JEHANGIR HOSPITAL

REASON FOR SELECTION :

ARCHITECT : AR LAXMAN THITE

CLIENT : APOLLO GROUP. DELHI.

Capacity:325beds with range of Inpatient wards,150 cardiac patients.6 Operation theatres and multi disciplinary Out patient Departments.

Hospital Consultants:Indian Hospital Corporation Limited,(Apollo Hospitals Group) Indian Hospitals Corporation Limited.

Jehangir Hospital had entered into an agreement with the Apollo Hospitals Group to manage the existing operations as well as design and implement the project. The primary aim of the expansion project is to add speciality services and upgrade the existing departments and facilities.

Since 1991 the Jehangir Hospital & Medical Center has been gradually computerized and various departments have been provided with terminals. Soon after the new building came up, the facilities of Cat scan and of nuclear medical were introduced .The bed capacity of the hospital will go up from 198 to 250 beds. The project also envisages construction of six ultramodern operation theatres, 44 intensive care beds, dedicated day care surgery unit, emergency and trauma care unit, six bed dialysis unit, organ transplant unit and dedicated departments of urology, chest medicine, dentistry and orthopaedics.

Jehangir Hospital is centrally located in the prime area of Pune.It is well connected by the public transport system from all areas of the city. It is approximately ½ km from the Pune railway station and/ or Pune Bus depot, and one could easily reach the hospital by foot from here. The distance from Airport to this hospital is approximately 10 kms.

LOCATION :

SURROUNDINGS :The hospital is located in the central area surrounded by railway line and commercial buildings.It has N M WADIA INSTITUTE in its campus.There is noise of railway line.

CLIMATIC ASPECT : •The climate of Pune is moderate .•This climate is dealt by air conditioning 60 %of the hospital which keeps a check on air pollution from road side.•As the air for Operation theatres and Critical areas should be filtered.•Wind direction is predominantly from west and south-west direction.•Natural light and ventilation is provided with the help of courtyards.

SITE :Actually one old bungalow is now developed asa hospital. The main entrance to the hospital is from the main square.

ENTRANCE

•The hospital complex has two main entrances.One from the main road (Sasson road).The other entrance ,is from N M WADIA INSTITUTE . This is also used as a service entry for trucks bringing in goods like oxygen cylinders etc.

SITE PLAN

TOPOGRAPHY :The plot is square in shape having gentle slope towards highway.

POSITIONING :

SERVICES

•The ground coverage is less the srvices are housed in the old structure which are ground structures.

PLANNING :As the hospital is in developing stage the space utilised for hospital building which is G+5 is only 45%.Space utilised for services 20%, For landscapingis 10% and For parking is 25%

LANDSCAPE :•Artificial plants are used in interiors for landscaping.•Flower beds are provided at the entrance which gives a soothing effect.•A large space is given for landscaping.•There are huge trees like gulmohar in the courtyard.

HOSPITAL 60%

PARKING 25%

SERVICES 20%

LANDSCAPE 10%

PARKING SPACE :A large parking space is present in front of the Hospital building for visitors.Though the land along side is a large vacant plot being used for parking, it is possible that the hospital managementplans further expansion.

Ample space is provided for car and two wheeler parking. The parking lots are separate for doctors, visitors and staff.The internal road is concrete road leading to the main entrance of hospital building.

ELEVATIONS :•The massing itself creates a soothing elevation .•The color used is white and sky blue mosaic tiles for the entrance porch. •The sloping roofs with mangalore tiles are contrasting to the hospital building.•The recessed windows act as shading device.

MASSING :•The curved front façade gives a free flowing effect.•The old structure of sloping roof and the new building are interlocked in each other .•The central building is G+5 and the services are ground structured.•The entrance porch is the most prominent and appealing feature with its radial form.

