Design5researchpaperinhospital.docx

A. Definition of Hospital A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a heart attack. A district hospital typically is the major health care facility in its region, with large numbers of beds for intensive care and additional beds for patients who need long-term care. Specialized hospitals include trauma centers, rehabilitation hospitals, children's hospitals, seniors' (geriatric) hospitals, and hospitals for dealing with specific medical needs such as psychiatric treatment (see psychiatric hospital) and certain disease categories. Specialized hospitals can help reduce health care costs compared to general hospitals. Hospitals are classified as general, specialty, or government depending on the sources of income received. A teaching hospital combines assistance to people with teaching to medical students and nurses. The medical facility smaller than a hospital is generally called a clinic. Hospitals have a range of departments (e.g. surgery and urgent care) and specialist units such as cardiology. Some hospitals have outpatient departments and some have chronic treatment units. Common support units include a pharmacy, pathology, and radiology. Hospitals are usually funded by the public sector, health organizations (for profit or nonprofit), health insurance companies, or charities, including direct charitable donations. Historically, hospitals were often founded and funded by religious orders, or by charitable individuals and leaders. Currently, hospitals are largely staffed by professional physicians, surgeons, nurses, and allied health practitioners, whereas in the past, this work was usually performed by the members of founding religious orders or by volunteers. However, there are various Catholic religious orders, such as the Alexians and the Bon Secours Sisters that still focus on hospital ministry in the late 1990s, as well as several other Christian denominations, including the Methodists and Lutherans, which run hospitals. In accordance with the original meaning of the word, hospitals were originally "places of hospitality", and this meaning is still preserved in the names of some institutions such as the Royal Hospital Chelsea, established in 1681 as a retirement and nursing home for veteran soldiers.

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Types

Lehigh Valley Hospital in Allentown, Pennsylvania Some patients go to a hospital just for diagnosis, treatment, or therapy and then leave ("outpatients") without staying overnight; while others are "admitted" and stay overnight or for several days or weeks or months ("inpatients"). Hospitals usually are distinguished from other types of medical facilities by their ability to admit and care for inpatients whilst the others, which are smaller, are often described as clinics.

General/Acute-Care The best-known type of hospital is the general hospital, also known as an acute-care hospital. These facilities handle many kinds of disease and injury, and normally have an emergency department (sometimes known as "accident & emergency") or trauma center to deal with immediate and urgent threats to health. Larger cities may have several hospitals of varying sizes and facilities. Some hospitals, especially in the United States and Canada, have their own ambulance service.

District A district hospital typically is the major health care facility in its region, with large numbers of beds for intensive care, critical care, and long-term care. In California, "district hospital" refers specifically to a class of healthcare facility created shortly after World War II to address a shortage of hospital beds in many local communities. Even today, district hospitals are the sole public hospitals in 19 of California's counties, and are the sole locally-accessible hospital within 9 additional counties in which one or more other hospitals are present at substantial distance from a local community. Twenty-eight of California's rural hospitals and 20 of its critical-access hospitals are district hospitals. They are formed by local municipalities, have boards that are individually elected by their local communities, and exist to serve local needs. They are a particularly important provider of healthcare to uninsured patients and patients with Medi-Cal (which is California's Medicaid program, serving low-income persons, some senior citizens, persons with disabilities, children in foster care, and pregnant women). In 2012, District hospitals provided $54 million in uncompensated care in California.

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Specialized

Starship Children's Healthis a children's hospital in Auckland, New Zealand. Types of specialized hospitals include rehabilitation hospitals, children's hospitals, seniors' (geriatric) hospitals, long-term acute care facilities and hospitals for dealing with specific medical needs such as psychiatric problems (see psychiatric hospital), certain disease categories such as cardiac, oncology, or orthopedic problems, and so forth. In Germany specialized hospitals are called Fachkrankenhaus; an example is Fachkrankenhaus Coswig (thoracic surgery). A hospital may be a single building or a number of buildings on a campus. Many hospitals with pre-twentieth-century origins began as one building and evolved into campuses. Some hospitals are affiliated with universities for medical research and the training of medical personnel such as physicians and nurses, often called teaching hospitals. Worldwide, most hospitals are run on a nonprofit basis by governments or charities. There are however a few exceptions, e.g. China, where government funding only constitutes 10% of income of hospitals. (Need citation here. Chinese sources seem conflicted about the for-profit/non-profit ratio of hospitals in China) Specialised hospitals can help reduce health care costs compared to general hospitals. For example, Narayana Health's Bangalore cardiac unit, which is specialised in cardiac surgery, allows for significantly greater number of patients. It has 3000 beds (more than 20 times the average American hospital) and in pediatric heart surgery alone, it performs 3000 heart operations annually, making it by far the largest such facility in the world. Surgeons are paid on a fixed salary instead of per operation; thus, the costs to the hospital drops when the number of procedures increases, taking advantage of economies of scale. Additionally, it is argued that costs go down as all its specialists become efficient by working on one "production line" procedure.

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Teaching

McMaster University Medical Centre is a teaching hospital in Hamilton, Ontario A teaching hospital combines assistance to people with teaching to medical students and nurses and often is linked to a medical school, nursing school or university. In some countries like UK exists the clinical attachment system that is defined as a period of time when a doctor is attached to a named supervisor in a clinical unit, with the broad aims of observing clinical practice in the UK and the role of doctors and other healthcare professionals in the National Health Service (NHS).

Clinics Main article: Clinic The medical facility smaller than a hospital is generally called a clinic, and often is run by a government agency for health services or a private partnership of physicians (in nations where private practise is allowed). Clinics generally provide only outpatient services.

Departments or wards

Resuscitation room bed after a trauma intervention, showing the highly technical equipment of modern hospitals Hospitals consist of departments, traditionally called wards, especially when they have beds for inpatients, when they are sometimes also called inpatient wards. Hospitals may have acute 4

services such as an emergency department or specialist trauma center, burn unit, surgery, or urgent care. These may then be backed up by more specialist units such as the following:

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Emergency department Cardiology Intensive care unit Pediatric intensive care unit Neonatal intensive care unit Cardiovascular intensive care unit Neurology Oncology Obstetrics and gynecology, colloquially, maternity ward

In addition, there is the department of nursing, often headed by a chief nursing officer or director of nursing. This department is responsible for the administration of professional nursing practice, research, and policy for the hospital. Nursing permeates every part of a hospital. Many units or wards have both a nursing and a medical director that serve as administrators for their respective disciplines within that specialty. For example, in an intensive care nursery, the director of neonatology is responsible for the medical staff and medical care while the nursing manager/director for the intensive care nursery is responsible for all of the nurses and nursing care in that unit/ward. Some hospitals have outpatient departments and some have chronic treatment units such as behavioral health services, dentistry, dermatology, psychiatric ward, rehabilitation services, and physical therapy. Common support units include a dispensary or pharmacy, pathology, and radiology. On the non-medical side, there often are medical records departments, release of information departments, information management (a.k.a. IM, IT or IS), clinical engineering (a.k.a. biomed), facilities management, plant ops (operations, also known as maintenance), dining services, and security departments.

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Buildings

The medical center at the University of Virginia shows the growing trend for modern architecture in hospitals.

