CC BY
358
ARCHITECTURE / <<€®yL®qUQUM~J®U©MaL>>#9I13)),2(0]9
ARCHITECTURE
UDC 725.51
Bulakh Irina Valerievna
PhD of Architecture, Associate Professor Department of Design of the Architectural Environment,
Kiev National University of Construction and Architecture ORCID: 0000-0002-3264-2505; ResearcherID:V-4802-2018; Spin-Kod: 9274-0113
DOI: 10.24411/2520-6990-2019-10213 NEW APPROACHES TO THE FUNCTIONAL PLANNING OF HOSPITALS AND ENTRANCE
GROUPS OF MEDICAL INSTITUTIONS
The rapid development of medical technologies, methods of diagnosis and treatment, the accelerated rhythm of life of a modern person in an urbanized space, of course, requires new architectural solutions in the design of medical institutions. The need for innovative approaches begins with a viewing of the functional-planning organization of the entrance group of a medical institution. This statement is due to the fact that a shorter waiting time satisfies the patient, however, certain features of the room layout can increase the waiting time for the patient and reduce the time of admission. Speaking about the outpatient center, the increase in the duration of the intakes accordingly reduces their total number per day, limiting the workload of the center. To address this issue, it is advisable to take into account the following functional and planning features: the design of multifunctional cabinets with portable equipment; the creation of dressing rooms for patients; storage for materials in the office; centralized registration.
Multifunctional cabinets with portable equipment. In many medical institutions, doctors perform various functions in different offices. As a result, there are waves of increase and decline in patient flows, which often do not coincide for different specialized cabinets. Multifunctional cabinets with portable equipment allow you to perform any task in any room. A striking example is the department of preoperative diagnosis. Ten multifunctional cabinets with portable equipment provide greater flexibility than five rooms with ECG equipment and five laboratories. Patients do not need to wait for their turn to one office, if they can use any office.
Changing rooms. Planning a medical facility can reduce patient waiting times, including through the installation of dressing rooms at examination rooms. For example, in the tomographic center separate dressing rooms for each imaging method usually lead to their uneven use. Grouping locker rooms can compensate for waiting times and balance uneven patient flows. A group of adjacent changing rooms with lockers for patients' belongings compensate for the need to hold onto the dressing room until the patient returns.
Storage for materials in the office. Having prepared the materials at hand, the medical staff gets the opportunity to concentrate on the examination and treatment of patients. Storage of materials, instruments and even office equipment (printer) in separate and remote areas limits the time spent on their search and collection.
Centralized registration. In many outpatient centers, patients must be registered at the main registration
desk, as well as at a specialized unit of the medical institution. This procedure requires a repetition each time the patient visits the medical facility. Each registration adds 5 to 10 minutes to the patient's visit. The way out of this situation can be the implementation of all registration functions at the main rack and the transfer of patient information in electronic form to the necessary department. It should be noted that the pleasure of the patient to visit the medical institution is reduced every five minutes of waiting. Saving even one minute per visit significantly increases the time and cost savings for organizing the provision of medical services during the year. Considering what influence this may have over the year of the work of the medical institution, designing while taking into account time savings is very important.
The next functional-planning element of the medical institution, which is considered as part of this publication and requires corresponding changes, is the inpatient unit. The word "hospital" evokes the immediate and traditional image of wards, patients and nurses. The hospital is an important element of the medical complex, but recent changes in medical technology have led to the fact that most medical services are provided in other departments of the medical institution. Hospital wards and nursing posts have been the subject of many studies in the design of hospitals over the past 50 years, and new data have led to the emergence of a "scientifically based" medical design: bedridden patients recover faster and feel better if there is a family near them. more personal space and amenities, and also have a view of the nature from the windows of the chamber and access to the open air. Studies have also shown that nurses work better if they are provided with decentralized jobs near patients, which reduces the time they move; Single rooms provide greater flexibility in terms of levels of care and privacy while reducing patient movement.
The architectural form of the inpatient component should reflect the functional needs: compact blocks of hospital wards or wards with appropriate decentralization of nursing posts instead of long corridors of traditional hospitals, as well as a large building perimeter to ensure maximum window size for patients. Centralized support facilities, such as conference rooms and staff rooms, can be designed for several departments; however, each unit needs a separate space for storing medicines, food and facilities for waste disposal, organizing workplaces for doctors and nurses, and proper storage of tools and equipment. Since patient rooms are constantly occupied, the orientation of windows in the wards with respect to the sun and the environment is important. New directions in the design of patient
«C@yL@qyiym-J®yrMaL»#9îl3),2@19 / ARCHITECTURE
9
rooms are determined by funding systems and cultural expectations to the same extent as medical practice. When the health care system supports more staff and more generous use of space, trends and regulatory requirements move toward larger individual premises with optimal infection control and amenities, such as a private toilet and shower, communications. Spacious single rooms have greater flexibility in reorienting and replacing equipment and furniture. The long-term plan for the operation of a medical facility is that individual units and departments will be periodically updated. In this sense, hospitals, in which chambers remain the norm for four or more places, should gradually be modified. Inpatient treatment areas are very specialized facilities that are often only cosmetically updated for many years and which are not easily converted for other purposes. The number of beds in the department is determined by the principle of the optimal number for the most effective nursing care and short movement of staff, and usually consists of 24 to 40 beds. Within the department it is necessary to separate the flow of visitors, staff and patients. The location of nursing posts should provide a clear and separate circulation of clean and polluted materials to support services such as food, materials, pharmacy and laundry. Beds for intensive care should be on the same level close to the operating room in order to ensure patient transportation as soon as possible. For maximum flexibility, it is best to place all types of intensive care units together on the same floor. Inpatient departments require direct access to diagnostic and treatment services, effective access to additional services, but they should be separated from outpatient areas and the administrative part. Of course, it is not always possible to adhere to all the above principles in the functional planning organization of the medical space, but approaching this goal affects the overall performance of the medical institution.