ENTRANCE PORCH

COMPONENTS OF THE HOSPITAL :

GROUND FLOOR :CASUALTYRADIOLOGYC.T. SCANENDOSCOPYDENTALMAMMOGRAPHYSTRESS TESTULTRASOUND2D ECHOCARDIOGRAPHY

OPD ROOMS 1-20PFT, ECG, EEGOP BILLINGHEALTH CHECKSAMPLE COLLECTIONBLOOD BANKLABORATORYADMINISTRATION

BASEMENT :SOCIAL WORKERAUDIOLOGYOPD ROOMS 21-29PHYSIOTHERAPYMEDICAL RECORDSONCOLOGY

FIRST FLOOR :ICU 101-130HDU 131-138

DIALYSIS CENTRE

SECOND FLOOR :OTsCATH LABCARDIAC POST OPBEDS NO 201-250

PLANNING :The old was developed step by step using available funds that’s why there are lacunas in the planning.The actual plan of hospital square in shape with one rectangular general ward block is connected to it at an angle.

The old bungalow is now used as the administrative section and APOLLO TELEMEDICINE CENTRE.The building blocks such as HR dept, maintenance, marketing dept, day care unit, and lecture hall, general ward,Kitchen is provided on the back side of the main hospital building.Medical shop, bank A.T.M centre, and generator room and transformer room is at the entrance on the right hand side.

NURSING AND STAFF PATTERN :The nursing counters are positioned properly containing cabinets, computers, intercom facility, And patient’s records.They are planned at the entrance of ICUs ,HDUs, and OT’s And at the center of corridors.The no. of beds – 325No of staff – 1000ICU – proportion – 1:1Private rooms – 1:2General ward – 1:4Ward boys – 6 per floor.

DOCTORS CONSULTING ROOM

AC plant is adjacent to the administrative block.The percentage of open space is around 10% of the plot area.

ENTRANCE

DIAGNOSTICCENTRE

OFFICESOUT PATIENTDEPARTMENT

ACCOUNTING/BILLING

RECEPTION/ADMISSION

LIBRARY BLOOD BANK

LIFT

PRIVATE ROOMS

INTENSIVE CARE UNITS

ICU PATIENTWAITING

LIFTS

CATHETER LAB.OPERATION THEATRES

POST OPERATION

RELATIVES WAITING

CSSD

GROUND FLOOR

FIRST FLOOR

SECOND FLOOR

LIFTS

SUITES DELUXE ROOMSNURSES

STATIONS

TYPICAL FLOOR

SECTION SECTION

FLOWCHART

AIR COMPRESSORROOM

ENGINEERING DEPT.

NURSES $ DOCTORSQUARTERS

LINEN DEPT.EMERGENCY

OFFICES

LAUNDRY

MARKETING DEPT.

STAFF PARKING

BIOGAS PLANT

HOSPITALBUILDING

BIO MEDICALDEPT.

TIMES OFFICE

NURSINGHALL

DAY CARECENTRE

MORTUARY

SEPTIC OT

BOC GAS PLANT

MAINENTRANCE

SERVICE ENTRY

FLOW CHART

HISTORY OF JEHANGIR HOSPITAL

Dr.Edulji H Coyaji had a dream to start a hospital where he could treat the poor and rich alike. The hospital was named Jehangir Nursing Home after Sir Cowasji Jehangir's son Jehangir who died in an accident in 1944. From the beginning the nursing home was registered as a trust and it was run by a Board of trustees, Within a short while the Nursing home increased to a 60 bedded hospital. Facilities like the medical stores, pathology laboratory, and x-ray were provided soon after its inception. A well-equipped operation theater with most modern facilities were provided for the surgeons. Since 1991 the Jehangir Hospital & Medical Center has been gradually computerized and various departments have been provided with terminals. The hospital with attachment to the Bharati Vidyapeeth Medical College for teaching has also started research projects under the H.C.J.M.R.I.