Architecture

The National Health ServiceNorfolk and Norwich University Hospital in the UK, showing the utilitarian architecture of many modern hospitals

Hospital chapel at Fawcett Memorial Hospital (Port Charlotte, Florida)

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Modern hospital buildings are designed to minimize the effort of medical personnel and the possibility of contamination while maximizing the efficiency of the whole system. Travel time for personnel within the hospital and the transportation of patients between units is facilitated and minimized. The building also should be built to accommodate heavy departments such as radiology and operating rooms while space for special wiring, plumbing, and waste disposal must be allowed for in the design. However, many hospitals, even those considered "modern", are the product of continual and often badly managed growth over decades or even centuries, with utilitarian new sections added on as needs and finances dictate. As a result, Dutch architectural historian Cor Wagenaar has called many hospitals: "... built catastrophes, anonymous institutional complexes run by vast bureaucracies, and totally unfit for the purpose they have been designed for ... They are hardly ever functional, and instead of making patients feel at home, they produce stress and anxiety." Some newer hospitals now try to re-establish design that takes the patient's psychological needs into account, such as providing more fresh air, better views and more pleasant color schemes. These ideas harken back to the late eighteenth century, when the concept of providing fresh air and access to the 'healing powers of nature' were first employed by hospital architects in improving their buildings. The research of British Medical Association is showing that good hospital design can reduce patient's recovery time. Exposure to daylight is effective in reducing depression. Single-sex accommodation help ensure that patients are treated in privacy and with dignity. Exposure to nature and hospital gardens is also important – looking out windows improves patients' moods and reduces blood pressure and stress level. Open windows in patient rooms have also demonstrated some evidence of beneficial outcomes by improving airflow and increased microbial diversity. Eliminating long corridors can reduce nurses' fatigue and stress. Another ongoing major development is the change from a ward-based system (where patients are accommodated in communal rooms, separated by movable partitions) to one in which they are accommodated in individual rooms. The ward-based system has been described as very efficient, especially for the medical staff, but is considered to be more stressful for patients and detrimental to their privacy. A major constraint on providing all patients with their own rooms is however found in the higher cost of building and operating such a hospital; this causes some hospitals to charge for private rooms.

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Government Tertiary Hospital (G3) The primary mission of G3 Hospital is to provide the best possible care and treatment to all in need of hospitalization regardless of race, creed, color, social status and political belief. In this connection, G3 Hospital pursues the following beliefs: 1. That the patients are people with individual needs, that is, physical, spiritual and emotional needs. 2. That the patients are the reason for the hospital's existence: thus, the restoration and maintenance of health and well-being are ultimate aims of patient care; 3. That the patients, as well as the health workers, are part of the social structure and therefore will endeavor to work closely with allied professions, patient's family, and the community in planning for his care; 4. That hospital service goa!s can best be attained only through cooperative and coordinated planning, mutual understanding, conscientious dedication of all who are privileged to take part or contribute in that care. In addition to the aforementioned beliefs, the communicable diseases ward, the medical ward, and the surgical nursing service department have adopted specific philosophies. Communicable Diseases Ward Philosophy: A patient is any person, well or ill receiving services from the health practitioner. Nursing is concerned with services that are directed towards providing care which promotes and maintains health, prevents, detects, and treats diseases and disability and restores the highest possible level of health following illnesses or an injury. Ergo, we the communicable diseases ward personnel believe that it is our joint responsibility to render these services based on our learned principles and on the belief of the value and uniqueness of every person. We strive for a holistic view of man, his totality as a person, not a fact or a theory, including the social, cultural, and psychological factors as these affect the patient. With our knowledge and skills, we hope to continue growing mentally, so that an improved quality of nursing care may be rendered to all patients regardless of culture, race, religion or ethnic background. We will try to extend our care not only to the patient but also to his family and community as well, to gradually change their unscientific knowledge, attitudes and practices regarding health for the improvement of our community. Medical Ward Philosophy: A patient is any person well or ill, receiving services from the practitioner. Nursing is concerned with services to this person - services that are directed toward providing care which promotes and maintains health, prevents defects and treats diseases and disability and restores the highest possible level of health following illness or injury. Ergo, we the medical ward personnel believe that it is our joint responsibility to render these services based on our learned principles and on the belief in the value and uniqueness of every person. We strive for a holistic view of man, his totality as a person, not a fact or a theory, including the social, cultural, and psychological factors as these affect the patient. With our knowledge and skills we hope to continue growing mentally so that an improved quality of nursing care may be rendered to all patients, regardless of culture, race, religion, or ethnic background, we will try to extend our care not only to the patient but also to his family and community as well, as to gradually change their unscientific knowledge, attitudes.

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Surgical Nursing Service Philosophy: The major concern of the Surgical Nursing Service Department is to render services primarily to surgical patients' needs in general. When we talk of patients' needs in the Department, we refer to the patients as a biopsychosocial being. Since this Department is primarily for surgical cases, the cases specifically encountered are those that are purely surgical. But related cases other than those mentioned are also to be treated accordingly and not to be neglected. The focus then in giving or rendering care in this Department is geared more towards surgical cases, the needs of patients before and after surgery. We refer to these as the pre-operative and post-operative care of the patients. Before rendering services as has been mentioned above, harmonious relationships should be maintained among members of the surgical team and other personnel. Above all, as nurses, we should not only establish harmonious relationship with the personnel in this Departrnen4 but also with the patients and their families in order to have cooperation in assessing and meeting his needs. The objectives of the hospital are expressed as follows. General Objective: To improve the welfare of the population through the reduction of morbidity and mortality from diseases prevalent in the (community) and control of health-related problems/conditions that have negative influence on the health status of the(community) with the active participation and involvement of the people of the village/communities and other health related agencies. Specific Objectives: 1. Health and Health-Related Objectives 1.1 To deliver effective and efficient tertiary medical and health care to the patient. 1.2 To preserve the health of the people through preventive and rehabilitative aspects of medical and health care. 1.3 To maintain, sustain, and coordinate primary health care development activities in already initiated rural areas through the integration of (lower level) health offices. 1.4 To reduce the infant mortality rate (IMR) from 63.2%/1000 in 1980 to 48.7%/1000 live birth in the next six years, 1987-1992. 1.5 To reduce the crude death rate (CDR) from 8.3/1000 in 1980 to 7.3/1000 population in the next six years, 1987-1992. 1.6 To reduce the crude birth rate (CBR) from 32.3/1000 in 1980 to 29.3/1000 population in the next six years, 1987-1992. 1.7 To reduce the population growth rate from 3.4 percent in 1980 to 2.2 percent in the next six years 1987-1992. 1.8 To increase the proportion of normal and mild underweight pre-schoolers from 83.8% in 1992 to 88% in 1987-1992 and school children from 84.9% in 1982 to 91.8% in 1987-1992. 2. Management Objectives:

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2.1 To provide for the teaching and training of {resident trainees, medical nursing, midwifery and other para-medical students. 2.2 To develop the medical staff and other hospital personnel by sending them to in-service training and seminars in Cebu or Manila with the approval of the Regional Director. 2.3 To train, improve management planning and technical skills of health and health related workers at all levels from staff management to rank and file responsible in delivering effective and efficient health programs and projects. 2.4 To improve intra/intersectoral collaborations for the support of primary health care development activities. 2.5 To undertake studies and researches to improve planning and management of programs and to improve service delivery. 2.6 To continue the upgrading of hospitals to their appropriate level of service by acquiring sophisticated equipment and facilities and upgrading of services capabilities of personnel. Regarding quality patient care, the hospital staff state, "We have to treat the patients using a holistic approach and give comprehensive care to patients. This means that patient care includes not only the physical aspect but also the psychological and spiritual care of the patients." The staffs awareness of hospital goals and objectives, especially health-related objectives is reinforced by regular general meetings every third Wednesday of each month. Department meetings and section meetings are also conducted every now and then.

