Malaysia Prepared by MINISTRY OF HEALTH eae Final Report: 1. MoH Operational & Health Facility Planning Policies 2. Review Of Design & Building Standards of Hospital 3. Development Of Buciget Estimation Methodotogy uly 2006 : Ministry of Health, Malaysia World Health Organization * QC Mediconsule aciconsl Planning & Con Atafs/8 One Armpare Bu Solan Ampang thames 2/2 ting Services Sd, Bhd. (4494861) ns Ave. 12000 Ampang, Selangor, Malaysia Tot +603-4283 3200 Fox: ++60:3-4259 3199CONTENT (ECUTIVE SUMMARY .. ! | ines Pe Mediconsule INTRODUCTION .. ASSESSMENT OF HEALTH POLICI Stans, Review oF ExisTING DOCUMENTS... REVIEW OF DESIGN & BUILDING STANDARDS FOR HOSPITALS ... 3.1.1 NETTROOM AREA (NRA).. 3.1.2. Nerr DEPARTMENT AREA (NDA) 3.1.3. GROSS DEPARTMENT AREA [GDA] 3.1.4 ENGINEERING 31.5 eave. 3.1.6 GROSS BULDING AREA (BGA) 3.1.7 BULDING EFRCENCY.. 3.2.1 DEPARTMENT CIRCULATION FACIORS.. 9.2.2 BULDING CIRCULATION FACTORS ‘Connwors.. 3.3.1 CoRmDOR WIDTH GUDEUNES. Room Sizes 3.4.1 ROOMSIZE COMPARISON. 3.4.2 GENER ROOM UST FOR HOSPITAL OF 500 BEDS AND OVER.. DEVELOPMENT OF BUDGET ESTIMATION METHODOLOGY... DEVELOPMENT PLANNING PROCESS, PROCESS For OBTAINING DEVELOPMENT BUDGET APPROVAL FROM CENTRAL AGENCIES EPU, TREASURY ane 16 ‘Current METHODS FOR CREATING PROJECT BUDGET BY Mo! REVIEWING CURRENT PROCESS FOR PREPARING PROJECTS/ PROGRAMMES FOR IMPLEMENTATION. IWRMKS 7 1 FLOWCHART OF PROJECT IMPLEMENTATION PROCESS, 4,44.2. CURRENT METHODOLOGY OF BUDGET ESTIMATION, 44.3 COSTPER BED METHODOLOGY .. 44.4 PROCESS OF CONTROLLING COSTS DURING PLANNING AND DESIGN STAGE. 4.5 SHORTCOMINGS IN SYSTEM OF PROJECT IMPLEMENTATION. a6 RECOMMENDATIONS.. 4.6.1 RECOMMENDATON 4.6.2 RECOMMENDATION 2. 46.3 RECOMMENDATION . 4.6.4 RECOMMENDATION 4, 46.5. RECOMMENDATION sFERENCE .. BR BRRBNE ACKNOWLEDGEMENT .. ANNEXES “Annex 1 ; Documentation of policies related to design & engineering ‘Annex 2 : Documentation of policies related to equipment and vehicles Annex 3 : Documentation of policies related to operation Annex 4: Documentation of policies related to other ‘Annex § : Summary Schedule of Areas of Six Malaysian Hospitals by Department ‘Annex 6 : Generic Room Ust for Hospital of 500 Beds & Over sty 2006 @ Pagybbreviation Hi eno (&K Mediconsule Gross Building Area ‘Construction Industry Development Board Economic Planning Unit Gross Department Area Inter-Agencies Planning Groups Jabatan Kerja Rayo Mediconsuit Planning and Consulting Services Sdn. Bhd. Ministry of Finance Ministry of Health Nett Department Area Nett Room Area Schedule of Areas World Health Organisation ule 2 pee PosEXECUTIVE SUMMARY This report is a compilation of Report Number 1 to 3 of the Assessment of Design fences for Public Heaith Care Facilities for Malaysion Hospitals. Report 1 covers the collecting, reviewing and compiling of MoH planning policies related Ff) cesigns engeetng (ii) equipment & vehicles, and (iil) operations and (iv) other general policies. port 2 focuses on the efficiency of health facility planning and design in terms of Ice by building, departments, and crifical rooms. Report 3 analyses MoH's cument practice of project budget estimates and suggests altemative methodology. rot Report & Mediconsule1, V1 INTRODUCTION Background diconsult Planning & Consulting Services Sdn. Bhd. (Mediconsult) was invited by the inistry of Health (MoH) - Planning and Development Division, to assess the design iciencies of goverment heaith facilities in Malaysia. objectives of the assessment are: o a sed Compile current operational policies related to design. engineering, equipment ‘and operation; Evaluate the spatial efficiency of health facility design by health foctity, departments, and ctitical rooms; Develop a methodology for deriving of budgetary project cost for future health facies: ‘on the funds avaiable, ihe Consultancy will initially concentrate on Project Pemning Methodology as agreed from the discussion with the MoH. The implementation for Methodology for Macro Health Services and Room Data Planning tools will be identified after further discussion with the Ministry of Health. 2 I Based ooocc jvc Repon QC Mediconsult . Methodology ‘on documents received and discussions held with agencies and institutions involved In the planning of health care faciities, the following process for the assessment has been applied: Collecting, reviewing and compiling of MoH planning policies: Review current design and building standards and norms: Study of various hospital concept design: Study design concepts of various hospital departments in Malaysia: Comparative study of room areas of various hospitals in Malaysia and other counties; Study of implication of engineering design on spatial requirement; Review current methodology employed by MoH for facility budget estimation; Investigate issues of developing methodology for deriving at project budgetary costs:2 ASSESSMENT OF HEALTH POLICIES ah Status THis ossessment covers the collating, reviewing and compiling of MoH planning policies. THe majority of these have been provided by the MoH and some by JKR. Within the framework of the project it Is not the responsiblity of the consultant to evaluate and ‘comment on the health policies. The evaluation of the health policy may be a scope for future assignments ond the consultant may propose fo further develop ond standardise policies. 2 Review of Existing Documents ‘On the whole. there have been many health facility planning related documents produced over the past decade by the vorious departments of the MoH. The documents largely consist of guidelines, norms or policies on health facility design ond engineering and equipment including vehicle ond operations. THe background for the various guidelines is the “Gorispanduan Perancangan Kemudahan Kesihatan Rancangan Malaysia Ke-8, Jilid | & 2" (Guidelines for Planning yalth Facilities under Eighth Malaysia Plan, Volume 1 & 2) compiled by the Ministry of Health, Planning and Development Division. This comprehensive document could be ‘as a sound boss for health facility planning. Nevertheless, considering the number ‘of guidelines ond policies, which were produced over past years. it is understandably challenging to include everything in one single publication. Therefore, this sees of planning guidelines for the Malaysia Pians wil have to be complemented with other élevant guidelines / policies that have not been included in the publication. yore large, itis found that the MoH has compiled relevant guidelines / policies over the ars. Evidenced by files / documents belonging to individuals these have been circulated out of their own initiative. instead of being held as ready-to-use pooled resources. The guidelines / policies issued have not been systematically documented ‘and filed; as a result, they are difficult to access and refer to, especially for new comers joining the MoH Planning and Development Division or JKR, Some guidelines / policies documents in the files are found to be incomplete and scattered; some are without date source of document. In addition, there is no categorization of the guidelines / policies, jaking references even more difficult. consultant has tabulated and broadly categorized all the documents provided to ‘ehable quick searching/ browsing of them. The documents are categorized into: Design & Engineering, a Equipment & Vehicle, Q Operations; and Other policies. pal Repo! MediconsuleThe documentation [please refer to Annexes | ~ 4) are compiled based on these cdlegories and if a policy covers more than one category the policy will appear in all int categories. ‘The compilation of the documents should assist the MoH in developing a standard policy ‘a methodology of establishing procedures and fools to have one updated policy ar document for the various health faciities. Roper ‘MediconsuleREVIEW OF DESIGN & BUILDING STANDARDS FOR HOSPITALS is section is to propose a number of acceptable base standards for the planning of Health Core Facilties in Malaysia. It is intended that this section will eventually be expanded and will form part of a comprehensive Malaysian Health Facilities Guidelines documeni(s}. which the MoH Malaysia intends to develop. process of planning of Health Care Facities can be separated into 6 distinct stages and defined as follows; 1 - Services Planning is the stage at which long term strategies for the delivery of services at local, regional \d