References
1. Ковальська Г. Л., Бiбер С. Г. Аспекти за-провадження нових форм навчання студенпв-ар-xrreKTopiB у закладах вищо! освгти Украши. Colloquium-journal. Warszawa, 2019. №3(27). C.4-6. DOI: 10.24411/2520-6990-2019-10001.
2. Булах I. В. Аналiз наукових дослщжень в аспекп арxiтектурно-мiстобудiвного проектування заклащв охорони здоров'я. Науковий вюник будiв-ництва. Харшв, 2018. Т. 93(3) С. 29-36. DOI: 1029295/23117257-2018-93-3-29-36
3. Булах I. В. Передумови художньо-естетич-ного формування архитектурного середовища тку-вальних заклащв. Науковий вюник будiвництва. Харкiв, 2018. Т. 94(4). С. 9-14. DOI: 10.29295/23117257-2018-94-4-9-14
4. Булах I. В. Мiстобудiвна система дитячих л^вальних комплекав. Науковий вюник будiв-ництва. Харшв, 2019. Т. 95(1). С. 12-18. DOI: 10.29295/2311-7257-2019-95-1-12-18
5. Булах I. В. Проблемне поле завдань реор-гашзацп мережi дитячих л^вальних закладiв Украши. Мiстобудування та територiальне пла-нування. Кшв, 2017. №63. С. 45-51.
6. Булах I. В. Аналiз юнуючо! архгтектурно-
мiстобудiвноï мережi лiкувально-профiлактичних закладiв Украши. Мютобудування та територiальне планування. Кшв, 2018. №68. С. 46-53.
7. Булах I. В. Соцiально-економiчнi та демо-графiчнi чинники реформування мiстобудiвноï ме-режi дитячих закладiв охорони здоров'я Украши. Мютобудування та територiальне планування. Кшв, 2019. №69. С. 27-32.
8. Булах I. В. Передумови реоргашзацп ме-режi дитячих лшувальних закладiв Украши. Су-часш проблеми архiтектури та мiстобудування. Кшв, 2017. №47. С. 444-450.
9. Булах I. В. Ландшафт i вода, як основа су-часних свггових тенденцш в проектуваннi медич-них закладiв. Сучаснi проблеми архггектури та мiстобудування. Кшв, 2016. №46. С. 392-396.
10. Булах I. В. Сучасний закордонний досвiд проектування енергоефективних лжарень (досвiд Сiнгапура). Сучасш проблеми архiтектури та мюто-будування. Киïв, 2018. №50. С. 332-440.
11. Булах I. В. Досввд оргашзацп системи охорони здоров'я у Сполучених Штатах Америки та франци i3 визначенням в них мюця мережi дитячих лiкувальних заклащв. Сучаснi проблеми архггек-тури та мютобудування. Кшв, 2018. №52. С. 165-173.
12. Bulakh I. The main trends in organization of architectural environment of medical institutions. Web of Scholar. Warszawa, 2018. №5(23). Vol. 1. С. 59-62.
13. Bulakh I. V. Analysis of scientific research in the field of architectural and urban designing of children healing institutions. ^^шит^т™! Warszawa, 2018. №10(21). Vol.7. С. 5-8.
14. Bulakh I. V. Influence of environmental factor on projecting health care in Ukraine. ^toqu^m-jour-nal. Warszawa, 2018. №13(24). Vol.1. С. 9-11.
