architect-Engineer services are required for a Firm Fixed Price contract for site investigation, planning, programming, survey and geotechnical report, engineering studies (including vehicular traffic), space planning, interior design, schematic design, concept design, preliminary design, final design, parametric and construction cost estimating, other engineering services and construction phase services for the subject project. Construction phase services may include preparation of operation and maintenance manuals, shop drawing and construction submittal reviews, site visits, and technical assistance. Services may include commissioning design and support, design of tenant improvements and support services, operations and maintenance, startup services, and general project support to bring the facility to full operation. Services may also include additional site investigation, planning, and design services of renovation and/or demolition of the existing HOSPITAL, and relocation of existing equipment, furniture, and related items from the existing hospital to the new facility.

2. : The project includes healthcare facilities for emergency medicine with inpatient care/observation units, adequate space for medical/surgical and obstetrics inpatient care/ observation units, primary care and secondary medical care clinics, and administrative and support functions.

The Hospital facility will include, but not be limited to, medical/surgical observation beds, obstetrics LDRPs/birthing pavilion with inpatient care, ambulatory surgery and recovery, and clinics including primary care, multi-specialty clinics, cardiology, dermatology, dental, flight medicine and physical exams, obstetrics and gynecology, preventive medicine, behavior health, immunizations, and physical therapy. Ancillary services will include radiology, pharmacy, pathology, and administrative and support functions. Support facilities include: utilities (water, sewer, gas, HVAC, steam and electric services, permits, roadway realignment, paving, walks, parking, fencing, storm drainage, communication and information systems, fire protection and alarm systems, site improvements that include roadways and parking lots, landscaping buffers and additional site amenities, public access space, demolition of a pavilion type shelter, and any needed repairs.

Project will be designed in accordance with DoD Medical and Dental Treatment Facilities Design and Construction Criteria; Uniform Accessibility Standards ,People with Disabilities Act Accessibility Guidelines ,Interim Department of Defense Antiterrorism/Force Protection ( if applicable ), Architecture Construction Standards, Engineering and Design Systems Commissioning Procedures

The design will be prepared in the metric system of measurement or in feet.. Design drawings will be produced in a format fully compatible with AutoCad 2000 or higher, and translation to Microstation 32 Version 4.0.3 or higher at completion of design.

Specialized experience and technical competence of the firm and consultants in: (1) Design of new medical treatment and support facilities to include both ambulatory and inpatient care facilities. (2) Life safety and fire protection design of medical facilities. (3) Knowledge of the locality of the project including geologic features, climatic conditions, local construction methods, and National Capitol Planning Commission submission requirements. (4) Use of automated design systems described above. (5) Experience in energy conservation, pollution prevention, waste reduction, and the use of recovered materials. (6) Familiarity with Department of Defense anti-terrorism/force protection design criteria and construction standards. b. Qualified professional personnel in the following key disciplines: project management; medical facility planning, architecture, landscape architecture, mechanical, electrical, fire protection, structural, civil, transportation, and communication engineering; cost estimating; industrial hygiene; medical equipment planning; interior design; and O&M systems. Registered professionals are required in the following disciplines: architecture, mechanical, electrical, fire protection, structural, civil engineering, and a certified industrial hygienist. The evaluation will consider education, training, registration, overall and relevant experience, and longevity with the firm. The fire protection engineer shall be a registered professional engineer, have a minimum of 5 years experience dedicated to fire protection engineering, and one of the following: (1) have a degree in Fire Protection Engineering from an accredited university, (2) have passed the National Council of Examiners for Engineering and Surveys fire protection examination, or (3) be registered in an engineering discipline related to fire protection engineering. c. Experience producing quality designs based on an evaluation of a firm's Design Quality Management Plan (DQMP). The DQMP should include an organization chart and briefly address management approach, team organization, quality control procedures, cost control, value engineering, coordination of in-house disciplines and subcontractors, and prior experience of the prime firm and any significant consultants on similar projects. d. Past performance on DoD and other contracts with respect to quality of work, cost control, and compliance with performance schedules. e. Extent of participation of small businesses including woman owned small business, small disadvantaged businesses, historically black colleges and universities, and minority institutions in the proposed contract team, measured as a percentage of the total estimated effort.

Starting construction

Are you ready ? Get the safety helmet, safety shoes and Get the piles down

All information above hopefully would be such a helpful hints for you. We are not afraid of telling some of the tips above, Its just tiny information among thousands others must be gathered before everything is settled for construction. Our experience said that after we have reached maturing design and beginning the construction, or even the architectural and interior development, the lay out and redesigning occurred. Each hospital equipment brand has its own characteristic.