national level are developed. ‘Stage 2 - Functional Planning This is the stage at which the health services to be provided by an individual facility are defined for a given population. stage 3 Development Control Planning js the stage at which the program for the future development of the individual facility js| provided. The program provides an overall plan to control the future physical opment of the faciiy including viable stages of work, time scales ond costs. Project Planning This fs the stage at which the agreed stages of work for the individual health faciity are ned in detail. The various phases begin with development of the Design Brief and joceed from Block and Schematic Planning through to Construction Documents. ge 5 - Contract, Construction and Commissioning The 3 phases of Stage 5k the period at which an agreed tender or price is accepted for oh agreed scope of works in an agreed time. The on site building operations and weer ‘of the facility is completed, made ready for occupancy and handed over to client. Stage 6 - Evaivation THs ‘s the stage at which the compieted facility is evaluated after a term of occupancy. Tess guidelines ore intended for use in the Project Planning stage of Health Care Faciity development. It assumes: that the preceding stages have been completed. number of Malaysian Hospitals recently constructed or currently being constructed or planned were reviewed. Overseas Guidelines such as the NSW Heatth Facility Guidelines =| ier 2005; Queensiand Health, Planning and Design Guidelines, August 1998 and fed publications from the NHS Estates/UK were used to benchmark the Malaysianbut excluding the following: fire stairs or fre lobbies | 2. passing riser shafts | ifs, ft shafts and lift tobbies Normally the services cupboards or services ducts within the GDA colculation is not Inplodedt however for simplicity we have included them and in proposing the circulation factor have made allowance for their inclusion. ha Engineering is the sum of the areas of all engineering services plant rooms including service ‘edpboards; ft motor rooms and service/tiser shats, 3.1.5 Travel This 5 the area that represents the linking of the vorious departments In the hospital ‘outside of the departments. It is for the circulation of personnel and goods both horizontally and vertically. It includes all inter department corridors, fre stairs. fire lobbies, lift shafts and fift lobbies. Fire stairs: lift shatts and lift lobbies are included once for each tevel on which they occur. \ 3.1.6 Gross building area (BGA) This is the sum of the gross department, engineering and travel areas. This BGA does not include for unenclosed covered space but does include for enclosed or unenclosed covered wolkways that join detached buildings In the hospital complex. itis noted that all unenclosed covered space is included for costing purposes within the jantity Surveyors calculations. 3.1.7 Building efficiency This is the ratio of the sum of the nett room areas (NRA) fo the gross building orea (BGA) expressed as a percentage Le, NRA/BGA x 100= % efficiency. t Circulation Factors 1 Department circulation factors There ore many items that contribute to building costs and significant among them is the site of the buliding. The major factors affecting building size, room area and planning efficiency, are critica! elements that require fo be controled and monitored during the planning and building process. By establishing acceptable standards and guidelines feng typical rooms and departments, the SoA generated from the Medical Brief becomes an important tool in monitoring and delivering projects on budget. ial Raper — MediconsulrDéparmont and Building circulation factors are adopted ot the Project Plonning stage. The department Circulation Factor is an adopted percentage for each department that 's applied on ond added to the NDA of a deporiment to anive at a GDA for the department. De nts in c hospital are generically different and as such c different circulation factoris applied to each deportment. te have compared a number of Malaysian hospitals and researched overseas guidelines to artve at the following proposal for Department Circulation Factors covering [ist of typical departments occurring in Malaysian hospitals. Please refer to Annex 5 for a Summary schedule of areas of 6 Malaysian Hospitals on a depariment-by-department basis. fe are a number of anomalies evident in the schedule which would requite additional research to address. However by reviewing each department and discarding ‘wayward’ results we have been able to propose the following schedule of norms. ‘As con be seen in Table 1, the factors proposed are generally larger than the Australian guidelines. This can be explained as follows; 10. the use of wider conidors in Malaysia due in part to the greater number of visitors, 10. the inclusion of service ducts and cupboards in the proposed circulation factors, a the practice in Malaysic of locating the AHU room within the department and thus increasing conidor area. Q. differences in department conteni/size, @. differences in work practices. differences in nett area definition. vd 1 Circulation Factors ~ proposed Norms MOH Proposed = NSW HFG Departments % Circulation % ‘Accident & Emergency Day Core Unit Haemodiaiysis Outpatient Pharmacy Specialist Clinics Bums Unit €ardiac Core Ihpatient Ward High Dependency Intensive Core NICU Ny RESBS ssehacsses Bstee Fro! « -| | imaging a 35 Labour & Delivery 40-45, 35 Mortuary & Forensic 38 20 Operating Theatre M45, 35-40 Pathology 35 5 Ra ncology 88 90, Cai 30 25 ¢ssD 30 20 Hospital Medical Stores 25 NA 30 NA 0 NA 10 NA 32 25 _lppatientPhamacy 32. 25 Engineering & Mainfenance 25 15 Cleaning & Housekeeping 10 10 Linen & Laundry 10 10 Administration 30 20 Specialist Office 30 NA ‘On Call Unit 30 10 Cafeteria 25 NA Education & Training 2” 18 For Radiation Oncology the nett room crea of ‘bunker’ areas for treatment rooms for the Tinear accelerators and brachytherapy etc. are token as including the ‘bunker’ walls and the maze. sulation factors for a particular department wilt vary from facility to factity depending ‘on a number of factors, specific to the facility being planned such as; | a brief requirements, Le. whether the OF suite is briefed with a single condor o with sterile and ‘diy’ conidors: a the plan shape that may be due to site or building restrictions where elongated or ‘complicated shapes’ may increase the length of corridors: or a the plan forms, ie. in a ward with a ‘racetrack’ corridor rather than a single conidey, alll these, including the skil of the architect, will contribute to variance from the circulation factor nom. Itis important not to over or under provide for deparment circulation. To under provide will put unnecessary pressure on the planner which may result in dysfunctional planning and to over provide wil result in waste. The factors are guidelines and are a tool, for alt involved in the process, for planning ond monitoring the development and should not be sden as unchangeable as situations do vary from project to project. 1e appropriateness or otherwise of the circulation factors will be tested in the schematic ign stage of planning during which necessary adjustments require to be monitored as ‘will affect costing and budget. et Rape _ ‘Mediconsulr uty 2066 @ Pog 83.2.2. Building circulation factors Building circulation factors ore composed of travel and engineering and are the percentage applied to the GDA and added to it to arrive at c Gross Building Area. Travel is comprised of: @ the horizontal interdepartmental comidors 10. the lifts, ft lobbies and stoirs 0 fire stairs and fire lobbies The percentage of travel wil vary from project to project. Generally smaller lowsise hgsptcs wil have a lower percentage of travel than high-tise as the lift and fire stoir jrements increase with building height although, and depending on plan concept, the percentage of interdepartmental conidors may increase. In larger hospitals the percentage of space for lifts, lift lobbies, stairs, fire stairs and fire lobbies will be in the order of 8% fo 10% of GDA. ‘The percentage of Engineering wil generally be in the order of 12% to 15% of GDA. We propose ¢ Buliding Circulation factor in the range of 30% to 35%, depending on the complexity and size of the hospital, to be applied to the GDA to arive at the proposed BGA of the hospital. 