October 28, 2018

HHDS.21 - Facility Planning and Design

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Chapter 21 Summary
Facility Planning and Design

Chapter Author
Richard L. Miller - Earl Swensson Associates, Inc.

Some Commentary

A quick chapter about hospital facility planning and design. From my experience, the best way to learn this is to be involved directly in the process.

1. Introduction

A sequence of facility planning:

Facility needs assessment: this is a pretty tricky project. The goal of the facility needs assessment is to understand where an organization is going, how it is growing, what the anticipated average length of stay will be, for how many patients, how many operating rooms, emergency room beds are needed, etc, etc. There are a lot of metrics to bring together when trying to understand the strategic future direction of the hospital and create something that aligns with a sustainable business plan.

Ultimately, this complex process is distilled down into a “space program”, or the “program”.  The program is an itemized list of all the types of spaces required within the hospital, and the amount of space (eg square foot, number of offices, etc) each is required. This program allows architectures to understand what has to be built, and if they are on track to meet the needs of the facility owners.

Physical plant evaluation: this reviews the current physical plan, all its infrastructure systems, zoning, parking, etc, etc. The goal is to understand what changes to the physical plant are required to move towards the facility needs assessment.

Site evaluation:  if a new site is required, site selection is required. Carefully weighing a new site’s cost, marketing visibility, the usable space the site has for patient accessed services such as parking, emergency room, and clinics; as well as back-of-house loading docks, helipads, and emergency vehicle parking.

Master facility plan deliverables: the above steps lead to a master facility plan and budget.  This document can be worked on further by the primary architect or circulated for soliciting proposals from prospective architectural firms.

The design process

Once a master facility plan is developed more detailed design process can start

1. Conceptual design: high level design ideas, department locations, general operational flow are tested

2. Schematic design: illustrations help understand in more detail the work flow and efficiency of a layout.

3. Design development: the architectural details and speciality systems (conveyer belts, tube systems) are added; ass well as what people more typically think of in ‘architecture and interior design’ such as finishes.

4. Construction documents: this focuses more heavily on building’s systems, such as “mechanical, electrical, plumbing, and structural”


“The design team includes not only architects and engineers (civil, structural mechanical, electrical, and plumbing), but also other professional consultants who bring expertise to the project. These consultants often include the following: geotechnical codes and Americans with Disabilities Act (ADA) compliance, sustainability, traffic and parking, elevator, medical equipment planner, signage and way-finding, building skin, acoustics, and lighting”

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