Home Up Next


 

Administration

General Administration Areas Planning Issues

The administration areas in a hospital must be planned and designed based on the particular functional relationships that exist in any given organization. These relationships will be dependent on the mix of inpatient and outpatient services, the type of hospital (not-for-profit, public, private, religious order), the size of the physical plant, and the range of medical services offered. The program is designed to allow the user to estimate the size of individual functional areas in order to show the relative sizes of these areas in relation to the overall administrative space. Numbers of personnel within each administrative area as well as conference rooms and filing areas are the primary data sources that are used to predict square footage requirements.

Admitting

General Admitting Planning Issues

The most critical planning issues in the admitting department are the types and numbers of individual work areas , the total number of personnel on duty during the peak work shift, and the number of admits to the hospital per day. Recently trends in information systems and patient center care concept are reducing the staffing and levels of patient interaction in centralized registration service.

Ambulatory Care

General Ambulatory Planning Issues

The most critical planning issues in the ambulatory care department are the types of ambulatory services offered, the number of examinations performed in the department on the busiest days of the year, the number of physicians working in the clinic during the busiest four-hour periods of a day, and the amount and type of support functions controlled by the department.

Cardiac Catheterization

General Imaging Planning Issues

Critical planning issues in the planning of Cardiac Catheterization services include the scope of services provided , i.e.cardiac caths, angioplasty, EP studies, the support services required to manage pre- and post -procedures for patients, the number and type of personnel offices located in the department, and the amount and type of file storage controlled by the department.

Major shifts are currently occurring in the proportion of patients treated on an outpatient basis. There may also be economies of staffing and space if the patient prep and observation areas can be combined with other services such as surgery, endoscopy, and radiology.

Central Sterile (CS) Services

General Central Sterile Services Planning Issues

The central sterile service plays a critical role in the delivery of care which requires the highest standards of aseptic technique, such as surgery, emergency, obstetrics, and other services. The interrelationship with surgical services is the most critical issue at most hospitals. Where terminal sterilization of instruments occurs, where they are stored, how supplies are provided and the management of expensive inventory items typically drive the organization and space for CS. While most institutions have established a case-cart system for delivering supplies, some hospitals continue to manage major components of supply system within the surgery suite.

The recent move towards large, multi-hospital systems has the potential for regional centralization of some of the traditional CS functions. Some institutions are utilization of out-of-hospital vendors to manage the sterile processing of basic instrument sets. There is also an increasing interest in "just-in-time" stocking of sterile disposable items, resulting in major reductions in the bulk storage required within the services.

General Laboratory Planning Issues

Due to the highly specialized equipment and diversity of tests that can be performed in a hospital-based clinical lab, the establishment of a methodology for estimating space requires more detail than for many of the other services in the Space Planner.

Critical issues which may affect the space needs for this service include the level of centralization of specimen collection and processing, the utilization of satellite and "point of care" testing outside of the main laboratory, the automated and other specialized instrumentation, and the staffing patterns for the laboratory and related referral activities.

The basic approach to the planning of space for this service is to identify the number of workstations required along with additional bench space and floor area required for instrumentation within the service. This model allows the user to estimate space based on two levels of detail. One level provides a basic estimate using only the number of workstations provided in a division of the service. The second level of analysis includes both the workstation calculation and the estimate of additional instrumentation.

Dietary Services

General Dietary Services Planning Issues

The shift of hospital activity from inpatient to outpatient care has changed the traditional emphasis in the planning of dietary services from the bed census to a combination of inpatients and the growing outpatient/family and staff populations that typically present a peak demand for service at lunch.

The methodology used in this model is an adaptation of a space estimating approach described by Lendal H. Lotschervar and Margaret E. Terrell in their book Food Service Planning: Layout and Equipment, 2nd edition (Wiley, 1977)

EEG-EKG (Electrodiagnostics)

General EEG-EKG Planning Issues

The most critical planning issues in the EEG-EKG department are the types of electrodiagnostic services offered and the annual number of procedures performed in the department.

Emergency Service

General Emergency Service Planning Issues

Emergency room planning issues are centered on the need to provide sufficient space allocations to handle those periods of highest patient utilization. For this reason the data that the user is asked by the program to enter in the "Key Input Data" section are based on utilization figures that describe the single day of the year that will produce the most critical patient loads.

Endoscopy Suite

General Imaging Planning Issues

Critical planning issues in the planning of Endoscopy services include the scope of services provided (e.g. upper GI, lower GI, bronchoscope and other studies), the support services required to manage pre- and post -procedures for patients, and the number and type of personnel offices located in the department. Major shifts are currently occurring in the proportion of patients treated on an outpatient basis. There may also be economies of staffing and space if the patient prep and observation areas can be combined with other services such as surgery, cardiology, and radiology.

Engineering Services

General Engineering Services Planning Issues

The most critical planning issues in the engineering department are the types of services offered, the number of staff in the various services, and the total gross square footage within the hospital supported by these services.

Environmental Services

General Environmental Services Planning Issues

The most critical planning issues in the environmental department are the types of services offered, the number of staff in the various services, and the total gross square footage within the hospital supported by these services.