Government Secondary Hospital (G2) The mission of G2 Hospital is to provide health services to the constituents in its catchment area, eighty percent (80%) of whom are indigent. These health services are generally classified into two categories: curative services and preventive services. Preventive services include such programs as immunization, environmental sanitation and the promotion of breastfeeding. It is noted that some of these programs had been dependent on the priorities of the incumbent Secretary of the Department of Health. For instance, the primary health care program, which was initiated during the administration of former Secretary Jesus Azurin, is no longer given emphasis by the hospital. In fact, the barangay health care committee in the catchment areas exists in name only. At present, in keeping with the programs and priorities of Secretary Juan Flavier, G2 Hospital includes the family planning program as one of the priorities. The objectives of the hospital are presented in Table 3.1, with the corresponding strategies, activities and actors. Certain issues and critical success factors surround the operational goals, such as, the provision of high quality patient care, cost containment, good community relationships, recruitment and retention of professional staff, planning for expansion of hospital facilities and sharing services with other hospitals. Table 3.2 presents the internal critical success factors of G2 Hospital. Table 3.3 presents the external critical success factors of the operational goals.

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It is evident that the hospital's medical and administrative staff are aware of the mission, goals, and programs of the hospital. These are properly disseminated not only through memoranda and circulars but also through regular general meetings (which are also referred to as district meetings), sectional meetings and administrative meetings. On the provision of high quality patient care, the staff of G2 Hospital have adopted the popular dictum, "do everything possible, given the constraints." The chief of hospital admits that they can never assure complete patient satisfaction owing to budgetary constraints. In most cases, the budget allocated for the hospital is less than its proposed budget. Sometimes, the necessary medication can" never be given to the patient - at most, depending on whatever stocks area available in the pharmacy, only the initial dose can be given. The problem is further compounded by indigent patients who depend on the hospital for free medicines.

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B. Design of Hospital Let’s face it. A hospital is a place where nobody wants to be. By it’s very nature, it is somewhere scary and not too nice. Those of us who work every day in hospitals can easily forget this fact: Those who we serve would rather be anywhere else (and so they should). Think of all the things our patients would rather be doing — enjoying a leisurely afternoon with the family, out in the shopping mall, or at a dinner party with friends. Because of this, we have to think of hospitals in slightly different terms than many other institutions. For all the talk of patient satisfaction and improving the health care experience, hospitals will always be inherently different from hotels, restaurants, and airports — which are associated with excitement and a good time. But that doesn’t mean that we can’t put more thought into how we could make them more inviting and tolerable from a basic design perspective. As comfortable and healing as possible. That is, after all, the basic function of a hospital: to allow patients to rest and recover. in several different hospitals, all very different in terms of location and appearance, I have gained a fair idea of what a good hospital looks like, architecturally — both internally and externally. Here are some of those qualities: 1. An open lobby. The hospital entrance should be as open-plan as possible. Make use of as much natural light, greenery, water (I’ve worked in a hospital with a small waterfall in the lobby), and background music. 2. Glass exterior. This is being used by new hospitals, and imparts a more modern and “futuristic” feel. The worst external designs use a lot of concrete, dull in color, and bland from the outside. 3. Rethink corridors and don’t let them be too long. Traditionally hospital floors are based on a “corridor” design. Most intensive care units do not utilize this design, and will have patient rooms distributed around a central area (more circular design). That’s for a reason — corridors don’t promote vigilant patient care. 4. Flooring. Flooring is very important to the design of any area, and an often overlooked aspect in hospitals. Think carefully about the type and color of the floors. Avoid drab and dull colors. 5. Single-bed rooms. Multiple occupancy rooms are on the way out. Most hospitals now have two to a room, and the trend is for more isolation. 6. Minimize clutter. This gets back to an open space design, but it’s very important to minimize the amount of clutter that is located in corridors and patient rooms. Equipment that is not being used should be placed in storage areas. 7. Outside campus. New hospitals should only be built in places that are detached from the outside hustle and bustle. 8. Quiet and healing. Patients need to be able to recover in a comfortable and healing environment. The above design points are common to many of the best performing hospitals and those that usually get the best ratings. Obviously it is more difficult for hospitals that are already established — they can’t just change their whole design.

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C. Do’s and Don’ts Do:        

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Listen to the voice of the customer. Engage the patients and families as much as possible. Learn from your current state—the good and the bad. Bring in a fresh set of eyes. Go to the gemba—the place where the work is being done. Give the staff ownership. When it becomes “their” process, they’ll become the front line ambassadors for change. Work backward from a target goal, so every meeting is purposeful and occurs at the right time. Sweat the small stuff—it’s natural to spend lots of time on the big messy issues you’re trying to solve, but some of the “minor details” can make a huge impact on day-to-day work at the bedside. Examples: diaper scale shelf in bathroom, deeper isolation supply cabinets, theft-proof gaming systems, and task light for drawing labs. Embrace the use of mock-ups and encourage rapid prototyping. Require full participation from all stakeholders and adopt an “equal voice” rule in meetings. Consider program development and operations concurrently with design and construction. Implement a comprehensive review of organizational workflow and downstream effects. Solicit more frontline staff input from onset of design through completion. Appreciate the complexity and importance of equipment planning. Use standardization as a primary guiding principle. Synchronize the approach of the technology and construction implementation schedule. Improve physician engagement. Establish leaders for each floor/area. Schedule and conduct meetings to meet their schedules. Provide updates that are pertinent to what they want to hear. Keep most decisions at project team level. Escalate unresolved issues to the executive steering committee.

Don’t:  Underestimate the logistics of managing and facilitating large groups of people during this process.  Get started too late—if you have the right team in place, operations should inform design, not vice-versa.  Forget the power and importance of visioning—from your customer, your staff, administration, and your design and construction team.  Deviate from principles of standardization.  View the project as “facility-centric.”  Avoid or postpone crucial conversations with staff and medical staff (transparency dispels many unrealistic expectations).  Implement electronic medical records, and construction and occupancy of facility within close timeframes.  Deviate from team/project goals.  Conduct team sessions longer than two hours—if you do, provide food.  Change direction after the final decision is made.  Allow scope creep.

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D. Design Considerations General requirements; The following general requirements are to be obtained [2]

I. Environment: A hospital and other health facilities shall be so located that it is readily accessible to the community and reasonably free from undue noise, smoke, dust, foul odor, flood, and shall not be located adjacent to railroads, freight yards, children's playgrounds, airports, industrial plants, disposal plants.

II. Occupancy: A building designed for hospital / healthcare facility shall be used only for this purposes.

III. Safety: A hospital and other health facilities shall provide and maintain a safe environment for patients, personnel and public. The building shall be of such construction so that no hazards to the life and safety of patients, personnel and public exist. It shall be capable of withstanding weight and elements to which they may be subjected.   

