The goal is to construct a public health facility of a general type where people can stay and undergo treatment as well as get examined and receive counseling. The hospital provides primary health care performed by paramedics, obstetricians, and other medical professionals. Medical assistance is also provided by general practitioners and family doctors. The employees of this facility are obliged to provide specialized, high-tech, medical care for all patients.
The approximate land area that the facility occupies is 14000 m², including the territory surrounding it. Excluding the walking area and greenery sites located in front of the hospital, the total building area is 11040 m². The hospital is a three-story building, and the floor area is 3680 m². The facility includes premises for initial patient registration and reception, a registry, and a triage unit. The project also includes a laboratory and a hospital pharmacy. The number of beds is 230 in the inpatient department and 30 beds in the intensive care and rehabilitation department. The 40 hospital wards with beds and patients are located on the second floor, 20 on the left-wing, and 20 on the right wing, accordingly. For transporting patients on beds, it is recommended to install elevators.
It is necessary to place wards in between the sections to ensure a convenient connection with vertical and horizontal communications that link together the ward departments with other medical organizations’ departments. Therefore, the third floor is designed for office departments where all the doctors, nurses, and staff operate most of the time. The chief doctor’s office, the laboratory, and pharmacy as well as the secretary’s office and accounting department are also located on this floor. Finally, on the first floor, there is a reception, waiting area, and various doctors’ offices where patients can receive treatment or counseling. It is necessary to take into account fire safety requirements and evacuation routes as well.
The medical organization’s organizational type is organic, which allows it to adjust to adapt to changing conditions and environment of the area. This organizational strategy considers the demographics of the area’s population and other critical indicators. The organic type requires high efficiency and quality of work and quick response to various changes. The planning of the hospital’s recourses following the area’s requirements is a vital process.
The overall number of hospital personnel is 90, excluding the owner and administration of the hospital. The list of potential stakeholders in developing a hospital’s design project goes far beyond staff and patients. In addition, it is important to distinguish groups that may have multidirectional interests, despite belonging to the same stakeholder. The social and professional groups that can be considered interested parties include inpatients, outpatients, doctors, nurses, non-medical personnel, entrepreneurs, suppliers, visitors, representatives of the municipality, and emergency services.
The basis for the organization is functional zoning and arrangement of communications that provide convenient interconnections of all subdivisions of the hospital. The project implies building a hospital in the form of a single building of a limited number of stories to organize and establish proper communication and engagement between departments with clear functional zoning according to the degree of treatment intensity. The organizational communication type is top-down as centralized uniformity allows the hospital to function following the patients’ needs and timely provision of treatment, medical supplies, and the doctors’ various services.
Maximum centralization of diagnostic (including laboratory), medical (radiotherapy, rehabilitation treatment), and support services is necessary to ensure the accessibility of these functions for all hospital departments. The hospital’s organization is aimed at the comfort and safety of patients and the convenience and efficiency of staff.
A more efficient payment mechanism for inpatient care is paying for a completed case. The Diagnosis Related Groups (DRG) “provide a technical means for achieving more efficient management and financing of public and/or private hospital services” (Annear et al. 707).
DRG combines different diseases into cost-homogeneous groups with an estimated average cost of treatment. At the same time, hospitals receive a fixed payment for the treated patient, regardless of the intensity of treatment or the duration of the patient’s stay. The average length of hospital stay with the DRG payment system’s introduction is often reduced compared to other payment systems. This payment method saves about 10% of the facility’s costs. However, the DRG payment type requires careful preliminary costing and continuous monitoring of results.
Modern principles of the provision of medical services and the latest medical trends entail constant changes in the requirements for the design and construction of medical organizations’ buildings. The medical organization’s culture revolves around innovative diagnostic and treatment methods, the comfort and safety of patients, and the convenience and efficiency of staff work. Although humanization and patient orientation prioritize creating a comfortable and warm environment for both patients and staff, there are other significant goals. They focus on architecture, design and ergonomics, decoration, colors, and microclimate.
The task of architecture is to turn the hospital into an open and comfortable place of hope, treatment, care, and a collaborative striving for health. The creation of a comfortable environment for a patient’s round-the-clock stay is provided by developing design projects and color solutions as part of the therapeutic process, ensuring the privacy of patients by dividing the flows of inpatients and outpatients. The organization’s climate makes sure to secure a welcoming atmosphere for every patient and every individual that visits the hospital.
The healthcare facility is located in a city with a population of approximately 30,000 citizens. The hospital is expected to meet the local area’s requirements and has enough recourses to provide services for this number of citizens. The demographics of the area’s population have evolved over the past decades, as well as the requirements for medical facilities at the state and local levels. The population is growing in size and demands the implementation of appropriate measures in terms of the provision of medical care for the citizens. Compared to the death rates, the birth rate is growing every year, but the migration rate is low. The facility must consider the demographic indicators in planning its activities and estimate its abilities in the context of this population.
The urbanization of a modern hospital and its integration into the life of the city are also general trends for almost all developed countries. They are expressed in the openness of the hospital and great attention to the design of public spaces. The facility should have spacious entrance halls and main streets as well as such urban elements of service as banks or ATMs, cafes, small shops, and meeting and conference areas. Regardless of the area’s small population, the facility must spare no resources, effort, or budget on providing the best service for the citizens.
Reference
Annear, P. L., Kwon, S., Lorenzoni, L., Duckett, S., Huntington, D., Langenbrunner, J. C., Murakami, Y., Shon, C. & Xu, K. (2018). Pathways to DRG-based hospital payment systems in Japan, Korea, and Thailand. Health Policy, 122(7), 707–713. Web.