Imaging (Radiology)

General Imaging Planning Issues

The most critical planning issues in the imaging department are the types of diagnostic imagining services offered, the annual number of examinations performed in the department, the number and type of personnel offices located in the department, and the amount and type of file storage controlled by the department.

Acute Inpatient

General Acute-Care Planning Issues

The most critical planning issues in the acute-care department are the types of inpatient services offered, the annual number admits and patient days, and the presence or absence of patient-centered care services in the various inpatient services. The assumption of patient-centered care services will increase NSF space estimates to account for additional satellite pharmacy, food service, and diagnostic facilities, etc. The program is designed to calculate space estimates in the "Low NSF" columns based on 50 percent semi-private room occupancy, while the "High NSF" columns describe space requirements for private inpatient rooms only.

ICU-Stepdown Inpatient

General ICU-Stepdown Inpatient Planning Issues

The most critical planning issues in the ICU department are the types of inpatient services offered, the annual number admits and patient days, and the presence or absence of patient-centered care services in the various inpatient services. The assumption of patient-centered care services will increase NSF space estimates to account for additional satellite pharmacy, food service, and diagnostic facilities.

From a facilities perspective, the dividing line between critical care and stepdown bed are becoming blurred as hospitals seek to decompress critical case days and increase the flexibility of space allocations.

Laundry

General Laundry Planning Issues

The most critical planning issues in the laundry department are the types of services offered, the number of staff in the various services, and the total number of pounds of laundry processed within the hospital on an annual basis.

Lobby

General Lobby Planning Issues

The most critical planning issue in the lobby is the total number of admits to the hospital on the busiest day of the year.

Material Management Services

General Material Management Services Planning Issues

Perhaps no department in a hospital is experiencing as wide a range of changes as materials management. The wave of consolidation of hospitals into major networks provides opportunities for regionalization of warehousing functions, thereby eliminating major space requirements within an individual institution. Automation of order picking and industrial-style storage systems can also affect the space requirements.

As with Central Sterile, the implementation of "just in time" ordering systems has allowed on site inventories to be significantly reduced at some hospitals.

This model does not attempt to predict the long-term trends in these areas. The tool does, however, allow the user to estimate the space implications of alternative demand levels at a given institution. Through this approach one could test the sensitivity of alternative workloads on the materials management section.

Medical Records

General Medical Records Planning Issues

The most critical planning issues in the medical records department are the types and numbers of individual work areas and the total number of personnel on duty during the peak work shift and the type and number of patient records stored in the Medical Records department. It is assumed that records storage will be by standard or compact systems.

Nuclear Medicine Suite

General Nuclear Medicine Planning Issues

Although the primary focus of the nuclear medicine service is the gamma camera instrumentation, there are several components of this service which may also be provided, including In Vitro analysis of specimens, cardiac stress testing, and other procedures.

Occupational Therapy

General Occupational Therapy Planning Issues

The most critical planning issues in the occupational therapy department are the types of rehabilitative services offered and the annual number of procedures performed in the department. Utilization rates for occupational therapy treatment areas will be lower than those found in other treatment or diagnostic services because of the variety of procedures that a single patient may undergo during a single OT session. In this respect, the input data for the program measure individual procedures rather than patient visits.

Pharmacy

General Pharmacy Planning Issues

The most critical planning issues in the pharmacy areas are the types and numbers of individual work areas and the total number of personnel on duty during the peak work shift. It is assumed that satellite pharmacy spaces will be estimated in the program sections dealing with Inpatient Acute and ICU departments.

Physical Therapy

General Physical Therapy Planning Issues

The most critical planning issues in the physical therapy department are the types of rehabilitative services offered and the annual number of procedures performed in the department. Utilization rates for physical therapy treatment areas will be lower than those found in other treatment or diagnostic services because of the variety of procedures that a single patient may undergo during a single PT session. In this respect, the input data for the program measure individual procedures rather than patient visits.

Radiation Therapy

General Radiation Therapy Planning Issues

The most critical planning issues in the radiation therapy department are the types of treatment equipment utilized, the services offered, the annual number of treatments performed in the department, the number and type of personnel offices located in the department, and the number of simulators in the department.

Respiratory Therapy

General Respiratory Therapy Planning Issues

The most critical planning issues in the respiratory therapy department are the types of rehabilitative services offered and the annual number of procedures performed in the department.

Surgery

General Surgery Planning Issues

The most critical planning issues in the surgery department are the types of surgery services offered, the annual number of surgical cases performed in the department, the number and type of personnel offices located in the department, and the number and type of recovery areas located in the department. The shift to outpatient sameday surgeries is increasing the support space required within surgery for patient holding and recovery. Some institutions are integrating surgery outpatient holding with other services, such as cardiology, radiology and endoscopy.

Women’s Services

General Women’s Services Planning Issues

Over the past decade women’s services have been at the forefront of the change in attitude toward patient care. The shift from traditional labor and delivery rooms to LDR and LDRP suites has lead the movement of patient-centered care that is permeating most areas of health-care delivery.

This model recognizes that there may be a diversity of delivery environments which will be required in a Women’s service, along with a mix of nursing units for obstetrical and gynecology patients.