3.3. Corridors In comparison, the space in a hospital given over to circulation is generally greater in Malaysia than in Australia or the UK. 'Cortidors in Molaysia are generally wider, likely due in part because of the greater number of visitors. The following table compares the NSW, HFG guidelines and the present guidelines contained in the MoH Project Pre Bid Document Brief. The implications of wider corridors, as well as larger rooms, are quite significant with regards to project costs. An additional 300mm added to the width of a 2100mm wide: corridor adds 14.3% to the area of that corridor and, in so doing, increases the circulation factor of a department. Thus a department with a 1.35 circulation factor increases to a circulation factor of 1.40. This results in an overall increase in building area of 3.7% and ‘thus gives rise to a significant increase in project cost, A further analysis with on site evidence based assessment of comidor hierarchy and corridor widths is, we believe, warranted. 3.3.1 Corridor width guidelines The minimum requirements for Health Care Facility comidors are summorized in the following table: Fred ep KK Mediconsule ‘mite @ Boge 20Table 2: Conidor Width location Operating. Emergency, Birthing, ru inpatient ‘edical Imaging, ibulatory Care ‘Ambulatory Care / Outpatients Qutpatients/ Community Healthy Consulting Rooms Offices Amenities Inte-Departmental Contcors Hotel Services e.g. itchen, Laundry, stores Hotel Services e.g. Kitchen, Laundry, Stores 3.4 Room Sizes Trolley Movement Patients — Freq/ regular Pationts — Frea/ regular Patients- Occas/ Regular Patients- Rarely/ Never Patients — Never None None Services Patients Services None Min Cleat pee Clear 2100 2100 1800 1800 1200 1200 1200 1800 1200 2200 2100 1800 1200 1200 1200 2100 1500 Notes Consider door widths into adj mms, wider conidoss at entry pts for fuming trolleys/ beds Consider door widths into adj ms, wider contidors at entry pis for fuming troleys/ beds Door widths to ensure movt of troleys / beds from corridors to adj roomsis not restricted Part of Acute Care fociity Separated in accordance with BCA req'ts from acute facility, or stand-alone. Coridor length to be less than 12m Corridor length to be fess than 12m but depends upon traffic generated Major e.g. connecting +o other Units, large traffic flow. Minor = within unit Malaysia 2400 1500 1500 Seneraly room sizes do not affect circulation but the do have a significant affect on the jiding area. Room sizes are an outcome of room functionality and a comparison of room sizes overseas and in Malaysia show up a significant difference with, in general, the sie of rooms in Malaysian hospitals being larger. The following is a comparison of some randomly selected rooms in a few Malaysian hospitals just completed, compared to the NSW HFG recommended room sizes. vil Hope Mediconsule Poge #13.4.1 Room size comparison (Room NSW HEG Patient creas | Consulting Examination Room. 12 16-29 Procedure Room 20. 18:36 Trealment Room 14 18-23 ‘Operating room — gen.. Urology, Gynee, a2, AAAB Opthal, Plastic, etc. ‘Operating Room, large - Neuro, Ortho, 5 S455 Cardiac. | Operating Room -minor surgical, 3 3% indoscopic procedures under local, gen. inaesthetic Patient Bay — Resuscifation 25 | 15-23 Patient Bay ~Crfical 20 144) | Patient Bay — acute treatment 10-12 10 Patient Bay- non-acute treaiment 10 72 Patient Bay — Recovery z 324 Patient Bay Holding 9 624 (CU Isolation Roorn 25 19-28 ICU Bay ~criticol 24 16-22 ICU Bay —high dependency 20 1415 NICU infensive care bay 147 809.2; NICU high dependency. 127 $98 NICU low dependency 10. 60-94 ED Birthing Room 28 27 Renal Dialysis bay - chair trolley. 9 50-94 Renal Dialysis - Isolation room, 12 1422 1 Bedded room 15 16-22 ‘Thedded room isolation 15 16-22 bedded room, 25 2031 {4 Bedded Room a2 45-52, ‘Ante-room to Isolation Room 6 2 En-suite bathroom 1-2 beds 5 42-6 Ensuite Sathroom. shared 46 beds 6 1416) Disabled toilet 5: 6 Tolle. public 4 a Toilet - Patient 4 5 [Anaesthetic induction, 15; 1216} FEubicle change 2 15-2! Cubicle change - disable 4 35) Parenting room/ baby change cnd feed. é 10-16 Patient bay 9 72 Plaster room 14 16-26 Blay area 20 30-60, ‘interview /counseiing ~6 persons Wi Wig? Frol Rapert & Mediconsuteoor, NSW HEG {Support Areas ‘Glean Ufiity 13 Wa14 Dirty urity #12 915 Assisted Bath 15 12:18 Linen Bay. 2 153 ‘Store - Equioment 1420 10-22 ‘Store - General 9-10 1214 [Store = Files, 10 12} ‘Store = Stationary. 10 | WW ‘Store — Sterile Supplies i 12 12-24 [Cleaner room’ Ss 25. Disposal room & 56 Staff Areas i ! i ‘Meefing room (4 person) z B14 ‘Meeting room (6 person} 12 T0415 ‘Meeting room (12 pecon) 15 18 Meeting room (16 person} 20 28 Meeting room (20 person) 30 35 Office (2 person} 12 14 Office (3 person) 18 18 Office (4 person] 20 24 | Doctor office i 12} 12:18 | [Office - Sister/ Medical Assistant 2 10-12 Reception/clerical 16 16 Staff Station 1-2 persons E10, 1220 Staff Station 3 persons 14 15-26 ‘Staff Room 8 persons 15 17-22 Stoff station 14 7-20 Staff rest 15 16-27 {Scrub up/gowning 10 815} T tcspios recsuted are Sungai BAR, Abr Seta Serdang, Pondan and Sungal Petar Itis recognized that the schedule is not comprehensive and the rooms selected may not be representative of all room sizes. However it does indicate an apparent significant difference ond the Implications as shown below do point up an issue that requies addressing. ‘Taking the averages of the room sizes shown in the schedule indicates that the Malaysian spitat rooms are on average 13.5% larger. This would mean if translated throughout ie department that the department NDA would be 13.5% greater than recommended the NSW HFG. Thus a NSW HFG department of, for example, 1000sm NDA would with Malaysian sized ms be 1,350m? NDA. By applying average deparlment and duilding circulation ictors to these figures we see that this would result in the hospital in Malaysia being 35% ldrger in size than the one built fo the NSW HFG. ral Report MediconsuleIt is not realistic to apply this percentoge saving to all rooms/spaces throughout the hospital but by including @ review of corridor widths and room areas it would not be unrealistic to seek a 15% to 20% reduction in area. 1e cost implications of room ses and coridor widths are significant. By way of tion the Pandan hospital has a BGA of 108,750m2. A 15% area reduction would realize a saving of 16313m? ond at an average cost of RM3.700/m? equates to a "monetary saving of RME0:000000. There are reasons due fo service defivery, MoH policy and culture that resutt in room size variances, however the differences noted above and implications of cost indicate a for the issue fo be analysed and reviewed further. suggested previously regards corridor widths, we believe further anclysis is required ds room size guidelines. 3.4.2. Generic room list for hospital of 500 beds and over ‘The Department-by-Department Schedule of Areas (SOA), please refer to Annex 6 is the beginnings of what wil uiimately be a dynamic tool for the MoH fo use during project development. A set of facility standards wil enable the MOH to generate project budgets and development briefs within a controlled framework. By developing guidelines and ultimately a process framework will also assist the MoH to monitor projects as they proceed through the development process, | fi ua Repor QK Mediconsule -4. DEVELOPMENT OF BUDGET ESTIMATION | METHODOLOGY ‘This section shall analyse current methods for creating projact budgets. review and provide recommendations of the budget estimate methodology. _ It will focus on the initial budget preparction as projects are initially defined within Planning and Development Division of the Ministry of Health and before preparation of the full Project Brief. 4|1 Development Planning Process Before ciscussing further it would help us fo understand better the process of planning in Malaysa and the key players in the Implementation of development projects os well as their roles ond functions. National development planning is sustained by the Central Govemment in order to create and maintain conditions that will accelerate economic growth and social development in the country. Development planning comes under the purview of the Inter-Agencies Planning Groups (APGs}. The Economic Planning Unit (EPU) is the secretariat for each of the IAPGs whose work precedes the formulation of ony development plan. Planning is a two-way interactive process between the EPU, on the ‘one hand, and the ministies ond agencies, on the other. Central government determines the setting for macroJevel parameters, while the ministries and agencies translate the national development thrusts into programmes and projects. The 1oles of each party involved in the implementation of development projects is briefly ‘explained below: Economic Planning Unit (EPU) — evaluates socicl impact of development projects and approves macro project scope as well as budget estimate application by client ministries. 