Exits shall be restricted to the following types: door leading directly outside the building, interior stair, ramp, and exterior stair. Minimum of two (2) exits, remote from each other, shall be provided for each floor of the building. Exits shall terminate directly at an open space to the outside of the building.

IV. Security: A hospital and other health facilities shall ensure the security of person and property within the facility.

V. Patient Movement: Spaces shall be wide enough for free movement of patients, whether they are on beds, stretchers, or wheelchairs. Circulation routes for transferring patients from one area to another shall be available and free at all times.    

Corridors for access by patient and equipment shall have a minimum width of 2.44 meters. Corridors in areas not commonly used for bed, stretcher and equipment transport may be reduced in width to 1.83 meters. A ramp or elevator shall be provided for ancillary, clinical and nursing areas located on the upper floor. A ramp shall be provided as access to the entrance of the hospital not on the same level of the site.

VI. Lighting: All areas in a hospital and other health facilities shall be provided with sufficient illumination to promote comfort, healing and recovery of patients and to enable personnel in the performance of work.

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VII. Ventilation: Adequate ventilation shall be provided to ensure comfort of patients, personnel and public.

VIII. Auditory and Visual Privacy: A hospital and other health facilities shall observe acceptable sound level and adequate visual seclusion to achieve the acoustical and privacy requirements in designated areas allowing the unhampered conduct of activities.

IX. Water Supply: A hospital and other health facilities shall use an approved public water supply system whenever available. The water supply shall be potable, safe for drinking and adequate, and shall be brought into the building free of cross connections.

X. Waste Disposal: Liquid waste shall be discharged into an approved public sewerage system whenever available, radioactive waste and others hazards liquid waste to be collected and treated in accordance to international rules and solid waste shall be collected, treated and disposed of in accordance with applicable codes, laws or ordinances.

XI. Sanitation: Utilities for the maintenance of sanitary system, including approved water supply and sewerage system, shall be provided through the buildings and premises to ensure a clean and healthy environment

XII. Housekeeping: A hospital and other health facilities shall provide and maintain a healthy and aesthetic environment for patients, personnel and public.

XIII. Maintenance: There shall be an effective building maintenance program in place. The buildings and equipment shall be kept in a state of good repair. Proper maintenance shall be provided to prevent untimely breakdown of buildings and equipment.

XIV. Material Specification: Floors, walls and ceilings shall be of sturdy materials that shall allow durability, ease of cleaning and fire resistance.

XV. Segregation: Wards shall observe segregation of sexes. Separate toilet shall be maintained for patients and personnel, male and female.

XVI. Fire Protection: There shall be measures for detecting fire such as fire alarms in walls, Peepholes in doors or smoke detectors in ceilings. There shall be devices for quenching fire such as fire extinguishers or fire hoses that are easily visible and accessible in strategic areas.

XVII. Signage: There shall be an effective graphic system composed of a number of individual visual aids and devices arranged to provide information, orientation, direction, identification, prohibition, warning and official notice considered essential to the optimum operation of a hospital and other health facilities.

XVIII. Parking: A hospital and other health facilities shall provide a parking space XIX. Zoning: The different areas of a hospital shall be grouped according to zones as follows (fig.1): 

Outer Zone – areas that are immediately accessible to the public: emergency service, outpatient service, and administrative service. They shall be located near the entrance of the hospital. 15

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Second Zone – areas that receive workload from the outer zone: laboratory, pharmacy, and radiology. They shall be located near the outer zone. Inner Zone – areas that provide nursing care and management of patients: nursing service. They shall be located in private areas but accessible to guests. Deep Zone – areas that require asepsis to perform the prescribed services: surgical service, delivery service, nursery, and intensive care. They shall be segregated from the public areas but accessible to the outer, second and inner zones Service Zone – areas that provide support to hospital activities: dietary service, housekeeping service, maintenance and motor pool service, and mortuary. They shall be located in areas away from normal traffic.

fig.1

XX. Function: The different areas of a hospital shall be functionally related with each other; 

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The emergency service shall be located in the ground floor to ensure immediate access. A separate entrance to the emergency room shall be provided. The administrative service, particularly admitting office and business office, shall be located near the main entrance of the hospital. Offices for hospital management can be located in private areas. The surgical service shall be located and arranged to prevent nonrelated traffic. The operating room shall be as remote as practicable from the entrance to provide asepsis. The dressing room shall be 16

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located to avoid exposure to dirty areas after changing to surgical garments. The delivery service shall be located and arranged to prevent nonrelated traffic. The delivery room shall be as remote as practicable from the entrance to provide asepsis. The dressing room shall be located to avoid exposure to dirty areas after changing to surgical garments. The nursery shall be separate but immediately accessible from the delivery room. The nursing service shall be segregated from public areas. The nurse station shall be located to permit visual observation of patients. Nurse stations shall be provided in all inpatient units of the hospital. In wards the Rooms shall be of sufficient size to allow for work flow and patient movement. In wards the Toilets shall be immediately accessible from rooms. The dietary service shall be away from morgue.

XXI. Space: Adequate area shall be provided for the people, activity, furniture, equipment and utility.

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E. Departments Philippine hospital operations are very similar to their western counterparts. The DOH categorizes hospital services and departments according to their operational functions.

A. Medical Services 1. Department of Surgery This department is responsible for major and minor operations such as the removal of cysts and warts, appendectomy, orthopedic cases, etc. It is furnished with instruments, equipment and supplies to meet the medical needs of the patients. These include anesthetic agents, drugs,and supplies to combat shock and hemorrhage, special lighting for illumination of the operating field, sterilizing facilities, and many others. 2. Department of Pediatrics This department is responsible for the prevention, diagnosis, care, and treatment of children's diseases. It embraces the care of all children under 21 years, including the newborn, except, however, in cases involving contagious diseases and orthopedics. This section is composed of the immediate care room for the newborn - one for babies born in the hospital and another for those born outside. Low birth weight infants and full term ones that are weak are confined in the nursery until their conditions permit home care; otherwise, the newborn staysonly for two to three days after birth. 3. Out-Patient Department This is the connecting link between the hospital and the community, and is charged with the following functions: (1) maintenance &good health, (2) disease prevention and promotion of community health, (3) health education, and (4) care of the sick and family welfare. It participates in the training of the resident staff and the medical students. Aside from the prenatal clinic, this department also has clinics for well babies (for growth and development as well as immunization); sick babies both premature and mature ones; gynecology clinic with the sterility, tumor and cancer detection clinics; dental; and nutrition clinics. 4. Department of Gynecology This department is concerned with the diagnosis and treatment of its woman patients with conditions affecting the female generative organs. It is also concerned with preventive and promotive functions as in cancer detection, including breast cancer, and lactation management."