Jehangir Hospital begins expansion, modernisation project Apollo Group of Hospitals on Wednesday laid the foundation stone of the Rs four crore new building of the

Jehangir Hospital and Medical Centre as part of its expansion and modernisation project. Jehangir Hospital had entered into an agreement with the Apollo Hospitals Group to manage the existing

operations as well as design and implement the project. The primary aim of the expansion project is to add speciality services and upgrade the existing departments and facilities.

The project also envisages construction of six ultramodern operation theatres, 44 intensive care beds, dedicated day care surgery unit, emergency and trauma care unit, six bed dialysis unit, organ transplant unit

and dedicated departments of urology, chest medicine, dentistry and orthopaedics.

DESIGN :To smoothly integrate the proposed extension with the existing 5 stories hospital building. To keep the cost of the project within the available total budget of approximately Rs.20 crores (building and civil works, engineering and support services and hospital services including latest medical equipments). To avoid interruption of functioning of the hospital while the project is under implementation. To minimise the demolition of the existing old buildings in the first phase.

METHODOLOGY :Conducted a photographic study of the site to determine the layout and location of the various buildings of the hospital. The number of floors of each building and the functions occuring on each floor, The physical condition of structures (e.g. whether in new, good conditions or are old, dilapidated structures etc) How the different buildings are linked and accessed from one another. Compared the existing areas vis-à-vis the proposed area in terms of their volumes and linkages.

JEHANGIR HOSPITAL BAGS STATE ENERGY CONSERVATION AWARD Jehangir Hospital, Pune in association with Apollo Hospitals Group is one of the best professionally managed hospitals in Maharashtra. Recently awarded State Level Award in Energy Conservation & Management for the year 2003 speaks about this

1. CENTRAL AIR CONDITIONING PLANT :Energy is saved to the tune of Rs. 3 lac per annum without affecting the indoor air quality.

Private & deluxe rooms are provided with window AC units.Where as the operation theatre, ICU, ICCU, HDUs are provided with centralized airconditioning system.The AC plant is adjacent to the main administrative block, which creates unwanted noiseIn the neighboring day care ward.

2. WATER QUALITY AND MANAGEMENT :Energy is saved to the tune of Rs. 2 lac per annum by maintaining good water quality to all major equipments such as Central A/c plant cooling tower, autoclaves, boiler, coolers, etc. & also managing

pumping of water to the specific timings, arresting leakages, etc.

Water supply is done by the OHT & UGT. For hot water supply boiler room is provided on the rear side of the hospital.Effluent treatment plant is on the back side.Incinerator, shredder are placed on the terrace.

3. POWER FACTOR MAINTENANCE : Energy to the tune of Rs. 6.16 lac per annum was saved by maintaining our power factor near Unity (One) at all seasons, thus creating a healthy power scenario at the users end & indirectly helping the source, i.e. M.S.E.B

4. SOLAR WATER HEATING SYSTEM : There was energy saving to the tune of Rs. 4.79 lac per annum by the use of solar water heating systems for hot water, thereby eliminating electric geyzers & boilers which were conventional equipments.

ELECTRICITY :The DGset, transformer is placed at the entrance of campus which ideal.UPS are provided in the Operation Theatre. TELECOMMUNICATION :Intercom facility is provided for nurses ,doctors and also provided in private & deluxe rooms.Public telephone facility is provided in the waiting area.TV facility is provided only in AC private rooms & in deluxe rooms.

5.FIRE FIGHTING SYSTEM :Sprinklers are provided only in OTs.Provision of hose on every floor.STRUCTURAL SYSTEM :RCC

Department of Estate & HygieneWASTE SEGREGATIONThe waste at the Hospital is not kept untreated, all the recyclable waste at our Hospital is segregated, disfigured, disinfected and stored in a locked area. The Hospital has a centralised segregation area wherein all the waste is disinfected and crushed to the fullest extent and then sent out. Ward level segregation is done at the ward level by special colour coding of bins, cutting of needles with the help of needle cutter and disinfecting the waste by use of hypochloride solution.