2 Treasury, Ministry of Finance - makes available funds based on approved project | scope by EPU. 1 Public Works Department (JKR) - implements projects through any procurement method appropriate. |. Clent Ministies — plan programmes and projects based upon needs of the country. Project Management Consultants (PMC) - extemal consultants appointed by the client ministries to implement projects on thei behalf. sey 2006 44.2 Process For Obtaining Development Budget Approval From Ceniral Agencies — EPU, Treasury MoH submits project feasibilty justifications for development projects, site, project scope and cost estimates to EPU. ‘Sometimes proposes budget allocation for the RMK period ’ EPU evaluates justifications and considers population needs of catchment area. Does not scrutinize scope in detail, rather studies social impact of project to the community and economy , | EPU then approves project and budget allocation. Sets ceiling costs based upon MoH recommendations. t informs Treasury ‘ Treasury provides funds 4.3 Current Methods for Creating Project Budget by MoH 1 From discussion with MoH. the methods for creating project budget are a litle unclear, The process is explained as below: H 2. Project budget allocation is set for individual projects by MoH. The budget cost is derived from several modus operandi * For projects using the standard plans (as designed by JKR). the cost estimate 's prepared by JKR based upon preliminary design, floor area and finishes. ‘+ For projects of non-standard design, the budget is estimated using historical data for projects of similar nature, scope and size implemented in the past. The tule of thumb is the cost per bed, which is RM1.0 mil per bed. The : estimate is taken as it s without considerations for inflationary costs, current ‘material prices and tabour costs and construction conditions, Frool Report Ql Mediconsult Jy 208‘4.4 Reviewing Current Process For Preparing Projects/ Programmes For Implementation In RMK 9 banng for RMK 9 projects would be done a year before the launching of RMK 9, ie. in 2005. A conference workshop involving all state health directors, all heads of divisions, Program directors and all hospital directors, Representatives from the Central agencies, 'U, Treasury. aNd JKR are invited os observers. MoH would review its health services and forth its mission and vision. It would debate the strategies to be developed for the 5 to come. The workshop would discuss issues such as health services needs, delivery ystem, health costs, manpower requirements. medical technology and infrastructural ities. Planning strategies would have been established as fo the thrust of the RMK 9 it whether to develop more new facilies or to upgrade existing ones for ’xample. At this conference no projects are identified yet. Following the workshop, the State Health Directors and programme directors would work identifying specific programs and projects. They would prepare feasbillies papers fo sty the projects and propose a budget. The list of projects would be submitted to MoH fo be prioritized. Mol would then finalized the list of priority projecis and based on this list repare the budget allocation required. The Planning Unit of the MoH would decide on ject scope and the Development Unit (of MoH) would prepare a budgetary cost @stimates. The finalized list of projects will be submitted to EPU for approval, The following chart indicates how project implementation procedures /.e. how Ministry of Health's projects are implemented: 4.4.1 Flowchart of project implementation process texk/actvey Action by ‘ro Health planning Service review to establish ‘Mission, vision and Strategic planning & Tarrepebianning BY (MOH programme planning for health for P ext 5-year , Project identification Feasibility Studies ' + Health Situational Analysis in each Posen breces State/tegion on + list of projects with budget estimate : ‘ inal Report Mediconsule‘Submit to MoH Planning and Development Division will For prioritization of programs/projects ‘also prepare their budget estimate for : centrally planned projects Submit to EPU for approval + feasibilty study/ustification + scope/Brief Planning and Development Division + budget estimate based upon * norms or historical data ‘ EPU approves programs/projects EPU Social Sector Informs Treasury and MoH Treasury approves funds for RMK Treasury ‘ Mol receives funds for 5-year plan period through annual atfocettion Planning and Development Division (oH submits project Briefs to JKR UR implementation, ‘ IKR implements through various rement methods Le. turnkey, design JKR ‘and build, in-house feam,etc 4.4.2 Current methodology of budget estimation The issue with which this study is concemed about is the budget estimate that is provided fo EPU. If it is underestimated, it will cause problems io the implementation of these jects. Current method for producing a cost estimate is done using historical data of past rejects. For example, for a health clinic for a population of 100,000, a Type 3 Clinic Foal Report —— 1 Mediconsule _ uly 2008 4 Paproposed to EPU for approval is insufficient. If goes to illustrate that the cost per bed nom is not a reliable methodology for budgetary estimation. 4.44 Process of controlling costs during planning and design stage With such a procedure of project approval, there should be a process of controling costs ‘during plonning and design stage of the project. But the current system does not make Provision for projects to be designed to set budget. Contractors/consuttants are seldom \informed of the budget when assigned the job. They will be given the project Briet/scope to work on. Cost estimates are done after the design 's completed basing \upon the detailed scope provided by the MoH. very often the design is found fo have lexceeded the budget approved by EPU. When this happens, MoH would begin an ‘exercise fo reduce the scope of the project. The designers would have to redesign. The ituation has been going on for decades. The amount of abortive work in project implementation is significant. Due to changes needed to be made to the scope, many Projects are unable fo be implemented in time and therefore have to be postponed to the next Malaysia Pion. | 4.5 Shortcomings in System of Project Implementation From the current situations os discussed above, several shortcomings have been identified: The scope of project. very so offen, does not match up with the budget set because detailed scope is only done after the budget approval is obtained from EPUL 1] The rule of thumb method of RM 1.0 million per bed cost does not provide o true | reflection of the cost of the project as two hospitals of similar size in terms of beds, for example, may differ in content and the sophistication of medicol technologies required. The current system of producing a budget estimate for MoH projects lacks an ‘evidence-based approach. The methodology employed leads to inaccuracy in ' budget allocation, As a result, project implementation gets delayed and there ‘always be significant abortive work, which leads to a wasteful of funds. There appears to be a lack of coordination between establishing the scope of the project and the preparation of project budget estimates within MoH. @ There is a lack of knowledge on project implementation especially on the technical ond contractual implication if the process is not clearly understood. inal Repos! Mediconsule if ES @ PageThis could be due to the absence of building professionals involved in the budgetary process at MoH level as well as at the EPU level. .6 Recommendations ject budgeting is on essential component of effective project implementation rocess. Insufficient budget from the beginning of a project means either the estimation k inaccurate or the scope