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Hospital Planning and Building Standards – AIA, NHS, DIN INTERNATIONAL HEALTHCARE BUILDING STANDARDS & CODES – LATEST ON HARMONIZATION OF CODES AND ACCREDITATION HENNING LENSCH, RRP International Hospital Planners Pte Ltd Munich-Germany-Singapore September 2013
Toronto UIA 2013
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RRP
1. Comparison of AIA, NHS and DIN
2. Case Study 1: planned in accordance with AIA, not acceptable for NHS?
3. Case Study 2: Third Party Review and standards – please re-design?
4. Accreditation and Planning Standards – JCI instead of AIA/NHS/DIN
5. HAAD Abu Dhabi standards, based on Australia hospital standards
6. Outlook and recommendation – what to follow?
7. Question and Answers
Agenda
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1. Comparison between AIA, NHS and German DIN
Agenda
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RRP
AUS SICHT DES KRANKENHAUSES
What is the standard OT seize?
International projects, state of the art?
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1. Standards for hospital operation theatres
Example
AIA: 55 – 60 m2 NHS: 55 m2 Australasian: 42 – 52 m2 Canadian: 48 – 55 – 60 m2 Germany: different standards
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RRP
AUS SICHT DES KRANKENHAUSES
What is the minimum clear door
opening in patient rooms?
International projects, state of the art?
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1. Standards for clear opening in patient room doors
Example
AIA: 1.12 m clear opening Recommendation for clear opening more than 1.22 m NHS: 1.30 m structural opening Recommendation for opening of minimum 1.50 m Germany: 1.10 m clear opening In the average around 1.25 m
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OUTPATIENTS INPATIENTS
Standard for Safety – Standards for All?
The Architect’s Perspective – Clinical Path Ways and Workflow
Economy Meets Humanity
Standard for Workflow and Schedule of Accommodation?
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11 STANDARDS FOR………
Hotel
Nurse-school
Home for dementia
Home for the Elderly REHAB Imaging
Outpatient Department
Public Health Office
Private Hospital Special. Clinics
Daycare Operation Centre
Hospice Health-Park
Phyiotherapy Lifestyle and Spa
Core-Hospital
12 STANDARDS NHS, DIN, NHS and Australasian HFG
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Source: Dr. Ing. Monika Schill-Fendl, Planungsmethodik
AIA, NHS and German regulations
Agenda
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1. National insurance regulations, protection of staff
Germany – different requirements
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1. National insurance regulations, protection of staff
Germany – different requirements
Working D
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Design Concept – Staff area
TRACKER W
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Design Concept – staff change
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DIN 13080
DIN
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1. Syn-energy for the new hospital
German DIN
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Using the German DIN for schedules of accommodation
Actual location, United Arab Emirates
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Rehabilitation Clinic
250 beds
Ideal distribution of ward area according to Business Planning:
• V VIP
• VIP
• Single
• Double
• Clinic Standard (double)
TOTAL
• All relevant medical specialties and diagnostic equipment • separated workflow and VIP suites for Medical Check Ups
• Room categories according to Rehab Clinic
à use guest rooms as overflow for rehab patients
Outpatient Center with Diagnostic
Boarding House/ Accommodation
Mix of Rehabilitation, Outpatient Center and Hotel
# Rooms # Beds
10
20
60
60
20
170
10
20
60
120
40
250
Main sections
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Healing Architecture
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Using the German DIN for schedules of accommodation
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NHS example OT
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NHS layout examples – here OT
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NHS layout examples – here OT
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AIA structure
AIA
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AIA example
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AIA for Cath lab
Agenda
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2. Case Study 1: planned in accordance with AIA, not acceptable for NHS?
Agenda
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Comparison AIA and NHS
Agenda
Main difference between US and UK NHS design principles for Cath Lab: In the US (AIA), a dirty utility room is not required to be adjacent to the cath lab room In the US (AIA), rooms for preparation and anaesthesia could be shared and do not have to be adjacent to the cath lab procedure room In the UK (NHS), the cath lab shall have the following adjacent rooms: Anaesthesia, preparation, store room, scrub and gowning and control room.
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Following AIA, but not NHS
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1. Syn-energy for the new hospital
Agenda
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1. Syn-energy for the new hospital
Agenda
39 Agenda
Main differences between US and UK NHS design principles for OT: In the UK (NHS), the direct access of the scrub / gowning room, Anaesthetic, Dirty Utility and Preparation room is mandatory In the UK (NHS), the room for preparation is only not needed if the preparation could be done under the ultra-clean canopy in the operation theatre itself In the US (AIA), the ANAE area is the so called “induction room”, and this room could be shared between the OT and also be located not directly adjacent to the OT In the US (AIA), shared scrub zones can be located outside of the OT, in a more or less open zone (ventilation system to be designed in a way that a “air curtain” is more and less prohibiting water from the scrub to come contaminate other areas) In the UK (NHS), separated single room recovery spaces are requested. In the US, a curtain between recovery spaces can be accepted In the US (AIA), the transfer from the patient bed to the OT stretcher could be done in the OT. We do not see any clear requirements / procedure in the NHS guidelines. Here, we can only find the following: “increasing number of patients are transferred onto their beds rather than a trolley. A bed is significantly larger than a trolley.” In the UK (NHS), there are many requirements for the admission lounge, waiting room, administration office as integral to communication base etc. which are more and less referring to very specific workflows and procedures. Here, many of these basic requirements (also for ambulant / outpatient) are not fulfilled and must normally being discussed with the user.
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NHS layout examples – here OT
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AIA extract
AIA for OT
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3. Case Study 2: Third Party Review and standards – please re-design?
Agenda
Working D
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AIA Guidelines - Comparison
Working D
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AIA Guidelines - Comparison
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1. Is our design wrong?
Third party review according to AIA
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1. Is our design wrong?
Third party review according to AIA
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1. Is our design wrong?
Third party review according to AIA
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1. Is our design wrong?
Third party review according to AIA
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1. Is our design wrong? It is an ICU renovation project……..
Third party review according to AIA
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1. Is our design wrong?
Third party review according to AIA
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1. Is our design wrong?
Third party review according to AIA
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4. Accreditation and Planning Standards – JCI instead of AIA/NHS/DIN
Agenda
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Hospital Standard and JCI, example
56 Hospital Standard and JCI, example
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5. HAAD Abu Dhabi standards, based on Australia hospital standards
Agenda
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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi
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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi
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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi
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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi
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Further developments of mainly the Guidelines from Australia
HAAD Abu Dhabi
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6. Outlook and recommendation – what to follow?
Agenda
Custom
ers requirem
ents
Workplace design
There is no standard workplace design!
Standards are good, but……………..
Designing for Operational Change
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7. Questions and Answers
Agenda
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Hospital Planning and Building Standards – AIA, NHS, DIN INTERNATIONAL HEALTHCARE BUILDING STANDARDS & CODES – LATEST ON HARMONIZATION OF CODES AND ACCREDITATION HENNING LENSCH, RRP International Hospital Planners Pte Ltd Munich-Germany-Singapore September 2013
Toronto UIA 2013
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