15. Bulakh I.V. Complex public health institutions as a complex urban development system. Со11о-quium-journal. Warszawa, 2019. №1(25). Vol.2. С. 4-6. DOI: 10.24411/2520-6990-2019-00001
16. Булах !В. Питання нормативно-мюто-будiвного регулювання мiстобудiвноï системи заклащв охорони здоров'я. Сolloquium-journal. Warszawa, 2019. №2(26). Vol.1. С. 4-6. DOI: 10.24411/2520-6990-2019-00003
17. Булах !В. Нормативi особливосп проектування архiтектурно-мiстобудiвноï системи заклащв охорони здоров'я. Сolloquium-journal. Warszawa, 2019. №3(27). Vol.1. С. 4-10. DOI: 10.24411/25206990-2019-10001
18. Bulakh I.V. Urban network of institutions of the secondary and tertiary medical aid. ^^quium-journal. Warszawa, 2019. № 4(28). Vol. 1. С. 5-8. DOI: 10.24411/2520-6990-2019-10040
19. Bulakh I. V. Urban planning peculiarities of the formation of hospital districts of Ukraine. Со11о-quium-journal. Warszawa, 2019. №5(29). Vol. 1. С. 9-12. DOI: 10.24411/2520-6990-2019-10060
20. Bulakh I. V. European and American experience of optimizing the architectural-urban system of hospitals. ^toqu^m-journal. Warszawa, 2019. №7(31). Vol. 1. С. 4-6. DOI: 10.24411/2520-6990-
10
ARCHITECTURE / <<ШУШМиМ~^®и©Ма1>>#9(113)),2Ш9
2019-10152
21. Bulakh I. V. Hospital systems in eastern Europe. Colloquium-journal. Warszawa, 2019. №8(32). Vol. 1. C. 4-6. DOI: 10.24411/2520-6990-2019-10181
22. Bulakh I. V. Energy efficiency use of biocli-matic facades in medical buildings. Development of modern science: the experience of European countries and prospects for Ukraine: monograph / edited by authors. 3rd ed. Riga, Latvia: Baltija Publishing, 2019. Р 597-616. DOI: 10.30525/978-9934-571-78-7_62
23. Булах I. В. Архiтектурно-мiстобудiвна мережа заклащв охорони здоров'я Киева. 1нтернаука. 2018. Кшв, №14(54). С. 11-13.
24. Bulakh I. Architectural and urban planning network of children's health institutions. 1нтернаука. 2018. Кшв, №22(62). Том 1. С. 7-9.
25. Булах I. В. 1нтегращя медичних вимог в ор-гашзацш мiстобудiвноï мереж заклащв первинно1' медично1' допомоги. 1нтернаука. 2019. Кшв, №4(66). С. 7-9.
26. Bulakh I. The medicine and architecture of healthcare institutions at contemporary times in Ukraine. Вюник Одесько1' державноï академп будiв-ництва та архiтектури. Одеса, 2018. №73. С. 9-16.
27. Булах I. В. Центр реабштацп i релаксаци для учасникiв бойових дш. Проблеми теорiï та юторп архiтектури Украïни. Одеса, 2018. №18. С. 207-213.
28. Булах I. В. Зародження медицини i ди-нашка розвитку архiтектури медичних заклащв на теренах Украïни. Проблеми теори та iсторiï архггек-тури Украни. Одеса, 2019. №19. С. 37-44. DOI: 10.31650/2519-4208-2019-19-37-44
29. Булах I. В. Становления мережi дитячих
giKyBagbHux 3aKgagiB yKpaiHu, aK o6'eKTa MicTo-6ygiBHoro npoeKTyBaHHa y nepiog 3 1980-90 pp. XX CT. no nonaroK XI CT. ApxrreKTypHHH BicHHK KHYBA. KHIB, 2018. №16. C. 319-326.
30. Bygax I. B. Oco6^HBOCTi ^opMyBaHHa ap-xiTeKTypHO-MicTo6ygiBHoi' Mepe^i 3aKgagiB BTopuH-Hoi' MegHHHoi' gonoMoru. SCIENCE, RESEARCH, DEVELOPMENT: Monografia pokonferencyjna. Warszawa: Diamond trading tour, 2019. C. 7-9.
31. Bygax I. B. MeTogogoriHHi 3acagu guHaMiH-Hoi opraHi3aqii cucTeMH guTaHux giKyBagbHux kom-ngeKciB. SCIENCE, RESEARCH, DEVELOPMENT: Monografia pokonferencyjna. Warszawa: Diamond trading tour, 2019. C. 11-14.
32. Bygax I. B. TeopeTHHHHH gocBig chm-Bogi3ami y KpeaTHBHoMy yp6aHi3Mi. MoHorpa^ia. 3a 3ar. peg. B.C. ^epKeca Ta r.n. neTpumuH. .bBiB: Bh-gaвннцтвo .bBiBcbKoi nogrrexrnKH (2014): 577-583.
33. Bygax I. B. 3aragbHi nogo^eHHa cuMBogiH-Horo nigxogy go ^opMyBaHHa i po3BHTKy apxireK-TypHo-ngaHyBagbHoro o6pa3y MicbKoro npo-cropy. Zbior raportow naukowych. (2014):22.
34. Bygax I. B. npoeKTyBaHHa cynacHux guTanux giKyBagbHux 3aKgagiB 3 ypaxyBaHHaM icropuHHoro KoHTeKcTy oTOHyronoro apxiTeKTypHoro cepegoBuma MicT (gocBig BegHKo6puTaHii). European network for academic integrity. Brno: Baltija Publishing, 2018. P. 187-190.
35. Bulakh, I. "Symbol and methods of symbolizing in architecture and town-planning XV-XVIII century." Innovative development trends in modern technical sciences problems and prospects. San Francisco, California: B&M Publishing (2013): 12-14.