is over provided. Therefore it is crucial that the budget imate to be approved by the EPU matches the scope of the proposed project, as ihe IPproved budget wil form the basis for preparation of the design. Fa long time the methods used by MoH in preparing a budget estimate is based upon istorical data of past projects. Using historical data is sill acceptable provided data jollection is systematically done and analysed. As projecis hove become more ompiex and sophisticated, an objective approach to budget estimation needs to be employed. we ‘are proposing a budget estimation methodology using floor area. In section 3 on Reviewing of Design and Building Standards for Malaysian Hospitals, we have provided generic room lst and areas as well as grossing factors, which ore fo be used as fools in generating floor areas for specific projects. Following the process for project Implementation as indicated in 5.1 above, a step-by-step process is given below; Recommendation 1 From Strategic planning {from workshop) Undertake Situational analysis studies Establish needs Identifies development projects Establish feasibility and scope (service profile and functional content) of project Based upon functional contents of hospital, establish components of every department Establish schedule of rooms and room areas Establish net floor areas Apply grossing factors and calculate gross deparimental areas of hospital Apply cost per square metre (from JKR manual) or any other cost data available Add % cost of speciaiist works, ie. Mechanical and Electrical % cost for extemal works % cost of equipment and fumiture, % cost of preliminaries, a a a a a Qo coooo rel Ropott @ Mediconsule Duly 6 # Page 71+ %cost of tumkey element (from EPU Standard and Cost) for tumkey/design ‘end build projects} % contingency sum provisional sums if any ‘Add cost of land, a Apply voriation of prices (current materials, equipment and labour rates) from Department Statistics Variation of Prices Index, or CIDB Cost information index, or IKR variation of prices index. 2 Arive at total estimated budget of project. 4.2 Recommendation 2 Another methodology that can be developed to arrive af an early project budget is to develop departmental area norms based on major room component of the department. The major room component in the OT sulle is the number of operating rooms and in the Imaging department the number of Imaging procedural rooms. By developing such norms a department area schedule and a hospital gross building ‘area can be calculated based on the Needs Statement from which a budget cost can Be developed. However, it is not within the scope of this study to develop component area norms but ‘would requie to be part of a subsequent study, the need of which will be discussed with the MoH. 6.3 Recommendation 3 jOH has already developed generic project Briefs for 36 bedded hospital, 76 bed, 108 1d, 212 bed, 495 bed and 500 bed and over. These Briefs, which have detailed out the functional contents of each type of hospitals can be costed to form the basis for budgeting purposes by establishing the floor area norm for each component of the hospital. Apply the cost per square metre and the VOP as mentioned in Recommendation 1 above, to amive at the estimated cost. the generic costs would have to be updated regularly to take account of current market condition, 416.4 Recommendation 4 Ii order to produce a credible budget estimate, MoH may requite the services of cost consultants. This could be done by engaging Quantity Surveyor Consultants to prepare budget estimate. MoH could also use the services of JKR. Altematively MoH could 19 in several technical professionals to work in its organization for the task, CK Mediconsule July 2056 # Page4.6.5 Recommendation 5 Diuting the investigation into the issues of deriving at budgetary costs itis found that the ‘agencies involved in health project implementation lacks the knowledge in developing i project budget. The JKR, as the implementing agency, provides cost estimates based upon the scope given by the cfient ministries, But this is done after the project budget has been approved. In other words, the JKR is not being involved in the preparation of ject budgetary costs. Nevertheless, JKR does not favour the method of costing using functional norm such as the cost per bed as this method does not reflect the actual vel of technology provisions for the project. it much prefers the approach of estimating using the cost per square metre of floor areas. EPU, being the centrat agency that grants approval to development projects should st the methodology for deriving at budgetary costs not only for Ministry of Health projects but for all Ministries, so that there is consistency in budget preparation for the five-year plon period. As at present, the EPU has left it to the various Ministries to use their ‘own devises in developing a budget cost estimates. ‘We therefore would like to propose that the EPU adopts this methodology of deriving at budgetary costs for all development projects by all Ministries. inal Report l ‘MediconsuleReference 1 Building Plans of recently completed and under construction hospital projects in Malaysia: + Ministry of Health Molaysia, Bullding Plans of Sungai Buluh Hospttal, 2006. Ministry of Health Malaysia, Building Plans of Pandan Hospital, 2004. Ministry of Health Malaysia, Building Plans of Temertoh Hospital, 2005. Ministry of Health Malaysia, Building Plans of Ampang Hospital, 2005. Ministry of Health Malaysia, Building Plans of Jempot Hospital, 2004. ‘ Ministry of Health, Project Pre Bid Document Brief, September 2004 3, Jaboton Kerja Raya Malaysia [PWD Molaysic), Kepertuan Teknika! Senibino (Architectural Technical Requirements) The National Children’s and Women’s Hospital, 20 September 2004 Minisiry of Defence Malaysia, Building Plans of Ammed Forces Hospital, 2007. 4, Queensiand Health, Planning and Design Guidelines, August 1998 5. NSW HEALTH, NSW Health Facility Guidelines Revision v3.0. December 05. 6 Department of Health and the Welsh Office, Health Bullding Notes, HMSO Books, 1989 7. Ministry of Health, Planning and Development Division, 2005-06 8 Economic Planning Unit, Prime Minister's Department, 2006 9. Treasury, Ministry of Finance Malaysia, 2006 1 10. Department of Statistics Malaysia, Cost Information Index | 1]. Jabatan Kerja Raya, Kos Purata Semeier Persegi Kerja-Kerja Pembinaan Bangunan (Cost Per Square Metre for Building Construction Works), January 2005 fil June 2005, JKR 2080-01 36-05, Jiid 47, No. 12, 2005 12. JKR, Contract and Quantity Surveying Branch, Panduan Kos Bincon JKR | Cost Guidelines) ecition 2001, Preparation of Preliminary Cost Estimates, JKR 20800- 0119-2001 13. Construction Industry Development Board {CIDB}, Building Elemental Cost Analysis ‘Manual, Construction Industry Resource Centre, 2005 cknowledgement 1@ Consultants are grateful of the support and assistance given by the Moll - Plonning d ig Devecbrent Division, JKR, EPU and Treasury, Minisity of Finance during the fret Repes! | Mediconsulef@aeeneanpneeeenveaunannenAREER SOMETESRY Jo WoystAaad oj SOUTEPINE piluo-Kusdwoooy-seupoyy ‘seme BAY U sYeEND . “syeylanty UeWASNOH Jo UISIAald 10} sUEpING | _wussooy IN soEN UoPOKIA - : woo | ‘L aor kee “susoas g Alana 10) Woosiyeg Payesedes | seaeaurur atoos ya!oud yo aBweus] awn ‘8u0 ySe0) Ye ‘WoO! sed sesulest z UO posible SAN TE ETS, ‘Suquaeyd opouoT “sieysoy ‘sures fo[0y Gop uoTeNeINE ans to = ywoursedap | Sutures} Sesunu [fe JO} SuOU pue seUljopINS BuywUe|d fojoy yefond dogs woywanset | dan wHP{ey) | Ame 9664. samsmmcuria | "9 wopepounuosse “suauupede Jo s8z1s ety] Yo uonse66ns Wt _ys Surman 20f0 oyodsOH ‘ssoyend ue TIPO us ‘ogtap wouriojosop ers sopotereo weseyp o 676 om ue swOU Nd |_mcorrMAoN eid ae, | gwonreMiS | aes | “pw eaZTOR |S Tupuvsooter 4 [o1S0u pue © S8e19 0} 0 SsBID 10) Bale JOOY SSID samp saan wos | (Snamvero | 2 108e aa] > Hssei9 01.9 $8819 J0) Siujod saolves BuIpIING /OWDCES | qmod ywounsop pus puoowme se Ta zOTISHL © SSBID 0} Y SSEID JO} SyUIOd BuIUORIPUOO-Y | —se-smunb yosaIDAe8 39) Fuysna | ped ZoOUrL TH Hsseio ‘pm va soy e808 onumxap, | zanHr was wwopzog soot | OLY ssBIp Slayenb Jo} Curysiuy PUB Base JOOY Ssa1> ~songppm sna PPAR wos zooz | __rowmpon ‘nan | “€ shalors 9 swauuede v1 papirosd oq im ‘da Aq pansy Yooja WoL aursoore 61 | worst wonsdojssap | Ye}S JO SeLOGOED [16 10) $07 (saanuamtss) | wv ooo | pu summa HOW |Z wiser ano] yes pue Sarued YpfeoY Jo adAy PAUBAON oourdosoe | uo aseq suofepoUlluodo# YeIs Jo JequUINU LO LON | _ 3 noweporsensse srs wo WORSEN - coz |e Buea to | “TL JBHEND HEIS'L aaa semasip | pee . open yin Joie sou rovtang | rouge |e. poner ida | One GupeeuGue pue uBjsap 0) payejes Sepijod yo suonequawiNdaqPus BURSSy Syisibielnbal eouBuoped WwewaNbS Teomogje wauidinbo woos Uegia ‘uoneoyoads: wool ‘juewdinbe Jeuofypucd-spe GUYeAGD juowidinbe pue weyshs woos uBeo 404 uoNeOWoRdS som _Jeadoos pu wopwayoods moos wet) aw ‘yep ssqendsoy Matt 205 ‘are aaistiyt PUP ‘siuaurasinbou sese6 jeorpew | wopsrayc womdoanog pum Baronet -p Aojosampsaey puis JeJ2M ‘TeoUeI@ ‘SWORN /ANOKe! Jo sjUNcODR JOLIE OWN 0 posodond w= (1 1092 “mu | + ‘MGH ‘swing ‘N99 ‘NOI ‘NOIN "SRY (oan war “LO 40} sy2y}no JeIO} PUB JEUORIPPE ‘BUYS UO YEIEP | mog younpea) ueys4s se feoxPTE IO Conan war ‘Gupinaid sjvewieynbar sose6 yeorpelw {eUOMIPPY | 2x0 TwHoNEpPY ~ TeHEsOH SmseTOS 6661 | wore) xt | '£ se unprumfisut Su Sep -siolo} | nd wareis uvvundined muaBuow | 10a LOVLL/S9 _wostap weuoposop uy weysks dumnd, BujAes soyem, Jo sn ous uo Uojsined | vanouryeamt oncom tasrmndsx | swooxwants) | cme oooz | porsmemaHow | % ¥ umeupey | -s sKao01ae/e Soup yMeOY UL | sueE Ep esnding ufo wand | opaDLEAPKOT) wounandoc, |Suyuorypuca we pue warsAs sevem you Jo qwewaNnbsY ‘wep saad pe waned won ue | cwrzooe | werner |_T feOW}08/9 8 [ESIUEYSIN *E a qwownoop Jepues aunyuny | asooy pus pox wo Aas IED poxy 9 aBeyoed uBisep soue}U) jepeds "sous vwffennd | 6«/9CI-aHLL 4 ‘uawidinbe esoo| ‘eunyWiny UO MeIAaL [e1U9H | erdson 10} souyopms soxpmuy) HaiINe | -HaS/Od/Hifd -[ st ‘saquoujne Buyposdde 40 sjuaueuinbos spuepueys ‘jesodoid sepue} ‘oBsubs afi w yemanbos eM -| v1 ‘SaunpXy ‘se4ysiy UO welUasINbes [esNoNUOIY _6o GOR Epp e puny SUT (sp2q gog way arous pus “stood jeudsou ut pueBa| ) —spoq goz ump soy peso Jr) oe QUA SeUsiuy I1EM pu JooY ‘'BuIye0 Uo SeULjOPIND: SOREN MINNA 405 SOMTPT = | __ gd 0007 ‘el __wanmiosey weno eR. spi pcopatis | omeamprat wer | pone doer | oN. Gupssuibue pue uBIssp 0} payee! sapjjod yo suonequewnegesha POEL ow jwxmandap serwue(c) | wom zooc | meq onana OW | _“S Sueyed vopzommecg rT | 16/1/2159 ‘uot emndoppA2p ‘uoxed (eydsou ur siubhi uoneUEXS crepqnod unpaid isermods | poor) | ries zooz | pua Summa How | P Trdsoy opm un w seats AsENEY ‘mmrsig nosisuny, upon ges “worst ptoundorenep Wages pue Yeled UI warsks ansiteH |p xem w UKs (aAoENO LON, oxomy oooe | pur twa now | “€ (ooo mr sz “He BER “SHES 970 oon a sieudsou oles ouos iq pordoaae ‘sonmn ‘gsi Woenersg0 23) spp -y scans eowarsgo Jo spepUS TRUOEEK, UMWUW FeUONEN eyo GuIO=De | op muna yo an ‘past “DIH 40} eweUNSe 3800 pue juEUIdiNbS | _ pur jod jo suopeywaWNI0gEASE! CASES hd he dd ieda ST Toes Se = Toa : 2 bs re S| ef oe [Se oan om [Sl | ae EL ea | sn roe | on [on |e sis pel re 77 ra cir i. gpetecehet a SP = oe See ee . Se HSeSe a eate Sia are CSE eS ie ‘Saei| 181] era | wo] —va6a| yom [rasa] 72x |_ gato] revel 7a | tse] —geans| rex [sae] —a7aa| 7am aoe ee : aes some ares 2S ee BoE E aa ce "i a ate es —— | ce saa | aa a a = i 7 : ate “aa Se ae = ea 2 oe os a 28 aa ae fret eels me oe nl aan mat at — 3 SS see ta 7 at ra stata eee ea — Sl rt — Sel Sse — ert — fo cS SSSre ee — = a ee eee = Ft efoto SS = ce foe ae 2 eae Se = = ae it ee ate sae pe rvio amingeseneytnae= = See : : ee fea ee eee been ee eee = oe = mee ete ee ee wg ga ate te = Sse sae eae S = SS ra Sr abs Soe a = ze eee eee ee = = eae eee ee fanatic ese a ee elle mlm nd lm dm ll wl = bese | al alm [Calta Caleb bm sac SCS SS SS ee [STAPF PRR ES, bs aes oe a ee les eet zit} cass} se 4 24st 2 $97] 2% z20|__2el_ 190% Pen aioe Zs — Sat rete aa = See eae ae [GROSS DEPARTMENT AREA -GDA. eee] is ea773| 7570 Toa raz = =e as ate = ) ROSS AREA - BOA Toe7é0| se “Booz Eee : aes = =| ‘ive Panna EoereyxeAtte[AMENITIES - DRINKS VENDING TFAWAY FROM HOSPITAL Iman ENTRANCE a fuscrnes araeTe 2 ER PS apa) a earner sea __ bs XTEANCE 3 nEceeneNT rom Te OLE | So] a0 |e. cLERICAL SPICER STON 8 REVOUE lberarment brome stoRAcE FoR LECTONAREA rancnwaes wc. Joucunc srace jk we EK row rewiaion FERCO;O- at ae) Jr AULA AB NON bo PERSCRS PER PERIOD [ausuva aris. 3 FEEDRE ROOM 54 MOTHERS PATENT apa aa eocan racTiS RELATES jerome R23 CHLDREN ATONE a] ef a oma RCTTIES fre jaiaue HOLE f si2scoarwoas |] ae pa — lwastesnis PER UNT ligaTFoROALED ae = MOREN AY AREA |=) = Teese TOT PaLY AREA PROM _ TW AREA EARS ROG OR cc han TANCE n SHARED ANCILLARY SPACE COMMON SPACES a far, 1 SQUAT We, 2 WASH FE CHANGE FoR THE WHOLE a pear CaRNGNO FACETS locrarrace low eacHuevel @UEvELS __lassimeny | =a far ToLET ORT STAFF ONETME:T ato] — of staRcD BETWEEN WG junmrs; ar rTO we LocaTED oasis Jrouncent To Two cuNic lis Mar 10.8 LOCATED 7a [aenezR0oM atl oianen serween 2 caine "| GOUNSELING ROOM oR + aTAFe PATENT ato) ao fevered eerwaen s cuNC ___ hecouemnma RELATIVE _ _ ee rE a = i [eGoPuen S108 1 INEN STORE ap GAL ROOM = 4 peter eovernon Roo or ma PERGCHE a — al ORTON DEN, lauovisua. 0s STORE [140 [couson use AFF REST eR ae] a2 [ovarco ocrweEizoLnie lars /roue LocaTeD | _honcerro occ | a poaeTORET lroazs panes EXC 1S, yo SHARED BETVIEEN 2 GLNE fr sauar we, wasn Basi, lies: meF/TORELOCATED _ fonoicne nave conse JsDuACENT TOTWOCLNIC al cca ic wren [ap comer loseaement | Fence ue ernsron POR TH wr | ate lperanrNeNT: R= lpeRSoNNeL, a] IsHARED BETWEEN 2.cLINC lowing To BE LocATED |ADUACENT TO TWOCLING.with 2 COUGHES. PLASTER JCASTING TABLES, PLASTER Jsnics AnD PLASTER TRAPS; lsoMe PER COUCH leAsteR STORE PROCEDURE ROM [siTinnaNOR OT TABLE AND lor user [PLASTER WASH AREA JGATION AREA [NEUROLOGY AND NEUROSURGERY CLIN 7 JOLNIC MAIN WAIT AND HEALTH [FOR NDMIDUAL CLNIOUNT, AMIBULANT & NON = PATIENTS |RBSEPTION INDMIOUAL CLI UN {vSICA. ASSESSIIENT ROOM KéGNSULTANTS PATIENT SUEWATT |For INoROUAL Cant UN: lrore-12 Parents FoR THE PATENTS OF THE Joousuctanrs; ADJACENT fro THE ROOM [CONSULTATION | EXAMINATION FoR consuLraNTs |FOR REGISTRAR 10:9 |PATIENTS / PER ROOM PER DAY ‘AMONG DISCIPLINES lon scHEOULE BASIS JeduPvENT STORE |: STGRe PER BIEOPUNE [oxen uri. [PERSON IN CHARGE inn ymUTY — “1 Joerice pw STEM 32 _|uhEN STORE /5AY 3 ‘STORE IECTROENCEPHALGGRAPHTY ROOM [WITH VEDEO MONTORING naam JFOR INFLAMMABLE MATERA, STORE [SCH AS ETHANOL, ACETON leotoo10N, jc. AREA FOR STORAGE OF [TESTS GOGH AS VEPIERG WiNCOWS; GOGO |FoR PATIENTS ON TROLLEYS lwo WHEELCHARS (COUCHES lkor STORAGE OF EEG GRAPHS, FOR MINOR REPAR OF ‘CHLORIONG. AND OTHER: Jounicn, WASHING FACLTES. frou. [OFFICE AND ALSO ASEEG JREPORTING AND TEACHING (CAN AREA, foPen Gerice {AEDIATRIC CLIN SLNIC MAN WATT AND HEALTH JFOR NDIVSUAL CLINIC UNIT: Jrone-t2panents ~ fo onsicrais \ron ae panewTs oF THe |cONSULTANTS; ADIRCENT TO- [THER ROOMS _ REGISTRAR MO: 50 "ATENTS / PER ROOM PER DAY IREFER ScOE OF SERVICES: [SuARED ASMONG DISCIPLINES,jar ONE WAY OBSERVATION lanrarom), cory AND a WAY lConmanacaTion. [OSSTETRIGS AND GYNAECOLOGY GUC [oAINC MAIN WACT AND HEALTH [FOR IDWIGUALGLING UNIT, FOR. = JESUCATION AREA [AMBULAT 8 NOH-AMBLLANT __—_lparienrs | _ lnscerriON For mo VISUAL CANE UNIT af al riveica. ASSESSMENTROOM a] sa] te [CONSULTANTS PATIENT SUB WATT JFORINOIOUAL CONICUNTT: a _ ron a-12 PATIENTS TATIONEXAMINATION ROOM |FOR CONSULTANTS WATH ay wf RANGE ULTRASOUND _. (ESEACH 4 IGONSULTATIONEXAMINATION ROG [FOR REGISTRAR/NO: a] ia] 4 fswnen werween PATIENTS / PER ROOM PER. [DISCIPLINES ON SCHEDULE. EACH ROOM PRONIDED ass furs EDI RANGE lucrmasouND MACHINE 1 _ aha, 10] 20. [1 STORE PERDISGPLNE CE WASTER) FOR PERSON [oF luNew Store /eav ok I JFoRzcoucHES: Hage [GURFANED CUBICLES, WoL. JRESOLLTION COLOUR. ATTACHED TOLET JoopeceR ULTRASOUND Inacisne mEACHROOM a I Gueicces, —_ = — [Forshee oss Tess Fe Juri PASS THROUGH HATER fro THE CUNCAL LAB OR PATENTS ATA iv; lcqureen wna cTeLINKED jo CENT MONITOR AT loetiven surte ano Jconsuranr Rous. [cURTANED CUBLES sencpos |EQUPPED with COMPLETE lcouPoscoPe /LEEP SYSTEM AND loureanent wSTEROSCOPE: jERUATOLOGY [PGYGHATIIO CLINE, FOR NORIOUAL GUN ONT,STOLOGY | PSYCHIATRIC GLINE | [OpTPATIENT SERVICES ee {ISULTATION EXANENATION lrcroscomca ExARNATON (EC. SMEAR Jronars, LepROWN TEST, __ lestasve TEST) - _ 6 [eum toy UBoRATOR [am FACLTIES FOR VORS, a} ta) Fe |nGL Arran rOLET FoR la, coNOCOCCAL SHEAR, IrAeéG OF URETHRAL SMEARS ME TESTS 7 @ ITH DARK FIELD MCROSCOPE yay CAMERA VIDEO. _| _ lrwanroxeveoco5¥7 ror stannic. FUNGHL SMEAR yap IacroaoLocy AsoRATORY