B. Ancillary Services 1. X-Ray Unit The X-ray service is one of the most important facilities of the hospital. It provides service to all the hospital patients. This facility has been a valuable adjunct in the management of medical, surgical, obstetrics, pediatrics, and gynecological cases. Certain provisions, however,

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are made to protect patients and employees against over exposure to X-ray radiation, radiation from radium and other radioactive substances. 2. "The Pharmacy Service The Pharmacy service provides the drug and medicine requirements for both in-patients and out-patients. 3. The Dental Health Service The Dental Health Service provides and maintains standard dental health services to hospital patients. Aside from the care of in-patients, this service also takes care of patients in the out-patient department. 4. The Nursing Service The Nursing Service provides safe, effective, and well-planned nursing care for patients in the medical departments of the hospital. This service includes activities pertaining to the care of patients, technical care or the carrying out of treatment prescribed by the physicians, and those relating to prevention and rehabilitation. It is also involved in research work for the improvement of patient care. 5. Laboratory Department This department provides facilities for the application of scientific techniques for the diagnosis and control of diseases and for the scientific investigation of clinical phenomena associated with the disease. This department performs all laboratory examinations and provides facilities that will help arrive at the correct diagnosis. The services include fecalysis, urinalysis, blood chemistry, and anatomical pathology. It is also responsible for the bacteriological examination in the different units of the hospital, like the operating room, delivery room, _series, central formula room, and the central supply unit. 6. Anesthesia Unit The Anesthesia Unit of the hospital provides and maintains standard professional anesthesia service to operative and delivery cases. It is concerned with two specific functions: a) to render patients insensible to pain; and b) to provide supportive therapy for surgical patients before, during, and after the operation.

C. Administrative Services 1. The Administrative Services The Administrative Service directly supervises the following sections: business, personnel, cashiering, dietary, linen and laundry, property and procurement, maintenance and motor pool, dormitory, housekeeping and security. 2. The Accounting Service The Accounting Service maintains a recognized system of accounting and is responsible for all accounting data and the financial records of the hospital including cost analysis and billing. 3. Budget Office

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The Budget Office is responsible for providing assistance to the management of the hospital in the preparation of the annual, quarterly and other levels and types of budgets. It also monitors budgetary overruns and other discrepancies from the approved budget. 4. Admitting and Medical Records The Admitting Department functions mainly as the center for admissions, transfers, referrals, discharges or deaths. It also plays a role in the field of public relations not only withpatients, but also with the community, other hospital agencies, etc. The Medical Records Section of the hospital is the depository of the patients' medical records which are essential tools for the physician in treating the patient, and serve as a reference for the medical researchers. This section takes care of the medical records of discharged patients and furnishes medical statistics as may be required, especially for the regular Medical Audit

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History (Foreign) The safety-net role of public hospitals has evolved since 1700s when the first U.S. public hospital sheltered and provided medical healthcare to the poor. Until the late 20th century, public hospitals represented the "poor house" that undertook social welfare roles. The "poor house" also provided secondarily medical care, specifically during epidemics. For this reason, these "poor houses" were later known as "pest" houses. Following this phase was the "practitioner period" during which, the then welfare oriented urban public hospitals changed their focus to medical care and formalized nursing care. This new phase was highlighted by the private physicians providing care to patients outside their private practices into inpatient hospital settings. To put into practice the demands of the Flexner Report published in 1910, public hospitals later benefitted from the best medical care technology to hire full-time staff members, instruct medical and nursing students during the "academic period". The privatization of public hospitals was often contemplated during this period and stalled once an infectious disease outbreak such as influenza in 1918, tuberculosis in the early 1900s, and the polio epidemic in the 1950s hit the U.S.. At this time, with the goal to improve people's health and welfare by allowing for effective health planning and the creation of neighborhood health centers, health policies like the Social Security Act were enacted. This was followed by Medicare and Medicaid Act in 1965 that gave poor people in the U.S., access to inpatient and outpatient medical care from public hospitals after racial segregation ended in the South. With their mandate to care for low income patients, the public hospital started engaging in leadership roles in the communities they care for since the 1980s.

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Public Hospital A public hospital or government hospital is a hospital which is owned by a government and receives government funding. In some countries, this type of hospital provides medical care free of charge, the cost of which is covered by government reimbursement. Australia In Australia, public hospitals are operated and funded by each individual state's health department. The federal government also contributes funding. Services in public hospitals for all Australian citizens and permanent residents are fully subsidized by the federal government's Medicare Universal Healthcare program. Hospitals in Australia treat all Australian citizens and permanent residents regardless of their age, income, or social status. Emergency Departments are almost exclusively found in public hospitals. Private hospitals rarely operate emergency departments, and patients treated at these private facilities are billed for care. Some costs, however (pathology, X-ray) may qualify for billing under Medicare. Where patients hold private health insurance, after initial treatment by a public hospital's emergency department, the patient has the option of being transferred to a private hospital. Brazil The Brazilian health system is a mix composed by public hospitals, non-profit philanthropic hospitals, and private hospitals. The majority of the low and medium-income population uses services provided by public hospitals run by either by the State or the municipality. Since the inception of 1988 Federal Constitution, health care is a universal right for everyone living in Brazil: citizens, permanent residents, and foreigners. To provide this service, the Brazilian government created a national public health insurance system called SUS (Sistema Unico de Saúde, Unified Health System) in which all publicly funded hospitals (public and philanthropic entities) receive payments based on the number of patients and procedures performed. The construction and operation of hospitals and health clinics are also a responsibility of the government. The system provides universal coverage to all patients, including emergency care, preventive medicine, diagnostic procedures, surgeries (except cosmetic procedures) and medicine necessary to treat their condition. However, given budget constraints, these services are often unavailable in the majority of the country with the exception of major metropolitan regions, and even in those cities access to complex procedures may be delayed because of long lines. Despite this scenario, some patients were able to successfully sue the government for full SUS coverage for procedures performed in non-public facilities. Recently, new legislation has been enacted forbidding private hospitals to refuse treatment to patients with insufficient funds in case of life-threatening emergencies. The law also determines that the healthcare costs in this situation are to be paid by the SUS. Canada In Canada all hospitals are funded through Medicare, Canada's publicly funded universal health insurance system and operated by the provincial governments. Hospitals in Canada treat all Canadian citizens and permanent residents regardless of their age, income, or social status.

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India In India, public hospitals (called Government Hospitals) provide health care free at the point of use for any Indian citizen. These are usually individual state funded. However, hospitals funded by the central (federal) government also exist. State hospitals are run by the state (local) government and may be dispensaries, peripheral health centers, rural hospital, district hospitals or medical college hospitals (hospitals with affiliated medical college). In many states (like Tamil Nadu) the hospital bill is entirely funded by the state government with patient not having to pay anything for treatment. However, other hospitals will charge nominal amounts for admission to special rooms and for medical and surgical consumables. The reliability and approachability of doctors and staff in private hospitals have resulted in preference of people from the public to private health centers. However state owned hospitals in India are known for high patient load and there is persistent claims of incident relating to physical abuse on doctors and staff. Norway In Norway, all public hospitals are funded from the national budget and run by four Regional Health Authorities (RHA) owned by the Ministry of Health and Care Services. In addition to the public hospitals, a few privately owned health clinics are operating. The four Regional Health Authorities are: Northern Norway Regional Health Authority, Central Norway Regional Health Authority, Western Norway Regional Health Authority, and South-eastern Norway Regional Health Authority. All citizens are eligible for treatment free of charge in the public hospital system. According to The Patients' Rights Act, all citizens have the right to Free Hospital Choices. South Africa South Africa has private and public hospitals. Public hospitals are funded by the Department of Health. The majority of the patients use public hospitals in which patients pay a nominal fee, roughly $3–5. The patients point of entry usually is through primary health care (Clinics) usually run by nurses. The next level of care would be district hospitals which have General Practitioners and basic radiographs. The next level of care would be Regional hospitals which have general practitioners, specialists and ICU's, and CT SCANS. The highest level of care is Tertiary which includes super specialists, MRI scans, and nuclear medicine scans. Private patients either have healthcare insurance, known as medical aid, or have to pay the full amount privately if uninsured. United Kingdom In the UK public hospitals provide health care free at the point of use for the patient. Private health care is used by less than 8 percent of the population. The UK system is known as the National Health Service (NHS) and has been funded from general taxation since 1948. United States In the United States, two thirds of all urban hospitals are non-profit. The remaining third is split between for-profit and public, public hospitals not necessarily being not-for-profit hospital corporations. The urban public hospitals are often associated with medical schools. The largest public hospital system in the U.S. is NYC Health + Hospitals.