RED BINS - For infected wastes which includes cotton gauzes, linen, blood soaked cloth, catheters gloves etc.The above waste will be burnt in incinerators. YELLOW BINS - For body parts, body fluids, cytotoxic wastes, body waste etc.Apart from these RED and YELLOW wastes, no other item should be brought to the incinerators, If proper segregation of waste is not done the incinerator will not be able to function effectively, thus requiring frequent maintenance which is very expensive. WHITE BINS - For plastic wastes like I.V bottles, I.V tubings, syringes etc.The above waste will be sent for recycling scrap centre BLUE BINS - For all glass items.BLACK BINS - For general wastes for eg. Disposable polythene bags, coffee cups, all sorts of papers, flower vase, coconuts etc. The above waste will be collected near the incinerator and will be sent to corporation bins.GREEN BINS - For food waste and kitchen waste.The above waste will be sent to Corporation Bins.

VERMICULTURE

Our Hospital also has a specialised Vermiculture area with seven pitches for vermiculture fertilisers. Kitchen waste are all spread into vermiculture bins. The vermiculture is then converted into rich organic manure which serves as a useful source of rich fertiliser for landscaping of the Hospital and is also a source of income for garden development. PREVENTIVE MEASURES The infected waste are treated with hypochloride which makes the waste disinfected, thus preventing further infection.The needles and syringes are destroyed by scientific cutters, thus preventing reuse of the needles and syringer for further hygiene.Care is taken of air pollution It may be noted that from our Hospital the final waste is only in the form of ashes which is dumped in the Corporation bins thus avoiding pollution.

INCINERATOROur Hospital has its own incinerator wherein all the infected waste are burnt. These waste include needles, soiled bandages and mattresses, cotton and towels, diseased and amputed parts.

HOUSE KEEPING, LINEN AND LAUNDRY DEPARTMENTS :The patient rooms and bedside equipment of patients should be routinely cleaned and disinfected, especially disinfection of environmental surfaces, beds, bed rails, bedside equipment and other frequently touched surfaces. Handle, transport and process used linen in a manner that prevents contamination of clothing.

CRITICAL CARE SERVICES58 Bed ICU Complex comprising of15 bedded dedicated Neuro ICU $ 15 bedded Medical ICU10 bedded Neonatal ICU, Critical Care Maternity Unit

24 HOURS EMERGENCY COMPLEX

ULTRA MODERN OT COMPLEX6 OT Suites designed for maximumAseptic enironment.

Dedicated OTs with State of the Art Equipments

The planning of operation theatre is properly done with CSSD adjacent to it. The operation theatres andICUs $ HDUs are connected to each other by lifts. Proper lobby space is provided in front of OTs. Well planned OTs with nurses room, scrub room, changing room ,storage.The OT is provided with centralized Ac system.

Super Deluxe and AC Complex

Luxury AC Room

The placement of private and semiprivate rooms is properly done. Nurse’s counters are placed in such a way that each and every room is approached properly.

Sunshine WardA special 10 bedded children’s ward

Health Check Department

•NEGATIVE POINTS:The hospital is developed step by step that’s why there are some drawbacks in the planning.•Only the blood required for emergency department is to be brought from the blood bank which is on the other part of building block which is not favorable in case of any emergency.•The services area occupy more space and the travelling distance is increased.

CONCLUSION :

POSITIVE POINTS :•CSSD is placed near the Operation Theatres and separate autoclave for sterilisation of materials from wardsis placed on the terrace.•Well planned cores and their lobby which do not obstruct the patients flow and separate fire exit staircase.•Good amount of recovery beds are provided for post operation patients.Separate parking for staff, doctors and visitors which is advantageous for controlling.•The emergency (casualty) is located properly with the facility of minor operations and trauma, plaster room which is designed as per

space requirements.•The planning of OPD and the admission ,reception area is ideal.•The OPD is well planned with reception, billing.