A layout is a physical configuration of departments, work stations, and equipment in the conversion process. It is a spatial arrangement of physical resources used to create the product. The following chart shows an REL chart.
An REL chart indicates the relationship between different departments which is required to be considered in preparing a layout plain. The physical closeness of location of two different departments depends on the activities carried out by the departments and their activities being inter dependent.
How the relationship of different departments are to be considered in preparing layout:
Several commonly used approaches for facility layout design include:
(i) Distance minimization layout procedure
(ii) Interdependent activities of different departments
(iii) Computer software systems
(iv) Line balancing procedures
(v) Performance ratios
Hospitals are the most complex of building types. Each hospital is comprised of a wide range of services and functional units. These include diagnostic and treatment functions, such as clinical laboratories, imaging, emergency rooms, and surgery; hospitality functions, such as food service and housekeeping; and the fundamental inpatient care or bed-related function. This diversity is reflected in the breadth and specificity of regulations, codes, and oversight that govern hospital construction and operations. Each of the wide-ranging and constantly evolving functions of a hospital, including highly complicated mechanical, electrical, and telecommunications systems, requires specialized knowledge and expertise. No one person can reasonably have complete knowledge, which is why specialized consultants play an important role in hospital planning and design. The functional units within the hospital can have competing needs and priorities. Idealized scenarios and strongly-held individual preferences must be balanced against mandatory requirements, actual functional needs (internal traffic and relationship to other departments), and the financial status of the organization.
In addition to the wide range of services that must be accommodated, hospitals must serve and support many different users and stakeholders. Ideally, the design process incorporates direct input from the owner and from key hospital staff early on in the process. The designer also has to be an advocate for the patients, visitors, support staff, volunteers, and suppliers who do not generally have direct input into the design. Good hospital design integrates functional requirements with the human needs of its varied users.
The basic form of a hospital is, ideally, based on its functions:
• bed-related inpatient functions
• outpatient-related functions
• diagnostic and treatment functions
• administrative functions
• service functions (food, supply)
• research and teaching functions
Physical relationships between these functions determine the configuration of the hospital. Certain relationships between the various functions are required—as in the following flow diagrams.
These flow diagrams show the movement and communication of people, materials, and waste. Thus the physical configuration of a hospital and its transportation and logistic systems are inextricably intertwined. The transportation systems are influenced by the building configuration, and the configuration is heavily dependent on the transportation systems. The hospital configuration is also influenced by site restraints and opportunities, climate, surrounding facilities, budget, and available technology. New alternatives are generated by new medical needs and new technology.
In a large hospital, the form of the typical nursing unit, since it may be repeated many times, is a principal element of the overall configuration. Nursing units today tend to be more compact shapes than the elongated rectangles of the past. Compact rectangles, modified triangles, or even circles have been used in an attempt to shorten the distance between the nurse station and the patient's bed. The chosen solution is heavily dependent on program issues such as organization of the nursing program, number of beds to a nursing unit, and number of beds to a patient room.
An efficient hospital layout should:
• Promote staff efficiency by minimizing distance of necessary travel between frequently used spaces
• Allow easy visual supervision of patients by limited staff
• Include all needed spaces, but no redundant ones. This requires careful pre-design programming.
• Provide an efficient logistics system, which might include elevators, pneumatic tubes, box conveyors, manual or automated carts, and gravity or pneumatic chutes, for the efficient handling of food and clean supplies and the removal of waste, recyclables, and soiled material
• Make efficient use of space by locating support spaces so that they may be shared by adjacent functional areas, and by making prudent use of multi-purpose spaces
• Consolidate outpatient functions for more efficient operation—on first floor, if possible—for direct access by outpatients
• Group or combine functional areas with similar system requirements
• Provide optimal functional adjacencies, such as locating the surgical intensive care unit adjacent to the operating suite. These adjacencies should be based on a detailed functional program which describes the hospital's intended operations from the standpoint of patients, staff, and supplies.