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History (Local) The history of medicine in the Philippines discusses the folk medicinal practices and the medical applications used in Philippine society from the prehistoric times before the Spaniards were able to set a firm foothold on the islands of the Philippines for over 300 years, to the transition from Spanish rule to fifty-year American colonial embrace of the Philippines, and up to the establishment of the Philippine Republic of the present. Although according to Dr. José Policarpio Bantug in his book A Short History of Medicine in the Philippines During The Spanish Regime, 1565-1898 there were "no authentic monuments have come down to us that indicate with some certainty early medical practices" regarding the "beginnings of medicine in the Philippines" a historian from the United States named Edward Gaylord Borne described that the Philippines became "ahead of all the other European colonies" in providing healthcare to ill and invalid people during the start of the 17th century, a time period when the Philippines was a colony of Spain. From the 17th and 18th centuries, there had been a "state-of-the-art medical and pharmaceutical science" developed by Spanish friars based on Filipino curanderos (curandero being a Spanish term for a Filipino "folk therapist") that was "unique to the [Philippine] islands." The babaylans were the first healers within the tribal communities of ancient Philippines. Later emerged folk doctors and the training and deployment of true medical practitioners as can be seen in the progression of Philippine history. At present, medical personnel trained based on Western medicine - such as Filipino nurses, physicians, physical therapists, pharmacists, surgeons among others - coexists with the still thriving group of traditional healers that do not have formal education in scientific medicine who often cater to people living in impoverished areas of the Philippines. Hospitals in Philippines, particularly around Manila, frequently offer high quality healthcare. Yet, even the top hospitals might not measure up to the standards of comfort, cleanliness, and care you are accustomed to from hospitals in America. Very basic medical care is about all you'll find in many hospitals outside of the major urban areas. It is not unwise before considering a medical procedure to assess the standards of medical care in a hospital. Unfortunately for you, most hospitals in the Philippines require you to pay a sum upfront before they'll admit you. Local hospitals don't generally accept U.S. health insurance policies, but many U.S. insurance companies will reimburse patients for hospital costs--check with your insurance before you travel. Before being discharged from the hospital patients tend to be needed to pay their invoices in full.

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Hospitals Both the Spanish government and Spanish missionaries established a number of hospitals in the Philippines. The first hospital was erected by the Spaniards in Cebu during 1565. That first hospital was later transferred to Manila for the purpose of treating sick and wounded military personnel. The establishment of other health and charity institutions soon followed. The missionaries who established the early hospitals in the Philippines were the Franciscans, the Brotherhood of the Misericordia, the Brotherhood of San Juan de Dios, and the Dominicans. There were also lay government people who became founders of hospitals during the time period. Among the early hospitals in the Philippines were the following: Manila Manila had the Hospital Real de Españoles (Royal Spanish Hospital, existed from 1577 to 1898), the Hospital de los Indios Naturales (Hospital of Native Indians, existed from 1578 to 1603), Hospital de Santa Ana (St. Anne Hospital, founded in 1603, still exists today), Hospital de la Misericordia (Mercy Hospital, existed from 1578 to 1656), the Hospital of San Juan de Dios (St. John of God Hospital, established in 1656, and still existing to the present), Hospital de San Lazaro (Hospital of St. Lazarus, a hospital for lepers established in 1603, still exists today), Hospital de San Pedro Martir (St. Peter the Martyr Hospital, 1587 to 1599), and the Hospital de San Gabriel (St. Gabriel Hospital, a hospital that is specialty for the Chinese community of Binondo, 1599 to 1774). Cavite In Cavite, the Hospital del Espiritu Santo (Holy Spirit Hospital) existed from 1591 to 1662. This hospital took care of sailors, marine personnel, shipbuilders, and carpenters among others. Laguna In Laguna, the Hospital de Nuestra Señora de las Aguas Santas de Mainit (Our Lady of the Holy Waters Hospital in Mainit, Mainit being the name of a place with hot springs in Laguna) existed from 1597 to 1727 and then was re-established from 1877 and still existing up to the present. The hospital was built by Franciscan missionaries on top of the location of hot springs in Los Baños, Laguna due to the therapeutic effects of the natural springs to the body of sick people, as they had observed from Filipinos of the time who bathe in hot springs despite of being ill. Naga In Naga, the Hospital de Santiago (St. James's Hospital) existed from 1611 to 1691. Another hospital also named as the Hospital de San Lazaro (Hospital of St. Lazarus), which is different from the one catering to leper patients in Manila, existed from 1873 and is still functioning today.

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List of Hospitals in city of Manila                                          

Amisola Maternity Hospital - Hermosa Street, Manuguit, Tondo Canossa Health and Social Center Foundation, Inc. - E. Jacinto Street, Magsaysay Village, Tondo Chinese General Hospital and Medical Center - Blumentritt Road, Santa Cruz Clinica Arellano General Hospital - Doroteo Jose Street, Santa Cruz De Ocampo Memorial Medical Center - Nagtahan Street, Santa Mesa Dr. Jose Fabella Memorial Hospital - Lope de Vega Street, Santa Cruz Dr. Mirando Unciano, Sr. Medical Center - V. Mapa Street, Santa Mesa Esperanza Health Center - Santa Mesa F. Lanuza Health Center and Lying-in Clinic - Alvarez Street, Santa Cruz GAT Andres Bonifacio Memorial Medical Center - Delpan Street, Tondo Hospital of the Infant Jesus - Laong Laan Street, Sampaloc Jose R. Reyes Memorial Medical Center - San Lazaro Compound, Rizal Avenue, Santa Cruz Justice Jose Abad Santos General Hospital - Numancia St. Binondo Manila Manila Doctors' Hospital - United Nations Avenue, Ermita Maria Clara Health Center and Lying-in Clinic - Maria Clara corner Prudencio Streets, Sampaloc Mary Chiles General Hospital - Dalupan Street, Sampaloc Mary Johnston Hospital - Juan Nolasco Street, Tondo ManilaMed (formerly Medical Center Manila)[1] - General Luna Street, Ermita Metropolitan Medical Center - Masangkay Street, Tondo New Manila District Hospital - Pad. Peo, Santa Cruz Nephrology Center of Manila - San Andres Street corner Leon Guinto Street, Malate Ospital ng Maynila Medical Center - Quirino Avenue corner Roxas Boulevard, Malate Ospital ng Sampaloc - Geronimo Street, Sampaloc Ospital ng Tondo - Jose Abad Santos Avenue, Tondo Our Lady of Lourdes Hospital - P. Sanchez Street, Santa Mesa Pedro Gil Health Center and Lying-in Clinic - A. Francisco Street corner Perlita Street, San Andres Perpetual Help Hospital - Laong Laan Street, Sampaloc Perpetual Succor Hospital - Cayco Street, Sampaloc Philippine General Hospital - Taft Avenue, Ermita Presidential Security Group Station Hospital - Malacañang Park Saint Jude Hospital and Medical Center - Don Quijote corner Dimasalang Streets, Sampaloc San Lazaro Hospital - Quiricada Street, Santa Cruz Santa Ana Hospital - New Panaderos Street, Santa Ana Seamen's Hospital - Cabildo corner San Jose Streets, Intramuros The Family Clinic, Inc. - Maria Clara Street, Sampaloc Tondo Foreshore Health Center - Pacheco Street corner Santa Fe Street, Tondo Tondo Health Center - Gagalangin, Tondo Tondo Medical Center - Kalakal Street, Balut, Tondo Trinity Woman and Child Center "The Birthplace" - New Panaderos Street, Santa Ana Unciano General Hospital United Doctor's Medical Center - near Mabuhay Rotonda University of Santo Tomas Hospital - Arsenio Lacson Avenue, Sampaloc