PARASITE DENTIFICATION, Jranca.cuLTURE m0 T2ANGK , lewenns lobnTact CERMNTITS ROOM ron PERFORENG NO RENORE a] mo) ao fcc EAS FoR STORAE OF \eaTcH TEST ROO lpatcH Test MEN ALLERGENS AND t - . ses or panes PPEranTOPATHOLOGYSOL US [win MULTEOCIRAR a] =| ae Jowse converten rox licroscore, cory W0=0 oar Room lMonsTORING SvsTEM FoR jana oF oocTORS AND [raranenics WORKING lsranions wrth URED hucroscopes OREROOM Jror eroesy ano SoRGiCn, Jrroccounes ATION ROOM | Jroanrrc assessuei Roo fwr/one WARD [ATION FOR CHILOREN Ts 2 WAY IMUNECATION FOR ADULT: Jaw RECORDING AND lvowrorns equewent [RLASTIC SURGERY / BURNS / VASCULAR SURGERY CLINIC. ING WAN WAT AND REALTH FOR NDMMOUAL CLINE ONT, ROW AREA ron ANULANT 8 NON JAMBLLANT PATIENTS ___ scCePTON - [ror NOMOUAL GUNG ON {LYSICAL ASSESSWENT oe , {ONGULTANTE® PATIENT |ece ioNTOORL CUM UN, WAT Jronerepamenrs SONS TAOWEAURTON [cor consULTaNTS EONULTATIONEXAMUNATION FoR REGISTRAR MO: 30° _ [PATIENT PER ROOM PER DAY _ leven GoM INEN STORE /8AY GENERAL SOTREIrom cierT PLATE PATENTS lair sPeECH PROBLEMS: |nTH NASOPHARYNGEAL AND JoraraL ENDOSCOPIC CAMERA |axo DEO CAMERA INC MAIN WAIT AND HEALTH TOR AREA [FOR INOMOUAL CONIC ONT JFOR AMBLAANT & KON |aweuLaet PATIENTS. IREGERTON. JFOR WOViOUAL CUN'GUNT: [PHYSICAL ASSESSHENT ROOM |CONSULTANTS! PATIENT SU8 WAT [FoR nOWOUAL CLG UNIT lho s-s2PAMIEWTS [SGRSUCTATION EXAUNATION JFOR CONSULTANT; AL GE ROOMS fowrn WATER LET AnD OUTLET lovsTeM, exF EXAMINATION HIGH FREQUENCY UNIT, MOTORISED ENT JexARMNATION CHARL, WALL JMounreD oroscoPE 7 loerimamiwoscore SONGULTATION/ EXAMINATION — |FOR CONSULTANT: AL C2E ROOMS Jb.uc PONTs FOR OTHER INSTR. CONSULTANT EXAMAIRATION RIGISTRAR MO 30 “ATIENTS / PER ROOM PERDAY: Jat ce ocus wns waren cer ano outer SYSTEN fr ease USeT, HH Jesauency sucTon Us Reed Er BONANATON aR, HALL HOIRTED rossoreommaprosooee_|_ SONSULTATION / EXAMINATION |FOR REGISTRAR MO; 30 Jpaienrs 1 PER ROOM PER DAY, lai. cre ROOMS CONVERTIBLE JOaRK ROOMS WITH RLUMANATED [sweLLeN CHART, SUT LAME wre MOTORISED TABLE COMPLETE jwirH ACCESSORIES, ORECT 3 Jorce iarosien) is fiwastone mY [centro STORE"WORKLOAD EGUPHENT Noor ROOM. 7 [OUTPATIENT SERVICES on TOTAL seh “COMMENTS [FoR ADULTS; 2wav }iNCL. CONTROL AREA. BOOTH: (0 PROFF ROOM TH CALUBRATION NE JoaseRVATiON PANEL BETWEEN |SOUND PROOF AND EQUIPPED JDLOGY BOOTH AND jure cussioat ovcnosric JoonTro. AREA Jpure Tone auoloMeTy lw SPEAKERS FoR FREE on reo AUDOMETRY ‘CHILDRERINOL ONE 7 net. CONTROL AREA BOOTH: (AY MIRROR ROOM FOR STAFF |souno PROOF AND EQUIPPED Jano PARENT TH CUNIGAL DIAGNOSTIC 3 TONE AUDIOMETRY SPEAKERS FOR FREE |rep subrowerr jr EGUIPEMENT FOR AV AND [sop 367 YparRAL UGH: RELA lors. 1APE RECORDER WATE STHMOSPHERE: |SPEAKERS, MCROPHONEY: |acousTicaLLy TREATED AND |souno PROG ROOM FOR 10 lsurTABLE FOR RECORONNG lpersons [ano sounD-SENSTTVE leouremen [AIT ENT REVOLVING GOR, a] 3a) frova oarovess REQUIRED Jpuuntanns ano CALORIMETER Journc oFeRaTION Iron aromaTic CALORIE IRRIGATION SYSTEM: OPTICAL STIMULATION STUNENT; ICA STIMULATION BAR. JrxeD To THE WAL; Jprocrau conTROLLED IELECTRONYSTAGMOGRAPH JRECORDER wre AUTOMATIC. JcaLIBRATION oo alate ef 2 [rain ENT OPERATING TABLE, ye loPeRATING SATELLITE lucie avo Hace SUCTION Junirs _ TATION ROOM JFoR POST OPERATWE yale —_ lectnpustanon . IMACANT RENABITATION [7 METERS FROM END TO END, |NEAR REGISTRATION AND IN A |sriai.y LGHTED AREA 6 |care duo LABORATORY. a | 4 jusierainorsan: REGISTRATION AKON [BRIGHTLY LIGHTED AREA;TPATIENT SERVICES: "SPAGEROOM WORKLOAD) EOUPHENT Dam] TOTAL ‘COMMENTS [nati A-scan BScaNAND (EA. TOPOGRAPY eee! slleleg] = Jeni ionaneTED SweLLEN jcraRT ANO ALLOTHER fsrurMenTs NecDeD By lorTowerrust ‘we [EXCIMER LASER ROOM JIT} DOUBLE DOOR. COUCH lao pocTOR'S GHAR. |EXCWER LASER EQUIPMENT al “7 [PROCEDURE ROOM |vHTH SMALL OT TABLE AND lorena nicnOSCOPE [GLEAN exiRONMENT WITH |scmue-ue &.cownens. [ORAL AND WARILLADRAGIAL SURGERY (DENTAL SPECIALIST CUNIC) 1 [EAN NAN WAT AND JFOR INDMIDUAL CLIC UNT, -TH EDUCATION AREA. FoR aasBULANT 8 NON [auunanT PATIENTS. 2 |recePnon, [ror NDMSUAL CUNEGUNT: so] 0 fe “a [SONSULTANTS: PATIENT SUBWATT —_|FORINDITBUAL CLANIG UNF, (OR 812 PATIENTS sf 16 js SPEC DENTAL CHAR EACH Loaner suRaEES fSregAl Dewi GREG + JpRocesSING OF FLIS SENTAL DAR ROOM JDEVELPING OF KAY AND fsroRAGE OF WSTRUMENTS __Fewwans o-easseres . _ pcoorenroo feomerricrome a OeMTAL SRE __._ feos ee =a AC ORATOR pero | Frene —__fettorncac moni 2 18 [PREPARATION AREA WITH FACILITIES FOR ve facinTeRSATN NO [YOTAL DEPARTMENTAL NETAREA —[ mo {CULATION AREA AD 16516 [fOTAL DEPARTMENTAL GROSS AREA | rooPATIENT SERVICES IN [od one sop caw cone ASE AND SUB WAIT STENTS LOUNGE GHSULTATION/ SAMBTON TOUT ERMEDIATE CARE ZONE aLLow Zone TAS NONANMBDLANT -ATIENTSIESCORTS ON I aloleielee [TROLLEY AND WHEEL GHAR. leSeD0eD cunraN CUBICLES 7 |For wa cuscuES FoR WITH EMERGENCY FACILITIES [reowevs IGHAREO WATH CONSULTATION? Jamnamion [SHARED WITH CONSULTATION? lExAMeVATION WASH InoBae X-RAY BAY BAY [EBULISER ASTHINAEAY [FOR @ PATIENTS EQUIPED WITH JweDica GAS, NEBULISERS, MOBILE CHAIRS, REFRIGRATOR, WASHING FACLITIES, sRVATION AREA JURSE BASE OSERVATION BAYS ‘BEDS PER BAY, CURTIN Jouectes: 6 M2PER BED ANTI piary TITY as Ii Srrwer1 soMTwot Ts TOUT fi [wen waSeenen Pe ar jparrey [WARING & BEVERAGE [wana FacumEs \ERS ROOM SENERAL STORE, [NEN ea7 [OUTPATIENT SERVICES Tor "SPACEROOM ‘WORKLOADTEGUPMENT | WOOF | UNIT 0. room | area | area 4 z [wit PANTRY FACRITIES | JPanenr ReATMENT BAvs—”~RaAS WaT BEDS OR 2] +o] 20 JFORPATENTS arava Go | Jrccuns com Eacis wort freansrusion NSTTUTNG lrvano PED Msc fovoroxc puncs ETc. Joerwarocoor J2PUVA ROOMS WITH 1 PAV | Jpvororensry Anca racine exc 1 LOCAL Jouva Roca wins 2 cers OF kaso ano FOOT AN SCALP Jpova macrms: + ROOM Jax FoR PHOTO TrESTING Jror wa uveANDeaToH lresTia onoceRoMe Jequewen fecurraneo GuBiCLES FOR i Jcockeraw Reowe sxx Jaerucarion OF crs: 4 Jourranen cue FoR cer manwcewen; + Jourtanen cuBicue FoR loevo am cuewcal caureny a "28 [SuBWATTNG AREA. Tye © a [panne slale| |FOR DERMATOLOGY PATENTS p jamin wHa.e ON TREATMENT lpawvacy |FOR PIGMENT LASER ANO 1 IvascucaR LASER TREATMENT JPaTIENT CHANGING ROOMS [TROLLEY AND BEDWAT _ TAPP BASE - a [RECOVERY AND OBSERVATION AREA Jenooscory root aleealelesele) a) al JeNBOScdeY RooN we pocessaue Ov BED /TROwEY {EARTOSPECAL TREATMENT FOR UROLOGRUSE; ADIATION PROTECTION —Jrorumomesy[OUTPATIENT SERVICES "WORKLOAD EQUIPMENT STIENT TOLETS "7H FUNCTIONAL STUDIES =RATORY [TOE LOCATED NEAR THE lnecePTioN / REGISTRATION lr; cL. TOLET & SHOWER: IneAR THE ENTRANCE AREA, FOR TS PERSOWELINOL AV lequewent jnct: ABLUTION AREA |For 2.3 PERSONS AT ONE [rn [FOR 2.8 PERSON AT ONE Ire7 [OUTPATIENT SERVICES. Tre ‘SPRCEROOM “WORKLOAD TEGUIPHENT | NO.OF] ONT] TOTAL ‘COMMENTS v0 00H AREA 14 a ‘A [ENTRANCE AREA 1 [RECEPTION REGTRATIONT [nck OFFICE & RECORDS 8] 2 Joourorensen ___Jpevenuecoueemon wc - “2. ]MANWATING AREA _____ Fon 5 PERSONS, “TROLLEY Ao WHEELCHAIR PAR 4 [PATIENT CHANGING ROOM LOCKERS —_— 3 [PATIENT TOLETS jrsm, 1 sauAT Wea? . le wasteAsins Per UNIT [DISABLED TOLET - ‘8 [ESAMINUETION & ASSESSMENT AREA "TJEONGULTATION EXAMINATION FOR IEDICAL ASSESSMENT room ____|wrervew ano Review [counseling ROOM [MEDICAL SOCIAL STAFF INAEWODIALYSts TREATMENT 7% leans 1 72 \WiTH TVIDEO FAOLITS TEATMEITISCLATIONROGM [FOR HGH RISK CASES EG. 4 6 JHerarms |. _ [stoRAGE oF STERILE PAGS ya ls PRepanaTiON OF S€7S 73 [pRIVOTITY JFAcHTies For wasHiNG AND Ta] lsswrecTion: HOLDING AREA Jror orery unex ano USED lessorrens | _ a] ae) ae fem oRBLUP aN _ lcownins Facumes (CL WAR @ BEVERAGE yao FACAITIES FOR PATIENTS 7a. BAYS EO CAPD TREATHENT 4] 24) 2 PavAs FOR ALE ao . _ | Jrewueranienrs a} a) a Jur Sc OP ao _ | lsownmic Facies |FOR PREPARATION OF yf leeveraces _. _ [mse - # jrvesroe one romeo ya) eco veri lowsare Rus [pen LAR ROOMS pews woRSFor [MAINTENANCE AND WINOR 6 _ Inara OF OLS EQUPHENT . _ 73 ase AEA FOR WASHING AND STERLISING Ta] a |r000 vermin JWion NFzcTIONS cases) [ARTIFICIAL KIONEY AND TUBING Jecaurep ror ossieanion lor Now:NFECTED PATENTS lor Foruaun Fume WASHING AND STERRISINS _ _ acurmies _ . . 2 [WASHING AREA FoR WASHING AND STERILENG ~ 4 VETEATION jivrecrious cases) [naTFiCAL CONEY AND TUBING {ED FORDISPATION lor nrEcTED PATIENTS WASHING FORMALIN FUME _ Law sven sins Fac mes _ _ 7 [ePORAL ROM HOLDING CLRCAL No 7 | _ lceNERALWASTE 25, |SLEANERS ROOM _ | 4 27, |equrseent store” [sTorase oe owes maces | 135 SENERAL STORE ~ . 