What Good Strategic Design Can Do (Excerpt from 1998 Summer-Fall issue of Aesclepius)
"How does an organization measure the value of design as a strategic investment? Having worked as part of a team involved in the creation of a new children's hospital in Providence, R.I., and in Westchester County, N.Y., I believe it is essential to quantify this perceived value.
The following statistics, which were measured approximately four years after occupancy of the hospital in Providence reflect the experience of what good strategic design can do for an institution:
· Market share increased 20.5% in three years.
· Outpatient/emergency visits increased 25% the first year.
· Inpatient days increased each successive year after opening.
· Patient satisfaction increased 5.5% after opening.
· Monthly volunteers grew from 40 to 400.
· House staff applicants doubled in one year.
· Annual giving to the hospital increased from $125,000 to $1.5 million.
· More print columns were devoted to the hospital opening than any other event in the state's history.
In reflecting on the potential reasons for success, a significant component is the building design. Another element that significantly contributed to and enhanced the success of the building design was the involvement of the hospital1s multiple customers. Not only did hundreds of physicians, nurses, child life staff members, and other health professionals participate in every step of the process, but also parents and children."
Bruce Komiske, FACHE,
Executive Director
Children's Hospital Foundation at Westchester Medical Center
Valhalla, N.Y.

Patients Notice Changes
(Excerpt from Journal of Healthcare Design, Volume IX, proceedings from the Ninth Symposium on Healthcare Design)
"While a patient satisfaction survey does not pretend to be a rigorous scientific study, it does in fact provide evidence to show that both patients and staff members respond favorably to an environment that meets their needs and enhances their quality of life...
The effectiveness of Lenox Hill's efforts is being measured and demonstrated using the patient satisfaction survey data. The positive changes in our environments are demonstrated in the data from 1994 to 1996, which started at score of 66 for cheerfulness of room and is now over 70. Cleanliness of room, room temperature, noise level--everything is showing a steady trend line improvement..."
Charles Gianfagna
Vice President, Facilities Management
Lenox Hill Hospital
New York, N.Y.
Satisfied Customers
The following are comments gathered from customer satisfaction surveys at Children's Hospital and Health Center in San Diego:

"Overall a wonderful and calming experience."

"Great music in the waiting room, very soothing to the mind and ears. It was the nature and water sounds we most liked."

"We appreciate the bright surrounding and the kid friendly techniques."

"I loved the architecture and interior designing, it made for a very relaxed and comfortable environment for kids of all ages."

"The children’s activity room was wonderful, as was the healing garden."

"The windows and the fresh air and soothing and cheerful decorating and adorable playhouse and gardens made it extra tolerable."

"This is an excellent facility. It is too bad that most hospitals have not followed your example."

"A ball machine and interactive artwork are great for visiting siblings."

"If a child had to get sick, I am glad it happened in your area. You have a world-class institution."

"At night my son and I like to look at the lights that look like stars."

"Children’s Hospital is a great place to be if you have to be in a hospital. I love the stars in the ceiling and castle décor carried throughout the architecture."

"Great décor for the kids. The Healing Garden was very nice."

"The best hospital we have ever seen or been in. Everyone we know says the same. Our five year old cried when we took him home. He thought it was Club Med."

"Definitely a great hospital. The best were the star lights above the nurses’ station at night and the mobiles and play things in the walls of the hospital."

"Whoever designed the hospital must have been an inpatient before, the room doors that automatically shut quietly every time someone goes in and out, the amber light over the bed and the middle of night lighting, the beautiful courtyards outside the rooms, I could go on."

"It is a wonderful caring environment for children and families. If a child needs to be in a hospital, then Children’s is the place."
Architecture Raises Spirits
Excerpt from a letter to administrators at Lucile Salter Packard Children’s Hospital at Stanford in Palo Alto, California
"Thank you for saving our son’s life; that’s the major point of this letter…It covers our first stay, when our son, Kenneth, was in Room 2347 for 21 days in December and January. My wife and I took turns staying with him…
The building itself is wonderful. I didn’t realize, before this episode, how much architecture itself could raise my spirits. The wood floors and big windows in his room, the big windows (again), color scheme, and photographs in the public areas, all helped. Our son was delighted by the fountain; he went to see it every day he could walk around without his IV pole.
I noticed something nice, some little extra touch, that had cost extra but made our life easier, almost every day. Three random examples: the day bed in Kenneth’s room was big enough to be comfortable, even though I’m six feet tall and sleep on my stomach; my toes didn’t hang over the end. The bed had an adjustable reading light; I’ve read in bed since I was twelve and appreciated being able to do so at the hospital, easily. My wife and I both used the washer-dryer in the day room on the third floor; again, a small touch; again, it cost extra, again it made our lives easier. Thank you, architects.
All three of us liked the roof garden. I noticed especially the planters, one full of the little white flowers that smell like honey, the others full of brightly colored blossoms, right opposite the elevators. They are exactly the right height for someone three and a half feet tall, and you don’t have to walk (or be carried) very far to enjoy them. We visited the roof garden every day it was sunny; toward the end, Kenneth was walking two or three laps a day. Kenneth and I explored a couple of terrace gardens, too, but he liked the roof garden best of all. It was wonderful to be able to get away from the hospital smells, into the sunshine and flowers. . ."

Jed Park

Article by AHA ( American Hospital Association )

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