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Medical Center Manila

Philippine General Hospital

University of Santo Tomas Hospital

St. Luke's Medical Center 27

Ospital ng Maynila The Ospital ng Maynila Medical Center (Hospital of Manila; abbreviation: OMMC) is a 300-bed non-profit tertiary, general and training hospital in Malate, Manila, Philippines. It is the laboratory hospital of health science students (students of medicine, nursing and physical therapy) enrolled at the Pamantasan ng Lungsod ng Maynila, one of the Philippines' universities. As hospital operated and maintained through taxes paid by Manila residents, OMMC has for its primary concern the admission and treatment of patients who are bona fide residents of the city. Furthermore, it is responsible for the provision of an integrated community health program and research activities.

HISTORY Studies reveal that an alarming number of city residents die without medical attendance. During the year 1967, 16.45% of the total deaths in the city occurred without medical attendance, and 14.43% with incomplete medical attendance. Added to this problem was the fact all the four national hospitals located in the city cannot accommodate all needy patients and even refuse some 8,000 patients a month. The enactment on June 22, 1957, or Republic Act 1939, otherwise known as the Hospital Financing Act, spurred the City of Manila to establish its own hospital. The law required Manila to contribute 1% of its annual income for the operation and maintenance of national hospitals in the city. Events leading to the establishment of the city hospital followed rapidly: December 30, 1959– Then Councilor Eriberto A. Remigio sponsors, and the municipal board enacts, Ordinance No. 4201 appropriating the amount of PHP 1 million for the construction of the city hospital. 28

January 11, 1960– In his inaugural address before the municipal board, the late Mayor Arsenio H. Lacson endorsed the hospital project which he said would cost PHP 6 million. October 11, 1960– Mayor Lacson issues Executive Order No. 39 creating a city general hospital advisory committee. May 23, 1961– The municipal board, presided over by then Vice Mayor Antonio J. Villegas, passes Ordinance No. 4363 appropriating in additional amount of PHP 1.5 million, as requested by Mayor Lacson. April 11, 1962– Then President Diosdado Macapagal issues Presidential Proclamation No. 31 turning over to the City of Manila for hospital purposes the national government property at the corner of Harrison and Roxas Boulevard. April 15, 1962– Immediately upon assumption to office, Mayor Villegas pushes through the construction of the city hospital in the consonance with his program of “Libreng Pilipino” which hold, among other things, that the right to medical care is part of the larger and more basic right of the individual to life, liberty and the pursuit of happiness. September 11, 1962– The cornerstone of the city hospital is laid under the auspices of Mayor Antonio J. Villegas. October 20, 1962– At the instance of Mayor Villegas, the municipal board passes Ordinance No. 4636 naming the proposed city general hospital as the Arsenio H. Lacson Memorial Hospital. December 18, 1963– Actual construction work on the hospital building begins. December 5, 1968– Upon the insistent representations of Mayor Lacson’s widow, the municipal board passes Ordinanace No. 6807 renaming the hospital as the Ospital ng Maynila. OMMC was established on January 31, 1969 by the government of the City of Manila. The primary motivation in establishing the Medical Center was to provide city residents, 80% of who are classified as indigents, a better standard of medical care. It was originally planned to provide a total in-patient capacity of 300 beds and 60–90 nursery cribs. In addition, an outpatient department was included to provide medical care to ambulatory patients. In May 2005, OMMC renovated its Emergency Department, Infirmary Ward and Neonatal Intensive Care Unit (Nursery). Moreover, it also acquired 250 new hospital beds, two incubators, two respirators, and Computed Tomography (CT) Scan services that is free for all legitimate residents of Manila. On December 23, 2008, the hospital integrated the anthroposophic framework beginning with the institutionalization of integrative and complimentary alternative medicine through the help of Dr. Michaela Glocker, who is the leader of the Medical Section at the Goetheanum, the School of Spiritual Science in Dornach, Switzerland since 1988.

VISION & MISSION Vision To be a locally responsive, nationally recognized and globally competitive medical center of excellence in providing health care services, training and research. Mission To deliver quality health services to Manilans in particular and provide excellent education through training and research with utmost professionalism. 29

DEPARTMENTS / SERVICES OFFERED Multi-Specialty Services Offered We offer specialized health care services for the poor and underserved. We take pride in giving our patients with quality specialized services and holistic therapeutic approach. Internal Medicine  Gastroenterology 

Cardiology

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Nephrology

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Infectious Disease

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Endocrinology

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Hematology-Oncology

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Pulmonology

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Neurology

Surgery  Orthopedic 

Cardiothoracic

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Neurosurgery

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Plastic and Reconstructive surgery

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Urology

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General surgery

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Hepatobiliary

Obstetrics and Gynecology  Gyne-Oncology 

Perinatology

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Endocrinology Fertility

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Obstetric ultrasound

Ear, Nose and Throat  Otology 

Maxillofacial

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Reconstructive and Aesthetic surgery

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Neuro-otology

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Laryngology and Bronchoesophagology

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Head and Neck surgery

Dermatology  Acne Surgery 

Excision Biopsy

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Peeling

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Electrocautery

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Phototherapy 30

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Dermabrasion

Pathology  Laboratory 

Blood bank

Radiology  X-ray 

CT-scan

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Magnetic Resonance Imaging

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Ultrasound

Family Medicine  Acupuncture 

Palliative Care

Pediatrics  Neurology 

Nephrology

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Infectious Disease

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Neonatology

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Pulmonology

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Hematology-Oncology

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Gastroenterology

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Adolescent Pediatric

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Milk Bank

Ophthalmology  ED / Cornea 

Retina

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Neuro Ophthalmology

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Glaucoma / Cataract

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Plastic, Lacrimal, Orbit

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Pediatric Ophthalmology

Other Medical Services  Emergency Services 

Dental Services

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Psychiatry

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Physical Therapy

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Rehabilitation & Physical Therapy