25, junen store _ STORAGE OF CLEAN LWE: a 30" tuo Stone ror THe STORAGE oF 1 | __ ______pwsaTe ups: fd iSTER TAR TREATMENT PLANT |FOR TREATWENT OF WATER. 7 |stoRAGE AND DISTRIBUTION lrowserlice pan sr, squaTwoe fwasHensins PER UCT Tira Loner JroR 29 PERSONS: WAT racumes [FOTaL DEPARTWENTAL NET AREA IGIRCULATION AREA 40% JFOTAL DEPARTMENTAL, GROSS AREA [[oowmAaNICATION AND CONTROL FOR THE WARD; WORK TATION, COUNTER TOP AND (ORK TOP OBSERVATION OF "ATIENTS; CONTROL DUG ORR STONAND AREA |coMPUTER TERMINALS |woresTaTONs FOR lbocrors aKo STA JeBEDSRD CLASS Bay [sens /eAv, SHELVES FOR laornes, ReSUSCTATVE leQueMeNr, woRKTORS: 1 FOR MEDICINE TROLLEY {P STANDS, PORTABLE Jaucion MACHINES TACUTE NURSING BAY, huRseRY aay SHOULD BE JFACNS THIS AREA FOR [cLose caseRvaTion YpseD ano ovis BAY ‘BEDS / BAY, DAY SPACE, Jecosice Lockers: hNDWiOUAL WARDROBES AND lLouce cHwe a BED GD CLASS ROOM BEDS /ROOW; DAY EPACE wins2 Louse CHARS, |wctTORS CHARS; BEDSIDE [LOcKER. nOWCUAL WARDROBE IRLOGK WITH FACILITIES FOR Joownaic, SHOE RACK, CLRBCAL |ASHaNY ROOM WT LOUNGE IcHAR, VISTTOR CHAIR, LOCKER laNo WAROROE: ONE OF THE |sovaTion wand sHOULD BE loonvenaue To A S=CURTY JROOW WITH A TABLE AND lcoLAPSIBLE SED FOR THE /AROER. 3[ 8 jz sHowens, 1S0UATWWa, | PEDESTAL WC 1 WASHEASIN Jpcrunr. 1 shower. 1siTWo. le waseonn PER une presen HANDICAPPED ACCESSLE [FoR ISOLATION ROOMS oR oreSsino, WOUND [reEAMAENT ETC. [AGIAGENT TO GLEAN AND lorery unity ROOMS woRKsTORS FORLAVNG OUT lsrerwe ses JOLEAN ENVIRONMENT leRDoE FoR DRUGS ANDW INFUSION PACKS, MEDICINE AND lopessino TROLLEYS 7% [STORAGE OF STERILE |sureuses AND PAZPARATION [ANO PREPARATION FOR ALL [CLEAN ano STERILE SUPPLIES use THe TREATMENT TASTING OF BEDPANG, luriacs, SPUREM CUPSETC; lscoran WASHER, cISINFECTOR; [pench FoR uane TESTS | jar WORKTOPS AND SH InicrOWAvES OVEN AND |RerriceRATOR FOR FOOD STORAGE 7 LEANSING OF HOUSEKEEPING JecueNenT; SNK FOR DISPOSAL lon ony waver,2_INPATIENT SERVICES a Tae SOR ESRI [SE TOT Sa 2 Tea] sae [ en 2 ee EamanaGRGTRCSSARS] I] a Sane ne. amcor mente mc catte oon Secor cesarean sr ‘ee commocns : 7 Ramen oe RT tps nee ron arse mre ro fae RSTO NEES frmmiacesse Le omer in mane eee ceoe tere conewman oe eres La tater Pe ecrseanm2 Nowesncpxnen ficorccwars ners boca ce Hr ores oss ce Jat emer aon Leer ctcr ser aren Fe necunes ee a eet FRE es a} i amromnacarrs feereromer metoace Se owen be a Lamia taal “amma crmaeconne Lorene Lt ene oc Se cscs aro ae eer =} aa aomemenecea [sense ar we Wena tema lisrrcnuos cures _proaeee = ers + aoe TEER a areas remnerse Keniry seam arora Dee eat} at leona Meee = pa Se eT || er eerers ane [moremanonronat heaannaorrany Seo eines enue rr homo: a Ls rr cance Soren Prowse sctron bievaes z a Lior nme lremnsnetSoe Liowoe a a a Leones eaon Sete sareeINPATIENT SERVICES [yROUEY WHELLGHAIR PARR 48 [DENERAL STORE |For CoONSOWABLE, BULK sf sf 30 lsuPpLy ano STATIONARY. e_[EournaT STORE, IFOR MOBLE EOUPHENT yal 70 fassisreD earH [LONG BATH TUBE. afl sa 21] WASHING AND DRYING WASHING ANODRVING apo] 30 -ACILITIES FOR PATIENTS usc @_[pavroow ze C_|BTAFr AREAS, 23 [poctons oFAe=: yee ‘24 _|SSTERS OFFICE a 125 [Starr TOLET af af 28 RESTROOM hw PANTRY FACETS TE af 46] 38 lMicAOWAVE OVEN 4 FROGE @ ‘ROOM H BED, SITTING AREA, WRITING af) fwmmaTacreD wer FTABLE, DRESSING TABLE, lsHower /ARDROBE, TV, TELEPHONE NOTABLE LAP, 2 BewnarRcow Ferenc 7 % AVA FACILITIES I [AL DEPARTMENTAL WET AREA ae IROULATION AREA 35% 286 TAL DEPARTMENTAL GROSS AREA | "009, 2 ANGULAR FACIES BETWEEN TWO WARDS 2 jcouwres 7 J 20 TORETS 2 al |e FOR wHELCHA 3 Tar aren afta) es | were ABcUTION NYERROOM, rackmes 32 foTarr Hance MALE |owouai LOCKERS 3} 718 nN. We SHOWER: [Starr cuance FEMALE fiowiouaL LocKERS [20] ~ 20 _ ino. we /shOWER ‘34 JBISPOBAL ROOM fscraRaTE BAGS FOR ay ata [TOTAL SHARED NET AREA, JcIRCULATION AREA 3534 [TOTAL SwARED GROSS AREA2_TINPATIENT SERVICES Tew wear | Ow] TOTAL CouMENTS Wo oou | anca | ane, aL a (GE AREA + _[enteance Losey TARLOGE a] 8 2 fystTORS on yal 3 RELAIS a] ap fours eur VIEW ROOM 7 RELATIVES WAIN Rare Pe) foursce me oars once swarm wrth pereNwency WARD fuser rowers af 6 far Bf MuRNS AREA une se [urncov awarencon Ta] [reRsaamr 7 ed ea piso OEP CURTIN a2) usicue area we wee nano 3 |soemTonnooNs Jewrance eavoR ay a0 Jcrveen, cownans ant I frssene or coms a ynsoe aff (¢ _BUPFORT STORAGE AREA 4 feueanuTasry [STOREAGE OF REDON CALC Ty feearvens moisEvs, lstmavenous nRUSION PACKS 16 [parvum IASANG AND DISMFECTON ype lor uriva BEDPANS; ASHER SANTISER 76 ose earanr s[ as 7 PCUTE LABORATORT kRSeNT esa Pe 6 lesrmarons avo sooo cas [NALYSIS SHALL WASH AREA Te ROLLE PAR a a8 19 [peneRAL STORE [se] te z0_[ecuyent sToRE aL ala 21 [TERE srone s[ sol “zo Zune som az sf 7Za_|pueanens ROOM i] a8 2+ [pssPOsAL ROOM |] _# | swoiknee nccessece Jrrom outa 2 [Srareaoumes = perce SEL FOR OTS a _R] _«_|war nol coors sronen To THE ENTRANCE lawe 26_ pow RUESTHETT ORE i | 2 fours 27 fpNaESTHETSTS OFrice |FeRScnaL ASST AREA, || se ronacunisrarve CLERKS & OPENOFFICE FOR }ro Be Locare> curate unr [borricens, necerrion a WAT lin SEPARATE ACCESS wo |poororscrrce Fos ormcens [Biya Joven orice concert 7 stenorrice FACLIES FOR PAWATE fae VIEW 20 _|Sexma ROOM [ron 0 Penson 3] 30 paces Prom oursiGe 31 _JoNeatl ROOM 212] 96 JAMTACHED WC SHOWER sa [btarrrest eae RES af aah ae PRAYER OOM ye pra ne ABLaTION CAT be shana win oy 3 aFTOLES ear adver [ores SEPARA WETAREA | za [— IROULATONAREA 35% 2 [foTa: DEPARTMENTAL GROSS AREA 02_[INPATIENT SERVICES. Tew ‘SPACEROOM ‘WORKLOAD TEGUIPMENT | ROOF | UNTT”| TOTAL ‘COMMENTS No, oo | ance | area 2A ‘A [ENTRANCE AREA 7. [ETRaNce Losey ARLOGK, [FORD BED eTRETOHERS ys 2 fpeLaTMES warns [FOR 10 PERSONS. 1p) 12 foursme mew 3 _lsTacss ReLaTves INTERVIEW fs ry ING AREA, 3 E BASE ITH CON AND NTEROOH "]__1o] we [rors creer 4 BNGLE CUBICLES TH SEMI GLASSED WALLS [ 20 NOBOOR = TSTORAGE AREA [TREATMENT ROOM [RUECTIONS, PREPARATION OF 7 6 SETS FOR PROCEDURES 5 euTey [STORAGE OF UEDICINE, DRUGS yee [TREATMENT TROLLEYS, larravenous lneusionPAcks 7 [pervoniy |ASHING AND DSNFEGTON yee jor uriwaL acoPans; |ASHER SANTISER © [FLUOROSCOPY /PACENMOER IMonrToRy FLUOROSCOPY a] a) TABLE K MACHINE 2 PaneNTTOLET IMANOICAPPED ACCESSIBLE 7 [ASSISTED We / SHOWER, 70 paver [PREPARATION OF BEVERNGES ye [FOR PATENTS T fiROULEV Pare [TROUY, STRETGHER AND 7 4 . Swneerciue paRKiNs 12_lpenena s10Re a] ala 73 [EoUPMeNT STORE, a] af sa 4 STORE a] 9030 15 fing stone a] 3f 3 16 [PLEANERS ROOM 4 5 ‘17 Jprss0sAL ROOM a] of © {ecu Be accesaiLEFROW loursve D_ [starr FACITIES 7a STAFF ChaNGE SCESSISLE FORM OUTSIDE, wy 2 war mec Toonens, INcAR TO THe ENTRANCE lsrowers we 7a pociors ormce 7 % ‘2 _|BSTERS OFFICE 1 € 21__[Sewnaliacow’ [FORZO PERSONS a 2 722 [PNGALL ROOK 1 8 [ATIAGHED WE SHOWER, 23_[BIAFF REST TH PANTRY FACTS 4 © ‘24 _[praver Ron 2 a {wa wel ASTON 25 TOLETS sib Tee UT 2 6 (war [TOTAL DEPARTMENTAL WET AREA oo REUATION AREA 35% 184 [AL DEPARTMENTAL GROSS AREA 9,INPATIENT SERVICES: [REL WisroRs CHANGE jeer /ATION JOPEN BAY FOR 2 INCUBATORS, JexaunaTion TROLLEY: BABY loamy WTH RADIANT HEATER, [EWING CALERY [NURSING AREA [5a STAFF OBSERCATION JFoRTENSWE AND loBSERVATION AREAS [rcOTEAH INCL. LOBBY /ARLOGK fo weveaToRs SPACE wT 1 staRF 2 MoNTORNG loevice, ero; wuRSE louastavion wire woR«ToP; lanay RESUSCITATION )PMENT, m2 COT INCUBATIORS WCIROUMLAR looncert fe ncusarons; easy BATH wine RANT HESTER FROouin- vt MOTHER: [WTATTAGHEDTOLET, 1 JSHOWER,# swe, 1 sauAT Jwcarwasnensen EXCHANGE TRANSFUSION LLBE PREPARED ANDLAY OUT TROLLEYS; REFRIGRATOR FREEZER FOR STORAGE VACCINE AND DAUGS IGE FACILTES; STORAGE RECYLED CSSD TENS [COLLECTION lMoBice XRAY BAY pee ASOT {GAS ANALYSIS TABLE FACLTIV AND LA SNS, INGUBATOR CLEANING 7 ‘CLEANING, TAMINATION, ORYING, gNOR MAINTENANCE AND [TESTING OF INCUBATORS ING, TESTING AND INTENANCE OF VENTILATORS [STORAGE OF MLK SUPPLIES ano warns FACILITIESINPATIENT SERVICES: -AEEROOM [ENTRANCE AREA. WORKLOAD EQUPWENT TOTAL COMMENTS: [ENTRANCE LOBaY. [ASSESSMENT AREA |ASSESGUENT OF NEWEY laRRavED PATENTS ANO BATH [RELATIVES WARTIN [FOR 10 PERSONS. [visitor TOLET’ @ JNORSE Base TWiT CRETRAL MONTORS & [pocToRs weetnG AREA. a] 72 “a 2 | lorspoca, Row [otar CHANGE [wae ner LOCKERS, loocrors oF AcE: [sisrers OFFICE fsewvaR ROOM IFOR Ta PERSONS fon.caLL ROOM [aracheD we /enower [Sta REST, To PANTRY FACULTIES [pRavER ROOH [nar mck. ALTON, 2. 7 6 8 2 2 2 a 2 [stare TOLET. "TOTAL DEPARTWENTALNET AREA [GIRGWLATION AREA 35% TOTAL DEPARTMENTAL GROSS AREA. Ey -