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Social Services

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Free MRI and CT-Scan Services

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OPD Services

We are:  DOH Accredited HCI 31

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DOH Accredited Animal Bite Center

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Philhealth Accredited HCI

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Accredited Specialty Training Programs

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Mother-Baby Friendly Hospital

Better equipped Ospital ng Maynila unveiled The city government of Manila unveiled on Wednesday a fully-refurbished Ospital ng Maynila Medical Center (OMMC) which underwent a P300-million facelift. Dr. Rachel Mariñas, the hospital’s medical director, said the emergency room, the intensive care unit and operating room were renovated. “We have now complete facilities that are comparable to any private high-class hospital in the country,” Mariñas told reporters after the unveiling of the marker led by Dr. Loi Ejercito, wife of Mayor Joseph Ejercito Estrada who failed to attend the event. At least 500 Manila residents seek help daily at OMMC. The number does not include those who seek emergency services. Among the medical and laboratory equipment acquired are ECG machines, 2D echo machine, evoke otoacoustic emission machine, biological refrigerator, phacoemulsification machine, morgue freezer, video laryngoscope, fully automated hematology analyzer, coagulated analyzer, chemistry analyzer, digital flouroscopy and x-ray machines, among others. OMMC is a 300-bed tertiary hospital. Manila residents are treated there for free. There are six city-owned hospitals and services are free to all bonafide Manila constituents. “We have modern facilities and this is because our mayor wants a healthy citizenry,” Ejercito told reporters in an ambush interview. The OMMC was founded in 1969. It is also a teaching hospital with at least 100 resident doctors.

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Our group went to Department of Health located along Tayuman last November 13, 2018 (Monday) for the purpose of acquiring the Technical Guidelines for Hospital and Health Facilities Planning and Design for 25-bed hospital. It was approximately 30 minutes away from Adamson University if you will go there via LRT. Shown in the left picture is the building number 2 of the said department. This is the first building we went in to inquire for our purpose.

We were then transferred to another building to inquire about the manuals we needed. Although the next building still didn’t have what we needed. What it had were bunch of free magazines and brochures that promote safe-sex awareness that in our own opinion, is really needed especially nowadays that youths are more sexually active compared to the past generations. There are lots of basic knowledge that can be acquired in these magazines that is why we didn’t let the moment just pass by without a handful of those free stuffs and information. After some time, we go back to our main purpose on why went there and asked the 33

person in-charge of that office about the manuals. The helpful lady then told us to go back to building number 4 for the said need.

Building 4 is the last and final building that we went in through the Department of Health. The manuals were granted to us by the person in-charge of the office. Although there are some missing parts in the manuals, we could say that the visit in the said department was surely a success.

Our group’s visit in the Department of Health is somewhat tiring but it was a positive experience for us in general because we get to have what we needed and acquire some new knowledge for our own safety and health. Visits in these kind of places might sound boring and pointless at first. But it is actually helpful especially in our field which requires this basic knowledge in designing different building such as hospitals. As 3rd year architecture students, we look forward to visiting many more various places of this kind as we go deeper in this 34

profession and discovering more types of building to design as we hopefully continue our Architectural Design with Adamson University.

After exploring the Department of Health, our team immediately went straight to our chosen hospital to conduct the actual research on a Government Hospital. Our chosen site is the Ospital ng Maynila located in Quirino Avenue in Manila. The first thing we noticed is the grandiose ramp and entrance. This ramp is the access of both pedestrian and vehicles to the main lobby of the building. There was a landscape surrounded by the ramp and under the ramp were some rooms for the out-patient department.

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As we enter the lobby, to its left side was the offices like the Administrator’s Office, Director’s Office and the like. Also, right in front of the lobby was the Cashier, where the inpatients pay for their bills. To its right were the 3 elevators for all the vertical access. Actually, there was only 1 elevator functioning at the moment. These elevators caters all passengers including public, employees, the patients in stretchers and even the garbage.

In the upper ground floor level were the E.N.T. (Ear, Nose and Throat) Wards and the Obgyne Wards. Beside the Ob-gyne wards are the Delivery rooms. As we enter the Ob gyne wards, there were 5-7 wards with 5 beds each. The NICU (Neonatal Intensive Care Unit) was located also in this area but with limited access.

After this, we asked the janitors to lead us to the morgue. It was located at the lower ground floor level. We went down through the stairs and passed through a hallway with rooms on both side. These rooms are, according to the janitors, storages and the like. The pharmacy is also located here.

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The morgue is separated to the main building. It is located inside a gate a little under the ramp of the façade. The garbage area is right across this area with a separate shed. From the morgue, we walked through the driveway to see the emergency room.

The emergency room is located at the right side, below the façade. The entrance is secured with the guards. There are few seats for the waiting area located outside the building, but roofed. The emergency also uses the same elevators as seen in the lobby.

After seeing the emergency room, went to the outpatient department. The OPD is located at the left side of the façade. There were many waiting seats provided in this area. This area is not enclosed inside the building, but is roofed and surrounded by the landscape. The enclosed part are the rooms where the testing and consultation are operated. There are also sections where the designated sickness or concern are located.

The parking areas are located at the lower ground floor level, beside the emergency area.

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The team had enjoyed conducting the research in the Ospital ng Maynila. We had encounter a lot of problems that might help us in considering these factors as our reference in the future plates. These challenges must be taken into considerations. We also had taken notes on how the zoning were presented in this hospital plan. Overall, this experience helped us develop deeper of our understanding in hospital planning.

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PROBLEM OBSERVED WITHIN ThE VICINITY OF “OSPITAL NG MAYNILA” ●Going to the entrance and lobby of the said government hospital, we saw some parts of the sidewalk area of the ramp-like drop off that aren’t safe. Some parts don’t have railings that will prevent someone from falling to the lower area (which is in this case a landscape giving aesthetic to the entire place). It’s not safe considering some unexpected circumstances.

●No proper garbage disposal circulation. Housekeeping personnel used the public elevators to disposed waste from each floors which is inappropriate.

●Closing of some entrances and exits

●According to most of the patients, losing your personal belongings are prone to this Hospital

●Location of public toilets are hard to find

●Pharmacy is located below the building. Hassle at all.

●Lack of signages

●Location of morgue is reasonable but the facility itself isn’t taken care of. No proper ways to preserved the dead body for it is expose to heat and bacteria from a dirty environment.

●Waiting area in emergency room are located outside the building. No cover or protection from any kind of weather.

RECOMMENDATIONS Have a monthly checking of the facilities in and outside the hospital. Check if it meets and didn’t violate any laws from B.P. 344 and other requirements that will help improve the comfortability and convenience of the users since it’s a public/government hospital. Also, improve the security system of the hospital. Since it’s open to public, might as well provide precautions to the patients and their love ones. Implementing some programs that can help in the security of the hospital must take place. Provide garbage chute or service elevator for housekeeping personnel. Using of signage to indicate direction or location of spaces is really helpful. Also, taking advantages in using colors that will inply the intensity of the signages will help people to identify the spaces. Provide canopy for emergency room’s waiting area or a temporary tent if no big fund for canopy to provide protection from any kind of weather.

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